W912QR21R0013_SWPPP-0000.pdf

Solicitation For Improve Family Housing Wright-Patterson AFB, OH

P2: 476088

Design Bid Build

Stormwater Pollution Prevention Plan (SWPPP)

Certified Final Submittal

18 February 2021

W912QR21R0013

ARIMS: 200A

Disposition: Maintain for 15yrs after construction

W912QR21R0013-0000

Stormwater Pollution Prevention Plan (SWPPP)

Wright-Patterson AFB, OH

EPA SWPPP i

Stormwater Pollution Prevention Plan (SWPPP)

For Construction Activities At:

Improve Family Housing

Wright-Patterson AFB, OH 45433

Base Operator: 937-257-1110

SWPPP Prepared For:

Wright-Patterson Air Force Base

Wright-Patterson AFB, OH 45433

Base Operator: 937-257-1110

SWPPP Prepared By:

Barge Design Solutions

1370 Vanguard Boulevard

Miamisburg, OH 45342

937-438-0378

SWPPP Preparation Date:

06/08/2020

Estimated Project Dates:

Project Start Date: Insert Date

Project Completion Date: Insert Date

Wright-Patterson AFB, OH

EPA SWPPP ii

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 Perimeter Controls

4.2 Sediment Track-Out

4.3 Stockpiled Sediment or Soil

4.4 Minimize Dust

4.5 Minimize the Disturbance of Steep Slopes

4.6 Topsoil

4.7 Soil Compaction

4.8 Storm Drain Inlets

4.9 Dewatering Practices

4.10 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

SECTION 6: INSPECTION AND CORRECTIVE ACTION

6.1 Inspection Personnel and Procedures

6.2 Delegation of Authority

SECTION 7: TRAINING

SECTION 8: CERTIFICATION AND NOTIFICATION

SWPPP APPENDICES

Wright-Patterson AFB, OH

EPA SWPPP Template, Version 2.1 1

SECTION 1: CONTACT INFORMATION/RESPONSIBLE PARTIES

1.1 Operator(s) / Subcontractor(s)

Operator(s):

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):

TBD

Insert Name

Insert Address

Insert City, State, Zip Code

Insert Telephone Number

Insert area of control (if more than one operator at site)

Emergency 24-Hour Contact:

Insert Company or Organization Name

Insert Name

Insert Telephone Number

1.2 Stormwater Team

Stormwater Team

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

Understand the Applicable

Requirements

EPA SWPPP Template, Version 2.1 2

TBD

Insert Position

Insert Email

Insert Responsibility ☐ Yes

Date: Click here to enter a date.

TBD

Insert Position

TBD

Insert Position

[Insert or delete rows as necessary.]

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: Improve Family Housing

Project Street/Location: 420-524 Metzger Dr., 706-818 Pearson Rd., 419-523 Johnson Dr.

City: Wright-Patterson AFB

State: Ohio

ZIP Code: 45433

County or Similar Subdivision: Greene County

Business days and hours for the project: Insert Text Here

Project Latitude/Longitude

Latitude: 39.8097º N

(decimal degrees)

Longitude: - -84.0424 º W

(decimal degrees)

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

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?

https://www.epa.gov/sites/production/files/2017-02/documents/2017_cgp_final_appendix_a_-_definitions_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)?

[001] Hebble

Creek ☐ Yes ☒ No ☐ Yes ☒ No ☐ Yes ☒ No

[002] Hebble

Creek ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☒ No

[003] ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No [INSERT "Tier

2", "Tier 2.5", or "Tier 3"]

[004] ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No [INSERT "Tier

2", "Tier 2.5", or "Tier 3"]

[005] ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No [INSERT "Tier

2", "Tier 2.5", or "Tier 3"]

[006] ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No [INSERT "Tier

2", "Tier 2.5", or "Tier 3"]

[Include additional rows or delete as necessary.]

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:

The existing housing built in 1935 will be modified, improved, and additions to these will be built.

The existing driveways will be updated as necessary to provide a driveway to new garages for each housing unit and old garages will be renovated.

