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ATTACHMENT B: SWPPP INSPECTION FORM .'iiLole G R O U P Minnesota Pollution Control Agency 32-DLdfdyelueRudd NVlth ATTACHMENT B: St. Paul, MN 55135-4144 Construction Stormwater Inspection Checklist Construction Stormwator Program Doc Type Permitting Checklist Note: This inspection report does not address all aspects of the National Pollutant Discharge Elimination System/State Disposal System (NPDES/SDS) Construction Stormwater permit (Permit) issued on August 1, 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. Facility Information Site name: Facility address: City: Inspection Information State: Permit number: Zip code: Inspector name: Phone number: Date (mmldd/yyyy): Time: ❑ am ❑ pm Is the inspector certified in sediment and erosion control and it is documented in the Stormwater Pollution Prevention Plan (SWPPP)? ❑ Yes ❑ No Is this inspection routine or in response to a storm event: Rainfall amount (if applicable): Is site within one aerial mile of special or impaired water? []Yes ❑No If yes, follow Appendix A and other applicable permit requirements. Note: If NA is selected at anytime, specify why in the comment area for that section. Erosion Control Requirement (Part IV.B) www.pca.state.mn.us 651-296-6300 800-657-3864 TTY 651-282-5332 or 800-657-3864 • Available in alternative formats wq-stnm2-36 • 314114 Page 1 of 4 CivilSite G R O U P 6. Do pipe outlets have energy dissipation? ❑ I ❑ ❑ Comments: Sediment Control Requirement (Part IV.C.) Has access been restricted to onsite hazardous materials? Yes No NA 1. Soil stabilization where no construction activity for 14 days? 7 days were applicable) ❑ ❑ ❑ 2. Has the need to disturb steep slopes been minimized? ❑ ❑ ❑ 3. All ditches stabilized 200' back from point of discharge within 24 hours? Not mulch ❑ ❑ ❑ 4. Are there erosion BMP's for onsite stockpiles? ❑ ❑ ❑ 5. Are appropriate BMP's installed protecting inletsfoutlets? ❑ ❑ ❑ www.pca.state.mn.us 651-296-6300 800-657-3864 TTY 651-282-5332 or 800-657-3864 • Available in alternative formats wq-stnm2-36 • 314114 Page 1 of 4 CivilSite G R O U P 6. Do pipe outlets have energy dissipation? ❑ I ❑ ❑ Comments: Sediment Control Requirement (Part IV.C.) Comments: Maintenance -Erosion and Sediment Control BMPs (Part IV.E.) Has access been restricted to onsite hazardous materials? Yes No NA 1. Perimeter control installed on all down gradientperimeters? ❑ ❑ ❑ 2. Perimeter control trenched in where appropriate? ❑ ❑ ❑ 3. 50 Foot -natural buffer maintained around all surface waters? ❑ ❑ ❑ 4. If No, have redundant sediment controls been installed? ❑ ❑ ❑ 4. Inlet protection on all catch basins and culvert inlets? Ln 5. Vehicle tracking Best Management Practices (BMPs) at all site exits? ❑ ❑ ❑ 6. All tracked sediment removed within 24 hours? 1-1 El 11 7. Are all infiltrations stems staked and marked to avoid compaction? ❑ ❑ ❑ 8. Are all infiltration areas protected with a pretreatment device? ❑ ❑ ❑ 9. Do all stockpiles have perimeter control? ❑ ❑ ❑ Comments: Maintenance -Erosion and Sediment Control BMPs (Part IV.E.) Comments: Other Yes I No I NA 1. Are all materials that can leach pollutants under cover? I ❑ I ❑ I ❑ G R O U P 2. Has access been restricted to onsite hazardous materials? Yes No I NA 1. Are all previously stabilized areas maintaining 90% ground cover? ❑ ❑ ❑ 2. Any ditch erosion observed? ❑ ❑ ❑ 3. Perimeter Control -Has sediment reached one half the height of the device? ❑ ❑ ❑ 4. Are inlet protection devices maintained and functioning ro erl ? ❑ ❑ ❑ Comments: Other Yes I No I NA 1. Are all materials that can leach pollutants under cover? I ❑ I ❑ I ❑ G R O U P 2. Has access been restricted to onsite hazardous materials? ❑ I ❑ I ❑ 3. Does on-site fueling only occur in a contained area? ❑ ❑ ❑ 4. Are all solid wastes being properly disposed of? ❑ ❑ ❑ 5. Is the concrete washout area completely contained? n n n Comments: 7. Were any discharges seen during this inspection, sediment, water, or otherwise? ❑ Yes ❑ No 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 I ILD of the permit? Describe: 9. Is any dewatering occurring on site? ❑ Yes ❑ No 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? 10. Is a copy of the SWPPP located on the construction site? ❑ Yes ❑ No 11. Has the SWPPP been followed and implemented on site? ❑ Yes ❑ No 12. Is a sedimentation basin required for this project as specified in the permit? ❑ Yes ❑ No If yes, are they maintained as specified in the permit? ❑ Yes ❑ No 13. Is the topsoil on this project being preserved? ❑ Yes ❑ No If yes, explain how the topsoil is being preserved. If not, explain why it was infeasible. 