Alabama Administrative Code › Title 335 - ALABAMA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT › GENERAL ADMINISTRATION › Chapter 335-1-1 - ORGANIZATION › Section 335-1-1-.07 - 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 C
ode 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
Title VI Complaint Form
572
Air Program
Specifications for Air Curtain Incinerators
M-1
17
MEME Vendor Application
39
Registration Form for the Construction,
								Installation, or Modification of an Incinerator
M-3
52
Operating Permit Application Facility
								Identification Form
M-8
103
Permit Application for Indirect Heating Equipment
M-4
104
Permit Application for Manufacturing or Processing
								Operation
M-6
105
Permit Application for Waste Disposal
M-3
106
Permit Application for Stationary Internal
								Combustion
Engines
M-8
107
Permit Application for Loading and Storage of
								Organic Compounds
M-3
108
Permit Application for Volatile Organic Compound
								Surface Coating Emission Source
M-4
109
Permit Application for Air Pollution Control Device
M-5
110
Permit Application for Solvent Metal Cleaning
M-2
112
Seal Gap Test Form
M-2
184
Air Permit Application for Gasoline Dispensing
								Facilities
M-6
197
Gasoline Transport Tank Truck Application
M-4
198
Cargo Tank Tightness Test Report
M-1
309
Bulk (Gasoline) Plant Application
M-2
331
Emissions Statement Reporting Form
M-1
372
Excess Emission Monitoring Report
373
Exemption Claim Form for Cofired Combustors
								(Appendix H - Division 3)
M-1
374
Exemption Claim Form for Incinerators Burning Only
								Pathological, Low-Level Radioactive, and Chemotherapeutic Waste (Appendix H -
								Division 3)
M-1
375
Gasoline Dispensing Facility Information Survey
M-1
378
Open Burning Incident Report
434
Perc Dry Cleaner Status Update
M-1
436
Permit Application for Compliance Schedule
M-2
437
Permit Application for Continuous Emission
								Monitoring
Systems (CEMS)
M-1
438
Petroleum Solvent Dry Cleaning Questionnaire
M-1
440
Remediation Approval Form
M-2
448
Remediation Reporting Form
M-2
449
112(j) Part 1 Applicability
								Notification
493
Birmingham Fuel Supplier Report
M-1
494
Notice of Demolition and/or Asbestos Removal
M-1
496
Asbestos Removal Contractor
								Certification
497
Visible Emission Field Test Sheet
502
CAIR Permit Application (for sources covered under
								a CAIR SIP)
519
Coastal Program
Joint Application and Notification U. S. Department
								of Army, Corps of Engineers Alabama Department of Environmental Management
M-3
166
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
M-1
316
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
M-1
327
Application for a Permit for the Construction of
								SingleFamily Dwellings, Duplexes, or Other Similar Structures on Properties
								Intersected by the Construction Control Line in the Alabama Coastal Area
M-1
328
Application for Approval of a Non-Regulated Use in
								the Alabama Coastal Area Developments and Subdivisions of Property Greater than
								5 Acres in Size
M-1
329
Waste/Remediation
								Program
Alabama Recycling Fund Grant Application
M-2
9
Solid Waste Landfill Operator Initial Certification
								Application
11
Solid Waste Landfill Operator Reciprocal
								Certification Application
12
Solid Waste Landfill Operator Certification
								Renewal
13
Processing and Recycling General Information
								Recycling Registration
M-2
15
Annual Recycling Report
16
Composting Facility Application
M-1
18
UST Annual Walkthrough Inspection Checklist Log
M-3
19
UST 3 Year Spill Prevention Equipment (Spill
