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ATTACHMENT B: SWPPP INSPECTION FORM
<br />Minnesota Pollution
<br />Control Agency
<br />52011.4feyette Road Noah
<br />SL Paul, MN 5515SA194
<br />CivilSite
<br />G R O U P
<br />ATTACHMENT B:
<br />Construction Stormwater
<br />Inspection Checklist
<br />Construction Stormwater Program
<br />Doc Type Permitting Checklist
<br />Note: This inspection report does not address all aspects of the National Pollutant Discharge Elimination System/State Disposal
<br />System (NPDES/SDS) Construction Stormwater permit (Permit) issued on August 1, 2013. The completion of this checklist does not
<br />guarantee that all permit requirements are in compliance; it is the responsibility of the Permittee(s) to read and understand the
<br />permit requirements.
<br />Facility Information
<br />Site name:
<br />Facility address: Permit number:
<br />City: State: Zip code:
<br />Inspection Information
<br />Inspector name: Phone number:
<br />Date (mnVdd/yyyy): Time: ❑ am ❑ pm
<br />Is the inspector certified in sediment and erosion control and it is documented in the Stormwater Pollution Prevention Plan
<br />(SWPPP)? ❑ Yes ❑ No
<br />Is this inspection routine or in response to a storm event:
<br />Rainfall amount (if applicable):
<br />Is site within one aerial mile of special or impaired water? ❑ Yes []No
<br />If yes, follow Appendix A and other applicable permit requirements.
<br />Note: If NA is selected at anytime, specify why in the comment area for that section.
<br />Erosion Control Requirement (Part IV.B)
<br />Yes I No I NA
<br />2.
<br />Has the need to disturb steep slopes been minimized?
<br />171
<br />0
<br />1 11
<br />3.
<br />All ditches stabilized 200' back from point of discharge within 24 hours? Not mulch
<br />❑
<br />❑
<br />❑
<br />4.
<br />Are there erosion BM P's for onsite stockpiles?
<br />❑
<br />❑
<br />❑
<br />5.
<br />Are aDDrooriate BM P's installed Drotectina inletstoutlets?
<br />n
<br />n
<br />n
<br />www.pca.state.mn.us • 651-296-6300 • 800-657-3864 TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
<br />wq-strm2-36 • 314114 Page 1 of 4
<br />�Cv1J iSite
<br />G R O U P
<br />6. Do pipe outlets have energy dissipation? ❑ ❑ ❑
<br />Comments:
<br />Sediment Control Requirement (Part W.C.)
<br />CivilSite
<br />G R O U P
<br />2. Has access been restricted to onsite hazardous materials? ❑ L1 L1
<br />3. Does on-site fueling only occur in a contained area? ❑ 13 El
<br />4. Are all solid wastes being properly disposed of? ❑ 11 ❑
<br />5. Is the concrete washout area connDletely contained? ❑ ❑ ❑
<br />Comments:
<br />7. Were any discharges seen during this inspection, sediment, water, or otherwise? []Yes ❑ No
<br />If yes, state the exact location of all points of discharge. Photograph the discharge and describe the discharge (color, odor,
<br />foam, oil sheen, etc). How will it be removed? How did the discharge happen? How much was discharged? How will it be
<br />stopped, and how long will it take to stop? Is the discharge going into an adjacent site? Was the discharge a sediment delta? If
<br />yes, will the delta be recovered within 7 days?
<br />8. Will a permanent storrnroater management system be utilized in this project as required and in accordance with Part IIID of the
<br />permit? Describe:
<br />9. Is any dewatering occurring on site? ❑ Yes ❑ No
<br />If yes, where? What BMP is being used? How much water is being dewatered? Is the water clear? Where is the water being
<br />discharged to?
<br />10. Is a copy of the SWPPP located on the construction site? []Yes ❑ No
<br />11. Has the SWPPP been followed and implemented on site? ❑ Yes []No
<br />12. Is a sedimentation basin required for this project as specified in the permit? ❑ Yes ❑ No
<br />If yes, are they maintained as specified in the permit? []Yes ❑ No
<br />13. Is the topsoil on this project being preserved? []Yes ❑No
<br />If yes, explain how the topsoil is being preserved. If not, explain why it was infeasible.
<br />14. Are all infiltration systems marked to avoid compaction? ❑ Yes ❑ No
<br />Do all infiltration areas have pretreatment devices? ❑ Yes ❑ No
<br />www.pca.state.mn.us • 651-296-6300 • 800-657-3864 TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
<br />wq-strm2-36 • 314114 Page 3 of 4
<br />Civil Site
<br />G R O U P
<br />15. Description of areas of non-compliance noted during the inspection, required corrective actions, and recommended date of
<br />completion of corrective actions:
<br />16. Proposed amendments to the SWPPP:
<br />Yes I No I NA 17. Potential areas of future concern:
<br />2. Perimeter control trenched in where appropriate?
