Stormwater_Pollution_Prevention_Plan_Report.pdf

Stormwater Pollution Prevention Plan (SWPPP) NH FH 47-1(001) Rehabilitation of Tripoli Road

EPA SWPPP Template, Version 1.0 iii

For Construction Activities At:

White Mountain National Forest

Grafton County, New Hampshire Insert Project/Site Telephone Number

SWPPP Prepared For:

Federal Highway Administration (FHWA) Kevin Rose

21400 Ridgetop Circle Sterling, VA 20166

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

SWPPP Prepared By:

FHWA

Eric Rothermel

21400 Ridgetop Circle Sterling, VA 20166

(703) 404-6365 Eric.Rothermel@dot.gov

SWPPP Preparation Date:

4/3/2014

Estimated Project Dates:

Project Start Date: 9/2/2014 Project Completion Date: 10/31/2014

EPA SWPPP Template, Version 1.0 iv

Contents

SECTION 1: CONTACT INFORMATION/RESPONSIBLE PARTIES

1.1 Operator(s) / Subcontractor(s)

1.2 Stormwater Team

SECTION 2: SITE EVALUATION, ASSESSMENT, AND PLANNING

2.1 Project/Site Information

2.2 Discharge Information

2.3 Nature of the Construction Activity

2.4 Sequence and Estimated Dates of Construction Activities

2.5 Allowable Non-Stormwater Discharges

2.6 Site Maps

SECTION 3: DOCUMENTATION OF COMPLIANCE WITH OTHER FEDERAL REQUIREMENTS

3.1 Endangered Species Protection

3.2 Historic Preservation

3.3 Safe Drinking Water Act Underground Injection Control Requirements

SECTION 4: EROSION AND SEDIMENT CONTROLS

4.1 Natural Buffers or Equivalent Sediment Controls

4.2 Perimeter Controls

4.3 Sediment Track-Out

4.4 Stockpiled Sediment or Soil

4.5 Minimize Dust

4.6 Minimize the Disturbance of Steep Slopes

4.7 Topsoil

4.8 Soil Compaction

4.9 Storm Drain Inlets

4.10 Constructed Stormwater Conveyance Channels

4.11 Sediment Basins

4.12 Chemical Treatment

4.13 Dewatering Practices

4.14 Other Stormwater Controls

4.15 Site Stabilization

SECTION 5: POLLUTION PREVENTION STANDARDS

5.1 Potential Sources of Pollution

5.2 Spill Prevention and Response

5.3 Fueling and Maintenance of Equipment or Vehicles

5.4 Washing of Equipment and Vehicles

5.5 Storage, Handling, and Disposal of Construction Products, Materials, and Wastes

5.6 Washing of Applicators and Containers used for Paint, Concrete or Other Materials

5.7 Fertilizers

5.8 Other Pollution Prevention Practices

SECTION 6: INSPECTION AND CORRECTIVE ACTION

6.1 Inspection Personnel and Procedures

6.2 Corrective Action

6.3 Delegation of Authority

SECTION 7: TRAINING

SECTION 8: CERTIFICATION AND NOTIFICATION

SWPPP APPENDICES

EPA SWPPP Template, Version 1.0 1

SECTION 1: CONTACT INFORMATION/RESPONSIBLE PARTIES

1.1 Operator(s) / Subcontractor(s)

Operator(s):

Company or Organization Name: Federal Highway Administration Name: Kevin Rose Address: 21400 Ridgetop Circle City, State, Zip Code: Sterling, VA 20166 Telephone Number: (571) 434-1541 Email: Kevin.Rose@dot.gov Insert area of control (if more than one operator at site):

[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 Name:

Insert Telephone Number:

Instructions (see definition of “operator” at CGP Part 1.1.a):

― Identify the operator(s) who will be engaged in construction activities at the site.

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 the Template.

mailto:Kevin.Rose@dot.gov

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1.2 Stormwater Team

Role or Responsibility: SWPPP Development Position: Environmental Protection Specialist Name: Eric Rothermel Telephone Number: (703) 404-6365 Email: Eric.Rothermel@dot.gov

Insert Role or Responsibility: SWPPP Development Insert Position: Environmental Protection Specialist Insert Name: Lana Lau Insert Telephone Number: (703) 404-6314 Insert Email: Lana.Lau@dot.gov

Insert Role or Responsibility:

Insert Position:

Insert Name:

Insert Email:

Instructions (see CGP Part 7.2.1):

― Identify the staff members (by name or position) that comprise the project’s stormwater team as well as their individual responsibilities. At a minimum the stormwater team is comprised of individuals who are responsible for overseeing the development of the SWPPP, any later modifications to it, and for compliance with the requirements in this permit (i.e., installing and maintaining stormwater controls, conducting site inspections, and taking corrective actions where required).

― Each member of the stormwater team must have ready access to either an electronic or paper copy of applicable portions of the 2012 CGP and your SWPPP.

