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HomeMy WebLinkAboutWPO201400008 Permit 2017-11-01 I+ Notice of Termination General VPDES Permit for Discharges of Stormwater from Construction Activities (VAR10) (Please Type or Print All Information) 1. Construction Activity Operator: Name: Ulliman Schutte Construction Contact: John Arnold Mailing Address: 306 6th St SW City: Roanoke State:VA Zip:24016 Phone: 434-987-6423 Email address(if available): )amold©ullimanschutte.com 2. Name and Location of the Construction Activity: (As listed on the Registration Statement.) Name: Crozet Water Treatment Plant Address(if available): 4673 Three Notched Rd City:CharlottesvilleState: VA Zip: 22901 County(if not located within a City): Albemarle Latitude(decimal degrees): 38.0675 N Longitude(decimal degrees). '78.6601 W 3. General Permit Registration Number: 4. Reason for Terminating Coverage Under the General Permit: (The operator shall submit a Notice of Termination after one or more of the following conditions have been met.) x❑ A. Necessary permanent control measures included in the SWPPP for the site are in place and functioning effectively and final stabilization has been achieved on all portions of the site for which the operator is responsible. When applicable. long-term responsibility and maintenance requirements for permanent control measures shall be recorded in the local land records prior to the submission of a notice of termination; ❑ B.Another operator has assumed control over all areas of the site that have not been finally stabilized and obtained coverage for the ongoing discharge; ❑ C.Coverage under an alternative VPDES or state permit has been obtained;or ❑ D. For residential construction only,temporary soil stabilization has been completed and the residence has been transferred to the homeowner. The notice of termination should be submitted no later than 30 days after one of the above conditions being met. Authorization to discharge terminates at midnight on the date that the notice of termination is submitted for the conditions set forth in subsections B through D above, unless otherwise notified by the VSMP authority or the Department. Termination of authorizations to discharge for the conditions set forth in subsection A above shall be effective upon notification from the Department that the provisions of subsection A have been met or 60 days after submittal of the notice of terminations, whichever occurs first. 5. Permanent Control Measures Installed: (When applicable, a list of the on-site and off-site permanent control measures (both structural and nonstructural)that were installed to comply with the stormwater management technical criteria.Attach a separate list if additional space is needed.) Permanent Control Measure#1 Type of Permanent Control Measure: Bioretention Cell# 1 Date Functional: 11/1/17 Address(if available): 4673 Three Notched Rd City: Charlottesville State: VA Zip: 22901 County(if not located within a City): Albemarle County Latitude(decimal degrees): 38.0675 N Longitude(decimal degrees)`78.6601 W Receiving Water: Lickinghole Creek Total Acres Treated: 0.25 Impervious Acres Treated:0.15 01/2014 Page 1 of Permanent Control Measure#2 Type of Permanent Control Measure: Bioretention Cell#2 Date Functional: 11/1/17 Address(if available): 4673 Three Notched Rd City: Charlottesville State: VA • Zip: 22901 County(if not located within a City): Albemarle County Latitude(decimal degrees): 38.0675 N Longitude(decimal degrees): 78.6596 W Receiving Water: Lickinghole Creek Total Acres Treated: 0.10 Impervious Acres Treated: 0.06 Permanent Control Measure#3 Type of Permanent Control Measure: Bioretention Cell#3 Date Functional: 11/1/17 Address(if available): 4673 Three Notched Rd City: Charlottesville State: VA Zip: 22901 County(if not located within a City): Albemarle County Latitude(decimal degrees): 38.0676 N Longitude(decimal degrees): 78.6594 W Receiving Water: Lickinghole Creek Total Acres Treated: 0.21 Impervious Acres Treated: 0.03 6. Participation in a Regional Stormwater Management Plan: (When applicable, information related to the participation in a regional stormwater management plan.Attach a separate list if additional space is needed.) Regional Stormwater Management Facility Type of Regional Stormwater Management Facility: Address(if available): City: State: Zip: County(if not located within a City): Latitude(decimal degrees): Longitude(decimal degrees): Total Site Acres Treated: Impervious Site Acres Treated: 7. Perpetual Nutrient Credits: (When applicable, information related to perpetual nutrient credits that were acquired in accordance with§62.1-44.15:35 of the Code of Virginia.Attach a separate list if additional space is needed.) Nonpoint Nutrient Credit Generating Entity Name: Perpetual Nutrient Credits Acquired(lbs/acre/year): 8. Certification:"I certify under penalty of law that I have read and understand this Notice of Termination 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." Printed Name: John Arnold Title: Project Engineer Signature: 9.-% 04"0744 Date: 6/7/18 (Please sign in INK. This Certification must be signed by the appropriate person associated with the operator identified in Item#1.) 