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Wastewater and State Revolving Fund (SRF) Forms
Permitting information

Transmittal form & number
for permit applications


Fees & payments

Master list of forms
SRF - Clean Water and Drinking Water

Analysis of Homeowner Septic Repair Special Revenue Account

Revised March 2003.
Used by Commonwealth communities participating in Title 5 betterment loans, for their quarterly reporting requirements.
Filing Options: MS Word Form 176 KB | PDF Form 15 KB

SRF Loan Application - Planning Stage

Revised January 2008.
Financial Assistance Application Form for use by local governments with Planning projects appearing on the CWSRF or DWSRF Intended Use Plan.
Filing Options: MS Word Form 691 KB | PDF Form 146 KB

Clean Water SRF

2008 CWSRF Project Evaluation Form (PEF)

Revised June 2007.
Notice of project solicitation and Project Evaluation Form for the Clean Water SRF Program for 2008.
Cover letter: MS Word 46 KB | PDF 18 KB
Filing Options: MS Word Form 389 KB | PDF Form 53 KB
Instructions: MS Word 101 KB | PDF 61 KB

2008 CWSRF Project Selection Criteria

Revised June 2007.
MassDEP rating criteria for the 2008 Clean Water SRF project selection.
Filing Options: MS Word Form 120 KB | PDF Form 25 KB

Loan Application - Construction Stage

Revised January 2008.
Financial Assistance Application Form for use by local governmental units with Construction projects appearing on the CWSRF Intended Use Plan.
Filing Options: MS Word Form 785 KB | PDF Form 180 KB

Drinking Water SRF

2008 DWSRF Project Evaluation Form (PEF)

Revised June 2007.
Project Evaluation Form and instructions for the 2008 Drinking Water SRF Project Solicitation.
Cover letter: MS Word 48 KB | PDF 19 KB
Filing Options: MS Word 343 KB | PDF 67 KB
Instructions: MS Word 64 KB | PDF 35 KB

2008 DWSRF Project Selection Criteria

Revised June 2007.
MassDEP rating criteria for the 2008 Drinking Water SRF project selection.
Filing Options: MS Word Form 67 KB | PDF Form 24 KB

DWSRF Loan Application and Financial Assistance Application form

Revised January 2008.
For use by local governmental units and other public water suppliers with projects appearing on the DWSRF Intended Use Plan.
Filing Options: MS Word Form 729 KB | PDF Form 164 KB

Plan & Spec Package

Complete Plan & Specification Preparation Package

Revised September 2007.
For preparing SRF Construction Plans and Specifications, including supplemental forms for Minority and Women-Owned Business requirements. The  checklist portion of this package can also be downloaded separately (see below).
Filing Options: MS Word Form 793 KB | PDF Form 393 KB

Plan and Specification Checklist
Checklist portion ONLY of Plan and Specification preparation package. Supplemental forms are not included.
MS Word 224 KB | PDF 75 KB

Revised Cost Estimate Summary Sheet

Revised April 2002.
Use with State Revolving Fund applications.
Filing Options: MS Word Form 125 KB | PDF Form 16 KB

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Groundwater Discharge/Water Reuse Permits

Frequently Asked Questions and more information about Groundwater Discharge permitting

Web page

Permitting Process for Groundwater Discharge permitting

Web page

Permitting Process for Water Reuse Projects

Web page

314 CMR 2.00: Permit Procedures

Procedures for processing applications for surface water discharges, groundwater discharges, and sewer extensions and connections. Updated on 12/27/96.
Web page

BRP WP 05 Groundwater Discharge - Experimental

Revised November 2003.
Filing Options: MS Word Form 247 KB | PDF Form 115 KB
Instructions: MS Word 535 KB | PDF - included with form above

BRP WP 06, 08 - Groundwater Discharge - Major & Minor

Revised November 2003.
Filing Options MS Word Form 247 KB | PDF Form 116 KB
Instructions: MS Word 598 KB | PDF - included with form above

BRP WP 10 - Groundwater Discharge - Other

Revised November 2003.
Filing Options MS Word Form 247 KB | PDF Form 114 KB
Instructions: MS Word 486 KB | PDF - included with form above

BRP WP 11, 12 - Groundwater Discharge - Renewals

Revised November 2003.
Filing Options: MS Word Form 247 KB | PDF 118 KB
Instructions: MS Word 542 KB | PDF - included with form above

BRP WP 42 Groundwater Discharge - Reclamation Projects

Revised November 2003.
Filing Options: MS Word Form 247 KB | PDF Form 114 KB
Instructions: MS Word 539 KB | PDF - included with form above

Certification form

Revised November 2003.
To accompany Forms BRP WP 05, 06, 08, 10, 11, 12, and 42 as required.
Filing Options: MS Word Form 113 KB | PDF Form 11 KB

