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Home My WebLink AboutPlanes Boats and Automobiles LTD dba PBA LTD; 2018-11-16; PWM19-657TRANRECORDED REQUESTED BY CITY OF CARLSBAD AND WHEN RECORDED PLEASE MAIL TO: City Clerk City of Carlsbad 1200 Carlsbad Village Drive Carlsbad, California 92008 DOC# 2018-0528669 111111111111 lllll 111111111111111111111111111111 IIIII IIIII IIIII IIII IIII Dec 27, 2018 09:18 AM OFFICIAL RECORDS Ernest J. Dronen burg, Jr., SAN DIEGO COUNTY RECORDER FEES $0.00 (SB2 Atkins $0.00) PAGES 1 Space above this line for Recorder's use. PARCEL NO: NOTICE OF COMPLETION Notice is hereby given that: 1. The undersigned is owner of the interest or estate stated below in the property hereinafter described. 2. The full names of the undersigned is City of Carlsbad, a municipal corporation. 3. The full address of the undersigned is 1200 Carlsbad Village Drive, Carlsbad, California 92008. 4. The nature of the title of the undersigned is: In fee. 5. A work or improvement on the property hereinafter described was completed on November 20, 2018. 6. The name of the contractor for such work or improvement is Planes, Boats and Automobile, LTD. 7. The property on which said work or improvement was completed is in the City of Carlsbad, County of San Diego, State of California, and is described as follows: Project No.6606, (PWM19-657TRAN), Kelly Drive Channel Emergency Repair. 8. The street address of said property is at 4862 Kelly Drive, in the City of Carlsbad. I, the undersigned, say: CITY OF ~RLSBAD tt:i@;= -~CityMa~ VERIFICATION OF CITY CLERK I am the City Clerk of the City of tssbad, 1200 Carlsbad Village Drive, Carlsbad, California, 92008; the City Manager of said City on f; X>C,..., IO , 20~ accepted the above described work as completed and ordered that a Notice of Completion be filed. I declare under penalty of perjury that the foregoing is true and correct. Executed on f)oL. I °J , 20 /'?, at Carlsbad, California. C:\Users\epaiv\Desktop\NOC-Kelly Channel Emergency Repair.doc \.'l=~~,mJJ'l·~ ~ARBARA ENGLESON u-dty Clerk CITY OF CARLSBAD ACCEPTANCE OF PUBLIC IMPROVEMENTS COMPLETION OF PUBLIC IMPROVEMENTS Planes, Boats and Automobiles, LTD has completed the contract work required for Project No. 6606 (PWM19-657TRAN) Kelly Drive Channel 2018 Emergency Repair. City forces have inspected the work and found it to be satisfactory. The work consisted of: IMPROVEMENTS City of Carlsbad Concrete Channel Repair VALUE $2,149.37 CERTIFICATION OF COMPLETION OF IMPROVEMENTS fOf ....... Engineering Manage CITY MANAGER'S ACCEPTANCE OF PUBLIC IMPROVEMENTS The construction of the above described contract is deemed complete and hereby accepted. The City Clerk is hereby authorized to record the Notice of Completion and release the bonds in accordance with State Law and City Ordinances. The City of Carlsbad is hereby improvements . .. It . I . ~ /J;J~ ~ Scott Chadlci< APPROVED AS TO FORM: CELIA BREWER, City Attorney directed to commence maintaining the above described Date C:\Userslepaiv\Desktop\API -Kelly Channel Emergency Repair.doc Tracking#: PWM19-657TRAN CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT KELLY CHANNEL 2018 EMERGENCY REPAIR; CONT. NO. 66061 This agreement is made on the \~ day of ~~lt&\~W" , 2018, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Planes Boats & Automobiles LTD dba PBA LTD, a California corporation, whose principal place of business is 2029 East Mission Ave., Escondido, CA 92027 (hereinafter called "Contractor''). City and Contractor agree as follows: DESCRIPTION OF WORK. Contractor shall perform all work specified in the Contract documents for the project described by these Contract 'Documents (hereinafter called "Project"). PROVISIONS OF LABOR AND MATERIALS. Contractor shall provide all labor, materials, tools, equipment, and personnel to perform the work specified by the Contract Documents unless excepted elsewhere in this Contract. CONTRACT DOCUMENTS. The Contract Documents consist of this Contract, exhibits to this Contract, Contractor's Proposal, the Plans and Specifications, the General Provisions, addendum(s) to said Plans and Specifications, and all proper amendments and changes made thereto in accordance with this Contract or the Plans and Specifications, all of which are incorporated herein by this reference. When in conflict, this Contract will supersede terms and conditions in the Contractor's proposal. LABOR. Contractor will employ only skilled workers and abide by all State laws and City of Carlsbad Ordinances governing labor. GUARANTEE. Contractor guarantees all labor and materials furnished and agrees to complete the Project in accordance with directions and subject to inspection approval and acceptance by: Clayton Dobbs (City Project Manager) WAGE RATES. The general prevailing rate of wages for each craft or type of worker needed to execute the Contract shall be those as determined by the Director of Industrial Relations pursuant to Sections 1770, 1773 and 1773.1 of the Labor Code. Pursuant to Section 1773.2 of the Labor Code, a current copy of the applicable wage rates is on file in the Office of the City Engineer. Contractor shall not pay less than the said specified prevailing rates of wages to all workers employed by him or her in execution of the Contract. Contractor shall be responsible for insuring compliance with provisions of section 1777.5 of the Labor Code and section 4100 et seq. of the Public Contracts Code, "Subletting and Subcontracting Fair Practices Act." The City Engineer is the City's "duly authorized officer'' for the purposes of section 4107 and 4107.5. The provisions of Part 7, Chapter 1, of the Labor Code commencing with section 1720 shall apply to the Contract for work. A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, unless currently registered and qualified to perform public work pursuant to Section 1725.5. This project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. Contractor and any subcontractors shall comply with Section 1776 of the California Labor Code, which generally requires keeping accurate payroll records, verifying and certifying payroll records, and making them available for inspection. Contractor shall require any subcontractors to comply with Section 1776. KELLY CHANNEL 2018 EMERGENCY REPAIR Page 1 of 8 City Attorney Approved 9/27 /16 Tracking#: PWM19-657TRAN FALSE CLAIMS. Contractor hereby agrees that any contract claim submitted to the City must be asserted as part of the contract process as set forth in this agreement and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. The provisions of Carlsbad Municipal Code sections 3.32.025, 3.32.026, 3.32.027 and 3.32.028 pertaining to false claims are incorporated herein by reference. Contractor hereby acknowledges that the filing of a false claim may subject the Contractor to an administrative debarment proceeding wherein the contractor may be prevented from further bidding on public contracts for a period of up to five years and that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor or subcontractor f ~a'ffipating in contract bidding. Signature: ~ Print Name: D ,J h~ ,,,. ! · REQUIRED INSURANCE. The successful contractor shall provide to the City of Carlsbad, a Certification of Commercial General Liability and Property Damage Insurance and a Certificate of Workers' Compensation Insurance indicating coverage in a form approved by the California Insurance Commission. The certificates shall indicate coverage during the period of the contract and must be furnished to the City prior to the start of work. The minimum limits of liability insurance are to be placed with California admitted insurers that have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California's List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best's Key Rating Guide of at least "A:X"; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. Commercial General Liability Insurance of Injuries including accidental death, to any one person in an amount not less than ........ $1,000,000 Subject to the same limit for each person on account of one accident in an amount not less than ....... $1,000,000 Property damage insurance in an amount of not less than ........ $1,000,000 Automobile Liability Insurance in the amount of $1,000,000 combined single limit per accident for bodily injury and property damage. In addition, the auto policy must cover any vehicle used in the performance of the contract, used onsite or offsite, whether owned, non-owned or hired, and whether scheduled or non- scheduled. The automobile insurance certificate must state the coverage is for "any auto" and cannot be limited in any manner. The above policies shall have non-cancellation clauses providing that thirty (30) days written notice shall be given to the City prior to such cancellation. The policies shall name the City of Carlsbad as an additional insured. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY. Workers' Compensation limits as required by the California Labor Code. Workers' Compensation will not be required if Contractor has no employees and provides, to City's satisfaction, a declaration stating this. BUSINESS LICENSE. The Contractor and all subcontractors are required to have and maintain a valid City of Carlsbad Business License for the duration of the contract. KELLY CHANNEL 2018 EMERGENCY REPAIR Page 2 of 8 City Attorney Approved 9/27/16 Tracking#: PWM19-657TRAN INDEMNITY. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless the City, and its officers and employees, from all claims, loss, damage, injury and liability of every kind, nature and description, directly or indirectly arising from or in connection with the performance of the Contract or work; or from any failure or alleged failure of Contractor to comply with any applicable law, rules or regulations including those related to safety and health; and from any and all claims, loss, damages, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by the Contract, except for loss or damage caused by the sole or active negligence or willful misconduct of the City. The expenses of defense include all costs and expenses including attorneys' fees for litigation, arbitration, or other dispute resolution method. JURISDICTION. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this agreement is San Diego County, California. Start Work: Contractor agrees to start within five (5) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within ten (10) working days after commencing work. CONTRACTOR'S INFORMATION. Ill Ill Ill Ill Ill Ill Ill PBA Ltd., a California corporation (name of Contractor) 816826 (Contractor's license number) A & B -General Engineering & Building Contractor 1 /31 /19 (license class. and exp. date) 1000018273 (DIR registration number) 6/30/18 (DIR registration exp. date) KELLY CHANNEL 2018 EMERGENCY REPAIR Page 3 of 8 2029 East Mission Ave. (street address) Escondido, CALIFORNIA 92027 (city/state/zip) 760-801-5238 (telephone no.) 760-729-7913 (fax no.) pbalim ited@gmail.com (e-mail address) City Attorney Approved 9/27/16 Tracking#: PWM19-657TRAN AUTHORITY. The individuals executing this Agreement and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Agreement. CONTRACTOR PLANES BOATS & AUTOMOBILES LTD dba PBA LTD, a Califor ia corporation By: (sign here) CITY OF CARLSBAD, a municipal corporation of the State of California By: 1<0,,.._, 'Dohenkt, -P134 /I('{ .lL'<.., (print name/ti e) By: (sign here) C1v{l£fv ~ ~A'\; Fl ~J f(l;f[J~T fer (print name/title) If required by City, proper notarial acknowledgment of execution by Contractor must be attached . .!f...E. corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A Chairman, President, or Vice-President Group B Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: KELLY CHANNEL 2018 EMERGENCY REPAIR Page 4 of 8 City Attorney Approved 9/27 /16 Tracking#: PWM19-657TRAN EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each sub-contractor whom the Contractor proposes to subcontract portions of the Project in excess of one-half of one percent of the total bid, and the portion of the Project which will be done by each sub-contractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a sub-contractor for any portion of the Project to be performed under the contract in excess of one-half of one percent of the bid, the contractor shall be deemed to have agreed to perform such portion, and that the Contractor shall not be permitted to sublet or subcontract that portion of the work, except in cases of public emergency or necessity, and then only after a finding, reduced in writing as a public record of the Awarding Authority, setting forth the facts constituting the emergency or necessity in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Section 4100 et seq. of the California Public Contract Code). If no subcontractors are to be employed on the project, enter the word "NONE." SUBCONTRACTORS Portion of Business Name and DIR License No., %of Project to be Address Registration Classification & Total Subcontracted No. Expiration Date Contract -------/ IA 1/ / ;- I Total% Subcontracted: __ ff~,_~ __ _ The Contractor must perform no less than fifty percent (50%) of the work with its own forces KELLY CHANNEL 2018 EMERGENCY REPAIR Page 5 of 8 City Attorney Approved 9/27/16 Tracking#: PWM19-657TRAN EXHIBIT B KELLY CHANNEL 2018 EMERGENCY REPAIR JOB QUOTATION Contractor will provide all material, labor and equipment needed to repair approximately 24 linear feet of a concrete protected channel behind the residence located at 4866 Kelly Drive. Contractor will adhere to the Tier 1 SWPPP and repair plan prepared for the project, the United States Army Corp Regional General Permit 63 obtained for the project, and all established guidelines set forth in the Standard Specifications for Public Works Constructions, 2018 ed. (The Greenbook) for this project, specifically: concrete finishing, coring, consistency, walkways/joint, and clean-up (pgs. 196, 409, 65, 327 & 349). JOB QUOTATION ITEM UNIT QTY DESCRIPTION NO. 1 LS 1 Mobilization 2 LS 1 Site Dewatering 3 Cubic 52 Concrete Channel Repair Yard 4 LS 1 Bond *Includes taxes, fees, expenses and all other costs. KELLY CHANNEL 2018 EMERGENCY REPAIR Page 6 of 8 UNIT PRICE Price -$4,000 -$18,700 $385.00 $20,020 -$2,000 TOTAL* $44,720 City Attorney Approved 9/27/16 EXHIBITC LABOR AND MATERIALS BOND Tracking#: PWM19-657TRAN Bond Number: SCS1000869 Premium: $1,453.00 WHEREAS, the City of Carlsbad, State of California, has awarded to Planes Boats & Automobiles LTD dba PBA LTD (hereinafter designated as the "Principal"), a Contract for: KELLY CHANNEL 