Date:
Project/Site Name: County:
(Modification
or
Change
of
Information
Only)
Prior Approved NPDES Permit or File Number:
Prior Approved Anderson County Stormwater Permit Number:
Under Anderson County Code of Ordinances Chapter 38, Article V. and
South Carolina NPDES General
Permit
For Stormwater Discharges From Construction Activities
SCR100000
NOTICE OF INTENT (NOI)
For Coverage(s) of Primary
Permittees
(Maintain As Part of On-Site
SWPPP)
For Official Use Only
SCR10
Complete:
File Number:
Permit Number:
Submittal Package
Submission of this Notice of Intent constitutes notice that
the Applicant identified in Section II intends to be
authorized as a Primary Permittee in the state of South
Carolina under NPDES General Permit SCR1000000.
Fees required for review and NPDES coverage of each
application type are as listed on page 2 of the
Instructions.
I. Notice of Intent (NOI) Application Type(s)
A. Project (Application/Review) Type(s) (Select ALL that apply):
New Project (Initial Notification) Ongoing Project: Permitted or Un-Permitted
Late Notification Low Impact Development (LID) or Project Design Above Regulatory Requirements
New Owner/Operator or Company Name Change (see instructions, attach Form A (Transfer of Ownership))
Major Modification
MS4 Project Review
Change of Information/Other (Specify):
B. If Applicable, identify additional entities designated as MS4 Reviewer and MS4 Operator (i.e., City of Anderson)
MS4 Reviewer MS4 Operator
II. Primary Permittee Information
Change of Information
Person or Company
If a Company, are you a
Lending Institution or
Gov ernment Entity?
Company EIN
(If
applic able):
EIN:
A. Primary Permittee Name:
Mailing Address: City: State: Zip:
Phone: Fax: Email Address:
B. Contact /ODSA Name (If different from above OR if owner is a
company):
Mailing Address: City: State: Zip:
Phone: Fax: Email Address:
C. Property Owner Name
(If
different
from
above)
:
Mailing Address: City: State: Zip:
Phone: Fax: Email Address:
III. Comprehensive Stormwater Pollution Prevention Plan (C-SWPPP) Preparer Information Change of Information
A. C-SWPPP Preparer Name:
B. Registered Professional Engineer Landscape Architect Tier B Land Surveyor S.C. Registration #:
C. Company/Firm Name: S.C. COA #
:
Mailing Address: City: State: Zip:
Phone: Fax:
Email Address:
IV. Project/Site Information
Change of Information
A. Type of Construction Activity(ies) (Select ALL that apply):
Commercial Industrial Institutional Mass Grading Linear Utility/Infrastructure
Residential: Single-family Residential: Multi-family Multi-use (Commercial & Residential)
Site Preparation (No New Impervious Area) Other
(Specify)
B. Site Address/Location (street address, nearest intersection,
etc.)
City/Town (If in limits): Zip Code:
Latitude: ’ ” N Longitude: - ’ ” W (Source): GPS
Web Site:
Tax Map Number (s)
(List
all):
08/2016 (Modified from DHEC 2617 (10/2012))
1
1. Small Construction Activity Waiver(s) From NPDES permitting (Section 1.4 & Appendix B)? Yes No
If "Yes", Identify requested waiver: Rainfall Erosivity Waiver TMDL Waiver Equivalent Analysis Waiver
2. Detention Waiver (72-302(B)? Yes No
3.
Other (Specify):
C. Is this site located on Indian Land? Yes No
D. Proposed Start Date
:
Proposed Completion Date:
E. Disturbed Area
(nearest
tenth
of
an
acre)
: Total Area (nearest tenth of an acre):
F. Modification Only:(
nearest
tenth
of
an
acre):
Disturbed Area: Current (Approved) Area:
Disturbed Area Change (Increase Only): Total Disturbed Area (After Change):
G. Is this project part of a Larger Common Plan for Development or Sale (LCP)? Yes No
LCP/ Overall Development Name: Check here if this is the First Phase.
Previous State Permit/File Number:
Previous NPDES Coverage Number: SCR10
H. Any Flooding Problems exist downstream of or adjacent to this site? Yes No (If "Yes", provide detailed description of
flooding problems and applicable floodway/flood zone information in the C-SWPPP).
I. Active S.C. DHEC or Anderson County Warning Notice, Notice to Comply or Notice of Violation for this site or LCP?
Yes No
J. List Relevant State and Federal Environmental Permits or Approvals applied for or obtained for this site (e.g., RCRA,
USACOE, Nationwide, etc.). If None, list None.
K. Any Waiver(s)/Variances/Exceptions Requested for this Project? (If "Yes", identify below and include Waiver Request and
Justificat
ions in the C-SWPPP for each proposed request).
V. Water
body Information (Attach additional sheet(s) as needed)
Change of Information
A. Receiving Waterbody(s) (RWB) Information (List the nearest and next nearest receiving waterbodies to which the sites
stormwater discharges will drain. If stormwater discharges drain to multiple waterbodies, list all such waterbodies).
1. Name of Receiving Waterbodies (RWB)
2. Distance to
3. Classification of
RWB
RWB (feet)
a. Nearest:
b. Next Nearest:
c. Other Waterbodies:
B. Waters of the U.S. / State Information (Attach additional sheet(s) as needed)
Waters of the U.S./ State 1. On the site?
2. Delineated/
Identified?
3. Impacts? 4. Amount of impacts
a. Jurisdictional wetlands Yes No Yes No Yes No Ac
b. Non-jurisdictional wetlands Yes No Yes No Yes No Ac
c. Other Water(s): Yes No Yes No Yes No Ac Feet
5. If "Yes" for impacts in B.3, describe each impact and activity, and list all permits (e.g., USACOE Nationwide Permit, DHEC
General Permit) and certifications that have been applied for or obtained for each impact:
C. S.C. Navigable Waters (SCNW) Information DHEC will address any issues related to State Navigable Waters' Program under
SC Regulation 19-450 during the review of the C-SWPPP for activities that will NOT require a 404 permit or a 401 certification. (Attach
additional sheet(s) as needed).
