Laserfiche WebLink
III. Summary of Storm Water Pollution Prevention Program ( SWPPP). <br />Required Application Attachments <br />Complete a one page SWPPP Summary Sheet and a BMP Description Sheet for each type of BMP that will <br />be implemented. (See last two pages of the application form.) <br />A. Is the SWPPP Summary Sheet attached? <br />B. Is one BMP Description Sheet attached for each BMP? <br />C. How many BMP Description Sheets are attached? <br />®Yes ❑No <br />IEjYes ❑No <br />IV. Limitations, of Coverage <br />A. Part II Limitations on Coverage and Appendix C <br />I have read Part II Limitations on Coverage and Appendix C of the MS4 general permit and Yes <br />certify that we intend to comply with the applicable requirements of those sections. <br />E. Special Waters <br />Please refer to the Guidance Manual for Small Municipal Separate Storm Sewer Systems (MS4s) and the <br />enclosed map to complete this section. <br />1. Does the MS4 discharge into Prohibited Waters as defined in Minn. R. 7050.0180, <br />subp. 3, 4, and 5? See Attachment Four of the Guidance Manual for Small Municipal <br />Separate Storm Sewer Systems (MS4s) for further information. If yes, please list below <br />and contact Lou Flynn at (651) 296 -6575 or louis.Ilynn @state.nm.us. Be advised that <br />you will be required to obtain an individual permit versus a general permit. <br />❑Yes ®No <br />2. Does the MS4 discharge into waters with a Restricted Discharge as defined in Minn. R. DYes ©No <br />7050.0180, subp. 6, 6a, and 6b? If yes, please list below and comply with Part IX, <br />Appendix C, Item B. See Attachment Four of the Guidance Manual for Small Municipal <br />Separate Storm Sewer Systems (MS4s) for further information. <br />3. Does the MS4 discharge into Trout Waters as defined in Minn. R. 6264.0050 subp. 2 & ❑Yes ®No <br />4? If yes, please list below and comply with Part IX, Appendix C, Item C. See <br />Attachments Two and Three of the Guidance Manual for Small Municipal Separate <br />Storm Sewer Systems (MS4s) for further information. <br />4. Does the MS4 discharge into Wetlands as defined in Minn. R. 7050.0130, subp. F? See <br />Attachment Four of the Guidance Manual for Small Municipal Separate Storm Sewer <br />Systems (MS4s) for further information. <br />5. Does the MS4 have a process to evaluate discharges that require applicable <br />Environmental Review as required by State or federal laws? See Part IX of the <br />Guidance Manual for S /pall Municipal Separate Storm Sewer Systems (MS4s) for further <br />information. <br />6. Does the MS4 have a process to evaluate discharges whose direct, indirect, interrelated, <br />interconnected, or independent impacts may jeopardize a listed Endangered or <br />Threatened Species or adversely modify a designated critical habitat? See Part IX of the <br />Guidance Manual for Small Municipal Separate Storni Sewer Systems (MS4s) for further <br />information. <br />MPCA MS4 Storm water Permit Application <br />5 018 <br />- 1 0 - <br />Yes EN <br />Yes ❑No <br />®Yes ❑No <br />02/06/03 <br />