SWPPP_Russian_River_Campground_Road,_AK_FS_CNF_1015(1)_Kenai_Peninsula_County,_Alaska.pdf

TAB 1: SWPPP/ESCP Narrative

TAB 2: NPDES Permit (Construction General Permit or Corresponding State Permit)

TAB 3: NOI, EPA/State Acknowledgement, Other Applicable EPA/State Correspondence

TAB 4: Delegation of Authority

TABS: Maps

TAB 6: Erosion/Sediment Control Plan Sheets (plan set and BMP typical details)

TAB 7: Permanent Stabilization and Revegetation Plan(plan sets and details)

TAB 8: SWPPP Amendment Log

TAB 9: Erosion/Sediment Control Inspection Reports and Requirements

TAB 10: Corrective Action Log

TAB 11: Water Quality Monitoring, Reporting Requirements, and Reports

TAB 12: Training Log

TAB 13: Waste and/or Borrow Site Information

TAB 14: Grading and Stabilization .Log

TAB 15: Hazardous Spill Plan

TAB 16: Other Applicable Permits(§ 404, § 401, Oregon Remove-Fill Permit)

TAB 17: NPDES Quality Assurance Checklist

TAB 18: NPDES Notice of Termination (NOT)

SWPPP/ESCP NARRATIVE

SECTION l: RESPONSIBLE PARTIES/CONTACT INFORMATION

1.1 Operator(s):

1.2 Construction Site SWPPP Contact(s):

l.3 SWPPP Prepared by:

l.4 NPDES Storn1water Permit

1.5 SWPPP Administrator

1.6 Permitting Authority for FHWA/WFLHD Projects

SECTION 2: PROJECT INFORMATION

2.1 Project Name and Location

2.2 Project Site Characteristics

SECTION 3: NATURE OF CONSTRUCTION ACTIVITY

3.1 General Descliption of Project and Scope ofWork:

3.2 Sequence and Estimated Dates of Construction Activities

3.3 Potential Sources of Pollutants

SEC1'ION 4: SI1'E MAPS

SJ~CTION 5: l)ISCHARGES

5.1 Allowable Non-Storm,vater Discharges

5.2 Receiving Waters:

5.3 Water Quality Monitoring Requirements

SECTION 6: COMPLIANCE WITH OTHER APPLICABLE REQUIREMENTS

6.1 Endangered Species Protection

6.2 Historic Preservation

6.3 Safe Drinking Water Act Underg1·ound Injection Control Requirements

SECTION 7: EROSION AND SEDIMENT CONTROLS

7.1 Natural Buffers or Equivalent Sediment Controls

7 .2 Perimeter Controls

7 .3 Sediment Track-Out

7.4 Stockpiled Soil or Other Erodible Materials

7.5 Minimize Dust

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7.6 Minimize Disturbance of Steep Slopes

7 .7 Topsoil Conservation

7 .8 Minimize Soil Coin paction

7.9 Storm Drain Inlets and Culvert Inlets

7.10 Constructed Stormwater Conveyance Channels and Culvert Outlets

7 .11 Sediment Basins

7 .12 Chemical Treatment

7 .13 De\vatering Practices

7.14 Erosion Control and Stabilization

7.15 Removal ofBMPs

7 .16 Post Construction Measures

SECTION 8: OPERATIONAL CONTROLS/GOOD HOUSEKEEPING MEASURES ... 29

8.1 Hazardous Spill Plan

8.2 SpillsfReleases in Excess of Reportable Quantities

8.3 EquipmentN ehicle Fueling and Maintenance Practices

8.4 EquipmentN chicle Washing

8.5 Material Handling and Waste Management

8.6 Designate Concrete Washout Areas

SECTION 9: INSPECTIONS

9.1 Inspection Frequency

9.2 Corrective Actions

SECTION 10: DELEGATIONS OF AUTHORITY

SEC1'ION 11: STAFF TRAINING

SECTION 12: CERTIFICATION AND NOTIFICATION

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NOTE: The likely locations of these discharges are identified on the site map TAB 5 and/or

TAB6

5.2 Receiving Waters:

Are there any surface waters located within 50 feet of the construction disturbance? Yes

· Name(s) of the first surface water that receives stormwater directly from your site and/or from the MS4

Impaired Waters/TDMLs:

Answer the following for each surface water listed in Table 1:

Is this surface What pollutant(s) is Has a TMDL Pollutant(s) for which water listed as causing the been there is a TDML "impaired?" impairment? completed?

YesD No~

1. 1YesONo~

G. IYesONo~ YesD No~

YesD NoD Yes No

YesD NoD NoD

Source used to determine whether or not your project discharges into an impaired water:

Click here to enter text.

Tier 2, 2.5 or 3 Waters Answer the following for each surface water listed in Table 1:

If yes, specify which Tier.

If applicable, documentation of consultation with State or Federal TMDL authorities on consistency of SWPPP conditions with the approved TMDL is found in TAB 11. The control

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Criterion E.

Criterion F.

correspondence between yourself and the Services in your SWPPP and

NOL

Consultation between a Federal Agency and the U.S. Fish and Wildlife Service and/or the National Marine Fisheries Service under section 7 of the ESA has been concluded. The consultation must have addressed the effects of the construction site's discharges and discharge-related activities on federally-listed threatened or endangered species and federally designated critical habitat. The result of this consultation must be either:

l. a biological opinion that concludes that the action in question (taking into account the effects of your site's discharges and discharge-related activities) is not likely to jeopardize the continued existence of listed species, nor the destruction or adverse modification of critical habitat; or

IL written concurrence from the applicable Service(s) with a finding that the site's discharges and discharge-related activities are not likely to adversely affect federally-listed species or federally-designated habitat.

