HomeMy WebLinkAboutWPO202000050 Notice of Termination - VSMP 2022-11-22VIRGINIA DEPARTMENT OF ENVIRONMENTAL QUALITY
GENERAL VPDES PERMIT FOR DISCHARGES OF STORMWATER FROM CONSTRUCTION ACTIVITIES (VAR10)
NOTICE OF TERMINATION 2019
� Permit Coverage Number (VAR10####):'"' N/T
Section 1. Operator/Permlttee 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 VARSO Permit).
Construction Activity
Operator Name:
Birdwood Golf Course/ University of Virginia Foundation
Contact Person:
Narith Al Hardanee
Address:
P.O. Box 400218
City, State, Zip Code:
Charlottesville, VA, 22904
Phone Number:
1434) 270-1502 -
Primary Emali;
hal-hardanee@uvafoundation.com
CC Email:
Section 11. Construction Activity Location Information. Project site Information.
Construction Activity Name: Birdwood Golf Course
Address: 410 Golf course Drive
City and/or County and Zip Code: Charlottesville, VA, 7.2903
Latitude and Longitude
(6-digit, decimal degrees format): 38.048423,-78.540285
Sectlon 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):
2 A. 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. Far 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 SW PPP. and the residence has been transferred to the homeowner.
Rev 04/2019 PAGE 1 1 6
GENERAL PERMIT (VAR30) NOTICE OF TERMINATION 2019
SectloolkPIrticipation 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.
re or
`Section V. erpetual Nutrient Credits. if your site is utilizing nutrient credits, provide information related to the perpetual nutrient
cre s that were acquired In accordance with § 62.1-44.15:35 of the Code of Virginia. Attach a separate list If needed.
Non point Nutrient Credit Generating Ent"
(Bank Namejy
:
Perpetual Nutrient Credits Acquired
( ounds/acres/ ear:
---Jadudelhe affidavit of sale for all nutrient credits acquired. Is the affidavit of sale of nutrient credits attached? OYES ONO
�Sec�tlon V manent 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. Eneineer'sCertification Statement
❑ e. As -built plans (construction record drawings) — digital
❑ C. As-bullt plans (construction record drawings) —full-sized, paper
❑D. StormwaterManagementPlans— digital
❑ E. BMP Maintenance Agreement —notarized original, for public and private projects under DEQ's VSMP Authority
Stormwater Management Faclllty Tvnes folease choose from the followina AMR tvaesh
Bloretentlon 1
Bioretentlon 2
Bioretettion basin
Bioretention filter
Constructed Wetland 1
Constructed Wetland 2
Constructed wetlands
Dry Swale 1
Dry Swale 2
Emended detention (2 x WQ Vol)
Extended Detention Pond 1
Extended Detention Pond 2
Rev 04/2019
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 II (4 x WQ Vol)
Retention basin ill (4 x WQ Vol
with aquatic bench)
Sand filter
sheetfiow to Vegetated Filter or
Conserved Open Space 2
Soil Amendments
Urban Bloretention
Vegetated filter strip
Vegetated Roof
Vegetated Roof 2
Wet Pond 1
Wet Pond 2
Wet Swale 1
Wet Swale 2
PAGE 2 16
CONSTRUCTION GENERAL PERMIT (VAR30) NOTICE OF TERMINATION 2019
Stormwater Management Facility #1
BMPT e:
Date BMP Became Functional:
Address (if available):
i
City and/or County and Zip Code:
Latitude and Longitude
6-di it, decimal degrees format):
Receiving Waters)
outfall discharge)!
Tota I Acres Treated
(reportto one -hundredth of an acre):
Impervious Acres Treated
(report to one -hundredth of an acre):
Stormwater Management Facility #2
j
BMPT e:
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 (VARSO) 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
�violati(on�s." /� i J
Printed Name: !—tOlYl'rV1 AL �6ro6te-
Signature (signed in ink):
Date:
Section Vlll, Submittal instructlons. 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 D£Q. 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 Starmwater Management Suite 1400
PO Box 1105 .
Richmond VA 23218
constructioneo0 de a.virainla. go_v
Rev 04/2019
If the locality is the VSMP Authorityplease send to:
The local VSMP Authority (Insert address below)
permit terminations may be delayed if there are
outstanding annual permit maintenance fee balances due.
PAGE 4 16