Drinking Water

Application and Modification Forms

• Application for a Permit to Operate a Public Water System (Word Format) [Revised Nov. 2012] *updated*

• Drinking Water Project Submittal [Revised Jun 2001]

• Wellhead Protection: New Well / Spring Application [Revised Nov. 2012] *updated*

• Chemical Monitoring Laboratory Report Form [Revised Oct 2000]

• Public Water System Water Conservation Questionnaire (Word Format) [Revised Jan 2004]

Sanitary Survey for Public Water Systems

• 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]

Treatment Plant Monthly Operating Report Forms

• Surface Water Treatment Plant Monthly Operating Report Forms (Excel Format) [Revised Nov 2005]

• Ground Water Treatment Plant Monthly Operating Report Forms (Excel Format) [Revised Dec 2003]

Disinfection Byproducts (TTHM & HAA5) Report Forms

• TTHM/HAA5 Monitoring Plan Form [Revised Mar 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]

Laboratory Certification for Drinking Water

• Manual for Chemical and Radiochemical Certification of Drinking Water Laboratories (Word format) [Revised Sep 2003]

Erosion and Sedimentation

• Variance Application for 25-foot Vegetative Buffer Encroachment [Revised March 2011]

• Variance Application for 50-foot Vegetative Buffer Encroachment [Revised March 2011]

• Model Soil Erosion, Sedimentation And Pollution Control Ordinance

*link to Technical Guidance page*

• Field Guide for Determining the Presence of State Waters that Require a Buffer [Sept. 2006]

Michael Berry

Peggy Chambers

Jan Sammons

404.675.6240

404.675.6240

Engineering and Technical Support (Wastewater)

• 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 March 2002]

• Instructions for Submitting the Inspection Checklist

• Sanitary Sewer Extension Submittal [Revised Dec. 2011]

404.362.2680

Non-Point Source

Section 319(h) Nonpoint Source Implementation Grant

Under Section 319(h) of the Clean Water Act, the U. S. Environmental Protection Agency (USEPA) awards a Nonpoint Source Implementation Grant to the Georgia Environmental Protection Division (GAEPD) to fund eligible projects, which support the implementation of the Georgia Nonpoint Source Management Program. Section 319(h) Grant funds for the prevention, control, and/or abatement of Nonpoint Sources of Pollution (NPS pollution) are available via competitive process to public agencies in Georgia.

Update July 17, 2012: FY2013 funds are now available. Please use the updated FY2013 grant application and guidance materials for your proposals.  Application deadline is October 31, 2012 - CLOSED

• Grant Announcement -
  • FY2013 Grant Announcement

• Grant Application -
  • Section 319(h) FY2013 Nonpoint Source Implementation Grant Application (Word Format) [Revised July 2012]

• Grant Project Implementation and Drawdown Schedule -
  • Section 319(h) FY2013 Grant Project Implementation and Schedule (Excel Format) [July 2012]  This document is a required component of the FY2013 319(h) Grant application and will be used to track the completion of tasks and reporting requirements and the expenditure of fund.

• Grant Guidelines -
  • Section 319(h) FY2013 Grant Guidelines [Revised July 2012]

• Grant Match FAQ -
  • Local Match Contributions for 319(h) Grants - Frequently Asked Questions (FAQs) [July 2012]

• Priority Projects -
• Priority is given to projects developing, revising, and/or implementing a TMDL Implementation Plan or Watershed Plan in order to alleviate the criterion violated as identified in Georgia’s Section 305(b)/303(d) list of impaired waters.

Storm Water

Construction

Notice of Intent Forms

• Notice of Intent for Primary Permittees (MS Word format) Version 2008 [Revised March 2011]
• Notice of Intent for Primary Permittees (PDF format) Version 2008 [Revised March 2011]

• Notice of Intent for Secondary Permittees (MS Word format) Version 2008 [Revised March 2011]
• Notice of Intent for Secondary Permittees (PDF format) Version 2008 [Revised March 2011]

• Notice of Intent for Blanket Secondary Permittees (MS Word format) Version 2008 [Revised March 2011]
• Notice of Intent for Blanket Secondary Permittees (PDF format) Version 2008 [Revised March 2011]

• Notice of Intent for Tertiary Permittees (MS Word format) Version 2008 [Revised March 2011]
• Notice of Intent for Tertiary Permittees (PDF format) Version 2008 [Revised March 2011]

 

Notice of Termination Forms

• Notice of Termination (MS Word format) Version 2008 [Revised March 2011]
• Notice of Termination (PDF format) Version 2008 [Revised March 2011]

• Notice of Termination for Blanket Secondary Permittees (MS Word format) Version 2008 [Revised March 2011]
• Notice of Termination for Blanket Secondary Permittees (PDF format) Version 2008 [Revised March 2011]
  

Construction Land Disturbance Fees Form

• GAEPD - Construction Land Disturbance Fees Form (Word Format) [Revised Aug 2008]
  • NPDES Construction Permit's Fee Fact Sheet [Revised August 2008]

Industrial *Updated 1/31/2013*

The 2012 NPDES General Permit No. GAR050000 for Storm Water Discharges Associated with Industrial Activity (2012 IGP) was issued April 16, 2012. This is the replacement permit for the 2006 IGP (GAR000000) which expired on July 31, 2011. The new general permit became effective on June 1, 2012.