1. Are S.C. Navigable Waters (SCNW) on the site: Yes No
a.
If "No", do not complete this question. Proceed to Section D (Impaired Waterbodies).
b.
If
"Yes",
p
rovide the name of S.C. Navigable Waters (SCNW) on the site:
2. If "Yes" for C.1, will construction activities cross over or occur in, under, or thru the SCNW? Yes No
If "Yes", describe SCNW activities (e.g., road crossing, sub-aqueous utility line, temporary or permanent structures, etc.)
and proceed to Section C.3:
3. Identify permits providing coverage of SCNW activities proposed for your site. If NONE, list none.
Permits/Certifications
Permit or Certification No.
Corresponding Covered SCNW Activity(ies)
a. DHEC General/ Other DHEC Permit
b. USACOE 404 Permit or 401
Certification
c. SCNW Permit
If applied for or issued, identify Date
applied for or issued:
All Activities or Some Activities (Describe):
d. If a SCNW Permit has NOT been applied for provide an additional plan sheet that shows plan and profile views
(drawn to scale) of the SCNW and associated activities. Include a description of all proposed activities on this plan.
08/2016 (Modified from DHEC 2617 (10/2012))
2
Previous Anderson County Permit/File Number:
S
i
gna
t
u
res
and
Certifications DO NOT SIGN IN BLACK INK! Read the Certifications below (in entirety). Provide date,
printed
name, and signatures below. If you are a New
Owner/Operator,
as Primary Permittee you must also sign and date the applicable
Comprehensive SWPPP Acceptance & Compliance Agreement below.
C
-
S
WPPP
PREPARER: “One copy of the C-SWPPP, all specifications and supporting calculations, forms, and reports are
herewith submitted and made a part of this application. I have placed my signature and seal on the design
documents submitted signifying that I accept responsibility for the design of the system. Further, I certify to the best
of
my knowledge and belief that the design is consistent with the requirements of Title 48, Chapter 14 of the Code of
Laws
of SC, 1976 as amended, pursuant to Regulation 72-300 et seq. (if applicable), and in accordance with the
terms
and conditions of SCR100000.” (This should be the person identified in Section
III
).
D. Impaired
Waterbodies
Information (Attach additional sheet(s) as needed)
1. 303(d) Listed Impaired Waterbodies
a.
Name of Nearest DHEC
Water
Quality Monitoring
Stations (WQMS)(s) that receives stormwater from
your construction site and/or thru an MS4 and the
Name of the Corresponding Waterbody?
b.
Is this WQMS(s)
listed on
t
he
most
current 303(d) List?
I
f
"
No", proceed to
Section 2 of this table.
If "Yes", complete
it
e
m
s
c thru f.
c. List the
pollutant(s)
identified as
“CAUSES” of
the
impairment.
d. Will any
pollutants causing
the impairment be
present in your
site’s construction
stormwater
discharges?
e.
If "Yes" for
d
,
list the
“
USE
SUPP
O
R
T
”
impairment(s)
affected by the
pollutant(s)
identified in c.
Nearest DHEC WQMS(s) Corresponding
Waterbody
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
f.
If "Yes" for d above, will use of the BMPs proposed for your
p
r
o
j
ec
t
ensure the
s
i
t
e
’
s
discharges will NOT
contribute
to or
No
cause further WQS violations for the impairment(s) listed in c? Yes
(NOTE: If "No" for f, this site is NOT eligible for coverage under the CGP). See Instructions.
Instructions.
2. TMDL Impaired Waterbodies
a.
Name of Nearest DHEC
Water
Quality Monitoring
Stations (WQMS)(s) that
receives stormwater from
your construction site and/or
thru an MS4?
b. Has a TMDL(s) been
developed for
this
WQMS(s)?
If "No", identify as
s
uch
below and proceed to
Section VI. If "Y
e
s"
,
complete items c thru f
of this table.
c.
If "Yes" for
b
,
what pollutants
are listed as
“CAUSES” or
causing the
impairment?
d.
If "Yes" for b, has
the standard been
“ATTAINED” or “
Fully
Supported”
for
the impairment(s)?
e.
If "No" for d (Not Attained),
will any pollutants causing the
impairment be present in your
site’s construction stormwater
discharges?
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
f.
If "Yes" for e above, are your discharges consistent with the assumptions and requirements of the TMDL(s)?
Yes No
(NOTE: If "No" for f, this site is NOT eligible for coverage under the CGP). See Instructions.
VI.
Printed Name of
C
-
S
WPPP
Preparer
Signature of
C
-
S
WPPP
Preparer
S.C. Registration
#
PRIMARY PERMITTEE: “I or I (on behalf of my company and its contractors and agents), as the case may be, 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 understand that DHEC enforcement actions may be taken if the terms and
conditions of the C-SWPPP are not met and I am aware that there are significant penalties for submitting false
information, including the possibility of fine and imprisonment for knowing violations.”
“I or I (on behalf of my company and its contractors and agents), as the case may be, also hereby certify that all
land-disturbing construction and associated activity pertaining to this site shall be accomplished pursuant to and in
keeping with the terms and conditions of the approved plans and SCR100000. I also certify that a responsible person will
be assigned to the project for day-to-day control. I hereby grant authorization to the to S.C. Department of Health
and Environmental Control (DHEC) and/or Anderson County the right of access to the site at all times for the purpose of
on site inspections during the course of construction and to perform maintenance inspections following the completion
of the land-disturbing activity.” (See Section 122.22 of S.C. Reg. 61-9 for signatory authority information.) Having
understood the above information, I am signing this certification as Primary Permittee to the aforementioned NPDES
general permit.”
