HomeMy WebLinkAbout20170169RESOLUTION
RE: APPROVE ANNUAL REPORT FOR 2016 HERBICIDE APPLICATIONS AND
AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with an Annual Report for 2016 Herbicide
Applications from the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Department of Public Works, to the Colorado
Department of Public Health and Environment, commencing upon the execution of signatures,
with further terms and conditions being as stated in said annual report, and
WHEREAS, after review, the Board deems it advisable to approve said annual report, a
copy of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Annual Report for 2016 Herbicide Applications from the County of
Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on
behalf of the Department of Public Works, to the Colorado Department of Public Health and
Environment be and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said annual report.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 11th day of January, A.D., 2017.
BOARD OF COUNTY COMMISSIONERS
WELD CO . TY, COLO ' 'O
ATTEST: dadtvs) .X;l�tO
Weld County Clerk to the Board
BY:CP\OLes.¢_,(.
APP
puty Clerk to the Board
'Attorney
Date of signature: O t /'1 / 11
Ju ie A. Cozad, Chair
Steve Moreno, Pro -Tern
Sean P. Conway
e Freeman
Cc Pc,WCTG3/yen/On/Fc)
01 OCp/
arbara Kirkmeye
2017-0169
EG0074
MEMORANDUM
TO: Clerk to the Board DATE: January 5, 2017
FROM: Tina Booton, Public Work
Jay McDonald, Director Public Works
SUBJECT: Agenda Item
C5513e4C-614a2Q__
Attached is the Annual Report for herbicide applications made in 2016 under the NPDES
requirements. The Chair's signature is required on this document. With the original returned
to Public Works, attn: Tina Booton for submission to CDPHE. Please add this item to the
agenda for Wednesday, January 11, 2017.
2017-0169
BOARD OF COUNTY COMMISSIONERS
PASS -AROUND REVIEW/ WORK SESSION REQUEST
RE: Pesticide Annual Report for NPDES Compliance
DEPARTMENT: Public Works DATE: January 3.2017
PERSON REQUESTING: Tina Booton
Brief description of the problem/issue:
As part of the National Pollutant Discharge Elimination System (NPDES) requirements for making chemical
(pesticide) applications to areas that may impact waters of the State, an annual report must be filed with the
Colorado Department of Public Health and Environment (CDPHE) by February of the following year.
This annual report is required to cover all chemical applications for the 2016 calendar year. This includes bare -
ground treatments from January 1, 2016 through December 31, 2016 as well as all roadside treatments and
handgun applications made during this same time frame. This permit started in 2013 with threshold
requirements set at 20 linear miles or 80 surface acres. The first two years of the report were estimates of the
quantities that would be used for the year. While in 2015 CDPHE changed the process to report after the year
ended so that quantities reported would be accurate instead of estimated values.
A fee of $275 is being assessed with the submission of this annual report. A bill will be mailed in April after
CDPHE has received our report. This fee was included in the Weed Division budget planning process for 2017.
Attached is the completed compliance certificate for 2016 for review and signature.
What options exist for the Board? (Include consequences, impacts, costs, etc. of options)
Option A- Sign the annual report.
Option B- Authorize another agent to sign the annual report.
Recommendation:
Option A- Sign the annual report.
Julie Cozad, Chair
Steve Moreno, Pro-Tem
Barbara Kirkmeyer
Mike Freeman
Sean P. Conway
M\FORMS\WorkSevsion-passaround7.o le doc.
Approve Schedule
ecommen a ati a n Work Session
Other/Comments:
CDPS ANNUAL REPORT FOR DISCHARGES FROM THE APPLICATION OF PESTICIDES COG86OOOO
COLORADO
Department of Public
Health b Environment
Dedicated to protecting and improving the health and environment of the people of Colorado
ANNUAL REPORT FOR DISCHARGES FROM THE APPLICATION OF PESTICIDES COG860000
PHOTO COPIES, FAXED COPIES, PDF COPIES, or EMAILED COPIES WILL NOT BE ACCEPTED
NOTE: SUBMISSION OF THIS REPORT CONSTITUTES A RECORD OF COMPLIANCE FOR DISCHARGES MADE TO
WATERS OF THE STATE ONLY.
