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ATTACHMENT B: SWPPP INSPECTION FORM NOTE: THIS INSPECTION REPORT DOES NOT ADDRESS ALL ASPECTS OF THE NATIONAL APOLLUTANT DISCHARGE ELIMINATION SYSTEM/STATE DISPOSAL SYSTEM (NPDES/SDS) CONSTRUCTION STORMWATER PERMIT ISSUED ON AUGUST 1, ATTACHMENT C: MAINTENANCE PLAN FOR PERMANENT STORM WATER TREATMENT SYSTEM 2013. THE COMPLETION OF THIS CHECKLIST DOES NOT GUARANTEE THAT ALL PERMIT REQUIREMENTS ARE IN COMPLIANCE; IT IS THE RESPONSIBILITY OF THE PERMITTEE(S) TO READ AND UNDERSTAND THE PERMIT REQUIREMENTS. ATTACHMENT C - ABOVE -GROUND ❑ ❑ 2. PERIMETER CONTROL TRENCHED IN WHERE APPROPRIATE? FACILITY MANAGEMENT SCHEDULE FACILITY INFORMATION ❑ 3. 50 FOOT NATURAL BUFFER MAINTAINED AROUND ALL SURFACE WATERS? ❑ SITE NAME: ❑ 3.1. IF NO, HAVE REDUNDANT SEDIMENT CONTROLS BEEN INSTALLED? 1 . ALL STORMWATER RETENTION, DETENTION AND TREATMENT BASINS MUST BE INSPECTED AT LEAST ONCE A YEAR TO DETERMINE THAT BASIN FACILITY ADDRESS: PERMIT NUMBER: ❑ 4. INLET PROTECTION ON ALL CATCH BASINS AND CULVERT INLETS? RETENTION AND TREATMENT CHARACTERISTICS ARE ADEQUATE. A STORAGE TREATMENT BASIN WILL BE CONSIDERED INADEQUATE IF SEDIMENT CITY: STATE: ZIP CODE: ❑ 5. VEHICLE TRACKING BEST MANAGEMENT PRACTICES (BMP'S) AT ALL SITE EXITS? HAS DECREASED THE WET STORAGE VOLUME BY 50 PERCENT OR DRY STORAGE VOLUME BY 25 PERCENT OF ITS ORIGINAL DESIGN VOLUME. ❑ ❑ 6. ALL TRACKED SEDIMENT REMOVED WITHIN 24 HOURS? BASED ON THIS INSPECTION, IF A STORMWATER BASIN REQUIRES SEDIMENT CLEANOUT, THE BASIN WILL BE RESTORED TO ITS ORIGINAL DESIGN INSPECTION INFORMATION ❑ 7. ARE ALL INFILTRATION SYSTEMS STAKED AND MARKED TO AVOID COMPACTION? CONTOURS AND VEGETATED STATE WITHIN ONE YEAR OF THE INSPECTION DATE. INSPECTOR NAME: PHONE NUMBER: ❑ 8. ARE ALL INFILTRATION AREAS PROTECTED WITH A PRETREATMENT DEVICE? 2. ALL OUTLET STRUCTURES, CULVERTS, OUTFALL STRUCTURES AND OTHER STORMWATER FACILITIES FOR WHICH MAINTENANCE REQUIREMENTS DATE (MM/DD/YYYY): TIME: AM / PM ❑ 9. DO ALL STOCKPILES HAVE PERIMETER CONTROLS? ARE NOT OTHERWISE SPECIFIED HEREIN MUST BE INSPECTED IN THE SPRING, SUMMER AND FALL OF EACH YEAR. WITHIN 30 DAYS OF THE IS THE INSPECTOR CERTIFIED IN SEDIMENT AND EROSION CONTROL AND IS IT DOCUMENTED IN THE STORMWATER POLLUTION PREVENTION PLAN (SWPPP)? INSPECTION DATE, ALL ACCUMULATED SEDIMENT AND DEBRIS MUST BE REMOVED SUCH