Printed Name of Primary Permittee
T
i
t
l
e
/
Po
s
i
t
i
on
Signature of Primary Permittee
Date
Signed
08/2016 (Modified from DHEC 2617 (10/2012))
3
FEE SCHEDULE
The schedule should be
attached to
the
NOI. Do
not
send
payment
in
wind
ow en
velope. DO
NOT
MAIL
CASH
. Anderson
County
or DHEC
will
notify
the
Project Owner/
Operator
if
the
subm
itted
che
ck
or
cred
it
card
paymen
t
cannot be
processed. The review clock will start when acceptable payment is received.
1.
Identify (√) the DHEC Project Review Type(s)
Enter NPDES Coverage Fee of $125 in the right-hand column if any of the following project/review
types apply to this application. Proceed to Item 2.
(√)
NPDES
Coverage Fee
a. Project or LCP (Item IV.G) that will ultimately disturb one (1) acre or more
Note: If your project will ultimately disturb less than one (1) acre AND
is NOT a part of a Larger
Common Plan, coverage under SCR100000 is not required; see
http://www.scdhec.gov/administration/library/d-2628.pdf (Notification Form for Sites Disturbing
Less Than 1-Acre Not Part of a Larger Common Plan, Non-Coastal County".)
$ . 00
b. New Owner/Operator (Transfer of Ownership)/Company Name Change
($125 NPDES Coverage fee is required by DHEC for Transfers of Ownership and Company Name Changes)
c. Unpermitted Ongoing Project or Late Notification
d.
MS4 Project Review (Item I.A and I.B) ($125 payable to DHEC thru MS4 Reviewer)
e. Other (Specify):
2.
Determine the Project Review Fees
PROJECT OR LCP THAT WILL ULTIMATELY DISTRUB ONE (1) ACRE OR MORE
(√)
Review Fees
a. Enter the disturbed area (Item IV.E) for this project. Proceed to Items 2.b and 2.c. (Nearest tenth of an acre)
b. Will this project or LCP (Item IV.G) ultimately disturb more than 1.0 acres
Yes No
c.
Is this project exempt from S.C. Reg. 72-300 et seq.?
Yes No
1.
If this project will not ultimately disturb more than 1.0 acre, and is not part of an LCP, your
project is automatically covered under the
NPDES permit and the NPDES coverage fee and review fee are not required. See the BOW-SPWS for “Less Than 1-Acre of Land
Disturbance – Non- Coastal Counties”.
2. If this project will ultimately disturb more than 1.0 acre, proceed to Item 2.d.
d. Enter the project review fees ($850 base fee plus $200/disturbed area) in the right-hand
column. (Multiply the disturbed area (Item 2.a) by $200/disturbed area plus $850).
$ . 00
4. Required Fees for DHEC and Method of Payment Add the value in the right-hand column of Item 1.
$ . 00
Identify the Method of Payment:
Payment by Check:
DHEC will contact you to provide instructions and the invoice number necessary for
check payment after Anderson County completes the review process. Please provide an
email address where the invoice number may be sent:
(Do not send the DHEC payment to Anderson County.)
Payment by Credit Card: (Check here if you wish to pay via credit card using the on-line payment system).
DHEC will contact you to provide instructions and the invoice number necessary for online payment. Please
provide an email address where the invoice number may be sent:
(Anderson County and DHEC
will not review this project until all required fees are received).
For official use only: Invoice Number
08/2016 (Modified from DHEC 2617 (10/2012))
4
$ . 00
5.
3. Determine the Anderson County Major Modification Fees
(√)
Mod. Fees
b.
Are there additional acres of disturbed area in the modification?
Yes
No
If part 3.b is yes, enter how many additional acres of disturbed area. (Nearest tenth of
an acre) Multiply the additional disturbed acres added during the modification by $200.
c.
acres
$ . 00
d. Enter the application fee ($500 base fee plus $200/disturbed area) in the right-hand
column. (Add the values calculated in 3.a and 3.c).
$ . 00
Required Fees for Anderson County and Method of Payment
Add the values in the right-hand columns of Items 2.d and 3.d.
Attach a signed and dated check payable to Anderson County to the front of this Fee Schedule. Please note that all checks must be
less than 30 days old.
a.
Is there a major modification as a part of this submittal?
If "Yes", fee is $500 and proceed to 3.b. If "No", proceed to 4.
Yes
No
$ . 00
Instructions for Completing the Notice or Intent (NO
I
)
If you are uncertain whether you need to obtain coverage under the NPDES General Permit for Stormwater Discharges from Construction
Activities, SCR100000 (CGP), if you cannot access the websites listed on the NOI and instructions, or if you have any other questions, contact
the Stormwater Permitting Section (SWP) at (803) 898-4300. Please see the Bureau of Water, Stormwater Permitting website (BOW-
S
PW
S
):
http://www.scdhec.gov/environment/water/swater/ for guidance and additional information regarding the CGP.
Who Must File a
NO
I
:
•
If S.C.
Department
of Transportation (SCDOT) is the Primary Permittee (Owner/ Operator), this NOI form
should not be used.
•
The Owner/ Operator of a single project or larger common plan for development or sale (LCP—see item IV.G of
instructions) that will ultimately disturb 1 acre or more (all counties).
• See the B
OW
-
S
PW
S for “Less Than 1-Acre of Land Disturbance - Non-Coastal Counties”.
Wh
er
e
t
o
F
il
e:
See the B
OW
-
S
PW
S for a current list of the areas that are reviewed by Municipal Separate Storm Sewer System (MS4) operators and
entities that have delegated review authority. For projects in these areas, the initial submittal should be made to the M S4 operator;
if initial submittal is made to DHEC for projects in these areas, the review process may be delayed. Please contact the appropriate
entity for additional information and requirements; for example, the M S4 operator may require that a different application form be
submitted. If a project crosses jurisdictional boundaries (e.g., sewer line in Greenville County and the city of M auldin), then
submittals to all appropriate MS4 operators, delegated entities, and DHEC must be coordinated.
