HomeMy WebLinkAboutDNR Notice of Intent NEIP Contract# 926-10/17/2016IOWA DEPARTMENT OF NATURAL RESOURCES
ENVIRONMENTAL PROTECTION DIVISION
NOTICE OF INTENT FOR NPDES COVERAGE UNDER GENERAL
PERMIT
CASHIER'S USE ONLY
0253-542-SW08-0581
Authorization #
Name
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, ROCK CRUSHING PLANTS, AND CONSTRUCTION SAND AND GRAVEL FACILITIES."
PERMIT INFORMATION
Has this storm water discharge been previously permitted? ❑ Yes ® No
If yes, please list authorization number
Under what General Permit are you applying for coverage?
General Permit No. 1 ❑ General Permit No. 2 ® General Permit No. 3 0
PERMIT FEE OPTIONS
For coverage under the NPDES General Permit the following fees apply:
O Annual Permit Fee $175 (per year) Maximum coverage is one year.
® 3 -year Permit Fee $350 Maximum coverage is three years.
O 4 -year Permit Fee $525 Maximum coverage is four years.
O 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 jlocation (not mailing address) of the facility or project for which permit coverage is requested.
NAME:
F.Y. 2017 Site Grading for Northeast Industrial Park -Cont. 926
STREET ADDRESS OF SITE:
North of Martin Luther King Jr. Drive and west of Northeast Drive
CITY:
Waterloo
COUNTY:
Black Hawk
STATE:
IA
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 will be directed.
NAME:
IDE Engineering, PLC
ADDRESS:
3731 Pheasant Lane, Suite #201
CITY:
Waterloo
STATE:
IA
ZIP CODE:
50701
TELEPHONE
(319) 464-7913.
Check the appropriate box to indicate the legal status of the operator of the facility.
0 Federal ❑ State ® Public 0 Private 0 Other (specify)
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,.
0512011 cmz Be sure to complete both sides of this form DNR Form 542-1415
FACILITY LOCATION OR LOCATION OF CONSTRUCTION SITE
Give the location by Vz section, section, township, range. (e.g., NW, 7, T78N, R3W).
1/4 SECTION
SECTION
TOWNSHIP
RANGE
NW
20
89
12
OWNER INFORMAT ON
Enter the name and full address of the owner of the facility.
MAIL TO:
STORM WATER COORDINATOR
IOWA DEPARTMENT OF NATURAL
RESOURCES
502 E 9TH ST
DES MOINES IA 50319-0034
NAME:
City of Waterloo
ADDRESS:
715 Mulberry Street
CITY:
Waterloo
STATE:
IA
ZIP CODE:
50703
TELEPHONE:
(319)291.4312
OUTFALL INFORMATION
Discharge start date, i.e., when did/will the site begin operation or 10/1/92, whichever is later: 11/21/2016
Is any storm water monitoring information available describing the concentration of pollutants in storm water discharges?
❑ Yes ®No
NOTE: Do not attach any storm water monitoring information with the application.
Receiving water(s) to the first uniquely named water*ay in Iowa (e.g., road ditch to unnamed tributary to Mud Creek to South Skunk
River): "'
Blowers Creek 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
® ❑
® ❑
GENERAL PERMIT NO. 2 AND GENERAL PERMIT NO. 3 APPLICANTS COMPLETE THIS SECTION.
Description of Project (describe in one sentence what is being constructed):
Grading of approximately 55 acres of expansion area of the Northeast Industrial Park and associated work.
For General Permit No. 3 - Is this facility to be moved this: year?. -. ❑.Yes Z No
Number of Acres of Disturbed Soil: 55.0
(Construction Activities Only)
Estimated Timetable For Activities / Projects, i.e., approximately when did/will the project begin and end:
Begin construction 11/21/2016 - End construction 06/01/2017
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.
1 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. 1 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)
SIGNATURE:
TITLEp,"A
AND9COMPANY NAME OF SIGNATORY:
\CL Dov''
D E:
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05/2011 cmz
Be sure to completeboth sides of this form
DNR Form 542-1415
Item Coversheet Page 1 of 1
CITY OF WATERLOO
Council Communication
Resolution approving Notice of Intent for NPDES coverage under general permit to the Iowa Department of Natural Resources for FY 2017 Site
Grading for Northeast Industrial Park, Contract No. 926, and authorize Mayor to execute said document.
City Council Meeting: 10/17/2016
Prepared: 10/12/2016
SUBJECT:
Submitted by:
Recommended Action:
Expenditure Required:
Resolution approving Notice of Intent for NPDES coverage under general permit to the Iowa
Department of Natural Resources for FY 2017 Site Grading for Northeast Industrial Park, Contract
No. 926, and authorize Mayor to execute said document.
Submitted By: Jeff Bales, Associate Engineer
Recommend approval. These documents have been reviewed by this office and recommends approval
by the City Council.
$350.00 (3 -year permit)
Source of Funds: TIF Funds
http://waterloo.novusagenda.com/AgendaWeb/CoverSheet.aspx?ItemID=65 82 10/12/2016