ࡱ> 86/0129#` bjbj\.\. >D>D4hJY"888|d4$Y&Y&Y&Y&Y&Y&Y$[hK^JY]+++JY88Y+88$Y+$YK(S8 Ü[>;lNN$YY0YN^g^S^S+9+++JYJY#p+++Y++++dzSdRzd Appendix A: SWPPP Template Instructions To help you develop the narrative section of your construction site SWPPP, EPA has created this electronic SWPPP template. The template is designed to help guide you through the SWPPP development process and help ensure that your SWPPP addresses all the necessary elements stated in your construction general permit. You should use this template with EPAs guidance on Developing Your Stormwater Pollution Prevention Plan. Both are available on EPAs website at  HYPERLINK "http://www.epa.gov/npdes/swpppguide" www.epa.gov/npdes/swpppguide This template covers the SWPPP elements that most state construction general permits require, however, you are strongly encouraged to customize this template. There are two major reasons to customize this template: To reflect the terms and conditions of your construction general permit To reflect the conditions at your site Some states might have their own SWPPP template. If so, use the state-suggested format. In such cases, this document and its template might provide useful background information. Using the SWPPP Template Each section of this template includes instructions and space for project information. You should read the instructions for each section as you complete the project information. This template was developed in Word so that you can easily add tables and additional text. Some sections may require only a brief description while others may require several pages of explanation. Tips for completing the SWPPP template If there is more than one construction operator for your project, consider coordinating development of your SWPPP with the other operators. Multiple operators may share the same SWPPP, but make sure that responsibilities are clearly described. Modify this SWPPP template so that it addresses the requirements in your construction general permit and meets the needs of your project. Consider adding permit citations in the SWPPP when you address a specific permit requirement. Stormwater Pollution Prevention Plan For:  FORMTEXT Insert Project Name  FORMTEXT Insert Project Site Location/Address  FORMTEXT Insert City, State, Zip Code  FORMTEXT Insert Project Site Telephone Number (if applicable) Operator(s):  FORMTEXT Insert Company or Organization Name  FORMTEXT Insert Name  FORMTEXT Insert Address  FORMTEXT Insert City, State, Zip Code  FORMTEXT Insert Telephone Number  FORMTEXT Insert Fax/Email Stormwater Manager and SWPPP Contact(s):  FORMTEXT Insert Company or Organization Name  FORMTEXT Insert Name  FORMTEXT Insert Address  FORMTEXT Insert City, State, Zip Code  FORMTEXT Insert Telephone Number  FORMTEXT Insert Fax/Email SWPPP Preparation Date:  FORMTEXT       Estimated Project Dates: Start of Construction: __ __ / __ __ / __ __ __ __ Completion of Construction: __ __ / __ __ / __ __ __ __ Table of Contents  TOC \o "1-2" \h \z \u  HYPERLINK \l "_Toc156126626" SECTION 1: SITE EVALUATION, ASSESSMENT, AND PLANNING  PAGEREF _Toc156126626 \h 1  HYPERLINK \l "_Toc156126627" 1.1 Project/Site Information  PAGEREF _Toc156126627 \h 1  HYPERLINK \l "_Toc156126628" 1.2 Contact Information/Responsible Parties  PAGEREF _Toc156126628 \h 2  HYPERLINK \l "_Toc156126629" 1.3 Nature and Sequence of Construction Activity  PAGEREF _Toc156126629 \h 3  HYPERLINK \l "_Toc156126630" 1.4 Soils, Slopes, Vegetation, and Current Drainage Patterns  PAGEREF _Toc156126630 \h 4  HYPERLINK \l "_Toc156126631" 1.5 Construction Site Estimates  PAGEREF _Toc156126631 \h 5  HYPERLINK \l "_Toc156126632" 1.6 Receiving Waters  PAGEREF _Toc156126632 \h 5  HYPERLINK \l "_Toc156126633" 1.6 Receiving Waters (continued)  PAGEREF _Toc156126633 \h 6  HYPERLINK \l "_Toc156126634" 1.7 Site Features and Sensitive Areas to be Protected  PAGEREF _Toc156126634 \h 6  HYPERLINK \l "_Toc156126635" 1.8 Potential Sources of Pollution  PAGEREF _Toc156126635 \h 6  HYPERLINK \l "_Toc156126636" 1.8 Potential Sources of Pollution (continued)  PAGEREF _Toc156126636 \h 7  HYPERLINK \l "_Toc156126637" 1.9 Endangered Species Certification  PAGEREF _Toc156126637 \h 7  HYPERLINK \l "_Toc156126638" 1.10 Historic Preservation  PAGEREF _Toc156126638 \h 7  HYPERLINK \l "_Toc156126639" 1.10 Historic Preservation (Continued)  PAGEREF _Toc156126639 \h 8  HYPERLINK \l "_Toc156126640" 1.11 Maps  PAGEREF _Toc156126640 \h 8  HYPERLINK \l "_Toc156126641" SECTION 2: EROSION AND SEDIMENT CONTROL BMPS  PAGEREF _Toc156126641 \h 9  HYPERLINK \l "_Toc156126642" SECTION 3: GOOD HOUSEKEEPING BMPS  PAGEREF _Toc156126642 \h 15  HYPERLINK \l "_Toc156126643" 3.1 Good Housekeeping BMPs  PAGEREF _Toc156126643 \h 15  HYPERLINK \l "_Toc156126644" 3.2 Allowable Non-Stormwater Discharge Management  PAGEREF _Toc156126644 \h 18  HYPERLINK \l "_Toc156126645" SECTION 4: SELECTING POST-CONSTRUCTION BMPs  PAGEREF _Toc156126645 \h 19  HYPERLINK \l "_Toc156126646" SECTION 5: INSPECTIONS and MAINTENANCE  PAGEREF _Toc156126646 \h 21  HYPERLINK \l "_Toc156126647" 5.1 Inspections  PAGEREF _Toc156126647 \h 21  HYPERLINK \l "_Toc156126648" 5.2 Maintenance of Controls  PAGEREF _Toc156126648 \h 22  HYPERLINK \l "_Toc156126649" 5.3 Corrective Action Log  PAGEREF _Toc156126649 \h 22  HYPERLINK \l "_Toc156126650" SECTION 6: Recordkeeping and Training  PAGEREF _Toc156126650 \h 23  HYPERLINK \l "_Toc156126651" 6.1 Recordkeeping  PAGEREF _Toc156126651 \h 23  HYPERLINK \l "_Toc156126652" 6.2 Log of Changes to the SWPPP  PAGEREF _Toc156126652 \h 23  HYPERLINK \l "_Toc156126653" 6.3 Training  PAGEREF _Toc156126653 \h 24  HYPERLINK \l "_Toc156126654" SECTION 7: FINAL STABILIZATION  PAGEREF _Toc156126654 \h 25  HYPERLINK \l "_Toc156126655" SECTION 8: CERTIFICATION AND NOTIFICATION  PAGEREF _Toc156126655 \h 26  HYPERLINK \l "_Toc156126656" SWPPP APPENDICES  PAGEREF _Toc156126656 \h 27  HYPERLINK \l "_Toc156126657" App A - General Location Map  PAGEREF _Toc156126657 \h 27  HYPERLINK \l "_Toc156126658" App B - Site Maps  PAGEREF _Toc156126658 \h 27  HYPERLINK \l "_Toc156126659" App C - Copy of Construction General Permit  PAGEREF _Toc156126659 \h 27  HYPERLINK \l "_Toc156126660" App D - Copy of NOI and acknowledgement letter from EPA/State  PAGEREF _Toc156126660 \h 27  HYPERLINK \l "_Toc156126661" App E - Inspection Reports  PAGEREF _Toc156126661 \h 27  HYPERLINK \l "_Toc156126662" App F - Corrective Action Log (or in Section 5.3)  PAGEREF _Toc156126662 \h 27  HYPERLINK \l "_Toc156126663" App G - Log of Changes and Updates to SWPPP (or in Section 6.3)  PAGEREF _Toc156126663 \h 27  HYPERLINK \l "_Toc156126664" App H - Subcontractor Certifications/Agreements  PAGEREF _Toc156126664 \h 27  HYPERLINK \l "_Toc156126665" App I - BMP specifications and details  PAGEREF _Toc156126665 \h 27  HYPERLINK \l "_Toc156126666" App J - Additional Information (i.e., Endangered Species and Historic Preservation documentation)  PAGEREF _Toc156126666 \h 27  SECTION 1: SITE EVALUATION, ASSESSMENT, AND PLANNING 1.1 Project/Site Information Instructions: In this section you can gather some basic site information that will be helpful to you later when you file for permit coverage. For more information, see Developing Your Stormwater Pollution Prevention Plan: A SWPPP Guide for Construction Sites (also known as the SWPPP Guide), Chapter 2 Detailed information on determining your sites latitude and longitude can be found at  HYPERLINK "http://www.epa.gov/npdes/stormwater/latlong" www.epa.gov/npdes/stormwater/latlong Project Information: Project/Site Name: ______________________________________________________________ Project Street/Location: __________________________________________________________ City: _____________________________ State: ____________ Zip Code: _________________ County or Similar Subdivision: ____________________________________________________ Latitude/Longitude (Use one of three possible formats, and specify method) Latitude: Longitude: 1. _ _ _ _ ' _ _ '' N (degrees, minutes, seconds) 1. _ _ _ _ ' _ _ '' W (degrees, minutes, seconds) 2. _ _ _ _ . _ _ ' N (degrees, minutes, decimal) 2. _ _ _ _ . _ _ ' W (degrees, minutes, decimal) 3. _ _ . _ _ _ _ N (decimal) 3. _ _ . _ _ _ _ W (decimal) Method for determining latitude/longitude:  FORMCHECKBOX  USGS topographic map (specify scale: ____________)  FORMCHECKBOX  EPA Web site  FORMCHECKBOX  GPS  FORMCHECKBOX  Other (please specify):_________________________________________________________ Is the project located in Indian country?  FORMCHECKBOX  Yes  FORMCHECKBOX  No If yes, name of Reservation, or if not part of a Reservation, indicate "not applicable." _________ _____________________________________________________________________________ Is this project considered a federal facility?  FORMCHECKBOX  Yes  FORMCHECKBOX  No NPDES project or permit tracking number:________________________________ (This is the unique identifying number assigned to your project by your permitting authority after you have applied for coverage under the appropriate NPDES construction general permit.) 1.2 Contact Information/Responsible Parties Instructions: List the operator(s), project managers, stormwater manager, and person or organization that prepared the SWPPP. Indicate respective responsibilities, where appropriate. Also, list subcontractors expected to work on-site. Notify subcontractors of stormwater requirements applicable to their work. See SWPPP Guide, Chapter 2.B. and your construction general permit for the definition of operator. Project Information: Operator(s):  FORMTEXT Insert Company or Organization Name  FORMTEXT Insert Name  FORMTEXT Insert Address  FORMTEXT Insert City, State, Zip Code  FORMTEXT Insert Telephone Number  FORMTEXT Insert Fax/Email  FORMTEXT Insert area of control (if more than one operator at site) Repeat as necessary Project Manager(s) or Site Supervisor(s):  FORMTEXT Insert Name  FORMTEXT Insert Company or Organization Name  FORMTEXT Insert Address  FORMTEXT Insert City, State, Zip Code  FORMTEXT Insert Telephone Number  FORMTEXT Insert Fax/Email  FORMTEXT Insert area of control (if more than one operator at site) Repeat as necessary Stormwater Manager and SWPPP Contact(s):  FORMTEXT Insert Name  FORMTEXT Insert Company or Organization Name  FORMTEXT Insert Address  FORMTEXT Insert City, State, Zip Code  FORMTEXT Insert Telephone Number  FORMTEXT Insert Fax/Email (Optional) Repeat as necessary This SWPPP Was Prepared By:  FORMTEXT Insert Name  FORMTEXT Insert Company or Organization Name  FORMTEXT Insert Address  FORMTEXT Insert