6100-056 Draft State NPDES eRule Phase 2 Alternative Phase 2

Attachment 1 – Draft State NPDES eRule Phase 2 Alternative Phase 2 Compliance

Deadline Request

	STATE NPDES ERULE PHASE 2 ALTERNATIVE PHASE 2 COMPLIANCE DEADLINE REQUEST FORM OMB APPROVED 2020-NEW EXP. MM/YYYY	FOR EPA USE ONLY
		[Date Received]

Director Information

Director Email Address	Director Telephone Number

ALTERNATIVE PHASE 2 COMPLIANCE DEADLINE REQUEST SUPPORTING INFORMATION

INSTRUCTIONS: Identify each general permit, program report, and/or related data elements covered by the request and the corresponding alternative Phase 2 compliance deadline(s).

Provide a rationale for the delay and enough details (e.g., tasks, milestones, roles and responsibilities, necessary resources) to clearly describe how the program will successfully implement electronic reporting for general permit, program report, and/or related data element covered by the request.

If the request covers some but not all facilities subject to the general permit or program report requirement use this form to identify each facility covered by the request and the corresponding alternative Phase 2 compliance deadline(s).

(Attach additional pages if needed)

SIGNATURE

SCAN TO PDF AND RETURN COMPLETED APPLICATION TO: [email protected]	Director Printed Name
	Signature	Date

A2-1