								Bucket) Integrity Test Report (Hydrostatic and Vacuum Method)
M-3
20
UST Alabama Tank Trust Fund Cost Proposal Part I
M-5
31
UST Alabama Tank Trust Fund Payment Request Part I
M-5
32
Disposal Approval Request
M-1
278
UST Notification for Underground Storage Tanks
M-4
279
UST Notification for Above Ground Storage Tanks
M-4
283
Solid Waste Profile Sheet
M-3
300
SARA Title III Section 302: Extremely Hazardous
								Substance Notification
M-1
302
Permit Application Solid Waste Disposal Facility
								Construction/Demolition Landfill
M-2
305
UST Notice of Temporary Closure
M-2
310
Alabama Hazardous Waste/Used Oil Transporter Permit
								Application
M-2
317
Alternative Medical Waste Treatment Technology
								Equipment Approval Application
323
UST Annual Statistical Inventory Reconciliation
								(SIR) Report Form
M-2
326
Application for Name Change or Transfer of Permit
								or Exemption
M-5
330
UST Cathodic Protection Monitoring Form
M-2
332
UST Impressed Current Cathodic Protection System
								60-Day Inspection Log
M-1
400
UST Interior Lining Inspection Form
403
UST Interior Lining Report Form
404
UST Manual Interstitial Monitoring Monthly Log
M-1
406
SARA Title III Section 311: SDS/MSDS Reporting
M-1
407
Application for Medical Waste Generator
								Notification
M-3
410
Medical Waste Transporter Permit Application
M-5
411
Medical Waste Treatment Permit Application
M-5
412
Medical Waste Storage Permit
								Application
413
UST 30 Day Statistical Inventory Reconciliation
								(SIR) Log
M-3
414
UST Notice of Intent to Permanently Close
								Underground Storage Tanks or Piping
M-4
422
UST Notice of Proposed UST New Installation or
								Modification
M-5
423
Notification of Election of Coverage under The
								Alabama Drycleaning Environmental Response Trust Fund Act
M-3
425
Permit Application Solid Waste Disposal Facility
M-2
439
UST Statistical Inventory Reconciliation SIR 7 Day
								Release Investigation Report
M-3
460
UST Tank Trust Fund Eligibility/Ineligibility
								Determination Form
M-1
462
UST Underground and Above Ground Storage Tank
								Transfer of Ownership
M-3
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-4
474
UST Free Product Recovery Report
								Form
475
UST Groundwater Monitoring Report Form
M-1
476
UST Line Tightness Test Report Form
M-3
477
UST Natural Attenuation Monitoring Report
								Form
478
UST Release Fact Sheet
479
UST Release Report Form
M-3
480
UST Site Classification System
								Checklist
481
UST System Effectiveness Monitoring Report
								Form
482
UST Tracer Tank Tightness Test Report Form
M-2
483
UST Ullage Tank Tightness Test Report Form
M-2
484
UST Tank Tightness Test (Vacuum) Report
M-3
485
UST Volumetric Overfill Tank Tightness Test Report
								Form
M-2
486
UST Volumetric Underfill Tank Tightness Test Report
								Form
M-1
487
UST Closure Total Potential VOC Emissions
								Calculations
492
Voluntary Cleanup Program Application
M-3
521
Technical Proposal for Qualification as a Large
								Site Scrap Tire Fund Remediation Center
M-1
530
Scrap Tire Manifest
M-4
536
Scrap Tire Registration & Exemption Application
M-7
537
Scrap Tire Transporter Permit Application
M-8
538
Scrap Tire Quarterly Report
M-6
539
Scrap Tire Processor Permit Application
M-7
540
Scrap Tire Site Registration
M-1
541
Brownfields State Revolving Fund Pre-Application
								Form
M-1
542
Brownfields State Revolving Fund Application Form
M-1
543
Cathodic Protection Monitoring for Galvanic Systems
M-2
545
Alabama Hazardous Waste Receipt for Samples and
								Documents
546
Brownfields Assessment Request Application
