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Forms for ECLS Programs

 

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ECLS

Name of Form

Form Number

Facility Update Form

583-D

TRL Bypass Report Form

619-011

TRL Monthly Operation Report

619-001

Soil Profilers

Name of Form

Form Number

Certified Soil Profiler Application

641-011

Certificate Bond for Certified Installers or Soil Profilers

641-001

 

New Procedures (and Affidavit) for Obtaining Individual Licenses/Certifications

 

Certified Installers

Name of Form

Form Number

 

Certificate Bond for Certified Installer

641-001

 

Certification Examination Application

641-002

 

New Procedures (and Affidavit) for Obtaining Individual Licenses/Certifications

 

 

Compliance Report

641-003

On-Site Sewage System

Name of Form

Form Number

 

On-Site Sewage Treatment System Inspection Report

641-576A/S

 

Soil Test On-Site Sewage Treatment Report

641-581SP

 

Perc Test On-Site Sewage Treatment Report

641-581P

 

Certification Document Form

641-581Cert

 

Supplemental Application for an Alternative On-Site Sewage Disposal System

641-581Supp

 

Request for Authorization/Permit to Construct an On-Site Sewage Disposal System

641-575

On-Site Sewage System-Interactive Forms

Name of Form

Form Number

 

On-Site Sewage Treatment System Inspection Report

641-576A/S

 

Soil Test On-Site Sewage Treatment Report

641-581SP

 

Perc Test On-Site Sewage Treatment Report

641-581P

Small Public Water Supplies

Name of Form

Form Number

 

Application for a Permit to Construct a Minor Water System

624-001

 

Final Inspection Request for Minor Water System

624-003

 

Wellhead Protection Checklist for Minor Water Systems

624-002

Request for Services

Name of Form

Form Number

 

Request for Services

641-005

Septage Pumpers and Transporters

Name of Form

Form Number

 

Septage Pumper and Transporter Application

645-001

 

Consent for Disposal of Septage

645-004

 

Application for Permit to Land Apply Septage

645-006

 

Acknowledgement Form

645-007

 

Septage Bypass Form

645-009

 

Application for Permit to Treat Septage

645-011

 

Application for Authorization to Operate a Septage Storage Facility

645-012

 

Land Application Record

 

Storm Water (Construction/Industrial)

Name of Form

Form Number

 

Notice of Intent (NOI) for Stormwater Discharges Associated with Construction Activity

606-002A

 

Notice of Intent (NOI) for Stormwater Discharges Associated with Industrial Activity

606-002B

 

Notice of Termination (NOT) for Stormwater Discharges Associated with Industrial or Construction Activity

606-003

 

No Exposure Certification (NEC) Associated with Industrial Activity

606-004

 

Annual Comprehensive Site Compliance Evaluation Report (ACSCER) associated with Industrial Activity

606-005

 

Notice of Certification of Industrial Existence (NCIE) Associated with Industrial Activity

606-006

Environmental Complaints

Name of Form

Form Number

 

Complaint Form and Instructions

No number