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Home My WebLink AboutState of Colorado Stormwater Discharge Permit SystemDocuSlgn Envelope ID: F0615Q18-15113.444A-BBAC-776D0B955210 STATE OF COLORADO COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT Dedicated W protecting and Improving the health and environment of the people of Colorado Water Quality Control Division 4300 Cherry Creek Drive South WQCD•WQPS-B2 Denver, CO 80246-1530 (3031692-3500 www.coloradowaterpermlts.com For Agency Use Only Permit Number Assigned CORDS - Date Received _/_/' -� 12/14/2015 1 07:59 PT COLORADO DISCHARGE PERMIT SYSTEM (CDPS) STORMWATER DISCHARGE ASSOCIATED WITH CONSTRUCTION ACTIVITIES APPLICATION PHOTO COPIES, FAXED COPIES, PDF COPIES OR EMAILS WILL NOT 8E ACCEPTED. Please print or type. Original signatures are required. All items must be completed accurately and in their entirety for the application to be deemed complete. incomplete appl tabors will not be processed until all knformation is received which will ultimately delay the Issuance of a permit. If more space b required to answer any question, please attach additional sheets to the application form. Applications must be submitted by mail or hand delivered to: Colorado Department of Public Health and Environment Water Quality Control Division 4300 Cherry Creek Drive South WQCD-WQPS-B2 Denver, CO 80246-1530 Any addit anal information that you would like the Division to consider In deve op ng the permit should be provided with the application. Examples include effluent data and/or modeling and planned pollutant removal strategies. PERMIT INFORMATION Reason for Application: L�-�[ J NEW CERT ❑ RENEW CERT EXISTING CERTB Applicant is: I✓ Property Owner Contractor/Operator A. CONTACT INFORMATION—NOT ALL CONTACTS MAY APPLY *indicates required * PERMITTEE (if more than one please add additional pages) • ORGANIZATION FORMAL NAME: Public Service Company of Colorado 1) • PERMITTEE CONTACT the person authorized to sign and certify the permit application. This person receives all permit correspondences and is the person responsible for ensuring compliance with the permit. Responsible Person (Title): Manager of Environmental Services Currently Held By (Person): FirsiName: Quinn LastName: Kilty Telephone: 303-294-2165 Email Address: quinn.v.kilty@xcelenergy.com organization- Mailing rganizationMailing Address: City Public Service Company of Colorado 1800 Larimer Street, Suite 1300 Environmental Services Denver State: CO hip Code: 80202 This form must be signed by the Permittee (listed In item 1) to be considered complete. Per Regulation 61 In all cases, It shall be signed as follows: In the case of corporations, by a responsible corporate officer. For the purposes of this section, the responsible corporate officer Is responsible for the overall operation of the facility from which the discharge described in the application originates. In the case of a partnership, by a general partner. In the case of a sole proprietorship, by the proprietor. In the case of a municipal, state, or other public facility, by either a principal executive officer or ranking elected official. *** ELECTRONICALLY SUBMITTED STORMWATER CONSTRUCTION APPLICATION *** Public Service Company of Colorado - 08:30:49 -12/14/2015 4fac0b4d-2741-4e35-8634-1968fcec8122 SW Canttructbn Application for Public SeMce Canpany of Colorado Gain LaFS DocuSign Envelope ID: F0615018 -151B -444A -BRAC -778008955219 2) DMR COGNIZANT OFFICIAL (Le. authorized agent) the person or position authorized to sign and certify reports required by the Division including Discharge Monitoring Reports •DMR's, Annual Reports, Compliance Schedule submittals, and other Information requested by the Division. The Division will transmit pre-printed reports (re. DMR's) to this person. If more than one, please add additional pages. ❑ Same as 1) permittee Responsible Person (Title): Currently Held By (Person): FirstName: tastName: Telephone: Email Address: Organization: Mailing Address: City: State: CO Zip Code: Per Regulation 61 : All reports required by permits, and other information requested by the Division shall be signed by the permittee or by a duly authorized representative of that person. A person is a duly authorized representative only if: 1. The authorization is made in writing by the permittee. 