M-1
550
UST Line Leak Detector (LLD) Test Report
M-3
551
UST 3 Year Containment Sump Integrity Test Report
								(Low Level Method)
M-1
556
UST 3 Year Containment Sump Integrity Test Report
M-1
557
UST 30 Day Walkthrough Inspection Checklist Log
M-2
558
UST 3 Year Overfill Prevention Equipment
								Inspection
Report
M-2
559
UST Annual Probe and Sensor Test Report
M-1
560
UST Annual Release Detection Equipment Operation
								and Calibration Testing Log
M-2
561
UST Compatibility Demonstration Log
M-1
562
UST Manual Tank Gauging Monthly Log
M-1
563
UST Annual Liquid Sensor Inspection and
								Functionality Test
M-1
564
UST Annual Tank Gauge Test Report
M-1
565
UST Automatic Line Leak Detector (ALLD) and Line
								Tightness Test Report
M-1
566
Application for Facility Name Change or Transfer of
								Solid Waste Disposal Facility Permit
568
Beneficial Use Facility Registration Application
M-1
569
Beneficial Use Annual Reporting
M-1
571
Notification of Regulated Waste Activity
M-7
8700-12
Water Program
Drinking Water - Groundwater System Monthly
								Operational Data Report
M-1
8
Information Needed for 316(b) Determination in
								Regard to General NPDES Permits
14
Notice of Termination NPDES General Permit Number
								ALR100000
M-2
21
NPDES Construction Stormwater Inspection Report and
								BMP Certification
M-1
23
Notice of Intent NPDES General Permit Number
								ALR100000 (Construction Stormwater)
M-3
24
NPDES Construction Stormwater Noncompliance
								Notification
M-1
25
Notice of Intent-NPDES General Permit Number
								ALG850000
M-4
26
Drinking Water - Operational Evaluation Level
								Exceedance Report
M-2
27
Notice of Intent-General Permit Number ALG870000
								(Pesticides)
M-2
28
ADEM NPDES Pesticide Adverse Incident Report
M-1
29
Notice of Termination - NPDES General Permit Number
								ALG870000
M-1
30
EDWRS Permittee Registration Form
33
EDWRS Lab Registration Form
34
EDWRS Terms and Conditions
								Agreement
35
Drinking Water - Total Coliform Rule - Level
								1
Assessment
M-2
36
Drinking Water - Total Coliform Rule - Level
								2
Assessment
M-2
37
Drinking Water- Certification of Well
								Completion
59
Drinking Water - Notification of Intent to Drill a
								Water Well
60
Drinking Water - Purchase Water System Monthly
								Operation Report
M-1
185
State Indirect Discharge (SID) Permit Application
M-6
186
NPDES Individual Permit Application Supplementary
								Information for Industrial Facilities
M-7
187
NPDES Individual Permit Application Supplementary
								Information for Publicly-Owned Treatment Works (POTW), Other Treatment Works
								Treating Domestic Sewage (TWTDS), and Public Water Supply Treatment Plants
M-4
188
Permit Application of Reclaimed Water Reuse
								(RWR)
189
Application for Alabama Well Driller's License
M-1
193
Water Well Driller Reciprocal
								Application
194
Water Well Standards Program License
								Renewal
195
Drinking Water - Filter Plant Monthly Operational
								Data Report
M-1
242
Drinking Water - Monthly Membrane Surface Plant
								Operational Data Report
M-1
243
Drinking Water - Application for Approval to Use a
								Water Supply Well
259
Alternative Analysis
311
Calculation of Total Annualized Project Cost for
								PublicSector Projects
312
Calculation of Total Annualized Project Cost for
								Private-Sector Projects
313
ADEM Baseline Monitoring Report Submittal
								Form
314
NPDES Individual Permit Application (Mining
								Operations)
M-6
315
Annual Certification Form for Discharges Associated