Projects Located in Unincorporated Areas of Anderson County and inside the City of Belton
All Other
A
r
ea
s
Refer to DHEC
NOI Form 2617
Anderson County
Stormwater Management
731 Michelin Blvd.
Anderson, SC 29626
S
ubm
i
tt
a
l
Pa
ck
age
f
or
S
WPPP
and
CSWPPP:
•
When performing a full technical review, you must include the original, signed NOI form, fee schedule
with required fees, one (1) copy of the Comprehensive Stormwater Pollution Prevention Plan (C-SWPPP), and one (1) of all
other supporting documentation with the initial submittal.
These documents must also be submitted in electronic format as Adobe PDF files on USB supported media. A submission is not
considered complete until all forms in both formats are received.
•
•
F
o
r
Mod
ific
a
t
io
n
p
r
o
j
ec
t
s
whe
r
e
Anderson County
pe
r
f
o
rm
s
a
t
echn
ic
a
l
review, see Section I of the instructions.
Complete the applicable sections of the NOI Form. Submit an original, signed NOI form, appropriate fee schedule (C) with
required fees, one (1) copy of SWPPP revisions,
and one (1) copy of all other supporting documentation, including
necessary engineering calculations. No review clock is required for Modification r
e
v
i
ew
s
.
08/2016 (Modified from DHEC 2617 (10/2012))
•
This form is only applicable to the unincorporated areas of Anderson County and inside the City of Belton.
5
For projects ultim
a
t
e
ly
d
is
t
u
r
b
i
ng
m
o
r
e
t
han
1 acres, the Stormwater Management and Sediment and Erosion Control Plan Review
Checklist For Design Professionals must be completed and attached. If this project will NOT ultimately disturb more than 1.0 acre
AND is not part of an LCP, your project is automatically covered by the NPDES Permit. Fees are not required. See the BOW-SPWS for
“Less Than 1-Acre of Land Disturbance – Non-Coastal Counties.
Fee Schedules:
Make sure to answer all applicable questions on the appropriate Fee Schedule. Complete Fee Schedule A for N
on
-
Coa
s
t
a
l
p
r
o
j
ec
t
s
.
Attach Form A, as required, for Transfer of Ownership.
Office Mechanics and Filing
:
The original NOI form and supporting documentation will be kept in the Anderson County Stormwater Management
files.
Date: Enter today’s date.
P
r
o
j
ec
t
/S
i
t
e
Name: The Project/ Site
Name
should be
a
unique or distinguishing name (e.g., not Proposed Subdivision).
NOTE: Anderson County and DHEC must be notified in writing if the Project/ Site Name changes.
County: If the project is in multiple counties, list the county in which the majority of the site is located.
See the “Where to File” section. List the other counties in which the site is located in the C-SWPPP.
P
r
i
o
r
App
r
o
v
ed
NPDE
S
Pe
rm
i
t
Number (
Ma
j
o
r Modification or Change of Information Only): Provide the NPDES permit
number (SCR number)or File Number previously assigned to the project or LCP.
I.
Notice of Intent (NOI) Application Type(s) (See Section 2.4 of CGP for submission deadlines and notification
requirements).
A.
P
r
o
j
ec
t
(Application) Type
-
Select ALL applicable application types that best describe your project
or
application. Section 2 of the Construction General Permit (CGP) may be reviewed for further information on
each type of application listed in this section. As an example, if your project is one that is a new startup, then
“New Project” should be selected. If your project is a new startup that will be located in Beaufort County,
that will also be expedited, then “New Project”, “OCRM Project Review”, and “Expedited Review Program”
should each be selected to describe your application. To determine if the project design is considered to be
above regulatory requirements or Low Impact Development, see the “Expedited Review Standard Operating
Procedures” document. If none of the application types listed in this section apply or clearly define the intent
of your project, select “Other” and provide specific details that clearly describe the intent of your NOI
application.
NOTE: Anderson County and DHEC must be notified in writing within fourteen (14) business days of a new
Owner (person, lending institution, government institution, etc.) taking title to or ownership of a prior approved
ongoing NPDES construction project/site. A new Property Owner must complete all applicable sections of
Form A (Transfer of Ownership) and submit this form to DHEC or respective MS4 with the NOI application.
Written notification is also required when the Owner or Developer’s company name changes for a prior
approved construction permit.
NOTE: Major Modifications allowed by Anderson County and DHEC are listed in Section 3.1.7 of the CGP. If your
project is a major modification, complete any applicable sections of the NOI. Please note that Section V
(Waterbody Information) of the prior approved NOI must be reviewed for changes prior to submitting any
modification request to DHEC. If changes have occurred, identify as Change of
Information on the NOI form
and provide the revised information in this section. Attach a detailed Narrative and revised C-SWPPP
documents to the major modification request.
B. MS4 Reviewer and MS4 Operator
-
If this project is located inside an additional Municipal Separate Storm
Sewer System (MS4) and must be reviewed and approved by a MS4 entity prior to submission to Anderson
County and DHEC, then select “MS4 Project Review” as application type in Item A and provide the names of
the entities that will perform the review and the MS4 Operator. Urbanized area boundary
maps are available at http://cfpub.epa.gov/npdes/stormwater/urbanmapresult.cfm?state=SC. See the
following website for information about MS4s: http://www.scdhec.gov/environment/water/swnsms4.htm.
Note: Some MS4s have increased their review jurisdiction boundaries beyond the original urbanized area
map. Please confirm with the appropriate MS4 regarding review jurisdiction.
II.
