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The DEQ 605 006 form, known as the Annual Comprehensive Site Compliance Evaluation Report for Industrial Facilities (ACSCER), serves a critical function in ensuring that industrial facilities comply with environmental regulations concerning storm water discharges. This form, required by the Oklahoma Department of Environmental Quality, must be submitted annually by all authorized industrial facilities. It provides a structured framework for operators to demonstrate compliance with the Oklahoma Pollutant Discharge Elimination System (OPDES) program. Specifically, Part B of the form notifies that the facility is exempt from conducting Benchmark Monitoring for storm water discharges, provided certain conditions are met. The form requires detailed information, including the OPDES permit authorization number, operator and facility location details, and a certification section that underscores the legal responsibilities of the signatory. Moreover, operators must report on various compliance metrics, such as the number of routine inspections conducted, corrective actions taken for any identified deficiencies, and the implementation status of Best Management Practices (BMPs). This comprehensive reporting not only aids in regulatory compliance but also fosters accountability and transparency within the industrial sector regarding environmental stewardship.
Document Example
See Page 4 for Instructions
DEQ
FORM
Sept. 5, 2011
Oklahoma Department of Environmental Quality
Annual Comprehensive Site Compliance Evaluation Report
for Industrial Facilities (ACSCER)
Submission of this Comprehensive Site Compliance Evaluation Report, Part B, provides notice that the party identified in Section I of this form is not required to conduct Benchmark Monitoring for storm water discharges associated with industrial activities under the OPDES program. This Annual Comprehensive Site Compliance Evaluation Report is required for all authorized industrial facilities.
All Requested Information Must Be Provided On This Form (Part A) and the ACSCER Form (Part B).
See Instructions On Page 4 of The Form.
Section I.
OPDES Permit Authorization Number:
Section II. Facility Operator Information
Name: ______________________________________________ Phone:_________________________________
Address:______________________________________________________________________________________
City: __________________________________ County:_____________________ Zip Code:__________________
Section III. Facility Location
Name:_____________________________________________________ Phone:____________________________
Address: ______________________________________________________________________________________
City: _________________________________ County: _________________________ Zip Code:_______________
Latitude: ____________________________ Longitude:___________________________
Section IV. Certification
I certify under penalty of law that I have read and understand the requirements for filing this Comprehensive Site Compliance Evaluation Report, which is to be filed by March 1st of each year beginning in 2012.
This report is also to be retained as part of the SWP3 for at least three (3) years from the date permit coverage expires or is terminated and will be made available to any State or Federal Inspector visiting this facility. All records of actions taken in accordance with 4.10 of this permit as part of the Storm Water Pollution Prevention Plan will be retained for at least three (3) years from the date permit coverage expires or is terminated. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based upon my inquiry of the person or persons who manage the system, or those persons directly involved in gathering the information, the information submitted is to the best of my knowledge and belief true, accurate, and complete. I am aware there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations.
Print Name: ________________________________________________ |
Date:_________________________ |
Signature:__________________________________________________ |
Title:_________________________ |
1
Annual Comprehensive Site Compliance Evaluation Report - Part B
Page 1.
Reporting Period: ______________________________.
How many routine facility inspections did you perform during the reporting period? ___________
How many corrective actions (Part 4.2.17.3) to remove the original violation and document these actions according to corrective action deadlines?
Date |
Deficiencies |
Corrected (Y or N) |
Date Corrected |
______________ |
_________________________ |
__________ |
____________ |
______________ |
_________________________ |
__________ |
____________ |
______________ |
_________________________ |
__________ |
____________ |
______________ |
_________________________ |
__________ |
____________ |
What must you do to correct the deficiencies that remain uncorrected?
______________________________________________________________________________
______________________________________________________________________________
Were all BMPs you indicated you would be using in your SWP3 (Part 4.2.8) including good housekeeping practices, actually being implemented at the time of the Annual Comprehensive Site Compliance Evaluation? Yes _____ No_____
If one or more BMPs were not being implemented, were corrective actions taken after the FIRST inspection to find the problem?