								with Petroleum Storage and Handling Areas
M-2
324
Drinking Water - Chemical Monitoring Data Report
M-1
335
Drinking Water - Chemical Monitoring Waiver
								Application
M-1
336
Clean Water State Revolving Fund (CWSRF)
								Loan
Application Form
M-3
339
Clean Water State Revolving Fund (CWSRF)
								Preapplication Form
M-4
340
Coalbed Methane Stormwater Inspection Summary
								Report
M-1
343
Coalbed Methane Temporary Pit Wastewater
								Land
Application Certification Report
M-1
344
Drinking Water - Community Public Notification
								Certification Form
345
Drinking Water - Community System Susceptibility
								Analysis Sheet
M-1
346
Drinking Water - Consumer Confidence Report (CCR)
								Certification Form
M-2
347
Drinking Water State Revolving Fund (DWSRF) Loan
								Application Form
M-3
369
Drinking Water State Revolving Fund (DWSRF)
								Preapplication Form
M-4
370
NPDES Individual Permit Application Addendum
M-1
376
NPDES Individual Permit Application Minor Permit
								Modification Addendum
M-2
377
Notice of Intent-NPDES General Permit Number
								ALG110000
M-5
380
Notice of Intent-NPDES General Permit Number
								ALG120000
M-6
381
Notice of Intent-NPDES General Permit Number
								ALG140000
M-5
382
Notice of Intent-NPDES General Permit Number
								ALG150000
M-4
383
Notice of Intent-NPDES General Permit Number
								ALG160000
M-4
384
Notice of Intent-NPDES General Permit Number
								ALG170000
M-4
385
Notice of Intent-NPDES General Permit Number
								ALG180000
M-4
386
Notice of Intent-NPDES General Permit Number
								ALG020000
M-4
387
Notice of Intent-NPDES General Permit Number
								ALG200000
M-4
388
Notice of Intent-NPDES General Permit Number
								ALG230000
M-4
389
Notice of Intent-NPDES General Permit Number
								ALG240000
M-4
390
Notice of Intent-NPDES General Permit Number
								ALG250000
M-5
391
Notice of Intent-NPDES General Permit Number
								ALG280000
M-5
392
Notice of Intent-NPDES General Permit Number
								ALG030000
M-4
393
Notice of Intent-NPDES General Permit Number
								ALG340000
M-5
394
Notice of Intent-NPDES General Permit Number
								ALG360000
M-6
395
Notice of Intent-NPDES General Permit Number
								ALG060000
M-5
396
Notice of Intent-NPDES General Permit Number
								ALG670000
M-4
397
Drinking Water - Lead and Copper Monitoring Data
								Report
M-1
405
Material Safety Data Sheet
								Reporting
407
Drinking Water - Maximum Residual Disinfectant
								Level Input Form (Samples)
M-1
408
Sanitary Sewer Overflow (SSO) Event Reporting Form
M-4
415
Municipal Water Pollution Prevention (MWPP) Annual
								Report (Collection Systems) Package
M-1
416
Municipal Water Pollution Prevention (MWPP) Annual
								Report Package
M-3
417
Municipal Water Pollution Prevention Resolution
								Form
418
MWPP Sewage Sludge Survey
M-1
419
Drinking Water - Non-Community Public Notification
								Certification Form
420
NPDES/SID Non-Compliance Notification Form
M-4
421
NPDES Annual Notice of Registration
								(NOR)
429
NPDES Individual Permit Pollution
								Abatement/Treatment Measures and Sediment Control Structures Certification
								Report
M-2
432
NPDES Permitted Coalbed Methane Operations
								Pollution Abatement/Treatment Measures and Waste Treatment Facilities
								Certification Report
M-1
433
Operator Certification Renewal Form
M-1
435
Plant and Collection System Personnel
								Inventory
441
Drinking Water - Potable Water Laboratory
								Certification Application
M-3
442
Drinking Water - Progress Report Form
M-1
443
Drinking Water - Project Completion Form
M-2