P
r
i
ma
ry
P
er
m
i
tt
ee Information
Identify whether the Primary Permittee is a person or a company. If a company, identify if it is a lending institution or
government entity. Provide the Employer Identification Number (EIN) as established by the U.S. Internal
Revenue Service for the company. The EIN is commonly referred to as the taxpayer ID. If the company does not
have an EIN (e.g., single member LLC, sole proprietorship). D
O
NOT
li
s
t
a
S
oc
i
a
l
S
ecu
r
i
ty number.
08/2016 (Modified from DHEC 2617 (10/2012))
6
A. Primary Permittee Name - Provide the complete, legal name of the person or entity (company) that will be the
Contact/ODSA
Name – Complete if different from II. A or O/O is a company. Provide the complete legal name of
the person identified as the Contact or Operator of Daily Site Activities (ODSA) for the project. This can be
someone other than the person that has signatory authority for the company. Often the Contact person is also
referred to as the ODSA. Provide the complete mailing address for the person, other than the permittee,
Anderson County or DHEC may contact. This address can be different from the mailing address entered for the
O/O.
C. Property Owner Name – If different from II.A or B, list the complete, legal name of the current Property Owner(s)
of the site. Enter the complete mailing address for the Property Owner. N
PDE
S
co
v
e
r
age
will
be
issued
t
o
the
Primary
Permittee identified
in
Section
II.A,
not the Property Owner,
unless same entity. If there are multiple Property
Owners, attach additional sheets with all information requested in Section II.C.
III.
Comprehensive Stormwater Pollution Prevention Plan (C-SWPPP) Preparer Information
A.
C
-
S
WPPP
Preparer Name – Provide the name of the C-SWPPP Preparer for this project.
B. Registered Professional – Identify whether the C-SWPPP Preparer is a Registered South Carolina Professional
Engineer, Tier B Surveyor, or Landscape Architect. For projects disturbing more than 2 acres, the C-SWPPP
preparer must be one of the listed professionals or federal government employee as described in Title 40,
Chapter 22,and as required and allowed by the qualified individual’s respective act and regulations.
C. Company/Firm Name
-
Provide the complete, legal name of the company and S.C. Certificate of Authorization
(S.C. COA number). Enter the complete mailing address. Anderson County and DHEC may contact the C-
SWPPP Preparer via email. See the following websites for information about COA requirements for Landscape
Architecture firms http://www.dnr.sc.gov/land/LandscArch/LAlicense.html and Engineering and Surveying firms
http://www.llr.state.sc.us/POL/Engineers/.
Enter N/A for S.C. COA if the firm is not required to have a COA.
IV.
Pr
o
j
ec
t
/S
i
t
e Information
A. Type of Construction Activity(ies) - Select ALL activity types that best describe the development proposed for the
site. “Institutional” includes schools and other publicly owned projects, except linear projects. “Site Preparation”
includes clearing, grubbing, and grading only; no new impervious areas should be proposed ifthis activity type is
selected. If none describe the development, then select “Other” and list the activity.
B. Site Address/Location
-
List the site address. If the site address is unknown, list the road name(s) on which the site is
located, the nearest intersection, or other detailed description of the site location. List a city/town only if the site is
within the city/ town limits. List zip code (if kn
own). Provide the latitude/longitude and tax map numbers. See the
following website for assistance in obtaining latitude/ longitude coordinates: http://www.epa.gov/tri/report/
siting_tool/index.htm. Latitude (from 32° to 35°) and longitude (-78° to -83°) should be for the center of the site.
Minutes (’) and seconds (”) should be from 0 to 59. Identify the lat/long data source.
C. Indian Lands – Identify if this sit
e is located on Indian lands.
D. Proposed Start
Date/Completion Date
– Provide proposed project start and completion dates.
E. Disturbed Area/Total Area - Enter the disturbed area for the project and the total area for the site. The disturbed
areas must be rounded to the nearest tenth of an acre. For su
bdivisions, if the exact build-out is not known, the
disturbed area can be estimated using the following equation:
Disturbed area= 2(Maximum Footprint of
House)(#
of lots) + Road/
R
i
gh
t
-
o
f
-
Wa
y areas + Other
ea
s
e
m
en
t
s
/
disturbance. NOTE:
Provide written notification if the actual disturbed area exceeds the disturbed area on the approved N
O
I
.
F. Modification Only: Change to Disturbed Area – If your modification to a prior approved project will increase or
decrease the disturbed area, complete this section
and see Section I of the Instructions. Enter the current
approved disturbed area and proposed increase (+) or decrease (-) to the disturbed area. If "No" change,
enter 0.0. Enter the new total disturbed area (after change). Round each entry to the nearest tenth of an acre.
G. Larger Common Plan for
Development
or Sale (LCP) - The plan in LCP is “broadly defined as any announcement or
piece of documentation (including a sign, public notice or hearing, sales pitch, advertisement, drawing, permit
application, zoning request, computer design, etc.) or physical demarcation (including boundary signs, lot stakes,
surveyor markings, etc.) indicating construction activities may occur on a specific plot.” [63 Federal Register No.
128, July 6, Page 6 1998, p. 36491] For example, if master calculations have been prepared and/ or submitted for
an entire site, then all phases and parcels at that site would be considered part of an LCP. If the site is part of a
subdivision, industrial park, commercial park, etc., then it is considered to be part of an LCP. List a unique,
distinguishing LCP/ Overall Development name. This name should not reference a specific phase. This LCP/
Overall Development name should also be listed on all NOIs for future projects that are part of this LCP, including
subsequent phases. Check the box if this is the first phase of the LCP. List the previous state permit/ file number
and previous NPDES coverage number if applicable. (DO NOT enter SCR100000). If not known, contact
DHEC for assistance.
08/2016 (Modified from DHEC 2617 (10/2012))
7
Primary Permittee (Owner/Operator, O/O) for the project. If a person, provide the Title or Position. If a
company, provide the complete, legal name of the company. Do not list the D/B/A (Doing Business As) name.
NOTE: If S.C. Department of Transportation (SCDOT) is the O/O, this NOI form should NOT be used.
