Clean Fill Certification Form

Management of Fill Policy

If any person wants to use clean fill under this policy, complete Form FP-001, Certification of Clean Fill, and submit it to DEP electronically on the DEP website link (Residual Waste section) listed below.  Choose the FP-001 Clean Fill Certification Electronic Submission Link.

Visual Inspection Report

Sample Instrument of Declarations and Covenants

The sample legal Instrument for the Declaration of Restrictions and Covenants has been posted to the DEP website.  Please follow the link to access the new form for Post Construction Stormwater Management systems. This form should be used by permittees when filing instruments and plans/record drawings with the recorder of deeds offices so that the recorder knows what to do with the instruments and how to file them. 

Please note that applicants are instructed to attach certain items to the filing form for filing such as the instrument, record drawings, and other pertinent information.  Please note that there is no requirement for the district or DEP to check these forms before submission, they are strictly to ease and standardize the filing process at the recorder of deeds level.  The Recorder of Deeds Association will be passing along information to all of their constituents informing them of the form and its use concurrently.

Depending on your site, other agreements or instrument filings may be required. Examples are listed below.

O&M Deed Restriction for Buffers

PCSM Filing Notice

The DEP has recently made revisions to the Notice of Termination Forms.  The NOT FAQ Sheet revised January 21, 2022 will assist in preparing the NOT form:  NOT FAQ Revised January 21, 2022

The forms and instructions may be found by accessing the DEP E&S Resources page (Notice of Termination) following these links:  Notice of Termination Instructions  and  Notice of Termination Form

After October 1, 2020 please do not submit Notice of Termination Forms that have revision dates prior to 9/2020.

Application for NPDES Permit Transfer Instructions

  • 3800-PM-BCW0041A (instructions) and B (form)

Chapter 102 Forms 3800-FM-BCW0271

  • Co Permittee Liability Release Form
  • Co Permittee Acknowledgement Form
  • County Notification Form
  • Municipal Notification Form
  • Visual Site Inspection Report
  • Pre-Applicaton Meeting Request Form
  • MS4-CSS Notification Form

Sample Landowner Notification of PCSM O&M

The Incomplete/Technically Deficient Extension Request Application can be found here: Incomplete / Technically Deficient Extension Request Application Form & Policy

Corrective Action Plan Guidance

Corrective Action Plans (CAPs) can be utilized when there is an unforeseen failure within a stormwater management system prior to the termination of an NPDES permit. Examples of this type of failure could include a lack of infiltration within a basin or raingarden. CAPs can also be developed if a project’s earth disturbance becomes larger than one acre without first obtaining an NPDES permit, and subsequently must comply with Chapter 102 regulations through an enforcement action. If you believe that you may need to develop a Corrective Action Plan for your site, please contact the BCCD office and make an appointment with the appropriate E&S Technician immediately.

Managed Release Concept Design Template (MRC)

PAG -02 General and Individual Permit FAQ Revised August 23, 2021 –  The FAQ for PAG-02 and Individual Permits is available on DEP’s website (, select E&S Resources). This document will change over time.

NPDES GUIDANCE Please note the information available below

Pre Application Meeting Request Form 3800 FM-BCW0271E Rev. 01/2021

Disturbed Acre Fee Guidance

Site Stabilization Guidelines

BCCD Standard Notes

NPDES Major vs Minor Amendment FAQ Please be aware that the BCCD now charges fees for the review of  both Minor Amendments and Major Amendments. Please, see page 2 of the BCCD General Information Form/E&S Application for details.  The following “Quick Guide” will provide a summary of necessary items Quick Guide To Major and Minor Amendments

Alternative Best Management Practices and Managed Release Concept

The PA DEP E Library contains all of the documents that we try to provide here on the BCCD website. We encourage applicants to explore the PA DEP resource and download documents directly from the E Library.

Click to visit the PA DEP E Library E&S Resources Page

Click to visit the PA DEP E Library Chapter 102 Forms Page

Contact Information

Susan Seykot

NPDES Permit Coordinator

Phone: (215) 345-7577 x101