UNITED STATES OF AMERICA

DEPARTMENT OF TRANSPORTATION

OFFICE OF THE SECRETARY

WASHINGTON, DC

Issued by the Department of Transportation on November 2, 2005

NOTICE OF ACTION TAKEN -- DOCKET OST-2005-22645

________________________________________________________________________
_________________________________

This serves as notice to the public of the action described below, taken
by the Department official indicated (no additional confirming order
will be issued in this matter).

Application of US AIRWAYS, INC. (US Airways) filed 10/3/05 for:

XX Exemption for two years under 49 U.S.C. 40109 to provide the
following service:

Scheduled foreign air transportation of persons, property, and mail
between (1) the terminal point Phoenix, Arizona, on the one hand, and
the terminal points Mexico City, Mazatlan, Puerto Vallarta, San Jose del
Cabo, Acapulco, Guadalajara, Guaymas, Hermosillo, Ixtapa/Zihuatanejo,
Manzanillo, and Cancun, Mexico, on the other hand; (2) the terminal
point Las Vegas, Nevada, on the one hand, and the terminal points Puerto
Vallarta and San Jose del Cabo, Mexico, on the other hand; and (3) the
terminal point Los Angeles, California, on the one hand and the terminal
points Acapulco and Puerto Vallarta, Mexico, on the other hand.  US
Airways also requests authority to combine this exemption authority with
all of US Airways’ existing certificate and exemption authority,
consistent with applicable international agreements.

US Airways states that it requests this authority in order to expand
services under a code-share arrangement with America West and/or Mesa
Airlines operating as America West Express (America West), whereby US
Airways will place its “US” code on flights operated by America West
in the respective city-pair markets.

Applicant rep: Joanne W. Young<PHONE_NUMBER>	DOT Analyst: Tretha
Chromey<PHONE_NUMBER>

D I S P O S I T I O N

XX	Granted (subject to conditions, see below)

The above action was effective when taken:  November 2, 2005, through
November 2, 2007.

Action taken by:	Paul L. Gretch, Director

			Office of International Aviation

XX  The authority granted is consistent with the aviation agreement
between the United States and Mexico.

Except to the extent exempted or waived, this authority is subject to
the terms, conditions, and limitations indicated:

	XX The holder’s certificates of public convenience and necessity

	XX Standard exemption conditions (attached)

Conditions:  The U.S.-Mexico exemption authority granted is subject to
the dormancy notice requirements set forth in condition 7 of Appendix A
of Order 88-10-2, and is limited to code-share services only.

The code-share operations conducted under this authorization are subject
to the following conditions:

The code-sharing operations conducted under this authority must comply
with 14 CFR 257 and with any amendment to the Department’s regulations
concerning code-share arrangements that may be adopted.  Notwithstanding
any provisions in the contract between the carriers, our approval here
is expressly conditioned upon the requirements that the subject foreign
air transportation be sold in the name of the carrier holding out such
service in computer reservation systems and elsewhere; that the carrier
selling such transportation (i.e., the carrier shown on the ticket)
accept responsibility for the entirety of the code-share journey for all
obligations established in its contract of carriage with the passenger;
and that the passenger liability of the operating carrier be unaffected;
and

The authority granted here is specifically conditioned so that neither
US Airways nor America West shall give any force or effect to any
contractual provisions between themselves that are contrary to these
conditions.

The route integration authority granted is subject to the condition that
any service provided under this exemption shall be consistent with all
applicable agreements between the United States and the foreign
countries involved.  Furthermore, (a) nothing in award of the route
integration authority granted should be construed as conferring upon US
Airways rights (including fifth-freedom intermediate and/or beyond
rights) to serve markets where U.S. carrier entry is limited unless US
Airways notifies the Department of its intent to serve such a market and
unless and until the Department has completed any necessary carrier
selection procedures to determine which carrier(s) should be authorized
to exercise such rights; and (b) should there be a request by any
carrier to use the limited-entry route rights that are included in US
Airways’ authority by virtue of the route integration exemption
granted here, but that are not then being used by US Airways, the
holding of such authority by route integration will not be considered as
providing any preference for US Airways in a competitive carrier
selection proceeding to determine which carrier(s) should be entitled to
use the authority at issue.

________________________________________________________________________
______

On the basis of data officially noticeable under Rule 24(g) of the
Department's regulations, we found the applicant qualified to provide
the exemption services authorized.

Under authority assigned by the Department in its regulations, 14 CFR
Part 385, we found that (1) our action was consistent with Department
policy; (2) grant of the authority was consistent with the public
interest; and (3) grant of the authority would not constitute a major
regulatory action under the Energy Policy and Conservation Act of 1975.
To the extent not granted, we denied all requests in the referenced
Docket.  We may amend, modify, or revoke the authority granted in this
Notice at any time without hearing at our discretion.

Persons entitled to petition the Department for review of the action set
forth in this Notice under the Department’s regulations, 14 CFR
§385.30, may file their petitions within seven (7) days after the date
of issuance of this Notice.  This action was effective when taken, and
the filing of a petition for review will not alter such effectiveness.

An electronic version of this document is available on the World Wide
Web at:

  HYPERLINK "http://dms.dot.gov//reports/reports_aviation.asp"
http://dms.dot.gov//reports/reports_aviation.asp

APPENDIX

U.S. Carrier Exemption Conditions

In the conduct of the operations authorized, the U.S. carrier
applicant(s) shall:

(1)  Hold at all times effective operating authority from the government
of each country served;

(2)  Comply with applicable requirements concerning oversales contained
in 14 CFR 250 (for scheduled operations, if authorized);

(3)  Comply with the requirements for reporting data contained in 14 CFR
241;

(4)  Comply with requirements for minimum insurance coverage, and for
certifying that coverage to the Department, contained in 14 CFR 205;

(5)  Except as specifically exempted or otherwise provided for in a
Department Order, comply with the requirements of 14 CFR 203, concerning
waiver of Warsaw Convention liability limits and defenses;

(6)  Comply with all applicable requirements of the Federal Aviation
Administration and with all applicable U.S. Government requirements
concerning security, including, but not limited to, 49 CFR Part 1544.
To assure compliance with all applicable U.S. Government requirements
concerning security, the holder shall, before commencing any new service
(including charter flights) to or from a foreign airport, contact its
International Principal Security Inspector (IPSI) to advise the IPSI of
its plans and to find out whether the Transportation Security
Administration has determined that security is adequate to allow such
airport(s) to be served; and

(7)  Comply with such other reasonable terms, conditions, and
limitations required by the public interest as may be prescribed by the
Department of Transportation, with all applicable orders and regulations
of other U.S. agencies and courts, and with all applicable laws of the
United States.

The authority granted shall be effective only during the period when the
holder is in compliance with the conditions imposed above.

05/2004

 US Airways states that on September 27, 2005, America West Holdings
Corporation merged with US Airways Group, Inc.  As a result, America
West became a subsidiary of US Airways Group.


