DEQ Form 606-004 "No Exposure Certification (Nec) for Exclusion From the Pdes Multi-Sector General Permit Okr05 for Stormwater Discharges Associated With Industrial Activity" - Oklahoma

What Is DEQ Form 606-004?

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

Form Details:

  • Released on July 5, 2017;
  • The latest edition provided by the Oklahoma 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 DEQ Form 606-004 by clicking the link below or browse more documents and templates provided by the Oklahoma Department of Environmental Quality.

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Download DEQ Form 606-004 "No Exposure Certification (Nec) for Exclusion From the Pdes Multi-Sector General Permit Okr05 for Stormwater Discharges Associated With Industrial Activity" - Oklahoma

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Oklahoma Department of Environmental Quality
DEQ Form
No Exposure Certification (NEC)
606-004
for Exclusion from the OPDES Multi-Sector General Permit OKR05
July 5, 2017
for Stormwater Discharges Associated with Industrial Activity
Submission of this No Exposure Certification constitutes notice that the operator identified in Section I does not require permit authorization
under the OPDES Multi-Sector General Permit OKR05 for stormwater discharges associated with industrial activity from the facility identified in
Section II of this form due to the existence of a condition of no exposure. A condition of no exposure exists at an industrial facility when all
industrial materials and activities are protected by a storm resistant shelter to prevent exposure to rain, snow, snowmelt, and/or runoff.
Industrial materials or activities include, but are not limited to, material handling equipment or activities, industrial machinery, raw materials,
intermediate products, by-products, final products, or waste products. Material handling activities include the storage, loading and unloading,
transportation, or conveyance of any raw material, intermediate product, final product or waste product. A storm resistant shelter is not
required for the following industrial materials and activities:
Drums, barrels, tanks, and similar containers that are tightly sealed, provided those containers are not deteriorated and do not leak.
Sealed means banded or otherwise secured and without operational taps or valves;
Adequately maintained vehicles used in material handling; and
Final products, other than products that would be mobilized in stormwater discharges (e.g., rock salt).
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. By signing and submitting this No
Exposure Certification form, the operator in Section I is certifying that a condition of no exposure exists at its facility or site all the time, and is
obligated to comply with the terms and conditions of 40 CFR § 122.26(g).
All requested information must be provided on this form. See completing instructions on page 3 of this form.
I. Operator Information
Operator Name:
_____________________________________________________________________________________
Mailing Address:
___________________________________________________________________________________
City:
County:
State:
Zip Code:
____________________
______________________
_________
_________________
Operator’s Point of Contact :
Title:
__________________________________________
__________________________
Phone:
Email:
_____________________________
__________________________________________
II. Facility Location
Facility Name:
Phone:
_____________________________________________________
__________________________
Address:
___________________________________________________________________________________________
OK
City:
County:
State:
Zip Code:
_____________________
_______________________
________
_______________
Facility’s Point of Contact :
Title:
____________________________________________
__________________________
Phone:
E-mail:
_________________________
______________________________________
Latitude:
Longitude:
at the entrance of the Facility
_______________________
_________________________
DEQ Authorization No. OKR
, if your facility had coverage under previous OPDES Permit
_____________________
SIC Code or 2-digit Activity Code, Primary:
Sector:
Secondary:
Sector:
____________
_______
___________
_______
Total size of the facility associated with industrial activity
acres
________________
Have you paved or roofed over a formerly exposed, pervious area in order to qualify for the no exposure exclusion?
Yes
No
If Yes, indicate approximately how much area was paved or roofed over
acres
__________________
Oklahoma Department of Environmental Quality
DEQ Form
No Exposure Certification (NEC)
606-004
for Exclusion from the OPDES Multi-Sector General Permit OKR05
July 5, 2017
for Stormwater Discharges Associated with Industrial Activity
Submission of this No Exposure Certification constitutes notice that the operator identified in Section I does not require permit authorization
under the OPDES Multi-Sector General Permit OKR05 for stormwater discharges associated with industrial activity from the facility identified in
Section II of this form due to the existence of a condition of no exposure. A condition of no exposure exists at an industrial facility when all
industrial materials and activities are protected by a storm resistant shelter to prevent exposure to rain, snow, snowmelt, and/or runoff.
Industrial materials or activities include, but are not limited to, material handling equipment or activities, industrial machinery, raw materials,
intermediate products, by-products, final products, or waste products. Material handling activities include the storage, loading and unloading,
transportation, or conveyance of any raw material, intermediate product, final product or waste product. A storm resistant shelter is not
required for the following industrial materials and activities:
Drums, barrels, tanks, and similar containers that are tightly sealed, provided those containers are not deteriorated and do not leak.
