DRAFT SWPPP.docx

Construction Stormwater Pollution Prevention Plan Template To be covered under the U.S. Environmental Protection Agency’s (EPA) Construction General Permit (CGP), all construction operators are required to develop a “Stormwater Pollution Prevention Plan” (or “SWPPP”) prior to submitting a Notice of Intent (NOI) for permit coverage. EPA created this SWPPP Template to help you develop a SWPPP that is compliant with the minimum requirements of Part 7 of EPA’s 2022 Construction General Permit (“2022 CGP”), and is customizable to your specific project and site.

Instructions for Using the SWPPP Template Each section of the SWPPP Template includes instructions and space for your project and site information. Read the instructions for each section before you complete that section. Specific instructions on what information to include is indicated in each text field in blue text. Click on the blue text and the instructions will disappear once you start typing. The SWPPP Template is an editable document file so that you can easily add tables and additional text and delete unneeded or non-applicable fields. Note that some sections may require only a brief description while others may require several pages of explanation.

The following tips for using this template will help ensure that you meet the minimum permit requirements:

· Read the 2022 CGP thoroughly before you begin preparation of your SWPPP to ensure that you have a working understanding of the permit’s underlying requirements. You will also need to consult Part 9 of the permit to determine if your State or Tribe has included additional requirements that affect you.

· Complete the SWPPP prior to submitting your NOI for permit coverage. This is required in Parts 1.4 and 7.1.

· If you prepared a SWPPP under a previous version of EPA’s CGP, you must update your SWPPP to ensure that the 2022 CGP requirements are addressed prior to submitting your NOI.

· If there is more than one construction operator for your project, consider coordinating development of your SWPPP with the other operators.

· Once EPA has provided your site with coverage under the CGP, include your NOI, your authorization email, and a copy of the CGP as attachments to the SWPPP. See Appendices B and C of the SWPPP Template.

While EPA has made every effort to ensure the accuracy of all instructions contained in the SWPPP Template, it is the permit, not the template, that determines the actual obligations of regulated construction stormwater discharges. In the event of a conflict between the SWPPP Template and any corresponding provision of the 2022 CGP, you must abide by the requirements in the permit. EPA welcomes comments on the SWPPP Template at any time and will consider those comments in any future revision of this document. You may contact EPA for CGP-related inquiries at cgp@epa.gov.

Stormwater Pollution Prevention Plan (SWPPP)

For Construction Activities At:

Parkway Pavement Rehabilitation from MP 239.23 to MP 251.00 including ramps, access roads, and parking areas and wedge and level from MP 86 to MP 102 Natchez Trace Parkway, MP 239.23 to MP 251.00 as well as MP 86 to MP 102 Pontotoc, Chickasaw, Hinds, and Madison Counties, Mississippi

Operator(s):

U.S. Department of Transportation Federal Highway Administration Eastern Federal Lands Highway Division 22001 Loudoun County Parkway Building E-2, Suite 300 Ashburn, VA 20147 Kevin Rose, Environment Team Manager

(571) 434-1541 Kevin.Rose@dot.gov

SWPPP Prepared By:

Federal Highway Administration Timberley Belish 22001 Loudoun County Parkway Building E-2, Suite 300 Ashburn, VA 20147

(703) 404-6341 Timberley.belish@dot.gov SWPPP Preparation Date:

09/12/2022

Estimated Project Dates:

Project Start Date: 02/20/2023

Project Completion Date: 04/22/2024

Contents

Stormwater Pollution Prevention Plan (SWPPP)

NATR 3E16 3F25

i

SECTION 1: CONTACT INFORMATION/RESPONSIBLE PARTIES

1.1 Operator(s) / Subcontractor(s)

Instructions (see definition of “operator” at CGP Part 1.1.1):

Identify all site operators who will be engaged in construction activities at the site and the areas of the site over which each operator has control (Part 7.2.1). Indicate respective responsibilities, where appropriate. Also include the 24-hour emergency contact.

List subcontractors expected to work on-site. Notify subcontractors of stormwater requirements applicable to their work.

Consider using Subcontractor Agreements such as the type included as a sample in Appendix G of this Template.

Operator(s):

Federal Highways Administration Eastern Federal Lands

Kevin Rose

22001 Loudoun County Pkwy, E2, STE 300

Ashburn, VA 20147

(571) 434-1541

Kevin.Rose@dot.gov

[Repeat as necessary.]