(g) Property rights. This permit does not convey any property rights of any sort, or any exclusive privilege.
    (h) Duty to provide information. The permittee shall furnish to the Director, within a reasonable time, any information which the Director may request to determine whether cause exists for modifying, revoking and reissuing, or terminating this permit or to determine compliance with this permit. The permittee shall also furnish to the Director upon request, copies of records required to be kept by this permit.
    (i) Inspection and entry. The permittee shall allow the Director, or an authorized representative (including an authorized contractor acting as a representative of the Administrator), upon presentation of credentials and other documents as may be required by law, to:
    (1) Enter upon the permittee's premises where a regulated facility or activity is located or conducted, or where records must be kept under the conditions of this permit;
    (2) Have access to and copy, at reasonable times, any records that must be kept under the conditions of this permit;
    (3) Inspect at reasonable times any facilities, equipment (including monitoring and control equipment), practices, or operations regulated or required under this permit; and
    (4) Sample or monitor at reasonable times, for the purposes of assuring permit compliance or as otherwise authorized by the Clean Water Act, any substances or parameters at any location.
    (j) Monitoring and records. (1) Samples and measurements taken for the purpose of monitoring shall be representative of the monitored activity.
    (2) Except for records of monitoring information required by this permit related to the permittee's sewage sludge use and disposal activities, which shall be retained for a period of at least five years (or longer as required by 40 CFR part 503), the permittee shall retain records of all monitoring information, including all calibration and maintenance records and all original strip chart recordings for continuous monitoring instrumentation, copies of all reports required by this permit, and records of all data used to complete the application for this permit, for a period of at least 3 years from the date of the sample, measurement, report or application. This period may be extended by request of the Director at any time.
    (3) Records of monitoring information shall include:
    (i) The date, exact place, and time of sampling or measurements;
    (ii) The individual(s) who performed the sampling or measurements;
    (iii) The date(s) analyses were performed;
    (iv) The individual(s) who performed the analyses;
    (v) The analytical techniques or methods used; and
    (vi) The results of such analyses.
    (4) Monitoring must be conducted according to test procedures approved under 40 CFR Part 136 unless another method is required under 40 CFR subchapters N or O.
    (5) The Clean Water Act provides that any person who falsifies, tampers with, or knowingly renders inaccurate any monitoring device or method required to be maintained under this permit shall, upon conviction, be punished by a fine of not more than $10,000, or by imprisonment for not more than 2 years, or both. If a conviction of a person is for a violation committed after a first conviction of such person under this paragraph, punishment is a fine of not more than $20,000 per day of violation, or by imprisonment of not more than 4 years, or both.
    (k) Signatory requirement. (1) All applications, reports, or information submitted to the Director shall be signed and certified. (See §122.22)
    (2) The CWA provides that any person who knowingly makes any false statement, representation, or certification in any record or other document submitted or required to be maintained under this permit, including monitoring reports or reports of compliance or non-compliance shall, upon conviction, be punished by a fine of not more than $10,000 per violation, or by imprisonment for not more than 6 months per violation, or by both.
    (l) Reporting requirements -- (1) Planned changes. The permittee shall give notice to the Director as soon as possible of any planned physical alterations or additions to the permitted facility. Notice is required only when:
    (i) The alteration or addition to a permitted facility may meet one of the criteria for determining whether a facility is a new source in §122.29(b); or
    (ii) The alteration or addition could significantly change the nature or increase the quantity of pollutants discharged. This notification applies to pollutants which are subject neither to effluent limitations in the permit, nor to notification requirements under §122.42(a)(1).
    (iii) The alteration or addition results in a significant change in the permittee's sludge use or disposal practices, and such alteration, addition, or change may justify the application of permit conditions that are different from or absent in the existing permit, including notification of additional use or disposal sites not reported during the permit application process or not reported pursuant to an approved land application plan;
    (2) Anticipated noncompliance. The permittee shall give advance notice to the Director of any planned changes in the permitted facility or activity which may result in noncompliance with permit requirements.
    (3) Transfers. This permit is not transferable to any person except after notice to the Director. The Director may require modification or revocation and reissuance of the permit to change the name of the permittee and incorporate such other requirements as may be necessary under the Clean Water Act. (See §122.61; in some cases, modification or revocation and reissuance is mandatory.)
    (4) Monitoring reports. Monitoring results shall be reported at the intervals specified elsewhere in this permit.
    (i) Monitoring results must be reported on a Discharge Monitoring Report (DMR) or forms provided or specified by the Director for reporting results of monitoring of sludge use or disposal practices. As of December 21, 2016, all reports and forms submitted in compliance with this section must be submitted electronically by the permittee to the Director or initial recipient as defined in 40 CFR 127.2(b) in compliance with this section and 40 CFR Part 3 (including, in all cases, subpart D to Part 3), §122.22, and 40 CFR Part 127. Part 127 is not intended to undo existing requirements for electronic reporting. Prior to this date, and independent of Part 127, permittees may be required to report electronically if specified by a particular permit or if required to do so by state law.
    (ii) If the permittee monitors any pollutant more frequently than required by the permit using test procedures approved under 40 CFR Part 136, or another method required for an industry-specific waste stream under 40 CFR subchapters N or O, the results of such monitoring shall be included in the calculation and reporting of the data submitted in the DMR or sludge reporting form specified by the (iii) Calculations for all limitations which require averaging of measurements shall utilize an arithmetic mean unless otherwise specified by the Director in the permit.
    (5) Compliance schedules. Reports of compliance or noncompliance with, or any progress reports on, interim and final requirements contained in any compliance schedule of this permit shall be submitted no later than 14 days following each schedule date.
    (6) Twenty-four hour reporting.
    (i) The permittee shall report any noncompliance which may endanger health or the environment. Any information shall be provided orally within 24 hours from the time the permittee becomes aware of the circumstances. A report shall also be provided within 5 days of the time the permittee becomes aware of the circumstances. The report shall contain a description of the noncompliance and its cause; the period of noncompliance, including exact dates and times), and if the noncompliance has not been corrected, the anticipated time it is expected to continue; and steps taken or planned to reduce, eliminate, and prevent reoccurrence of the noncompliance. For noncompliance events related to combined sewer overflows, sanitary sewer overflows, or bypass events, these reports must include the data described above (with the exception of time of discovery) as well as the type of event (combined sewer overflows, sanitary sewer overflows, or bypass events), type of sewer overflow structure (e.g., manhole, combine sewer overflow outfall), discharge volumes untreated by the treatment works treating domestic sewage, types of human health and environmental impacts of the sewer overflow event, and whether the noncompliance was related to wet weather. As of December 21, 2020, all reports related to combined sewer overflows, sanitary sewer overflows, or bypass events submitted in compliance with this section must be submitted electronically by the permittee to the Director or initial recipient as defined in 40 CFR 127.2(b) in compliance with this section and 40 CFR Part 3 (including, in all cases, subpart D to Part 3), §122.22, and 40 CFR Part 127. Part 127 is not intended to undo existing requirements for electronic reporting. Prior to this date, and independent of Part 127, permittees may be required to electronically submit reports related to combined sewer overflows, sanitary sewer overflows, or bypass events under this section by a particular permit or if required to do so by state law. The Director may also require permittees to electronically submit reports not related to combined sewer overflows, sanitary sewer overflows, or bypass events under this section.
    (ii) The following shall be included as information which must be reported within 24 hours under this paragraph.
    (A) Any unanticipated bypass which exceeds any effluent limitation in the permit. (See §122.41(g).
    (B) Any upset which exceeds any effluent limitation in the permit.
    (C) Violation of a maximum daily discharge limitation for any of the pollutants listed by the Director in the permit to be reported within 24 hours. (See §122.44(g).)
    (iii) The Director may waive the written report on a case-by-case basis for reports under paragraph (l)(6)(ii) of this section if the oral report has been received within 24 hours.
    (7) Other noncompliance. The permittee shall report all instances of noncompliance not reported under paragraphs (l)(4), (5), and (6) of this section, at the time monitoring reports are submitted. The reports shall contain the information listed in paragraph (l)(6). For noncompliance events related to combined sewer overflows, sanitary sewer overflows, or bypass events, these reports shall contain the information described in paragraph (l)(6) and the applicable required data in appendix A to 40 CFR Part 127. As of December 21, 2020 all reports related to combined sewer overflows, sanitary sewer overflows, or bypass events submitted in compliance with this section must be submitted electronically by the permittee to the Director or initial recipient as defined in 40 CFR 127.2(b) in compliance with this section and 40 CFR Part 3 (including, in all cases, subpart D to Part 3), §122.22, and 40 CFR Part 127. Part 127 is not intended to undo existing requirements for electronic reporting. Prior to this date, and independent of Part 127, permittees may be required to electronically submit reports related to combined sewer overflows, sanitary sewer overflows, or bypass events under this section by a particular permit or if required to do so by state law. The Director may also require permittees to electronically submit reports not related to combined sewer overflows, sanitary sewer overflows, or bypass events under this section.
    (8) Other information. Where the permittee becomes aware that it failed to submit any relevant facts in a permit application or submitted incorrect information in a permit application or in any report to the Director, it shall promptly submit such facts or information.
    (9) Identification of the initial recipient for NPDES electronic reporting data. The owner, operator, or the duly authorized representative of an NPDES-regulated entity is required to electronically submit the required NPDES information (as specified in appendix A to 40 CFR Part 127) to the appropriate initial recipient, as determined by EPA, and as defined in §127.2(b) of this chapter. EPA will identify and publish the list of initial recipients on its Web site and in the Federal Register, by state and by NPDES data group [see §127.2(c) of this chapter]. EPA will update and maintain this listing.
    (m) Bypass -- (1) Definitions. (i) Bypass means the intentional diversion of waste streams from any portion of a treatment facility.
    (ii) Severe property damage means substantial physical damage to property, damage to the treatment facilities which causes them to become inoperable, or substantial and permanent loss of natural resources which can reasonably be expected to occur in the absence of a bypass. Severe property damage does not mean economic loss caused by delays in production.
    (2) Bypass not exceeding limitations. The permittee may allow any bypass to occur which does not cause effluent limitations to be exceeded, but only if it also is for essential maintenance to assure efficient operation. These bypasses are not subject to the provisions of paragraphs (m)(3) and (m)(4) of this section.
    (3) Notice -- (i) Anticipated bypass. If the permittee knows in advance of the need for a bypass, it shall submit prior notice, if possible at least ten days before the date of the bypass. As of December 21, 2020 all notices submitted in compliance with this section must be submitted electronically by the permittee to the Director or initial recipient as defined in 40 CFR 127.2(b) in compliance with this section and 40 CFR Part 3 (including, in all cases, subpart D to Part 3), §122.22, and 40 CFR Part 127. Part 127 is not intended to undo existing requirements for electronic reporting. Prior to this date, and independent of Part 127, permittees may be required to report electronically if specified by a particular permit or if required to do so by state law.
    (ii) Unanticipated bypass. The permittee shall submit notice of an unanticipated bypass as required in paragraph (l)(6) of this section (24-hour notice). As of December 21, 2020 all notices submitted in compliance with this section must be submitted electronically by the permittee to the Director or initial recipient as defined in 40 CFR 127.2(b) in compliance with this section and 40 CFR Part 3 (including, in all cases, subpart D to Part 3), §122.22, and 40 CFR Part 127. Part 127 is not intended to undo existing requirements for electronic reporting. Prior to this date, and independent of Part 127, permittees may be required to report electronically if specified by a particular permit or if required to do so by state law.
    (4) Prohibition of bypass. (i) Bypass is prohibited, and the Director may take enforcement action against a permittee for bypass, unless:
    (A) Bypass was unavoidable to prevent loss of life, personal injury, or severe property damage;
    (B) There were no feasible alternatives to the bypass, such as the use of auxiliary treatment facilities, retention of untreated wastes, or maintenance during normal periods of equipment downtime. This condition is not satisfied if adequate back-up equipment should have been installed in the exercise of reasonable engineering judgment to prevent a bypass which occurred during normal periods of equipment downtime or preventive maintenance; and
    (C) The permittee submitted notices as required under paragraph (m)(3) of this section.
    (ii) The Director may approve an anticipated bypass, after considering its adverse effects, if the Director determines that it will meet the three conditions listed above in paragraph (m)(4)(i) of this section.
    (n) Upset -- (1) Definition. Upset means an exceptional incident in which there is unintentional and temporary noncompliance with technology based permit effluent limitations because of factors beyond the reasonable control of the permittee. An upset does not include noncompliance to the extent caused by operational error, improperly designed treatment facilities, inadequate treatment facilities, lack of preventive maintenance, or careless or improper operation.
    (2) Effect of an upset. An upset constitutes an affirmative defense to an action brought for noncompliance with such technology based permit effluent limitations if the requirements of paragraph (n)(3) of this section are met. No determination made during administrative review of claims that noncompliance was caused by upset, and before an action for noncompliance, is final administrative action subject to judicial review.
    (3) Conditions necessary for a demonstration of upset. A permittee who wishes to establish the affirmative defense of upset shall demonstrate, through properly signed, contemporaneous operating logs, or other relevant evidence that:
    (i) An upset occurred and the permittee can identify the cause(s) of the upset;
    (ii) The permitted facility was at the time being properly operated; and
    (iii) The permittee submitted notice of the upset as required in paragraph (l)(6)(ii)(B) of this section (24 hour notice).
    (iv) The permittee complied with any remedial measures required under paragraph (d) of this section.
    (4) Burden of proof. In any enforcement proceeding the permittee seeking to establish the occurrence of an upset has the burden of proof.