City, State, Zip Code  FORMTEXT Insert Telephone Number  FORMTEXT Insert Fax/Email Subcontractor(s):  FORMTEXT Insert Company or Organization Name  FORMTEXT Insert Name  FORMTEXT Insert Address  FORMTEXT Insert City, State, Zip Code  FORMTEXT Insert Telephone Number  FORMTEXT Insert Fax/Email Repeat as necessary Emergency 24 hour contact:  FORMTEXT Insert Name  FORMTEXT Insert Telephone Number 1.3 Nature and Sequence of Construction Activity Instructions: Briefly describe the nature of the construction activity and approximate timeframes (one or more paragraphs, depending on the nature and complexity of the project). See SWPPP Guide, Chapter 3.A. for more information. Project Information: Describe the general scope of the work for the project, major phases of construction, etc:  FORMTEXT INSERT TEXT HERE What is the function of the construction activity?  FORMCHECKBOX  Residential  FORMCHECKBOX  Commercial  FORMCHECKBOX  Industrial  FORMCHECKBOX  Road Construction  FORMCHECKBOX  Linear Utility  FORMCHECKBOX  Other (please specify):_________________________________________________________ Estimated Project Start Date: __ __ / __ __ / __ __ __ __ Estimated Project Completion Date: __ __ / __ __ / __ __ __ __ 1.4 Soils, Slopes, Vegetation, and Current Drainage Patterns Instructions: Describe the existing soil conditions at the construction site including soil types, slopes and slope lengths, drainage patterns, and other topographic features that might affect erosion and sediment control. Also, note any historic site contamination evident from existing site features and known past usage of the site. This information should also be included on your site maps (See SWPPP Guide, Chapter 3.C.). For more information, see SWPPP Guide, Chapter 3.A. for more information. Project Information: Soil type(s):  FORMTEXT INSERT TEXT HERE  FORMTEXT INSERT TEXT HERE Slopes (describe current slopes and note any changes due to grading or fill activities):  FORMTEXT INSERT TEXT HERE  FORMTEXT INSERT TEXT HERE Drainage Patterns (describe current drainage patterns and note any changes dues to grading or fill activities):  FORMTEXT INSERT TEXT HERE  FORMTEXT INSERT TEXT HERE Vegetation:  FORMTEXT INSERT TEXT HERE  FORMTEXT INSERT TEXT HERE Other:  FORMTEXT INSERT TEXT HERE  FORMTEXT INSERT TEXT HERE 1.5 Construction Site Estimates Instructions: Estimate the area to be disturbed by excavation, grading, or other construction activities, including dedicated off-site borrow and fill areas. Calculate the percentage of impervious surface area before and after construction Calculate the runoff coefficients before and after construction. For more information, see SWPPP Guide, Chapter 3.A. and Appendix C Project Information: The following are estimates of the construction site: Construction Site Area to be disturbed  FORMTEXT       acres Total Project Area  FORMTEXT       acres Percentage impervious area before construction  FORMTEXT       % Runoff coefficient before construction  FORMTEXT       Percentage impervious area after construction  FORMTEXT       % Runoff coefficient after construction  FORMTEXT       1.6 Receiving Waters Instructions: List the waterbody(s) that would receive stormwater from your site, including streams, rivers, lakes, coastal waters, and wetlands. Describe each as clearly as possible, such as Mill Creek, a tributary to the Potomac River, etc. Note any stream crossings, if applicable. List the storm sewer system or drainage system that stormwater from your site could discharge to and the waterbody(s) that it ultimately discharges to. If any of the waterbodies above are impaired and/or subject toTMDLs, please list the pollutants causing the impairment and any specific requirements in the TMDL(s) that are applicable to construction sites. Your SWPPP should specifically include measures to prevent the discharge of these pollutants. For more information, please see SWPPP Guide, Chapter 3.A. and 3.B. Also visit  HYPERLINK "http://www.epa.gov/npdes/stormwater/tmdl" www.epa.gov/npdes/stormwater/tmdl for more information and a list of TMDL contacts and links by state. 1.6 Receiving Waters (continued) Project Information: Description of receiving waters:  FORMTEXT INSERT TEXT HERE Description of storm sewer systems:  FORMTEXT INSERT TEXT HERE Description of impaired waters or waters subject to TMDLs:  FORMTEXT INSERT TEXT HERE 1.7 Site Features and Sensitive Areas to be Protected Instructions: Describe unique site features including streams, stream buffers, wetlands, specimen trees, natural vegetation, steep slopes, or highly erodible soils that are to be preserved. Describe measures to protect these features. Include these features and areas on your site maps. For more information, see SWPPP Guide, Chapter 3.A. and 3.B. for more information Project Information: Description of unique features and measures to protect them:  FORMTEXT INSERT TEXT OR TABLE HERE 1.8 Potential Sources of Pollution Instructions: Identify and list all potential sources of sediment from construction materials and activities which may reasonably be expected to affect the quality of stormwater discharges from the construction site. Identify and list all potential sources of pollution, other than sediment, from construction materials