1. Instructions: UIC Class V Well Motor Vehicle Rinse Water, Snow/Ice Melt or Rain Drip Non-Exposure Form and Certification Statement doc format of Instructions: UIC Non-Exposure Form
pdf format of UIC Non-Exposure Form

  2. UIC Class V Well Motor Vehicle Rinse Water, Snow/Ice Melt or Rain Drip Non-Exposure Form and Certification Statement doc format of UIC Non-Exposure Form
pdf format of UIC Non-Exposure Form

Permit Fact Sheet 

  1. Introduction

    For the purpose of this form and its instructions, all references to Motor Vehicle Rinse Water shall be interpreted to meet the following definition:

    Water generated from rinsing vehicles with detergent-free, solvent-free water under low pressure for the sole purpose of removing surface dust from a vehicle. The vehicle washing must not include undercarriage or engine washing, boat bottom washing nor washing of vehicles and other equipment exposed to contamination such as vehicles at a fire, at a spill site or vehicles used to transport hazardous material.

    Submission of this Motor Vehicle Rinse Water, Snow/Ice Melt and Rain Drip Non-Exposure Form and Certification Statement constitutes notice that the facility or municipality owning or operating motor vehicle rinse water infiltration/injection well system certifies that the areas where hazardous substances are used or stored are not in contact with the motor vehicle rinse water that is infiltrated/injected into or onto the ground. This certification is required as part of inventory registration to qualify as a Rule Authorized UIC Class V Well for motor vehicle rinse water disposal to an infiltration / injection system.

    A condition of “non-exposure” exists at a site when all hazardous materials/wastes and activities with the potential to contaminate groundwater are segregated from the area used to rinse the dust and/or salt from vehicles. The storage of motor vehicle fluids such as motor oil and antifreeze is prohibited within the perimeters of the area(s) that drain to ground surface or to a UIC Class V well.

    If any industrial activities take place or materials/wastes are stored in the drainage area, the facility or site is not eligible for the non-exposure exclusion. Industrial materials or activities include, but are not limited to, stored or generated toxic or hazardous materials, petroleum products, material handling equipment or activities, industrial machinery, raw materials, intermediate products, by-products, final products, or waste products. Material handling activities include the storage, loading and unloading, transportation, or conveyance of any raw material, intermediate product, final product or waste product.
  2. Who may file a Non-Exposure Certification?

    Massachusetts law prohibits the discharge of contaminated vehicle wash water into waters of the U.S., including groundwater, without either qualifying as Rule Authorized or having been issued a Massachusetts Department of Environmental Protection (MassDEP) Groundwater Discharge Permit. Discharges of motor vehicle rinse water, snow/ice melt and rain drip may qualify as Rule Authorized and thereby be eligible to obtain an Underground Injection Control (UIC) Registration (regulated under 310 CMR 27.00) from MassDEP if the proponent of the discharge can certify that a condition of "non exposure" exists at the facility or site. If you are only registering your Motor Vehicle - Rinse Water, Snow/Ice Melt, or Rain Drip well(s) for Pre-Closure then you are not required to submit this non-exposure form.
  3. Obtaining and Maintaining the Non-Exposure Exclusion

    This form is used to certify that a condition of non-exposure exists at the facility or site described herein. The facility operator must maintain a condition of non-exposure at its facility or site in order for the nonexposure exclusion to remain applicable. If conditions change resulting in the discharge or potential discharge of contaminants to the UIC Class V well, then the facility operator must file a UIC Pre-Closure form with the MassDEP UIC Registration Program and immediately discontinue the discharge. If the facility operator wishes to continue discharging the motor vehicle -rinse water, snow/ice melt or rain drip to the ground surface or subsurface then that entity shall obtain a Ground Water Discharge Permit (regulated under 314 CMR 5.00) from the MassDEP Groundwater Discharge Program.
  4. Completing the Form

    One form must be completed for each facility or site for which you are seeking to certify a condition of non-exposure. Please make sure that you have addressed all applicable questions and have made a photocopy for your records before sending the completed form to the above address. If you have not previously applied for and obtained a UIC Registration number from the MassDEP UIC Program for this motor vehicle - rinse water, snow/ice melt or rain drip discharge, then this Non-Exposure form must accompany a UIC Registration application package (BRP WS-06).
  5. Where do I send the form?

    Send signed original document to:
    One Winter Street - 5th floor
    Boston, MA 02108
    ATTN: UIC Program