Ala. Admin. Code r. 335-1-1-.07
(3) Form and Instructions. The Director may require such forms within the rules as he deems necessary. The content of such forms and instructions for their completion may be prescribed by the Director including the changes of such from time to time. Federal forms as published by the Environmental Protection Agency may be used in lieu of state developed forms. Departmental forms prescribed by the Director shall be identified and numbered as follows:
| Name of Forms | Form Number |
| Title VI Complaint Form | 572 |
| Air Program | |
| Specifications for Air Curtain Incinerators M-1 | 17 |
| MEME Vendor Application | 39 |
| Registration Form for the Construction, Installation, or Modification of an Incinerator M-3 | 52 |
| Operating Permit Application Facility Identification Form M-8 | 103 |
| Permit Application for Indirect Heating Equipment M-4 | 104 |
| Permit Application for Manufacturing or Processing Operation M-6 | 105 |
| Permit Application for Waste Disposal M-3 | 106 |
| Permit Application for Stationary Internal Combustion Engines M-8 | 107 |
| Permit Application for Loading and Storage of Organic Compounds M-3 | 108 |
| Permit Application for Volatile Organic Compound Surface Coating Emission Source M-4 | 109 |
| Permit Application for Air Pollution Control Device M-5 | 110 |
| Permit Application for Solvent Metal Cleaning M-2 | 112 |
| Seal Gap Test Form M-2 | 184 |
| Air Permit Application for Gasoline Dispensing Facilities M-6 | 197 |
| Gasoline Transport Tank Truck Application M-4 | 198 |
| Cargo Tank Tightness Test Report M-1 | 309 |
| Bulk (Gasoline) Plant Application M-3 | 331 |
| Emissions Statement Reporting Form M-1 | 372 |
| Excess Emission Monitoring Report | 373 |
| Exemption Claim Form for Cofired Combustors (Appendix H – Division 3) M-1 | 374 |
| Exemption Claim Form for Incinerators Burning Only Pathological, Low-Level Radioactive, and Chemotherapeutic Waste (Appendix H – Division 3) M-1 | 375 |
| Gasoline Dispensing Facility Information Survey M-1 | 378 |
| Open Burning Incident Report | 434 |
| Perc Dry Cleaner Status Update M-1 | 436 |
| Permit Application for Compliance Schedule M-2 | 437 |
| Permit Application for Continuous Emission Monitoring Systems (CEMS) M-1 | 438 |
| Petroleum Solvent Dry Cleaning Questionnaire M-1 | 440 |
| Remediation Approval Form M-2 | 448 |
| Remediation Reporting Form M-2 | 449 |
| 112(j) Part 1 Applicability Notification | 493 |
| Birmingham Fuel Supplier Report M-1 | 494 |
| Notice of Demolition and/or Asbestos Removal M-2 | 496 |
| Asbestos Removal Contractor Certification M-1 | 497 |
| Visible Emission Field Test Sheet | 502 |
| CAIR Permit Application (for sources covered under a CAIR SIP) | 519 |
| Coastal Program | |
| Joint Application and Notification U. S. Department of Army, Corps of Engineers Alabama Department of Environmental Management M-3 | 166 |
| Alabama Coastal Area Management Program Application for Approval of a Non-Regulated Use ADEM Administrative Code rule 335-8-1-.11 Groundwater Extraction 50 PM or Greater M-1 | 316 |
| Application for a Permit for the Construction for a Motel, Hotel, or Other Multi-Unit Development on a Property Intersected by the Construction Control Line in the Alabama Coastal Area M-1 | 327 |
| Application for a Permit for the Construction of Single-Family Dwellings, Duplexes, or Other Similar Structures on Properties Intersected by the Construction Control Line in the Alabama Coastal Area M-1 | 328 |
