The URL can be used to link to this page

Home My WebLink AboutWPO202200043 VSMP - SWPPP 2022-10-21COUNTY OF ALBEMARLE �lil'lllll Department of Community Development =-w 401 McIntire Road, North Wing Charlottesville, Virginia 22902-4596 Tel. (434) 296-5832 • Fax (434) 972-4126 Stormwater Pollution Prevention Plan (SWPPP) For Construction Activities At: �(/ p Project Name: -TJ Address: M (Orion Lane 6-oZ4, 0. a?a3a- Name: Name: Prnnarrrl by SWPPP Preparation Date: i0I1SIa'a, (This document is to be made publicly available according to 9VAC25-880-70, Part II, section D) Issued — 10/2014 Stormwater Pollution Prevention Plan (SWPPP) Albemarle County CONTENTS: (Prom Albemarle Comity Code Sec. 17-405) 1. Registration statement 2. Notice of general permit coverage 3. Nature of activity 4. Erosion and Sediment Control Plan. 5. Stormwater Management Plan 6. Pollution Prevention Plan. 7. Discharges to impaired waters, surface waters within an applicable TMDL wasteload allocation, and exceptional waters. 8. Qualified personnel 9. Signed Certification 10. Delegation of authority. 11. General permit copy 12. Inspection logs Issued — 10/2014 Stormwater Pollution Prevention Plan (SWPPP) Albemarle County Section 1. Registration statement (Provide a signed completed copy of (lie DEQ registration statement) Issued—10/2014 Stoimwater Pollution Prevention Plan (SWPPP) Albemarle County VIRGINIA DEPARTMENT OF ENVIRONMENTAL QUALITY GENERAL VPDES PERMIT FOR DISCHARGES OF STORMWATER FROM CONSTRUCTION ACTIVITIES (VAR10) RWISTRATION STATEMENT 2019 Application type. VNEW PERMIT ISSUANCE (CHOOSE ONE) ❑ MODIFICATION WITH ACREAGE INCREASE ❑ MODIFICATION WITHOUT ACREAGE INCREASE ❑ EXISTING PERMIT RE -ISSUANCE Section I. Operator/Permittee Information. PERMIT #: PLAN/ID #: TECHNICAL CRITERIA: IIB ❑ IIC ❑ 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 must sign the certification in Section V. (per Part III. K. of the VAR10 Permit). Operator Name: Contact person: j u Address: 154.* City, State and Zip Code: to vi «P Phone Number: -Q Primary and CC Email: LVIU qr - Q CD 'T r4 . S (Y) B. Electronic correspondence. To receive a filed covers letter or to pay by credit card, y must choose YES and include a valid email. May we transmit correspondence electronically? YESJ NO ❑ Section II. Construction Activity Information. A. Include a site map showing the location of the existing or proposed land -disturbing activities, the limits of land disturbance, construction entrances and all waterbodies receiving stormwater discharges from the site. B. Project site location information. Construction Activity Name: j C Address: Pion City and/or County and Zip Code: T,) - Construction Activity Entrance Location (description, street address and/or latitude/longitude in decimal degrees): Latitude and Longitude (6-digit, decimal degrees format): _ .O(a C) (�j3W C. Acreage totals for all land -disturbing activities to be included under this permit 04rage. Report to the nearest one -hundredth of an acre. Total land area of development (include entire area to be disturbed as approved in the Stormwater Management Plan): r� I "e-5 Primary estimated area to be disturbed (include portions with Erosion and Sediment Control Plan approval only): r q (hLS Off -site estimated area to be disturbed (if applicable): D. Property Owner Status: FEDERAL ❑ STATE ❑ PUBLIC ❑ PRIVATE E. Nature of the Construction Activity Description (i.e. commercial, industrial, residential, agricultural, environmental, utility): ' & l R05 I F. Municipal Separate Storm Sewer System (MS4) name(s) (if the site is discharging to a MS4): G. Estimated Project Dates (MM/DD/YYYY). Start