Alabama Administrative Code › Title 335 - ALABAMA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT › GENERAL ADMINISTRATION › Chapter 335-1-1 - ORGANIZATION › Section 335-1-1-.01 - Departmental Forms, Instructions, And Procedures

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Designation as the State Environmental
				Control Agency. The Department is the State Environmental Control Agency for
				the purposes of federal environmental law including the Federal Clean Air Act,
				42 U.S.C.
				7401 et seq., as amended; the Federal Clean
				Water Act,
				33 U.S.C.
				1251 et seq., as amended; the Federal Safe
				Drinking Water Act, 42 U.S.C. A 201 et seq., as amended. The Department is
				authorized to take all actions necessary and appropriate to secure the benefits
				of federal environmental laws. The Department operates in conformity with such
				federal laws, policies, and procedures, as provided in the Act.
(2) Policies and Procedures. The Commission,
				through the adoption of rules pursuant to
Code of Ala.
				1975
, §
									22-22A-7(c)(6),
				establishes environmental policies and procedures.
(3) Form and Instructions. The Director may
				require such forms within the rules as he deems necessary. The content of such
				forms and instructions for their completion may be prescribed by the Director
				including the changes of such from time to time. Federal forms as published by
				the Environmental Protection Agency may be used in lieu of state developed
				forms. Departmental forms prescribed by the Director shall be identified and
				numbered as follows:
Name of Forms
Form Number
112 (j) Part 1 Applicability Notification
493
ADEM Baseline Monitoring Report Submittal
								Form
314
ADEM NPDES Individual Permit Application M-3
315
ADEM NPDES Pesticide Adverse Incident Report
29
ADEM Line Leak Detector (LLD) Test Report Form
								M-1
551
Air Permit Application For Gasoline Dispensing
								Facilities M-5
197
Alabama Clean Vessel Act Grant Application
517
Alabama Coastal Area Management Program Application
								for Approval of a Non-Regulated Use ADEM Administrative Code rule
								335-8-1-.11 Groundwater
								Extraction 50 PM or Greater
316
Alabama Hazardous Waste Receipt for Samples and
								Documents
546
Alabama Hazardous Waste/Used Oil Transporter Permit
								Application
317
Alabama Recycling Fund Grant Application
9
Alabama Tank Trust Fund Cost Proposal Form
318
Alabama Tank Trust Fund Payment Request Form
319
Alternative Analysis
311
Alternative Medical Waste Treatment Technology
								Equipment Approval Application
323
Annual Certification Form for Discharges Associated
								with Petroleum Storage and Handling Areas M-1
324
Annual Containment Sump Inspection Log
19
Annual Recycling Report
16
Annual Statistical Inventory Reconciliation (SIR)
								Report Form
326
Application for a Permit for the Construction for a
								Motel, Hotel, or Other Multi-Unit Development on a Property Intersected by the
								Construction Control Line in the Alabama Coastal Area
327
Application for a Permit for the Construction of
								Single Family Dwellings, Duplexes, or Other Similar Structures on Properties
								Intersected by the Construction Control Line in the Alabama Coastal Area
328
Application for Alabama Well Driller's License
								M-1
193
Application for Approval of a Non-Regulated Use in
								the Alabama Coastal Area Developments and Subdivisions of Property Greater than
								5 Acres in Size
329
Application for Approval to Use a Water Supply
								Well
259
Application for Name Change or Transfer of Permit
								or Exemption M-4
330
Asbestos Removal Contractor Certification
497
Birmingham Fuel Supplier Report M-4
494
Boating Infrastructure Grant Application
518
Brownfields Assessment Request Application
