SWPPP - KS FTFW KIRW 14(1) 104(1).pdf

Stormwater Pollution Prevention Plan (SWPPP) Kirwin National Wildlife Refuge

EPA SWPPP Template, Version 2.1 i

Construction Stormwater Pollution Prevention Plan Template To be covered under the U.S. Environmental Protection Agency’s (EPA) Construction General Permit (CGP), all construction operators are required to develop a “Stormwater Pollution Prevention Plan” (or “SWPPP”) prior to submitting a Notice of Intent (NOI) for permit coverage.

EPA created this SWPPP Template to help you develop a SWPPP that is compliant with the minimum requirements of Part 7 of EPA’s 2017 Construction General Permit (“2017 CGP”), and is customizable to your specific project and site.

Instructions for Using the SWPPP Template

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

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

• Read the 2017 CGP thoroughly before you begin preparation of your SWPPP to ensure that you have a working understanding of the permit’s underlying requirements. You will also need to consult Part 9 of the permit to determine if your state or tribe has included additional requirements that affect you.

• Complete the SWPPP prior to submitting your Notice of Intent (NOI) for permit coverage.

This is required in Parts 1.4 and 7.1.

• If you prepared a SWPPP under a previous version of EPA’s CGP, you must update your SWPPP to ensure that the 2017 CGP requirements are addressed prior to submitting your

NOI.

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

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

While EPA has made every effort to ensure the accuracy of all instructions contained in the SWPPP Template, it is the permit, not the template, that determines the actual obligations of regulated construction stormwater discharges. In the event of a conflict between the SWPPP Template and any corresponding provision of the 2017 CGP, you must abide by the requirements in the permit. EPA welcomes comments on the SWPPP Template at any time and will consider those comments in any future revision of this document. You may contact EPA for CGP-related inquiries at cgp@epa.gov.

https://www.epa.gov/sites/production/files/2017-03/documents/2017_cgp_final_permit_508.pdf https://www.epa.gov/sites/production/files/2017-03/documents/2017_cgp_final_permit_508.pdf mailto:cgp@epa.gov

EPA SWPPP Template, Version 2.1 ii

For Construction Activities At:

702 East Xavier Road

Kirwin, KS 67644

(785) 543-6673

SWPPP Prepared For:

Federal Highway Administration Eastern Federal Lands Highway Division Yanina Kirtley

21400 Ridgetop Circle Sterling, VA 20166

(703) 404-6281 yanina.kirtley@dot.gov

SWPPP Prepared By:

HDR

Colleen Koenig

1670 Broadway, Suite 3400 Denver, CO 80202-4824

(303)323-9878 colleen.koenig@hdrinc.com

SWPPP Preparation Date:

02/03/2020

Estimated Project Dates:

Project Start Date: (Tentatively) 05/01/2020

Project Completion Date: (Tentatively) 10/01/2020

EPA SWPPP Template, Version 2.1 iii

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

EPA SWPPP Template, Version 2.1 iv

SECTION 7: TRAINING

SECTION 8: CERTIFICATION AND NOTIFICATION

SWPPP APPENDICES

EPA SWPPP Template, Version 2.1 1

SECTION 1: CONTACT INFORMATION/RESPONSIBLE PARTIES

1.1 Operator(s) / Subcontractor(s)

Operator(s):

Insert Company or Organization Name TBD 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)

[Repeat as necessary.]

Subcontractor(s):

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)

[Repeat as necessary.]

Emergency 24-Hour Contact:

Insert Name Insert Telephone Number

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

― 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.

EPA SWPPP Template, Version 2.1 2

1.2 Stormwater Team

Stormwater Team Name and/or position, and contact Responsibilities I Have Read the CGP and

Understand the Applicable Requirements

Colleen Koenig Hydraulics (303)323-9878 colleen.koenig@hdrinc.com

SWPPP Preparer for Design

☒ Yes Date: 9/13/2019

Chris Hansen Environmental Protection Specialist Federal Highway Administration 703-404-6272 christopher.hansen@dot.gov

Preparer. Made minor corrections.