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SECTION 2: SITE EVALUATION, ASSESSMENT, AND PLANNING

2.1 Project/Site Information

Project Name and Address

Project/Site Name: NH FH 47-1(001) Rehabilitation of Tripoli Road Project Street/Location: Tripoli Road City: Towns of Woodstock and Thornton State: NH ZIP Code: 03262, 03285 County or Similar Subdivision: Grafton County

Project Latitude/Longitude

(Use one of three possible formats, and specify method) Latitude: Longitude:

1. 43 º 59 ' 42.648'' N (degrees, minutes, seconds) 1. 71 º 38 ' 32.317'' W (degrees, minutes, seconds)

2. _ _ º _ _ . _ _' N (degrees, minutes, decimal) 2. _ _ º _ _ . _ _' W (degrees, minutes, decimal)

3. _ _ . _ _ _ _ º N (decimal) 3. _ _ . _ _ _ _ º W (decimal)

Method for determining latitude/longitude:

USGS topographic map (specify scale: ) EPA Web site GPS Other (please specify):

Horizontal Reference Datum:

NAD 27 NAD 83 or WGS 84 Unknown

If you used a U.S.G.S topographic map, what was the scale? ____________________________

Additional Project Information

Is the project/site located on Indian country lands, or located on a property of religious or cultural significance to an Indian tribe? Yes No

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: N/A

Instructions (see “Project/Site Information” section of Appendix J – NOI form):

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

― Detailed information on determining your site’s latitude and longitude can be found at www.epa.gov/npdes/stormwater/latlong http://www.epa.gov/npdes/stormwater/latlong

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If you are conducting earth-disturbing activities in response to a public emergency, document the cause of the public emergency (e.g., natural disaster, extreme flooding conditions), information substantiating its occurrence (e.g., state disaster declaration), and a description of the construction necessary to reestablish effective public services: N/A

Are you applying for permit coverage as a “federal operator” as defined in Appendix A of the 2012 CGP? Yes No

2.2 Discharge Information

Does your project/site discharge stormwater into a Municipal Separate Storm Sewer System (MS4)? Yes No

Are there any surface waters that are located within 50 feet of your construction disturbances?

Yes No

Instructions (see “Discharge Information” section of Appendix F – NOI form):

― In this section, include information relating to your site’s discharge. This information corresponds to the “Discharge Information” section of the NOI form. Because you may be using EPA’s mapping tool to answer some of these questions, and the tool is accessed in the eNOI system, you may find it necessary to leave some questions unanswered until you have completed that portion of the NOI.

― For Table 1, list the name of the first surface water that receives discharges from your site. If your site has discharges to multiple surface waters, indicate the names of all such waters.

― For Table 2, if any of the surface waters you listed out in Table 1 are listed as impaired by the applicable State or Tribe, provide specified information about pollutants causing the impairment and whether or not a Total Maximum Daily Load (TMDL) has been completed for the surface water. For more information on TMDLs and impaired waters, including a list of TMDL contacts and links by state, visit www.epa.gov/npdes/stormwater/tmdl.

― For Table 3, indicate whether any of the surface waters you listed out in Table 1 are designated as Tier 2, 2.5, or 3 waters by your State or Tribe. See Appendix F for more information.

http://www.epa.gov/npdes/stormwater/tmdl

EPA SWPPP Template, Version 1.0 5

Table 1 – Names of Receiving Waters Name(s) of the first surface water that receives stormwater directly from your site and/or from the MS4 (note: multiple rows provided where your site has more than one point of discharge that flows to different surface waters) 1.Tributary to the Pemigewasset River 2.Talford Brook 3.

4.

5.

6.

[Include additional rows as necessary.]

Table 2 – Impaired Waters / TMDLs (Answer the following for each surface water listed in Table 1 above)

Is this surface water listed as “impaired”?

If you answered yes, then answer the following:

What pollutant(s) are causing the impairment?

Has a TMDL been completed?

Title of the TMDL document Pollutant(s) for which there is a TMDL

1. YES NO PH, Acidity, caustic conditions YES NO

2. YES NO PH, Acidity, caustic conditions YES NO

3. YES NO YES NO

4. YES NO YES NO

5. YES NO YES NO

6. YES NO YES NO

Describe the method(s) you used to determine whether or not your project/site discharges to an impaired water: INSERT TEXT HERE

Table 3 – Tier 2, 2.5, or 3 Waters (Answer the following for each surface water listed in Table 1 above)

Is this surface water designated as a Tier 2, Tier 2.5, or Tier 3 water?

(see Appendix F)

If you answered yes, specify which Tier (2, 2.5, or 3) the surface water is designated as?

1. YES NO Tier 2

2. YES NO Tier 3

3. YES NO INSERT "Tier 2", "Tier 2.5", or "Tier 3"

4. YES NO INSERT "Tier 2", "Tier 2.5", or "Tier 3"

5. YES NO INSERT "Tier 2", "Tier 2.5", or "Tier 3"

6. YES NO INSERT "Tier 2", "Tier 2.5", or "Tier 3"

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2.3 Nature of the Construction Activity

General Description of Project Provide a general description of the construction project:

The reconstruction of a 1.5 mile segment of Tripoli Road. This work includes the replacement of 22 culverts, grading, aggregate base, drainage, and other miscellaneous work.

