Fillable NOTICE OF INTENT (NOI) For Coverage(s) of Primary (Town of Fort Mill)

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NOTICE OF INTENT (NOI) For Coverage(s) of Primary (Town of Fort Mill)

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NOTICE OF INTENT (NOI)
For Coverage(s) of Primary Permittees
Under South Carolina NPDES General Permit
For Stormwater Discharges From Construction Activities SCR100000
(Maintain As Part of On-Site SWPPP)
For Official Use Onl
y
File Number: ______________________
Permit Number: SCR10_____________
Submittal Package Complete: ___________________
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.
Date: ____________________________
Project/Site Name: _____________________________________________________ County: ______________________________________
(Modification or Change of Information Only) Prior Approved NPDES Permit or File Number: ___________________________________
Do you want this project to be considered for the Expedited Review Program (ERP)? Yes or No (See 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: (see instructions, attach Form B (Major Modifications))
MS4 Project Review
Ocean and Coastal Resource Management (OCRM) Review
Change of Information/Other (Specify): __________________________________________________________________
B. If Applicable, identify the entity designated as MS4 Reviewer and MS4 Operator (i.e., Lexington County, City of
Greer, etc.): MS4 Reviewer_________________________________ MS4 Operator ___________________________________
II. Primary Permittee Information Change of Information
Person or Company
If a Company, are you a
Lending Institution or Government Entity?
Company EIN
(If applicable): 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): ______________________________________________________________________________________
DHEC 2617 (10/2012)
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 (acres): ________________
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 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
Justifications i
n the C-SWPPP for each proposed request).
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): ____________________________________________
V. Waterbody 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
RWB (feet)
3. Classification of
RWB
a. Nearest: _______________________________________
b. Next Nearest: __________________________________
c. Coastal Zone ONLY: Coastal Receiving Water (CRW): ________________________
Not Applicable
d. 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
d. Coastal Zone ONLY: Direct Critical Area 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 (Section 2.6.5) The Department 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. I
f no, do not complete this question. Proceed to Section D (Impaired Waterbodies).
b. If yes, provide 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.
DHEC 2617 (10/2012)
)
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?
Nearest DHEC WQMS(s) Corresponding
Waterbody
b. Is this WQMS(s)
listed on the most
current 303(d) List? If
No, proceed to
Section 2 of this table.
If Yes, complete items
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
SUPPORT”
impairment(s)
affected by the
pollutant(s)
identified in c.
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 project ensure the site’s discharges will NOT contribute to or
cause further WQS violations for the impairment(s) listed in c? Yes No
(NOTE: If no for f, this site is NOT eligible for coverage under the CGP). See 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 such
below and proceed to
Section VI. If Yes,
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. Signatures 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-SWPPP 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).
_________________________________ ____________________________ ______________________________
Printed Name of C-SWPPP Preparer Signature of C-SWPPP 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 the local implementing agency 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 Title/Position
_____
____________________________________ __________________________________________
Signature of Primary Permittee Date Signed
DHEC 2617 (10/2012)
NPDES CGP FEE SCHEDULE A
(All Counties EXCEPT Beaufort, Berkeley, Charleston, Colleton, Dorchester, Georgetown, Horry, and Jasper)
The schedule should be attached to DHEC Form 2617. Do not send payment in window envelope. DO NOT MAIL CASH.
DHEC will notify the Project Owner/ Operator if the submitted check or credit card payment cannot be processed. The
review clock will start when acceptable payment is received.
1. Identify (√) the 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”
b. New Owner/Operator (Transfer of Ownership)/Company Name Change
($125 NPDES Coverage fee is required by the Department 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 Department thru MS4 Reviewer)
e. Other (Specify): _________________________________________________________
$ ________. 00
2. Determine the Project Review Fees (Review fees cannot exceed $2000 for a project)
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 this
p
ermit 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 Count
ies”.
2. If this project will ultimately disturb more than 1.0 acre, proceed to Item 2.d.
d. Enter the project review fees (based on $100/disturbed area) in the right-hand column.
(Mu
ltiply the disturbed area (Item 2.a) by $100/disturbed area).
If the disturbed area for this project (Item
2.a.) totals 20.0 acres or more, enter $2000 in the right-hand column.
Review fees cannot exceed $2000 for a project.
$ ________. 00
4.
Identify the Method of Paym
ent:
Payment by Check:
Attach a signed and dated check payable to S.C. DHEC
to the front of this Fee Schedule.
Please note that all checks must be less than 30 days old
and must be for the entire required fees.
