The Operative Sentence

A reading room for the primary documents behind operating-room safety and surgical fluid waste.

Register B

Sewer-use ordinances of large POTWs

Of the six codes we read closely, blood is named in two, and in both it arrives through a clause about obstruction or about pathogens rather than about medical waste.

First published
2026-08-06
Last reviewed
2026-08-06
Next review
2027-03-01
Review cadence
Annual, on 1 March
Rows
11 utilities: 1 verified, 2 qualified, 3 silent, 5 not checked
Compiled by
Zane Hitchcox, publisher — not a clinician and not a lawyer; has never worked in an operating room
Review status
Every verdict rests on primary text quoted in its row or on a keyword scan published with it. Not clinically reviewed. Not legally reviewed.
Version
1.0

The Operative Sentence is an independent reference publication. It is not affiliated with BioDrain Medical, Inc., Axe Compute Inc., DeRoyal Industries, Inc. or any manufacturer, and it sells, services and recommends nothing. This page describes what published regulations, guidelines and studies say. It is not legal advice, not clinical advice, and not a substitute for your facility’s exposure control plan, your state’s rules or your sewer authority’s ordinance. Nobody who writes these pages has worked in an operating room. This publication is not a standards body and nothing here is a standard, a guideline or a government publication.

The finding this register exists to state

In the two codes here that name blood and whose words we hold, the clause it sits in is not a medical-waste clause. The Los Angeles County Sanitation Districts prohibit “whole blood” — the obstruction-list term inherited from the EPA model ordinance — and the City of Los Angeles prohibits discharge “suspected or known to contain bloodborne pathogen(s)”, which is the one transcribed clause on this page that treats blood as a biological hazard in its own right. Boston’s MWRA names neither, and reaches the question only by cross-reference to the Massachusetts health rule, which permits free-draining blood.

Whether that pattern holds across the other five codes is a hypothesis, not a finding, and we are not publishing it as one. Our research pass left an impression that Philadelphia and Detroit reach blood through the obstruction clause and that Hampton Roads and DC Water reach it as a biological hazard. We did not transcribe the operative clause or the section number in any of those four, or in Chicago’s. Under this publication’s own rule an untranscribed impression is not a verdict, so those five ship Not checked with the retrieval fact and the date and nothing else, and the sentence above names only the utilities whose words are printed on this page. Transcribing the five is the first item of the next review, and it is the work that would turn the hypothesis into a finding or kill it.

The Los Angeles County clause is a plumbing rationale, not a pathogen rationale, and that inverts the framing the reader arrives with. The commercial argument for enclosed fluid-waste handling is built almost entirely on exposure to pathogens. The one federal instrument standing behind every code on this page is not worried about pathogens at all; it is worried about grease, grit and clogging: 40 CFR 403.5(b), the national pretreatment standard, does not contain the words blood, medical, infectious or pathological anywhere, and reaches blood only derivatively through obstruction and oxygen demand.12

Six of the eleven codes below were read closely and five were not, so the finding above rests on two utilities. That is a thin base for a general claim about American sewer law, which is why no general claim is made here.

The “whole blood” clause is a slaughterhouse clause

A large number of American city codes prohibit discharging “whole blood.” It reads like a medical-waste rule. It is not one. The phrase descends from the Environmental Protection Agency’s Model Pretreatment Ordinance, where it appears in a list of things that settle, mat and obstruct.11

EPA Model Pretreatment Ordinance, EPA 833-B-06-002 (January 2007) · prohibited-discharge list, retrieved 2026-08-06

grease, animal guts or tissues, paunch manure, bones, hair, hides or fleshings, entrails, whole blood, feathers, ashes, cinders, sand, spent lime… spent grains, spent hops…

“Whole blood” sits between entrails and feathers. The neighbours are the interpretation. EPA marks this clause optional — it is not a mandatory national pretreatment standard, and a city that adopts it is adopting a model, not implementing a federal requirement. The same clause was confirmed present in municipal codes in eight states during the research pass behind this register — Washington, Idaho, Ohio, Iowa, Colorado, Pennsylvania, Maryland and Michigan.

Reading a city’s “whole blood” clause as a hospital rule is a category error, and it is precisely the keyword trap anyone surveying municipal codes will fall into, because the search term matches and the context does not travel with it. We have not seen this written down anywhere else. It does not mean the clause cannot reach a hospital discharge — a prohibition is a prohibition, whatever its ancestry — but it does mean that a reader who finds it and concludes their utility has taken a position on infectious waste has misread the document.

