Environmental Justice Opt-In Request Form

​Please complete this form to request opt-in consideration for a project within the Commonwealth of PA that may be applicable to the Department of Environmental Protection’s (DEP’s) EJ Policy (EJ Policy Revision (pa.gov). You can submit a single form per project even though a single project may have several affiliated permits. Forms can be completed within the EJ portal, by contacting the Office of Environmental Justice (OEJ) at 717-772-5633, or by downloading, completing, and submitting a physical form to RA-EPOEJ@pa.gov.

Opt-in project - A project requiring permits, authorizations, or approvals from DEP that otherwise does not automatically trigger DEP's EJ Policy, but which DEP determines should be evaluated under the EJ Policy based on identified community concerns, present or anticipated environmental impacts, or reasonably anticipated significant adverse community environmental burden.

Concerns about EXISTING projects can be submitted through the Environmental Complaints (pa.gov).

NOTE: The Opt-In Request Form is not required as a prerequisite for the DEP to process particular projects in accordance with the EJ Policy; rather, it is available to facilitate requests from the public.

Contact Info: This information is OPTIONAL, but if provided, may be used for correspondence as needed.

Select all applicable issues of concern: each area concerns with the respective DEP section webpage

Helpful links: Have you checked out the Office of Environmental Justice (pa.gov) webpage?

Here are some additional helpful links that may be of use in your EJ applicability evaluations (DEP eNOTICE tool, eFacts, etc.)

Consider nominating yourself or referring someone for a DEP Advisory Committees (pa.gov)

Upload any supporting documentation