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Water Quality Permit Application and Miscellaneous Forms

IMPORTANT NOTICE: Please be aware that new fees will be effective on July 1, 2009. Permit applications received by MPCA on and after July 1, 2009, and before implementation of the rule, are subject to the new fees and will be charged retroactive fees, as necessary. For more information, go to the MPCA’s Air and Water Permit Fees Web page.

MPCA water quality permits establish specific limits and requirements to protect Minnesota's surface and ground water quality for a variety of uses, including drinking water, fishing and recreation. Permits are regularly reviewed and updated as they expire, allowing the MPCA to incorporate new information about the impacts of pollutants to the environment in subsequent permits. Permits are enforced through a combination of self-reporting (reports to the MPCA, U.S. EPA or both) and compliance monitoring.

Small businesses are encouraged to visit the Environmental Guide for Small Business — Water Quality information on this Web site for an overview of wastewater management issues.

Requests for Permit Discharge Limits

To request preliminary effluent limits for a proposed facility with a surface water discharge, use the following form. When you've completed the form, submit to Beckie Olson, Permit Document Coordinator, 520 Lafayette Road N, St Paul, Minnesota 55155-4194.

• Preliminary Effluent Limit Review Request Form

Instructions for Completing and Submitting Application Forms

To apply for a water quality permit, look through the following list of instructions and forms to select those appropriate for your project. If you'd like assistance or have questions about the forms, please contact the MPCA's Customer Assistance Center at 651-297-2274, or toll-free 800-646-6247. When you have completed your application, submit two copies of each form to Beckie Olson, Permit Document Coordinator, 520 Lafayette Road N., St. Paul, Minnesota 55155-4194.

Each form is available as either a Microsoft Word template file for word processing (.doc or .dot) or an Adobe Acrobat file (.pdf) or both. If you use the word processing template (.dot) version, you can fill in the appropriate information directly on the form. If you download the Adobe Acrobat Reader from this Web site, you should be able to read and print the Acrobat (.pdf) forms and complete them manually.

Permit Application Forms

Permit Transfer/Name Change Form

The following application form should be used for all National Pollutant Discharge Elimination System (NPDES) and State Disposal System (SDS) permit transfers or permittee name changes, except for coverage under the industrial stormwater, construction stormwater and municipal separate stormwater system general permits.

• Permit Transfer Name Change Form

The following is guidance for Homeowner's Associations planning to become Permittee for an MPCA-permitted wastewater treatment facility.

• Transfer of MPCA Wastewater Permits: A Homeowner's Association Guide

Request for Permit Termination

• Request for Permit Termination Form

Forms Required for Most Applications

All National Pollutant Discharge Elimination System (NPDES) and State Disposal System (SDS) permit applications (except for permit transfers or name changes, sanitary sewer extensions, and applications for coverage under the industrial stormwater, construction stormwater and municipal separate stormwater system general permits) must have a Water Quality Transmittal Form (2 pages). Most NPDES permit applications also require an additional form, NPDES Permit Application - Appendix A (1 page). So if you are constructing or expanding a facility, modifying a facility or re-permitting an existing facility you should include these forms in your application package.

• Water Quality Transmittal Form
• NPDES Permit Application - Appendix A.

Feedlots

For feedlot permit applications and information, visit the Feedlots page on this Web site.

Stormwater

If you are applying for permits involving the management of stormwater or run-off, either from a construction project or an industrial facility, visit the stormwater page on the MPCA Web site.

Municipal/Domestic Facilities

Those facilities that process primarily wastewater from domestic sanitary sewer sources (sewage) are considered municipal facilities. These include city wastewater districts treatment, sanitary districts, wayside rest areas, national or state parks, mobile home parks, and resorts. Municipal permits can be "major," "regular," or "general," depending upon how much wastewater is discharged and what types of pollutants might be found in the wastewater. If you have any questions about what category your facility is in, contact the MPCA Customer Assistance Center. Additional information is available on the wastewater page on this Web site.