EPA ADMINISTERS THE PESTICIDE GENERAL PERMIT FOR FEDERAL FACILITIES. CONTACT EPA FOR FURTHER INFORMATION
REGARDING FEDERAL FACILITIES.
Please print or type. Original signatures are required. Submission of this completed Annual Report constitutes
notice that the Operator identified under item B.2 is authorized to discharge pollutants to surface waters of the
state of Colorado. To certify compliance, all information required on this form must be completed. See instructions
at the end of this form for completing the certification.
Year of report
Jan- Dec 2014
Jan- Dec 2017
Jan- Dec 2015
Jan- Dec 2018
Jan- Dec 2016
Submit forms to:
Colorado Department of Public Health and Environment
Water Quality Control Division
4300 Cherry Creek Drive South WQCD-P-B2
Denver, Colorado 80246-1530
ANNUAL REPORT
A. Notice of Status
1. Mark whether this is the first time you are certifying compliance under the Pesticide General Permit or if
this is a change of information for a discharge already certified under the Pesticide General Permit. If this is
a change of information, supply the Operator Name for the discharge.
a.❑ First time Annual Report
b.II Annual Report representing new information (e.g. reporting for a new discharge season)
Certification number
c.❑ Annual Report Change of Information:
Operator name
Please note: When selecting A.1.b above, please fill out Item number B.1 below (Decision -maker name
and mailing address) and modify the pertinent fields of the Annual Report as necessary.
B. Contact Information
1. Legal Contact (Decision Maker)
Company Name Weld County
First Name Julie
Title Board of County Commissioners Chair
Last Name Cozad
Mailing Address PO Box 758
City, State and Zip Code Greeley, CO 80632
Phone 970-336-7204
E-mail Address iaozad@weldgov.com
Cell
2. Is the Decision Maker for this Annual Report a Large Entity as defined in Appendix A of the permit?
D YES
❑ NO
Note that if you answered "Yes" to question B.2, you are required to develop a Pesticide Discharge
Management Plan (PDMP) that reflects all pesticide uses for which you are requesting permit coverage.
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CDPS ANNUAL REPORT FOR DISCHARGES FROM THE APPLICATION OF PESTICIDES COG860000
3. Operator (if different from Decision Maker)
Company NameWeld County
Mailing Address PO Box 758
City, State and Zip Code Greeley, CO 80632
First Name Tina Last Name Booton
Title Weed Division Supervisor
Phone 970400-3770
E-mail Address tbooton@weldgov.com
Cell 970-381-4052
4. Operator Type (check one):
❑ State Govt Li Local Govt
❑ Mosquito Control District(or similar)
❑ Irrigation Control District (or similar)
❑ Weed Control District (or similar)
❑ Other:
5. Facility Contact ❑ same as applicant
Company Name Weld County
Mailing Address PO Box 758
City, State and Zip Code Greeley, CO 80632
First Name Tina
Title Weed Division Supervisor
Last Name
Booton
Phone 970-400-3770
E-mail Address tbooton@weldgov.com
Cell 970-381-4052
Additional Operator Information if applicable:
6. Authorized Reporting Agent (DMR Cognizant Official) 0 same as applicant
(i.e. person or position authorized to sign and certify reports required by the permit: DMR's,
Annual Reports, Compliance Schedule submittals, etc., as requested by the division.)
