HomeMy WebLinkAboutWPO201300066 Bond Release 2018-10-037ZVA
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COUNTY OF ALBEMARLE
Department of Community Development
401 McIntire Road, North Wing
Charlottesville, Virginia 22902-4596
Phone (434) 296-5832 Fax (r434) 9724126
EROSION CONTROL PERFORMANCE BOND RELEASE
PROJECT NAME: /V,9,
PLAN/PERMIT NO.: S/b ?d13 — oao625'
DATE: ®Ete
This project has been satisfactorily completed and the erosion control performance bond may be
released at this time if all re -inspection and annual maintenance fees invoiced have been paid.
Erosion Control Inspector
DEQ Termination Date 3 ar N/A
ND
Community Development Department
All fees invoiced on the above project have bee d. lecte
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Direct r of Community Development / un#y Engineer
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Date
Cc: Ana Kilmer Revised:07/o3/2ola
Notice of Termination
General VPDES Permit for Discharges of Stormwater from Construction Activities (VAR10)
(Please Type or Print All information)
1. Construction Activity Operator: �j�
Name: �/ i c�4C70'
Contact AICAL-Ae)C-/Of3Z;/
Mailing Address:.
City:
Email address (if
2. Name and Local
State:— V+4-- Zip: Phone: /U2
lag
Construction Activity. (As listed on the Registration Statement.)
Address (if available): 75
City: cAar i �tSv
County (if not located within a
State:
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Zip:_ ZZ-qal
Latitude (decimal degrees): 3 Gr V 3, _ Longitude (decimal degrees):
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3. General Permit Registration Number: 1/ 10 D_ 711
4. Reason for Terminating Coverage Under the General Permit: (The operator shall submit a Notice of Termination after one or
more of the following conditions have been met.)
A. Necessary permanent control measures included in the SWPPP for the site are in place and functioning effectively and final
bilization has been achieved on all portions of the site for which the operator is responsible. When applicable, long-term
responsibility and maintenance re uirements for permanent control measures shall be recorded in the local land records rior
to the submission of a notice of termination:
❑ B. Another operator has assumed control over all areas of the site that have not been finally stabilized and obtained coverage
for the ongoing discharge;
❑ C. Coverage under an alternative VPDES or state permit has been obtained; or
❑ D. For residential construction only, temporary soil stabilization has been completed and the residence has been transferred to
the homeowner.
The notice of termination should be submitted no later than 30 days after one of the above conditions being met Authorization to
discharge terminates at midnight on the date that the notice of termination is submitted for the conditions set forth in subsections B
through D above, unless otherwise notified by the VSMP authority or the Department Termination of authorizations to discharge
for the conditions set forth in subsection A above shall be effective upon notification from the Department that the provisions of
subsection A have been met or 60 days after submittal of the notice of terminations, whichever occurs first
5. Permanent Control Measures Installed: (When applicable, a list of the on -site and off -site permanent control measures (both
structural and nonstructural) that were installed to comply with the stormwater management technical criteria. Attach a separate list
if additional space is needed.)
Permanent Control Measure #1
Type of Permanent Control Measure:
Date Functional:
Address (if available)
City: State: Zip:
County (if not located within a City):
Latitude (decimal degrees): Longitude (decimal degrees):
Receiving Water:
Total Acres Treated: Impervious Acres Treated:
012014
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Permanent Control Measure #2
Type of Permanent Control Measure:
Date Functional:
Address (if available):
City: State: Zip:
County (if not located within a City):
Latitude (decimal degrees): Longitude (decimal degrees):
Receiving Water.
Total Acres Treated: Impervious Acres Treated:
Permanent Control Measure #3
Type of Permanent Control Measure:
Date Functional:
Address (if
County (if not located within a City):
Latitude (decimal degrees):,
Receiving Water:
Total Acres
State: Zip:
Longitude (decimal degrees):
Impervious Acres Treated:
6. Participation in a Regional Stormwater Management Plan: (When applicable, information related to the participation in a
regional stormwater management plan. Attach a separate list if additional space is needed.)
Regional Stormwater Management Facllity
Type of Regional Stormwater Management Facility:
Address (if available):
City: State: Zip:
County (if not located within a City):
Latitude (decimal degrees): Longitude (decimal degrees):
Total Site Acres Treated: Impervious Site Acres Treated:
7. Perpetual Nutrient Credits: (When applicable, information related to perpetual nutrient credits that were acquired in accordance
with § 62.1-44.15:35 of the Code of Virginia. Attach a separate list if additional space is needed.)
Nonoolnt Nutrient Credit Generating Entity
Name:
Perpetual Nutrient Credits Acquired (lbstacretyear):
8. Certification: "I certify under penalty of law that I have read and understand this Notice of Termination and that this document and
all attachments were prepared in accordance with a system designed to assure that qualified personnel properly gathered and
evaluated the information submitted. Based on my inquiry of the person or persons who manage the system or those persons
directly responsible for gathering the information, the information submitted is to the best of my knowledge and belief true,
accurate, and complete. I am aware that there are significant penalties for submitting false information including the possibility of
fine and imprisonment for knowing violations."
Printed Name: Title:
Signature: Date:
(Please sign in INK. This Certification must be signed by the appropriate person associated with the operator identified in
Item #1.)
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