Size of Construction Project What is the size of the property (in acres), the total area expected to be disturbed by the construction activities (in acres), and the maximum area expected to be disturbed at any one time?

SIZE OF PROPERTY (in acres): 45,000 acres TOTAL AREA OF CONSTRUCTION DISTURBANCES (in acres): 1.90 acres MAXIMUM AREA TO BE DISTURBED AT ANY ONE TIME (in acres): 350,000 sq. feet

[Repeat as necessary for individual project phases.]

Construction Support Activities To be completed by Contractor 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) DESCRIPTION OF CONSTRUCTION SUPPORT ACTIVITY: Construction staging INSERT CONTACT INFORMATION FOR CONSTRUCTION SUPPORT ACTIVITY (Name, Telephone No., Email Address) LOCATION INFORMATION FOR CONSTRUCTION SUPPORT ACTIVITY (Address and/or Latitude/Longitude): The Contractor will be able to use the existing roadway, which will be closed for construction. If this area is insufficient, the Contractor will find another area off Government property.

[Repeat as necessary.]

Instructions (see CGP Parts 1.3.c and 7.2.2):

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

― Describe the size of the property (in acres) and the total area expected to be disturbed by the construction activities (in acres), construction support activities covered by this permit (see Part 1.3.c of the permit), and the maximum area expected to be disturbed at any one time.

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2.4 Sequence and Estimated Dates of Construction Activities

Phase I Erosion and Sediment Control

Prior to any clearing, grubbing, or excavation construct perimeter controls to ensure the disturbed sediment does not leave the project site. Perimeter controls include silt fence and other specific measures outside the construction limits.

Phase II Intermediate Controls

Apply intermediate controls during rough grading operations. Install silt fence in areas surrounding the culverts as called out in the Erosion and Sediment Control Plans. Install filter berms in ditches along the roadway.

Apply temporary turf establishment in disturbed areas that will remain exposed for over 14 calendar days within 7 days.

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

Install inlet protection prior to diverting stormwater through inlets.

Upon completion of culverts, ensure that culvert entrances, outlets and outlet channels are at final grade and are stabilized.

Provide silt fence around all stock piled excavated roadway materials. Apply temporary turf establishment to stockpiles remaining in place for longer than 14 days within 7 days of stockpiling.

Instructions (see CGP Part 7.2.5):

― Describe the intended construction sequence and timing of major activities.

― For each phase of construction, include the following information:

Installation of stormwater controls, and when they will be made operational;

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

Cessation, temporarily or permanently, of construction activities on the site, or in designated portions of the site;

Final or temporary stabilization of areas of exposed soil. The dates for stabilization must reflect the applicable deadlines to which you are subject to in Part 2.2.1; and

Removal of temporary stormwater conveyances/channels and other stormwater control measures, removal of construction equipment and vehicles, and cessation of any pollutant-generating activities.

― The construction sequence must reflect the following requirements:

Part 2.1.1.1 (area of disturbance);

Part 2.1.1.3.a (installation of stormwater controls); and Parts 2.2.1.1, 2.2.1.2, 2.2.1.3 (stabilization deadlines).

― Also, see EPA’s Construction Sequencing BMP Fact Sheet at http://www.epa.gov/npdes/stormwater/menuofbmps/construction/cons_seq) http://www.epa.gov/npdes/stormwater/menuofbmps/construction/cons_seq

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

Phase III Final Construction and Stabilization

After completion of roadway work, do the following as directed by the CO:

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

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

• Inspect, clean, and repair all culvert outlet protection, riprap basins, and stabilized channels.

• Remove all devices used for dewatering.

• Remove silt fence only after all upslope areas are stabilized and vegetation is well established.

[Repeat as needed.]

2.5 Allowable Non-Stormwater Discharges

List of Allowable Non-Stormwater Discharges Present at the Site

Instructions (see CGP Parts 1.3.d and 7.2.8):

― Identify all allowable sources of non-stormwater discharges. The allowable non-stormwater discharges identified in Part 1.3.d of the 2012 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;

Routine external building wash down that does not use detergents;

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 was waters directly into any surface water, storm drain inlet, or stormwater conveyance, 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 Construction dewatering water that has been treated by an appropriate control.

EPA SWPPP Template, Version 1.0 8

Type of Allowable Non-Stormwater Discharge Likely to be Present at

Your Site?

Discharges from emergency fire-fighting activities YES NO Fire hydrant flushings YES NO Landscape irrigation YES NO

Waters used to wash vehicles and equipment YES NO Water used to control dust YES NO Potable water including uncontaminated water line flushings YES NO Routine external building wash down YES NO Pavement wash waters YES NO Uncontaminated air conditioning or compressor condensate YES NO

Uncontaminated, non-turbid discharges of ground water or spring water YES NO Foundation or footing drains YES NO Construction dewatering water YES NO

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

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2.6 Site Maps

Instructions (see CGP Part 7.2.6):

― 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;

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

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

Locations of any crossings of surface waters;

Designated points on the site where vehicles will exit onto paved roads;

Locations of structures and other impervious surfaces upon completion of construction; and Locations of construction support activity areas covered by this permit.

