Nebraska Pretreatment Program (NPP) Form - Wastewater - T-119 App E
This information is provided by the Nebraska Department of Environment and Energy to assist the public and regulated community.
Form #: WAT049 Applications and Forms
Revised: 6/1/05
SizeFile Name
60 KB Appendix E.pdf

Permit Application for a Facility Discharging Process Wastewater from
Manufacturing and Commercial Operations to a
Municipal Publicly Owned Treatment Works (POTW)

Note: Effective Oct. 1, 2009, any individual submitting any application or form that would derive public benefit from the state must also fill out a United States Citizenship Attestation form. This applies to individuals submitting the forms on their own behalf. If applicable, please fill out the United States Citizenship Attestation form below and submit it with the relevant applications and forms.

United States Citizenship Attestation Form

This Complete Form is only available as an Adobe Acrobat (PDF) file.
File size is 97 KB