Ohio modification form 2026

1. Click ‘Get Form’ to open the Ohio Modification Form in our editor.
2. Begin by entering the facility name and Ohio EPA permit number in the designated fields. Ensure accuracy as this information is crucial for processing your application.
3. Provide the organization’s name responsible for the facility, along with its address, location, and telephone number. Fill in all sections completely, including street, city, state, zip code, and county.
4. In section D, describe in detail the provisions of the permit you wish to modify. If necessary, attach additional pages for clarity.
5. Section E requires you to explain why a modification is desired. Refer to Ohio Administrative Code 3745-33-04(D) for guidance on valid grounds for modification.
6. Complete section F by naming the receiving water or waters affected by your discharge.
7. In section G, provide a detailed description of the requested modification. If applicable, attach any required Permit to Install applications.
8. Finally, certify your application by filling out your name, official title, phone number, signature, and date signed at the bottom of the form.

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