BRP WP 68 - Treatment Works Plan Approval

Revised June 2007.
Instructions: MS Word 411 KB | PDF 29 KB

Groundwater Discharge Reporting

Groundwater Discharge Report Forms

Filing Options: eDEP Online

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Industrial Wastewater/Holding Tanks

BWP IW 02, 03, 05, 30, 31, 32 - Groundwater Discharge

Revised January 2002.
Filing Options: MS Word Form 399 KB | PDF 208 KB
Instructions: MS Word 570 KB | PDF - included with form above

BWP IW 16, 18, 26, 27, 35, 36, 37 - Surface Water Discharge (NPDES)

Revised October 2005.
Filing Options: MS Word 327 KB | PDF 759 KB
Instructions: MS Word 533 KB | PDF - included with form above

BWP IW 38, 39 - Permit for Industrial Sewer User

Revised March 2008.
Application Form
MS Word Form 312 KB

Instructions
MS Word 608 KB

Toxic Pollutants Form
MS Word Form 210 KB

Additional IWPS Form
MS Word Form 180 KB

Documentation of Public Notice Form
MS Word 134 KB

Fact Sheet for Facilities in the MWRA Service Area
MS Word 45 KB

NOTE: If you need these forms in an alternate format, please contact John Reinhardt at 617-292-5667 or john.reinhardt@state.ma.us.

Industrial Wastewater Sewer Connection Certification

Web page

Industrial Wastewater Holding Tank Compliance Certification (DEP 01) & Return to Compliance Plan

Web page

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Residuals Management Approvals

BRP WP 28 Sampling and Analysis Plan Approval
BRP WP 29 Approval of Suitability (AOS)
BRP WP 30 Certification of Land Application Projects Greater than or Equal to 0.5 Acres in Size
BRP WP 31 Certification of Land Application Projects Less than or Equal to 0.5 Acres in Size
BRP WP 32 Renewals or Modifications to Land Application Certifications

Revised February 2002
Filing Options: MS Word Form 415 KB | PDF 279 KB
Instructions: MS Word 542 KB | PDF - included with form above

BRP WP 33 - Approval of Wastewater Treatment Residual Landfills

Revised June 2007.
Instructions: MS Word 572 KB | PDF 154 KB

BRP WP 34 - Approval of Closure Plans for Wastewater Residual Landfills

Revised June 2007.
Instructions: MS Word 521 KB | PDF 158 KB

BRP WP 35 - Approval of Design Plans and Specifications for Residuals Treatment Facilities

Revised June 2007.
Instructions: MS Word 521 KB | PDF 51 KB

BRP WP 44 Modifications to Residuals Management Landfills

Revised June 2007.
Instructions: MS Word 523 KB | PDF 157 KB

BRP WP 45 - Modifications to Residuals Management Facilities

Revised June 2007.
Instructions: MS Word 486 KB | PDF 57 KB

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Sanitary Sewer Overflow/Bypass/Backup Notification

Owners and operators of wastewater collection or treatment systems must notify MassDEP by phone and in writing whenever there is an emergency overflow, bypass of wastewater or a backup of sewage into a building, within 5 days of the time you become aware of the overflow, bypass or backup.

Revised May 2005.
Filing Options: MS Word Form 149 KB | PDF Form 46 KB
Instructions: MS Word 176 KB | PDF - included with form above

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Sewer Connections/Extensions

Important Note: The Bureau of Resource Protection (BRP) issues sewer connection and extension permits for domestic sewage from residential, educational, and commercial facilities. The Industrial Wastewater Program of the Bureau of Waste Prevention (BWP) issues permits for wastewater generated by certain industrial facilities.

List by SIC Code of industrial facilities regulated by BWP
Web page

BWP IW 38, 39 - Permit for Industrial Sewer User

Revised January 2007.
Web page

Industrial Wastewater Sewer Connection Certification

Web page

BRP WP 55, 71, 74 - Sewer System Extension, Connection, or Industrial Wastewater

Revised January 2007.
Filing Options: MS Word Form 198 KB | PDF 70 KB
Instructions: MS Word 252 KB | PDF - included with form above

BRP WP 72, 73 - Compliance Certification for Sewer Extensions less than 1000 ft or Sanitary & Industrial Connections 15,000-50,000gpd

Revised January 2007.
Filing Options: MS Word Form 174 KB | PDF 66 KB
Instructions: MS Word 135 KB | PDF - included with form above

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Stormwater

How Stormwater Permitting Works

Web page

BRP WM 08 - NPDES Stormwater General Permit Notice of Intent for Discharges from Small Municipal Separate Storm Sewer Systems (MS4s)

Revised March 2007.
Filing Options: MS Word 161 KB | PDF 206 KB
Instructions: MS Word 306 KB | PDF - included with form above
Excel Time Frames Form: MS Excel 161 KB | PDF 60 KB