Date: 7 ( Completion Date: 1111015 H. Is this construction activity part of a larger common plan of YES development or sale? X NO ❑ Rev 11/2020 PAGE 1 1 6 CONSTRUCTION GENERAL PERMIT (VAR10) REGISTRATION STATEMENT 2019 I. 6" Order Hydrologic Unit Code (HUC) and Receiving Water Name(s). Include additional areas on a separate page. HUC NAME(S) OF RECEIVING WATERBODY Section III. Off -site Suanort Activitv Location Information. List all off -site support activities and excavated material disposal areas being utilized for this project. Include additional areas on a separate page. Off -site Activity Name: Address: City or County: Off -site Activity Entrance Location (description, street address and/or latitude/longitude in decimal degrees): Latitude and Longitude (6-digit, decimal degrees format): Is this off -site activity an excavated material disposal area? YES ❑ NO ❑ If this off -site activity is an excavated material disposal area, list the contents of the excavated fill material: Will a separate VPDES permit cover this off -site activity? YES ❑ NO ❑ Section IV. Other Information. A. A stormwater pollution prevention plan (SWPPP) must be prepared in accordance with the requirements of the General VPDES Permit for Discharges of Stormwater from Construction Activities prior to submitting the Registration Statement. By signing the Registration Statement, the operator is certifying that the SWPPP has been prepared. B. Has an Erosion and Sediment Control Plan been submitted to the VESC Authority for review? YES ❑ NO ❑ Erosion and Sediment Control Plan Approval Date (for the estimated area to be disturbed MM/DD/YYYY): C. Has land -disturbance commenced? YES ❑ NO ❑ D. Annual Standards and Specifications. If this project is utilizing approved Annual Standards and Specifications (AS&S), attached the completed AS&S Entity Form. AS&S Entity Name (if different from the Operator identified in Section I): E. Billing information (leave blank if same as the Operator identified in Section I. above). This entity will receive Annual Permit Maintenance and Permit Modification Fee invoices (if applicable). Billing Name: Contact Name: Address: City, State and Zip Code: Phone Number: Primary and CC Email: Rev 11/2020 PAGE 2 16 CONSTRUCTION GENERAL PERMIT (VAR10) REGISTRATION STATEMENT 2019 Section V. Certification. A person representing the operator as identified in Section I. A. and meeting the requirements of 9VAC25-880-70. Part III. K must physically sign this certification. A typed signature is not acceptable. Please note that operator is defined in 9VAC25-870-10 as follows: "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 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 (H) the person has day-to-day operational control of those activities at a project that are necessary to ensure compliance with a storm water 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 storm water discharges from Municipal Separate Storm Sewer Systems (MS4s), operator means the operator of the regulated MS4 system. 9VAC25-880-70. Part Ill. K. Signatory Requirements. Registration Statement. All Registration Statements shall be signed as follows: 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 (H) 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 for 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 partnership 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 (H) 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 Signed: V +0I1g Ia v Section VI. Submittal Instructions. Submit this form to the VSMP Authority. If the locality is the VSMP Authority, please send your Registration Statement submittal 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: If the locality is the VSMP Authority, please send to: Department of Environmental Quality Office of Stormwater Management Suite 1400 PO Box 1105 Richmond VA 23218 COnstructioneq@deg. VirAi n ia.1;OV Rev 11/2020 PAGE 3 16 Section 3. Nat n•e of activity (Provide a detailed narrative of (lie construction activities. 