T-NPDES_Generic_Permit_Template.pdf

Form 251-B

Version 1.01

NPDES CGP SWPPP Template for FDOT Projects This template was produced to meet the requirements of the State of Florida Department of

Environmental Protection NPDES Generic Permit for Stormwater Discharge from Large and

Small Construction Activities (CGP), effective 02/2015, Table 4.7.1.

This template is intended for use on traditional design-bid-build contracts. The information for each item is intended to be supplied the entity identified in parentheses. (Contractor) refers to the Department’s construction contractor and subcontractor(s). (Design) refers to the

Department’s in-house or consultant design team. (Design/Contractor) items are intended to be initially provided by Design and supplemented, as needed, by the Contractor.

Italic text was obtained directly from DEP Document No. 62-621.300(4)(a) effective 02/2015. In all cases, the requirements listed in the NPDES CGP shall control.

Submit all required documents associated with the NPDES CGP prior to the preconstruction conference in accordance with FDOT Standard Specification Section 104.

(Contractor) Stormwater Team Identify the personnel (by name or position) that are part of the stormwater team responsible for implementing the SWPPP, including the qualified inspector. List their individual responsibilities in developing or implementing the SWPPP.

Note: If additional rows are needed, attach supplemental table.

Name or Position Qualified Inspector (Yes/No) (if Yes, provide FDEP Certification Number)

Responsibilities (Developing or implementing)

(Contractor) Contractors/Subcontractors List all the contractors or subcontractors who will be conducting construction activities at the site, and identify the areas of the site in which they will be working. All listed contractors and subcontractors must sign the certification.

Company Name Work Area

Note: If additional rows are needed, attach supplemental table.

(Contractor) Signed Certifications Complete FDOT Contractor Certification - NPDES Generic Permit for Storm Water Discharges

From Large and Small Construction Activities (FDOT Form No. 650-040-07) for the Contractor and all subcontractors that are conducting construction activities at the site, including but not limited to, installing, maintaining, and inspecting erosion control items, environmental sampling and testing activities, earthwork, dewatering, paving, etc.

"I certify under penalty of law that I understand, and shall comply with, the terms and conditions of the State of Florida Generic Permit for Stormwater Discharge from Large and Small

Construction Activities and this Stormwater Pollution Prevention Plan."

Name Title Form 650-040-07 Completed https://pdl.fdot.gov/api/form/downloadAttachment/10980997

Site/Construction Activities (Design) Describe the nature of the construction activity.

Clearing and grubbing, site grading, sidewalk construction, sodding.

(Contractor) Describe the intended sequence and time table of major activities that will disturb soils.

(Contractor) Include the scheduled starting and ending date for each major activity such as land clearing, grubbing, grading, cut and fill, dewatering operations, installation of erosion and sediment controls, installation of stormwater management systems, paving, final or temporary stabilization of exposed soil, and removal of construction equipment and vehicles.

Major Activity Start Date End Date

Estimate the total area of the site and the total area that is expected to be disturbed by excavation, grading, or other construction activity.

(Design) Total area of site – (as shown on Contract Plans) 6.62 Acre(s)

(Contractor) Any additional area(s) outside project limits Acre(s)

Total Acre(s)

(Design) Total Area expected to be disturbed by excavation or grading as shown on Contract Plans

2.01 Acre(s)

(Contractor) Any additional areas expected to be disturbed by other construction activities (staging, stockpiling, etc.)

Acre(s)

Total Acre(s)

(Design) Include existing data on soil types and the quality of any existing discharge from the site.

Existing data on soil types is provided on the Roadway Soil Survey sheet in the Contract Plans

Set.

Soil to be distrubed is existing roadway fill.Stormwater discharge is typical roadway runoff from urban storm sewer system.

(Design/Construction) * For each proposed discharge point provide the following:

Latitude Longitude Station Offset Drainage Area (acres)

Discharge to Surface Water or

MS4

30°06'46.2"N 81°47'50.0"W 10+72 62.31' RT 2.98 Inlet

30°06'31.0"N 81°46'59.2"W 311+65 29.79' RT 2.57 MS4

30°06'19.0"N 81°46'51.9"W 411+15 34.75' RT 1.07 Inlet

*If temporary/interim discharge points used during construction to be provided by contractor, if applicable.

(Contractor) Estimate the amount of land that will be cleared during the construction activity for each drainage area.

Site Map Include a site map showing all of the following:

(Design) Develop the Stormwater Runoff Control Concept (SRCC) in accordance with FDOT

Design Manual (FDM) Chapters 251 and 908. The SRCC is developed to support the temporary erosion and sediment control summary of pay items listed within the Estimated Quantities

Report.

(Contractor) Update or add to the SRCC to develop the NPDES CGP Site Map, as applicable:

• Boundaries of the property (any additional areas used by contractor outside the limits shown in the Contract Plans Set)

• Entrance/Exit Points

• Locations where construction activities will occur.

• Locations where dewatering operation will occur.

