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Application, Registration, and Reporting Forms

Bureau of Air Quality

Air Permitting - Construction Applications*


For sources requesting to install new or modify existing equipment. Forms D-2566 through D-2570 and any information required by these forms or instructions should be included in order for a construction permit application to be complete.

Previous application forms will no longer be accepted.
Form Name DHEC
Form #
ePermitting
Facility Information (Instructions) - Identifies the facility, verify the physical address of the facility, identify the primary products or services provided by the facility, and establish the permit contact, and Owner or Operator for the facility. D-2566 -
Equipment / Processes (Instructions) - Identifies the equipment and processes that will be added, removed or modified at the facility, including the size and type along with the make and model, and any associated control devices and/or emission points. D-2567 -
Control Devices (Instructions) - Describes all of the control devices for the various equipment and processes and the associated emission points. D-2568 -
Emissions (Instructions) - Provides before and after emissions and a "Summary of Projected Change in Facility Wide Potential Emissions" calculated at maximum design capacity. D-2569 -
Regulatory Review (Instructions) - Provides a complete regulatory review of all applicable and non-applicable state and federal regulations. D-2570 -
Application Revision Request (Instructions) - Identifies the Construction Permit Application Forms that have been amended which are being resubmitted for review of the proposed revision to the original construction permit. D-2571 -
Modeling Information (Instructions) - Provides Source (Stack) Dispersion Parameters for any new sources (stacks) or any revised sources (stacks). D-2573 -
Expedited Review Program SOP - Air Quality Construction Permits - 
Protocol and procedures for submitting an expedited construction permit under the Expedited Review Program.
- -
Expedited Review Request Form - Air Quality Construction Permits
(Instructions) -  Request for submittal of construction applications into the Expedited Review Program
D-2212 -
* Beginning January 1, 2011, all construction permit applications will have to address greenhouse gas emissions and tailoring rule applicability.
For more detailed information about the construction forms or Expedited Review Program, please contact Alyson Hayes at (803) 898-3836.

Air Permitting - Notification

Form Name DHEC
Form #
ePermitting
Start of Construction Notification (Instructions) - Identifies all of the equipment and control devices, as listed in the original construction permit, for which construction has started. D-2572 -
Facility Relocation Application Form (Instructions) - The Facility Relocation Application Form serves as a request from the requirement to obtain a construction permit for facility relocation. D-0662 -
Operating Ranges (Instructions) - For use by existing permitted sources to submit required operating permit ranges in accordance with issued permits. D-0304 -
Low NOX Assembly Replacement Notification (Instructions) - This form will be used for notifying the Agency that the facility is replacing an existing burner assembly per SC Regulation 61-62.5, Standard 5.2. The facility must make written notification of the request to the Bureau of Air Quality within seven (7) days prior to register the replacement unit. D-2935 -
Transfer of Ownership / Operation (Instructions) - For use by all facilities to transfer ownership of air quality permits. D-2954 -
Exempt Source Log (Instructions
Used to identify activities/sources that the Bureau of Air Quality has exempted from construction permitting requirements.

D-0721

 
On-site Implementation Log (Instructions
Used to document all activities allowed under the permit flexibility condition found in your Bureau of Air Quality operating permit.

D-0722

-
Facility Information Update (Instructions) - For use by all facilities to update general permit information D-2959 -
Air Permit Cancellation (Instructions) - For use by existing permitted sources to request cancellation of all air permits due to facility closure. D-2374 -
For more detailed information about these forms contact Alyson Hayes at (803) 898-3836.

Air Permitting - Operating Permits

Form Name DHEC
Form #
ePermitting
Operating Permit Request / Notification of Initial Start-Up / Certification of Construction (Instructions) - Used to request Operating Permit, notify BAQ of initial start-up of equipment, and to certify that construction was performed per an issued construction permit D-2574 -
State Operating Permit and Conditional Major Operating Permit Renewal Request Form (Instructions) - For use for facilities requesting renewal of their State or Conditional Major Operating Permit. D-2955 -
For more detailed information about the operating permit forms contact Alyson Hayes at (803) 898-3836.

Air Permitting - Registration Permits

Form Name DHEC
Form #
ePermitting
Registration Permit Request for Auto Body Refinishing Shops
Used to request coverage under a Registration Permit for auto body shops.
D-2089 -
Registration Permit Application for Cotton Ginning Operations
Used to request coverage under a Registration Permit for cotton ginning operations.
D-2344 -
Registration Permit Application for Crematory Operations
Used to request coverage under a Registration Permit for crematory operations.
D-0131 -
Registration Permit Application for Fuel Combustion Operations
Used to request coverage under a Registration Permit for fuel combustion operations
D-2958 -
Registration Permit Application for Temporary Crushing and Screening Operations
Used to request coverage under a Registration Permit for temporary crushing and screening operations.
D-1494 -
Registration Permit Application for Wood Working Operations (Flowchart) (Instructions)
Used to request coverage under a Registration Permit for wood working operations.
D-0872  
     
For more detailed information about the registration permit forms contact Alyson Hayes at (803) 898-3836.

Air Permitting - Title V Permit

The Title V Application forms have been revised. Previous versions of the application forms will no longer be accepted after April 1, 2014.

Form Name DHEC
Form #
ePermitting
Facility Relocation Application Form (Instructions) - The Facility Relocation Application Form serves as a request from the requirement to obtain a construction permit for facility relocation. D-0662 -
For more detailed information about the Title V forms contact Alyson Hayes at (803) 898-3836.

Asbestos - Demolition and Renovation Application Forms

Form Name DHEC
Form #
ePermitting
Demolition License Application - for the notification of regulated demolition projects. D-3428 -
Asbestos Abatement Project License Application - for the notification of regulated asbestos abatement projects. D-3430 -
Abatement Project Quarterly Report - for the quarterly reporting of small-scale abatement projects by facilities holding a Group License (i.e., Industrial Manufacturing & Electrical Generating Facilities). D-3575 -
Waste Shipment Record - for the documentation of asbestos-waste transport and disposal. D-3688 -
For more detailed information about Asbestos Forms, visit the Asbestos Contacts and Forms website or contact Robin Mack at (803) 898-4270.