Payment by Credit Card: (Check here if you wish to pay via credit card using the on-line payment system).
The Department will contact you to provide instructions and the invoice number necessary for online payment.
Please provide an e-mail address where the invoice number may be sent: ________________________________
For official use only: Invoice Number ___________________
DHEC 2617 (10/2012)
3. Total Required Fees Add the values in the right-hand columns of Items 1 and 2.d. Proceed to Item 4.
(The Department will not review this project until all required fees are received).
$ ________. 000
NPDES CGP FEE SCHEDULE B
(ONLY for Beaufort, Berkeley, Charleston, Colleton, Dorchester, Georgetown, Horry, and Jasper Counties)
Submit payment for NPDES Coverage fees only to DHEC.
The schedule should be attached to DHEC Form 2617. Do not send payment in window envelope. DO NOT MAIL CASH. DHEC will notify
the Project Owner/ Operator if the check or credit card payment cannot be processed. The review clock will start when acceptable
payment is received and after the project is deemed consistent with the S.C. Coastal Zone Management Plan.
1. Identify (√) the Project/Review Types
(NOTE: You may ONLY select Item 1.a OR 1.b BELOW). 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(s)
a. Project or LCP that is located within ½ mile of CRW (Item V.A) that will ultimately disturb more
than 0.5 acres
(if select a, do not select b)
b. Project or LCP that is NOT located within ½ mile of CRW (Item V.A) that will ultimately disturb
one (1) acre or more (if select b, do not select a)
c. New Owner/Operator (Transfer of Ownership)/Company Name Change
($125 NPDES Coverage fee is required by the Department for Transfers of Ownership and Company Name Changes)
d. Unpermitted Ongoing Project or Late Notification
e. MS4 Project Review (Item I.A and I.B)
f. Other (Specify): _________________________________________________________
$ ________. 00
2. Determine the Project Review Fees (Review fees cannot exceed $2000 for a project).
NOTE: COMPLETE ITEM 2.a BELOW. COMPLETE EITHER SECTION 3 OR SECTION 4. DO NOT COMPLETE BOTH SECTIONS.
a. Enter the disturbed area (Item IV.E) for this project. Proceed to Item 3 OR Item 4.
_______ (nearest tenth of an acre)
3. PROJECT OR LCP LOCATED WITHIN ½ MILE OF A CRW (ITEM V.A)
(√)
Review Fees
a. Will this project or LCP (Item IV.G) ultimately disturb more than 0.5 acres?
Yes No
b. Is this project exempt from S. C. Reg. 72-300 et seq.?
Yes No
1. If this project will NOT ultimately disturb more than 0.5 acres and is not part of an LCP, your project is automatically covered under this
permit and the NPDES coverage fee and review fee are not required. See section 1.3.1.B. See the BOW-SPWS for “Less Than 1-Acre of
Land Disturbance - Coastal Counties”.
2. If this project or LCP will ultimately disturb more than 0.5 acres, proceed to Item 3.c.
c. Enter the project review fees (based on $100/ disturbed acre) in the right-hand column. (Multiply
the disturbed area (Item 2.a.) by $100/disturbed area). If the disturbed area for this project (Item 2.a.) totals 20.0 acres or
more, enter $2000 in the right-hand colum
n. Review fees cannot exceed $2000 for a project. Proceed to item 3.d
$ ___
_____. 00
d. Total Required Fees (Coastal Project located WITHIN ½ mile of a CRW (Item V.A)
Add the values in the right-hand columns of Items 1 and 3.c. (The Department will not review this project until all
required fees are received). Proceed to Item 5.
$ ________. 00
4. PROJECT OR LCP NOT LOCATED WITHIN ½ MILE OF A CRW (ITEM V.A)
(√)
Review Fees
a. Will this project or LCP (Item IV.G) ultimately disturb one (1) acre or more?
Yes No
b. Is this project exempt from S. C. Reg. 72-300 et seq.?
Yes No
1. If this project will NOT ultimately disturb one (1) acre or more, and is not part of an LCP, coverage under SCR100000 is NOT required; see
the
BOW-SPWS for “Less Than 1-Acre of Land Disturbance - Coastal Counties”.
2. If this project or LCP will ultimately disturb one (1) acre or more, proceed to Item 4.c.
c. Enter the project review fees (based on $100/ disturbed acre) in the right-hand column. (Multiply
the disturbed area (Item 2.a.) by $100/disturbed area). If the disturbed area for this project (Item 2.a.) totals 20.0 acres or more,
enter $2000 in the right-hand column. Review fees cannot exceed $2000 for a project. Proceed to item 4.d.
