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HomeMy WebLinkAboutNPDES-1/25/2016 2016 Midport Blvd Ext. Phase III Cont No. 894IOWA DEPARTMENT OF NATURAL RESOURCES ENVIRONMENTAL PROTECTION DIVISION NOTICE OF INTENT FOR NPDES COVERAGE UNDER GENERAL PERMIT No.1 FOR "STORM WATER DISCHARGES ASSOCIATED WITH INDUSTRIAL ACTIVITY" or No. 2 FOR "STORM WATER DISCHARGES ASSOCIATED WITH INDUSTRIAL ACTIVITY FOR CONSTRUCTION ACTIVITIES" or No. 3 FOR "STORM WATER DISCHARGE ASSOCIATED WITH INDUSTRIAL ACTIVITY FOR ASPHALT PLANTS, CONCRETE BATCH PLANTS, ROCI{ CRUSHING PLANTS, AND CONSTRUCTION SAND AND GRAVEL FACILITIES." PERMIT INFORMATION Has this storm water discharge been previously permitted? 0 Yes I] No If yes, please list authorization number - Under what General Permit are you applying for coverage? General Permit No. 1 ❑ General Permit No. 2 E General Permit No. 3 0 rig IDNR CASHIER'S USE ONLY 0253-542-8W08-0581 PERMIT FEE OPTIONS For coverage under the NPDES General Permit the following fees apply: ❑ Annual Permit Fee $175 (per year) Maximum coverage is one year. N 3 -year Permit Fee $350 Maximum coverage is three years. ❑ 4 -year Permit Fee $525 Maximum coverage is four years. ❑ 5 -year Permit Fee $700 Maximum coverage is five years. Checks should be made payable to: Iowa Department of Natural Resources. FACILITY OR PROJECT INFORMATION Enter the name and full address/location not mailing address) of the facility or project for which permit coverage is NAME: Midp ort Boulevard Extension Phase III STREET ADDRESS OF SI1'E: 2701 Midbort Blvd., Waterloo, IA CITY: Waterloo COUNTY: Black Hawk County STATE: Iowa ZIP CODE: 50703 CONTACT INFORMATION Give name, mailing address and telephone number of a contact person (Attach additional information on separate pages as needed). This will be the address to which all correspondence will be sent and to which all questions regarding your application and compliance with the permit w'll be directed. NAME: Jeff Bales ADDRESS: 715 Mulberry Street CITY: Waterloo STATE: Iowa ZIP CODE: 50703 Check the appropriate box to indicate the legal status of the operator of the facility. ❑ Federal 0 State I Public 0 Private 0 Other (specify) TELEPHONE ( 319) 291-4312 SIC CODE (General Permit No. 1 & 3 Applicants Only) SIC code refers to Standard Industrial Classification code number used to classify establishments by type of economic activity. Be sure to complete both sides of this form. 542-1415 (Rev. 7/08) FACILITY LOCATION OR LOCATION OF CONSTRUCTION SITE Give the location by'A section , se 1/4 SECTION SEt.1 ON TOWNSHIP RANGE SE IA 4 89N 13 W OWNER INFORMATION Enter the name and full address of the owner of the facility. NAME: City of Waterloo, Iowa MAIL TO: STORM WATER COORDINATOR IOWA DEPARTMENT OF NATURAL RESOURCES 502 E. 9m STREET DES MOINES, IA 50319-0034 ADDRESS: City Hall, 715 Mulberry Street CITY: Waterloo STATE: Iowa ZIP CODE: 50703 OUTFALL INFORMATION TELEPHONE: ( 319) 291- 4301 Discharge start date, i.e., when did/will the site begin operation or 10/1/92, whichever is later: March Ist, 2016 Is any storm water monitoring information available describing the concentration of pollutants in storm water discharges? 0 Yes ❑x No NOTE: Do not attach any storm water monitoring information with the application. Receiving water(s) to the first uniquely named waterway in Iowa, (e.g., road ditch to unnamed tributary to Mud Creek to South Skunk River): Storm Sewer Piping and roadway drainage ditches along Midport Boulevard to Airline Highway ditches to an unnamed drainageway ultimately to the Cedar River. Compliance With The Following Conditions: Has the Storm Water Pollution Prevention Plan been developed prior to the submittal of this Notice of Intent and does the plan meet the requirements of' the applicable General Permit? (do not submit the SWPPP with the application) Will the Storm Water Pollution Prevention Plan comply with approved State (Section 161A.64, Code of Iowa) or local sediment and erosion plans? (for General Permit 2 only) Have two public notices been published for at least one day, one each in the two newspapers with the largest circulation in the area where the discharge is located, and are the proofs of notice attached? (new applications only) Yes No X X X GENERAL PERMIT NO. 2 AND GENERAL PERMIT NO. 3 APPLICANTS COMPLETE THIS SECTION. Description of Project (describe in one sentence what is being constructed): Construction of approximately 1730 feet of new grading and paving along with associated roadway stonn sewer and ditching. For General Permit No. 3 - Is this facility to be moved this year? 0 Yes 0 No Number of Acres of Disturbed Soil: 4.6 (Construction Activities Only) Estimated Timetable For Activities / Projects, i.e., approximately when did/will the project begin and end: Start: March 1st, 2016 End: December 31'r, 2016 CERTIFICATION — ALL APPLICATIONS MUST BE SIGNED Only the following individuals may sign the certification: owner of site, principal executive officer of at least the level of vice- president of the company owning the site, a general partner of the company owning the site, principal executive officer or ranking elected official of the public entity owning the site, any of the above of the general contracting company for construction sites. I certify under penalty of law that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified people 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, this information is to the best of my knowledge and belief, true, accurate, and complete. I further certify that the terms and conditions of the general permit will be met. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. NAME: (print or type) Quentin M. Hart TITLE: Mayor, City of Waterloo SIGNATURE: DATE: AECOM Storm Water Pollution Prevention Plan (SWPPP) FY 2016 Midport Boulevard Extension, Phase Ill PCC Pavement - Grade and New Waterloo, Iowa 1.4 PROJECT OWNER CERTIFICATIONS Project Owner's NPDES Certification: "I hereby 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 am aware that there are significant penalties for submitting false information, including the possibility of the fine and imprisonment for knowing violations. This document was prepared in compliance NPDES General Permit No. 2 requirements and with the City of Waterloo Municipal Code of Ordinances 8-4B: Construction Site Erosion and Sediment Control.: Name Quentin Hart Type, Stamp or Print Legibly Title Mayor Company Name City of Waterloo Address 715 Mulberry Street Waterloo, Iowa 50702 Project Location: Midport Boulevard Extension North of Airline Highway Between ConAgra Foods and Standard Forwarding Telephone Number 319-291-4286 Signed By: Date: (president, vice-president, general partner of proprietor) 6044012&400SWPPP/FY16 MMpSBNd Sd Phlll-SWPPP-TEXdocx 3 January 2016