Asbestos - Disposal Authorization Forms

Form Name DHEC
Form #
ePermitting
Notification of Non-Friable Asbestos Abatement Project - for obtaining disposal authorization to transport nonregulated asbestos-containing materials to a DHEC approved landfill. D-3654 -
Notification of Residential Non-Friable Asbestos Abatement Project - 
for obtaining disposal authorization to transport nonregulated asbestos-containing materials removed from a nonregulated residence to a DHEC approved landfill.
D-3653 -
Temporary Asbestos Storage Containment Area License Application - 
for obtaining authorization to temporarily store waste from Small and Minor projects at a specified location by Non-industrial Facilities and Asbestos Abatement Contractors.
D-3423 -
Temporary Asbestos Storage License Application Directions - 
directions for completing the Temporary Asbestos Storage Containment Area License application.
- -
For more detailed information about Asbestos Forms, visit the Asbestos Contacts and Forms website or contact Robin Mack at (803) 898-4270.

Asbestos - Abatement License Forms

Form Name DHEC
Form #
ePermitting
Asbestos Abatement License Application - for obtaining personnel and contractor licensing for disciplines described here. D-2925 -
Application Form for Asbestos Group License - for obtaining Industrial Group Licenses or Non-industrial Facility Operations & Maintenance (O & M) Licenses. D-3422 -
For more detailed information about Asbestos Forms, visit the Asbestos Contacts and Forms website or contact Robin Mack at (803) 898-4270.

Asbestos - Training

Form Name DHEC
Form #
ePermitting
Application for Asbestos Training Course Approval (pdf) – for seeking DHEC approval to conduct asbestos training in South Carolina. D-3895.pdf -
Application for Asbestos Instructor Approval (pdf) – for any individual seeking approval as an instructor for any asbestos course discipline regulated by DHEC. D-3894 -
 

Emissions Inventory

Form Name DHEC
Form #
ePermitting
Emission Inventory Point Source Data Report - DHEC has developed and now requires Emissions Inventories to be performed and submitted using Web Satellite i-STEPS (aka WebSteps, WebSat and Web Satellite). Use of this form to report an Emissions Inventory is only allowed at the request of or with the written permission of the Emissions Inventory Section of DHEC's Bureau of Air Quality. D-1904 -
Electronic Signature Agreement - This form must be submitted to allow the responsible official to electronically sign the facility's Web-Steps Submittal. D-1040 -
Electronic Registration Agreement - This agreement is to be filled out and signed by the person or persons who will actually be entering the data into Web-Steps. D-1041 -
For more detailed information about performing an emissons inventory or HAP Emission Summary, visit the Emissions Inventory website or contact Lynn Barnes at (803) 898-4298.

Ground-level Ozone Nonattainment Areas: Reporting Requirements

Form Name DHEC
Form #
ePermitting
Emissions Statement Reporting Form - Section 182(a)(3)(B) of the Clean Air Act requires South Carolina's State Implementation Plan (SIP) to contain a requirement for all owners or operators of stationary sources located in a nonattainment area that emit either NOX or VOC to submit a statement of actual emissions annually. D-1216 -
For more detailed information about Emissions Statement Reporting Form, please visit the Reporting Requirements for Ground-level Ozone Nonattainment Areas website or contact
Lynn Barnes at (803) 898-4298.

Maximum Achievable Control Technology (MACT)

Form Name DHEC
Form #
ePermitting
Ongoing Compliance Report, Subpart N - 40 CFR Part 63, Subpart N: National Emission Standards for Chromium Emissions from Hard and Decorative Chromium Electroplating and Chromium Anodizing Tanks D-2909 -

SC Clean Air Interstate Rule (CAIR) Programs / NOX SIP Call

Form Name DHEC
Form #
ePermitting
CAIR Permit Application - identifies the facility, name the facility's authorized CAIR account representatives, list the facility's affected emission units, and identify the SC CAIR programs the affected emissions units are subject to. D-2069 -
CAIR Permit Application Instructions - Instructions for filling out a CAIR Permit Application D-2069
Instructions
-
For more information please visit our CAIR website or contact Veronica Barringer at (803) 898-4127.

Source Evaluation/Stack Testing

Form Name DHEC
Form #
ePermitting
Site-Specific Test Plan/Final Report Checklist - Prior to conducting a source test subject to Regulation 61-62.1 Section IV, the owner or operator are required to submit a site-specific test plan detailing all source testing methods to be used at a permitted facility. - -
For more information about source evaluation, contact Michael Shroup at (803) 898-4051.

Title V Annual Compliance Certification (TVACC)

Form Name DHEC
Form #
ePermitting
Title V Annual Compliance Certification - required annual certification from Title V permitted facilities to list deviations from the terms or conditions in their Title V permits. D-3650 -
For more information or questions about our forms, please visit the Compliance Reporting website
or contact Dawn Jordan at (803) 898-4075.

Bureau of Environmental Health

Food Safety

Form Name DHEC
Form #
ePermitting
Application for Retail Food Establishment Permit - Apply to operate retail food establishment D-1769 -
File a Food Safety Complaint - Use this online form to file a food safety complaint about a South Carolina Food Service D-1218 -
Bureau of Environmental Health, Division of Food Protection - Phone: (803) 896-0640 Fax: (803) 896-0645.

Septic Tanks

Form Name DHEC
Form #
ePermitting
Application for Permit to Construct an Individual Sewage Treatment and Disposal System D-1740 -
Application for License to Construct or Clean Onsite Wastewater Systems and Self-Contained Toilets D-1777 -
Bureau of Environmental Health, Onsite Wastewater Management Division - Phone: (803) 898-4329 Fax: (803) 896-0645.