THAT EACH STORMWATER FACILITY OPERATES AS IS THIS INSPECTION ROUTINE OR IN RESPONSE TO A STORM EVENT: DESIGNED AND PERMITTED. CONTRIBUTING DRAINAGE AREAS MUST BE KEPT CLEAR OF LITTER AND VEGETATIVE DEBRIS, INFLOW PIPES AND RAINFALL AMOUNT (IF APPLICABLE): OVERFLOW SPILLWAYS KEPT CLEAR, INLET AREAS KEPT CLEAN, AND UNDESIRABLE VEGETATION REMOVED. EROSION IMPAIRING THE FUNCTION IS THE SITE WITHIN ONE AERIAL MILE OF A SPECIAL OR IMPAIRED WATER? OR INTEGRITY OF THE FACILITIES, IF ANY, WILL BE CORRECTED, AND ANY STRUCTURAL DAMAGE IMPAIRING OR THREATENING TO IMPAIR THE IF YES, FOLLOW APPENDIX A AND OTHER APPLICABLE PERMIT REQUIREMENTS FUNCTION OF THE FACILITIES MUST BE REPAIRED. 3. VOLUME CONTROL FACILITIES AND CONTRIBUTING DRAINAGE AREAS MUST BE INSPECTED EVERY THREE MONTHS DURING THE OPERATIONAL NOTE: IF N/A IS SELECTED AT ANY TIME, SPECIFY WHY IN THE COMMENT AREA FOR THAT SECTION. PERIOD (BETWEEN SPRING SNOWMELT AND FIRST SUBSTANTIAL SNOWFALL) AND MONITORED AFTER RAINFALL EVENTS OF 1 INCH OR MORE TO ENSURE THAT THE CONTRIBUTING DRAINAGE AREA IS CLEAR OF LITTER AND DEBRIS, INFLOW PIPES AND OVERFLOW SPILLWAYS ARE CLEAR, INLET AREAS ARE CLEAN, UNDESIRABLE VEGETATION IS REMOVED AND THERE IS NO EROSION IMPAIRING OR THREATENING TO IMPAIR THE FUNCTION EROSION CONTROL REQUIREMENT (PART IV.B) OF A FACILITY. IF SEDIMENT HAS ACCUMULATED IN A INFILTRATION FEATURE, WITHIN 30 DAYS OF INSPECTION DEPOSITED SEDIMENTS MUST BE Y N N/A REMOVED, THE INFILTRATION CAPACITY OF THE UNDERLYING SOILS MUST BE RESTORED, AND ANY SURFACE DISTURBANCE MUST BE STABILIZED. 1. SOIL STABILIZATION WHERE NO CONSTRUCTION ACTIVITY FOR 14 DAYS? (7 DAYS WHERE APPLICABLE) ❑ ❑ ❑ INSPECTION MUST ENSURE THAT SEDIMENT TRAPS AND FOREBAYS ARE TRAPPING SEDIMENT AND THAT MORE THAN 50 PERCENT OF THE 2. HAS THE NEED TO DISTURB STEEP SLOPES BEEN MINIMIZED? ❑ ❑ ❑ STORAGE VOLUME REMAINS, THE CONTRIBUTING DRAINAGE AREA IS STABLE (I.E., NO EROSION IS OBSERVED), AND INLETS AND 3. ALL DITCHES STABILIZED 200; BACK FROM POINT OF DISCHARGE WITHIN 24 HOURS? (NOT MULCH) ❑ ❑ ❑ OUTLET/OVERFLOW SPILLWAYS ARE IN GOOD CONDITIONS WITH NO EROSION. MAINTENANCE TECHNIQUES USED MUST PROTECT THE 4. ARE THERE BMP'S FOR ONSITE STOCKPILES? ❑ ❑ ❑ INFILTRATION CAPACITY OF THE PRACTICE BY LIMITING SOIL COMPACTION TO THE GREATEST EXTENT POSSIBLE (E.G., BY USING LOW -IMPACT 5. ARE APPROPRIATE BMP'S INSTALLED PROTECTING INLETS/OUTLETS? ❑ ❑ ❑ EARTH -MOVING EQUIPMENT). 