Size of Construction Site

Size of Property 14.20 AC

Total Area Expected to be Disturbed by

Construction Activities

14.20 Ac

Maximum Area Expected to be Disturbed at

Any One Time

1 AC

[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 there be demolition of any structure built or renovated before January 1, 1980?

☒ Yes ☐ No

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”)?

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)

New Pavement/Concrete Sediment

Waste disposal Trash

Vehicles Fuel spill

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

EPA SWPPP Template, Version 2.1 6

[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):

Staging and storage area to be on the Northerly and Southerly sides of Chandler Drive, Easterly of Pearson Road, between 708 and 732 Pearson Road. This location is shown on Sheet CG111 on the SWPPP Plan. Concrete plant will provide concrete for the site.

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

First set of buildings and garages

Estimated Start Date of Construction Activities for this Phase INSERT ESTIMATED DATE

Estimated End Date of Construction Activities for this Phase INSERT ESTIMATED DATE

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 IA

531 Lahm Circle building

Estimated Start Date of Construction Activities for this Phase 10/1/2021

Estimated End Date of Construction Activities for this Phase 4/29/2022

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

Phase II

Second set of buildings and garages

Estimated Start Date of Construction Activities for this Phase INSERT ESTIMATED DATE

EPA SWPPP Template, Version 2.1 7

Estimated End Date of Construction Activities for this Phase INSERT ESTIMATED DATE

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]

Bid Option 0001

448 Metzger Drive building

Estimated Start Date of Construction Activities for this Phase 10/1/2022

Estimated End Date of Construction Activities for this Phase 3/1/2023

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]

Bid Option 0002

419 Johnson Drive building

Estimated Start Date of Construction Activities for this Phase INSERT ESTIMATED DATE

Estimated End Date of Construction Activities for this Phase INSERT ESTIMATED DATE

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]

Bid Option 0003

437/439 Johnson Drive building

Estimated Start Date of Construction Activities for this Phase INSERT ESTIMATED DATE

Estimated End Date of Construction Activities for this Phase INSERT ESTIMATED DATE

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]

Bid Option 0004

706/708 Johnson Drive building

Estimated Start Date of Construction Activities for this Phase INSERT ESTIMATED DATE

Estimated End Date of Construction Activities for this Phase INSERT ESTIMATED DATE

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

2.5 Authorized Non-Stormwater Discharges

List of Authorized Non-Stormwater Discharges Present at the Site

EPA SWPPP Template, Version 2.1 8

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

Uncontaminated, non-turbid discharges of ground water or spring water ☐ Yes ☒ No

Foundation or footing drains ☒ Yes ☐ No

Construction dewatering water ☒ Yes ☐ No

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

2.6 Site Maps

SEE ATTACHED SWPPP APPENDIX A

EPA SWPPP Template, Version 2.1 9

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. INSERT SPECIFIC DOCUMENT AND/OR WEBSITE RELIED UPON

☐ 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 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 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

EPA SWPPP Template, Version 2.1 10

☐ 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 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

EPA SWPPP Template, Version 2.1 11

✓ 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: INSERT FEDERAL AGENCY(IES) INVOLVED

✓ Field/regional office(s) providing consultation: INSERT FIELD/REGIONAL OFFICE(S)

PROVIDING CONSULTATION

✓ Tracking numbers associated with consultation: INSERT CONSULTATION TRACKING

NUMBER(S)

✓ Date consultation completed: INSERT DATE CONSULTATION COMPLETED

✓ 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 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

EPA SWPPP Template, Version 2.1 12

✓ 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: Underground Detention

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

Appendix E, Step 2

If you answered yes in Step 1, have prior surveys or evaluations conducted on the site already determined that historic properties do not exist, or that prior disturbances at the site have precluded the existence of historic properties? ☐ YES ☒ NO

▪ 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

EPA SWPPP Template, Version 2.1 13 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. 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. 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

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)

EPA SWPPP Template, Version 2.1 14

SECTION 4: EROSION AND SEDIMENT CONTROLS

Erosion and sediment control are handled with inlet protection and silt fences shown in Appendix

A. Both of these have no long-term maintenance but will be removed when project has been completed.

Since this is a renovation, most of the existing systems are adequate.