Major Facilities

Municipal major facilities must complete U.S. Environmental Protection Agency (EPA) forms. These EPA forms are provided for your convenience. (Appendix A, under "Forms Required for All Applications," will be necessary here.) You may also obtain these forms on the U.S. EPA Web site.

• EPA NPDES Form 2A Application (22 pages)

Regular Facilities

The following form is appropriate for facilities that discharge surface water but are not classified as major facilities.

• Attachment for Municipal Facilities (5 pages)

Land Application of Wastewater

If you are applying for a permit for the land application of domestic wastewater, for example by spray irrigation, complete the following form.

• Attachment for Municipal Land Application Facilities (4 pages)

Stabilization Ponds

If you are applying for a permit for a stabilization pond, your application must include the following forms.

• Attachment for Stabilization Pond Information Sheet (2 pages)

Septic Systems (Individual Sewage Treatment Systems - ISTS)

For permitting and other regulatory information on septic systems serving other than a single-family home, visit the Businesses with ISTS, Class V, Small Communities and Cluster Septic Systems: Regulatory and Other Considerations Web page.

Sanitary Sewer Extensions - New Application Forms for 2009

New application form is now available.  Beginning January 1, 2010 applications that are not on the new form will be returned.

Changes from the previous forms:

• The application and design certification forms have been combined into a single application
• A location map is required to be submitted with all applications
• New questions regarding bypass/overflows in the collection and treatment system.
• Additional signature is required from the wastewater treatment plant authority, or sanitary district if other than the city.

Minn. Stat. 115.07, Subd. 3, states that it is unlawful for any person to make any change in, addition to or extension of an existing disposal system (includes sewer system) or point source, or part thereof, to effect any facility expansion, production increase (change in influent flow), or process modification which results in a new or increased discharge of pollutants until plans and specifications have been approved by the agency.

New Fact Sheet regarding when a permit is required - 2009

See the new Sanitary Sewer Modification or Extension fact sheet below for more detailed information about when a permit is required. Individual sewer service connections may not require a permit if they are covered under another permit. If you have questions about the permit process or whether a permit is required or not, contact the Municipal Wastewater Section compliance staff assigned to the region the project is located.  MPCA regional staff directories are located on the Regional Office Web page.

Please note the following:

• The average turnaround time for the MPCA to review a sanitary sewer application and issue/mail a sanitary sewer permit (following the fast-track process) is about two weeks. However, during spring and summer when large numbers of permit applications are received, the turnaround time may be up to four to six weeks or longer
• When submitting projects located in the seven county metropolitan area, the application form must be sent to the the Metropolitan Council Environmental Services (MCES) for review at: MCES, 390 N. Robert St., St. Paul, MN 55101, and approved prior to submittal to the MPCA.
• For any other city served by a sanitary district or another city’s wastewater treatment plant, the application form must also be signed by the that treatment authority prior to submittal to the MPCA.

Sanitary Sewer Extension Permit Information and Forms

• Sanitary Sewer Extension Permit Application form (new in 2009)
• Sanitary Sewer Modifications, Additions, or Extension Permits – When are Permits Required (new in June 2009)
• Sanitary Sewer Extension Permitting Process

Biosolids

If your facility produces biosolids (sewage sludge), you will need the following forms.

• Attachment for Biosolids Information Sheet (2 pages)
• Biosolids Site Application Form
• Biosolids Annual Report
• General Management Requirements for the Application of Biosolids
to Agricultural Sites

Potable Water Treatment Plants

If you are applying for a permit for a water treatment plant that discharges to storm sewers, directly to surface water, or groundwater complete the following form. For additional information on Potable Water Treatment Plant wastewater, visit the wastewater page on this Web site.

• Water Treatment Plant Application Form (2 pages)

Industrial Process Wastewater

Industrial process wastewater is wastewater which, during manufacturing or processing, comes into direct contact with (or is left over from production of) a raw material, intermediate product, finished product, byproduct or waste product. (Industrial process wastewater must not be routed to a septic system, because this may lead to groundwater contamination that can be expensive and difficult to clean up.) Additional information is available on the wastewater page on this Web site.

