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Home My WebLink AboutWPO201900035 Notice of Termination - VSMP 2022-11-29 VIRGINIA DEPARTMENT OF ENVIRONMENTAL QUALITY GENERAL VPDES PERMIT FOR DISCHARGES OF STORMWATER FROM CONSTRUCTION ACTIVITIES(VAR10) NOTICE OF TERMINATION 2019 w Permit Coverage Number(VAR10####): %3 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: C ^�\ l - am _VD vl.NSt) \J Contact Person: V` - , �C ��PN— Address: L V-5S `p .u-GL _p City,State,Zip Code: l AA A-4/\/3 e -% ke_ ( \, k 27.A.0 Z Phone Number: ik-b`-,- Z'A.'--\ O OL. \ \ Primary Email: _ V\L,ouyp ®�\it jc, C�1.JS .ic_ o nco��J , C CC Email: /t QN vc..-\ ' oN + C-Gl•• , Section II. Construction Activity Location Information. Project site information. Construction Activity Name: 1..,2- j'j V4._C_t-L t.-4,..../e_. 6._.)GKNe 1 WO 2/As-o j36 + Address: '2-Z6)5— Ottc c c� 1...,,,,,.1...,,,,,.,_c City and/or County and Zip Code: CINLI-vAckkpf2v(NX.42,- VA, 2-.7_5\0\ i Latitude and Longitude (6-digit,decimal degrees format): LIS'S"- 1 CA t ( LONG— "IR o Sc( • \0 w Section III. Reason for Terminating Coverage under the General Permit. The operator shall submit a Notice of Termination within 30 ays after meeting one or more of the following conditions(select one or more): 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 O 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. Rev 04/2019 PAGE 1 16 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 j 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): �, .` ss Perpetual Nutrient Credits Acquired Iv 1 (pounds/acres/year): Include the affidavit of sale for all nutrient credits acquired. Is the affidavit of sale of nutrient credits attached? OYES 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 Extended detention-enhanced Other IIC(manufactured Soil Amendments Bioretention 2 Filtering Practice 1 treatment device,etc.) Urban Bioretention Bioretention basin Filtering Practice 2 Permeable Pavement 1 Vegetated filter strip Bioretention filter Grass Channel Permeable Pavement 2 Vegetated Roof 1 Constructed Wetland 1 Grassed swale Rainwater Harvesting Vegetated Roof 2 Constructed Wetland 2 Infiltration(1 x WQ Vol) Retention basin I(3 x WQ Vol) Wet Pond 1 Constructed wetlands Infiltration(2 x WQ Vol) Retention basin II(4 x WQ Vol) Wet Pond 2 Dry Swale 1 Infiltration 1 Retention basin III(4 x WQ Vol Wet Swale 1 Dry Swale 2 Infiltration 2 with aquatic bench) Wet Swale 2 Extended detention(2 x WQ Vol) Other IIB(manufactured Sand filter Extended Detention Pond 1 treatment device,etc.) Sheetflow to Vegetated Filter or Extended Detention Pond 2 Conserved Open Space 2 Rev 04/2019 PAGE 2 16 CONSTRUCTION GENERAL PERMIT(VAR10) NOTICE OF TERMINATION 2019 Stormwater Management Facility#1 I r C, BMP Type: �C7U� 'C l��n � - 1r�� C�-•��c' ti�.� 1 I Date BfV1P Became Functional: at \G`L 20 t \ _ I, Address(if available): �k 5 c—c�� r City and/or County and Zip Code: e"�� V 2Z \U Latitude and Longitude (6-digit,decimal degrees format): �� 33 l-c�A 5 trtCty Receiving Water(s) O2O_2 l.-k. • 1_ S V``VQ�' (outfall discharge): 1V Total Acres Treated (report to one-hundredth of an acre): , Z-c; Impervious Acres Treated `,5 (report to one-hundredth of an acre): Stormwater Management Facility#2 BMP Type: )-�.r� ,pJ ew�•�n� Date BMP Became Functional: 1 I Z 12C)ZZ Address(if available): L�� 1�� , �: City and/or County and Zip Code: ` "� I V�C -2..z.ckV\ Latitude and Longitude S Z gqLctA (6-digit,decimal degrees format):. r n�� , Receiving Water(s) (outfall discharge): \ 20b C'`-' ,p��F�> -t Total Acres Treated (report to one-hundredth of an acre): r 2c) �"� Impervious Acres Treated (report to one-hundredth of an acre): t Stormwater Management Facility#3 BMP Type: Date BMP Became Functional: Address(if available): City and/or County and lip Cade_ 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 Ili 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."S /// �" ` ^�` Printed Name: �v.��c LTG / GJ Mc�v`� �c 0,ut.(tw— �as��u5C) 1 Signature(signed in ink): 'e ? 0-1 JJ Date: I t 4 ( -� Section VIII.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: If the locality is the VSMP Authority,please send to: Department of Environmental Quality The Local VSMP Authority(insert address below) Office of Stormwater Management Suite 1400 PO Box 1105 Richmond VA 23218 constructiongp@dmvirginia.gov Permit terminations may be delayed if there are outstanding annual permit maintenance fee balances due. Rev 04/2019 PAGE 4 16