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  Permit Forms & Fee Schedules Back BWPC Home Page   
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    Submit all permit application forms with the appropriate application fee to:

    Nevada Division of Environmental Protection
    Bureau of Water Pollution Control
    901 South Stewart Street, Suite 4001
    Carson City, Nevada 89701-5249
National Pollutant Discharge Elimination System (NPDES) Permits
Form Description Revision Date File Format
PDF DOC

NOTE: For facilities that discharge to surface waters, Nevada uses the Federal NPDES Discharge Permit Program Forms. The NPDES permit links below take you directly to the form at the U.S. Environmental Protection Agency's (EPA's) website.

EPA Form 1 - General Information
Nevada REQUIRES that this form accompany at least one of the Series 2 Forms listed below

-- 2.51 MB file size

N/A

NPDES Supplemental Information Form
Nevada REQUIRES that this form accompany all NPDES applications except Form 2B - CAFOs

03/13

225 KB file size 386 KB file size

NPDES Application Form 2A - New & Existing Publicly Owned Treatment Works

-- 132 KB file size

N/A

NPDES Application Form 2B - New & Existing Concentrated Animal Feeding Operations (CAFOs) and Aquatic Animal Production Facilities

-- 580 KB file size

N/A

NDEP CAFO Discharge Supplemental Application (in addition to Form 2B)
Nevada REQUIRES that this form accompany all CAFO related NPDES applications (Form 2B above)

05/13

225 KB file size 386 KB file size

CAFO Flow Chart [Definitions & other information]

--

N/A

NPDES Application Form 2C - Existing Manufacturing, Commercial, Mining and Silvicultural Discharges)

-- 2.94 MB file size

N/A

NPDES Application Form 2D - New Manufacturing, Commercial, Mining and Silvicultural Discharges

-- 992 KB file size

N/A

NPDES Application Form 2E - Manufacturing, Commercial, Mining and Silvicultural Facilities That Discharge NON-PROCESS Wastewater

-- 1.0 MB file size

N/A

Temporary Permit Application for Working in Waterways
(Formerly known as a "Rolling Stock Permit")

-- 15 KB file size

N/A

Regulated Chemicals

-- 21.7 KB file size

N/A




Stormwater Applications and Information
Form Description Revision Date File Format
PDF DOC

Notice of Change ("NOC") of Owner or Operator under General Permit NVR100000 for Stormwater Discharges Associated with Construction Activity

NA

82 KB file size 25 KB file size

Mining Stormwater Annual Report Template

NA

NA

25 KB file size

Notice of Intent (NOI) - Small MS4s

NA

82 KB file size

NA

Stormwater Annual Report Template - Small MS4

NA

82 KB file size

NA

Stormwater General Permits - Notice of Termination ("NOT") for Coverage under a General NPDES Permit

NA

82 KB file size

25 KB file size

Stormwater Information: Go Here




Groundwater Discharge Permits
Form Description Revision Date File Format
PDF DOC

Nevada Groundwater Discharge Permit Application

03/13

327 KB file size 533 KB file size

Toxics list for Nevada Groundwater Discharge Application

08/03

82 KB file size 25 KB file size

Groundwater Discharge Application for Reclaimed Water Use

03/13

9 KB file size 43 KB file size

NDEP - CAFO Discharge to Waters of the State Supplemental Application

05/13

225 KB file size 386 KB file size

Temporary Discharge Permit Application

(Pursuant to NRS 445A.485, a temporary permit may be issued for a maximum of a 180 day (6 month) period of time. After which time the discharge shall cease or the discharger shall have applied for and received a Permanent Discharge Permit.)

03/13

80.5 KB file size 39 KB file size

"Profile 1" Analysis List

9/09

5 KB file size



Reporting Form and Instructions
Form Description Revision Date File Format
PDF DOC
Note: The following DMR form applies to all NPDES and Groundwater Discharge permits above.

Discharge Monitoring Report (DMR) Form

-- 28.7 KB file size 55 KB file size

General instruction for completing Discharge Monitoring Report (Omb No. 2000-0015)

-- 10.2 KB file size

N/A

Discharge Monitoring Report (DMR) Certification for NetDMR Reportting -- (Permittees are required to submit a completed and signed original copy of this form to the BWPC prior receiving authorization to submit DMR data electronically).