Major Facilities

Industrial major facilities must complete the U.S. EPA forms outlined below. You may also obtain these forms on the U.S. EPA web site.

• EPA Application Form 1 (10 pages of instructions, 16 pages total)
• EPA Application Form 2C (5 pages of instructions, 25 pages total)

Regular Facilities

The forms needed for regular facility permits are dependent upon whether the wastewater from the facility is discharged to surface water or land-applied.

• Attachment for Industrial Surface Water Discharge Wastewater Treatment Facilities (5 pages)
• Attachment for Land Treatment of Industrial Process Wastewater (6 pages)
• Attachment for On-Land Disposal Site Approval (5 pages)

This On-Land Disposal Site Approval form should also be used for sites proposed for the on-land application of other types of non-domestic wastewater.

Pretreatment

Use of the sanitary sewer for non-domestic wastewater requires the approval of the local wastewater treatment authority. Since non-domestic wastewater is often very different from domestic wastewater, pretreatment before sewering is usually needed.

If a facility generates industrial process wastewater that comes from metal-finishing or other industrial processes covered by the EPA categories listed in 40 CFR 413 - 471 and if this wastewater is routed to the sanitary sewer system, the pretreatment form below must be provided to the MPCA directly.

• Pretreatment State Disposal System Permit Application (4 pages)
• Additional Instructions for Pretreatment Permit Application (4 pages)

Gravel/Stone/Asphalt

• Attachment for Construction Sand and Gravel, Rock Quarrying and Hot Mix Asphalt Production Facilities (6 pages)
• Annual Report and Site Inventory
• Construction Sand and Gravel, Aggregate and Hot Mix Asphalt Activities Permit Information

Dredged Materials

• Attachment for Dredged Material Disposal (6 pages)

Industrial By-products

Examples of industrial byproducts include drinking water treatment lime sludges, wastewater pretreatment sludges, industrial process wastewater treatment sludges, pulp and paper mill sludges, and food processing wastes (including silage and whey). For more information and additional forms, visit the Land Application of Industrial Products page on this Web site.

• Attachment for Industrial By-products Land Application (Type IV Materials Only) (5 pages)

Noncontact Cooling Water

• Attachment for Noncontact Cooling Water (5 pages)

Ground Water Pump Outs

• Attachment for Ground Water Pump Out (5 pages)

Pesticide Permit Program

• Pesticide Permit Program

Wetlands

While the MPCA is not the primary agency processing wetland permits, the agency does review them after other appropriate environmental agencies. If you plan to conduct activities that may impact wetlands, visit the Minnesota Board of Water and Soil Resources Web site.

Clean Water Act Section 401 Certification

• Clean Water Act Section 401 Water Quality Certification

Forms to Provide Feedback to MPCA

The MPCA recently revised many of its forms and would appreciate your comments on what would make these forms, the permit application process, or the instructions more "user-friendly." Return this form (1 page) either with your permit package or in a separate envelope, if you'd like to provide feedback anonymously.

• Feedback Form

Phosphorus Links

• MPCA Phosphorus Strategy. One part of the MPCA's comprehensive phosphorus strategy is a strategy for addressing phosphorus in National Pollutant Discharge Elimination System (NPDES) permitting. The purpose of the NPDES Phosphorus Strategy is to develop a consistent framework for applying phosphorus controls in permits, which outlines the variables to be considered by MPCA staff in making decisions on what should be included in a permit.
  
  
• Phosphorus Management Plan Development Resources. Use a template to help prepare Phosphorus Management Plans for wastewater treament facilities. A checklist, tip sheet and fact sheets are also included to help identify sources of phosphorus and evaluate strategies for phosphorus reduction. Read about how industries and businesses have successfully reduced phosphorus effluent to wastewater treatment facilities.
  
  
• Minnesota River Basin General Phosphorus Permit. This permit, issued on December 1, 2006, is derived from the Lower Minnesota River Watershed Dissolved Oxygen TMDL. It regulates the discharge of phosphorus from NPDES sources in the Minnesota River Basin and establishes a pollutant trading program.