Okaloosa County BOCC — 2013 meeting #1182 (date undetermined) — NPDES Notice of Intent 2013 — reading text

For FDEP Internal Use Only NOTICE OF INTENT Permit ID: FLR_____ TO USE GENERIC PERMIT FOR DISCHARGE OF STORMWATER FROM PHASE II MUNICIPAL SEPARATE STORM SEWER SYSTEMS (RULE 62-621.300(7)(b), F.A.C.) INSTRUCTIONS: ¢ This NOI must be completed and submitted to the Department to authorize use of the Generic Permit for Discharge of Stormwater from Phase II Municipal Separate Storm Sewer Systems ("MS4 GP"), provided in Rule 62-621.300(7)(a), F.A.C. required attachments to: 2 " NPDES Stormwater Notices Center e The type of municipal separate storm sewer system that qualifies for coverage under the MS4 GP M.S. #2510 Submit NOI, permit fee, and and the applicable Phase II MS4 stormwater management program requirements are specified in the permit. You should familiarize yourself with the MS4 GP before completing this NOI. Florida Department of Submit this full leted NOI it fe id ired attach ts b il to the add. i Be oe Raveaion e Submit this fully complete , permit fee, and required attachments by mail to the address in 2600 Blair Stone Road the box at right. DO NOT SUBMIT any materials not in the checklist in Section V. of this NOI. Tallahassee, FL 32399-2400 e Please print or type information in the appropriate areas below and complete each section. SECTION I. PHASE II MS4 OPERATOR INFORMATION A Name of the Phase Il MS4 Operator: Okaloosa County B. Name of the Phase II MS4 Responsible Authority: Don Amunds Title: Chairman - Board of County Commissioners Mailing Address: 1804 Lewis Turner Blvd City: Fort Walton Beach Zip Code: 32547 County: Okaloosa Telephone Number: 850-651-7105 Cc. | Name of the Designated Phase Il MS4 Stormwater Management Program Contact: John Hofstad Title: Public Works Director Department: Public Works Mailing Address: 1759 South Ferdon Blvd City: Crestview Zip Code: 32536 County: Okaloosa Telephone Number: 850-689-5772 E-mail Address: jhofstad@co.okaloosa.fl.us D. | Location of the Phase II MS4 (if different than the mailing address in Section I.C. above): Street Address: City: Zip Code: County: E. | Approximate center of the Phase II MS4: Latitude: 30 ° 35 ‘ 25 “ Longitude: -86 ° 34 ‘ 44 “ F. | Phase ll MS4 ownership status (check one): Public O State LT Federal Total resident population of the Phase II MS4: 190,083 H. | Name of the urbanized area(s) the Phase II MS4 is located within (if applicable): iF Name of the Water Management District the Phase II MS4 is located within (check all that apply): Northwest Florida Water Management District C1 Southwest Florida Water Management District CD Suwanee River Water Management District OO St. John's River Water Management District 1 South Florida Water Management District DEP Form 62-621.300(7)(b), May 1, 2003 Page 1 of 13 SECTION Il. SHARING RESPONSIBILITY You may rely on another entity to satisfy some or all of your permit obligations if the conditions in Part IX of the MS4 GP are met. Another entity may implement one or more of the measures and/or a component of a measure on your behalf. You may rely on another entity to satisfy all permit obligations (including annual reporting) but only if the entity is permitted under Chapter 62-624, F.A.C. Note the following: ¢ You will remain responsible for compliance with your permit obligations if the other entity(ies) fails to implement the control measure(s) ora component thereof on your behalf. You must establish a written agreement with the other entity(ies) before submitting this NOI. ¢ Relying on another entity, or entities, either partially or fully does not preclude you from the obligation to fully complete this NOI, including the information required in Section IV. A. | 1. | Has another entity, regulated under Chapter 62-624, F.A.C., agreed to implement all of your permit obligations on your behalf? [1 Yes Kl No If yes, complete Section II.A.2. If no, skip to Section II.B. Name of Entity: Contact Name: Title: Department: Mailing Address: City: Zip Code: County: Telephone Number: E-mail Address: B. | 1. | Has another entity agreed to implement one or more of the minimum control measures (or a component thereof) on your behalf? CL] Yes KI No If yes, complete Sections |I.B.2. and II.B.3. (See the note below for any additional entities) 2. | Control measure(s) or component of a control measure to be implemented by the other entity: Name of Entity: Contact Name: Title: Department: Mailing Address: City: [ Zip Code: County: Telephone Number: E-mail Address: Note: For each additional entity sharing stormwater management program responsibilities with you, provide on a separate sheet the information requested in Sections II.B.2. and II.B.3. Title the sheet "Section II.B: Additional Entities Information" and attach it to this NOI. SECTION Ill. RECEIVING WATERS Identify the named receiving waterbodies to which your Phase II MS4 discharges. Include all such waterbodies known to you at the time of this application: Santa Rosa Sound Choctawhatchee Bay Gulf of Mexico Yellow River Blackwater River Shoal River DEP Form 62-621.300(7)(b), May 1, 2003 Page 2 of 13 SECTION IV. MINIMUM CONTROL MEASURES A. | Complete the Phase Il MS4 Stormwater Management Program (SWMP) Elements Form in Appendix A for each minimum control measure described in Part VI. of the MS4 GP, except the Post-construction Stormwater Management in New Development and Redevelopment minimum control measure if you have chosen the qualifying alternative program option for this measure under Part X. of the permit. If you choose, however, to implement BMPs for the Post-construction measure, please complete a SWMP Elements Form for the measure. Include in the SWMP Elements Form all best management practices (BMPs) currently