11. The authorization specifies either an Individual or a position having responsibility for the overall operation of the regulated facility or activity such as the position of plant manager, operator of a well or a well field, superintendent, position of equivalent responsibility, or an individual or position having overall responsibility for environmental matters for the company. (A duly authorized representative may thus be either a named individual or any Individual occupying a named position); and The written authorization is submitted to the Division. 3) SITE CONTACT local contact for questions relating to the facility & discharge authorized by this permit ❑ Same as l) Permittee Responsible Person (Title): Construction Supervisor Currently Heid By (Person): FIrsiName: David LastName: Vara 303-628-2809 david.r.varaQxcelenergy.com Telephone: Email Address: Organization: Public Service Company of Colorado Mailing Address: 95001-76 City: Henderson State: CO Zip code: 80640 4) *BILLING CONTACT if different than the permittee. ❑ Same as 1) Permittee Responsible Person (Title): Manager of Environmental Services Currently Held By (Person): FirsMName: Qulnn LastName. Kilty Telephone: 303-294-2165 Email Address: quinn.v.kiltycxcelenergy.com Organization:Public Service Company of Colorado Mailing address: 1800 Larimer Street, Suite 1300 Environmental Services City: Denver State: CO Zip Code: 80202 *** ELECTRONICALLY SUBMITTED STORMWATER CONSTRUCTION APPLICATION *** Public Service Company of Colorado - 08:30:49 -1211412015 4fac0b4d-2741-4e35-8634-1968fcec8122 sw [nniuuct+on Appilutlan far. Pudic Service Company of Colorado pp 2 o1 5 DocuSign Envelope ID: F0615D18.151 B -444A -BRAC -778D08955219 5) OTHER CONTACT TYPES (check below) Add pages if necessary: Responsible Person (Title); Environmental Analyst Currently Held By (Person): Rebecca LastMame: Sturgeon FlrstName: Telephone: 303-294-2189 Email Address: rebecca.sturgeon@xcelenergy.com om Organization: Public Service Company of Colorado Malting Address: 1800 Larimer Street, Suite 1300 Environmental Services c ty: Denver State; CO Zip Code: 80202 ❑ Pretreatment Coordinator ❑ Environmental Contact ❑ Biosolids Responsible Party ❑ Other ❑ Property Owner ❑ Inspection Facility Contact ❑ Consultant B) PERMITTED PROJECT/FACILITY INFORMATION Project/FadlltyNome Rifle Lite 230/345 kV Substation Street Address or Cross Streets 620 County Road 319 ElCompliance Contact ❑Stormwater MS4 Responsible Person ❑✓ 5tormwater Authorized Representative (e.g., "5. of Park St. between 5th Ave. and 10th Ave.", or "W. side of C.R. 21, 3.25 miles N. of Hwy 10"; A street name without an address, Intersection, mile marker, or other Identifying information describing the location of the project is not adequate. For linear projects, the route of the project shou?d be described as best as possible with the location more accurately indicated by a map.) city- Rifle zip Code: 81650 County: Garfield Facility Latitude/Longitude - (approximate center of site to nearest 15 seconds using one of the following formats) ❑ Dee mai Degrees OR 001A Latitude ogress (too decimal plans) 0 Degrees, Minutes, Seconds 001A Latitude 39 • 31 17.18 • Dogmas Minutes Seconds 00tA Longitude 0O1A Longitude (e.g., 39.703',104.933') ng;ress Ito 3 decimal p4us1 107 a 44 • 28.48 - e.g., 39'46'11"N, 104'53'11"W Dress Minato Seconds For the approximate center point of the property, to the nearest 15 seconds. The latitude and longitude must be provided as either degrees, minutes, and seconds, or In decimal degrees with three decimal places. This information may be obtained from a variety of sources, including: • Surveyors or engineers for the project should have, or be able to calculate, this information. • EPA maintains a web -based siting tool as part of their Toxic Release Inventory program that uses Interactive maps and aerial pho- tography to help users get latitude and longitude. The siting tool tan be accessed at www.epa.gov/tri/report/siting_tool/Index.htm • U.S. Geological Survey topographical map(s), available at area map stores. • Using a Global Positioning System (GPS) unit to obtain a direct reading. Note: the latitude/longitude required above is not the directional degrees, minutes, and seconds provided on a site legal description to define property boundaries. C) MAP (Attachment) If no map is submitted, the permit will not be issued Facility Information Map: Attach a map that indicates the site location and that CLEARLY shows the boundaries of the area that will be disturbed. Maps must be no larger than 11x17 Inches. 