HomeMy WebLinkAbout6584 MITC-UTER Material Staging Yard CDPS Permit ApplicationA. PERMIT INFORMATION
Reason for Application
þ NEW CERT ¨RENEW CERT
¨MODIFICATION ¨TRANSFER
¨CHANGE OF CONTACT ¨TERMINATION
Existing Cert #
B. PERMITTED PROJECT/FACILITY INFORMATION
Facility Name:Xcel 6584 MITC-UTER Material Staging
Yard
Original ID:
Property Address 1:0.9 miles southeast of
CR 311 and CR 335
Property Address 2:County:Garfield
City:Unicorporated State:CO Zip Code:81647
Latitude :39.529868 Longitude :-107.610443
SIC Code Description
4911 Electric services
C. CONTACT INFORMATION
1) *OPERATOR – RESPONSIBLE OFFICIAL - the party that has operation control over day to day activities – may be the same as the
Owner
Receiving Water Name Receiving Water Type
Colorado River Ultimate
Ward and Reynolds Ditch Immediate
ASSIGNED PERMIT NUMBER
Date Received 08/12/2024 16:59:45
MM DD YYYY HH:MM:SS
Revised: 3-2016
STORMWATER DISCHARGE ASSOCIATED WITH CONSTRUCTION ACTIVITIES APPLICATION
COLORADO DISCHARGE PERMIT SYSTEM (CDPS)
PHOTO COPIES, FAXED COPIES, PDF COPIES OR EMAILS WILL NOT BE ACCEPTED.
Any additional information that you would like the Division to consider in developing the permit should be provided with
the application. Examples include effluent data and/or modeling and planned pollutant removal strategies.
Beginning July 1, 2016, invoices will be based on acres disturbed.
DO NOT PAY THE FEES NOW – Invoices will be sent after the receipt of the application.
Disturbed Acreage for this application (see page 4)
¨Less than 1 acre ($83 initial fee, $165 annual fee)
¨1-30 acres ($175 initial fee, $350 annual fee)
¨Greater than 30 acres ($270 initial fee, $540 annual fee)
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Responsible Person (Title): Manager of
Environmental
Services
First Name:Chad Last Name:Campbell
Telephone No:202-285-6590 Email Address:chad.campbell@xcelenergy
.com
Organization: Public Service Company
of Colorado (PSCo)
Mailing Address:1800 Larimer Street, Suite 1300
City:Denver State:CO Zip Code:80202
2) *PROPERTY OWNER (CO-PERMITTEE) RESPONSIBLE OFFICIAL
Responsible Person (Title): Manager of
Environmental
Services
First Name:Chad Last Name:Campbell
Telephone No:202-285-6590 Email Address:chad.campbell@xcelenergy.c
om
Organization: Public Service Company of
Colorado (PSCo)
Mailing Address:1800 Larimer Street, Suite 1300
City:Denver State:CO Zip Code:80202
3) *SITE CONTACT (local contact for questions relating to the facility & discharge authorized by this permit)
Responsible Person (Title): Stormwater
Compliance
First Name:Tensy Last Name:Thatcher
Telephone No:9709030595 Email Address:tensy.c.thatcher@xcelenerg
y.com
Organization: Public Service Company of
Colorado (PSCo)
Mailing Address:1800 Larimer Street, Suite 1300
City:Denver State:CO Zip Code:80202
4) *BILLING CONTACT
Responsible Person (Title): Manager of
Environmental
Services
First Name:Chad Last Name:Campbell
Telephone No:202-285-6590 Email Address:Organization: Public Service Company of
Colorado (PSCo)
Mailing Address:1800 Larimer Street, Suite 1300
City:Denver State:CO Zip Code:80202
5) OTHER CONTACT TYPES
Title First
Name
Last
Name
Phone Email Address City State Zip Contact Type Other
6) Former Permittee (transfer)
Responsible Person (Title): First Name:Last Name:
Email Address:Company:
D. LEGAL DESCRIPTION
Legal description: if subdivided, provide the legal description below, or indicate that it is not applicatable. Do not supply Township/Range/Section
or metes and bounds description of the site.
Subdivision(s): Lot(s):Block(s):
OR
þ Not applicable (site has not been subdivided)
¨Facility additional description info
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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.)
¨Commercial Development ¨Residential Development ¨Highway and Transportation Development
þ Pipeline and Utilities (including natural gas, electricity, water, and communications)
¨Oil and Gas Exploration and Well Pad Development
¨Non-structural and other development (i.e. parks, trails, stream realignment, bank stabilization, demolition, etc.)
¨Other
G. ANTICIPATED CONSTRUCTION SCHEDULE
Construction Start Date:09/03/2024 Final Stabilization Date:09/30/2027
• 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 he site is finally stabilized. This means that all ground surface disturbing
activities at the site have been completed and all disturbed areas have either been 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 is finally stabilized. Even if you are only doing one 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 to a new responsible operator.
SIGNATURE REQUIREMENTS:
TERMINATION CERTIFICATION
¨By checking this box I understand that by submitting this notice of termination, I am no longer authorized to discharge stormwater
associated with construction activity by the general permit. I understand that discharging pollutants in stormwater associated with
construction activities to the waters of the State of Colorado, where such discharges are not authorized by a CDPS permit, is unlawful
under the Colorado Water Quality Control Act and the Clean Water Act.
þ STORMWATER MANAGEMENT PLAN CERTIFICATION (on new and renewals)
By checking this box “I certify under penalty of law that a complete Stormwater Management Plan, has been/or will be completed, prior to
the commencement of any construction 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/or will be, 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 fine and imprisonment for knowing violations.”
THIS PORTION OF THE SIGNATURE LANGUAGE IS REQUIRED ON ALL SUBMITTALS
"I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons
who manage the system, or those persons directly responsible for gathering the information, the information submitted is to the best of my
knowledge and belief, true, accurate and complete. I am aware that there are significant penalties for submitting false information, including the
possibility of fine and imprisonment for knowing violations."
“I 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.”
E. AREA OF CONSTRUCTION SITE
Total area of construction site 15 acres
Total area of project disturbance 14.5 acres
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Signature of Operator Date Signed
Name (printed)Title
Signature of Owner Date Signed
Name (printed)Title
Signature: The applicant must be either the owner and operator of the construction site. Refer to Part B of the instructions for additional information.
The application must be signed by the applicant to be considered complete. In all cases, it shall be signed as follows:
(Regulation 61.4 (1ei)
a) In the case of corporations, by the responsible corporate officer is responsible for the overall operation of the facility from which the discharge
described in the form originates
b) In the case of a partnership, by a general partner.
c) In 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, ranking elected official, (a principal executive
officer has responsibility for the overall operation of the facility from which the discharge originates).
FORMER PERMITTEE used for transfers
Signature (Legally Responsible Party)Date
Name (printed)Title
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Material Yard
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