HomeMy WebLinkAboutWPO201700045 Permit WPO VSMP 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.Hugh Shytle
Contact:
Mailing Address:36 Page Road
City Weston State:Ma Zip:02493 Phone:617 306-1949
Email address(if available):shytle@comcast.net
Indicate if DEQ may transmit general permit correspondence electronically: Yes® No 0
2. Existing General Permit Registration Number(for renewals only):
3. Name and Location of the Construction Activity:
Name Shytte Residence in Blandemar Farms
Address(if available):
City: State: Zip:
County(if not located within a City):Albemarle
Latitude(decimal degrees):37.9963 N Longitude(decimal degrees):-78.6214 W
Name and Location of all Off-site Support Activities to be covered under the general permit:
Name.
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): Federal❑ State❑ Public❑ Private 0
5. Nature of the Construction Activity(e.g.,commercial,industrial,residential,agricultural,oil and gas,etc.):
Residential
6. Name of the Receiving Water(s)and Hydrologic Unit Code(HUC):
Name:North Fork Hardware River Name:
HUC:JM-46 HUC:
7. If the discharge is through a Municipal Separate Storm Sewer System(MS4),the name of the MS4 operator:
Albemarle County
8. Estimated Project Start and Completion Date:
Start Date(mm/dd/yyyy):08/01/2017 Completion Date(mm/dd/yyyy):12/31/2018
9. Total Land Area of Development(to the nearest one-hundredth acre):21.00
Estimated Area to be Disturbed(to the nearest one-hundredth acre):4.66
10. Is the area to be disturbed part of a larger common plan of development or sale? Yes® No 0
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 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 comple . I am aware that there are ignificant penalties for submitting false information including the possibility of
fine and imprisonm for}tno vi ons."
Printed Name: A "M Title:
Signature. Date: ( ,-7- (7
(Please sign in INK. This Certification must signed by the appropriate person associated with the operator identified in
Item#1.)
01/2014
Page 1 of 1
STORMWATER POLLUTION PREVENTION PLAN
Shytle Residence in Blandemar
SINGLE FAMILY RESIDENCE
COMMON PLAN of DEVELOPMENT or SALE
STORMWATER POLLUTION PREVENTION PLAN(SWPPP)
For Construction Activities At:
Shytle Residence
Blandemar Farms-Waldemar Drive
Charlottesville,VA,22903
Latitude:37.9963 N(decimal degrees)
Longitude:-78.6214 W(decimal degrees)
Construction Activity Operator:
Hugh Shytle
36 Page Road
Weston,MA 02493
(617)306-1949
shytle@comcast.net
24-hour Emergency Contact;Hugh Shytle-(617)306-1949
SWPPP Preparation Date:
June 7,2017
CERTIFICATION
1 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,includi t possibility of fi and imprisonment for knowing violations."
Operator Name: t51- Y16
Title:
Signature:
Date: r 7- 17
//
7
07/2014, Rev. 1 Single Family Residence,CPoD,SWPPP
STORMWATER POLLUTION PREVENTION PLAN
Shytle Residence in Blandemar
1.0 SWPPP Documents Located Onsite&Available for Review
SWPPP Document Type Located Onsite&Available for Review?
Registration Statement ® Yes ❑ NA
Notice of Coverage Letter ® Yes ❑ NA
Construction General Permit ® Yes ❑ NA
Site Plan ® Yes ❑ NA
Erosion&Sediment Control Plan(or agreement in lieu of) ® Yes ❑ NA
Stormwater Management Plan (or agreement in lieu of) ® Yes ❑ NA
2.0 Authorized Non-Stormwater Discharges
Type of Authorized Non-Stormwater Discharge Likely Present at Your Project Site?
External buildings wash down ® Yes ❑ No
Uncontaminated foundation or footing drains ® Yes ❑ No
Uncontaminated excavation dewatering ❑ Yes ® No
Landscape irrigation ❑ Yes ® No
Others[describe] ❑ Yes ❑ No
3.0 Pollution Prevention Awareness
Employees will be given a "walk through" of the site identifying areas of possible pollution and will be shown Erosion
and Sediment Controls and Pollution Prevention Practices(identified in Sections 4.0 and 5.0 of this SWPPP)that are
applicable to their assigned job duties. A refresher meeting and `walk through" will be conducted on an as needed
basis.