in place or planned for each element of each minimum control measure. There is no limit to the number of BMPs you may include. Make copies of the form as necessary to accommodate all of your BMPs. The completed forms, in their entirety, will be considered by the Department to be the outline of your proposed stormwater management program. Attach all completed forms to this NOI. B. | Provide the total number of pages of SWMP Elements Forms that are attached to this NOI for each minimum control measure: Minimum Control Measure # of Pages Public Education and Outreach as to Stormwater Impacts 1 Public Involvement/Public Participation Illicit Discharge Detection and Elimination Construction Site Stormwater Runoff Control Post-construction Stormwater Management in New Development and Redevelopment Pollution Prevention/Good Housekeeping for Municipal Operations alo in ja fo SECTION V. MATERIALS TO BE SUBMITTED WITH THIS NOI Only the following materials are to be submitted to the Department along with your fully completed and signed NOI (check the appropriate box to indicate whether the item is attached or is not applicable): Attached NIA x The permit application fee, as prescribed by Rule 62-4.050(4)(d)(6), F.A.C. Make all check and money orders payable to the Florida Department of Environmental Protection. xX A fully completed Phase Il MS4 Stormwater Management Program Elements Form (see Appendix A) for each minimum control measure except the Post-construction Stormwater Management in New Development and Redevelopment minimum control measure if you have chosen the qualifying alternative program option for this measure under Part X. of the MS4 GP. Oo x) Additional entities information, as required under the note in Section II.B. of this NOI. DO NOT SUBMIT ANY OTHER MATERIALS (such as your complete Stormwater Management Plan, ordinances, storm sewer map, public outreach, etc.) SECTION VI. CERTIFICATION STATEMENT AND SIGNATURE The Responsible Authority listed in Section |.B. of this NOI must sign the following certification statement:' | 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 gathered and evaluated the information submitted. Based upon 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. | am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Name of Phase || MS4 Responsible Authority (type or print): _Don Amunds Title: Chairman Board of Okaloosa County Commissioners Signature: Date: / i/ ' Signatory requirements are contained in Rule 62-620.305, F.A.C. DEP Form 62-621.300(7)(b), May 1, 2003 Page 3 of 13 INSTRUCTIONS FOR APPENDIX A PHASE II MS4 STORMWATER MANAGEMENT PROGRAM (SWMP) ELEMENTS FORM General Instructions Complete this form for each minimum control measure described in Part VI. of the Generic Permit for Discharge of Stormwater from Phase II Municipal Separate Storm Sewer Systems (MS4 GP") provided in Rule 62-621.300(7)(a), F.A.C., except the Post-construction Stormwater Management in New Development and Redevelopment minimum control measure if you have chosen the qualifying alternative program option for this measure under Part X. of the permit. If you choose, however, to implement BMPs for the Post- construction measure, please complete a SWMP Elements Form for the measure. Include all best management practices (BMPs) currently in place or planned for each element of each minimum control measure. There is no limit to the total number of BMPs you may include. Make copies of the form as necessary to accommodate all of your BMPs. The completed forms, in their entirety, will be considered by the Department to be the outline of your proposed stormwater management program. Attach the forms to the NOI and submit to the Department at the address provided on the NOI. Please print or type information in the appropriate areas of this form. Section A.I: MINIMUM CONTROL MEASURE Indicate which minimum control measure the BMPs in Section A.Il. address. Check only one measure. Use a separate form for each measure. Section A.ll: BEST MANAGEMENT PRACTICES Include BMPs only for the measure you have identified in Section A.l. The Department encourages the use of the Florida Land Development Manual: A Guide to Sound Land and Water Management (FDER, 1988) and the U.S. Environmental Protection Agency's National Menu of Best Management Practices for Storm Water Phase II in developing Phase I! stormwater management programs. Both are available from the Department. Element ID: Table 1 below includes all the minimum control measure elements required under Part IV. of the MS4 GP. Using Table 1, identify which element of the minimum control measure each BMP addresses. For example, a BMP addressing the procedures for site plan review under the Construction Site Stormwater Runoff Control Minimum Control Measure would be labeled as "4d." You must include at least one BMP for each element. BMP Number: For each minimum control measure, number the BMPs starting with 01 and continue the numbering in sequential order on any additional forms for the measure. The numbering of the BMPs is for reference purposes only and does not provide additional weight to, nor prioritize, one BMP over another. Measurable Goals: List the measurable goal(s) foreach BMP. You must include at least one measurable goal for each BMP and may include as many as necessary for the BMP — you are not limited to the four lines provided on the form. Schedule for Implementation/Completion: For each measurable goal, include the year each action will be implemented and, as applicable, the interim milestones, completion date, or planned frequency of the action. Responsible Entity/Department: Include the name of the entity (if other than the Phase Il MS4 Operator) or of the internal department (if it is the Phase II MS4 Operator) responsible