Notice of Termination Form Aquatic Mosquito Control General Permit 2025

1. Click ‘Get Form’ to open the Notice of Termination Form in the editor.
2. In the 'Permittee Information' section, enter your name, company, mailing address, city, state, email, phone number, and zip code. Ensure all details are accurate for effective communication.
3. Proceed to the 'Permit Site Information' section. Fill in your permit number, site name (e.g., Mosquito Control District), nearest city, and county. This information is crucial for identifying your permit coverage.
4. In the 'Certification of Permittee' section, read the statement carefully. Print your name clearly and provide your signature along with the date on the designated lines. This certifies that all pesticide discharges have been eliminated.
5. Once completed, save your document and follow the instructions to submit it to the Department of Ecology at the provided address. Retain a copy for your records.

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