Yes _____ No_____ |
All BMPs were being implemented ______ |
Was/were the same failure(s) to implement a BMP deficiency(ies) noted in more than one inspection?
Yes _____ No_____ |
No deficiencies noted in any inspection ________ |
Did any of your routine facility inspections find that one or more of your BMPs was not effective in controlling the pollutant source for which it was designed?
Yes _____ No_____ |
All BMPs were effective ______ |
If you found one or more ineffective BMPs, have they all been replaced with an alternative or modified BMP?
Yes _____ No_____ |
All BMPs were being effective ______ |
Is there additional BMPs needed to address any conditions requiring corrective action? Yes _____ No_____
At any time during the reporting period, did you discover any previously unidentified illicit discharges from your facility or previously unidentified pollutants in the existing discharges?
Yes _____ No_____
Have all illicit discharges (including any discovered in previous years) been eliminated or permitted?
Yes _____ No_____ |
Permit applied for ______ No known illicit discharges ______ |
Have any significant spills or leaks occurred at your facility during the reporting period? Yes _____ No_____
If any significant spills or leaks occurred, did they result in either a dry weather discharge or an actual discharge of the spilled or leaked material commingled with storm water (as opposed to the spilled material being washed away by storm water?)
Yes _____ No_____
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Part B. Page 2
If any significant spills or leaks occurred, did they result in more than the minimum amounts of material being discharged in storm water? Base your answer on your knowledge of the material you spilled or that leaked. The minimum amounts could vary with the nature (toxicity, oxygen demand, pH, etc.) of the spilled or leaked material from amounts left after normal "sweeping" type cleanup to the point at which even trace amounts left
after cleanup could cause an environmental problem.
Yes _____ |
No_____ |
No spills or leaks occurred______ |
Have all known spills or leaks been cleaned up or otherwise prevented from contaminating storm water that
would be discharged under the authority of this permit?
Yes _____ No_____ |
No spills or leaks occurred______ |
How many times did you visually monitor all your storm water discharges at all the facility outfalls during the reporting year, and document the condition of and around the outfalls, including flow dissipation measures to prevent scouring? (Count only those done in accordance with the procedures at Part 5.1 - Quarterly Visual Monitoring)
Yes _____ No_____ |
Number of Visual Monitoring _______ |
Would the results of your visual monitoring indicate that there are pollutants in your storm water discharges that are not adequately controlled by your current BMPs?
Yes _____ No_____
If the results of your visual monitoring indicated a potential problem, was it due to one or more of the following?
1.New pollutant source (including exposure of previously unexposed material).
2.Failure to implement or maintain an existing BMP.
3.Less than expected performance from a BMP.
4.No BMP was selected to deal with that problem.
5.N/A (No problems identified)
If your visual monitoring indicated a potential problem, what have you done to resolve the problem?
1.Eliminated exposure or pollutant source.
2.Modified existing BMPs.
3.Added a new BMP.
4.Plan to address problem by end of current reporting year.
5.Nothing planned.
6.N/A (No problems identified).
Did any analysis of any element tested during any previous discharge monitoring period exceed the numeric limitation value?
Yes _____ No_____
If your answer to the previous question was "Yes", please name the element and the test results.
Element |
Test Results |
Element |
Test Results |
_________________ |
_____________ |
_________________ |
_____________ |
_________________ |
_____________ |
_________________ |
_____________ |
_________________ |
_____________ |
_________________ |
_____________ |
Is there any required revisions to the SWP3 resulting from the inspection?
Yes _____ No_____
3
Exhibit 5 Annual Comprehensive Site Compliance Evaluation Report - Instructions
Instructions for Completing the Annual Comprehensive Site Compliance Evaluation Report
Form
When to File an ACSCER Form:
Permittees who are presently covered under an issued OPDES general permit for storm water discharges associated with industrial activity must submit an Annual Comprehensive Site Compliance Evaluation Report by March 1st of each year, beginning in 2012. This is in lieu of filing analytical benchmark discharge monitoring reports. If you need assistance or have questions, contact the Storm Water Program of the Environmental Complaints & Local Services of the DEQ at (405)
Section I: Permit Information:
Enter the existing OPDES General Storm Water Multi- Sector Industrial Permit number assigned to the facility identified in Section II.