― Locations of all surface waters, including wetlands, that exists on or near your site.

Indicate which waterbodies are listed as impaired, and which are identified by your state, tribe, or EPA as Tier 2, Tier 2.5, or Tier 3 waters.

― The boundary lines of any natural buffer areas. See CGP Part 2.1.2.1.a.

― Areas of federally-listed critical habitat for endangered or threatened species.

― Topography of the site, existing vegetative cover (e.g., forest, pasture, pavement, structures), and drainage pattern(s) of stormwater and allowable non-stormwater flow onto, over, and from the site property before and after major grading activities.

― Stormwater and allowable non-stormwater discharge locations, including:

Locations of any storm drain inlets on the site and in the immediate vicinity of the site; and Locations where stormwater or allowable non-stormwater will be discharged to surface waters (including wetlands).

― Locations of all potential pollutant-generating activities.

― Locations of stormwater control measures.

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

EPA SWPPP Template, Version 1.0 10

SECTION 3: DOCUMENTATION OF COMPLIANCE WITH OTHER FEDERAL REQUIREMENTS

3.1 Endangered Species Protection

Eligibility Criterion Under which criterion listed in Appendix D are you eligible for coverage under this permit?

A B C D E

For reference purposes, the eligibility criteria listed in Appendix D are as follows:

Criterion A. No federally-listed threatened or endangered species or their designated critical habitat(s) are likely to occur in your site’s “action area” as defined in Appendix A of this permit.

Criterion B. 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 and there is no reason to believe that federally-listed species or federally-designated critical habitat not considered in the prior 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 operator’s certification. By certifying eligibility under this Criterion, you agree to comply with any effluent limitations or conditions upon which the other operator's certification was based. You must include in your NOI the tracking number from the other operator’s notification of authorization under this permit. If your certification is based on another operator’s certification under Criterion C, you must provide EPA with the relevant supporting information required of existing dischargers in Criterion C in your NOI form.

Criterion C. Federally-listed threatened or endangered species or their designated critical habitat(s) are likely to occur in or near your site’s “action area,” and your site’s discharges and discharge-related activities are not likely to adversely affect listed threatened or endangered species or critical habitat. This determination 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 adversely affect listed species and critical habitat. To make this certification, you must include the following in your NOI: 1) any federally listed species and/or designated habitat located in your “action area”; and 2) the distance between your site and the listed species or designated critical habitat (in miles). You must also include a copy of your site map with your NOI.

Instructions (see CGP Parts 1.1.e, 7.2.14.1, Appendix D, and the “Endangered Species Protection” section of the Appendix J – NOI form):

Follow the process in Appendix D of the permit for determining which eligibility criterion (A-E) you have met with respect to the protection of endangered species. You will ― Include documentation supporting your determination of eligibility.

― Additional information on Endangered Species Act (ESA) provisions for EPA’s

Construction General Permit is at www.epa.gov/npdes/stormwater/esa http://www.epa.gov/npdes/stormwater/esa

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Criterion D. Coordination between you and the Services has been concluded. The coordination must have addressed the effects of your site’s discharges and discharge-related activities on federally-listed threatened or endangered species and federally-designated critical habitat, and must have resulted in a written concurrence from the relevant Service(s) that your site’s discharges and discharge-related activities are not likely to adversely affect listed species or critical habitat. You must include copies of the correspondence between yourself and the Services in your SWPPP and your NOI.

Criterion E. 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:

i. 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

ii. 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 your NOI.

Criterion F. 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 your NOI.

Supporting Documentation Provide documentation for the applicable eligibility criterion you select in Appendix D, as follows:

For criterion A, indicate the basis for your determination that no federally-listed threatened or endangered species or their designated critical habitat(s) are likely to occur in your site’s action area (as defined in Appendix A of the permit). Check the applicable source of information you relied upon:

Specific communication with staff of the U.S. Fish & Wildlife Service or National Marine Fisheries Service. INSERT DATE OF COMMUNICATION AND WHO YOU SPOKE WITH

Publicly available species list. INSERT SPECIFIC DOCUMENT AND/OR WEBSITE RELIED UPON Other source: INSERT SPECIFIC SOURCE

For criterion B, provide the Tracking Number from the other operator’s notification of permit authorization: INSERT AUTHORIZATION TRACKING NUMBER FROM OTHER OPERATOR'S

NOTIFICATION LETTER/EMAIL

Provide a brief summary of the basis used by the other operator for selecting criterion A, B, C, D, E, or F: INSERT TEXT HERE

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For criterion C, provide the following information:

INSERT LIST OF FEDERALLY-LISTED SPECIES OR FEDERALLY-DESIGNATED CRITICAL HABITAT

LOCATED IN YOUR ACTION AREA

INSERT DISTANCE BETWEEN YOUR SITE AND THE LISTED SPECIES OR CRITICAL HABITAT (in miles) Also, provide a brief summary of the basis used for determining that your site’s discharges and discharge-related activities are not likely to adversely affect listed species or critical habitat:

INSERT TEXT HERE

For criterion D, E, or F, attach copies of any letters or other communication between you and the U.S. Fish & Wildlife Service or National Marine Fisheries Service concluding consultation or coordination activities. See Appendix D for the USFWS concurrence letter.

