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No Exposure Form forUnderground Injection Control (UIC) WellsThe purpose of this form is to determine if stormwater that drains to a UIC well comes in contact with pollution generating land uses at
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How to fill out no exposure form for

01
Obtain the no exposure form from your local health department or online.
02
Fill out your personal information such as name, address, and contact information.
03
Check off the box indicating that you have had no exposure to any infectious diseases within the specified time frame.
04
Sign and date the form to certify that the information provided is accurate.
05
Submit the completed form to the appropriate authority or organization as required.

Who needs no exposure form for?

01
Individuals who have had no exposure to any infectious diseases within the specified time frame may need to fill out a no exposure form.

What is No Exposure for Form?

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The no exposure form is used by facilities that do not have any exposure to pollutant discharges from industrial activities, certifying their eligibility for exemption from certain permitting requirements.
Facilities that are discharging stormwater associated with industrial activities and can demonstrate that their operations have no exposure to water or air pollutants are required to file a no exposure form.
To fill out the no exposure form, the applicant must complete the required sections accurately, provide necessary supporting documentation, verify the accuracy of the information provided, and submit the form to the appropriate regulatory agency.
The purpose of the no exposure form is to certify that a facility's operations do not expose stormwater to pollutants, thereby qualifying for exemption from the NPDES stormwater discharge permit requirements.
The no exposure form must report information including the facility's name, address, descriptions of the industrial activities, and certification that there are no discharges of process wastewater or stormwater exposed to industrial materials.
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