Table of Contents
Agency Forms
- IDEM Complaint Form - 50014 [PDF]
- Public Records Request Form - 55542 [PDF] [DOC]
Office of Air Quality
Clean Air Interstate Rule (CAIR)
- EE-01 EE/RE Set Aside NOx Allowance Application - 52719 [PDF] [DOC]
- EE-02 Ozone Control Period Notification of Results - 52720 [PDF] [DOC]
- EE-03 EE/RE Set Aside Nox Allowance Reapplication - 52721 [PDF] [DOC]
Voluntary Idling Program
- Voluntary Idling Pledge - 53902 [PDF]
Permits Branch
General Source Data
- Air Permit Application Cover Sheet - 50639 [PDF] [DOC]
- Air Permit Application Form Checklist - 51607 [DOC]
- GSD-01 General Source Data - Basic Source Level Information - 50640 [PDF] [DOC]
- GSD-02 General Source Data - Plant Layout Diagram - 51605 [PDF] [DOC]
- GSD-03 General Source Data - Process Flow Diagram - 51599 [PDF] [DOC]
- GSD-04 General Source Data - Stack / Vent Information - 51606 [PDF] [DOC]
- GSD-05 General Source Data - Emissions Unit Information - 51610 [PDF] [DOC]
- GSD-06 General Source Data - Particulate Emissions - 51612 [PDF] [DOC]
- GSD-07 General Source Data - Criteria Pollutant Emissions Summary - 51602 [PDF] [DOC]
- GSD-08 General Source Data - Hazardous Air Pollutant Emissions Summary - 51604 [PDF] [DOC]
- GSD-09 General Source Data - Summary of Additional Information - 51611 [PDF] [DOC]
- GSD-10 General Source Data - Insignificant Activity - 51596 [PDF] [DOC]
- GSD-11 General Source Data - Alternative Operating Scenario Summary - 51601 [PDF] [DOC]
- GSD-12 General Source Data - Affidavit of Non-applicability - 51600 [PDF] [DOC]
- GSD-13 General Source Data - Affidavit of Applicability - 51603 [PDF] [DOC]
- GSD-14 General Source Data - Owners and Occupants Notified - 51609 [PDF] [DOC]
- GSD-15 General Source Data - Government Officials Notified - 51608 [PDF] [DOC]
- Air Permit Application - Renewal Checklist - 51755 [PDF] [DOC]
Process Information
- AEF-01 Alternative Emissions Factor Request - 51860 [PDF] [DOC]
- PI-01 Miscellaneous Processes - 52534 [PDF] [DOC]
- PI-02A Combustion Unit Summary - 52535 [PDF] [DOC]
- PI-02B Combustion: Boilers, Process Heaters, & Furnaces - 52536 [PDF] [DOC]
- PI-02C Combustion: Turbines & Internal Combustion Engines - 52537 [PDF] [DOC]
- PI-02D Combustion: Incinerators & Combustors - 52538 [PDF] [DOC]
- PI-02E Combustion: Kilns - 52539 [PDF] [DOC]
- PI-02F Combustion: Fuel Use - 52540 [PDF] [DOC]
- PI-02G Combustion: Emission Factors - 52541 [PDF] [DOC]
- PI-02H Combustion: Federal Rule Applicability - 52542 [PDF] [DOC]
- PI-03 Storage and Handling of Bulk Material - 52543 [PDF] [DOC]
- PI-04 Asphalt Plants - 52544 [PDF] [DOC]
- PI-05 Brick / Clay Products - 52545 [PDF] [DOC]
- PI-06 Electroplating Operations - 52546 [PDF] [DOC]
- PI-07 Welding Operations - 52547 [PDF] [DOC]
- PI-08 Concrete Batchers - 52548 [PDF] [DOC]
- PI-09 Degreasing - 52549 [PDF] [DOC]
- PI-10 Dry Cleaners - 52550 [PDF] [DOC]
- PI-11 Foundry Operations - 52551 [PDF] [DOC]
- PI-12 Grain Elevators - 52552 [PDF] [DOC]
- PI-13 Lime Manufacturing - 52553 [PDF] [DOC]
- PI-14 Liquid Organic Compound Storage - 52554 [PDF] [DOC]
- PI-14ALT Alternate Version of Liquid Organic Compound Storage - 52555 [PDF] [DOC]
- PI-15 Portland Cement Manufacturing - 52556 [PDF] [DOC]
- PI-16 Reinforced Plastics & Composites - 52557 [PDF] [DOC]
- PI-17 Blasting Operations - 52558 [PDF] [DOC]
- PI-18 Mineral Processing - 52559 [PDF] [DOC]
- PI-19 Surface Coating & Printing Operations - 52560 [PDF] [DOC]
- PI-20 Woodworking / Plastic Machining - 52561 [PDF] [DOC]
- PI-21 On-site Soil Remediation - 52570 [PDF] [DOC]
- PI-22 Ethanol Plants (Under Development)
Control Equipment
- CE-01 Control Equipment Summary - 51904 [PDF] [DOC]