4.1 Perimeter Controls

General

▪ Silt fence will be installed in fronts and backs of units and along construction limits of work disturbance areas. Inlet protection will be provided to protect inlets from sediment during construction.

Specific Perimeter Controls

Silt Fence

Description: Silt fence will be installed in fronts and backs of units and along construction limits in work disturbance areas. These will be in place before construction is started.

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

Sediment to be removed once it has accumulated to one half the original height of the barrier. Filter fabric shall be replaced whenever it has deteriorated to such an extend that the effectiveness of the fabric is reduced.

Design

Specifications

Detail shown on plans

[Repeat as needed for individual perimeter controls.]

4.2 Sediment Track-Out

▪ Construction Entrance/Exits will be used to minimize tracking.

Specific Track-Out Controls

Construction Entrance/Exit

Description: Gravel construction entrance/exits will be installed as necessary to prevent tracking. When washing is required, it shall be done in an area stabilized with crushed stone that drains into an approved sediment trap or sediment basin.

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

Where sediment has been tracked-out from the 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.

EPA SWPPP Template, Version 2.1 15

Design

Detail shown on plans

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

4.3 Stockpiled Sediment or Soil

General

Staging and stockpile area to be on the Northerly and Southerly sides of Chandler Drive, Easterly of Pearson

Road, between 708 and 732 Pearson Road. This location is shown on Sheet V-101 on the Site Plan.

Specific Stockpile Controls

Stockpile

Description: Stockpile to be neat and away from any storm structures.

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements hosing down or sweeping soil or sediment accumulated on pavement or other impervious surfaces into any stormwater conveyance, storm drain inlet, or water of the U.S. is prohibited.

Design

Specifications

INCLUDE COPIES OF DESIGN SPECIFICATIONS HERE

[Repeat as needed for individual stockpile controls.]

4.4 Minimize Dust

▪ Construction entrance/exit, if dust becomes a problem water may be sprayed to reduce the dust, but with the light amount of earthwork, dust is not likely to be a problem.

Specific Dust Controls

Construction Entrance/exit

Description: Construction entrance/exit to be installed where necessary.

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE DUST CONTROL

Design

Detail shown on plans.

[Repeat as needed for individual dust controls.]

4.5 Minimize Steep Slope Disturbances

General

▪ N/A. Slopes on site to be less than 10%. Proposed grading is very minor and should have little to no impact on the existing slopes

Specific Steep Slope Controls

N/A

Description: INSERT DESCRIPTION OF STEEP SLOPE CONTROL TO BE INSTALLED

EPA SWPPP Template, Version 2.1 16

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE STEEP SLOPE CONTROL

Design

INCLUDE COPIES OF DESIGN SPECIFICATIONS HERE

[Repeat as needed for individual steep slope controls.]

4.6 Topsoil

▪ Top layer of topsoil to be stripped and replaced with 4” of new topsoil.

Specific Topsoil Controls

4” layer of new topsoil

▪ Description: Top layer of topsoil to be stripped and replaced with 4” of new topsoil.

Previous topsoil to be repurposed on site or discarded by contractor with an approved method.

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE TOPSOIL CONTROL

Design

[Repeat as needed for individual topsoil controls.]

4.7 Soil Compaction

General

Backfill adjacent to any and all types of structures shall be placed and compacted between 85 and 90 percent laboratory maximum density for cohesionless materials to prevent wedging action or eccentric loading upon or against the structure.

Specific Soil Compaction Controls

Soil Compaction

Description: Compaction shall be accomplished by sheepsfoot rollers, pneumatic-tired rollers, steel-wheeled rollers, vibratory compactors, or other approved equipment to meet acceptable compaction.

Compaction shall be accomplished by sheepsfoot rollers, pneumatic-tired rollers, steel-wheeled rollers, vibratory compactors, or other approved equipment.