Subcontractor(s):

Insert Company or Organization Name

Insert Name

Insert Address

Insert City, State, Zip Code

Insert Telephone Number

Insert Fax/Email

Insert area of control (if more than one operator at site)

Emergency 24-Hour Contact:

Insert Company or Organization Name

Insert Name

Insert Telephone Number

1.2 Stormwater Team

Instructions (see CGP Parts 6 and 7.2.2):

Identify the individuals (by name and position) that you have made part of the project’s stormwater team pursuant to CGP Part 6.1, their individual responsibilities, and which members are responsible for inspections. At a minimum the stormwater team is comprised of individuals who are responsible for the design, installation, maintenance, and/or repair of stormwater controls; the application and storage of treatment chemicals (if applicable); conducting inspections as required in CGP Part 4.1; and taking corrective actions as required in Part 5.

Each member of the stormwater team must have ready access to either an electronic or paper copy of applicable portions of the 2022 CGP and the SWPPP.

Each member of the stormwater team must understand the requirements of the 2022 CGP and their specific responsibilities with respect to those requirements, including the information in Part 6.2.

For projects that receive coverage under the 2022 CGP on or after February 17, 2023, to be considered a qualified person under Part 4.1 to conduct inspections under Part 4, you must, at a minimum, either:

· Have completed the EPA construction inspection course developed for this permit and have passed the exam; or

· Hold a current valid construction inspection certification or license from a program that, at a minimum, covers the following:

· Principles and practices of erosion and sediment control and pollution prevention practices at construction sites;

· Proper installation, and maintenance of erosion and sediment controls and pollution prevention practices used at construction sites; and

· Performance of inspections, including the proper completion of required reports and documentation, consistent with the requirements of Part 4.

Note that if one of the following topics (e.g., installation and maintenance of pollution prevention practices) is not covered by the non-EPA training program, you may consider supplementing the training with the analogous module of the EPA course (e.g., Module 4) that covers the missing topic.

Include documentation showing completion of trainings in Appendix I of this SWPPP template.

For projects that receive coverage under the 2022 CGP prior to February 17, 2023, any personnel conducting site inspections pursuant to Part 4 on your site must, at a minimum:

· Be knowledgeable in the principles and practice of erosion and sediment controls and pollution prevention,

· Possess the appropriate skills and training in conditions at the construction site that could impact stormwater quality, and

· Possess the appropriate skills and training in the effectiveness of any stormwater controls selected and installed to meet the requirements of this permit.

Stormwater Team

Kevin S. Rose Environmental Compliance Team Leader 571-434-1541 Kevin.Rose@dot.gov

☐ No

☒ Yes Date: 9/12/2022

Timberley Belish Environmental Protection Specialist 703-404-6341 Timberley.belish@dot.gov

☐ No

☒ Yes Date: 9/5/2022

Insert Name of Responsible Person Insert Position Insert Telephone Number Insert Email

☐ No

☐ Yes Date: Click here to enter a date.

[Insert or delete rows as necessary.]

Stormwater Team Members Who Conduct Inspections Pursuant to CGP Part 4

Insert Name of Responsible Person Insert Position Insert Telephone Number Insert Email

☐ Proper installation and maintenance of erosion and sediment controls and pollution prevention practices used at construction sites ☐ Performance of inspections, including the proper completion of required reports and documentation, consistent with the requirements of Part 4

Insert Name of Responsible Person Insert Position Insert Telephone Number Insert Email

☐ Proper installation and maintenance of erosion and sediment controls and pollution prevention practices used at construction sites ☐ Performance of inspections, including the proper completion of required reports and documentation, consistent with the requirements of Part 4

Insert Name of Responsible Person Insert Position Insert Telephone Number Insert Email

☐ Proper installation and maintenance of erosion and sediment controls and pollution prevention practices used at construction sites ☐ Performance of inspections, including the proper completion of required reports and documentation, consistent with the requirements of Part 4

[Insert or delete rows as necessary.]

SECTION 2: SITE EVALUATION, ASSESSMENT, AND PLANNING

2.1 Project/Site Information

Instructions (see “Project/Site Information,” Section IV of Appendix H – NOI Form and Instructions):

In this section, compile basic site information that will be helpful when you file your NOI.

Project Name and Address

Project/Site Name: Parkway Pavement Rehabilitation from MP 239.23 to MP 251.00 including ramps, access roads, and parking areas and wedges and level from MP 86 to MP 102

Street/Location: Natchez Trace Parkway, MP 239.23 to MP 251.00 as well as MP 86 to MP 102

City: Clinton, Ridgeland, Van Vleet and Troy

State: Mississippi

ZIP Code: Not Applicable

County or Similar Government Division: Pontotoc, Chickasaw, Hinds, and Madison Counties

Project Latitude/Longitude

Latitude: 33.985975º N (decimal degrees) Longitude: - 88.911606 º W (decimal degrees)

Latitude/longitude data source: ☒ Map ☐ GPS ☐ Other (please specify): _______________

Horizontal Reference Datum: ☐ NAD 27 ☒ NAD 83 ☐ WGS 84

Additional Site Information

If yes, provide the name of the Indian Tribe associated with the area of Indian country (including the name of Indian reservation if applicable), or if not in Indian country, provide the name of the Indian Tribe associated with the property: Insert Text Here

2.2 Discharge Information

Instructions (see “Discharge Information,” Section V of Appendix H – NOI Form and Instructions):

In this section, include information relating to your site’s discharge. This information corresponds to the “Discharge Information” section of the NOI form.