Appendix C.
Areas Covered
EPA provides permit coverage for classes of point source discharges that occur in areas where EPA is the NPDES permitting authority. The geographic coverage of the draft 2021 PGP is listed below. This permit also applies in all areas of Indian Country that are not covered by an EPA-approved permitting program, for example, the areas of Indian Country described below:
1. EPA Region 1: Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island, Vermont
Where EPA is Permitting Authority
MAG87####	Massachusetts, including Indian Country within Massachusetts
CTG87###E	Indian Country within Connecticut
NHG87####	New Hampshire
RIG87###E	Indian Country within Rhode Island
VTG87###E	Federal facilities within Vermont
--------------------------------------------------------------------------------
2. EPA Region 2: New Jersey, New York, Puerto Rico, United States Virgin Islands
Where EPA is Permitting Authority
NYG87###E	Indian Country within New York State
PRG87####	Puerto Rico
3. EPA Region 3: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia
Where EPA is Permitting Authority
DCG87####	The District of Columbia
DEG87###E	Federal facilities within Delaware
VAG87###E	Indian Country within Virginia
4. EPA Region 4: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee
Where EPA is Permitting Authority
ALG87###E	Indian Country within Alabama
FLG87###E	Indian Country within Florida
MSG87###E	Indian Country within Mississippi
NCG87###E	Indian Country within North Carolina
5. EPA Region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin
Where EPA is Permitting Authority
ING87###E	Indian Country within Indiana
MIG87###E	Indian Country within Michigan
MNG87###E	Indian Country within Minnesota
WIG87###E	Indian Country within Wisconsin
6. EPA Region 6: Arkansas, Louisiana, Oklahoma, Texas, New Mexico (except see Region 9 for Navajo, and see Region 8 for Ute Mountain Reservation)
Where EPA is Permitting Authority
LAG87###E	Indian Country within Louisiana
NMG87####	New Mexico, including Indian Country within New Mexico, except Navajo Reservation (see Region 9) and Ute Mountain Reservation (see Region 8)
OKG87###E	Indian Country within Oklahoma
TXG87###E	Indian Country within Texas and discharges in Texas that are not under the authority of the Texas Commission on Environmental Quality (e.g., activities associated with the exploration, development, or production of oil or gas or geothermal resources, and transportation of crude oil or natural gas by pipeline)
7. EPA Region 7: Iowa, Kansas, Missouri, Nebraska (except see Region 8 for Pine Ridge Reservation)
Where EPA is Permitting Authority
IAG87###E	Indian Country within Iowa
KSG87###E	Indian Country within Kansas
NEG87###E	Indian Country within Nebraska, except Pine Ridge Reservation (see Region 8)
8. EPA Region 8: Colorado, Montana, North Dakota, South Dakota, Wyoming, Utah (except see Region 9 for Goshute Reservation and Navajo Reservation), the Ute Mountain Reservation in NM, and the Pine Ridge Reservation in Nebraska
Where EPA is Permitting Authority
COG87###E	Federal facilities within Colorado and Indian Country within Colorado as well as the portion of the Ute Mountain Reservation located within New Mexico
MTG87###E	Indian Country within Montana
NDG87###E	Indian Country within North Dakota
SDG87###E	Indian Country within South Dakota as well as the portion of the Pine Ridge Reservation located within Nebraska (see Region 7)
UTG87###E	Indian Country within Utah, except Goshute and Navajo Reservation (see Region 9)
WYG87###E	Indian Country within Wyoming
9. EPA Region 9: California, Hawaii, Nevada, Guam, American Samoa, the Commonwealth of the Northern Mariana Islands, the Goshute Reservation in Utah and Nevada, the Navajo Reservation in Utah, New Mexico, and Arizona, the Duck Valley Reservation in Idaho, and the Fort McDermitt Reservation in Oregon
Where EPA is Permitting Authority
ASG87####	The Island of American Samoa
AZG87###E	Indian Country within Arizona, as well as Navajo Reservation within New Mexico (see Region 6) and Utah (See Region 8)
CAG87###E	Indian Country within California
GUG87####	The Island of Guam
JAG87####	Johnston Atoll
MWG87####	Midway Island, Wake Island, and other unincorporated U.S. possessions
NIG87####	Commonwealth of the Northern Mariana Islands
NVG87###E	Indian Country within Nevada, as well as the Duck Valley Reservation within Idaho, the Fort McDermitt Reservation within Oregon (see Region 10) and the Goshute Reservation within Utah (see Region 8)
10. EPA Region 10: Alaska, Washington, Idaho (except see Region 9 for Duck Valley Reservation), and Oregon (except see Region 9 for Fort McDermitt Reservation)
Where EPA is Permitting Authority
AKG87###E	Indian Country and the Denali National Park and Preserve within Alaska
IDG87###E	Indian Country within Idaho, except Duck Valley Reservation (see Region 9)
ORG87###E	Indian Country within Oregon, except Fort McDermitt Reservation (see Region 9)
WAG87###E	Federal Facilities within Washington and Indian Country within Washington where there is no EPA-approved permitting program (e.g., the Puyallup Tribal trust lands within the 1873 survey area of the Puyallup Reservation)
Appendix D.
Notice of Intent Form
Part 7.8 requires you to use the NPDES eNOI System to prepare and submit your NOI unless the electronic system is unavailable. If you are given a waiver by the EPA Regional Office to use a paper NOI form, and you elect to use it, you must complete and submit the following form.