Installation INSERT APPROXIMATE DATE OF

INSTALLATION

Maintenance

Requirements

INSERT MAINTENANCE REQUIREMENTS FOR

THE SOIL COMPACTION CONTROL

Design

Specifications

INCLUDE COPIES OF DESIGN

SPECIFICATIONS HERE

EPA SWPPP Template, Version 2.1 17

[Repeat as needed for individual soil compaction controls.]

4.8 Storm Drain Inlets

▪ Inlet Sedimentation Control Devices to be installed at all inlets.

Specific Storm Drain Inlet Controls

INSERT NAME OF STORM DRAIN INLET CONTROL TO BE INSTALLED

Description: Inlet protection with filters to be installed at each inlet.

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

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

Design

Detail shown on plans.

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

4.9 Dewatering Practices

General

▪ While excavation is open, the water level shall be maintained continuously, at least 2’ below the working level.

Specific Dewatering Practices

Dewatering

▪ Description: Groundwater flowing toward or into excavations shall be controlled to prevent sloughing of excavation slopes and walls, boils, uplift and heave in the excavation and to eliminate interference with orderly progress of construction. Control measures shall be taken by the time the excavation reaches the water level in order to maintain the integrity of the in situ material. While excavation is open, the water level shall be maintained continuously, at least 2’ below the working level.

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

With backwash water, either haul it away for disposal or return it to the beginning of the treatment process; and replace and clean the filter media used in dewatering devices when the pressure differential equals or exceeds the manufacturer’s specifications.

Design

Specifications

EPA SWPPP Template, Version 2.1 18

[Repeat as needed for individual dewatering practices.]

4.10 Site Stabilization

Total Amount of Land Disturbance Occurring at Any One Time

☒ Five Acres or less

☐ More than Five Acres

Use this template box if you are not located in an arid, semi-arid, or drought-stricken area

INSERT NAME OF SITE STABILIZATION PRACTICE

☒ Vegetative ☐ Non-Vegetative

☐ Temporary ☒ Permanent

Description:

▪ INSERT DESCRIPTION OF STABILIZATION PRACTICE TO BE INSTALLED

▪ NOTE HOW DESIGN WILL MEET REQUIREMENTS OF PART 2.2.14.b

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Completion INSERT APPROXIMATE COMPLETION DATE

Maintenance

Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE STABILIZATION PRACTICE

Design

[Repeat as needed for additional stabilization practices.]

Use this template box if unforeseen circumstances have delayed the initiation and/or completion of vegetative stabilization. Note: You will not be able to include this information in your initial SWPPP. If you are affected by circumstances such as those described in CGP Part 2.2.14.a.iii, you will need to modify your SWPPP to include this information.

INSERT NAME OF SITE STABILIZATION PRACTICE

☐ Vegetative

☐ Temporary ☐ Permanent

Description:

▪ INSERT DESCRIPTION OF STABILIZATION PRACTICE TO BE INSTALLED

▪ NOTE HOW DESIGN WILL MEET REQUIREMENTS OF PART 2.2.14.b

Justification

INSERT DESCRIPTION OF CIRCUMSTANCES THAT PREVENT YOU FROM MEETING

THE DEADLINES REQUIRED IN CGP PARTS 2.2.14.a

Installation and completion schedule

Vegetative Measures:

DESCRIBE THE SCHEDULE YOU WILL FOLLOW FOR INITIATING AND COMPLETING

VEGETATIVE STABILIZATION

▪ Approximate installation date: INSERT APPROXIMATE DATE

▪ Approximate completion date: INSERT APPROXIMATE DATE

EPA SWPPP Template, Version 2.1 19

Non-Vegetative Measures:

(must be completed within 14 days of the cessation of construction if disturbing

5 acres or less; within 7 days if disturbing more than 5 acres)

▪ Approximate installation date: INSERT APPROXIMATE DATE

▪ Approximate completion date: INSERT APPROXIMATE DATE

Maintenance

Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE STABILIZATION PRACTICE

Design

[Repeat as needed for additional stabilization practices.]

EPA SWPPP Template, Version 2.1 20

SECTION 5: POLLUTION PREVENTION STANDARDS

5.1 Potential Sources of Pollution

Construction Site Pollutants

Almost sources of pollution are anticipated, most of the project is interior renovation with a garage addition.

