Memorial Day closure

Most City of Portland offices will be closed Monday, May 27, in observance of Memorial Day.

Dental Practice Discharge Authorization and Annual Certification

The EPA requires the City to implement amalgam waste management rules for dental practices. All dental practices that discharge wastewater to a Portland-owned wastewater treatment facility must verify that they are in compliance with these rules.

The form will take 30-45 minutes to complete.

On this Page

Initial Compliance Certification Report

All Dental Practices must submit an Initial Compliance Certification Report — even if the practice seems like it could be exempt from the required best management practices of the Dental Amalgam Rule.

Initial Report Due Dates

If your practice opened after July 15, 2017, the report is due 30 days after the practice opened. If you purchased an existing practice, the new owner must submit the report within 30 days of taking ownership.

The EPA requires an original signature on this report.

Please mail the original form to:

Water Pollution Control Lab
Attn: Dental Amalgam Program
6543 N Burlington Ave.
Portland, OR 97203

Annual Certification Report

Only dental practices that are required to implement the BMPs must submit the annual certification report. Exempt practices do not need to meet this ongoing reporting requirement.

Annual Report Due Dates

This report must be received by the City no later than October 15 of each year starting in 2021. The report does not require an original signature. You may return the form either by e-mail or mail.

To respond by email, please send the completed PDF form to:

To respond by mail, please send the original form to:

Water Pollution Control Lab
Attn: Dental Amalgam Program
Portland Water Pollution Control Lab
6543 N Burlington Ave.
Portland, OR 9720

Program Fee

The annual program fee is $170. The annual fee assists in recovering costs associated with permitting, inspecting, and monitoring facilities that meet the City’s ADCM requirements.  The fee is billed at the start of the fiscal year in July.