HomeMy WebLinkAboutWPO201700077 Correspondence 2019-04-29DRAFT VIfRGINIA DEPARTMENT OF ENVIRONMENTAL, QUALITY —
VPDFd L IRMIT FOR LASCHARGE5 OF SoORM01ATER FROM fOR 01 : ICI USE ONLY
CONSTRUCTION AC'HVITIEs ID Number _
)VAR10) REGISTRATION s AUEMEN technical Criteria VB€s 17 UtlB 7
NEW ISSUANCE I i
MOIDIEIC:ATWN WITH ACREAGE INCREASE I I
re Number
f
k-xlsting Permit Coverag . (if applicable) _._:_r be
5ectlon I. Opperator/Perimittee Information.
Rl' ISSUANCE M
MODIFICATION WITIIOU I AGREAGF INCREASE I
A. Construction Activity Operator (Permittee). The person or entity that is applying for permit coverage and will have
operational control over construction activities to ensure compliance with the general permit. ;A person with
signatory authority for this operator rnu.st sign the certification in Section A, (per Part III. K. of the VAR1.0 Permit).
Construction Activity
Operator Name:
Contact person
Address:
AC Willard, Inc.
Josh Rector
295 Memory Lane
City, state zip code: Troy, VA 22974
Phone number: 434-977-3750 _
Primary email: josh@agdillard.com
Cc Email: Mike.Collins@branchbuilds.com; Matthew.Corbett@brarichbuilds.co;
brianhroy@gmail.com
B. Billing Information (leave blank if same as the Operator identified in Section I. A. above). This entity will receive
Annual Permit Maintenance and Permit Modification Fee invoices (it applicable).
Name: Woolen Mills LLC
Contact person: Brian Roy
Address: 1012-C Druid Ave
City, state zip code: Charlottesville, VA 22903
Phone number: 434-996-3904
Primary email: brianhroy@gmail.com
CC Email:
C. May we transmit correspondence electronically? You must choose YES and include a valid email in order to pay by
credit card and to receive your permit coverage approval letter via email:
DEQ 199-DRAFT PAGE 1 18
CONSTRUCTION GENERAL PERMIT (VAI"d10IRIIEGISiRABIONS'u`ATEMENT
Section i0. construction Activity Locaflon linfornration Project site information.
A. Includes site map , howing the lunation vt the existing or prolpo,,ed land disturbing ac t ivif es, the lirnits crf and
disturbance, COnSt UChOn suer 3nces mid all water hodios receiving stonrivvater discharges from Hip site,
R. Construction Activity (Name: Woolen Mills Plop erty
Address: 2100 IE Market Street
City and/or County and Zip code: Charlottesville, VA 22902
Latitude and Longitude
(6-digit decimal degrees): (ahrarloltesvilie, VA 22902
C. Construction Activity Entrance Location
(description, street address and/or
latitude./longitude in decimal degrees): 38.019400,-78.456182
Section Ill. Offsite Support Activity Location information. List all offsite support activities to be included under this
perrnit registration. Enter additional areas on a separate page. Offsite areas not included on this registration will need
to obtain coverage under a separate VPDES permit.
A. Offsite Activity Name:
Address:
City and/or County and Zip code:
Latitude and Longitude
(6-digit decimal degrees):
B. Offsite Activity Entrance Location
(description, street address and/or
latitude/longitude in decimal degrees):
Section IV. Site Information.
A. Acreage totals for all land -disturbing activities to be included under
this permit coverage.
(to the nearest one -hundredth of an acre)
Total land area of development (include the entire
area to be disturbed under the approved Stormwater
10.38 AC
Management Plan):
Estimated area to be disturbed (portions with Erosion
6.68 AC
and Sediment Control Plan approval only):
Offsite estimated area to be disturbed (if applicable):
C. Property owner status:
D. [Nature of the construction activity description (i.e.
commercial, industrial, residential, agricultural,
environmental):
Public commercial
E. Municipal Separate Storm Sewer System (MS4)
name (if discharging to a MS4): Albemarle
DEQ 199-DRAFT
B. Estimated Project Dates
(M M/D D/YYYY)
Start date: 11/01/2018
Completion date: 08/2019
PAGE 2 18
CONS'f6r3d9H.rIIC11*kGh:If+Jk.RA1.,MfARMIr(VAI4'e,106 REalasTRA'll`IC`ti'=9"S ratlifldltu;r`i t
his consr:ruction activity is fart of a cone non plan of development of sale: YES I 1 NON
G. 6" 01 der Hydrologic Unit Code (I IM) and associated Receiving Water Name(s). Include additional HUCs grid
receiving waters on a separate page.