Bureau of Environmental Health Services

Bureau of Environmental Health Services

Form Name DHEC
Form #
ePermitting
Application for Laboratory Certification- Use this form to apply for DHEC laboratory certification D-2802 -
Instructions for Completing Laboratory Certification Application- Instructions for Form D-2802 D-2802i -
Chlorite Analysis form (pdf) - This form is designed for laboratories performing chlorite and/or chlorine dioxide analyses. ---- -
Colilert-18® Fecal Coliform QC Form (pdf) - This is an example form for performing media quality control checks with pure cultures for fecal coliform analyses. ---- -
Colilert® QC Form (pdf) - This is an example form for performing media quality control checks with pure cultures for total coliform/E. coli analyses. ---- -
Colilert Quanti-Tray® Total Coliform/E. coli MPN Form (pdf) - This form is designed for laboratories performing total coliform/E. coli MPN analyses using the Quanti-Tray®. ---- -
Colilert-18 Quanti-Tray® Fecal Coliform MPN Form (pdf) - This form is designed for laboratories performing fecal coliform MPN analyses using the Quanti-Tray®. ---- -
Enterococci Medium Quality Control Record (08/05) (pdf) - This is an example record that the laboratory may use to record the quality control checks performed on the medium. ---- -
Enterolert© Sample Analysis Form (10/06) (pdf) - This is a form that laboratories may use when recording enterolert© results. ---- -
Initial Demonstration of Capability (IDOC) form (pdf) - This form is designed for laboratories performing organic analyses. The form includes all required information to make the necessary review possible. Please ensure that when applying for certification, the IDOC studies submitted include all of the information included on this form. ---- -
Method Detection Limit (MDL) form (pdf) - This form is designed for laboratories performing organic analyses. The form includes all required information to make the necessary review possible. Please ensure that when applying for certification, the MDL studies submitted include all of the information included on this form. ---- -
Spore Ampule Sterilization Confirmation (pdf) - This is an example form for performing spore ampule sterilization checks on the autoclave. ---- -
Bureau of Environmental Services, Office of Laboratory Certification - Phone: (803) 896-0970 Fax: (803) 896-0850.

Health care Facilities Licensing

Health care Facilities Licensing

Form Name DHEC
Form #
ePermitting
All Health care Facility Forms
For additional information, contact: Division Director Gwendolyn Thompson - (803) 545-4370

Bureau of Land and Waste Management

Electronic Manufacturers

Form Name DHEC
Form #
ePermitting
Covered Electronic Devices Manufacturer Registration (D-2425) D-2425 Covered Electronic Devices Manufacturer Registration (D-2425)

Drycleaners

Form Name DHEC
Form #
ePermitting
Drycleaner Eligibility Application - Drycleaner Eligibility Application D-3469 -
Instructions for Drycleaner Eligibility Application D-3469 -
Drycleaner Notice of Property Transfer or Name Change - Drycleaner Notice of Property Transfer or Name Change D-2057 -
Drycleaner Containment Structure Certification Form - Drycleaner Containment Structure Certification Form D-3879 -
Drycleaner Findings of Due Diligence Form - Drycleaner Findings of Due Diligence Form D-3471 -
For more information or questions about our Dry Cleaning Forms,
please contact Robert Hodges at (803)-898-0919.

Hazardous Waste

Form Name DHEC
Form #
ePermitting
Hazardous Waste Transporter Permit Application - Hazardous Waste Transporter Permit Application --- -
Introduction to the South Carolina Notifications of Regulated Waste Activity Form  - Introduction and basic generators information for the Notification of Regulated Waste Activity --- -
Notification of Regulated Waste Activity Form (Instructions) - The Notification and Reporting Form is used by companies that are required under the South Carolina Hazardous Waste Management Regulations, 6I-79.262.13, 263.13, 264.5 and 265.5 to notify the South Carolina Department of Health and Environmental Control (SCDHEC) that they are involved in hazardous waste activities. SCDHEC is responsible for assigning the Environmental Protection Agency Identification Number (EPA ID #). D-2701 -
Introduction to Hazardous Waste Reports - Introduction and basic generators information for the Notification and the Hazardous Waste Reports --- -
Quarterly Hazardous Waste Report Codes - Form Codes, Management Method Codes, Source Codes, and Waste Minimization Codes --- -
Quarterly Hazardous Waste Report - Generation and On-Site Treatment, Storage, Disposal and Recovery (Instructions) -  "Generation and On-Site T,S,D,R" - This form is used to report the amount IN POUNDS of hazardous waste generated during a quarter. Any waste generated on-site and then treated, stored, (accumulated), disposed of (on-site) or recovered should be reported on this form. The treatment, disposal and recovery activities mentioned here may require either currently having Interim Status or obtaining a Hazardous Waste Permit from S.C. DHEC. Large Quantity Generators are allowed to store (accumulate) hazardous waste under 90 days without a permit. The EPA ID # and name of all initial transporters who hauled hazardous waste for you during this quarter. D-1962 -
Quarterly Hazardous Waste Report - Waste Shipped Off-Site for Treatment, Storage, Disposal and Recovery (Instructions) -  "Waste Shipped Off-Site for T,S,D,R" - This form is a log of manifested hazardous waste shipments transported off-site for a quarter. D-1963 -
Quarterly Hazardous Waste Report - Off-Site Facility Report (Instructions) -  "Off-Site Facility Report" - This form is to be completed only by those companies who accept hazardous waste that was generated by other companies for the purpose of treatment, storage, disposal and/or recovery. The treatment, storage, disposal and recovery activities mentioned here require either currently having Interim Status or obtaining a Hazardous Waste Permit from S.C. DHEC. D-1964 -
Hazardous Waste Index (Instructions) -  "Hazardous Waste Index" - This form is used to create an index of all the hazardous waste streams a company generates. When a new waste stream is generated, this form is to be completed and submitted with the rest of the quarterly report forms. Please do not repeat old waste stream information. This form is never required to be completed by those companies who submit an Annual Declaration. D-1965 -
RCRA Part A Permit Application - Instructions and Forms - RCRA Part A Permit Application - Instructions and Forms EPA 8700-23 -
Waste Minimization Report - Waste Minimization Report - Large Quantity Generators are Required to Submit D-3446 -
For more information or questions about Regulated Waste Activity, Hazardous Waste Transporters, and Hazardous Waste Reporting Forms, please contact Lillian McFadden at (803) 898-0486.

Infectious Waste

Form Name DHEC
Form #
ePermitting
Checklist for Infectious Waste Management Plan Review - Checklist for Infectious Waste Management Plan Review --- -
Infectious Waste Generator Registration - Infectious Waste Generator Registration D-1999 -
Infectious Waste Transporter Registration - Infectious Waste Transporter Registration D-3408 -
Infectious Waste Transporter Certificate of Insurance - Infectious Waste Transporter Certificate of Insurance D-3407 -
Infectious Waste Manifest - The Program recommends that the Infectious Waste Manifest be printed as a four page carbonless form. It is also recommended that the four pages be printed on different color paper. D-2116 -
For more information or questions about Infectious Waste Reporting Forms, please contact Kim Clyburn at 898-0239.