Section II. Facility Operator Information:
Give the legal name of the person, firm, public organization or any other entity that owns or operates the facility described in this application. The name of the operator may or may not be the same name as the facility. The operator of the facility is the legal entity that controls the facility's operation, rather than the plant or site manager.
Section III: Facility/Site Location Information:
Enter the facility’s official or legal name and complete address, telephone, city, state, and ZIP code. If the facility lacks a street address, indicate the latitude and longitude of the facility to the nearest 15 seconds.
Section IV: Certification
The ACSCER form must be signed by a responsible party such as the owner or an officer, such as: president, vice president, secretary, and treasurer of either a corporation, company, trust, partnership, or sole proprietorship by a general partner or the proprietor. For a municipality, state, Federal, or other public facility: by either a principal executive officer or ranking elected official.
How to complete the Comprehensive Site Compliance Evaluation Report Part B (see Section 4.2.17)
1.Inspect all areas where materials or activities are exposed to storm water, and areas where spills and leaks have occurred within the past 3 years.
2.Report industrial material, residue or trash on the ground that could contaminate or be washed away.
3.Prevent leaks or spills from industrial equipment, drums, barrels, tanks, etc.
4.Prevent offsite tracking of industrial material or sediment.
5.Prevent tracking or blowing of raw, final, or waste material from areas of no exposure to exposed areas.
6.Include evidence of, or potential for pollutants entering the drainage system.
Corrective Actions (see Part 4.2.17.3):
1.Review to determine if revisions/modifications to eliminate problems or meet the effluent limits in this permit;
2.Document your discovery of any of the conditions listed in Part 4.2.17.3.a and b within 24 hours and any corrective actions to be taken to eliminate or further investigate the deficiency within 14 days of such discovery.
3. Complete the corrective action report with the information included in Part 4.2.17.3.d..
Reporting is required by March 1st of the year beginning in 2012.
Where to file an ACSCER :
DEQ - ECLS
Storm Water Program
P.O. Box 1677
Oklahoma City, Oklahoma
4
Dos and Don'ts
When filling out the DEQ 605 006 form, keep these guidelines in mind:
- Provide all requested information accurately in both Part A and Part B of the form.
- Sign and date the certification section to confirm the truthfulness of the information provided.
- Ensure that the facility operator's information is complete and reflects the correct legal entity.
- Review the instructions on Page 4 thoroughly to understand the requirements before submission.
- Retain copies of the form and any supporting documents for at least three years.
Avoid these common mistakes:
- Do not leave any sections of the form blank; incomplete forms may delay processing.
- Do not submit the form after the March 1st deadline; late submissions can result in penalties.
- Do not use outdated information; ensure all data reflects the current status of the facility.
- Do not ignore the need for corrective actions if deficiencies are identified during inspections.
- Do not forget to document any significant spills or leaks that occurred during the reporting period.
Create Common Templates
Mv3011 - For efficiency, it is best to gather all required information before starting the DPSMV 3011 form.
When engaging in the transfer of ownership for personal property, it is vital to use a document like the Arizona Bill of Sale, which can be obtained from sources such as arizonapdfs.com/bill-of-sale-template/. This form not only provides legal proof of the transaction but also helps avoid ambiguities by detailing the item description, purchase price, and the signatures of both parties involved.
Bc Maid Forms - Once submitted, processing times may vary, so patience is advised when waiting for approval.
Detailed Instructions for Filling Out Deq 605 006
Filling out the DEQ 605 006 form is an important step for authorized industrial facilities to demonstrate compliance with storm water discharge regulations. This form needs to be completed accurately to ensure that all required information is provided. Below are the steps to guide you through the process of filling out the form.
- Locate the DEQ 605 006 form and ensure you have the latest version.
- Begin with Section I and enter your OPDES Permit Authorization Number.