4.0 Erosion&Sediment Controls
Select all Estimated Estimated Responsible
that apply Erosion&Sediment Control Installation Removal Party
Date bate
® Construction Entrance 08/01/2017 10/01/2018
(Std. &Spec. 3.02)
® Silt Fence 08/01/2017 12/01/2018
(Std. &Spec. 3.05)
® Culvert Inlet Protection 08/01/2017 12/01/2018
(Std. &Spec. 3.08)
® Outlet Protection 08/01/2017 12/01/2018
(Std. &Spec. 3.18)
® Rip Rap 08/01/2017 12/01/2018 Construction Activity
(Std. &Spec. 3.19) Operator(See Cover
® Rock Check Dam Page of this SWPPP)
(Std. &Spec. 3.20) 09/01/2017 12/01/2018
® Level Spreader 10/01/2017 NA
(Std. &Spec. 3.21)
® Temporary Seeding As required NA
(Std. &Spec. 3.31) by 3.31
® Permanent Seeding 03/01/2018 NA
(Std. &Spec. 3.32)
07/2014, Rev. 1 Single Family Residence, CPoD, SWPPP
STORMWATER POLLUTION PREVENTION PLAN
Shytle Residence in Blandemar
Sodding 10/01/2018 N
(Std. &Spec. 3.33)
Mulching
(Std. &Spec. 3.35) 03/01/2018 NA
Soil Stabilization Blankets&Matting 10/01/2017 NA
(Std. &Spec. 3.36)
Dust Control
(Std. &Spec. 3.37) 08/01/2017 NA
07/2014, Rev. 1 Single Family Residence, CPoD, SWPPP
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STORMWATER POLLUTION PREVENTION PLAN
Shytle Residence in Blandemar
Pollution Prevention Practices:
(1) Clearing, grading, excavating and un-stabilized areas — Utilize erosion and sediment controls to prevent
sediment laden or turbid runoff from leaving the construction site. Dispose of clearing debris at acceptable
disposal sites. Apply permanent or temporary stabilization, sodding and/or mulching to denuded areas in
accordance with the erosion and sediment control specifications and the general VPDES permit for
discharges of stormwater from construction activities.
(2) Paving operations — Cover storm drain inlets during paving operations and utilize pollution prevention
materials such as drip pans and absorbent/oil dry for all paving machines to limit leaks and spills of paving
materials and fluids.
(3) Concrete washout and cement waste—Direct concrete wash water into a leak-proof container or leak-proof
settling basin that is 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.
(4) Structure construction, stucco, painting and cleaning— Enclose, cover or berm building material storage
areas if susceptible to contaminated stormwater runoff. Conduct painting operations consistent with local air
quality and OSHA regulations. Mix paint indoors, in a containment area or in a flat unpaved area. 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.
(5) Dewatering operations — Construction site dewatering from building footings or other sources may not be
discharged without treatment. Sediment laden or turbid water shall be filtered, settled or similarly treated prior
to discharge.
(6) Material delivery and storage — Designate areas of the construction site for material delivery and storage.
Place near construction entrances, away from waterways, and avoid transport near drainage paths or
waterways.
(7) Material use during building process — Use materials only where and when needed to complete the
construction activity. Follow manufacturer's instructions regarding uses, protective equipment, ventilation,
flammability and mixing of chemicals.
(8) Solid waste disposal — Designate a waste collection area on the construction site that does not receive a
substantial amount of runoff from upland areas and does not drain directly to a waterway. Ensure that
containers have lids so they can be covered before periods of rain, and keep containers in a covered area
whenever possible. Schedule waste collection to prevent the containers from overfilling.
(9) Sanitary waste — Prevent the discharge of sanitary waste by providing convenient and well-maintained
portable sanitary facilities. Locate sanitary facilities in a convenient location away from waterways.