                 United States Environmental Protection Agency
                             Washington, DC 20460
Notice of Intent (NOI) of Coverage Under the Pesticide General Permit (PGP) for Discharges from the Application of Pesticides
                                 Form Approved
                              OMB No.
2040-0004
Submission of this completed Notice of Intent (NOI) constitutes notice that the Operator identified in Section B intends to be authorized to discharge pollutants to waters of the United States within the pest management area identified in Section C under EPA's Pesticide General Permit. Submission of this NOI constitutes notice that the party identified in Section B of this form has read, understands, and meets the eligibility conditions of Part 1 of the permit; agrees to comply with all applicable terms and conditions of the permit; and understands that continued authorization under the permit is contingent on maintaining eligibility for coverage. To be granted coverage, all information required on this form must be completed. Please read and make sure you comply with all permit requirements, including the requirement for large entities to prepare a Pesticide Discharge Management Plan (PDMP) prior to NOI submittal. Refer to the instructions at the end of this form to complete your NOI.
Approval to Use Paper NOI Form (Electronic Submission Waiver)
 Has the EPA Regional Office granted you a waiver from electronic reporting*?        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 Decision-maker is physically located in a geographical 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 Decision-maker has limitations regarding available computer access or computer capability.
 Name of EPA staff person who granted the waiver:

 Date approval obtained:

                                       /

                                       /

 *Note: You are required to obtain approval from the applicable EPA Regional Office prior to using this paper NOI form. If you have not obtained a waiver, you must file this form electronically using EPA's NPDES eReporting Tool (NeT) at https://www.epa.gov/npdes/pesticide-permitting.
A. Notice of Intent Status
 1. Mark whether this is the first time you are requesting coverage under the 2021 PGP, or if this is a change of information for a discharge already covered under the 2021 PGP. If this is a change of information, supply the NPDES permit tracking number for the discharge.
   a.  Original NOI Submission

   b.  NOI Change of Information:

 (NPDES Permit Tracking Number)

          Please note:  When selecting A.1.b please fill out Section B (Operator Name and Mailing Address) and the fields of the NOI that need to be modified.
B. Operator Information
  1.	Operator Name:

  2.	Operator Type (check one):
   a.	 Federal government	b.  State government	c. Local government
   d.	 Mosquito control district (or similar)	e.  Irrigation control district (or similar)	f.  Weed control district (or similar)
      g.  Other: If other, provide brief description of type of Operator:

  3.  Are you a large entity as defined in Appendix A of the permit?  (check one):   Yes	 No
     Please note: If you answer "Yes" to question 3 you are required to develop a Pesticide Discharge Management Plan (PDMP) and submit an Annual Report reflecting all pesticide uses for which you are requesting permit coverage under this NOI.

  4. In which state are your pest management areas located? Please specify only one state per NOI:

  5.	Mailing Address:
   a. Street:

   b. City:

                                                                      c. State:

 d. ZIP Code:

                                       -

   e. Telephone:

                                       -

                                       -

                                      Ext

                                                                        f. Fax:

                                       -

                                       -

   g. Contact Name:

   h. E-mail:

C. Pest Management Areas: Complete Section C for each Pest Management Area for which coverage under EPA's Pesticide General Permit is desired. Copy this section for additional Pest Management Areas.
Pest Management Area #___ of ##___
  1. Pest Management Area Name:
     Provide a map of the location of the Pest Management Area or describe the location of the Pest Management Area in detail.

   2. Are any of your activities for which you are requesting coverage under this NOI occurring on Indian Country?          Yes           No
        If yes, identify the reservation or otherwise describe those areas:

   3.  Are any of your activities (in this pest management area) for which you are requesting coverage under this NOI occurring on areas considered "federal facilities" as defined by the permit?   Yes       No
  4. Mailing address and contact information of the pesticide Applicator (or check here  if same as provided in Section B):
   a. Street:

   b. City:

                                                                      c. State:

 d. ZIP Code:

                                       -

   e. Telephone:

                                       -

                                       -

                                      Ext

                                                                        f. Fax:

                                       -

                                       -

   g. Contact Name:

   h. E-mail:

  5. Pesticide Use Patterns to be included in this Pest Management Area (check all that apply):
     a.  Mosquito and Other Flying Insect Pest  Control
   b.  Weed and Algae Pest Control
  c.  Animal Pest Control
  d.  Forest Canopy Pest Control
  6. 	Receiving Waters (check one):
   a.  Coverage requested for all waters of the United States within the Pest Management Area identified above.
   b.  Coverage requested specifically for the following waters of the United States within the Pest Management Area identified above.

   c.  Coverage requested for all waters of the United States within the Pest Management Area identified above except for:

     7.  Tier 3 Waters
    Is coverage requested for discharge to a Tier 3 water (Outstanding National Resource Water) of the United States?  Yes    No
If yes, answer a and b:
      	a. Name of Tier 3 water(s):
      b.	Provide rationale for determination that pesticide discharge is necessary to protect water quality, the environment, and/or public health and that any such discharge will not degrade water quality or will degrade water quality only on a short-term or temporary basis:

  8.  Water Quality, Impaired Waters
   Operators are not eligible for coverage under this permit for any discharges from a pesticide application to waters of the United States if the waters are identified as impaired by a substance which is either an active ingredient of the pesticide designated for use or is a degradate of such an active ingredient. See Part <IP_ADDRESS> of the permit. Check one:
     a.  Waters are NOT impaired by any substance which is either an active ingredient of a pesticide to be discharged or a degradate of such an active ingredient
     b.  Waters are on a current state list as being impaired by a substance which is either an active ingredient of a pesticide to be discharged or a degradate of such an active ingredient; however, evidence is attached documenting that the waters are no longer impaired.

