Air Protection Branch

• Air Quality Permit Information [Revised continually]

• General BART and Regional Haze Information [Revised May 2002]
• BART Survey Worksheet Form [Revised May 2002] (Excel Format)

• Information and Forms

• Gasoline Marketing General Information [May 2003]
• Gasoline Marketing Report Form [Revised May 2002] (Excel Format)

• General Information [Revised May 2004]
• Repair Report Form (Excel format) [Revised May 2002]
• Tank Truck Report Form (Excel format) [Revised May 2002]
• Trailer Mounted Report Form (Excel format) [Revised May 2002]

• Notification Form [Revised Feb 1999]
• Instructions [Revised Feb 1999]

• LEV/ZEV Tax Credit Fact Sheet [Revised September 2004]
• Low Emission Vehicle Tax Credit Form [Revised May 2002]
• Zero Emission Vehicle Tax Credit Form [Revised May 2002]
• Electric Vehicle Charger Credit Form [Revised May 2002]
• Offsite Link: Alternate Fuel Data Center (US Dept. of Energy)

Water Resources Branch

• UIC Mixed Waste Non-Domestic Septic Systems Permit Application Form [Revised Sep 2001]
• UIC Application Form [Revised Apr 2001]
• UIC Application Checklist [Revised Dec 1991]
• UIC Pilot Test Notification Form [Revised Feb 2000]

• Water Well Contractor Application Form [Revised Aug 1997]
• Sample Irrevocable Letter of Credit [Revised Apr 2002]
• Performance Bond Form for Water Well Contractors and Drillers [Revised Nov 2001]

Hazardous Waste Management Branch

• Hazardous Waste Trust Fund Application - Request for Advance [Revised 4/24/2001]
• Hazardous Waste Trust Fund Application - Request for Reimbursement Part 1 [Revised 1/18/2001]
• Hazardous Waste Trust Fund Application - Request for Reimbursement Part 2 [Revised 1/18/2001]
• Hazardous Site Response Act (HSRA) Release Notification/Reporting Form [Revised May 2000]
• Example Completed Hazardous Site Response Act (HSRA) Release Notification/Reporting Form [Revised May 2000]
• Hazardous Waste Trust Fund Application - Model Resolution

Guidance document to aid in determining which fees and how those fees are calculated by the regulated community.

The Hazardous Waste Report is the implementing guidance to support the reporting by hazardous waste generators and treatment, storage, or disposal facilities (TSDFs) required by the Resource Conservation and Recovery Act of 1976 (RCRA). RCRA Sections 3002 and 3004, as amended by the Hazardous and Solid Waste Amendments of 1984 (HSWA), requires reporting to EPA or to authorized States at least every two years. EPD adopts Federal Hazardous Waste Regulations by reference. The Biennial Hazardous Waste Report is collected nationally every two years. 2004 was not a national reporting year. No forms packages were sent to Large Quantity Generators or Treatment, Storage or Disposal facilities this year (2005). 2005 will be a reporting year and report packages will be mailed in early 2006 for reporting of 2005 information on the quantities, type, and management method of generated hazardous wastes and hazardous wastes received from off site. Forms will be due by March 1, 2006.

All Large Quantity Generators (LQG) are required to submit a Waste Reduction Plan every two years at the time of the Biennial Report (see section above). This plan is to outline current waste production at the facility and plans for future reduction of that waste. Since 2004 was not a Biennial Report year, a Waste Reduction Plan is not required for 2005. Forms will be sent with the Biennial Report package in early 2006. The 2006 Waste Reduction Plan will be due by March 1, 2006.

This form and associated instructions are designed to help you determine if you are subject to the requirements under the Resource Conservation and Recovery Act (RCRA) for notifying the State of Georgia of your regulated waste activities. The instructions will assist you in obtaining an U.S. EPA Identification Number by completing and submitting EPA Form 8700-12 for initial notifications, or in revising EPA Form 8700-12 subsequent notifications. You are required to complete an EPA Form 8700-12 whenever any of the facility information contained on the form changes. The instructions also include appendices on typical waste streams produced by small quantity generators and typical waste streams and EPA Hazardous Waste Numbers. This link is to http://www.epa.gov/epaoswer/hazwaste/data/form8700/forms.htm .

• EPA Form 8700-12: Notification of Regulated Waste Activity Forms and Instruction

The Resource Conservation and Recovery Act (RCRA) requires anyone who owns or operates a facility where hazardous waste is treated, stored, or disposed to have a permit. RCRA establishes a procedure for obtaining interim status which allows existing facilities to continue operating until a final hazardous waste permit is issued. This form and associated instructions are submitted to the State of Georgia and are required for a Federal permit to treat, store, or dispose of hazardous waste under the Resource Conservation and Recovery Act (RCRA). The form defines the processes to be used for treatment, storage, and disposal of hazardous wastes; the design capacity of such processes and the specific hazardous wastes to be handled at a facility. Interim status is also explained.