Company Name
Mailing Address
City, State and Zip Code
First Name Last Name
Title
Phone Cell
E-mail Address
7. Billing Address and Contact ❑ same as applicant
Company Name Weld County
Mailing Address PO Box 758
City, State and Zip Code Greeley, CO 80632
First Name Tina
Title Weed Division Supervisor
Last Name Booton
Phone 970-400-3770
E-mail Address tbooton@weldgov.com
Cell 970381-4052
2of3
CDPS ANNUAL REPORT FOR DISCHARGES FROM THE APPLICATION OF PESTICIDES COG860000
C. ANNUAL REPORT REQUIRED SIGNATURE
Signature of Operator: The Annual Report must be signed to be considered complete. In all cases, it shall
be signed as follows:
a) In the case of corporations, by a principal executive officer of at least the level of vice-president or his or her
duly authorized representative, if such representative is responsible for the overall operation of the facility from which
the discharge described in this form originates.
b) In the case of a partnership, by a general partner.
c) In the case of a sole proprietorship, by the proprietor.
d) In the case of a municipal, state, or other public facility, by either a principal executive officer, ranking elected
official, or other dutyauthorized employee if such representative is responsible for the overall operation of the facility
from which the discharge described in theform originates.
"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 gather and evaluate the information submitted. On the basis of my inquiry of the person or
persons who manage the system, or those persons directly responsible for gathering the information,
the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility
of fine and imprisonment for knowing violations."
Certifier Name (printed) Julie A. Cozad
Certifier Title Board of County Commissioners Chair
Certifier Emailjcozad@weldgov.com
Certifier Signature/Responsible Offici
3 of 3
Date Signed
JAN 11 2017
c -O/ 7 e)/(O 9
CDPS ANNUAL REPORT FOR DISCHARGES FROM THE APPLICATION OF PESTICIDES COGS60000
Complete and Attach Pages 4 and 4A for Each Pest Management Area
D. Pest Management Areas
Complete this section for each Pest Management Area for which Pesticide General Permit coverage is desired.
Pest management area, as defined in Appendix A of the permit, can be a large area (e.g., an entire town) or a very
specific well-defined management area (e.g., a lake). Thus, a pest management area can have one or more treatment
areas
1. Pest Management Area Information: Area # 1 of ## 1 (e.g. 1 of 5),
please attach additional pages as needed if you are certifying multiple areas.
2. Pest Management Area Name: Unincorporated Weld County
Street Address, if applicable (or cross streets)
City CO, Zip Code
County Weld County
3. Provide a map of the location of the Pest Management Area showing the treatment area within the
Pest Management Area
(Attach Map)
4. Size of Treatment Area 2.509.798 Acres or 31,901,760 Linear Feet
5. Contact Information for pesticide applicator ❑ Same as operator listed in item 1 page 1 of application
Company Name Weld County
Mailing Address PO Box 758
City, State and Zip Code Greeley, CFO 80632
First Name Tina Last Name Booton
Title Weed Division Supervisor
Phone 970-400-3770 Cell. 970-405-0419
E-mail Address tbooton@weldgov.com
6. Pesticide Use Patterns to be included in this Pest Management Area (Check all that apply)
❑ Mosquito and other flying insect pest control
❑ Forest canopy pest control
p Animal pest control
Q Weed and algae pest contol
7. Receiving Waters as applies to Pest Management Area -Item 1 above (Check One)
Q For an surface waters of the state
❑ For the following surface waters of the state
❑ For all surface waters of the state except for:
8. Outstanding Waters
Is coverage requested for discharges to outstanding water(s) of the state? YES ❑ NO D
If YES Name of Outstanding Water(s)
Provide rationale for determination that pesticide discharges are necessary to protect water quality, the
environment, and/or public health and that any such discharge will not degrade water quality or will
degrade water quality only on a short term or temporary basis - attach additional pages as needed:
CDPS ANNUAL REPORT FOR DISCHARGES FROM THE APPLICATION OF PESTICIDES COG860000
9. Water Quality Impaired Waters
Operators are not eligible for coverage under this permit for any discharges from a pesticide application to
surface waters of the state if the waters are identified as impaired by a substance which is either an active
ingredient of the pesticide designated for use or is a degradate of such an active ingredient. (Check one)
El Waters are NOT impaired by any substance which is either an active ingredient of a pesticide to be
discharged or a degredate of such an active ingredient.
