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WPO201600036 Plan - Stormwater Stormwater Management Plan 2016-04-26
Stormwater Pollution Prevention Plan (SWPPP) For Construction Activities At: Carver Bridge Pallas Hill Lane (No assigned address) Charlottesville, VA 22901 Prepared by: B. Clark Gathright,P.E. 100 10th St NE Suite 200 Charlottesville,VA 22901 434-971-8848 cgathright@dgarchs.com Prepared for: Thomas A Carver 848 Flordon Drive Charlottesville,VA 22901 434-245-5800 tac@harrenequity.com SWPPP Preparation Date: April 26,2016 CONTENTS: 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 Registration Statement General VPDES Permit for Discharges of Stormwater from Construction Activities (VAR10) (Please Type or Print All Information) 1. Construction Activity Operator: (General permit coverage will be issued to this operator. The Certification in Item#12 must be signed by the appropriate person associated with this operator) Name:Sage Homes Contact:: Michael Boyes Mailing Address:3033 Alberene Church Lane City: Esmont State: VA Zip:22937 Phone:434409-9154 Email address(if available):sagehomeslic( ornail.com Indicate if DEQ may transmit general permit correspondence electronically:Yes No 2. Existing General Permit Registration Number(for renewals only): 3. Name and Location of the Construction Activity: Name: Tom Carver Address(if available):Pallas Hill Lane City:Charlottesville State:VA Zip:22901 County(if not located within a City):Albemarle Latitude(decimal degrees):38°03'51"N Longitude(decimal degrees): 78°32'56"W Name and Location of all Off-site Support Activities to be covered under the general permit: Name: N/A Address(if available): City: State: Zip: County(if not located within a City): Latitude(decimal degrees): Longitude(decimal degrees): 4. Status of the Construction Activity (check only one):Private 5. Nature of the Construction Activity (e.g.,commercial,industrial,residential,agricultural,oil and gas,etc.): Construct a bridge 6. Name of the Receiving Water(s)and Hydrologic Unit Code(HUC): Name:Rivanna Name: HUC:02080204 HUC: 7. If the discharge Is through a Municipal Separate Storm Sewer System(MS4),the name of the MS4 operator: 8. Estimated Project Start and Completion Date: Start Date(06/01/2016): Completion Date(07/01/2016): 9. Total Land Area of Development(to the nearest one-hundredth acre): 4.62 Ac. Estimated Area to be Disturbed(to the nearest one-hundredth acre):0.36 Ac 10.Is the area to be disturbed part of a larger common plan of development or sale?No 11.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 this Registration Statement. By signing this Registration Statement the operator is certifying that the SWPPP has been prepared, 12.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 suibmifed. 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 imprisonment for-knowing ' g-vrolattons." _ - — ------ Printed Name: ha I as A. C°r V E'.r C•r Title: Signature: '(//44-€1.4------- Date: 4 1-1 (Please sign in IN This Certification must be signed by the appropriate person associated with the operator identified in Item#1.) Issued 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County Section 2. Notice of general permit coverage N/A-less than 1 acre of disturbed area,no DEQ permit required. Section 3. Nature of activity This project is involves the construction of a new bridge on a 4.62 acre parcel in Broomley subdivision. The site work will include the new bridge and a road to allow large vehicles to access the bridge site. The bridge will cross Ivy Creek, adjacent to Brook Rd in the Farmington subdivision. The property(T.M. 59 Parcel 37C7)is in the Jack Jouett Magisterial District. Approximately 038 acres will be disturbed. It is the desire of the owner and the contractor to construct the bridge in late spring/early summer of 2016. Commencement of construction is dependent on the fabrication and delivery lead-time necessary for the pre-cast bridge components, and is expected to be completed within 5 weeks, weather permitting. • Week 1-Install erosion and sediment control measures,clear and grade access road to project site and install crushed stone base. Excavate and pour concrete footings. • Week 2 -Achieve concrete bearing strength. • Week 3 -Place precast arch and wingwall components. • Week 4 -Backfill and compact behind bridge structure. Complete final grading and permanent stabilization measures. Stream buffer mitigation work can be completed at any time during this process. Section 4. Erosion and Sediment Control Plan. A reduced, 11x17 copy of the latest Erosion and Sediment Control Plan is attached. Section 5. Stormwater Management Plan A. Refer to Erosion and Sediment Control Plan. Issued— 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County Section 6. Pollution Prevention Plan. A. Refer to Erosion and Sediment Control Plan. B. Sources of Pollutants,locations,and prevention practices Pollutant,or Pollutant Prevention Practices, Generating Activity Location on site Control Measures Follow Erosion and Sediment Control