SIU-CIU Compliance Report when EPA or State is the Control Authority

Required by EPA Regulations - 403.12(e) and (h)

Example Data Entry Form

[Note: Users will also be able to batch this data into this form via a spreadsheet or CSV file.]

1. SIU/CIU NPDES Number <system generated>

2. Start Date of Reporting Period (YYYY-MM-DD)

3. End Date of Reporting Period (YYYY-MM-DD) 

4. NPDES Data Group Number 8

<system generated>

Non-Significant Categorical Industrial User (NSCIU) Certification to Control Authority: 

[Note: Click on the above box if you are certifying that you are a non-significant categorical industrial user (NSCIU). If you are 

certifying that you are a NSCIU then you will be presented with a statement to certify and submit. The remainder of this form is for 

SUI and CIUs. ]
Effluent Monitoring Data

INSTRUCTIONS: Please use the Monitoring Location drop down list to view the monitoring requirements and limits that apply to 

your facility. [Note: For each NPDES ID there may be more than one monitoring location (or “Permitted Feature ID”) for each 

SIU/CIU.]

Monitoring 

Location:

Effluent Monitoring Data (Data Entry by SIU/CIU)

Parameter

Quantity or Loading Quality or Concentration Number 

of

Exceptions

Frequency 

of Analysis

Sample 

Average Max Units Min Average Max Units Type

*

Sample 

Measurement

* *

Permit 

Requirement * * * * * * * *

*

Sample 

Measurement * *

Permit 

Requirement * * * * * * * *

*

Sample 

Measurement

* *

Permit 

Requirement * * * * * * * *

* Note: These data on limits and required monitoring will be auto-populated when the user makes a selection with the above 

Monitoring Location dropdown list. These data will only be viewable by the SIU/CIU.

Check here if no discharge at this monitoring location for entire reporting period
Standard Signature Block and Certification 

Statement for CWA Reporting (in compliance 

with CFR Parts 3, 122.22, and 127).

Narrative Condition and Permit Schedules

INSTRUCTIONS: Please use the following table to enter dates and create attachments to this form for any Best Management 

Practices (BMP), special monitoring, or additional reporting requirements that might apply to your facility. Please check the box in 

the “Add Attachments” column to attach any BMP compliance statements, additional monitoring activities, or reports to this form 

for each unique narrative condition.

Narrative 

Condition 

Number

Narrative 

Condition 

Description Code

Narrative Condition Event Schedule 

Date

Actual 

Date

Add 

Attachments

(as necessary)

* * * *

* * * *

* * * *

* * * *

* Note: These data on narrative conditions and schedule dates will be auto-populated and only be viewable by the SIU/CIU.

[NOTE: Narrative conditions and schedules specify additional requirements in addition to the effluent monitoring requirements and 

might include Best Management Practices (BMP), special monitoring, or additional reporting requirements (e.g., toxicity reduction 

evaluations). Where the narrative condition contains a schedule or a reporting requirement, ICIS – NPDES considers the condition to 

be date-based. An example of a date-based narrative condition would be a requirement for the SIU/CIU to submit progress reports 

to the Control Authority by a certain date for the construction of a wastewater treatment system. Narrative Conditions that do not 

establish a schedule or reporting are considered non-date-based (e.g., requirement for the SIU/CIU to develop and maintain a Best 

Management Practices (BMP) plan).] 

SUBMIT 

REPORT