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HomeMy WebLinkAboutWPO201800009 Plan - Stormwater WPO VSMP 2018-01-15 .r40. COUNTY OF ALBEMARLE 1 Department of Community Development Kci 401 McIntire Road,North Wing ,�' +� Charlottesville,Virginia 22902-4596 "> it' Tel.(434)296-5832 •Fax(434)972-4126 t 11iGrg\` Stormwater Pollution Prevention Plan (SWPPP) For Construction Activities At: Project Name:©,60 7;2/N/ 'd C�/� 267✓ ` "gi'l 11A�v o13) 7/) 3.3, 3 3 3�14�J Address: 2e97-5 3o13 ,ou2/%2 StVe'r7`it;),OD 1773 3/—35j re/e. T eolleie blie2 &/3a Prepared by: Name: Gf//Z de/c1/ Preparedfor: Name: ?7,)V1 SWPPP Preparation Date: Q 0.5-70/ (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 CONTENTS: (from Albemarle County Code Sec. 17-405) 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 Section 1. Registration statement (Provide a signed completed copy of the DEQ registration statement) 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 thh ppropriate person associated with this operator.) Name: C 42// 73)/J) %5 Contact: 20/L2, r,ed.9g // J Mailing Address: A de4 ,0,7( 5-6 City: ,e2e37 5U/2 State: 1/9 Zip:"f-,/ft Phone: Email address(if available): z 2i/s eh(L//q III a Jilt/J/6/c'YS• n Indicate if DEQ may transmit general permit correspondence electronically: Yes x No❑ 2. Existing General Permit Registration Number(for renewals only):/0//9 3. Name and Location of the Construction Activity: Name: a•D T.e�./9/2l ., OCf'/ 2073,1'7,'�0?9 3)/2 308 3`33 3 �,9,t�.TJ r" Address(if available): i( r.0? —t 73 ,Qp/.e eie ST.656/ 'MD ZoTS 3 3 ,41 Y 3 e. City: State: //A? Zip: ac2934 County(if not located within a City): /9,e6/4i/-CE___ r� Latitude(decimal degrees): 3 B. O531904 Longitude (decimal degrees): /o• 2.3750 Name and Location of all Off-site Support Activities to be covered under the general permit: Name: A2/9 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 N. 5. Nature of the Construction Activity (e.g.,commercial, industrial,residential,agricultural,oil and gas,etc.): 6. Name of the Receiving Water(s and Hydrologic Unit CodeC� (HUC): Name: g/V..e/2& Clikryc�f///�'A/7 Name: HUC: 0 08VACY J,�h-O 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(mm/dd/yyyy): D-3/O//7=10/ Completion Date(mm/dd/yyyy): 03/0/,o7O.AQ 9. Total Land Area of Development(to the nearest one-hundredth acre): m 95 .9(',e? Estimated Area to be Disturbed(to the nearest one-hundredth acre): i/Lf,es 10. Is the area to be disturbed part of a larger common plan of development or sale? Yes tO 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 complete. I am aware that there are significant penalties for submitting false information including the possibility of fine and imprisonment for know g violations." ,,// /� Printed Name: &/"..A., Title: au (�i,..c..Vr. 1/r O.4) Signature: P/' ‘foir Date: Ci /57070/,3 (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 Instructions for Completing the Registration Statement General VPDES Permit for Discharges of Stormwater from Construction Activities (VAR10) GENERAL The entities that are considered operators will commonly consist of the owner or developer of a project (the party with control of project plans A.Coverage Under this General Permit. and specifications)or the general contractor(the party with day to day operational control of the activities at the project site which are Any operator applying for coverage under this general permit who is necessary to ensure compliance with the general permit). required to submit a Registration Statement (see Section B below) must submit a complete Registration Statement to the Department. Provide the legal name(do not use a colloquial name),contact,mailing The Registration Statement serves as a Notice of Intent for coverage address, telephone number, and email address (if available) of the under the General VPDES Permit for Discharges of Stormwater from construction activity operator;general permit coverage will be issued to Construction Activities(VAR10). this operator. Indicate if the Department may transmit general permit correspondence electronically. B.Single-family Detached Residential Structures. Item 2: Existing General Permit Registration Number. Operators with an existing stormwater discharge or proposing a new stormwater discharge associated with the construction of a single- For reapplications only, provide the existing general permit registration family detached residential structure are not required to submit a number for the construction activity. This item does not need to be Registration Statement or the Department of Environmental Quality completed for new construction activities applying for general Permit (DEQ)portion of the general permit fee. coverage. Operators of these types of discharges are authorized to discharge Item 3: Name and Location of the Construction Activity under