Form 3-GP.SW/06 "Notice of Intent (Noi) for Storm Water Discharges Associated With Industrial Activity to Be Covered Under the Npdes General Permit" - Delaware

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

Form Details:

  • Released on July 1, 2010;
  • The latest edition provided by the Delaware Department of Natural Resources and Environmental Control;
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Instructions Form 3-GP.SW/06
Notice of Intent (NOI) For Storm Water Discharges Associated With Industrial Activity
To Be Covered Under the NPDES General Permit
A FEE IS REQUIRED UPON SUBMISSION OF THE NOI
FILING A NOTICE OF INTENT (NOI) FORM
Under Federal Law, through the Clean Water Act, any point
NUMBER 2.
source discharge of pollutants to surface waters of the United
Enter the contact information for the on-site person responsible for complying
States requires a permit. These permits are issued under the
with the NPDES Storm Water Program.
National Pollutant Discharge Elimination System (NPDES)
program.
NUMBER 3.
Describe the types of industrial activities being conducted at the facility.
The EPA can authorize any State, which displays the
appropriate capability, to operate the NPDES program.
NUMBER 4.
Delaware received this authority in April 1974. The 1987
List in descending order of significance, up to four 4-digit standard industrial
amendments of the Clean Water Act require national
classification (SIC) codes which best describe the principal products or services
regulations to be issued for controlling pollutants entrained in
provided at the facility requesting coverage
storm water discharges. The national regulations were issued on
November 6, 1990.
For industrial activities listed in the Regulations Governing Storm Water
Discharges Associated with Industrial Activity which do not have SIC codes that
The
Delaware
NPDES
Storm
Water
General
Permit
accurately describe their activities, the following 4 character codes are to be
Regulations require permits for facilities which discharge storm
used:
water associated with industrial activity. Industrial activity is
defined as activity which results in the exposure of significant
HZ =
Hazardous waste treatment, storage, or disposal facilities, including
materials to precipitation. Significant materials are substances,
those that are operating under interim status or a permit under subtitle C
products or wastes which can contribute pollutants to runoff
of RCRA;
when storm water comes in contact with these materials.
LF =
Landfills, land application sites, and open dumps that receive or have
received any industrial wastes, including those that are subject to
Delaware law requires a permit for any discharge of pollutants
regulation under subtitle D of RCRA;
to waters of the State. Therefore, the NPDES Storm Water
SE =
Steam electric power generating facilities, including coal and coke
Program applies to sheet-flow as well as point source
handling sites,
discharges from sites or facilities engaged industrial activity in
TW =
Treatment works treating domestic sewage or any other sewage sludge
Delaware.
or wastewater treatment device or system, used in the storage treatment
recycling, and reclamation of municipal or domestic sewage.
*New facilities, facilities covered by an individual permit,
and existing facilities not currently covered by a NPDES
NUMBER 5.
Indicate yes or no if the facility is subject to SARA Title III, Section 313 (Toxic
permit that elect to be covered under this section must
Chemical Release Reporting) requirements. The Emergency Planning and
prepare and implement a Storm Water Plan (SWP) prior to
submitting the NOI form. The SWP must be submitted with
Community Right-to-Know Act (also known as SARA Title III or EPCRA)
establishes requirements for federal, state, and local governments and industry
the NOI form.
regarding emergency planning and "Community Right-to-Know" (CRTK)
reporting on hazardous and toxic chemicals.
SUBMIT THE NOI FORM TO:
DNREC, Division of Water
Surface Water Discharges Section
NUMBER 6.
89 Kings Highway, Dover, DE 19901
State law provides for severe penalties for submitting false information
on this application form. This application shall be signed as follows:
A $200.00 non-refundable fee MADE PAYABLE to DNREC is
For a corporation: by a responsible corporate officer, which means:
required upon submission for any facility seeking initial first-time
(i)
president, secretary, treasurer, or vice-president of the corporation
coverage. Thereafter, a $200.00 annual permit fee will be billed on
in charge of a principal business function, or any other person who
or after July 1 each fiscal year. If you are an existing facility
performs similar policy or decision making functions for the
seeking to renew permit coverage and your facility is current
corporation, or
(ii)
the manager of one or more manufacturing, production, or
with the annual fee, the application fee need not be included at
operating facilities, provided the manager is authorized to make
time of renewal.