• RCRA Part A Instructions (Adobe) [Revised July 19, 2005]
• RCRA Part A Application Form (Adobe) [Revised September 3, 2004]
• RCRA Part A Application Form (WordPerfect 8+) [Revised September 3, 2004]
• RCRA Part A Application Form (MS Word) [Revised September 3, 2004]

Land Protection Branch

• Asbestos Project Notification Form [Revised Aug 2005]
• Completion Notification for removal or Encapsulation of Asbestos [Revised ?]
• Completion Notification for Annual Blanket Notification Projects [Revised ?]
• Georgia Asbestos Waste Shipment Record (WSR) [Revised Aug 2005]

• Application for License, Asbestos Abatement contractor [Revised ?]
• Asbestos Contractor License Renewal Application Form [Revised Feb 2002]
• Company Name Change Application
• Agent Change Application

• Asbestos Training Provider Application
• Materials Needed for Approval of Asbestos Training Programs

• Application for Accreditation of Lead Based Paint Training Program [Revised Feb 1997]
• Application for Notice to Proceed with Lead Abatement
• Notice of Change in Abatement Project
• Abatement Completion Notification
• Certification Checklist for Applicants for Lead Based Paint Certification [Revised ?]

Initial Applications

• English Lead Worker Initial Application
• Spanish Lead Worker Initial Application
• Lead Project Supervisor Initial Application
• Lead Inspector Initial Application
• Lead Risk Assessor Initial Application
• Combined Inspector/Risk Assessor Initial Application
• Lead Project Designer Initial Application
• Lead Firm Initial Application

Renewal Applications

• English Lead Worker Renewal Application
• Spanish Lead Worker Renewal Application
• Lead Project Supervisor Renewal Application
• Lead Inspector Renewal Application
• Lead Risk Assessor Renewal Application
• Combined Inspector/Risk Assessor Renewal Application
• Lead Project Designer Renewal Application
• Lead Firm Renewal Application

• Scrap Tire Carrier Permit Application [Revised Oct 2004]
• Application for Retail Tire Dealer/Scrap Tire Generator ID Number [Revised Oct 2004]
• Scrap Tire Transportation Manifest [Revised Aug 2004 ]
• Scrap Tire Carrier Bond [Revised Jun 1996]
• Irrevocable Letter of Credit Format [Revised Jun 1996]
• Tire Fee Report [Revised Feb 2005]
• Scrap Tire Processor Quarterly Report [Revised Jan 2001]
• Scrap Tire Carrier Quarterly Report [Revised Feb 2005]
• Scrap Tire Sorter Quarterly Report [Revised Jan 2001]

• Application for Solid Waste Handling Permit and Request for Site Suitability [Revised Jun 1996]
• Form for the Notification of Permit By Rule Operations [Revised Sep 1997]

• Application for a Surface Mining Permit & Surface Mining Land Use Plan Form [Revised Sep 1996]
• Instructions for Surface Mining Land Use Plan Development [Revised Oct 1996]
• Annual Surface Mining Permit Status Report format [Revised Apr 2004]
• Instructions for (the completion of) Surface Mining Annual Permit Status Report [Revised ?]

• Georgia Underground Storage Tank (GUST) Closure Activity Form (GUST-29) [Revised Jul 1999]
• GUST On-Site Supervisor Qualification Form (UST-CP2) [Revised ?]
• GUST Trust Fund Reimbursable and Non-reimbursable Cost (GUST-59) [Revised Dec 1995]
• GUST Trust Fund Application (GUST-36) [Revised Jul 1995]
• Underground Storage Tank Literature (USTMP-11) [Revised Apr 2004]
• GUST Notification Data for an Underground Storage Tank (GUST-42) [Revised Nov 1994]
• GUST Request forms for reimbursement for a CAP-A remediation (GUST-91) [Revised ?]
• GUST Request forms for reimbursement for a CAP-B remediation (GUST-92) [Revised ?]
• GUST Request form for reimbursement (GUST-4A) [Revised Jan 2002]
• Georgia Corrosion Protection Test Forms [Revised Dec 2003]
• Link to the On-Line Underground Storage Tank Registration Site. Register a facility or Check the status