FINAL PERMIT AND FORMS: NPDES General Permit No. GAR050000 for Storm Water Discharges Associated with Industrial Activity (2012 IGP) [April 16, 2012]

Existing permitttees will have 30 days after the effective date of the 2012 IGP to submit a 2012 Notice of Intent (2012 NOI, Version 2012 only) to obtain coverage under the new permit.

New facilities and/or facilities that are seeking new coverage under the 2012 IGP must submit an NOI 7 days before commencing discharge.

The 2012 forms (Notice of Intent, No Exposure Exclusion, Notice of Termination and Annual Report Form) are now available on the NPDES Industrial Storm Water General Permits web page. Older versions of these forms will not be accepted.

For information regarding GAR050000 contact Mark Wyland, Lyn Mickelson or Frances Carpenter at 404.675.6240. 

Municipal

• ANNUAL REPORT FORM - Phase I LARGE Municipal Separate Storm Sewer System (MS4) (Word format) [Revised March 2011]

• ANNUAL REPORT FORM- Phase I Medium Municipal Separate Storm Sewer System (MS4) (Word format) [revised Jan.2013] 

• ANNUAL REPORT FORM - Phase II Municipal Separate Storm Sewer System (MS4) (Word Format) [Revised Oct. 2008]

• NOTICE OF INTENT– Phase II Municipal Separate Storm Sewer System (MS4) (Word Format) [Revised July 2012]

• STORM WATER MANAGEMENT PROGRAM GUIDANCE - Phase II MS4 Storm Water Management Program Preparation [January 2013]

Construction

Jan Sammons

Industrial

Mark Wyland

Lyn Mickelson

Frances Carpenter

Municipal

Mildred Granderson

Connie Haynes

Lyn Mickelson

Lisa Perrett

404.675.6240

404.675.6240

404.675.6240

Wastewater (NPDES & LAS)

• 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

Gigi Steele

Jane Hendricks

404.362.2680

404.362.2680

• UIC Mixed Waste Non-Domestic Septic Systems Permit Application Form [Revised July 2010]

• UIC Application Form [Revised July 2010]

• UIC Application Checklist [Revised Dec 1991]

• UIC Pilot Test Notification Form [Revised July 2010]

• Water Well Driller and Pump Installer Information

Jim Kennedy

Ted Jackson

404.463.0679

404.656.5660

Water Withdrawal Permitting

Agricultural

• Agricultural Permitting Unit Information Page hosted by UGA/NESPAL with links to Aerial Photo Reference Maps *NOTE: Offsite Link*

• Agricultural Withdrawal Application (Abobe format) [Revised August 2008]

• Agricultural Well Completion Data Form (MS Word format) [Revised March 2008]

• Agricultural Well Pump Information Form (Adobe format) [Revised Sep 2011]

• EPD Request For Changes To Agricultural Withdrawal Permit (Adobe format) [Revised April 2010]

• Notification of Agricultural Water Withdrawal Permit Relinquishment, Inactivation, or Revocation (Adobe format) [Revised Aug 2011]

• GASWCC Flow Meter Approval Form and Contact Map (Adobe format) [Revised Nov. 2010]

• Low Flow Plan Guide - Drought Contingency Plan 

Municipal and Industrial Surface Water

• Industrial Surface Water Withdrawal Application (Word format) [Revised Nov 2009]

• Municipal Surface Water Withdrawal New Application (Word format) [Revised Nov 2009]

• Surface Water Monthly Withdrawal Report - Raw Water Intake Data (Excel format) [Revised Jul 2005 ]

• Surface Water Withdrawal Interbasin Transfer Annual Report (Excel format) [Revised Apr 2004]

• Surface Water Coosa-Tallapoosa River Basin Withdrawal Interbasin Transfer Monthly Report (Excel format) [Revised Apr 2004]

• Water Conservation Progress Report (Word format) [Revised Aug. 2010]

Municipal and Industrial Groundwater

All Groundwater Permit Applicants Must Complete:

• Part A Application - General System Information
  • Part A Application Form - General System Information (MS Word Format) [Revised Aug. 2008] 

• Part A Application Form - General System Information (Editable Adobe .PDF Format) [Revised Aug. 2008]

• Part B Application - Well Data
  • Part B Application Form - Well Data (MS Word Format) [Revised Aug. 2008]
  • Part B Application Form - Well Data (Editable Adobe .PDF Format) [Revised Aug. 2008]

• Monthly Groundwater Use Reporting Form (MS Excel Format) [Jan. 2009]

• Monthly Groundwater Use Reporting Form (MS Office 2010 Excel Format .xlsx) [Jan. 2013] Note:  Downloads as compressed .zip file

 

Municipal Groundwater Permit Applicants Must Also Complete:

• Municipal Water Conservation Plan [Revised Apr 2004]
• Municipal Water Conservation Plan Characteristics [Revised Apr 2004]
• Water Conservation Progress Report (Word format) [Revised Aug. 2010]
• 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

229.391.2400

404.362.2637

404.675.1680