and activities which may reasonably be expected to affect the quality of stormwater discharges from the construction site. See SWPPP Guide, Chapter 3.A. for more information. Project Information: Potentials sources of sediment to stormwater runoff:  FORMTEXT INSERT TEXT OR TABLE HERE  FORMTEXT INSERT TEXT HERE 1.8 Potential Sources of Pollution (continued) Potential pollutants and sources, other than sediment, to stormwater runoff:  FORMTEXT INSERT TEXT OR TABLE HERE  FORMTEXT INSERT TEXT HERE 1.9 Endangered Species Certification Instructions: Before commencing construction, determine whether endangered or threatened species or their critical habitats are on or near your site. Adapt this section as needed for state or tribal endangered species requirements. For more information on this topic, see SWPPP Guide, Chapter 3.B. Additional information related to EPAs Construction General Permit can be found at  HYPERLINK "http://www.epa.gov/npdes/stormwater/esa" www.epa.gov/npdes/stormwater/esa Project Information: Are endangered or threatened species and critical habitats on or near the project area?  FORMCHECKBOX  Yes  FORMCHECKBOX  No Describe how this determination was made:  FORMTEXT INSERT TEXT HERE If yes, describe the species and/or critical habitat:  FORMTEXT INSERT TEXT HERE If yes, describe or refer to documentation which determines the likelihood of an impact on identified species and/or habitat and the steps taken to address that impact. (Note, if species are present on or near your project site, EPA strongly recommends that the site operator work closely with the appropriate field office of the U.S. Fish and Wildlife Service or National Marine Fisheries Service. Please contact a state or tribal official for concerns related to state or tribal listing of species.)  FORMTEXT INSERT TEXT HERE 1.10 Historic Preservation Instructions: Before you begin construction, you should review federal and any applicable state, local, or tribal historic preservation laws and determine if there are historic sites on or near your project. If so, you may need to make adjustments to your construction plans or to your stormwater controls to ensure that these historic sites are not damaged. For more information see SWPPP Guide, Chapter 3.B or contact your state or tribal historic preservation officer. 1.10 Historic Preservation (Continued) Project Information: Are there any historic sites on or near the construction site?  FORMCHECKBOX  Yes  FORMCHECKBOX  No Describe how this determination was made:  FORMTEXT INSERT TEXT HERE If yes, describe or refer to documentation which determines the likelihood of an impact on this historic site and the steps taken to address that impact.  FORMTEXT INSERT TEXT HERE 1.11 Maps Instructions: Attach at least two site maps. The first should show the undeveloped site and its current features. An additional map or maps should be created to show the developed site or the major phases of development, for more complicated sites. These maps should include:  FORMCHECKBOX  Direction(s) of stormwater flow and approximate slopes before and after major grading activities  FORMCHECKBOX  Areas and timing of soil disturbance and areas that will not be disturbed  FORMCHECKBOX  Natural features to be preserved  FORMCHECKBOX  Locations of major structural and non-structural BMPs identified in the SWPPP  FORMCHECKBOX  Locations and timing of stabilization measures  FORMCHECKBOX  Locations of off-site material, waste, borrow, or equipment storage areas  FORMCHECKBOX  Locations of all waters of the U.S., including wetlands  FORMCHECKBOX  Locations where stormwater discharges to a surface water  FORMCHECKBOX  Locations of storm drain inlets  FORMCHECKBOX  Areas where final stabilization has been accomplished  FORMCHECKBOX  For more information, see SWPPP Guide, Chapter 3.C. Project Information: Include the site maps with the SWPPP. SECTION 2: EROSION AND SEDIMENT CONTROL BMPS Instructions: Describe the BMPs that will be implemented to control pollutants in stormwater discharges. For each major activity identified:  FORMCHECKBOX  Clearly describe appropriate control measures.  FORMCHECKBOX  Describe the general sequence during the construction process in which the measures will be implemented.  FORMCHECKBOX  Describe the maintenance and inspection procedures that will be undertaken for that specific BMP.  FORMCHECKBOX  Include protocols, thresholds, and schedules for cleaning, repairing, or replacing damaged or failing BMPs.  FORMCHECKBOX  Identify staff responsible for maintaining BMPs.  