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Last Modified:  5/15/2008
Kentucky Pollutant Discharge Elimination System (KPDES) Permit Application Forms

This page provides access to Kentucky Pollutant Discharge Elimination System (KPDES) forms for permit applications and forms related to oil and gas and to antidegradation. These forms are available in both Word and PDF format.

KPDES Individual Permits

          
  • General Instructions
Word PDF
  • Form 1 Instructions
Word PDF
  • Form 1 - Submit with all KPDES applications for individual permits
Word PDF
  • Form A - For municipal wastewater discharges
  • Form A - Instructions

Word
Word

PDF
PDF
  • Form B - For concentrated animal feeding operations (CAFOs)
Word PDF
  • Form C - For process wastewater discharges associated with manufacturing establishments and mining operations
Word PDF
  • Form F - For individual permit coverage for storm water associated industrial activity
Word PDF
  • Form SC - For services, wholesale and retail trade, and all other establishments that have sanitary and/or non-process discharges
Word PDF
  • Change in Ownership Certification for KPDES permits
Word PDF
  • No Discharge Certification
Word

PDF

Kentucky Inter-Municipal Operational Permits (KIMOPs)

   
  • Form KIMOP
Word PDF

Kentucky No Discharge Operational Permits (KNDOPs)

   
  • Form ND - For facilities that do not have a point source discharge but use other means of disposal such as land application, subsurface injection, closed circuit, etc.
Word PDF
  • Short Form B - For agricultural waste handling systems that do not have a point source discharge (also used for obtaining a construction permit)
Word PDF
  • Site Survey Request - Kentucky No Discharge Operational Permit for Agricultural Wastes Handling System - For facilities that handle agricultural wastes
Word PDF

KPDES General Permits

   

CAFO General Permit Coverages

   
  • NOI-CAFO - Notice of Intent for general permit coverage for concentrated animal feeding operations (poultry, swine, beef and dairy)
Word PDF

Coal Mining Operations General Permit Coverages

   
  • NOI-CM - Notice of Intent for general permit coverage for coal mining
Word PDF
  • NOT-CM - Notice of Termination of general permit coverage for coal mining
Word PDF
Drinking Water Plant Activities General Permit Coverages    
  • NOI-WTP - Notice of Intent for general permit coverage for wastewater discharges associated with drinking water plant activities
Word PDF
  • NOT-WTP - Notice of Termination of general permit coverage for wastewater discharges associated with drinking water plant activities
Word PDF
Groundwater Remediation General Permit Coverages    
  • NOI-GW - Notice of Intent for general permit coverage for discharges associated with remediation activities involving gasoline and/or diesel fuel
Word PDF
  • NOI-GWT - Notice of Intent for general permit coverage for temporary discharge of treated groundwater associated with remediation activities involving gasoline and/or diesel fuel
Word PDF
  • NOT-GW - Notice of Termination of general permit coverage for discharges of treated groundwater associated with remediation activities involving gasoline and /or diesel fuel
Word PDF
Highway Maintenance and Equipment Facilities General Permit Coverages    
  • NOI-HWY - Notice of Intent for general permit coverage for wastewater discharges associated with highway maintenance and equipment facilities
Word PDF
  • NOT-HWY - Notice of Termination of general permit coverage for wastewater discharges associated with highway maintenance and equipment facilities
Word PDF
Individual Family Residences General Permit Coverages    
  • NOI-IFR - Notice of Intent for general permit coverage for wastewater discharges associated with individual family residences
Word PDF
Noncoal (Mineral) Mining Operations General Permit Coverages    
  • NOI-MM - Notice of Intent for general permit coverage for mineral mining
Word PDF
  • Notice of Termination of Noncoal (Mineral Mining) facilities
Word PDF
Storm Water General Permit Coverages    
  • NOI-SMS4 - Notice of Intent for a general permit for municipal separate storm sewer systems
Word PDF
  • NOI-SW - Notice of Intent for general permit coverage for storm water discharges associated with industrial or construction activities under the KPDES general permit
Word PDF
  • NOT-SW - Notice of Termination of coverage under the KPDES general permit for storm water discharges associated with industrial activity
Word PDF

Oil and Gas Related Forms

      
  • Application for Construction and Operation of a Produced Water Holding Pit
Word PDF
  • Application to Dispose of Produced Water Off-Facility
Word PDF
  • Produced Water Disposal Registration
Word PDF
  • Transfer of Ownership for Oil and Gas Facilities
Word PDF

Antidegradation Related Forms

   
  • High Quality Water Alternatives Analysis
Word PDF
  • Exceptional Water Alternatives Analysis
Word PDF
Individual permits

Kentucky Pollutant Discharge Elimination System
14 Reilly Road
Frankfort, KY 40601
Phone: 502-564-3410 ext 477
Fax: 502-564-5105
E-mail: jory.becker@ky.gov