Edmonds School Dist. - Turf Install~·""" .. ~ "(
~-.f Did you know you can submit your NOi electronically using our secure, easy to use
on line system? www. ecy. wa. gov/programs/wq/stormwater/construction/enoi. html
DEPARTMENT OF
ECOLOGY
State of Washington
NOTICE OF INTENT (NOi)
APPLICATION FORM
Construction Stormwater General
Permit
Check if applicable:
D Change or Update Permit Information
D Modification of Permit Coverage
Permlt#WAR. ____ _
Please print or type all sections of this aoollcation. All fields are required unless otherwise marked.fuse ftsbJ to navigate through nerds}
I. Operator/Permittee (Party with operational control over plans and specifications or day-to-day operational control of activities that
ensure compliance with Stormwater Pollution Prevention Plan (SWPPP) and permit conditions. Ecology will send correspondence and
permit fee invoices to the oerrnittee on record.)
Name: Matt Finch Company: Edmonds School District No.15
E-mail:finchm@edrnonds.wednetedu Unified Business Identifier (UBI): None
Business Phone: Ext. (UBI is a nine-digit number used to identify a business entity.
425-431-7167 Write "none" If you do not have a UBI number.)
Cell Phone (Optional): Fax (Optional):
Mailing Address:
20420 681h Avenue West City: State: Zip+4:
Lynnwood WA 98036
II. Property Owner (The party listed on the County Assessor's records as owner and taxpayer of the parcel[s] for which permit
coverage is requested. Ecology will not send correspondence and permit fee invoices to the Property Owner unless he/she is also
the permittee. The Property Owner information will be used for emergency contact ourposes .)
Name: Edmonds School District No. 15 Company (if applicable): N /A
Business Phone: Ext. Unified Business Identifier (UBI): None
425-431-7167 (UBI is a nine-digit number used to identi,Y a business entity. Cell Phone (Optional): Fax (Optional): Write "none" if you do not have a UBI number.)
E-mail:finchm@edmonds.wednet.edu I
-
Mailing Address: City: State: Zip+4:
20420 68th Avenue West Lynnwood WA 98036
Ill. On-site Contact Person (Typically the Certified Erosion & Sediment Control Lead or Operator/Pemuuee)
Name: Company:
To be determined -oubliclv bid project
Business Phone: Ext. Mailing Address:
Cell Phone (Optional) Fax (Optional): City: State: Zip+4:
E-mail:
IV. WQWebDMR (Electronic Discharge Monitoring Reporting)
You must submit monthly discharge monitoring reports using Ecology's WQWebOMR system. To sign up for WQWebDMR,
or to register a new site, go to www .ecv .wa.gov/programs/wq/permits/paris /p ortal.html. If you are unable to submit your OMRs
electronically, you may contact Ecology to request a waiver. Ecology will generally only grant waiver requests to those permittees
without Internet access . Only a permittee or representative , designated in writing, may request access to or a waiver from
WQWebDMR. To have the ability to use the system immediate ly, you must submit the Electronic Signature Agreement with
your application . If you have questions on this process, contact Ecology's WQWebDMR staff at WQWebPortal@ecy .wa .gov or
800-633-6193 or 360-407-7097 (local).
-:di-'.5 ECY 020 85 (Rev. 12114)
v. Site Information
Site or Project Name Site Acreage
Former Woodway High School Multipurpose Sports Total size of your site/project, including support activities such as
Fields off-site equipment staging yards, material storage areas, borrow
Street Address or Location Description (If the site lacks a areas, etc. (that YQ!! own/control): 39.75acres.
street address, list its specific location . For example,
Intersection of Highway 61 and 34.) Total area of soil disturbance (grading and/or excavating) for your
site/project over the life of the project: 5. 92acres. (Note: 1 acre =
23200100th Avenue West 43,560 ft2.)