550
Brownfields State Revolving Fund Application
								Form
543
Brownfields State Revolving Fund Pre-Application
								Form
542
Bulk (Gasoline) Plant Application M-2
331
CAIR Permit Application (for sources covered under
								a CAIR SIP)
519
Calculation of Total Annualized Project Cost for
								Private-Sector Projects
313
Calculation of Total Annualized Project Cost for
								Public-Sector Projects
312
Cargo Tank Tightness Test Report M-l
309
Cathodic Protection Monitoring Form M-l
332
Cathodic Protection Monitoring for Galvanic
								Systems
545
CBM NPDES Stormwater Discharge Monitoring
								Report
333
CBM Toxicity Test Report Summary
334
Chemical Monitoring Data Report
335
Chemical Monitoring Waiver Application
336
Chemical Sampling Chain of Custody Form
337
Clean Water State Revolving Fund (CWSRF) Loan
								Application Form
339
Clean Water State Revolving Fund (CWSRF)
								Preapplication Form M-2
340
Coal Permit Precipitation Event Discharge
								Limitations Exemption Claim Report M-2
342
Coalbed Methane Stormwater Inspection Summary
								Report M-l
343
Coalbed Methane Temporary Pit Wastewater Land
								Application Certification Report M-1
344
Community Public Notification Certification
								Form
345
Community System Susceptibility Analysis
								Sheet
346
Composing Facility Application
18
Consumer Confidence Report Certification Form
								M-1
347
Cooling Water Supplemental Information M-1
510
CT Profiling Spreadsheet
535
Discharge Monitoring Report for CBM Coal - Type 60
								Effluent
348
Discharge Monitoring Report for CBM Coal - Type 60
								Manual
349
Discharge Monitoring Report for CBM Coal - Type 60
								Standard
350
Discharge Monitoring Report for Coal - Type 1 &
								Type 3
351
Discharge Monitoring Report for Coal - Type
								11
352
Discharge Monitoring Report for Coal - Type
								13
353
Discharge Monitoring Report for Coal - Type 14 Sand
								& Gravel
354
Discharge Monitoring Report for Coal - Type 14 Fire
								Clay
355
Discharge Monitoring Report for Coal - Type 14
								Shale -Common Clay
356
Discharge Monitoring Report for Coal - Type
								15
357
Discharge Monitoring Report for Coal - Type
								38
358
Discharge Monitoring Report for Coal - Type 5 &
								Type 7
359
Discharge Monitoring Report for Coal - Type
								9
360
Discharge Monitoring Report for NonCoal - Type
								30
361
Discharge Monitoring Report for NonCoal - Type
								32
362
Discharge Monitoring Report for NonCoal - Type
								34
363
Discharge Monitoring Report for NonCoal - Type 36
								& Type 48 & Type 50
364
Discharge Monitoring Report for NonCoal - Type
								41
365
Discharge Monitoring Report for NonCoal - Type
								42
366
Discharge Monitoring Report for NonCoal - Type 44
								& Type 45
367
Discharge Monitoring Report for NonCoal - Type
								46
368
Disposal Approval Request
278
Documentation of Disability Related Needs
533
Drinking Water State Revolving Fund (DWSRF) Loan
								Application Form
369
Drinking Water State Revolving Fund (DWSRF)
								Preapplication Form M-2
370
EDMR-1 Permittee Registration Form
511
EDMR-2 Electronic Signature Application
								Agreement
512
EDMR-3 Deactivation Request Form
513
EDMR Daily Discharge Monitoring Report Form
514
EDMR Monthly Discharge Monitoring Report
								Form
515
EHS Notification Form
534
Emissions Statement Reporting Form M-1
372
Excess Emission Monitoring Report
373
Exemption Claim Form for Cofired Combustors
								(Appendix H -Division 3)
374
Exemption Claim Form for Incinerators Burning Only
								Pathological, Low-Level Radioactive, and Chemotherapeutic Waste (Appendix H -
								Division 3)
375
NPDES Individual Permit Application Addendum
								M-1
376
NPDES Individual Permit Application Minor Permit
