HomeMy WebLinkAbout2015-01-06 Stormwater Correspondence }
Company: Bradstreet Partners, LLc
ATT : Willard Perkins
28 Andover Street
Andover MA 01810
Project/Site: 70 Main Street
o Main Street
North Andover MA 01
Permit Tracking Number: MAR12B696
This email acknowledges that a complete Notice of Intent l of form seeping coverage under
EPA's construction General Permit CGP is now active. Your Vol was completed and submitted
on Friday, May 15, 2015. coverage under this permit began at the conclusion of your 14 day
siting period on Friday, May 29, 2015, unless otherwise notified by EPA.
For tracking purposes, the following number has been assigned to your N of form:MAR 1213 9 .
Attached to this email, you will find an electronic copy of your completed of which should be
posted at your site.
As stated above, this email acknowledges receipt of a complete i l 1. However, It is not an EPA
determination of the validity of the information you provided. Your eligibility for coverage under this
permit is based on the validity of the certification you provided. Your electronic signature on this
form certifies that you have read, understood, and are implementing all of the applicable
requirements. An important aspect of this certification requires that you have correctly determined
whether you are eligible for coverage under this permit.
As you know, the CGP requires you to have developed a Stormw ter Pollution Prevention Plan
(SWPPP) prior to submitting your fool. The CGP also includes specific requirements for erosion
and sediment control, stabilization, pollution prevention, inspections, corrective actions, and staff
training. You must also comply with any additional location--specific requirements applicable to
your state or tribal area as described in the CGP. Note that a copy of the CGP must be kept with
your S PPP. An electronic copy of the CGP and additional guidance materials can be viewed and
downloaded at: http,-//www.epa.gov/npdes/stormwater
You have indicated In your NOI that you discharge to at least one surface water that is listed a
impaired by the state or tribe in which your project is located. if your site discharges to one or
more surface waters that are impaired for sediment or a sediment-related param t r (e.g., total
suspended solids or turbidity) or nutrients .g., nitrogen or phosphorus), you are required to
comply with additional storm water control requirements pertaining to site inspections in Part 4.1.3
and the deadline to complete site stabilization in Part 2.2.1.3.c. if your site discharges to surface
waters that are impaired for pollutants other than a sediment or nutrients, or related pollutants, you
are only subject to additional requirements if EPA informs you separately of such requirements.
If you have general questions regarding the stormw ter program or your responsibilities under the
CGP, please call your region contact. Regional contact email and phone number can be found at-
http://cfpub.epa.gov/npdes/contacts.cfm
If you have questions about your NOI form, please call the EPA NOI Processing Center at - 66-
352-7755 (toll free) Or send an inquirer via the Online form at:
http://cfpub.epa.gov/npdes/nolcontact.cfm
If you have difficulty accessing CD C, please contact the CDC Help Desk t: 33) 890-1995.
You can return to the eNOI system using the following link at any time
https-//cdx.epa.gov/SSL/cdx/login.asp-
EPA NOI Processing Center
Operated Av nti Corporation
1200 Pennsylvania Ave., NW
Mail Code: 4203M
Washington, DC 20460
1-366-352-7755
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UNITED STATES ENVII NM TAL PI T TIC AGENCY
iPD� WAHtNTfN D 040
FORMNOTICE F INTENT(li t)FOR FORM ATE DISCHARGESForm Approved.
10- � ASSOCIATED WITH CONSTRUGTION ACTIVITY UNDER AN OMB Nos. 040-0004
NPDES GENERAL PERMIT
Submission of this Notice of Intent I)constitutes notice that the operator identified in Section II of this form requests authorization to discharge pursuant to the
NPDES Construction General Permit( P)permit number identified in Section I of this form.Subm ssion of this NO]also constitutes notice that the operator identified
to Section ll of this form meets the eligibility requirements of Parts 1.1 and 1.2 of the CGP for the project identified in Section III of this form.Permit coverage is
required prior to commencement of construction activity until you are eligible to terminate coverage as detailed in Part 8 of the CGP,To obtain authorization,you must
submit a complete and accurate N I fora.Discharges are not authorized if your IV I is incomplete or inaccurate or if you were never eligible for permit coverage.