14. Are all infiltration systems marked to avoid compaction? ❑ Yes ❑ No Do all infiltration areas have pretreatment devices? ❑ Yes ❑ No www.pca.state. mn.us 651-296-6300 800-657-3864 TTY 651-282-5332 or 800-657-3864 . Available in alternative formats wq-strm2-36 . 314114 Page 3 of 4 ,,ivilSite G R O U P 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 extensivelmore 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 BMPs until another Permittee has obtained coverage under this Permit according to Part 11.8.5., or the project has undergone Final Stabilization and a Notice of Termination has been submitted to the MPGA. www.pca.state.mn.us • 651-296-6300 . 800-657-3864 TTY 651-282-5332 or 800-657-3864 • Available in alternative formats www.pca.state.mn.us • 651-296-6300 . 800.657.3864 TTY 651.282.5332 or 800-657-3864 . Available in alternative formats wq-strm2-36 . 314114 Page 2 of 4 wq-strm2-36 • 314114 Page 4 of 4 ATTACHMENT C: MAINTENANCE PLAN FOR PERMANENT STORM WATER TREATMENT SYSTEM �LivftSite G R U U P ATTACHMENT C COR7 00� qN' 4931 W. 35TH ST. SUITE 200 ST. LOUIS PARK, MN 55416 CivilSiteGroup.com Matt Pavek 763-213-3944 Pat Sarver 952-250-2003 STORMWATER MANAGEMENT FACILITY MAINTENANCE SCHEDULE LAKE W�EST 1 . All stormwater retention, detention and treatment basins must be inspected at least once a year to determine that basin retention and treatment DEVELOPMENT, LLC characteristics are adequate. A storage treatment basin will be considered inadequate if sediment has decreased the wet storage volume by 50 percent or dry storage volume by 25 percent of its original design volume. Based on this inspection, if a stormwater basin requires sediment cleanout, the basin will be restored to its original design contours and vegetated state within one year of the inspection date. 2. All grit chambers, sump catch basins, sump manholes, outlet structures, culverts, outfall structuresandother stormwater facilities forwhich maintenance requirements are not otherwise specified herein must be inspected in the spring, summer and fall of each year. Within 30 days of the inspection date, all accumulated sediment and debris must be removed such that each stormwater facility operates as designed and permitted. Contributing drainage areas must be kept clear of litter and vegetative debris, inflow pipes and overflow spillways kept clear, inlet areas kept clean, and undesirable vegetation removed. Erosion impairing the function or integrity of the facilities., if any, will be corrected, and any structural damage impairing or threatening to impair the function of the facilities must be repaired. 3. Volume control facilities and contributing drainage areas must be inspected every three months during the operational period (between spring snowmelt and first substantial snowfall) and monitored after rainfall events of 1 I- M inch or more to ensure that the contributing drainage area is clear of litter and LID debris, inflow pipes and overflow spillways are clear, inlet areas are clean, Ln undesirable vegetation is removed and there is no erosion impairing or " Z threatening to impair the function of a facility. If sediment has accumulated in a infiltration feature, within 30 days of inspection deposited sediments must be Z removed, the infiltration capacity of the underlying soils must be restored, and LO W Z any surface disturbance must be stabilized. Inspection must ensure that C O sediment traps and forebays are trapping sediment and that more than 50 Z a.Z Lu V O p Z 1 oJ J 0� W co O > N *� 1 V'"I It e Lu Q W ~ G R O U P n LL percent of the storage volume remains, the contributing drainage area is stable ri > Cal� ti (i.e., no erosion is observed), and inlets and outlet/overflow spillways are in OQ L good conditions with no erosion. Maintenance techniques used must protect C:) the infiltration capacity of the practice by limiting soil compaction to the M 30 >_ greatest extent possible (e.g., by using low -impact earth -moving equipment). (� W = 4. Underground storage chambers must be inspected at least once a 1,17 year to ensure that adequate storage capacity remains. Capacity will be LID considered inadequate if sediment has decreased the storage volume by 50 percent of its original design volume. Accumulated debris and sediment will be w removed, and inlet and outlet structures will be cleared of any flow O impediments. IL 2 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. - Mafthew R. Pavek DATE 07/19/17 LICENSE NO. 44263 ISSUE/SUBMITTAL SUMMARY REVISION SUMMARY PROJECT NO.: 17059 PRELIMINARY SWPPP - ATTACHMENTS SW1 05 COPYRIGHT 2017 CIVIL SITE GROUP INC.