111Clnde or reference a construction schedule and sequence. lnclude any phasing) c�.b bhp � �vV PP P Tpl� Ilk 4,h OILc��l Issued — 10/2014 Stormwater Pollution Prevention Plan (SWPPP) Albemarle County Section 5. Stormwater Management Plan (Provide a reduced 1 I x 17 copy of the latest stormwater management plan. Do not reference only.) Issued— 10/2014 Stormwater Pollution Prevention Plan (SWPPP) Albemarle County OLD TRAIL VILLAGE - BLOCK 7C MT& uenvm�mrss ..,.o.. VIRGINIA STORMWATER MANAGEMENT (WPO) PLAN COUNTY OF ALBEMARLE, VIRGINIA WP0202100024 4/26/2021 VICINITY MAP 1'-1000' DEVELOPER: MARCH MOUNTAIN PROPERTIES LUC 1005 HEATHERCROFT CIRCLE SUITE 100 CROZET, VA 22932 CONTACT: DAVE BROCKMAN TELEPHONE:(702) 985-9088 EMAIL: DAVE@OLDTRAILVRIAGE.COM ENGINEER OF RECORD: TIMMONS GROUP 608 PRESTON AVE. SUITE 200 CHARLOTTESVILLE, VA 22903 CONTACT: CLINT SHIFFUEff, P.E. TELEPHONE:(434) 327-1690 EMAIL: CUNT.SHIFFLETTCTIMMONS.0 VL,7 00 a x U Lt• 0j1� �S ;Fg44gnr T. ' . O€ c I1J �'p P gMPq g r� s51 Yp P---% . -- p p p p p= p i F p i p s V pid - }AIM W12 �il$}'ft= �B�®�® i.iefi 4�ri ei?ejj3= ;!f{r�iF}gFt F € r�l LY [ iit fill lip TIMMONS GROUP ••'':'�• OLD TRAIL BLOCK 7C p F e �VILLAGE B 9 NoMs a oteruLs g ®yp pR�p r� g... L iz leg �5, V - allI jim— wnc Im #s a m i TIMMONS GROUP w.,...oArlao ..'�. 8Z e OLD TRAIL VILLAGE — BLOCK 7C 8 9 Z 1 GRACING S DRAINAGE PLAN a gtgias 1W p C C to, i WN �f 3NYI1NOW3gy1J njII��III �' �� fib g3`3g� 1 IIt z II LJ E3{ � m AA a �- �I R [ p I h a TIMMONS GROUP ��--�..•..._ OLD TRAIL VILLAGE - BLOCK 7C ° un�m at w Section 4. Erosion and Sediment Control Plan. (Provide a reduced, 1 Ix17 copy of the latest Erosion and Sediment Control Plan. Do not reference only.) Issued — 10/2014 Stoiinwater Pollution Prevention Plan (S WPPP) Albemarle County R WANEIImM IObTF.r1I9ERR IIPOIFwSB/I YINMIIdI N.V/M.!! LLmII.Mtl/ _ lllr®11p9N aawnn DID _ Raerosv- � EKwe'xr "' Y E4 a '`!,� � - �_ ��T OLD rRAN, arvc Emvr ►v meri iurR ; q� �?I OI ll �y __ r pwsrr y, � i o''T' V _ _ Rmarow l �' �`♦ \Q,� w,v ww ss� °v� Q � m � • )g � yp l t tqI q HH? EEIN EII +111 q� \ \ ErN� Elp NO �� rol yr n xM ,pf6l l erp~ SAp _�i�r-1W-� pp /� Ey�gW�yr EF (KJarrl /my,m p/p NNFL meWm _ � Y/WICM Ire y mmn lYi]M m�vYwrrt�i �amEx � ET x.l � I M410 // % N,� ,T .'.rteTffA. ��e EIIW gym— T� � _� �— y isewl rxcxm EUEusxir I _�� S i `• !'F, ',,. //wJap I_ rp wCN J _— =J --� ;ENNEL E �1 /mm 6�' m - In aDAD leiS eF�� II al / if --- wriwW.wpNvnAWEn \ \ --%� / (f�,�� avnFxEexEExcE•e• • a � • rrsrEE.urevYEew \ / � / \ / na�ot/�a'>v�Jp I • NmmrzwxuxrwEx � � roRsmreo • rmww: IbyF "" s • �A ,� run asr.masn� \ /�9 It �l1� m�ror.m �i• ' ` we�m�e f � e11WM \ ,� ; ' rwmmvrJxc N ro Yw�iI11 \ \ � .� mY IRWNmLOiK 9GLE Pau �t � ,EEL4rl1r \ \ c. / / J m/m.ro a,a I F ,w B ro - -J, J R m'FIpYGYY/II msn{Fns I � I I SUBDIVISION PLNI OLD TRAIL VILLAGE - - I BLOCK 7C O LOTS 27.56 PART OF TAX MAP PARCELS �9 SSE-1.7B, SSE-1.95D7, S 55E4-35A 0 2 W7 UJ09EPH C. I�DLET� WHITE HALL DISTRICT �Neo ALBEMARLE COUNTY, NROINK _3995 _ LNG 1 PLAT WINA VACATED WEM mre:nn.rz /ms suu:t•. Eo• 9UR'�0 sxeersors ].N.o1J35E wr Section 6. Pollution Prevention Plan. (reference County Code 17-404 and State Regulation 9VAC25-880-70 part II section A.4) A. Plan showing pollution activities and prevention practices (Provide a reduced 