List all of the stormwater points of discharge from your site. Identify each point of discharge with a unique 3-digit ID (e.g., 001, 002).

For each unique point of discharge you list, specify the name of the first receiving water that receives stormwater directly from the point of discharge and/or from the MS4 that the point of discharge discharges to. You may have multiple points of discharge that discharge to the same receiving water. For assistance in identifying the receiving water to which you discharge, you may use EPA’s Stormwater Discharge Mapping Tool.

Next, specify whether any waters of the U.S. that you discharge to are listed as “impaired” as defined in Appendix A, and the pollutants causing the impairment. Identify any Total Maximum Daily Loads (TMDL) that have been completed for any of the waters of the U.S. that you discharge to and the pollutants for which there is a TMDL. For more information on impaired waters and TMDLs, including a list of TMDL contacts and links by State, visit https://www.epa.gov/tmdl. For assistance in identifying any impaired waters or applicable TMDLs, you may use EPA’s Stormwater Discharge Mapping Tool.

Finally, indicate whether any receiving water that you discharge to is designated as a Tier 2, Tier 2.5, or Tier 3 water and if so, what the designation is (2, 2.5, or 3). A list of Tier 2, 2.5, and 3 waters located in the areas eligible for coverage under this permit can be found at https://www.epa.gov/npdes/construction-general-permit-resources-tools-and-templates.

Does your project/site discharge stormwater into a Municipal Separate Storm Sewer System (MS4)?

Are there any waters of the U.S. within 50 feet of your project’s earth disturbances?

☐ Yes ☒ No ☒ Yes ☐ No

For each point of discharge, provide a point of discharge ID (a unique 3-digit ID, e.g., 001, 002), the name of the first receiving water that receives stormwater directly from the point of discharge and/or from the MS4 that the point of discharge discharges to, and the following receiving water information, if applicable:

Pollutant(s) for which there is a TMDL:

☐ Yes ☐ No

☐ Yes ☐ No

☐ Yes ☐ No

☐ Yes ☐ No

☐ Yes ☐ No

☐ Yes ☐ No

[Include additional rows or delete as necessary.]

2.3 Nature of the Construction Activities

Instructions (see CGP Parts 1.2.1.c and 7.2.3):

Provide a general description of the nature of the construction activities at your site.

Describe the size of the property (in acres or length in miles if a linear construction site), the total area expected to be disturbed by the construction activities (to the nearest quarter acre or quarter mile if a linear construction site), and the maximum area expected to be disturbed at any one time.

A description of any on-site and off-site construction support activity areas covered by this permit;

Indicate the type of construction site, whether there will be certain demolition activities, and whether the predevelopment land use was for agriculture.

Provide a list and description of all pollutant-generating activities (e.g., paving operations; concrete, paint, and stucco washout and waste disposal; solid waste storage and disposal; and dewatering operations) and indicate for each activity the associated pollutants or pollutant constituents (e.g., sediment, fertilizers, pesticides, paints, caulks, sealants, fluorescent light ballasts, contaminated substrates, solvents, fuels) which could be discharged in stormwater from your construction site.

Describe the construction support activities covered by this permit (see Part 1.2.1.c of the permit).

General Description of Project Provide a general description of the nature of your construction activities, including the age or dates of past renovations for structures that are undergoing demolition:

The National Park Service (NPS), in cooperation with the Federal Highway Administration, proposes to resurface 26.71 miles of Natchez Trace Parkway from Milepost 238.84 (RIP MP 241.40) to Milepost 251 (RIP MP 253.24), which is designated as Section 3E and 3F, including ramps at the Parkway intersection with SR 32, Davis Lake Road, and SR 41, and various parking/pull-off. The work will include an asphalt overlay, shoulder material, widening, spot patching and leveling, pavement markings, raised profile edge striping at bridge approaches, and other work. Milling is required at bridges and parking/pull-off areas to maintain a 6-inch curb reveal. The Hernando Desoto parking area requires a handicap accessible parking space, including striping, signage, and a curb ramp.