- HUC I2Ek:rMNGWAAFIRBODY(S)
f72084}204(14t}4IVeoones,--Creek/ RIvarana River
Section V. Other Information
A. A stormwater pollution prevention plan (SWPPP) must be prepared in accordance with the requirements of the
General VP DES Permit for Discharges of Stormwater from Construction Activities pgi�r to submitting the registration
statement. By signing the registration statement, the operator is certifying that the SWPPP has been prepared.
R. Has an Erosion and Sediment Control Plan been approved for the disturbance in Section IV. A.' YES 9 NO ❑
If yes, provide the date of Erosion and Sediment Control Plan
C. Land disturbance has commenced: YES N NO ❑
D. Storrnwater management maintenance agreement included (if applicable): 'YES ❑ Not Applicable ❑
E. if this project is using approved Annual Standards and Specifications (AS&S), attach the completed AS&S Entity
Form. AS&S Entity Name (if' different from the Operator identified in Section il. A.):
DEQ 199-DRAFT PAGE 3 18
CONSTRUC_rIIONGI'.NCRALP1.FUVHT�VARIOa REGISTRATION TAEI-MANI
Snc:tlon VL r:,furtificadoirt. This ce rnfication must be signed by a rrerson repro %enting the operator identified in Section II.
A. and meeting the requirernenis of 9VAC25-880-70. Part III. K. Please note that operator is defined in 9VAC25 870-10
as follows:
"Operator" means the owner or operarrn of any faacility or activity subject to the Act and this chapter', nn the context of storm water
associated with is large orsmall eonstructioo activity, operator means any person associated with a construction project that meets
either of the following two criteria: (i) the person has direct operational control over construction plans and specifications, including
the ability to make modifications to those plans and specifications or (ii) the person has day-to-day operational r.onirol of those
activities at a project that are necessary to ensure compliance with a stormo aterpollunon prevention plan for the site of other state
permit or VSMP authority permit conditions (i.e., they are authorized to direct workers at a site to carry out activities required by the
stormwater pollution prevention plan ar comply with other permit conditions). In the context of stoi'mwater discharges, from
Municipal Separate Storm.sewer Systems (MS4.$), operator means the operator of flip regulated IW54 system.
9VAC25-880-70. Part III. K Signatory Requirements:
1. Registration statement. All registration statements shunt be signed as fonlonvs:
a. For a corporation: by a responsible corporate officer. For the purpose of this chapter, a responsible corporate officer
means: (i) a president, secretary, treasurer, or vice-president of the corporation in charge of a principal business function, or
any other person who performs similar policy making or decision -making functions for the corporation; or (ii) the manager
of one or more manufacturing, production, or operating facilities, provided the manager is authorized to make management
decisions that govern the operation of the regulated facility including having the explicit or implicit duty of making major
capital investment recommendations, and initiating and directing other comprehensive measures to assure long-term
compliance with environmental laws and regulations; the manager can ensure that the necessary systems are established or
actions taken to gather complete and accurate information far state permit application requirements, and where authority
to sign documents has been assigned or delegated to the manager in accordance with corporate procedures;
b. For a ponnership or sole proprietorship: by a general partner or the proprietor, respectively; or
c. For a municipality, state, federal, or other public agency: by either a principal executive officer or ranking elected official.
For purposes of this chapter, a principal executive officer of a public agency includes: (i) the chief executive officer of the
agency or (ii) a senior executive officer having responsibility for the overall operations of a principal geographic unit of the
agency.
