Compliance Assistance Request

1. Would you like to request a:

2. Please complete the following form in order for us to arrange a Hazardous Waste Compliance Assistance Site Visit. All fields are required.

Name of Facility

Address of Facility

City

Zip Code

County

EPA/DEP Identification Number of Facility (N/A if unknown)

Type of Facility (for example - boat building, paint shop, auto repair)

Facility Website (N/A if none)

Name of Person Requesting the Hazardous Waste Compliance Assistance Site Visit

Email Address of Person Requesting the Hazardous Waste Assistance Site Visit (N/A if none)

Name of Primary Contact

Phone Number

2. Please complete the following form in order for us to arrange a Permit Determination.

Name of Facility

Address of Facility

City

Zip Code

County

Type of Facility (Domestic Wastewater or Industrial Wastewater)

Please provide a brief description of activity (i.e. car wash, alternative energy, package plant, etc.)

Name of Person Requesting Permit Determination

Email Address of Person Requesting the Permit Determination

Phone Number

2. Please complete the following form in order for us to arrange a Wastewater Compliance Operator Outreach Training Event or Compliance Assistance Site Visit.

Are you requesting a training event or compliance assistance site visit?

Name of Facility

Address of Facility

City

Zip Code

County

Type of Facility (Domestic or Industrial)

Name of Person Requesting the training or site visit

Email Address of person requesting training or site visit

Phone Number

Please briefly describe your needs.

2. Please complete the following form in order for us to arrange a Drinking Water Compliance Assistance Site Visit.

Public Waster System (PWS) ID#:

Name of Facility

Address of Facility

City

Zip Code

County

Name of Person Requesting Site Visit

Email Address of Person Requesting Site Visit

Phone Number

Please briefly describe your needs.

2. Please complete the following form in order to arrange an Air Pollution Compliance Assistance Site Visit.

Name of Facility

Address of Facility

City

Zip Code

County

AIRS Identification Number of Facility (N/A if unknown)

Type of Facility (i.e. boat building, paint shop, drycleaner, asphalt)

Facility Website (N/A if none)

Name of Person Requesting Site Visit

Email Address of Person Requesting Site Visit

Name of Primary Contact

Phone Number

2. Please complete the following form in order for us to arrange a Dock or Wetlands Compliance Assistance Site Visit.

Is your question about a dock or wetlands?

Name of Current Owner

Address Where Dock or Property is Located

City

Zip Code

County

Name of Person Requesting Inspection

Email Address of Person Requesting Inspection (N/A if none)

Phone Number

2. Please complete the following form in order for us to arrange a Storage Tanks Compliance Assistance Site Visit.

Name of Facility

Address of Facility

City

Zip Code

County

DEP Facility ID# (N/A if unknown)

Type of Facility (i.e. gas station, marina, emergency generator)

Name of Person Requesting Inspection

Email Address of Person Requesting Inspection

Phone Number