Get 3400 170

Filling out the 3400 170 Notice of Termination form is an important step for facilities that wish to cease the discharge of storm water associated with industrial activities. This guide provides clear instructions to help users complete the form accurately and efficiently.

Follow the steps to complete the 3400 170 online.

1. Click ‘Get Form’ button to access the Notice of Termination form and open it in the editor.
2. In Section I, provide the owner or operator contact information. Include the name of the individual, organization, or company; the facility contact’s last name; mailing address; title; municipality; state; zip code; and telephone number.
3. In Section II, fill in the facility or site information. Provide the facility name as it appears on the permit authorization, the location address if different from the mailing address, and the facility identification number (FID and/or FIN) if known.
4. In Section III, outline the reason for the termination request. If applicable, provide details like the new owner's name and address if the facility was sold or transferred, or indicate whether the facility is moving or inactive. Answer the questions regarding control over industrial activities and exposure to storm water.
5. In Section IV, complete the certification and signature section. Ensure an authorized representative from the facility signs the form and provides their printed name, title, company name, mailing address, and date signed.
6. Review the filled-out form for completeness and accuracy. Save changes, then download or print the completed form for your records.
7. Submit the completed form by mailing it to the appropriate Wisconsin Department of Natural Resources office associated with your facility's location.

Complete your Notice of Termination form online today to ensure compliance with storm water discharge regulations.