Mining

Form Name DHEC
Form #
ePermitting
MR-200: Application for an Exploration Certificate ($300.00 fee)  - Application for an Exploration Certificate ($300.00 fee) D-3100 -
MR-300: Reclamation Plan for Exploration - Reclamation Plan for Exploration D-3101 -
MR-400GP1: Application for a General Mine Operating Permit ($375.00 fee). An NPDES permit must be obtained prior to any mining under the GP1 - Click here for GP1 Reclamation Plan D-3114 -
MR-400: Application for an Individual Mine Operating Permit ($600 fee ) - 
Click here
if site is in SC Coastal Zone Management Area -Beaufort, Berkeley, Charleston, Colleton, Dorchester, Georgetown, Horry, Jasper counties
Click here
for Information to Mine in Water Bodies
D-3102 -
MR-500: Reclamation Plan for an Individual Mine Operating Permit - Reclamation Plan for an Individual Mine Operating Permit D-3103 -
MR-600: Land Entry Agreement for Land Owned by Mine Operator - Land Entry Agreement for Land Owned by Mine Operator D-3104 -
MR-700: Land Entry Agreement for Land Leased by Mine Operator - Land Entry Agreement for Land Leased by Mine Operator D-3105 -
MR-800: Reclamation Bond Form to Post a Surety Bond - Reclamation Bond Form to Post a Surety Bond D-3106 -
MR-900: Reclamation Bond Form to Post a Bond Other than a Surety Bond - Reclamation Bond Form to Post a Bond Other than a Surety Bond D-3107 -
MR-1000: Assignment - Assignment of Reclamation Bind D-3108 -
MR-1050: Irrevocable Letter of Credit - Irrevocable Letter of Credit D-3109 -
MR-1100 : Annual Reclamation Report to be submitted with $375.00 annual fee - Mining Annual Operating Fee per mine D-3110 -
MR-1300: Application for Modifying a Mine Operating Permit and/or Reclamation Plan - Application for Modifying a Mine Operating Permit and/or Reclamation Plan D-3111 -
MR-1400: Mine Operating Permit Transfer Agreement - Mine Operating Permit Transfer Agreement D-3112 -
For more information or questions about Mining Forms, please contact Wendy Hamilton at (803) 898-1368.

Radioactive Waste

Form Name DHEC
Form #
ePermitting
Application for Radioactive Waste Transport Permit - Application for Radioactive Waste Transport Permit D-0800 -
Radioactive Waste Shipment Prior Notification and Manifest Form - Radioactive Waste Shipment Prior Notification and Manifest Form D-0802 -
Radioactive Waste Shipment Certification - Radioactive Waste Shipment Certification D-0803 -
For more information or questions about Radioactive Waste Forms, please contact Kim Clyburn at (803) 898-0239.

Solid Waste Compliance

Form Name DHEC
Form #
ePermitting
Annual Report SW Mgt WT Collection, Processing & Disposal Facilities D-2718 -

South Carolina Solid Waste Transfer Stations Annual Report​ (07/2014)

Instructions

D-1350  

Class -1 Landfill Annual Report Form

Instructions

D-1342 -

Class -2 Landfill Annual Report Form

Instructions

D-1321 -

Class-3 Landfill Annual Report Form

Instructions

D-3122 -

Composting / Wood Chipping Facility Annual Report Form

Instructions

D-1343 -
Lead Acid Battery Facilities Registration Form - Lead Acid Battery Facilities Registration Form D-2733 -
Solid Waste Financial Assurance - Trust Fund Agreement - Solid Waste Financial Assurance - Trust Fund Agreement --- -

SW Incineration and Pyrolysis Annual Report Form

Instructions

D-1272 -

SW Processing Facility Annual Report Form

Instructions

D-1331 -

SW Used Oil Transporters - Transfer Station Annual Report Form 

Instructions

D-1317 -
Used Oil Collection Center and Aggregation Point - Used Oil Collection Center and Aggregation Point --- -
Used Oil Transporter Registration Instructions - Used Oil Transporter Registration Instructions --- -
Used Oil Transporter and Transfer Facility Registration - Used Oil Transporter and Transfer Facility Registration D-2716 -
Used Oil Transporter Certificate of Insurance - Used Oil Transporter Certificate of Insurance D-2717 -
Waste Tire Hauler Annual Report Form - S.C. Waste Tire Hauler Annual Report Form --- -
Waste Tire Hauler Registration - WTP - Application for South Carolina Waste Tire Hauler Registration - WTP D-2735 -
Waste Tire Hauler Manifest - WTP - South Carolina Waste Tire Hauler Manifest - WTP D-2738 -
For more information or questions about Waste Tires, Lead Acid Battery, or Used Oil Forms, please contact Marty Lindler at (803) 898-0456

Solid Waste Permitting

Form Name DHEC
Form #
ePermitting
Application for Permit to Construct a Solid Waste Management System - Application for Permit to Construct a Solid Waste Management System D-1932 -
Application for Registration or Permit to Land Apply - Application for Registration or Permit to Land Apply D-3568 -
Application of Registration for Structural Fill - Application of Registration for Structural Fill D-3570 -
Application for Permit to Construct a Solid Waste Tire Facility - Application for Permit to Construct a Solid Waste Tire Facility D-3571 -
Registration for Wood Chipping, Shredding and/or Composting - Registration for Wood Chipping, Shredding and/or Composting D-1988 -
Notice of Intent to Operate a Land-Clearing Debris and Yard Trash Landfill - Notice of Intent to Operate a Land-Clearing Debris and Yard Trash Landfill D-3569 -
Solid Waste Financial Assurance - Financial Guarantee Bond - Solid Waste Financial Assurance - Financial Guarantee Bond --- -
Solid Waste Financial Assurance - Irrevocable Letter of Credit - Solid Waste Financial Assurance - Irrevocable Letter of Credit --- -
Solid Waste Financial Assurance - Performance Bond - Solid Waste Financial Assurance - Performance Bond --- -
Solid Waste Financial Assurance - Standby Trust Fund Agreement - Solid Waste Financial Assurance - Standby Trust Fund Agreement --- -
For more information or questions about Solid Waste Permitting, please contact Joan Litton at (803) 898-1337