<br />3. 50 Foot -natural buffer maintained around all surface waters? ❑ ❑ ❑
<br />If No, have redundant sediment controls been installed? ❑ ❑ ❑
<br />5. Vehicle tracking Best Management Practices BMPs at all site exits? I ❑ I ❑ I El
<br />6. All tracked sediment removed within 24 hours? I ❑ I ❑ I ❑
<br />8. Are all infiltration areas Drotected with a Dretreatment device? 1 ❑ 1 ❑ 1 ❑
<br />Comments:
<br />Maintenance -Erosion and Sediment Control BMPs (Part IV.E.)
<br />Comments:
<br />Other
<br />Yes I No
<br />1. Are all materials that can leach Dollutants under cover? I ❑ I ❑ I ❑
<br />www.pca.state.mn.us • 651-296-6300 , 800-657-3864 TTY 651-282-5332 or 800-657-3864 • Available in altemative formats
<br />wq-strm2-36 • 314114 Page 2of4
<br />18. Additional comments:
<br />Disclosures:
<br />• After discovery, the permit requires many of the deficiencies that may be found in this checklist be corrected within a
<br />specified period of time. See permit for more details.
<br />• This inspection checklist is an option for small construction sites. Large construction sites and linear projects require more
<br />extensivelmore location specific inspection requirements.
<br />• The Permittee(s) is/are responsible for the inspection and maintenance of temporary and permanent water quality
<br />management BMP's as well as erosion prevention and sediment control BMPs until another Permittee has obtained
<br />coverage under this Permit according to Part 11.6.5., or the project has undergone Final Stabilization and a Notice of
<br />Termination has been submitted to the MPCA.
<br />www.pca.state.mn.us , 651-296-6300 • 800-657-3864 TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
<br />%q-strm2-36 • 314114 Page 4 of 4
<br />ATTACHMENT C: MAINTENANCE PLAN FOR PERMANENT STORM WATER TREATMENT SYSTEM
<br />CivilSite
<br />G R 4c), U P
<br />ATTACHMENT C
<br />STORMWATER MANAGEMENT FACILITY
<br />MAINTENANCE SCHEDULE
<br />1. All stormwater retention, detention and treatment basins must be
<br />inspected at least once a year to determine that basin retention and treatment
<br />characteristics are adequate. A storage treatment basin will be considered
<br />inadequate if sediment has decreased the wet storage volume by 50 percent or
<br />dry storage volume by 25 percent of its original design volume. Based on this
<br />inspection, if a stormwater basin requires sediment cleanout, the basin will be
<br />restored to its original design contours and vegetated state within one year of
<br />the inspection date.
<br />2. All grit chambers, sump catch basins, sump manholes, outlet
<br />structures, culverts, outfall structures and other stormwater facilities for which
<br />maintenance requirements are not otherwise specified herein must be inspected
<br />in the spring, summer and fall of each year. Within 30 days of the inspection
<br />date, all accumulated sediment and debris must be removed such that each
<br />stormwater facility operates as designed and permitted. Contributing drainage
<br />areas must be kept clear of litter and vegetative debris, inflow pipes and
<br />overflow spillways kept clear, inlet areas kept clean, and undesirable vegetation
<br />removed. Erosion impairing the function or integrity of the facilities, if any, will
<br />be corrected, and any structural damage impairing or threatening to impair the
<br />function of the facilities must be repaired.
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<br />4931 W. 35TH ST. SUITE 200
<br />ST. LOUIS PARK, MN 55416
<br />CivilSiteGroup.com
<br />Matt Pavek
<br />763-213-3944
<br />Pat Sarver
<br />952-250-2003
<br />LAKE', IIIA
<br />DEVELOPMENT. LLC
<br />3. Volume control facilities and contributing drainage areas must be
<br />Yes
<br />No
<br />I NA
<br />1.
<br />Are all previously stabilized areas maintaining 90% ground cover?
<br />❑
<br />❑
<br />❑
<br />2.
<br />Any ditch erosion observed?
<br />❑
<br />❑
<br />❑
<br />3.
<br />Perimeter Control -Has sediment reached one half the height of the device?
<br />❑
<br />❑
<br />❑
<br />4.
<br />Are inlet protection devices maintained and functioning ro erl ?
<br />❑
<br />❑
<br />❑
<br />Comments:
<br />Other
<br />Yes I No
<br />1. Are all materials that can leach Dollutants under cover? I ❑ I ❑ I ❑
<br />www.pca.state.mn.us • 651-296-6300 , 800-657-3864 TTY 651-282-5332 or 800-657-3864 • Available in altemative formats
<br />wq-strm2-36 • 314114 Page 2of4
<br />18. Additional comments:
<br />Disclosures:
<br />• After discovery, the permit requires many of the deficiencies that may be found in this checklist be corrected within a
<br />specified period of time. See permit for more details.