2018 EMERGENCY REPAIR CONTRACT NO. 66061 in the City of Carlsbad, in strict conformity with the drawings and specifications, and other Contract Documents now on file in the Office of the City Clerk of the City of Carlsbad and all of which are incorporated herein by this reference. WHEREAS, Principal has executed or is about to execute said Contract and the terms thereof require the furnishing of a bond, providing that if Principal or any of its subcontractors shall fail to pay for any materials, provisions, provender or other supplies or teams used in, upon or about the performance of the work agreed to be done, or for any work or labor done thereon of any kind, the Surety on this bond will pay the same to the extent hereinafter set forth. NOW, THEREFORE, WE, Planes Boats & Automobiles LTD dba PBA LTD, as Principal, (hereinafter designated as the "Contractor"), and United Surety Insurance Company as Surety, are held firmly bound unto the City of Carlsbad in the sum of forty-four thousand seven hundred twenty Dollars ($44,720), said sum being an amount equal to: One hundred percent (100%) of the total amount payable under the terms of the Contract by the City of Carlsbad, and for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors, or assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if the Contractor or his/her subcontractors fail to pay for any materials, provisions, provender, supplies, or teams used in, upon, for, or about the performance of the work contracted to be done, or for any other work or labor thereon of any kind, consistent with California Civil Code section 9100, or for amounts due under the Unemployment Insurance Code with respect to the work or labor performed under this Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the contractor and subcontractors pursuant to section 13020 of the Unemployment Insurance Code with respect to the work and labor, that the Surety will pay for the same, and, also, in case suit is brought upon the bond, reasonable attorney's fees, to be fixed by the court consistent with California Civil Code section 9554. This bond shall inure to the benefit of any of the persons named in California Civil Code section 9100, so as to give a right of action to those persons or their assigns in any suit brought upon the bond. Surety stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the work to be performed hereunder or the specifications accompanying the same shall affect its obligations on this bond, and it does hereby waive notice of any change, extension of time, alterations or addition to the terms of the contract or to the work or to the specifications. KELLY CHANNEL 2018 EMERGENCY REPAIR Page 7 of 8 City Attorney Approved 9/27/16 Tracking#: PWM19-657TRAN In the event that Contractor is an individual, it is agreed that the death of any such Contractor shall not exonerate the Surety from its obligations under this bond. Executed by CONTRACTOR this / (a of l) C UG h') b~r , 20Jf. CONTRACTOR: (print name here \/ p 4 .$ELo~ 13~ Lj-0 (title and organization of signa ory) By: . J /) (3,\b\?flT ,~~'-1 1==-110 (sign here) /L '- day Executed by SURETY this __ _.1..,.5'"""th.......__ day of _ _,N......,.o ..... v .... e .... m....,b,..e...,r...._ _____ , 20~. SURETY: United Surety Insurance Company (name of Surety) 292 Newberry Street Ste 105 Boston, MA 02115 (address of Surety) By: Steven A Swartz (printed name of Attorney-in-Fact) (attach corporate resolution showing current power (print name here) of attorney) ~£·~\b_~~-t~a---'--"---1-fu._~l_1~~~s __ Df'G_Js-t· f~0/1-Lto (title and~ization of signAfory) (Proper notarial acknowledgment of execution by CONTRACTOR and SURETY must be attached.) (President or vice-president and secretary or assistant secretary must sign for corporations. If only one officer signs, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering that officer to bind the corporation.) APPROVED AS TO FORM: KELLY CHANNEL 2018 EMERGENCY REPAIR Page 8 of 8 City Attorney Approved 9/27/16 Califomia All-Purpose Certificate of Acknowledgment A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of __ O~ra_n..,.g,...e~---------S.S. On November 15, 2018 before me, Bethany Johnson, Notary Public personally appeared ---~S=te=v~e~n~A~-~S~w~a=rtz~---------------- who proved to me on the basis of satisfactory evidence to be the person(s:) whose name(s) is~)e subscribed to the within instrument and acknowledged to me that he/skt)!{~¥ executed the same in his/k.ooxtlllltli:. authorized capacity(~). and that by his~~~~ signature(!.) on the instrument the person(K), or the entity upon behalf of which the person~) acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. document titled/for the pu Payment Bond -PBA Ltd. -City of Carlsbad containing __ 2_ pages, and dated November 15, 2018 The signer(s) capacity or authority is/are as: D lndividual(s) IZI Attorney-in-fact D Corporate Officer(s) _____________ _ • Guardian/Conservator D Partner -Limited/General D Trustee(s) • Other: ________________ _ representing: _ _,U.._.o .... i .... te ... d...,S ..... u .... r_..e"'ty ..... l ..... o .... su.,..r....,a.._.n..,.ce.._..C..,o..,..m..ll'p ... a ... o..,.y __ _ . :,, / @ ' BETHANY JOHNSON Notary Public -California Orange County C ornmission # 2207129 My Comm. Expires Jul 27, 2021 ',)! Additional Information Method of Signer Identification __ z z l> Proved to me on the basis of satisfactory evidence: D form(s) of identification D credible witness(es) Notarial event is detailed in notary journal on: Page#__ Entry# __ Notary contact: _________ _ Other D Additional Signer D Signer(s) Thumbprints(s) •------------- • • Agency Code: 171372 , • POWER OF ATTORNEY UNITED CASUALTY AND SURETY INSURANCE COMPANY USCASUALTYANDSURETYINSURANCECOMPANY UNITED SURETY INSURANCE COMPANY KNOW ALL MEN BY THESE PRESENTS: That United Casualty and Surety Insurance Company , a corporation of the Commonwealth of Massachusetts, and US Casualty and Surety Insurance Company and United Surety Insurance Company, assumed names of United Casualty and Surety Insurance Company (collectively, the Companies"), do by these presents make, constirute and appoint: Steven A. Swartz, Kelly A. Specht, Kandis Gregory, Richard P. Ford, Thomas C. Buckner, Michael Herranen its true and lawful Attomey(s)-in-Fact, each in their separate capacity if more than one is named above, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include riders, amendments, and consents of surety, providing the bond penalty does not exceed Ope Mmlop Five Hundred Thousand & 00/100 Dollars ($1,500,000.00). This Power of Attorney shall expire without further action on pccymbyr 3 I"~. This Power of Attorney is granted under and by authority of the following resolutions adopted by the Board of Directors of the Companies at a meeting duly called and held on the l" day of July, 1993: Resolved that the President. Treasurer, or Secretary be and they are hereby authorized and empowered to appoint Attorneys-in-Fact of the Company, in its name and as its acts to execute and acknowledge for and on its behalf as Surety any and all bonds, recognizances, contracts of indemnity, waivers of citation and all other writings obligatory in the nature thereof, with power to attach thereto the seal of the Company. Any such writings so executed by such Attorneys-in-Fact shall be binding UJ><Jn the Company as if they had been duly executed and acknowledged by the regularly elected Officers of the Company in their own proper persons. That the signature of any officer authorized by Resolutions of this Board and the Company seal may be affixed by facsimile to any J><Jwer of attorney or special power of attorney or certification of either given for the execution of any bond, undertaking, recognizance or other written obligation in the nature thereof; such signature and seal, when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed. IN WITNESS WHEREOF, the Companies have caused this instrument to be signed and their corporate seals to be hereunto affixed, this 9th day of July, 2018. Corporate Seals Commonwealth of Massachusetts County of Suffolk ss: UNITED CASUALTY AND SURETY INSURANCE COMPANY US CASUALTY AND SURETY INSURANCE COMPANY UNITED SURETY INSURANCE COMPANY Michael J. Scholl, President On this 9th day of July, 20 I 8, before me , Thomas P. Carrigan, Jr., a notary public, personally appeared Michael J. Scholl, President of United Casualty and Surety Insurance Company, US Casualty and Surety Insurance Company and United Surety Insurance Company, who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the Commonwealth of Massachusetts that the foregoing paragraph is true and correct. WITNESS my hand and seal. -~--=~'-----£;./4 __ .«-'-~--(Seal) . ' Thomas P. Carrigan, Jr., Notary Public I, Robert F. Thomas, Chief Operating Officer of United Casualty and Surety Insurance Company, US Casualty and Surety Insurance Company and United Surety Insurance Company do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, which is still in full force and effect; furthennorc, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Boston, Massachusetts t.'iis _---15lt) __ day of November . _.2..,0u1_..8~-- Corperate Seals Robert F. Thomas, Chief Operating Officer TO CONFIRM AUTHENTICITY OF THIS BOND OR DOCUMENT CALL (800) 829-2663 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of <:z1Jl.01"-?i:, . On lb tJo~ -:4~ before me, ~ i[~-i:;-,J~~ Date / -~Here Insert Nam~ and Title of the Officer -.thl·rJ P,.) -personally appeared ____ ____..c _______ .,___ _________________ _ amep1 of Sign&f(s) who proved to me on the basis of satisfactory evidence to be the l)erson~) whose nameM is/a~ subscribed to the within instrument and acknowledged to me that he/s~/~ey executed the same in his/~rlj.fleir authorized capacity(ie~and that by his/her1th6 signature~ on the instrument the person~, or ttfo entity upon behalf of which the person(s);'acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Place Notary Sea/ Above ----------------oPTIONAL---------------- Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Docume~ . "-I [ Title or Type of Document: (;t-l/rtlrJ~ ~ I Document Date: _l_t_l_-\l~~t ~---- Number of Pages: ___ Signer(s) 0 er Than Named Above: ____________ _ Capacity(ies) Claimed by Signer(s) Signer's Name: ____________ _ Signer's Name: ____________ _ I· 1 Corporate Officer -Title(s): ______ _ 1 ·1 Corporate Officer -Title(s): ______ _ '. I Partner - I ·. Limited i i General : Partner -· J Limited '. ! General , Individual ::....; Attorney in Fact , ' Individual : J Attorney in Fact Trustee ~ Guardian or Conservator ,-Trustee LJ Guardian or Conservator : Other: ______________ _ I : Other: ______________ _ Signer Is Representing: _________ _ Signer Is Representing: _________ _ ©2014 National Notary Association• www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completi'l9 this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. Place Notary Seal Above I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ' ---------------oPnONAL--------------- Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: _____________ Document Date: _______ _ Number of Pages: ___ Signer(s) Other Than Named Above: ____________ _ Capacity(ies) Claimed by Signer(s) Signer's Name: ___________ _ • Corporate Officer -Title(s): ______ _ Signer's Name: ___________ _ D Corporate Officer -Title(s): ______ _ • Partner -D Limited D General D Partner -D Limited D General • Individual • Attorney in Fact D Individual • Attorney in Fact • Trustee • Guardian or Conservator D Trustee D Guardian or Conservator D Other: _____________ _ D Other: _____________ _ Signer Is Representing: ________ _ Signer Is Representing: ________ _ ©2014 National Notary Association· www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 DEPARTMENT OF THE ARMY CORPS OF ENGINEERS, LOS ANGELES DISTRICT 5900 LA PLACE COURT, SUITE 100 CARLSBAD, CA 92008 October 23, 2018 SUBJECT: Regional General Permit Verification Paz Gomez City of Carlsbad-Public Works 1635 Faraday Ave Carlsbad, California 92008 Dear Mr./Ms. Gomez: Attachment A I am responding to your request (SPL-2018-00626-JDR) for a Department of the Army permit for your proposed project, City of Carlsbad -Kelly Channel Failure. The proposed project is located at 4862 Kelly Drive, in the city of Carlsbad, San Diego County, California. Because this project would result in a discharge of dredged and/or fill material into waters of the United States a Department of the Army permit is required pursuant to Section 404 of the Clean Water Act (33 USC 1344; 33 CPR parts 323 and 330). I have determined construction of your proposed project, if constructed as described in your application, would comply with Regional General Permit (RGP) No 63. Specifically, Repair and Protection Activities in Emergency Situations, and as shown in the enclosed figure(s) titled Figure 2, you are authorized to: 1. Specifically, and as shown in the attached Figure 2, this verification authorizes the permanent discharge of 27 CY of concrete into 0.005 acres (250 square feet) of jurisdictional non wetland waters of the U.S., specifically Kelly Channel, for the purpose of repairing an existing portion a concrete lined channel to protect private property from the imminent threat of storm damage. Project related impacts will result in the permanent loss of0.005 acres of jurisdictional non wetland waters of the U.S. 2. Specifically, and as shown in the attached Figure 3a and 3b, this verification authorizes the temporary installation of BMPs including geotextile and mat (plastic cover) and check dam (gravel bags) per the storm water pollution prevention plan into jurisdictional non wetland waters of the U.S., specifically Kelly Channel, for the purpose of repairing an existing portion a concrete lined channel to protect private property from the imminent threat of storm damage. -2- For this RGP verification letter to be valid, you must comply with all of the terms and conditions stated in the enclosed copy of the RGP. Furthermore, you must comply with the following non-discretionary Special Conditions: Special Conditions: I. Prior to initiating construction in waters of the U.S., the Permittee shall submit to the Corps Regulatory Division a complete set of final detailed grading/construction plans showing all work and structures in waters of the U.S. All plans shall be in compliance with the Final Map and Drawing Standards for the South Pacific Division Regulatory Program dated February 10, 2016 (http://www.spd.usace.army.mil/Missions/Regulatory/PublicNoticesandReferences/tabid/ 10390/Article/651327/updated-map-and-drawing-standards.aspx). All plan sheets shall be signed, dated, and submitted on paper no larger than 1 lx 17 inches. No work in waters of the U.S. is authorized until the Permittee receives, in writing (by letter or email), Corps Regulatory Division approval of the final detailed grading/construction plans. The Permittee shall ensure that the project is built in accordance with the Corps-approved plans. 