Parcel ID#: 27033600202200 (Optional) Concrete I Engineered Soils
How many yards of concrete will be poured over the life of the
Type of Construction Activity (check all that apply): project? lliyd3 (estimate)
D Residential
D Commercial How many yards of recycled concrete will be used over the life of
D Industrial the project? .Qyd 3 (estimate)
D Highway or Road (city ,county, state)
t8'J Utilities (specify): storm, e l ~i;;trica l Will any engineered soils be used? (For example: manufactured
[gl Other (specify):grading soil stabilizers, fly ash, cement treated base, cement kiln dust, etc.)
0Yes (81 No
City (or nearest city): Edmonds Zip Code: Estimated project start-up date (mm/dd/yy): 05/25/2015
County: Snohomish 98020 Estimated project completion date (mm/dd/yy): 09/18/2015
Record the latitude and longitude of the main entrance to the site or the approximate center of site.
Latitude: 47.78643 ON Longitude: -122 .37080 ow
Vl. Existing Site Conditions
1. Are you aware of contaminated soils present on the site? 0Yes ig] No
2. Are you aware of groundwater contamination located within the site boundary? 0Yes ig] No
3. If you answered yes to questions 1 or 2, will any contaminated soils be disturbed or will any contaminated groundwater be
discharged due to the proposed construction activity? D Yes 0No
["Contaminated" and "contamination" here mean containing any hazardous substance (as defined in WAC 173-340-200) that does not
occur naturally or occurs at greater than natural background levels.]
If you answered yes to Question 3, please provide detailed information on the locations, contaminants, and contaminant
concentrations (if known), and pollution prevention and/or treatment Best Management Practices (BMPs) proposed to control the
discharge of soil/groundwater contaminants. This information should include related portions of the Stormwater Pollution Prevention
Plan (SWPPP) that describe how contaminated and potentially contaminated construction stormwater and dewatering water will be
managed .
VII. Stormwater Pollution Prevention Plan (SWPPP)
You must develop a SWPPP prior to starting construction. Do not submit your SWPPP with your application. The exception is that
Ecology may request a copy of all or part of the SWPPP if you answered yes to the questions in Part VI.
ECY 020-85 (Rev. 12/14) 2
VIII. Best Manaaement Practices (BMPs)
You must use the BMPs listed in the Stonnwater Management Manual for Western Washington or the Stonnwater Management
Manual for Eastern Washington or other manuals approved by Ecology. Alternatively, you may use demonstrably equivalent BMPs
on the basis of pennit condmon S9.C.4. If you intend to use a BMP at your site that is not included in these manuals, but that you
believe meets the definition of a demonstrably equivalent BMP, you must notify the appropriate regional office.
www .ecj'..wa.gov/Qrogram sfwgfs tormw ater/construction/c ontacts .htm l (See Definitions in the Construction Stormwater General
Permit).*
*Note that if you receive permit coverage without indicating the preference for a demonstrably equivalent BMP and later decide to use one, you
must orovide Ecology wif/1 notice of the selection of an equivalent BMP no Jess than 60 days before the intended use of the equivalent BMP.
IX. DischaraelRecelving Water Information
Indicate whether your site's stormwater andfor dewatering water could enter surface waters, directly andfor indirectly:
IZI Water will discharge directly or indirectly (through a storm drain system or roadside ditch) into one or more surface waterbodies
(wetlands, creeks, lakes, and all other surface waters and water courses).
If your discharge is to a storm sewer system, provide the name of the operator of the stonn sewer system:
(e.g., City of Tacoma): City of Edmonds
(NOTE: If your stonnwater discharges to a storm sewer system operated by the City of Seattle, King County, Snohomish County, City
of Taco ma. Pierce County, or Clark County, you must also submit a copy of this NOi to the appropriate jurisdiction .)
0 Water will discharge to ground with 100% infiltration, with no potential to reach surface waters under any conditions.
If your project includes dewatering, you must include dewatering plans and discharge locations in your site Stonnwater Pollution
Prevention Plan.
Location of Outfall Into Surface Waterbody
Enter the outfall identifier code, waterbody name, and latitudeflongitude of the point(s) where the site has the potential to discharge
into a waterbody (the outfall). Enter all locations. See illustration of Surface Waterbody Outfall locatlons at the end of this form.