FORMCHECKBOX  (If your SWPPP is shared by multiple operators, indicate the operator responsible for each BMP.) Categorize each BMP under one of the following 10 areas of BMP activity as described below:  FORMCHECKBOX  Minimize disturbed area and protect natural features and soil  FORMCHECKBOX  Phase Construction Activity  FORMCHECKBOX  Control Stormwater flowing onto and through the project  FORMCHECKBOX  Stabilize Soils  FORMCHECKBOX  Protect Slopes  FORMCHECKBOX  Protect Storm Drain Inlets  FORMCHECKBOX  Establish perimeter controls and sediment barriers  FORMCHECKBOX  Retain Sediment On-Site and Control Dewatering Practices  FORMCHECKBOX  Establish Stabilized Construction Exits  FORMCHECKBOX  Any Additional BMPs Note the location of each BMP on your site map(s). Any structural BMPs should have design specifications and details referred to and attached as appendices to the SWPPP. For more information, see SWPPP Guide, Chapter 4. Consult your states design manual or one of those listed in Appendix D of the SWPPP Guide. For more information or ideas on BMPs see EPAs National Menu of BMPs  HYPERLINK "http://www.epa.gov/npdes/stormwater/menuofbmps" http://www.epa.gov/npdes/stormwater/menuofbmps Project Information: 1. Minimize Disturbed Area and Protect Natural Features and Soil: Describe the areas that will be disturbed with each phase of construction and the methods (signs, fences, etc.) that you will use to protect those areas that should not be disturbed. Describe natural features identified earlier and how each will be protected during construction activity. Also describe how topsoil will be preserved. Include these areas and associated BMPs on your site map(s) also. (See SWPPP Guide, Chapter 4, ESC Principle 1 for more information.)  FORMTEXT INSERT Text or TABLE HERE, include inspection and maintenance schedules as appropriate and staff responsible for maintenance Phase Construction Activity: Describe the intended construction sequencing and timing of major activities, including grading activities, road and utility installation, and building phases. (See SWPPP Guide, Chapter 4, ESC Principle 2 for more information.) It may be useful to develop a separate, detailed site map for each phase of construction. Phase I  FORMCHECKBOX   FORMTEXT Describe phase  FORMCHECKBOX   FORMTEXT Duration of phase (start date, end date)  FORMCHECKBOX   FORMTEXT List BMPs associated with this phase  FORMCHECKBOX   FORMTEXT List BMPs associated with this phase  FORMCHECKBOX   FORMTEXT Describe stabilization methods for this phase (describe any temporary stabilization methods that will be used before final stabilization) Repeat as needed Phase II  FORMCHECKBOX   FORMTEXT Describe phase  FORMCHECKBOX   FORMTEXT Duration of phase (start date, end date)  FORMCHECKBOX   FORMTEXT List BMPs associated with this phase  FORMCHECKBOX   FORMTEXT List BMPs associated with this phase  FORMCHECKBOX   FORMTEXT Describe stabilization methods for this phase (describe any temporary stabilization methods that will be used before final stabilization) Repeat as needed 2. Control Stormwater Flowing Onto and Through the Project: Describe structural practices (i.e., diversions, berms, ditches, storage basins) including design specifications and details used to divert flows from exposed soils, retain or detain flows, or otherwise limit runoff and the discharge of pollutants from exposed areas of the site. (See SWPPP Guide, Chapter 4, ESC Principle 3 for more information.) BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff  FORMTEXT INSERT TEXT HERE 4. Stabilize Soils: Describe controls (i.e., temporary seeding with native vegetation, hydroseeding, etc.) to stabilize exposed soils where construction activities have temporarily or permanently ceased. Also describe measures to control dust generation. Use of impervious surfaces for stabilization should be avoided whenever possible. (See SWPPP Guide, Chapter 4, ESC Principle 4 for more information.) BMP Description:  FORMTEXT INSERT TEXT HERE  FORMCHECKBOX  Permanent  FORMCHECKBOX  Temporary Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE BMP Description:  FORMTEXT INSERT TEXT HERE  FORMCHECKBOX  Permanent  FORMCHECKBOX  Temporary Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE 5. Protect Slopes: Describe controls (i.e., erosion control blankets, tackifiers, etc.) including design specifications and details that will be implemented to protect all slopes. (See SWPPP Guide, Chapter 4, ESC Principle 5 for more information.) BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE 6. Protect Storm Drain Inlets: Describe controls (i.e., inserts, rock-filled bags, or block and gravel, etc.) including design specifications and details that will be implemented to protect all inlets receiving stormwater from the project during the entire duration of the project. (See SWPPP Guide, Chapter 4, ESC Principle 6 for more information.) BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE 7. Establish perimeter controls and sediment barriers: Describe structural practices (i.e., silt fences or fiber rolls) including design specifications and details to filter and trap sediment before it leaves the construction site. (See SWPPP Guide, Chapter 4, ESC Principle 7 for more information.) BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE 8. Retain Sediment On-Site and Control Dewatering Practices: Describe sediment control practices (i.e., sediment trap or sediment basin), including design specifications and details (volume, dimensions, outlet structure) that will be implemented at the construction site to retain sediments on-site. Describe dewatering practices that will be implemented if water must be removed from an area so that construction activity can continue. (See SWPPP Guide, Chapter 4, ESC Principle 8 for more information.) BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE 9. Establish Stabilized Construction Exits: Describe location(s) of vehicle entrance(s) and