Provide the complete mailing address of the person/company identified in II.A as the Primary Permittee.
B.
H. Flooding Problems – Identify whether flooding problems exist on the site, or downstream or adjacent to the site. If
I.
Active S.C. DHEC or Anderson County Warning Notice/Notice to Comply/Notice of Violation – Select yes if DHEC or
Anderson County has issued a Warning Notice, Notice to Comply, or NOtice of Violation for the site or any site within
the LCP. Provide additional information about the Notice (e.g., Order number) and a copy of correspondence with
DHEC or Anderson County regarding the Notice in your C-SWPPP.
J. State and Federal Environmental Permits or Approvals – List relevant state and federal permits applied for.
See
§ 122.21(f) of S.C. Regulation 61-9
http://www.s cdhec.gov/environment/water/regs/r61-9.pdf
for a list of permits,
approvals, and programs that should be considered. If inaccurate, NPDES coverage may be invalid.
K.
Waiver(s) - Identify any waivers requested for your project or construction site. Provide details and required
V. W
a
t
er
bo
dy Information
A. R
ece
i
v
i
ng
Waterbody(s) (RWB) Information
1. The Nearest receiving waterbody (RWB) is the nearest Waters of the State (WoS). See definition in §122.2 of
S.C. Regulation 61-9 - http://www.scdhec.gov/environmen
t/water/regs/r61-9.pdf to which the site’s
stormwater discharges will drain. The nearest RWB must be listed in reference to a named waterbody, if the
RWB is unnamed. For example, if the site’s stormwater discharges drain to a stream on the site, then the
nearest RWB would be the stream. If the stream is not named, then determine the nearest named waterbody
(e.g., Grove Creek) into which the stream will flow and list the nearest RWB as a tributary to the named
waterbody (e.g., Tributary to Grove Creek). Then, the Next Nearest named RWB would be Grove Creek. If the
site’s stormwater discharges drain to multiple waterbodies, then list all such waterbodies; attach additional
sheets, if necessary.
2.
Provide the distance, in feet to each receiving waterbody.
3.
Provide the classification f o r ea ch named waterbody.
See S. C .
Regulation 61-69
(http://www.scdhec.gov/environment/water/regs/r61-69.pdf)
for a list of classifications of waterbodies within S.C.
If the nearest RWB is unnamed, then search the document for the nearest named RWB. If the nearest, named
RWB is not listed, then continue searching the document for the next, named waterbody, proceeding
downstream from the site. For example, a site in Anderson County drains to a tributary of Hornbuckle Creek,
then to Hornbuckle Creek, then to Middle Branch, and then to Brushy Creek/ Big Brushy Creek. First, search
the document for Hornbuckle Creek, then Middle Branch, then Brushy Creek. Because there are 3 listings for
Brushy Creek, the next, named waterbody (Saluda River) must be determined. Note that the county for this
record for Brushy Creek is listed as Pickens because the headwaters of Brushy Creek are in Pickens County.
The classification of the tributary to Hornbuckle Creek is “FW—Freshwaters”.
B.
Wa
t
e
r
s
of the U.S/State Information
1.
Complete the “On the Site?” column for items a-d. If "Yes" is selected for that column, then the next 3 columns
must be completed. If there are other waters of the U.S./ State (WoS) on the site not listed in items a and b
(e.g., stream, river, lake, pond), then list those in item c. Jurisdictional wetlands are under ACOE jurisdiction.
2. Delineation means identification by U.S. Army Corps of Engineers (USACOE) or wetlands consultant. Also, see the
Stormwater Management and Sediment and Erosion Control Plan Review Checklist for Design Professionals
for information about delineation requirements. If there are WoS within 100’ of the disturbed area that were not
delineated/identified, then explain this in the narrative; this includes WoS that are not on the project site but are
within 100’ of the disturbed area.
3.
Impacts - If construction activities will occur in and/ or will impact WoS, then select yes for “Impacts?”
4. Amount of Impacts - List the amount of impacts to WoS. Provide an additional, separate plan sheet that shows
all WoS on the site and the impacted areas. If there are proposed impacts to WoS, please contact USACOE
(866-329-8187) and S.C. DHEC Water Quality Certification, Standards & Wetlands Programs Section
(803-898-4300) to determine additional requirements before submitting this NOI. Please note that it is the
P
r
o
j
ec
t
Owner/
Ope
r
a
t
o
r
’
s
responsibility to ensure
that
all WoS are shown and identified in the
C
-
S
WPPP
.
6.
If "Yes" for impacts in B.3, describe each impact and activity, and list all permits (e.g., U.S. Army Corps of
Engineers (USACOE) Nationwide Permit, DHEC General Permit) and certifications that have been applied for or
obtained for each impact. Describe the activity(s), whether the impact is permanent or temporary, and any
other relevant information. Provide a copy of all permits and certifications for and correspondence with
USACOE and DHEC for the impacts. Include all plats referenced in the permits or correspondence.
08/2016 (Modified from DHEC 2617 (10/2012))
8
"Yes", provide detailed explanation of the extent and impact in your C-SWPPP. NOTE: All C-SWPPP applications
must include a Floodway Map/FEMA Flood Insurance Map (See Checklist) with an outline of the project boundary
on the map. NOTE: The Anderson County Development Standards Department regulates the placement of fill in
floodplains.
justifications in the C-SWPPP.
C. S.
C
. Navigable Waters (SCNW) Information
1. Are SCNW on the site? See
http://www.scdhec.gov/environment/water/navwater.htm
for the definition of
SCNW and other information related to SCNW. Or, contact S.C. DHEC Water Quality Certification, Standards
& Wetlands Programs Section at (803) 898-4300 for assistance determining the navigability of the waters on
your site or with questions related to SCNW. If "Yes" to C.1, list the name of the SCNW. If the SCNW is
not named, then provide a description that references the nearest, named waterbody (e.g., tributary to
Grove Creek). If "No" to C.1, do not complete questions C.2 thru C.3 of this section.