Plan.Dispose of Clearing and grading, Land disturbance area clearing debris at acceptable footing excavation disposal sites. Seed and mulch, or sod within 7 days of land clearing Concrete Direct concrete wash water into washout and Locate in existing parking a leak-proof container or leak- cement waste area proof settling basin that is designed so that no overflows can occur Sanitary waste Location shown on plan Convenient and well- maintained portable sanitary facilities will be provided,and Material delivery and storage At bridge site Materials will be set in place directly from the delivery vehicles. Follow Erosion and Sediment Landscape areas shown on Control Plan. Apply fertilizers Landscaping operations mitigation plan in accordance with manufacturer's recommendations and not during rainfall events Minimization of exposure to precipitation and stormwater.Minimize the exposure of building materials, building products, construction wastes,trash, landscape materials, fertilizers, sanitary waste, and other materials present on the site to precipitation and to stormwater. C. Non-stormwater discharges Discharge Pollutants or Pollutant Location on Site Constituents None anticipated Issued— 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County D. Person responsible for pollution prevention practices Michael Boyes Sage Homes 3033 Alberene Church Lane Esmont,VA 22937 434-409-9154 sagehomesllc@gmail.com E. Response and reporting practices Minimize discharges from 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; (1)Prevent and respond to leaks, spills, and other releases including (i) procedures for expeditiously stopping, containing, and cleaning up spills, leaks, and other releases; and (ii) procedures for reporting leaks, spills, and other releases in accordance with 9VAC25-880-70,Part III G; (2)Prevent the discharge of spilled and leaked fuels and chemicals from vehicle fueling and maintenance activities (e.g., providing secondary containment such as spill berms, decks, spill containment pallets,providing cover where appropriate,and having spill kits readily available); (3)Prevent the discharge of soaps, solvents, detergents, and wash water from construction materials, including the clean-up of stucco, paint, form release oils, and curing compounds (e.g., providing (i) cover (e.g., plastic sheeting or temporary roofs) to prevent contact with stormwater; (ii) collection and proper disposal in a manner to prevent contact with stormwater; and (iii) a similarly effective means designed to prevent discharge of these pollutants); (4)Minimize the discharge of pollutants from vehicle and equipment washing, wheel wash water, and other types of washing (e.g., locating activities away from surface waters and stormwater inlets or conveyance and directing wash waters to sediment basins or traps, using filtration devices such as filter bags or sand filters,or using similarly effective controls); (5)Direct concrete wash water into a leak-proof container or leak-proof settling basin. The container or basin shall be designed so that no overflows can occur due to inadequate sizing or precipitation. Hardened concrete wastes shall be removed and disposed of in a manner consistent with the handling of other construction wastes. Liquid concrete wastes shall be removed and disposed of in a manner consistent with the handling of other construction wash waters and shall not be discharged to surface waters; (6) Minimize the discharge of pollutants from storage, handling, and disposal of construction products, materials, and wastes including (i) building products such as asphalt sealants, copper flashing, roofing materials, adhesives, and concrete admixtures; (ii) pesticides, herbicides, insecticides, fertilizers, and landscape materials; and (iii) construction and domestic wastes such as packaging materials, scrap construction materials, masonry products, timber, pipe and electrical cuttings,plastics, Styrofoam, concrete,and other trash or building materials; Issued— 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County (7)Prevent the discharge of fuels, oils, and other petroleum products, hazardous or toxic wastes, and sanitary wastes. Report all spills, leaks and discharges as follows; Reports of unauthorized discharges. Any operator who discharges or causes or allows a discharge of sewage, industrial waste,other wastes or any noxious or deleterious substance or a hazardous substance or oil in an amount equal to or in excess of a reportable quantity established under either 40 CFR Part 110,40 CFR Part 117,40 CFR Part 302, or§ 62.1-44.34:19 of the Code of Virginia that occurs during a 24-hour period into or upon surface waters or who discharges or causes or allows a discharge that may reasonably be expected to enter surface waters, shall notify the Department of Environmental Quality of the discharge immediately upon discovery of the discharge,but in no case later than within 24 hours after said discovery.A written report of the unauthorized discharge shall be submitted to the department