OWNEROPERAT OR I hereby accept transfer of the general NPDES permit which was issued to I have reviewed the terms and conditions of the general permit and the Storm ID: 817870
Download Pdf The PPT/PDF document "��Effective 2016NOTO Notic..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
��Effective 2016NOTO Notic
��Effective 2016NOTO Notice of Transfer of Ownership Page 1NOTICE OF TRANSFER OF OWNERSHIP FORM (NOTO)For Stormwater Discharges Associated with Industrial ActivityAuthorized by a Kansas Water PollutionControl General Permit Underthe National Pollutant Discharge EliminationSystemSubmission of the Notice of Transfer of Ownership (NOTO) constitutes notice that the new permittee, or an authorized representative, requests . OWNER/OPERATOR I hereby accept transfer of the general NPDES permit, which was issued to ____________________________. I have reviewed the terms and conditions of the general permit and the Stormwater Pollution Prevention plan and accept full responsibility, coverage, and liability. This transfer will be effective when KDHE confirms the transfer.The NEW owner/operator is:Owner or Operator’s Name:______________________________Contact Name:____________________________________Mailing Address:_______________________________________ City: State:Zip Code:__________If permit is being transferred, permit fee billing information from the NOI is needed. I certif
y under penalty of law that I have perso
y under penalty of law that I have personally examined and am familiar with the information described herein, and based upon my inquiry of Zip Code:______mail Address:__________________________________________________________ Kansas Permit No.________________________________ Federal Permit No.___________________________________________Permittee Signature:_____________________________________________ Date: ______________________________Permittee Name:___________________________________ Title: __________________________Phone Number: ___________________��Effective 2016NOTO Notice of Transfer of Ownership Page 2Name of Industrial Facility: ______________Notice of Transfer of Ownership FormKansas Permit No.Federal Permit No.___________________________For Official Use Only: Comments: Permit Transfer Approved: □ Y; □ N Reviewer DateSubmit the NOTO form with original signatures to:Kansas Department of Health and EnvironmentBureau of Water, Industrial Programs SectionSW Jackson, Suite 420Topeka, KS 66612KDHE Contact Information:Phone: (785)296mail: stormwater@kdheks.gov