Form 3510-6 Proposed Notice of Intent (NOI) Form

2026 MSGP

Appendix G – Notice of Intent (NOI) Form

NOTE: EPA proposes the text in this Appendix as part of the Proposed 2026 MSGP.
Proposed Appendix G - Notice of Intent (NOI) Form
Part 7.2 requires you to use the NPDES eReporting Tool, or “NeT”, to prepare and submit your
Notice of Intent (NOI). However, if the applicable EPA Regional office grants you a waiver to use
a paper NOI form, and you elect to use it, you must complete and submit the following form.

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Submission of this NOI constitutes notice that the operator identified in Section C of this form
requests authorization to discharge pursuant to the NPDES Multi-Sector General Permit (MSGP)
permit number identified in Section B of this form. Submission of this NOI also constitutes notice
that the operator identified in Section C of this form meets the eligibility conditions of Part 1.1 of
the MSGP for the facility identified in Section D of this form. To obtain authorization, you must
submit a complete and accurate NOI form. Discharges are not authorized if your NOI is
incomplete or inaccurate or if you were never eligible for permit coverage. Refer to the
instructions at the end of this form to complete your NOI.

NPDES Form 3510-6

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2026 MSGP

Appendix G – Notice of Intent (NOI) Form
Instructions for Completing EPA Form 3510-6
Notice of Intent (NOI) for Stormwater Discharges
Associated with Industrial Activity Under the NPDES Multi-Sector General Permit
This Form Replaces Form 3510-6 (03/21)

Form Approved OMB No. 2040-NEW

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“operator”. Provide the operator’s mailing address, phone number, and
Who Must File an NOI Form
e-mail.
Correspondence for the NOI will be sent to this address. Also
Under section 402(p) of the Clean Water Act (CWA) and regulations
at 40 CFR Part 122, stormwater discharges associated with industrial provide the name and title for the operator point of contact (note that
activity are prohibited to waters of the United States unless authorized the point of contact name may be the same as the operator name).
under a National Pollutant Discharge Elimination System (NPDES) If the NOI was prepared by someone other than the certifier (for
permit. You can obtain coverage under the MSGP by submitting a example, if the NOI was prepared by the facility SWPPP contact or a
completed Notice of Intent (NOI) if you are an operator of a facility: consultant for the certifier’s signature), include the full name,
organization, phone number, and e-mail address of the NOI preparer.
• that is located in a jurisdiction where EPA is the permitting
authority, listed in Appendix C of the MSGP,
Section D. Facility Information
• that discharges stormwater associated with industrial activities, Enter the official or legal name and complete address, including city,
identified in Appendix D of the MSGP,
state, ZIP code, and county or similar government subdivision of the
• that meets the eligibility requirements in Part 1.1 of the permit,
facility. If the facility lacks a street address, indicate the general location
• that has developed a stormwater pollution prevention plan of the facility (e.g., Intersection of State Highways 61 and 34). Complete
(SWPPP) in accordance with Part 6 of the MSGP; and
facility information must be provided for permit coverage to be
• that installs and implements control measures in accordance granted.
with Part 2 and Part 8 to meet numeric and non-numeric effluent
Provide the latitude and longitude of your facility in decimal degrees format.
limits.
The latitude and longitude of your facility can be determined in several
Completing the Form
different ways, including through the use of global positioning system (GPS)
Obtain and read a copy of the 2026 MSGP, viewable at
receivers, U.S. Geological Survey (USGS) topographic or quadrangle maps.
https://www.epa.gov/npdes/stormwater-discharges-industrialFor consistency, EPA requests that measurements be taken from the
activities. To complete this form, type or print, using uppercase
approximate center of the facility. Specify which method you used to
letters, in the appropriate areas only. Please place each character
determine latitude and longitude. If a USGS topographic map is used,
between the marks. Abbreviate if necessary to stay within the
specify the scale of the map used. Enter the horizontal reference datum for
number of characters allowed for each item. Use only one space
your latitude and longitude. The horizontal reference datum used on USGS
for breaks between words, but not for punctuation marks unless
topographic maps is shown on the bottom left corner of USGS topographic
they are needed to clarify your response. Please submit original
maps; it is also available for GPS receivers.
document with signature in ink - do not send a photocopied
Indicate whether the facility is on Indian Country, and if so, provide the
signature.
name of the Indian Tribe associated with the area of Indian Country
Section A. Approval to Use Paper NOI Form
(including name of Indian reservation, if applicable).
You must indicate whether you have been granted a waiver from
electronic reporting from the EPA Regional Office. Note that you are Indicate whether the facility is on federal lands. If so, indicate whether
not authorized to use this paper NOI form unless the EPA Regional the facility is on a land of exclusive federal jurisdiction and provide the
Office has approved its use. Where you have obtained approval to name of the land of exclusive federal jurisdiction. Refer to Appendix A
use this form, indicate the waiver that you have been granted, the of the MSGP for the definition of “lands of exclusive federal jurisdiction.”
name of the EPA staff person who granted the waiver, and the date Indicate whether you are seeking coverage under this permit as a
that approval was provided.
“federal operator” as defined in Appendix A. Also check the ownership
type for the facility (e.g., Federal Facility, Privately Owned Facility,
See https://www.epa.gov/npdes/contact-us-stormwater for a list
Municipality, County Government, Corporation, State Government,
of EPA Regional Office contacts.
Tribal Government, School District, District, Mixed Ownership [e.g.,
Section B. Permit Information
public/private], Municipal or Water District).
Provide the master permit number of the permit under which you are
applying for coverage (see Appendix C of the general permit for the Enter the estimated area of industrial activity at your facility exposed to
stormwater to the nearest quarter acre.
list of eligible master permit numbers).
Indicate whether, during coverage under this permit, there will be
You must indicate whether you are a new discharger or a new source
stormwater discharges from paved surfaces that will be initially sealed
(see Appendix A for the definitions). If you are not a new discharger
or a new source, you must indicate whether stormwater discharges or re-sealed with coal-tar sealcoat where industrial activities are
located.
from your facility have been previously covered under another
NPDES permit. If yes, you must provide the unique NPDES ID (i.e., List the four-digit Standard Industrial Classification (SIC) code or two
permit tracking number) for the previous permit your facility was character activity code of your primary industrial activity. Your primary
covered under. If you were previously covered under EPA’s 2021 industrial activity includes any activities performed on-site which are (1)
MSGP and were subject to benchmark monitoring, you must indicate identified by the facility’s primary SIC code and included in the
which AIM Level (i.e., Baseline, Level 1, Level 2, Level 3) you were in descriptions of 40 CFR 122.26(b)(14)(ii), (iii), (vi), or (viii); or (2) included in
when the permit expired.
the narrative descriptions of 40 CFR 122.26(b)(14)(i), (iv), (v), (vii), or (ix).
See Appendix D of the MSGP for a complete list of SIC codes and
You must also indicate whether you have a pending enforcement
activities codes covered under the MSGP.
action by EPA, a state, or a citizen, related to industrial stormwater.
Also provide the applicable sector and subsector associated with the
Section C. Facility Operator Information
SIC code or activity code for your primary industrial activities. For a
Provide the legal name of the person, firm, public organization, or any complete list of sector and subsector codes, see Appendix D of the
other entity that operates the facility described in this NOI. An MSGP. If your facility has co-located industrial activities that are not
operator of a facility is the legal entity that controls the operation of identified as your primary industrial activity, identify the sector,
the facility. Refer to Appendix A of the permit for the definition of