The project includes additional work to repair unstable areas, two slide areas, four sites of road settlement, and two settlements at the bridge abutments. The work will include the construction of a Mechanically Stabilized Earth (MSE) wall or Reinforced Soil Slope (RSS) for the slide areas, deep patch repair for road settlement, installing wingwalls to an existing headwall, and wedge and leveling to the settlement at the bridge abutment.

If you are conducting earth-disturbing activities in response to a public emergency, document the cause of the public emergency (e.g., mud slides, earthquake, extreme flooding conditions, widespread disruption in essential public services), information substantiating its occurrence (e.g., State disaster declaration or similar State or local declaration), and a description of the construction necessary to reestablish affected public services:

Insert Text Here Not Applicable

Business days and hours for the project: 135 work days, 0700 to 1800

Size of Construction Site

[Repeat as necessary for individual project phases.]

Type of Construction Site (check all that apply):

☐ Single-Family Residential ☐ Multi-Family Residential ☐ Commercial ☐ Industrial ☐ Institutional ☒ Highway or Road ☐ Utility ☐ Other ____________________________

Pollutant-Generating Activities List and describe all pollutant-generating activities and indicate for each activity the associated pollutants or pollutant constituents that could be discharged in stormwater from your construction site. Take into account where potential spills and leaks could occur that contribute pollutants to stormwater discharges, and any known hazardous or toxic substances, such as PCBs and asbestos, that will be disturbed during construction.

Pollutant-Generating Activity (e.g., paving operations; concrete, paint, and stucco washout and waste disposal; solid waste storage and disposal; and dewatering operations) Pollutants or Pollutant Constituents (e.g., sediment, fertilizers, pesticides, paints, caulks, sealants, fluorescent light ballasts, contaminated substrates, solvents, fuels)

[Include additional rows or delete as necessary.]

Construction Support Activities (only provide if applicable)

Describe any construction support activities for the project (e.g., concrete or asphalt batch plants, equipment staging yards, material storage areas, excavated material disposal areas, borrow areas):

Insert Description of Construction Support Activity

Contact information for construction support activity:

Insert Name Insert Telephone No.

Insert Email Insert Address And/Or Latitude/Longitude

2.4 Sequence and Estimated Dates of Construction Activities

Instructions (see CGP Part 7.2.3):

Describe the intended construction sequence and duration of major activities.

For each portion or phase of the construction site, include the following:

· Commencement and duration of construction activities, including clearing and grubbing, mass grading, demolition activities, site preparation (i.e., excavating, cutting and filling), final grading, and creation of soil and vegetation stockpiles requiring stabilization;

· Temporary or permanent cessation of construction activities in each portion of the site;

· Temporary or final stabilization of exposed areas for each portion of the site. The dates for stabilization must reflect the applicable deadlines to which you are subject to in Part 2.2.14; and

· Removal of temporary stormwater controls and construction equipment or vehicles, and cessation of any construction-related pollutant-generating activities.

The construction sequence must reflect the following requirements:

· Part 2.1.3 (installation of stormwater controls); and

· Parts 2.2.14 (stabilization deadlines).

Phase I Prior to any clearing, grubbing, or excavation, construct perimeter controls to ensure that disturbed sediment does not leave the project site. Perimeter controls include fiber roll and other specified measures outside the construction limits.

[Add additional dates as necessary]

[Add additional dates as necessary]

Phase II Apply intermediate controls during rough grading operations. Install filter berms in ditches along the roadway.

Apply temporary turf establishment in disturbed areas that will remain exposed for over 14 days within 7 days. Apply permanent turf establishment to the finished slopes according to Section 625.

At the end of each day’s grading operations, shape earthwork to minimize and control erosion from storm runoff.

Provide fiber roll around all stockpiled excavated roadway material. Apply temporary turf establishment to stockpiles remaining in place longer than 14 days within 7 days of stockpiling.

Provide watering for dust control within the construction limits, on active haul roads, and in pits and staging areas.

[Add additional dates as necessary]

Phase III After completion of roadway construction, do the following as directed by the CO:

Finish grading and apply permanent turf establishment to any remaining disturbed areas.

Where necessary, replace eroded topsoil and re-apply permanent turf establishment to disturbed areas where vegetation has not established.

Remove fiber roll only after all upslope areas are stabilized and vegetation is well established.

[Add additional dates as necessary]

[Repeat as needed.]

