Form 308 "Application for Short-Term Exemption From Surface Water Quality Standards for Emergency Remediation" - Montana

What Is Form 308?

This is a legal form that was released by the Montana Department of Environmental Quality - a government authority operating within Montana. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2012;
  • The latest edition provided by the Montana Department of Environmental Quality;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 308 by clicking the link below or browse more documents and templates provided by the Montana Department of Environmental Quality.

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Download Form 308 "Application for Short-Term Exemption From Surface Water Quality Standards for Emergency Remediation" - Montana

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AGENCY USE
Permit No.:
Date Rec’d
Amount Rec’d
Check No.
WATER PROTECTION BUREAU
Rec’d By
FORM
Application for Short-Term Exemption from Surface Water
308
Quality Standards for Emergency Remediation
This form may be filled out on-screen, then printed, signed, and submitted. Please do not submit via e-mail or
fax. Department policy requires original signatures and payment of all required fees before review may begin.
Section A – Owner/Operator
Name:
Mailing Address:
City:
State:
Zip Code:
Telephone:
Section B – Contractor responsible for the activity
Name:
Mailing Address:
City:
State:
Zip Code:
Telephone:
Section C – Receiving Water
Name of water body:
Type of water body:
Name of downstream water body:
County (or counties) of the construction site:
Revised 01/2012
Page 1 of 3
AGENCY USE
Permit No.:
Date Rec’d
Amount Rec’d
Check No.
WATER PROTECTION BUREAU
Rec’d By
FORM
Application for Short-Term Exemption from Surface Water
308
Quality Standards for Emergency Remediation
This form may be filled out on-screen, then printed, signed, and submitted. Please do not submit via e-mail or
fax. Department policy requires original signatures and payment of all required fees before review may begin.
Section A – Owner/Operator
Name:
Mailing Address:
City:
State:
Zip Code:
Telephone:
Section B – Contractor responsible for the activity
Name:
Mailing Address:
City:
State:
Zip Code:
Telephone:
Section C – Receiving Water
Name of water body:
Type of water body:
Name of downstream water body:
County (or counties) of the construction site:
Revised 01/2012
Page 1 of 3
Legal description:
Township:
Range:
Section:
¼ Section:
Latitude:
Longitude:
Date activity will commence:
Projected date of completion:
Section D – Other Applications
List applications submitted to other agencies or entities for additional permits or authorizations and the status
of those applications (approved on what date; denied on what date; pending, submittal date):
Section E – Description of activity
Describe the proposed activity:
Discuss any alternatives to the proposed action that were or may be considered:
Describe any measures planned to minimize or eliminate harmful or detrimental impacts to beneficial uses
(non-target aquatic life, public health, and recreation):
Revised 01/2012
Page 2 of 3
Describe how this activity will be monitored:
Section F - CERTIFICATION
Permittee Information: This form must be completed, signed, and certified as follows:
• For a corporation, by a principal officer of at least the level of vice president;
• For a partnership or sole proprietorship, by a general partner or the proprietor, respectively; or
• For a municipality, state, federal, or other public facility, by either a principal executive officer or
ranking elected official.
All Applicants Must Complete the Following Certification:
I certify under penalty of law that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the persons who manage the system, or those
persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information; including the possibility of fine and imprisonment for knowing violations. [75-5-
633, MCA]
A. Name (Type or Print)
C. Phone No.
B. Title (Type or Print)
D. Signature
E. Date Signed
The Department will not process this form until all of the requested information is supplied, and the appropriate
fees are paid. Return this form and the applicable fee to:
Department of Environmental Quality
Water Protection Bureau
PO Box 200901
Helena, MT 59620-0901
(406) 444-3080
Revised 01/2012
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