HomeMy WebLinkAboutWI0800439_DEEMED FILES_20151113Permit Number WI0800439
Program Category
Deemed Ground Water
Permit Type
Injection Deemed Stormwater Drainage Well
Primary Reviewer
michael.rogers
Coastal SWRule
Permitted Flow
Facility
Facility Name
lula Street Infiltration Trench
Location Address
613 Waynick Blvd
Wrightsville Beach
Owner
Owner Name
Town of Wrightsville Beach
Dates/Events
NC
Orig Issue
11/13/2015
App Received
11/9/2015
Regulated Activities
State Stormwater -Infiltration System
Outfall
Waterbody Name
28480
Draft Initiated
Scheduled
Issuance Public Notice
Central Files: APS SWP
11/13/2015
Permit Tracking Slip
Status
Active
Version
1.00
Project Type
New Project
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Wilmington
County
New Hanover
Facility Contact Affiliation
Owner Type
Government -Municipal
Owner Affiliation
Jonathan Babin
Manager Stormwater
PO Box 626
Wrightsville Beach
Issue
11/13/2015
Effective
11/13/2015
NC 28480
Expiration
Requested /Received Events
Streamlndex Number Current Class Subbasin
Rogers, Michael
From: Rogers, Michael
Sent:
To:
Friday, November 13, 2015 5:27 PM
'jbabin@towb.org'
Cc: King, Morella s; Gregson, Jim
Subject: WI0800439 lula Street Infiltration Trench NOi
Thank you for submitting the Notification for Stormwater Drainage Wells for the above referenced site. The Central
Office of the WQROS received your complete NOi on November 9, 2015. Please note the following:
Please remember to submit a Notification form within 30 days of any change of status.
You can scan and send these forms directly to me at michael.ro gers @ncdenr.gov, send by fax to my attention at 919-
807-6406, or via regular mail to address below. When submitting the above forms, you will need to enter the nine-digit
alpha-numeric number on the form (i.e., WI0XXXXXX) that has been assigned to the injection activity at this site. This
notification has been given the deemed permit number WI0800439. This number is also referenced in the subject line of
this email. You may if you wish, scan and send back as attachments in re p ly to this email, as it will already have the
assigned deemed permit number in the subject line.
Thank you for your cooperation.
Michael Rogers, P.G. (NC & FL)
Hydrogeologist
NCDENR-DWR
Water Quality Regional Operations Section
1636 Mail Service Center
Raleigh, NC 27699
Direct No. 919-807-6406
http://portal.ncdenr.org/web/wq/aps/gwpro/reporting-forms
NOTE : Per Executive Order No. 150, all e -mails sent to and from this account are subject to the North Carolina Public
Records Law and may be disclosed to third parties.
1
Ro gers, Michael
From: Rogers , Michael
Sent:
To:
Friday, November 13, 2015 5:26 PM
King , Morella s; Gregson , Jim
Subject:
Attachments:
FW: WI0800439 lula Street Infiltration Trench
20151113165055762 .pdf
Please find attached a Notification for Stormwater Drainage Wells.
-----Original Message-----
From: Michael Rogers [mailto:michael.rogers@ncdenr.gov]
Sent: Friday, November 13, 2015 4:51 PM
To: Rogers, Michael <michael.rogers@ncdenr.gov>
Subject:
This E-mail was sent from "RNPAC7DD0" (Aficio 2075).
Scan Date: 11.13.2015 16:50:55 (-0500)
Queries to: robin.markham@ncdenr.gov
1
NORTH CARQLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
NOTIFICATION FOR STORMWATER DRAINAGE WELLS
Stormwater drainage wells are Class 5 injection wells "permitted by rule" and do not require an individual
injection well permit when constructed in accordance with the rules of15A NC `AC 02C . 0200.
As described in 15A NCAC 02C .0227 this applies to rooftop runoff infiltration systems and certain other
stormwater infiltration systems implemented as Best Management Practices designed in accordance with State
stormwater regulations or an approved local government stormwater program. Additional guidance is available
online at http�'flporial,nettenr orxlwebAilialislgiiprolivectinn siormw uif'.r
This notification, form shall be submitted within 30 days of a change of status as described in Part D below.
Print Clearly or Type Information. Illegible Submittals Will Be Returned As Incomplete.
DATE: October 21 , 20 15
PERMIT NO. (to be completed by DWR)
A. STATUS OF WELL OWNER (choose one]P
(1) Single Family Residence
(2) Business/Organization
(3) Government: State Municipal X County
NOV (19 2131,
Water Quakye►Reglar�
Federal
B. WELL OWNER — For single family residences list the property owner(s). For all others, list name of the
business, organization, or government agency and person delegated signature authority:
Town of Wriehtsville Beach, Jonathan Babin. Stormwater Manauer
Mailing Address: 321 Causeway Drive. PO Box 626
City: Wrightsville Beach State: NC Zip Code: 28480
Ph#: 910-239-5055 EMAIL: ji:abineowb.orr
C. WELL FACILITY
(1) Name of Facility. Iula St Infiltration Trench
(2) Physical Address: 613 Wayniek Blvd
(3)
City: WriQhtsville Beach
State: NC Zip Code: 28480
Facility Location Identified By (check one):
[ x ] Attached facility site map with property boundaries, or
[ ] Geographic Coordinates: Latitude: Of for Longitude: 9 ?.,gU6
Reference Datum: Position Accuracy:
Method of Data Collection:
D. WELL STATUS — Indicate the status of the well or well system (choose one):
Proposed x Active Inactive Temporarily Abandoned Permanently Abandoned
UIC Stormwater Injection Notification Form
(Revised 8/8/2013) Page }
E. SIGNATURES — The following section is to be completed as required below or by that person's authorised
agent. 15A NCAC 02C .021 Ire t requires signatures as follows:
(a) for a corporation: by a responsible corporate officer;
(b) for a partnership or sole proprietorship: by a general partner or the proprietor, respectively;
(c) for a municipality or a state, federal, or other public agency: by either a principal executive
officer or ranking publicly elected official;
(d) for all others: by the well owner;
(e) for any other person authorized to act on behalf of the applicant: documentation shall be
submitted with the notification that clearly identifies the person, grants them signature
authority, and is signed and dated by the applicant
"I hereby cert5 under penalty of law, that I have personally examined and am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon
the injection well and all red appurtenances in accordance with the 1544 NC4C 02C 0200 Rules."
Ia,r -Town thatevri
Signature of Property Owner/Applicant
`fk1
Print or Type Full Name
Signature of Authorized Agent, if any
Print or Type Full Name
Submit one copy attic completed notification package to:
DWR — Aquifer Protection Section
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone: 919-807-6464 Fax: 919-807-6496
UIC 5tormwater Injection Notification Form (Revised 8/8/2013) Page 2
WithersRavenel
131 .. '1/2 Wilmington Street
/ Raleigh, NC 27601
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