Sealed means banded or otherwise secured and without operational taps or valves;
Adequately maintained vehicles used in material handling; and
Final products, other than products that would be mobilized in stormwater discharges (e.g., rock salt).
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. By signing and submitting this No
Exposure Certification form, the operator in Section I is certifying that a condition of no exposure exists at its facility or site all the time, and is
obligated to comply with the terms and conditions of 40 CFR § 122.26(g).
All requested information must be provided on this form. See completing instructions on page 3 of this form.
I. Operator Information
Operator Name:
_____________________________________________________________________________________
Mailing Address:
___________________________________________________________________________________
City:
County:
State:
Zip Code:
____________________
______________________
_________
_________________
Operator’s Point of Contact :
Title:
__________________________________________
__________________________
Phone:
Email:
_____________________________
__________________________________________
II. Facility Location
Facility Name:
Phone:
_____________________________________________________
__________________________
Address:
___________________________________________________________________________________________
OK
City:
County:
State:
Zip Code:
_____________________
_______________________
________
_______________
Facility’s Point of Contact :
Title:
____________________________________________
__________________________
Phone:
E-mail:
_________________________
______________________________________
Latitude:
Longitude:
at the entrance of the Facility
_______________________
_________________________
DEQ Authorization No. OKR
, if your facility had coverage under previous OPDES Permit
_____________________
SIC Code or 2-digit Activity Code, Primary:
Sector:
Secondary:
Sector:
____________
_______
___________
_______
Total size of the facility associated with industrial activity
acres
________________
Have you paved or roofed over a formerly exposed, pervious area in order to qualify for the no exposure exclusion?
Yes
No
If Yes, indicate approximately how much area was paved or roofed over
acres
__________________
III. Exposure Checklist
Are any of the following materials or activities exposed to stormwater, now or in the foreseeable future?
If your answer is Yes to any of these questions, you are not eligible for the No Exposure Exclusion.
Yes
No
(Please check either Yes or No in the appropriate box)
Using, storing, or cleaning industrial machinery or equipment, and areas where residuals from using,
1.
storing or cleaning industrial machinery or equipment remain and are exposed to stormwater
2.
Materials or residuals on the ground or in stormwater inlets from spills/leaks
3.
Materials or products from past industrial activity
4.
Material handling equipment (except adequately maintained vehicles)
5.
Materials or products during loading/unloading or transporting activities
Materials or products stored outdoors (except finished products intended for outside use, e.g., new cars,
6.
where exposure to stormwater doesn’t result in the discharge of pollutants)
Materials contained in open, deteriorated, or leaking storage drums, barrels, tanks, and similar
7.
containers
8.
Materials or products handled/stored on roads or railways owned or maintained by the discharger
9.
Waste Material (except waste in covered, non-leaking containers such as dumpsters)
10.
Application or disposal of process wastewater (unless otherwise permitted)
Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise regulated
11.
(i.e., under an air quality control permit) and evident in the stormwater outflow
IV. Certification
I certify under penalty of law that I have read and understand the eligibility requirements for claiming a condition of no exposure
and obtaining an exclusion from OPDES stormwater permitting; and that there are no discharges of stormwater contaminated by
exposure to industrial activities or materials from the industrial facility identified in this document (except as allowed under 40 CFR
§ 122.26(g)(2) as adopted and incorporated by reference in OAC 252:606-1-3(b)(3)(L)).
I understand that I am obligated to submit a no exposure certification form once every 5 years to DEQ and to the operator of the
local MS4 into which this facility discharges stormwater (where applicable). I understand that I must allow DEQ or MS4 operator
where the stormwater discharge is into the local MS4, to perform inspections to confirm the condition of no exposure and to make
such inspection reports publicly available upon request. I understand that I must obtain coverage under an OPDES permit prior to
any discharge of stormwater from the facility.
Additionally, 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 gathered and evaluated the information
submitted. Based upon my inquiry of the person or persons who manage the system, or those persons directly involved in gathering
the information, the information submitted is to the best of my knowledge and belief true, accurate and complete. I am aware
there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing
violations.
Print Name:
Title:
____________________________________________
_____________________________________
Signature:
Date:
____________________________________________
________________________________
Phone:
Email:
______________________________
___________________________________________
For DEQ use only: Assigned Application Number:
_____________________________
Instructions for Completing
No Exposure Certification (NEC) Form 606-004
for Stormwater Discharges Associated with Industrial Activity
under the OPDES Multi-Sector General Permit OKR05
Who May File an NEC
Check Yes or No as appropriate to indicate if you have paved or roofed