- CE-02 Particulate Control Equipment Baghouse or Fabric Filter - 51953 [PDF] [DOC]
- CE-03 Particulates - Cyclone - 52620 [PDF] [DOC]
- CE-04 Particulates - Electrostatic Precipitator - 52621 [PDF] [DOC]
- CE-05 Particulates - Wet Collector / Scrubber / Absorber - 52622 [PDF] [DOC]
- CE-06 Organics - Flare / Oxidizer / Incinerator - 52623 [PDF] [DOC]
- CE-07 Organics - Absorbers - 52624 [PDF] [DOC]
- CE-08 Organics - Condenser - 52625 [PDF] [DOC]
- CE-09 Reduction Technology - 52626 [PDF] [DOC]
- CE-10 Miscellaneous Control Equipment - 52436 [PDF] [DOC]
Compliance Determination for Part 70 Sources
- CD-01 Emissions Unit Compliance Status - 51861 [PDF] [DOC]
- CD-02 Compliance Plan Requirements Per Applicable Requirement - 51862 [PDF] [DOC]
- CD-03 Compliance Plan Requirements Per Emissions Unit - 51863 [PDF] [DOC]
- CD-04 Compliance Schedule and Certification - 51864 [PDF] [DOC]
Best Available Control Technology
- Analysis of Best Available Control Technology
- PSD / Emission Offset Checklist
Emission Credit Registry
- EC-01 Emission Credit Registry - Generation of Emission Credits - 51783 [PDF] [DOC]
- EC-02 Emission Credit Registry - Transfer of Emission Credits - 51784 [PDF] [DOC]
- EC-03 Emission Credit Registry - Use of Emission Credits - 51785 [PDF] [DOC]
- EC-04 Emission Credit Registry - Emission Credit Request - 51906 [PDF] [DOC]
Plantwide Applicability Limits
- PAL-01: Actuals Plantwide Applicability Limit - 52451 [PDF] [DOC]
- PAL-02: Revised Plantwide Applicability Limit - 52452 [PDF] [DOC]
- PAL-03: Plantwide Applicability Limit Renewal - 52453 [PDF] [DOC]
- PAL-04: Request for Termination of Plantwide Applicability Limit - 52454 [PDF] [DOC]
Air Toxics
Special Permits
- Interim Approval
- Phase 2 Acid Rain Permit
Source Specific Operating Agreements (SSOA) Instructions (Forms Under Development)
- OA-01 Summary of Application and Existing Agreements [PDF] [DOC]
- OA-02 Industrial / Commercial Surface Coating Operations -OR- Graphic Arts Operations (326 IAC 2-9-2.5) [PDF] [DOC]
- OA-03 Surface Coating or Graphic Arts Operations (326 IAC 2-9-3) [PDF] [DOC]
- OA-04 Woodworking Operations (326 IAC 2-9-4) [PDF] [DOC]
- OA-05 Abrasive Cleaning Operations (326 IAC 2-9-5) [PDF] [DOC]
- OA-06 Grain Elevators (326 IAC 2-9-6) [PDF] [DOC]
- OA-07 Sand And Gravel Plants (326 IAC 2-9-7) [PDF] [DOC]
- OA-08 Crushed Stone Processing Plants (326 IAC 2-9-8) [PDF] [DOC]
- OA-09 Ready-Mix Concrete Batch Plants (326 IAC 2-9-9) [PDF] [DOC]
- OA-10 Coal Mines And Coal Preparation Plants (326 IAC 2-9-10) [PDF] [DOC]
- OA-11 Automobile Refinishing Operations (326 IAC 2-9-11) [PDF] [DOC]
- OA-12 Degreasing Operations (326 IAC 2-9-12) [PDF] [DOC]
- OA-13 External Combustion Sources (326 IAC 2-9-13) [PDF] [DOC]
- OA-14 Internal Combustion Sources (326 IAC 2-9-14) [PDF] [DOC]
Compliance Branch
- Drycleaner Notification Form - 48625 [DOC]
- Drycleaner Notification of Compliance Status - 53430 [DOC]
- Fire Training Notification Form - 54801 [PDF] [DOC]
- Identification of Potentially Affected Persons - 49635 [PDF] [DOC]
- Initial Notification Report Under Regulation 40 CFR Part 63, Subpart DDDDD - 51956 [PDF]
- Notification of Demolition and Renovation Operations - 44593 [PDF]
- Request for Use of an Air Curtain Open Pit Destructor - 43688 [PDF] [DOC]
- Request for Variance from 326 IAC 4-1 (Fire Training) - 49634 [PDF] [DOC]
- Request for Variance from 326 IAC 4-1 (Motor Vehicle Fire Training) - 50337 [PDF] [DOC]
- Request for Variance from 326 IAC 4-1 (Prescribed Vegetation Burn) - 50864 [PDF] [DOC]
- Request for Variance from 326 IAC 4-1 (Tree Waste or Clean Wood Waste) - 43692 [PDF] [DOC]
Asbestos
- Application Checksheet for Asbestos Contractor - 52571 [DOC]