D. Endangered Species Protection: Complete Section D for each Pest Management Area for which coverage under EPA's Pesticide General Permit is desired. Copy this section for additional Pest Management Areas.
Pest Management Area #___ of ##___
  1. Identify the criterion for which you are eligible for permit coverage as it applies to Federally Listed Threatened or Endangered Species (i.e., Species) and/or Federally Designated Critical Habitat (i.e., Habitat). Check one:
  a. 	Pesticide application activities will not result in a point source discharge to one or more waters of the United States containing National Marine Fisheries Service (NMFS) Listed Resources of Concern, as defined in Appendix A, of the PGP.
  b. 	Pesticide application activities for which permit coverage is being requested will discharge to one or more waters of the United States containing NMFS Listed Resources of Concern, as defined in Appendix A of the PGP, but consultation with NMFS under Section 7 of the Endangered Species Act (ESA) has been concluded for pesticide application activities covered under the PGP. Consultations can be either formal or informal, and would have occurred only as a result of a separate federal action. The consultation addressed the effects of pesticide discharges and discharge-related activities on federally-listed threatened or endangered species and federally-designated critical habitat, and must have resulted in either:
      i. A biological opinion from NMFS finding no jeopardy to federally-listed species and no destruction/adverse modification of federally-designated critical habitat; or
      ii. Written concurrence from NMFS with a finding that the pesticide discharges and discharge-related activities are not likely to adversely affect federally-listed species or federally-designated critical habitat.
  c. 	Pesticide application activities for which permit coverage is being requested will discharge to one or more waters of the United States containing NMFS Listed Resources of Concern, as defined in Appendix A of the PGP, but all "take" of these resources associated with such pesticide application activities has been authorized through NMFS' issuance of a permit under section 10 of the ESA, and such authorization addresses the effects of the pesticide discharges and discharge-related activities on federally-listed species and federally-designated critical habitat. (The term "take" means to harass, pursue, hunt, shoot, wound, kill, trap, capture, or collect, or to attempt to engage in any such conduct. See Section 3 of the Endangered Species Act, 16 U.S.C. § 1532 (19).)
  d. 	Pesticide application activities were, or will be, discharged to one or more waters of the United States containing NMFS Listed Resources of Concern, as defined in Appendix A of the PGP, but only in response to a Declared Pest Emergency Situation.
  e. 	Pesticide application activities for which permit coverage is being requested in the NOI will discharge to one or more waters of the United States containing NMFS Listed Resources of Concern, as defined in Appendix A of the PGP. Eligible discharges include those where the Decision-maker includes in the NOI written correspondence from NMFS that pesticide application activities performed consistent with appropriate measures will avoid or eliminate the likelihood of adverse effects to NMFS Listed Resources of Concern.
  f. 	Pesticide application activities for which permit coverage is being requested in the NOI will discharge to one or more waters of the United States containing NMFS Listed Resources of Concern, as defined in Appendix A of the PGP. Eligible discharges include those from pesticide application activities that are demonstrated by the Decision-maker as not likely to adversely affect NMFS Listed Resources of Concern or that the pest poses a greater threat to the NMFS Listed Resources of Concern than does the discharge of the pesticide.
  2. If you checked criterion d or criterion f above, provide the following information for all discharges to waters of the United States containing NMFS Listed Resources of Concern identified within the pest management area for which permit coverage is being requested. For discharges pursuant to criterion d, Declared Pest Emergency Situations, information for items a through g should also include any discharges that have already occurred prior to NOI submission as well as the activities you performed in the 15 day period before submission of this NOI was required. In some cases, implementation of pest management measures as specified in the permit involves a degree of "adaptive management" such that exact timing and quantities of applications cannot be determined in advance for the duration of the permit. In such cases, the permittee must provide the required information to the extent feasible and consistent with the implementation of the selected pest management measures.
   a.	Describe the location of the pest management area in detail or provide a map of the location
   b.	Pest(s) to be controlled:

   c.	Pesticide product(s) to be discharged and method of application:
   d. 	Planned quantity and rate of discharge(s) for each method of application:
   e.	Number of planned discharges:  ____________
   f.	Approximate date(s) of planned discharge(s):
   g.	Your rationale supporting your determination that you meet the criterion for which you are submitting this NOI, for example, the specific BMPs applied, visual monitoring, equipment and/or site inspections, and other appropriate measures that will be undertaken to avoid or eliminate the likelihood of adverse effects. For certifications pursuant to criterion d, indicate whether the discharge is likely to adversely affect NMFS Listed Resources of Concern in response to a pest emergency and, if so, any feasible measures to avoid or eliminate such adverse effects; for example, it is not sufficient to state that "integrated pest management procedures will be applied" without describing the specific measures to be taken (attach additional pages as necessary):

E. Certification
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 gather and evaluate the information submitted. On the basis of 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.
 Printed Name:

 Title:

 E-Mail:

  Signature/Responsible Official:

                                                                          Date:

                                       /

                                       /

NOI Preparer (Complete if NOI was prepared by someone other than the certifier)
 Preparer Name:

 Organization:

 Phone:

                                       -

                                       -

                                      Ext

                                                                          Date:

                                       /

                                       /

 E-Mail:

Instructions for Completing the Notice of Intent (NOI) for Coverage Under the Pesticide General Permit (PGP) for Discharges from the Application of Pesticides

Who Must File a NOI with EPA?
Any Operator, as described in Part 1.2.2 of the permit and meeting the eligibility requirements identified in Part 1.1 of the permit and Table 1-1 below must submit a complete and accurate NOI. As required in the permit, only certain Operators who are also Decision-makers must submit NOIs.
Table 1-1. Decision-Makers Required to Submit NOIs
PGP Part/
Pesticide Use
                    Which Decision-Makers Must Submit NOIs?
                  For Which Pesticide Application Activities?
All four use patterns identified in Part 1.1.1
Any Decision-maker with an eligible discharge to a Tier 3 water (Outstanding National Resource Water) consistent with Part <IP_ADDRESS>
Activities resulting in a discharge to a Tier 3 water
All four use patterns identified in Part 1.1.1
Any Decision-maker with an eligible discharge to waters of the United States containing NMFS Listed Resources of Concern, as defined in Appendix A
Activities resulting in a discharge to waters of the United States containing NMFS Listed Resources of Concern, as defined in Appendix A
1.1.1(a) -
Mosquito and Other Flying Insect Pest Control
Any Agency for which pest management for land resource stewardship is an integral part of the organization's operations.
All activities resulting in a discharge for which the Federal or State agency is responsible for pest control

Mosquito control districts, or similar pest control districts
All activities resulting in a discharge for which the Decision-maker is responsible for pest control

Local governments or other entities who exceed the annual treatment area threshold identified here
Adulticide treatment if more than 6,400 acres during a calendar year
1.1.1(b) -
Weed and Algae Pest Control
Any Agency for which pest management for land resource stewardship is an integral part of the organization's operations.
All activities resulting in a discharge for which the Federal or State agency is responsible for pest control

Irrigation and weed control districts, or similar pest control districts
All activities resulting in a discharge for which the Decision-maker is responsible for pest control

Local governments or other entities who exceed the annual treatment area threshold identified here
Treatment during a calendar year if more than either:
20 linear miles
OR
80 acres of water (i.e., surface area)
1.1.1(c) -
Animal Pest Control
Any Agency for which pest management for land resource stewardship is an integral part of the organization's operations.
All activities resulting in a discharge for which the Federal or State agency is responsible for pest control

Local governments or other entities who exceed the annual treatment area threshold identified here
Treatment during a calendar year if more than either:
20 linear miles
OR
80 acres of water (i.e., surface area)
1.1.1.(d) -
Forest Canopy Pest Control
Any Agency for which pest management for land resource stewardship is an integral part of the organization's operations.
All activities resulting in a discharge for which the Federal or State agency is responsible for pest control

