Request for a Clean Water Act (CWA) Section 401 Water Quality Certification Please provide the following information to request a CWA Section 401 Water Quality Certification: Applicant Address____________________________________________________________________ City, State, Zip______________________________________________________________ Applicant Contact (phone, fax, email)____________________________________________ Agent (if applicable) _______________________________________________________________ Address____________________________________________________________________ City, State, Zip______________________________________________________________ Agent Contact (phone, fax, email)_______________________________________________ Project Name______________________________________________________________________ County_____________________________________________________________________ Affected Waterbody(ies)_______________________________________________________ Project Location (Township and Range or UTM)___________________________________ Project Description_________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ The Colorado Water Quality Control Division (WQCD) requires the following items in order to process a CWA Section 401 Water Quality Certification: ____Signed copy of U.S. Army Corp of Engineers 404 Permit Application ____Site map and plans of proposed project (if not included in 404 Permit Application) ____List or narrative of Best Management Practices (BMPs): This includes construction BMPs and long-term BMPs, if applicable, associated with the proposed project. More information on BMPs is available in Regulation No. 82 and from the WQCD. Based on COE Regulatory Office submit this form and required items to: Grand Junction, Durango, and Pueblo COE Denver COE Regulatory OfficeRegulatory OfficesJohn Hranac Scott Garncarz WQCD-WSP-EDU-B2 WQCD-WSP-EDU-B2 Colorado Department of Public Health and Colorado Department of Public Health and Environment Environment 4300 Cherry Creek Drive South 4300 Cherry Creek Drive South Denver, Colorado 80246-1530 Denver, Colorado 80246-1530 Additional information, including the Colorado 401 Certification Regulation No. 82 can be found on the internet at www.colorado.gov/cdphe/401Certifications. For further information regarding the 401 Certification process, including the WQCD’s BMP guidance, please contact John Hranac ([email protected], (303) 692-3586) or Scott Garncarz ([email protected], (303) 6922374) at the Colorado Water Quality Control Division.