Certification: " i certify under penalty of law that I have read and understand this registration statement 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:
Signature (signed in Ink):
Date:
Submit this form to the VSMP Authority. If DEQ is the VSMP Authority, please send to:
Department
PO Box 1105
Richmond VA 23218
DEQ 199-DRAFT PAGE 4 18
INSTRUCTIONS
CONSTRUCTION GENERAL PIERMI T REGHS T RATION STATEMENT
PLEA.SE600 NOT SUBMIT WITHREGISTRATION SIAa"EMENT
his re'is'tiaron seak,rnent is rot coverage un er Life Genera VPDF.S Permit'[or Discharges of Storrnwater corn
Coins'truction Activities, -I "he following permit actions are covered by this form: new issuance, re -issuance, moditicat.ion
with an increase in acreage and plan modifications that do not result in an increase in acreage.
Choose NEW ISSUANCE if this regisrral ion statement submittal is to obtain a new permit: coverage, RE-ISSLIANCE to
renew an active, expiring permit coverage or (MODIFICATION to rnodify an active permit coverage When modifying
permit coverage, indicate if the modification is increasing the amount of acreage previous covered (MODIFICATION
WITH ACREAGE INCIRLASE) or changing the site design with no increase in acreage (MODIFICATION WITHOUT ACREAGE
INCREASE).
Existing PermiC Coverage Number. Provide the permit number for a modification or rei.ssuance (i.e. VAR] 0114 t#).
Section II. Operator/Rermlttee information.
A. Construction Activity Operator (Permittee). The person or entity that is applying for permit coverage and will have
operational control over construction activities to ensure compliance with the general permit. For companies, use the
complete, active, legal entity name as registered with a state corporation commission. Entities that are considered
operators commonly consist of the property owner, developer of a project (the party with control of project plans and
specifications), or general contractor (the party with day--to-day operational control of the activities at the project site
that are necessary to ensure compliance with the general permit). If an individual person is named as the operator, that
person (or a representative of) must sign the certification in section V. I. An operator can be one of the following:
9VAC25-870-10. Definitions.
"Operator" means the owner or operator of any facility or activity subject to the Act and this chapter. In the context- of
stormwater associated with a large or small construction activity, operator means any person associated with a
construction project that rneets either of the following two criteria: (i) the person has direct operational control over
construction plans and specifications, including the ability to make modifications to those plans and specifications or (h)
the person has day-to-day operational control of those activities at a project that are necessary to ensure compliance
with a stormwater pollution prevention plan for the site or other state permit or VSMP authority permit conditions (i.e.,
they are authorized to direct workers at a site to carry out activities required by the stormwater pollution prevention plan
or comply with other permit conditions). In the context of stormwater discharges from Municipal Separate Storm Sewer
Systems (MS4s), operator means the operator of the regulated MS4 system.
"Owner" means the Commonwealth or any of its political subdivisions including, but not limited to, sanitation district
commissions and authorities, and any public or private institution, corporation, association, firm or company organized
or existing under the laws of this or any other state or country, or any officer or agency of the United States, or any
person or group of persons acting individually or as a group that owns, operates, charters, rents, or otherwise exercises
control over or is responsible for any actual or potential discharge of sewage, industrial wastes, or other wastes or
pollutants to state waters, or any facility or operation that has the capability to alter the physical, chemical, or biological
properties of state waters in contravention of § E2.1-44.5 of the Code of Virginia, the Act and this chapter.
"Person " means any individual, corporation, partnership, association, state, municipality, commission, or political
subdivision of a state, governmental body, including a federal, state, or local entity as applicable, any interstate body or
any other legal entity.
B. Billing information. If the person or entity responsible for billing/invoicing is different from the operator, please
complete this section. If they are the same, leave this section blank.
DEQ 199-DRAFT PAGE 5 18
INSTRUCTIONS
1IONS
CONSTRUCTION GENERAL. PERMIT REGISTRATION STATEME14T
MEASti DoNOTSRd&tMITWITHTRSERtEGRSERdAG`IONSTA6'CC3Cd A
C, May we t ransmik correspondence electronically? If you choose 'RCS to this question amd provide an email address in
`section 1. A., rail correspondence., forms, invoices and notifications will be transmitted by ern aiIto the operator. This will
also allow the operator to pay by credit card and receive permit coverage approval letters immediately upon approval.
Section H, Constirauction Activity tco at en finfa rniatton. Location information related to i1he projeci site.
