Forms

These forms are available for DEQ land protection activities.

Contaminated Media  Available Formats
Contaminated Media Use Form                                                           Word    
Contaminated Media Management and Re-use Variance  PDF       
Cost Estimate  
Landfill Cost Estimate Worksheets, CEW-01 and CEW-02 PDF Excel  
Landfill cost estimate form, DEQ Form CE SWDF PDF Word    
SWMF cost estimate form, DEQ Form CE SWMF                                                  PDF Word    
Disclosure Statement  
Applicant Disclosure Form DISC-01 PDF Word    
Applicant Disclosure Form DISC-02 PDF Word    
Applicant Disclosure Form DISC-03                                                      PDF Word    
Frequently Asked Questions regarding  the disclosure forms                  PDF      
Exempt Yard Waste  
Yard Waste Composting Annual Report PDF    
Exempt Yard Waste Compost Facility Certification PDF    
Exempt Yard Waste & Herbivorous Manures Compost Facility Certification                                                PDF    
Groundwater
ARSC-01 - Groundwater Annual Report Submission Checklist                     PDF    
Hazardous Waste  
Application for temporary emergency permit to store, transport or treat hazardous waste Word    
Application for a Transporter Permit
Transporter Permit Application Requirements		 PDF   Online
Recycling  
Form DEQ 50-11S ( Recycling Equipment Tax Credit ) PDF    
Form DEQ 50-11 (Recycling Equipment Tax Certification for Local Tax Exemption) PDF    
Form DEQ 50-12 ( Waste Motor Oil Burner Tax Credit )                                             PDF    
Guidance for Certification of Recycling Equipment and Machinery             PDF      
Guidance for Certification of Waste Motor Oil Burning Equipment PDF      
Regulated Medical Waste  
Petition for evaluation and approval of regulated medical waste treatment technology PDF Word    
Request for Certification (Local Government), DEQ Form CERT-01                                             PDF    
Special Waste Disposal Request
Special Waste Disposal Request                                                                PDF Word    
Instructions for Completing SWDR PDF      
Solid Waste Permitting
Landfill Mining Application Form PDF Word    
Form SW PTA Part A application form for solid waste management facilities PDF Excel  
SW PTB Part B application form for solid waste management facilities
Instructions for Completing DEQ Form SW PTB 		PDF Excel  
Permit-by-Rule Application Form             PDF Word    
Permit-by-Rule checklist for Solid Waste Management Facilities PDF    Excel  
Permit application for emergency debris waste piles PDF  Word     
Form SW-11-1 Local government certification form for solid waste facilities PDF      
Form SW-11-1 Local government certification form for FFCP facilities PDF       
DEQ Form SW-11-2, Solid Waste Permit –NOI-Host Agreement Certification from Locality PDF      
Certificate-to-operate checklist for solid waste disposal facilities PDF PDF    
SWIA
Form DEQ 50-25 Reporting table for Solid Waste Information                      PDF    
Form DEQ 50-25 Instructions on completing form DEQ 50-25 PDF    
Other
Open dump evaluation criteria                                                                   PDF Word    
Application for Vessel Certificate of Financial Responsibility Word    
Solid Waste Annual Permit Fee Quarter Payment Form PF001 PDF      
Trade Secret Protection Request Form    Word    
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Virginia Department of
Environmental Quality
629 East Main Street
P.O. Box 1105
Richmond, VA 23218
(804)698-4000

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