Permit Forms
Download Instructions:
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Submit all permit application forms with the appropriate application fee to:
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Water Pollution Control E-Permitting System - In an effort to improve our service to the public, NDEP has developed an electronic process for submitting permit applications. By selecting "Online" next to the forms, the applicant will be directed to the registration/sign-in page. Please register (sign-in) and complete the application on-line, print and sign the certification letter, then mail it to NDEP with the appropriate application fee(s).
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National Pollutant Discharge Elimination System (NPDES) Permits
For facilities that discharge to surface waters, Nevada uses the Federal NPDES Discharge Permit Program forms and requirements.
Notice of Termination ("NOT") for Coverage under General NPDES Permit Online The person signing this form must be an authorized signatory. This form cannot be forwarded to sign after filling, so if you are filling out the form you must be a principal executive officer of the corporation; a general partner of the partnership; the proprietor of a sole proprietorship; a principal executive office, ranking elected official or authorized employee of the municipal, state, or other public facility; or a duly authorized representative that has an authorization letter on file with Water Pollution Control. |
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Stormwater Applications and Information
| Form Description | Revision | Format | |
|---|---|---|---|
| Mining Stormwater Annual Report Template | 06/15 |  | |
| Mining Stormwater Pollution Prevention Plan (SWPPP) Template | 2015 | | |
| Construction Stormwater Pollution Prevention Plan (SWPPP) Template | 2017 |
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| Industrial Stormwater Pollution Prevention Plan (SWPPP) Template and Forms | -- |
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| Notice of Intent (NOI) - Small MS4s, Construction, Industrial, and Mining | -- | -- | |
| Stormwater Annual Report Template - Small MS4 | -- | | |
Stormwater General Permits - Notice of Termination ("NOT") for Coverage under a General NPDES Permit The person signing this form must be an authorized signatory. This form cannot be forwarded to sign after filling, so if you are filling out the form you must be a principal executive officer of the corporation; a general partner of the partnership; the proprietor of a sole proprietorship; a principal executive office, ranking elected official or authorized employee of the municipal, state, or other public facility; or a duly authorized representative that has an authorization letter on file with Water Pollution Control. | -- | -- | Online |
Stormwater Information: Go Here | -- | -- | -- |
Water Pollution Control (WPC) Discharge Permits
| Form Description | Revision | Format | |
|---|---|---|---|
Nevada WPC (Groundwater) Discharge Permit Application | File | Online | |
Toxics list for Nevada Groundwater Discharge Application | 08/03 | | |
Groundwater Discharge Application for Reclaimed Water Use | File | Online | |
NDEP - CAFO Discharge to Waters of the State Supplemental Application | File | Online | |
Temporary Discharge Permit Application | File | Online | |
"Profile 1" Analysis List | 10/14 | |
Reporting Form and Instructions
| Form Description | Revision | Format | |
|---|---|---|---|
| Note: The following DMR form applies to all NPDES and Groundwater Discharge permits above. | -- | -- | |
Discharge Monitoring Report (DMR) Reporting | -- | NetDMR | |
General instruction for completing Discharge Monitoring Report in NetDMR | -- |
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Guidance for the Use of Significant Figures and Rounding Convention in Water Quality Permitting | 2017 |
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Underground Injection Control (UIC) Permits
| Form Description | Revision | Format | |
|---|---|---|---|
| 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 | -- | | Online |
UIC Form U110: UIC Mechanical Integrity Test Report Form | 05/17 |
| Online |
UIC Form U111: UIC Mechanical Integrity Test Report - Geothermal | 05/17 |
| Online |
UIC Form U120: UIC Injection Well Completion Report (Class II/Geothermal) | 05/17 |
| Online |
UIC Form U200: UIC Permit Application | 05/17 |
| Online |
UIC Form U201: General Class 5 Well Attachments | 05/17 |
| Online |
UIC Form U202: Class 2 Oil/Gas, Class 3 Solution Mining, or Class 5 Geothermal Well Attachments | 05/17 |
| Online |
UIC Form U203: Class 5 Remediation or Tracer Test Attachments | 05/17 |
| Online |
UIC Form U210: UIC Remediation NOI | 11/17 |
| Online |
UIC Form U211: Approval Request for Domestic Geothermal Injection Wells | 05/17 |
| Online |
UIC Form U220: UIC Permit Acknowledgement Form U220 | 05/17 |
| Online |
UIC Form U230: UIC Field Sampling & Monitoring Summary | 05/17 |
| Online |
UIC Sample List 1 | -- | | Online |
UIC Sample List 2 | -- | | Online |
UIC Sample List 3 | -- | | Online |
UIC Water Sample List – Class 2 wells | 05/17 |
| Online |
UIC Form U240: UIC Requests for Chemical Use | 05/17 |
| Online |
UIC Form U250: Notice to Transfer Injection Permit / Change of Ownership | 05/17 |
| Online |
UIC Form U310: UIC Notice of Termination The person signing this form must be an authorized signatory. This form cannot be forwarded to sign after filling, so if you are filling out the form you must be a principal executive officer of the corporation; a general partner of the partnership; the proprietor of a sole proprietorship; a principal executive office, ranking elected official or authorized employee of the municipal, state, or other public facility; or a duly authorized representative that has an authorization letter on file with Water Pollution Control. | 10/16 |
| Online |
Discharge Basin Form - Associated with UIC Permit | 05/17 |
| Online |
Oil/Water Separator Notice of Intent (NOI) | -- |
| Online |
Injection Well Notification Form | -- | | Online |
Class V Well Pre-closure Notification Form | 05/17 |
| Online |
Requests for Tracer Use in Ground Water | -- | | Online |
UIC Permit Cancellation Guidance | -- | | -- |
Onsite Sewage Disposal Systems
| Form Description | Revision | Format | |
|---|---|---|---|
OSDS - Application for Design Plan Approval | 05/17 |
| Online |
OSDS - Notice of Intent (NOI) to Discharge | 05/17 |
| Online |
OSDS - Notice of Termination (NOT) The person signing this form must be an authorized signatory. This form cannot be forwarded to sign after filling, so if you are filling out the form you must be a principal executive officer of the corporation; a general partner of the partnership; the proprietor of a sole proprietorship; a principal executive office, ranking elected official or authorized employee of the municipal, state, or other public facility; or a duly authorized representative that has an authorization letter on file with Water Pollution Control. | 05/17 |
| Online |
OSDS - Large Capacity Annual Report Form | -- | | Online |
| OSDS - Nevada Infiltrator Chamber System Sizing Chart | -- | | -- |
Temporary Holding Tanks - Application for Plan Approval | 05/17 |
| Online |
Temporary Holding Tanks - Notice of Intent (NOI) for coverage | 05/17 |
| Online |
Permanent Holding Tanks - Application for Plan Approval | 05/17 |
| Online |
| Permanent Holding Tanks - Notice of Intent (NOI) for coverage | 05/17 |
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