2.5 Authorized Non-Stormwater Discharges

Instructions (see CGP Parts 1.2.2 and 7.2.5):

Identify all authorized non-stormwater discharges. The authorized non-stormwater discharges identified in Part 1.2.2 of the 2022 CGP include:

· Discharges from emergency fire-fighting activities;

· Fire hydrant flushings;

· Landscape irrigation;

· Waters used to wash vehicles and equipment, provided that there is no discharge of soaps, solvents, or detergents used for such purposes;

· Water used to control dust;

· Potable water including uncontaminated water line flushings;

· External building washdown, provided soaps, solvents and detergents are not used, and external surfaces do not contain hazardous substances as defined in CGP Appendix A (e.g., paint or caulk containing polychlorinated biphenyls (PCBs));

· Pavement wash waters provided spills or leaks of toxic or hazardous materials have not occurred (unless all spilled material has been removed) and detergents are not used. You are prohibited from directing pavement wash waters directly into any receiving water, storm drain inlet, or constructed or natural site drainage features, unless the conveyance is connected to a sediment basin, sediment trap, or similarly effective control;

· Uncontaminated air conditioning or compressor condensate;

· Uncontaminated, non-turbid discharges of ground water or spring water;

· Foundation or footing drains where flows are not contaminated with process materials such as solvents or contaminated ground water; and

· Uncontaminated construction dewatering water discharged in accordance with Part 2.4.

List of Authorized Non-Stormwater Discharges Present at the Site

(Note: You are required to identify the likely locations of these authorized non-stormwater discharges on your site map. See Section 2.6, below, of this SWPPP Template.)

2.6 Site Maps

Instructions (see CGP Part 7.2.4):

Attach site maps in Appendix A of the Template. For most projects, a series of site maps is necessary and recommended. The first should show the undeveloped site and its current features. An additional map or maps should be created to show the developed site or, for more complicated sites, show the major phases of development.

These maps must include the following features:

Boundaries of the property and of the locations where construction will occur, including:

· Locations where earth-disturbing activities will occur, noting any phasing of construction activities and any demolition activities;

· Approximate slopes before and after major grading activities. Note any areas of steep slopes, as defined in CGP Appendix A;

· Locations where sediment, soil, or other construction materials will be stockpiled;

· Locations of any crossings of receiving waters;

· Designated points where vehicles will exit onto paved roads;

· Locations of structures and other impervious surfaces upon completion of construction; and

· Locations of on-site and off-site construction support activity areas covered by the permit (see CGP Part 1.2.1.c).

Locations of any receiving waters, including wetlands, within your site and all receiving waters within one mile downstream of the site’s discharge point(s). Indicate which receiving waters are listed as impaired, and which are identified by your State, Tribe, or EPA as Tier 2, Tier 2.5, or Tier 3 waters.

Any areas of Federally-listed critical habitat for endangered or threatened species within the action area of the site as defined in CGP Appendix A (Helpful resources: CGP Appendix D and www.epa.gov/npdes/construction-general-permit-cgp-threatened-and-endangered-species-eligibility).

Type and extent of pre-construction cover on the site (e.g., vegetative cover, forest, pasture, pavement, structures).

Drainage pattern(s) of stormwater and authorized non-stormwater before and after major grading activities.

Stormwater and authorized non-stormwater discharge locations, including:

· Locations where stormwater and/or authorized non-stormwater will be discharged to storm drain inlets, including a notation of whether the inlet conveys stormwater to a sediment basin, sediment trap, or similarly effective control; and

· Locations where stormwater or allowable non-stormwater will be discharged directly to receiving waters, including wetlands (i.e., not via a storm drain inlet).

· Locations where turbidity benchmark monitoring will take place to comply with Part 3.3, if applicable to your site.

Locations of all potential pollutant-generating activities identified in Part 7.2.3g (note: you should have those identified in Section 2.3 (Nature of the Construction Activities) in this SWPPP Template).

Designated areas where construction wastes that are covered by the exception in Part 2.3.3e.ii (i.e., they are not pollutant-generating) will be stored.

Locations of stormwater controls, including natural buffer areas and any shared controls utilized to comply with the permit.

Locations where polymers, flocculants, or other treatment chemicals will be used and stored.

SECTION 3: DOCUMENTATION OF COMPLIANCE WITH OTHER FEDERAL REQUIREMENTS

3.1 Endangered Species Protection

Instructions (see CGP Parts 1.1.5, 7.2.9.a, Appendix D, and the “Endangered Species Protection” section of the Appendix H – NOI Form and Instructions as well as resources available at www.epa.gov/npdes/construction-general-permit-cgp-threatened-and-endangered-species-eligibility):

Using the instructions in Appendix D of the permit, determine which criterion listed below (A-F) applies with respect to the protection of endangered species. To make this determination, you must use information from BOTH the National Marine Fisheries Service (NMFS) and U.S. Fish and Wildlife Service (USFWS). Both the NMFS and USFWS maintain lists of Endangered Species Act-listed (ESA-listed) species and designated critical habitat. Operators must consult both when determining their eligibility.