El Waters are on a current state list as being impaired by a substance which is either an active ingredient
of a pesticide to be discharged or a degradate of such an active ingredient; however, evidence is
attached documenting that the waters are no longer impaired.
10. Pest Evaluation
a. Identify the target pest(s) and explain why pest control is needed*
See Attached Sheet
*Please attach additional pages as necessary
b. Describe pest management measure(s) implemented before first pesticide application For
example, identify if you have performed physical control techniques such as pulling weeds,
removing breeding habitat, or trapping animals.*
See Attached Sheet
*Please attach additional pages as necessary
11. Pesticide Application Start Date January 1, 2016 End Date December 31, 2016
12. Name of each pesticide product used, EPA Registration number and Quantity of pesticide applied
(as packaged or as formulated). The total quantity of pesticide applied and the pesticide application
end date must be completed as soon as possible but no later than 14 days after completion of
Desticide apDlication for this aroiect.
Product Name
EPA Registration Number
Quantity
(lbs OR gallons)
Application method
e.g., fixed wing aircraft, backpack
sprayer
2,4-D
11773-2
lb
Gal 839.95
Hanagun 15%, Chemical injection truck 85%
Vanquish
228-397
lb
Gal 559.25
chemical injection truck 100%
Tordon 22K
62719-6
lb
Gal 279.38
Handgun 5%; chemical injection truck 95%
Milestone
62719-519
lb
Gal 16.59
Handgun 25%, chemical injection truck 75%
Plateau
241-365
lb
Gal 17.975
Handgun 25%; chemical injection truck 75%
*Please attach additional pages as necessary
13. Visual monitoring was conducted during pesticide application and/or post application ❑ YES ❑ NO
If no describe why not:
14. Were any adverse effects identified during visual monitoring? ❑ YES 0 NO If yes, describe:
Pest Management Area Information Pages 4 and 4A
Attached Sheet: Weld County Compliance Certificate
Question 10 A:
Target Pest(s): Purple Loosestrife, Russian olive, Tamarisk, Canada Thistle, Field Bindweed, Diffuse
Knapweed, Russian knapweed, Hoary Cress, Perennial Pepperweed, Leafy Spurge, Musk thistle, Scotch
thistle, Bull thistle, Absinth Wormwood, Dalmatian Toadflax, Spotted Knapweed, Russian thistle, Kochia,
Sunflowers, and Cockleburs.
The first fourteen plant species are deemed noxious weeds by the Colorado Department of Agriculture.
They need to be controlled and not allowed to expand their population borders. Some of the species are
also set for mandatory eradication based on the location of the weeds along routes of spread such as
roadsides, irrigation ditches and rivers.
The last four species are nuisance weeds that limit visibility and movement along the road system in Weld
County.
Question 10 B:
Due to the size of Weld County and the number of miles that must be maintained throughout the County,
no other pest management measures are implemented before the roadside spraying operation begins.
While the roadside spraying operation is being conducted decisions are made in the field as to the need
to spray areas as the trucks are passing by.
12. Name of each pesticide product used.
Product Name
EPA Registration
No.
Quantity
Application Method
Telar DF
352-404
16.8 oz
Handgun 100%
Rodeo (glyphosate)
62719-324
30.4 gal
Handgun 100%
Escort
352-439
4.3 oz
Handgun 100%
Sahara DG
241-372
239.2 lbs
Handgun 100%
Perspective
342-846
3.4 lbs
Handgun 50%; Tank Mix Truck
50%
Clearcast
241-437-67890
1.125 gal
Handgun 100%
Frequency
7969-281
4.19 gal
Handgun 100%
Krovar
432-1551
18 lbs
Handgun 100%
Esplanade
432-1516
2.5 oz
Handgun 100%
Piper
59639-193
36.625 lbs
Handgun 50%; Tank Mix Truck
50%
Krenite
352-395
0.5 gal
Handgun 100%
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Instructions Part 1
Completing the Annual Report Form:
To complete this form, type or print in the appropriate areas. Please make sure you complete all questions. Make sure you
make a photocopy for your records before you send the completed original form to the address above.
