The Clean Water Act

The Clean Water Act* (CWA) is a comprehensive U.S. statute that addresses water pollution. The statute has been amended many times since it was first enacted in 1948, but its basic objective has remained the same: “to restore and maintain the chemical, physical, and biological integrity of the Nation’s waters” (33 U.S.C. § 1251a). The centerpiece of this statute, established by the 1972 amendments, is the prohibition of any point-source discharge of pollutants into surface waters without a National Pollutant Discharge Elimination System (NPDES) permit. NPDES permits are issued either by the U.S. Environmental Protection Agency (EPA) or a state environmental agency; today, most states are authorized to administer their own NPDES permit program. The 1987 amendments required NPDES stormwater permit programs for urbanized areas and construction activities that disturb one or more acres of land. EPA regulations, effective in 2002, set forth requirements to prevent oil from reaching surface waters and adjoining shorelines. All three of these requirements in CWA may apply to healthcare facilities (see Clean Water Act Requirements Potentially Applicable to Healthcare Facilities).

_______________ * The Clean Water Act is codified in Title 33, Chapter 26 of the United States Code, sections 1251-1376, cited as 33 U.S.C. §§ 1251-1376. However it is most commonly referred to as the Clean Water Act and cited using those citations. Thus, 33 U.S.C. § 1251(a) would be cited as CWA § 101(a). _______________

The prohibition against discharging pollutants in surface water without an NPDES permit and the associated requirement that indirect dischargers pretreat their wastewater before discharging it into a publicly owned treatment works (POTW) are the oldest, and probably the most familiar, CWA requirements to apply to healthcare facilities. All healthcare facilities generate wastewater during the course of their daily operations. This pollutant-contaminated wastewater is discharged either directly into surface waters or indirectly into surface waters after it has been treated by a POTW.

The second requirement—NPDES permits for certain stormwater dischargers—is the newest CWA requirement potentially applicable to hospitals and probably the one facilities are least familiar with. Hospitals that are undergoing large enough construction projects and government hospitals located in urbanized areas, as defined by...