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DEPARTMENT OE ENVIRONMENTAL QUALITYPermit No: VA0C50001 Effective Date: March 01, 2020, Expiration Date: February 28, 2025 AUTHORIZATION TO DISCHARGE UNDERTAKE VIRGINIA POLLUTANT DISCHARGE ELIMINATION

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How to fill out authorization to discharge under

01

Fill out the patient's information including name, date of birth, and medical record number

02

Include the reason for discharge and any special instructions for aftercare

03

Sign and date the form as the authorized healthcare provider

Who needs authorization to discharge under?

01

Healthcare providers who are discharging a patient from their care

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What is authorization to discharge under?

Authorization to discharge is under the Clean Water Act.

Who is required to file authorization to discharge under?

Any entity discharging pollutants into waters of the United States is required to file authorization to discharge.

How to fill out authorization to discharge under?

Authorization to discharge can be filled out online through the EPA's eReporting Tool.

What is the purpose of authorization to discharge under?

The purpose of authorization to discharge is to regulate and monitor the discharge of pollutants into water bodies.

What information must be reported on authorization to discharge under?

Information such as the type and amount of pollutants being discharged, the location of the discharge point, and the methods used for pollution control must be reported on authorization to discharge.

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