Check only 1 box, include the required information, and provide a sound basis for supporting the criterion selected. Select the most conservative criterion that applies.

Include documentation supporting your determination of eligibility required in the Endangered Species Protection section of the NOI in NeT or the ESA worksheet in CGP Appendix D.

Eligibility Criterion Following the process outlined in Appendix D, under which criterion are you eligible for coverage under this permit?

☐ Criterion A: No ESA-listed species and/or designated critical habitat present in action area. Using the process outlined in Appendix D of the CGP, you certify that ESA-listed species and designated critical habitat(s) under the jurisdiction of the USFWS or NMFS are not likely to occur in your site’s “action area” as defined in Appendix A of the CGP. Please Note: NMFS’ jurisdiction includes ESA-listed marine and estuarine species that spawn in inland rivers.

☐ Check to confirm you have provided documentation in your SWPPP as required by CGP Appendix D (Note: reliance on State resources is not acceptable; see CGP Appendix D).

Documentation: Insert Text Here

☐ Criterion B: Eligibility requirements met by another operator under the 2022 CGP. The construction site’s discharges and discharge-related activities were already addressed in another operator’s valid certification of eligibility for your “action area” under eligibility Criterion A, C, D, E, or F of the 2022 CGP and you have confirmed that no additional ESA-listed species and/or designated critical habitat under the jurisdiction of USFWS and/or NMFS not considered in the that certification may be present or located in the “action area.” To certify your eligibility under this criterion, there must be no lapse of NPDES permit coverage in the other CGP operator’s certification. By certifying eligibility under this criterion, you agree to comply with any conditions upon which the other CGP operator's certification was based. You must include in your NOI the NPDES ID from the other 2022 CGP operator’s notification of authorization under this permit and list any measures that you must comply with. If your certification is based on another 2022 CGP operator’s certification under criterion C, you must provide EPA with the relevant supporting information required of existing dischargers in Criterion C.

☐ Check to confirm you have provided documentation in your SWPPP as required by CGP Appendix D.

Documentation: Insert Text Here

☐ Criterion C: Discharges not likely to result in any short- or long-term adverse effects to ESA-listed species and/or designated critical habitat. ESA-listed species and/or designated critical habitat(s) under the jurisdiction of the USFWS and/or NMFS are likely to occur in or near your site’s “action area,” and you certify to EPA that your site’s discharges and discharge-related activities are not likely to result in any short- or long-term adverse effects to ESA-listed threatened or endangered species and/or designated critical habitat. This certification may include consideration of any stormwater controls and/or management practices you will adopt to ensure that your discharges and discharge-related activities are not likely to result in any short- or long-term adverse effects to ESA-listed species and/or designated critical habitat. To certify your eligibility under this criterion, indicate 1) the ESA-listed species and/or designated habitat located in your “action area” using the process outlined in Appendix D of this permit; 2) the distance between the site and the listed species and/or designated critical habitat in the action area (in miles); and 3) a rationale describing specifically how short- or long-term adverse effects to ESA-listed species will be avoided from the discharges and discharge-related activities. (Note: You must include a copy of your site map from your SWPPP showing the upland and in-water extent of your “action area” with your NOI.)

☐ Check to confirm you have provided documentation in your SWPPP as required by CGP Appendix D.

Documentation: Insert Text Here

☐ Criterion D: Coordination with USFWS and/or NMFS has successfully concluded. Coordination between you and the USFWS and/or NMFS has concluded. The coordination must have addressed the effects of your site’s discharges and discharge-related activities on ESA-listed species and/or designated critical habitat under the jurisdiction of USFWS and/or NMFS, and resulted in a written confirmation from USFWS and/or NMFS that the effects of your site’s discharges and discharge-related activities are not likely to result in any short- or long-term adverse effects. By certifying eligibility under this criterion, you agree to comply with any conditions you must meet for your site’s discharges and discharge-related activities to not likely result in any short- or long-term adverse effects. You must include copies of the correspondence with the participating agencies in your SWPPP and this NOI.

☐ Check to confirm you have provided documentation in your SWPPP as required by CGP Appendix D.

