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HomeMy WebLinkAboutWPO202000014 Other 2022-05-06VIRGINIA DEPARTMENT OF ENVIRONMENTAL QUALITY GENERAL VPDES PERMIT FOR DISCHARGES OF STORMWATER FROM CONSTRUCTION ACTIVITIES (VAR10) NOTICE OF TERMINATION 2019 Permit Coverage Number (VAR10####): R:Zy17 -O3loI I C Section I. Operator/Permittee Information. The person or entity that has active permit coverage approval and operational control over construction activities to ensure compliance with the general permit. A person with signatory authority for this operator must sign the certification in Section VII (per Part III. K. of the VAR10 Permit). Construction Activity Operator Name: nr4a n Lp SNOu/ Contact Person: Dtz et n P .Sn0I / Address: '10S .LC/ 4 h Gf%a-Y City, State, Zip Code: Ch2/'&0712D1;11e r 1/4 ,2,2 99 J Phone Number: /{ 3 <f Primary Email: ` uetne S/10l0/� gXgjl Cam 7 CC Email: Section II. Construction Activity Location Information. Project site information. Construction Activity Name: !7/10n _lkicl4Trlcll Pa/'k Address: /700 -19/ B AM312ow P©//17- L- M City and/or County and Zip Code: Ghar/D��//e-w;Ie .. o 1A29b2 Latitude and Longitude p��jj/� (6-digit, decimal degrees format): 3 7 9EET, . 2,,5-0 9 Section III. Reason for Terminating Coverage under the General Permit. The operator shall submit a Notice of Termination within 30 days after meeting one or more of the following conditions (select one or more): RA. Necessary permanent control measures included in the SWPPP for the site are in place and functioning effectively and final stabilization has been achieved on all portions of the site for which the operator is responsible. When applicable, long-term responsibility and maintenance requirements for permanent control measures shall be recorded in the local land records prior 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, the operator has provided written notification to the homeowner about the importance of final stabilization and incorporating a copy of the notification and signed certification statement into the SWPPP, and the residence has been transferred to the homeowner. Rev04/2019 PAGE 1 1 6 CONSTRUCTION GENERAL PERMIT (VAR10) NOTICE OF TERMINATION 2019 Section IV. Participation in a Regional Stormwater Management Plan. If your site discharges to a regional stormwater management facility, provide information related to the regional stormwater management plan. Attach a separate list if discharging to multiple regional facilities. Regional Stormwater Management Facility Type: Address: City and/or County and Zip Code: Latitude and Longitude (6-digit, decimal degrees format): Total Acres Treated by Regional Facility (report to one -hundredth of an acre): Impervious Acres Treated by Regional Facility (report to one -hundredth of an acre): Section V. Perpetual Nutrient Credits. If your site is utilizing nutrient credits, provide information related to the perpetual nutrient credits that were acquired in accordance with § 62.1-44.15:35 of the Code of Virginia. Attach a separate list if needed. Nonpoint Nutrient Credit Generating Entity (Bank Name): Perpetual Nutrient Credits Acquired (pounds/acres/year): Include the affidavit of sale for all nutrient credits acquired. Is the affidavit of sale of nutrient credits attached? DYES ONO Section VI. Permanent Control Measures. If applicable, list the post -development stormwater management facilities or best management practices (BMPs) that were constructed and installed as part of this activity to comply with the stormwater management technical criteria (structural and nonstructural, on -site and off -site). Attach a separate list if needed. If you have permanent control measures, the following items are required to be included with this form in order to complete your Notice of Termination submittal: ❑ A. Engineer's Certification Statement ❑ B. As -built plans (construction record drawings) —digital ❑ C. As -built plans (construction record drawings) —full-sized, paper ❑ D. Stormwater Management Plans — digital ❑ E. BMP Maintenance Agreement — notarized original, for public and private projects under DEQ's VSMP Authority Stormwater Management Facility Types (please choose from the following bmp types): Bioretention 1 Bioretention 2 Bioretention basin Bioretention filter Constructed Wetland 1 Constructed Wetland 2 Constructed wetlands Dry Swale 1 Dry Swale 2 Extended detention (2 x WQ Vol) Extended Detention Pond 1 Extended Detention Pond 2 Extended detention -enhanced Filtering Practice 1 Filtering Practice 2 Grass Channel Grassed swale Infiltration (1 x WQ Vol) Infiltration (2 x WQ Vol) Infiltration 1 Infiltration 2 Other IIB (manufactured treatment device, etc.) Other IIC (manufactured treatment device, etc.) Permeable Pavement 1 Permeable Pavement 2 Rainwater Harvesting Retention basin 1 (3 x WQ Vol) Retention basin It (4 x WQ Vol) Retention basin III (4 x WQ Vol with aquatic bench) Sand filter Sheetflow to Vegetated Filter or Conserved Open Space 2 Soll Amendments Urban Bioretention Vegetated filter strip Vegetated Roof 1 Vegetated Roof 2 Wet Pond I Wet Pond 2 Wet Swale 1 Wet Swale 2 Rev 04/2019 PAGE 2 16 CONSTRUCTION GENERAL PERMIT (VAR10) NOTICE OF TERMINATION 2029 Stormwater Management Facility #1 BMP Type: Date BMP Became Functional: Address (if available): City and/or County and Zip Code: Latitude and Longitude (6-digit, decimal degrees format): Receiving Water(s) (outfall discharge): Total Acres Treated (report to one -hundredth of an acre): Impervious Acres Treated (report to one -hundredth of an acre): stormwater Management Facility #2 BMP Type: Date BMP Became Functional: Address (if available): City and/or County and Zip Code: Latitude and Longitude (6-digit, decimal degrees format): Receiving Water(s) (outfall discharge): Total Acres Treated (report to one -hundredth of an acre): Impervious Acres Treated (report to one -hundredth of an acre): Stormwater Management Facility #3 BMP Type: Date BMP Became Functional: Address (if available): City and/or County and Zip Code: Latitude and Longitude (6-digit, decimal degrees format): Receiving Water(s) (outfall discharge): Total Acres Treated (report to one -hundredth of an acre): Impervious Acres Treated (report to one -hundredth of an acre): Rev 04/2019 PAGE 3 16 CONSTRUCTION GENERAL PERMIT (VAR10) NOTICE OF TERMINATION 2019 Section VII. Certification. This Certification must be signed by a person representing the operator identified in Section I. and meeting the requirements of 9VAC25-880-70 Part III K. 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: OLZ a n P .SnD Al Signature (signed in ink) Date: 15--6 - -1O e2 2 Section Vill. Submittal Instructions. Please submit this form to the Virginia Stormwater Management Program (VSMP) Authority that has jurisdiction for your construction activity. If the locality is the VSMP Authority, please submit your form directly to the locality; do NOT send this form to DEQ. A list of local VSMP Authorities is available here: VSMP Authorities. If DEQ is the VSMP Authority, please send to: Department of Environmental Quality Office of Stormwater Management Suite 1400 PO Box 1105 Richmond VA 23218 constructiongp@deq.virginia.gov If the locality is the VSMP Authority, please send to: The Local VSMP Authority (insert address below) Permit terminations may be delayed if there are outstanding annual permit maintenance fee balances due. Rev 04/2019 PAGE 4 1 E