UNDI BYPASS EPA_CompiledSWPPP_Final_13FEB2023.pdf

Stormwater Pollution Prevention Plan

SWPPP

For:

Federal Highway Administration Western Federal Lands Highway Division

WA Jefferson 150009(1) Undi Road Bypass

Jefferson, WA, Project Engineer General Contractor

Table of Contents

SWPPP TABS

TAB 1: SWPPP Narrative

TAB 2: Permit (Construction General Permit)

TAB 3: NOI, Acknowledgement, Other Applicable

TAB 4: Delegation of Authority

TAB 5: aps

TAB 6: Erosion/Sediment Control Plan Sheets ( lan et and BMP ypical etails)

TAB 7: Revegetation Plan (if applicable)

TAB 8: SWPPP Amendment Log

TAB 9: Inspection Reports

TAB 10: Corrective Action Log

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

TAB 12: Training Certificat Log

TAB 13: Government-Selected Waste, Borrow, Staging Sites

TAB 14: Grading and Stabilization Log

TAB 15: Hazardous Spill Plan or Spill Prevention, Control, and Countermeasures (SPCC)

TAB 16: Endangered Species Act (ESA) & Cultural Resources (Section 106) Documentation

TAB 17: Quality Assurance Checklist

TAB 18: Notice of Termination (NOT)

Tab 1

Stormwater Pollution Prevention Plan (SWPPP) Undi Road Bypass Improvements 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 2022 Construction General Permit (“2022 CGP”), and is customizable to your specific project and site.

Instructions for Using the SWPPP Template

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

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

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

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

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

NOI.

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

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

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

ii

For Construction Activities At:

Undi Road Bypass Forks, WA, 98331

Insert Project/Site Telephone Number

SWPPP Prepared For:

Insert Operator Company or Organization Name Insert Name

Insert Address Insert City, State, Zip Code Insert Telephone Number

Insert Fax/Email

SWPPP Prepared By:

Federal Highway Administration (FHWA) Western Federal Lands Highway Division

610 East Fifth Street Vancouver, WA, 98661

360-619-7700 Fax: 360-619-7846

SWPPP Preparation Date:

01/31/2023

Estimated Project Dates:

Project Start Date: 06/15/2023

Project Completion Date: 10/31/2023 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 Activities

2.4 Sequence and Estimated Dates of Construction Activities

2.5 Authorized Non-Stormwater Discharges

2.6 Site Maps

SECTION 3: DOCUMENTATION OF COMPLIANCE WITH OTHER FEDERAL

REQUIREMENTS

3.1 Endangered Species Protection

3.2 Historic Property Screening Process

3.3 Safe Drinking Water Act Underground Injection Control Requirements ...20

SECTION 4: EROSION AND SEDIMENT CONTROLS AND DEWATERING PRACTICES ...21

4.1 Natural Buffers or Equivalent Sediment Controls

4.2 Perimeter Controls

4.3 Sediment Track-Out

4.4 Stockpiles or Land Clearing Debris Piles Comprised of Sediment or Soil ...26

4.5 Minimize Dust

4.6 Minimize Steep Slope Disturbances

4.7 Topsoil

4.8 Soil Compaction

4.9 Storm Drain Inlets

4.10 Constructed Site Drainage Feature

4.11 Sediment Basins or Similar Impoundments

4.12 Chemical Treatment

4.13 Dewatering Practices

4.14 Other Stormwater Controls

4.15 Site Stabilization

SECTION 5: POLLUTION PREVENTION CONTROLS

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 Building Products, Materials, and Wastes 36

5.6 Washing of Applicators and Containers used for Stucco, Paint, Concrete, Form Release Oils, Cutting Compounds, or Other Materials