You must include copies of the correspondence between yourself and the Services in your SWPPP and NOL

Your construction activities are authorized through the issuance of a permit under section 10 of the ESA, and this authorization addresses the effects of the site's discharges and discharge-related activities on federally listed species and federally-designated critical habitat. You must include copies of the correspondence between yourself and the Services in your SWPPP and NOL

Support Documentation for Endangered Species criterion eligibility is filed in TAB 16.

6.2 Historic Preservation

1. Will the project involve installation of any of the following stom1water controls that entail subsurface earth disturbance? No

Dike

D Berm

D Catch Basin

D Pond

D Ditch, trench, swale, perimeter drain, etc.

D Culvert

D Other ground-disturbing stonnwater control Click here to enter text

If the project involves no installation of earth-disturbing stormwater controls, then no further historic preservation screening is necessary (for NPDES permitting purposes).

lf answer to step 1 is Yes, have professional surveys or evaluations dete1mined that hisloric properties do not exist (or have prior disturbances at the site precluded the existence of historic properties)? Choose an item.

Provide documentation for the basis of this determination. Click here to enter text

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3. If answer to step 2 is No, have professional surveys or evaluations determined that installation of stormwater controls will have no effect on historic properties?

Provide documentation for the basis of this determination. SllPO concurrence Jetter

4. Has the State Historic Preservation Officer (SHPO), Tribal Historic Preservation Office (THPO) or other tribal representative concurred with the determinations of effects on historic properties?

Provide the nature of their response. No Adverse Effect

6.3 Safe Drinking Water Act Underground Injection Control Requirements

Will the project plan install any of the following controls? No

Check all that apply:

D Infiltration trenches (if stormwater is directed to any bored, drilled, driven shaft or dug hole that is deeper than is widest surface dimensfon, 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.

D 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 tluid distribution system)

If yes, provide documentation of communications with the EPA or applicable State agency.

Click here to enter text.

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L8'.] The project will provide and maintain an undisturbed natural buffer that is less than 50 feet in width and is supplemented by additional erosion and sediment controls, which in combination achieves the sediment load reduction equivalent to a 50-foot undisturbed natural buffer.

The locations of natural buffers are shown on the Erosion and Sediment Control Plan sheets in TAB 6.

Insert the width of the natural buff er to be retained Click here to enter text.

Insert description of additional erosion and sediment controls to be used in combination with the natural huff er: here to enter text.

Document the method used to determine that the above combination of natural buffer and sediment and erosion controls equal the estimated sediment removal capacity of a 50-foot undisturbed natural buffer: Click to enter text.

It is infeasible to provide and maintain an undisturbed natural buffer of any size, therefore, the project will implement erosion and sediment controls that achieve the sediment load reduction equivalent to a 50-foot undisturbed natural buffer.

Insert rationale for concluding that providing and maintaining a natural buffer of any size is infeasible: Click here to enter text.

Insert description of erosion and sediment controls to he used to achieve the sediment load reduction equivalent to a 50-foot undisturbed natural buffer: Click here to enter text.

D The project qualifies for one of the exceptions in EPA CGP Part 2.1 l .e

D For a "linear project", site constraints (e.g. limited right of way) make it infeasible for the project to meet any of the CGP part 2.1.2.1.a compliance alternatives.

Other exception (state type): Click here to enter text.

Document why it is infeasible to meet one of the buffer compliance alternatives: Click here to enter text.

Insert description of erosion and sediment controls to be used to achieve the sediment load· reduction equivalent to a 50-foot undisturbed natural buffer: Click here to enter text

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7.6 Minimize Disturbance of Steep Slopes

Describe how disturbance of steep slopes will be minimized. Describe controls (e.g. erosion control blankets, tackifiers) that will be implemented to minimize sediment discharges from slope disturbances.

If applicable, describe how stonnwater run-on and run-off will be managed. Flows may be diverted from exposed soils by retaining/detaining flows or otherwise minimizing runoff and the discharge of pollutants from exposed areas of the site. Placement of structural practices in floodplains will be avoided to the degree technologically and economically practicable and achievable.

D Not applicable to this project. Reason: here to enter text

If applicable:

Control measure: Silt Fence placed around disturbed areas SCR 157 and F sheets

Implementation: During active construction, if used

Maintenance requirements: Periodic inspections in accordance with COP to ensure erosion control measures are in place, there is no overtopping, rilling, or other erosive conditions

Control measure: Blanket

Implementation: During active construction, if used

Maintenance requirements: Inspection will ensure good contact with the ground is achieved and maintained. Damaged areas will be repaired and properly secured.

Control measure: Straw Mulch

Implementation: During active construction, if used

Maintenance requirements: Maintain thickness of cover. Any area showing signs of erosion shall be remulched and/or protected by a blanket or net.

Add other measures as needed.

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7.7 Topsoil Conservation

Describe how topsoil will be preserved, if feasible. If conservation of topsoil is infeasible, explain why, and describe alternate methods to be used to insure optimum vegetation survival and growth.