Local governments or other entities who exceed the annual treatment area threshold identified here
Treatment if more than 6,400 acres during a calendar year
If you have questions about whether you need to file an NOI or questions about completing the form, see https://www.epa.gov/npdes/pesticide-permitting or contact the NOI Center toll free at<PHONE_NUMBER>.
One NOI can be submitted for multiple pest management areas in a state for which you are seeking permit coverage; however, no more than one state can be included on any single NOI form.
When to File the NOI?
Do not file your NOI until you have obtained and thoroughly read a copy of the permit. A copy of the permit is on EPA's website (https://www.epa.gov/npdes/pesticide-permitting).The permit describes procedures to ensure your eligibility, prepare your Pesticide Discharge Management Plan (PDMP), and complete the NOI form questions -- all of which must be done before you sign the NOI certification statement attesting to the accuracy and completeness of your NOI. You will also need a copy of the permit once you have obtained coverage so that you can comply with the implementation requirements of the permit. Note:  PDMP is not required for 1) any application made in response to a Declared Pest Emergency Situation, as defined in Appendix A of the permit; and 2) any Decision-maker who is required to submit an NOI solely because their application results in a point source discharge to waters of the United States containing NMFS Listed Resources of Concern, as defined in Appendix A of the permit.
Approval to Use Paper NOI Form: Note that you are not authorized to use this paper NOI 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.
For any discharges after October 31, 2021: Decision-makers meeting the eligibility requirements identified in the Part 1.1 of the permit and Table 1-1 must submit a complete and accurate NOI according to Table 1-2 and Table 1-3 and consistent with the requirements of Part 1.2 of the permit.  Note: NOIs submitted under the 2016 PGP are automatically terminated on October 31, 2021. Decision-makers who are required to submit an NOI must submit a new NOI to obtain coverage under the 2021 PGP.
Table 1-2. NOI Submittal Deadlines and Discharge Authorization Dates for Discharges from the Application of Pesticides [1]