| Application for Approval of a Non-Regulated Use in the Alabama Coastal Area Developments and Subdivisions of Property Greater than 5 Acres in Size M-1 | 329 |
| Waste/Remediation Program | |
| Alabama Recycling Fund Grant Application M-2 | 9 |
| Solid Waste Landfill Operator Initial Certification Application | 11 |
| Solid Waste Landfill Operator Reciprocal Certification Application | 12 |
| Solid Waste Landfill Operator Certification Renewal | 13 |
| Processing and Recycling General Information Recycling Registration M-3 | 15 |
| Annual Recycling Report | 16 |
| Composting Facility Application M-1 | 18 |
| UST Annual Walkthrough Inspection Checklist Log M-3 | 19 |
| UST 3 Year Spill Prevention Equipment (Spill Bucket) Integrity Test Report (Hydrostatic and Vacuum Method) M-3 | 20 |
| UST Alabama Tank Trust Fund Cost Proposal Part I M-6 | 31 |
| UST Alabama Tank Trust Fund Payment Request Part I M-7 | 32 |
| Disposal Approval Request M-1 | 278 |
| UST Notification for Underground Storage Tanks M-4 | 279 |
| UST Notification for Above Ground Storage Tanks M-4 | 283 |
| Solid Waste Profile Sheet M-4 | 300 |
| SARA Title III Section 302: Extremely Hazardous Substance Notification M-1 | 302 |
| Permit Application Solid Waste Disposal Facility Construction/Demolition Landfill M-2 | 305 |
| UST Notice of Temporary Closure M-2 | 310 |
| Alabama Hazardous Waste/Used Oil Transporter Permit Application M-3 | 317 |
| Alternative Medical Waste Treatment Technology Equipment Approval Application | 323 |
| UST Annual Statistical Inventory Reconciliation (SIR) Report Form M-2 | 326 |
| Application for Name Change or Transfer of Permit or Exemption M-5 | 330 |
| UST Cathodic Protection Monitoring Form M-2 | 332 |
| UST Impressed Current Cathodic Protection System 60-Day Inspection Log M-1 | 400 |
| UST Interior Lining Inspection Form | 403 |
| UST Interior Lining Report Form | 404 |
| UST Manual Interstitial Monitoring Monthly Log M-1 | 406 |
| SARA Title III Section 311: SDS/MSDS Reporting M-1 | 407 |
| Application for Medical Waste Generator Notification M-3 | 410 |
| Medical Waste Transporter Permit Application M-5 | 411 |
| Medical Waste Treatment Permit Application M-5 | 412 |
| Medical Waste Storage Permit Application | 413 |
| UST 30 Day Statistical Inventory Reconciliation (SIR) Log M-3 | 414 |
| UST Notice of Intent to Permanently Close Underground Storage Tanks or Piping M-4 | 422 |
| UST Notice of Proposed UST New Installation or Modification M-5 | 423 |
| Notification of Election of Coverage under The Alabama Drycleaning Environmental Response Trust Fund Act M-3 | 425 |
| Permit Application Solid Waste Disposal Facility M-2 | 439 |
| UST Statistical Inventory Reconciliation SIR 7 Day Release Investigation Report M-3 | 460 |
| UST Tank Trust Fund Eligibility/Ineligibility Determination Form M-1 | 462 |
| UST Underground and Above Ground Storage Tank Transfer of Ownership M-3 | 469 |
| UST ARBCA Tier 1 Report Forms | 471 |
| UST ARBCA Tier 2 Report Forms | 472 |
| UST ARBCA Tier 3 Report Forms | 473 |
| UST Closure Site Assessment Report Form M-4 | 474 |
| UST Free Product Recovery Report Form | 475 |
| UST Groundwater Monitoring Report Form M-1 | 476 |
| UST Line Tightness Test Report Form M-3 | 477 |
| UST Natural Attenuation Monitoring Report Form | 478 |
| UST Release Fact Sheet | 479 |