exit(s), procedures to remove accumulated sediment off-site (i.e., vehicle tracking), and stabilization practices (i.e., stone pads and/or wash racks) to minimize off-site vehicle tracking of sediments and discharges to stormwater. (See SWPPP Guide, Chapter 4, ESC Principle 9 for more information.) BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE 10. Additional BMPs: Describe additional BMPs that may not fit into the above categories. BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE SECTION 3: GOOD HOUSEKEEPING BMPS 3.1 Good Housekeeping BMPs Instructions: Describe the key good housekeeping and pollution prevention (P2) measures that will be implemented to control pollutants in stormwater. Categorize each good housekeeping and pollution prevention (P2) BMP under one of the following 7 categories and follow the instructions to SWPPP Guide your description:  FORMCHECKBOX  Material Handling and Waste Management:  FORMCHECKBOX  Establish Proper Building Material Staging Areas:  FORMCHECKBOX  Designate Washout Areas:  FORMCHECKBOX  Establish proper equipment/vehicle fueling and maintenance practices:  FORMCHECKBOX  Allowable non-stormwater discharges and control equipment/vehicle washing:  FORMCHECKBOX  Spill Prevention and Control Plan:  FORMCHECKBOX  Any Additional BMPs: For more information, see SWPPP Guide, Chapter 5. Consult your states design manual or resources in Appendix D of the SWPPP Guide. For more information or ideas on BMPs, see EPAs National Menu of BMPs  HYPERLINK "http://www.epa.gov/npdes/stormwater/menuofbmps" http://www.epa.gov/npdes/stormwater/menuofbmps Project Information: 1. Material Handling and Waste Management: Describe measures (i.e., trash disposal, sanitary wastes, recycling, and proper material handling) to prevent the discharge of solid materials to waters of the U.S., except as authorized by a permit issued under section 404 of the CWA. (See SWPPP Guide, Chapter 5, P2 Principle 1) BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE 2. Establish Proper Building Material Staging Areas: Describe construction materials expected to be stored on-site and procedures for storage of materials to minimize exposure of the materials to stormwater. (See SWPPP Guide, Chapter 5, P2 Principle 2 for more information.) BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE 3. Designate Washout Areas: Describe location(s) and controls to minimize the potential for stormwater pollution from washout areas for concrete mixers, paint, stucco, etc. (See SWPPP Guide, Chapter 5, P2 Principle 3 for more information.) BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE 4. Establish proper equipment/vehicle fueling and maintenance practices: Describe equipment/vehicle fueling and maintenance practices that will be implemented to control pollutants to stormwater (e.g., secondary containment, drip pans, spill kits, etc.) (See SWPPP Guide, Chapter 5, P2 Principle 4 for more information.) BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE 5. Allowable non-stormwater discharges and control equipment/vehicle washing: For the allowable non-stormwater discharge(s) associated with construction industrial activity identified, describe controls and measures that will be implemented at those sites to minimize pollutant discharges. (See SWPPP Guide, Chapter 5, P2 Principle 5 for more information.) BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE 6. Spill Prevention and Control Plan: Describe the spill prevention and control plan to include ways to reduce the chance of spills, stop the source of spills, contain and clean up spills, dispose of materials contaminated by spills, and train personnel responsible for spill prevention and control. (See SWPPP Guide, Chapter 5, P2 Principle 6 for more information.)  FORMTEXT INSERT TEXT HERE 7. Any Additional BMPs: Describe any additional BMPs that dont fit into the above categories. Indicate the problem they are intended to address. BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE 3.2 Allowable Non-Stormwater Discharge Management Instructions: Identify all allowable sources of non-stormwater discharges (except flows from firefighting activities) that are not identified above. Identify measures used to eliminate or reduce these discharges and the BMPs used to prevent them from becoming contaminated. For more information, see SWPPP Guide, Chapter 3.A. Also, review your permit for exact details. Project Information: List allowable non-stormwater discharges and the measures used to eliminate or reduce them and to prevent them from becoming contaminated:  FORMTEXT INSERT TEXT HERE SECTION 4: SELECTING POST-CONSTRUCTION BMPs Instructions: Describe all post-construction stormwater management measures that will be installed during the construction process to control pollutants in stormwater discharges after construction operations have been completed. Examples of post-construction BMPs include:  FORMCHECKBOX  Biofilters  FORMCHECKBOX  Detention/retention devices  FORMCHECKBOX  Earth dikes, drainage swales, and lined ditches  FORMCHECKBOX  Infiltration Basins  FORMCHECKBOX  Porous Pavement  FORMCHECKBOX  Other proprietary permanent structural BMPs  FORMCHECKBOX  Outlet protection/velocity dissipation devices  FORMCHECKBOX  Slope