AUGUST 2001 S COMPLIANCE STATUS REPORT for THE

AUGUST 2001’s COMPLIANCE STATUS REPORT FOR THE

CONSTRUCTION STORM WATER GENERAL PERMIT

PROJECT NAME:

WDID #:

PART A: PERMITTEE INFORMATION

Owner Information (Note, if a change in ownership has occurred, the new owner must file a Notice Of Intent (NOI) and the old owner must file a Notice of Termination (NOT):

Name:Street:

Contact:City: State:

Phone:Zip Code:

Developer Information:

Name: Street:

Contact:City: State:

Phone:Zip Code:

PART B: CONSTRUCTION SITE INFORMATION

(Please complete all of the following information. Failure to do so may be considered noncompliance.)

Project Name:

Site Latitude: Site Longitude:Site Post Mile Marker:

Site Address (Street and main cross-street):

Site City: Site Zip Code:

Site Phone: ext. #: Site Fax#:

Project Manager: Manager’s Cellular #:

Manger’s Pager#:

Size of Site (acres): # Acres Remaining to be Disturbed:

% of Site’s Area Disturbed :

% of Site’s Mass Grading: % Impervious Coverage Before Activity:

Projected % Impervious Coverage upon completion:

Expected Completion Date of Grading:

Expected Completion Date of Site Project:

PART C: CONTACT INFORMATION

Contact Person for Permit Compliance Concerns ( Who should respond to requests from the Regional Board for technical reports? If same information as in ‘Owner Information’ section, then please leave blank.):

Name: Title: Phone #: ext. #:

Cellular Phone #: Pager #: Fax #:

Street:

City: State: Zip:

AUGUST 2001’s COMPLIANCE STATUS REPORT FOR THE

CONSTRUCTION STORM WATER GENERAL PERMIT

PART D: NARRATIVE DESCRIPTION OF WORK

On this sheet or on an attached sheet, you must include a narrative description of the following items.

• Current project status including, but not limited to grading, site disturbance, erosion and sediment control practices already in effect.
• Best Management Practices (BMPs – effective erosion and sediment control measures) that will be implemented prior to the next wet season (2001-2002), including a time schedule for implementation.
• Describe any major upcoming events such as project completion, land disturbances, selling of parcels, or transfer of ownership.
• Construction Time Schedule.

IF YOU HAVE A PERMIT AND HAVE NOT STARTED CONSTRUCTION ACTIVITY, PLEASE EXPLAIN BRIEFLY THE STATUS OF YOUR PROJECT AND PROVIDE CONSTRUCTION TIME SCHEDULE.

PART E: SECTION A of the GENERAL PERMIT,

STORM WATER POLLUTION PREVENTION PLAN (SWPPP)

Section A.1-4:

Are you implementing a SWPPP? Yes No

If yes, date SWPPP prepared: Date SWPPP last updated:

------

Comments:______

Section A.5-8:

Does your SWPPP include a description of potential pollutant sources, including storm water runoff containing sediment? Yes No

Note: If you have an active construction site, or you will have any soil disturbance activities during the

wet season, then you must submit a map.

If yes, attach a copy of the color-coded site map with a legend included showing:

 Areas of soil disturbance that have been stabilized.

 Areas of active grading.

 Areas to be graded along with a time schedule.

 Areas of potential soil erosion where control practices will be implemented prior to October

15th. Also indicate the type of control practices and time schedule for implementation.

 Locations of post-construction projects (i.e. ponds and detention basins).

 Location of designated concrete wash-out pit and construction material storage area on site map.

Which of the following erosion and sedimentation control methods are included in your SWPPP?

Temporary Seeding Silt Fences Subsurface Drains

Permanent Seeding Detention Basins Pipe Slope Drains

Mulching Sediment Traps Storm Drain Inlet Protection

Sod Stabilization Sediment Basins Drainage Swales

Vegetative Buffer Strips Check Dams Rock Outlet Protection

Protection of Trees Fiber Rolls

Brush Barriers Other______

Section A.9:

Have all non-storm water discharges from the site been eliminated or otherwise permitted? Yes No

If yes, please attach a description of the measures taken to eliminate all non-storm water discharges.