Defer to the instructions at the end of this form.
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Have you been givers approval from the Regional Office to use this paper t 31 fora*? Yes N
If fires,provide the reason you need to use this paper form,the name of the EPA Regional Office staff person who approved your use of this form,and the date of
approval:
Beason for using paper form:
Name of EPA staff person:
Date approval obtained:
bate:You are required to obtain approval from the applicable Regional Office prior to using this paper#COI form.
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Permit umber: MAR120000 (see Appendix D of the CGP for the list of eligible permit numbers)
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Name: Bradstreet Partners,LLD
Phone: 9784755400 Fax(Optional)-
Email: wperkins@hearthstonerealty.com
IRS Employer Identification Number(EIN): 46-4602902
Point of Contact(First Marne,Middle Initial,Last Nagle): Willard D Perkins
Mailing Address:
Street: 28 Andove€Street
City: Andover State: MA Zip: 01810
t Preparer(Complete if NO]was prepared by someone other than the certifier):
Prepared by(First Name,Middle Initial,Last Name): Katherine A Cruz
Organization: HANCOCK ASSOCIATES
Phone: 97 777- 99 Fax(Optional)-
E-mail: kcruz@hancockassociates.com
EPA Form 351(-9 totus:Adive Pone:I of 4
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Project/SiteName: 70 Main Street
Project/Site Address:
treet/Location:
City: North Andover State: MA Zip: 0164
County or similar government subdivision: Essex
For the project/site for which you are seeking permit coverage,provide the following Information:
Latitude/Longitude(Use one of three possible formats,and specify method)
Latitude 1. (degree ,minutes,seconds) Longitude 1. W(degrees,minutes,seconds)
2. t degrees,minutes,decimal) 2. W(degrees,minutes,decimal)
. 42.7041 l (degrees,decimals) 3 71.1325 W degrees,decimals)
Latitude/Longitude Data Source: U.S,G,S topographical reap EPA Web Site E] GPS 21 father:%w vAoucbmap.co
If you used a U.S. .S.topographic map,what was the scale?
Horizontal Reference Datum: NAD 27 AD 83 or WGS 84 2] Unknown
Is your project located in Indian Country lands? Yes 0 No
If yes,provide the name of the Indian tribe associated with the area of Indian country(including name of Indian reservation,if applicable),or if not in Indian
country,provide the name of the Indian tribe associated with the property:
Are you requesting coverage under this N I as a"federal operator*'as defined in Appendix A? El Yes 0 No
Estimated Project Start Date:06101/2015 Estimated Project Completion Date:06/36l2017
Estimated Area to be Disturbed(to the nearest quarter acre):1.1
Have earth-disturbing activities commenced on your projec site [:]Yes 0 No
If yes,is your project an emergency-related project"? � Yes � o
Have stormwater discharges from your project/site been covered previously under an NPDES permit? (]lies 0 No
If yes,provide the Tracking Nu if you had coverage under EPA's CG P or the NPD S permit number if you had coverage under an EPA individual
permit;
o
Does your project/site discharge storrnwater into a Municipal Separate Storm 0 lies o
Sewer System(MS4)'?
Are there any surface waters within 50 feet of your projects earth disturbances? []Yes 0 No
Deceiving Waters and Wetlands Information:(Attach a separate list if necessary)
Surface water(s)to Impaired Water Listed Water Pollutant(s) Tier 2,2.5 or 3 Source TtVIDL Marne and
which discharge
I ot[�ta1 t
Merrimack liver Yes OTHER CAUSE iNo http://www.mass,govleea/
d ocsld a p/ovate rlre o u roes/
POLYCHLORINATED 6 v 114Wlistp.pdf
BIP E YLS(P BS
Describe the methods you used to complete the above table:Please refer to theSource(s)in the above table.