management decisions which govern the operation of the regulated
COMPLETING THE FORM
facility including having the explicit or implicit duty of making
Type or print your responses in the appropriate fields. Abbreviate
major capital investment recommendations, and initiating and
if necessary. Failure to complete the form in full may result in a
directing other comprehensive measures to assure long term
delay of permit coverage or return of the incomplete application
environmental
compliance
with
environmental
laws
and
form.
regulations; the manager can ensure that the necessary systems are
established or actions taken to gather complete and accurate
NUMBER 1.
information for permit application requirements; and where
Give the legal name of the facility/site or entity which is applying
authority to sign documents has been assigned or delegated to the
for coverage. Enter full name, physical and mailing address,
manager in accordance with corporate procedures;
parcel number, and latitude and longitude of the approximate
center of the site as a decimal to at least six (6) decimal points
For a partnership or sole proprietorship: by a general partner or the
(i.e., Lat: 0.000001, Lon: 0.000001). The latitude and longitude
proprietor; or
For a municipal, State, Federal, or other public facility: by either a
of your facility can be located on USGS quadrangle maps.
Latitude and longitude may also be obtained at the Census
principal executive or ranking elected official.
Bureau Internet site: http://www.census.gov/cgi-bin/gazetteer.
Provide the name of the receiving water body and the associated
Additional information is available at
watershed.
http://www.wr.dnrec.delaware.gov/Services/Pages/SurfaceWaterDischarges.aspx
Instructions Form 3-GP.SW/06
Notice of Intent (NOI) For Storm Water Discharges Associated With Industrial Activity
To Be Covered Under the NPDES General Permit
A FEE IS REQUIRED UPON SUBMISSION OF THE NOI
FILING A NOTICE OF INTENT (NOI) FORM
Under Federal Law, through the Clean Water Act, any point
NUMBER 2.
source discharge of pollutants to surface waters of the United
Enter the contact information for the on-site person responsible for complying
States requires a permit. These permits are issued under the
with the NPDES Storm Water Program.
National Pollutant Discharge Elimination System (NPDES)
program.
NUMBER 3.
Describe the types of industrial activities being conducted at the facility.
The EPA can authorize any State, which displays the
appropriate capability, to operate the NPDES program.
NUMBER 4.
Delaware received this authority in April 1974. The 1987
List in descending order of significance, up to four 4-digit standard industrial
amendments of the Clean Water Act require national
classification (SIC) codes which best describe the principal products or services
regulations to be issued for controlling pollutants entrained in
provided at the facility requesting coverage
storm water discharges. The national regulations were issued on
November 6, 1990.
For industrial activities listed in the Regulations Governing Storm Water
Discharges Associated with Industrial Activity which do not have SIC codes that
The
Delaware
NPDES
Storm
Water
General
Permit
accurately describe their activities, the following 4 character codes are to be
Regulations require permits for facilities which discharge storm
used:
water associated with industrial activity. Industrial activity is
defined as activity which results in the exposure of significant
HZ =
Hazardous waste treatment, storage, or disposal facilities, including
materials to precipitation. Significant materials are substances,
those that are operating under interim status or a permit under subtitle C
products or wastes which can contribute pollutants to runoff
of RCRA;
when storm water comes in contact with these materials.
LF =
Landfills, land application sites, and open dumps that receive or have
received any industrial wastes, including those that are subject to
Delaware law requires a permit for any discharge of pollutants
regulation under subtitle D of RCRA;
to waters of the State. Therefore, the NPDES Storm Water
SE =
Steam electric power generating facilities, including coal and coke
Program applies to sheet-flow as well as point source
handling sites,
discharges from sites or facilities engaged industrial activity in
TW =
Treatment works treating domestic sewage or any other sewage sludge
Delaware.
or wastewater treatment device or system, used in the storage treatment
recycling, and reclamation of municipal or domestic sewage.
*New facilities, facilities covered by an individual permit,
and existing facilities not currently covered by a NPDES
NUMBER 5.
Indicate yes or no if the facility is subject to SARA Title III, Section 313 (Toxic
permit that elect to be covered under this section must
Chemical Release Reporting) requirements. The Emergency Planning and
prepare and implement a Storm Water Plan (SWP) prior to
submitting the NOI form. The SWP must be submitted with
Community Right-to-Know Act (also known as SARA Title III or EPCRA)
establishes requirements for federal, state, and local governments and industry
the NOI form.
regarding emergency planning and "Community Right-to-Know" (CRTK)
reporting on hazardous and toxic chemicals.