2. If "Yes" to C.1 and construction activities proposed by your project will cross over or occur in, under, or thru the
SCNW, describe SCNW activities (e.g., road crossing, sub-aqueous utility line, temporary or permanent
structures, etc.). This includes temporary and permanent crossings with roads, utility lines, etc.
3. Identify permits providing SCNW Activity(ies) coverages for your site.
a.
b.
Identify proposed activities covered under a DHEC General Permit or other DHEC permit. Identify permit
number(s) and corresponding activities covered under each. See the following website for a list of DHEC
General Permits for activities in some SCNW: http://www.scdhec.gov/environment/water/docs/gp/gp.xls.
See the “Notes” column to determine what types of activities are covered under each permit.
Identify USACOE 404 Permit or 401 Certification issued for the site. Identify permit number(s) or
certification(s) and corresponding activities covered under each.
c. If applicable, identify the date the SCNW permit was applied for. Identify whether the permit applied for
will cover ALL activities listed in C.2 of some activities listed in C.2. List covered activities.
d. If a SCNW permit has NOT already been applied for or issued for all of the activities in SCNW for this site,
then those activities and conditions can be addressed during the review of the C-SWPPP, and a separate
State Navigable Waters permit is not required. Provide an additional plan sheet with plan and profile
views (drawn to scale) of SCNW and associated activities; include activities description on the plan sheet.
D. Im
pa
i
r
ed
Waterbodies Information (Section 3.2.12 of the CGP)
NOTE: The TM DL, 303(d), and Non-Point Source water quality tool is a mapping system showing detail ed information on
WQMS locations, water quality status, and much more. The tool is available at the following website along with
instructions for using the tool: http://www.scdhec.gov/environment/water/tmdl/.
1.
303(d) Listed Impaired Waterbodies
a. List the nearest SCDHEC Water Quality Monitoring Station(s) to which the site’s construction stormwater
discharges will drain and its corresponding waterbody. See the following website for the most current
303(d) List for Impaired Waters and related information:
http://www.scdhec.gov/environment/water/tmdl/.
NOTE:
DHEC
has
determined that construction
SW discharges are expected to contain pollutants causing
the following impairments: TURBIDITY, B
I
O
(
Mac
r
o
i
n
v
e
r
t
eb
r
a
t
e
),
TP
(
To
t
a
l
Pho
s
pho
r
u
s
),
TN
(
To
t
a
l
N
i
t
r
ogen
),
Ch
l
o
r
oph
y
ll
-
a
,
and
FC
(
Feca
l
co
li
f
o
rm)
i
n
S
he
ll
f
i
s
h
Ha
rv
e
s
t
i
ng
Wa
t
e
r
s
i
n
t
he
SCCZ. Carefully evaluate whether
the site’s construction SW discharges will contain any pollutants causing other impairments not explicitly
listed above. You should also consider previous land uses at the site in answering this question. For
example, if the previous land use was a copper processing facility and the impairment at the nearest
WQMS is copper, then you should carefully evaluate whether the site’s construction SW discharges would
contain copper.
b. Identify whether this WQMS is listed on the most current 303(d) List. The 303(d) list is available in Microsoft
Excel and Adobe Reader formats. WQMS locations are available for each watershed at the website
provided in 1.a as well using the TMDL, 303(d), and
Non
-
Po
i
n
t
Source water quality tool. To search the
303(d) list to determine whether a WQMS is listed, select “Edit” from the top toolbar of your web browser.
Then, select “Find”. Enter the WQMS exactly as listed on the map and hit enter.
If none of the WQMS(s) are
found, then select "No" and proceed to item V.D.2 (TMDL Impaired Waterbodies). If any of hte WQMS(s) are found,
then select "Yes" and proceed to item c.
c. If "Yes" for b, list the impairment(s) or pollutants identified as cause(s) of the impairment (see last column
labeled “CAUSE”) for the WQMS(s) and proceed to item d.
d.
Identify whether the site’s stormwater discharges contain any pollutants causing the impairment(s). I
f
"No"
f
o
r
d
,
p
r
oceed
t
o
i
t
e
m
V
.
D
.2 (
TMDL
I
m
pa
i
r
ed
Waterbodies). I
f
"Y
e
s"
t
o
d
and
t
he
r
ece
i
v
i
ng
wa
t
e
r
i
s
li
s
t
ed
on
the
most
current
303(d) List
of
Impaired Waters for a sediment or a sediment-related parameter, BIO
(macroinvertebrate), turbidity, Total Phosphorous, Total Nitrogen, Chlorophyll-a, or Fecal coliform in
Shellfish Harvesting Waters in the SCCZ. You must carefully evaluate all selected BMPs and their
performance to ensure that the construction site’s Stormwater discharges will not contribute to or cause a
violation of water quality standards. I
f
"Y
e
s"
f
o
r
d
and
t
he
d
i
s
t
u
r
bed
a
r
ea
i
s
l
e
ss
t
han
25 acres, include an
evaluation of the
Best
Management Practices (BMPs) proposed for the site as described in Section
3.2.12.B(I) of the CGP in the C-SWPPP. I
f
"Y
e
s"
f
o
r
d
and
t
he
d
i
s
t
u
r
bed
a
r
ea
i
s
g
r
ea
t
e
r t
han
o
r
equa
l
t
o
25
acres, then provide a written qualitative and quantitative assessment of the BMPs proposed in the C-
SWPPP for the site as described in section 3.2.12.B(II) of the CGP. For more information on this subject,
please see the DHEC publication entitled “Antidegradation for Activities Contributing to NonPoint Source
Pollution to Impaired Waters.” This publication can be downloaded at the following DHEC WEB site
www.scdhec.gov/eqc/water/pubs/antidegnps.pdf.
