WQ - ESPR - Search and Retrieval Form

Wastewater Document Retrieval Request Form

This form and fee is not required if you perform your own search and retrieval. Please refer to the Departments Environmental Data Management System (EDMS) Map Explorer, or you may go through the hardcopy records at your local area office
The fee for searching, retrieving, and copying the document or record of a wastewater discharge system per property legal description is $25 as required by 18 AAC 72.955(c)
- Payment is required before the search is conducted, and is assessed whether information is found for the property or not
- Fees paid for searches are not refundable
- Upon completion of this form, you'll receive an invoice quote within one to three business days for the search fee
This form is not required for searching, retrieving, and copying wastewater system information; it is provided to assist in the process
If the aggregate sum of searches within a a calender month exceeds 200 pages or 5 hours of staff time, additional fees may be required

Property Information: (Please provide all relevant information regarding the property to increase success rate)

Legal Description

Physical Address

Facility Name

Additional Information (previous business names, owner names, etc.)

Contact Information for the requestor

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

I would like my information sent via:

The area office closest to my request:

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Submittal Acknowledgement

Please verify that you are human