Underground Storage Tanks - Assessment and Corrective Action Section

Form Name DHEC
Form #
ePermitting
Analytical Methodology - Analytical Methodology --- -
Appendix A - Standard Field Cleaning (Decontamination) Procedures - Appendix A - Standard Field Cleaning (Decontamination) Procedures --- -
Assessment Component Invoice and Instructions 7/1/2011 - Assessment Component Invoice and Instructions 7/1/2011 D-3664 -
Assessment Component Cost Agreement 7/1/11 --- -
Assessment Component Invoice and Instructions 11/1/13 D-0728    
Assessment Component Invoice and Instructions 5/15/14 D-0728A    
Assessment Component Cost Agreement 5/15/14  5-2014  
Corrective Action Corrective Action (CA) Invoice (pre 8/1/2012) --- -
Corrective Action Corrective Action (CA) Invoice Free Product Only D-0426 -
Dissolve Clean-Up (CA) Invoice -  Dissolve Clean-Up (CA) Invoice D-3728 -
Field Data Sheet - Gauging   D-0424  
Field Data Sheet - Sampling D-0423  
Free Product Dissolve Clean-UP (CA) Invoice - Free Product Dissolve Clean-UP (CA) Invoice D-3868 -
Initial Groundwater Assessment Invoice - Initial Ground Water Assessment Invoice D-3666 -
Quality Assurance Program Plan - Quality Assurance Program Plan --- -
Contractor's Addendum, Quality Assurance Program Plan - Contractor's Addendum, Quality Assurance Program Plan --- -
Request for Review - Request for Review D-3668 -
Seasonal Tanks    
Site Rehabilitation Contractor Certification Application - Site Rehabilitation Contractor Certification Application D-3499 -
Site-Specific Work Plan D-0653 -
Slug Test - Slug Test D-3531 -
SUPERB Allowable Costs 2011 - SUPERB Allowable Costs 2011 --- -
Tier I Assessment Invoice - Tier I Assessment Invoice D-3665 -
Well Installation or Boring Invoice 11/1/13   D-0725  
Well Installation or Boring Invoice 5/15/14   D-0725A  
Well Installation or Boring Invoice - Well Installation or Boring Invoice D-3667 -
For more information or questions about our UST Assessment and Correction Action Forms please call (803) 898-2544

Underground Storage Tanks - Regulatory Compliance Section

Form Name DHEC
Form #
ePermitting
Alternate Fuel Installation Application - Alternate Fuel Installation Application D-3885 -
Assessment Guidelines for Permanent Closure and Change in Service - Assessment Guidelines for Permanent Closure and Change in Service --- -
Certificate of Financial Responsibility - Certificate of Financial Responsibility D-3472 -
Class A/B Operator Log - Class A/B Operator Log D-2213 -
Financial Responsibility Mechanisms Information Sheet - Financial Responsibility Mechanisms Information Sheet --- -
List of Insurance Agencies - List of Insurance Agencies --- -
Monthly Statistical Inventory Reconciliation (SIR) Report - Monthly Statistical Inventory Reconciliation (SIR) Report D-3574 -
Notification of USTs No Longer in Operation - Notification of USTs No Longer in Operation D-3856 -
Notification of USTs Currently in Operation - Notification of USTs Currently in Operation D-1917 -
Rectifier Log - Rectifier Log D-0648 -
Seasonal Tanks - Seasonal Tanks --- -
Site Check Fact Sheet - Site Check Fact Sheet --- -
Spill Bucket Integrity Testing - Spill Bucket Integrity Testing D-2562 -
State of South Carolina Galvanic (Sacrificial Anode) Cathodic Protection System Evaluation - State of South Carolina Galvanic (Sacrificial Anode) Cathodic Protection System Evaluation D-2550 -
State of South Carolina Impressed Current Cathodic Protection System Evaluation - State of South Carolina Impressed Current Cathodic Protection System Evaluation D-2551 -
Sump Integrity Testing Form - Sump Integrity Testing Form D-2086 -
Tank and Sludge Disposal Form - Tank and Sludge Disposal Form D-2233 -
Underground Storage Tank - Application for Permit to Install - Underground Storage Tank - Application for Permit to Install D-2101 -
Underground Storage Tank - Application for Permit to Operate - Underground Storage Tank - Application for Permit to Operate D-1959 -
Underground Storage Tank Transfer of Ownership - Underground Storage Tank Transfer of Ownership D-3871 -
72-Hour Release Report - 72-Hour Release Report --- -
For more information or questions about our UST Regulatory Compliance Forms, please call (803) 898-0589.

Waste Assessment

Form Name DHEC Form # ePermitting
Frequently Asked Questions - >DHEC 3660, 3661, 3662, 3657, 3658, 3659 --- -
Generator's Knowledge Certification - Generator's Knowledge Certification D-3574 -
RCRA & SW - TCLP Metals - Microsoft Excel needed to open spreadsheets D-3657  
Industrial RCRA - TCLP Volatiles - Microsoft Excel needed to open spreadsheets D-3658 -
Industrial RCRA & SW - TCLP Semi-Volatiles - Microsoft Excel needed to open spreadsheets D-3659  
Industrial Inorganic TCLP/R.61-58.5 - Microsoft Excel needed to open spreadsheets D-3660  
Industrial Volatile TCLP/R.61-58.5 - Microsoft Excel needed to open spreadsheets D-3661 -
Industrial Semi-Volatile TCLP/R.61-58.5 - Microsoft Excel needed to open spreadsheets D-3662 -
Industrial RCRA - TCLP Metals  - Microsoft Excel needed to open spreadsheets D-3667 -
Analyte Batch Report and Concentrations - Microsoft Excel needed to open spreadsheets D-3732 -
Cross Reference Report for QA and Analyte - Microsoft Excel needed to open spreadsheets D-3733 -
Land Application - Microsoft Excel needed to open spreadsheets D-3734 -
Simple Random Sampling Method for Hazardous Waste - Microsoft Excel needed to open spreadsheets D-3782 -
Instructions for Simple Random Sampling Method for Hazardous Waste D-3782  
Stratified Random Sampling Method - Microsoft Excel needed to open spreadsheets D-3783 -
Instructions for Statistical Analyses for Random Simple and Stratified Sampling - Instructions for Statistical Analyses for Random Simple and Stratified Sampling D-3782, 3783 -
TCLP Variable Detection Levels Memo (rev. 3/6/2013) - TCLP Variable Detection Levels Memo --- -
For more information or questions about Waste Assessment Forms, please contact Steve Burdick at (803) 898-1317.