NPDES Form 3510-6

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2026 MSGP

Appendix G – Notice of Intent (NOI) Form
Instructions for Completing EPA Form 3510-6
Notice of Intent (NOI) for Stormwater Discharges
Associated with Industrial Activity Under the NPDES Multi-Sector General Permit
This Form Replaces Form 3510-6 (03/21)

Form Approved OMB No. 2040-NEW

subsector, SIC, and activity codes that describe these other industrial water is saltwater or freshwater, and indicate whether discharges from the
facility will enter into a water of the U.S that is designated as a Tier 2, Tier
activities.
2.5, or Tier 3 water. A list of Tier 2, 2.5, and 3 waters is provided at
For Sector A facilities (Timber Products), indicate whether you https://www.epa.gov/npdes/stormwater-discharges-industrialmanufacture, use or store creosote or creosote treated wood in activities-fact-sheets-and-guidance. If the answer is “yes”, name all
areas that are exposed to precipitation.
waters designated as Tier 2, Tier 2.5, or Tier 3 to which the facility will
For Sector S facilities (Air Transportation), indicate whether you discharge. Note that you are ineligible for coverage if you are a new
anticipate that the entire airport facility will use more than 100,000 discharger or a new source to waters designated as Tier 3 (outstanding
gallons of pure glycol in glycol-based deicing fluids and/or 100 tons national resource waters) for antidegradation purposes under 40 CFR
or more of urea on an average annual basis. If so, additional effluent 131.13(a)(3).
limits and monitoring conditions apply to your discharge (see Part 8.S If your facility is in subsector K1 or G2, you must also indicate, for each
of the permit).
unique discharge point, if the receiving water is still/standing (lentic)
(e.g., a lake or impoundment) or flowing (lotic) (e.g., a river or stream).

You must also provide information about the discharge point
latitude/longitude, including data source, the scale (if applicable), and
the horizontal reference datum. See the instructions in Section D for more
information about determining the latitude and longitude.