The largest sewer authority in the country says nothing

New York City’s sewer code does not contain the word blood. Neither does King County’s. Both were scanned by machine, both counts were zero, and the terms and the extent of the scan are published in the rows.1, 3 New York’s rules do prohibit the solid carriers of blood — bandages, gauze, cotton balls, swabs, hypodermic needles — while never mentioning the fluid itself. What reaches the sewer lawfully does so through a definition written for households.

15 RCNY § 19-01, definition of “sanitary wastes” · read from an Internet Archive raw capture, 2026-08-06

bodily wastes, wash water, or similar matter

A silent code is not a permissive code and it is not a prohibitive one. It is a code that has not addressed the question, which means the answer for a New York City generator is settled somewhere else — by New York State’s medical-waste rule, which this publication has not read, and by the facility’s own policy. We are recording an absence, not granting a permission, and the distinction is the whole reason the Silent label exists as a separate status rather than being folded into a yes.

This is a survey of published law, not advice about your facility. A generator has to check its own state rule and its own publicly owned treatment works’ sewer-use ordinance. Either can be stricter than the other, both bind independently, and a discharge that a state permits can still violate the receiving utility’s code.

Table 1. Eleven large publicly owned treatment works, read for blood and for medical or infectious waste.
Utility, and the code we read Blood Medical / infectious waste Text we hold Status Retrieval, and what qualifies it
New York City DEP
NYC Admin. Code Title 24, ch. 5; 15 RCNY §§ 19-01, 19-02, 19-03
Not named anywhere in the code Not named anywhere in the code bodily wastes, wash water, or similar matterbandages, gauze, cotton balls, swabs and hypodermic needles Silent Machine count of blood, infectious, medical and pathological across the code and rules named: zero occurrences, 2026-08-06. § 19-03(a)(1) prohibits the solid carriers of blood and never the fluid. Blood reaches the sewer through the “sanitary wastes” definition. Read from Internet Archive raw captures because amlegal.com returns a Cloudflare 403; cross-checked against the DEP penalty schedule on the city’s own rules server. Character count of the extraction not recorded.
King County, Washington
King County Code Title 28
Not named anywhere in the title Not named anywhere in the title No provision found to quote. Silent 438,901 characters of Title 28 extracted and scanned for blood, infectious, medical, pathological, biohazard and body fluid: zero hits, 2026-08-06. Do not confuse this with King County’s solid-waste rule. The Waste Acceptance Rule PUT 7-16 says human blood and blood products in free-flowing or fluid form are not accepted at county transfer facilities — that is landfill law, and it pushes liquid blood toward the sewer rather than away from it.
San Francisco
City sewer-use provisions in the municipal code
Not named in the provisions we read Not named in the provisions we read No provision found to quote. Silent Scanned for the same terms as New York, 2026-08-06, no occurrences. Read from an Internet Archive raw capture because amlegal.com returns a Cloudflare 403. This is the weakest of the three silent rows: our log recorded neither the article number of the provisions read nor a character count for the extraction, so the scan cannot be reproduced from what is published here. It will be redone with both at the next review.
Metropolitan Water Reclamation District of Greater Chicago
District sewage and waste control ordinance
Not published Not published No text transcribed. Not checked Opened in the research pass on 2026-08-06. Neither the operative clause nor the section number was transcribed, so no verdict is offered and the two columns to the left stay empty. What we hold is the fact of the retrieval and its date.
City of Los Angeles
Los Angeles Municipal Code, industrial waste and sewer-use provisions
Prohibited where the discharge is suspected or known to bear bloodborne pathogens Prohibited; the term is not defined in the code suspected or known to contain bloodborne pathogen(s) Qualified Read 2026-08-06 from an Internet Archive raw capture; amlegal.com returns a Cloudflare 403 to both automated fetch and curl. Qualified because the retrieval is capture-only — we can show what the page said on the capture date, not what it says now — and because our log did not record the section number. The one transcribed clause in this table that regulates blood as a biological hazard rather than as an obstruction solid.
Sanitation Districts of Los Angeles County
Fifth amended wastewater ordinance, effective 1 July 1998
Prohibited — the term used is “whole blood” Conditional, on the Chief Engineer’s approval whole blood Qualified Possibly superseded. The Districts’ current ordinance PDF returns HTTP 403 and has no Internet Archive capture. The text we hold is the fifth amended ordinance effective 1998-07-01, read from a 2016 snapshot on 2026-08-06. Twenty-eight years is a long time for a wastewater ordinance to stand unamended, and we have no evidence either way. The term “whole blood” is the EPA model-ordinance obstruction clause, not a medical-waste provision.
Hampton Roads Sanitation District, Virginia
HRSD sewer-use regulations, § 304
Not published Not published No text transcribed. Not checked Opened in the research pass on 2026-08-06. Neither the operative clause nor the section number was transcribed, so no verdict is offered and the two columns to the left stay empty. What we hold is the fact of the retrieval and its date.
DC Water, District of Columbia
District wastewater discharge regulations
Not published Not published No text transcribed. Not checked Opened in the research pass on 2026-08-06. Neither the operative clause nor the section number was transcribed, so no verdict is offered and the two columns to the left stay empty. What we hold is the fact of the retrieval and its date.
Philadelphia Water Department
Philadelphia Code, sewer-use provisions
Not published Not published No text transcribed. Not checked Opened in the research pass on 2026-08-06. Neither the operative clause nor the section number was transcribed, so no verdict is offered and the two columns to the left stay empty. What we hold is the fact of the retrieval and its date.
Detroit / Great Lakes Water Authority
Wastewater discharge ordinance
Not published Not published No text transcribed. Not checked Opened in the research pass on 2026-08-06. Neither the operative clause nor the section number was transcribed, so no verdict is offered and the two columns to the left stay empty. What we hold is the fact of the retrieval and its date.
Massachusetts Water Resources Authority (Boston)
360 CMR 10.023(18)
Conditional — the prohibition defers to 105 CMR 480.200, which permits free-draining blood The same deferral … whose disposal via the municipal Sewerage System or via a septic system is prohibited by 105 CMR 480.200. Verified Retrieved 2026-08-06. The cross-reference is circular and resolves to a permission. MWRA prohibits infectious medical waste whose disposal is prohibited by the state health rule; the state health rule, at 105 CMR 480.200(A)(1), affirmatively permits free-draining blood and blood products, excepting blood-saturated materials. The ordinance therefore bans what the health rule bans, and the health rule does not ban this.

