Maple Ridge 4 DEP Permit
Maple Ridge 4 DEP Permit
Maple Ridge 4 DEP Permit
Joyce Cowdrey
Earthtech Enterprises
5425 Golden Gate Pkwy Ste 3
Naples, FL 34116 7524
Dear Permittee:
The Florida Department of Environmental Protection has received and processed your Notice of Intent to
Use Generic Permit for Stormwater Discharge from Large and Small Construction Activities and
Dewatering Operations (NOI) and the accompanying processing fee. This letter acknowledges that:
Your project identification number is FLR20AM37-001. Please include this number on all future
correspondence to the Department regarding this permit.
This letter is not your permit; however, this letter does serve as verification of permit coverage. A copy
of the permit language is available online at https://www.flrules.org/Gateway/reference.asp?No=Ref-04265
or by contacting the NPDES Stormwater Notices Center.
Your permit coverage becomes effective January 09, 2016 and will expire January 08, 2021. To
terminate your coverage prior to this expiration date, you must file a National Pollutant Discharge
Elimination System (NPDES) Stormwater Notice of Termination, DEP Form 62-621.300(6) (NOT). An
NOT must be filed within 14 days of either (a) your final stabilization of the site or (b) your relinquishment
of control of the construction activities to a new operator. Terminating coverage under the CGP will also
terminate your dewatering operations. You may not exclusively terminate dewatering operation under this
form.
To renew your coverage beyond the expiration date, you must submit a new NOI and processing fee to the
Department no later than two days before coverage expires.
Until your permit coverage is terminated, modified, or revoked, you are authorized to discharge stormwater
from the construction site referenced in your NOI to surface waters in accordance with the terms and
conditions of the CGP. Some key conditions of the CGP are:
Projects that discharge stormwater associated with construction activity to a municipal separate stormwater
system (MS4) shall submit a copy of the NOI or the Acknowledgement Letter within 7 days of receipt to
the operator of the MS4.
If you have any questions concerning this Acknowledgment Letter, please contact the NPDES Stormwater
Notices Center at (866) 336-6312 (toll-free).
Sincerely,
You must submit this completed Notice of Intent (NOI) form to the Department to get coverage under the Generic Permit for
Stormwater Discharge from Large and Small Construction Activities provided in subsection 62-621.300(4), F.A.C. The
Generic Permit document [DEP Document 62-621.300(4)(a)] tells you what construction activity qualifies for coverage, how
you obtain and terminate coverage, what you must do to minimize pollution from your construction site, and what conditions
apply to your project to use the generic permit. You must submit the appropriate generic permit fee, as specified in
paragraph 62-4.050(4)(d), F.A.C., with this NOI Form to obtain permit coverage. You must read and understand the
requirements of the generic permit document and the attached instructions before completing this NOI form. Please print
or type information in the appropriate areas below.
For construction activities also requiring an Individual Environmental Resource Permit (ERP), under Chapter 62-
330, F.A.C.:
If your construction activities are already authorized by a valid Individual ERP issued by the Department, Water
Management District or a Delegated Local Government, you may also elect to use this NOI form to provide the
required notice of commencement of construction, in lieu of Form 62-330.350(1) (“Construction Commencement
Notice”).
Do you wish to also provide notice of commencement of construction activities authorized under an Individual ERP
permit through the use of this form? Yes ■ No
I. IDENTIFICATION NUMBER:
FLR20AM37-001
A. Facility ID (if renewing coverage): _____________________________________________
11-02336-P 4
B. ERP Permit Number* (if applicable): ___________________________________________
C. ERP Permitting Agency (if applicable): _________________________________________
*If the ERP permit authorizes phased construction, please also indicate which phase.
Page 1 of 6
DEP Form 62-621.300(4)(b)
Effective Date: 02/10/2015
H. Responsible Authority’s Phone No.: (239) 948-3116
H. Is the site located on Indian Country Lands? Yes ■ No I. Water Management District: SFWMD
A. Indicate whether the ■ Large Construction (Project will disturb 5 or more acres of land, Fee $400)
project is Large or Small
Construction (check only Small Construction (Project will disturb between 1 and 4.99 acres of land, Fee $250)
one):
72.00
B. Approximate total area of land disturbance from commencement through completion of construction: _________ acres
C. SWPPP Location: Address in Part III above ■ Address in Part IV above Other address (specify below)
D. SWPPP Address:
Page 2 of 6
DEP Form 62-621.300(4)(b)
Effective Date: 02/10/2015
http://ca.dep.state.fl.us/mapdirect/?focus=contamlocator. The ICR may be accessed at:
http://www.dep.state.fl.us/waste/categories/brownfields/pages/ICR.htm, or
http://ca.dep.state.fl.us/mapdirect/?focus=icr
YES Continue to VI.C, below.
