Instructions for Filling Out Water Quality Certification Application

APPLICANT:
The applicant is the party legally responsible for the discharge. Please include name/title/company/address/phone/fax number/e-mail address.

AGENT:
Complete only if certification document is being transmitted by an agent/consultant. Please include name/title/company/address/phone/fax number/e-mail address.

FILING FEE:
23 CCR Sections 2200(e) and 3833(b)(2) prescribe the following fees for certification:

  • The total fee, including deposit, for issuing standard certification (no potential for water quality impacts--please consult with the Regional Board before making this determination) as defined in Subsection 3831(p) shall be $500 or, if $500 does not cover the agency's cost to issue certification, the appropriate one-time amount determined from items 3 or 4 below.
  • The total fee, including deposit, for taking any other certification action for a discharge of fill/excavated or dredge material shall be the appropriate one-time amount determined from items 3 or 4 below.
  • The total fee, including deposit, for issuing a certification action for fill:
    • One acre or less, total fee of $1,000
    • More than one acre, $1,000 per acre or part thereof, to a up to a maximum of $10,000
  • The total fee, including deposit, for issuing a certification action for dredging:
    • Less than 10,000 cubic yards - flat fee of $500
    • 10,000 to 20,000 cubic yards -flat fee of $2,000
    • More that 20,000 cubic yards - $2,000 plus $250 for each additional 5,000 cubic yards or part thereof, up to the statutory maximum of $10,000.

Dredging generally includes removing sediment in deeper water to increase the depth. Impacts to beneficial uses are best described by the volume of sediment discharged. Dredging typically occurs to facilitate navigation and for aggregate extraction in marine waters.

All fees should be made payable to the Santa Ana Regional Water Quality Control Board and submitted to 3737 Main Street, Suite 500, Riverside, CA 92501-3348, Attn: 401 Certification

PROJECT DESCRIPTION:
State project title, describe purpose and final goal of project, project activities including expected diversions of water around the project; attach a hydrology report detailing the discharges (Q10 and Q100) for pre- and post-construction (if your project is a development), proposed schedule of project, project location (attach map of suitable quality and detail), and total size of project area.
If the project for which Section 401 certification is sought is part of a larger plan of development, then the description of diversions and hydrology must include the development as a whole. A map of the larger plan of development should be included. Please detail total size of entire project area (including larger plan of development, where applicable).

RECEIVING WATER:
Name(s) of affected water body(ies) that may receive a discharge and type(s) of receiving water body(ies) (i.e., river, stream, lake, wetland, harbor, bay, etc.). Most receiving water bodies are listed in the Water Quality Control Plan, Santa Ana Region (Basin Plan). For unlisted waters, the major tributary(ies) must be identified.

Identify major tributary(ies) of receiving water(s).

FILL/EXCAVATED AREA:
For the receiving water body(ies) identified above please indicate total estimated quantity of waters of the United States that may be impacted temporarily or permanently by any discharge other than dredging. The estimated quantity of waters to be impacted by any discharge shall be reported in acres and, for channels, shorelines, riparian corridors, and other linear habitat, linear feet.

Please indicate type(s) of material proposed to be discharged in waters of the United States.

DREDGE VOLUME:
For the receiving water body(ies) identified, please indicate total estimated quantity of waters of the United States that may be impacted temporarily or permanently by dredging. The estimated quantity of waters to be impacted by any dredging shall be reported in cubic yards.

Please indicate type(s) of material proposed to be discharged in waters of the United States.

FEDERAL PERMIT:
Specify the federal permit or license being sought. For a 404 permit, give the Corps control number if it is available. For nationwide permits, give the applicable nationwide permit number. Please attach a copy of the federal permit or license application.

CALIFORNIA ENVIRONMENTAL QUALITY ACT (CEQA):
Please indicate the type of CEQA document (e.g., Final Environmental Impact Report (FEIR), Mitigated Negative Declaration, etc.) and the lead agency. Please submit a copy of the final CEQA (State) or National Environmental Protection Act (NEPA - federal) document, including the notice of determination. A NEPA document must be functionally equivalent to a CEQA document. If exempt from CEQA/NEPA requirements, specify the code section under which it is exempt and explain exemption used. An application may be considered complete without a CEQA document, but we cannot issue a certification until we receive the final certified CEQA document.