Ocean and Coastal Resource Management

Critical Area/Wetlands Permitting - Forms

Form Name DHEC
Form #
ePermitting
Beachfront Notification Form D- 3896 -

Coastal Zone Consistency - Policy Group Checklists

D-0479
~
D-0492

-
Construction Placard Request Form D-3911 -
Critical Area Line Setting Request D-3902 -
Critical Area Permit Application D- 3898 -
General Coastal Zone Consistency Request Form D-0352  
General Permit Application D-3903  
Request to Amend a Critical Area Permit D-3897 -
Request for Maintenance and Repair Authorization D-3899 -
Permit Assignment/Transfer Form D-3900 -
Request to Extend a Critical Area Permit D-3901 -
State Coastal Zone Consistency Request Form D-0478 -

Bureau of Water

Agricultural Facilities

Form Name DHEC
Form #
ePermitting
Burial Site Request - Daily & Mass Burial Site Request Form
D-2622 -
Request for a Preliminary Site Inspection - Preliminary Site Inspection Form D-2623 -
Notice of Intent to Construct an Agricultural Facility - Notice of Intent Form for the New Agricultural Facilities D-3579 -
Agricultural Animal Facilities (Other than Swine) - Standard Application Form for New or Expanding Agricultural Animal Facilities Other than Swine D-3580 -
New or Expanding Small Swine Facilities (500,000 lbs or less) - Standard Application Form for New or Expanding Small Swine Facilities (500,000 lbs or less) D-3577 -
New or Expanding Large Swine Facilities (500,001 lbs or more) - Standard Application Form for New or Expanding Large Swine Facilities (500,001 lbs or more) D-3578 -
Stacking Shed and/or Composter - Standard Application Form for Stacking Shed and/or Composter D-2512 -
Agricultural Manure Brokers - Standard Application Form for Agricultural Manure Brokers D-2514 -
Agricultural Manure Applicators - Standard Application Form for Agricultural Manure Applicators D-2510 -
Modifications (for existing facilities) - Standard Application Form for Agricultural Facilities Modifications (for existing facilities) D-2511 -
Agricultural Permit Transfer of Ownership or Operation - Standard Application Form for Agricultural Permit Transfer of Ownership or Operation D-2513 -
Integrator Registration Form - Request for Integrator Registration Form D-2516 -
Manure Balance Sheet - Manure Balance Sheet for Manure Brokers - -
Manure Transfer Agreement - Manure Transfer Agreement Form - -
Bill Chaplin - (803) 898-3532

Dams

Form Name DHEC
Form #
ePermitting
Application to Construct or Alter a Dam - Application to Construct or Alter a Dam D-2602 -
John Poole - (803) 898-4212
Bill Chaplin - (803) 898-3532

Drinking Water

Form Name DHEC
Form #
ePermitting
Construction Permit Application - Drinking Water and/or Wastewater Facilities - This form must be completed as part of an application package submitted for DHEC approval of water and/or wastewater systems construction plans D-1970 -
Small Business Water System Construction Permit Application - For building a well system for small business (not federally-defined systems) D-1206 -
Water Line Extensions - General Construction Permit Application for Public Water Supply Systems - For utilities who design their own water line extensions and meet certain criteria. D-2507 -
Application for Transfer of Operating Permit for A Public Water System - Drinking water systems have operating permits that must be transferred (and a viability review completed) D-1329 -
Bacteriological Analysis Input Form  - This form is used by all Community and Non-Transient Non-Community PWS to reports their monthly/quarterly bacteriological samples as well as their average Chlorine Residual. D-1974 -
Optimum Corrosion Control Treatment (OCCT) Recommendation - Desktop Evaluation Short Form for Small and Medium Public Water Systems - This form is used to describe a small or medium public water system after the system has exceeded a Lead & Copper Rule trigger value. The Department requires a water system that has exceeded a trigger value to complete an Optimum Corrosion Control Treatment study and this form is used to help determine if the proposed treatment will be effective at lowering lead and/or copper levels. D-2134 -
Optimum Corrosion Control Treatment - Documentation Flushing Records - This form is used to document water system flushing activities after a water system has proposed flushing as optimum treatment to lower Lead and Copper values. D-2515 -
Controlled Fluoridation Monthly Report - This form is submitted to the Department monthly by drinking water systems that add fluoride to the water D-2613 -
Rich Welch - (803) 898-3546 (Plants/Treatment)
Wayne Stokes - (803) 898-4159 (Lines)

Groundwater Monitoring

Form Name DHEC
Form #
ePermitting
Monitoring Well Application - Use to request approval from DHEC to install groundwater monitoring wells at a site D-3736 -
Groundwater Monitoring Report - Use to report groundwater monitoring data to DHEC if such data are required by a wastewater or sludge disposal permit D-2110 -
Chuck Gorman - (803) 898-3112

(Groundwater) Underground Injection Control

Form Name DHEC
Form #
ePermitting
Underground Injection Control Permit Application - Permit application for the emplacment of fluids into the subsurface through a well. D-2502 -
Guidance Document for Underground Injection Control Permit - Permit guide for Underground Injection Control - -
Chris Wargo - (803) 898-3799

Groundwater Use and Capacity Use

Form Name DHEC
Form #
ePermitting
Groundwater Withdrawal Permit Application - Applicable for groundwater withdrawals exceeding 3 million gallons in any given month in a Designated Capacity Use Area D-2504 -
Groundwater Withdrawal Renewal Permit Application - Applicable for groundwater withdrawals exceeding 3 million gallons in any given month in a Designated Capacity Use Area D-3581 -
Notice Of Intent (New well construction) and Directions - Applicable for groundwater withdrawals exceeding 3 million gallons in any given month in the Coastal Plain Region outside of a Designated Capacity Use Area D-3724 -
Water Use Registration - Applicable for groundwater withdrawals exceeding 3 million gallons in any given month in the Piedmont Region D-3764 -
Capacity Use Program Permitting - Permitting guide for groundwater withdrawal in Designated Capacity Use Areas - -
Paul Bristol - (803) 898-3559
Alex Butler - (803) 898-3575

Navigable Waters

Form Name DHEC
Form #
ePermitting
Permit Application for Construction in Navigable Waters (Individual, General Permits) - Application for construction of any structure in, over or under navigable waters of the state of South Carolina D-2065 -
Chuck Hightower - (803) 898-0369
Heather Preston - (803) 898-3105