If no, please indicate which of the following non-storm water discharges exist on your site:

Spills Landscape Irrigation Wash Waters

Pipe Testing Storage Tanks Leaks Dust Control Runoff

Pipe Flushing Dewatering Other ______

Section A.10-13:

Your SWPPP must include control measures to reduce pollutants in storm water discharges after all construction phases are completed (Post-Construction), including an operations and maintenance schedule, short and long term funding sources, and responsible parties?

Please indicate which of the following post-construction measures will be implemented in your project/site:

Clustered Development Wet Ponds Extended Detention Basins

Constructed Storm water Wetlands Grassy Swales Home Owner Education

Inlet Filters (e.g. ,“Fossil Filters”) Oil/Water Separators Vegetated Filter Strips

Infiltration Devices (e.g., infiltration trenches or basins) Porous Pavement

Media Filters (e.g., sand filters or compost storm water filters)

Site Design______(e.g., draining roof runoff to landscaped areas)

Other ______

Comments:______

______

August 2001’s Compliance Status Report continued:

PROJECT NAME:

PART F: SECTION B of the GENERAL PERMIT,

MONITORING PROGRAM AND REPORTING REQUIREMENTS

Section B.1-3:

Have you inspected your site prior to anticipated storms? Yes No

Frequency of inspections?______

Comments:______

Have you inspected your site following storm events? Yes No

Frequency of inspections?______

Comments:______

Have you kept records of all the wet and dry month inspections? Yes No

If yes, please attach a few examples of previously performed inspection reports.

Comments:______

Section B.4-6:

Do you certify, based on your site inspections, that your site is in compliance with the requirements of the NPDES General Permit for Discharges of Storm Water Runoff Associated with Construction Activity?

Yes No

Comments:______

PART G: SECTION C of the GENERAL PERMIT,

STANDARD PROVISIONS FOR CONSTRUCTION ACTIVITY

Section C.10 and C.12:

“ I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system or those persons directly responsible for gathering the information, the information submitted is the best of my knowledge and belief, true, accurate and complete. I am aware that there are significant penalties for submitting false information, including the possibly of fine and imprisonment for knowing violations.”

Section C.9

Printed Name: ______

Signature: ______Date Signed: ______

(Please see Important Note #5 of enclosed attachments concerning allowable signatures.)

Title: ______

IMPORTANT INFORMATION

1. Every Annual Report must come with a color-coded site map. This map must include all items in Section A.5 of the General permit.

1. Longitude and Latitude must be filled out, with minutes and seconds. (If unable to get exact coordinates, give as close as you are able and make a note in the comment section.)

1. B.4 requires that copies of your monitoring records must be included in the Annual Report. Not all of the records must be submitted. Only one copy of your monitoring record for each month during the wet and dry seasons is needed.

1. If you are a developer and have sold any of the land covered in the permit, you must include the name and address of the purchaser. Your submitted map must also show this information.

1. Not everyone is allowed to sign the annual report. Provision C.9 on page 22 of General Permit gives specific guidelines on who can and cannot sign the annual report.

1. If your project site is complete and you are submitting an NOT, you are also required to submit photos of the completed project, a Post Construction implementation plan, and a site map, indicating the location of the photos.

Note that if any of the above-requested items are not complete on the submitted annual report, the permit tee may be fined up to $5,000.00 per day after the due date until the requested information is received. Note that the Board may not be able to notify the permittee of missing items until after the required due date. This may not reduce any liabilities incurred by the permittee. If you are unable to supply any of the above requested information, prior to the submittal date, contact the Board. Exceptions may be made on a case-by-case basis.

Finally, if a change of ownership has occurred, the new owner must submit a Notice of Intent and the previous owner must submit a Notice of Termination. It is also advised that the previous owner inform the new owner of the need to submit the proper documentation. For companies with a name change, send official documentation showing that the company has changed its name.