Erosion and sediment control measures for topsoil stockpiles (and other erodible materials) are shown in section 4.4.

p

Conservation of topsoil is Infeasible:

Reason: to enter text.

Alternate method: to enter text.

D Conservation of topsoil is Feasible:

Conservation measure: to enter text.

Implementation: to enter text.

Maintenance requirements: to enter text.

Conservation measure: to enter text.

Implementation: to enter text.

Maintenance requirements: to enter text.

Add other measures as needed.

7.8 Minimize Soil Compaction

Minimize soil compaction in areas where final vegetative stabilization will occur and where infiltration practices will be installed.

D Not applicable to this project. Reason: Click here to enter text.

If applicable:

Control measure: Distribute layer of soft vegetative top soil after compaction complete

Implementation: After soil compaction is complete and prior to revegetation efforts

Maintenance requirements: Maximize depth whenever possible and seed as soon as practicable.

If seeding cannot occur in a timely manner, other BMPs (nets, blankets, etc.) will be placed to mitigate erosion.

Control measure: Click here to enter text.

Implementation: Click here to enter text.

Maintenance requirements: Click here to enter text.

Add other measures as needed.

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8.1 Hazardous Spill Plan

Spills and potential stormwater contamination will be controlled to reduce the chance of spills, stop the source of spills, contain and clean up spills, and dispose of materials contaminated by spills.

Spill prevention and response actions are outlined in the Hazardous Spill Plan or Spill Prevention, Control, and Countenneasure Plan (SPCC) whichever is applicable, Construction sites may be subject to 40 CFR Part 112 regulations that require the preparation and implementation of a Spill Prevention. Control and Countenneasure Plan if the facility is a non transportation-related facility that: has a total storage capacity greater than 1,320 gallons or a completely buried storage capacity greater than 42,000 gallons and could reasonably be expected to discharge oil in quantities that may be harmful to navigable waters of the United States and adjoining shorelines. See EPA website: http://www.epa.gov/OEM/content/spcc/index.htm

Implementation: Prior to construction activities and throughout construction.

8.2 Spills/Releases in Excess of Reportable Quantities

This permit does not provide authorization to discharge hazardous substances or oil resulting from an on-site spill. This permit does not provide relief from the federal reporting requirements of 40 CFR Part 110, 40 CFR Paii 1 17 and 40 CFR Part 302 relating to spills or other releases of oils or hazardous substances.

For a release containing a hazardous substance or oil in an amount equal to or in excess of a reportable quantity established under either 40 CFR Part 110, 40 CFR Part 117 or 40 CFR Part 302, occurs during a 24-hour period:

• Notice will be provided to the National Response Center (800-424-8802) in accordance with the requirements of 40 CFR Part 110, 40 CFR Part 117 and 40 CFR Part 302 as soon as site staff have knowledge of the discharge; and written notice will be provided within 7 calendar days of knowledge of the release, provide a description of the release, the circumstances leading to the release, and the date of a release.

• Measures to prevent the reoccurrence of such releases will be implemented.

8.3 EquipmentNehicle Fueling and Maintenance Practices

On-site fueling areas will have a spill kit present, visible, and maintained. Employees and subcontractors will receive training regarding equipment/vehicle fueling and maintenance practices, including proper fueling procedures, proper use of pumps, emergency shutoff valves (training efforts documented in ).

On-site vehicles and equipment will be inspected daily for leaks, equipment damage, and other service problems.

Designate vehicle/equipment service will be marked and the areas will be located away from drainage facilities and watercourses to prevent stormwater run-on and runoff. Designated washout areas will be shown on the SWPPP plan sheets ( ).

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Drip pans, drip cloths, or absorbent pads will be used when replacing spent fluids. All spent fluids will be collected and store in appropriate labeled containers in the proper storage areas.

Implementation: Prior to construction activities and throughout construction.

8.4 Equipinent/Vehide Washing

Equipment/vehicle washing and allowable non-stonnwater will be controlled using procedures and practices include using off-site facilities; washing in designated, contained areas only;

eliminating discharges to the storm drain by infiltrating the wash water or routing to the sanitary sewer. The locations of equipment/vehicle washing areas, stonn drains, tributary drainage areas, and surface waterbodies on or near the site are shown and updated on the SWPPP plan sheets

Implementation: Prior to construction activities and throughout construction.

8.5 Material Handling and Waste Management

Measures will be put in place and maintained to prevent the discharge of solid materials to receiving waters, except as authorized by a permit issued under the §404 permit.

• Designated trash and bulk waste-collection areas on-site (location of areas are shown and updated on plan sheets, / ).

e Litter and debris from the construction will be cleaned up on a daily basis.

e Waste-collection areas will be located away from streets, gutters, watercourses, and storm drains. Secondary containment around waste collection areas will be implemented if needed to further minimize the likelihood of contaminated discharges.

• Portable restrooms will be located away from streets, gutters, watercourses, and storm drains (location of areas are shown and updated on plan sheets, ). Secondary containment around waste collection areas will be implemented if needed to further minimize the likelihood of contaminated discharges.

• Portable restrooms will have tie-downs or stake downs in areas of high winds or susceptibility to vandalism.

e Hazardous waste-collection areas will be designated on-site (location of areas arc shown and updated on plan sheets, ' ). Secondary containment around waste collection areas will be implemented if needed to further minimize the likelihood of contaminated discharges.

• Hazardous waste containers will be routinely inspected to ensure that all containers are labeled properly and that no leaks are present.