Program Coordination Branch

• Application for Radioactive Materials License [Revised Feb 1995]
• Application for Radioactive Materials License (Word Format) [Revised Feb 1995]
• Fee Schedule for Radioactive Materials Licenses [Revised May 2003]
• Georgia Emergency Radiological Assistance Telephone Numbers [Revised Jan 1999]
• Notice to Employees: Standards for Protection Against Radiation (English/Español) [Revised Jun 2000]
• Request to Terminate Radioactive Material License [Revised Jan 1998]
• Reciprocity for Out-of-State Users of Radioactive Materials [Revised Jul 2003]
• Reciprocity Notification (rich text format) [Revised Aug 1995]
• Reciprocity Notification (Adobe format) [Revised Aug 1995]

• Emergency Planning and Community Right to Know Section 312 Tier II Software [Revised Nov 2004]

Watershed Protection Branch

• Variance Application for 25-foot Vegetative Buffer Encroachment [Revised Jan 2005]
• Variance Application for 50-foot Trout Stream Buffer Encroachment [Revised Feb 2001]
• Variance Application for 50-foot Vegetative Buffer Encroachment [Revised Jan 2005]
• Model Soil Erosion and Sedimentation Control Ordinance

• Inspection Checklist and Enforcement Tracking (**SHORT FORM) [ Revised MAR 2002 ]
  • Instructions for Submitting the Inspection Checklist and Enforcement Tracking form
• Inspection Checklist (**LONG FORM) [ Revised MAR 2002 ]
  • Instructions for Submitting the Inspection Checklist
• Sanitary Sewer Extension Submittal [Revised Mar 2001]

Sam Shepherd

404.675.1697

404.675.6232

• Nonpoint Source Implementation Grant - Section 319(h) FY03 Grant [Revised Feb 2003]

Construction

• Notice of Intent for Primary Permittees (Word format) [Revised Aug 2003]
• Notice of Intent for Primary Permittees (Adobe format) [Revised Aug 2003 ]
  
• Notice of Intent for Secondary Permittees (Word format) [Revised Aug 2003]
• Notice of Intent for Secondary Permittees (Adobe format) [Revised Aug 2003]
  
• Notice of Intent for Blanket Secondary Permittees (Word format) [Revised Aug 2003]
• Notice of Intent for Blanket Secondary Permittees (Adobe format) [Revised Aug 2003]
  
• Notice of Intent for Tertiary Permittees (Word format) [Revised Aug 2003]
• Notice of Intent for Tertiary Permittees (Adobe format) [Revised Aug 2003]
  
• Notice of Termination (Word format) [Revised Aug 2003]
• Notice of Termination (Adobe format) [Revised Aug 2003]
  
• Notice of Termination for Blanket Secondary Permittees (Word format) [Revised Aug 2003]
• Notice of Termination for Blanket Secondary Permittees (Adobe format) [Revised Aug 2003]

• NPDES Construction Permit's Fee Fact Sheet [Revised Dec 2003]
  
• EPD-Construction Land Disturbance Fees (Word Format) [Revised Jan 2004]
• EPD-Construction Land Disturbance Fees (Adobe Format) [Revised Jan 2004]

Industrial

April 28, 2005 Update: The 2005 - 2010 NPDES General Permit No. GAR000000 for Storm Water Discharges Associated with Industrial Activity has been appealed by two parties. The permit has therefore been stayed pending an administrative hearing, and will not become effective as planned on May 2, 2005. The Notice of Intent (Version 2005) will not be released until the appeals are resolved and the permit is either reinstated or reissued. The extended 1998 - 2003 General Permit will remain in effect until that time, and all industrial storm water dischargers should continue to meet the requirements of that permit.

EPD will provide further updates on this website periodically.

• Notice of Termination - Industrial Activities (Adobe format) [Revised Aug 2000]
• Notice of Termination - Industrial Activities (Word Perfect format) [Revised Aug 2000]
• Industrial No Exposure Certification Form [Revised Aug 2001]

Municipal

• Phase I MS4 Annual Report Form (Word format) [Revised Mar 2005]
  
• Georgia Notice of Intent (Phase II Municipal) (Adobe format) [Revised Jan 2003]
• Georgia Notice of Intent (Phase II Municipal) (Word format) [Revised Jan 2003]
  
• Phase II Annual Report Form [Revised Nov 2004]

Construction

Jan Sammons

Industrial

Chip Scroggs

Municipal

Lyn Mickelson

Barbara Seal

Lisa Perrett

404.675.6240

404.675.6240

404.675.6240

404.675.6240

404.675.6240

• Wastewater (NPDES, LAS,& Pretreatment)
• NPDES EPA Form1
• NPDES EPA Form2A
• NPDES EPA Form2C
• NPDES EPA Form2D
• NPDES EPA Form2E
• NPDES EPA Form2F
• Application for an LAS Permit
• Application for a Pretreatment Permit [Revised
  Jan 2005]
• Offsite Link (Animal Feeding Operation Permitting Information and Forms)
  • UGA Extension Service