- Application for Asbestos Contractor License - 52575 [DOC]
- Application for Asbestos Training Course - Provider Approval - 48741 [DOC]
- Application for Duplicate Asbestos License - 48740 [DOC]
- Application for Individual Asbestos License - 43786 [DOC]
- Notification of Demolition and Renovation Operations - 44593 [PDF]
Outdoor Hydronic Heaters
Stack Test Forms
- Compliance Test Protocol Form - 55003 [PDF]
- RATA Notification Protocol Form - 55059 [PDF]
- VOCs & Toxics Compliance Test Protocol Form - 55058 [PDF]
Programs Branch
- AES-01 Air Emission Statement Certification - 52052 [PDF] [DOC]
- AES-02 General Facility Information - 52053 [PDF] [DOC]
- AES-03 Stack Information - 52054 [PDF] [DOC]
- AES-04 Abatement Equipment - 52055 [PDF] [DOC]
- AES-05 Group/Process/Emissions Information - 52056 [PDF] [DOC]
- AES-06 Voluntary Hazardous Air Pollutant Reporting - 52057 [PDF] [DOC]
DieselWise
- DieselWise Indiana Vendor Information Form - 53778 [PDF]
Office of Land Quality
- Adjacent Landowner/Occupant Affidavit - 51872 [DOC]
- Field Tile Monitoring At Land Application Sites (Personal Document) - 51910 [DOC]
Auto Salvage Recyclers
- Application for Indiana Salvage Motor Vehicle Business License - 40248 [PDF]
- Auto Salvage Recyclers Certification Program Certification Statement - 53766 [PDF]
- Auto Salvage Recyclers Environmental Self-Audit Checklist - 53765 [PDF]
- Indiana Clean Yard Best Management Practices Checklist - 53924 [DOC]
- Payment for Mercury Switches from End-of-life Vehicles (ELVs) - 53238 [PDF] [DOC]
Confined Feeding Operations
- Complete CFO/CAFO Application Packet - 55051 [PDF]
- CFO Closure Certification - 55054 [PDF]
- CFO Construction Affidavit - 51255 [PDF]
- CFO Construction Notification - 50210 [PDF]
- CFO Facility Change Notification - 50209 [PDF]
- CFO Request for Approval Transfer - 49832 [PDF]
- CFO Request for Approval to Surface Apply Manure to Frozen or Snow-Covered Ground - 55162 [PDF]
- CFO Request for Exiting the Program - 49827 [PDF]
- Professional Engineer Certification Construction of Concrete Liquid Manure Storage Structures - 55053 [PDF]
- Professional Engineer Certification Construction of Earthen Liquid Manure Storage Structures - 55052 [PDF]
- Professional Engineer Certification for Construction of Geomembrane Lined Liquid Manure Storage Structures - 55716 [PDF] [DOC]
The following operator record forms and documents are not returned to IDEM:
The following compliance information forms and documents are not required, but recommended to be maintained on site:
NPDES CAFO Individual Permit Forms
- CAFO Annual Report - 52510 [PDF]
- CAFO Closure of Manure, Litter, Process Wastewater Storage Structures - 51913 [PDF]
- CAFO Construction Completion Affidavit - 55056 [PDF]
- CAFO Construction Notification - 51911 [PDF]
- CAFO Removal from NPDES CAFO Permit Program - 55055 [PDF]
The following operator record forms are not returned to IDEM:
Electronic Waste
- Registration Form for Storage and Processing Facilities - 54138 [PDF]
Hazardous Waste Facilities
- Annual Manifest Report OS Form - 52717 [PDF] [DOC]
- Annual Manifest Report WG Form - 52718 [PDF] [DOC]
- Biennial Report CC - Closure/Post Closure Cost Estimate - 52387 [PDF] [DOC]
- Biennial Report GM - Generation, Shipment, and Management - 52388 [PDF] [DOC]
- Biennial Report OI - Off-site Identification - 52389 [PDF] [DOC]
- Biennial Report WM - Waste Minimization - 52390 [PDF] [DOC]
- Biennial Report WR - Waste Received - 52391 [PDF] [DOC]
- Facility Permit Fee Transmittal - 47214 [DOC]
- Hazardous Waste Disposal Fee - 46244 [PDF] [DOC]
- Transfer Facilities Notification - 52123 [PDF] [DOC]
- Used Oil Management Report - 52392 [PDF] [DOC]
Guidance:
Institutional Controls
