Application Forms Non-Discharge Branch Use the tabs below to view the application forms and miscellaneous documents. Electronic Applications are now being accepted! Notice: The 15A NCAC 02T and 02U Rules have changed. The application forms may reference the old rule citation. For questions regarding the application forms, please contact Nathaniel Thornburg. Application Forms Permit Type New / Modification3 Application Renewal Application Ownership / Name Change Single-Family Residence System SFRWWIS 06-16 SFRWWISO&M 08-13 SFRLRW 11-13 SFRWWIS-R 02-21 SFRWWIS-CO 03-21 Wastewater Irrigation System WWIS 06-16 WWIS-R 02-21 NDPONC 06-16 High-Rate Infiltration System HRIS 06-16 HRIS-R 02-21 NDPONC 06-16 Closed-Loop Recycle System CLRS 06-16 CLRS-R 02-21 NDPONC 06-16 Other Wastewater System ONDWWS 06-16 ONDWWS-R 02-21 NDPONC 06-16 Reclaimed Water Bulk Distribution RWPI 06-16 RWBD 06-16 RWS-R 02-21 NDPONC 06-16 Reclaimed Water Conjunctive Utilization RWPI 06-16 RWCU 06-16 RWS-R 02-21 NDPONC 06-16 Reclaimed Water Generation RWPI 06-16 RWG 06-16 RWS-R 02-21 NDPONC 06-16 Reclaimed Water Dedicated (Non-Conjunctive) Utilization RWPI 06-16 RWNC 06-16 RWS-R 02-21 NDPONC 06-16 Reclaimed Water Distribution Lines RWPI 06-16 RWDL 06-16 RWS-R 02-21 NDPONC 06-16 Reclaimed Water Local Program Approval RWPI 06-16 RWLPA 06-16 RWS-R 02-21 NDPONC 06-16 Reclaimed Water Wetlands Augmentation RWPI 06-16 RWWA 06-16 RWS-R 02-21 NDPONC 06-16 Residuals Class A Distribution 1, 2 DCAR 06-16 RSC 06-16 DCAR 06-16 RSC 06-16 Residuals Land Application Program 1, 2 RLAP 06-16 LOA 06-16 RSC 06-16 RLAP 06-16 LOA 06-16 RSC 06-16 Residuals Surface Disposal 1, 2 SDR 06-16 RSC 06-16 SDR 06-16 RSC 06-16 1 - The County Manager Notification (Form: CMN) has been updated in accordance with Session Law 2013-340, which is intended to provide the county board an opportunity to comment on proposed residuals land application sites within their county. Accordingly, the form title has been changed to County Board Notification (Form: CBN). The updated form is required prior to the permitting of proposed new fields, and can be found as part of the Form: RLAP (under section V. Land Application Site Certification). Please note that this notification is not required for fields deemed permitted to receive Class A residuals under 15A NCAC 02T .1100. 2 - The web location of our Critical Watershed Map has been changed to a permanent location at: Water Supply Watersheds. 3 - For questions about which portions of the application form(s) are required for modifications, please contact Nathaniel Thornburg. Miscellaneous Documents Documents Form Download Checklist for Boat Washing Operations with Closed-Loop Recycle System N/A PDF Coastal Area Map - 15A NCAC 02H .0403 N/A JPG Developer Operational Agreement DEV 01-20 PDF General Permit to Discharge Reclaimed Water from Conjunctive Use Reclaimed Water Systems NCG580000 PDF Homeowner's Association Operational Agreement HOA 01-20 PDF Operator Designation Form WPCSOCC PDF Setback Waiver Form - Class B Residuals NDRMPW-LAS 11-18 PDF Setback Waiver Form - Residual Treatment/Storage/Disposal NDRMPW-ST 11-18 PDF Setback Waiver Form - Wastewater & Reclaimed Water NDWSW 02-19 PDF Signature Delegation Authority Letter NDSDAL 01-20 DOC Watershed Classification Attachment WSCA 08-13 PDF