Documentation: Insert Text Here

☒ Criterion E: ESA Section 7 consultation has successfully concluded. Consultation between a Federal agency and the USFWS and/or NMFS under section 7 of the ESA has concluded. Consultations can be either formal or informal, and would have occurred only as a result of a separate Federal action (e.g., during application for an individual wastewater discharge permit or the issuance of a wetlands dredge and fill permit), and the consultation must have addressed the effects of your construction activity’s discharges and discharge-related activities on all ESA-listed threatened or endangered species and all designated critical habitat under the jurisdiction of each Service, as appropriate, in your action area. The result of this consultation must be either:

0. A biological opinion currently in effect that determined that the action in question (taking into account the effects of your facility’s discharges and discharge-related activities) is likely to adversely affect, but is not likely to jeopardize the continued existence of listed species or result in the destruction or adverse modification of critical habitat. The biological opinion must have included the effects of your facility’s discharges and discharge-related activities on all the listed species and designated critical habitat in your action area under the jurisdiction of each Service, as appropriate. To be eligible under (i), any reasonable and prudent measures specified in the incidental take statement must be implemented;

0. Written concurrence (e.g., letter of concurrence) from the applicable Service(s) with a determination that your facility’s discharges and discharge-related activities are not likely to adversely affect ESA-listed species and/or designated critical habitat. The concurrence letter must have included the effects of your facility’s discharges and discharge-related activities on all the ESA-listed species and/or designated critical habitat on your species list(s) acquired from USFWS and/or NMFS as part of this worksheet.

The consultation does not warrant reinitiation under 50 CFR §402.16; or, if reinitiation of consultation is required (e.g., due to a new species listing, critical habitat designation, or new information), the Federal action agency has reinitiated the consultation and the result of the consultation is consistent with the statements above. (Note: you must include any reinitiation documentation from the Services or consulting Federal agency with your NOI.) - ☒ Check to confirm you have provided documentation in your SWPPP as required by CGP Appendix D.

Documentation: Insert Text Here

☐ Criterion F: Issuance of section 10 permit. Potential take is authorized through the issuance of a permit under section 10 of the ESA by the USFWS and/or NMFS, and this authorization addresses the effects of the site’s discharges and discharge-related activities on ESA-listed species and designated critical habitat. You must include copies of the correspondence between yourself and the participating agencies in your SWPPP and your NOI.

☐ Check to confirm you have provided documentation in your SWPPP as required by CGP Appendix D.

Documentation: Insert Text Here

3.2 Historic Property Screening Process

Instructions (see CGP Part 1.1.6, 7.2.9.b, Appendix E, and the “Historic Preservation” section of the Appendix H – NOI Form and Instructions):

Follow the screening process in Appendix E of the permit to determine whether your installation of subsurface earth-disturbing stormwater controls will have an effect on historic properties.

Include documentation supporting your determination of eligibility.

To contact your applicable State historic preservation office, information is available at https://ncshpo.org/directory/ To contact your applicable Tribal historic preservation office, information is available at https://grantsdev.cr.nps.gov/THPO_Review/index.cfm

Appendix E, Step 1 Do you plan on installing any stormwater controls that require subsurface earth disturbance, including, but not limited to, any of the following stormwater controls at your site? Check all that apply below, and proceed to Appendix E, Step 2.

☐ Dike ☒ Berm ☐ Catch Basin ☐ Pond ☒ Constructed Site Drainage Feature (e.g., ditch, trench, perimeter drain, swale, etc.)

☒ Culvert ☐ Channel ☐ Other type of ground-disturbing stormwater control: Insert Specific Type of Stormwater Control

(Note: If you will not be installing any subsurface earth-disturbing stormwater controls, no further documentation is required for Section 3.2 of the Template.)

Appendix E, Step 2 If you answered yes in Step 1, have prior professional cultural resource surveys or other evaluations determined that historic properties do not exist, or have prior disturbances at the site have precluded the existence of historic properties? ☐ YES ☒ NO

· If yes, no further documentation is required for Section 3.2 of the Template and you may provide the prior documentation in your SWPPP.

· Insert references and information sources relied upon to determine that prior to your project, no historic properties exist at your site based on available information, including information that may be provided by your applicable SHPO, THPO, or other Tribal representative or references and information sources relied upon to determine that prior earth disturbances may have eliminated he possibility that historic properties exist on your site.

· If no, proceed to Appendix E, Step 3.

Appendix E, Step 3 If you answered no in Step 2, have you determined that your installation of subsurface earth-disturbing stormwater controls will have no effect on historic properties? ☐ YES ☒ NO

· If yes, provide documentation of the basis for your determination.

· The NPS completed an Assessment of Actions Having an Effect on Historic Properties (approved on December 19, 2019), documenting that the proposed project would have no adverse on historic properties.

· If no, proceed to Appendix E, Step 4.