Pesticides - NPDES

Form Name DHEC
Form #
ePermitting

Notice of Intent (NOI): NPDES General Permit for Discharges from the Application of Pesticides (SCG160000) - For coverage to spray for mosquitoes, control aquatic weeds, manage rights-of-way, etc

D-2732 Notice of Intent (NOI): NPDES General Permit for Discharges from the Application of Pesticides
Jeff deBessonet - (803) 898-4157

Private Well

Form Name DHEC
Form #
ePermitting
Notice of Intent - Well location information submitted prior to installation of an individual residential well or irrigation well D-3647 -
Water Well Record Form - Well construction information submitted by well driller after well is completed D-1903 -
Mike Longshore - (803) 898-1261

Recreational Waters

Form Name DHEC
Form #
ePermitting
Swimming Pool Application to Construct a Recreational Water Facility - To build a public swimming pool, water park, etc. D-2501 -
Swimming Pool Final Inspection Checklist - Items needed prior to requesting an approval to place a pool into operation following construction. D-1931 -
Swimming Pool Change Order Request Form - Modifications to public pools that dont require a construction permit. D-3627 -
Swimming Pool Facility Information Sheet - The purpose of this form is to allow the Department to maintain accurate information on facility billing addresses and site contact information including their Pool Operator of Record. D-3441 -
Swimming Pool Incident Report - This form serves as the required written record when notifying the Department of a serious incident involving a permitted aquatic facility. D-3785 -
Swimming Pool Inspection Report - This form is used by summer inspectors and recreational water mangers when inspecting commercial swimming pools (types A, B, C, D, E, F and G) in SC. Pool operators may use this as guidance. D-1928  
Natural Recreational Facility Application for Initial Certification - Required for the initial permitting of a natural swimming area. Submitted in conjunction with the five initial water quality samples determining the fitness of the location of the proposed swimming beach. D-3821 -
Natural Recreational Facility Application for Annual Permit to Operate - This form is required annually and is used to update facility contact information and to notify the Department of the owner's intent to operate for the coming season. D-1926 -
Bacteriological Analysis Input Form - Submitted to the Department by the owner/operator of a natural swimming area, or their agent, and enumerates the Fecal Coliform sample results for the previous sample period. Required approximately every two weeks during the swimming season. D-3631 -
L. Jim Ridge - (803) 898-4015
Wanda M. Wigfall - (803) 898-3926

State Revolving Fund

Form Name DHEC
Form #
ePermitting
Drinking Water Project Questionnaire - Used to submit a potential project for consideration of funding through the Drinking Water State Revolving Loan Fund (DWSRF) for eligible drinking water construction/activities. D-3463 -
Wastewater Project Questionnaire - Used to submit a potential project for consideration of funding through the Clean Water State Revolving Loan Fund (CWSRF) for eligible wastewater, stormwater or 319 nonpoint source construction/activities. D-3561 -
Draw Request Form - Used to request payment from the State Revolving Loan Fund. D-3585 -
Official Designation and Signature Form - Used to specify which project representatives are to represent the project sponsor in all matters pertaining to administration of the SRF loan. D-3586 -
Monthly Construction Inspection Report - Used to document the progress of an SRF project under construction. D-3587 -
Schedule for Construction - Schedule for Construction Used to document the expected schedule of milestones from project start to completion. D-3588 -
Project Construction Summary - Check sheet that assists sponsors in supplying the required information and documents to the SRF Section. D-3589 -
Certification Regarding Debarment, Suspension and Other Responsibility Matters - Used to certify that possible participants are not debarred, suspended or otherwise excluded from participation in Federal assistance programs. D-3590 -
Prime Contractor's Subagreement Certification - Used to certify whether or not a contractor plans to use subcontractors to perform work for any part of the project. D-3591 -
Certification by Proposed Prime or Subcontractor Regarding Equal Employment Opportunity - For any bidder or prospective contractor/subcontractor to certify whether they have participated and been compliant in any previous contract subject to the equal opportunity clause. D-3592 -
SRF - Certification Regarding Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 - Used to certify compliance with the Uniform Relocation Assistance And Real Property Act of 1970, regarding property acquisition. D-3594 -
Preaward Compliance Review Report for All Applicants Requesting Federal Financial Assistance - Used to document the compliance of recipients of Federal financial assistance from the EPA regarding various Federal statutes/requirements EPA 4700-4 -
MBE/WBE Utilization Under Federal Grants, Cooperative Agreements, and Interagency Agreements - Completed by recipients of Federal assistance regarding to report the accomplishment of minority/women business enterprises (MBE/WBE). EPA 5700-52A -
Project Sponsor's "American Iron and Steel" Certification for Direct Equipment/Material Purchases - Used to certify that all iron and steel products used in an SRF project are produced in the US, unless granted a waiver. D-0962 -
Bidder's "American Iron and Steel" Certification - Used to certify that all iron and steel products used in an SRF project are produced in the US, unless granted a waiver. D-2556 -
Project Sponsor's "American Iron and Steel" Certification - Used to certify that the project is in compliance with American Iron and Steel requirements during project construction. D-2558 -
Lynne I. Lasalle - (803) 898-4395

Stormwater - NPDES

Form Name DHEC
Form #
ePermitting
Storm Water Notice of Intent - For Coverage Under the Storm Water NPDES General Permit for Discharges Associated with Industrial Activity Except Construction D-2611 -
The Notification Form for Sites Disturbing Less Than 1-Acre. This form is for use on projects located outside of the eight coastal counties (Beaufort, Berkeley, Charleston, Colleton, Dorchester, Georgetown, Horry, and Jasper) and that are NOT part of a larger common plan for development or sale.
D-2628 -
Storm Water Notice of Termination - For Terminating Coverage Under the Storm Water NPDES General Permit for Discharges Associated with Industrial Activity. D-2609 -
Storm Water Notice of Termination - For Terminating Coverage Under the Storm Water NPDES General Permit for Discharges Associated with Construction Activity. D-2610 -
Notice of Intent (NOI) for Coverage(s) of Primary Permittees Under South Carolina NPDES General Permit for Stormwater Discharges From Construction Activities - Revision to DHEC Form 2617 for coverage under the new 2012 Stormwater NPDES General Permit       D-2617 -
Consolidated Permits Program - Application Form 1 - This is EPA's Application Form 1. It contains general information about the applicant and facility. This form must accompany the individual NPDES permit application - Form 2f. EPA 3510 -
No Exposure Certification for Exclusions from NPDES Stormwater Permitting - This form is to be used if industrial materials or activities are not exposed to stormwater, this form may be used to request an exemption. D-2616 -
Erosion Prevention and Sediment Control Monthly Report - This form may be used to meet the monthly reporting requirements found in the NPDES Construction General Permit. D-1356 -
Individual Lot Notice of Intent - For Coverage of Secondary Permittees Within Residential Subdivisions Under the new 2012 Stormwater NPDES General Permit  D-0432 -
Annual Blanket Notice of Intent - For Statewide Coverage of Utility Providers Within Common Developments Under the new 2012 Stormwater NPDES General Permit  D-0433  
Jill Stewart - (803) 898-0439