2. Within 45 calendar days of completion of authorized work in waters of the U.S., the Permittee shall submit to the Corps Regulatory Division a post-project implementation memorandum including the following information: a) Date(s) work within waters of the U.S. was initiated and completed; b) Summary of compliance status with each special condition of this permit (including any noncompliance that previously occurred or is currently occurring and corrective actions taken or proposed to achieve compliance); c) Color photographs (including map of photo points) taken at the project site before and after construction for those aspects directly associated with petmanent impacts to waters of the U.S. such that the extent of authorized fills can be verified; d) One copy of "as built" drawings for the entire project. Electronic submittal (Adobe PDF format) is preferred. All sheets must be signed, dated, and to-scale. If submitting paper copies, sheets must be no larger than 11 x 17 inches; and e) Signed Certification of Compliance (attached as part of this permit package). 3. At the conclusion of the project, all temporary fill shall be removed and the area shall be restored to pre-construction conditions (contours and vegetated condition) to the maximum extent practicable. The Permittee shall hydroseed the disturbed portions of the earthen stream banks with native non-invasive vegetation of facultative upland (FACU) or wetter species, as appropriate. The Permittee shall submit the proposed planting palette for review and approval by the Corps, prior to initiation of construction. The Permittee shall ensure the hydroseeded areas are maintained and monitored for a period of two years after completing the seeding activities, such that less than 10 percent of the areas disturbed by the project are vegetated by non-native and invasive plant species. Monitoring reports shall be submitted by the Permittee -3- to the Corps, by May 15th annually, one and two years following hydroseeding, documenting the recovery of the restored areas. 4. This permit is contingent upon the issuance of a Section 40 I Water Quality Certification (WQC) from the San Diego Regional Water Quality Control Board (RWQCB). The Permittee shall abide by the terms and conditions of the Clean Water Act Section 401 WQC. The Pennittee shall submit the Section 401 WQC to the Corps Regulatory Division (preferably via email) within two weeks ofreceipt from the issuing state agency. The Permittee shall not proceed with construction until receiving an email or other written notification from Corps Regulatory Division acknowledging the Clean Water Act 401 WQC has been received, reviewed, and deetermined to be acceptable. If the RWQCB fails to act on a request for certification within 60 days after receipt of a complete application, please notify the Corps so we may consider whether a waiver of water quality certification is warranted pursuant to 33 CFR 325.2(b)(l)(ii). 5. The Permittee shall allow the Corps to inspect the authorized activities at any time deemed necessary to verify compliance with permit terms and conditions. 6. Pursuant to 36 C.F.R. section 800.13, in the event of any discoveries during construction of either human remains, archaeological deposits, or any other type of historic property, the Permittee shall notify the Corps Project Manager for this project (Jonah Reenders at 760-602- 4841) and the Corps' Archaeology Staff (Danielle Storey at 213-452-3855 or Meg McDonald at 213-452-3849) within 24 hours. The Permittee shall immediately suspend all work in any area(s) where potential cultural resources are discovered. The Permittee shall not resume construction in the area surrounding the potential cultural resources until the Corps Regulatory Division re-authorizes project construction, per 36 C.F.R. section 800.13 7. All vehicle maintenance, staging, storage, and dispensing of fuel shall occur in designated upland areas. These designated upland areas shall be located in such a manner as to prevent any runoff entering waters of the U.S. 8. No debris, soil, silt, sand, sawdust, rubbish, cement, or concrete washings thereof, oil or petroleum products, from construction shall be allowed to enter into or be placed where it may be washed by rainfall or runoff into waters of the U.S. Therefore, the Pennittee shall employ all BMPs necessary to prevent toxic materials, silt, debris, or excessive erosion from entering waters of the U.S. during project construction. Upon completion of the activities authorized by the permit, any excess material or debris shall be removed from the work area and disposed of in an appropriate upland site. No later than one year following completion of authorized work in waters of the U.S., the permittee shall ensure all sites within waters of the U.S. subject to authorized, temporary impacts are restored to pre-project alignments, elevation contours, and conditions to the maximum extent -4- practicable to ensure expeditious resumption of aquatic resource functions. No later than 45 calendar days following completion of authorized work in waters of the U.S., the permittee shall submit a memorandum documenting compliance with this special condition. The work authorized by this RGP must be underway no later than fourteen (14) calendar days from date of issuance of this letter of verification. All work must be completed no later than October 26, 2018. If the Permittee is unable to complete the authorized work by this date, the Permittee must request, in writing, an extension from the Corps Regulatory Division prior to the deadline. As noted in General Condition 26 ofRGP 63 the Permittee shall provide a written report of activities completed within 45 days of project completion. A general permit does not grant any property rights or exclusive privileges. Also, it does not authorize any injury to the property or rights of others or authorize interference with any existing or proposed Federal project. Furthermore, it does not obviate the need to obtain other Federal, State, or local authorizations required by law. Thank you for participating in the regulatory program. If you have any questions, contact Jonah Reenders at 760-602-4841 or via e-mail at Jonah.D.Reenders@usace.army.mil. Please help me to evaluate and improve the regulatory experience for others by completing the customer survey form at http://corpsmapu.usace.army.mil/cm apex/f?p=regulatory survey. Enclosure(s) Sincerely, 1 Digitally signed by DAH L.KYLE.J DAHLKYLEJ.1273446261 ON: c==US, ()l:::U.5. Government, 1273446261 ou;Do0,00;PKl,ou;USA, • cn=DAHL.KYLEJ.1273446261 Date: 2018.10.24 14:41:24-07'00' Kyle Dahl Team Lead South Coast Branch Figure 1 LOCATION MAP NOT TO SCALE PROJECT NAME PROJECT EXHIBIT KELLY CHANNEL EMERGENCY REPAIR NUMBER 1 6606 PLOTTED B~ SCOTT EVANS PLOT DATF:9/27/18 PATH:D: \11UNSPORTATION DCPARTMENT\DESIGN DMSION\DAN/El. mlN'f\KW.Y DRAJNAG£\6606.DIIG LOS ANGELES DISTRICT U.S. ARMY CORPS OF ENGINEERS DEPARTMENT OF THE ARMY REGIONAL GENERAL PERMIT NUMBER 63 FOR REPAIR AND PROTECTION ACTIVITIES IN EMERGENCY SITUATIONS SPONSOR AND ISSUING OFFICE: U.S. Army Corps of Engineers, Los Angeles District PERMIT NUMBER: Regional General Permit No. 63 (File No. SPL-2013-00609-BAH) ISSUANCE DATE: November 29, 2013 PERMITTEE: Public agencies, businesses, or private parties (i.e., the public in general) Note: The term "you" and its derivatives, as used in this permit, means the permittee. The term "this office" refers to the Los Angeles District office of the Corps of Engineers, which has jurisdiction over the permitted activity, or the appropriate official of this office acting under the authority of the commanding officer. After you receive written approval that your project complies with the terms and conditions of this RGP from this office, you are authorized to perform work in accordance with the General Conditions and any project-specific conditions specified below. PROJECT DESCRIPTION: This permit authorizes discharges of dredged or fill material into Waters of the United States, including wetlands, and/or work or structures in Navigable Waters of the United States for necessary repair and protection measures associated with an emergency situation. An "emergency situation" is present where there is a clear, sudden, unexpected, and imminent threat to life or property demanding immediate action to prevent or mitigate loss of, or damage to, life, health, property or essential public services (i.e., a situation that could potentially result in an unacceptable hazard to life or a significant loss of property if corrective action requiring a permit is not undertaken immediately). PROJECT LOCATION: Within those parts of the State of California subject to regulatory review by this office, including the coastal slopes of San Luis Obispo County, all of Santa Barbara County except for the Carrizo Plain, Ventura, Los Angeles, San Bernardino, Riverside, Orange, San Diego, Imperial and Inyo counties, Mono County to the Conway Summit above Mono Lake, the southern slopes of the Tehachapi Mountains in Kem County, and all of the State of Arizona. In the event of future modifications to District boundaries, this permit would also apply in any areas so revised. GENERAL CONDITIONS OF THIS RGP: 1. Time Period Covered: lbis RGP shall expire on November 22, 2018. 2. Notification/Communication: a. Timing: The applicant must notify the District Engineer (DE) as early as possible and shall not begin the activity until notified by the DE that the activity may proceed under this RGP with any site-specific special conditions imposed by the District or Division Engineer. The Corps recognizes there may be situations where imminent threats to life or property occur and the applicant has not received a notice to proceed from the DE. It is not the intention of this office to imply that one allows such threat to life or property result in actual loss. If one proceeds without such notice from the DE, one must ensure that prior notice of such a unilateral decision to proceed is made to this office by telephone, facsimile, e-mail, delivered written notice or other alternative means. b. Contents of Notification: The notification should be in writing and include the following information: (1) The name, address, e-mail address and telephone number of the applicant and the designated point of contact and their address, e-mail address and telephone number; (2) The location of the proposed project, including the identification of the waterbody(ies) (this should include a copy of a U.S. Geologic Survey [USGS] topographic map, electronic map images, annotated photographs, Thomas Guide map, or hand-drawn location map with suitable landmarks; the map should have sufficient detail to clearly indicate the location and extent of the project, as well as detailed directions to the site); (3) A brief, but clear, description of the imminent threat to life or property and the proposed project's purpose and need; (4) A description of methods anticipated to be used to rectify the situation ("field engineering" is not an adequate description. It is presumed if one mobilizes materiel and a particular piece of equipment to a site, then one probably has a fairly well-defined intention for that materiel and equipment. Photographs, visual renderings of the project, plans, drawings or sketches showing the area to be impacted, cross sections showing details of construction, if appropriate, and a short narrative describing how the work is to be completed should be provided as a minimum); and (5) A brief description of the project area's existing conditions and anticipated environmental impacts resulting from the proposed work (amount of dredge or fill material, acreage of disturbance, removal of significant vegetation, loss of habitat, etc.). c. Form of Notification: The standard Application for Department of the Army Permit (Form ENG 4345), available from the District's website at http://www.spl.usace.army.mil/Portals/17/docs/regulatory/Permit_Process/Eng4345_20 12OCT.pdf, may be used as the notification and must include all of the information required in General Condition 2.b. Items (1)-(5) above. A letter, facsimile transmission or electronic mail may also be used. In certain situations where there is an imminent threat to life or property and the applicant is unable to make direct contact with this office, a message shall be left on voice mail or an e-mail message shall be sent. Again, 2 those messages should include the information identified in General Condition 2.b. Items (1)-(5) above. Formal written notification should be sent to this office as soon as possible. d. Agency Coordination: Upon receipt of a notification, the DE will immediately provide (i.e., by facsimile transmission, overnight mail, electronic mail or other expeditious manner) a copy to the offices of the Environmental Protection Agency (EPA), the U.S. Fish and Wildlife Service (FWS), the National Marine Fisheries Service (NMFS), the Monterey Bay National Marine Sanctuary, the California Department of Fish and Wildlife (CDFW), the California State Water Resources Control Board (SWRCB), the Arizona Department of Environmental Quality (ADEQ), the Arizona Game and Fish Department, the Navajo Nation, the Hopi Tribe, the Hualapai Tribe, the White Mountain Apache Tribe; the Big Pine Paiute Tribe of Owens Valley, the Bishop Paiute Tribe, and the Twenty-Nine Palms Band of Mission Indians (collectively, "Tribes"), the California Regional Water Quality Control Boards (RWQCB), the California Coastal Commission (CCC), and the State and Tribal Historic Preservation Offices of California or Arizona (SHPO/THPO), as appropriate. These agencies will be requested to provide a response to the Corps Regulatory Branch Project Manager as expeditiously as possible by telephone, facsimile transmission (fax) or e-mail, indicating whether they intend to provide substantive, site-specific comments regarding the proposed project. If notified that comments will be provided by an agency or tribal representative, the DE will allow them to provide their comments in a short timeframe determined by the DE on a case- by-case basis to not likely result in loss of life or property before