444
Release Information Form
447
Representative Stormwater Outfall Certification
M-3
450
Request for NPDES Permit Post-Mining Discharge
								Limitations (Coal Mining Operations)
M-2
451
Request for Release from NPDES Permit Monitoring
								and Reporting Requirements (Mining Operations)
M-3
452
Request to Remove Subsurface Withdrawal from
								Discharge Structure (NPDES-Permitted Mining Operations)
M-2
453
Request to Remove Treatment Basin/Pond or Other
								Discharge Structure (NPDES-Permitted Mining Operations)
M-3
454
Required Information for Mixing Zone Modeling
M-1
455
SID Discharge Monitoring Report Form
								(Monthly)
457
SID Discharge Monitoring Report Form
								(Quarterly)
458
SRF Payment Request Form
459
Drinking Water - Surface Source Susceptibility
								Analysis Worksheet
M-1
461
Toxicity Discharge Monitoring Report
								Form
464
Toxicity Test Report Summary
465
NPDES/SID/UIC Permit Transfer Agreement
M-3
466
Drinking Water - Construction Permit Application
M-2
488
Drinking Water - Modification Permit
								Application
489
Drinking Water - Renewal Permit Application
M-2
490
Drinking Water - Public Water System Information
								Update
M-1
491
Notice of Intent-NPDES General Permit Number
								ALG890000
M-6
498
Notice of Termination - NPDES General Permit Number
								ALG890000
M-4
499
NPDES Noncoal/Nonmetallic Mining and Dry Processing
								Less than Five Acres Stormwater Inspection Report and BMP Certification
M-3
500
NPDES Small Mining Noncompliance Notification
								Report
M-4
501
Notice of Intent - NPDES General Permit Number
								ALR040000 (MS4 Phase II)
M-3
503
Water and Wastewater Operator Exam Application
M-1
505
Water and Wastewater Operator Experience
								Verification
M-1
506
Water and Wastewater Reciprocal Application
M-1
507
Water and Wastewater Operator for Multiple Systems
M-1
508
Cooling Water Supplemental Information
M-2
510
EDMR Daily Discharge Monitoring Report
								Form
514
EDMR Monthly Discharge Monitoring Report
								Form
515
Supplemental Petroleum Application
								Information
516
Alabama Clean Vessel Act Grant
								Application
517
Boating Infrastructure Grant
								Application
518
General Phase II MS4 Stormwater Permit Renewal
								Notice of Intent
M-1
520
Notice of Intent-NPDES General Permit Number
								ALG640000
M-6
522
Hydrogeology Unit Evaluation Report
								Form
531
Documentation of Disability Related
								Needs
533
Drinking Water - Giardia and Virus Profile
								Spreadsheet
M-1
535
Drinking Water - WTP Quarterly Report for the
								Disinfectants and Disinfection Byproducts Rule
M-2
547
NPDES Individual Permit Application (Coalbed
								Methane Operations)
M-4
549
Notice of Intent-UIC General Permit Number
								ALIG010000
552
Notice of Intent-UIC General Permit Number
								ALIG020000
553
Notice of Termination - NPDES General Permits
								(Industrial Activities)
554
No Exposure Certification for Exclusion from NPDES
								Stormwater Permitting for Industrial Activities
M-1
555
NPDES Mining and Preparation Plant Outfall Data for
								Metals, Cyanide, and Total Phenols
567
One-Time Compliance Report for Dental
								Dischargers
570
Forms are available on the ADEM website at
www.adem.alabama.gov
.
Appendix A, Forms can no longer be found at the end of the
					 Chapter 335-1-1. It will be placed at the end of all chapters in Division
					 335-1.
Author:
Marilyn Elliott, Russell A. Kelly,
					 Aubrey White, David Hutchinson, Brian C. Espy
Statutory Authority:
Code of Ala.
					 1975
, §§22-22A-5, 22-22A-6, 22-22A-8, 411-22-4,
					 41-22-5.