Wastewater - Compliance

Form Name DHEC
Form #
ePermitting
Sewer System Overflow or Pump Station Failure Report Form Form is to be used for reporting a sewer system overflow or pump station failure. D-3685 -
Satellite Sewer System Owner Notification Form - general permit coverage for operation of a sewer collection system where the final treatment for wastewater is by another entity D-2614 -
Dale Stoudemire - (803) 898-4209

Wastewater - Construction

Form Name DHEC
Form #
ePermitting
General Construction Permit Application - The initial application for a public entity to be considered for general permit coverage. D-1794 -
General Construction Permit NOI - The form used to notify DHEC of a proposed construction project, once a public entity has been approved for general permit coverage. D-1793 -
Construction Permit Application - Water and/or Wastewater Facilities - For building water and sewer lines, treatment systems, wells, etc. D-1970 -
Industrial Wastewater Facility Closure Form  D-1795 -
Wayne Stokes - (803) 898-4159 (Lines)
Mike Montebello - (803) 898-4228 (Facilities)

Wastewater - ND Permits

Form Name DHEC
Form #
ePermitting
No Discharge or ND Permit Application - The ND Permit Application is used as part of a Preliminary Engineering Report (PER) submittal for New, Expanding, and Renewals of Wastewater Treatment Plants with Land Disposal of Wastewater or Sludge. Sludge Supplement must accompany NPDES and ND Forms. ---- -
Location Supplement for NPDES and ND Permit Applications - To confirm the location of the proposed discharge ---- -
Sludge Disposal Supplement for NPDES and ND Permit Applications - To provide details about sludge management proposed from the applicable wastewater treatment system. ---- -
Mike Montebello - (803) 898-4228 (Domestic)
Crystal Rippy - (803) 898-3964 (Industrial)
Bureau of Water - Phone: (803) 898-4300 Fax: (803) 898-3795.

Wastewater - NPDES

Form Name DHEC
Form #
ePermitting
Notice of Intent (NOI) Potable Water Treatment Plants (SCG646000) - General permit coverage for discharges from water treatment systems D-1813 -
Notice of Intent (NOI) - NPDES General Permit for Bulk Petroleum Facility Discharges SCG340000 - General permit coverage for discharges associated with bulk petroleum facilities D-2624 -
Notice of Intent (NOI) - Discharges Associated with Nonmetallic Mineral Mining Facilities - NPDES General Permit #SCG730000 - General permit coverage for mining operations not involving metals (e.g., sand and gravel mining) D-3559 -
Notice of Intent (NOI) - Hydrostatic Test Water: Discharges From New and Used Oil and Gas Lines and Tanks - NPDES General Permit #SCG670000 - General permit coverage for testing for these lines and tanks D-3729 -
Notice of Intent (NOI) - Utility Water Discharges - NPDES General Permit #SCG250000 - General permit coverage for a variety of utility water discharges within a certain threshold D-3632 -
Notice of Intent (NOI) - Vehicle Wash Water: Discharges From Vehicle Wash Water Discharges - NPDES General Permit #SCG750000 D-3756 -
Consolidated Permits Program - Application Form 1 - General Information
This is EPA's Application Form 1. It contains general information about the applicant and facility. This form must accompany the NPDES permit application.
EPA 3510 -
Consolidated Permits Program - Application Form 2C - Wastewater Discharge Information
EPA Form 2C is used by existing industrial facilities when reapplying for an NPDES permit. Instructions are included. This form must be accompanied by EPA Form 1, the Location Supplement, and the Sludge Supplement.
Location Supplement for NPDES and ND Permit Applications
Sludge Disposal Supplement for NPDES and ND Permit Applications
Mixing Zone Supplement
EPA 3510-2C -
Application Form 2D - New Dischargers and New Sources: Application to Discharge Process Wastewater
EPA Form 2D is used by industrial facilities when applying for new discharges or new sources. Instructions are included. This form must be accompanied by EPA Form 1, the Antidegradation Supplement, the Location Supplement, and the Sludge Supplement.
Location Supplement for NPDES and ND Permit Applications
Sludge Disposal Supplement for NPDES and ND Permit Applications
Mixing Zone Supplement
EPA 3510-2D -
Application Form 2E - Facilities Which Do Not Discharge Process Wastewater
EPA Form 2E is used by facilities which do not discharge process wastewater. Instructions are included.This form must be accompanied by EPA Form 1, the Location Supplement, and the Sludge Supplement.
Location Supplement for NPDES and ND Permit Applications
Sludge Disposal Supplement for NPDES and ND Permit Applications
Mixing Zone Supplement
EPA 3510-2E -
Antidegradation Supplement for NPDES Permit Applications
The Antidegradation Supplement must be filed when an NPDES application is for a new or expanding discharge (including new/increased loadings).
D-3590 -
EPA Form 2A
is used by municipal facilities when applying for new discharges or new sources. Instructions are included. This form must be accompanied by the Antidegradation Supplement, the Location Supplement, and EPA Form 2S.
Location Supplement for NPDES and ND Permit Applications
Sludge Disposal Supplement for NPDES and ND Permit Applications
Mixing Zone Supplement
EPA 3510-2A -
EPA Form 2S
is used by municipal facilities when applying for new discharges or new sources. Instructions are included. This form must be accompanied by the Form 2A and the Location Supplement.
Location Supplement for NPDES and ND Permit Applications

EPA 3510-2S -
Mike Montebello - (803) 898-4228 (Domestic)
Crystal Rippy - (803) 898-3964 (Industrial)

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