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NPDES Individual Permit Forms

The NPDES Individual Permit is regulated under Hawaii Administrative Rules, Chapter 11-55, Water Pollution Control, effective June 15, 2009. The amendments to HAR, Chapter 11-55, Water Pollution Control repealed the requirement for applicants to submit the National Pollutant Discharge Elimination System permit application or Notice of Intent to the Department of Land and Natural Resources, State Historic Preservation Division.

Apply for an NPDES Individual Permit with the EPA or CWB application forms and guidelines listed below and the CWB-NPDES Signatory and Certification Statement.

  • CWB-NPDES Signatory and Certification Statement to NPDES Permit Applications and Guidelines (Rev. 11/20/2002). This Statement shall be submitted with the $1000 filling fee and EPA or CWB application form(s).


  • Zone of Mixing - CWB-ZOM Form and Guidelines (Rev. 1/31/2003). As applicable, this form shall be submitted with the application.


  • CWB-Individual NPDES Form C and Guidelines: Application for permit to discharge storm water associated with construction activities. The EPA Form 3510-1 is not required to be submitted with this form.


  • Submittal Instructions to obtain coverage under an Individual NPDES Permit for discharges of storm water associated with construction activities:

    1. Transmittal or cover letter (hard copy).
    2. Original signed CWB-NPDES Signatory and Certification Statement to NPDES Permit Applications, (hard copy).
    3. $1000 Filing Fee.
    4. CD or DVD containing the following in pdf format:
        - CWB-NPDES Signatory and Certification Statement to NPDES Permit Applications.
        - CWB-Individual NPDES Form C (Rev. 09/30/2004) with responses for Item Nos. 1, 2, 3, 4, 5, and 16 only.
        - Certified and complete CWB SSCBMP Plan Template.
        - All applicable attachments.
    5. The specified number of hard copies of all submitted documents:
        Two (2) sets for projects on the Island of Hawaii.
        One (1) set for projects on the Islands of Kauai, Maui, Molokai, Lanai, and Kahoolawe.
        No additional sets for projects on the Island of Oahu.
    6. Replace “NGPC File No. HIR10_ _ _ _ ” on page 1 of the CWB SSCBMP Plan Template
        with “NPDES Permit No. HIS000_ _ _. ”


  • EPA Forms from EPA NPDES Permit Applications and Forms webpage (scroll to the applicable link on the page to obtain the EPA Form).
    Use Adobe Reader to open these files. Even though these publications are PDF files, these documents allow you to type directly onto the form and save the PDF with the form fields populated. You should enter your facility information on the form, print it, sign it, and mail the form to the CWB address below.

    • NPDES Form 1 Application (EPA Form 3510-1)
      General Information. Must be submitted by all facilities applying for an individual NPDES permit, with the exception of construction activities submitting CWB-Individual NPDES Form C and municipal separate storm sewer systems (MS4s).

    • NPDES Form 2A Application (EPA Form 3510-2A)
      Application for permit to discharge municipal wastewater from publicly owned treatment works

    • NPDES Form 2B Application (EPA Form 3510-2B)
      Application for permit to discharge wastewater (from) concentrated animal feeding operations and aquatic animal production facilities

    • NPDES Form 2C Application (EPA Form 3510-2C)
      Application for permit to discharge wastewater (from) existing manufacturing, commercial, mining and silvicultural operations. Revisions proposed for Form 2C have been discontinued.

    • NPDES Form 2D Application (EPA Form 3510-2D)
      Application for permit to discharge process wastewater (from) new sources and new dischargers.

    • NPDES Form 2E Application (EPA Form 3510-2E)
      Application for facilities which do not discharge process wastewater.

    • NPDES Form 2F Application (EPA Form 3510-2F)
      Application for permit to discharge storm water associated with industrial activity.

    • NPDES Form 2S Application (EPA Form 3510-2S)
      Application for sewage sludge (biosolids) permit for new and existing treatment works treating domestic sewage (TWTDS).


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