Notice of Termination (NOT) Form

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UNITED STATES ENVIRONMENTAL PROTECTION AGENCY
WASHINGTON, DC 20460 FORM APPROVED
NOTICE OF TERMINATION (NOT) OF COVERAGE UNDER NPDES GENERAL PERMIT FOR
DISCHARGES INCIDENTAL TO THE NORMAL VESSEL OPERATION

OMB No.

2040-0004

Submission of this Notice of Termination (NOT) constitutes notice that the party identified in Section B of this form is no longer authorized to
discharge any discharge incidental to the normal operation of a vessel under the NPDES program for the vessel identified in Section C of this
form. All necessary information must be included on this form. Refer to the instructions at the end of this form.
A. Permit Information

1. NPDES Permit Tracking Number: ___________________________________
2. Reason for Termination (check one only):
a. You transferred operational control to another operator.
Date of transfer: _______________________________________________

Country: _______________________________

New Owner/Operator Name: _____________________________________

City: __________________________________

Address Line 1: ________________________________________________

State: _____ Zip: ____________

Address Line 2: ________________________________________________

Phone: ________________________________

Company E-mail: ______________________________________________
b. You terminated vessel operations in waters subject to the General Permit.
c. You obtained coverage under an individual or alternative NPDES permit.
Permit Number: ________________________________________________

Effective Date: _________________________

B. Vessel Owner/Operator Information

1. Name: ______________________________________________________________________________________________________
2. IRS Employer Information Number/Owner Operator IMO Number: _______________________________________________________
3. Name of Certifying Official:______________________________________________________________________________________
4. Mailing Address:
a. Street: _______________________________________________________

e. Country: ______________________________

b. City: ________________________________________________________

f. Phone: _______________________________

c. State: _____

g. Fax (Optional): _________________________

d. Zip: ___________

h. E-mail: _______________________________________________________
C. Vessel Voyage Information

1. Vessel Name: _______________________________________________________________________________________________
2. Vessel ID/Registered Number/Vessel IMO number: __________________________________________________________________
3. Vessel Call Sign: _____________________________________________________________________________________________
4. Flag State/Port of Registry: _____________________________________________________________________________________
D. Certifier Name and Title
I certify under penalty of law that the information contained in this form is, to the best of my knowledge and belief, true, accurate and complete. I
understand that by submitting this Notice of Termination, I am no longer authorized to discharge any effluent associated with normal vessel
operation under this general permit, and that discharging pollutants related to the normal operation of a vessel in to waters of the United States is
unlawful under the Clean Water Act where the discharge is not authorized by a NPDES permit. I also understand that the submittal of this Notice
of Termination does not release an operator from liability for any violations of this permit or the Clean Water Act.
Furthermore, 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 contained therein. Based on my inquiry
of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information contained is,
to the best of my knowledge and belief, true, accurate, and complete. I have no personal knowledge that the information submitted is other than
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.

Print Name: ______________________________________________________________
Title:

___________________________________________________________________

Signature: ________________________________________________________________
E-mail: ________________________________________________________

Date:

