3510-13 Notice of Termination (NOT) Form

Appendix I - Notice of Termination (NOT) Form and Instructions

Part 8.3 requires you to use the NPDES eReporting Tool, or “NeT” system, to prepare and submit your NOT electronically. However, if the EPA Regional Office grants you a waiver to use a paper NOT form, and you elect to use it, you must complete and submit the following form.

NPDES Form 3510-13

U.S. Environmental Protection Agency Washington, DC 20460 Notice of Termination for the 2022 NPDES Construction General Permit

OMB No. 2040-0004 2040-NEW Exp. Date 02/16/2027

Submission of this Notice of Termination constitutes notice that the operator identified in Section III of this form is no longer authorized discharge pursuant to the NPDES Construction General Permit (CGP) from the site identified in Section IV of this form. All necessary information must be included on this form. Refer to the instructions at the end of this form.

Section I. Approval to Use Paper NOI Form

Paper NOI Form

Have you been granted a waiver from electronic reporting from the Regional Office*?

¨ Yes

¨ No

If yes, check which waiver you have been granted, the name of the EPA Regional Office staff person who granted the waiver, and the date of approval:

Waiver granted:

¨ The owner/operator’s headquarters is physically located in a geographic area (i.e., ZIP code or census tract) that is identified as under-served for broadband Internet access in the most recent report from the Federal Communications Commission. ¨ The owner/operator has issues regarding available computer access or computer capability.

Name of EPA staff person that granted the waiver

Date approval obtained (MM/DD/YYYY)

* Note: You are required to obtain approval from the applicable Regional Office prior to using this paper NOI form. If you have not obtained a waiver, you must file this form electronically using the NPDES eReporting Tool (NeT).

Section II. Permit Information

Permit

NPDES ID

Reason for Termination (Check only one):

¨

You have completed all construction activities at your site, and you have met all other requirements in Part 8.2.1.

¨

Check this box to confirm that you have attached photographs as required by Part 8.2.1.a that document your compliance with the permit’s final stabilization requirements.

¨

Another operator has assumed control over all areas of the site and that operator has submitted an NOI and obtained coverage under the CGP.

¨

You have obtained coverage under an individual permit or another general NPDES permit addressing stormwater discharges from the construction site.

Section III. OPerator Information

Operator Information

Operator Name

Mailing Address

Street

City

State

ZIP Code

County or Similar Government Division

Phone Number

Email Address

Section IV. Project/Site Information
Project/Site Address	Project/Site Name
	Street/Location
	City			State			ZIP Code
	County or Similar Government Division:
Section V. Certification Information
Certification Information		I 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 knowing violations.
		First Name	Middle Initial		Last Name
		Title
		Signature				Date (MM/DD/YYYY)
		Email Address

Instructions for Completing EPA Form 3510-13

Notice of Termination for the 2022 NPDES Construction General Permit

NPDES Form Date (02/22) This Form Replaces Form 3510-13 (02/17) Form Approved OMB No. 2040-0004 and 2040-NEW

General Instructions

Who May File an NOT Form?

Permittees who are presently covered under the EPA-issued 2022 Construction General Permit (CGP) for Stormwater Discharges Associated with Construction Activity may submit an NOT form when: (1) earth-disturbing activities at the site are completed and the conditions in Parts 8.2.1.a through 8.2.1.b are met; or (2) the permittee has transferred all areas under its control to another operator, and that operator has submitted and obtained coverage under this permit; or (3) the permittee has obtained coverage under a different NPDES permit for the same discharges.

Completing the Form

Type or print, using uppercase letters, in the appropriate areas only. Please place each character between the marks. Abbreviate if necessary to stay within the number of characters allowed for each item. Use only one space for breaks between words, but not for punctuation marks unless they are needed to clarify your response. If you have any questions about this form, refer to https://www.epa.gov/npdes/stormwater-discharges-construction-activities#cgp or telephone EPA’s NOI Processing Center at (866) 352-7755. Please submit original document with signature in ink - do not send a photocopied signature.