<br />• This inspection checklist is an option for small construction sites. Large construction sites and linear projects require more
<br />extensivelmore location specific inspection requirements.
<br />• The Permittee(s) is/are responsible for the inspection and maintenance of temporary and permanent water quality
<br />management BMP's as well as erosion prevention and sediment control BMPs until another Permittee has obtained
<br />coverage under this Permit according to Part 11.6.5., or the project has undergone Final Stabilization and a Notice of
<br />Termination has been submitted to the MPCA.
<br />www.pca.state.mn.us , 651-296-6300 • 800-657-3864 TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
<br />%q-strm2-36 • 314114 Page 4 of 4
<br />ATTACHMENT C: MAINTENANCE PLAN FOR PERMANENT STORM WATER TREATMENT SYSTEM
<br />CivilSite
<br />G R 4c), U P
<br />ATTACHMENT C
<br />STORMWATER MANAGEMENT FACILITY
<br />MAINTENANCE SCHEDULE
<br />1. All stormwater retention, detention and treatment basins must be
<br />inspected at least once a year to determine that basin retention and treatment
<br />characteristics are adequate. A storage treatment basin will be considered
<br />inadequate if sediment has decreased the wet storage volume by 50 percent or
<br />dry storage volume by 25 percent of its original design volume. Based on this
<br />inspection, if a stormwater basin requires sediment cleanout, the basin will be
<br />restored to its original design contours and vegetated state within one year of
<br />the inspection date.
<br />2. All grit chambers, sump catch basins, sump manholes, outlet
<br />structures, culverts, outfall structures and other stormwater facilities for which
<br />maintenance requirements are not otherwise specified herein must be inspected
<br />in the spring, summer and fall of each year. Within 30 days of the inspection
<br />date, all accumulated sediment and debris must be removed such that each
<br />stormwater facility operates as designed and permitted. Contributing drainage
<br />areas must be kept clear of litter and vegetative debris, inflow pipes and
<br />overflow spillways kept clear, inlet areas kept clean, and undesirable vegetation
<br />removed. Erosion impairing the function or integrity of the facilities, if any, will
<br />be corrected, and any structural damage impairing or threatening to impair the
<br />function of the facilities must be repaired.
<br />00C,�'
<br />7� R9�,
<br />(Z IC Co C C
<br />4931 W. 35TH ST. SUITE 200
<br />ST. LOUIS PARK, MN 55416
<br />CivilSiteGroup.com
<br />Matt Pavek
<br />763-213-3944
<br />Pat Sarver
<br />952-250-2003
<br />LAKE', IIIA
<br />DEVELOPMENT. LLC
<br />3. Volume control facilities and contributing drainage areas must be
<br />inspected every three months during the operational period (between spring
<br />snowmelt and first substantial snowfall) and monitored after rainfall events of 1
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<br />inch or more to ensure that the contributing drainage area is clear of litter and
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<br />debris, inflow pipes and overflow spillways are clear, inlet areas are clean,
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<br />undesirable vegetation is removed and there is no erosion impairing or
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<br />threatening to impair the function of a facility. If sediment has accumulated in a
<br />infiltration feature, within 30 days of inspection deposited sediments must be
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<br />removed, the infiltration capacity of the underlying soils must be restored, and
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<br />any surface disturbance must be stabilized. Inspection must ensure that
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<br />sediment traps and forebays are trapping sediment and that more than 50
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<br />percent of the storage volume remains, the contributing drainage area is stable
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<br />(i.e., no erosion is observed), and inlets and outlet/overflow spillways are in
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<br />good conditions with no erosion. Maintenance techniques used must protect
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<br />the infiltration capacity of the practice by limiting soil compaction to the
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<br />greatest extent possible (e.g., by using low -impact earth -moving equipment).
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<br />4. Underground storage chambers must be inspected at least once a
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<br />year to ensure that adequate storage capacity remains. Capacity will be
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<br />considered inadequate if sediment has decreased the storage volume by 50
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<br />percent of its original design volume. Accumulated debris and sediment will be
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<br />removed, and inlet and outlet structures will be cleared of any flow
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<br />impediments.
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<br />I HEREBY CERTIFY THAT THIS PLAN,
<br />SPECIFICATION, OR REPORT WAS
<br />PREPARED BY ME OR UNDER MY DIRECT
<br />SUPERVISION AND THAT I AM A DULY
<br />LICENSED PROFESSIONAL ENGINEER
<br />UNDER THE LAWS OF THE STATE OF
<br />MINNESOTA.
<br />- Matthew R. Pavek
<br />DATE 06/07/18 LICENSE No. 44263
<br />ISSUE/SUBMITTAL SUMMARY
<br />DATE I DESCRIPTION
<br />06/07/18 1 CONSTRUCTION PLANS
<br />REVISION SUMMARY
<br />'ROJECT NO.: 17059
<br />SWPPP - ATTACHMENTS
<br />SW1
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