• Include the names and locations of both direct and indirect discharges to surface waterbodies, even if the risk of discharge is
low or limited to periods of extreme weather. Attach a separate list if necessary.
• Give each point a unique 1-4 digit alpha numeric code. This code will be used for identifying these points in WQWebDMR.
• Some large construction projects (for example, subdivisions, roads, or pipelines) may discharge into several waterbodies .
• If the creek or tributary is unnamed, use a format such as "unnamed tributary to Deschutes River."
• If the site discharges to a stormwater conveyance system that in tum flows to a surface waterbody, include the surface
waterbody name and location.
Outfall Identifier Code. These cannot be Surface Waterbody Name at Latitude Longitude
symbols. (Maximum of four characters). the Outfall Decimal Degrees Decimal Degrees
Exa111ple: 001A Example: Puget Sound 47.5289047° N -122.3123550° w
0 0 1 A Deer Creek 47.79152° N -122.37790° w
ON _ow
ON ow
If your site discharges to a waterbody that is on the impaired waterbodies list (e.g., 303[d] list) for turbidity, fine sediment, high pH, or
phosphorus, Ecology will require additional documentation before issuing permit coverage and these sites will be subject to addflional
sampling and numeric effluent limits (per Permit Condition SB). Ecology will notify you if any additional sampling requirements apply.
Information on impaired waterbodies is available online at: http:llwww.e cv.waqov/programslwq/303dlindex.html .
ECY 020-85 (Rev. 12114) 3
X. State Environmental Policl Act (SEPA}
This Notice of Intent (NOi) is incomplete and cannot be approved until the applicable SEPA requirements under Chapter 197-11 WAC
are met.
Who is the SEPA lead agency on your site?Edmo nds Sc hool Di strict .
Has the SEPA lead agency issued a final decision on your checklist? (if there Is a comment period, the SEPA decision is
final at the clo se of the comment pe ri od) 0 No !81 Yes D Exempt* (*attach written documentati on if Exempt).
If No : The NOi is incomplete. Ecology will hold the application until a final SEPA decision is made or the Construction Stormwater
NOi public comment period ends, whichever is later. You must notify Ecology once the SEPA lead agency has Issued a final
decision following any comment period.
If Yes: Type of SEPA threshold determination issued: [8J Determination of Non-Significance (ONS) D Mitigated DNS (MONS)
0 Determination of Significance (OS) 0 Final Environmental Impact Statement (EIS) 0 Other:
• Date when SEPA comment period ended or will end: 03/13115
Notify Ecology if the SEPA determination is appealed. More SEPA infonnation is available at:
www. eel:'.'.. wa .g_ov/Q.rog_ramslsealseg_ale-review. html.
XI. Other Ecoloav National Pollutant Discharge Elimination System (NPDES) and/or State Waste Discharge Permits
List any other Water Quality permits (Industrial stormwater, Individual stormwater, etc.) for this site :
Name of Water Quality Permit Permit Number
XII. Public Notice
You must publish a public notice at least once a week for two consecutive weeks with at least seven days between publications, in a
newspaper of general circulation in the county in which the construction is to take place . Ecology cannot grant permit coverage
sooner than the end of the 30-day public comment period, which begins on the date of the second public notice.
Mail or fax (360-407-6426) the NOi to Ecology on or before the first public notice date. If you fax the public notice to Ecology, you
must also mail a hard copy. Failure to do so may delay the issuance of your pennit.
Provide the exact dates (mm/dd/yy) that the first and second public notices will appear in the newspaper(s):
Name of the newspaper publishing the notices: Seattle Daily Journal of Comme rce
First notice: 04/.3..Q. /.15.
Second notice: !lS/.Ql 115. (Begins 30-day public comment period.)
For ex am ole: Fi rst notlce : Frid ay 01/01 /14 Second notice : Friday 01/08 /1 4
ECY 020-85 (Rev. 12/14) 4
PUBLIC NOTICE TEMPLATE
Complete this template using project-specific infonnation and submit to a local newspaper with general circulation within the county
where the project is located . The language in bold is required by WAC 173-226-130 and must be included in its entirety . (Either use
the fill-in template below or attach on a separate sheet of paper, if necessary.)
