HomeMy WebLinkAboutWPO201700061 Plan - Stormwater WPO VSMP 2017-08-11 (2) ,f' COUNTY OF ALBEMARLE
i--f•1;}�:';• Department of Community Development
401 McIntire Road,North Wing
\.,., ,.I Charlottesville, Virginia 22902-4596
Tel. (434)296-5832 • Fax(434) 972-4126
/9,c /p Stormwater Pollution Prevention Plan (SWPPP)
For Construction Activities At:
' �/ ci�?�, ITS J9—
Project Name li't/T Gt" Se11,LIP5Zei j �;
Address: 167' 39`,V9 6'dl ev ,Ice4t.)l>; C.. d.e7-d,22
. 255-.?'W c 2- kl,<) 4%:�S /447.Z2
�/ Prepared by:
Name: &i%& (/c'' l�y
Prepared for:
Na,t : (i'A/ ,//-'O S
SWPPP Preparation Date: 8/4///7
7
(This document is to be made publicly available according to 9VAC25-880-70. Part II. section D)
Issued— 10'2014 Stormwater Pollution Prevention Plan(SWPPP) Albemarle County
Registration Statement g/i)&f.)PE9
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 ttappropriate person associated with this operator.)
Name' L''/2/ /0 •&112'Z 7' S
Contact. a'/21 l''.
Mailing Address: Al, `,/6
City: (�g11Q,Le)77�? ,.//��-� State: 4`. Zip: 9?‘ Phone: 9.: /' y "j�,��ir
Email address (if available): 421//, ci'eliG(' erezi4;huj/&/er-s, i-6
Indicate if DEQ may transmit general permit correspondence electronically: Yes El No ❑
2. Existing General Permit Registration Number(for renewals only): X//9
3. Name and Location of the Construction Activity:
Name: ( - ef �<<tx., /o7- g&3/QA)D /Ors 39.- 44/ ,�
Address (if available). .-7 - 7i5 72&i} /.--2,-(Z-i-5 49,67F ,r A7539-44/ 60r o' _ zi,till5 i
City: (//4/lW?Li7 ?c1/%/C State:State: 1 1 Zip: ai/A/
County (if not located within a City): .4•z73F/71rs)•E'1 E
Latitude (decimal degrees): 3J 1 0.5WV y Longitude (decimal degrees): 28,..374.9
9
Name and Location of all Off-site Support Activities to be covered under the general permit:
Name: A,//s71
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 Ed
5. Nature of the Construction Activity (e.g., commercial, industrial, residential, agricultural, oil and gas,etc.):
72 i ex)/719(.-
6.
c)/719(.-
6. Name of the Receiving Waters) and Hydrologic Unit Code(HUC):
Name:/,-,!/�f/1,�,,�� /f ea -�F�E'l;jets /�'irt,iie�/ L/'Name:
HUC: ei.G -C- 0 HUC:
7. If the discharge is through a Municipal Separate Storm Sewer System (MS4), the name of the MS4 operator:
A-iU
8. Estimated Project Start and OComplet'on Date:
Start Date (mm/dd/yyyy): //�Y,1uf? Completion Date (mm/dd/yyyy): C24/0.:3/ 0/9
9. Total Land Area of Development(to the nearest one-hundredth acre): 46
Estimated Area to be Disturbed (to the nearest one-hundredth acre): P 85 ,
10. Is the area to be disturbed part of a larger common plan of development or sale? Yes [i 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 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 kn9wing violations." ,
Printed Name: C2iG� (' /- Title: v i 4 G/' •4'... //C�j/�.C.i`
Signature: I7///t Date: 'VW/'
(Please sign in INK. This Certification must be signed by the appropriate person associated with the operator identified in
Item#1.)
07/2014 Page 1 of 1
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