Implementation: Throughout construction.

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Flocculants

Frozen Ground

Good Housekeeping Measures

Grubbing

Impaired Water

Indian Country above, or

2011 ACGP Appendix C Permit No. AKRIOOOOO

Page C-7

b. The homebuilder has established temporary stabilization including perimeter controls for an individual lot prior to occupation of the home by the homeowner and informing the homeowner of the need for, and benefits of, final stabilization.

5. For construction projects on land used for agricultural purposes (e.g., pipelines across crop or range land, staging areas for highway construction, etc.), final stabilization may be accomplished by returning the disturbed land to its preconstruction agricultural use.

Areas disturbed that were not previously used for agricultural activities, such as buffer strips immediately adjacent to "water of the United States," and areas which are not being returned to their preconstruction agricultural use must meet the final stabilization criteria (1) or (2) or (3) above.

Are substances that interact with suspended particles and bind them together to form floes. These floes more readily settle out compared to individual particles.

For the purposes of this permit, is characterized by soil temperature below freezing. Frozen ground by itself is not considered an acceptable stabilization control measure. If may be used in combination with control measures (e.g. track walking, downgradient control measures, etc.)

For the purposes of this permit, means storm water controls designed to reduce or eliminate the addition of pollutants to construction site discharges through analysis of pollutant sources, implementation of proper handling and/or disposal practices, employee education, and other actions.

For the purposes of this permit, means the stripping and removal of the root mass on or near the ground surface. This is considered soil disturbance activity and requires coverage under this permit.

(or "Water Quality Impaired Water" or "Water Quality Limited Segment") is defined as a water that is impaired for purposes of this permit if it has been identified by the State of Alaska or EPA pursuant to Section 303(d) of the Clean Water Act as not meeting applicable State water quality standards (These waters are called "water quality limited segments" under 40 CFR 30.2(j)). Impaired waters include both waters with approved or established TMDLs, and those for which a TMDL has not yet been approved or established.

Defined at 40 CFR §122.2 to mean:

1. All land within the limits of any Indian reservation under the jurisdiction of the United States Government, notwithstanding the

Large Construction Activity

Linear Project

Maintenance Only Projects

Master Plan

Mean Annual Precipitation

Minimize

2011 ACGP Appendix C Permit No. AK RI 00000

Page C-8 issuance of any patent, and including rights-of-way running through the reservation;

2. All dependent Indian communities with the borders of the United States whether within the originally or subsequently acquired territory thereof and whether within or without the limits of a state;

and

3. All Indian allotments, the Indian titles to which have not been extinguished, including rights-of-ways running through the same.

Defined at 40 CFR §122.26(b)(14)(x) and iricorporated here by reference. A large construction activity includes clearing, grading, and excavating resulting in a land disturbance that will disturb equal to or greater than five acres of land or will disturb less than five acres of total land area but is part of a larger common plan of development or sale that will ultimately disturb equal to or greater than five acres.

Large construction activity does not include routine maintenance that is performed to maintain the original line and grade, hydraulic capacity of conveyance channels, or original purpose of the site.

ls a land disturbing activity as conducted by an underground/overhead utility or highway department, including but not limited to any cable line or wire for the transmission of electrical energy; any conveyance pipeline for transportation of gaseous or liquid substance; any cable line for communications; or any other energy resource transmission right-of-way or utility infrastructure (e.g., roads and highways) along a long narrow area.

For the purposes of this permit, means projects that repair existing roads or ditches or similar maintenance projects

For the purposes of this permit, means if the permittee has a long range master plan of development (e.g. a rural infrastructure improvement project or military base construction) where some portions of the master plan are a conceptual rather than a specific plan of future development and the future construction activities would, if they occur at all, happen over an extended time period, the permittee may consider the "conceptual" phases of a master plan to be separate "common plans" provided the periods of construction for the physically interconnected phases do not overlap.

This is the average total precipitation based on weather records. This data is available on the website for the Western Regional Climate Center Mvw.wrcc.dri.edu/summary/Climsmak.html.

To reduce and/or eliminate to the extent achievable using control measures and good housekeeping measures that are technologically available and economically practicable and achievable in light of best

Minimize Pollutant Discharge

Municipality

Municipal Separate Storm Sewer System

(MS4)

Nephelometric Turbidity Unit (NTU)

New Project

New Source

New Source Perfonnance Standards (NSPS) industry practices.

See 'Minimize'

2011 ACGP Appendix C Permit No. AKR I 00000

Page C-9

A home rule municipality is a municipal corporation and political subdivision. It is a city or a borough that has adopted a home rule charter, or it is a unified municipality. A home rule municipality has all legislative powers not prohibited by law or chaiier. (§ 3 ch 74 SLA l 985) A general law municipality is a municipal corporation and political subdivision and is an unchartered borough or city. It has legislative powers conferred by law. (§ 3 ch 74 SLA 1985)

Defined at 40 CFR § l 22.26(b )(8) to mean a conveyance or system of conveyances (including roads with drainage systems, municipal streets, catch basins, curbs, gutters, ditches, manmade channels, or storm drains):

1. Owned and operated by a state, city, town, borough, county, parish, district, association, or other public body (created by or pursuant to State law) having jurisdiction over disposal of sewage, industrial wastes, storm water, or other wastes, including special districts under State law such as a sewer district, flood control district or drainage district, or similar entity, or an Indian tribe or an authorized Indian tribal organization, or a designated and approved management agency under Section 208 of the CWA that discharges to waters of the United States;

2. Designed or used for collecting or conveying storm water;

3. Which is not a combined sewer; and

4. Which is not part of a Publicly Owned Treatment Works (POTW) as defined at 40 CFR § 122.2.

ls an expression of the optical property that causes light to be scattered and absorbed rather than transmitted in a straight line through the water.