Agricultural

• Agricultural Withdrawal Application [Revised Jul 2004]
• Agricultural Withdrawal Application (Word format) [Revised Jul 2004]
• Agricultural Well Completion Data Form [Revised Jul 2003]
• Agricultural Well Completion Data Form (Word format) [Revised Jul 2003]
• Offsite Link: County Maps for Agricultural Withdrawal Application (Note: Scroll to the bottom for county maps. After selecting a county, click on the printer icon above and to the left of the map to print.)

Municipal and Industrial Surface Water

• Industrial Surface Water Withdrawal Application [Revised Apr 2004]
• Industrial Surface Water Withdrawal Application (Word format) [Revised Apr 2004]
• Municipal Surface Water Withdrawal Application [Revised Apr 2004]
• Municipal Surface Water Withdrawal New Application (Word format) [Revised Apr 2004]
• Online Data Entry for Drought-Related Water Withdrawals [Revised Jun 2000]
• Surface Water Monthly Withdrawal Report - Raw Water Intake Data (Excel format) [Revised July 2005]
• Surface Water Withdrawal Interbasin Transfer Annual Report (Excel format) [Revised July 2005]
• Surface Water Coosa-Tallapoosa River Basin Withdrawal Interbasin Transfer Monthly Report (Excel format) [Revised July 2005]

Municipal and Industrial Ground Water

All Groundwater Permit Applicants Must Complete:

• Part A Application Form [Revised Aug 2005]
• Part B Application Form [Revised Mar 2003]
• Groundwater Use Report (Jan - Jun) [Revised Jul 2005]
• Groundwater Use Report (Jul - Dec) [Revised Jul 2005]

Municipal Groundwater Permit Applicants Must Also Complete:

• Municipal Water Conservation Plan [Revised Apr 2004]
• Municipal Water Conservation Plan Characteristics [Revised Apr 2004]
• 5-Year Water Conservation Progress Report for Municipal facilities [Revised Mar 2003]
• Submit a signed copy of HB489 Service Delivery Strategy (from the Georgia Department of Community Affairs)

Industrial Groundwater Permit Applicants Must Also Complete:

• Industrial Water Conservation Plan [Revised Apr 2004]
• 5-Year Water Conservation Progress Report for Industrial facilities [Revised Mar 2003]

Golf Course Groundwater Permit Applicants Must Also Complete:

• Golf Course Water Conservation Plan [Revised Apr 2004]
• Golf Course Water Conservation Plan Characteristics [Revised Apr 2004]
• 5-Year Water Conservation Progress Report for Golf Course facilities [Revised Mar 2003]

Agricultural Cliff Lewis

Surface Water
Ade Oke

Groundwater
Bill Frechette

404.463.9880

404.362.2637

404.675.1680

Water Resources Branch

• Public Water System Water Conservation Questionnaire (Word Format) [Revised Jan 2004] TTHM/HAA5 Monitoring Plan Form [Revised Mar 2003]
• Wellhead Protection: New Well / Spring Application [Revised Mar 2003]
• Chemical Monitoring Laboratory Report Form [Revised Oct 2000]
• Application for a Permit to Operate a Public Water System (Adobe Format) [Revised Oct 2003]
• Application for a Permit to Operate a Public Water System (Word Format) [Revised Oct 2003]
• Drinking Water Project Sumbittal [Revised Jun 2001]
• Surface Water Sanitary Survey for Public Water Systems [Revised May 2001]
• Surface Water System Description (Part B) Sanitary Survey for Public Water Systems [Revised May 2001]
• Ground/Purchased Water Sanitary Survey for Public Water Systems [Revised May 2001]
• Ground/Purchased Water System Description (Part B) Sanitary Survey for Public Water Systems [Revised May 2001]
• Surface Water Treatment Plant Monthly Operating Report Forms (Excel Format) [Revised Aug 2001]
• Ground Water Treatment Plant Monthly Operating Report Forms (Excel Format) [Revised Dec 2003]
• Stage 1 Disinfectants and Disinfection Byproducts Quarterly Reporting for Total Trihalomethanes (TTHM) and Haloacetic Acids (HAA5) [Revised Dec 2003]
• Compliance Determination: Treatment Technique for DBP Precursor Removal (TOC Removal Report) [Revised Dec 2003]
• Manual for Chemical and Radiochemical Certification of Drinking Water Laboratories (Word format) [Revised Sep 2003]