Project Information Form

Project Information Form

Thank You for Completing This Form

The following questions are required to complete a SWPPP and/or permit(s) including the NOI.

A complete and accurate form will reduce the number of phone calls/emails and your turnaround time.

Silver Leaf Services - Silver Leaf Scope of Work*

Please select all services you need Silver Leaf SWPPP to provide.

Select or enter value

Project Name*

Account Manager

Please select your Account Manager if known.

Select or enter value

Job #/Work Order #/PO #*

This would be your company's internal reference number

Project Street Address*

Project City*

Project State*

Utah

Idaho

Wyoming

Project Zip Code*

Project GPS Coordinates-LAT/LONG*

Parcel Number*

Type of Construction*

Please select all that apply.

Select or enter value

Is this project a subdivision?*

Select

Please list ALL approved lots if Yes Subdivision*

Project Completion Company*

If the scope of work includes vertical construction, who will be the responsible contractor?

Site Activities*

Please select all that apply

Select or enter value

Total Project Acreage*

Total Disturbed Acreage*

Construction Start Date*

Construction End Date*

Who is the property owner? (Company)*

Who is the long-term owner of the property or building, not the general contractor. Owner: Has legal ownership of property on which construction activity is taking place. Except in the case of leased property, an owner is the party that has ultimate control over the destiny of a project.

Owner Address*

(Address, City, State, Zip Code)

Owner's Representative Name*

Owner's Representative Title*

Owner's Representative Email*

Owner's Representative Phone #*

Operator*

Company responsible for contracting with Silver Leaf for the engineered SWPPP and/or other SWPPP services. (Usually the company filling out this form).

Operator: The party which has operational control over construction plans and specifications (the owner or a lessor)

The party which has day-to-day operational control of those activities at a project that are necessary to ensure compliance with the permit conditions (they are authorized to direct workers at a site to carry out activities required by the permit; in most cases this is the general contractor of the project)

Operator Street Address*

Operator City

Operator State

Operator Zip

Operator Phone*

Project Manager*

Project Manager Email*

Project Manager Cell Phone #

Site Superintendent

Site Superintendent Email

Site Superintendent Cell phone #

If your project requires additional costs, outside of the confirmed bid, who is authorized to approve and sign the change order request(s)?*

Name, Phone, Email

Billing Contact*

Billing Phone*

Preferred Invoice Method*

Select

Billing Email*

Your Name*

Person filling out this form.

Your Email*

Your Phone*

Who is filing the State NOI?*

If other, please attach a copy of the NOI in the box below. *Required for site compliance.

Silver Leaf SWPPP

Other

State NOI Signatory (Person)*

The person responsible for registering and certifying the State NOI through the NPDES E-Reporting System. They will receive an email from kayla@silverleafswppp.com with instructions on how to proceed.

Signatory Title*

Signatory Email*

Signatory Phone*

Who will prepare city Land Disturbance Permit?*

If other, please attach copy of LDP in box below. *Required for site compliance.

Silver Leaf SWPPP

Other

Is Silver Leaf preparing the SWPPP document?*

If NO, please attach a copy of the SWPPP Document in the box below. *Required for site compliance.

Yes

Fuel or oil storage on site?*

Yes

Is there an area adjacent to the project site where you will be storing materials, dirt, and/or other raw materials?*

Yes

Link to Civil File/Maps

We need the Civil, Grading Drainage Sheet, and the Existing Condition Plans (if applicable) to complete your SWPPP. Please include the link to these files here or attach them in the box at the bottom of the this form.

Who is installing the BMPs?*

Silver Leaf SWPPP

Other

Other Company Installing BMP's*

BMP's Company Phone Number*

BMP's Company Email*

SWPPP Signage Provided by?*

Silver Leaf SWPPP

Other

Concrete Washout Signage provided by?*

Silver Leaf SWPPP

Other

SWPPP Inspections provided by?*

Silver Leaf SWPPP

Other

Company Providing Inspections*

Inspection Company's Phone Number*

Inspection Company's Phone Email*

Dewatering needs?*

Do you anticipate removing ground water from site?

Yes

Not sure

If yes, who will file Dewatering permit?

Silver Leaf SWPPP

Other

File Upload

Drag and drop files here or

AUTHORIZATION

By Submitting this form you are authorizing Silver Leaf SWPPP to complete a SWPPP, permit application(s) and/or services (where indicated) using the provided information. You agree to pay all quoted charges related to this transaction. If you have any questions, please contact us prior to submitting this form.

SWPPP Authorization*

I agree

I disagree

Send me a copy of my responses

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