1 lxl7 copy of a site plan on which all of the following activity locations are clearly marked. Keep this plan up-to-date with ongoing site changes and inspections.) Issued—10/2014 Stormwater Pollution Prevention Plan (SWPPP) Albemarle County a WYtIf NVM WJIIF.W}rT eIYi1FABLYT YI,WNmR.W M1lr metOI.IRDr _ ��n gn aarraM- 1 uLs 0NI _ _y t --` ein,ccevT ramer'm�i•wpsBr� - _ - -� _ _ o<arnnu narvc raw.Y I \ R ieA.saNw I R' \\\ \RR wra wl wxr I � RI R' mq I I v/ NFnv 1 V o I y ors °our 91 F ME", _ xax k A'alB VAp,Y[NOTx 111IW r �rIZI� - Y' /� aE[apiyµq prp rLwACa �_ w rmlMv,.a.ar.mewrr 1 ,� HMr '�`Yrr �_r-�wr (TI WL EI FNf, �. nei /r[J OO arr � ffi _ � VENNEL aOAnAr. p NY651fO4NT iPl� R 9 - Hpl' 8A I i y I rm r'M - rnruriwruvrFAeer \ f 1 I I s _--�__pS sarNFwwwrea \\ \ 1 1 , g srs,rAwgwNAeen .0 v I sa �°ed00u°°�a (��4T'�{o A� �r asawrtwr e , , + mervBdsO \ \ T na%YGNE \ • mllU4l4.M ' .SW' E)•MIO' TR4 WBF9Ir \ �. / I ' 0 M mWW as ,c,ra t:B AeIM'Y EVEABII � � �L m lwN,lp 1pY I W I I SUBOIVISION PLAT _ x I OLD TRAIL VILLAGE I BLOCK 7C LOTS 27.56 PART OF QN�TH 0,r r' TAX MAP PARCELS 55E-1-7B, 55E-1-35W, & 55E-1-36A o Z MTHE �t0.9EPH C. MUY3 WHITE HALL DISTRICT Lc. N0.3385 ALBEMARLE COUNTY, NROINIA � C Q; PLAT M•WVALATm BMBBBX • BURVD mTUAsmrL ss srAu:1 •-M' 6NM]WB J.N.VJB.B] OIIMYN a: NIL CNKK n: XM Pp - KQ� LW, `i B. Sources of Pollutants, locations. and prevention Dractices Pollutant, or Pollutant Generating Activity Location on site Prevention Practices, Control Measures Fuel, gas, oil, coolant Not to be stored on site Not to be stored on site, clean any s Concrete Concrete wash out wash out, dispose when dry Paint Garages Wash In washout cleaning materials garages Wash in washout Asphalt Only used to pave use leftovers for curbs Termite spray Sprayed around foundation per code Drywall compound Garages Let dry and dispose of block mortar within silt fencing Cure before disposing of Tile grout Inside clean In washout C. Sources of Pollutants, continued. Compton activities and minimum control and prevention ractices Pollutant, or Pollutant Location on site Prevention Practices, Generating Activity Control Measures Follow Erosion and Sediment Control Clearing, grading, excavating, and m- Land disturbance area Plan. Dispose of clearing debris at stabilized areas acceptable disposal site& Seed and mulch, orsodwithia7da oflendd Cover atom[ drain inlets and use drip Paving operations Roads and driveways pans and absorbentfoil dry for all paving machines to limit leaks and spills ' Direct concrete wash water into a leak - Concrete washout Current location and detail shown proof container or leakproof settling and cement waste on plan basin that is designed so that no overflows can occur Enclose or cover material storage areas. Mix paint indoors in a containment area or Structure construction, stucco, Structures in a flat unpaved area. Prevent the painting, and cleaning discharge of soaps, solvents, detergents and wash water, paint, form release oils and owing compounds. Water shall be filtered, settled or similarly Dewatering operations Dewatering sites shown on plan treated'prior to discharge as shown on plan. Designated areas for material delivery Material delivery and storage Designated area shown on plan and storage. Placed near construction entrances, away from waterways and drainage paths Material use during building process Building areas Follow manufacturer's instructions . MSDS's attached waste collection area will notreceive a substantial amount ofrunoff from upland Solid waste disposal Current designated container mess areas and does not drain directly to a on plan waterway. Containers have lids