| UST Release Report Form M-3 | 480 |
| UST Site Classification System Checklist | 481 |
| UST System Effectiveness Monitoring Report Form | 482 |
| UST Tracer Tank Tightness Test Report Form M-2 | 483 |
| UST Ullage Tank Tightness Test Report Form M-2 | 484 |
| UST Tank Tightness Test (Vacuum) Report M-3 | 485 |
| UST Volumetric Overfill Tank Tightness Test Report Form M-2 | 486 |
| UST Volumetric Underfill Tank Tightness Test Report Form M-1 | 487 |
| UST Closure Total Potential VOC Emissions Calculations | 492 |
| Voluntary Cleanup Program Application M-3 | 521 |
| Technical Proposal for Qualification as a Large Site Scrap Tire Fund Remediation Center M-1 | 530 |
| Scrap Tire Manifest M-4 | 536 |
| Scrap Tire Registration & Exemption Application M-8 | 537 |
| Scrap Tire Transporter Permit Application M-8 | 538 |
| Scrap Tire Quarterly Report M-6 | 539 |
| Scrap Tire Processor Permit Application M-7 | 540 |
| Scrap Tire Site Registration M-1 | 541 |
| Brownfields State Revolving Fund Pre-Application Form M-1 | 542 |
| Brownfields State Revolving Fund Application Form M-1 | 543 |
| Cathodic Protection Monitoring for Galvanic Systems M-2 | 545 |
| Alabama Hazardous Waste Receipt for Samples and Documents | 546 |
| Brownfields Assessment Request Application M-1 | 550 |
| UST Line Leak Detector (LLD) Test Report M-3 | 551 |
| UST 3 Year Containment Sump Integrity Test Report (Low Level Method) M-1 | 556 |
| UST 3 Year Containment Sump Integrity Test Report M-1 | 557 |
| UST 30 Day Walkthrough Inspection Checklist Log M-2 | 558 |
| UST 3 Year Overfill Prevention Equipment Inspection Report M-2 | 559 |
| UST Annual Probe and Sensor Test Report M-1 | 560 |
| UST Annual Release Detection Equipment Operation and Calibration Testing Log M-2 | 561 |
| UST Compatibility Demonstration Log M-1 | 562 |
| UST Manual Tank Gauging Monthly Log M-1 | 563 |
| UST Annual Liquid Sensor Inspection and Functionality Test M-1 | 564 |
| UST Annual Tank Gauge Test Report M-1 | 565 |
| UST Automatic Line Leak Detector (ALLD) and Line Tightness Test Report M-1 | 566 |
| Application for Facility Name Change or Transfer of Solid Waste Disposal Facility Permit | 568 |
| Beneficial Use Facility Registration Application M-1 | 569 |
| Beneficial Use Annual Reporting M-1 | 571 |
| Notification of Regulated Waste Activity M-8 | 8700-12 |
| Water Program | |
| Drinking Water - Groundwater System Monthly Operational Data Report M-1 | 8 |
| Information Needed for 316(b) Determination in Regard to General NPDES Permits | 14 |
| Notice of Termination NPDES General Permit Number ALR100000 M-2 | 21 |
| NPDES Construction Stormwater Inspection Report and BMP Certification M-1 | 23 |
| Notice of Intent NPDES General Permit Number ALR100000 (Construction Stormwater) M-3 | 24 |
| NPDES Construction Stormwater Noncompliance Notification M-1 | 25 |
| Notice of Intent-NPDES General Permit Number ALG850000 M-4 | 26 |
| Drinking Water - Operational Evaluation Level Exceedance Report M-2 | 27 |
| Notice of Intent-General Permit Number ALG870000 (Pesticides) M-2 | 28 |
| ADEM NPDES Pesticide Adverse Incident Report M-1 | 29 |
| Notice of Termination – NPDES General Permit Number ALG870000 M-1 | 30 |
| EDWRS Permittee Registration Form | 33 |
| EDWRS Lab Registration Form | 34 |
| EDWRS Terms and Conditions Agreement | 35 |
| Drinking Water - Total Coliform Rule – Level 1 Assessment M-2 | 36 |
