HomeMy Public PortalAbout476683NOTE: 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/CORRECTIVE ACTIONS NEEDED
A. TREATMENT AREA
Signs of clogging (e.g., standing water)? 0 1 2 3 N/A
Debris (e.g., trash) accumulation? 0 1 2 3 N/A
Sediment accumulation? 0 1 2 3 N/A
Standing water? 0 1 2 3 N/A
Evidence of deterioration? 0 1 2 3 N/A
Exposed soil in areas discharging or adjacent to the paver system? 0 1 2 3 N/A
Spalling or cracking of pavement observed?0 1 2 3 N/A
Collapsing areas of paver system?0 1 2 3 N/A
Other (describe)? 0 1 2 3 N/A
B. HAZARDS
Have there been complaints from residents? 0 1 2 3 N/A
Public hazards noted? 0 1 2 3 N/A
*If any 2-3 ratings are given in Sections A-B 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
Date of Inspection: _________________________________________________________
Owner Phone Number: ______________________________________________________
Overall Drainage Area Conditions:
Circle Type: Porous Asphalt Pervious Concrete Permeable Paver Blocks
NOTE TO INSPECTOR: All personnel entering any confined spaces must take appropriate safety measures and follow applicable OSHA regulations.
D. PHOTOGRAPHS
STORMWATER MANAGEMENT FACILITY MAINTENANCE INSPECTION CHECKLIST
INSPECTION CHECKLIST – PERVIOUS PAVEMENT
P Job Number: ____________________________________________________________
C. CORRECTIVE ACTIONS*
Inspector: ________________________________________________________________
Site Conditions: ___________________________________________________________________________________________________________________________________________
MSD BMP Inspection Checklist Form. Rev 2012