Pollutant-Generating Activity

Pollutants or Pollutant

Constituents

(that could be discharged if exposed to stormwater)

Location on Site

(or reference SWPPP site map where this is shown)

Paving Any of the garage additions in

Appendix A

[Include additional rows as necessary.]

EPA SWPPP Template, Version 2.1 21

5.2 Spill Prevention and Response

The contractor shall be responsible for containment of all spills. The contractor is responsible for maintaining spill containment and cleanup equipment and materials on site that are appropriate for the quantity and type of materials being stored. The contractor shall clean up all spills that result from construction activities. The cleanup methods shall be as required or acceptable by the contracting officer or contracting officers technical representative.

5.3 Fueling and Maintenance of Equipment or Vehicles

General

▪ Contractor will be responsible for keeping their vehicles free of leaks and shall be responsible for any leaks or spills that may occur.

Specific Pollution Prevention Practices

INSERT NAME OF POLLUTION PREVENTION PRACTICE

Description: INSERT DESCRIPTION OF PRACTICE TO BE INSTALLED

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE POLLUTION PREVENTION

PRACTICE

Design

IF APPLICABLE INCLUDE COPIES OF DESIGN SPECIFICATIONS HERE

[Repeat as needed.]

5.4 Washing of Equipment and Vehicles

General

▪ Vehicles shall be washed only on an area stabilized with crushed stone that drains into an approved sediment trap. Generally this area will be located in the Staging area shown on sheet

CG111.

▪ Description: Vehicles shall be washed only on an area stabilized with crushed stone that drains into an approved sediment trap.

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE POLLUTION PREVENTION

PRACTICE

Design

EPA SWPPP Template, Version 2.1 22

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

5.5.1 Building Products

(Note: Examples include asphalt sealants, copper flashing, roofing materials, adhesives, concrete admixtures, and gravel and mulch stockpiles.)

▪ Building items shall be stored in the designated storage area only.

Storage and Stockpile location

Description: All Storage of materials shall be stored in the location designated.

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

Keep the storage area clean and organized and all storage items piled neatly.

5.5.2 Pesticides, Herbicides, Insecticides, Fertilizers, and Landscape Materials

▪ The use of pesticides, herbicides, and insecticides are not permitted.

Pesticides, herbicides, intsecticides

▪ The use of pesticides, herbicides, and insecticides are not permitted.

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE POLLUTION PREVENTION

PRACTICE

5.5.3 Diesel Fuel, Oil, Hydraulic Fluids, Other Petroleum Products, and Other Chemicals

▪ Report all spills of more than one gallon of material or all spills that enter any sewer or drain.

Description: Report spills of more than one gallon of material. Report all spills of any size if the material enters a sewer or drain. Report all spills of any size that create a fire hazard. Report these spills to the base fire department by calling 911or 937-257-9111 from a cell phone or off-base line. Fire dispatch can be notified by calling 937-257-3033 and also notify the governement’s project manager.

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE POLLUTION PREVENTION

PRACTICE

EPA SWPPP Template, Version 2.1 23

5.5.4 Hazardous or Toxic Waste

(Note: Examples include paints, solvents, petroleum-based products, wood preservatives, additives, curing compounds, acids.)

▪ Hazardous spills of any size to be reported to the base fire department by calling 911 or Fire

Dispatch at 937-257-3033 and notify the government’s project inspector.

▪ Description: Hazardous spills of any size to be reported to the base fire department by calling 911 or Fire Dispatch at 937-257-3033 and notify the government’s project inspector.

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE POLLUTION PREVENTION

PRACTICE

5.5.5 Construction and Domestic Waste

(Note: Examples include packaging materials, scrap construction materials, masonry products, timber, pipe and electrical cuttings, plastics, styrofoam, concrete, and other trash or building materials.)

▪ The contractor shall coordinate all waste management activities with the COR and WPAFB Waste management. Waste handling and disposal activities shall be conducted in accordance with applicable state and federal regulations for waste material. WPAFB will be given 1 months’ notice for waste shipping.