- Environmental Restrictive Covenant / Deed Notice Modification or Termination Request - 56082 [PDF] [DOC]
Land Application of Biosolids and Other Pollutant-bearing Waters
- Notification for the Construction of a Storage Structure for Biosolids/Industrial Waste Product or Pollutant-bearing Water - 50405 [DOC]
- Permit Application for the Construction of a Storage Structure for Biosolids/Industrial Waste Product or Pollutant-Bearing Water - 50406 [DOC]
- Notification for the Land Application of Agricultural Lime Substitute - 50407 [DOC]
- Permit Application for the Marketing and/or Distribution of Biosolids - 50408 [DOC]
- Permit Application for the Land Application of Domestic Wastewater - 50409 [DOC]
- Permit Application for the Land Application of Biosolids - 50410 [DOC]
- Permit Application for the Marketing and/or Distribution of Industrial Waste Products - 53514 [DOC]
- Permit Application for the Land Application of Industrial Waste Products - 53517 [DOC]
- Notification for the Land Application of Small Quantities of Pollutant-bearing Water - 53558 [DOC]
- Permit Application for the Land Application of Industrial Process Wastewater - 53584 [DOC]
- Record of Remedy Selection (Remediation Work Plan or Corrective Action Plan) - 54471 [DOC]
- Record of Site Closure (Remedial Action or Corrective Action) - 54472 [DOC]
Solid Waste Facilities
- Adjacent Landowner/Occupant Affidavit - 51872 [PDF] [DOC]
- Alternative Fuel Processor Registration Application - 55308 [PDF]
- Biomass Digester/Gasification Facility Registration Application - 55309 [PDF]
- Insignificant Permit Modification Checklist Solid Waste Land Disposal Facilities - 53317 [DOC]
- Mobile Home Salvaging Facility Registration Application - 55307 [PDF]
- Municipal Solid Waste Landfill Closure Plan (329 IAC 10-22) - 50391 [DOC]
- Municipal Solid Waste Landfill Post-Closure Plan (329 IAC 10-23) - 50388 [DOC]
- Solid Waste Disposal Fee Report - 50413 [PDF]
- Solid Waste Management Fee Return - 46830 [PDF]
- Solid Waste Facility Permit Application & Registration Fee Transmittal - 47215 [PDF] [DOC]
- Solid Waste Facility Transfer Application - 50393 [PDF]
- Solid Waste Land Disposal Facility Permit Application - 50404 [PDF] [DOC]
- Solid Waste Processing Facilities and Incinerators / New Facility and Major Modification Permit Application Checklist - 53315 [PDF] [DOC]
- Solid Waste Processing Facility Permit Application - 50392 [PDF] [DOC]
- Solid Waste Processing Facility Permit Renewal Application - 50387 [PDF] [DOC]
- Transfer Station Annual Report - 51885 [PDF]
State Cleanup Program
- Independent Closure Process - Site Closure [PDF] [DOC]
Underground Storage Tanks (UST) Branch
Excess Liability Trust Fund (ELTF)
- ELTF Claims Application - 47139 [XLS]
- ELTF Eligibility Application - 55459 [PDF]
- ELTF Confirmation of Emergency Response Status - 55458 [XLS]
- ELTF Scope of Work for Leaking UST Sites - 51955 [PDF] [DOC]
- ELTF Site Categorization for Prioritization of Claims - 59120 [PDF] [DOC]
Leaking Underground Storage Tank (LUST) Program
- LUST Further Site Investigation (FSI) Report Cover Sheet & Report Format [PDF] [DOC]
- LUST Initial Incident Report - 54487 [PDF] [DOC]
- LUST Initial Site Characterization (ISC) Checklist [PDF] [DOC]
- LUST Initial Site Characterization (ISC) Report Cover Sheet & Report Format [PDF] [DOC]
- LUST No Further Action Request Cover Sheet and Report Format - 56088 [PDF] [DOC]
- LUST Quarterly Monitoring Report (QMR) Cover Sheet and Report Format - 56087 [PDF] [DOC]
Underground Storage Tank (UST) Program
- UST Notice of Intent to Purchase UST and Reinstate Eligibility - 48079 [PDF]
- UST Notification Form - 45223 [PDF]
- UST Request for Certificate of Financial Assurance for UST - 52884 [PDF]