and the VSMP authority within five days of discovery of the discharge. The written report shall contain: 1. A description of the nature and location of the discharge; 2. The cause of the discharge; 3. The date on which the discharge occurred; 4. The length of time that the discharge continued; 5. The volume of the discharge; 6. If the discharge is continuing,how long it is expected to continue; 7. If the discharge is continuing,what the expected total volume of the discharge will be; and 8. Any steps planned or taken to reduce, eliminate and prevent a recurrence of the present discharge or any future discharges not authorized by this general permit. Discharges reportable to the department and the VSMP authority under the immediate reporting requirements of other regulations are exempted from this requirement. F. Pollution Prevention Awareness 1. Personnel involved in clearing,grading,or general construction activities receive initial(first day)tour of site,with emphasis on critical resources (steep slopes, Shadwell Creek). 2. Identify Limits of Disturbance for all personnel—on plans, stake in field. Identify stream buffer impacts—on plans, stake in field. Explain ESC measures pre-requisite to land disturbance. 3. If ESC measures are not installed(per plans) and functional(per inspection),then no grading will be permissible. No land disturbance prior to ESC measures. 4. Any new personnel receive tour/training—#1-3,above. (Ultimate VPDES GP compliance responsibility lies with Construction Activity Operator) 5. Orientation for personnel unfamiliar with ESC: control measures and individual ESC maintenance duties/responsibilities shall be explained to them. 6. It is important to report and repair signs of deterioration or damage to any ESC measure, or PPP practice and not neglect them. 7. The consequence of failing to imaintain ESC imeasures(ref. VPDES GP)or properly report will result in a stop work order. 8. It is important to maintain_good housekeeping during construction activities; spill prevention care when fueling;use and proper disposal of liquids. 9. Explain where spill prevention/response kits located; explain how to use. 10. Explain what may and may not be placed in solid waste dumpster. 11. Instruct personnel in proper disposal of hazardous waste. 12. Explain on-site location of SWPPP doc,MSDS sheets. Issued— 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County 13. Explain location of emergency phone numbers. 14. Explain expectation in event of spills. 15. Monitor concrete truck wash-out. 16. Perform inspections as required. 17. Furnish refresher training(1 x mo), if the schedule is delayed. 18. Maintain records,items 1-17. Section 7. Discharges to impaired waters, surface waters within an applicable TMDL wasteload allocation, and exceptional waters. N/A Section 8. Qualified personnel The following personnel are responsible for inspections; Michael Boyes Sage Homes 3033 Alberene Church Lane Esmont, VA 22937 434-409-9154 sagehomesllc@gmail.com Issued— 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County Section 9. Signed Certification CERTIFICATION "I certify under penalty of law that I have read and understand this document 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." Owner/Operator Name: IA1C e\ l 5 v1 Company: Saje. 1-‘,3 vkel Title: OwrYrI ()Wides t� Signature: Date: 412-7114 Section 10. Delegation of authority. Delegation of Authority I,Tom Carver,hereby designate the person or specifically described position below to be a duly authorized representative for the purpose of overseeing compliance with environmental requirements,including the Construction General Permit,at the Carver Bridge construction site. The designee is authorized to sign any reports,stormwater pollution prevention plans and all other documents required by the permit. Michael Boyes Sage Homes 3033 Alberene Church Lane Esmont,VA 22937 434-409-9154 By signing this authorization, I confirm 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". Title: Owner Signature: „)`L+'r�,'%- --f Date: <-,t•,3--7 (4' Issued—10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County Section 11. General permit copy Issued— 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County Section 12. Inspection logs Issued— 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County • Genera)'Irfointtrr#lon (±ked':,v (rye fa r ... ., Name of Project Carver Bridge CGP Tracking No. Inspection Dote Inspector Name,Title& Contact Information Present Phase of Construction Inspection Location(if multiple inspections are required,specify location where this inspection is being conducted) Inspection Frequency(Note:you maybe subject to different inspection frequencies in different areas of the site.Check all that apply.) Standard Frequency: Weekly Every 14 days and within 24 hours of a 0.25"rain Increased Frequency: Every 7 days and within 24 hours of a 0.25"rain(for areas of sites discharging to sediment or nutrient-impaired waters or to waters designated as Tier 2,Tier 2.5,or Tier 3) Reduced Frequency: Once per month(for stabilized areas) Once per month and within 24 hours of a 0.25"rain(for arid,semi-arid,or drought-stricken areas during seasonally dry periods or during drought) Once per month(for frozen conditions where earth-disturbing activities are being conducted) Was this inspection triggered by a 0.25"storm event? Yes No If yes,how did you determined whether a 0.25"storm event has occurred? Rain gauge on site Weather station representative of site.Specify weather station source: Total rainfall amount that triggered the inspection(in inches): Unsafe Conditions for Inspection Did you determine that any portion of your site was unsafe for inspection per CGP Part 4.1.5? Yes No If"yes",complete the following: - Describe the conditions that prevented you from conducting the inspection in this location: - Location(s)where conditions were found: Issued—10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County Instructions for Filling Out"General Information"Section Name of Project Enter the name for the project. CGP Tracking No. Enter the tracking number that was assigned to your NOI application for permit coverage. Inspection Date Enter the date you conducted the inspection. Inspector Name,Title&Contact Information Provide the name of the person(s) (either a member of your company's staff or a contractor or subcontractor)that conducted this inspection.Provide the inspector's name,title,and contact information as directed in the form. Present Phase of Construction If this project is being completed in more than one phase,indicate which phase it is currently in. Inspection Location If your project has multiple locations where you conduct separate inspections,specify the location where this inspection is being conducted.If only one inspection is conducted for your entire project,enter"Entire Site."If necessary,complete additional inspection report forms for each separate inspection location. Inspection Frequency Check the box that describes the inspection frequency that applies to you.Note that you may be subject to different inspection frequencies in different areas of your site.If your project does not discharge to a"sensitive water"(i.e.,a water impaired for sediment or nutrients,or listed as Tier 2,2.5,or 3 by your state or tribe) and you are not affected by any of the circumstances described in CGP Part 4.1.4,then you can choose your frequency based on CGP Part 4.1.2-either weekly, or every other week and within 24 hrs of a 0.25 in storm event.For any portion of your site that discharges to a sensitive water,your inspection frequency for that area is fixed under CGP Part 4.1.3 at weekly and within 24 hrs of a 0.25 inch storm event.If portions of your site are stabilized,are located in arid,semi-arid,or drought-stricken areas,or are subject to frozen conditions,consult CGP Part 4.1.4 for the applicable inspection frequency.Check all the inspection frequencies that apply to your project. Was This Inspection Triggered by a 0.25 Inch Storm Event? If you were required to conduct this inspection because of a 0.25 inch(or greater)rain event,indicate whether you relied on an on-site rain gauge or a nearby weather station(and where the weather station is located).Also,specify the total amount of rainfall for this specific storm event. Unsafe Conditions for Inspection Inspections are not required where a portion of the site or the entire site is subject to unsafe conditions.See CGP Part 4.1.5.These conditions should not regularly occur,and should not be consistently present on a site.Generally,unsafe conditions are those that render the site(or a portion of it)inaccessible or that would pose a significant probability of injury to applicable personnel.Examples could include severe storm or flood conditions,high winds,and downed electrical wires. If your site,or a portion of it,is affected by unsafe conditions during the time of your inspection,provide a description of the conditions that prevented you from conducting the inspection and what parts of the site were affected.If the entire site was considered unsafe,specify the location as"Entire site" Issued—10/2014 Stonnwater Pollution Prevention Plan(SWPPP)Albemarle County t: t[Hti t [["ElftoMW*.e s at P flut[dtr Pct Oft• y PlidOe gttO a:ft p . ` �se `rte'oc n teesi Type/location of P2 Practices Repairs or Corrective Date on Which Notes [Add an additional sheet If Other Action Maintenance or necessary] Maintenance Required?* Corrective Action Needed?* First Identified? Yes No Yes No 1. Yes No Yes No 2. Yes No Yes No Yes No Yes No 3. Yes No Yes No 4. Yes No Yes No 5. Yes No Yes No 6. Yes No Yes No 7. Yes No Yes No 8. Yes No Yes No 9. 