Instructions for Completing the Contractor Certification Form
If you are uncertain whether you need to obtain coverage under the NPDES General Permit for Stormwater Discharges From Construction
Activities SCR100000 (CGP), if you cannot access the websites listed in these instructions, or if you have any questions, contact the Bureau
of Water Stormwater Permitting Section at (803) 898-4300 or the Coastal Stormwater Permitting Section at (843) 953-0200. Please see the
Bureau of Water, Stormwater Permitting website (http://www.scdhec.gov/stormwater) for guidance and additional information.
DHEC 0437 (10/2012)
Who Must Complete a Contractor Certification Form
Contractors (who are not Permittees or Annual Blanket Utility providers), employed by a Primary or Secondary
Permittee of a construction project or site, must complete a Contractor Certification Form before performing any
land-disturbing activities at the construction site. Contractor Certification Forms do not require Department
approval, however, this form must be signed, dated, and submitted by each contractor to the Owner/Operator
prior to commencement of land-disturbing activities by the contractor.
General Guidance for this Form
Are there Other Requirements for Contractors
Completing this form?
Contractors completing this form must also attend a
pre-construction conference, and sign and date a Pre-
Construction Conference Certification Agreement for
each project or construction site where they will be
performing construction activities. Contractors cannot
work at a construction site until they sign this
certification form and document attendance at the Pre-
Construction Conference held for the project or
construction site.
See Section 4.1 of the 2012 CGP for
additional information.
What Does This Certification Mean?
Upon signing this certification, the contractor is
accountable to DHEC to ensure the terms and
conditions of the approved Stormwater Pollution
Prevention Plan (developed for the respective
construction project or site) and the Construction
General Permit (CGP) are implemented and adhered to
in the respective area(s) of the plan where each
contractor and/or company signing this form will be
performing work. Each contractor becomes subject to
DHEC enforcement actions if permit conditions are not
met.
See Sections 2.2.3 and 2.3.2 of the 2012 CGP for
additional information.
Should the Owner/Operator Retain This Form?
The Owner/Operator of the construction site must
retain completed Contractor Certification Forms with
the approved On-Site SWPPP. This form must be
retained for at least three years from the date permit
coverage expires or is terminated.
Instructions for Completing this Form
Please print legibly and complete all spaces on the
form. Abbreviate if necessary to stay within the space
allowed for each item and submit the completed form
to the Owner/Operator for the specific project or
construction site listed in Section A.
Section A - Project Information
Provide all requested information. Enter the date,
NPDES coverage number, and Tracking No. provided
by the Department for the approved SWPPP. Enter
the official or legal name of the project or site, as
approved by the Department. If this project is for an
individual lot or group of lots, provide the lot
number(s). Provide the name of the Owner/Operator.
Section B –Contractor Information
Provide your legal name and title/position. As
applicable, provide the legal (formal) name of the
company, firm, public organization, or any other entity
(you are employed by or represent) on whose behalf
you will be performing contractor construction
activities. Provide your mailing address, telephone
and e-mail address. Briefly describe construction-
related duties and responsibilities you or your
company will perform for this project at the
construction site.
Section C – Contractor Certification Statements &
Agreement
Read the certification statements (in entirety). Provide
your printed name and title or position. Date and sign
the certification agreement. Return the signed and
dated form to the Owner/Operator. DO NOT SIGN IN
BLACK INK. Sheets 1 and 2 are formatted for
multiple contractor signatures. Sheet 2 is ONLY for
signatures within a specific company. Each may be
copied as necessary. Sign and date the Termination
of Contractor Certification Agreement when the
services you provide for this project are complete.
Return the signed and dated form to the
Owner/Operator for record retention as a part of the
On-Site SWPPP (OS-SWPPP).
