17HT-DOI.pdf

DECLARATION OF INTENT

To Comply With The Terms and Conditions of General Permit for Discharges from Tanks, Pipes, Other Liquid Containment Structures, Dewatering Activities, and Groundwater Remediation

(General Discharge Permit No. 17-HT; NPDES Permit Number MDG67)

By signing this Declaration I am acknowledging it is my intent, for all new and existing discharges from tanks, pipes, other liquid containment structures, dewatering activities, and groundwater remediation [as described in Part I (Permit Applicability) of the 17-HT Permit], to voluntarily consent to the Consent Order

To Comply With The Terms and Conditions of the General Permit for Discharges from Tanks, Pipes, Other

Containment Structures, Dewatering Activities, and Groundwater Remediation, No. 17-HT (“Order”) of the

Maryland Department of the Environment, requiring me to abide by the terms and conditions of the General

Permit for Discharges from Tanks, Pipes, Other Liquid Containment Structures, Dewatering Activities, and

Groundwater Remediation (General Discharge Permit Number 17-HT, NPDES Permit Number MDG67)

(“17-HT Permit") until the deadline for new registrations required under a new general permit, or the date that

I obtain coverage under an individual discharge permit or alternative general permit, whichever comes first.

I further declare:

1. With this Declaration, I am submitting a Notice of Intent (“NOI”) in accordance with all requirements of

Part II of the 17-HT Permit and agree to refrain from performing any activity covered under the 17-HT

Permit prior to receiving documentation of approval from MDE.

2. I acknowledge that, in determining whether to approve the NOI, MDE will follow the NOI Approval

Process as set forth in Part II.A. of the 17-HT Permit.

3. After receiving documentation that MDE has approved the NOI, I agree to comply with all terms and conditions of the 17-HT Permit.

4. I understand that MDE’s approval of my NOI does not constitute permit coverage under the expired 17-

HT Permit.

5. I acknowledge that MDE may require me to apply for and obtain an individual permit or coverage under an alternative general permit in accordance with the requirements and procedures set forth in Part I.E. of the 17-HT Permit.

6. I acknowledge that failure to comply with the terms and conditions of the Order will subject me to potential civil and administrative penalties pursuant to Section 9-342 of the Environment Article of the

Annotated Code of Maryland for failure to comply with the Order and for discharging from tanks, pipes, other liquid containment structures, dewatering activities, and groundwater remediation without a discharge permit.

To be completed by a responsible corporate officer, proprietor, general partner, principal executive officer, or ranking elected official or their duly authorized representative, as detailed in Part II.C of the permit.

Signature of Applicant Date

Printed Name and Title of Applicant