(10) Landscaping operations — Maintain as much existing vegetation as practicable. Apply permanent or
temporary stabilization, sodding and/or mulching to denuded areas in accordance with the erosion and
sediment control specifications and the general VPDES permit for discharges of stormwater from construction
activities. Apply nutrients in accordance with manufacturer's recommendations and not during rainfall events.
(11) Others—If applicable, describe your Pollution Prevention Practice.
6.0 Stormwater Management Controls
Sel
Estiect all
that
Stormwater Management Control mated Responsible
Date Party
Post-development Stormwater Management Controls Common Plan
❑ provided by a NA Construction
Larger Common Plan of Development or Sale Activity Operator
❑ Rooftop Disconnection NA
Sheetflow to Vegetated Filter(1 or 2) 10/01/2017
Via Level Spreaders
Construction
❑ Grass Channel NA Activity Operator
(See Cover Page of
❑ Rainwater Harvesting NA this SWPPP)
❑ Permeable Pavement(1 or 2) NA
07/2014, Rev. 1 Single Family Residence, CPoD, SWPPP
STORMWATER POLLUTION PREVENTION PLAN
Shytle Residence in Blandemar
Select all Estimated Responsible
that apply Stormwater Management Control Installation Party
Date
❑ Infiltration (1 or2) NA
Construction
❑ Bioretention (1 or 2) NA Activity Operator
(See Cover Page of
this SWPPP)
❑ Others[describe] Insert Date
7.0 Spill Prevention&Response
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.
1St 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 LIKELY TO 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.
8. 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 Blue Ridge Regional Office(Roanoke) 540-562-6700
DEQ Blue Ridge Regional Office(Lynchburg) 434-582-5120
DEQ Northern Regional Office 703-583-3800
DEQ Piedmont Regional Office 804-527-5020
DEQ Southwest Regional Office 276-676-4800
DEQ Tidewater Regional Office 757-518-2000
DEQ Valley Regional Office 540-574-7800
Nights,Holidays&Weekends
VA Dept. of Emergency Management 804-674-2400
24 Hour Reporting Service
Local Contacts
Local Fire Department (434)296-5807
Local Police Department (434)971-1583
07/2014, Rev. 1 Single Family Residence, CPoD, SWPPP
STORMWATER POLLUTION PREVENTION PLAN
Shytle Residence in Blandemar
8.0 Inspections&Corrective Action Log(make additional copies as necessary)
Qualified Inspector
Company/Organization: TBD
Name: TBD
Telephone Number: TBD
Qualifications: TBD
Inspection Schedule
Discharges to surface waters:
❑ Once every 5 business days; or
• Once every 10 business days and no later than 48 hours following a measurable storm event.
Discharges to impaired waters,surface waters within a TMDL watershed,or exceptional waters:
❑ Once every 4 business days; or
• Once every 5 business days and no later than 48 hours following a measurable storm event.
Inspection Date:
Measurable Storm Event:
Best Management In Compliance Corrective Action Needed; Date Corrective
Practices(BMPs) with SWPPP? Responsible Party Action Taken
Erosion&Sediment
Controls ❑Yes ❑ No
(Section 4.0)
Pollution Prevention
Practices ❑Yes ❑ No
(Section 5.0)
Stormwater ❑Yes ❑ No
Management Controls
(Section 6.0) ❑ NA
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."
Operator Name: Inspector Name:
Signature: Signature:
Date: Date:
•
07/2014, Rev. 1 Single Family Residence, CPoD, SWPPP
STORMWATER POLLUTION PREVENTION PLAN
Shytle Residence in Blandemar
9.0 Grading&Stabilization Activities Log
Date oe
Grading Description Date
f thng Stabilization Description of the
Activi Grading Activity Stabilization Measure
ty Activity Measures
Initiated (including location) Ceased Initiated (including location)
10.0 SWPPP Modification&Update Log
Modification Modification P
Description of the Modification/Update Prepared By
Date (name&title)
07/2014, Rev. 1 Single Family Residence, CPoD, SWPPP
INSTRUCTIONS for COMPLETING the
SINGE FAMILY RESIDENCE,COMMON PLAN of DEVELOPMENT or SALE
STORMWATER POLLUTION PREVENTION PLAN (SWPPP)
General
A Stormwater Pollution Prevention Plan (SWPPP) must be developed prior to obtaining locality (e.g., City, County, Town)
authorization to commence land disturbance.
