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HomeMy WebLinkAboutNCC202674_NOI Application_20200625Action History (UTC-05:00) Eastern Time (US & Canada) Submit by Anonymous User 6/22/2020 9:48:22 AM (NCG01 NOI Submission) Approve by Morman, Alaina 6/23/2020 4:24:09 PM (Review- Construction NOI 27315) • The task was assigned to Morman, Alaina by round robin distribution 6/22/2020 9:49 AM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: June 24, 2020 5:00 PM 6/22/2020 9:49 AM Submit by Selkane, Aziza 6/25/2020 3:29:12 PM (Payment Verification for NCC202674) * Diehl & Phillips, P.A. Consulting Engineers • Selkane, Aziza assigned the task to Selkane, Aziza 6/25/2020 3:28 PM The task was assigned to DEMLR NCG01 Payment Team. The due date is: August 4, 2020 5:00 PM 6/23/2020 4:24 PM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW quallly A. Project Information Part A. Project Location and Waterbody Information Are you submitting IT No an NOI that was r Yes rejected before? 1a. Project Name * The Cape Wastewater Treatment Plant Expansion & Modifications 1 b. Specific Lot This field rray be used to list specifc lot numbers. Numbers 2. County* New Hanover 3. Highway or Street 900 The Cape Boulevard Address* Street narre only is acceptable if no address number assigned yet 4.CityorTownship* Wilmington 5. State * NC 6. Zip Code * 28412 7. Latitude* Enter the latitude in decimal degrees 34.0760 8. Longitude* Enter the longitude in decimal degrees (M.JST be negative) -77.9000 If you do not know the latitude and longitude coordinates for this project, you can search the location on this map of North Carolina. Look for the coordinates in the bottom left corner. 9. Date to Begin* 06/24/2020 Estinated Construction Project Start Date 10. Date to End * 05/17/2021 Estimated Construction Project End Date 11. SIC (Primary) * Other (9999) Standard Industrial Classification for Leveloprrent 12. Acres to be 1.37 disturbed* (including off -site borrow and waste areas) 13. Total site area 4.68 (acres) * 14. Post- 0.70 construction (Estirrated) impervious area (acres) * NCC Project NCC-NEW I-1-2020-The Cape Wastewater Treatment Plant Tracking ID Expansion & Modifications Assigned autorratically Below you must enter waterbody information for surface waters affected by this project. Please consult DWR's Surface Water Classifications Map Viewer to find waterbody name and corresponding index number. Please enter only immediate receiving waterbodies - not waters downstream of those unless the project extends there. You may enter up to 3 waterbodies if needed. 15a. Receiving Telfairs Creek Waterbody* Ibrre of w aterbody into w hich storrrw ater runoff w ill discharge 15b. Waterbody 18-87-31.5-1 Index No.* NCWaterbody Index Number Stormwater rJ No discharges will flow r- Yes to additional wate rs * 16a. Is this project r Yes subject to the NC r No, not subject to NC SPCA Sediment Pollution Control Act?* B. Permittee Information Part B. ^ Fternittee Inforrration - Legally Fbsponsible Entity and Individual Important: The person who signs the NOI Certification Form and signs the Certification in Section E of this application form should be the same person as listed in THIS SECTION, or an authorized responsible individual within the same organization. That person must be a responsible corporate officer who owns or operates the construction activity, such as a president, secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part IV, Section B, Item (6) of the NCG010000 General Permit. For more information on signatory requirements, see Part IV, Section B, Item (6) of that permit. 1. Organization Legally Pesponsible Entity Name * Aqua North Carolina, Inc. IF pernittee is an individual (i.e., organization does not apply), enter first and last narre in this field. 2. First Name * Michael If Corporation, enter Faegistered Agent First %rre 3. Last Name* Melton IF Corporation, enter F;bgistered Agent Last %ne 3b. Title Engineering Manager 4. Permitee E-mail MAMeltonA@AquaAmerica.com Address* 5. Permittee (704) 489-9404 x 57238 Telephone No.* 6. Permittee Mailing Street Address Address* 202 Mackenan Drive Address Line 2 aty Cary Fbstal / Zip Code 27511-6447 Check box if the street address the same as mailing address 7. Permittee Street Address * V Yes Street Address 202 Mackenan Drive Address Line 2 City Cary Fbstal / Zip Code 27511-6447 8. Type of Non -Government Ownership* State / Rovince / Pegion NC Country us State / Frovince / Faegion NC Country us C. Site Contact Information Part C. Roject Site Contact Inforrration .................................................................................................................................................................................................... 