/

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Instructions for Completing the Notice of Termination (NOT) for Discharges Incidental to the Normal Operation of a Vessel under the NPDES Vessel General Permit
Who Must File an NOT Form?
Any owner/operator who was required to submit an NOI under Part 1.5.1.1 and
meets the conditions of Part 1.6.1.2 of the General Permit is required to submit an
NOT to end coverage under this permit.
If you have questions about whether you need to file an NOT or questions about
completing the form, refer to www.epa.gov/npdes/vessels/eNOI or contact the NOI
center at 1­866­352­7755.
If you have specific questions about the Vessels General Permit please send a
detailed email to [email protected] for assistance.
Where to File the NOT Form
EPA encourages you to complete the NOT electronically via the Internet. EPA’s
Vessels Electronic Notice of Intent System (eNOI) at
www.epa.gov/npdes/vessels/enoi. Filing electronically is the fastest way to terminate
permit coverage and help ensure that your NOT is complete. If you choose not to
file electronically, you must send the NOT to one of the addresses listed below.
NOTs sent regular mail:
EPA Vessel Notice Processing Center (4203M)
USEPA
1200 Pennsylvania Avenue, NW
Washington, DC 20460
NOTs sent overnight/express mail:
EPA Vessel Notice Processing Center
EPA East Building, Rm. 7420
1201 Constitution Avenue, NW
Washington, DC 20004
(202) 564-9545
If you have questions about whether you need to file an NOT or questions about
completing the form, refer to www.epa.gov/npdes/vessels/eNOI or contact the NOI
center at 1­866­352­7755.
If you file a paper NOT, please submit the original with a signature in ink – Do
Not Send Copies. Also, faxed copies will not be accepted.
Completing the NOI Form
To complete this form, type or print in uppercase letters in the appropriate areas
only. Please make sure you complete all questions. Make sure you make a
photocopy for your records before you send the completed original form to the
address above.
Section A. Permit Information
1. Enter the existing NPDES Vessels General permit Tracking Number assigned to
the vessel by EPA’s Vessels Processing Center. If you do not know the permit
tracking number, contact the Vessels Processing Center at (866) 352­7755.
2. Select the appropriate box to indicate why you are submitting an NOT to end
permit coverage. There are three options to choose from: because you have sold
or transferred the vessel and are no longer the owner or operator, because the
vessel is no longer traveling in or discharging to waters subject to this permit, or
because you have obtained individual or alternative permit coverage.
2a. Select this box if you have sold or transferred the vessel, please provide the
date of transfer as well as the name and contact information of the new
owner/operator
2b. If the vessel is no longer traveling in or discharging to waters subject to this
permit.
2c. If you have obtained an individual or alternative permit, please provide the
permit number and date permit coverage begins in the space given.
.
Section B. Vessel Owner/Operator Information
1. Provide the full legal name of the person, firm, public organization, or other
entity that is the owner/operator of the vessel described in this application.
2. Provide the Employer Identification Number (EIN from the Internal Revenue
Service (IRS)), commonly referred to as your taxpayer ID number. If the
owner/operator does not have an EIN, enter the International Maritime
Organization (IMO) Registered Owner or Company (DOC) number. If the
owner/operator does not have an EIN or IMO Owner or company number, enter
“NA” in the space provided.
3. Provide the name of the Certifying Official.
4. Provide the owner/operator’s mailing address, telephone number, fax number
(optional), and email address. Correspondence will be sent to this address.

If the vessel does not have an identification number, enter “NA” in the space
provided.
3. Enter the vessel call sign, if applicable. If the vessel does not have a call sign,
enter “NA” in the space provided.
4. Provide the flag state or port of registry. If the vessel does not have a flag state
or port of registry, enter “NA” in the space provided.
Section D. Certification
Carefully read the certification statement. By completing and submitting the NOT,
the owner/operator certifies that every applicable General permit requirement will be
met. Enter certifier’s printed name and title. Sign and date the form. (CAUTION: An
unsigned or undated NOT form will prevent the termination of permit coverage.)
Federal statutes provide for severe penalties for submitting false information on this
application form. Federal regulations require this application to be signed as follows:
For a corporation: by a responsible corporate officer, which means:
(i) president, secretary, treasurer, or vice­president 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; or
For a municipal, State, Federal, or other public facility: by either a principal
executive or ranking elected official.
Paperwork Reduction Act Notice
Public reporting burden for this certification is estimated to average 0.25 hours per
certification, including time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing and reviewing
the collection of information. Burden means the total time, effort, or financial
resources expended by persons to generate, maintain, retain, or disclose to provide
information to or for a Federal agency. This includes the time needed to review
instructions; develop, acquire, install, and utilize technology and systems for the
purposes of collecting, validating, and verifying information, processing and
maintaining information, and disclosing and providing information; adjust the existing
ways to comply with any previously applicable instructions and requirements; train
personnel to be able to respond to a collection of information; search data sources;
complete and review the collection of information; and transmit or otherwise disclose
the information. 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. Send comments regarding the burden estimate, any other
aspect of the collection of information, or suggestions for improving this form,
including any suggestions which may increase or reduce this burden to: Director,
Office of Information Collection, Collection Services Division (2823), USEPA, 1200
Pennsylvania Avenue, NW, Washington, DC 20460. Include the OMB control
number of this form on any correspondence. Do not send the completed NOTform
to this address.

Section C. Vessel Information
1. Provide the vessel’s official or legal name, if applicable. If the vessel does not
have a name, enter “NA” in the space provided.
2. Provide the vessel’s identification, registered identification number, or IMO Ship
number, as applicable. Indicate the type of number used to identify the vessel.
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