A. Notice of Status
1. Status Indicate if this is the first time you are requesting coverage under the permit for these discharges. Refer to Table
2 for report submittal deadlines and discharge authorization dates. If this is a change of information for a discharge
where the Annual Report has already been submitted, supply the name of the Operator under which the Annual Report
was submitted. For additional details regarding a change of information, see Table 3. Also fill out Item 1 of this form
(Operator Name and Mailing Address) and the associated fields of information that need to be modified on the Annual
Report.
B. Operator Information
1 is the Operator a large entity as defined in Appendix A?
a. YES - (Note that a "Yes" here will require preparation of a Pesticide Discharge Management Plan reflecting uses
for which you seek coverage).
b. NO - (Note that a "No" answer does not necessarily exempt you from submitting a Annual Report as you
may need to submit if thresholds are exceeded. Please see Table 7-2. If you do not meet the threshold for submittal
of an Annual Report, you are requested to complete and retain this application for at least 3 years from the
date that coverage is granted under the permit or until the permit expires or is terminated.
2. Provide the legal name of the person, firm, public organization or any other public entity that is the Decision -maker for
the pesticides applications described in this notice. A Decision -maker is an Operator who has control over the decision to
perform pesticide applications, including the ability to modify those decisions, that result in a discharge to Waters of the
State.
3. Indicate the type of Operator: federal government, state government, local government, mosquito control district
(or similar), irrigation control district (or similar), weed control district (or similar), or other. If other, provide brief
description of type of Operator in the space provided
Additional Operator information, if applicable:
4. Provide the Facility mailing address, telephone number(s) and email address.
5. Provide the Authorized Reporting Agent (DMR Cognizant Official) contact information
6. Provide the Billing contact and address.
C. Certification
Enter the certifier's printed name and title. Sign and date the form. For more information about the certification
statement and signature, see Appendix B of the permit. (CAUTION: An unsigned or undated form will not be accepted.)
Signature of Operator: The Annual Report must be signed by the Decision -maker to be considered complete.
In all cases, it shall be signed as follows:
a) In the case of corporations, by a principal executive officer of at least the level of vice-president or his or her
duly authorized representative, if such representative is responsible for the overall operation of the facility from
which the discharge described in the application originates.
b) In the case of a partnership, by a general partner.
c) In the case of a sole proprietorship, by the proprietor.
d) In the case of a municipal, state, or other public facility, by either a principal executive officer, ranking elected official,
or other duly authorized employee if such representative is responsible for the overall operation of the facility from
which the discharge described in the form originates.
D. Pest Management Area: Information for each Pest Management Area for which coverage under the State 's Pesticide
General Permit is desired.
1) Indicate whether you are submitting an Annual Report for multiple pest management areas.
A pest management area is the area of land, including any water, for which you have responsibility and are authorized
to conduct pest management activities as covered by this permit (e.g., if you are a mosquito control district, your pest
management area is the total area of the district). You must complete the Pest Management Area information page for
each pest management area. If you are submitting an Annual Report for only one area, enter "1" of "1." If you are
submitting Annual Reports for multiple pest management areas, enter the number "X" of "XX" (the specific number of
the area of the total number of pest management areas for which you are requesting coverage).
2) Enter the name of the pest management area.
3) Attach a map of the pest management area or describe the location of the pest management area in the space provided.
4) Enter the size of the treatment area in acres or linear feet
5) Enter the mailing address of the contact person for the pest management area.
If this address is the same as the Decision -maker's mailing address, indicate that by checking the box.
If it is a different address, enter the mailing address, telephone number, fax number (optional), contact name, and
e-mail address.
6) Indicate the pesticide use patterns for the pest management area for which the Annual Report is required.
For additional information regarding pesticide use patterns, see Part 1.1.1 of the permit.
Check all the use patterns that apply to the pest management area.