6. DO PIPE OUTLETS HAVE ENERGY DISSIPATION? n n I-1 COMMENTS: SEDIMENT CONTROL REQUIREMENT (PART IV.C) Y N N/A 1. PERIMETER CONTROL INSTALLED ON ALL DOWN GRADIENT PERIMETERS? ❑ ❑ ❑ 2. PERIMETER CONTROL TRENCHED IN WHERE APPROPRIATE? ❑ ❑ ❑ 3. 50 FOOT NATURAL BUFFER MAINTAINED AROUND ALL SURFACE WATERS? ❑ ❑ ❑ 3.1. IF NO, HAVE REDUNDANT SEDIMENT CONTROLS BEEN INSTALLED? ❑ ❑ ❑ 4. INLET PROTECTION ON ALL CATCH BASINS AND CULVERT INLETS? ❑ ❑ ❑ 5. VEHICLE TRACKING BEST MANAGEMENT PRACTICES (BMP'S) AT ALL SITE EXITS? ❑ ❑ ❑ 6. ALL TRACKED SEDIMENT REMOVED WITHIN 24 HOURS? ❑ ❑ ❑ 7. ARE ALL INFILTRATION SYSTEMS STAKED AND MARKED TO AVOID COMPACTION? ❑ ❑ ❑ 8. ARE ALL INFILTRATION AREAS PROTECTED WITH A PRETREATMENT DEVICE? ❑ ❑ ❑ 9. DO ALL STOCKPILES HAVE PERIMETER CONTROLS? ❑ ❑ ❑ COMMENTS: MAINTENANCE -EROSION AND SEDIMENT CONTROL BMP'S (PART IV.E.) Y N N/A 1. ARE ALL PREVIOUSLY STABILIZED AREAS MAINTAINING 90% GROUND COVER? ❑ ❑ ❑ 2. ANY UlIGHER06101\101361ERVIED? ❑ ❑ ❑ 3. PERIMETER CONTROL --HAS SEDIMENT REACHED ONE HALF THE HEIGHT OF THE DEVICE? ❑ ❑ ❑ 4. ARE INLET PROTECTION DEVICES MAINTAINED AND FUNCTIONING PROPERLY? COMMENTS: OTHER Y N N/A 1. ARE ALL MATERIALS THAT CAN LEACH POLLUTANTS UNDER COVER? ❑ ❑ ❑ 2. HAS ACCESS BEEN RESTRICTED TO ONSITE HAZARDOUS MATERIALS? ❑ ❑ ❑ 3. DOES ON-SITE FUELING ONLY OCCUR IN A CONTAINED AREA? ❑ ❑ ❑ . ❑ ❑ ❑ 5. IS THE CONCRETE WASHOUT AREA COMPLETELY CONTAINED? 6. IS THE CONCRETE WASHOUT AREA MARKED WITH SIGN? El El El COMMENTS: Y N N/A 7. WERE ANY DISCHARGES SEEN DURING THIS INSPECTION, SEDIMENT, WATER, OR OTHERWISE? 7.1. IF YES, STATE THE EXACT LOCATION OF ALL POINTS OF DISCHARGE. PHOTOGRAPH THE DISCHARGE AND DESCRIBE THE DISCHARGE (COLOR, ODOR, FOAM, OIL SHEEN, ETC). HOW WILL IT BE REMOVED? HOW DID THE DISCHARGE HAPPEN? HOW MUCH WAS DISCHARGED? HOW WILL IT BE STOPPED, AND HOW LONG WILL IT TAKE TO STOP? IS THE DISCHARGE GOING INTO AN ADJACENT SITE? WAS THE DISCHARGE A SEDIMENT DELTA? IF YES, WILL THE DELTA BE RECOVERED WITHIN 7 DAYS? 8. WILL A PERMANENT STORMWATER MANAGEMENT SYSTEM BE UTILIZED IN THIS PROJECT AS REQUIRED AND IN ACCORDANCE WITH PART III.D OF THE PERMIT? DESCRIBE: Y N N/A 9. IS ANY DEWATERING OCCURRING ON SITE? ❑ ❑ ❑ 9.1. IF YES, WHERE? WHAT BMP IS BEING USED? HOW MUCH WATER IS BEING DEWATERED? IS THE WATER CLEAR? WHERE IS THE WATER