Voluntary Remediation Program
- Application and Instructions - 47271 [PDF] [DOC]
- Remediation Completion Report Completeness Checklist - 54168 [PDF] [DOC]
- Remediation Work Plan Completeness Checklist - 53413 [PDF]
Waste Tires
- Application for Waste Tire Storage Site Registration (or Renewal) - 47222 [PDF]
- IDEM Waste Tire Transporter Registration (Or Renewal) - 47220 [DOC]
- Registered Tire Storage Site Closure Cost Estimate - 53784 [DOC]
- Waste Tire Manifest - 47273 [PDF]
- Waste Tire Facility Closure Notification - 55351 [DOC]
Wastewater (Septage) Program
- Application for Septage Management Business & Vehicle Permits - 50399 [DOC]
- Application for a Wastewater Management Land Application Site Permit - 50403 [DOC]
- Application for a Wastewater Management Storage/Treatment Facility Permit - 50402 [DOC]
Yard Waste Composting Program
- Yard Waste Composting Facility Registration Application - 50414 [PDF] [DOC]
The following forms are not State Forms. These forms are examples intended only for guidance. Do not fill and/or submit the following forms.
Office of Program Support
- Earth Day Speaker Request Form - 53454 [PDF] [DOC]
- Final Report For Organic Projects - 51984 [PDF] [DOC]
- Final Report For Recycling Projects - 51985 [PDF] [DOC]
- Good Character Disclosure Statement - 50400 [PDF] [DOC]
- Grant Expenditure Report - 51986 [PDF] [DOC]
CLEAN Community Challenge
- CLEAN Community Challenge New Applicant Pre-Application - 56136 [DOC]
- CLEAN Community Challenge Annual Performance Report - 53116 [PDF] [DOC]
- CLEAN Community Challenge Program Application - 51826 [DOC]
Drug Lab Cleanup
- Application for Listing as a Qualified Inspector for Drug Lab Cleanup - 53316 [PDF] [DOC]
- Notification of Demolition for Drug Lab Cleanup - 55660 [PDF] [DOC]
- Qualified Inspector's Certificate of Illegal Drug Lab Cleanup - 53276[PDF] [DOC]
- Student Registration for Illegal Drug Lab Cleanup Training - 55457 [PDF] [DOC]
Electronic Waste Program (Indiana E-Cycle)
- Indiana E-Cycle Collector Annual Report - 54481 [PDF] [DOC]
- Indiana E-Cycle Collector Registration - 54137 [PDF] [DOC]
- Indiana E-Cycle Manufacturer Annual Report - State Form 54534 [PDF] [DOC]
- Indiana E-Cycle Manufacturer Registration - State Form 54198 [PDF] [DOC]
- Indiana E-Cycle Recycler Annual Report - 54482 [PDF] [DOC]
- Indiana E-Cycle Recycler Registration - 54139 [PDF] [DOC]
Environmental Stewardship Program
- Environmental Stewardship Program Annual Performance Report - 53475 [PDF] [DOC]
- Environmental Stewardship Program Application - 52772 [PDF] [DOC]
- Environmental Stewardship Program Checklist for Potential Regulatory Incentives - 53706 [PDF] [DOC]
Governor’s Awards for Environmental Excellence
- Governor's Awards for Environmental Excellence - 51656 [PDF] [DOC]
- Governor's Environmental Art Challenge Entry - 51756 [PDF] [DOC]
Recycling
- Recycling Activity Report for Recycler Facility [PDF]
Recycling Market Development Program
- Recyclable Materials Market Directory Survey [PDF] [DOC]
- Recycling Promotion and Assistance Fund Recycling Market Development Grant [PDF] [DOC]
Self-Disclosure and Environmental Audit
- Self-Disclosure and Environmental Audit Application Form - 55075 [PDF] [DOC]
Office of Water Quality
Drinking Water & Wastewater Facilities
Public Water Supply
- Application for Construction Permit For Public Water System - 35058 [PDF]
- Backflow Device Test Form - 55788 [PDF] [DOC]
- CCR Electronic Delivery Certification - Drinking Water - 55623 [PDF] [DOC]
- CCR Certification in Drinking Water - 54187 [PDF]
- Chlorine and Chloramines Residual Reporting (DS) - 53296 [PDF] [DOC]
- Chlorine and Chloramines Residual Reporting (POE) - 53295 [PDF] [DOC]