0) LEGAL DESCRIPTION Legal description: If subdivided, provide the legal description below, or Indicate that itis not applicable (do not supply Township/Range/Section or metes and bounds description of site) Subdtvlsion(s): Lolls) OR ❑✓ Not applicable (site has not been subdivided) Block(s) *** ELECTRONICALLY SUBMITTED STORMWATER CONSTRUCTION APPLICATION *** Public Service Company of Colorado - 08:30:49 -12/14/2015 4fac0b4d-2741-4e35-8634-1968fcec8122 SW ranstluctbn Amo tlnn rar. Pubit:SeMce Company of Colorado pear 3 of S DocuSlgn Envelope ID: F0615D18-15113.444A-BBAC-77800B955219 E) AREA OF CONSTRUCTION SITE Total area of project site 3'02 Area of project site to undergo disturbance 1 £B Note: aside from clearing, grading and excavation activities, disturbed areas also include areas receiving overburden (e.g., stockpiles), demolition areas, and areas with heavy equipment/vehicle traffic and storage that disturb existing vegetative cover Total disturbed area of Larger Common Plan of Development or Sale. If applicable: —10 acres (transmission line work to be separate permit) (i.e., total, Including all phases, filings, tots, and infrastructure not covered by this application) Provide both the total area of the construction site, and the area that will undergo disturbance, in acres. Note: aside from clearing, grading and excavation activities, disturbed areas also include areas receiving overburden (e g., stockpiles), demolition areas, and areas with heavy equipment/vehicle traffic and storage that disturb existing vegetative cover (see construction activity description under the APPLICABILITY section on page 1). If the project Is part of a larger common plan of development or safe (see the definition under the APPLICABILITY section on page 1), the disturbed area of the total plan must also be Included. F) NATURE OF CONSTRUCTION ACTIVITY Check the appropriate box(s) or provide a brief description that Indicates the general nature of the construction activities. (The full description of activities must be Included in the Stormwater Management Plan.) 0 Single Family Residential Development Multi -Family Residential Development 0 Commercial Development El011 and Gas Production and/or Exploration (including pad sites and associated Infrastructure) ElHighway/Road Development (not including roadways associated with commercial or residential development) ❑✓ Other—Description: Expansion of existing substation G) ANTICIPATED CONSTRUCTION SCHEDULE Construction Start Date: March 2016 Final Stabilization Date: October 2016 (rock stabilization) • Construction Start Date - This is the day you expect to begin ground disturbing activities, Including grubbing, stockpiling, excavating, demolition, and grading activities. • Final Stabilization Date - in terms of permit coverage, this is when the site is finally stabilized. This means that alt ground surface disturbing activities at the site have been completed, and all disturbed areas have been either built on, paved, or a uniform vegetative cover has been established with an individual plant density of at least 70 percent of pre -disturbance levels. Permit coverage must be maintained until the site Es finally stabilized. Even if you are only doing ane part of the project, the estimated final stabilization date must be for the overall project. If permit coverage Is still required once your part is completed, the permit certification may be transferred or reassigned to a new responsible entlty(s). H) RECEIVING WATERS (If discharge is to a ditch or storm sewer, Include the name of the ultimate receiving waters) Immediate Receiving Water(s): SWale5 and Dry Creek Ultimate Receiving Water(s): Dry Creek - a tributary to Colorado River Identify the receiving water of the stormwater from your site. Receiving waters are any waters of the State of Colorado. This includes all water courses, even if they are usually dry. if stormwater from the construction site enters a ditch or storm sewer system, identify that system and Indicate the ultimate receiving water for the ditch or storm sewer. Note: a stormwater discharge permit does not allow a discharge Into a ditch or storm sewer system without the approval of the owner/ operator of that system. *** ELECTRONICALLY SUBMITTED STORMWATER CONSTRUCTION APPLICATION *** Public Service Company of Colorado - 08:30:49 -12114/2015 4fac0b4d-2741-4e35-8634-1968fcec8122 SW [anftrrxtlon Application tar. Pubbc Sorvlce Company or Colorado page 4 al 5 DocuSlgn Envelope ID: FOB15D18-151B-444A-BBAC-778008955219 I) SIGNATURE PAGE I. You may print