3.2 Historic Preservation

Appendix E, Step 1 Do you plan on installing 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 Stormwater Conveyance Channel (e.g., ditch, trench, perimeter drain, swale, etc.)

Culvert Other type of ground-disturbing stormwater control: INSERT SPECIFIC TYPE OF

STORMWATER CONTROL

(Note: If you will not be installing any ground-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 surveys or evaluations conducted on the site already determined that historic properties do not exist, or that prior disturbances at the site have precluded the existence of historic properties? YES NO

Instructions (see CGP Part 1.1.f, 7.2.14.2, Appendix E, and the “Historic Preservation” section of the Appendix F – NOI form):

Follow the screening process in Appendix E of the permit for determining 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 or tribal historic preservation office, information is available at www.achp.gov/programs/html.

http://www.achp.gov/programs/html

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

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. See Appendix E for documentation of SHPO’s finding that no historic properties would be affected.

If no, proceed to Appendix E, Step 4.

Appendix E, Step 4 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 whether the subsurface earth disturbances caused by the installation of stormwater controls affect historic properties? YES NO

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

If yes, describe the nature of their response:

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

LETTERS, EMAILS, OR OTHER COMMUNICATION BETWEEN YOU AND THE APPLICABLE SHPO,

THPO, OR OTHER TRIBAL REPRESENTATIVE

No agreement has been reached regarding measures to mitigate effects to historic properties from the installation of stormwater controls. 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

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3.3 Safe Drinking Water Act Underground Injection Control Requirements

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

Instructions (see CGP Part 7.2.14.3):

― If you will use any of the identified controls in this section, include documentation of contact between you and 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:

http://water.epa.gov/type/groundwater/uic/whereyoulive.cfm.

http://water.epa.gov/type/groundwater/uic/whereyoulive.cfm

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SECTION 4: EROSION AND SEDIMENT CONTROLS

4.1 Natural Buffers or Equivalent Sediment Controls

Buffer Compliance Alternatives Are there any surface waters within 50 feet of your project’s earth disturbances? YES NO

(Note: If no, no further documentation is required for the SWPPP Template.)

Check the compliance alternative that you have chosen:

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.)

I will provide and maintain an undisturbed natural buffer that is less than 50 feet 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.

(Note (1): You must show the 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

General Instructions (See CGP Parts 2.1 and 7.2.10):

― Describe the erosion and sediment controls that will be installed and maintained at your site.

― For more information or ideas on BMPs, see EPA’s National Menu of BMPs http://www.epa.gov/npdes/stormwater/menuofbmps

Instructions (see CGP Parts 2.1.2.1 and 7.2.9, and Appendix G):

This section only applies to you if a surface water is located within 50 feet your construction activities. If this is the case, consult CGP Part 2.1.2.1 and Appendix G for information on how to comply with the buffer requirements.

― Describe the compliance alternative (CGP Part 2.1.2.1.a.i, ii, or iii) that was chosen to meet the buffer requirements, and include any required documentation supporting the alternative selected. 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 2.1.2.1.e, include documentation related to your qualification for such exceptions.

http://www.epa.gov/npdes/stormwater/menuofbmps

EPA SWPPP Template, Version 1.0 16 sediment controls. Also, show on the site map any velocity dissipation devices used to prevent erosion within the natural buffer area.)

INSERT WIDTH OF NATURAL BUFFER TO BE RETAINED

INSERT EITHER ONE OF THE FOLLOWING:

(1) THE ESTIMATED SEDIMENT REMOVAL FROM A 50-FOOT BUFFER USING APPLICABLE TABLES

IN APP. G, ATTACHMENT 1. INCLUDE INFORMATION ABOUT THE BUFFER VEGETATION AND

SOIL TYPE THAT PREDOMINATE AT YOUR SITE

OR

(2) IF YOU CONDUCTED A SITE-SPECIFIC CALCULATION FOR THE ESTIMATED SEDIMENT

REMOVAL OF A 50-FOOT BUFFER, PROVIDE THE SPECIFIC REMOVAL EFFICIENCY, AND

INFORMATION YOU RELIED UPON TO MAKE YOUR SITE-SPECIFIC CALCULATION.