• Drainage patterns and approximate slopes and elevations anticipated after major grading activities.

• Areas of soil disturbance.

• Location of major structural and nonstructural controls.

• Location of areas where stabilization practices are expected to occur.

• Location where stormwater is proposed to be discharged during construction to a surface water or MS4.

The Design File Reference Table (below) lists various CADD files that may be used to develop and/or support the CGP Site Map.

Design File Reference Table

Site Map Elements Contract Plan CADD.zip Folder File Name

Boundaries of the property

Plan Sheets

Roadway Planrd* Ref: rwdtrd*

Locations where construction activities will occur

Plan Sheets Roadway Planrd*

Drainage patterns Drainage Map Drainage Drmprd*

Approximate slopes and elevations anticipated after major grading activities

Plan/Profile Sheets Cross Sections

Roadway

Planrd* Rdxsrd*

Pond Sheet(s) Bridge Hydraulic Recommendation Sheet(s) Lateral Ditch XS Sheet(s)

Drainage Pdplrd* Pdxsrd* Ldxsrd*

Areas of soil disturbance

Typical Section Plan Sheets

Roadway Planrd* Qtdsrd* clearing and grubbing limits model

Areas which will not be disturbed

Plan Sheets Roadway Planrd*

Location of major structural and nonstructural controls

Plan Sheets Estimated Quantities Report

Roadway

Planrd* Ref: Drprrd* Qtdsrd* E&SC pay item models

Location of areas where stabilization practices are expected to occur

Typical Section Plan Sheets Estimated Quantities Report

Roadway Typsrd* Planrd* Qtdsrd* Turf pay item models

Location of surface waters and wetlands

Plan Sheets Roadway Planrd* Ref: wetlrd*

Location where stormwater is proposed to be discharged during construction to a surface water or MS4

Plan Sheets

Drainage Map

Roadway

Drainage

Planrd* Ref: Drprrd*

Drmprd*

(Contractor) Non-Stormwater Discharges List all non-stormwater discharges covered under this permit and the pollution prevention procedures that will be implemented.

You can discharge the following types of non-stormwater discharges, if they are listed in your

SWPPP and your SWPPP includes appropriate pollution prevention procedures as to not cause or contribute to a violation of water quality standards.

The following table is a list of the allowable CGP non-stormwater discharges from CGP Part 3.2.

Included (Y/N)

Discharge Type Pollution Prevention Procedures to be implemented

Discharges from firefighting activities.

Fire hydrant flushings.

Waters without detergents used to spray off loose solids from vehicles.

Waters used to control dust.

Potable water sources such as waterline flushings.

Landscape irrigation water and drainage.

Routine external building washdown provided no detergents are used.

Pavement washwaters that do not contain detergents, leaks, spills of toxic or hazardous materials.

Air conditioning condensate.

Spring water.

Foundation or footing drain flows that are not contaminated with process material such as solvents.

Noncontaminated ground water associated with dewatering activities as described in Part 3.4.

See NPDES CGP Part 3.3 for prohibited non-stormwater discharges.

(Contractor) Dewatering Controls, if applicable Include a description of the BMPs that will be used to ensure that discharges of noncontaminated ground water from dewatering operations do not cause or contribute to violations of state water quality standards.

(Contractor) BMPs Describe the BMPs that will be implemented for each major activity and the timing during the construction process that they will be implemented. (See Part 5 )

(Design) Permanent Stormwater Management Controls Describe the stormwater management controls or BMPs (e.g., stormwater detention or retention systems, vegetated swales, or velocity dissipation devices at discharge points) that will be installed during the construction process to control pollutants in stormwater discharges. (See

Part 5.7)

BMP's including inlet protection shall be installed to prevent sediment discharge offsite. These shall be installed prior to any other construction acitvity and shall be removed after construction is complete.

(Contractor) Inspections Must be at least once every seven calendar days and within 24- hours of the end of a storm event that is 0.50 inches or greater (even if it rains on the weekend or a holiday). Your site must be inspected by a qualified inspector that you must provide (See Part 6).

Inspections are required to be documented on FDOT Form 650-040-03. Maintain records in accordance with the NPDES CGP.

Responsible Authority for NPDES CGP – per Rule 62-620.305, F.A.C.

Company Name Position

Duly Authorized Representative(s)

A duly authorized representative is a person who has been designated by the responsible authority to sign documents relating to this permit on the responsible authority’s behalf. A responsible authority may authorize a duly authorized representative by submitting to the

Notices Center, by email or in writing an authorization that names either an individual or a position having overall responsibility for the operation of the your project, such as the project engineer, project superintendent, a position of equivalent responsibility, or an individual or position having overall responsibility for implementing the CGP at the site.

Company Name Position Delegation of Authority letter submitted to Notices Center https://pdl.fdot.gov/api/form/downloadAttachment/10980991 mailto:NPDES-stormwater@dep.state.fl.us

(Contractor) Maintenance Describe the maintenance activities and schedules that will be followed to keep BMPs in good and effective operating condition.