Application Forms Non-Discharge Branch Use the tabs below to view the application forms and miscellaneous documents. Electronic Applications are now being accepted! Notice: The 15A NCAC 02T and 02U Rules have changed. The application forms may reference the old rule citation. For questions regarding the application forms, please contact Nathaniel Thornburg. Application Forms Permit Type New / Modification3 Application Renewal Application Ownership / Name Change Single-Family Residence System SFRWWIS 06-16 SFRWWISO&M 08-13 SFRLRW 11-13 SFRWWIS-R 02-21 SFRWWIS-CO 03-21 Wastewater Irrigation System WWIS 06-16 WWIS-R 02-21 NDPONC 06-16 High-Rate Infiltration System HRIS 06-16 HRIS-R 02-21 NDPONC 06-16 Closed-Loop Recycle System CLRS 06-16 CLRS-R 02-21 NDPONC 06-16 Other Wastewater System ONDWWS 06-16 ONDWWS-R 02-21 NDPONC 06-16 Reclaimed Water Bulk Distribution RWPI 06-16 RWBD 06-16 RWS-R 02-21 NDPONC 06-16 Reclaimed Water Conjunctive Utilization RWPI 06-16 RWCU 06-16 RWS-R 02-21 NDPONC 06-16 Reclaimed Water Generation RWPI 06-16 RWG 06-16 RWS-R 02-21 NDPONC 06-16 Reclaimed Water Dedicated (Non-Conjunctive) Utilization RWPI 06-16 RWNC 06-16 RWS-R 02-21 NDPONC 06-16 Reclaimed Water Distribution Lines RWPI 06-16 RWDL 06-16 RWS-R 02-21 NDPONC 06-16 Reclaimed Water Local Program Approval RWPI 06-16 RWLPA 06-16 RWS-R 02-21 NDPONC 06-16 Reclaimed Water Wetlands Augmentation RWPI 06-16 RWWA 06-16 RWS-R 02-21 NDPONC 06-16 Residuals Class A Distribution 1, 2 DCAR 06-16 RSC 06-16 DCAR 06-16 RSC 06-16 Residuals Land Application Program 1, 2 RLAP 06-16 LOA 06-16 RSC 06-16 RLAP 06-16 LOA 06-16 RSC 06-16 Residuals Surface Disposal 1, 2 SDR 06-16 RSC 06-16 SDR 06-16 RSC 06-16 1 - The County Manager Notification (Form: CMN) has been updated in accordance with Session Law 2013-340, which is intended to provide the county board an opportunity to comment on proposed residuals land application sites within their county. Accordingly, the form title has been changed to County Board Notification (Form: CBN). The updated form is required prior to the permitting of proposed new fields, and can be found as part of the Form: RLAP (under section V. Land Application Site Certification). Please note that this notification is not required for fields deemed permitted to receive Class A residuals under 15A NCAC 02T .1100. 2 - The web location of our Critical Watershed Map has been changed to a permanent location at: Water Supply Watersheds. 3 - For questions about which portions of the application form(s) are required for modifications, please contact Nathaniel Thornburg. Miscellaneous Documents Documents Form Download Checklist for Boat Washing Operations with Closed-Loop Recycle System N/A PDF Coastal Area Map - 15A NCAC 02H .0403 N/A JPG Developer Operational Agreement DEV 01-20 PDF General Permit to Discharge Reclaimed Water from Conjunctive Use Reclaimed Water Systems NCG580000 PDF Homeowner's Association Operational Agreement HOA 01-20 PDF Operator Designation Form WPCSOCC PDF Setback Waiver Form - Class B Residuals NDRMPW-LAS 11-18 PDF Setback Waiver Form - Residual Treatment/Storage/Disposal NDRMPW-ST 11-18 PDF Setback Waiver Form - Wastewater & Reclaimed Water NDWSW 02-19 PDF Signature Delegation Authority Letter NDSDAL 01-20 DOC Watershed Classification Attachment WSCA 08-13 PDF