☒ Yes Date: 3/3/2020

Insert name of responsible person Insert Position Insert Telephone Number Insert Email

Insert Responsibility ☐ Yes Date: Click here to enter a date.

Instructions (see CGP Part 7.2.2):

― Identify the individuals (by name or position) that are part of the project’s stormwater team, their individual responsibilities, and which members are responsible for inspections. 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 permit requirements (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 2017 CGP and the SWPPP.

EPA SWPPP Template, Version 2.1 3

SECTION 2: SITE EVALUATION, ASSESSMENT, AND PLANNING

2.1 Project/Site Information

Project Name and Address

Project/Site Name: Kirwin National Wildlife Refuge Project Street/Location: 702 East Xavier Road City: Kirwin State: Kansas ZIP Code: 67644 County or Similar Subdivision: Phillips

Business days and hours for the project: Monday - Friday 8a.m. - 5 p.m.

Project Latitude/Longitude

Latitude: 39.651458º N (decimal degrees)

Longitude: - 99.122658 º W (decimal degrees)

(Several locations within the site, this location is based on RTE 014 Southside Drive) Latitude/longitude data source:

☐ Map ☒ GPS ☐ Other (please specify): __________________________________________

Horizontal Reference Datum:

☐ NAD 27 ☒ NAD 83 ☐ WGS 84

Additional Project Information

Are you requesting permit coverage as a “federal operator” as defined in Appendix A of the 2017 CGP?

☒ Yes ☐ No

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:

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 when you file your NOI.

https://www.epa.gov/sites/production/files/2017-02/documents/2017_cgp_final_appendix_a_-_definitions_508.pdf

EPA SWPPP Template, Version 2.1 4

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:

2.2 Discharge Information

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

☐ Yes ☒ No

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

☒ Yes ☐ No

Instructions (see “Discharge Information” section of Appendix J – 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.

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

― For each unique point of discharge you list, specify the name of the first water of the

U.S. that receives stormwater directly from the point of discharge and/or from the MS4 that the point of discharge discharges to. You may have multiple points of discharge that discharge to the same receiving water.

― Next, specify whether any waters of the U.S. that you discharge to are listed as “impaired” as defined in Appendix A, and the pollutants causing the impairment.

Identify any Total Maximum Daily Loads (TMDL) that have been completed for any of the waters of the U.S. that you discharge to and the pollutants for which there is a TMDL.

For more information on impaired waters and TMDLs, including a list of TMDL contacts and links by state, visit https://www.epa.gov/tmdl.

― Finally, indicate whether any water of the U.S. that you discharge to is designated as a Tier 2, Tier 2.5, or Tier 3 water and if so, what the designation is (2, 2.5, or 3). A list of Tier 2, 2.5, and 3 waters is provided in Appendix F.

https://www.epa.gov/sites/production/files/2017-02/documents/2017_cgp_final_appendix_a_-_definitions_508.pdf https://www.epa.gov/tmdl https://www.epa.gov/sites/production/files/2017-02/documents/2017_cgp_final_appendix_f_-_tier_3_tier_2_and_tier_2.5_waters_508.pdf

EPA SWPPP Template, Version 2.1 5

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

Point of Discharge

ID

Name of receiving water:

Is the receiving water impaired (on the CWA 303(d) list)?

If yes, list the pollutants that are causing the impairment:

Has a TMDL been completed for this receiving waterbody?

If yes, list TMDL Name and ID:

Pollutant(s) for which there is a

TMDL:

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

If yes, specify which Tier (2, 2.5, or 3)?

88+25

Bow Creek ☒ Yes ☐ No Arsenic, Sulfate, Total Phosphorus, Selenium

☐ Yes ☒ No ☐ Yes ☐ No

122+25

Bow Creek ☒ Yes ☐ No Arsenic, Sulfate, Total Phosphorus, Selenium

☐ Yes ☒ No ☐ Yes ☐ No

☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No

EPA SWPPP Template, Version 2.1 5

2.3 Nature of the Construction Activities

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

FHWA proposes roadway improvements to unpaved roads accessing Kirwin National Wildlife Refuge in Phillips County, Kansas. We propose resurfacing approximately 4.6 miles with aggregate material, resurfacing several parking areas, replacing culverts in three locations, stabilizing road embankment with rip rap material at several locations, and other minor miscellaneous work.