making a decision on the proposed project. The DE will fully consider any comments received within the specified timeframe concerning the proposed activity's compliance with the conditions of the agency's authority, the need to impose terms and conditions to avoid and minimize adverse effects on aquatic resources, and the need for mitigation to reduce the project's adverse environmental effects to a minimal level. The DE will indicate the results of that consideration in the administrative record associated with the notification and will provide an informal response to the commenting agency by electronic mail, facsimile transmission or other means. e. Mitigation: Discharges of dredged or fill material into Waters of the United States must be avoided or minimized to the maximum extent practicable at the project site. Compensation for unavoidable discharge of fill materials may require appropriate mitigation measures. Factors that the DE will consider when determining the suitability of appropriate and practicable mitigation will include, but are not limited to: (1) The approximate functions and values of the aquatic resource being impacted, such as habitat value, aquifer recharge, sediment conveyance or retention, flood storage, etc.; (2) The permanence of the project's impacts on the resource; and (3) The potential long-term effects of the action on remaining functions and values of the impacted aquatic resource. To be practicable, the mitigation must be available and capable of being done considering costs, existing technology, and logistics in light of the overall project purposes. Examples of mitigation that may be appropriate and practicable include, but are not limited to: reducing the size of the project; establishing wetland or upland buffer zones to protect aquatic resource values; replacing the loss of aquatic resource 3 values by creating, restoring, or enhancing similar functions and values; or using bioremediation techniques in conjunction with other methods to offset project impacts. To the extent appropriate, applicants should consider mitigation banking and other forms of mitigation, including contributions to wetland trust funds or in-lieu fees to organizations such as State, county or other governmental or non-governmental natural resource management organizations, where such fees contribute to the restoration, creation, replacement, enhancement, or preservation of aquatic resources. f. District Engineer's Decision: In reviewing the notification for the proposed activity, the DE will determine whether the activity would likely result in more than minimal individual or cumulative adverse environmental effects or may be contrary to the public's interest. The applicant may, as an option, submit a proposed mitigation plan with the notification to expedite the process and the DE will consider any mitigation (See General Condition 2.e. above.) the applicant has included in the proposal in determining whether the net adverse environmental effects for the proposed work are minimal. If the DE determines the activity complies with the terms and conditions of this RGP and the adverse effects are minimal, this office will notify the applicant and include any situation-specific conditions deemed necessary. If the applicant elects to submit a mitigation plan as part of the proposed project, the DE will expeditiously review the proposed plan also. However, the DE may approve the mitigation proposal after the work is approved and project work has commenced. If the DE determines the adverse effects of the proposed work are more than minimal, the DE will notify the applicant either: (1) That the project does not qualify for authorization under this RGP and instruct the applicant on the procedures to seek authorization under an individual permit or other general permit, or (2) That the project is authorized under this RGP subject to the applicant submitting a mitigation proposal that would reduce the adverse effects to the minimal level. 3. Authorized Work: Any work authorized by this RGP must be the minimum necessary to alleviate the immediate emergency, unless complete reconstruction only results in very minor additional impact to aquatic resources and logistical concerns indicate such reconstruction is as expedient considering the condition of the project site and is limited to in-kind replacement or refurbishment. Moderate upgrading would be considered if the applicant wishes to use bioremediation or other environmentally sensitive solutions. The RGP may NOT be used to upgrade an existing structure to current standards when that activity would result in additional adverse effects on aquatic resources, except in very limited circumstances. Such upgrade projects shall be considered separate activities for which other forms of authorization will be required. Work not described in permit application documentation but deemed necessary after a field assessment is not authorized unless coordinated with the Regulatory project manager and acknowledged by appropriate means (i.e., e-mail or facsimile transmission, memo to the record, etc.). These coordinated permit modifications must also be described in sufficient detail in the post-project report (see RGP 63 General Condition 26). 4. Start Work Date: Any projects authorized under this RGP must be initiated within fourteen (14) days of receiving authorization to proceed. If the project start time can be delayed for 4 more than two weeks, the imminent threat of impending loss may have diminished in magnitude, as well as immediacy, and generally would not meet the definition of an "emergency." However, there may be limited circumstances where, after notice to and input by the agencies, logistical considerations necessitate an extension beyond 14 days. Further, this RGP cannot be used to authorize long-planned-for projects, nor shall it be used for projects that are likely to have been known to the applicant but for which an application was not submitted in a timely manner. That is, the Corps and other agencies are not obligated to authorize work for a self-described emergency situation unless we agree that the situation qualifies as an emergency as defined on page 1. 5. Access to Site: You must allow representatives from this office and other agencies to inspect the authorized activity at any time deemed necessary to ensure the project is being or has been accomplished in accordance with the terms and conditions of this RGP. 6. Tribal Rights: No activity or its operation may impair reserved tribal rights, including, but not limited to, reserved water rights and treaty fishing and hunting rights. 7. Water Quality Certification: Within Los Angeles District, water quality certifications pursuant to Section 401 of the Clean Water Act are administered by the California State Water Resources Control Board (SWRCB) and the Arizona Department of Environmental Quality (ADEQ) for non-tribal land, the U.S. Environmental Protection Agency for tribal lands of Tribes not treated as States, and seven Native American Tribes that are treated as States for Section 401 water quality certification. Section 401 water quality certification from the USEP A is pending as of the date of this permit. Permittees working on tribal land in Los Angeles District must receive individual Section 401 water quality certification from the EPA or one of the seven Tribes identified on page 3 as appropriate. Conditions of the pending water quality certification from the EPA will be incorporated when issued and the permit modified appropriately. ARIZONA The ADEQ issued its conditional certification (401 cert reading file rs313:041) on October 24, 2013. As with previous reissuances of the RGP, conditions within issued Section 401 certifications are included within the body of the RGP to facilitate dissemination of information to permittees regarding water quality certifications for work authorized under RGP 63. The ADEQ's water quality conditions are adopted within this permit as RGP 63 General Conditions. For Arizona Pennittees on Non-tribal Land: The Arizona Department of Environmental QualihJ (ADEQ) issued a conditional Section 401 water qualihJ certification for RGP 63 dated October 24, 2013 for all waters of the United States on non-tribal lands in the State of Arizona, with the following exceptions: • Impaired Waters, as defined under Clean Water Act Section 303(d); • Non-Attaining Waters • Outstanding Arizona Waters, or • if the remediation or repair activity is not started within 30 days of the event causing the damage. 5 With the exception of these three categories of waters of the State and projects that cannot be initiated within 30 days of the event resulting in imminent threat to loss of life or properh;, the prospective permittee will be required to acquire an individual Section 401 water quality certification from the ADEQ. ADEQ maintains a list of impaired and non-attaining waters at: http:!lwww.azdeq.gov/environ/water/assessmentlassess.html ADEQ maintains a list of outstanding waters at: http:llwww.azdeq.gov/environ/water/standards/index.html ADEQ contact information: Mailing address: Arizona Department of Environmental Quality Surface Water Section, 401 Certifications, mailstop 5415A-1 1110 W. Washington St. Phoenix, AZ 85007 Telephone: (602) 771-4502 ADEQ CWA 401 Water QualihJ Certification of these activities to operate under the tenns ( including the conditions herein) of the applicable CoE CWA RGP does not affect or modifiJ in any way the obligations or liabilihJ of any person for any damages, injun;, or loss, resulting from these activities. T1zis Certification is not intended to waive any other federal, state or local laws. ADEQ's issuance of this Section 401 water qualihJ certification for RGP 63 does not imply or suggest that requirements for other state permits including, but not limited to Aquifer Protection Permits, Arizona Pollutant Discharge Elimination System permits, or Reclaimed Water permits are met or superseded. Prospective permittees should contact the ADEQ to ensure all applicable permits are obtained. Furthermore, ADE Q's certification relies on the following definitions: • Waters of the U.S. (WUS) are defined by the Corps of Engineers and the U.S. Environmental Protection Agene1; under the Clean Water Act. ADEQ's certification applies only to activities in any WUS. • Temporan; means not longer than the period of any project schedule. • Native material/fill is defined as pollutant-free soil, sand, gravel, etc. that constitutes the streambed or banks in the immediate area of the permitted work. • Emergene1; vehicles and emergene1; responders are not restricted In; the conditions in this certification. This State Water QualihJ Certification is issued by ADEQ under the authorihJ of Section 401(a) of the federal CWA (33 U.S.C. §1251 et seq.) and A.R.S. 49-202. The conditions listed below are in addition to conditions in pending CWA 404 RGP 63 SPL-2013-00609-BAH to be issued by the U.S. Army Corps of Engineers (CoE). These conditions are enforceable by CoE. Civil penalties up to a maximum of$25,000 per day of violation may be levied if these certification conditions are violated. Criminal penalties may also be levied if a person knowingly violates any provision of the CWA. 6 This certification is only for the activities described in the subject RGP and is valid for five years or the same period as the RGP, whichever is shorter. Any extensions or other modifications of the RGP will also require ADEQ review and may require modification of the 401 Certification. • The permittee shall provide a copy of these State 401 Water QualihJ Certification Conditions to all appropriate contractors and subcontractors. The permittee shall also post and maintain a legible copy of this certification letter in a weather-resistant location at the construction site where it may be seen by the workers. • The permittee shall notifiJ ADEQ of completion within 30 days after project completion. • The permittee is responsible for all activities certified herein and any exceedences of water qualihJ standards (WQS) in any WUS that such activities may cause or contribute to. Specific Conditions 1) Any discharge occurring as a result of activities certified for the subject project shall not cause an exceedence of WQS. ApplicabilihJ of this condition is as defined in A.A.C. R18-11-102. 2) This certification does not authorize the discharge of wastewater, process residues or other waste to any WUS. 3) Runoff and seepage from activities certified herein shall not cause an exceedence of Arizona WQS for any WUS. 4) Work shall be conducted and monitored to ensure that pollution from the activities certified herein does not cause an exceedence of Arizona WQS in any WUS. 5) Except as specified in the application and supporting documents and allowed, specified or not prohibited in the RGP or elsewhere in this certification, activities herein certified shall be performed during periods of low flow (baseflow or less) in any perennial WUS, or no flow in the case of ephemeral and intermittent WUS. No work shall be done, nor shall any equipment or vehicles enter any WUS while flow is present, unless all conditions in this certification are met. 6) The effectiveness of all pollution control measures, including those preventing erosion and sedimentation, shall be reevaluated after each flow event and repaired/modified as needed. 7) Permittee must minimize clearing, grubbing, scraping or otherwise limit exposure of erodible surface to the minimum necessary for each construction phase or location. 8) Except as specified in the application and supporting documents and allowed, specified or not prohibited in the RGP or elsewhere in this certification, if activities certified herein are likely to cause or contribute to an exceedence of water qualihJ standard, or create an impediment to the passage of fish or other aquatic life -operations shall cease until the problem is resolved or until control measures have been undertaken. 9) Except as specified in the application and supporting documents and allowed, specified or not prohibited in the RGP or elsewhere in this certification, erosion control, sediment control 7 and/or bank protection measures shall be installed before construction and pre-operation activities, and shall be maintained during construction and post-construction periods to minimize channel or bank erosion, soil loss and sedimentation. Control measures shall not be constructed of uncemented or unconfined imported soil, or other materials easily transported by flow. 10) For portions of the project utilizing potable water or groundwater for irrigation or dust control, direct runoff of such water shall be limited to the extent practicable and shall not cause downstream erosion or flooding. 