Source: municipal and district codes as named in each row, retrieved during a research pass completed 2026-08-06, pulled as raw HTML or PDF and de-tagged locally, then read or machine-scanned. No quotation in this table passed through a summariser. Ellipses remove words and never remove a qualifier, a condition or a scope limitation. Full citations are in Sources below.

Do not rely on the Los Angeles County row as current

The text in the Sanitation Districts of Los Angeles County row is the fifth amended wastewater ordinance effective 1 July 1998, read from a 2016 snapshot. The Districts’ current ordinance PDF returns HTTP 403 and no archive capture of it exists. We are publishing what we hold because a 1998 ordinance is better evidence than a paraphrase, and we are telling you plainly that we cannot confirm it is the text in force. If you need to know what the Districts require today, ask the Districts.

Houston, Miami-Dade and Atlanta are not covered

This register does not cover Houston, Miami-Dade or Atlanta. They were not read. They are uncovered, not silent, and the difference is the entire point of the status vocabulary: a silent row is a scan that came back empty, and an uncovered utility is one we never opened. We make no claim about their codes in either direction, and no absence in the table above should be read as one. Three of the largest metropolitan sewer systems in the United States are missing from an eleven-row table, and any reader drawing a national conclusion from these rows should start there.

How these codes were retrieved, and what that cost

Municipal code publishing is the worst-served corner of primary-source law on the open web, and this register is shaped by that more than by any editorial decision we made.

The commercial host that publishes New York, Los Angeles and San Francisco’s codes returns a Cloudflare 403 to automated retrieval and to curl alike. Those three had to come from Internet Archive raw captures. Where a second official server existed we verified against it — New York City’s own rules server carries the DEP penalty schedule, which served that purpose. Where no second server existed, the row is qualified, because a capture proves what a page said on a date and not what it says today.

The Los Angeles County Sanitation Districts’ current ordinance is behind a 403 with no capture at all, which is the single worst provenance on this page and is flagged as such above.

Five rows are marked not checked because we opened the code and did not transcribe it. That is a discipline decision rather than a research failure. This register does not print a verdict on a clause it cannot show you, and it does not print our recollection of a clause either, which is why those five rows carry the retrieval fact and the date and no characterisation of what the code says. We would rather publish five honest gaps than five confident sentences a reader cannot audit. Closing them is the first item of the next review.