and sign this document and mall the hard copy to the State along with required documents. OR 2. Electronic Submission Signature You may choose to submit your application electronically, along with required attachments. To do so, click the SUBMIT tertian below which will direct you, via e -mall , to sign the document electronically using the DocuSlgn Electronic Signature process. Once complete, you will receive, again via a -mall, an electronically stamped Adobe pdf of this application. Print the signature page from the electronically stamped pdf, sign it and mail it to the WQCO Permits Section to complete the application process (address is on page 1 of the application). • The Division encourages use of the electronic submission of the application and electronic signature. This method meets signature requirements as required by the State of Colorado. • The Ink signed copy of the electronically stamped pdf signature page is also required. This requirement meets Federal EPA Requirements. Processing of the application will begin with the receipt of the valid electronic signature. STORMWATER MANAGEMENT PLAN CERTIFICATION 1 certify under penalty of law that a complete Stormwater Management Plan, as described In Appendix B of this application, has been prepared for my activity. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the Stormwater Management Plan Is, to the best of my knowledge and belief, true, accurate, and complete I am aware that there are significant penalties for falsely certifying the completion of said SWMP, Including the possibility of (Inc and imprisonment for knowing violations." "I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the Information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted 1s to the best of my knowledge and belief, true, accurate and complete. I am aware that there are significant penalties far submitting false Information, Induding the possibility of fine and Imprisonment for knowing violations.' 1 understand that submittal of this application Is for coverage under the State of Colorado General Permit for Stormwater Discharges Associated with Construction Activity for the entirety of the construction site/project described and applied for, until such time as the application is amended or the certification Is transferred, inactivated, or expired' (Reg 61.4(1)(h)] nocuSlaned by ��y�, V ft) /. f * 12/14/2015 Electronic Slgnalur Ink Signature Date: Signature of Legally Respo uitie eaP an or'Authorised Agent (submissi ust nciude original sign, ur Quinn Kilty Name (printed) Manager of Environmental Services Title This form must be signed by the Permittee to be considered complete Per Regulation 61 In all cam., it shall be signed as follows a) In the case of corporations, by a responsible corporate officer. Far the purposes of this section, the responsible corporate officer is responsible for the over all operation of the facility from which the discharge described In the application originates. b) In the case of a partnership, by a general partner. c) to the case of a sole proprietorship, by the proprietor, d) In the case of a municipal, state, or other public facility, by either a principal executive officer or ranking elected official 3rd Party Preparer. If this form was prepared by an authorized agent on behalf of the Permittee, please complete the gelds below. Rebecca Sturgeon rebecca.sturgeon@xcelenergy.com Preparer Name (printed) Email Address DO NOT INCLUDE A COPY OF THE STORMWATER MANAGEMENT PLAN D0 NOT INCLUDE PAYMENT—AN INVOICE WILL BE SENT AFTER THE CERTIFICATION IS ISSUED. *** ELECTRONICALLY SUBMITTED STORMWATER CONSTRUCTION APPLICATION''** Public Service Company of Colorado - 08:30:49 - 12/14/2013 4fac0b4d-2741-4e35-8634-1968fcec8122 sw commit lion AVPlrallen roc. Public SeMco Company of Colorado pawl. 5 of 5 1 inch =1,500 feet 0 380 760 1,520 Feet ,'.,i) 111 rt. i GRASS /OE, .t.1.'4..d11.11 4.Y Creek Legend Approximate Construction Limits 4,q• 11 Notes: 'I. Total project construction limits are approximately 3.02 acres. Sail disturbance is approximately 1.68 acres. 2. Receiving Waters: Unnamed tributaries, Dry Creek and Colorado River rat 2�Pmrr1 FIIna4151144.1n7515t.1[19l'IMIC.A[1fJhCIStFi�o 1 61y�eenng Mae mei I ARAPAHOE COUNTY, COLORADO WRIGHT WATER ENGINEERS, INC. 2490 W 26TH AVE 100A DENVER, CO. 80211 (303) 480-1700 RIFLE - UTE (WO#119489111) STATE PERMIT MAP SECTION 14 TOWNSHIP 6S, RANGE 93W, 6TH PM. Rase Mao. USCS 1 74k Tnonnnr PROJECT NO. 151-102.000 FIGURE 1