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Annual BMP Maintenance Report Form_2020wMicrosoft Word - BMP inspection report_2010.doc POST CONSTRUCTION STORMWATER BMP ANNUAL MAINTENANCE REPORT Post-Construction Inspection and Maintenance Report Form Per MSD Rules and Regulations and Engineering Design Requirements for Sanitary Sewer and Stormwater Drainage Facilities (Section 4.060.08) a Maintenance Agreement is executed by BMP owners prior to plan approval and an annual maintenance report is required to be submitted to MSD. This completed form and attachments should be submitted annually, no later than March 31st of the year following the reporting year, to: Metropolitan St. Louis Sewer District – Division of Environmental Compliance, c/o Phase II Stormwater Management Program, 10 E. Grand Avenue, St. Louis, MO 63147. For consistency and for your convenience, MSD is providing this Annual BMP Maintenance Report Form for optional use by BMP owners. This report form and the inspection checklists are not mandatory for use and are being provided as templates to ensure compliance with minimal maintenance requirements. Use of this form and/or the referenced inspection checklists developed by MSD will not exempt BMP owners from the design and maintenance requirements specified in the Stormwater Management Facilities Report. GENERAL INFORMATION. Please fill out only one report form per site. (Fill out ALL information) DATE: REPORT YEAR: MSD Project Number (e.g. P001234500 or 18MSD-12345): Project Name (i.e. Subdivision Name, Store Name): Physical Address/Location of BMP: Property Owner Name: Is this a new owner? (YES) (NO) Property Owner Mailing Address: Property Owner E-mail Address: Property Owner Telephone Number: () Owner’s Designated Contact (Person or Company responsible for inspections/maintenance/reporting): Owner Designated Contact’s Telephone Number: () Owner Designated Contact’s E-mail address: BMP Annual Maintenance Report Form Rev. 2020 Page 1 MSD Project Number: INSPECTION CHECKLIST & BMP SUMMARY TABLE. Please attach a copy of the most recent inspection form/checklist. If the system is a proprietary system, the manufacturer’s inspection checklist should be obtained from the manufacturer for use. Fill-in the actual number of BMP devices on the table below. Attach color photos as appropriate, to show condition of each BMP. Inspection checklists can be found online at http://www.stlmsd.com/what-we-do/stormwater-management/bmp-toolbox/maintenance-responsibilitieswww.stlmsd.com/what-we-do/stormwater-management/bmp-toolbox/maintenance-responsibilities. These inspection checklists are provided for convenience to ensure compliance with minimal maintenance requirements. Use of these inspection checklists does not exempt BMP owners from design and maintenance requirements specified in the SWMFR. BMP Device Type Number per Site BMP Device Type Number per Site Bioretention/Raingarden Filter (Specify) Porous Pavement Amended Soils Detention/Retention Basin or Pond Hydrodynamic Separator Open Channel (Swales) Other (Specify) MAJOR MAINTENANCE & CORRECTIVE ACTIONS SUMMARY. Please complete the table below summarizing major maintenance activities conducted and any corrective actions taken. Date Completed Deficiency Observed Needing Correction Corrective Action/Maintenance Activity Completed SITE PHOTOGRAPHS. Please attach photographs showing current condition of BMPs on site. One panoramic view of the site and one close-up photo of each area are sufficient. BMP Annual Maintenance Report Form Rev. 2020 Page 2