08/2016 (Modified from DHEC 2617 (10/2012))
9
e. If "Yes"
to
d , list the
“USE” support
impairment (AL, FISH,
REC,
SHELLFISH)
affected
by
the pollutant
or
impairement listed in item c.
f.
If "Yes" for d, w
ill
u
s
e
o
f
t
he
B
MP
s
p
r
opo
s
ed
f
o
r y
ou
r
p
r
o
j
ec
t
en
s
u
r
e
t
he
stormwater discharges
l
ea
v
i
ng
the
site
will
NOT
con
t
r
i
bu
t
e
to or cause
wa
t
e
r
qua
li
t
y
s
t
anda
r
d
v
i
o
l
a
t
i
on
s
f
o
r
t
he
i
m
pa
i
rm
en
t
(
s
)
li
s
t
ed
i
n
c?
NOTE: I
f
y
ou
r answer to item f is "
No"
,
t
h
i
s
s
i
t
e
is
NOT
eligible
f
o
r
co
v
e
r
age
unde
r
t
he
CGP. You may
contact Anderson County or DHEC to determine if an individual permit application is necessary or you
may revise your project to include appropriate Best Management Practices, controls, and procedures to
bring your discharge into compliance.
2.
TMD
L Impaired Waterbodies
a.
List the nearest SCDHEC water quality monitoring station(s) to which the site’s construction stormwater
discharges will drain. List WQMS identified in part V.D.1.a of this table.
b.
Identify whether a TMDL is listed for this WQMS. NOTE: See the following website for a list of all WQMS with
Approved S.C. Total Maximum Daily Loads (TMDLs): http://www.scdhec.gov/environment/water/tmdl/.
Select “Approved SC TMDLS”, then select “Sites Covered Under an Approved TMDL and Corresponding
WQ Attainment Status”. Select “Edit” from the top toolbar. Then, select “Find”. Enter the WQMS exactly as
listed and hit enter. I
f
a
WQM
S is
NOT
f
ound
,
t
hen
s
e
l
ec
t
“No
,
”
S
t
op
and
p
r
oceed
t
o
S
ec
t
i
on
VI.
I
f
a
WQM
S
i
s
f
ound
, then s
e
l
ec
t
“
Y
e
s
” and
p
r
oceed
t
o
i
t
e
m c.
c.
If "Yes" for b, identify and list the impairment(s) or pollutants listed as CAUSE(S) of the impairment (see 7th
column labeled “CAUSE”) and proceed to item d. If the WQMS(s) is impaired for more than one parameter,
then the WQMS will be listed multiple times on successive rows.
d.
If "Yes" for b, identify whether the standard has
been ATTAINED for the impairment(s). NOTE: See the 8th
column labeled “USE SUPPORT” to determine if the standard has been attained for each impairment for
each WQMS. “FULLY
SUPPORTED”
means the s
t
anda
r
d
ha
s
been
attained for the impairment listed in the
“CAUSE” column. “NOT
SUPPORTED”
means
that
the s
t
anda
r
d
ha
s
NOT
been
attained
for
that
impairment. I
f
"
No"
f
o
r
d
(
t
he
s
t
anda
r
d
ha
s
NOT
been
a
tt
a
i
ned
(
NOT
S
UPPORTED
)
f
o
r
a
ll
i
m
pa
i
rm
en
t
s
f
o
r all WQMS(s)),
proceed
to
i
t
e
m
e.
I
f
"Yes"
f
o
r
d
(
t
he
standard ha
s
been
attained
f
o
r all impairments
f
o
r all WQMS(s)), pr
oceed to Section
V
I
.
e. Identify whether the site’s stormwater discharges contain any pollutants causing the impairment(s). If
"No" for e, proceed to Section VI. If "Yes" for e, proceed to f.
f.
If "Yes" for e, ar
e
y
ou
r
d
i
s
cha
r
ge
s
con
s
i
s
t
e
nt with
a
ss
u
m
p
t
i
on
s
and
r
equ
i
r
e
m
en
t
s
o
f
t
he
TMDL(s)? NOTE: If y
ou
r
answer to item
f
is "
No",
this site is
NOT
eligible
for coverage under the
CGP. You may contact Anderson County or
DHEC to confirm that adherence to a C-SWPPP that meets the requirements of the CGP will be consistent with the TMDL.
Where a TMDL has not specified a WLA applicable to construction stormwater discharges, but has not specifically
excluded these discharges, adherence to a C-SWPPP that meets the requirements of the CGP will generally be
assumed to be consistent with the approved TMD L. If the TMDL specifically precludes such discharges, the site is not
eligible for coverage under the CGP.
VI. Signatures
and
Certifications DO NOT SIGN IN BLACK INK! The NOI must have original signatures unless the
application being submitted to DHEC is one approved by an MS4.
C
-
S
WPPP
Preparer
-
The same registered professional must sign and seal the NOI form, C-SWPPP, calculations,
and supporting documentation.
Primary Permittee
-
If the Primary Permittee or Project Owner/ Operator is a company, print the name of the
person who is signing the NOI for the Owner/ Operator. A person with signatory authority for the Owner/
Operator must sign the application. The C-SWPPP Preparer cannot sign the application for the Owner/
Operator. The C-SWPPP, all reports, including monthly reports, and any information requested by DHEC must
be prepared under the direction or supervision of a person with signatory authority for the Owner/ Operator
or a duly authorized representative.
See below for a summary and §122.22 of S.C. Reg. 61-9 (Appendix C of the CGP) for complete information
about signatory authority requirements.
• Corporation: A responsible corporate officer (e.g., president, vice-president, certain managers).
• Partnership or Sole Proprietorship: A general partner or the proprietor, respectively.
• Municipality, State, Federal or Other Public Agency: Principal executive officer or ranking elected
official.
08/2016 (Modified from DHEC 2617 (10/2012))
10