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For Sector G, H, or J facilities (Metal Mining, Coal Mining, or Mineral
Mining), indicate whether you anticipate performing earth disturbing
activities prior to active mining as described in Parts 8.G.3.2.b,
8.H.3.2.b, or 8.J.3.2.b. If so, indicate whether you anticipate
conducting construction dewatering as defined in Appendix A.

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For Sector G facilities (Metal Mining), indicate if you have any Identify whether your facility discharges into a MS4. If yes, provide the
discharge from waste rock or overburden piles and check the type name of the MS4 operator. If you are uncertain of the MS4 operator,
of ore(s) mined at the facility.
contact your local government for that information.
Indicate whether your facility is currently inactive and unstaffed. Note If you discharge into freshwater and are subject to any benchmark
that if your facility becomes inactive and unstaffed and/or industrial monitoring requirements for metals (see the requirements applicable to
materials or activities become exposed to stormwater during the your Sector(s) in Part 8 of the permit), indicate the hardness for your
permit term, you must submit an NOI modification to reflect the receiving water(s). See Appendix J of the permit for information about
change.
determining waterbody hardness.

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Section E. Discharge Information
You must confirm that you understand that the MSGP only authorizes
the allowable stormwater discharges listed in Part 1.2.1 and the
allowable non-stormwater discharges listed in Part 1.2.2. Any
discharges not expressly authorized under the MSGP are not covered
by the MSGP or the permit shield provision of the CWA Section 402(k)
and they cannot become authorized or shielded by disclosure to
EPA, state, or local authorities via the NOI to be covered by the permit
or by any other means (e.g., in the SWPPP or during an inspection). If
any discharges requiring NPDES permit coverage other than the
allowable stormwater and non-stormwater discharges listed in
Parts 1.2.1 and 1.2.2 will be discharged, they must either be
eliminated or covered under another NPDES permit.
Depending on your industrial activities, your facility may be subject to
federal effluent limitation guidelines which include additional effluent
limits and monitoring requirements for your facility. Please review
these requirements, described in Part 2.1.3 of the MSGP, and check
any appropriate boxes on the NOI form.

You must identify all the discharge points from your facility that
discharge stormwater. Each outfall must be assigned a unique 3-digit ID
(e.g., 001, 002, 003). You must also provide the latitude and longitude
for each discharge point from your facility. Indicate whether any
discharge points are substantially identical to a discharge point already
listed, and identify the discharge point it is identical to. For each unique
discharge point you list, you must specify the name of the first water of
the U.S. that receives stormwater directly from the discharge point
and/or from the Municipal Separate Storm Sewer (MS4) that the
discharge point discharges to. You must specify whether any receiving
waters that you discharge to are listed as “impaired” as defined in
Appendix A, and the pollutants for which the water is impaired. You
must also identify any Total Maximum Daily Loads (TMDL) that have
been completed for any of the waters of the U.S. that you discharge to.
For each unique discharge point you must indicate whether the receiving

NPDES Form 3510-6

If your facility is located in EPA Regions 1 or 10, indicate whether your
facility will discharge to a federal CERCLA site listed in Appendix L Note
that if your facility will discharge into a federal CERCLA site listed in
Appendix L you are not eligible for coverage under this permit unless you
notify the EPA Regional Office in advance and the EPA Regional Office
authorizes coverage under this permit after you have included adequate
controls and/or procedures designed to ensure that discharges will not
lead to recontamination of aquatic media at the CERCLA site such that
your discharge will cause or contribute to an exceedance of a water
quality standard.
Operators in New Mexico, indicate whether you anticipate the
discharge of groundwater or spring water from your facility. If yes, you
must provide information on flow and potential to encounter impacted
ground or spring water such that there is a potential for contamination.
You
must
also
use
the
mapper
tool
located
at
https://gis.web.env.nm.gov/oem/ to determine if the groundwater
sources listed are located near the anticipated source of groundwater
or spring water such that there is potential for contamination. If potential
for contamination exists, you must provide a summary of test data
indicating the quality of the groundwater or spring water to be
discharged.
Section F. Stormwater Pollution Prevention Plan (SWPPP) Information
All facilities eligible for coverage under this permit are required to
prepare a SWPPP in advance of filing the NOI, in accordance with Part
6. Indicate whether the SWPPP has been prepared in advance of filing
the NOI.
Indicate the contact information (name, phone, and e-mail) for the
person who developed the SWPPP for this facility.

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2026 MSGP

Appendix G – Notice of Intent (NOI) Form
Instructions for Completing EPA Form 3510-6
Notice of Intent (NOI) for Stormwater Discharges
Associated with Industrial Activity Under the NPDES Multi-Sector General Permit
This Form Replaces Form 3510-6 (03/21)

You must identify how your SWPPP information will be made
available, consistent with Part 6.4 of the permit. If you are making your
SWPPP publicly available on a web site, check Option 1 and provide
the appropriate Internet URL address. If you are not providing a URL,
check Option 2 and attach your SWPPP to this NOI form.

