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APPENDIX 4
CALIFORNIA REGIONAL WATER QUALITY CONTROL BOARD
LOS ANGELES REGION
EXAMPLE OF NOTICE OF INTENT
TO COMPLY WITH ORDER NO. R4-2005-XXXX
CONDITIONAL WAIVER OF WASTE DISCHARGE REQUIREMENTS
FOR
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01
Start by filling out the header section of the form, which includes your name, address, and contact information.
02
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03
In the body of the form, clearly state your intent or purpose for submitting this notice. Make sure to provide specific details and reasons for your intent.
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If applicable, attach any supporting documents or evidence to validate your intent. This could include contracts, agreements, or any other relevant paperwork.
05
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Who needs 13-64 notice of intent-individualdoc:
01
Individuals who are planning to undertake a specific action or project that requires notifying a government agency or other interested parties may need to fill out a 13-64 notice of intent-individualdoc.
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This form is typically required for activities such as construction projects, land development, or any other action that may have potential impacts on the environment or surrounding communities.
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It is important to check with the specific government agency or authority to determine if this form is necessary for your particular situation.
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