Teresa Marks, Director
5301 Northshore Drive
North Little Rock, AR 72118-5317 
(501) 682-0744

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1. General Forms

• Change in Signatory Authorization Form
• Disclosure Statement
• Permit Transfer
• Short Term Activity Authorization (STAA)
• Sanitary Sewer Overflow (SSO) Tabular Report Form
• 24-hour Sanitary Sewer Overflow (SSO) Online Report
• Noncompliance Report (NCR) Form
• Discharge Monitoring Report (DMR)  for discharge Permits
• Discharge Monitoring Report (DMR) for  Stormwater Permits

2. Discharge Permits Forms

• ADEQ Form1 (Municipal, Non-municipal, Industrial and Construction forms combined):
  • PDF File
  • MS Word 2002 document template
     
• EPA United States Environmental Protection Agency (US EPA) Forms:
  • Form 2A, Municipal Wastewater Discharges
  • Form 2B, Concentrated Animal Feeding Operations
  • Form 2C, Process Wastewater Discharges, Existing Sources
  • Form 2D, Process Wastewater Discharges, New Sources
  • Form 2E, Domestic Non-Process Wastewater Discharges
  • Form 2F, Industrial Stormwater Dishcharges
     
• PPS (Priority Pollutant Scan) - (PDF)
• PPS (Priority Pollutant Scan) - (Word)
• Notices of Intent (Non stormwater general permits)
• Notices of Intent (Stormwater general permits)

3. No-Discharge Permits Forms

(For more information in regard to each Form please click on No-Discharges Permits Forms)

• Animal Waste Disposal Permit Application
• Annual Report Form
• Land Use Contract
• Land Application Record
• Salt Water Disposal Notice of Intent
• Subsurface Wastewater Disposal Permit Application
• Waste Storage Pond Closure Guidelines
• Waste Storage/Land Application Permit Application
• Waste Storage/Land Application of Drilling Fluids Permit Application - (PDF)
• Waste Storage/Land Application of Drilling Fluids Permit Application - (Word)
• Request for Land Application Authorization
• Request for Land Application Authorization
• Construction, Operation, and Closure of Pits NOI – 00000-WG-P-NOI
• Construction, Operation, and Closure of Pits NOT– 00000-WG-P-NOT
• Land Application of Water-Based Drilling Fluids NOI - 00000-WG-LA-NOI
• Land Application of Water-Based Drilling Fluids NOT - 00000-WG-LA-NOT
• Monthly Monitoring Report Forms

4. Short Term Activity Authorization

Work in waters of the State require a short term activity authorization (STAA) by Arkansas Department of Environmental Quality (ADEQ) and may require a Corp of Engineers (USACE) permit.

• ROUTINE WORK and DISASTER (State or Federal) (For goverment use only) - (PDF)
• ROUTINE WORK and DISASTER (State or Federal) (For goverment use only) - (Excel)
• WATER QUALITY – Section 10, 401, and 404 Permits
  Work in waters of the State require authorization by Arkansas Department of Environmental Quality (ADEQ) and may require a Corp of Engineers (USACE) permit.
• Short Term Activity Authorization (STAA) - (PDF)
• Short Term Activity Authorization (STAA) - (WORD)

For non-disaster related federal permits, contact the Corp of Engineers directly