NOTICE PURSUANT TO INFORMATION PRACTICES ACT OF 1977 (CIV. CODE. ยง 1798.17) The State Water Resources Control Board is requesting personal identifying information about the diverter/discharger and the person filing for this Small Irrigation Use Registration (SIUR) and coverage under the statewide General Waste Discharge Requirements and Waiver of Waste Discharge Requirements for Discharges of Waste Associated with Cannabis Cultivation Activities (General Order). The agency officials responsible for this system of records are Robert Cervantes, Senior Engineer, whose business address is 1001 I Street, 14th Floor, Sacramento, CA 95814 and whose business telephone is (916) 341-5300, and Kevin Porzio, Senior Engineer, whose business address is 1001 I Street, 15th Floor, Sacramento, CA 95814 and whose business telephone is (916) 341-6914. Upon request, the agency official(s) shall inform an individual regarding the location of his or her records and the categories of any persons who use the information in these records.

The State Water Resources Control Board is empowered to require the submission of personal identifying information by California Water Code sections 1228 and 13260. The submission of the name, address, and phone number of the diverter/discharger and person filing for SIUR and General Order coverage is mandatory. The submission of the e-mail address of the diverter/discharger and person filing for SIUR and General Order coverage is voluntary. Failure to provide the mandatory information for SIUR coverage can result in the imposition of administrative civil liability in the amount of $500 and an additional $250 per day for each additional day on which the violation continues if the person fails to cure the violation within 30 days after the State Water Resources Control Board has called the violation to the attention of the person. Failure to provide the mandatory information for General Order coverage can result in the imposition of administrative civil liability in the amount of $1,000 per day.

This personal identifying information is collected to facilitate better water management and waste discharge management by the State Water Resources Control Board. The State Water Resources Control Board will not automatically post personal identifying information to public databases. However, the State Water Resources Control Board may be legally required to disclose personal identifying information under any of the circumstances described in Civil Code, section 1798.24. Such circumstances may include, but are not limited to, responding to a request pursuant to the California Public Records Act or responding to a subpoena from a federal agency.

I acknowledge and accept these conditions.