Learn More

Storm Water

Other

Industrial Storm Water Permit Forms

NOTICE: Reissuance of the General Wisconsin Pollutant Discharge Elimination System (WPDES) Industrial Storm Water Discharge Permits

In accordance with state and federal law, the Tier 1 and Tier 2 Industrial Storm Water General Permits (WPDES Permit No. WI-S067849-2 and WI-S067857-2 used by the Department of Natural Resources (Department) to cover qualifying industrial activities under Subchapter II of NR 216, Wis. Adm. Code, expire every five years. Consequently, the current industrial general permits are scheduled to expire on March 31, 2006.

The Department will not require that permittees complete a new permit application for continued coverage under one of the reissued industrial general permits listed above. The Department will automatically cover industrial activity under the reissued industrial permit when it becomes available. This might not occur until after March 31, 2006. As indicated in Part VI.D. of the industrial permits, permit coverage will continue in force and effect until the Department revokes the permit or replaces it with a reissued permit.

Runoff in parking lot

WPDES Storm Water Permit Forms

To submit a form to the Department, click on the link below, print the form, complete the necessary information, and submit it to the appropriate address as listed on the form.

Industrial Facility Permit Forms

These are the current versions as of the dates listed on each form. Older versions of these forms should not be submitted. Doing so could delay permit coverage.

Form/Publication Name Pub # Date
Notice of Intent PDF [458KB] | Fillable MS-Word [620KB]* A Notice of Intent is the application form to obtain coverage under a WPDES Storm Water Permit. 3400-163 10/07/05
Notice of Termination [20KB] A Notice of Termination (NOT) form is required to terminate permit coverage. It is especially important for industrial facilities that cease operations or move to a new location to submit an NOT to the Department. 3400-170 11/05/02
Non-metallic Mining Notice of Intent [177KB] A Notice of Intent is the application form to obtain a WPDES Storm Water Permit. 3400-179 5/28/04
Storm Water Pollution Prevention Plan Summary PDF [97KB] | Fillable Word [237KB]* 3400-167 10/27/05
Annual Facility Site Compliance Inspection Report PDF [27KB] 3400-176 3/30/05
Quarterly Visual Inspection - Field Sheet [5KB] 3400-176a 3/21/01
Storm Water Chemical Analysis Report [22KB] 3400-176b 3/21/01
Tier 1 Industrial General Permit To Discharge Under WPDES [157KB] S067849-2 10/26/05
Tier 1 Fact Sheet [58KB] - 9/29/05
Tier 2 Industrial General Permit To Discharge Under WPDES [156KB] S067857-2 10/26/05
Tier 2 Fact Sheet [55KB] - 9/29/05
Non-metallic Mining General Permit - Storm Water [96KB] 0046515-4 mod1 4/10/06
Auto Parts Recycling GP & Briefing Memo [187KB] S059145-1 6/16/03
Scrap Recycling GP & Briefing Memo [188KB] S058831-1 6/16/03
No Exposure Certification PDF [82KB] | Fillable MS-Word [72KB]* 3400-188 04/05/05
* Note: This file can be downloaded and used to fill out and print the form.  However, the form must still be signed and sent in to the Department.  E-mail submissions cannot be accepted.
Wisconsin Storm Water Manual
Originally published in 1994, this technical manual was developed to aid local units of government, developers, contractors, and consulting engineers in controlling storm water pollutants from existing and new developments. Part One is an overview. The second part of the manual is an elaboration of technical design guidelines for storm water management practices.
Industrial Storm Water Pollution Prevention Planning Manual
This manual reflects the requirements in a Tier 1 or Tier 2 Industrial Storm Water Discharge permit for preparing an industrial storm water pollution prevention plan. The four phases discussed are planning and organization, assessment, plan design, and evaluation and monitoring.
Wisconsin Guidance for Industrial Storm Water Sampling
This document introduces and prepares one for storm water sampling in Wisconsin. You also learn how to establish a sampling program and make appropriate collections of storm water samples. It is primarily designed to help the owners/operators of an industrial site in the planning for and fulfilling of the Wisconsin Pollutant Discharge Elimination System (WPDES) Tier 1 Storm Water Discharge permit sampling requirements.
WI Administrative Code NR216
Wisconsin Adminstrative Code NR 216 addresses the details of the Storm Water Permit Program.
DOA Document Sales & Distribution [PDF 535KB]
202 S. Thornton Ave.
P. O. Box 7840
Madison, WI 53707-7840
Credit card orders: 800-362-7253
Information: 608-266-3358






Contact Jim Bertolacini with feedback about this page.
Last Revised: Monday June 30 2008