HomeMy WebLinkAboutIowa Department of Natural Resources-10/16/2013NOTICE OF DISCONTINUATION
OF A STORM WATER DISCHARGE
COVERED UNDER IOWA NPDES GENERAL PERMIT NO. 2
FOR CONSTRUCTION ACTIVITIES
Name of the owner or facility to which the storm water discharge general permit coverage was issued.
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List the complete permit authorization number for the discharge. This number is provided on the bottom of the
authorization sheet.
List the date the construction site reached final stabilization as defined on the back of this form.
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The following certification must be signed in accordance with the signatory requirements of the general permit (see
back side).
I certify under penalty of law that disturbed soils at the identified facility have been finally stabilized and temporary
erosion and sediment control measures have been removed or will be removed at an appropriate time. I understand
that by submitting this Notice of Discontinuation, I am no longer authorized to discharge storm water associated
with industrial activity for construction activities by Iowa Department of Natural Resources NPDES General Permit
No. 2 and that discharging pollutants from storm water associated with industrial activity to waters of the United
States is unlawful under the Clean Water Act where the discharge is not authorized by an NPDES permit.
I further certify under penalty of law that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated
the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible for gathering. the information, the information submitted is, to the best of my knowledge and
belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fine and imprisonment for lmown violations.
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Return to:
Storm Water Coordinator
Department of Natural Resources
502 E. 9th Street
Des Moines, JA 50319-0034
542-8115 (over)
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