INSERT DESCRIPTION OF ADDITIONAL EROSION AND SEDIMENT CONTROLS TO BE USED IN

COMBINATION WITH NATURAL BUFFER AREA

INSERT THE FOLLOWING INFORMATION:

- (1) SPECIFY THE MODEL OR OTHER TOOL USED TO ESTIMATE SEDIMENT LOAD

REDUCTIONS FROM THE COMBINATION OF THE BUFFER AREA AND ADDITIONAL EROSION

AND SEDIMENT CONTROLS INSTALLED AT YOUR SITE, AND

- (2) INCLUDE THE RESULTS OF CALCULATIONS SHOWING THAT THE COMBINATION OF

YOUR BUFFER AREA AND THE ADDITIONAL EROSION AND SEDIMENT CONTROLS

INSTALLED AT YOUR SITE WILL MEET OR EXCEED THE SEDIMENT REMOVAL EFFICIENCY OF

A 50-FOOT BUFFER

It is infeasible to provide and maintain an undisturbed natural buffer of any size, therefore I 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 IT IS INFEASIBLE TO PROVIDE AND MAINTAIN A

NATURAL BUFFER OF ANY SIZE

INSERT EITHER ONE OF THE FOLLOWING:

(1) THE ESTIMATED SEDIMENT REMOVAL FROM A 50-FOOT BUFFER USING APPLICABLE TABLES

IN APP. G, ATTACHMENT 1. INCLUDE INFORMATION ABOUT THE BUFFER VEGETATION AND

SOIL TYPE THAT PREDOMINATE AT YOUR SITE

OR

(2) IF YOU CONDUCTED A SITE-SPECIFIC CALCULATION FOR THE ESTIMATED SEDIMENT

REMOVAL OF A 50-FOOT BUFFER, PROVIDE THE SPECIFIC REMOVAL EFFICIENCY, AND

INFORMATION YOU RELIED UPON TO MAKE YOUR SITE-SPECIFIC CALCULATION.

INSERT DESCRIPTION OF ADDITIONAL EROSION AND SEDIMENT CONTROLS TO BE USED IN

COMBINATION WITH NATURAL BUFFER AREA

INSERT THE FOLLOWING INFORMATION:

- (1) SPECIFY THE MODEL OR OTHER TOOL USED TO ESTIMATE SEDIMENT LOAD

REDUCTIONS FROM THE EROSION AND SEDIMENT CONTROLS INSTALLED AT YOUR SITE,

AND

- (2) INCLUDE THE RESULTS OF CALCULATIONS SHOWING THAT THE ADDITIONAL EROSION

AND SEDIMENT CONTROLS INSTALLED AT YOUR SITE WILL MEET OR EXCEED THE SEDIMENT

REMOVAL EFFICIENCY OF A 50-FOOT BUFFER

EPA SWPPP Template, Version 1.0 17

I qualify for one of the exceptions in Part 2.1.2.1.e. (If you have checked this box, provide information on the applicable buffer exception that applies, below.)

Buffer Exceptions Which of the following exceptions to the buffer requirements applies to your site?

There is no discharge of stormwater to the surface water that is located 50 feet from my construction disturbances.

(Note: If this exception applies, no further documentation is required for Section 4.1 of the Template.)

No natural buffer exists due to preexisting development disturbances that occurred prior to the initiation of planning for this project.

(Note (1): If this exception applies, no further documentation is required for Section 4.1 of the Template.)

(Note (2): Where some natural buffer exists but portions of the area within 50 feet of the surface water are occupied by preexisting development disturbances, you must still comply with the one of the CGP Part 2.1.2.1.a compliance alternatives.)

For a “linear project” (defined in Appendix A), site constraints (e.g., limited right-of-way) make it infeasible for me to meet any of the CGP Part 2.1.2.1.a compliance alternatives. It is infeasible for us to have a 50 foot buffer because we are doing a culvert project which may have water running through it. We will use silt fence and other E&S Controls to minimize the impacts. Culvert work will be completed during dry periods.

The project qualifies as “small residential lot” construction (defined in Part 2.1.2.1.e.iv and in Appendix A).

For Alternative 1 (see Appendix G, Part G.2.3.2.a):

INSERT WIDTH OF NATURAL BUFFER TO BE RETAINED

INSERT APPLICABLE REQUIREMENTS BASED ON TABLE G-1

INSERT DESCRIPTION OF HOW YOU WILL COMPLY WITH THESE REQUIREMENTS

For Alternative 2 (see Appendix G, Part G.2.3.2.b):

INSERT (1) THE ASSIGNED RISK LEVEL BASED ON APPLICABLE TABLE IN APP. G, PART

G.2.3.2.b, AND (2) THE PREDOMINANT SOIL TYPE AND AVERAGE SLOPE AT YOUR SITE

INSERT APPLICABLE REQUIREMENTS BASED ON APP. G, TABLE G-7

INSERT DESCRIPTION OF HOW YOU WILL COMPLY WITH THESE REQUIREMENTS

Buffer disturbances are authorized under a CWA Section 404 permit. INSERT DESCRIPTION OF ANY

EARTH DISTURBANCES THAT WILL OCCUR WITHIN THE BUFFER AREA

(Note (1): If this exception applies, no further documentation is required for Section 4.1 of the Template.)

(Note (2): This exception only applies to the limits of disturbance authorized under the Section 404 permit, and does not apply to any upland portion of the construction project.)

Buffer disturbances will occur for the construction of a water-dependent structure or water access area (e.g., pier, boat ramp, and trail). INSERT DESCRIPTION OF ANY EARTH DISTURBANCES THAT

WILL OCCUR WITHIN THE BUFFER AREA

(Note (1): If this exception applies, no further documentation is required for Section 4.1 of the Template.)

