HomeMy WebLinkAboutWPO201700078 Permit Minor Amendment 2018-04-05 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: Albemarle County School Board
Contact: Joe P. Letteri
Mailing Address: 401 McIntire Road
City: Charlottesville State: VA Zip: 22902
Phone (434)975-9340
Email address(if available): jletteri@k12albemarle.org
Indicate if DEQ may transmit general permit correspondence electronically: Yes❑V No❑
2. Existing General Permit Registration Number(for renewals only):
3. Name and Location of the Construction Activity:
Name: Western Albemarle High School Science Labs
Address(if available): 5941 Rockfish Gap Turnpike
City: Crozet State: Virginia Zip: 22932
County(if not located within a City): Albemarle County
Latitude(decimal degrees): 38.047216 Longitude(decimal degrees): -78.707217
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 Q Private❑
5. Nature of the Construction Activity(e.g.,commercial,industrial, residential,agricultural,oil and gas,etc.):
Public: County School
6. Name of the Receivin Waterl)and Hydrologic11Unit Cde(HUC):
Name: f�i+rertn MQ( luec S-1- ar on 6025341-- Name:
HUC: 02080204 O\h\ C�1 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): 06/01/2018 Completion Date(mm/dd/yyyy): 08/01/2019
9. Total Land Area of Development(to the nearest one-hundredth acre): 75.0
Estimated Area to be Disturbed(to the nearest one-hundredth acre): 1.16
10. Is the area to be disturbed part of a larger common plan of development or sale? Yes❑ No 2
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 imprison mnt for knowing violations."
Printed Name: Joseph c %i e R -
11, �.nik.A.,,
Title: ^ec;n � .^ 4
Signature: .,, P• Date: 1-S•13
(Please sign in NK. This Certification must be signed by the appropriate person associated with the operator identified in
Item#1.)
07/2014
Page 1 of 1
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: Albemarle County School Board
Contact: Joe P. Letteri
Mailing Address: 401 McIntire Road
City: Charlottesville State: VA Zip: 22902 Phone: (434)975-9340
Email address(if available): jletteri@k12albemarle.org
Indicate if DEQ may transmit general permit correspondence electronically: Yes 2 No❑
2. Existing General Permit Registration Number(for renewals only):
3. Name and Location of the Construction Activity:
Name: Western Albemarle High School Science Labs
Address(if available): 5941 Rockfish Gap Turnpike
City: Crozet State: Virginia Zip: 22932
County(if not located within a City): Albemarle County
Latitude(decimal degrees): 38.047216 Longitude(decimal degrees): -78.707217
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 Q Private❑
5. Nature of the Construction Activity(e.g.,commercial,industrial, residential,agricultural,oil and gas,etc.):
Public: County School
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:
Albemarle County
8. Estimated Project Start and Completion Date:
Start Date(mm/dd/yyyy): 06/01/2018 Completion Date(mm/dd/yyyy): 08/01/2019
9. Total Land Area of Development(to the nearest one-hundredth acre): 75.0
Estimated Area to be Disturbed(to the nearest one-hundredth acre): 1.16
10. Is the area to be disturbed part of a larger common plan of development or sale? Yes❑ No Q
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 imprisonTent for knowing violations:" 1,
Printed Name: Joseph ) .Z i c R Title: +J..,ec:n 4.1 P.., S"ftc r/V
Signature: ,,, Ib Date: y•S•(S
(Please sign in NK. This Certification must be signed by the appropriate person associated with the operator identified in
Item#1.)
07/2014
Page 1 of 1
Section 9. Signed Certification
(Provide certification according to 9VAC25-870-370. For purposes of plan review and approvals, this
certification should be the owner of the property. the same signature as appears on the bonds and
applications. Another operator can be designated on the delegation of authority form to follow.)
CERTIFICATION
"I certify under penalty of law that this document and all attachments were prepared under my direction
or supervision in accordance with a system designed to assure that qualified personnel properly gather
and evaluate 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: Mr. Joseph P. Letteri
Company: Albemarle County School Board
Title: Dire't•r of Buildii a ervices
Signature: dui '. �V
Date: 11 .41-5- t&
Mr.Joseph P. Letteri
Albemarle County School Board
401 Mcintire Rd
Charlottesville, VA 22902
434.975.9340
Issued— 10/2014 Stormwater Pollution Prevention Plan (SWPPP) Albemarle County
•
}
Section 9. Signed Certification
(Provide certification according to 9VAC25-870-370. For purposes of plan review and approvals, this
certification should be the owner of the property. the same signature as appears on the bonds and
applications. Another operator can be designated on the delegation of authority form to follow.)
CERTIFICATION
"I certify under penalty of law that this document and all attachments were prepared under my direction
or supervision in accordance with a system designed to assure that qualified personnel properly gather
and evaluate 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: Mr. Joseph P. Letteri
Company: Albemarle County School Board
Title: Direi •r of Build'.,,, ervices
Signature: ". 414,
Date: I .41-5- ie)
Mr. Joseph P. Letteri
Albemarle County School Board
401 Mcintire Rd
Charlottesville, VA 22902
434.975.9340
•
Issued— 10/2014 Stormwater Pollution Prevention Plan (SWPPP) Albemarle County