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Get Afsci Form 3400 176

Ce: This form is authorized by s. NR 216.29(1)(e), Wis. Adm. Code. Submittal of a completed form to the Department is mandatory for industrial facilities covered by a storm water general or individual permit, excluding coverage in certain permits described in s. NR 216.24 (1), Wis. Adm. Code. Failure to submit a completed form to the Department may result in fines up to $25,000 per day pursuant to s. 283.91, Wis. Stats. Personally identifiable information on this form may be used for other water.

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