Size of Construction Site

Size of Property 4.6 miles and 1217 SQYD Total Area Expected to be Disturbed by Construction Activities

2 acres

Maximum Area Expected to be Disturbed at Any One Time

2 acres

Type of Construction Site (check all that apply):

☐ Single-Family Residential ☐ Multi-Family Residential ☐ Commercial ☐ Industrial

☐ Institutional ☒ Highway or Road ☐ Utility ☐ Other ____________________________

Will there be demolition of any structure built or renovated before January 1, 1980? ☐ Yes ☒ No

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

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

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

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

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

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

EPA SWPPP Template, Version 2.1 6

If yes, do any of the structures being demolished have at least 10,000 square feet of floor space?

☐ Yes ☒ No ☐ N/A

Was the pre-development land use used for agriculture (see Appendix A for definition of “agricultural land”)?

☐ Yes ☒ No

Pollutant-Generating Activities

List and describe all pollutant-generating activities and indicate for each activity the type of pollutant that will be generated. Take into account where potential spills and leaks could occur that contribute pollutants to stormwater discharges, and any known hazardous or toxic substances, such as PCBs and asbestos, that will be disturbed during construction.

Pollutant-Generating Activity (e.g., paving operations; concrete, paint, and stucco washout and waste disposal; solid waste storage and disposal; and dewatering operations)

Pollutants or Pollutant Constituents (e.g., sediment, fertilizers, pesticides, paints, caulks, sealants, fluorescent light ballasts, contaminated substrates, solvents, fuels)

Removal of existing pavement sediment Paving operations materials, sediments Staging Areas fuel, equipment, sediment erosion

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

equipment and material storage areas

Contact information for construction support activity:

INSERT NAME : TBD

INSERT TELEPHONE NO.

INSERT EMAIL

INSERT ADDRESS AND/OR LATITUDE/LONGITUDE

https://www.epa.gov/sites/production/files/2017-02/documents/2017_cgp_final_appendix_a_-_definitions_508.pdf

EPA SWPPP Template, Version 2.1 7

2.4 Sequence and Estimated Dates of Construction Activities

Phase I

South Drive Road RTE 014 (South Section) Estimated Start Date of Construction Activities for this Phase 5/12/2020 Estimated End Date of Construction Activities for this Phase 7/7/2020 Estimated Date(s) of Application of Stabilization Measures for Areas of the Site Required to be Stabilized

6/24/2020

Estimated Date(s) when Stormwater Controls will be Removed

INSERT ESTIMATED DATE

Phase II Silver Bridge Road RTE106 Estimated Start Date of Construction Activities for this Phase 5/12/2020 Estimated End Date of Construction Activities for this Phase 5/19/2020 Estimated Date(s) of Application of Stabilization Measures

5/19/2020

Phase III Silver Bridge North Parking RTE940 Estimated Start Date of Construction Activities for this Phase 5/12/2020 Estimated End Date of Construction Activities for this Phase 5/20/2020 Estimated Date(s) of Application of Stabilization Measures

5/20/2020

Instructions (see CGP Part 7.2.5):

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

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

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

Temporary or permanent cessation of construction activities;

Temporary or final stabilization of areas of exposed soil. The dates for stabilization must reflect the applicable deadlines to which you are subject to in Part 2.2.14; and Removal of temporary stormwater controls and construction equipment or vehicles, and cessation of any pollutant-generating activities.

― The construction sequence must reflect the following requirements:

Part 2.1.3 (installation of stormwater controls); and Parts 2.2.14 (stabilization deadlines).