11) The permittee is responsible for ensuring construction material and/or fill (other than native fill or that necessanJ to support revegetation) placed in any WUS, shall not include materials that can cause or contribute to pollution of the WUS. Examples of prohibited fill include pollutant-contaminated soil and materials defined as pollutants or hazardous in Arizona Revised Statutes (A.R.S.) § 49-201. Fill used to support vegetation rooting or growth shall be protected from erosion. Any washing of fill material must occur outside of any WUS prior to placement and the rinseate from such washing shall be settled, filtered or otherwise treated to prevent migration of pollutants (including sediment) or from causing erosion to any WUS. Other than replacement of native fill or material used to support vegetation rooting or growth, fill placed in locations subject to scour must resist washout whether such resistance is derived via particle size limits, presence of a binder, vegetation, or other armoring. Acceptable construction materials that will or may contact water in any WUS are: untreated logs and lumber; natural stone (crushed or not), crushed clean concrete (reciJcled concrete); native fill; precast, sprayed or cast-in-place concrete (including soil cement and unmodified grouts); steel (including galvanized); plastic and aluminum. Use of other materials may be allowed, but require written approval from ADEQ. 12) Any dredged material or waste material is to be placed and retained in areas outside any WUS. Runoff from this material/area is to be settled, filtered or otherwise treated to prevent migration of pollutants (including sediment) to any WUS. 13) Except as specified in the application and supporting documents and allowed, specified or not prohibited in the RGP or elsewhere in this certification, upon completion of construction the permittee shall ensure no adverse change, due to the subject project, has occurred in the stability with respect to stream hydraulics, erosion and sedimentation, of any WUS including upstream and downstream from the project. If such change has occurred, the permittee shall take steps to restore the pre-project stabilihJ of any impacted segments. 14) All disturbed areas shall be restored and revegetated as soon as physically practicable. Vegetation shall be maintained on unarmored banks and slopes to stabilize soil and prevent erosion. 8 15) If retention/detention basins are included in a project, permittee will complete the grading necessanJ to direct runoff towards retention/detention basins no later than immediately following initial land clearing or rough grading. Retention/detention basins shall be sized to accept storm runoff and capture sediment prior to it entering any WUS. Detention basins will provide detention through the use of controlled outflow spillways and shall cause no significant change to the hydraulic conditions of the upstream or downstream WUS outside of the project boundaries. The basins shall be maintained; e.g., lzave sediment removed, as required to maintain their function. 16) Except as specified in the application and supporting documents and allowed, specified or not prohibited in the RGP or elsewhere in this certification, when flow is present in any WUS within the project area, the permittee and any contractor will not alter the flow lnj any means except to prevent erosion or pollution of any WUS. 17) Silt laden or turbid water resulting from activities certified herein shall be settled, filtered or otherwise treated to ensure no violation of Arizona WQS in any WUS. 18) Wizen flow in any WUS in tlze work area is sufficient to erode, camJ or deposit material, activities certified herein shall cease until: • the flow decreases below the point where sediment movement ceases, or • control measures have been undertaken; e.g., equipment and materials easily transported lnj flow are protected with non-erodible barriers or moved outside the flow area. 19) Except as specified in the application and supporting documents and allowed, specified or not prohibited in the RGP or elsewhere in this certification, the permittee will erect any barriers, covers, shields and other protective devices as necessanJ to prevent any construction materials, equipment or contaminants/pollutants from falling, being thrown or otherwise entering any WUS. 20) The permittee must designate area(s) for equipment staging and storage located entirely outside of any WUS. In addition, the pennittee must designate areas, located entirely outside of any WUS, for fuel, oil and other petroleum product storage and for solid waste containment. All precautions shall be taken to avoid the release of wastes, fuel or other pollutants to any WUS. Any equipment maintenance, was/zing or fueling that cannot be done offsite will be performed in the designated area with the following exception: equipment too large or unwieldy to be readily moved; e.g., large cranes, may be fueled and serviced in the WUS (but outside of standing or flowing water) as long as material specifically manufactured and sold as spill containment is in place during fueling/servicing. All equipment shall be inspected for leaks, al/ leaks shall be repaired and all repaired equipment will be cleaned to remove any fuel or other fluid residue prior to use ·within (including crossing) any WUS. 9 Tize permittee shall have a spill containment plan onsite to ensure that pollutants are prevented from entering any WUS. Any pollutant generated by activities certified herein shall be properly disposed of in accordance with applicable regulations. A spill response kit will be maintained in this (these) area(s) to mitigate any spills. The kit will include material specifically manufactured and sold as spill adsorbent/absorbent and spill containment. The permittee will ensure that whenever there is activihJ on the site, that there are personnel on site trained in the proper response to spills and the use of spill response equipment. 21) Except as specified in the application and supporting documents and allowed, specified or not prohibited in the RGP or elsewhere in this certification, permanent and temporan; pipes and culverted crossings shall be adequately sized to handle expected flow and properly set with end section, splash pads, headwalls or other structures that dissipate water energy to control erosion. 22) All temporan; structures constructed of imported materials and all permanent structures, including but not limited to, access roadways; culverted and unculverted crossings; staging areas; material stockpiles; berms, dikes and pads, shall be constructed so as to accommodate overtopping and must resist washout of the feature by stream flow. Any temporary crossing, other than fords on native material, shall be constructed in such a manner so as to provide armoring of the stream channel. Materials used to provide this armoring shall not include anything easily transportable by flow. Examples of acceptable materials include steel plates, untreated wooden planks, pre-cast concrete planks or blocks; examples of unacceptable materials include clay, silt, sand and gravel finer than cobble (roughly fist-sized). The armoring must, via mass, anchoring systems or a combination of the two, resist washout. Permittee will take measures necessan; to prevent approaches to any WUS crossing from causing erosion or contributing sediment to any WUS. No vehicles or equipment shall ford any unarmored WUS crossing when flow greater than baseflow is present. Any ford, other than fords on native material, shall be designed, and maintained as necessan;, to earn; the proposed traffic without causing erosion or sedimentation of the stream channel while dry or during a flow event equal to or less than the crossing's design event. No unarmored ford shall be subject to heavy-truck or equipment traffic after a flow event until the stream bed is dry enough to support the traffic without disturbing streambed material to a greater extent than in dnJ conditions. Light vehicles (less than 14,000 pounds gross weight) are not restricted by this condition. 23) Temporan; structures constructed of imported materials are to be removed no later than upon completion of the permitted activihJ- 10 24) TemporanJ structures constructed of native materials, if they provide an obstacle to flow or can contribute to or cause sedimentation or erosion, are to be removed no later than upon completion of the permitted activihJ. 25) Upon completion of the activities certified herein (except as noted in condition 26 ---concrete curing), areas within any WUS shall be promptly cleared of all forms, piling, construction residues, equipment, debris or other obstructions. Washout of concrete handling equipment must not take place within any WUS and any washout runoff shall be prevented from entering any WUS. 26) If fully, partially or occasionally submerged structures are constructed of cast-in-place concrete instead of pre-cast concrete, pem1ittee will take steps; e.g., sheet piling or temporanJ dams, to prevent contact between water (instream and runoff) and the concrete until it cures and until any curing agents have evaporated or otherwise cease to be available; i.e., are no longer a pollutant threat. Where possible, construction work ·will be during extreme low water conditions or at a time and season with the highest probability of ensuring work is done in "thednf'. 27) Any permanent WUS crossings other than fords, shall not be equipped with gutters, drains, scuppers or other conve11ances that allow untreated runoff (due to events equal to or lesser in magnitude than the design event for the crossing structure) to directly enter a WUS if such runoff can be directed to a local stormwater drainage, containment and/or treatment system. 28) Pennittee will clear debris as needed from culverts, ditches, dips and other drainage structures in any WUS to prevent clogging or conditions that may lead to washout. END OF ADEQ SECTION 401 WATER QUALITY CERTIFICATION CONDITIONS CALIFORNIA The SWRCB issued its conditional certification (File No. SB13006IN) on November 25, 2013. As with previous reissuances of the RGP, conditions within issued Section 401 certifications are included within the body of the RGP to facilitate dissemination of information to permittees regarding water quality certifications for work authorized under RGP 63. The SWRCB's water quality conditions are adopted within this permit as RGP 63 General Conditions. For California Pennittees on Non-tribal Land: The State Water Resources Control Board (SWRCB) issued a conditional Section 401 water qualihJ certification for RGP 63 dated November 25, 2013 for all waters of the United States on non-tribal lands Los Angeles District in the State of California, with the following exception: The State's certification does not apply to any discharge from any activihJ involving a hydroelectric facilihJ requiring a Federal EnergiJ Regulatory Commission (FERC) license or an amendment to a FERC license unless the pertinent Certification application was filed pursuant to title 23 of the California Code of Regulations subsection 3855(b) and the application specifically identified that a FERC license or amendment to a FERC license for a hydroelectric facilihJ was being sought. 11 The SWRCB's certification for Regional General Permit No. 63 for Emergency Situations, SB13006IN,is contingent on all of the conditions listed below being met, and any discharge from an authorized project being in compliance with applicable provisions of Clean Water Act sections 301 (Effluent Limitations), 302 (Water Quality Related Effluent Limitations), 303 (Water QualihJ Standards and Implementation Plans), 306 (National Standards of Performance), and 307 (Toxic and Pretreatment Effluent Standards). Discharges covered under this certification are also regulated pursuant to State Water Board Water Quality Order No. 2003-0017-DWQ which authorizes the State's certification to serve as Waste Discharge Requirements pursuant to the Porter-Cologne Water Quality Control Act. (Wat. Code, § 13000 et seq.) Except as modified In; any of the certification conditions below, all certification actions are contingent on (a) the discharge being limited and all proposed mitigation being completed in strict compliance with the conditions of the certification and the attachments to the certification, and (b) compliance with all applicable requirements of Statewide Water QualihJ Control Plans and Policies and the Regional Water Boards' Water Quality Control Plans and Policies. Regional Water QualihJ Control Plan Information Water qualih; standards and control measures for the Regional Water Qualih; Control Boards (Regional Water Board) are contained in the Water QualihJ Control Plan (Basin Plan) for each region. The Basin Plan designates the beneficial uses for all surface and ground waters within the Regional Water Board's jurisdiction and is the master water quality control planning document. The beneficial uses of water specifically identified in the Basin Plan generally apply to all of its tributaries. The receiving waters and beneficial uses of waters potentially impacted by this Project are located on the appropriate Regional Water Board website. The Basin Plan information may be obtained from the State Water Board's website: http://www.waterboards.ca.gov/. A. Standard Conditions 1. This Certification action is subject to modification or revocation upon administrative or judicial review, including review and amendment pursuant to section 13330 of the California Water Code and section 3867 of title 23 of the California Code of Regulations. 2. This Certification action is not intended and must not be construed to apply to any discharge from any activihJ involving a hydroelectric facilihJ requiring a Federal Energi; Regulaton; Commission (FERC) license or an amendment to a FERC license unless the pertinent Certification application was filed pursuant to title 23 of the California Code of Regulations subsection 3855(b) and the application specifically identified that a FERC license or amendment to a FERC license for a hydroelectric facilihJ was being sought. 3. This Certification is conditioned upon full payment of any fee required under California Code of Regulations, chapter 28, title 23, and owed by the Applicant. 