A. A site snap indicating the location of the existing or proposed land -disturbing activities, the limits o'l land disturbance,
construction entrances and all water bodies receiving stormwater discharges from the site must be included with the
submittal of this form. Aerial imagery reaps or topographic [naps showing the required items are. acceptable. Plan sheet
sized site maps are not required. Please consult your VSMP authority if you have additional questions regarding site
map requirements.
B. Provide a descriptive project name (it is helpful to use the sarne naming convention as listed on the 5tormwater
plans), 911 street address (if available), city/county of the construction activity, 6-digit latitude and longitude in decimal
degrees format for the centroid, main construction entrance or start and end points for linear projects (i.e. 37.1234N/-
77.1234iA/).
C. Construction Activity Entrance Location. Provide an address or decimal degrees coordinates and a description of the
main construction entrance where the permit coverage letter will be posted.
Section Ill. Offsite Support Activity Location Information.
This general permit also authorizes stormwater discharges from support activities (e.g., concrete or asphalt batch plants,
equipment staging yards, material storage areas, excavated material disposal areas, borrow areas) located on -site or off -
site provided that (i) the support activity is directly related to a construction activity that is required to have general
permit coverage; (ii) the support activity is not a commercial operation, nor does it serve multiple unrelated
construction activities by different operators; (III) the support activity does not operate beyond the completion of the
construction activity it supports; (iv) the support activity is identified in the registration statement at the time of general
permit coverage; (v) appropriate control measures are identified in a SWPPP and implemented to address the discharges
from the support activity areas; and (vi) all applicable state, federal, and local approvals are obtained for the support
activity.
If requesting permit coverage for offsite activities, please complete this section. List additional offsite areas to be
included under this permit coverage on a separate page. offsite areas not included on this registration will need to
obtain coverage under a separate VPDES permit.
A. offsite activity location information. Provide a descriptive offsite project name, 911 street address (if available) and
city/county of all off -site support activities. Provide the 6-digit latitude and longitude in decimal degrees (i.e. 37.1234N,-
77.1234W). Please note that off -site activities not covered under this permit may require separate permit coverage.
B. offsite activity entrance location. Provide an address or decimal degrees coordinates and a description of the main
construction entrance.
A. Acreage totals for all land -disturbing activities, on- and off -site, to be included under this permit. Acreages are to be
reported to the nearest one -hundredth acre (two decimal places; i.e. 1.15 acres). Provide the total acreage of the
development as approved on the Stormwater Management Plans and the estimated acreage to be disturbed by the
construction activity as approved under the Erosion and Sediment Control Plans. The offsite estimated area to be
disturbed is the sum of the disturbed acreages for all offsite support activities to be covered under this general permit.
DEQ 199-DRAFT PAGE 6 18
WTAUCTIBUU S
CONSf'k"UCT&ONGENUAI. PERiVIT'RECEISTRATiINNNSTATEMENT
FAEASE DOt NOTSUBMIT 8rVITV TPIE REGISTRATION SUAO EME'N" T
Permit fees are calculated based on your disc 1u bed ac.i cage col:al for all areas bein,,g disturbed under this permit coverage
(the suiin of all ons to and offsite disturbed acieages).
N. r-mirnated Project Dates. Provide the estirated'pro ect start Aare and completion date in Month/Day/Year or
MINI/DD/YYYY format (i.e. 07/30/2019).
C. Property owner status. The status of the construction activity property owner. Any property not ovdned by a
government entity or agency (i.e. federal, stage or local governments) is PRIVATE.
D. Nature ofthe. construction activity description. Choose the designation that best describes the post -construction use
of this project (you may choose more than one). (i.e. Residential, Commercial, Industrial, Agricultural, Environmental,
Educational, Oil and Gas, Utility, Transportation, Institutional, etc.). Describe the project (i.e. Cornmercial--one new
office huilding and associated parking and utilities; Transportation - Roads, sidewalks and utilifies; Agricultural e-.3
Poultry Houses, etc.).
E. Municipal Separate .Storm Sewer System (MS4) narne(.$) it discharging to a MS4. If stormwater is discharged through a
MS4 (either partially or completely), provide the narne of the MS4(s) that will be receiving water from this construction
activity. The MS4 name is typically the town, city, county, institute or federal facility where the construction activity is
located.
