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Application for Transfer of a Wastewater Facility or Activity Permit


Complete Form 62-620.910(11) by clicking on the document (pdf) below.  

Please review the Electronic Submission Instructions and Domestic Wastewater Permit Application Fees documents prior to submitting a form electronically.

Form 62-620.910(11) should not be submitted electronically by facilities permitted to discharge to surface waters [i.e., facilities that are permitted under the National Pollutant Discharge Elimination System (NPDES) program and have a permit number beginning with “FL0”]. For NPDES facilities, mail the completed form along with all required attachments and fees to the appropriate DEP District Office. If you have questions regarding the method of submittal, please contact the appropriate DEP District Office.

If your facility does not discharge to surface waters (non-NPDES) and you would like to submit the form electronically, please email the completed form to the appropriate DEP District Office’s email address

Note, if your facility is regulated by a delegated local program and you want to submit the form electronically, please contact your delegated local program.

Form Number: 
Effective-Revision Date: 
Monday, October 23, 2000
Last Modified:
September 6, 2023 - 8:13am

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