12 B. General Conditions 1. This Certification is limited to emergenctJ actions that meet the California Environmental QualihJ Act (CEQA) (Public Resources Code, § 21000 et seq.) definition of an "emergenct;," which is defined as follows: A sudden, unexpected occurrence, involving a clear and imminent danger, demanding immediate action to prevent or mitigate loss of, or damage to, life, health, properhJ, or essential public services. Emergene1; includes such occurrences as fire, flood, earthquake, or other soil or geologic movement, as well as such occurrences as riot, accident, or sabotage. (Pub. Resources Code, § 21060.3.) Enzergenct; actions must meet the above definition of" emergenct/' and demonstrate an imminent threat to qualiftJ for this Certification. For actions that do not qualiftJ for enrollment under this Certification, the discharger (i.e. the person or entihJ proposing to conduct actions which may result in a discharge to a water of the state) must contact either the State Water Board or the applicable Regional Water Board to apply for an individual water qualihJ certification. 2. This Certification is limited to emergenctJ actions that satisfiJ one or more of the following exemption criteria as defined by the CEQA Guidelines (Cal. Code Regs., tit. 14, § 15269.): a. Projects to maintain, repair, restore, demolish, or replace properhJ or facilities damaged or destroyed as a result of a disaster in a disaster stricken area in which a state of emergenctJ has been proclaimed by the Governor pursuant to the California EmergenctJ Services Act, commencing with section 8550 of the Government Code. b. EmergenctJ repairs to publicly or privately owned service facilities necessan; to maintain service essential to the public health, safehJ, or welfare. c. Specific actions necessan; to prevent or mitigate an emergency. This does not include long-term projects undertaken for the purpose of preventing or mitigating a situation that lzas a low probabilihJ of occurrence in the short- tenn. d. Projects undertaken, carried out, or approved by a public agenci; to maintain, repair, or restore an existing highway damaged blj fire, flood, storm, earthquake, land subsidence, gradual earth movement, or landslide, provided that the project is within the existing right of way of that highway and is initiated within one year of the damage occurring. This does not apply to highways designated as official State scenic highways, nor any project undertaken, carried out, or approved by a public agenctJ to expand or widen a highway damaged bl; fire, flood, storm, earthquake, land subsidence, gradual earth movement, or landslide. 13 e. Seismic work on highways and bridges pursuant to section 180.2 of the Streets and Highways Code, section 180 et seq. 3. This Certification is limited only to sudden, unexpected emergenci; situations defined in General Conditions 1 and 2 above that: (1) have occurred, or (2) have a high probabilihJ of occurring in the short term as a result of recently discovered factors or events not related to known or expected conditions. Additionally, the sudden, unexpected emergency situation must have the potential to result in an unacceptable hazard to life or a significant loss of properhJ if corrective action is not undertaken within a time period less than the normal time needed to process an application under standard procedures. 4. Emergenci; repairs and reconstruction must begin within fourteen (14) calendar days of receiving authorization to proceed and shall be completed within one year of enrollment pursuant to this Certification. All repairs and reconstruction shall be kept to the minimum necessan; to alleviate the immediate emergenci; and limited to in-kind replacement or refurbishment of on-site features. Minor upgrading may be considered if a discharger uses bioremediation or other environmentally sensitive solutions. Permanent restoration work other than that performed as an associated part of the emergency actions, including any minor upgrades, shall not be performed without prior approval and authorization by the State Water Board or the applicable Regional Water Board. C. Administrative Conditions 1. Water Quality Standards Maintained Permitted actions must not cause a violation of any applicable water qualihJ standards, including impairment of designated beneficial uses for receiving waters as adopted in the Basin Plan by a Regional Water Board or a State Water Board water qualihJ control plan or policiJ-11ze Water Boards may impose monitoring requirements at any time in order to ensure that permitted discharges and activities comport with any applicable water qualihJ standards and/or effluent limitations. 2. California Endangered Species Act Permitted actions shall not result in the taking of any State endangered species, threatened species, or candidate species, or the habitat of such a species unless the activihJ is authorized by the California Department of Fish and Wildlife pursuant to a permit, memorandum of understanding, or other document or program in accordance with Fish and Game Code sections 2081, 2081.1, or 2086. 3. Project Site Access Water Boards staff or an authorized representative, upon presentation of credentials and other documents as may be required by law, shall be granted permission to enter the dischargers' site(s) at reasonable times, to ensure compliance with the terms and conditions of this Certification and/or to determine the impacts the discharge may have on waters of the state. 14 4. Compliance Failure to comply with any condition of this Certification shall constitute a violation of the Clean Water Act and the Porter-Cologne Water Quality Control Act. Any activities enrolled pursuant to this Certification previously granted, shall immediately be revoked and any or all discharges shall cease. The Applicant and/or the discharger may then be subject to administrative and/or civil liabilihJ pursuant to Water Code section 13385. D. Best Management Practices (BMPs) 1. At all times, appropriate h;pes and sufficient quantities of materials shall be maintained on-site to contain any spill or inadvertent release of materials that may cause a condition of pollution or nuisance if the materials reach waters of the United States and/or state. 2. Fueling, lubrication, maintenance, storage, and staging of vehicles and equipment must not result in a discharge to any waters of the state, and shall be located outside of waters of the state in areas where accidental spills are not likely to enter or affect such waters. 3. If construction related materials reach surface waters, appropriate spill response procedures must be initiated as soon as the incident is discovered. In addition, the State Water Board and applicable Regional Water Board staffs shall be notified pursuant to subsection VII (C) of this Certification within twenty-four (24) hours of the occurrence. 4. Construction materials and debris from all construction work areas shall be removed following completion of the emergenci; actions. 5. Water diversion activities must not result in the degradation of beneficial uses or exceedance of water quality objectives of the receiving waters. Any temporan; dam or other artificial obstruction constructed must only be built from materials such as clean gravel which will cause little or no siltation. Normal flows must be restored to the affected stream immediately upon completion of work at that location. 6. All necessan; BMPs to control erosion and runoff from areas associated with the emergenci; actions shall be implemented. All areas of temporan; impacts and all other areas of temporan; disturbance which could result in a discharge or a threatened discharge to waters of the United States and/or state shall be restored to pre-disturbance conditions. Restoration must include grading of disturbed areas to pre-project contours and revegetation with native species. 7. The revegetation palette must not contain any plants listed on the California Invasive Plant Council Invasive Plant Inventon;, which can be found online at: http:llwww.cal-ipc.org!ip!inventory!weedlist.php. 15 Mitigation Pemzitted activities must first avoid and then minimize adverse impacts on aquatic resources to the maximum extent practicable. Any remaining unavoidable adverse impacts to the aquatic resources may be offset by compensatonJ mitigation requirements in accordance with the conditions of RGP 63. Emergency Notification and Fee Requirements A. Tize State Water Board and the applicable Regional Water Board must receive notification by the discharger at least 48 hours prior to initiating emergenCIJ actions. Tizis notification must be followed within three (3) business days by submission of all of the information in the EmergenCIJ Notification Form (Attachment D). The Certification fee must be submitted with Attachment D in accordance with California Code of Regulations, title 23, section 2200 ($145.00 as of October, 2013; this amount is subject to change annually). Failure to promptly pay the correct fee amount may result in an inabilihJ to be enrolled pursuant to this Certification. B. Tize Water Boards recognize there may be situations where imminent threats to life or property occur and the discharger has not received a notice to proceed. If immediate, specific actions, as defined in the California Code of Regulations, title 14, section 15269( c), are required by a discharger and prior notice to the State Water Board and the applicable Regional Water Board is not possible, then the discharger must contact the State Water Board and the applicable Regional Water Board within one (1) business day of the emergenCIJ action. This notification must be followed within three (3) business days by submission of all of the information in the EmergenCIJ Notification Fann (Attachment D). C. Notification may be via telephone, facsimile, e-mail, delivered written notice, or other verifiable means. A staff directory that includes contact information for the State and Regional Water Boards is found at: http :I lwww. wa terboards. ca. govlwa ter _ issues/programs/ cwa401 I docs/ s taffdirectonJ. pdf For Regional Water Board map boundaries, see: http://www. waterboards. ca.gov!waterboards _map.shtml For State Water Board Phone: (916) 341-5455 (Division of Water Qualihj) Fax: (916) 341-5463 (Attention: Manager CWA Section 401 WQC Program) Email: Stateboard401@waterboards.ca.gov (Subject: RGP 63) Written notice should be sent to the following addresses: ATTN: Manager CWA Section 401 WQC Program Division of Water QualihJ 16 State Water Resources Control Board 1001 I St. 15th Floor Sacramento, CA 95814 ATTN: Manager CWA Section 401 WQC Program Insert address of appropriate Regional Water Board, obtained from: http://www.waterboards.ca.gov/water _issueslprograms!cwa401/docs!staffdirectonJ.pdf Final Reporting Requirements A. The discharger must provide the State Water Board and the applicable Regional Water Board copies of all correspondence and reports that are submitted to the Corps to satisfiJ the requirements of RGP 63. In addition, the discharger must fill in and submit the form provided in Attachment E. This information must be submitted within 45 calendar days of completion of any emergency actions conducted under RGP 63. B. Failure to submit Attachment E within 45 calendar days of completion of any emergenC1J actions conducted under this Certification may result in the imposition of administrative and/or civil liability pursuant to Water Code section 13385. C. Electronic submission of all reporting requirements is preferred, however the Final Report Form (Attachment E), must be completed and submitted as a pdf with a valid signature. END OF SWRCB SECTION 401 WATER QUALITY CERTIFICATION CONDITIONS 8. Coastal Zone Management: For those projects affecting uses or resources of the coastal zone, the Federal Coastal Zone Management Act (CZMA) requires that the permittee obtain concurrence from the California Coastal Commission that the project is consistent with the State's certified Coastal Management Program. For activities within the coastal zone that require a coastal development permit from the commission, the permittees should contact the Commission office to request an emergency permit, and no additional federal consistency review is necessary. For activities within the coastal zone that require a coastal development permit from a local government with a certified local coastal program, the permittee should contact the appropriate local government. Because a coastal permit issued by a local agency does not satisfy the federal consistency requirements of the CZMA, the permittee should also contact Larry Simon, Federal Consistency Coordinator for the Commission, at 415-904-5400 to determine the appropriate emergency procedures. For any activity outside the coastal zone, but with the potential to affect coastal uses or resources, or for any activity conducted by a federal agency, the permittee should contact Larry Simon, Federal Consistency Coordinator for the Commission at 415-904-5400 to determine the appropriate emergency procedures. Due to the often limited time constraints with emergency actions, the Corps would not require the permittee to provide proof of review by the Commission, if such an action would result in undue harm to life or property. However, the Corps will require the permittee to provide evidence of consistency upon completion of the project unless the Corps is already 17 aware that a particular project, class of projects, or projects in a particular area described by the Commission, have received such determinations or waivers. Disposal of flood-delivered sediments into the marine environment is not authorized under RGP 63 due to potential adverse effects to the habitat and water quality. If such activity is proposed, it shall be addressed through other permitting procedures. 