- Consumer Notice of Lead Result in Drinking Water - 55275 [PDF] [DOC]
- Electronic Sample Entry (eSE) Subscriber Agreement - 55656 [PDF]
- Emergency Drinking Water Construction Permit Request Form - 54188 [PDF] [DOC]
- Filter Backwash Recycling Rule (FBRR) Recordkeeping - 54186 [PDF]
- IE/LT1 SWTR Combined Filter Effluent Turbidity - 53294 [PDF]
- Inorganic Chemicals (IOC's) IN Drinking Water - 53285 [PDF]
- Lead & Copper (PBCU) In Drinking Water Reporting - 53289 [PDF]
- Level 1 Assessment – Non-Transient Non-Community (NTNC) or Community Water Systems (CWS) - 52998 [PDF] [DOC]
- Level 1 Assessment - Transient Non-Community Water Systems - 52999 [PDF] [DOC]
- Level 2 Assessment - Non-Transient Non-Community (NTNC) or Community Water Systems (CWS) - 55981 [PDF] [DOC]
- Level 2 Assessment - Transient Non-Community Water Systems - 55983 [PDF] [DOC]
- Monthly Bromate Reporting - 53290 [PDF]
- Monthly Chlorine Dioxide Monitoring - 53282 [PDF]
- Monthly Chlorite Monitoring - 53283 [PDF]
- Monthly Individual Filter Effluent (IFE) Turbidity Monitoring - 53293 [PDF]
- Monthly Report of Operation of Water Treatment Plant - 34609 [PDF]
- Monthly Total Organic Carbon Removal Reporting - 53284 [PDF]
- New System Questionnaire - 46977 [PDF] [DOC]
- New Well Site Application - 50896 [PDF] [DOC]
- Nitrate & Nitrite In Drinking Water - 53281 [PDF]
- Notice of Intent to Construct a Water Main Extension - 49008 [PDF]
- Reporting of Aboveground Storage Tanks - 55906 [PDF]
- Seasonal Systems Start-up Requirements - 55927 [PDF]
- Seasonal Systems Start-up Requirements (Hand Pump(s) Only) - 53001 [PDF]
- Stage 2 Disinfectants and Disinfection Byproducts Rule Reporting - 54923 [PDF] [DOC]
- Stage 2 Operational Evaluation - Distribution System - 55261 [PDF] [DOC]
- Stage 2 Operational Evaluation - Source Water - 55263 [PDF] [DOC]
- Stage 2 Operational Evaluation - Summary - 55260 [PDF] [DOC]
- Stage 2 Operational Evaluation - Treatment Process - 55262 [PDF] [DOC]
- Synthetic Organic Compounds (SOC's) In Drinking Water - 53287 [PDF]
- Total Coliform / Groundwater Rule Reporting - 53297 [PDF]
- Total Coliform Site Sampling Plan- Non-Transient Non-Community Water Systems (NTNC) 53016 [PDF]
- Total Coliform Site Sampling Plan- Transient Non-Community Water Systems (TNC) 55982 [PDF] [DOC]
- Trihalomethanes (TTHM) And Haloacetic Acids (HAA5) Analyses In Drinking Water - 53288 [PDF]
- Volatile Organic Compounds (VOC's) In Drinking Water - 53286 [PDF]
- Water Quality Parameters And Source Water Reporting - 53292 [PDF]
Wastewater Facilities
- Wastewater Reporting Notices and Instructions (MROs and MMRs)
- Application for Approval to Use Water Treatment Additives - 50000 [PDF]
- Application for Industrial Wastewater Pretreatment (IWP) Permit - 50271 [PDF]
- Application for Industrial Wastewater Treatment Construction Permit Per 327 IAC 3 - 53161 [DOC]
- Application for Preliminary Effluent Limitations - 53912 [PDF] [DOC]
- Application for Sanitary Sewer Construction - 53159 [DOC]
- Application for Wastewater Treatment Plant Construction Permit Per 327 IAC 3 - 53160 [DOC]
- Bypass/Overflow Incident Report - 48373 [PDF] [DOC]
- Identification of Potentially Affected Parties - 49456 [PDF] [DOC]
- Industrial Streamlined Mercury Variance (SMV) Application - 52111 [PDF] [DOC]
- Monthly Monitoring Report (MMR) for Industrial Discharge Permits - 30530 [PDF] [XLS]
- Monthly Monitoring Report (MMR) for Wet Weather Treatment Facilities - 56109 [XLS]
- Monthly Report of Operation Activated Sludge Type Wastewater Treatment Plant - Expanded - 10829 [PDF] [XLS]
- Monthly Report of Operation Activated Sludge Type Wastewater Treatment Plant - Standard - 53463 [PDF] [XLS]