$ ________. 00
d. Total Required Fees (Coastal Project NOT located WITHIN ½ mile of a CRW (Item V.A)
Add the values in the right-hand columns of Items 1 and 4.c. (The Department will not review this project until all
required fees are received). Proceed to Item 5.
$ ________. 00
5. Identify the Method of Payment: Payment by Check: (Attach a signed and dated check payable to S.C. DHEC to the front of
this fee schedule. All checks must be less than 30 days old and must be for the entire amount of required fees). .
Payment by Credit Card:
(Check here if you wish to pay via credit card using the on-line payment system). The Department will contact you via e-mail to provide instructions
and the invoice number necessary for online payment.
Please provide an e-mail address where the invoice number may be sent:
________________________________________
For official use only: Invoice Number ______________________________________________________________________
DHEC 2617 (10/2012)
Instructions for Completing the Notice or Intent (NOI)
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 or Coastal Stormwater Permitting Section (CSWP) at (843) 953-0200. Projects located
in the S.C. Coastal Zone (SCCZ—Beaufort, Berkeley, Charleston, Colleton, Dorchester, Georgetown, Horry, and Jasper counties) are reviewed
by CSWP. Please see the Bureau of Water, Stormwater Permitting website (BOW-SPWS):
http://www.scdhec.gov/environment/water/swater/ for guidance and additional information regarding the CGP.
Who Must File a NOI:
• If S.C. Department of Transportation (SCDOT) is the Primary Permittee (Owner/ Operator), this NOI form (Form 2617)
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).
• In the SCCZ, the Owner/Operator of a single project or LCP that is located within ½ mile of a coastal receiving
water (CRW) (See item V.A of the instructions) and will ultimately disturb more than 0.5 acres.
• See the BOW-SPWS for “Less Than 1-Acre of Land Disturbance - Non-Coastal Counties” and “Less Than 1-Acre of Land Disturbance
- Coastal Counties”.
Where to File:
See the BOW-SPWS 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 MS4 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 MS4 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 Mauldin), then
submittals to all appropriate MS4 operators, delegated entities, and DHEC must be coordinated.
Projects Located in the SCCZ All Other Areas
S.C. DHEC—Bureau of Water
Coastal Stormwater Permitting Section
1362 McMillan Ave., Suite 400
Charleston, S.C. 29405
S.C.DHEC—Bureau of Water
Stormwater Permitting Section
2600 Bull Street
Columbia, SC 29201-1708
Submittal Package for SWP and CSWP:
• When DHEC performs a full technical review, you must include the original, signed NOI form, appropriate fee schedule (A or
B) with required fees, one (1) copy of the Comprehensive Stormwater Pollution Prevention Plan (C-SWPPP), and one (1) copy
of all other supporting documentation with the initial submittal. For projects in the non coastal counties disturbing greater
than or equal to 1 acre and less than or equal to 2 acres, one (1) copy of the C-SWPPP and one (1) copy of supporting
documentation can be submitted with the initial submittal. In the SCCZ, applications for Coastal Zone Consistency
certification are to be filed with requests for NPDES construction coverage and will then be routed internally to the Office of
Ocean and Coastal Resource Management (OCRM) for review. OCRM submittal requirements can be located at:
http://www.scdhec.gov/environment/ocrm/czc.htm
• When a regulated MS4 or entity implementing Regulation 72-300 performs the technical review, you must include a copy of
the MS4 approved NOI form or MS4 approved application, the $125 NPDES fee, and one (1) copy of the MS4 approval. In the
SCCZ,applications for Coastal Zone Consistency certification are to be filed with requests for NPDES construction coverage
and will then be routed internally to OCRM for review.
• For projects ultimately disturbing more than 1 acres, the checklist must be completed and attached when DHEC reviews your C-
SWPPP. In the SCCZ, for projects ultimately disturbing more than 0.5 acres and located within ½ mile of a CRW, the checklist must
be completed and attached. See BOW-SPWS for the most current version of the checklist. If this project will NOT ultimately disturb
more than 0.5 acres (Coastal Counties) or more than 1.0 acre (Non-Coastal Counties) AND is not part of an LCP, your project is
automatically covered under this permit and the NPDES coverage fee and review fee are not required. See the BOW-SPWS for “Less
Than 1-Acre of Land Disturbance - Coastal Counties AND “Less Than 1-Acre of Land Disturbance – Non-Coastal Counties.