9. Endangered Species: No activity is authorized under this RGP which is likely to jeopardize the continued existence of a threatened or endangered species or destroy or adversely modify designated critical habitat as identified under the Federal Endangered Species Act (ESA). Authorization of an activity by the RGP does NOT authorize the "take" of a listed threatened or endangered species, as defined under the Federal ESA. The U.S. Fish and Wildlife Service and/or National Marine Fisheries Service may provide project-specific recommendations to avoid or minimize potential take of listed species or adverse modification of designated critical habitat. The Corps would remain the final arbiter regarding the degree to which the recommendations would be incorporated into the emergency authorization. Information on the location of listed or proposed threatened or endangered species and their designated or proposed critical habitat can be obtained directly from the FWS or NMFS or from their websites at: USFWS -http://www.fws.gov/endangered/ NMFS-http://www.nmfs.noaa.gov/pr/species/ 10. Historic Properties: Impacts to historic properties listed, proposed for listing, or potentially eligible for listing in the National Register of Historic Places will be avoided to the maximum extent practicable. If such resources are impacted because of actions authorized under this RGP, the permittee shall provide a full report of the action and the impacts incurred by the resource to this office within 45 days after completion of the action. The Corps, the State and Tribal Historic Preservation Officers, and/or the Advisory Council for Historic Preservation will then jointly make a determination as to appropriate procedures and/or mitigation to be addressed. If you discover any previously unknown historic or archeological remains while accomplishing the activity authorized by this RGP, you must immediately notify the Corps Regulatory Branch who will initiate the Federal and State coordination required to determine if the remains warrant a recovery effort or if the site is eligible for listing in the National Register of Historic Places. 11. Regional and Case-by-Case Conditions: The activity must comply with any regional conditions added by the Division Engineer (see CFR Part 330.4(e)) and with any case-specific conditions added by the District Engineer. 12. Erosion and Siltation Controls: Every effort must be made to ensure any material dredged or excavated from Waters of the United States is not likely to be washed back into any Waters of the United States. When feasible, erosion and siltation controls, such as siltation or turbidity curtains, sedimentation basins, and/or straw bales or other means designed to minimize turbidity in the watercourse above background levels existing at the time of construction, shall be used and maintained in effective operating condition during construction unless conditions preclude their use, or if conditions are such that the proposed work would not increase turbidity levels above the background level existing at the time of the work. All exposed soil 18 and other fills, as well as any work below the ordinary high water mark or high tide line, must be stabilized at the earliest practicable date to preclude additional damage to the project area through erosion or siltation. 13. Equipment: When feasible, and if personnel would not be put into any additional potential hazard, heavy equipment working in wetlands must be placed on mats, or other measures must be taken to minimize soil disturbance, such as use of wide-treaded equipment or floatation devices. 14. Suitable Material: No discharge of dredged or fill material may consist of unsuitable material (e.g., trash, debris, car bodies, asphalt, etc.) and material discharged must be free from toxic pollutants in toxic amounts. (See Section 307 of the Clean Water Act) 15. Wild and Scenic Rivers: No activity may occur in a component of the National Wild and Scenic River System, or in a river officially designated by Congress as a "study river" for possible inclusion in the system while that river is in an official study status, unless the Federal agency with direct management responsibility for that river has determined in writing that the proposed activity would not adversely effect the Wild and Scenic River designation or study status. Information on Wild and Scenic Rivers may be obtained from the Federal land management agency in the area (e.g., FWS, National Park Service, USDA Forest Service, Bureau of Land Management). Designated Wild and Scenic River segments in the Los Angeles District include the following: CALIFORNIA Bautista Creek, from the San Bernardino National Forest boundary in Section 36, T6S, R2E to the San Bernardino National Forest boundary in Section 2, T6S, RlE. (9.8 miles; USDA Forest Service) Palm Canyon Creek, from the southern boundary of Section 6, T7S, R5E to the San Bernardino National Forest boundary in Section 1, T6S, R4E. (8.1 miles; USDA Forest Service) Fuller Mill Creek, from the source of Fuller Mill Creek in the San Jacinto Wilderness to its confluence with the North Fork San Jacinto River. (3.5 miles; USDA Forest Service) San Jacinto River (North Fork), from the source of the North Fork San Jacinto River at Deer Springs in Mt. San Jacinto State Park to the northern boundary of Section 17, T55, R2E. (10.2 miles; USDA Forest Service) Piru Creek, from 0.5 miles downstream of Pyramid Dam at the first bridge crossing to the boundary between Los Angeles and Ventura Counties. (7.3 miles; USDA Forest Service) Sespe Creek, the main stem from its confluence with Rock Creek and Howard Creek downstream to where it leaves Section 26, T5N, R20W. (31.5 miles; USDA Forest Service) 19 Sisquoc River, from its origin downstream to the Los Padres National Forest boundary. (33.0 miles; USDA Forest Service) Cottonwood Creek in the White Mountains, Inyo County, from its headwaters at the spring in Section 27, T4S, R34E to the northern boundary of Section 5, T4S, R34E. (21.5 miles; USDA Forest Service) Owens River Headwaters, Deadman Creek from the two-forked source east of San Joaquin Peak to 100 feet upstream of Big Springs; the upper Owens River from 100 feet upstream of Big Springs to the private property boundary in Section 19, T2S, R28E; and Glass Creek from its two-forked source to its confluence with Deadman Creek. (19.1 miles; USDA Forest Service) ARIZONA Fossil Creek, from the confluence of Sand Rock and Calf Pen Canyons to its confluence with the Verde River. (16.8 miles; USDA Forest Service) Verde River, from the section line between Section 26 and 27, T13N, R5E, Gila-Salt River meridian to the confluence of Red Creek with the Verde River in Section 34, T9 l/2N, R6E. (40.5 miles; USDA Forest Service) 16. Aquatic Life Movements: No activity may substantially disrupt the movement of those species of aquatic life indigenous to the water body, including those species that normally migrate through the area. Culverts placed in streams must be installed to maintain low flow conditions. For coastal watersheds in Los Angeles District known to harbor one or more life stages of anadromous salmonid fishes (e.g., steelhead or salmon), all projects requiring replacement of culverts under road crossings shall consider a bridge crossing design that ensures passage and/or spawning of these species is not hindered in any way. In these areas, bridge designs that span the stream or river, including designs for pier-or pile-supported spans, or designs based on use of a bottomless arch culvert simulating the natural stream bed (i.e., substrate and strearnflow conditions in the culvert are similar to undisturbed stream bed channel conditions) shall be employed unless it can be demonstrated the stream or river does not support resources important to anadromous salmonids, including migration of adults and smolts, or rearing and spawning. 17. Shellfish Production: No discharge of dredged or fill material may occur in areas of concentrated natural or commercial shellfish production, unless the discharge is directly related to a shellfish harvesting activity authorized by the Corps' Nationwide Permit (NWP) 4. 18. Spawning Areas: Discharges in spawning areas during spawning seasons must be avoided to the maximum extent practicable. 19. Waterfowl Breeding Areas: Discharges into breeding areas for migratory waterfowl must be avoided to the maximum extent practicable. 20 20. Navigation: No activity may cause more than a minimal adverse effect on the course or capacity of a navigable water. The permittee shall agree that, if future operations by the United States require the removal, relocation, or other alteration of the structure or work herein authorized, or if, in the opinion of the Secretary of the Army or his authorized representative, said structure or work shall cause unreasonable obstruction to the free navigation of the navigable waters, the permittee will be required, upon due notice from the Corps of Engineers, to remove, relocate, or alter the structural work or obstructions caused thereby, without expenses to the United States. No claim shall be made against the United States on account of any such removal or alteration. 21. Water Supply Intakes: No discharge of dredged or fill material may occur in the proximity of a public water supply intake except where the discharge is for repair of the public water supply intake structures or adjacent bank stabilization. 22. Obstruction of High Flows: To the maximum extent practicable, discharges must not permanently restrict or impede the passage of normal or expected high flows or cause the relocation of the water except within the existing river plain unless the primary purpose of the fill is to impound waters. 23. Adverse Effects from Impoundments: If the discharge creates an impoundment of water, adverse effects on the aquatic system caused by the accelerated passage of water and/or the restriction of its flow shall be minimized to the maximum extent practicable. 24. Proper Maintenance: Any structure or fill authorized by this RGP shall be maintained, including maintenance to ensure public safety, unless it is later determined that the structure is further contributing to other adverse conditions to private or public property. In such situations, corrective measures will be taken to rectify these adverse conditions, including removal and/or redesign of the original emergency corrective action, or appropriate mitigation as determined through coordination with you and the appropriate Federal and State agencies. Temporary levees constructed to control flows shall not be maintained beyond the current storm season (i.e., maintenance of temporary levees is not authorized after the storm season in which the need arose). 25. Removal of Temporary Fills: Temporary fills shall be removed in their entirety and the affected areas returned to pre-existing elevations and revegetated with appropriate native riparian or wetland vegetation common to the area. If an area impacted by such a temporary fill is considered likely to naturally re-establish native riparian or wetland vegetation to a level similar to pre-project or pre-event conditions within two years, you will not be required to do so. 26. Reports: You shall provide a concise written report to this office as soon as practicable (within 45 days of completing the project) after completion of any action conducted under this RGP. PROVIDING THIS REPORT IS MANDATORY. This office has additional responsibilities pursuant to consultation with the FWS and NMFS under Section 7 of the ESA. Further, these reports enable us to track the use of this RGP to verify that the minimal effects determination is being met as required by Section 404(e) of the CW A. Failure to provide timely reports 21 following responses to emergencies is non-compliance with the General Conditions of this RGP and would be considered a violation (33 CFR Part 326.4(d)). At a minimum the Report shall include the following: I. The name, address, e-mail address and telephone number of: 1. the applicant, and 2. the applicant's agent (if appropriate) II. Full description of the activity including: 1. description of the emergency and the potential for loss of life or property; 2. purpose of the activity; 3. final goal of the entire activity; 4. location (e.g., latitude/longitude or UTM coordinates; section/township/range on appropriate USGS topo map; electronic map images; Thomas Guide map; or other source to accurately portray project location); 5. size and description of project area (include maps or drawings showing the areal and lineal extent of the project, and pre-and post-construction photographs); 6. quantities of materials used; 7. information on receiving waterbody impacted including: a) name of waterbody b) type of receiving waterbody (e.g., river/streambed, lake/reservoir, ocean/estuary/bay, riparian area, wetland type, etc.) c) temporary/permanent adverse impact(s) in acres/cubic yards/linear feet d) compensatory mitigation in acres/cubic yards/linear feet e) other mitigation steps (to avoid, minimize, compensate); and 8. information on federally listed or proposed endangered species or designated or proposed critical habitat (notification must be provided to FWS and/or NMFS as appropriate) including: a) temporary/permanent adverse impacts b) compensatory mitigation c) other mitigation steps (to avoid, minimize, compensate). If there are a substantial number of projects and this requirement would consume large quantities of your staff resources, you may, as an option, submit a comprehensive report providing all of the information requested above. If the project was conducted in an area known to harbor Federally listed or proposed endangered species or designated or proposed critical habitat, you must include a list of measures taken to minimize harm to the species and/or habitat and include an additional copy of the report for the FWS and/or the NMFS, as appropriate. If mitigation was determined to be appropriate for a specific project or group of projects, a mitigation proposal must be submitted to this office for review and approval. FURTHER INFORMATION: 1. Congressional Authorities: Activities conducted under this RGP are authorized pursuant to: (X) Section 10 of the River and Harbor Act of 1899 (33 U.S.C. 403). (X) Section 404 of the Clean Water Act (33 U.S.C. 1344). 22 2. Limits of authorization under RGP 63: a. This permit does not obviate the need to obtain other Federal, State, or local authorizations required by law. b. This permit does not grant any property rights or exclusive privileges. c. This permit does not authorize any injury to the property or rights of others. d. This permit does not authorize interference with any existing or proposed Federal project. 3. Limits of Federal Liability: In issuing this permit, the Federal Government does not assume any liability for the following: a. Damages to the permitted project or uses thereof as a result of other permitted or unpermitted activities or from natural causes. b. Damages to the permitted project or uses thereof as a result of current or future activities undertaken by or on behalf of the United States in the public interest. c. Damages to persons, property, or to other permitted or unpermitted activities or structures caused by the activity authorized by this permit. d. Design or construction deficiencies associated with the permitted work. e. Damage claims associated with any future modification, suspension, or revocation of this permit. 