F. This construction activity is part of a common plan of development or sale. "Common plan of development or sale"
means a contiguous area where separate and distinct construction activities may be taking place at different times on
different schedules per 9VAC25-870-10. Definitions. I.e, a subdivision, commercial development, business park, etc.
G. 6"' Order Hydrologic Unit Code (HUC) and associated Receiving Water Narne(s). Provide all 6" order HUCs and
receiving waters for the site and offsite areas that could potentially receive stormwater runoff discharging from this
activity. The HUC can be either a 12-digit number (i.e. 0208010101) or 2-letter, 2-number code (i.e. JL52). Include
additional HUCs or receiving waters on a separate page. You may utilize DEQ's web -based CIS application, VEGIS, to
obtain this information.
* VEGIS application link: DEQ's VEGIS Mapping Application
® Instructions for utilizing DEQ's VEGIS application link: CGP-GGIS HUC Instructions
Section V. Other Information.
A. A stormwater pollution prevention plan (SWPPP) must be prepared prior to submitting the registration statement per
9VAC25-880. See 9VAC25-880-70. Part II. of the General Permit for the SWPPP requirements.
B. Indicate if the Erosion and Sediment Control Plan for the estimated area to be disturbed listed in Section IV. A. has
been approved. If YES, indicate the date of original plan approval.
C. If land disturbance has commenced, choose YES. "Land disturbance" or "land -disturbing activity" means a man-made
change to the land surface that may result in soil erosion or has the potential to change its runoff characteristics,
including construction activity such as the clearing, grading, excavating, or filling of land per §62.1-44.15:24. Definitions.
D. stormwater Management Maintenance Agreement per 9VAC25-870-112 A. Choose YES if a maintenance agreement
has been included for review and approval.
E. If this project is using approved Annual Standards and Specifications (AS&S), attach the completed AS&S Entity Form.
If the AS&S Entity is different than the operator identified in Section I. A., list the AS&S Entity Name.. The AS&S entity is
the entity or agency that holds the approved annual standards & specification.
DEQ 199-DRAFT PAGE 7 18
INSTRUCTIONS
CONSTRUCTION GENERAL PERt' 117REMSTRATiON5"G'A(I4(<FiiENT
PUMSE DO p" OrsgC@3M11" O i'riq FHE RF61STRAi"IONVAu4`ibr ENT.
AS&.S Entity Foi rn links Anm).-iI Siaiidar.Is nod apt s if I( a fmns LnLiLy I n i oi rrrriicu i or )i
Sec.tlJoi-i Vf- Ceu tlM.a±don,
A properly authorized individual associated with the operator identified in Section I. A. ofthe Registration StaternenC is
responsible for certifying and signing the Registration Statement Staga siatules provide for severe penalties for
subrrritting false Information on the Registraton Staternent. State m ulation.s require that the Registration Staternent be
signed as follows per 9VAC25-880-70 Part III. K. L:
a. For a corporation: by a responsible corporate officer. lot, the purpose of this part, a responsible corporate officer
fneons:
(i) A president, secretary, treasurer, or vice-president of the corporation in charge of a principal business
function, crony other person who performs .similar policy -making or decision -making functions for the
corporation, or
(it) the roonager of one or more manufacturing, production, or operating facilities, provided the manager is
authorized to make management decisions that govern the operation of the regulated facility including having
the explicit or implicit duty of making major capital investment recommendations, and initiating and directing
other comprehensive measures to assure long-term compliance with environmental laws and regulations; the
manager can ensure that the necessary systems are established or actions taken to gather complete and
accurate information far permit application requirements; and where authority to .start docurnents has been
assigned or delegated to the manager in accordance with corporate procedures.
b. For a partnership or sole proprietorship: by a general partner or the proprietor, respectively.
c. For a municipality, state, federal, or otherpublic agency: by either a principal executive officer or ranking elected
official. For purposes of this part, a principal executive officer of a public agency includes:
(i) The chief executive officer of the agency, or
(ii) A senior executive officer having responsibility for the overall operations of a principal geographic unit of the
agency.
DEQ 199-DRAFT PAGE 8 18