protection  FORMCHECKBOX  Vegetated strips and/or swales Identify any applicable federal, state, local, or tribal requirements for design or installation. Describe how low impact designs or smart growth considerations have been incorporated into the design. Any structural BMPs should have design specifications and details referred to and attached as appendices to the SWPPP. For more information on this topic, please refer to your states stormwater manual. You may also want to consult one of the references listed in Appendix D of the SWPPP Guide. Visit the post-construction section of EPAs Menu of BMPs at:  HYPERLINK "http://www.epa.gov/npes/menuofbmps" www.epa.gov/npes/menuofbmps Project Information: BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE BMP Description:  FORMTEXT INSERT TEXT HERE Installation Schedule:  FORMTEXT INSERT TEXT HERE Maintenance and Inspection:  FORMTEXT INSERT TEXT HERE Responsible Staff:  FORMTEXT INSERT TEXT HERE SECTION 5: INSPECTIONS and MAINTENANCE 5.1 Inspections Instructions: Identify the individual(s) responsible for conducting inspections and describe their qualifications. Reference or attach the inspection form that will be utilized. Describe the frequency that inspections will occur at your site including any correlations to storm frequency and intensity. Note that inspection details for particular BMPs should be included in Sections 2 and 3. You should also document the repairs and maintenance that you undertake as a result of your inspections. These actions can be documented in the corrective actions log described in Section 5.3 below. For more on this topic, see SWPPP Guide, Chapters 6 and 8. Also, see suggested inspection form in Appendix B. Project Information: 1. Inspection Personnel: Identify the person(s) who will be responsible for conducting inspections and describe their qualifications.  FORMTEXT INSERT TEXT HERE 2. Inspection Schedule and Procedures: i. Describe the inspection schedules and procedures you have developed for your site (include frequency of inspections for each BMP or group of BMPs, indicate when you will inspect, e.g. before/during/and after rain events, spot inspections, etc.).  FORMTEXT INSERT TEXT OR TABLE HERE ii. Describe the general procedures for correcting problems when they are identified. Include responsible staff and timeframes for making corrections.  FORMTEXT INSERT TEXT OR TABLE HERE iii. Attach a copy of the inspection report you will use for your site.  FORMTEXT REFERENCE ATTACHMENT 5.2 Maintenance of Controls Instructions: Summarize routine maintenance of structural and non-structural BMPs. Include schedules (daily, weekly, etc.) as well as the staff responsible. Maintenance procedures for individual BMPs should be included in Section 2 and 3. Specific maintenance activities can be documented in the corrective action log described below in Section 5.3. For more on this topic, see SWPPP Guide, Chapters 4 and 5 and the suggestions on the Sample Inspection Report in Appendix B. Project Information: Maintenance Procedures:  FORMTEXT INSERT TEXT OR TABLE HERE 5.3 Corrective Action Log Instructions: Create here, or as an attachment, a corrective action log. This log should describe repair, replacement, and maintenance of BMPs undertaken based on the inspections and maintenance procedures described above. Actions related to the findings of inspections should reference the specific inspection report. This log should describe actions taken, date completed, and note the person that completed the work. Project Information: Corrective Action Log:  FORMTEXT INSERT TABLE HERE or REFERENCE ATTACHMENT SECTION 6: Recordkeeping and Training 6.1 Recordkeeping Instructions: The following is a list of records you should keep at your project site available for inspectors to review: Dates of grading, construction activity, (and stabilization which is covered in Section 7). A copy of the construction general permit (attach). The signed and certified NOI form or permit application form (attach). A copy of the letter from the EPA/State notifying you of their receipt of your complete NOI/application (attach). Inspection reports (attach). Records relating to endangered species and historic preservation (attach). Check your permit for additional details. For more on this subject, see SWPPP Guide, Chapter 6.C. Project Information: Dates when major grading activities occur:  FORMTEXT INSERT TEXT OR TABLE HERE Dates when construction activities temporarily or permanently cease on a portion of the site  FORMTEXT INSERT TEXT OR TABLE HERE 6.2 Log of Changes to the SWPPP Instructions: Create a log here, or as an attachment, of changes and updates to the SWPPP. You should include additions of new BMPs, replacement of failed BMPs, significant changes in the activities or their timing on the project, changes in personnel, changes in inspection and maintenance procedures, and updates to site maps, etc. Project Information: Log of changes and updates to the SWPPP CREATE LOG HERE or as an ATTACHMENT 6.3 Training Instructions: Training your staff and subcontractors is an effective BMP. As with the other steps you take to prevent stormwater problems at your site, you should document the training that you conduct for your staff, for those with