Get Retail Water Facility License Application - Cdph Ca

Completing the Retail Water Facility License Application online can streamline the process of obtaining or renewing your license. This guide will provide you with clear, step-by-step instructions to ensure that you fill out the application accurately and completely.

Follow the steps to successfully complete your application.

1. Press the ‘Get Form’ button to obtain the application and open it in your editor.
2. Indicate whether you are a new applicant or a renewal by placing an 'X' in the appropriate box at the top of the form. If there is a change in location, ownership, or both, select the relevant option.
3. Enter the full name of your firm in the designated field.
4. If your firm operates under a different name, list any additional 'doing business as' (DBA) names in the provided section.
5. Fill in the facility address, including the number, street, city, state, and ZIP code.
6. If your mailing address differs from the facility address, provide the mailing address in the respective fields, including any P.O. Box details.
7. Enter the name and title of the facility operator in the specified fields.
8. Provide the facility's telephone number and FAX number in the required sections.
9. Input a 24-hour emergency telephone number where individuals can reach you in case of an emergency.
10. Include the facility's email address.
11. Provide the name and title of the correspondent along with their telephone and FAX numbers.
12. If the facility is located outside the United States, specify the country.
13. Input the facility's website URL, if applicable.
14. Indicate whether there is a water vending machine at the facility and its location (inside or outside).
15. Select the type of ownership by placing an 'X' next to the applicable option.
16. If applicable, enter the corporate name and state of incorporation.
17. List the names and titles of the owners or officers associated with the business.
18. Select the type of water treatment used at the facility by marking the corresponding boxes.
19. Mark the types of water products dispensed by placing an 'X' next to the appropriate options.
20. Indicate whether the water source is public or private, providing additional details as prompted.
21. Finally, sign the application, date it, and print your name and title.
22. After completing all sections, review the application for accuracy before saving your changes, printing, or sharing the form as needed.

Start your application process online today to secure your Retail Water Facility License.