covered before periods of rain, or are in a covered area Scheduled collection to prevent Issued — 10/2014 Stolmwater Pollution Prevention Plan (SWPPP) Albemarle County Pollutant, or Pollutant Location on site Prevention Practices, Generating Activity Control Measures overfilling. MATERIALS NOT TO BE BURIED ON -SITE Convenient and well -maintained portable sanitary facilities will be Sanitary waste Current locations shown on plan provided, and located away from waterways or inlets. Such facilities shall be regularly maintained. Apply fertilizers in accordance with Landsenping operations Landscape areas shown on plan manufacturer's recommendations and not during rainfall events To be treated in a sediment basin or Wash Waters Wash areas shown on plan better control as specified on plan. Minimize the discharge of pollutants from equipment and vehicle washing Vehicle and equipment washing areas and details shown on Provide containment and filtering for all plan plan wash waters per the plan Minimization ojexpositre to precipitation and stormwater. Minimize the exposure of building materials, building products, construction wastes, trash, landscape materials, fertilizers, pesticides, herbicides, detergents, sanitary waste, and other materials present on the site to precipitation and to stormwater. (Identify al I non-stormwater discharges to occur on your site. Keep this plan up-to-date with ongoing site changes and inspections. See CGP, 9VAC25-880-70 section E for examples of non-stormwater discharges.) D. Non-stormwater discharees Dischnrge Pollutants or Pollutant Location on Site Constituents ni� Issued—10/2014 Stormwater Pollution Prevention Plan (S WPPP) Albemarle County E. Persons responsible for pollution prevention practices (Provide the names and contact information for all persons responsible for prevention practices as listed above.) -was Joe . 5� cr b)-d 6 t uA at�cic raac� 9 It>a'l . CO t11 F. Response and reporting practices Minimize dischages fi•an spills and leaks. Minimize the discharge of pollutants from spills and leaks and implement chemical spill and leak prevention and response procedures as follows. Respond to all spills, leaks and discharges as follows; Report all spills, leaks and discharges as follows; (Provide detailed response and reporting practices according to 9VAC25-880-70, Part II, section AA.e.) �eC a4ac-6.e4 sh.,+-,t" G. Pollution Prevention Awareness (Describe training and procedures to provide awareness and compliance for all measures in this document; waste management, wash waters, prevention measures, etc.) Issued — 10/2014 Stormwater Pollution Prevention Plan (SWPPP) Albemarle County F. Response and reporting practices Most spills can be cleaned up following manufacturer specifications. Absorbent/oil dry, sealable containers, plastic bags, and shovels/brooms are suggested minimum spill response items that should be available at this location. 1" Priority: Protect all people 2nd Priority: Protect equipment and property 3rd Priority: Protect the environment 1. Check for hazards (flammable material, noxious fumes, cause of spill) — if flammable liquid, turn off engines and nearby electrical equipment. If serious hazards are present, leave the area and call 911. LARGE SPILLS ARE LIKELYTO PRESENT A HAZARD. 2. Make sure the spill area is safe to enter and that it does not pose an immediate threat to health or safety of any person. 3. Stop the spill source. 4. Call co-workers and supervisor for assistance and to make them aware of the spill and potential dangers. 5. If possible, stop spill from entering drains (use absorbent or other material as necessary). 