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Will p
use you polymers,flocculants,or other treatment chemicals at your construction situ � Yes � No
y
If yes,will you use cationic treatment chemicals*at your construction site? [:]Yes No
If yes,have you been authorized to use cationic treatment chemicals by your applicable EPA R egional Office in advance of ❑ Yes [J No
filing your I I*
FPA Fonn M1(4 lotus:Active Page:2 of 4
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If you have been authorized to use cationic treatment chemicals by your applicable EPA Regional Officer attach a copy of your authorization letter and include
documentation of the appropriate controls and implementation procedures designed to ensure that your use of cationic treatment chemicals will not lead to a
violation of water quality standards.
Please indicate the treatment chemicals that you will use:
*Note:You are ineligible For coverage under this permit unless you notify your applicable E PA Regional Office in advance and the EPA office authorizes
coverage under this permit after you have included appropriate controls and implementation procedures designed to ensure that your use of cationic treatment
chemicals will not lead to a violation of water duality standards.
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Has the SWPPP been prepared in advance of filing this t l? Yes
PPP Contact Information:
First Larne,Middle initial,Last Name- Mark YanoWitz.
Organization: Verdeco Designs,Inc.
Phone: 978-8 7-9191 Fax(Optional):
E-mail: marka@yerdecodesigns.corn
............. . ...n. .....
Using the instructions in Appendix D of the GGP,under which criterion listed in Appendix D are you eligible for coverage under this permit(only check 1 box)
Provide a brief summary of the basis for criterion selection listed in Appendix D e.g.,communication with U.S.Fish and Wildlife Service or National Marine Fisheries
Service,specific study):MassGIS OLIVERHE P Priority Habitats of Rare Species and Estimated Habitats of Rare Wildlife datalayers
If you select criterion f,provide the Tracking Number from the other operator's notification of authorization under this permit:
If you select criterion C,you must attach a copy of your site reap(see Part 7.2. of the permit),and you mint answer the following questions:
What federally-listed species or federally-designated critical habitat are located in your"action area":
What is the distance between your site and the listed species or critical habitat(miles):
If you select criterion Dr E,or I~,attach copies of any letters or other corn muni ations between you and the U.S.Fish and Wildlife Service or National Marine Fisheries
Service.
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Is your project/site located on a property of religious or cultural significance to an Indian tribe's e VI No
If yes,provide the name of the Indian tribe associated with the property:
Yes No
Are you installing any stormwater controls as described its Appendix E that require subsurface earth disturbance's(Appendix E,Step 1
If yes,have prior surveys or evaluations conducted on the site have already determined historic properties do not exist,or that prior Yes ❑ No
disturbances have precluded the existence of historic properties' Appendix E,Step )
If no,have you determined that your installation of subsurface earth-disturbing stormwat r controls will have no effect on
� o
historic properties?(Appendix Er Step ) ❑ ❑
If no,did the SHP ,THE' ,or other tribal representative(whichever applies)respond to you within the 18 calendar
days to indicate whether the subsurface earth disturbances caused by the installation of stormwater controls affect ❑ e s N o
historic properties' (Appendix E,Step )
If yes,describe the nature of their response:
Written indication that adverse effects to historic properties from the installation of stormwater controls can be mitigated by agreed upon
actions.
No agreement has been reached regarding measures to mitigate effects to historic properties from the installation of storrnwater
controls.
Other:
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EPA Form 351Q-9 Stalks:Active Page:3 of 4
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision In acGordance 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 tines are significant penalties for submitting false information,including the possibility of fine and imprisonment for knowing violations.
First Name,Middle Initial,Last lame:Willard D Perkins
Title:
Signature: Date:Friday,May 15,2015
-mail,wperkins@harthstonereaty.eorn
EPA Form 3510-9 tofus:Active Page:4 of 4
UNITED STATES ENVIRONMENTAL PROTECTION AGENCY
NPDES WASHINGTON,DC 20460 Forrn Approved.
FORM NOTICE F INTENT(N I)FOR T €M ATE DISCHARGES OMB Nos. 4 - 004 :.