5.7 Application of Fertilizers

iv

5.8 Other Pollution Prevention Practices

SECTION 6: INSPECTION, MAINTENANCE, AND CORRECTIVE ACTION

6.1 Inspection Personnel and Procedures

6.2 Corrective Action

6.3 Delegation of Authority

SECTION 7: TURBIDITY BENCHMARK MONITORING FOR DEWATERING DISCHARGES

SECTION 8: CERTIFICATION AND NOTIFICATION

SWPPP APPENDICES

SECTION 1: CONTACT INFORMATION/RESPONSIBLE PARTIES

1.1 Operator(s) / Subcontractor(s)

Operator(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)

[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)

Emergency 24-Hour Contact:

Insert Name Insert Telephone Number

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

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

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

1.2 Stormwater Team

Instructions (see CGP Parts 6 and 7.2.2):

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

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

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

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

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

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

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

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

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

Provide copies of training certificates in Tab 12. Training/Certification Log is found in Tab 12 of the SWPPP

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

Be knowledgeable in the principles and practice of erosion and sediment controls and pollution prevention, Possess the appropriate skills and training in conditions at the construction site that could impact stormwater quality, and

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

Stormwater Team Name and/or Position, and Contact Responsibilities I Have Completed

Training Required by CGP Part 6.2

I Have Read the CGP and Understand the

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

Insert Responsibility Yes No

Yes Date: Click here to enter a date.

Insert Name of Responsible Person Insert Position Insert Telephone Number Insert Email a date.

Insert Name of Responsible Person Insert Position Insert Telephone Number Insert Email a date.

[Insert or delete rows as necessary.]

Stormwater Team Members Who Conduct Inspections Pursuant to CGP Part 4 Name and/or Position and Contact Training(s) Received

Date Training(s)

Completed

If Training is a Non-EPA Training, Confirm that it Satisfies the Minimum

Elements of CGP Part 6.3.b Insert Name of Responsible Person Insert Position Insert Telephone Number Insert Email

Insert Title of Training Received

Date: Click here to enter a date.

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

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

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

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

Insert Title of Training Received

Date: Click here to enter a date.

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

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

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

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

Insert Title of Training Received

Date: Click here to enter a date.

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

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

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

[Insert or delete rows as necessary.]

SECTION 2: SITE EVALUATION, ASSESSMENT, AND PLANNING

2.1 Project/Site Information

Project Name and Address

Project/Site Name: Undi Road Bypass Improvements Street/Location: Project spans all of Undi Bypass Road City: Forks State: Washington ZIP Code: 98331

County or Similar Government Division: Jefferson County

Project Latitude/Longitude

Latitude: 47.8849º N (decimal degrees)

Longitude: - 124.3241 º W (decimal degrees)

Latitude/longitude data source: Map GPS Other (please specify): Google Earth

Horizontal Reference Datum: NAD 27 NAD 83 WGS 84

Additional Site Information

Is your site located on Indian country lands, or 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: NA

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

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

2.2 Discharge Information

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

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

Yes No

Yes No

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

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

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

For each unique point of discharge you list, specify the name of the first receiving water that receives stormwater directly from the point of discharge and/or from the MS4 that the point of discharge discharges to. You may have multiple points of discharge that discharge to the same receiving water.

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

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2.3 Nature of the Construction Activities

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

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

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

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

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

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

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

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

The Federal Highway Administration (FHWA), Western Federal Lands Highway Division (WFL), in partnership with Olympic National Park, Olympic National Forest, Jefferson and Clallam Counties, are undertaking the Undi Road Bypass Improvements project located in Jefferson and Clallam Counties, WA (see attached vicinity map). This project is being funded by the Federal Lands Access Program (FLAP) with County match. This project has logical termini points (both intersections that serve as the start/stop points of the detour) and independent utility, as the road outside of the project area was reviewed and does not require any rehabilitation at this time.

In 2016, a landslide occurred along Undi Road as a result of erosion at the toe of the slope caused by the Bogachiel River. The road damage caused by the landslide was severe and it was not feasible to reconstruct the existing roadway. An alternative route was needed to provide access. In 2016, Jefferson County constructed a bypass which utilized some existing Department of Natural Resources (DNR) roads as well as constructed 3,500 feet of new road to join existing DNR roads.