EPA SWPPP Template, Version 1.0 18

4.2 Perimeter Controls

General Do not modify the type, size, or location of any control or practice without prior approval from the

Contracting Officer (CO).

Do not allow construction equipment to operate on or access the down-slope side of the perimeter control measures.

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

Specific Perimeter Controls

Perimeter Control # 1: Silt Fence Perimeter Control Description

Silt Fence will be installed prior to any clearing, grubbing, or excavation, construct perimeter controls to ensure that disturbed sediment does not leave the project site.

Installation Contractor will be in charge of this.

Maintenance Requirements

Before sediment build up is 0.5 feet deep at the silt fence.

If the fabric is damaged, replace or repair as necessary.

[Repeat as needed for individual perimeter controls.]

Instructions (see CGP Parts 2.1.2.2 and 7.2.10):

― Describe sediment controls that will be used (e.g., silt fences, filter berms, temporary diversion dikes, or fiber rolls) to meet the Part 2.1.2.2 requirement to “install sediment controls along those perimeter areas of your site that will receive stormwater from earth-disturbing activities.”

― For linear projects, where you have determined that the use of perimeter controls in portions of the site is impracticable, document why you believe this is to be the case.

― Also see, EPA’s Silt Fence BMP Fact Sheet at www.epa.gov/npdes/stormwater/menuofbmps/construction/silt_fences or Fiber Rolls BMP Fact Sheet at www.epa.gov/npdes/stormwater/menuofbmps/construction/fiber_rolls http://www.epa.gov/npdes/pubs/www.epa.gov/npdes/stormwater/menuofbmps/construction/silt_fences http://www.epa.gov/npdes/stormwater/menuofbmps/construction/fiber_rolls

EPA SWPPP Template, Version 1.0 19

4.3 Sediment Track-Out

Do not allow construction vehicles to track sediment out of the construction limits.

Specific Track-Out Controls

Track-Out Control # 1

Track-Out Control Description

INSERT DESCRIPTION OF TRACK-OUT CONTROL TO BE INSTALLED

INCLUDE COPIES OF DESIGN SPECIFICATIONS HERE

INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE TRACK-OUT CONTROL.

(Note: At a minimum, you must provide for maintenance that meets the following requirement in CGP Part 2.1.2.3.d: “Where sediment has been tracked-out from your site onto the surface of off-site streets, other paved areas, and sidewalks, you must remove the deposited sediment by the end of the same work day in which the track-out occurs or by the end of the next work day if track-out occurs on a non-work day. You must remove the track-out by sweeping, shoveling, or vacuuming these surfaces, or by using other similarly effective means of sediment removal. You are prohibited from hosing or sweeping tracked-out sediment into any stormwater conveyance (unless it is connected to a sediment basin, sediment trap, or similarly effective control), storm drain inlet, or surface water.”)

[Repeat as needed for individual track-out controls.]

Instructions (see CGP Parts 2.1.2.3 and 7.2.10):

― Describe stormwater controls that will be used to “minimize the track-out of sediment onto off-site streets, other paved areas, and sidewalks from vehicles exiting your construction site.”

― Describe location(s) of vehicle exit(s), procedures to remove accumulated sediment off-site (e.g., vehicle tracking), and stabilization practices (e.g., stone pads or wash racks or both) to minimize off-site vehicle tracking of sediment. Also include the design, installation, and maintenance specifications for each control.

― Also, see EPA’s Construction Entrances BMP Fact Sheet at www.epa.gov/npdes/stormwater/menuofbmps/construction/cons_entrance http://www.epa.gov/npdes/stormwater/menuofbmps/construction/cons_entrance

EPA SWPPP Template, Version 1.0 20

4.4 Stockpiled Sediment or Soil

Provide silt fence around all stockpiled excavated roadway materials. Allow temporary turf establishment to stockpiles remaining in place longer than 14 days within 7 days of stockpiling.

Specific Stockpile Controls

Stockpile Control # 1: Silt Fence Stockpiled Sediment/Soil Control Description

INSERT DESCRIPTION OF STOCKPILE CONTROL TO BE INSTALLED

Maintenance Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE STOCKPILE CONTROL.

(Note: At a minimum, you must comply with following requirement in CGP Part 2.1.2.4.d: Do not hose down or sweep soil or sediment accumulated on pavement or other impervious surfaces into any stormwater conveyance (unless connected to a sediment basin, sediment trap, or similarly effective control), storm drain inlet, or surface water.)

[Repeat as needed for individual stockpile controls.]

4.5 Minimize Dust

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

Specific Dust Controls

Instructions (see CGP Parts 2.1.2.4 and 7.2.10):

― Describe stormwater controls and other measures you will take to minimize the discharge of sediment or soil particles from stockpiled sediment or soil. Include a description of structural practices (e.g., diversions, berms, ditches, storage basins), including design, installation, and maintenance specifications, used to divert flows from stockpiled sediment or soil, retain or detain flows, or otherwise limit exposure and the discharge of pollutants from stockpiled sediment or soil.

― Also, describe any controls or procedures used to minimize exposure resulting from adding to or removing materials from the pile.

Instructions (see CGP Parts 2.1.2.5 and 7.2.10):

Describe controls and procedures you will use at your project/site to minimize the generation of dust.