Appendix E, Steps 4 and 5 If you answered no in Step 3, did the State Historic Preservation Officer (SHPO), Tribal Historic Preservation Office (THPO), or other Tribal representative (whichever applies) respond to you within 15 calendar days to indicate their views as to the likelihood that historic properties are potentially present on your site and may be impacted by the installation of stormwater controls that require subsurface earth disturbance? ☒ YES ☐ NO

· If yes, describe the nature of their response:

☐ Written indication that no historic properties will be affected by the installation of stormwater controls. Insert copies of letters, emails, or other communication between you and the applicable SHPO, THPO, or other Tribal representative

☒ Written indication that adverse effects to historic properties from the installation of stormwater controls can be mitigated by agreed upon actions.

Historic structures are in the area of potential effect (APE) but will not be adversely affected by the proposed projects. The Parkway’s designed historic landscape is present but will not be adversely affected by the proposed activities. There are ethnographic resources within the APE such as Mount Locust, Gordon House, Emerald, Boyd, Bynum, Pharr, Bear, and Gordon Mounds. No activities are permitted at or near these or any ethnographic resources.

☐ No agreement has been reached regarding measures to mitigate effects to historic properties from the installation of stormwater controls. Provide a description of any significant remaining disagreements regarding mitigation measures and insert copies of letters, emails, or other communication between you and the applicable SHPO, THPO, or other Tribal representative

☐ Other: Insert copies of letters, emails, or other communication between you and the applicable SHPO, THPO, or other Tribal representative

· If no, no further documentation is required for Section 3.2 of the Template.

3.3 Safe Drinking Water Act Underground Injection Control Requirements Instructions (see CGP Part 7.2.9.c):

If you will use any of the identified controls in this section, document any contact you have had with the applicable State agency or EPA Regional Office responsible for implementing the requirements for underground injection wells in the Safe Drinking Water Act and EPA’s implementing regulations at 40 CFR Parts 144-147.

For State UIC program contacts, refer to the following EPA website: https://www.epa.gov/uic.

Do you plan to install any of the following controls? Check all that apply below.

☐ Infiltration trenches (if stormwater is directed to any bored, drilled, driven shaft or dug hole that is deeper than its widest surface dimension, or has a subsurface fluid distribution system) ☐ Commercially manufactured pre-cast or pre-built proprietary subsurface detention vaults, chambers, or other devices designed to capture and infiltrate stormwater flow ☐ Drywells, seepage pits, or improved sinkholes (if stormwater is directed to any bored, drilled, driven shaft or dug hole that is deeper than its widest surface dimension, or has a subsurface fluid distribution system) If yes, insert copies of letters, emails, or other communication between you and the State agency or EPA regional office.

SECTION 4: EROSION AND SEDIMENT CONTROLS AND DEWATERING PRACTICES

General Instructions (See CGP Parts 2.2 and 7.2.6):

Describe the erosion and sediment controls that will be implemented at your site to meet the requirements of CGP Part 2.2.

Describe any applicable stormwater control design specifications (including references to any manufacturer specifications and/or erosion and sediment control manuals/ordinances relied upon).

Describe any routine stormwater control maintenance specifications.

Describe the projected schedule for stormwater control installation/implementation.

4.1 Natural Buffers or Equivalent Sediment Controls

Instructions (see CGP Parts 2.2.1 and 7.2.6.b.i, and Appendix F):

This section only applies to you if discharge to a receiving water is located within 50 feet of your site’s earth disturbances. If this is the case, consult CGP Part 2.2.1 and Appendix F for information on how to comply with the buffer requirements.

Describe the compliance alternative (CGP Part 2.2.1.a.i, ii, or iii) that you will implement to meet the buffer requirements, and include any required documentation supporting the alternative selected. For alternative 3, also include why it is infeasible for you to provide and maintain an undisturbed natural buffer of any size. For “linear construction sites” where it is infeasible to implement alternative 1, 2, or 3, also include a description of any buffer width retained and/or supplemental erosion and sediment controls installed. The compliance alternative selected must be maintained throughout the duration of permit coverage. However, if you select a different compliance alternative during your period of permit coverage, you must modify your SWPPP to reflect this change.

If you qualify for one of the exceptions in CGP Part 2.2.1.b, include documentation related to your qualification for such exceptions.

Buffer Compliance Alternatives Are there any receiving waters within 50 feet of your project’s earth disturbances? ☒ YES ☐ NO (Note: If no, no further documentation is required for Section 4.1 in the SWPPP Template. Continue to Section 4.2.)

Check the compliance alternative that you have chosen:

☐ (i) I will provide and maintain a 50-foot undisturbed natural buffer.

(Note 1: You must show the 50-foot boundary line of the natural buffer on your site map.)

(Note 2: You must show on your site map how all discharges from your construction disturbances through the natural buffer area will first be treated by the site’s erosion and sediment controls. Also, show on the site map any velocity dissipation devices used to prevent erosion within the natural buffer area.)

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