▪ Description: The contractor shall coordinate all waste management activities with the

COR and WPAFB Waste management. Waste handling and disposal activities shall be conducted in accordance with applicable state and federal regulations for waste material. WPAFB will be given 1 months’ notice for waste shipping. All debris not scheduled for recycling shall be disposed at a landfill approved by the WPAFB Waste

Management Team.

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE POLLUTION PREVENTION

PRACTICE

EPA SWPPP Template, Version 2.1 24

5.5.6 Sanitary Waste

▪ INSERT GENERAL DESCRIPTION OF HOW YOU WILL COMPLY WITH CGP PART 2.3.3.f

Description: INSERT DESCRIPTION OF PRACTICE TO BE INSTALLED

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE POLLUTION PREVENTION

PRACTICE

Design

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

▪ Concrete washout area will be provided in the staging area to clean concrete out of any containers or vehicles.

Description: Concrete washout area

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE POLLUTION PREVENTION

PRACTICE

Design

See note on SWPPP plans - CG501

5.7 Fertilizers

General

▪ Apply at a rate and in amounts consistent with manufacturer’s specifications and at the appropriate time.

EPA SWPPP Template, Version 2.1 25

Description: INSERT DESCRIPTION OF PRACTICE TO BE INSTALLED

Installation INSERT APPROXIMATE DATE OF INSTALLATION

Maintenance

Requirements

INSERT MAINTENANCE REQUIREMENTS FOR THE POLLUTION PREVENTION

PRACTICE

Design

[Repeat as needed for individual fertilizer practices.]

SECTION 6: INSPECTION, MAINTENANCE, AND CORRECTIVE ACTION

6.1 Inspection Personnel and Procedures

Personnel Responsible for Inspections

INSERT NAMES OF PERSONNEL OR TYPES OF PERSONNEL WHO WILL BE CONDUCTING SITE

INSPECTIONS HERE

Note: All personnel conducting inspections must be considered a “qualified person.” CGP

Part 4.1 clarifies that a “qualified person” is a person knowledgeable in the principles and practices of erosion and sediment controls and pollution prevention, who possesses the appropriate skills and training to assess conditions at the construction site that could impact stormwater quality, and the appropriate skills and training to assess the effectiveness of any stormwater controls selected and installed to meet the requirements of this permit.

Inspection Schedule

Select the inspection frequency(ies) that applies, based on CGP Parts 4.2, 4.3, or 4.4

(Note: you may be subject to different inspection frequencies in different areas of the site. Check all that apply)

Standard Frequency:

☒ Every 7 days

☐ Every 14 days and within 24 hours of a 0.25” rain or the occurrence of runoff from snowmelt sufficient to cause a discharge

Inspection Report Forms

INSERT COPY OF ANY INSPECTION REPORT FORMS YOU WILL USE HERE OR IN APPENDIX D OF THIS

SWPPP TEMPLATE

(Note: EPA has developed a sample inspection form that CGP operators can use. The form is available at https://www.epa.gov/npdes/stormwater-discharges-construction-activities#resources) https://www.epa.gov/npdes/stormwater-discharges-construction-activities#resources

EPA SWPPP Template, Version 2.1 26

6.2 Corrective Action

Personnel Responsible for Corrective Actions

INSERT NAMES OF PERSONNEL OR TYPES OF PERSONNEL RESPONSIBLE FOR CORRECTIVE

ACTIONS

Corrective Action Forms

INSERT A COPY OF ANY CORRECTIVE ACTION FORMS YOU WILL USE HERE OR IN APPENDIX E OF

THIS SWPPP TEMPLATE

(Note: EPA has developed a sample corrective action form that CGP operators can use. The form is available at https://www.epa.gov/npdes/stormwater-discharges-construction-activities#resources)

6.2 Delegation of Authority

Duly Authorized Representative(s) or Position(s):

Insert Company or Organization Name

Insert Name

Insert Position

Insert Address

Insert City, State, Zip Code

Instructions:

― Identify the individual(s) or positions within the company who have been delegated authority to sign inspection reports.