								Modification Addendum M-1
377
Gasoline Dispensing Facility Information Survey
								M-1
378
Gasoline Transport Tank Truck Application
								M-2
198
General Permit ALR100000 Facility Sign
22
General Permit Application Package - NOI-11
								M-2
380
General Permit Application Package - NOI-12
								M-2
381
General Permit Application Package - NOT-14
								M-2
382
General Permit Application Package - NOI-15
								M-1
383
General Permit Application Package - NOI-16
								M-1
384
General Permit Application Package - NOI-17
								M-1
385
General Permit Application Package - NOI-18
								M-1
386
General Permit Application Package - NOT-2
								M-1
387
General Permit Application Package - NOI-20
								M-1
388
General Permit Application Package - NOI-23
								M-1
389
General Permit Application Package - NOI-24
								M-1
390
General Permit Application Package - NOI-25
								M-2
391
General Permit Application Package - NOI-28
								M-3
392
General Permit Application Package - NOT-3
								M-1
393
General Permit Application Package - NOI-34
								M-1
394
General Permit Application Package - NOI-36
								M-3
395
General Permit Application Package - NOT-6
								M-1
396
General Permit Application Package - NOI-67
								M-1
397
General Permit Application Package - NOI-64
								M-1
522
General Phase II MS4 Stormwater Permit
								Renewal
520
General Permit for Phase II Small Municipal
								Separate Storm Sewer Systems (MS4) ALNOI M-2
503
General Permit Renewal Form M-1
398
Groundwater System Monthly Operational Data
								Report
8
Hydrogeology Unit Evaluation Report Form
531
Hydrograph Control Release (HCR) Attachment
399
Name of Forms
Form Number
Impressed Current Cathodic Protection System 60-Day
								Inspection Log
400
Individual NPDES Permit Noncompliance Notification
								(5-day Report)
401
Information Needed for 316 (b) Determination in
								Regards to General NPDES Permits
14
Interior Lining Inspection Form
403
Interior Lining Report Form
404
Joint Application and Notification U. S. Department
								of Army, Corps of Engineers Alabama Department of Environmental Management
								M-l
166
Lead and Copper Monitoring Data Report
405
Major Source Operation Permit Skeleton Form
495
Manual Interstitial Monitoring Monthly Log
406
Material Safety Data Sheet Reporting
407
Maximum Residual Disinfectant Level Input Form
								(Samples)
408
Maximum Residual Disinfectant Level Input Form
								(Sources)
409
Medical Waste Notification Form M-1
410
Medical Waste Transporter Permit Application
								M-4
411
Medical Waste Treatment Permit Application
								M-4
412
Monthly Filter Plant Monthly Operational Data
								Report M-4
242
Monthly Membrane Surface Plant Operational Data
								Report
243
Monthly Statistical Inventory Reconciliation (SIR)
								Report
414
Municipal POTW SS0/MS4 Event Reporting Form
								M-l
415
Municipal Water Pollution Prevention (MWPP) Annual
								Report (Collection Systems) Package M-l
416
Municipal Water Pollution Prevention (MWPP) Annual
								Report Package M-2
417
Municipal Water Pollution Prevention Resolution
								Form
418
MWPP Sewage Sludge Survey
419
Non-Community Public Notification Certification
								Form
420
Non-Compliance Report Form M-2
421
Notice of Demolition and/or Asbestos Removal
								M-l
496
Notice of Intent-General Permit ALR100000
24
Notice of Intent-General Permit ALG850000
26
Notice of Intent-General Permit ALG870000
28
Notice of Intent to Permanently Close Underground
								Storage Tanks M-1
422
Name of Forms
Form Number
Notice of Proposed UST New Installation or Upgrade
								M-l
423
Notice of Temporary Closure M-l
310
Notice of Termination-General Permit Number
								ALG870000
30
Notification - Above the Threshold Planning