• For Modification projects where DHEC performs a technical review, see Section I of the instructions and Form B. Complete
the applicable sections of the NOI Form. Complete the Form B Checklist. 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 reviews.
Authorization to discharge is granted based on the timeframes specified in the table below. For project sites located in the SCCZ, the
timeframes provided below do not commence until a Coastal Zone Consistency determination has been issued for the site.
Review Type Allotted Review Time Frame
Regulated MS4 or entity implementing Regulation
72-300
7 business days of DHEC receipt of a complete NOI and fee payment.
DHEC (when construction site is subject to State C-
SWPPP reviews)
20 business days of DHEC receipt of a complete NOI and fee payment.
S. C. Coastal Zone (SCCZ) Requirements:
For projects that are located within ½ mile of a CRW and involve greater than 0.5 acres of land disturbance, a registered engineer,
landscape architect, or Tier B surveyor must prepare, amend when necessary, certify, and stamp the C-SWPPP as required and
allowed by the qualified individual’s respective act and regulations. Regulation 72-307(C)(5)(g) establishes additional requirements
for projects located in the SCCZ. The additional water quality measures are outlined in Chapter III, Section XIII of the South Carolina
Coastal Zone Management Program, as refined available at http://www.scdhec.gov/environment/ocrm/czmp.htm
DHEC 2617 (10/2012)
Fee Schedules:
Make sure to answer all applicable questions on the appropriate Fee Schedule. Complete Fee Schedule A for Non-Coastal projects;
Schedule B for Coastal projects. Attach Form A, as required, for Transfer of Ownership. Attach Form B for major modifications to a prior
approved project with Fee Schedule C if DHEC reviews your modification.
Office Mechanics and Filing:
The original NOI form for projects located outside of MS4 areas and supporting documentation will be kept in the
Central Office files (hard copy or digitized copy) in accordance with the Retention Schedule.
Date: Enter today’s date.
Project/Site Name: The Project/ Site Name should be a unique or distinguishing name (e.g., not Proposed Subdivision).
NOTE: 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. If part of the
project is in the SCCZ, then list the coastal county in which the majority of the site is located and submit the project
to CSWP; see the “Where to File” section. List the other cou
nties in which the site is located in the C-SWPPP.
Prior Approved NPDES Permit Number (Major Modification or Change of Information Only): Provide the NPDES permit
number (SCR number)or File Number previously assigned to the project or LCP.
Expedited Review Program (ERP): For additional information about ERP, see the ERP website
http://www.scdhec.gov/environment/water/swater/expeditedReview.htm. DHEC will notify the Project Owner/
Operator if the project is selected for review in the ERP. There are additional required fees for participation in this
program; these ERP fees should not be submitted until DHEC has notified the Project Owner/ Operator that the
project was selected for participation in the ERP. In the SCCZ, please note that projects impacting Geographic
Areas of Particular Concern (GAPCs) and/or wetlands may not eligible for participation. Consult OCRM staff.
I. Notice of Intent (NOI) Application Type(s) (See Section 2.4 of CGP for submission deadlines and notification
requirements)
A. Project (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: 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 the Department 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 the Department are listed in Section 3.1.7 of the CGP. If your project is
a major modification, complete Form B, Fee Schedule C, and applicable sections of the NOI per directions
identified on Form B. Please note that Section V (Waterbody Information) of the prior approved NOI must be
reviewed for changes prior to submitting any modification request to the Department. 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.
A. M
S4 Reviewer and MS4 Operator - If this project is located inside a Municipal Separate Storm Sewer System
(MS4) and must be reviewed and approved by a MS4 entity prior to submission to 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. Primary Permittee 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). DO NOT list a Social Security number
DHEC 2617 (10/2012)
A. Primary Permittee Name - Provide the complete, legal name of the person or entity (company) that will be the
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 (Form 2617) should NOT be used.
Provide the complete mailing address of the person/company identified in II.A as the Primary Permittee.
B. 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, the
Department 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. NPDES coverage will be issued to 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-SWPPP 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. In the
SCCZ, projects that are located within ½ mile of a CRW and that involve greater than 0.5 acres of land
disturbance, 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. 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. Project/Site 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 if this 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 known). 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 site 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 subdivisions, 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/ Right-of-Way areas + Other easements/
disturbance. NOTE: Provide written notification if the actual disturbed area exceeds the disturbed area on the approved NOI.
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 en
ter SCR100000). If not known, contact the
Department for assistance.
DHEC 2617 (10/2012)
H. Flooding Problems – Identify whether flooding problems exist on the site, or downstream or adjacent to the site. If
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 Department does not regulate the placement of fill in floodplains. Contact local city or county official.
