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Home My WebLink AboutWI0800439_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 I /, ~ • ) ., I I ·-} I; .,I ' . / I I I l . / ' ' 4 /L,// u , / i I I NC:2 .. i""5 ·06 J'IJ()V' 'l5 Pt,,i! 3 L ( I I I j/,u / ! ( /I I ' I • $0.48~ US POSTAGE FIRST-CLASS 071V01046065 27511 000000001