Stormwater Notice of Intent
Environmental Services Department
Menominee Indian Tribe of Wisconsin
Menominee Forestry and Environmental Resources
Center
P.O. Box 670
Keshena, WI 54135
(715) 799-4937
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I certify under penalty of law that I have read and understand
the eligibility requirements for claiming a condition of no exposure
and obtaining an exclusion from NPDES stormwater permitting and that
there are no discharges of stormwater contaminated by exposure to
industrial activities or materials from the industrial facility identified
in this document. I understand that I am obligated to submit a no
exposure certification form once every five years to the NPDES permitting
authority and, if requested, to the operator of the local MS4 into
which this facility discharges (where applicable). I understand that
I must allow the NPDES permitting authority, or MS4 operator where
the discharge is into the local MS4, to perform inspections to confirm
the condition of no exposure and to make such inspection reports publicly
available upon request. I understand that I must obtain coverage under
a NPDES permit prior to any point source discharge of stormwater from
the facility. 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.
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