Edmonds School District No. 15. contact Edward Peters , at 20420 681h Avenue West. Lynnwood, WA 98036 . Is
seeking coverage under the Washington State Department of Ecology's Construction Stormwater NPDES and State Waste
Discharge General Permit.
The proposed project, Former Woodway High School Multipurpose Sports Fields , is located at 23200 1001h
Avenue West ' in the City of Edmonds , in Snohomish County
This project involves 5.92 acres of soil disturbance for grading, synthetic turf field resurfacing, paving and stormwater
Improvements construction activities.
(List all construction activitie s; for example, residential, commercial, industrial, highway, utility).
The receiving water(s) ls/are Deer Creek (List all named and un-
named surface waterbodies, or ground water if applicable, waters identified in section IX).
Any persons desiring to present their views to the department of Ecology regarding this application may do so In writing
within thirty days of the last date of publication of this notice. Comments shall be submitted to the department of Ecology.
Any person Interested In the department's action on this application may notify the department of their Interest within thirty
days of the last date of publication of this notice. Ecology reviews public comments and considers whether discharges from
this project would cause a measurable change In receiving water quality, and, if so, whether the project Is necessary and In
the overriding publlc Interest according to Tier II antldegradatlon requirements under WAC 173·201A·320.
Comments can be submitted to:
Department of Ecology
Attn: Water Quality Program, Construction Stormwater
PO Box 47696, Olympia, WA 98504-7696
XIII. Certification of Permlttees
"/ certify under penalty of law that this document and all attachments were prepared under my direction or supeNision 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 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. n
Matt Finch I Edmonds School District No . 15 Design & Construction Manager
Printed Name I Company Tille .
~•-:-A"
-.:> ~ 04/29/2015
Signature of Operator/Permittee Date
* Signature of Operator/Permittee requirements:
A. For a corporation: By a responsible corporate officer of at least the level of vice president.
8. For a partnership or sole proprietorship: By a general partner or the proprietor, respectively.
C. For a municipality, state, federal, or other public facility: By either a principal executive officer or ranking elected official.
Please sign and return this document to the following address:
Department of Ecology
Attn: Water Quality Program, Construction Stonnwater
PO Box47696
Olympia, WA 98504-7696
ECY 020-85 (Rev. 12114) 5
D!IMTMEHT OF Eeot.OGV
• Transfer of Coverage JUL 1 7 2015
Construction Stormwater General Permit WAl'IR QUAUTY PROGAAM
DEPARTMENT Of This fonn transfers pennit coverage for all, or a portion Permit# WAR-303159
ECOLOGY of a site to one or more new operators.
State af W.1hlnJ•an
Type of permit transfer (check one}: 0 Partial transfer ~ Complete transfer
Specific date that permit responsibility, coverage, and llabilily, is transferred to new operator: 07/06/15
Please see instructions for details on type of transfer.
Current Operator/Permittee Information
For partial transfers:
•List total size of prolect/slte remaining under your operational control following transfer: 5.92 acres.
•List total area or soil disturbance remaining under your operational control following transfer: 5.92 acres.
•Submitting this fonn meets the requirement to submit an updated NOi (General Pennlt Condition G9)
·cunenl Operator/Permltlee Name:~ -~· ...--..: . Company: ___ --·· ~. -Stewart Mhvre Edmonds SchOo l District
Business Phone : Ext: Mailing Address :
425.431 .7000 20420· 6Bth Avenue West
Cell Phone: Fax (optional):
Emall : mhyres@cdmonds.wcdnctcdu City: I State : I Z ip••t
Lynnwood WA 98036-7400
SlgAatu,.• (H••'•"''°~ "'"'"~viii)' Title: Executive Director, Business Operations
(""] /} ~ --. I Date://-Z//~ .)'\VO!~-. .1_,1 ( I l
I I .