Oklahoma State law at Title 27A OS § 2-6-205 prohibits point source
over a formerly exposed, pervious area (i.e., lawn, meadow, dirt, or
discharges of stormwater associated with industrial activity to waters
gravel road or parking lot) in order to qualify for no exposure. Indicate
of the State without first obtaining an Oklahoma Pollutant Discharge
)
how much area (to the nearest quarter of an acre
was paved or roofed.
Elimination System (OPDES) permit from DEQ. However, OPDES
Section III. Exposure Checklist
permit coverage is not required for discharges of stormwater
associated with industrial activity identified at 40 CFR § 122.26
Check Yes or No as appropriate to describe the exposure condition at
(b)(14)(i) - (xi), except (x), if the discharger can certify that a condition
your facility. If you answer Yes to any of the questions in this section, a
of No Exposure exists at the industrial facility or site. Stormwater
potential for exposure exists at your site and you cannot certify to a
discharges from construction activities identified in 40 CFR § 122.26
condition of no exposure. You must obtain (or already have) coverage
(b)(14)(x) and (b)(15) are not eligible for the "No Exposure Exclusion".
under an OPDES stormwater permit. After obtaining permit coverage,
you can institute modifications to eliminate the potential for a discharge
Obtaining and Maintaining the NEC
of stormwater exposed to industrial activity, and then certify to a
This form must be used to certify that a condition of no exposure
condition of no exposure.
exists at the industrial facility or site described herein. This
Section IV. Certification
certification must be re-submitted at least once every 5 years. The
industrial facility operator must maintain a condition of no exposure
The NEC Form must be signed as follows:
at its facility or site in order for the no exposure exclusion to remain
For a corporation: by a responsible corporate officer, which means: (i) a
applicable. If conditions change, resulting in the exposure of
president, secretary, treasurer, or vice-president of the corporation in
materials and activities to stormwater, the facility operator must
charge of a principal business function, or any other person who
obtain coverage under an OPDES permit immediately.
performs similar policy or decision making functions for the
corporation, or (ii) the manager of one or more manufacturing,
Completing the NEC Form
production, or operating facilities, provided, the manager is authorized
You must type or print letters in appropriate areas only. One form
to make management decisions which govern the operation of the
must be completed for each facility or site for which you are seeking
regulated facility including having the explicit or implicit duty of making
to certify a condition of no exposure. Make sure you complete this
major capital investment recommendations, and initiating and directing
Form with accurate information and address all applicable questions
other comprehensive measures to assure long term environmental
and make a copy for your record before submitting a completed form
compliance with environmental law and regulations; the manager can
to DEQ.
ensure that the necessary systems are established or actions taken to
Section I. Operator Information
gather complete and accurate information for permit application
requirements; and where authority to sign documents had been
Provide the legal name of the firm, public organization, person or any
assigned or delegated to the manager in accordance with corporate
other entity that operates the facility or site described in this
procedures;
certification Form. An operator is the legal entity that controls the
facility's operation and is responsible for its day-to-day activity, rather
For a partnership or sole proprietorship: by a general partner or the
than the plant or site manager. Provide complete mailing address of
proprietors, respectively (Note: for limited liability company (LLC) - by
the operator including city, county, state, and ZIP code. Include
one of its owners, called managing members/partners of the company),
operator’s point of contact name, title, phone number and a valid
or;
email address.
For a municipality, state, Federal, or other public facility: by either a
Section II. Facility Location
principal executive or ranking elected official.
Enter the official or legal name of the facility or site. Enter the
If you have questions, contact Stormwater Unit of Environmental
complete physical address of the facility (absolutely no P.O. Box)
Complaints and Local Services (ECLS) of DEQ at (405) 702-6100 or email
including city, county, state, and ZIP code; in case of no defined
to
ecls-stormwaterpermitting@deq.ok.gov
address, provide a geographical description (e.g., intersection of
Where to File the NEC Form
Route 9 and State Highway 66). Include facility’s point of contact
information. Enter the latitude and longitude of the approximate
:
Completed NEC form must be submitted to the following address
center of the facility or site in degrees, minutes, and seconds.
Stormwater Unit of ECLS
Indicate if the facility was previously covered under an OPDES
Oklahoma DEQ
stormwater permit. If so, include the authorization number.
P.O. Box 1677, Oklahoma City, OK 73101-1677
Enter the four-digit primary SIC code or the Activity Code. Use the
or fax it to: (405)702-6226
Standard Industrial Classification Manual, 1987. Enter the Sector
or email it to:
ecls-stormwaterpermitting@deq.ok.gov
Code (A through AD) under which your facility is permitted.
Commencing December 21, 2020, NEC must be electronically submitted
Enter the total size of the facility’s site associated with industrial
to DEQ. Instructions on how to access and use the appropriate electronic
.
activity to the nearest tenth of an acre
reporting tool will be made available on DEQ’s website prior to the
December 21, 2020 compliance deadline.
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