4. Reliance on Applicant's Data: The determination of this office that issuance of verification under RGP 63 is not contrary to the public interest was made in reliance on the information provided by the permittee. 5. Reevaluation: This office may reevaluate its decision to issue this RGP, or on the verification that any particular activity qualifies for this RGP, at any time circumstances warrant. Circumstances that could require a reevaluation include, but are not limited to, the following: a. You fail to comply with the terms and conditions of this permit. b. The information provided by you in support of your permit verification request or after- action report proves to have been false, incomplete, or inaccurate. See Item 4 above. c. Significant new information surfaces which this office did not consider in reaching the original public interest decision. Such a reevaluation may result in a determination that it is appropriate to use the suspension, modification, and revocation procedures contained in 33 CFR 325.7 or enforcement procedures such as those contained in 33 CFR 326.4 and 326.5. The referenced enforcement procedures provide for the issuance of an administrative order requiring you to comply with the terms and conditions of your permit and for the initiation of legal action where appropriate. You will be required to pay for any corrective measures ordered by this office, and if you fail to comply with such directive, this office may, in certain situations (such as those specified in 33 CFR 209.170), accomplish the corrective measures by contract or otherwise and bill you for the cost. This permit becomes effective when the Federal official, designated to act for the Secretary of the Army, has signed below. 23 DAVID J. CASTANON Chief, Regulatory Division 24 29 Nov 2013 DATE LEGEND: ~ -t 0 1°20 40 EXISTING ACCESS GATE LOCATION OF REPAIR AREA CONCRETE DELIVERY AND PUMP LOCATION INGRESS AND EGRESS ROUTE ' 120 =•·-.a- l'!A5T S IDI! Attachment 8 1----..,,__---+----•Ntt------, I ]w_l .T M C\.AN A ~ 0 R C11Nl~ i I -~-' • I • i :<-r-..------------i· ' . -:sE.CTION B-B EXISTING CONDITION PER DWG. 152-8 HEIGHT FT 8 SECTION B-B REPAIR AREA ESTIMATED QUANTITIES SPAN WIDTH VOID VOLUME FT FT CY 20 9 27 "AS BUILT" RCE __ EXP----OAT[ RE\'IE'IIED BY: ~SPECTOR DATr KELLY CHANNEL EMERGENCY REPAIR STORM WATER POLLUTION PREVENTION NOTES 1. ALL NECESSARY EQUIPMENT AND MATERIALS SHALL BE AVAILABLE ON SITE TO FACILITATE RAPID INSTALLATION OF EROSION AND SEDIMENT CONTROL BMPs WHEN RAIN IS EMINENT. 2. THE OWNER/CONTRACTOR SHALL RESTORE ALL EROSION CONTROL DEVICES TO WORKING ORDER TO THE SATISFACTION OF THE CITY INSPECTOR AFTER EACH RUN-OFF PRODUCING RAINFALL 3. THE OWNER/CONTRACTOR SHALL INSTALL ADDITIONAL EROSION CONTROL MEASURES AS MAY BE REQUIRED BY THE CITY INSPECTOR DUE TO INCOMPLETE GRADING OPERATIONS OR UNFORESEEN CIRCUMSTANCES WHICH MAY ARISE. 4. ALL REMOVABLE PROTECTIVE DEVICES SHALL BE IN PLACE AT THE END OF EACH WORKING DAY WHEN THE FIVE (5) DAY RAIN PROBABILITY FORECAST EXCEEDS FORTY PECENT ( 40%). SILT AND OTHER DEBRIS SHALL BE REMOVED AFTER EACH RAINFALL. 5. ALL GRAVEL BAGS SHALL CONTAIN 3/4 INCH MINIMUM AGGREGATE. 6. ADEQUATE EROSION AND SEDIMENT CONTROL AND PERIMETER PROTECTION BEST MANAGEMENT PRACTICE MEASURES MUST BE INSTALLED AND MAINTAINED. 7. THE CITY INSPECTOR SHALL HAVE THE AUTHORITY TO ALTER THIS PLAN DURING OR BEFORE CONSTRUCTION AS NEEDED TO ENSURE COMPLIANCE WITH CITY STORM WATER QUALITY REGULATIONS. OWNER'S CERTIFICATE: I UNDERSTAND AND ACKNOWLE!JGE 11-IAT I MUST: (1) IMPLEMENT BEST MANAGEMENT PRACTICES (BMPS) DURING CONSTRUCTION ACTIVITIES TO 11-IE MAXIMUM EXTENT PRACTICABLE TO AVOID 11-IE MOBIUZA TION OF POl.lUT ANTS SUCH AS SEDIMENT AND TO AVOID 11-IE EXPOSURE OF STORM WATER TO CONSTRUCTION RELATED POLLUTANTS; AND (2) ADHERE TO, AND AT ALL TIMES, COMPLY W111-I 11-IIS CITY APPROVED TIER 1 CONSTRUCTION SWPPP 11-IROUGHOUT 11-IE DURATION OF 11-IE CONSTRUCTION ACTIVITIES UNTIL 11-IE CONSTRUCTION WORK IS COMPLETE AND APPROVED BY 11-IE CITY Of CARLSBAD. Daniel Zimny O\liNER(S)/OVINER'S AG~ O'IIN~ AGE~RE) E-29 Attachment C STORM WATER COMPLIANCE FORM TIER 1 CONSTRUCTION SWPPP E-29 BEST MANAGEMENT PRACTICES (BMP) SELECTION TABLE CB SW Erosion Control Sediment Control BMPs Tracking Non-Sloon Water Waste Management and Materials BMPs ConlrolBMPs Management BMPs Pollution Control BMPs :3 :3 6 i il " "' :g " " ., C ] I C: .5 "' E C Ii C 0 .!2 "E ·i 0 " 0 i " " >, ~ '"' " ., "' I; ? ,!; " "' C .. "' "" ! .5 'E £ ~ ~ C ~ u L,.J ~ !l .!2 0 'l;; Best Management Practice' ,'d .5 015 ., a, a. 0 !l c -;,:c i] ij :J Ji ·'= \j al"' ,g s u ~ u 5., " ., i " 'i 2 2 li (BMP) Description • .. ., g ~~ "' C C :, ~ H '3 "" .. E <.> c C 'a a, il~ aa " "' -.. .. 2!; '"' C .. ~ ~-~ f !~ ue ~l Cc,, ii .. a:: ~~ ~~ en~ "ti-~ ]§--~ t ct~ " .. bg ~ '8 t-~ " LL ~ ~ l! t:, ~g ~ti Ii ii '=~ " " a g a. iii 1:;_g ., & ~ <.> ""' i~ 'l, 'l, 0 ~a ~ 0 "E 0 ., t5 ~ _., " ;,: we (;I iJ5 Vl V'l> V') iii~ ii,.: V'l<>: o,_ >u '"'"' 2 ii, &u "''"' CASQA Oesignation """'7 r--00 0, ,., ... "' "' r--00 0 N ' ,,, r--00 ' N ,., ... "' I I I ' ' I I I I I I ' ' I I I I I I I I u u u u L,.J Ill IJ,j L,.J L,.J IJ,j L,.J IJ,j g; g; V') Vl (/) (/) ii ii ii i i Construction Activity L,.J ..... L,.J L,.J V') V') (/) V') z z z z Gradlna/Soil Disturbance Trenchina/Excavation StockoTiina Dn1llna/Borlna Concrete/ Asphalt Sawcuttinq Concrete Flatwonc --- - -Pavina Conduit/Pipe Installation Stucco/Mortar Wor1< Waste Disposal Staoina It av Down Area -- - -Eouipment Maintenance and Fuelina Hazardous Substance Use/Storooe Dewaterlno --Site Access Across Dirt Other (listl: Instructions: 1. Check the box to the left of all applicable construction octivi\y (first column) expected to occur during construction. 2. Located along the top of the BMP Tobie is a list of BMP's with it's corresponding California Stormwater Quality Association (CASQA) designation number. Choose one or more BMPs you intend to use during construction from the list. Check the box where the chosen activity row inter.;ects with \he BMP column. 3. Refer to the CASQA construction handbook for information and details of \he chosen BMPs and how to apply them \o the project. SHOW THE LOCATIONS OF ALL CHOSEN BMPsABOVE ON THE PROJECTS SITE PLAN/EROSION CONTROL PLAN. SEE THE REVERSE SIDE OF THIS SHEET FOR A SAMPLE EROSION CONTROL PLAN. Page 1 of 1 PROJECT INFORMATION Site Address: 4862 Kelly Drive, Carlsbad CA 92008 Assessor's Parcel Number. _2_o7_2_3•_2_6_oo ____ _ Emergency Contact Nome: Daniel Zlmny 24 Hour Phone: _7_60-_60_2_-7_5_5_1 _____ _ Construction Threat \o Storm Water Quality (Check Box) • MEDIUM O LOW NC: 66 00 :i::2 U2 "' 00 I I i i - - REV 02/16 SYMBOL DWG TIER 1 SWPPP LEGEND DESCRIPTION m EC-7 GEOTEXTILE & MAT (PLASTIC COVER) SE-4 CHECK DAM (GRAVEL BAGS) f%¥d SE-10 STORM DRAIN INLET PROTECTION TR-1 STABILIZED INGRESS/EGRESS ~ TR-2 STABILIZED ROADWAY • WM-1 MATERIAL DELIVERY (SHOTCRETE) WM-4 SPILL PREVENTION AND CONTROL WM-8 CONCRETE WASTE MANAGEMENT W WM-2 MATERIAL USE AREA (SHOTCRETE) SWPPP NOTES G) USE RIGHT OF ENTRY AGREEMENT FOR 4866 KELLY DRIVE TO EXTEND PUMP HOSE OVER PROPERTY AND CONVEY SHOTCRETE DIRECTLY INTO FORMS 0 LAY PLASTIC WRAP WITHIN WORK AREA PER CASQA EC-7 TO PROVIDE A PROTECTIVE BARRIER OVER THE NATURAL CHANNEL BED. REMOVE PLASTIC AND COLLECTED DEBRIS AT END OF REPAIR @ DEWATER PONDED WATER FROM SITE © DISCHARGE PUMPED WATER DIRECTLY ONTO CONCRETE LINED PORTION OF THE CHANNEL TO PREVENT EROSION FROM DEWATERING. USE PLASTIC WRAP AS NECESSARY. © FOOT TRAFFIC INGRESS/EGRESS ONLY ~ $ ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ~ 10/11/2018 ,-THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. ~ORT ANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. ----- If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on ~ certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Lori Lee NAME: E360 Insurance Services m£>NJn Extl: (888) 862-6750 I FAX IA/C Nol: (888) 256-0809 16542 Ventura Blvd., Suite 300 E-MAIL Lori@e360insurance.com Ann~~~~- Encino, CA 91436 INSURER(SI AFFORDING COVERAGE NAIC# Phone ~-(888) 862-6750 Fax (888) 256-0809 INSURER A: State Fund INSURED INSURER B: National General - Planes Boats and Automobile LTD INSURER C: Benchmark Insurance Company 2029 E. Mission Ave INSURER D: _J I INSURER E: Escondido CA 92027 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . ~ COMMERCIAL GENERAL LIABILITY • CLAIMS-MADE ~ OCCUR ADOLSUBR 'N"" wvn POLICY NUMBER LIMITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES /Ea occurrence) $ 1,000,000 $ 50,000 lf:L_ TYPE OF INSURANCE --' •------------c • ------------ GE N'L AGGREGATE LIMIT APPLIES PER: ~ POLICY • j'f i§'T • LOC • OTHER BIC5018852 10/12/2018 10/12/2019 MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS -COMP/OP AGG $ 5,000 $ 1,000,000 1 $ 2,000,000 $ 2,000,000 ! $ •T~:y :~:~I C°ll SCHEDULED ~EiD~:~~~~:RY (P~-,-p-ers_o_n_) -+---:$--•-_-----~------.00 AU O ABILITY COMBINED SINGLE LIMIT 1 00r000~ 'B • f~~~DONLY ~ AUTOS 2006201912 03/07/2018 03/07/2019 BODILYINJURY(Peraccident) $ ---- l D l10~6i ONL y • fc1T~~~~E~ f-~p=(PR=e9=~=z=i=r."~n=R~AM~A~G=E~---+--- L_-•~-----=•~------+--+----+----------+----l-------l-------+--$ ----___, i • UMBRELLA LIAB • OCCUR I C • EXCESS LIAB • CLAIMS-MADE I •~ED • RETENTION $ I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N ANY PROPRIETOR/PARTNER/EXECUTIVE,~ . A OFFICER/MEMBER EXCLUDED? L1'_j N / A (Mandatory in NH) I If yes, describe under ,_. ~-. DESCRIPTION OF OPERATIONS below Y 9219205-18 09/30/2018 09/30/2019 EACH OCCURRENCE AGGREGATE $ f-----------+---------·- •OTH-ER E.L. EACH ACCOENT E.L. DISEASE -EA EMPLOYE E.L. DISEASE -POLICY LIMIT $ $ 1,000,000.00 $ 1,000,000.00 i $ 1,000,000.00 l I : ~~~~~~--'--~-~~-~~--__,___----+-~--'-------~-1 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ***10 days notice if cancelled for non-payment of premium*** L___ _____ -------------------------------------------------CERTIFICATE HOLDER I I I I City of Car1sbad/CMWD c/o EXIGIS Insurance Compliance Services P.O. Box 4668-ECM #35050 New York, NY 10163-4668 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE L.~--~~--~-~--~-~~ I j I I © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) QF The ACORD name and logo are registered marks of ACORD I I ENDORSEMENT PRIMARY BLANKET ADDITIONAL INSURED I ENDT. NO. I 6 I G0103 (ed 09/24/09) IT IS AGREED COVERAGE IS PROVIDED TO THE ADDITIONAL INSURED(S) AS FOLLOWS: 1. SECTION II OF THE POLICY (WHO IS AN INSURED) IS AMENDED TO INCLUDE ANY PERSON OR ORGANIZATION THAT THE NAMED INSURED HAS AGREED IN AN INSURED CONTRACT TO NAME AS AN ADDITIONAL INSURED PROVIDED THE BODILY INJURY OR PROPERTY DAMAGE OCCURS SUBSEQUENT TO THE EXECUTION OF THE INSURED CONTRACT AND THE BODILY INJURY OR PROPERTY DAMAGE ARISES FROM YOUR WORK PERFORMED DURING THE POLICY TERM. 2. PARAGRAPH 6.0. IS HEREBY ADDED TO SECTION IV, COMMERCIAL GENERAL LIABILITY CONDITIONS, OF THE POLICY, AS FOLLOWS: D. NOTWITHSTANDING ANYTHING TO THE CONTRARY IN PARAGRAPHS 6.A., 6.B., OR 6.C. HEREOF, THE INDEMNITY PROVIDED BY THIS INSURANCE IS PRIMARY AND NONCONTRIBUTORY FOR ANY PERSON OR ORGANIZATION THAT IS AN ADDITIONAL INSURED UNDER THIS POLICY AND THAT YOU HAVE AGREED, IN AN INSURED CONTRACT, TO PROVIDE PRIMARY ADDITIONAL INSURED COVERAGE. 3 THE APPLICABLE LIMIT OF THE COMPANY'S LIABILITY SHALL NOT BE INCREASED BY THE INCLUSION OF ANY NUMBER OF ADDITIONAL INSUREDS. 4 OTHER THAN AS EXPRESSLY MODIFIED HEREIN, COVERAGE FOR THE ADDITIONAL INSURED IS GOVERNED BY THE TERMS AND CONDITIONS OF THIS POLICY, INCLUDING THE INSURING AGREEMENTS. 5 THE COVERAGE PROVIDED FOR THE ADDITIONAL INSURED IS ONLY TO THE EXTENT OF DAMAGES FROM BODILY INJURY OR PROPERTY DAMAGE ARISING OUT OF THE NEGLIGENCE OR STRICT LIABILITY OF THE NAMED INSURED. NO COVERAGE IS PROVIDED FOR BODILY INJURY OR PROPERTY DAMAGE ARISING OUT OF ACTS, ERRORS OR OMISSIONS OF THE ADDITIONAL INSURED. 6. NO COVERAGE IS PROVIDED TO AN ADDITIONAL INSURED FOR DAMAGES BECAUSE OF BODILY INJURY TO AN EMPLOYEE OF THE NAMED INSURED, WHETHER SUIT IS BROUGHT OR CLAIM IS MADE BY THE EMPLOYEE OR THE PARENT, SPOUSE, CHILD OR SIBLING OF SUCH EMPLOYEE, OR ANY ENTITY SEEKING DAMAGES BECAUSE OF INJURY TO SUCH EMPLOYEE. Policy Number BIC5018852 ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Insured Planes Boats and Automobiles LTD Effective 10/12/2018 BENCHMARK INSURANCE COMPANY Countersiqnature of Authorized Representative © 2009 WESTCAP ENDORSEMENT I ENDT. NO. I 7 I G0905 (ed 09/24/09) WAIVER OF SUBROGATION -BLANKET IT IS AGREED, FOR AN ADDITIONAL PREMIUM OF$ lnclnM&D , THAT THE TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS) IS AMENDED AS FOLLOWS: WE WAIVE ANY RIGHT OF RECOVERY WE MAY HAVE AGAINST ANY PERSON OR ORGANIZATION THAT QUALIFIES AS AN ADDITIONAL INSURED PURSUANT TO THE TERMS OF ENDORSEMENT NUMBER 6 BECAUSE OF PAYMENTS WE MAKE FOR BODILY INJURY OR PROPERTY DAMAGE ARISING OUT OF (i) YOUR WORK PERFORMED DURING THE POLICY PERIOD UNDER AN INSURED CONTRACT WITH THAT PERSON OR ORGANIZATION, PROVIDED THAT THE BODILY INJURY OR PROPERTY DAMAGE OCCURS SUBSEQUENT TO THE EXECUTION OF THE INSURED CONTRACT, OR (ii) YOUR PRODUCT MANUFACTURED OR SOLD DURING THE POLICY PERIOD UNDER AN INSURED CONTRACT WITH THAT PERSON OR ORGANIZATION, PROVIDED THAT THE BODILY INJURY OR PROPERTY DAMAGE OCCURS SUBSEQUENT TO THE EXECUTION OF THE INSURED CONTRACT. Policy Number BIC5018852 ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Insured Planes Boats and Automobiles LTD Effective 10/12/2018 Countersignature of Authorized Representative BENCHMARK INSURANCE COMPANY <D 2009 WESTCAP STATE ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION REP 04 9219205-18 RENEWAL l,..:QMPEN5ATION INSLJAANCE FUNO HOME OFFICE SAN FRANCISCO SC 6-49-53-71 PAGE 1 EFFECTIVE OCTOBER 11, 2018 AT 12.01 A.M. AND EXPIRING SEPTEMBER 30, 2019 AT 12.01 A.M. ALL EFFECTIVE OATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME PB A, LTD 2029 EMISSION AVE ESCONDIDO, CA 92027 ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND WAIVES ANY RIGHT OF SUBROGATION AGAINST, CITY OF CARLSBAD CMWD WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS POLICY IN CONNECTION WITH WORK PERFORMED BY, PB A, LTD IT IS FURTHER AGREED THAT THE INSURED SHALL MAINTAIN PAYROLL RECORDS ACCURATELY SEGREGATING THE REMUNERATION OF EMPLOYEES WHILE ENGAGED IN WORK FOR THE ABOVE EMPLOYER. IT IS FURTHER AGREED THAT PREMIUM ON THE EARNINGS OF SUCH EMPLOYEES SHALL BE INCREASED BY 03%. NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: OCTOBER 17, 2018 2570 ~!(~ PRESIDENT AND CEO SCIF FORM 10217 (REV.4-2018) OLO DP 217