EPA SWPPP Template, Version 2.1 8

Phase IV Silver Bridge Parking A & B RTE014 Estimated Start Date of Construction Activities for this Phase 5/12/2020 Estimated End Date of Construction Activities for this Phase 5/21/2020 Estimated Date(s) of Application of Stabilization Measures

5/21/2020

Phase V The Kiln Road RTE109 Estimated Start Date of Construction Activities for this Phase 5/12/2020 Estimated End Date of Construction Activities for this Phase 5/21/2020 Estimated Date(s) of Application of Stabilization Measures

5/21/2020

Phase VI The Kiln Road End Parking RTE109 Estimated Start Date of Construction Activities for this Phase 5/12/2020 Estimated End Date of Construction Activities for this Phase 5/27/2020 Estimated Date(s) of Application of Stabilization Measures

5/27/2020

Phase VII South Side Drive RTE014 (North Section) Estimated Start Date of Construction Activities for this Phase 5/14/2020 Estimated End Date of Construction Activities for this Phase 7/17/2020 Estimated Date(s) of Application of Stabilization Measures

7/17/2020

EPA SWPPP Template, Version 2.1 9

2.5 Authorized Non-Stormwater Discharges

List of Authorized Non-Stormwater Discharges Present at the Site

Type of Authorized 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 External building washdown (soaps/solvents are not used and external surfaces do not contain hazardous substances)

☐ Yes ☒ No

Pavement wash waters ☐ Yes ☒ No Uncontaminated air conditioning or compressor condensate ☐ Yes ☒ No

Instructions (see CGP Parts 1.2.2 and 7.2.5):

― Identify all authorized sources of non-stormwater discharges. The authorized non-stormwater discharges identified in Part 1.2.2 of the 2017 CGP include:

Discharges from emergency fire-fighting activities;

Fire hydrant flushings;

Landscape irrigation;

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

Water used to control dust;

Potable water including uncontaminated water line flushings;

External building washdown, provided soaps, solvents and detergents are not used, and external surfaces do not contain hazardous substances (e.g., paint or caulk containing PCBs);

Pavement wash waters provided spills or leaks of toxic or hazardous materials have not occurred (unless all spilled material has been removed) and detergents are not used. You are prohibited from directing pavement wash waters directly into any water of the U.S., 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 discharged in accordance with Part 2.4.

EPA SWPPP Template, Version 2.1 10

Uncontaminated, non-turbid discharges of ground water or spring water ☐ Yes ☒ No Foundation or footing drains ☐ Yes ☒ No Construction dewatering water ☐ Yes ☒ No

2.6 Site Maps

Instructions (see CGP Part 7.2.4):

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

These maps must include the following features:

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

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

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

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

Locations of any crossings of waters of the U.S.;

Designated points where vehicles will exit onto paved roads;

Locations of structures and other impervious surfaces upon completion of construction; and Locations of on-site and off-site construction support activity areas covered by this permit (see Part 1.2.1.c).

― Locations of all waters of the U.S., including wetlands, on your site and within one mile downstream of the site’s discharge point. 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.

― Areas of federally-listed critical habitat for endangered or threatened species within the site and/or at discharge locations.

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

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

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

Locations where stormwater and/or authorized non-stormwater will be discharged to storm drain inlets; and Locations where stormwater or allowable non-stormwater will be discharged to waters of the U.S. (including wetlands).

― Locations of all potential pollutant-generating activities.

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

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

EPA SWPPP Template, Version 2.1 11

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?

☐ Criterion A: No ESA-listed species and/or designated critical habitat present in action area.

Using the process outlined in Appendix D of this permit, you certify that ESA-listed species and designated critical habitat(s) under the jurisdiction of the USFWS or NMFS are not likely to occur in your site’s “action area” as defined in Appendix A of this permit.

Basis statement content/Supporting documentation: A basis statement supporting the selection of Criterion A should identify the USFWS and NMFS information sources used.

Attaching aerial image(s) of the site to your NOI is helpful to EPA, USFWS, and NMFS in confirming eligibility under this criterion. Please Note: NMFS’ jurisdiction includes ESA-listed marine and estuarine species that spawn in inland rivers. Check the applicable source(s) of information you relied upon:

☐ Specific communication with staff of the USFWS and/or NMFS. INSERT DATE OF

COMMUNICATION AND WHO YOU SPOKE WITH

☐ Species list from USFWS and/or NMFS. See the CGP ESA webpage, Step 2 for available websites.