― Attach a copy of the signed delegation of authority (see example in Appendix J of the

Template.)

― For more on this topic, see Appendix I, Subsection 11 of EPA’s CGP.

EPA SWPPP Template, Version 2.1 27

SECTION 7: TRAINING

Table 7-1: Documentation for Completion of Training

Name Describe Training Date Training Completed

INSERT NAME OF PERSONNEL INSERT COMPLETION DATE

INSERT NAME OF PERSONNEL INSERT COMPLETION DATE

INSERT NAME OF PERSONNEL INSERT COMPLETION DATE

INSERT NAME OF PERSONNEL INSERT COMPLETION DATE

INSERT NAME OF PERSONNEL INSERT COMPLETION DATE

INSERT NAME OF PERSONNEL INSERT COMPLETION DATE

INSERT NAME OF PERSONNEL INSERT COMPLETION DATE

INSERT NAME OF PERSONNEL INSERT COMPLETION DATE

INSERT NAME OF PERSONNEL INSERT COMPLETION DATE

INSERT NAME OF PERSONNEL INSERT COMPLETION DATE

INSERT NAME OF PERSONNEL INSERT COMPLETION DATE

INSERT NAME OF PERSONNEL INSERT COMPLETION DATE

INSERT NAME OF PERSONNEL INSERT COMPLETION DATE

INSERT NAME OF PERSONNEL INSERT COMPLETION DATE

INSERT NAME OF PERSONNEL INSERT COMPLETION DATE

Instructions (see CGP Part 6 and 7.2.8):

― Complete the table below to provide documentation that the personnel required to be trained in CGP Part 6 completed the appropriate training

― If personnel will be taking course training (which is not required as part of the CGP), consider using Appendix I of this SWPPP template to track completion of this training

― The following personnel, at a minimum, must receive training, and therefore should be listed out individually in the table below:

✓ Personnel who are responsible for the design, installation, maintenance, and/or repair of stormwater controls (including pollution prevention measures);

✓ Personnel responsible for the application and storage of treatment chemicals

(if applicable);

✓ Personnel who are responsible for conducting inspections as required in Part

4.1; and

✓ Personnel who are responsible for taking corrective actions as required in Part

5.

― CGP Part 6 requires that the required personnel must be trained to understand the following if related to the scope of their job duties:

✓ The permit deadlines associated with installation, maintenance, and removal of stormwater controls and with stabilization;

✓ The location of all stormwater controls on the site required by this permit, and how they are to be maintained;

✓ The proper procedures to follow with respect to the permit’s pollution prevention requirements; and

✓ When and how to conduct inspections, record applicable findings, and take corrective actions.

EPA SWPPP Template, Version 2.1 28

EPA SWPPP Template, Version 2.1 29

SECTION 8: CERTIFICATION AND NOTIFICATION

I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I have no personal knowledge that the information submitted is other than true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations.

Name: Title:

Signature: Date:

[Repeat as needed for multiple construction operators at the site.]

Instructions (CGP Appendix I, Part I.11.b):

― The following certification statement must be signed and dated by a person who meets the requirements of Appendix I, Part I.11.b.

― This certification must be re-signed in the event of a SWPPP Modification.

EPA SWPPP Template, Version 2.1 30

SWPPP APPENDICES

Attach the following documentation to the SWPPP:

Appendix A – Site Maps

Appendix B – Copy of 2017 CGP

Appendix C – Inspection Form

Appendix D – Corrective Action Form

Appendix E – SWPPP Amendment Log

Appendix F – Subcontractor Certifications/Agreements

Appendix G – Grading and Stabilization Activities Log

Appendix H – Training Log

Appendix I – Delegation of Authority

EPA SWPPP Template, Version 2.1

Appendix A – Site Maps

Appendix B – Copy of 2017 CGP

Appendix C – Copy of Inspection Form

Appendix D – Copy of Corrective Action Form

Appendix E – SWPPP Amendment Log

No. Description of the Amendment Date of

Amendment

Amendment…