The "commencement of construction" occurs after the effective date of this permit.

For the purpose of this permit, is any source whose discharges are defined in 40 CFR § 122.26(b )(14 )(x) and (b )(15), that commences construction activity after the effective date of the new Construction &Development rule.

Are technology-based standards for a construction site that qualifies as new source under 40 CFR §450.24.

Temporary Stabilization

Total Maximum Daily Load (TMDL)

TMDL Waiver

Treatment Chemicals

Turbidmeter

Turbidity

Water Quality Impaired

Water Quality Standard

Waters of the United States

Wetland conclusion of use of the support activity.

2011 ACGP Appendix C Permit No. AKR I 00000

Page C-19

For the purposes of this permit, means protecting soils from erosion by rainfall, snow melt, runoff, or wind, with surface roughening or a surface cover, including, but not limited to, establishment of ground vegetation, application of mulch, surface tackifers, rolled erosion control products, gravel or paving.

The sum of the individual waste load allocations (WLAs) for point sources and load allocations (LAs) for nonpoint sources and natural background. If receiving water has only one point source discharger, the TMDL is the sum of that point source WLA plus the LAs for any nonpoint sources of pollution and natural background sources, tributaries, or adjacent segments. TMDLs can be expressed in terms of either mass per time, toxicity, or other appropriate measure.

Means a waiver, available only to small construction activities, based on an EPA established or approved TMDL.

For the purposes of this permit, means chemicals specifically used for chemical coagulation, chemical flocculation, erosion control or sediment control.

For the purposes of this permit, means an instrument that measures the amount of light scattered at right angles to an incident light beam by particles present in a storm water sample.

Means a condition of water quality characterized by the presence of suspended solids and/or organic material.

See 'Impaired Water.'

For the purposes of this permit, means the Alaska Water Quality Standards (18 AAC 70) as approved by U.S. EPA. As defined in 40 CFR § 131.3 water quality standards are provisions of State or Federal law which consist of a designated use or uses for the waters of the United States and water quality criteria for such waters based upon such uses. Water quality standards are to protect the public health or welfare, enhance the quality of water and serve the purposes of the Clean Water Act.

Has the meaning given in 40 CFR § 122.2.

Those areas that are inundated or saturated by surface or groundwater at a frequency and duration sufficient to support, and that under normal circumstances do support, a prevalence of vegetation typically adapted for life in saturated soil conditions. Wetlands generally

Winter Construction

Winter Shutdown

2011 ACGP Appendix C Permit No. AKR 100000

Page C-20 include swamps, marshes, bogs, and similar areas.

For the purposes of this permit, means the commencement of construction specifically during frozen conditions to aid in construction. Typically, this period is from December to March and is approximately from after fall freeze-up to before spring thaw.

For the purposes of this permit, means the cessation of soil disturbing or soil stabilizing construction activity for the winter. Typically this period is from October/November to April/May and is approximately from fall freeze-up to spring thaw.

(For Agency Use) Permit Authorization #: _________________ OASys Tracking #: _________________

2016 CGP NOI (November 2015) Page 1 of 4

Notice of Intent (NOI) Modification for Storm Water Discharges Associated with

Construction Activity filed under an APDES General Permit

(Please copy content exactly from your NOI. Indicate changes on the next page.)

Current NOI Information

I. Permit Authorization Number, Project Name, Operator:

Instructions for Completing a Modification to an APDES Notice of Intent (NOI) Use the form on the subsequent pages to indicate the items for which you are submitting this modification. Only enter the information you wish to change. You may use this form to modify an NOI that you submitted to ADEC for coverage under the Construction General Permit (CGP). If you have any questions about modifying your NOI, call the DEC Storm Water Program at (907) 269-8117.

When Should You Modify Your Notice of Intent (NOI)?

• You can use this form to update or correct information on your NOI, including:

• Owner/Operator address and contact information

• Site Information

• Start or End dates

• Number of acres to be disturbed

(Note, if the original project disturbance was between 1 and < 5 acres, and now will disturb five acres or more, a SWPPP must also be submitted with the NOI modification. Please note the CGP has different provisions for small and large construction projects.)

• Storm Water Pollution Prevention Plan (SWPPP) location and contact information

• Continuation of expired permit in accordance with Part 2.6.

When must you Submit a Notice of Termination (NOT) Instead of a Modification Form?

• The owner/operator has changed: You must submit a NOT when you transfer control of a site to a new owner/operator. The new owner/operator must then file a new NOI to obtain coverage under DEC’s CGP.

Coverage is not transferable.

2016 CGP NOI (November 2015) Page 2 of 4

Notice of Intent (NOI) for Storm Water Discharges Associated with Construction Activity under an APDES Construction General Permit

Submission of this Notice of Intent (NOI) constitutes notice that the party identified in Section II of this form requests authorization to discharge pursuant to the APDES Construction General Permit (CGP, AKR100000). Submission of this NOI also constitutes notice that the party identified in Section II of this form meets the eligibility requirements of the CGP for the project identified in Section IV of this form. Permit authorization is required prior to commencement of construction activity until you are eligible to terminate coverage as detailed in the CGP. To obtain authorization, you must submit a complete and accurate NOI form. Refer to the instructions at the end of this form.

