HomeMy Public PortalAbout476687NOTE: 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
Provide stable conveyance into facility?0 1 2 3 N/A
Excessive trash/debris/sediment accumulation?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
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
Is vegetation overgrown with invasive species?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
Maintenance access to facility?0 1 2 3 N/A
Condition of structural components?0 1 2 3 N/A
Excessive trash/debris/sediment?0 1 2 3 N/A
Evidence of erosion?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
Presence of the invasive species/seeds?0 1 2 3 N/A
Dead vegetation/exposed soil?0 1 2 3 N/A
Outlets provide stable conveyance out of facility?0 1 2 3 N/A
Excessive trash/debris/sediment accumlation at inlet?0 1 2 3 N/A
Evidence of erosion at/around inlet?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
C. FACILITY
P Job Number: ____________________________________________________________
Inspector: ________________________________________________________________
Date of Inspection: _________________________________________________________
Owner Phone Number: ______________________________________________________
Site Conditions: ___________________________________________________________________________________________________________________________________________
A. INLETS (If not piped, identify as overland flow)
D. OUTLET/OVERFLOW STRUCTURE
E. HAZARDS
G. PHOTOGRAPHS
F. CORRECTIVE ACTIONS*
NOTE TO INSPECTOR: All personnel entering any confined spaces must take appropriate safety measures and follow applicable OSHA regulations.
STORMWATER MANAGEMENT FACILITY MAINTENANCE INSPECTION CHECKLIST
INSPECTION CHECKLIST – INFILTRATION
Circle Type: I-1: Infiltration Trench I:2 Infiltration Basin
Overall Drainage Area Conditions:
B. PRETREATMENT
MSD BMP Inspection Checklist Form. Rev 2013