New Operator/Pennittee Information
I. New Operator/Pennittee (Party with operational control over plans and specifications or day-to-day operational control of activities
which .ensure compliance with Stormwater Pollution Prevention Plan (SWPPP) and permit conditions. Ecology will send correspondence
and permil fee invoices to the permittee on record.)
Name: Gree Welsbrich Company: FieldTurf USA
Bus iness Phone: Ext: Unified Business ldenlifier(UBI): 602 046132
425.246.8087 (UBI is a nine-<ligit number used to identify a business entity.
Write "none " If vou do not have a UBI number.)
~-~ll~(9Pt!<>nal):-...~ Fax (Optional}: .E-mail: ..
·~ . ,,..,_,___, ....... ..,....._ --· ---.. -·greg.weisbrich@fieldturf.~ -Mailing Address: City : I State: I Zip +4:
2804 269th Avenue NE Redmond WA 98053-2928
II. Property Owner (The party listed on ttle County Assesso(s records as owner and taxpayer ol1he parcel{s) tor which pennit coverage
Is requested. Ecology will .!!21 send correspondence and permit fee invo~s to the Property Owner. The Property OWner information will
be userJ for emergency contact purposes.)
Name : Stewart Mhyre Comoanv: Edmonds School District
Business Phone: Ext Unified Business Identifier (UBI): 319009065
42S.431.1000 (UBI is a nine-digit number used to identify a business entity.
Write "none" If vou do not have a UBI number.)
Cell Phone {Optional): Fax (OptionaO : E-mail:
mhyres@edmonds.wednetedu
Malling Addl9SS: City: I State: I Zip +4:
20420 • 68th Avenue West Lynnwood WA 98036-7400
ECY 020-87a (Rev. 12/14) Form Page 1
111. On·Sfte Contact Person(s) (Typically the Certified Erosion and Sediment Control Lead or Operator/Permittee)
Name: Ryan Wolter Com~: FieldTurf)!~rthwest
Business Phone: Ext: Malting Address:
360.668-8989 280413130 93rd Avenue SE. Bid~ B
Cell Phone: Fax(Opttonal):
425.405.2543 City: State: Zip+4:
Email: ryan@ftnw.com Snohomish WA . 98296
N. Site/Project Information
Site or Project Na1J1e Site Acreage
Fonner Woodwa~ HS Field Improvements Total size of your site/project (that !2Ji! own/control): 5.92acres.
Street Address or location Description (//the site lachs a (Note: 1 acre = 43,560 ff2.)
street addrass, list its specific /ocallon. For example,
lnterseclion of tfig#way 61 and 34.) Total area of soil disturbance (grading and/or excavating} for~
siw/proJect over the Ute of the project: 5.92acres.
23200 -100th Avenue Wes~ Edmonds, WA
Concrete I Eng ineered Soils
ParcellO#: (Optional) How many yams of concrete will be poured? 26Qyd3 -ceslim'cile) -
Type of Construction Activity (check all that apply'): How many yards of recycled concrete will be used? .Qyd3 (esti mate)
0 Residential ·
D Commercial Will any engineered soils be used? (For example; cement treated
0 Industrial base , cement kiln dust, etc.)
0 Highway or Road (city ,county , state) 0Yes 18JNo
t8l Utlllttes (spec ify): Dr ainage
18] Other (specify):S)'.Dlll ~tic Tu cf
City (or nearest city): Edmonds Zip Code: Estimated project start-up date (mm/dd/yy): 06/08/15
County: Snohomish 98020 Estimated project completion dale (mm/dd/yy}: 10/01/lSG
Record the latitude and longttude of the main entrance to the site or the approximate center of site.
Latttude: 47o4T11" ON Longitude: 122021'15" "W
For ssslstanc& with Tatitude and longitude. refer1o BllY of t11e fo,,owlng websites: www.gellatlon .com or
htlp://www .wortdatlas .com/aatta slimageg .htm . Please convert all latitude and ~de coon1inates into decimal degrees format. For
help with this process, go to: hNg//www.fcc.gov/mblaudiolbicke/L.DDDMM.SS ·d~clm.al .fl.lml.