■ NO Continue to Part VII.
VIII. CERTIFICATION 1:
I certify under penalty of law 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 gather and evaluate 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 there are significant penalties for submitting false information, including the possibility of fine
and imprisonment for knowing violations.
If providing notice of commencement of construction as required by an Individual Environmental Resource Permit, I also
certify that I am authorized by the Permittee (identified in Part III.A., above), to commence construction activities
authorized by the ERP Permit (identified in Part I.B., above).
1
Signatory requirements are contained in Rule 62-620.305, F.A.C.
Page 3 of 6
DEP Form 62-621.300(4)(b)
Effective Date: 02/10/2015
INSTRUCTIONS – DEP FORM 62-621.300(4)(b)
NOTICE OF INTENT (NOI) TO USE GENERIC PERMIT FOR STORMWATER DISCHARGE FROM LARGE
AND SMALL CONSTRUCTION ACTIVITIES
You must file the NOI and obtain coverage under the Construction Generic Permit if you discharge stormwater associated
with large or small construction activities to surface waters of the State, including through a Municipal Separate Storm
Sewer System (MS4), http://www.dep.state.fl.us/water/stormwater/npdes/docs/all_ms4_by_county.pdf.
The Department encourages the electronic submission of NOIs using the Department’s Interactive Notice of Intent (iNOI)
available at http://www.fldepportal.com/go/. NOIs also may be submitted by paper copy to the following address:
Permit fees for large and small construction activities to be covered under the generic permit are specified in paragraph 62-
4.050(4)(d), F.A.C. and available on our http://www.dep.state.fl.us/water/stormwater/npdes/fees.htm. You must submit the
appropriate generic permit fee (either for large 5+ acres $400 or small 1- 4.99 acres $250 construction activities) with the
completed NOI to obtain coverage under the generic permit. Generic permit coverage will not be granted without
payment of the appropriate permit fee.
If the NOI is submitted electronically, the permit fee must be paid on-line by credit card or check. If the NOI is submitted
using a paper copy, the permit fee must be paid by either check or money order made payable to: “Florida Department of
Environmental Protection”.
If you are renewing coverage, please enter the project’s DEP identification number (generic permit coverage number) if
known. If this is a new project without an ID number then leave this item blank. If you know your ERP Permit Number or
ERP Permitting Agency (if applicable) please identify it here, if not then leave these items blank.
Check the box to indicate whether you have completed your Stormwater Pollution Prevention Plan. You must complete your
SWPPP and be ready to implement it before submitting your NOI.
Item A.: Provide the legal name of the person, firm, contractor, public organization or other legal entity that owns or
operates the construction activity described in this NOI. The operator is the legal entity that has authority to control those
activities at the project necessary to ensure compliance with the terms and conditions of the generic permit.
Item B.: Enter the appropriate one letter code from the list below to indicate the legal status of the operator:
Items C. – F.: Provide the complete mailing address of the operator, including city, state and zip code.
Page 4 of 6
DEP Form 62-621.300(4)(b)
Effective Date: 02/10/2015
Items G. – J.: Provide the name, telephone and fax number (including area code) and E-mail address of the person
authorized to submit this NOI on behalf of the operator (e.g., Jane Smith, President of Smith Construction Company on
behalf of the operator, Smith Construction Company; John Doe, Public Works Director on behalf of the operator, City of
Townsville; etc.). This should be the same person as indicated in the certification in Part VI.
Items A. – E.: Enter the official or legal name and complete street address, including city, state and zip code of the project.
Do not provide a P.O. Box number as the street address. If it lacks a street address, describe the project site location (e.g.,
intersection of State Road 1 and Smith Street).
Item G.: Enter the latitude and longitude, in degrees-minutes-seconds format, of the approximate center of the project.