INSTRUCTIONS Part 1
7) Receiving Waters
Indicate if permit coverage is being requested for all Waters of the State within the pest management area or
if permit coverage is being requested to specific Waters of the State within the pest management area.
If specific waters are being requested, write the names of the waterbodies.
If permit coverage is being requested for all waters of the State within the pest management area except for
specific waterbodies, name those specific waterbodies in the space provided.
EPA's Water Locator Tool can help you identify the closest receiving water to your facility
http://cfpub.epa.gov/npdes/stormwater/tmdltool.cfm.
8) Outstanding Waters
Indicate if permit coverage is being requested to discharge to an Outstanding Water of the State. If yes, write the
name(s) of the Outstanding water(s) in the space provided. Describe and demonstrate why it is necessary to apply
the pesticide, (e.g. to protect the water quality, environment, and/or public health) and detail why said discharge
will not degrade water quality or will degrade water quality only on a short-term or temporary basis.
9) Water Quality Impaired Waters
Verify that waters within the pest management area are either not impaired by substances which are either
active ingredients in the pesticide planned for use, or degradates of such active ingredients; OR that evidence
shows that the target waters in question are no longer impaired. See Part 1.1.2.1 of the permit for more
information on discharges to Water Quality Impaired Waters.
10) Pest Evaluation
a. Identify the target pest(s) and provide a brief description of why pest control is needed.
a. Provide a brief description of any Pest Management Measure(s) implemented before pesticide application.
For example, identify if you have performed physical control techniques such as pulling weeds, removing
breeding habitat, or trapping animals.
11) Pesticide Application Start and End Dates
12) Name of each pesticide product used, EPA Registration number and Quantity of pesticide applied (as packaged or as
formulated)
1. Provide the company name and contact information of the pesticide applicator.
2. Enter the date that the pesticide application began and ended.
3. Enter the trade name or active ingredient of each pesticide product used including the EPA Registration
Number, the quantity of pesticide applied, and the method used to apply the pesticide (e.g., fixed wing
aircraft, backpack sprayer).
13) Indicate if visual monitoring was conducted during the pesticide application and/or post -application.
If visual monitoring was not performed, provide a brief description of why visual monitoring was not
conducted.
14) Indicate if there were any adverse effects identified during visual monitoring_
Provide a brief description of effects seen.
INSTRUCTIONS Part 2
Who Must File a ANNUAL REPORT with the Division?
Any Operator meeting the eligibility requirements identified in Part 1.1 of the permit and Table 1 below must submit a complete an
Annual Report. As required in the permit, only certain Operators that are also Decision -makers must submit Annual Reports.
Table 1. Decision -Makers Required to Submit Annual Reports
Permit Part/ Pesticide Use
Which Decision -Makers Must Submit Annual Reports?
For Which Pesticide Application Activities?
All four use patterns
identified
Any Decision -maker with an eligible discharge to an
Outstanding Water consistent with Part 1.1.2.2
Activities resulting in a discharge to an
Outstanding Water
1.1.1(a) - Mosquito and Other
Flying Insect Pest Control
Any Agency for which pest management for land
resource stewardship is an integral part of the
organization's operations.
All activities resulting in a discharge for
which the State agency is responsible for
pest control
Mosquito control districts, or similar pest control
districts
All activities resulting in a discharge for
which the Decision -maker is responsible for
pest control
Local governments or other entities that exceed the
annual treatment area threshold identified here
Adutticide treatment if more than
6,400 acres during a calendar year
1.1.1(b) - Weed and Algae
Pest Control
Any Agency for which pest management for land
resource stewardship is an integral part of the
organization's operations.
All activities resulting in a discharge for
which the Federal or State agency is
responsible for pest control
Irrigation and weed control districts, or similar pest
control districts
All activities resulting in a discharge for
which the Decision -maker is responsible for
pest control
Local governments or other entities that exceed the
annual treatment area threshold identified here
Treatment during a calendar year
if more than either:
20 linear miles OR
80 acres of water (i.e., surface area)
1.1.1(c) - Animal Pest Control
Any Agency for which pest management for land
resource stewardship is an integral part of the
organization's operations.
