test Wastewater Availability Request Form Name(Required) First Last Email(Required) Phone(Required)Company Mailing Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are you the property owner?(Required) Yes No If no, please provide property owner(s) name: Property InformationTax Map Number(s)*(Required)Type of Property(Required) Residential Commercial Will the property be subdivided?(Required) Yes No If Yes, Total Number of Lots Note: If the property will be subdivided, please email a copy of the proposed plat to hoffmand@jipsd.org.After submitting this form, for the following types of commercial buildings, email the items requested to David J. Hoffman, Jr. (Director of Wastewater Services) at hoffmand@jipsd.org.For Restaurants: - Application for a grease trap - Copy of the seating chart and menu - Square footage of the building(s) - A set of the design drawings. For All Other Commercial Buildings: - Number of employees expected - Square footage of the buildings(s) - A set of design drawingsPlease provide any additional information that will be important to know about the property/properties:EmailThis field is for validation purposes and should be left unchanged.