☐ Criterion B: Eligibility requirements met by another operator under the 2017 CGP. The construction site’s discharges and discharge-related activities were already addressed in another operator’s valid certification of eligibility for your “action area” under eligibility Criterion A, C, D, E, or F of the 2017 CGP and you have confirmed that no additional ESA-listed species and/or designated critical habitat under the jurisdiction of USFWS and/or NMFS not considered in the that certification may be present or located in the “action area.” To certify your eligibility under this criterion, there must be no lapse of NPDES permit coverage in the other CGP operator’s certification. By certifying eligibility under this criterion, you agree to comply with any conditions upon which the other CGP operator's certification was based. You must include in your NOI the NPDES ID from the other 2017CGP operator’s notification of authorization under this permit. If your certification is based on another 2017 CGP operator’s certification under criterion C, you must provide EPA with the

Instructions (see CGP Parts 1.1.5, 7.2.9.a, Appendix D, and the “Endangered Species Protection” section of the Appendix J – NOI form):

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

― Check only 1 box, include the required information and provide a sound basis for supporting the criterion selected. Select the most conservative criterion that applies ― Include documentation supporting your determination of eligibility.

― A step-by-step guide and flow-chart on ESA provisions for EPA’s CGP is available at https://www.epa.gov/npdes/stormwater-discharges-construction-activities#species https://www.epa.gov/sites/production/files/2017-02/documents/2017_cgp_final_appendix_d_-_endangered_species_reqs_508.pdf https://www.epa.gov/npdes/stormwater-discharges-construction-activities#esa https://www.epa.gov/sites/production/files/2017-02/documents/2017_cgp_final_appendix_d_-_endangered_species_reqs_508.pdf https://www.epa.gov/npdes/stormwater-discharges-construction-activities#species

EPA SWPPP Template, Version 2.1 12 relevant supporting information required of existing dischargers in criterion C in your NOI form.

Basis statement content/Supporting documentation: A basis statement supporting the selection of Criterion B should identify the eligibility criterion of the other CGP NOI, the authorization date, and confirmation that the authorization is effective.

Provide the 9-digit NPDES ID number from the other operator’s NOI under the 2017

CGP: __ __ __ __ __ __ __ __ __

Authorization date of the other 2017 CGP operator: INSERT AUTHORIZATION DATE

OF OTHER OPERATOR

Eligibility criterion of the other 2017 CGP operator: ☐A ☐C ☐D ☐E ☐F Provide a brief summary of the basis the other operator used for selecting criterion

A, C, D, E, or F: INSERT TEXT HERE

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

NOI.

Basis statement content/Supporting documentation: A basis statement supporting the selection of Criterion C should identify the information resources and expertise (e.g., state or federal biologists) used to arrive at this conclusion. Any supporting documentation should explicitly state that both ESA-listed species and designated critical habitat under the jurisdiction of the USFWS and/or NMFS were considered in the evaluation.

Resources used to make determination: INSERT RESOURCES YOU USED TO

DETERMINE THAT DISCHARGES ARE NOT LIKELY TO ADVERSELY AFFECT ESA-LISTED

SPECIES OR DESIGNATED CRITICAL HABITAT

ESA-listed Species/Critical Habitat in action area: INSERT LIST OF ESA-LISTED SPECIES

OR DESIGNATED CRITICAL HABITAT LOCATED IN YOUR ACTION AREA

Distance between site and ESA-listed Species/Critical Habitat: INSERT DISTANCE BETWEEN YOUR SITE AND THE ESA-LISTED SPECIES OR CRITICAL HABITAT (in miles)

How adverse effects will be avoided: DESCRIBE SPECIFICALLY HOW ADVERSE

EFFECTS TO ESA-LISTED SPECIES WILL BE AVOIDED FROM THE DISCHARGES AND

DISCHARGE-RELATED ACTIVITIES

☐ Criterion D: Coordination with USFWS and/or NMFS has successfully concluded.