6. Stop spill from spreading (use absorbent or other material). 7. If spilled material has entered a storm sewer; contact locality's storm water department. B. Clean up spilled material according to manufacturer specifications; for liquid spills, use absorbent materials and do not flush area with water. 9. Properly dispose of cleaning materials and used absorbent material according to manufacturer specifications. Emergency Contacts: Normal Working Hours DEQ Valley Regional Office 540-574-7800 Nights, Holidays & Weekends VA Dept. of Emergency Management 804-674-2400 G. Polution Prevention Awareness All Project Managers for our company are trained to comply with standard SWPPP procedures. This includes the following: • Tarping and un-tarping dumpsters • Removal and disposal of concrete washouts • Location of toilets and dumpsters • Silt fence requirements • Removal and disposal of any spilled pollutants • Daily and weekly reporting practices Section 7. Discharges to impaired waters, surface waters within an applicable TMDL wasteload allocation, and exceptional waters. (Provide detailed measures for any applicable TMDL) Issued — 10/2014 Stormwater Pollution Prevention Plan (SWPPP) Albemarle County Section 8. Qualified personnel The following persomiel are responsible for inspections; (Provide the name, telephone number, and qualifications of the qualified personnel conducting inspections.) -Joe 40sban5 to, 0 c61 (7 Ib3)Wsa - 44A5 (434) a4a- 03b 4 PnjDr& Manaer VP o-� Cpns L d Issued — 10/2014 Stormwater Pollution Prevention Plan (S WPPP) Albemarle County Section 9. Signed Certification (Provide certification according to 9VAC25-870-370) CERTIFICATION "I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate 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." Operator Name: 'N ILA Iary) n ��. Company: 6-� IJt��"/n�I` ` S I Title: V P (� &/ ns} t� i` —4-LQ+� Signature: WAVY~• A ' >6 Date: I p I 16 I as Issued — 10/2014 Stonnwater Pollution Prevention Plan (S WI'PP) Albemarle County Section 10. Delegation of authority. (Provide the persons or positions with authority to sign inspection reports or to modify the stormwater pollution prevention plan. A formal, signed delegation of authority is needed.) Delegation of Authority I, W1 haM b. (name), hereby designate the person or specifically described position below to be a duly authorized repres�p�fve or the rp a of gverseeing compliance with environmental requirements, including the Construction General Permit, at the DIN IIAaI . OAX In4S 40-4koconstruction site. The designee is authorized to sign any reports, stormwater pollution preventi n�� pl""an��s and all other documents required by the permit. �� u�Slyal.S (name of person or position) (company) (� (J (address) ?j7j1, Y \fir (city, state, zip) C h�Gjl7,rl�ntS V I UP , UAO 1 (phone) By si�ning )a onzation��onfirm that I meet the requirements to make such a designation as set forth in the Construction General Permit (CGP), and that the designee above meets the definition of a "duly authorized representative". Operator Name: LI I 0 • 60—fo Company: � `� '�S P Title: 1/ Y . td �—, f1 Signature: RAWa Date: (Q I k e) 6 Issued — 10/2014 Stotmwater Pollution Prevention Plan (S WPPP) Albemarle County Section 11. General permit copy (Provide a copy of the construction general permit, 9VAC25-880) Issued — 10/2014 Stormwater Pollution Prevention Plan (S WPPP) Albemarle County Section 12. Inspection logs (Provide templates for your inspections. Requirements are listed in 9VAC25-880-70, Part 11, section B and P.) )�U OA� sb-a4 f" Issued — 10/2014 Stomnvater Pollution Prevention Plan (SWPPP) Albemarle County Community Date