I. Single/Multiple NOI Project Is this NOI for a project with a single NOI? ☐ Yes ☐ No

If “No,” then your project has multiple NOIs, will the fee be paid with this NOI? ☐ Yes ☐ No If “No,” then enter the name of the operator paying the fee:

II. Operator Information Organization: Name: Title:

Phone: Fax (optional): Email:

Mailing Address: Street (PO Box):

City: State: Zip:

III. Billing Contact Information

Mailing Address:

Street (PO Box):

IV. Project / Site Information Project Name: Estimated Start Date: Estimated End Date:

Brief Description of Project: Estimated Area to be Disturbed (nearest tenth acre):

Is your project / site less than one-acre, but part of a common plan of development? ☐ Yes ☐ No

If “Yes”, provide the Permit Authorization Number and name of the common plan of development:

Number:

Name:

Have storm water discharges from your project / site been authorized previously by a DEC permit? ☐ Yes ☐ No If “Yes,” provide the Permit Authorization Number for the previous DEC permit?

If “Yes,” have you updated your SWPPP according to the 2016 CGP? ☐ Yes ☐ No

Location Address:

Street: Borough or similar government subdivision:

Alaska Latitude (decimal degree, 5 places): Longitude (decimal degree, 5 places): Determined By:

☐ GPS ☐ USGS Topographic Map ☐ Other If you used a USGS Topographic map, what was the scale?

2016 CGP NOI (November 2015) Page 3 of 4

V. SWPPP (Storm Water Pollution Prevention Plan) Has the SWPPP been prepared in advance of filing this NOI? ☐ Yes ☐ No For projects with 5 or more acres of disturbance, has a SWPPP been submitted to DEC? ☐ Yes ☐ No, ≤ 5 acres Location of SWPPP for Viewing: ☐ Address in Section II ☐ Address in Section IV ☐ Other If other: Street:

SWPPP Contact Information (if different than that in Section II):

VI. Permanent Storm Water Controls Will you construct a permanent storm water management control measure at the project site (Part 4.11)? ☐ Yes ☐ No

If “Yes”, indicate the type of measure to be installed:

☐ Pond ☐ Oil/Water/Grit Separator ☐ Proprietary Storm Water Sedimentation Device ☐ Other:

VII. Discharge Information Does your project discharge into a Municipal Separate Storm Sewer System (MS4)? ☐ Yes ☐ No If yes, name of the MS4 Operator:

Receiving Water and Wetlands Information: (if additional space is needed for this question, attach separate sheet or annotate in Section XI.)

a. Identify the name(s) of waterbodies or wetlands to which you discharge.

Impaired waters/303d Listed waters:

(see http://dec.alaska.gov/water/wqsar/Docs/impairedwaters.pdf or http://dec.alaska.gov/water/wqsar/map.html, and http://dec.alaska.gov/water/tmdl/tmdl_index.htm.

b. Are any of your discharges directly into any segment of a 303d Listed Water, i.e.

“Impaired” Water?

c. If you answered YES to question b, then answer the following three questions:

i. What pollutant(s) are causing the impairment?

ii. Are the pollutant(s) causing the impairment present in your discharge?

iii. Is the discharge consistent with the assumptions and requirements of applicable EPA approved or established Total Maximum Daily Load (TMDL(s))?

Yes No Yes No Yes No

VIII. Treatment Chemicals Will you use control measures such as polymers, flocculants or other treatment chemicals at your construction site?

☐ Yes ☐ No

NOTE: If you are unsure at the filing of the NOI, check “No” and then if you use treatment chemicals file an NOI Modification form indicating “Yes.”

If “Yes”, indicate the following polymers, flocculants, or other treatment chemicals that will be used at your construction site:

☐ Alum ☐ Gypsum ☐ Polyacrylamide (PAM) ☐ Polyaluminum Chloride ☐ Other:

http://dec.alaska.gov/water/wqsar/Docs/impairedwaters.pdf http://dec.alaska.gov/water/wqsar/map.html http://dec.alaska.gov/water/tmdl/tmdl_index.htm

2016 CGP NOI (November 2015) Page 4 of 4

IX. Certification Information An Alaska Pollutant Discharge Elimination System (APDES) permit application or report must be signed by an individual with the appropriate authority per 18 AAC 83.385. For additional information, please refer to 18 AAC 83.385 at the following link:

http://dec.alaska.gov/commish/regulations/pdfs/18%20AAC%2083.pdf#page=71 Signing Authority: Please identify your authority to sign APDES permit applications and reports. (Select only one) ☐ Corporate Executive Officer 18 AAC 83.385

(a)(1)(A) For a corporation, 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-or decision-making functions for the corporation.

☐ Corporate Operations Manager 18 AAC 83.385 (a)(1)(B)

For a corporation, the manager of one or more manufacturing, production, or operating facilities.

☐ Sole Proprietor or General Partner

18 AAC 83.385

(a)(2)

For a partnership or sole proprietorship, the general partner or the proprietor respectively.

☐ Public Agency, Chief Executive Officer

18 AAC 83.385

(a)(3)(A)

For a municipality, state, or other public agency, the chief executive officer of the agency.