Coordination between you and the USFWS and/or NMFS has concluded. The coordination must have addressed the effects of your site’s discharges and discharge-related activities

EPA SWPPP Template, Version 2.1 13 on ESA-listed species and/or designated critical habitat under the jurisdiction of USFWS and/or NMFS, and resulted in a written concurrence from USFWS and/or NMFS that your site’s discharges and discharge-related activities are not likely to adversely affect listed species and/or critical habitat. You must include copies of the correspondence with the participating agencies in your SWPPP and this NOI.

Basis statement content/Supporting documentation: A basis statement supporting the selection of Criterion D should identify whether USFWS or NMFS or both agencies participated in coordination, the field office/regional office(s) providing that coordination, and the date that coordination concluded.

Agency coordinated with: ☐USFWS ☐ NMFS Field/regional office(s) providing coordination: INSERT FIELD/REGIONAL OFFICE(S)

PROVIDING COORDINATION

Date coordination concluded: INSERT DATE COORDINATION CONCLUDED Attach copies of any letters or other communication between you and the U.S. Fish

& Wildlife Service or National Marine Fisheries Service concluding coordination activities.

☒ Criterion E: ESA Section 7 consultation has successfully concluded. Consultation between a Federal Agency and the USFWS and/or NMFS under section 7 of the ESA has concluded.

The consultation must have addressed the effects of the construction site’s discharges and discharge-related activities on ESA-listed species and/or designated critical habitat under the jurisdiction of USFWS and/or NMFS. To certify eligibility under this criterion, Indicate the result of the consultation:

☐ Biological opinion from USFWS and/or NMFS 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

☒ Written concurrence from USFWS and/or NMFS with a finding that the site’s discharges and discharge-related activities are not likely to adversely affect ESA-listed species and/or designated critical habitat. You must include copies of the correspondence between yourself and the USFWS and/or NMFS in your SWPPP and this NOI.

Basis statement content/Supporting documentation: A basis statement supporting the selection of Criterion E should identify the federal action agency(ies) involved, the field office/regional office(s) providing that consultation, any tracking numbers of identifiers associated with that consultation (e.g., IPaC number, PCTS number), and the date the consultation was completed.

Federal agency(ies) involved: Federal Highway Administration; US Fish and Wildlife Service

Field/regional office(s) providing consultation: Kansas ES Field Office Tracking numbers associated with consultation: n/a Date consultation completed: 8/19/2019 Attach copies of any letters or other communication between you and the U.S. Fish

& Wildlife Service or National Marine Fisheries Service concluding consultation.

☐ Criterion F: Issuance of section 10 permit. Potential take is authorized through the issuance of a permit under section 10 of the ESA by the USFWS and/or NMFS, and this authorization

EPA SWPPP Template, Version 2.1 14 addresses the effects of the site’s discharges and discharge-related activities on ESA-listed species and designated critical habitat. You must include copies of the correspondence between yourself and the participating agencies in your SWPPP and your NOI.

Basis statement content/Supporting documentation: A basis statement supporting the selection of Criterion F should identify whether USFWS or NMFS or both agencies provided a section 10 permit, the field office/regional office(s) providing permit(s), any tracking numbers of identifiers associated with that consultation (e.g., IPaC number, PCTS number), and the date the permit was granted.

Agency providing section 10 permit: ☐USFWS ☐NMFS Field/regional office(s) providing permit: INSERT FIELD/REGIONAL OFFICE(S)

PROVIDING PERMIT

Tracking numbers associated with consultation: INSERT CONSULTATION TRACKING

NUMBER(S)

Date permit granted: INSERT DATE PERMIT GRANTED Attach copies of any letters or other communication between you and the U.S. Fish

& Wildlife Service or National Marine Fisheries Service.

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: riprap (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

Instructions (see CGP Part 1.1.6, 7.2.9.b, Appendix E, and the “Historic Preservation” section of the Appendix J – 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

EPA SWPPP Template, Version 2.1 15

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

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. INSERT REFERENCES TO

DOCUMENTS, STUDIES, OR OTHER SOURCES RELIED UPON

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 no historic properties will be affected by the installation of stormwater controls.