								Quantities (TPQ) of Extremely Hazardous Substances
424
Notification for Above Ground Storage Tanks
								M-1
283
Notification for Underground Storage Tanks
								M-1
279
Notification of Election of Coverage under The
								Alabama Drycleaning Environmental Response Trust Fund Act
425
Notification of Intent to Drill a Water Well
60
Notification of Regulated Waste Activity M-2
8700-12
N0X Budget Permit
								Application Form
426
N0X Budget Retired Unit
								Exemption Claim Form
427
NPDES Annual Notice of Registration (NOR)
429
NPDES Coalbed Methane Operation M-2
549
NPDES Noncoal/Nonmetallic Mining and Dry Processing
								Less than Five Acres, Program Notice of Registration Form M-2
498
NPDES Noncoal/Nonmetallic Mining and Dry Processing
								Less than Five Acres Stormwater Inspection Report and BMP Certification Form
								M-l
500
NPDES Noncoal/Nonmetallic and Dry Processing Less
								than Five Acres Stormwater Noncompliance Notification Report Form M-1
501
NPDES Construction, Noncoal Mining Less than Five
								Acres Stormwater Registration Termination Request and Certification Form
								M-1
499
NPDES Construction Stormwater Inspection Report and
								BMP Certification
23
NPDES Construction Stormwater Noncompliance
								Notification
25
NPDES Discharge Monitoring Report Form
								(Monthly)
430
NPDES Discharge Monitoring Report Form
								(Quarterly)
431
NPDES Individual Permit Pollution
								Abatement/Treatment Measures and Sediment Control Structures Certification
								Report M-2
432
NPDES Permit Application Semi-Public And Private
								Facilities M-1
188
NPDES Permit Application Supplementary Information
								M-3
187
NPDES Permitted Coalbed Methane Operations
								Pollution Abatement/Treatment Measures and Waste Treatment Facilities
								Certification Report M-l
433
Open Burning Incident Report
434
Operating Permit Application Facility
								Identification Form M-5
103
Name of Forms
Form Number
Operational Evaluation Level Exceedance
								Report
27
Operator Certification Renewal Form M-1
435
Perc Dry Cleaner Status Update M-1
436
Permit Application for Air Pollution Control Device
								M-2
110
Permit Application for Compliance Schedule
								M-1
437
Permit Application for Continuous Emission
								Monitoring Systems (CEMS)
438
Permit Application for Indirect Heating Equipment
								M-1
104
Permit Application for Loading and Storage of
								Organic Compounds M-1
108
Permit Application for Manufacturing or Processing
								Operation M-3
105
Permit Application Solid Waste Disposal
								Facility
439
Permit Application Solid Waste Disposal Facility
								Construction/Demolition Landfill
305
Permit Application for Solvent Metal
								Cleaning
112
Permit Application for Stationary Internal
								Combustion Engines M-5
107
Permit Application for Volatile Organic Compound
								Surface Coating Emission Source M-2
109
Permit Application for Waste Disposal
106
Petroleum Solvent Dry Cleaning Questionnaire
440
Plant and Collection System Personnel
								Inventory
441
Pollution Prevention Survey
548
Potable Water Laboratory Certification Application
								M-2
442
Processing and Recycling General Information
15
Progress Report Form
443
Project Completion Form
444
PSD Project Information Form
445
Purchase Water System Monthly Operation
								Report
185
Raw Sewage Bypass and Overflow Event Reporting
								Form
446
Registration Form for the Construction,
								Installation, or Modification of an Incinerator M-2
52
Release Information Form
447
Remediation Approval Form M-2
448
Remediation Reporting Form M-2
449
Representative Stormwater Outfall Certification
								M-2
450
Request for Coal Permit Post-Mining Discharge
								Limitations M -1
451
Request for Release from Monitoring and Reporting