this general permit immediately upon the general permit's Information. effective date of July 1,2014. Provide the official name, street address(if available),city or county(if C.To Apply for Permit Coverage. not located within a City)of the construction activity. Also, provide the latitude and longitude in decimal degrees of the approximate center of 1. New Construction Activities. Any operator proposing a new the construction activity(e.g.,N 37.5000,W 77.5000). stormwater discharge from construction activities shall submit a complete Registration Statement to the Department prior to the Name and Location of Off-site Support Activity Information. commencement of land disturbance, unless exempted by Section B above. Any operator proposing a new stormwater discharge from This general permit also authorizes stormwater discharges from construction activities in response to a public emergency where the support activities (e.g., concrete or asphalt batch plants, equipment related work requires immediate authorization to avoid imminent staging yards, material storage areas, excavated material disposal endangerment to human health or the environment is immediately areas, borrow areas)located on-site or off-site provided that (i) the authorized to discharge under this general permit and must submit a support activity is directly related to a construction activity that is complete Registration Statement to the Department no later than 30 required to have general permit coverage;(ii)the support activity is not days after commencing land disturbance; documentation to a commercial operation, nor does it serve multiple unrelated substantiate the occurrence of the public emergency must construction activities by different operators; (iii) the support activity accompany the Registration Statement. does not operate beyond the completion of the construction activity it supports; (iv) the support activity is identified in the registration 2. Existing Construction Activities. Any operator that was statement at the time of general permit coverage; (v) appropriate authorized to discharge under the general permit issued in 2009, control measures are identified in a SWPPP and implemented to and who intends to continue coverage under this general permit, address the discharges from the support activity areas; and (vi) all shall submit a complete Registration Statement to the Department applicable state, federal, and local approvals are obtained for the on or before June 1,2014,unless exempted by Section B above. support activity. D.Where to Submit Registration Statements. Provide the official name,street address(if available), City and County (if not located within a City) of all off-site support activities to be All Registration Statements should be submitted to: covered under this general permit. Also, provide the latitude and longitude in decimal degrees of the approximate center of the off-site Department of Environmental Quality support activities (e.g., N 37.5000, W 77.5000). Also, if an off-site Office of Stormwater Management,l0`"Floor support activity is going to be covered under this general permit the P.O.Box 1105 total land area of the off-site support activity and the estimated area to Richmond,VA 23218 be disturbed by the off-site support activity need to be included in Item #9. LINE-BY-LINE INSTRUCTIONS Item 4:Status of the Construction Activity. Item 1:Construction Activity Operator Information. Indicate the appropriate status (Federal, State, Public, or Private) of "Operator" means the owner or operator of any facility or activity the construction activity. subject to the Stormwater Management Act and regulations. In the context of stormwater associated with a large or small construction Item 5: Nature of the Construction Activity. activity, operator means any person associated with a construction project that meets either of the following two criteria:(i)the person has Provide a brief description of the construction activity, such as direct operational control over construction plans and specifications, commercial, residential, agricultural, oil and gas, etc.This list is not all including the ability to make modifications to those plans and inclusive. specifications or (ii) the person has day-to-day operational control of those activities at a project that are necessary to ensure compliance Item 6:Receiving Waters(s)and HUC Information. with a stormwater pollution prevention plan for the site or other state permit or VSMP authority permit conditions(i.e.,they are authorized to Provide the name of the receiving water(s)and corresponding HUC_ for direct workers at" a site to carry out activities required by the all stormwater discharges including any stormwater discharges from stormwater pollution prevention plan or comply with other permit off-site support activities to be covered under this general permit. conditions). Hydrologic Unit Code or HUC is a watershed unit established in the most recent version of Virginia's 6th order national watershed boundary dataset. 