BRP WM 09 - Approval of NPDES Stormwater Pollution Prevention Plans for Construction or Industrial General Permits Discharging to Outstanding Resource Waters (ORWs)

Revised March 2007.
Filing Options: MS Word 121 KB | PDF 225 KB
Instructions: MS Word 501 KB | PDF - included with form above

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Surface Water Discharge Permits (NPDES General Permits)

NPDES Permitting Q&A

Web page

BRP WM 10 - Request for General Permit Coverage: Construction Site Dewatering

Revised October 2005.
Filing Options MS Word Form 155 KB | PDF Form 65 KB
Instructions: MS Word 435 KB | PDF - included with form above

BRP WM 11 - Request for General Permit Coverage: Surface Water Discharge Of Non-Contact Cooling Water

Revised October 2005.
Filing Options MS Word Form 142 KB | PDF Form 72 KB
Instructions: MS Word 433 KB | PDF - included with form above

BRP WM 12 - Request for General Permit Coverage: Remediation & Miscellaneous Contaminated Sites

Revised June 2007.
MassDEP is accepting EPA's Notice of Intent Form for this pemit.
More information:
From US EPA:
US EPA Web site
EPA Form ("Notice of Intent Instructions and Suggested Form")
US EPA Web site
Instructions: MS Word 270 KB | PDF 35 KB

BRP WM 13 - Request for General Permit Coverage: Surface Water Discharge from a Water Treatment Facility

Revised May 2003.
Filing Options MS Word Form 141 KB | PDF Form 59 KB
Instructions: MS Word 435 KB | PDF - included with form above

BRP WM 14 - Request for General Permit Coverage: Surface Water Discharge Of Reverse Osmosis Reject Water

Revised May 2003.
Filing Options MS Word Form 168 KB | PDF Form 100 KB
Instructions: MS Word 436 KB | PDF - included with form above

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Surface Water Discharge Permits (NPDES - Non-Industrial)

BRP WM 02A - Application for Permit to Discharge Municipal Wastewater

Revised August 2007.
Filing Options MS Word Form 186 KB | PDF Form 63 KB
Instructions: MS Word 392 KB | PDF - included with form above

BRP WM 05 - Permit and Plan Approval for Type II Discharge (Non-Industrial)

Revised May 2003.
Filing Options MS Word 191 KB | PDF 87 KB
Instructions: MS Word 503 KB | PDF - included with form above

BRP WM 06 - Permit and Plan Approval for Type I Discharge (Non-Industrial)

Revised May 2003.
Filing Options MS Word 160 KB | PDF 87 KB
Instructions: MS Word 503 KB | PDF - included with form above

BRP WM 07 - Permit Renewal/Plan Modification (Non-Industrial)

Revised June 2007.
Filing Options MS Word 191 KB | PDF 87 KB
Instructions: MS Word 503 KB | PDF - included with form above

BRP WP 68 - Treatment Works Plan Approval (June 2007)

Revised June 2007.
Instructions: MS Word Form 411 KB | PDF Form 29 KB

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Wastewater Operator Certification

Graded wastewater treatment plants by town

Revised August 2005.
Contact the Board of Wastewater Treatment Plants Certification Program in writing if there are any changes to your facility name, address or grading.
Combined municipal and industrial list: MS Word 514 KB | PDF 258 KB
List of municipal WT plants: MS Word 160 KB | PDF 86 KB
List of industrial WT plants: MS Word 341 KB | PDF 166 KB

Status Change Form

Revised October 2005.
For changes in operator contact information or to make other changes in status that do not require passing an exam.
Filing Options: MS Word 51 KB | PDF 33 KB

Upgrade to Emergency Certification

Revised October 2005.
To enable an operator to work at a facility for up to six months in a position for which the operator is not otherwise certified.
Filing Options: MS Word 44 KB | PDF 24 KB

Upgrade to Provisional Certification

Revised October 2005.
To allow an operator with emergency certifications to continue as operator at a specified facility for an additional six months under certain circumstances.
Filing Options: MS Word 45 KB | PDF 25 KB

Upgrade to Combined Grade 7

Revised October 2005.
To certify an operator as Grade 7.
Filing Options: MS Word 44 KB | PDF 25 KB

Reciprocity

Revised October 2005.
To allow an operator certified in other states to apply for certification in Massachusetts.
Filing Options: MS Word 45 KB | PDF 25 KB

Statement of Qualifications

Revised October 2005.
To document an operator's status as a certified operator.
Filing Options: MS Word 31 KB | PDF 12 KB

Education Requirements for Recertification

Revised October 2005.
Documentation requirements for training or coursework in order for operators to receive Training Contact Hours.
Filing Options: MS Word 39 KB | PDF 25 KB

Request for Training Contact Hours Evaluation

Revised October 2005.
To be used by providers of training and/or operators to provide information about opportunities to earn Training Contact Hours.
Filing Options: MS Word 33 KB | PDF 20 KB

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