10. Issued—10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County Page 2 of 5 *Note:The permit differentiates between conditions requiring repairs and maintenance,and those requiring corrective action.The permit requires maintenance in order to keep controls in effective operating condition and requires repairs if controls are not operating as intended.Corrective actions are triggered only for specific,more serious conditions,which include:1)A required stormwater control was never installed,was installed incorrectly,or not in accordance with the requirements in Part 2 and/or 3;2)You become aware that the stormwater controls you have installed and are maintaining are not effective enough for the discharge to meet applicable water quality standards or applicable requirements in Part 3.1;3)One of the prohibited discharges in Part 2.3.1 is occurring or has occurred;or 4)EPA requires corrective actions as a result of a permit violation found during an inspection carried out under Part 4.2.If a condition on your site requires a corrective action,you must also fill out a corrective action form found at www.eoa.gov/nodes/stormwater/swoop See Part 5 of the permit for more information. Instructions for Filling Out the"Erosion and Sediment Control"Table Type and Location of ELS Controls Provide a list of all erosion and sediment)E&S)controls that your SWPPP indicates will be installed and implemented at your site.This list must include at a minimum all E&S controls required by CGP Part 2.1.2.Include also any natural buffers established under CGP Part 2.1.2.1.Buffer requirements apply if your project's earth- disturbing activities will occur within 50 feet of a surface water.You may group your E&S controls on your form if you have several of the same type of controls(e.g., you may group"Inlet Protection Measures","Perimeter Controls",and"Stockpile Controls"together on one line),but if there are any problems with a specific control,you must separately identify the location of the control,whether repairs or maintenance or corrective action are necessary,and in the notes section you must describe the specifics about the problem you observed. Repairs or Other Maintenance Needed? Answer"yes"if the E&S control requires a repair of any kind(due to normal wear and tear,or as a result of damage)or requires maintenance in order for the control to continue operating effectively.At o minimum,maintenance is required in the following specific instances:(1)for perimeter controls,whenever sediment has accumulated to 1/2 or more the above-ground height of the control(CGP Part 2.1.2.2.b):(2)where sediment has been tracked-out onto the surface of off-site streets or other paved areas(COP Part 2.1.2.3.d);(3)for inlet protection measures,when sediment accumulates,the filter becomes clogged,and/or performance is compromised(CGP Part 2.1.2.9.b);and(4)for sediment basins,as necessary to maintain at least 1/2 of the design capacity of the basin(COP Part 2.1.3.2.b).Note:In many cases,"yes"answers are expected and indicate a project with an active operation and maintenance program.You should also answer"yes"if work to fix the problem is still ongoing from the previous inspection. Corrective Action Needed? Answer"yes"if during your inspection you found any of the following conditions to be present(CGP,Part 5.2.1):(1)a required E&S control was never installed,was installed incorrectly,or not in accordance with the corresponding CGP Part 2 or 3 requirement;(2)you become aware that the inadequacy of the E&S control has led to an exceedance of an applicable water quality standard;or(3)EPA requires corrective action for an E&S control as a result of a permit violation found during an inspection carried out under Part 4.2.If you answer"yes",you must take corrective action and complete a corrective action report,found at www.eoa.gov/nodes/stormwater/swoop.Note:You should answer"yes"if work to fix the problem from a previous inspection is still ongoing. Date on Which Maintenance or Corrective Action First Identified? Provide the date on which the condition that triggered the need for maintenance or corrective action was first identified.If the condition was just discovered during this inspection,enter the inspection date.If the condition is a carryover from a previous inspection,enter the original date of the condition's discovery. Notes For each E&S control and the area immediately surrounding it,note whether the control is properly installed and whether it appears to be working to minimize sediment discharge.Describe any problem conditions you observed such as the following,and why you think they occurred as well as actions(e.g.,repairs, Issued—10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County Page 3 of 5 maintenance,or corrective action)you will take or have taken to fix the problem: 1. Failure to install or to properly install a required E&S control 2. Damage or destruction to an E&S control caused by vehicles,equipment,or personnel,a storm event,or other event 3. Mud or sediment deposits found downslope from E&S controls 4. Sediment tracked out onto paved areas by vehicles leaving construction site 5. Noticeable erosion at discharge outlets or at adjacent streambanks or channels 6. Erosion of the site's sloped areas(e.g.,formation of rills or gullies) 7. E&S control is no longer working due to lack of maintenance For buffer areas,make note of whether they are marked off as required,whether there