Page 103 - _ 180314 Special Yucaipa GSA Packet

Timing:

If the applicant does not receive a NOE or NOA from the Regional Water Board within 45 days
of the date of receipt of the signed notification, the applicant may assume that the project meets
the conditions of certification and may proceed with the project under the conditions of the
NWPs and this certification. In no case may the project commence before the appropriate fee is
paid.

Instructions for Completion of the
2012 Certified Nationwide Permits Notification Form

Notifications and the appropriate fee shall be submitted to the 401 Program Manager for the
affected Regional Water Board, and a copy of the notification shall be submitted to State Water
Board’s Division of Water Quality, 401 Certification Program Manager. Addresses and web site
information are provided in the 2012 Certified Nationwide Permit Notification Form. A copy of
this form follows these instructions.

Forms may also be obtained by contacting the staff of the applicable Regional Water Board.

Fees may be changed at any time. To determine the correct fee, consult the “Dredge and Fill
Fee Calculator” under “Resources for Applicants” at:
http://www.waterboards.ca.gov/water_issues/programs/cwa401, or contact the Regional Water
Board staff. Please attach the fee check to the first page of the signed notification form.

(a) Provide the name, address, telephone number and, if available, e-mail address of:

1) the applicant; and
2) the applicant’s agent (if an agent is submitting the notification).

All regulatory actions, including waivers of action, by any federal agencies must be disclosed in
Items (b) and (c).

(b) Provide complete identification of all federal licenses/permits being sought for or
applying to the proposed activity, including the:

1) federal agency;
2) type (e. g., Nationwide Permit Number); and
3) file number(s) assigned by the federal agency(ies), if available.

For each permit identified in (b) above, provide complete copies of either:

1) the application(s) for federal license(s)/permit(s) being sought for the activity; or
2) if no federal applications are required, any notification(s) concerning the proposed
activity issued by the federal agency(ies); or
3) if no federal notification is issued, any correspondence between the applicant and the
federal agency(ies) describing or discussing the proposed activity.

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Yucaipa Groundwater Sustainability Agency - March 14, 2018 - Page 99 of 226