| Drinking Water - Total Coliform Rule – Level 2 Assessment M-2 | 37 |
| Drinking Water- Certification of Well Completion | 59 |
| Drinking Water - Notification of Intent to Drill a Water Well | 60 |
| Drinking Water - Purchase Water System Monthly Operation Report M-1 | 185 |
| State Indirect Discharge (SID) Permit Application M-6 | 186 |
| NPDES Individual Permit Application Supplementary Information for Industrial Facilities M-7 | 187 |
| NPDES Individual Permit Application Supplementary Information for Publicly-Owned Treatment Works (POTW), Other Treatment Works Treating Domestic Sewage (TWTDS), and Public Water Supply Treatment Plants M-4 | 188 |
| Permit Application of Reclaimed Water Reuse (RWR) | 189 |
| Application for Alabama Well Driller’s License M-1 | 193 |
| Water Well Driller Reciprocal Application | 194 |
| Water Well Standards Program License Renewal | 195 |
| Drinking Water - Filter Plant Monthly Operational Data Report M-1 | 242 |
| Drinking Water - Monthly Membrane Surface Plant Operational Data Report M-1 | 243 |
| Drinking Water - Application for Approval to Use a Water Supply Well | 259 |
| Alternative Analysis | 311 |
| Calculation of Total Annualized Project Cost for Public-Sector Projects | 312 |
| Calculation of Total Annualized Project Cost for Private-Sector Projects | 313 |
| ADEM Baseline Monitoring Report Submittal Form | 314 |
| NPDES Individual Permit Application (Mining Operations) M-6 | 315 |
| Annual Certification Form for Discharges Associated with Petroleum Storage and Handling Areas M-2 | 324 |
| Drinking Water - Chemical Monitoring Data Report M-1 | 335 |
| Drinking Water - Chemical Monitoring Waiver Application M-1 | 336 |
| Clean Water State Revolving Fund (CWSRF) Loan Application Form M-3 | 339 |
| Clean Water State Revolving Fund (CWSRF) Preapplication Form M-4 | 340 |
| Coalbed Methane Stormwater Inspection Summary Report M-1 | 343 |
| Coalbed Methane Temporary Pit Wastewater Land Application Certification Report M-1 | 344 |
| Drinking Water - Community Public Notification Certification Form | 345 |
| Drinking Water - Community System Susceptibility Analysis Sheet M-1 | 346 |
| Drinking Water – Consumer Confidence Report (CCR) Certification Form M-2 | 347 |
| Drinking Water State Revolving Fund (DWSRF) Loan Application Form M-3 | 369 |
| Drinking Water State Revolving Fund (DWSRF) Preapplication Form M-4 | 370 |
| NPDES Individual Permit Application Addendum M-1 | 376 |
| NPDES Individual Permit Application Minor Permit Modification Addendum M-2 | 377 |
| Notice of Intent-NPDES General Permit Number ALG110000 M-5 | 380 |
| Notice of Intent-NPDES General Permit Number ALG120000 M-6 | 381 |
| Notice of Intent-NPDES General Permit Number ALG140000 M-5 | 382 |
| Notice of Intent-NPDES General Permit Number ALG150000 M-4 | 383 |
| Notice of Intent-NPDES General Permit Number ALG160000 M-4 | 384 |
| Notice of Intent-NPDES General Permit Number ALG170000 M-4 | 385 |
| Notice of Intent-NPDES General Permit Number ALG180000 M-4 | 386 |
| Notice of Intent-NPDES General Permit Number ALG020000 M-4 | 387 |
| Notice of Intent-NPDES General Permit Number ALG200000 M-4 | 388 |
| Notice of Intent-NPDES General Permit Number ALG230000 M-4 | 389 |
| Notice of Intent-NPDES General Permit Number ALG240000 M-4 | 390 |
| Notice of Intent-NPDES General Permit Number ALG250000 M-5 | 391 |
| Notice of Intent-NPDES General Permit Number ALG280000 M-5 | 392 |