								Requirements M-l
452
Request to Remove Subsurface Withdrawal From
								Discharge Structure M-l
453
Request to Remove Treatment Basin/Pond or Other
								Discharge Structure M-l
454
Required Information for Mixing Zone Modeling
								M-l
455
SARA Title III Section 302 Notification
302
Scrap Tire Manifest M-3
536
Scrap Tire Processor Permit Application M-3
540
Scrap Tire Quarterly Report M-3
539
Scrap Tire Registration & Exemption Application
								M-4
537
Scrap Tire Site Registration
541
Scrap Tire Transporter Permit Application
								M-4
538
Seal Gap Test Form
184
Segmental Water System Certification
								Application
456
SID Discharge Monitoring Report Form
								(Monthly)
457
SID Discharge Monitoring Report Form
								(Quarterly)
458
Solid Waste Landfill Operator Certification
								Renewal
13
Solid Waste Landfill Operator Initial Certification
								Application
11
Solid Waste Landfill Operator Reciprocal
								Certification Application
12
Solid Waste Profile Sheet
300
Specifications for Air Curtain Incinerators
17
Spill Catchment Basin/Spill Bucket Annual Test
								Log
20
SRF Payment Request Form
459
State Indirect Discharge Permit Application
								M-4
186
Statistical Inventory Reconciliation SIR 7 Day
								Release Investigation Notice Form
460
Supplemental Petroleum Application
								Information
516
Surface Source Susceptibility Analysis
								Worksheet
461
Tank Trust Fund Eligibility/Ineligibility
								Determination Form
462
Technical Proposal for Qualification as a Large
								Site Scrap Tire Fund Remediation Center M-l
530
Termination Request-General Permit Number
								ALR100000
21
Name of Forms
Form Number
Toxicity Discharge Monitoring Report Form
464
Toxicity Test Report Summary
465
Transfer Agreement Form
466
UIC Permit Application for Coal Mining Wastewater
								M-l
532
Underground and Above Ground Storage Tank Transfer
								of Ownership M-l
469
UST ARBCA Tier 1 Report Forms
471
UST ARBCA Tier 2 Report Forms
472
UST ARBCA Tier 3 Report Forms
473
UST Closure Site Assessment Report Form M-2
474
UST Closure Total Potential VOC Emissions
								Calculations
492
UST Free Product Recovery Report Form
475
UST Groundwater Monitoring Report Form
476
UST Line Tightness Test Report Form M-l
477
UST Natural Attenuation Monitoring Report
								Form
478
UST Release Fact Sheet
479
UST Release Report Form M-2
480
UST Site Classification System Checklist
481
UST System Effectiveness Monitoring Report
								Form
482
UST Tracer Tank Tightness Test Report Form
								M-l
483
UST Ullage Tank Tightness Test Report Form
								M-l
484
UST Vacuum Tank Tightness Test Report Form
485
UST Volumetric Overfill Tank Tightness Test Report
								Form M-l
486
UST Volumetric Underfill Tank Tightness Test Report
								Form
487
Visible Emission Field Test Sheet
502
Voluntary Cleanup Program Application
521
Water Supply Construction Permit Application
								M-l
488
Water Supply Permit Application
								(Modification)
489
Water Supply Permit Application (Renewal)
								M-l
490
Water System Update
491
Water Treatment Plant Quarterly Report for the
								Disinfectants and Disinfection Byproducts Rule M-l
547
Water and Wastewater Operator Exam Application
								M-l
505
Water and Wastewater Operator Experience
								Verification M-l
506
Water and Wastewater Operator for Multiple Systems
								M-l
508
Water and Wastewater Reciprocal Application
								M-l
507
Water Well Driller Reciprocal Application
194
Water Well Standards Program License Renewal
195
Rule .07 was renumbered to .01 as per certification filed
					 April 15, 2014; effective May 20, 2014.
Authors:
Marilyn Elliott, Russell A.
					 Kelly
Statutory Authority:
Code of Ala.
					 1975
, §§
											22-22A-5,
					 22-22A-6,
					 22-22A-8, 411-22-4,
					 41-22-5.