- In Section II, fill in the Facility Operator Information:
- Provide the legal name of the operator.
- Enter the operator’s phone number.
- Complete the address, including city, county, and zip code.
- Move to Section III and provide the Facility Location Information:
- Enter the facility’s name and phone number.
- Complete the facility's address, including city, county, and zip code.
- Input the latitude and longitude of the facility.
- In Section IV, complete the Certification section:
- Print your name and date.
- Sign the form and include your title.
- Proceed to Part B and fill out the reporting period and inspection details, including:
- Number of routine facility inspections conducted.
- Details of corrective actions taken for any violations.
- Information regarding Best Management Practices (BMPs) implementation.
- Details on any significant spills or leaks that occurred.
- Review all entries for accuracy and completeness before submitting.
- Submit the completed form to the DEQ - ECLS Storm Water Program at the provided address.
Once you have filled out the form, it’s essential to keep a copy for your records. The form must be submitted by March 1st each year, starting in 2012, and should be retained as part of your Storm Water Pollution Prevention Plan for at least three years. If you have questions or need assistance, don’t hesitate to reach out to the DEQ Storm Water Program.
Documents used along the form
The DEQ 605 006 form, known as the Annual Comprehensive Site Compliance Evaluation Report for Industrial Facilities, is a vital document for authorized industrial facilities in Oklahoma. In addition to this form, several other documents and forms are commonly used to ensure compliance with environmental regulations. Each of these documents plays a crucial role in maintaining environmental standards and reporting requirements.
- SWP3 (Storm Water Pollution Prevention Plan): This plan outlines the measures a facility will implement to minimize pollutants in storm water discharges. It includes best management practices (BMPs) tailored to the specific activities and materials at the facility.
- Benchmark Monitoring Report: Required for facilities that must conduct benchmark monitoring, this report details the results of storm water sampling and analysis. It helps determine if the facility is meeting the established benchmarks for pollutant levels.
- Corrective Action Report: This document is used to document any deficiencies identified during inspections and the corrective actions taken. It ensures that any issues are addressed promptly and effectively to maintain compliance.
- Inspection Reports: These reports summarize the findings of routine facility inspections. They detail any observed violations, the effectiveness of BMPs, and any necessary follow-up actions.
- Illicit Discharge Detection and Elimination (IDDE) Report: This report focuses on identifying and eliminating unauthorized discharges into the storm water system. It includes documentation of inspections and any actions taken to address illicit discharges.
- Texas Bill of Sale Form: This essential document facilitates the transfer of ownership of personal property between individuals, outlining the details necessary for a smooth transaction. You can find a template for this form at Fast PDF Templates.
- Annual Compliance Report: This comprehensive report provides an overview of the facility's compliance status over the year. It includes summaries of inspections, monitoring results, and any incidents that may have occurred.
These documents collectively support the efforts of industrial facilities to comply with environmental regulations, ensuring that they manage storm water discharges responsibly. Proper documentation and adherence to these requirements contribute to the protection of water quality and the environment.
Your Questions, Answered
What is the purpose of the DEQ 605 006 form?
The DEQ 605 006 form is the Annual Comprehensive Site Compliance Evaluation Report for Industrial Facilities. It serves as a notification that the facility identified is not required to conduct Benchmark Monitoring for storm water discharges associated with industrial activities under the OPDES program. This report is mandatory for all authorized industrial facilities and must be submitted annually by March 1st.
Who is responsible for completing and signing the form?
The form must be completed and signed by a responsible party, such as the owner or an officer of the facility. This could be a president, vice president, secretary, or treasurer of a corporation. For public facilities, the signature must come from a principal executive officer or a ranking elected official. It is crucial that the person signing certifies that they understand the requirements and that the information provided is accurate.
What information is required on the form?
The form requires several key pieces of information:
- OPDES Permit Authorization Number
- Facility Operator Information, including name, phone number, and address
- Facility Location, including latitude and longitude if no street address is available
- Certification of compliance with the reporting requirements
All sections must be filled out completely to ensure compliance with regulations.
What happens if deficiencies are found during the compliance evaluation?