Item H.: Indicate whether the project is located on Indian Country Lands. If the project is located on Indian Lands you
may not use this generic permit. Instead, you must apply to the http://cfpub.epa.gov/npdes/stormwater/const.cfm (EPA) for
coverage.
Item I.: Enter the appropriate five or six letter code from the list below to indicate the
http://www.dep.state.fl.us/secretary/watman/default.htm in which your project is located:
Items J. – M.: Enter the name, telephone and fax number (including area code) and E-mail address of the project contact
person. The project contact is the person who is thoroughly familiar with the project, the facts reported in this NOI and
who can be contacted by the Department if necessary.
Item N.: Enter additional E-mail correspondence as needed to receive permit related documentation. (Optional)
Item A.: Check the appropriate box to indicate whether the project involves large construction activity or small construction
activity. Check one box only.
“Large Construction Activity” means construction activity resulting in the disturbance of five (5) or more acres of total land
area. Large construction activity also includes the disturbance of less than five acres of total land area that is part of a
larger common plan of development or sale such as a subdivision that will ultimately disturb five acres or more.
“Small Construction Activity” means construction activity resulting in the disturbance of equal to or greater than one (1)
acre and less than five (5) acres of total land area. Small construction activity also includes the disturbance of less than one
acre of total land area that is part of a larger common plan of development or sale that will ultimately disturb equal to or
greater than one acre and less than five acres.
Item B.: Provide the approximate total area of land disturbance, in acres, that the project will involve from commencement
of construction through completion.
Items C. - G.: Indicate the location where the Stormwater Pollution Prevention Plan (SWPPP) can be viewed. Provide the
address where the SWPPP can be viewed if other than as provided in Parts II or III of the NOI. Note that to be eligible for
coverage under the generic permit, the SWPPP must have been prepared prior to filing this NOI.
Item H.: Enter the estimated construction start and completion dates in the MM/DD/YY format.
Page 5 of 6
DEP Form 62-621.300(4)(b)
Effective Date: 02/10/2015
Part VI – Dewatering Information:
If your site has “noncontaminated ground water”, the CGP also authorizes discharges from ground water dewatering activities.
A site will be presumed to have uncontaminated if it is not contaminated and there are no known contamination sites within
500 feet of the site. You may use the Department’s http://webapps.dep.state.fl.us/DepClnup/welcome.do or the Institutional
Controls Registry (ICR) Web Viewer http://www.dep.state.fl.us/waste/categories/brownfields/pages/ICR.htm, to determine
the location of contaminate sites. The CGP does not authorize the discharge of contaminated ground water.
To be covered under a CGP, you must provide the following information about where the discharge from your project will
go. NOIs submitted without discharge information cannot be processed.
Item A.: If stormwater from your project discharges to a MS4 enter the name of the MS4 (e.g., City of Tallahassee MS4,
Orange County MS4, FDOT District 5 MS4, etc.). If stormwater from your project does not discharge to an MS4 but to
surface waters of the State, leave this item blank or indicate “N/A” and skip to Item B. of this part. Please note that if
your project discharges stormwater to an MS4, you must provide the MS4 operator with a copy of the completed
NOI. http://www.dep.state.fl.us/water/stormwater/npdes/docs/all_ms4_by_county.pdf
Item B.: If your project discharges stormwater to surface waters of the State, and not to an MS4, enter the name of the
receiving water body to which the stormwater is discharged. Please provide the first named water body to which the
stormwater from the project is discharged (e.g., Cypress Creek, Tampa Bay, unnamed ditch to St. Johns River, Tate’s Hell
Swamp, etc.).
In certain cases, stormwater from the project will discharge to both an MS4 and surface waters of the State. In this case,
complete both Item A. and Item B.
Type or print the name and official title of the Responsible Authority signing the certification. Please note that this must be
the same person indicated in Item II.G. as the Responsible Authority. Sign and date the certification.
Section 403.161, F.S., provides severe penalties for submitting false information on this application (NOI) or any reports or
records required by a permit. There are both civil and criminal penalties, in addition to the revocation of permit coverage for
submitting false information.
Rule 62-620.305, F.A.C., requires that the NOI and any reports required by the permit be signed as follows:
Page 6 of 6
DEP Form 62-621.300(4)(b)
Effective Date: 02/10/2015