HomeMy WebLinkAboutWPO202000028 Correspondence 2023-02-14 (2)VIRGINIA DEPARTMENT OF ENVIRONMENTAL QUALITY
GENERAL VPDES PERMIT FOR DISCHARGES OF STORMWATER FROM
CONSTRUCTION ACTIVITIES (VAR10)
REGISTRATION STATEMENT 2019
Application type. ❑ NEW PERMIT ISSUANCE
(CHOOSE ONE) 2 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:
Regents School of Charlotesville INC.
Contact person:
Courtney Palumbo
Address:
200 Bod Finley Way
City, State and Zip Code:
Charlottesville, VA 22903
Phone Number:
(434) 293-0633
Primary and CC Email:
cpalumbo@regents-school.org
B. Electronic correspondence. To receive an emailed coverage letter or to pay by credit card, you must choose YES
and include a valid email. May we transmit correspondence electronically? YES 2 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:
Regents School of Charlotesville
Address:
New Trinity presbyterian church on Reservoir road.
City and/or County and Zip Code:
Charlottesville, VA 22903
Construction Activity Entrance Location
(description, street address and/or
latitude/longitude in decimal degrees):
38.024797,-78.537732
Latitude and Longitude
(6-digit, decimal degrees format):
38.0249655,-78.5385486
C.
Acreage totals for all land -disturbing activities to be included under this permit coverage. 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):
19.11 acres
Primary estimated area to be disturbed (include portions with
Erosion and Sediment Control Plan approval only):
9.55 acres
Off -site estimated area to be disturbed (if applicable):
D.
Property Owner Status:
FEDERAL ❑ STATE ❑ PUBLIC ❑ PRIVATE 2
E.
Nature of the Construction Activity Description (i.e. commercial,
industrial, residential, agricultural, environmental, utility):
Commercial: School
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:
04-13-2022
Completion Date:
02-12-2024
H.
Is this construction activity part of a larger common plan of
development or sale?
YES ❑ NO 42
Rev 11/2020 PAGE 1 16
CONSTRUCTION GENERAL PERMIT (VAR10) REGISTRATION STATEMENT 2019
I. 6th Order Hydrologic Unit Code (HUC) and Receiving Water Name(s). Include additional areas on a separate page.
HUC
NAME(S) OF RECEIVING WATERBODY
020802040402
Rivanna River - Moores Creek
Section III. Off -site Support Activity 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:
N/A
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 Stormwaterfrom Construction Activities prior t0 submitting the
Registration Statement. By signing the Registration Statement, the operator is certifying that the SWPPP has been
prepared.
B.
Has an Erasion and Sediment Control Plan been
submitted to the VESC Authority for review?
YES 2 NO ❑
Erosion and Sediment Control Plan Approval Date (for
the estimated area to be disturbed MM/DD/YYYY):
12-16-2021
C.
Has land -disturbance commenced?
YES {a 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 (ii) 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 orcomply with otherpermit conditions). In the context of stormwater discharges from
Municipal Separate Storm Sewer Systems (MS4s), operator means the operator of the regulated MS4 system.
9VAC25-880-70. Part III. 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 (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 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 orsole 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;" possibility of fine aDdAmprisonment for knowing violations."
Printed Name:
Signature (signed in ink):
Date Signed: L —
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 Authorityplease send to:
Department of Environmental Quality
Office of Stormwater Management Suite 1400
PO Box 1105
Richmond VA 23218
constructiongpC@deg.virginia.gov
Rev 11/2020 PAGE 3 16