V. Existing Site Conditions
..
ECY 020-87a (Rev. 12114) Form Page2
1. Are you aware of contaminated soils present on the site? 0 Yes f8I No
2. Are you aware of groundwater contamination located within the site boundary? 0 Yes 181 No
3. lf you answered yes IO questions 1 or 2, will any contaminated soils be disturbed or will any contaminated groundwater be
discharged due to the proposed cons1ruction activity? 0 Yes 0 No
reontam inated" ood •contamination• here mean comalning any hazardous substance (as defined in WAC 173-340-200) that does not
occur naturally or occurs at greater than natural background levels.]
If you answered yes to Qu~ 3, please expla in below or on a separate paper In detail the locations, contaminants, and
concentrations, and polllllion prevention and/or treatment BMPs proposed to control the discharge of soil/groundwater contaminants.
Ecology may request a copy of your SWPPP.
VI. WQWebDMR (Electronic Discharge Monitoring Reporting)
• You ·must submit -monthly dlschargemonltorlng ·reportS using Ecology'sWQWebOMR system . To sign up for-WOWebDMR , or ..
to register a new site. go to YNM'.ecy.wa.gov/stormwater, and click on the 'Construction Stormwater" link. You wm find Information on
I WOWebDMR under the 'WQWebOMR a11d PARIS" link on lhe ri9ht~and side. If you are unable lo submit your DMRs eleclronlcally.
you may contact EcolOgy to request a wa iver. Ecology will generally only grant waiver requests to those permittees without intemet
I access. Only a permittee or representative, designated In writing, may request access lo or a waiver from WQWebDMR. To have the
ability to use the system immediately, you must submit the Bectronlc Signature Agreement with your transfer of coveraite
form . If you have questions on this process, contact Ecology's WOWebDMR staff at WebOMR-Stormwater@ecy.wa .9av or 36().407·
7097 .
VII. Discharge/Receiving Water Information
Indicate whether your site's stcrmwater and/or dewaterin9 water could ~nter surfaee waters, direeOy and/or indirectly:
181 Water Will discharge directly or indireclly {lhrough a storm drain system or roadside ditch) into one or more surf ace waterbodles
(v.eUands, creeks, lakes. and all other surface waters and water courses).
If your discharge is to a storm sewer system, provide the name of the operator of the stonn sewer sys~m:
(e.g., City of Tacoma): ... C=itv-=o"-'fE=d=mo=nd=s--------------------
(NOTE: If your stormwater discharges to a storm sewer system operated by the City of Seattle, King County , Snohomish
County, City of Tacoma, Pierce County, or Clark County.you must also submit a copy of 1his NOi to the appropriate
jurisdiction.)
0 Waler wm discharge to ground with 100% infiltration, with no potential to reach surface waters under any conditions .
. If your project illCl.ud.es dewatering, you must include dewaterlng plans and discharue locatiolls in your site Stormwater Pollutlon
·Prevention Plan. · --• -. . ..
Location of Outfall Into Surface Waterbody
Enler the outfaR identifier code, watelbody name, and latitude/longitude of the point(s) where the site has the potential to discharge
into a waterbody {tte outfaU). Enter all locations .
• Include the names and locations of both direct and indirect discharges to sulface watelbodies, even if the risk of discharge is
low or fimited 1o periods of extreme weather. Attach a separate list if necessary.
• Give each poinl a unique 1-4 digit alpha numeric code. This code will be used for identifying these poinlS in WOWebO~.
• Some large construclion projects (for example, subdivisions, roads. or pipefines) may discharge into several watelbodies.
• If the creek or tributary is unnamed, use a foimat such as "unnamed ltibutary to Deschlltes River."
• If the site discharges to a stonnwater conveyance system that In tum flows to a surface waterbody, include the surface
watefbody name and location.
Outfall Identifier Code. These Surface Waterbody Name at the
cannot be symbols. (Maximum Outfall
of 4 characteB}.
ECY 020 ·87a (Rev. 12114) Fonn Page3
Latitude
Deel mal Degrees
Longitude
Decimal Degrees