| Notice of Intent-NPDES General Permit Number ALG030000 M-4 | 393 |
| Notice of Intent-NPDES General Permit Number ALG340000 M-5 | 394 |
| Notice of Intent-NPDES General Permit Number ALG360000 M-6 | 395 |
| Notice of Intent-NPDES General Permit Number ALG060000 M-5 | 396 |
| Notice of Intent-NPDES General Permit Number ALG670000 M-4 | 397 |
| Drinking Water - Lead and Copper Monitoring Data Report M-1 | 405 |
| Material Safety Data Sheet Reporting | 407 |
| Drinking Water - Maximum Residual Disinfectant Level Input Form (Samples) M-1 | 408 |
| Sanitary Sewer Overflow (SSO) Event Reporting Form M-4 | 415 |
| Municipal Water Pollution Prevention (MWPP) Annual Report (Collection Systems) Package M-1 | 416 |
| Municipal Water Pollution Prevention (MWPP) Annual Report Package M-3 | 417 |
| Municipal Water Pollution Prevention Resolution Form | 418 |
| MWPP Sewage Sludge Survey M-1 | 419 |
| Drinking Water - Non-Community Public Notification Certification Form | 420 |
| NPDES/SID Non-Compliance Notification Form M-4 | 421 |
| NPDES Annual Notice of Registration (NOR) | 429 |
| NPDES Individual Permit Pollution Abatement/Treatment Measures and Sediment Control Structures Certification Report M-2 | 432 |
| NPDES Permitted Coalbed Methane Operations Pollution Abatement/Treatment Measures and Waste Treatment Facilities Certification Report M-1 | 433 |
| Operator Certification Renewal Form M-1 | 435 |
| Plant and Collection System Personnel Inventory | 441 |
| Drinking Water - Potable Water Laboratory Certification Application M-3 | 442 |
| Drinking Water - Progress Report Form M-1 | 443 |
| Drinking Water - Project Completion Form M-2 | 444 |
| Release Information Form | 447 |
| Representative Stormwater Outfall Certification M-3 | 450 |
| Request for NPDES Permit Post-Mining Discharge Limitations (Coal Mining Operations) M-2 | 451 |
| Request for Release from NPDES Permit Monitoring and Reporting Requirements (Mining Operations) M-3 | 452 |
| Request to Remove Subsurface Withdrawal from Discharge Structure (NPDES-Permitted Mining Operations) M-2 | 453 |
| Request to Remove Treatment Basin/Pond or Other Discharge Structure (NPDES-Permitted Mining Operations) M-3 | 454 |
| Required Information for Mixing Zone Modeling M-1 | 455 |
| SID Discharge Monitoring Report Form (Monthly) | 457 |
| SID Discharge Monitoring Report Form (Quarterly) | 458 |
| SRF Payment Request Form | 459 |
| Drinking Water - Surface Source Susceptibility Analysis Worksheet M-1 | 461 |
| Toxicity Discharge Monitoring Report Form | 464 |
| Toxicity Test Report Summary | 465 |
| NPDES/SID/UIC Permit Transfer Agreement M-3 | 466 |
| Drinking Water - Construction Permit Application M-2 | 488 |
| Drinking Water – Modification Permit Application | 489 |
| Drinking Water - Renewal Permit Application M-2 | 490 |
| Drinking Water – Public Water System Information Update M-1 | 491 |
| Notice of Intent–NPDES General Permit Number ALG890000 M-6 | 498 |
| Notice of Termination – NPDES General Permit Number ALG890000 M-4 | 499 |
| NPDES Noncoal/Nonmetallic Mining and Dry Processing Less than Five Acres Stormwater Inspection Report and BMP Certification M-3 | 500 |
| NPDES Small Mining Noncompliance Notification Report M-4 | 501 |
| Notice of Intent – NPDES General Permit Number ALR040000 (MS4 Phase II) M-3 | 503 |
| Water and Wastewater Operator Exam Application M-1 | 505 |
| Water and Wastewater Operator Experience Verification M-1 | 506 |