10-9 ASSOCIATED WITH CONSTRUCTION ACTIVITY UDDER AN rif EPA
NPIDES GENERAL PERMIT
Submission of this Notice of Intent(NO[)constitutes notice that the operator identified in Section II of this form requests authorization to discharge pursuant to the
NPDES Construction General Permit P)permit number identified in Section I of this form.Submission of this N01 also constitutes notice that the operator identified
in Section II of this form meets the eligibility requirements of Parts 1.1 and 1.2 of the CGP for the project identified in Section III of this form.Permit coverage is
required prior to commencement of construction activity until you are eligible to terminate coverage as detailed in Part 8 of the CGP.To obtain authorization,you must
submit a complete and accurate N1 form.Discharges are not authorized if your N1 is incomplete or inaccurate or if you were never eligible for permit coverage.
Refer to the instructions at the end of this form.
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Have you been given approval from the Regional Office to use this paper N01 form'? El lies E] 140
If yes,provide the reason you reed to use this paper form,the name of the EPA Regional Office staff person who approved your use of this form,and the date of
approval.
Reason for using paper form:
Name of EPA staff person:
Date approval obtained:
*Note:You are required to obtain approval from the applicable Reg Office prior to using this paper N I fora.
;y.
Permit Number: I A R120 g (see Appendix B of the D P for the list of eligible permit numbers)
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Marne: Bradstreet Partners,LLC
Phone: 9784755400 Fax(Optional)-
Email: wperkins@heatthstonerealty.com
IFS Employer Identification Number(EIN): 46- t290
Point of Contact(First Name,Middle Initial,Last Name)- Willard D Perkins
Mailing Address:
Street: 28 Andover Street
City: Andover State: MA Zip: 01810
NO Preparer( om plete if 1 was pro pared by someone other than the certifier);
Prepared by(First dame,Middle Initial,Last Name): (Catherine A Cruz
Organization:ation: HANCOCK ASSOCIATES
Phone: ( 3)777-3050 Fax(Optional)--
E-mail: kcruz@hancockassociates.com
EPA Fofm 510-9 1atus: ubn-Oed To EPA Page:I of 4
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ProjectlSite Name: 70 Main Street
PruiecUSRe Address:
Street/Location: 70 Main Street
City: Forth Andover State: MA Zip: 01845
County or similar government subdivision: Essex
For the project/site for which you are seeking permit coverage,provide the following information:
Latitude/Longitude(Use one of three possible formats,and specify method)
Latitude 1. (degrees,minutes,seconds) Longitude 1. W(degrees,minutes,seconds)
. l (degrees.,minutes,decimal) 2._.............................. . W(degrees,minutes,decimal)
3. 42.7041 t (degrees,decimals) 3. 71.1325 W(degrees,decimals)
Latitude/Longitude Data Source:❑ U.S.G.S topographical map ❑ EPA Web Site E] GPS ther:wvAv.itvu hrnap.com
If you used a f.1. . . .topographic map,what was the scale?
Horizontal Reference Datur3n: ❑ NAD 27 NAD 83 or WGS 84 Unknown
Is your project located in Indian Country lands? ❑ Yes No
If yes,provide the name of the Indian tribe associated with the area of Indian country(including name of Indian reservation,if applicable),or if not in Indian
country,provide the name of the Indian tribe associated with the property:
Are you requesting coverage under this f as a"federal operator"}as defined in Appendix A? ❑Yes 0 No
Estimated Project Start Date:06/011201 Estimated Project Completion Date: /30/2017
Estimated Area to be Disturbed to the nearest quarter acre}:1.1
Have earth-disturbing activities commenced on your pro'ectlsite? ❑ Yes j No
If yes,is your project an emergency-related project? Yes No
Have storrnwater discharges from your project/site been covered previously under an NPDES permit? ❑ Yes o
If yes,provide the Tracking Number if you had coverage under EPA's CGP or the I PDES permit number if you had coverage under an EPA individual
permit:
......................................
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................................ ..... ....
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Does your project/site discharge stormwater into a Municipal Separate Storm 2] Yes ❑ No
Sewer System(MS4)?
Are there any surface waters within 50 feet of your project's earth disturbances? ❑ Yes No
Receiving Waters and Wetlands Information:(Attach a separate list if necessary)
Surface water(s)to Impaired Water Listed Water Pollutant(s) Tier 2,2.5 or 3 Source TNIDL Name and
which discharge Pollutant
Merrimack River Yes OTHER CAUSE No http:!lwww.rnass.gov/eeal
P L CHL l I IATED docsldeplwaterlresourcesl
f3IPH.ENY.,S(P BS) 07v 114iwIi tp.pdf
Describe the methods you used to complete the above table:Please refer to the Source(s)in the above table.