07/2014 Page'1 of 2 , assigned or delegated to the manager in accordance with Item 7:MS4 Information. corporate procedures. If stormwater is discharged through a municipal separate storm sewer b. For a partnership or sole proprietorship: by a general partner or system(MS4),provide the name of the MS4 operator.The name of the the proprietor,respectively. MS4 operator is generally the Town, City, County,Institute or Federal facility where the construction activity is located. c. For a municipality,state, federal, or other public agency:by either a principal executive officer or ranking elected official. For purposes Item 8: Construction Activity Start and Completion Date of this part,a principal executive officer of a public agency includes: Information. (i)The chief executive officer of the agency,or Provide the estimated start date (month/day/year) of the construction activity. Provide the estimated completion date (month/day/year) of (ii) A senior executive officer having responsibility for the overall the construction activity. operations of a principal geographic unit of the agency. Item 9:Construction Activity Area Information. Provide the total area (to the nearest one-hundredth acre) of the development (i.e.., the total acreage of the larger common plan of development or sale). Include the total acreage of any off-site support activity to be covered under this general permit. Provide the estimated area (to the nearest one-hundredth acre) to be disturbed by the construction activity. Include the estimated area of land disturbance that will occur at any off-site support activity to be covered under this general permit. Item 10:Common Plan of Development or Sale Information. Indicate if the area to be disturbed by the construction activity is part of a larger common plan of development or sale. Larger common plan of development or sale is defined as a contiguous area where separate and distinct construction may be taking place at different times on different schedules. Plan is broadly defined as any announcement or documentation, including a sign, public notice or hearing, sales pitch, advertisement, drawing, permit application, zoning request, etc., or physical demarcation such as boundary signs, lot stakes, or surveyor markings indicating that construction activities may occur. Item 11:Stormwater Pollution Prevention Plan(SWPPP). 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(VAR10)prior to submitting this Registration Statement. By signing this Registration Statement the operator is certifying that the SWPPP has been prepared. Item 12:Certification. A properly authorized individual associated with the operator identified in Item 1 of the Registration Statement is responsible for certifying and signing the Registration Statement. Please sign the Registration Statement in INK. State statutes provide for severe penalties for submitting false information on the Registration Statement. State regulations require that the Registration Statement be signed as follows: a. For a corporation: by a responsible corporate officer. For the purpose of this part,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 permit application requirements; and where authority to sign documents has been 07/2014 Page 2 of 2 Section 2. Notice of general permit coverage (This notice is to be posted near the main entrance according to 9VAC25-880-70, Part II, section C.) (Provide a copy of the DEQ coverage letter when obtained) Issued— 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County Section 3. Nature of activity (Provide a detailed narrative of the construction activities. Include or reference a construction schedule and sequence. Include any phasing.) • et, ia/V7f,,6 '74/127*,&/1- 712e 427 e,A d/Pai � ��6243 / • Issued— 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County Section 4. Erosion and Sediment Control Plan. (Provide a reduced, 11x17 copy of the latest Erosion and Sediment Control Plan. Do not reference only.) Issued- 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County a a vg y a -A . m t4 17; ,n a o f 9 " l" R ' 0 g& ' P V _ C'``t n C N N OD < TI N ITl �i o�oet y n '' --_ >.1 ...4. 