☐ Public Agency, Senior Executive Officer

18 AAC 83.385

(a)(3)(B)

For a municipality, state, or other public agency, a senior executive officer having responsibility for the overall operations of a principal geographic unit or division of the agency.

☐ Operations Manager (Delegated Authority)*

18 AAC 83.385

(b)(2)(A)

For a duly authorized representative, an individual or a position having responsibility for the overall operation of the regulated facility or activity, including the position of plant manager, operator of a well or a well field, superintendent or position of equivalent responsibility.

☐ Environmental Manager (Delegated Authority)*

18 AAC 83.385

(b)(2)(B)

For a duly authorized representative, an individual or position having overall responsibility for environmental matters for the company.

* For Delegated Authority: If you select “Delegated Authority” (Duly Authorized Representative), the delegation must be made in writing and submitted to the DEC. Your signature will not be approved until DEC receives the written delegation.

An Example of written authorization delegating authority can be found on the Division of Water website:

http://dec.alaska.gov/Water/OASysHelp/attachments/Delegation_Authorization_Form.pdf

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.

Signature Date

X. NOI Preparer (Complete if NOI was prepared by someone other than the certifier.)

XI. Document Attachments and Supplemental Information Documents attached with this application:

☐ Copy of SWPPP if ≥ 5 acres of disturbance.

☐ Delegation of Signatory Authority.

http://dec.alaska.gov/commish/regulations/pdfs/18%20AAC%2083.pdf#page=71 http://dec.alaska.gov/Water/OASysHelp/attachments/Delegation_Authorization_Form.pdf

For Agency Use

Permit #: ________________

2016 CGP NOI (March 2016) Page 4 of 4

Attachment 1. (Fill in as necessary if more space is required for Receiving water and Wetlands Information.)

a. What is the name(s) of your receiving water(s) that receive storm water directly and/or through a MS4?

If your receiving water is impaired, then identify the name of the impaired segment, if applicable, in parenthesis following the receiving water name.

b. Are any of your discharges directly into any segment of an “impaired” water?

c. If you answered yes to question b, then answer the following three questions:

i. What pollutant(s) are causing the impairment?

ii. Are the pollutant(s) causing the impairment present in your discharge?

iii. Has the TMDL been completed for the pollutant(s) causing the impairment?

Yes No Yes No Yes No

2016 CGP NOI (November 2015) Page i of ii

Instructions for Completing a Notice of Intent (NOI) Form for Storm Water Discharges Associated with Construction Activity under an APDES Construction General Permit

Who Must File an NOI Form:

Operators of construction sites where one or more acres are disturbed, smaller sites that are part of a larger common plan of development or sale where there is a cumulative disturbance of at least one acre, or any other site specifically designated by the Director, must submit an NOI to obtain coverage under an APDES construction general permit. Each person, firm, public organization, or any other entity that meets either of the following criteria must file this form: (1) they have operational control over construction plans and specifications, including the ability to make modifications to those plans and specifications; or (2) they have day-to-day operational control of those activities at the project necessary to ensure compliance with SWPPP requirements or other permit conditions.

Completing the Form:

Obtain and read a copy of the APDES Construction General Permit. Type or print, in the appropriate areas only. “NA” can be entered in areas that are not applicable. If you have any questions about how or when to use this form, contact the DEC Storm Water Program at (907) 269-6285 or online at http://www.dec.state.ak.us/water/wnpspc/stormwater.

Section I. Single/Multiple NOI Project:

Indicate whether or not this is a single NOI project. If not, indicate if the fee will be paid with this NOI or another associated with this project. Provide the name of the operator that will be paying the fee.

Section II. Operator Information:

Provide the name of the contact person, title, and the legal name of the firm, public organization, or any other entity that operates the project described in this application. (An operator of a project is a legal entity that controls at least a portion of site operations and is not necessarily the site manager.) Also provide the operator’s mailing address, telephone number, fax number (optional) and e-mail address (to be notified via e-mail of NOI approval when available). Correspondence for the NOI will be sent to this address.

Section III. Billing Contact Information Provide the name of the contact person, title, and the legal name of the firm, public organization, or any other entity that is responsible for accounts payable for this project. Also provide the billing contact’s mailing address, telephone number, fax number (optional), and email address.

Correspondence for billing purposes will be sent to this address. If the billing contact is that same as the operator, check the box.

Section IV. Project/Site Information:

Enter the official or legal name, a brief description of the project or site, and complete street address, including city, state, zip code, and county or similar government subdivision of the project or site. If the project or site lacks a street address, indicate the general location of the site (e.g., Intersection of State Highways 61 and 34). Complete site information must be provided for permit authorization to be granted.

Provide the latitude and longitude of the facility in decimal degrees format with up to 5 digit accuracy. The latitude and longitude of your facility can be determined in several different ways, including through the use of global positioning system (GPS) receivers, U.S. Geological Survey (U.S.G.S.) topographic or quadrangle maps, Google Earth, Bing Maps, and EPA’s web-based siting tools, among others. For consistency, DEC requests that measurements be taken from the approximate center of the construction site. Applicants must specify which method they used to determine latitude and longitude. If a U.S.G.S.

topographic map is used, applicants are required to specify the scale of the map used. Enter the estimated construction start and completion dates using four digits for the year (i.e., 05/27/2016).