- Monthly Report of Operation Lagoon Type Wastewater Treatment Plant - 53343 [PDF] [XLS]
- Monthly Report of Operation Package Type Wastewater Treatment Plant - Less than 0.05 mgd - 53344 [PDF] [XLS]
- Monthly Report of Operation Sequencing Batch Reactor Wastewater Treatment Plant - 53339 [PDF] [XLS]
- Monthly Report of Operation Trickling Filter or RBC Wastewater Treatment Plant - 53340 [PDF] [XLS]
- Monthly Report of Operation Vertical Loop Reactor Wastewater Treatment Plant - 53341 [PDF] [XLS]
- Municipal Chloride Variance Application - 55044 [DOC]
- Municipal Streamlined Mercury Variance (SMV) Application - 52112 [PDF] [DOC]
- National Pollutant Discharge Elimination System (NPDES) CSO Monthly Report of Operations and Instructions - 50546 [XLS]
- Noncompliance 24-hour Notification Report - 52415 [DOC]
- NPDES Form 2C Application Package - 55637 [PDF]
- NPDES Form 2D Application Package - 51957 [PDF]
- NPDES Form 2E Application Package - 55639 [PDF]
- NPDES General Permit Notice of Intent Submittal Application - 49401 [PDF]
- NPDES Industrial Permit Information Application Instructions General Information Form - 51952 [PDF]
- NPDES Public Water Supply Permit Application Package - 50103 [PDF]
- NPDES Semi Public and Minor Municipal Permit Application - 54924 [PDF] [DOC]
Operator Certification and Continuing Education
- Certified Operator in Responsible Charge (CORC) Request for Information – Operator of Multiple Public Water Systems - 53249 [PDF] [DOC]
- Drinking Water Certification: Application for Approval of Continuing Education Training - 45675 [PDF]
- Drinking Water Certification: Continuing Education Credit Report - 45674 [PDF]
- Facility Specific Operator (FSO): Application for Water Treatment Plan and Water Distribution System Operator Certification - 53210 [PDF] [DOC]
- Public Water Supply: Application For Water Treatment Plant and Water Distribution System Operator Certification - 12094 [PDF] [DOC]
- Public Water Supply: Certified Operator in Responsible Charge (CORC) Request for Information – Operator of Multiple Public Water Systems [PDF] [DOC]
- Wastewater Operator Certification: Application for Wastewater Treatment Plant Operator Certification Examination - 47289 [PDF] [DOC]
- Wastewater Operator Certification: Application for Wastewater Treatment Plant Operator Certification Examination - Short Form for Apprenticeship Only - 53583 [PDF] [DOC]
- Wastewater Operator Apprentice: Application for Wastewater Treatment Plant Apprentice to Request Certification - 53785 [PDF]
- Wastewater Operator Provisional Certification: Application for Provisional Wastewater Treatment Plant Operator Certification - 51494 [PDF]
- Wastewater Operator Certification: Application for Wastewater Treatment Plant Operator Certification by Reciprocity - 47290 [PDF] [DOC]
- Wastewater Operator Continuing Education: Application for Approval of Continuing Education - 51138 [PDF]
- Wastewater Operator Continuing Education: Credit Report - 51139 [PDF]
Storm Water & Wetlands
- Rule 5: Notice of Intent (NOI) - 47487 [PDF] [DOC]
- Rule 5: Notice of Termination (NOT) Storm Water Runoff Associated With Construction Activity - 51514 [PDF] [DOC]
- Rule 6: General Permit Annual Report - 54185 [PDF] [DOC]
- Rule 6: Industrial Storm Water Discharge Monitoring Report - 53590 [PDF] [DOC]
- Rule 6: Notice of Intent (NOI) Letter - 51286 [PDF] [DOC]
- Rule 6: Storm Water Pollution Prevention Plan (SWP3) - 51287 [PDF] [DOC]
- Rule 6: Notice of Termination/Exclusion (NOT/E) Letter - 54087 [PDF] [DOC]
- Rule 13: Annual Report - 51278 [PDF] [DOC]
- Rule 13: Certification of the Development and Implementation, of a Program to Reduce Pollutant Run-Off from Municipal Operations for the Municipal Operations Pollution Prevention and Good Housekeeping MCM - 51281 [PDF] [DOC]