☐ 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

EPA SWPPP Template, Version 2.1 16

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 7.2.9.c):

― 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:

https://www.epa.gov/uic.

https://www.epa.gov/uic

EPA SWPPP Template, Version 2.1 17

SECTION 4: EROSION AND SEDIMENT CONTROLS

4.1 Natural Buffers or Equivalent Sediment Controls

Buffer Compliance Alternatives Are there any waters of the U.S. within 50 feet of your project’s earth disturbances? ☒ YES ☐ NO

Check the compliance alternative that you have chosen:

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

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

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

☐ (ii) 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 sediment controls. Also, show on the site map any velocity dissipation devices used to prevent erosion within the natural buffer area.)

General Instructions (See CGP Parts 2.2 and 7.2.6):

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

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

― Describe any routine stormwater control maintenance specifications.

― Describe the projected schedule for stormwater control installation/implementation.

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

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

― Describe the compliance alternative (CGP Part 2.2.1.a.i, ii, or iii) that 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 2.2.1.b, include documentation related to your qualification for such exceptions.

EPA SWPPP Template, Version 2.1 18

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

☒ (iii) 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.

• See plans, sheets “M” for detailed description. Protective measures include fiber rolls, dust control watering, and filter bags for dewatering.

☐ I qualify for one of the exceptions in Part 2.2.1.b. (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 water of the U.S. 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 2.2.1.a compliance alternatives.)

☐ For a “linear construction sites” (defined in Appendix A), site constraints (e.g., limited right-of-way) make it infeasible to meet any of the CGP Part 2.2.1.a compliance alternatives.

EPA SWPPP Template, Version 2.1 19

☐ The project qualifies as “small residential lot” construction (defined in Appendix A) (see Appendix G, Part G.3.2).

☐ For Alternative 1:

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:

INSERT (1) THE ASSIGNED RISK LEVEL BASED ON APP. G APPLICABLE TABLE G-2 THROUGH

G-6 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.

• Work includes replacement of culvert pipe and placement of rip-rap.

☐ 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

4.2 Perimeter Controls

General Fiber roll and temporary diversion berms will be used for culvert and riprap work.

Specific Perimeter Controls

Fiber Roll Description: Fiber roll will be placed around the perimeter of riprap culvert outlet protection prior to work starting.

Installation 5/12/2020 Maintenance Requirements

(Note: At a minimum, you must provide for maintenance that meets the following requirement in CGP 2.2.3.a:” Remove sediment before it has accumulated to one-half of the above-ground height of any perimeter control.")

Design Specifications

See FLH, Standard Specs Section 713.16 Silt Fence

Instructions (see CGP Parts 2.2.3 and 7.2.6.b.ii):

― Describe sediment controls that will be used (e.g., silt fences, filter berms, temporary diversion dikes, or fiber rolls) to meet the Part 2.2.3 requirement to “install sediment controls along any perimeter areas of the site that will receive pollutant discharges.”

― For linear projects, where you have determined that the use of perimeter controls in portions of the site is infeasible, document other practices that you will implement.

EPA SWPPP Template, Version 2.1 20

4.3 Sediment Track-Out

Stabilized Construction Exit

Specific Track-Out Controls

Stabilized Construction Exit Description: INSERT DESCRIPTION OF TRACK-OUT CONTROL TO BE INSTALLED Installation 5/12/2020 Maintenance Requirements

(Note: At a minimum, you must provide for maintenance that meets the following requirement in CGP Part 2.2.4.d: “Where sediment has been tracked-out from your site onto paved roads, sidewalks, or other paved areas outside of your site, remove the deposited sediment by the end of the same business day in which the track-out occurs or by the end of the next business day if track-out occurs on a non-business day. 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, storm drain inlet, or water of the U.S.”)

Design

See Standard Detail E157-01 and Specifications Section 157

4.4 Stockpiled Sediment or Soil

Specific Stockpile Controls

Instructions (see CGP Parts 2.2.4 and 7.2.6.b.iii):

― Describe stormwater controls that will be used to minimize sediment track-out.

― 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.

Instructions (see CGP Parts 2.2.5 and 7.2.6):

― 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…