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'____ .: ‘, , 01 4, .... _ 40,. / / ft ., \ 0 , TA,A10„ , illgC) , At, sl\rt: 4$ 1.7 ./Ae ••8 " 414N; /� _ _. N ;/ fel \ ,,, F' — `::, 41// 11::(0\ ,.:4"\/ *IlWrilp.'11111%yrimallilliPli „..s.,: iiik...,,,, ----ii -0 ,:,,,,._., . -,-, - 4./ ---pr _ - , 9 $iwrI, 1 •Ir ,-- -- . o s91 S vs;i 1.: E. . �� • _ • J m E&S CONTROL PLAN PHASE 2 k E§EP I§a ROUDABUSFI,GALE&ASSOCIATES INC. A = m OLD TRAIL p VILLAGE q sp 7,2 '•,..t5 ENGINEERS,SURVEYORS AND LAND PLANNERS 9. mm r1p BLOCKS 10, 1V, 171 18, &30 H y 8 �p8 p81f . A PROFESSIONAL CORPORATION m ~ N 8, N „g •j SERVING VIRGINIA SINCE 1966 4 EROSION&SEDIMENT CONTROL PLAN G O O - 914 MONTICELLO ROAD-CHARLOTTESVILLE.VIRGINIA 22902 ALBEMARLE COUNTY,VIRGINIA rD m a PHONE 4344177.0206-FAX 434-29&6220-EMAIL INFO@ROUDABUSH.COM Section 5. Stormwater Management Plan (Provide a reduced 11x17 copy of the latest stormwater management plan. Do not reference only.) Issued-10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County y% S ` ?:' 1/. J i! 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O D <I- w0 �m om m K O aNJ N N D co D o N N mN 'O n .T xi \y A N P i /'�Jy\ o . . T I1<1 O O O s fn D D [mo N N '( \ ' \ ‘N`,mA O> y T T tTT \ 7io .. o Low Am A w Wm \ � 6 ill _ _ siri A �� ,,. Op 9g'a N A� P r � N-. P (P ."I D3 ^pO 1A OA v j1 S D D g1S, #1y N T<m zt �+ J� o-< r m2 �C O O XV X 0 r = r - - 1 • D :p A i0 to T CO F',1 •A m �^ r= > tl' tW p m mAN rn_ w A ; Fill ; m `�xmio rg o 6 6 m pm y= m m o it rn w o f m '^2 O n o o n z° i Zo c= q m m-I N o n o D i z N p m g 20 , H un < - W m rn < N N s n rn m � � g 31 1� TDy a q i OT Section 6. Pollution Prevention Plan. (reference County Code 17-404 and State Regulation 9VAC25-880-70 part II section A.4) A. Plan showing pollution activities and prevention practices (Provide a reduced 1 1x17 copy of a site plan on which all of the following activity locations are clearly marked. Keep this plan up-to-date with ongoing site changes and inspections.) 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I I m 58� /t1P" 0 ��/]p py ° I 1 C40 J2 le �I / 012 ¢ ; m c rBLEX I I / /� o m I 0 ZQ 1} . I 10 rn t RUN RNE o of I ¢N CO yj of m \J pING VIP pY m m �7 WO oag1 0 1 i orn PI�pRGR�TA56�3 �- �rqo N J to m c3 I m PUgLI 05 PG 149.156 ui e¢ o m rnv p84215P 9Z 1 d Zw c4 S'Y a Jz a 1T. 01.141 VW Vl I UUULALLLI1 1U L1U11D,QALY PL GI,GILLIVfl yl Q\L1L GT Pollutant,or PollutantPrevention Practices, Location on site Generating Activity Control Measures Fuel,gas,oil,coolant Not to be stored on site Not to be stored on site,clean any sp Concrete Concrete wash out wash out,dispose when dry Paint Garages Wash in washout cleaning materials garages Wash in washout Asphalt Only used to pave use leftovers for curbs Termite spray Sprayed around foundation per code Drywall compound Garages Let dry and dispose of block mortar within silt fencing Cure before disposing of Tile grout inside clean in washout C. Sources of Pollutants,continued. Common activities and minimum control and prevention ractices Pollutant,or Pollutant Prevention Practices, Generating Activity Location on site Control Measures Follow Erosion and Sediment Control Clearing,grading,excavating,and un- Plan.Dispose of clearing debris at stabilized areas Land disturbance area acceptable disposal sites.Seed and mulch, or sod within 7 days of land clearing Cover storm drain inlets and use drip Paving operations Roads and driveways pans and absorbent/oil dry for all paving machines to limit leaks and spills Direct concrete wash water into a leak- Concrete washout Current location and detail shown proof container or leak-proof settling and cement waste on plan basin that is designed so that no overflows can occur Enclose or cover material storage areas. Mix paint indoors in a containment area or Structure construction,stucco, in a flat unpaved area.Prevent the Structures painting,and cleaning discharge of soaps,solvents,detergents and wash water,paint,form release oils and curing compounds. Water shall be filtered,settled or similarly Dewatering operations Dewatering sites shown on plan treated prior to discharge as shown on plan_ Designatedareas for material delivery and storage.Placed near construction Material delivery and storage Designated area shown on plan entrances,away from waterways and drainage paths Follow manufacturer's instructions Material use during building process Building areas .MSDS's attached waste collection area will not receive a substantial amount ofrunofffrom upland Solid waste disposal Current designated container areas areas and does not drain directly to a on plan waterway.Containers have lids covered before periods of rain,or are in a covered area.Scheduled collection to prevent Issued- 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County ollutalltor'o u ant-: a x� g :474710-0 n '}l �u ' z Y re entlon rachces,� -Z-A. 