Form Approved OMB No. 2040-NEW

For a partnership or sole proprietorship: By a general partner or the
proprietor, respectively; or

For a municipality, state, federal, or other public agency: By either a
principal executive officer or ranking elected official. For purposes of this
Part, a principal executive officer of a federal agency includes (i) the
Section G. Endangered Species Protection
chief executive officer of the agency, or (ii) a senior executive officer
Using the instructions in Appendix E, indicate the criterion (i.e., A, B, C, having responsibility for the overall operations of a principal geographic
D, or E) you are eligible under with regard to the protection of unit of the agency (e.g., Regional Administrator of EPA). Include the
federally listed endangered and threatened species and designated name and title of the person signing the form and the date of signing.
critical habitat per Part 1.1.4. A description of the basis for the criterion An unsigned or undated NOI form will not be considered eligible for
selected must also be provided.
permit coverage.

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If criterion B is selected, provide the NPDES ID (i.e., permit tracking
Modifying Your NOI
number) for the other operator who has certified their eligibility under
this permit. The NPDES ID was assigned when the operator received If you have been granted a waiver from your Regional Office from
electronic reporting, and if after submitting your NOI you need to correct
coverage under this permit.
or update any fields on this NOI form, you may do so by indicating
If criterion C is selected, you must specify the federally-listed species changes on this same form.
or designated critical habitat that are located in the “action area”
Paperwork Reduction Act Notice
of the facility. You must also indicate under which scenario you
determined you were eligible to submit your NOI under criterion C This collection of information is approved by OMB under the Paperwork
using Appendix E, and answer any corresponding questions.
Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 204 0-NEW ).
Responses to this collection of information are mandatory (40 CFR
If criterion D or E is selected, attach copies of any communications
122.26). An agency may not conduct or sponsor, and a person is not
between you and the U.S. Fish and Wildlife Service and National
required to respond to, a collection of information unless it displays a
Marine Fisheries Service to this NOI.
currently valid OMB control number. The public reporting and
recordkeeping burden for this collection of information is estimated to
Section H. Historic Preservation
be 4.35 hours per response. Send comments on the Agency’s need for
If the project is not located in Indian Country, indicate whether the
this information, the accuracy of the provided burden estimates and
project is located on a property of religious or cultural significance to
any suggested methods for minimizing respondent burden to the
an Indian Tribe, and if so, provide the name of the Indian Tribe
Regulatory Support Division Director, U.S. Environmental Protection
associated with the property. Use the instructions in Appendix F to
Agency (2821T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460.
complete the questions on the NOI form regarding historic
Include the OMB control number in any correspondence. Do not send
preservation.
the completed form to this address.
Section I. Certification
Submitting Your Form
Certification statement and signature (see Section B.11 of Appendix
If you have been granted a waiver from your Regional Office to submit
B of the MSGP for more information). Enter certifier’s printed name,
a paper NOI form, you must send your NOI by mail to one of the
title, and email address. Sign and date the form. (CAUTION: An
following addresses:
unsigned or undated NOI form will prevent the granting of permit
coverage.) Federal statutes provide for severe penalties for For Regular U.S. Mail Delivery:
submitting false information on this application form. Federal Stormwater Notice Processing Center
regulations require this application to be signed as follows:
Mail Code 4203M, ATTN: 2026 MSGP Reports
U.S. EPA
For a corporation: by a responsible corporate officer, which means:
1200 Pennsylvania Avenue, NW
(i) a president, secretary, treasurer, or vice-president of the Washington, DC 20460
corporation in charge of a principal business function, or any other
For Overnight/Express Mail Delivery:
person who performs similar policy- or decision-making functions for Stormwater Notice Processing Center
the corporation, or (ii) the manager of one or more manufacturing, William Jefferson Clinton East Building - Room 7420
production, or operating facilities, provided, the manager is
ATTN: 2026 MSGP Reports
authorized to make management decisions which govern the U.S. EPA
operation of the regulated facility including having the explicit or 1201 Constitution Avenue, NW
implicit duty of making major capital investment recommendations, Washington, DC 20004
and initiating and directing other comprehensive measures to assure
long-term environmental compliance with environmental laws and Visit this website for instructions on how to submit electronically:
regulations; the manager can ensure that the necessary systems are https://www.epa.gov/npdes/stormwater-discharges-industrial-activitiesestablished or actions taken to gather complete and accurate ereporting
information for permit application requirements; and where authority
to sign documents has been assigned or delegated to the manager
in accordance with corporate procedures.

NPDES Form 3510-6

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