The counties have determined that three locations along the Undi Road Bypass (from between MP 0 and MP 2, total length of 2.18 miles including a small portion of Undi Road, west of Site 1) need improvement to address safety concerns:

• Site 1 (Jefferson/Clallam County): Improve intersection. Presently, it is not clear to drivers that the Undi Road Bypass is the primary road. This results in drivers needing to turn around and backtrack when they reach the landslide blockage on Undi Road. The project will improve the intersection to make the primary route clear. This work includes signing, minor re-alignment, paving of the primary route, and striping.

• Site 2 (Clallam County): Improve the steep curve at the top of the first hill (entering from the west) on Undi Road Bypass. This corner has site distance deficiencies and is very difficult for large vehicles like horse trailers and campers to navigate. The project will improve the alignment and sight distances through 0.85 acre of tree removal, curve-widening, paving and striping.

• Site 3 (Jefferson County): The project will improve this intersection with paving and striping.

No ground disturbing work will occur.

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

NA

Business days and hours for the project: All days of the week, generally 800-1800

Size of Construction Site

Size of Property 2.18 miles, approximately 3 acres.

Total Area Expected to be Disturbed by Construction Activities

1.1 Acres

Maximum Area Expected to be Disturbed at Any One Time, Including On-site and Off-site Construction Support Areas

1.1 Acres

[Repeat as necessary for individual project phases.]

Type of Construction Site (check all that apply):

Single-Family Residential Multi-Family Residential Commercial Industrial

Institutional Highway or Road Utility Other ____________________________ Will you be discharging dewatering water from your site? Yes No If yes, will you be discharging dewatering water from a current or former Federal or State remediation site? Yes No

Pollutant-Generating Activities

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

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

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

Paving operations hydrocarbons

Fuel for small equipment (chainsaws, etc.) hydrocarbons

Paint Solvents, hydrocarbons

[Include additional rows or delete as necessary.]

Construction Support Activities (only provide if applicable)

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

Insert Description of Construction Support Activity

Contact information for construction support activity:

Insert Name Insert Telephone No.

Insert Email Insert Address And/Or Latitude/Longitude

2.4 Sequence and Estimated Dates of Construction Activities

Phase I

Road work at Site 1 Estimated Start Date of Construction Activities for this Phase

7/1/2023

Estimated End Date of Construction Activities for this Phase

10/31/2013

Estimated Date(s) of Application of Stabilization Measures for Areas of the Site Required to be Stabilized

Insert Estimated Date [Add additional dates as necessary]

Instructions (see CGP Part 7.2.3):

Describe the intended construction sequence and duration of major activities.

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

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

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

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

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

The construction sequence must reflect the following requirements:

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

Estimated Date(s) when Stormwater Controls will be Removed

Insert Estimated Date [Add additional dates as necessary]

Phase II Site 2 Estimated Start Date of Construction Activities for this Phase

7/15/2023

Estimated End Date of Construction Activities for this Phase

10/31/2023

Estimated Date(s) of Application of Stabilization Measures for Areas of the Site Required to be Stabilized

Insert Estimated Date [Add additional dates as necessary]

Estimated Date(s) when Stormwater Controls will be Removed

Insert Estimated Date [Add additional dates as necessary]

Phase III Site 3 and Pullouts (not ground disturbing) Estimated Start Date of Construction Activities for this Phase

8/1/2023

Estimated End Date of Construction Activities for this Phase

10/31/2023

Estimated Date(s) of Application of Stabilization Measures for Areas of the Site Required to be Stabilized

Insert Estimated Date [Add additional dates as necessary]

Estimated Date(s) when Stormwater Controls will be Removed

Insert Estimated Date [Add additional dates as necessary]

2.5 Authorized Non-Stormwater Discharges

List of Authorized Non-Stormwater Discharges Present at the Site

Authorized Non-Stormwater Discharge Will or May Occur at Your Site?