are signs of construction disturbance within the buffer,which is prohibited under the CGP,and whether there are visible signs of erosion resulting from discharges through the area. If repairs,maintenance,or corrective action is required,briefly note the reason.If repairs,maintenance,or corrective action have been completed,make a note of the date it was completed and what was done.If corrective action is required,note that you will need to complete a separate corrective action report describing the condition and your work to fix the problem. Issued—10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County • Condition or'tri el*Omani-tit foUution Prt fentiots s SC P i'art.2 3): s e+e 1 f ri sfru tto l Type/Location of P2 Practices Repairs or Corrective Date on Which Notes [Add an additional sheet If Other Action Maintenance or necessary] Maintenance Required?• Corrective Action Needed?* First Identified? 11 Yes No Yes No Yes No Yes No 12. Yes No Yes No Yes No Yes No 13. Yes No Yes No 14. Yes No Yes No 15. Yes No Yes No 16. Yes No Yes No 17. Yes No Yes No 18. Yes No Yes No •Note:The permit differentiates between conditions requiring repairs and maintenance,and those requiring corrective action.The permit requires maintenance in order to keep controls in effective operating condition and requires repairs if controls are not operating as intended.Corrective actions are triggered only for specific,more serious conditions,which include:1)A required stormwater control was never installed,was installed incorrectly,or not in accordance with the requirements in Part 2 and/or 3;2)You become aware that the stormwater controls you have installed and are maintaining are not effective enough for the discharge to meet applicable water quality standards or applicable requirements in Part 3.1;3)One of the prohibited discharges in Part 2.3.1 is occurring or has occurred;or 4)EPA requires corrective actions as a result of a permit violation found during an inspection carried out under Part 4.2.If a condition on your site requires a corrective action,you must also fill out a corrective action form found at www.epa.gov/nodes/stormwater/swppp.See Part 5 of the permit for more information. Issued—10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County Page 4 of 5 Instructions for Filling Out the"Pollution Prevention(P2)Practice"Table Type and Location of P2 Controls Provide a list of all pollution prevention(P2)practices that are implemented at your site.This list must include all P2 practices required by Part 2.3.3,and those that are described in your SWPPP. Repairs or Other Maintenance Needed? Answer"yes"if the P2 practice requires a repair of any kind(due to normal wear and tear,or as a result of damage)or requires maintenance in order for the control to continue operating effectively.Note:In many cases,"yes"answers are expected and indicate a project with an active operation and maintenance program. Corrective Action Needed? Answer"yes"if during your inspection you found any of the following conditions to be present(CGP,Part 5.2.1):(1)a required P2 practice was never installed,was installed incorrectly,or not in accordance with the corresponding CGP Part 2 requirement;(2)you become aware that the inadequacy of the P2 practice has led to an exceedance of an applicable water quality standard;(3)one of the"prohibited discharges"listed in CGP Part 2.3.1 is occurring or has occurred,or(4)EPA requires corrective action for a P2 practice as a result of a permit violation found during an inspection carried out under Part 4.2.If you answer"yes",you must take corrective action and complete a corrective action report(see www.epa.gov/nodes/stormwater/swoop).Note:You should answer"yes"if work to fix the problem from a previous inspection is still ongoing. Date on Which Maintenance or Corrective Action First Identified? Provide the date on which the condition that triggered the need for maintenance or corrective action was first identified.If the condition was just discovered during this inspection,enter the inspection date.If the condition is a carryover from a previous inspection,enter the original date of the condition's discovery. Notes For each P2 control and the area immediately surrounding it,note whether the control is properly installed,whether it appears to be working to minimize or eliminate pollutant discharges,and whether maintenance or corrective action is required.Describe problem conditions you observed such as the following,and why you think they occurred,as well as actions you will take or have taken to fix the problem: 1. Failure to install or to properly install a required P2 control 2. Damage or destruction to a P2 control caused by vehicles,equipment,or personnel,or a storm event 3. Evidence of a spill,leak,or other type of pollutant discharge,or failure to have properly cleaned up a previous spill,leak,or other type of pollutant discharge 4. Spill response supplies are absent,insufficient,or not where they are supposed to be located 5. Improper storage,handling,or disposal of