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NPDES Permit for Stormwater Discharges from Construction Activities- forms

This page last revised October 2016 

Although we do our best to keep these forms up to date, they are occasionally updated by DEP and the most current forms are available on DEP's "eLibrary" website.  If you are aware of updated forms not included on this page please notify us at your convenience. Thank-you.


Summary Sheet, Instructions for a General (PAG-02) OR Individual NPDES Permit for Stormwater Discharges Associated with Construction Activities, and Form FP-001, Certification of Origin of Clean Fill: 
Instructions, revised 8/2016

Notice of Intent for coverage under the General (PAG-02) NPDES Permit OR Application for an Individual NPDES Permit for Stormwater Discharges Associated with Construction Activities, Checklists for both, Appendix A land use information questions, Appendix B and C (Sample County and Sample Municipal land use letters), Appendix D. Worksheets 1-6; 10-15, and Checklist for Functional Equivalency of Riparian Buffers and Riparian Forest Buffers are included in this 41 page (total pages) document:
Notice of Intent or Application for a NPDES permit, revised 8/2016


General Information Form (GIF), Instructions, and Checklist (this form is used for several DEP permit/programs; required also for an Individual Permit NPDES for Stormwater Discharges Associated with Construction Activities): 
GIF, revised 5/2012

Instructions, revised 5/2012

Checklist, revised 5/2012


NPDES "self-inspection" Report Form (Required of all NPDES permit owner or operator to document operation and maintenance of all site BMPs on a weekly basis and after each stormwater event): 
Visual Site Inspection Report, 2/2012


Transferee/Co-Permittee Application for a General OR Individual NPDES Permit for Stormwater Discharges Associated with Construction Activities: 
Transferee/Co-Permittee Application, revised 9/2016

Co-Permittee Liability Release Form, to remove a Co-Permittee from a permitted site when the co-permittee is no longer an operator of the construction activity at an unstabilized site:
Co-Permittee Liability Release Form, dated 10/2015
 
Notice of Termination of a General OR Individual NPDES Permit for Discharges of Stormwater Associated with Construction Activities -OR- for an Erosion and Sediment Control Permit (Permit applied for BEFORE 11/19/10): 
Notice of Termination for a NPDES permit(Permit applied for BEFORE 11/19/10), revised 9/2016 New form, dated 9/2016

Notice of Termination of a General OR Individual NPDES Permit for Discharges of Stormwater Associated with Construction Activities -OR- for an Erosion and Sediment Control Permit (Permit applied for AFTER 11/19/10): 
Notice of Termination for a NPDES permit(Permit applied for AFTER 11/19/10), revised 10/2016 New form


Post Construction Stormwater Management (PCSM) Instrument Filing Notice form, to fulfill the PCSM obligations referenced in Chapter 102 regs, specifically 102.7 (related to permit termination) and 102.8(m) (related to PCSM long-term operation and maintenance requirements):
PCSM Instrument Filing Notice, revised 9/2016 New form

This document is a sample Instrument for the Declaration of Restrictions and Covenants (Instrument). Use of this template is not mandatory, but it is strongly recommended...
Sample Instrument, (no date)

Sample New Property Owner PCSM BMP(s) Notification and Operation & Maintenance Agreement:
Sample Agreement, (no date)

New “Pennsylvania Conservation Explorer” tool
In March 2016, the Pennsylvania Natural Heritage Program replaced the Pennsylvania
Natural Diversity Inventory (PNDI) Environmental Review tool with the new Pennsylvania Conservation
Explorer. This new tool is a “one stop shop” for conservation planning and PNDI Environmental
Review. The Explorer provides conservation information on biological diversity, protected
lands, streams and other natural resources for planning purposes and also allows users to
screen a project area for potential impacts to threatened, endangered, and special concern species.
As a reminder, a PNDI receipt is needed to apply for most permits and approvals under
the Ch. 102 and 105 programs. In order to obtain an online search receipt, the Pennsylvania Natural
Heritage Program now charges a convenience fee of $40.00 per project using Visa, MasterCard
or Discover Card
. Government agencies and Municipalities are exempt from this convenience
fee.
To conduct a PNDI search, go to:  www.naturalheritage.state.pa.us and follow the Quick Links for: "Conservation Explorer".

In addition, users may submit for a fee free review (For sites of any size, review free of cost- see instructions): 
PNDI Manual Submission Form, revised 2/2016


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