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Eastern Washinglon Phase II Municipal Stormwater Permit <br />"no" if any part of the MS4 is located on fee lands. The portion of the MS4 that is located on <br />tribal lands will not be covered under these permits. <br />B. For special purpose districts only, attach a map or maps delineating the geographic area served <br />by the MS4. <br />Part 5 — Co -Permittee information <br />Complete this part of the NOI only if you are applying with another entity as Co -Permittees to meet the <br />requirements of this permit. Permittees that apply as Co -Permittees are responsible for meeting permit <br />conditions related to their discharge(s). <br />If you are applying as a Co -Permittee with another entity or entities, please include as an attachment to <br />this NOI a summary of the permit obligations that will be carried out jointly among Co -Permittees. <br />The summary must identify the other Co-Permittee(s) and must be signed by the other Co-Permittee(s). <br />Part 6 - Relying on another entity to satisfy permit requirement(s) <br />Complete this part of the NOI only if you are relying on another entity to satisfy all of the requirements <br />of the permit. Permittees may rely on another entity provided the entity satisfies all of the requirements <br />it agrees to undertake (see 40 CFR 122.35(a)). <br />That other entity must agree to take responsibility and implement the permit requirement(s). <br />Permittees that rely on another entity to satisfy all of their permit obligations remain responsible for <br />permit compliance with those obligations if the other entity fails to implement the permit conditions. <br />If you are relying on another entity or entities to satisfy all of the permit obligations, please include as <br />an attachment to this NOI a summary of the permit obligations that will be carried out by another <br />entity. The summary must identify the other entity or entities and must be signed by the other entity or <br />entities. <br />Part 7 — Public notice <br />You must publish a public notice in a newspaper of general circulation in the county or city in which <br />the district or entity is located. The following sample public notice contains the required public notice <br />elements. <br />Sample Public Notice <br />(Name and address of municipality, district or other public entity) is seeking coverage under (select <br />one of the following): <br />■ Phase I Permit — "National Pollutant Discharge Elimination System and State Waste <br />Discharge General Permit for Discharges from Large and Medium Municipal Separate Storm <br />Sewer Systems" <br />■ Western Washington Phase II Permit — "National Pollutant Discharge Elimination System <br />and State Waste Discharge General Permit for Discharges from Small Municipal Separate <br />Storm Sewers in western Washington" <br />■ Eastern Washington Phase 11 Permit — "National Pollutant Discharge Elimination System <br />and State Waste Discharge General Permit for Discharges from Small Municipal Separate <br />Storm Sewers in eastern Washington" <br />The proposed permit will authorize stormwater discharges from the municipal separate storm sewer <br />system located in (city, town, or county). The permit requires (Name of municipality, district, or other <br />public entity) to develop and implement a stormwater management program that: <br />1. Reduces the discharge of pollutants to the maximum extent practicable. <br />2. Protects water quality. <br />3. Satisfies appropriate requirements of the Clean Water Act. <br />August 1, 2014 Appendix 5 - Notice a1'1nten1.1or Coverage Page 4 of 6 <br />