NPDES Permit for Stormwater Discharges from Construction Activities- forms

This page last revised March 2019

Although we do our best to keep these forms up to date, they are occasionally updated by DEP and the most current forms are available on the Department of Environmental Protection (DEP)'s "eLibrary" website. If you are aware of updated forms not included on this page please notify us at your convenience. Thank you.

NEW-- Summary Sheet, Instructions for a General (PAG-02) OR Individual NPDES Permit for Stormwater Discharges Associated with Construction Activities, and Form FP to 001, Certification of Origin of Clean Fill:
Instructions (PDF), revised March 2019

NEW-- Notice of Intent for coverage under the General (PAG-02) NPDES Permit OR Application for an Individual NPDES Permit for Stormwater Discharges Associated with Construction Activities, Checklists for both, Appendix A land use information questions, Appendix B and C (Sample County and Sample Municipal land use letters), Appendix D. Worksheets 1-6; 10-15, and Checklist for Functional Equivalency of Riparian Buffers and Riparian Forest Buffers are included in this 40 page (total pages) document:
Notice of Intent or Application for a NPDES permit, revised March 2019 

General Information Form (GIF), Instructions, and Checklist (this form is used for several DEP permit/programs; required also for an Individual Permit NPDES for Stormwater Discharges Associated with Construction Activities):

GIF (PDF), May 2012

Instructions (PDF), May 2012

Checklist (PDF), May 2012


NPDES "self-inspection" Report Form (NPDES permits require owner or operator to document operation and maintenance of all site BMPs on a weekly basis and after each stormwater event): Visual Site Inspection Report (PDF), May 2018


Transferee/Co-Permittee Application for a General OR Individual NPDES Permit for Stormwater Discharges Associated with Construction Activities:
Transferee/Co-Permittee Application (PDF), revised September 2016

Co-Permittee Liability Release Form, to remove a Co to Permittee from a permitted site when the co to permittee is no longer an operator of the construction activity at an unstabilized site: Co-Permittee Liability Release Form (PDF), dated July 2017


Notice of Termination of a General OR Individual NPDES Permit for Discharges of Stormwater Associated with Construction Activities -OR- for an Erosion and Sediment Control Permit (Permit applied for BEFORE November 19, 2010; form "a"): Notice of Termination for a NPDES permit (Permit applied for BEFORE November 19, 2010) (PDF), revised July 2017


Notice of Termination of a General OR Individual NPDES Permit for Discharges of Stormwater Associated with Construction Activities -OR- for an Erosion and Sediment Control Permit (Permit applied for AFTER November 19, 2010; form "b"): Notice of Termination for a NPDES permit (Permit applied for AFTER November 19, 2010) (PDF), revised January 2018

This document is a sample Instrument for the Declaration of Restrictions and Covenants (Instrument). Use of this template is not mandatory, but it is recommended...
Sample Instrument (PDF), (no date) 

Document providing some guidance on instrument filing (required for NPDES termination process when sites completed), providing 5 scenarios as examples. Note: this does not cover every possible scenario or situation.
Instrument Filing Scenarios (PDF), dated January 2018

Sample New Property Owner PCSM BMP(s) Notification and Operation and Maintenance Agreement: Sample Agreement (PDF), (no date)

Pennsylvania "Conservation Explorer" tool

In March 2016, the Pennsylvania Natural Heritage Program replaced the Pennsylvania Natural Diversity Inventory (PNDI) Environmental Review tool with the new Pennsylvania Conservation Explorer. This new tool is a "one stop shop" for conservation planning and PNDI Environmental Review. The Explorer provides conservation information on biological diversity, protected lands, streams and other natural resources for planning purposes and also allows users to screen a project area for potential impacts to threatened, endangered, and special concern species. As a reminder, a PNDI receipt is needed to apply for most permits and approvals under the Chapter 102 and 105 programs. In order to obtain an online search receipt, the Pennsylvania Natural Heritage Program charges a convenience fee of $40.00 per project using Visa, MasterCard or Discover Card. Government agencies and Municipalities are exempt from this convenience fee.

To conduct a PNDI search online, go to the Pennsylvania Natural Heritage Program site and follow the Quick Links for CONSERVATION EXPLORER.

  • In addition, users may submit for a fee free manual review (For sites of any size, review free of cost- see instructions): PNDI Manual Submission Form (PDF), revised February 2016. A manual review may take 4 to 8 weeks or longer for results.

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