's� 3§k ms �� OCatl n II Ite r � a s n eYatmg�AC �_ � z< vCIon roll easures i overfilling.MATERIALS NOT TO BE BURIED ON-SITE Convenient and well-maintained portable sanitary facilities will be Sanitary waste Current locations shown on plan provided,and located away from waterways or inlets.Such facilities shall be regularly maintained. Apply fertilizers in accordance with Landscaping operations Landscape areas shown on plan manufacturer's recommendations and not during rainfall events To be treated in a sediment basin or better control as specified on plan. Wash Waters Wash areas shown on plan Minimize the discharge of pollutants from equipment and vehicle washing Designated areas and details shown on Provide containment and filtering for all Vehicle and equipment washing plan wash waters per the plan Minimization of exposure to precipitation and stormwater.Minimize the exposure of building materials,building products, construction wastes,trash, landscape materials,fertilizers,pesticides,herbicides, detergents,sanitary waste, and other materials present on the site to precipitation and to stonnwater. (Identify all non-stormwater discharges to occur on your site. Keep this plan up-to-date with ongoing site changes and inspections. See CGP, 9VAC25-880-70 section E for examples of non-stormwater discharges.) D. Non-stormwater discharges Pollutants or Pollutant Location on Slte j- Constituents r * - Issued— 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County E. Persons responsible for pollution prevention practices (Provide the names and contact information for all persons responsible for prevention practices as listed above.) //c.,51-/A(-2- 1,y 223- 2Z2 9-VA5Jae, K6- Cra. but/c('ers, r c- j,�rG� &/.9 y3,/��,t/�- e26' w)/( ers d'Pahcd la/ers, net F. 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; Report all spills,leaks and discharges as follows; (Provide detailed res.onse and reportin practices according to 9VAC25-880-70, Part II, section A.4.e.) //7:,/ "Ala7,2ed detel)e)fpt G. Pollution Prevention Awareness (Describe training and procedures to provide awareness and compliance for all measures in this document; waste management, wash waters, prevention measures, etc.) Aee dieddlid Issued- 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County F. Response and reporting practices 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 Valley Regional Office 540-574-7800 Nights, Holidays&Weekends VA Dept.of Emergency Management 804-674-2400 G. Polution Prevention Awareness All Project Managers for our company are trained to comply with standard SWPPP procedures. This includes the following: • Tarping and un-tarping dumpsters • Removal and disposal of concrete washouts • Location of toilets and dumpsters • Silt fence requirements • Removal and disposal of any spilled pollutants • Daily and weekly reporting practices Section 7. Discharges to impaired waters, surface waters within an applicable TMDL wasteload allocation, and exceptional waters. (Provide detailed measures for any applicable TMDL) /0/ 42 Issued— 10/2014 Stormwater Pollution Prevention Plan(SWPPP) Albemarle County Section 8. Qualified personnel The following personnel are responsible for inspections; (Provide the name,telephone number, and qualifications of the qualified personnel conducting inspections.) �aE /44sli/9.v5 c 7�3-aha - /4 "&eT/1 /v,•Plf &/;/, y3"/—aYa— o36lJi° Issued- 10/2014 Stormwater Pollution Prevention Plan(SWPPP) Albemarle County Section 9. Signed Certification (Provide certification according to 9VAC25-870-370) 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." Operator Name: a/Z.L &g/9" Company: a/7l, Title:` �i� C d.0✓�/�l�C//l�.Cl Signature: U/1/14 v"91l Date: Ol//3P /F Issued— 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County Section '10. Delegation of authority. (Provide the persons or positions with authority to sign inspection reports or to modify the stormwater pollution prevention plan. A fonnial, signed delegation of authority is needed.) Delegation of Authority I, /j„Z de/714 (name),hereby designate the person or specifically described position below to be a duly authorized representative for the purpose ofoverseeingcompli ce with environmental requirements,including the Construction General Permit, at the Ap%,�,(J ,CQd t�/g 4075 al/ construction site. The designee is authorized to sign any reports,stormwater pollution prevention(plans and all other documents required by the permit. Tam /f/'05ig (name of person or position) ,F (company) 3 3$ co< ..,., O �� 6 (address) 0/7- 1/11.2.61 1d°2? f (city,state,zip) '203 -a���- 4'ya (phone) 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". Operator Name: /a Company: C,/A1f ,/jl(/GT��• Title: //e C,%0,5T,-//e 7 d ) Signature: Date: 0//`.5/P7O/E/ Issued— 10/2014 Stormwater Pollution Prevention Plan(S WPPP)Albemarle County Section 11. General permit copy (Provide a copy of the construction general permit, 9VAC25-880) Issued— 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County Section 12. Inspection logs (Provide templates for your inspections. Requirements are listed in 9VAC25-880-70, Part II, section B and F.) c.}11 #71///, )4902/991' Issued— 10/2014 Stormwater Pollution Prevention Plan(SWPPP)Albemarle County Community Job Date Report