WATER QUALITY IMPACTS MITIGATION:
Please identify the pollutants that may be associated with the proposed development. Describe the short-and long-term water quality impacts on the receiving waters and downstream waters that may result from discharge of these pollutants.

Please list any impacts to beneficial uses of the affected receiving water(s) and downstream water(s).

Please describe any mitigation measures to limit impacts on water quality standards in receiving water(s) and also downstream water(s). List the avoidance or alternative measures considered. If these measures are described in the final CEQA document, please reference page number(s). Indicate if no avoidance or alternative measures were considered.

FILL/EXCAVATION AND DREDGE MITIGATION:
Indicate the total estimated quantity (in acres and, where appropriate, linear feet) of
waters of the United States, by type of waters (i.e., jurisdictional wetland, streambed, lake/reservoir, etc.) proposed to be created, restored, enhanced, or preserved. The application shall include the following:

  1. A site map showing the location of the mitigation area in relationship to the impact area.
  2. A figure showing the proposed plant layout and plant palette.

If compensatory mitigation is to be provided in some other form, that shall be explained (e.g., mitigation banks).

Please note the acres of proposed mitigation that qualify as waters of the United States.

If a mitigation plan prepared in accordance with the Army Corps of Engineers\' guidelines will be submitted, the following information must be included:

  1. A site map showing the location of the mitigation area in relationship to the impact area.
  2. A figure showing the proposed plant layout and plant palette.
  3. A discussion of beneficial uses (as defined in the Basin Plan) of the receiving water and downstream waters that may be lost or impacted through project implementation, and how the proposed mitigation will compensate for these losses/impacts.
  4. A discussion of BMP maintenance and monitoring activities and duration, including the parties responsible for long-term maintenance of any BMP installed. In addition, if maintenance and monitoring are to be turned over to another agency/party, a letter shall be provided by that agency/party demonstrating that an agreement for such long-term maintenance/monitoring has been or will be reached.

THREATENED OR ENDANGERED SPECIES:
List threatened or endangered species that may be impacted by the construction or operation of the project. If the project is within the Riverside County Stephens\' Kangaroo Rat (SKR) fee area, so state, whether or not SKRs were found within the project boundaries. Note whether a Section 7 or 10 consultation has been or will be initiated with the U.S. Fish and Wildlife Service (Service). Note whether the U.S. Fish and Wildlife Service has or will issue a Biological Opinion. If the Service has issued a Biological Opinion, please note the date issued.

CALIFORNIA DEPARTMENT OF FISH AND GAME (CDFG) STREAMBED ALTERATION AGREEMENT:
Please attach a copy of any agreement with the California Department of Fish and Game ( per Fish and Game Code Sections 1600-1607). If you have applied for a Fish and Game agreement but have not yet received it, submit a copy of the application. If the proposed project is exempt from Fish and Game jurisdiction, state why it is exempt.

PAST/FUTURE PROPOSALS BY THE APPLICANT:
A brief list/description, including estimated adverse impacts of any projects implemented by the applicant within the last five years or planned for implementation in the next five years that relate in any way to the proposed activity or may impact the receiving body of water. For purposes of this item, the water body extends to a named source or stream segment identified in the relevant basin plan.

STORM WATER PERMIT STATUS:
Note the Storm Water permit status: e.g., Storm Water permit obtained; Notice of Intent has been/will be filed with the State Water Resources Control Board and the date filed; Storm Water Pollution Prevention Plan has been/will be prepared; reason that Storm Water permit is not required.

List examples of Best Management Practices (BMPs) that will be utilized to avoid/minimize impacts to water quality standards (i.e., water quality and beneficial uses) during and after construction.

Please discuss BMP maintenance and monitoring activities and duration, including the parties responsible for long-term maintenance of any BMP installed. In addition, if maintenance and monitoring will be provided through another agency/party, submit a letter from that agency/party demonstrating that an agreement for such long-term maintenance/monitoring has been or will be reached.

APPLICANT\'S OR AGENT\'S SIGNATURE and DATE:
Please sign and date the 401 Water Quality Standards Certification Application.

CONTACT
If you are unsure of what is required for a complete application, please contact Kirk Larkin, the 401 Coordinator, at (760) 776-8964.