Discharges from emergency fire-fighting activities Yes No Fire hydrant flushings Yes No Landscape irrigation Yes No

Instructions (see CGP Parts 1.2.2 and 7.2.5):

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

Discharges from emergency fire-fighting activities;

Fire hydrant flushings;

Landscape irrigation;

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

Water used to control dust;

Potable water including uncontaminated water line flushings;

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

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

Uncontaminated air conditioning or compressor condensate;

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

Foundation or footing drains where flows are not contaminated with process materials such as solvents or contaminated ground water; and Uncontaminated construction dewatering water discharged in accordance with

Part 2.4.

Authorized Non-Stormwater Discharge Will or May Occur at Your Site?

Water 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 Uncontaminated, non-turbid discharges of ground water or spring water Yes No Foundation or footing drains Yes No Uncontaminated construction dewatering water Yes No

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

2.6 Site Maps

Instructions (see CGP Part 7.2.4):

Attach site maps in Tabs 5 and 6 of the SWPPP Binder. For most projects, a series of site maps is necessary and recommended. The first should show the undeveloped site and its current features. An additional map or maps should be created to show the developed site or, for more complicated sites, show the major phases of development.

These maps must include the following features:

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

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

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

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

Locations of any crossings of receiving waters;

Designated points where vehicles will exit onto paved roads;

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

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

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

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

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

Stormwater and authorized non-stormwater discharge locations, including:

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

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

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

Locations of all potential pollutant-generating activities identified in Part 7.2.3g (note:

you should have those identified in Section 2.3 (Nature of the Construction Activities) in this SWPPP Template).

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

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

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

SECTION 3: DOCUMENTATION OF COMPLIANCE WITH OTHER FEDERAL REQUIREMENTS

3.1 Endangered Species Protection

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

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

Please Note: NMFS’ jurisdiction includes ESA-listed marine and estuarine species that spawn in inland rivers.

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

Documentation: NA

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

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

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

Copies of the ESA compliance documentation should be placed in Tab 16 of the

SWPPP.

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

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

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

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

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

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

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

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

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

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

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

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

NOI.) -

Documentation: USFWS was consulted and the Biological Opinion for the project is included in Appendix D.

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

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

3.2 Historic Property Screening Process

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

Dike

Berm

Catch Basin

Pond

Constructed Site Drainage Feature (e.g., ditch, trench, perimeter drain, swale, etc.)

Culvert

Channel

Other type of ground-disturbing stormwater control: Insert Specific Type of Stormwater Control

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

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

Include documentation supporting your determination of eligibility. Place copies of 106 compliance documentation in Tab 16 of the SWPPP.

To contact your applicable State historic preservation office, information is available at https://ncshpo.org/directory/

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

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

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

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

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

If no, proceed to Appendix E, Step 3.

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

If yes, provide documentation of the basis for your determination. Insert references to documents, studies, or other sources relied upon

If no, proceed to Appendix E, Step 4.

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

If yes, describe the nature of their response:

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

Written indication that adverse effects to historic properties from the installation of stormwater controls can be mitigated by agreed upon actions. 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. Provide a description of any significant remaining disagreements regarding mitigation measures and insert copies of letters, emails, or other communication between you and the applicable SHPO, THPO, or other Tribal representative

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

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

3.3 Safe Drinking Water Act Underground Injection Control Requirements

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

For State UIC program contacts, refer to the following EPA website:

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

SECTION 4: EROSION AND SEDIMENT CONTROLS AND DEWATERING PRACTICES

4.1 Natural Buffers or Equivalent Sediment Controls

Buffer Compliance Alternatives Are there any receiving waters 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 that achieve, in

General Instructions (See CGP Parts 2.2 and 7.2.6):

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

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

Describe any routine stormwater control maintenance specifications.

Describe the projected schedule for stormwater control installation/implementation.

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

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

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

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

combination, 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.)

Insert width of natural buffer to be retained Insert either of the following:

(1) The estimated sediment removal from a 50-foot buffer using applicable tables in Appendix F, 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…