specific stormwater responsibilities (e.g. installing, inspecting, and maintaining BMPs), and for subcontractors. Include dates, number of attendees, subjects covered, and length of training. For more on this subject, see SWPPP Guide, Chapter 8. Project Information: Describe Training Conducted: General stormwater and BMP awareness training for staff and subcontractors  FORMTEXT INSERT TEXT HERE Detailed training for staff and subcontractors with specific stormwater responsibilities  FORMTEXT INSERT TEXT HERE Individual(s) Responsible for Training:  FORMTEXT INSERT TEXT HERE SECTION 7: FINAL STABILIZATION Instructions: Describe procedures for final stabilization. If you complete major construction activities on part of your site, you can document your final stabilization efforts for that portion of the site. Many permits will allow you to then discontinue inspection activities in these areas (be sure to check your permit for exact requirements.) You can amend or add to this section as areas of your project are finally stabilized. Update your site plans to indicate areas that have achieved final stabilization. For more on this topic, see SWPPP Guide, Chapter 9. Project Information:  FORMTEXT INSERT TEXT HERE SECTION 8: CERTIFICATION AND NOTIFICATION Instructions: The SWPPP should be signed and certified by the construction operator(s). Attach a copy of the NOI and permit authorization letter received from EPA or the State in Appendix D. Project Information: 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 gathered and evaluated 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, to 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 possibility of fine and imprisonment for knowing violations. Name: ______________________________________ Title: ____________________________ Signature: ___________________________________ Date: ____________________________ 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 gathered and evaluated 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, to 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 possibility of fine and imprisonment for knowing violations. 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App G - Log of Changes and Updates to SWPPP (or in Section 6.3) App H - Subcontractor Certifications/Agreements App I - BMP specifications and details App J - Additional Information (i.e., Endangered Species and Historic Preservation documentation)     Stormwater Pollution Prevention Plan (SWPPP) INSERT PROJECT NAME and DATE PAGE  PAGE iii EPA SWPPP Template, Version 1.0, January 9, 2007   A\ijklopstwx{ݽ}w}wsici h}0Jjh}0JUhO hO0JjhO0JUh}h}B*CJaJphh}h}B*CJaJphh}h}CJaJh}CJaJh1jh1U jh7nh1<CJUaJ h h^ h h^~ h hhXY h hT h hLH! h h6%rsuvwyz{gd h]hgdI &`#$gdOh]hgdO &`#$gd1$&dPa$gdCd$a$gdCd h h^~h1 h}h} hUuvh}hydh} h}0Jjh}0JUhO0JmHnHu <001hP:ps %/ =!"#$% 901hP:p F/ =!"#$% 21h:pO/ =!"#$% DyK www.epa.gov/npdes/swpppguideyK Hhttp://www.epa.gov/npdes/swpppguideDText19Insert Project NameDText20$Insert Project Site Location/AddressDText21Insert City, State, Zip CodeDText224Insert Project Site Telephone Number (if applicable)DText12#Insert Company or Organization NameD Insert NameDInsert AddressDText11Insert City, State, Zip CodeDInsert Telephone NumberDText10Insert Fax/EmailDText12#Insert Company or Organization NameD Insert NameDInsert AddressDText11Insert City, State, Zip CodeDInsert Telephone NumberDText10Insert Fax/EmailDText24M/d/yyyy}DyK _Toc156126626}DyK _Toc156126626}DyK _Toc156126627}DyK _Toc156126627}DyK _Toc156126628}DyK _Toc156126628}DyK _Toc156126629}DyK _Toc156126629}DyK _Toc156126630}DyK _Toc156126630}DyK _Toc156126631}DyK _Toc156126631}DyK _Toc156126632}DyK _Toc156126632}DyK _Toc156126633}DyK _Toc156126633}DyK _Toc156126634}DyK _Toc156126634}DyK _Toc156126635}DyK _Toc156126635}DyK _Toc156126636}DyK _Toc156126636}DyK _Toc156126637}DyK _Toc156126637}DyK _Toc156126638}DyK _Toc156126638}DyK _Toc156126639}DyK _Toc156126639}DyK _Toc156126640}DyK _Toc156126640}DyK _Toc156126641}DyK _Toc156126641}DyK _Toc156126642}DyK _Toc156126642}DyK _Toc156126643}DyK _Toc156126643}DyK _Toc156126644}DyK _Toc156126644}DyK _Toc156126645}DyK _Toc156126645}DyK _Toc156126646}DyK 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CodeDText9Insert Telephone NumberDText10Insert Fax/EmailDText13:Insert area of control (if more than one operator at site)D Insert NameDText12#Insert Company or Organization NameDInsert AddressDText11Insert City, State, Zip CodeDInsert Telephone NumberDText10Insert Fax/EmailDText13:Insert area of control (if more than one operator at site)D Insert NameD#Insert Company or Organization NameDInsert AddressDText11Insert City, State, Zip CodeDInsert Telephone NumberDInsert Fax/EmailDText6 Insert NameD#Insert Company or Organization NameDText7Insert AddressDText11Insert City, State, Zip CodeDText8Insert Telephone NumberDInsert Fax/EmailD#Insert Company or Organization NameDText6 Insert NameDInsert AddressDText11Insert City, State, Zip CodeDText8Insert Telephone NumberDInsert Fax/EmailDText6 Insert NameDText8Insert Telephone NumberDText1INSERT TEXT HEREhDehDehDetDeCheck4tDeCheck4tDeCheck4DText1INSERT TEXT HEREDText1INSERT TEXT HEREDText1INSERT TEXT HEREDText1INSERT TEXT HEREDText1INSERT TEXT 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