01/2014 Page 2 of 2 • Instructions for Completing the Notice of Termination General VDPES Permit for Discharges of Stormwater from Construction Activities (VAR10) GENERAL b. The date that the permanent control measure became functional A Notice of Termination must be submitted when an operator no longer as a post-development stormwater management control; wishes to be covered under the General VPDES Permit for Discharges of Stormwater from Construction Activities(VAR10). c. The street address (if available), City or County (if not located within a City)of the permanent control measure; All Notice of Terminations should be submitted to: d.The latitude and longitude in decimal degrees of the approximate Department of Environmental Quality center of the permanent control measure; Office of Stormwater Management,10th Floor P.O.Box 1105 e.The receiving water of the permanent control measure;and Richmond,VA 23218 f. The number of total and impervious acres treated by the LINE-BY-LINE INSTRUCTIONS permanent control measure(to the nearest one-tenth of an acre). • Item 1: Construction Activity Operator Information. Attach a separate list if additional space is needed. Provide the legal name(do not use a colloquial name),contact,mailing Item 6: Participation in a Regional Stormwater Management Plan address, telephone number, and email address (if available) of the (when applicable). construction activity operator that was issued general permit coverage. For each Regional Stormwater Management Facility provide the Item 2: Name and Location of the Construction Activity following information: Information. a.The type of regional facility to which the site contributes; Provide the official name,street address(if available),city or county(if not located within a City)of the construction activity. Also,provide the b. The street address (if available), City or County (if not located latitude and longitude in decimal degrees of the approximate center of within a City)of the regional facility; the construction activity (e.g., N 37.5000, W 77.5000). NOTE: This information can be obtained from the previously submitted Registration c.The latitude and longitude in decimal degrees of the approximate Statement. center of the regional facility;and Item 3:General Permit Registration Number. d. The number of total and impervious site acres treated by the regional facility(to the nearest one-tenth of an acre). Provide the existing general permit registration number for the construction activity identified in Item 2. Attach a separate list if additional space is needed. Item 4:Reason for Termination. Item 7:Perpetual Nutrient Credits(when applicable). Indicate the appropriate reason for submitting this Notice of Provide the following information related to perpetual nutrient credits Termination. The Notice of Termination may only be submitted after that were acquired in accordance with§62.1-44.15:35 of the Code of one or more of the following conditions have been met: Virginia: a. Necessary permanent control measures included in the SWPPP a. The name of the nonpoint nutrient credit generating entity from for the site are in place and functioning effectively and final which perpetual nutrient credits were acquired;and stabilization has been achieved on all portions of the site for which the operator is responsible.When applicable,lona-tern responsibility b. The number of perpetual nutrient credits acquired (lbs. per acre and maintenance requirements for permanent control measures shall per year). be recorded in the local land records prior to the submission of a notice of termination; Attach a separate list if additional space is needed. b. Another operator has assumed control over all areas of the site Item 8:Certification. that have not been finally stabilized and obtained coverage for the ongoing discharge; A properly authorized individual associated with the operator identified in Item 1 of the Registration Statement is responsible for certifying and c. Coverage under an alternative VPDES or state permit has been signing the Registration Statement. Please sign the Registration obtained;or Statement in INK. d. For residential construction only, temporary soil stabilization has State statutes provide for severe penalties for submitting false been completed and the residence has been transferred to the information on the Registration Statement. State regulations require homeowner. that the Registration Statement be signed as follows: The Notice of Termination should be submitted no later than 30 days a. For a corporation: by a responsible corporate officer. For the after one of the above conditions being met. purpose of this part,a responsible corporate officer means: Item 5:Permanent Control Measures(when applicable). (i) A president, secretary, treasurer, or vice-president of the corporation in charge of a principal business function,or any other For each on-site and off-site permanent control measure (both person who performs similar policy-making or decision-making structural and non-structural) that was installed to comply with the functions for the corporation,or stormwater management technical criteria provide the following information: (ii) the manager of one or more manufacturing, production, or operating facilities, provided the manager is authorized to make a.The type of permanent control measure; management decisions that govern the operation of the regulated 01/2014 Page 1 of 2 • 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 assigned or delegated to the manager in accordance with corporate procedures. b. For a partnership or sole proprietorship: by a general partner or the proprietor,respectively. c. For a municipality,state,federal,or other public agency:by either a principal executive officer or ranking elected official. For purposes of this part,a principal executive officer of a public agency includes: (i)The chief executive officer of the agency,or (ii) A senior executive officer having responsibility for the overall operations of a principal geographic unit of the agency. 01/2014 Page 2 of 2