Operator Type
                            NOI Submission Deadline
                        Discharge Authorization Date[2]
Any Decision-maker with any discharge to waters of the United States containing NMFS Listed Resources of Concern, except for those discharges in response to a Declared Pest Emergency Situation, as defined in Appendix A.
At least 30 days before any discharge to waters of the United States containing NMFS Listed Resources of Concern, as defined in Appendix A. [5]
No earlier than 30 days after EPA posts on the Internet a receipt of a complete and accurate NOI.[3, 5]
Any Decision-maker with a discharge in response to a Declared Pest Emergency Situation for which that activity triggers the NOI requirement identified in Part 1.2.2, except for any discharges to waters of the United States containing NMFS Listed Resources of Concern.
No later than 30 days after beginning discharge.
Immediately upon beginning to discharge for activities conducted in response to a Declared Pest Emergency Situation.
Any Decision-maker with any discharge to waters of the United States containing NMFS Listed Resources of Concern, in response to a Declared Pest Emergency Situation, as defined in Appendix A.
No later than 15 days after beginning to discharge in response to a Declared Pest Emergency Situation.
Immediately upon beginning to discharge for activities conducted in response to a Declared Pest Emergency Situation for a period of at least 60 days. [4]
Any Decision-maker who exceeds any annual treatment area threshold.
At least 10 days before exceeding an annual treatment area threshold.
No earlier than 10 days after EPA posts on the Internet receipt of a complete and accurate NOI.
Any Decision-maker otherwise required to submit an NOI as identified in Table 1-1
At least 10 days before any discharge for which an NOI is required
No earlier than 10 days after EPA posts on the Internet receipt of a complete and accurate NOI.
[1]   State, territory and tribal specific requirements in addition to the requirements in this table are provided in Part 9 of the permit.
[2]  	On the basis of a review of an NOI or other information, EPA may delay authorization to discharge beyond any timeframe identified in Table 1-2, determine that additional technology-based and/or water quality-based effluent limitations or other conditions are necessary, or deny coverage under this permit and require submission of an application for an individual NPDES permit, as detailed in Part 1.3 of the permit.
[3]	Within 30 days after EPA posts on the Internet receipt of a complete and accurate NOI, for those areas with NMFS Listed Resources of Concern, as defined in Appendix A of the permit, NMFS will provide EPA with a determination as to whether it believes the eligibility criterion of "not likely to adversely affect listed species or designated critical habitat" has been met, could be met with conditions that NMFS identifies, or has not been met. EPA expects to rely on NMFS' determination in deciding whether to withhold authorization. If NMFS does not provide EPA with this information within 30 days of EPA posting on the Internet receipt of a complete and accurate NOI, the discharges will be authorized 30 days after EPA posts on the Internet receipt of a complete NOI.
[4]	In any Declared Pest Emergency Situation in areas with waters of the United States containing NMFS Listed Resources of Concern, NMFS will have 30 days after submission of an NOI to provide EPA with a determination as to whether the eligibility criteria of "not likely to adversely affect listed species or designated critical habitat" has been met, could be met with conditions that NMFS identifies, or has not been met. EPA expects to rely on NMFS' determination in deciding whether to allow continued permit coverage and if additional conditions are necessary. If NMFS does not provide EPA with a recommendation within 30 days of EPA posting on the Internet receipt of a complete and accurate NOI, authorization for these discharges will continue. If EPA identifies additional permit conditions, or includes additional permit conditions recommended by NMFS, as necessary to qualify discharges as eligible for coverage beyond 60 days under the PGP, those conditions remain in effect for the life of the permit.
[5]	EPA may authorize certain discharges in less than 30 days, but no fewer than 10 days, for any discharges authorized under Criterion B, C, or E of Part <IP_ADDRESS> (for which NMFS has already evaluated the effects of these discharges).
 Table 1-3. NOI Change of Information Submittal Deadlines and Discharge Authorization Dates
Operator Type
                            NOI Submission Deadline
                         Discharge Authorization Date
Any Decision-maker requiring permit coverage for a pest management area not identified on a previously submitted NOI for this permit, except for discharges to any; (1) Tier 3 water, or (2) waters of the United States containing NMFS Listed Resources of Concern. Except for such waters, changes other than identification of a new pest management area or a new pesticide use pattern do not require a revised NOI submittal.
At least 10 days before beginning to discharge in that newly identified area unless discharges are in response to a Declared Pest Emergency Situation in which case not later than 30 days after beginning discharge.
No earlier than 10 days after EPA posts on the Internet the receipt of a complete and accurate NOI unless discharges are in response to a Declared Pest Emergency Situation in which case coverage is available immediately upon beginning to discharge from activities conducted in response to Declared Pest Emergency Situation.
Any Decision-maker discharging to a Tier 3 water not identified by name on a previously submitted NOI for this permit, except for Tier 3 waters containing NMFS Listed Resources of Concern
At least 10 days before beginning to discharge in that newly identified area unless discharges are in response to a Declared Pest Emergency Situation in which case not later than 30 days after beginning discharge.
No earlier than 10 days after EPA posts on the Internet the receipt of a complete and accurate NOI unless discharges are in response to a Declared Pest Emergency Situation in which case coverage is available immediately upon beginning to discharge from activities conducted in response to Declared Pest Emergency Situation.
Any Decision-maker with any discharge to waters of the United States containing NMFS Listed Resources of Concern, as defined in Appendix A, not identified on a previously submitted NOI for this permit. This includes changes in any treatment area, pesticide product, method or rate of application, or approximate dates of applications.
At least 30 days before beginning to discharge in that newly identified treatment area unless discharges are in response to a Declared Pest Emergency Situation in which case not later than 15 days after beginning discharge.
No earlier than 30 days after EPA posts on the Internet receipt of a complete and accurate NOI unless discharges are in response to a Declared Pest Emergency Situation in which case coverage is available immediately upon beginning to discharge from activities conducted in response to Declared Pest Emergency Situation.
Where to File the NOI
The Decision-maker must prepare and submit the NOI using EPA's NPDES eReporting Tool (NeT) available on EPA's website (https://www.epa.gov/npdes/pesticide-permitting) unless the Decision-maker is granted a waiver from the requirement to use NeT for submission of the NOI. See Part 8 of the PGP for EPA Regional contacts. The Electronic Submission Waiver is at the top of this form.
EPA will immediately post on EPA's Website all NOIs received. Late NOIs will be accepted, but authorization to discharge will not be retroactive.
If you are granted a waiver from using NeT; you must send the NOI form to one of the addresses listed below.
  Via United States Mail:
  United States Environmental Protection Agency
Office of Water, Water Permits Division
Mail Code 4203M, ATTN: NPDES Pesticides
1200 Pennsylvania Avenue, NW
Washington, DC 20460
  Via overnight/express delivery:
  United States Environmental Protection Agency
Office of Water, Water Permits Division
EPA East Building - Room 7420, ATTN: NPDES Pesticides
1201 Constitution Avenue, NW
Washington, DC 20004
  Phone:<PHONE_NUMBER>
If you have questions, contact EPA's Pesticides Notice Processing Center toll free at<PHONE_NUMBER>.
  If you file a paper NOI, submit the original with a signature in ink. Do not send copies. Also, faxed copies will not be accepted.
  If you are required to develop a PDMP, that document does not need to be submitted for review unless specifically requested by EPA. You must keep a copy of your PDMP on-site or otherwise make it available to facility personnel responsible for implementing provisions of the permit.
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. You may also use this paper form as a checklist for the information you will need when filing an NOI electronically via EPA's NPDES eReporting Tool (NeT).
Section A. NOI Status
1.	Indicate if this is the first time you are requesting coverage under the permit or if this is a change of information.
a.	Check this box if this is the first time you are requesting coverage under the permit for these discharges. If this is the first time you are requesting coverage, refer to Table 1-2 for NOI submittal deadlines and discharge authorization dates.
b.	Check this box if this is a change of information for a discharge already covered under the permit. If this is a change of information, supply the NPDES permit tracking number that you received in your confirmation letter or e-mail from EPA's Pesticide Notice Processing Center. You can find the tracking number assigned to your previous NOI using EPA's NeT. For additional details regarding a change of information, see Table 1-3. Also fill out Section B of this form (Operator Name and Mailing Address) and the associated fields of information that need to be modified on the NOI.
Section B. Operator Information
1.	Provide the legal name of the person, firm, public organization or any other public entity who is the Decision-maker for the pesticides applications described in this notice. A Decision-maker is an Operator who has control over the decision to perform pesticide applications including the ability to modify those decisions that result in a discharge to waters of the United States.
2.	Indicate the type of Operator: federal government, state government, local government, mosquito control district (or similar), irrigation control district (or similar), weed control district (or similar), or other. If other, provide brief description of type of Operator in the space provided.
3.	Indicate whether or not you are a "large entity" as defined in Appendix A of the permit. Note that if you are a large entity, you are required to develop a Pesticide Discharge Management Plan (PDMP) and submit future Annual Reports reflecting all pesticide uses for which you are requesting permit coverage under this NOI.
4.	Indicate which state your pest management areas are located. Specify only one state per NOI. If there is more than one state, additional NOIs must be submitted.
5.	Provide the Decision-maker's mailing address, telephone number, fax number (optional), name, and e-mail address. Correspondence will be sent to this address.
Section C. Pest Management Area: Information for each Pest Management Area for which coverage under EPA's Pesticide General Permit is desired.
1.	Indicate whether you are submitting an NOI for multiple pest management areas. A pest management area is the area of land, including any water, for which you have responsibility and are authorized to conduct pest management activities as covered by this permit (e.g., if you are a mosquito control district, your pest management area is the total area of the district). You must complete a Section C for each pest management area. If you are submitting an NOI for only one area, enter "1" of "1." If you are submitting NOIs for multiple pest management areas, enter the number for the NOI for which you are requesting coverage followed by the total number of pest management areas for which you are requesting coverage. Enter the name of the pest management area. Attach a map of the pest management area or describe the location of the pest management area in the space provided. A mapping tool is available at https://www.epa.gov/npdes/pesticide-permitting.
2.	Indicate whether pesticide application will occur on Indian Country, and if so, provide the name of the reservation, if applicable.
3.	Indicate whether pesticide application will occur on a Federal Facility, as defined in Appendix A of the permit.
4.	Enter the mailing address of the contact person for the pest management area. If this address is the same as the Decision-maker's mailing address, indicate that by checking the box. If it is a different address, enter the mailing address, telephone number, fax number (optional), contact name, and e-mail address.
5.	Indicate the pesticide use patterns for the pest management area for which the NOI is required. For additional information regarding pesticide use patterns, see Part 1.1.1 of the permit. Check all the use patterns that apply to the pest management area.
6.	Indicate if permit coverage is being requested for all waters of the United States within the pest management area or if permit coverage is being requested to specific waters of the United States within the pest management area. If specific waters are being requested, write the names of the waterbodies. If permit coverage is being requested for all waters of the United States within the pest management area except for specific waterbodies, name those specific waterbodies in the space provided. EPA's Water Locator Tool can help you identify the closest receiving water to your facility (http://www.epa.gov/waterdata/waters-tools).
7.	Indicate if permit coverage is being requested to discharge to a Tier 3 (Outstanding National Resource Water) water of the United States. If yes, write the name(s) of the Tier 3 water(s) in the space provided. Describe and demonstrate why it is necessary to apply the pesticide discharge to protect the water quality, environment, and/or public health and that any such discharge will not degrade water quality or will degrade water quality only on a short-term or temporary basis.
8.	Verify that waters within the pest management area are either not impaired by substances which are either active ingredients in the pesticide planned for use or degradates of such active ingredients, OR that evidence shows that the target waters in question are no longer impaired. See Part <IP_ADDRESS> of the permit for more information on discharges to Water Quality Impaired Waters.
Section D. Endangered Species Protection. Complete Section D for each Pest Management Area for which coverage under EPA's PGP is desired.
Identify the Pest Management Areas, corresponding to those in Part C.
1. Coverage under the permit is available only for discharges and discharge-related activities, as defined in Appendix A of the permit, that are not likely to jeopardize the continued existence of any species that are federally- listed as endangered or threatened ("listed") under the Endangered Species Act (ESA) and not likely to result in the adverse modification or destruction of habitat that is federally-designated as critical under the ESA ("critical habitat") except as provided in criterion b, c, and for at least 60 days, d, below. For a subset of listed species and critical habitat, identified as NMFS Listed Resources of Concern and defined in Appendix A of the permit, there are specific criteria for determining eligibility. To demonstrate eligibility, you must meet one or more of the six criteria (a-f) for the entire term of coverage under the permit.
2. If you checked criterion d or criterion f, you are required to provide a description of the location of the pest management area or a map of the location of the pest management area, the pest(s) to be controlled, pesticide product(s) to be discharged and method of application, planned quantity and rate of discharge(s) for each application method, number of planned discharges, approximate date(s) of planned discharge(s), and the rational supporting your determination that you meet the criterion for which the Decision-maker is submitting this NOI and documentation demonstrating the finding of "not likely to adversely affect." If you certify under criteria f and do not hear from EPA within 30 days, you may assume your discharge is authorized. For certifications pursuant to criterion d, indicate whether the discharge is likely to adversely affect NMFS Listed Resources of Concern and, if so, any feasible measures to avoid or eliminate such adverse effects. If you are certifying under criterion d (which allows you to discharge 15 days before you even submit your NOI), your NOI should describe both the pest emergency activities you plan to do after you submit your NOI as well as the activities you performed in that 15 day period before you had to submit the NOI. See Part <IP_ADDRESS> of the permit for more information regarding Endangered and Threatened Species and Critical Habitat Protection. If you certify under criterion d and do not hear from EPA, you may assume that permit authorization continues unless notified otherwise. EPA may authorize certain discharges in less than 30 days, but no fewer than 10 days, for any discharges authorized under criterion b, c, or e (for which NMFS has already evaluated the effects of these discharges). If you certify under one of these criteria and do not hear from EPA within 30 days, you may assume your discharge is authorized.
Section E. Certification
Enter the certifier's printed name and title. Sign and date the form. For more information about the certification statement and signature, see 40 CFR 122.41(k). (CAUTION: An unsigned or undated form will not be accepted.) Federal statutes provide for severe penalties for submitting false information. Federal regulations require this application to be signed as follows:
For a corporation: by a responsible corporate officer, means:
(i)  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 that govern the operation of the regulated activity 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.
If the NOI was prepared by someone other than the certifier (for example, if the NOI was prepared by the PDMP contact or a consultant for the certifier's signature), include the name, organization, phone number and e-mail address of the NOI preparer.
Paperwork Reduction Act Notice
The public reporting and recordkeeping burden for this collection of information is estimated to average 2.5 hours or 150 minutes 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, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed NOI form to that address.