chemicals,building materials or products,fuels,or wastes 6. P2 practice is no longer working due to lack of maintenance If repairs,maintenance,or corrective action is required,briefly note the reason.If repairs,maintenance,or corrective action have been completed,make a note of the date it was completed and what was done.If corrective action is required,note that you will need to complete a separate corrective action report describing the condition and your work to fix the problem. Issued—10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County Stabilization of Exposed Soil(CGP Part /see reverse-forinstructions) Stabilization Area Stabilization Method Have You Initiated Notes [Add an additional sheet Stabilization? if necessary] 1. YES NO If yes,provide date: 2. YES NO If yes,provide date: 3. YES NO If yes,provide date: 4. YES NO If yes,provide date: 5. YES NO If yes,provide date: Description.of Discharges(C 1'Port 41,6,6) <: (see reverse for insstrructiorlst' Was a stormwater discharge or other discharge occurring from any part of your site at the time of the inspection? Yes No If"yes",provide the following information for each point of discharge: Discharge Location Observations [Add an additional sheet if necessary] 1. Describe the discharge: At points of discharge and the channels and banks of surface waters in the immediate vicinity,are there any visible signs of erosion and/or sediment accumulation that can be attributed to your discharge? Yes No If yes,describe what you see,specify the location(s)where these conditions were found,and indicate whether modification,maintenance,or corrective action is needed to resolve the issue: 2. Describe the discharge: At points of discharge and the channels and banks of surface waters in the immediate vicinity,are there any visible signs of erosion and/or sediment accumulation that can be attributed to your discharge? Yes No If yes,describe what you see,specify the location(s)where these conditions were found,and indicate whether modification,maintenance,or corrective action is needed to resolve the issue: Issued—10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County Instructions for Filling Out the"Stabilization of Exposed Soil"Table Stabilization Area List all areas where soil stabilization is required to begin because construction work in that area has permanently stopped or temporarily stopped(i.e.,work will stop for 14 or more days),and all areas where stabilization has been implemented. Stabilization Method For each area,specify the method of stabilization(e.g.,hydroseed,sod,planted vegetation,erosion control blanket,mulch,rock). Have You Initiated Stabilization For each area,indicate whether stabilization has been initiated. Notes For each area where stabilization has been initiated,describe the progress that has been made,and what additional actions are necessary to complete stabilization.Note the effectiveness of stabilization in preventing erosion.If stabilization has been initiated but not completed,make a note of the date it is to be completed.If stabilization has been completed,make a note of the date it was completed.If stabilization has not yet been initiated,make a note of the date it is to be initiated,and the date it is to be completed. Instructions for Filling Out the"Description of Discharges"Table You are only required to complete this section if a discharge is occurring at the time of the inspection. Was a Stormwater Discharge Occurring From Any Port of Your Site At The Time of the Inspection? During your inspection,examine all points of discharge from your site,and determine whether a discharge is occurring.If there is a discharge,answer"yes"and complete the questions below regarding the specific discharge.If there is not a discharge,answer"no"and skip to the next page. Discharge Location(repeat as necessary if there are multiple points of discharge) Location of discharge.Specify the location on your site where the discharge is occurring.The location may be an outlet from a stormwater control or constructed stormwater channel,a discharge into a storm sewer inlet,or a specific point on the site.Be as specific as possible;it is recommended that you refer to a precise point on your site map. Describe the discharge.Include a specific description of any noteworthy characteristics of the discharge such as color,odor;floating,settled,or suspended solids; foam;oil sheen;and other obvious pollution indicators. Are there visible signs of erosion or sediment accumulation?At each point of discharge and the channel and streambank in the immediate vicinity,visually assess whether there are any obvious signs of erosion and/or sediment accumulation that can be attributed to your discharge.If you answer"yes",include a description in the space provided of the erosion and sediment deposition that you have found,specify where on the site or in the surface water it is found,and indicate whether modification,maintenance,or corrective action is needed to resolve the issue. 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