Cover Pape
For a construction activity, enter the project/site name and physical address (if available), including city (or town), state and zip
code. Enter the latitude and longitude in decimal degrees of the construction activity.
Enter the Construction Activity Operator's company/organization name,the Operator's name and mailing address,including city(or
town),state,and zip code,telephone number,email address(if available),and a 24-hour emergency contact.
Enter the SWPPP preparation date.
The Construction Activity Operator identified on the cover page of the SWPPP is responsible for certifying the information contained
therein. Please sign the certification in INK. Please note that state statues require the SWPPP to be signed as follows:
(1)For a corporation:by a responsible corporate officer;
(2)For a partnership or sole proprietorship:by a general partner or the proprietor,respectively;
(3)For a municipality,state,federal,or other public agency:by either a principal executive officer or ranking elected official.
Section 1.0 SWPPP Documents Located Onsite&Available for Review
Utilize the provided checklist to ensure that the required SWPPP documents are located onsite and are available for review, if
applicable.
Section 2.0 Authorized Non-Stormwater Discharges
Identify the authorized non-stormwater discharges likely to be present at the project site. If an unlisted authorized non-stormwater
discharge is likely to be present at the project site,provide it here.
Section 3.0 Pollution Prevention Awareness
Provide employees with a "walk through"of the project site and identify areas of possible pollution,erosion and sediment controls,
and pollution prevention practices which are applicable to their assigned job duties. Conduct refresher meetings and perform
additional"walk throughs"on an as needed basis.
Section 4.0 Erosion&Sediment Controls
Identify the erosion and sediment controls to be implemented at the project site. For each erosion and sediment control, enter the
estimated installation date and estimated removal date. If an unlisted erosion and sediment control will be implemented at the
project site,provide the applicable information here.
Section 5.0 Potential Sources of Pollution&Pollution Prevention Practices
Identify the pollutant-generating activities likely to be present at the project site;implement and maintain the corresponding pollution
prevention practices. If an unlisted pollutant-generating activity is likely to be present at the project site, describe it, identify the
associated pollutant(s),and provide the corresponding pollution prevention practice(s)to be implemented and maintained.
Section 6.0 Stormwater Management Controls
Identify the stormwater management controls to be implemented at the project site,if applicable. For each stormwater management
control,enter the estimated installation date. If an unlisted stormwater management control will be implemented at the project site,
provide the applicable information here.
Section 7.0 Spill Prevention&Response
Most spills can be cleaned up following manufacturer specifications. The priority should be to protect all people, equipment,
property,and the environment. Enter the telephone number of your local fire and police departments.
Section 8.0 Inspections&Corrective Action Log
Enter the qualified inspector's company/organization name,the inspector's name,telephone number,and qualifications. Select the
applicable inspection schedule, enter the construction activity inspection date, and enter the date and rainfall amount of the last
measurable storm event(if applicable). Identify if the implemented best management practices are in compliance with the SWPPP.
Enter corrective actions needed;the party responsible for implementing the corrective actions,and the date corrective actions were
taken,if applicable. Make additional copies of the inspection and corrective action log as necessary.
Section 9.0 Grading&Stabilization Activities Log
Enter the date grading activities were initiated, a description of the grading activities including location, the date grading activities
ceased,the date stabilization measures were initiated,and a description of the stabilization measures including location.
Section 10.0 SWPPP Modification&Update Log
Enter the SWPPP modification date, description of the SWPPP modification/update, and the name and title of the SWPPP
modification preparer,if applicable.
07/2014, Rev. 1 Single Family Residence, CPoD, SWPPP