HomeMy Public PortalAbout476682NOTE: This checklist is not mandated for use by MSD and does not exempt BMP owners from design and maintenance requirements specified in the SWMFR.
Location: ________________________________________________
Owner Change since last inspection? Yes No
Owner Name:________________________________________________
Owner Address: _____________________________________________
INSPECTION RATING SYSTEM
0 = Good condition. Well maintained, no action required. Satisfactory Performance.
1 = Moderate condition. Should monitor. Satisfactory Performance.
2 = Degraded condition. Routine maintenance and repair needed. Unsatisfactory Performance.
3 = Serious condition. Immediate need for repair or replacement. Unsatisfactory Performance.
INSPECTION ITEMS RATING COMMENTS
Provide stable conveyance into facility?0 1 2 3 N/A
Excessive trash/debris/sediment accumulation?0 1 2 3 N/A
Signs of erosion?0 1 2 3 N/A
Excessive trash/debris/sediment?0 1 2 3 N/A
Evidence of standing water?
(Ponding, Noticeable Odors, Water Stains, Algae)0 1 2 3 N/A
Evidence of clogging?0 1 2 3 N/A
Dead vegetation/exposed soil?0 1 2 3 N/A
Evidence of erosion?0 1 2 3 N/A
Excessive trash/debris/sediment?0 1 2 3 N/A
Signs of erosion or movement of mulch (or pea gravel)?0 1 2 3 N/A
Evidence of oil/chemical/accumulation?0 1 2 3 N/A
Evidence of standing water?
(Ponding, Noticeable Odors, Water Stains, Algae)0 1 2 3 N/A
Underdrain system (if equipped) broken/clogged?0 1 2 3 N/A
Adequate plant covering present?0 1 2 3 N/A
Is vegetation overgrown?0 1 2 3 N/A
Dead vegetation/exposed soil?0 1 2 3 N/A
Signs of mulch layer thinning (or pea gravel)?0 1 2 3 N/A
Stable conveyance out of facility provided?0 1 2 3 N/A
Excessive trash/debris/sediment accumlation?0 1 2 3 N/A
Evidence of erosion at/around ?0 1 2 3 N/A
Complaints from local residents?0 1 2 3 N/A
Any public hazards observed (desribe if any)0 1 2 3 N/A
*If any 2-3 ratings are given in Sections A-E of this checklist, list corrective actions recommended or completed at the time of this inspection.
CORRECTIVE ACTIONS RECOMMENDED TO OWNER COMPLETED AT TIME OF INSPECTION
Please attach photographs, with descriptions, showing current condition of system and any defeciencies noted in this inspections
B. PRETREATMENT
D. OVERFLOW/OUTLET STRUCTURE
E. HAZARDS
STORMWATER MANAGEMENT FACILITY MAINTENANCE INSPECTION CHECKLIST
F. CORRECTIVE ACTIONS*
Overall Drainage Area Conditions:
Inspector: ________________________________________________________________
Date of Inspection: _________________________________________________________
G. PHOTOGRAPHS
BIORETENTION/RAIN GARDEN
A. INLET (If not piped, identify as overland flow)
C. TREATMENT AREA AND VEGETATION
Site Conditions: ___________________________________________________________________________________________________________________________________________
P Job Number: ____________________________________________________________
Owner Phone Number: ______________________________________________________
NOTE TO INSPECTOR: All personnel entering any confined spaces must take appropriate safety measures and follow applicable OSHA regulations.
MSD BMP Inspection Checklist Form. Rev 2013