2013

290 KB file size

N/A

Guidance for the Use of Significant Figures and Rounding Convention in Water Quality Permitting

2013

10.2 KB file size

N/A




Underground Injection Control (UIC) Permits
Form Description Revision Date File Format
PDF DOC
Note: Submission of a complete UIC application consists of a completed Form U200 and completion of the attachments from one of the other forms: U201, U202 or U203. Use the attachment form that applies to your type of UIC well.

UIC Form U100: Quarterly Class II Disposal/Injection Well Monitoring Report Form

-- 668 KB file size

UIC Form U110: UIC Mechanical Integrity Test Report Form

-- 668 KB file size 423 KB file size

UIC Form U111: UIC Mechanical Integrity Test Report - Geothermal

05/2012

211 KB file size 346 KB file size

UIC Form U120: UIC Injection Well Completion Report (Class II/Geothermal)

06/2010

668 KB file size 423 KB file size

UIC Form U200: UIC Permit Application

2/2014

229 KB file size 423 KB file size

UIC Form U201: General Class 5 Well Attachments

12/2006

229 KB file size 423 KB file size

UIC Form U202: Class 2 Oil/Gas, Class 3 Solution Mining, or Class 5 Geothermal Well Attachments

12/2006

229 KB file size 423 KB file size

UIC Form U203: Class 5 Remediation or Tracer Test Attachments

12/2006

229 KB file size 423 KB file size

UIC Form U210: UIC Remediation NOI

06/2007

229 KB file size 423 KB file size

UIC Form U211: Approval Request for Domestic Geothermal Injection Wells

11/2010

229 KB file size

UIC Form U220: UIC Permit Acknowledgement Form U220

06/2010

UIC Form U230: UIC Field Sampling & Monitoring Summary

11/2012

UIC Sample List 1

-- 668 KB file size

UIC Sample List 2

-- 668 KB file size

UIC Sample List 3

-- 668 KB file size

UIC Water Sample List Class 2 wells

-- 668 KB file size

UIC Form U240: UIC Requests for Chemical Use

03/2012

UIC Form U250: Notice to Transfer Injection Permit / Change of Ownershpi

06/2010

229 KB file size 423 KB file size

UIC Form U310: UIC Notice of Termination

06/2011

229 KB file size 423 KB file size

Discharge Basin Form - Associated with UIC Permit

02/2009

423 KB file size

Oil/Water Separator Notice of Intent (NOI)

-- 67 KB file size 26.5 KB file size

Injection Well Notification Form

-- 668 KB file size

N/A

Class V Well Pre-closure Notification Form

-- 668 KB file size 26.5 KB file size

Requests for Tracer Use in Ground Water

-- 668 KB file size

UIC Permit Cancellation Guidance

-- 668 KB file size



Onsite Sewage Disposal Systems
Form Description Revision Date File Format
PDF DOC

OSDS - Application for Design Plan Approval

-- 668 KB file size 26.5 KB file size

OSDS - Notice of Intent (NOI) to Discharge

-- 668 KB file size 26.5 KB file size

OSDS - Large Capacity Biennial Report Form

-- 668 KB file size 26.5 KB file size

OSDS - Nevada Infiltrator Chamber System Sizing Chart

-- 668 KB file size

NA

Temporary Holding Tanks - Application for Plan Approval

-- 668 KB file size 26.5 KB file size

Temporary Holding Tanks - Notice of Intent (NOI) for coverage

-- 668 KB file size 26.5 KB file size

Permanent Holding Tanks - Application for Plan Approval

-- 668 KB file size 26.5 KB file size

Permanent Holding Tanks - Notice of Intent (NOI) for coverage [pending]

--



Fee Schedules
Form Description Revision Date File Format
PDF DOC

Groundwater Discharge and NPDES Permits Fee Schedule
(fees due July 1, 2010 - June 30, 2012)

-- 14.7 KB file size

N/A

Underground Injection Control Permit Fee Schedule

-- 3.4 KB file size

N/A

Large Capacity Septic General Permit Notice of Intent = $400

Oil Water Separator General Permit Notice of Intent = $400

Temporary Discharge Permit Application Fee = $250

Other Notice of Intent (NOI) fees = $200

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