EPA SWPPP Template, Version 1.0 21

Dust Control # 1: Watering Dust Control Description

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

INCLUDE COPIES OF DESIGN SPECIFICATIONS HERE

Installation

INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE DUST CONTROL

[Repeat as needed for individual dust controls.]

4.6 Minimize the Disturbance of Steep Slopes

Do not allow construction equipment to operate on or access the down slope side of the perimeter control measures.

Specific Steep Slope Controls

Steep Slope Control # 1 Steep Slope Control Description

INSERT DESCRIPTION OF STEEP SLOPE CONTROL TO BE INSTALLED

Maintenance Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE STEEP SLOPE CONTROL

[Repeat as needed for individual steep slope controls.]

Instructions (see CGP Parts 2.1.2.6 and 7.2.10):

― Describe how you will minimize the disturbance to steep slopes (as defined by CGP

Appendix A).

― Describe controls (e.g., erosion control blankets, tackifiers), including design, installation and maintenance specifications, that will be implemented to minimize sediment discharges from slope disturbances.

― Also, see EPA’s Geotextiles BMP Fact Sheet at www.epa.gov/npdes/stormwater/menuofbmps/construction/geotextiles http://www.epa.gov/npdes/stormwater/menuofbmps/construction/geotextiles

EPA SWPPP Template, Version 1.0 22

4.7 Topsoil

Immediately initiate soil stabilization measures on any portion of the site where earth-disturbing activities have permanently or temporarily ceased.

Specific Topsoil Controls

Topsoil Control # 1 Topsoil Control Description

INSERT DESCRIPTION OF TOPSOIL CONTROL TO BE INSTALLED

Maintenance Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE TOPSOIL CONTROL

[Repeat as needed for individual topsoil controls.]

4.8 Soil Compaction

INSERT GENERAL DESCRIPTION OF HOW YOU WILL COMPLY WITH CGP PART 2.1.2.8

Specific Soil Compaction Controls

Soil Compaction Control # 1 Soil Compaction Control Description

INSERT DESCRIPTION OF SOIL COMPACTION CONTROL TO BE INSTALLED

Instructions (see CGP Parts 2.1.2.7 and 7.2.10):

― Describe how topsoil will be preserved and identify these areas and associated control measures on your site map(s).

― If it is infeasible for you to preserve topsoil on your site, provide an explanation for why this is the case.

Instructions (see CGP Parts 2.1.2.8 and 7.2.10):

― In areas where final vegetative stabilization will occur or where infiltration practices will be installed, describe the controls, including design, installation, and maintenance specifications that will be used to restrict vehicle or equipment access or condition the soil for seeding or planting.

EPA SWPPP Template, Version 1.0 23

INSERT MAINTENANCE REQUIREMENTS FOR THE SOIL COMPACTION CONTROL

[Repeat as needed for individual soil compaction controls.]

4.9 Storm Drain Inlets NOT APPLICABLE

Install inlet protection prior to diverting water through inlets.

Specific Storm Drain Inlet Controls

Storm Drain Inlet Control # 1 Storm Drain Inlet Control Description

INSERT DESCRIPTION OF STORM DRAIN INLET CONTROL TO BE INSTALLED

Installation

INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE STORM DRAIN INLET CONTROL

(Note: At a minimum, you must comply with following requirement in CGP Part 2.1.2.9.b:

“Clean, or remove and replace, the protection measures as sediment accumulates, the filter becomes clogged, and/or performance is compromised. Where there is evidence of sediment accumulation adjacent to the inlet protection measure, you must remove the deposited sediment by the end of the same work day in which it is found or by the end of the following work day if removal by the same work day is not feasible.”)

[Repeat as needed for individual storm drain inlet controls.]

Instructions (see CGP Parts 2.1.2.9 and 7.2.10):

― Describe controls (e.g., inserts, rock-filled bags, or block and gravel) including design, installation, and maintenance specifications that will be implemented to protect all inlets that will receive stormwater from your construction activities, and that you have authority to access.

― Also, see EPA’s Storm Drain Inlet Protection BMP Fact Sheet at www.epa.gov/npdes/stormwater/menuofbmps/construction/storm_drain http://www.epa.gov/npdes/stormwater/menuofbmps/construction/storm_drain

EPA SWPPP Template, Version 1.0 24

4.10 Constructed Stormwater Conveyance Channels

INSERT GENERAL DESCRIPTION OF HOW YOU WILL COMPLY WITH CGP PART 2.1.3.1

Specific Conveyance Channel Controls

Stormwater Conveyance Channel Control # 1 Stormwater Conveyance Channel Control Description

INSERT DESCRIPTION OF STORMWATER CONVEYANCE CHANNEL CONTROL TO BE INSTALLED

See sheet S03 of project plans.

INSERT MAINTENANCE REQUIREMENTS FOR THE STORMWATER CONVEYANCE CHANNEL CONTROL

[Repeat as needed for individual stormwater conveyance channel controls.]

4.11 Sediment Basins NOT APPLICABLE

INSERT GENERAL…