BEING DISCHARGED TO? Y N N/A 10. IS A COPY OF THE SWPPP LOCATED ON THE CONSTRUCTION SITE? ❑ ❑ ❑ 11. HAS THE SWPPP BEEN FOLLOWED AND IMPLEMENTED ON SITE? ❑ ❑ ❑ 12. IS A SEDIMENTATION BASIN REQUIRED FOR THIS PROJECT AS SPECIFIED IN THE PERMIT? ❑ ❑ ❑ 12.1. IF YES, ARE THEY MAINTAINED AS SPECIFIED IN THE PERMIT? ❑ ❑ ❑ 13. IS THE TOPSOIL ON THIS PROJECT BEING PRESERVED? ❑ ❑ ❑ 13.1. IF YES, EXPLAIN HOW THE TOPSOIL IS BEING PRESERVED. IF NO, EXPLAIN WHY IT WAS INFEASIBLE. 14. ARE ALL INFILTRATION SYSTEMS MARKED TO AVOID COMPACTION? Y ❑ N ❑ N/A ❑ 14.1. DO ALL INFILTRATION AREAS HAVE PRETREATMENT DEVICES? ❑ ❑ ❑ 15. DESCRIPTION OF AREAS OF NON-COMPLIANCE NOTED DURING THE INSPECTION, REQUIRED CORRECTIVE ACTIONS, AND RECOMMENDED DATE OF COMPLETION OF CORRECTIVE ACTIONS: 16. PROPOSED AMENDMENTS TO THE SWPPP: 17. POTENTIAL AREAS OF FUTURE CONCERN: 18. ADDITIONAL COMMENTS DISCLOSURES: • AFTER DISCOVERY, THE PERMIT REQUIRES MANY OF THE DEFICIENCIES THAT MAY BE FOUND IN THIS CHECKLIST BE CORRECTED WITHIN A SPECIFIED PERIOD OF TIME. SEE PERMIT FOR MORE DETAILS. • THIS INSPECTION CHECKLIST IS AN OPTION FOR SMALL CONSTRUCTION SITES. LARGE CONSTRUCTION SITES AND LINEAR PROJECTS REQUIRE MORE EXTENSIVE/MORE LOCATION SPECIFIC INSPECTION REQUIREMENTS. • THE PERMITTEE(S) IS/ARE RESPONSIBLE FOR THE INSPECTION AND MAINTENANCE OF TEMPORARY AND PERMANENT WATER QUALITY MANAGEMENT BMP'S AS WELL AS EROSION PREVENTION AND SEDIMENT CONTROL BMP'S UNTIL ANOTHER PERMITTEE HAS OBTAINED COVERAGE UNDER THIS PERMIT ACCORDING TO PART II.B.5., OR THE PROJECT HAS UNDERGONE FINAL STABILIZATION AND A NOTICE OF TERMINATION HAS BEEN SUBMITTED TO THE MPCA. O O O C� G3 O M p Civil Engineering • Surveying • Landscape Architecture 4931 W. 35th Street, Suite 200 St. Louis Park, MN 55416 civilsitegroup.com 612-615-0060 M I L L E P HANSON Cn z LU Q am a Nt M 't U')'^ v♦ U7 W O � 0 W =a O A Q LL U elf M N IZT U7 U7 Z _LD J O LU Z 2 C LU LU J 0 J U7 CO ti I HEREBY CERTIFY THAT THIS PLAN, SPECIFICATION, OR REPORT WAS PREPARED BY ME OR UNDER MY DIRECT SUPERVISION AND THAT I AM A DULY LICENSED PROFESSIONAL ENGINEER UNDER THE LAWS OF THE STATE OF MINNESOTA. Matthew R. Pavek DATE 2/15/19 LICENSE NO. 44263 ISSUE/SUBMITTAL SUMMARY DRAWN BY:BN REVIEWED BY: DK PROJECT NUMBER: 18125 REVISION SUMMARY DATE I DESCRIPTION SWPPP - ATTACHMENTS 2/14/2019 4:59 PM 0 COPYRIGHT2018 CIVIL SITE GROUP INC.