SUBMIT THE NOI FORM TO:
DNREC, Division of Water
Surface Water Discharges Section
NUMBER 6.
89 Kings Highway, Dover, DE 19901
State law provides for severe penalties for submitting false information
on this application form. This application shall be signed as follows:
A $200.00 non-refundable fee MADE PAYABLE to DNREC is
For a corporation: by a responsible corporate officer, which means:
required upon submission for any facility seeking initial first-time
(i)
president, secretary, treasurer, or vice-president of the corporation
coverage. Thereafter, a $200.00 annual permit fee will be billed on
in charge of a principal business function, or any other person who
or after July 1 each fiscal year. If you are an existing facility
performs similar policy or decision making functions for the
seeking to renew permit coverage and your facility is current
corporation, or
(ii)
the manager of one or more manufacturing, production, or
with the annual fee, the application fee need not be included at
operating facilities, provided the manager is authorized to make
time of renewal.
management decisions which govern the operation of the regulated
COMPLETING THE FORM
facility including having the explicit or implicit duty of making
Type or print your responses in the appropriate fields. Abbreviate
major capital investment recommendations, and initiating and
if necessary. Failure to complete the form in full may result in a
directing other comprehensive measures to assure long term
delay of permit coverage or return of the incomplete application
environmental
compliance
with
environmental
laws
and
form.
regulations; the manager can ensure that the necessary systems are
established or actions taken to gather complete and accurate
NUMBER 1.
information for permit application requirements; and where
Give the legal name of the facility/site or entity which is applying
authority to sign documents has been assigned or delegated to the
for coverage. Enter full name, physical and mailing address,
manager in accordance with corporate procedures;
parcel number, and latitude and longitude of the approximate
center of the site as a decimal to at least six (6) decimal points
For a partnership or sole proprietorship: by a general partner or the
(i.e., Lat: 0.000001, Lon: 0.000001). The latitude and longitude
proprietor; or
For a municipal, State, Federal, or other public facility: by either a
of your facility can be located on USGS quadrangle maps.
Latitude and longitude may also be obtained at the Census
principal executive or ranking elected official.
Bureau Internet site: http://www.census.gov/cgi-bin/gazetteer.
Provide the name of the receiving water body and the associated
Additional information is available at
watershed.
http://www.wr.dnrec.delaware.gov/Services/Pages/SurfaceWaterDischarges.aspx
State of Delaware
Department of Natural Resources and Environmental Control
Notice of Intent (NOI)
Request for Obtaining Coverage Under The Regulations Governing Storm
Form 3-GP.SW/06
Revised 07/01/10
Water Discharges Associated with Industrial Activities (Subsection 9.1)
Submission of this form serves as notification of the intention of the facility identified on this form, to adhere to the provisions of
The Regulations Governing Storm Water Discharges Associated with Industrial Activities (NPDES General Storm Water Permit
Program).
This form must be complete in order to obtain permit coverage. Please refer to the directions regarding the fee that is required.
Section 1: Facility Information
Facility Name
Mailing/
Billing Address
City
State
Zip
Physical Address
 Same as above
City
State
Zip
Tax Parcel ID
Within City Limits?  Yes  No
County:  Kent  New Castle  Sussex
Identify the watershed and the name of the water body or municipal
Latitude and Longitude expressed as a decimal to at least six (6)
storm sewer system (public MS4) which receives storm water runoff
decimal points
from the facility
Discharges To
Latitude
Longitude
Watershed
 Chesapeake Bay
 Delaware Bay
 Inland Bays/Atlantic Ocean
 Piedmont
Section 2: Contact Information (Responsible for facility compliance with the NPDES General Storm Water Permit)
Prefix
First
Middle
Last
Suffix
Title
Telephone Number
E-Mail Address
Section 3: Brief description of the types of industrial activities conducted at the facility
Section 4: List up to four (4) SIC Codes which describe the activities conducted at the facility
Section 5: Is the facility subject to SARA Title III, Section 313 Requirements?
Yes
No
Section 6: Certification
“I certify under penalty of law this document and all attachments were prepared under my direction, or supervision, in accordance with
a system designed to assure that qualified personnel gathered and evaluated the information submitted. Based upon my inquiry of the
person(s) directly responsible for gathering the information, the information is, to the best of my knowledge, true, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the possibility of a fine and
imprisonment for willful violations.”
Print Name & Title
Telephone Number
Signature
Date
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