If deficiencies are identified during the evaluation, corrective actions must be taken. The report requires documentation of any corrective actions taken to resolve violations, including dates and details of the actions. If any Best Management Practices (BMPs) are found to be ineffective, they must be replaced or modified. Additionally, all identified issues must be addressed within specified timeframes to ensure compliance with the OPDES program.
Common mistakes
Filling out the DEQ 605 006 form can be a straightforward process, but many individuals make common mistakes that can lead to complications. One major error is failing to provide all the requested information. Each section of the form is designed to capture specific details, and leaving out any part can result in delays or rejections. Ensure that every section, especially the OPDES Permit Authorization Number and facility operator information, is filled out completely.
Another frequent mistake is incorrect or incomplete facility location details. It’s essential to provide the legal name and full address of the facility, including city, county, and ZIP code. If a street address is unavailable, the latitude and longitude must be accurate. Missing or incorrect information in this area can create confusion and hinder compliance efforts.
People often overlook the certification section, which requires a signature from a responsible party. This can be a president, vice president, or another authorized individual. Not having the appropriate signature can invalidate the submission. Additionally, it’s crucial that the person signing the form understands the legal implications of the certification statement, as it asserts that all information is true and accurate.
Many individuals also fail to document the number of inspections and corrective actions taken during the reporting period. This information is vital for compliance and should be accurately reported. Incomplete records can lead to questions about the facility's adherence to regulations and may result in penalties.
Another common error involves the implementation of Best Management Practices (BMPs). Some people mistakenly indicate that all BMPs were being implemented when, in fact, some were not. It’s important to be honest about the status of BMPs and to report any deficiencies accurately. This honesty is crucial for maintaining compliance and ensuring that corrective actions are taken promptly.
Failure to report any significant spills or leaks is another mistake that can have serious consequences. If any spills occurred during the reporting period, they must be documented, including whether they resulted in discharges. Omitting this information can lead to significant penalties and damage to the facility's reputation.
People sometimes neglect to review previous discharge monitoring periods for any exceedances of numeric limitations. If there were any exceedances, these need to be reported clearly. Failing to mention this can suggest a lack of oversight or awareness of compliance issues.
Finally, some individuals do not take the time to review the form for accuracy before submission. Simple typos or errors can lead to misunderstandings and complications. Always double-check the information provided to ensure everything is correct and complete.
Misconceptions
Misconception 1: The DEQ 605 006 form is optional for industrial facilities.
This form is mandatory for all authorized industrial facilities under the OPDES program. It serves as the Annual Comprehensive Site Compliance Evaluation Report, which must be submitted by March 1st each year. Failure to submit the form can lead to penalties.
Misconception 2: Completing the form guarantees compliance with environmental regulations.
While submitting the DEQ 605 006 form is a critical step, it does not automatically ensure compliance. Facilities must actively implement Best Management Practices (BMPs) and correct any deficiencies identified during inspections to maintain compliance.
Misconception 3: Only the facility manager needs to sign the form.
The form must be signed by a responsible party, which can include the owner or an officer of the organization. This ensures accountability and that the information provided is accurate and complete.
Misconception 4: The form can be submitted at any time during the year.
The DEQ 605 006 form has a strict deadline. It must be submitted by March 1st each year. Timely submission is crucial to avoid potential fines or enforcement actions.
Document Attributes
| Fact Name | Fact Details |
|---|---|
| Form Title | Annual Comprehensive Site Compliance Evaluation Report for Industrial Facilities (ACSCER) |
| Governing Law | This form is governed by the Oklahoma Pollutant Discharge Elimination System (OPDES) program. |
| Filing Deadline | The ACSCER must be submitted by March 1st each year, starting in 2012. |
| Retention Period | Reports must be retained as part of the Storm Water Pollution Prevention Plan for at least three years after permit coverage expires or is terminated. |
| Required Inspections | Facilities must perform routine inspections and document any corrective actions taken during the reporting period. |
| Certification Requirement | The form must be certified by a responsible party, such as the facility owner or an authorized officer. |