State of Hawaii, Department of Health, Clean Water Branch All sections of this form MUST be NOI Form B completed for NOI for HAR, Chapter 11-55, Appendix B - NPDES General Permit National Pollutant Authorizing Discharges of Storm Water Associated with Industrial Discharge Activities Elimination System (NPDES) General Permit compliance. B.1 General Information – You are required to fulfill all requirements and check the box below. If you do not check the box, your NOI will be considered incomplete, and the CWB may deny your request for NPDES general permit coverage with prejudice. I certify that: I will design, implement, operate, and maintain a Water Pollution Control Plan (SWPCP) to ensure that my discharges of storm water associated with industrial activities will not violate HAR, Chapter 11-54; HAR, Chapter 11-55; and HAR, Chapter 11-55, Appendix B. All of my monitoring results will be reported in accordance with HAR, Chapter 11-55, Appendix B, Section 10 (e.g. Annual monitoring results shall be submitted 60 calendar days after sample collection). If I am issued a Notice of General Permit Coverage (NGPC) and I exceed any NGPC effluent limitation, I will continue to monitor and report the results for representative storm until the effluent limitations are met. I understand this is required in HAR, Chapter 11-55, Appendix B, Section 10. My SWPCP shall adequately address the minimum items in Attachment D of this form; contain appropriate measures to minimize the discharge of all pollutants associated with my industrial activity in storm water runoff; and contain appropriate measures to address Section 303(d) pollutants of concern for my receiving State water. B.2 Water Discharge Information –Storm Provide the storm water runoff quantity calculated while the representative sample was taken, or estimate the storm water runoff from the facility assuming a representative rainfall event (0.1 inch). (gallons per minute/cubic feet per second) B.3 –Maps Attach, and identify all maps (pdf - minimum 300 dpi) listed below, in Attachment A. Please reference which maps account for the features listed below. Island on which the facility is located. Vicinity of the facility on the island.
State of Hawaii, Department of Health, Clean Water Branch NOI Form B NOI for HAR, Chapter 11-55, Appendix B - NPDES General Permit Authorizing Discharges of Storm Water Associated with Industrial Activities All sections of this form MUST be completed for National Pollutant Discharge Elimination System (NPDES) General Permit compliance. B.1 – General Information You are required to fulfill all requirements and check the box below. If you do not check the box, your NOI will be considered incomplete, and the CWB may deny your request for NPDES general permit coverage with prejudice. I certify that: I will design, implement, operate, and maintain a Water Pollution Control Plan (SWPCP) to ensure that my discharges of storm water associated with industrial activities will not violate HAR, Chapter 11-54; HAR, Chapter 11-55; and HAR, Chapter 11-55, Appendix B. All of my monitoring results will be reported in accordance with HAR, Chapter 11-55, Appendix B, Section 10 (e.g. Annual monitoring results shall be submitted 60 calendar days after sample collection). If I am issued a Notice of General Permit Coverage (NGPC) and I exceed any NGPC effluent limitation, I will continue to monitor and report the results for representative storm until the effluent limitations are met. I understand this is required in HAR, Chapter 11-55, Appendix B, Section 10. My SWPCP shall adequately address the minimum items in Attachment D of this form; contain appropriate measures to minimize the discharge of all pollutants associated with my industrial activity in storm water runoff; and contain appropriate measures to address Section 303(d) pollutants of concern for my receiving State water. B.2 –Storm Water Discharge Information Provide the storm water runoff quantity calculated while the representative sample was taken, or estimate the storm water runoff from the facility assuming a representative rainfall event (0.1 inch). (gallons per minute/cubic feet per second) B.3 –Maps Attach, and identify all maps (pdf - minimum 300 dpi) listed below, in Attachment A. Please reference which maps account for the features listed below. Island on which the facility is located. Vicinity of the facility on the island.