1. Primary Site Michael Contact - First Name * 2. Primary Site Melton Contact - Last Name * 3. Title Engineering Manager 4. Site Contact E- MAMelton@AquaAmerica.com mail Address* 5. Site Contact 704-489-9404 Telephone No. 6. Organization Aqua North Carolina Name 7. Site Contact Street Address Mailing Address* 202 Mackenan Drive Address Line 2 city Cary Fbstal / Zip Code 27511-6447 8. Consultant Name (Optional) John Phillips First and Last nacre 9. Consultant E-mail jfphillips@bellsouth.net This person will be copied on all correspondence. 10. Consultant 919-467-9972 x5 Telephone No. State / Rovince / Region NC Country us D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 05/18/2020 Approved * 2. E&SC Plan Project #47-15 Revision #2 Number/ID * Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by* r Local Program 4. Local Program* New Hanover County Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a complete application. For linear projects, please also upload a site map showing the overall extent of the project or include the beginning point and end point coordinates in the "Notes" box below. 5. E&SC Plan The Cape Wastewater Expansion Revision 2.pdf 243.41KB Approval letter or Mist beRDFformat Grading Permit 6. Site Location Map Helpful for linear project review (Optional) Mast be FCFfornat. Rease do not upload entire set of E&SCplans. 7. Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded docurrents support the application. Include additional waterbodies for linear projects if necessary. 8. NOI Certification Notice of Intent Certification _06162020.pdf 367.8KB Form Mist be RDFfornat This is an Express r No Review Project* r Yes E. Certification North Carolina General Statute 143-215.66 (1) provides that: Any person who knowingly makes anyfalse statement, representation, or certification in any application, record, report, plan, or other document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case under this Artcle; or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the Commission implementing this Artcle shall be guilty ofa Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000). Under penalty of law, I certify that: 17 I am the person responsible for the construction activities of this project, for satisfying the requirements of this permit, and for any civil or criminal penalties incurred due to violations of this permit. rJ The information submitted in this NOI is, to the best of my knowledge and belief, true, accurate, and complete based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information. * 17 I will abide by all conditions of the NCG010000 General Permit and the approved Erosion and Sediment Control Plan. * rJ If the Erosion and Sediment Control Plan approved by the delegated program is not compliant with Part II (Stormwater Pollution Prevention Plan) of the NCG010000 General Permit. I will nonetheless ensure that all conditions of Part II of the permit are met on the project at all times. * 17 I hereby request coverage under the NCG010000 General Permit and understand that coverage under this permit will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an individual permit. Specify if you are:* r The Responsible Person named on this Notice of Intent f Authorized Responsible Person* Important: The person who electronically signs this Certification above must be the same person who signs the NOI Certification Form. If that person is signing on behalf of the Permittee, that individual must be an authorized responsible person within the same organization as the Permittee. *An authorized individual is a responsible corporate officer who owns or operates the construction activity, such as a president, secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part IV, Section B, Item (6) of the NCG010000 General Permit. For more information on signatory requirements, see Part IV, Section B, Item (6) of that permit. Signature Type Name* Michael A. Melton Title Director of Engineering Organization Legally Pesponsible Entity Aqua North Carolina, Inc. Date * 06/22/2020 F. Tracking and COC Info NOI Tracking No. 27315 NC Reference No. NCG01-2020-2674 Uses 'count number' variable (incremrented by SP) Certificate of NCC202674 Coverage (COC) Uses 'count number' variable (incremented by SP) No.* Count Number 2674 Sequential number for submittal that is incremented by Stored Frocedure COC Year 2020 Year of date reviewed (used to assign YY digits after "NOC' in COCno.)