Enter the estimated area (acres) to be disturbed including but not limited to: grubbing, excavation, grading, and utilities and infrastructure installation. Indicate to the nearest tenth of an acre. Note: 1 acre = 43,560 sq. ft.

Indicate whether or not the project/site has been previously covered by an EPA or DEC permit. If “Yes” provide the permit authorization number that the project/site was covered under.

If this is a project that was covered under a previous DEC construction general permit indicate whether or not the SWPPP has been updated in accordance with the 2016 Alaska Construction General Permit.

If the project or site is less than one-acre, but part of a common plan of development, provide the permit authorization number and name of the common plan of development.

Section V. SWPPP (Storm Water Pollution Prevention Plan) Information:

Indicate whether or not the SWPPP was prepared in advance of filing the NOI form. For projects with 5 acres or more of disturbance, has a SWPPP been submitted to DEC (Part 2.1.3)?

Check the appropriate box for the location where the SWPPP may be viewed. Provide the name, fax number (optional), and e-mail address of the contact person if different than that listed in Section II of the NOI form.

Section VI. Permanent Storm Water Controls A permittee must comply with applicable APDES MS4 permit requirements, local requirements, and the applicable requirements under 18 AAC 72.600 (i.e., Nondomestic Wastewater System Plan Review) regarding the design and installation of permanent storm water management controls.

Annotate the type of measure to be installed, and see Permit Part 4.11 for additional requirements regarding plan submittal deadlines.

Section VII. Discharge Information:

Identify the receiving water bodies or wetlands to which the project’s storm water will discharge. These should be the first bodies of water that the discharge will reach. (Note: If you http://www.dec.state.ak.us/water/wnpspc/stormwater

2016 CGP NOI (November 2015) Page ii of ii discharge to more than one water body, please indicate all such waters in the space provided and attach a separate sheet if necessary.) For example, if the discharge leaves your site and travels through a roadside swale or a storm sewer and then enters a stream that flows to a river, the stream would be the receiving water body. Waters of the U.S. include lakes, streams, creeks, rivers, wetlands, impoundments, estuaries, bays, oceans, and other surface bodies of water within the confines of the U.S. and U.S. coastal waters. (Waters of the U.S. do not include man-made structures created solely for the purpose of wastewater treatment.) U.S.G.S. topographical maps may be used to make this determination. If the map does not provide a name, use a format such as “unnamed tributary to Cross Creek”. If you discharge into a municipal separate storm sewer system (MS4), you must identify the water body into which that portion of the storm sewer discharges. That information should be readily available from the operator of the MS4.

Indicate if any of your storm water discharges from construction activities will be reach a 303d listed water (i.e., impaired water body)?

For a listing of impaired waters and an interactive map, see http://dec.alaska.gov/water/wqsar/Docs/impairedwaters.pdf or http://dec.alaska.gov/water/wqsar/map.html.

Indicate whether your storm water discharges from construction activities will be consistent with the assumptions and requirements of applicable EPA approved or established total maximum daily load(s)(TMDL(s)). To answer this question, refer to http://dec.alaska.gov/water/tmdl/tmdl_index.htm for specific TMDL information related to the construction general permit. You may also have to contact DEC. If there are no applicable TMDLs or no related requirements, please check the “yes” box in the NOI form.

Section VIII. Treatment Chemicals:

Indicate whether or not polymers, flocculants, or other treatment chemicals will be used. If you are unsure at the filing of the NOI, check “No” and then if you use them file an NOI Modification form indicating “Yes.”

Check the box next to any treatment chemical that will be used. If “Other” is checked, list the treatment chemicals.

Section IX. Certification Information:

The NOI must be signed as follows:

(1) For a corporation, a responsible corporate officer shall sign the NOI, a responsible corporate officer means:

(A) 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 - or decision-making functions for the corporation; or

(B) the manager of one or more manufacturing, production, or operating facilities, if

(i) 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 environmental compliance with environmental statutes and regulations;

(ii) the manager can ensure that the necessary systems are established or actions taken to gather complete and accurate information for permit application requirements; and

(iii) authority to sign documents has been assigned or delegated to the manager in accordance with corporate procedures.

(2) For a partnership or sole proprietorship, the general partner or the proprietor, respectively; or

(3) for a municipality, state, or other public agency, either a principal executive officer or ranking elected official shall sign the application; in this subsection, a principal executive officer of an agency means

(A) the chief executive officer of the agency; or

(B) a senior executive officer having responsibility for the overall operations of a principal geographic unit or division of the agency.

(4) Include the name, title, organization, address, telephone number, and email address of the person signing the form and the date of signing. An unsigned or undated NOI form will not be considered valid application for permit coverage.

Section X. NOI Preparer Information.

If the NOI was prepared by someone other than the certifier (for example, if the NOI was prepared by the project SWPPP contact or a consultant for the certifier’s signature), include the name, title, organization, address, telephone number, and email address of the NOI preparer.

Section XI. Document Attachments and Supplemental Information Include a copy of the SWPPP if ≥ 5 acres of disturbance.

Indicate documents attached and supplemental information.

Where to File NOI form Select one of three options:

1) Preferred Option: DEC encourages you to complete the

NOI form electronically via DEC’s Online Application System (OASys):

https://myalaska.state.ak.us/dec/water/OASys/Login.aspx.

Filing electronically is the fastest way to obtain permit coverage and help ensure that your NOI is complete.

2) If you file by mail please…