I. Active S. C. DHEC Warning Notice/Notice to Comply/Notice of Violation – Select yes if DHEC 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 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.scdhec.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
justifications in the C-SWPPP.
V. Waterbody Information
A. Receiving 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/environment/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 for each 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”.
4. SCCZ Only: Provide the Co
astal Receiving Water (CRW) to which the site’s stormwater discharges will drain.
This distance is used to determine permitting requirements. Coastal Receiving Water is defined as a receiving
water body as defined in the Policies and Procedures of the South Carolina Coastal Zone Management
Program, updated July 1995. This includes all regularly tidally influenced salt and fresh water marsh areas, all
lakes or ponds which are used primarily for public recreation or a public drinking water supply, and other
water bodies within the coastal zone, excluding wetlands, swamps, ditches and stormwater management
ponds which are not contiguous via an outfall or similar structure with a tidal water body.
5. Provide the distance, in feet to the CRW. Classification of RWB is not applicable for CRW.
B. Waters of the U. S. /State Information (See Section 2.6.2 thru 2.6.6 of the CGP)
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 checklist 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. For Direct Critical Area in the SCCZ, delineation
means identification by OCRM or wetlands consultant. OCRM staff may require identification of Direct Critical
Area by OCRM staff as part of its Coastal Zone Consistency review.
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. In the SCCZ, also contact S.C.
DHEC OCRM Wetlands Section (843-953-0200). Please note that it is the Project Owner/ Operator’s
responsibility to ensure that all WoS are shown and identified in the C-SWPPP. See Sections 2.6
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.
DHEC 2617 (10/2012)
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. 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.
b. 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. Impaired Waterbodies Information (Section 3.2.12)
NOTE: The TMDL, 303(d), and Non-Point Source water quality tool is a mapping system showing detailed 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/.
In the SCCZ, list the nearest upstream and downstream DHEC WQMS(s) and corresponding waterbody(ies).
Additionally, shellfish stations only monitor for Fecal coliform bacteria. Include both the nearest shellfish
monitoring station(s) and full WQMS(s) on the NOI for both upstream and downstream locations when shellfish
monitoring stations are present. If a shellfish monitoring site is not present then you only need to list
the full WQMS(s). When a shellfish monitoring station is present, everything but Fecal coliform bacteria needs
to be assessed at the full WQMS(s). Shellfish monitoring stations begin with numbers and full WQMS(s) begin
with letters.
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, BIO
(Macroinvertebrate), TP (Total Phosphorus), TN (Total Nitrogen), Chlorophyll-a, and FC (Fecal coliform) in
Shellfish Harvesting Waters in the 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-Point 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 the
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). If no
for d, proceed to item V.D.2 (TMDL Impaired Waterbodies). If yes to d and the receiving water is listed 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. If yes for d and the disturbed area is less than 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. If yes for d and the disturbed area is greater than or equal to 25 acres, then provide
a written qualitative and quantitative assessment of the BMPs proposed in the C-SWPPP for the site as
DHEC 2617 (10/2012)
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.
e. If yes to d , list the “USE” support impairment (AL, FISH, REC, SHELLFISH) affected by the pollutant or
impairment listed in item c.
f. If yes for d, will use of the BMPs proposed for your project ensure the stormwater discharges leaving the
site will NOT contribute to or cause further water quality standard violations for the impairment(s) listed in
c? NOTE: If your answer to item f is NO, this site is NOT eligible for coverage under the CGP. You may
contact the Department 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. TMDL Impaired Waterbodies
a. List the ne
arest 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.
If a WQMS is NOT found, then select “No,” Stop and proceed to Section VI. If a WQMS is found, then
select “Yes” and proceed to item 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 standard has been attained for the impairment listed in the
“CAUSE” column. “NOT SUPPORTED” means that the standard has NOT been attained for that impairment.
If no for d (the standard has NOT been attained (NOT SUPPORTED) for all impairments for all WQMS(s)),
proceed to item e. If yes for d (the standard has been attained for all impairments for all WQMS(s)),
proceed to Section VI.
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, are your discharges consistent with the assumptions and requirements of the TMDL(s)? NOTE: If
your answer to item f is NO, this site is NOT eligible for coverage under the CGP. You may contact the
Department 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 TMDL. 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-SWPPP 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.
DHEC 2617 (10/2012)
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NOTICE OF INTENT (NOI) For Coverage(s) of Primary (Town of Fort Mill)

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