- Rule 13: Certification of the Development, Implementation, Management and Enforcement of a Post-construction Storm Water Run-Off Control Program for the Post-construction Storm Water Run-Off Control MCM - 51274 [PDF] [DOC]
- Rule 13: Certification of the Development, Implementation, Management and Enforcement of an Erosion and Sediment Control Program for the Construction Site Storm Water Run-Off Control MCM - 51272 [PDF] [DOC]
- Rule 13: Certification of the Informational Program for the Public Education and Outreach MCM - 51279 [PDF] [DOC]
- Rule 13: Certification of the Plan to Detect, Address and Eliminate Illicit Discharges for the Illicit Detection and Elimination MCM - 51271 [PDF] [DOC]
- Rule 13: Certification of the Public Participation and Involvement Program for the Public Participation and Involvement MCM - 51273 [PDF] [DOC]
- Rule 13: Monthly Summary Report of Construction Projects - 51276 [PDF] [DOC]
- Rule 13: Notice of Intent (NOI) Letter - 51270 [PDF] [DOC]
- Rule 13: Storm Water Quality Management Plan (SWQMP) - Part A: Initial Application Certification Submittal and Checklist - 51277 [PDF] [DOC]
- Rule 13: Storm Water Quality Management Plan (SWQMP) - Part B: Baseline Characterization and Report Certification Checklist - 51275 [PDF] [DOC]
- Rule 13: Storm Water Quality Management Plan (SWQMP) - Part C: Program Implementation Certification Checklist - 51280 [PDF] [DOC]
- Wetlands: Application For Authorization to Discharge Dredged or Fill Material to Isolated Wetlands and/or Waters of the State - 51821 [PDF] [DOC]
- Wetlands: Section 401 WQC Regional General Permit Notification Form - 51937 [PDF] [DOC]
Watershed Management
- Hoosier Riverwatch Workshop Evaluation - 55189 [PDF] [DOC]
- Hoosier Riverwatch Workshop Registration - 55188 [PDF] [DOC]
- Hoosier Riverwatch Workshop Summary - 55190 [PDF] [DOC]
- Itemization of Invoice Expenditures - 50067 [PDF] [DOC]
- Report of In-kind/Cash Match Contributions - 50066 [PDF] [DOC]
- Section 205 Nonpoint Source Pollution Grant Application – 53970 [PDF] [DOC]
- Section 319 Nonpoint Source Pollution Grant Application - 49367 [PDF] [DOC]
- Section 319 & 205j Grant Program Progress Report Form - 50068 [PDF] [DOC]
- Section 319: 319A (Agriculture) Cost Share Form - 50065 [PDF]
- Section 319: 319U (Urban) Cost Share Form - 50063 [PDF]
Wellhead Protection
- Hoosier Water Guardian Award Fixed Radius Method Application - 53248 [PDF]
- Hoosier Water Guardian Award Application Model Method - 55411 [PDF] [DOC]
- Indiana Wellhead Protection Phase I Application - 54189 [PDF] [DOC]
- Indiana Wellhead Protection Phase II Application - 53117 [PDF]
- Indiana Wellhead Protection Phase II Five Year Update Forms - 53796 [PDF] [DOC]
- New Well Site Application - 50896 [DOC]
- Wellhead Protection Area Proximity Determination Request - 54297 [PDF]
Other Non-Agency Forms
Auditor of State
- Vendor Information - 53788 [PDF]
Bureau of Motor Vehicles
- Application for Salvage Motor Vehicle Business License - 40248 [PDF]
Department of Administration
- Indiana Economic Impact - Proposals and Contracts - 51778 [PDF] [XLS]
Department of Local Government Finance
- Statement for Deduction of Assessed Valuation - 18865 [PDF]
Department of Natural Resources
- Registration of a Significant Water Withdrawal Facility - 20094 [PDF]
U.S. Environmental Protection Agency
- Boiler MACT Initial Notification: National Emission Standards for Hazardous Air Pollutants (NESHAP) for Major Sources [PDF]
- CAIR Permit Application (Sources Covered Under the CAIR SIP) - Part 96 [DOC]
- CAIR Permit Application (Sources Covered under the FIP) - Part 97 [DOC]