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'� 1 <br /> l <br /> I . ' <br /> ����aeo�Ecr�oil:��`���`=�- NOTICE OF INTENT <br /> ��o� �� - TO USE <br /> �� �' "'` �� NPDES GENERIC PERMIT FOR STORMWATER <br /> � ��� <br /> � F�OR AI� DISCHARGE FROM LARGE AND SMALL <br /> �_ _ _ _ _ _ _ _ _ _ _ _ `_ _ _ _ . CONSTRUCTION ACTIVITIES <br /> (RULE 62-621.300(4), F.A.C.) <br /> You must submit this completed Notice of Intent(NOI)form to the Department to get coverage under the Generic Permit for <br /> Stormwater Discharge from Large and Small Construction Activities provided in subsection 62-621.300(4), F.A.C. The <br /> Generic Permit document[DEP Document 62-621.300(4)(a)]tells you what construction activity qualifies for coverage,how <br /> you obtain and terminate coverage,what you must do to minimize pollution from your construction site,and what conditions <br /> apply to your project to use the generic permit. You must submit the appropriate generic permit fee, as specified in <br /> paragraph 62-4.050(4)(d),F.A.C.,with this NOI Form to obtain permit coverage. You must read and understand the <br /> requirements of the generic permit document and the attached instructions before completing this NOI form. Please print <br /> or type information in the appropriate areas below. <br /> For construction activities also requiring an Individual Environmental Resource Permit (ERP), under Chapter 62- <br /> 330,F.A.C.: <br /> If your construction activities are already authorized by a valid Individual ERP issued by the Denartment,Water <br /> Mana�ement District or a Delegated Local Government, you may also elect to use this NOI form to provide the <br /> required notice of commencement of construction, in lieu of Form 62-330.350(1) ("Construction Commencement <br /> Notice"). <br /> Do you wish to also provide notice of commencement of construction activities authorized under an Individual ERP <br /> permit through the use of this form? ❑Yes ❑No <br /> I. IDENTIFICATION NUMBER: <br /> A.Facility ID(if renewing coverage): FLR20AK26-002 <br /> B.ERP Permit Number*(if applicable): <br /> C.ERP Permitting Agency(if applicable): <br /> *If the ERP permit authorizes phased construction,please also indicate which phase. I <br /> II. STORMWATER POLLUTION PREVENTION PLAN(SWPPP)DEVELOPED AND READY TO BE <br /> IMPLEMENTED: �Yes ❑No <br /> *If No,you mav not submit your NOI at this time. <br /> III. APPLICANT INFORMATION: <br /> A. Operator Name: The Keamey Companies <br /> *ERP Permittee Name(if different than"Operator"),if applicable: B.Operator Status: p <br /> C.Address: 9625 Wes Kearney Way <br /> D.City: Riverview E.State: FL F.Zip Code: 33578 0506 <br /> G.Responsible Authority: Brian Seeger <br /> Page 1 of 6 <br /> DEP Form 62-621300(4)(b) � <br /> Effective Date: 02/10/2015 <br />