What would change these rows

Where this could be wrong

The strongest objection to this register is that six of eleven codes is not enough to say anything general, and we agree, which is why the section above stops at two utilities and calls the rest a hypothesis. The impression we formed of Philadelphia, Detroit, Hampton Roads, DC Water and Chicago is not published as a finding and should not be quoted as one. The correct test of it is not whether it sounds true but whether those five hold up when they are transcribed, and if two of them turn out to be pathogen provisions rather than obstruction provisions the hypothesis is dead and we will say so, with a correction notice.

The second weakness is selection. Eleven utilities were read because eleven utilities were reachable, not because eleven is a representative sample of the publicly owned treatment works in the United States. Large coastal systems are overrepresented and the entire South is represented by one district in Virginia. Nothing here supports a statement beginning “most sewer authorities.” The correct phrasing, which we have tried to hold to throughout, is “in the eleven codes we read.”

Sources

Where our retrieval log recorded a URL, it is printed. Most entries below carry none: the municipal code host that publishes several of these returns a Cloudflare 403, the text came from Internet Archive raw captures, and our log kept the document and the date rather than the capture address. We do not print a URL we did not ourselves follow. Attaching capture addresses to every row is scheduled for the next review.

  1. New York City Administrative Code, Title 24, chapter 5; Rules of the City of New York, Title 15, §§ 19-01, 19-02, 19-03 (use of the public sewer). (Read from an Internet Archive raw capture 2026-08-06; capture URL not recorded.)
  2. New York City Department of Environmental Protection. Penalty schedule, published on the City of New York rules server — used as a second official server to cross-check the sewer-use rules. (Read 2026-08-06; URL not recorded.)
  3. King County Code, Title 28 (water pollution abatement and sewer use). 438,901 characters extracted and scanned. (Read 2026-08-06; URL not recorded.)
  4. King County. Waste Acceptance Rule PUT 7-16 — solid-waste rule, cited only to distinguish it from the sewer law. (Read 2026-08-06; URL not recorded.)
  5. San Francisco Municipal Code, sewer-use provisions. (Read from an Internet Archive raw capture 2026-08-06; article number and capture URL not recorded.)
  6. Los Angeles Municipal Code, industrial waste and sewer-use provisions. (Read from an Internet Archive raw capture 2026-08-06; section number and capture URL not recorded.)
  7. Sanitation Districts of Los Angeles County. Fifth amended wastewater ordinance, effective 1 July 1998, from a 2016 snapshot. The current ordinance PDF returns HTTP 403 and has no archive capture. server refused — archived copy (Read 2026-08-06.)
  8. Massachusetts Water Resources Authority. 360 CMR 10.023(18), prohibited discharges. (Read 2026-08-06; URL not recorded.)
  9. Massachusetts Department of Public Health. 105 CMR 480.200(A)(1) — the provision to which 360 CMR 10.023(18) defers. (Read 2026-08-06; URL not recorded.) See Register A.
  10. Metropolitan Water Reclamation District of Greater Chicago; Hampton Roads Sanitation District § 304; DC Water; Philadelphia Water Department; Detroit / Great Lakes Water Authority — opened 2026-08-06, operative clauses not transcribed. These five carry no verdict in Table 1 and are listed here so the reader can see exactly which documents the register is missing.
  11. United States Environmental Protection Agency. Model Pretreatment Ordinance, EPA 833-B-06-002, January 2007 — the optional prohibited-discharge list containing “whole blood.” (Read 2026-08-06; URL not recorded.)
  12. United States Environmental Protection Agency. National pretreatment standards: prohibited discharges, 40 CFR § 403.5(b). The words blood, medical, infectious and pathological do not appear in it. (Codified text read 2026-08-06 via the eCFR; retrieval URL not recorded in this register’s log.)

About this register

Compiled by Zane Hitchcox, publisher. Not clinically reviewed and not legally reviewed. How we work, and where it could be wrong, is at Method. The status vocabulary is at Editorial standards. No financial relationship with any manufacturer, distributor, waste contractor or trade body.

Revision history

  • 1.0 — 2026-08-06 — First publication. Eleven utilities: one verified, two qualified, three silent with the scan method published, five opened but not transcribed and published as not checked.

How to cite this page

Hitchcox Z. Sewer-use ordinances of large POTWs. The Operative Sentence. 2026-08-06. https://biodrainmedical.com/registers/sewer-use-ordinances/ (accessed YYYY-MM-DD).

Our prose, tables and diagrams are CC BY 4.0. Quoted government text is public-domain; third-party quotations remain their authors’.