Section I. Approval to Use Paper NOI Form

You must indicate whether you have been granted a waiver from electronic reporting from the EPA Regional Office. Note that you are not authorized to use this paper NOT form unless the EPA Regional Office has approved its use. Where you have obtained approval to use this form, indicate the waiver that you have been granted, the name of the EPA staff person who granted the waiver, and the date that approval was provided.

See https://www.epa.gov/npdes/contact-us-stormwater#regional for a list of EPA Regional Office contacts.

Section II. Permit Information

Enter the existing NPDES ID assigned to the project . If you do not know the NPDES ID number, or contact EPA’s NOI Processing Center at (866) 352-7755.

Indicate your reason for submitting this Notice of Termination by checking the appropriate box. Check only one. If you selected the first box, confirm that you have attached photographs as required by Part 8.2.1.a. All submitted photographs must: (1) be taken both before and after the site has met the final stabilization criteria in Part 2.2.14.c; (2) be clear and in focus, and in the original format and resolution; and (3) include the date each photograph was taken, and a brief description of the area of the site captured by the photograph (e.g., photo shows application of seed and erosion control mats to remaining exposed surfaces on northeast corner of site).

Section III. Operator Information

Provide the legal name of the person, firm, public organization, or any other entity that operates the project described in this NOT and is covered by the NPDES ID identified in Section II. Enter the complete mailing address, telephone number, and email address of the operator.

Section IV. Project/Site Information

Enter the official or legal name and complete street address, including city, state, ZIP code, and county or similar government subdivision of the project or site. If the project or site lacks a street address, indicate the general location of the site (e.g., Intersection of State Highways 61 and 34). Complete site information must be provided for termination of permit coverage to be valid.

Section V. Certification Information

The NOT, must be signed as follows:

For a corporation: By a responsible corporate officer. For the purpose of this Part, a responsible corporate officer means: (i) a president, secretary, treasurer, or vice-president of the corporation in charge of a principal business function, or any other person who performs similar policy-or decision-making functions for the corporation, or (ii) the manager of one or more manufacturing, production, or operating facilities, provided, the manager is authorized to make management decisions which govern the operation of the regulated facility including having the explicit or implicit duty of making major capital investment recommendations, and initiating and directing other comprehensive measures to assure long-term environmental compliance with environmental laws and regulations; the manager can ensure that the necessary systems are established or actions taken to gather complete and accurate information for permit application requirements; and where authority to sign documents has been assigned or delegated to the manager in accordance with corporate procedures.

For a partnership or sole proprietorship: By a general partner or the proprietor, respectively; or

For a municipality, state, federal, or other public agency: By either a principal executive officer or ranking elected official. For purposes of this Part, a principal executive officer of a federal agency includes (i) the chief executive officer of the agency, or (ii) a senior executive officer having responsibility for the overall operations of a principal geographic unit of the agency (e.g., Regional Administrator of EPA).

Include the name, title, and email address of the person signing the form and the date of signing. An unsigned or undated NOT form will not be considered valid termination of permit coverage.

Paperwork Reduction Act Notice

This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2XXX-XXXX). Responses to this collection of information are mandatory (40 CFR 122.26). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The public reporting and recordkeeping burden for this collection of information is estimated to be 1.2 hours per response. Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates and any suggested methods for minimizing respondent burden to the Regulatory Support Division Director, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

Submitting Your Form

Submit your NOT form by mail to one of the following addresses:

For Regular U.S. Mail Delivery:
Stormwater Notice Processing Center
Mail Code 4203M, ATTN: 2022 CGP
U.S. EPA
1200 Pennsylvania Avenue, NW
Washington, DC 20460

For Overnight/Express Mail Delivery:
Stormwater Notice Processing Center
William Jefferson Clinton East Building - Room 7420
ATTN: 2022 CGP
U.S. EPA
1201 Constitution Avenue, NW
Washington, DC 20004

Visit this website for instructions on how to submit electronically:

https://www.epa.gov/npdes/stormwater-discharges-construction-activities#ereporting