| Water and Wastewater Reciprocal Application M-1 | 507 |
| Water and Wastewater Operator for Multiple Systems M-1 | 508 |
| Cooling Water Supplemental Information M-2 | 510 |
| EDMR Daily Discharge Monitoring Report Form | 514 |
| EDMR Monthly Discharge Monitoring Report Form | 515 |
| Supplemental Petroleum Application Information | 516 |
| Alabama Clean Vessel Act Grant Application | 517 |
| Boating Infrastructure Grant Application | 518 |
| General Phase II MS4 Stormwater Permit Renewal Notice of Intent M-1 | 520 |
| Notice of Intent-NPDES General Permit Number ALG640000 M-6 | 522 |
| Hydrogeology Unit Evaluation Report Form | 531 |
| Documentation of Disability Related Needs | 533 |
| Drinking Water – Giardia and Virus Profile Spreadsheet M-1 | 535 |
| Drinking Water - WTP Quarterly Report for the Disinfectants and Disinfection Byproducts Rule M-2 | 547 |
| NPDES Individual Permit Application (Coalbed Methane Operations) M-4 | 549 |
| Notice of Intent-UIC General Permit Number ALIG010000 | 552 |
| Notice of Intent-UIC General Permit Number ALIG020000 | 553 |
| Notice of Termination – NPDES General Permits (Industrial Activities) | 554 |
| No Exposure Certification for Exclusion from NPDES Stormwater Permitting for Industrial Activities M-1 | 555 |
| NPDES Mining and Preparation Plant Outfall Data for Metals, Cyanide, and Total Phenols | 567 |
| One-Time Compliance Report for Dental Dischargers | 570 |
Ed. Note: Forms are available on the ADEM website at www.adem.alabama.gov.
Author: Marilyn Elliott, Russell A. Kelly, Aubrey White, David Hutchinson, Brian C. Espy
Statutory Authority: Code of Ala. 1975, §§22-22A-5, 22-22A-6, 22-22A-8, 411-22-4, 41-22-5.
Editor’s Note: Appendix A, Forms can no longer be found at the end of the Chapter 335-1-1. It will be placed at the end of all chapters in Division 335-1.
History: Amended: Filed June 26, 2002; effective July 31, 2002. Amended: Filed December 19, 2002; effective January 23, 2003. Amended: Filed June 30, 2004; effective August 4, 2004. Amended: Filed December 6, 2005; effective January 10, 2006. Amended: Filed June 6, 2006; effective July 11, 2006. Amended: Filed October 10, 2006; effective November 14, 2006. Amended: Filed December 18, 2007; effective January 22, 2008. Amended: Filed December 15, 2008; effective January 19, 2009. Amended: Filed December 15, 2009; effective January 19, 2010. Amended: Filed December 14, 2010; effective January 18, 2011. Amended: Filed October 25, 2011; effective November 29, 2011. Amended: Filed October 23, 2012; effective November 27, 2012. Amended: Filed April 15, 2014; effective May 20, 2014. Amended: Filed June 23, 2015; effective July 28, 2015. Amended (Appendix Also): Filed June 21, 2016; effective August 5, 2016. Amended (Appendix Also): Filed June 21, 2016; effective August 5, 2016. Amended: Filed August 22, 2017; effective October 6, 2017. Amended: Filed April 24, 2018; effective June 8, 2018. Amended: Filed October 23, 2018; effective November 7, 2018. Amended: Published February 28, 2020; effective April 13, 2020. Amended: Published December 31, 2020; effective February 14, 2021. Amended: Published April 29, 2022; effective June 13, 2022. Amended: Published December 30, 2022; effective February 13, 2023. Amended: Published February 29, 2024; effective April 14, 2024. Amended: Published December 31, 2025; effective February 14, 2026.