Will you use polymers,flocculants,or other treatment chemicals at your construction site? ❑ Yes o
If fires,will you use cationic treatment chernicals*at your construction site's ❑ Yes ❑ o
If yes,have you been authorized to use cationic treatment chemicals by your applicable EPA Regional Office in advance of ❑ Yes No
filing your NOV?
EPA Form 351E-9Mato:Submitted To EPA Po e:2 of 4
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If your have been authorized to use cationic treatment chemicals by your applicable EPA Regional Office,attach a copy of your authorization letter and include
documentation of the appropriate controls and implementation procedures designed to ensure that your use of cationic treatment chemicals will not lead to a
violation of water quality standards.
Please indicate the treatment chemicals that you will use:
Note:You are ineligible for coverage under this permit unless you notify your applicable EPA Regional Office in advance and the EPA office authorizes
coverage under this permit after you have included appropriate controls and implementation procedures designed to ensure that your use of cationic treatment
chemicals will not lead to a violation of water quality standards.
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Has the SWPPP been prepared in advance of fling this i Yes ❑ No
WPPP Contact Information:
First Marne,Middle Initial,Last fame: Mark Yanowitz
Organization: Verdeco Designs,Inc.
Phone: 7 - -9191 Fax(Optional):
E-mail: mark@verdeGodesigns.com
Using the instructions in Appendix D of the CGP,under which criterion listed in Appendix D are you eligible for coverage under this permit(only cheep I box)
Provide a brief summary of the basis for criterion selection listed in Appendix D(e.g.,communication with U.S.Fish and Wildlife Service or National Marine Fishedes
Service,specific sludy):MassGIS OLIVERNFIE P Priority Habitats of Dare Species and Estimated Habitats of Pare Wildlife datalayers
If you select criterion B,provide the Trac€cing Number from the other operator's notification of authorization under this permit:
If you select criterion C,you must attach a copy of your site map(see Part 7.2.6 of the permit),and you must answer the following questions-
What federally-listed species or federally-designated critical habitat are looted in your"action area":
What is the distance between your site and the listed species or critical habitat(rniles):
If you select criterion D,E,or F,attach copies of any letters or other communications between you and the U.S.Fish and Wildlife Service or National Marine Fisheries
Service.
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Yes o
I your project/site located on a property of�religiou� or cultural significance to an Indian tribe? El
If yes,provide the name of the Indian tribe associated with the property:
21 Yes ❑ No
Are you installing any stormwater controls as described in Appendix E that require subsurface earth disturbance?(Appendix E,Step
if yes,have prior surveys or evaluations conducted on the site have already determined historic properties do not exist,or that prier des No
disturbances have precluded the existence of historic properties?(Appendix E,Step )
If no,have you determined that your installation of subsurface earth-disturbing stormwater controls will have no effect on Yes ❑ Na
historic properties?(Appendix E,Step
If not did the SHPO,THPC,or other tribal representative(whichever app)ies)respond to you within the 15 calendar
days to indicate whether~the subsurface earth disturbances caused by the installation of stormwater controls affectElyes ❑ No
historic properties?(Appendix E,Step )
If yes,describe the nature of their response:
Written indication that adverse effects to histo Cc properties from the installation of stormwater controls can be€mitigated y agreed upon
:L actions,
No agreement has been reached regarding measures to mitigate effects to historic properties from the installation of stormwater
controls.
Other:
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1a u: brr01ed To EPA Page:3 of 4
I certify under penalty of laver 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 any knowledge and belief,true,accurate,and complete.I am
aware that there are significant penalties for submitting false information,including the possibility of fine and impOsonment for]snowing violations.
First Name,Middle Initial,LastName-Willard D Perkins
Title:
Signature: [date:Friday,May 15,201
-mail:wperkins@hearthstonerealty.com
EPA Form 35104 SIolus:5ubry'Iled To EPA Page:4 of 4