Appendix E.
Notice of Termination Form
Part 7.8 requires you to use the NPDES eNOI System to prepare and submit your NOT unless the electronic system is unavailable. If you are given a waiver by the EPA Regional Office to use a paper NOT form, and you elect to use it, you must complete and submit the following form.

                 United States Environmental Protection Agency
                             Washington, DC 20460
Notice of Termination (NOT) of Coverage under the Pesticide General Permit (PGP) for Discharges from the Application of Pesticides
                                 Form Approved
                              OMB No.
2040-0004
Approval to Use Paper NOT Form (Electronic Submission Waiver)
 Has the EPA Regional Office granted you a waiver from electronic reporting*?	 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 Decision-maker is physically located in a geographical 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 Decision-maker has limitations regarding available computer access or computer capability.
 Name of EPA staff person  who granted the waiver:

 Date approval obtained:

                                       /

                                       /

 *Note: You are required to obtain approval from the applicable EPA Regional Office prior to using this paper NOT form. If you have not obtained a waiver, you must file this form electronically using EPA's NPDES eReporting Tool (NeT) at https://www.epa.gov/npdes/pesticide-permitting.
A. Permit Information
1. NPDES Permit Tracking Number:

2. Reason for termination (check one only):
    a. You have ceased all discharges from the application of pesticides for which you obtained permit coverage and you do not expect to discharge during the remainder of the permit term.
    b. You have obtained permit coverage under an NPDES individual permit or alternative NPDES general permit for all pesticide discharges requiring NPDES permit coverage.
    c. A new Operator has taken over decision-making responsibility for the pest control activities covered under an existing NOI. Provide the transfer date and the new Operator information.
                                                              Date of transfer:

                                       /

                                       /

  New Operator Name:

  Street:

  City:

State:

ZIP Code:

                                       -

Telephone:

                                       -

                                       -

                                     Ext.

  E-mail:

B. Operator Information
1. Operator Name:

2. Mailing Address:

  Street:

  City:

State:

ZIP Code:

                                       -

Telephone:

                                       -

                                       -

                                     Ext.

3. Contact Name:

  E-mail:

C. Certification
I certify under penalty of law that I have met at least one of the reasons for terminating permit coverage listed in Section A above. I understand that by submitting this Notice of Termination, I am no longer authorized  to discharge pesticides to waters of the United States. This document and all attachments were prepared under my direction and supervision in accordance with a system designed to ensure that qualified personnel properly gather and evaluate the information submitted. On the basis of 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 or imprisonment. Additionally, I understand that the submittal of this Notice of Termination does not release a pesticide Operator from liability for any violations of the Clean Water Act.
 Printed Name:

 Title:

 E-Mail:

 Signature/Responsible Official:

                                                                          Date:

                                       /

                                       /

NOT Preparer (Complete if NOT was prepared by someone other than the certifier)
 Preparer Name:

 Organization:

 Phone:

                                       -

                                       -

                                     Ext.

                                                                          Date:

                                       /

                                       /

 E-Mail:

Instructions for Completing the Notice of Termination (NOT) of Coverage under the Pesticide General Permit (PGP) for
                 Discharges from the Application of Pesticides

Who Must File an NOT with EPA?
Any Operator required to submit a Notice of Intent (NOI) is required to submit a Notice of Termination (NOT) to end coverage under this permit. However, if EPA notifies the Operator to apply for an NPDES individual permit or alternative general permit, coverage under this permit terminates automatically. Dischargers automatically covered under this permit as identified in Part 1.2.3 of the permit are likewise automatically terminated upon permanent cessation of discharge consistent with any of the criteria identified in Part <IP_ADDRESS> of the permit. As required in the permit, only certain Operators who are also Decision-makers must submit NOIs. Note: NOIs submitted under the 2016 PGP are automatically terminated on October 31, 2021. Decision-maker who are required to submit an NOI must submit a new NOI to obtain coverage under the 2021 PGP.
If you have questions about whether you need to file an NOT or questions about completing the form, see https://www.epa.gov/npdes/pesticide-permitting or contact the NOI Center toll free at<PHONE_NUMBER>.
When to File the NOT?
Approval to Use Paper NOT Form: 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.
Operators must file the NOT form within 30 days after one or more of the conditions in Part <IP_ADDRESS> of the permit have been met.
Where to File the NOT?
Consistent with Part <IP_ADDRESS> of the permit, the Operator must submit the NOT using EPA's NPDES eReporting Tool (NeT) available on EPA's website (https://www.epa.gov/npdes/pesticide-permitting) unless the Operator is granted a waiver from the requirement to use NeT for submission of the NOT. See Part 8 of the PGP for EPA Regional contacts. The Electronic Submission Waiver is at the top of this NOT form.
Filing electronically is the fastest way to terminate permit coverage and help ensure that your NOT is complete.
If you are granted a waiver from using NeT; you must send the NOT form to one of the addresses listed below.
  Via United States Mail:
  United States Environmental Protection Agency
Office of Water, Water Permits Division
Mail Code 4203M, ATTN: NPDES Pesticides
1200 Pennsylvania Avenue, NW
Washington, DC 20460
  Via overnight/express delivery:
  United States Environmental Protection Agency
Office of Water, Water Permits Division
EPA East Building - Room 7420, ATTN: NPDES Pesticides
1201 Constitution Avenue, NW
Washington, DC 20004
Phone:<PHONE_NUMBER>
If you file a paper NOT, submit the original form with a signature in ink. Do not send copies. Also, faxed copies will not be accepted.
Completing the NOT Form
To complete this form, type or print in uppercase letters in the appropriate areas only. 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. You can also use this paper form as a checklist for the information you will need when filing an NOT electronically via EPA's NPDES eReporting Tool (NeT).
Section A. Permit Information
1.	Enter the existing NPDES Permit Tracking Number assigned by NeT or EPA's Pesticides Processing Center. You can find the tracking number assigned to your previous NOI using EPA's NeT.
2.	Select the appropriate box to indicate why you are submitting an NOT to end permit coverage. Select one of the three termination options:
  a. 	Select this box if you have ceased all discharges from the application of pesticides for which you obtained permit coverage and you do not expect to discharge during the remainder of the permit term.
  b. 	Select this box if you have obtained NPDES individual permit coverage or alternative NPDES permit coverage.
  c. 	Select this box if a new Operator has taken over decision-making responsibility of pest control activities covered under an existing NOI and you are no longer the Operator. Provide the date of transfer and the name and contact information of the new Operator.
Section B. Operator Information
1.	Provide the full legal name of the person, firm, public organization, or other entity that is the Operator who is the Decision-maker for the pesticide application described in this application.
2.	Provide the Operator's mailing address and telephone number. Correspondence will be sent to this address.
3.	Provide a contact person's full legal name and e-mail address. This person will be contacted regarding any NOT communication.
Section C. Certification
Carefully read the certification statement. By completing and submitting the NOT, the Operator certifies that the Operator is no longer authorized to discharge pesticides to waters of the United States. Provide the printed full legal name, title and email address of the certifier. 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 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 that govern the operation of the regulated activity 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.
If the NOT was prepared by someone other than the certifier (for example, if the NOT was prepared by the PDMP contact or a consultant for the certifier's signature), include the name, organization, phone number and e-mail address of the NOT preparer.
Paperwork Reduction Act Notice
The public reporting and recordkeeping burden for this collection of information is estimated to average 0.5 hours or 30 minutes 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, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed NOT form to that address.

Appendix F.
Pesticide Discharge Evaluation Worksheet

                 United States Environmental Protection Agency
                             Washington, DC 20460
Pesticide Discharge Evaluation Worksheet for the Pesticide General Permit (PGP) for Discharges from the Application of Pesticides
                                 Form Approved
                               OMB No.
2040-0004
 This worksheet is for any Operator who is also a Decision-maker required to submit a Notice of Intent (NOI) and is a small entity, as defined in Appendix A of the Pesticide General Permit (PGP). The information on this worksheet must be retained for each pesticide application activity.
A. General Information
 1. Operator Name:

 NPDES Permit Tracking Number:

 2. Worksheet Preparer Name: