EDMR Permittee Registration Form.pdf - Pennsylvania Department ... - elibrary dep state pa 2026

1. Click ‘Get Form’ to open it in the editor.
2. In Part A, enter the NPDES Permit Number, Facility Name, Mailing Address, and indicate if the facility is currently using eDMR by selecting 'Yes' or 'No'.
3. Move to Part B and specify User Account Information. Choose 'Add User' or 'Remove User' for each user you want to manage. Ensure you select an appropriate Account Type: Viewer, Preparer, or Certifier.
4. Fill in all required fields for each user including Last Name, First Name, Job Title, Employer’s Name, Mailing Address, Email Address, and Phone Number(s). Remember that each user must have a unique email address.
5. In Part C, certify the information by typing or printing your name and title before signing and dating the certification statement.
6. Attach necessary documents such as eDMR Trading Partner Agreement forms for all Certifiers and mail the completed form to the specified address.

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