All activities resulting in a discharge for
which the Federal or State agency is
responsible for pest control
Local governments or other entities that exceed the
annual treatment area threshold identified here
Treatment during a calendar year
if more than either:
20 linear miles OR
80 acres of water (i.e., surface area)
1.1.1.(d) - Forest Canopy Pest
Control
Any Agency for which pest management for land
resource stewardship is an integral part of the
organization's operations.
All activities resulting in a discharge for
which the Federal or State agency is
responsible for pest control
Local governments or other entities that exceed the
annual treatment area threshold identified here
Treatment if more than 6,400 acres during
a calendar year
If you have questions about whether you need to file a Annual Report or about completing this form, Contact the Division at
303-692-3517.
One Annual Report can be submitted for multiple pest management areas for which you are seeking permit coverage.
When to File the Annual Report Form:
Do not file your Annual Report until you have obtained and thoroughly read a copy of the permit. A copy of the permit is on the
Division's website www.coloradowaterpermits.com.The permit describes procedures to ensure your eligibility, prepare your Pesticide
Discharge Management Plan (PDMP), and complete the Annual Report form questions —all of which must be done before you
sign the certification statement on page 2 attesting to the accuracy and completeness of your Annual Report. You will also need a
copy of the permit once you have obtained coverage so that you can comply with the implementation requirements of the permit.
Note: The PDMP is not required for any application made in response to a Declared Pest Emergency Situation, as defined in Appendix
A of the permit. Annual Reports are due to the Division on the first of February each calendar year, and cover discharges made over
the course of the previous calendar year.
All eligible discharges are authorized for permit coverage. For any discharges after January 12, 2012, Decision -makers
meeting the eligibility requirements identified in the Part 1.1 of the permit and Table 1 must submit a complete and accurate
Annual Report according to Tables 2, and 3 and consistent with the requirements of the Part 1.2 of the permit.
INSTRUCTIONS Part 2
Table 2. Annual Report Submittal Deadlines and Discharge Authorization Dates for Discharges from the Application of
Pesticides
Operator Type
Annual Report
Submission Deadline
Discharges Authorization Datei
Any Decision -maker with a response to a
Declared Pest Emergency which triggers a
Annual Report requirement
At least 30 days after beginning
the discharges
Immediately upon beginning to discharge for
activities conducted in response to a
Declared Pest Emergency Situation.
Any Decision -maker that exceeds any annual
treatment threshold
February 1 of every calendar year,
covering applications made in the
previous calendar year.
Immediately
Any Decision -maker otherwise required to
submit a Annual Report as identified
in Table 1.
February 1 of every calendar year,
covering applications made in the
previous calendar year.
Immediately
On the basis of a review of an Annual Report or other information, the State may delay authorization to discharge beyond any
timeframe identified in Table 2, determine that additional technology -based and/or water quality -based effluent limitations or
other conditions are necessary, or deny coverage under this permit and require submission of an application for an individual CDPS
permit, as detailed in Part 1.3 of the permit.
TO CHANGE INFORMATION:
Dischargers are required to provide to the division, information as it relates to changes in pest management areas
and in contact information.
• To change contact information:
o Use the Change of Contact Form on the division website: coloradowaterpermits.com.
• To add new pest management areas
o Submit additional pages 4 and 4A of this document.
• Revised Annual Report is REQUIRED when:
1. New pest management area is added
2. New contact information is added
3. Discharges to Outstanding Waters not identified in any previous annual report are added
4. Declared Pest Emergency Situations require revised Annual Reports no later than 30 days
after the beginning of the discharge to control the emergency situation.
Reports should detail the emergency situation and results of efforts to control the target pest.
To File the Annual Report Form:
Colorado Department of Public Health and Environment
Water Quality Control Division
4300 Cherry Creek Drive South WQCD-P-B2
Denver, Colorado 80246-1530
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