Get Oh Epa 4233 2007-2025

This guide provides step-by-step instructions on how to fill out the Ohio NPDES Permit Modification Form, known as OH EPA 4233, online. By following these instructions, users can efficiently complete the form required for modifying an existing NPDES permit.

Follow the steps to complete the OH EPA 4233 form online.

1. Click ‘Get Form’ button to access the OH EPA 4233 form and open it in your preferred editing interface.
2. In the 'Facility Name' field, enter the name of the facility seeking the permit modification.
3. Complete the 'Date Received' section with the date of submission in the format yy/mm/dd.
4. Input your Ohio EPA Permit Number in the designated field.
5. Fill in the 'Application Number' field with the appropriate application identification number.
6. For section A, provide the permit number for which a modification is being requested.
7. In section B, enter the name of the organization responsible for the facility.
8. In section C, detail the address, location, and telephone number of the facility producing the permitted discharge by filling out the sub-fields provided.
9. In section D, describe in detail the provisions of the permit the applicant wishes to modify. Attach additional pages as necessary for comprehensive details.
10. In section E, explain the reasons why a modification is desired, referring to the Ohio Administrative Code if needed. You may attach additional sheets for this section as well.
11. In section F, specify the name of the receiving water or waters related to the discharge.
12. In section G, provide sufficient detail about the requested modification to enable the Ohio Environmental Protection Agency to process your request. If a Permit to Install is required, attach the completed application for that permit.
13. In the certification section, type or print your name and official title, along with your phone number, and provide your signature. Finally, include the date you signed the document.
14. Once all fields are completed, review the information for accuracy, then save changes, download the form, or print it for submission as needed.

Complete your OH EPA 4233 form online to ensure timely processing of your application.