HomeMy Public PortalAbout476700NOTE: 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
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
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 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) functioning?0 1 2 3 N/A
Mulch layer, pea gravel, or turf grass in good condition?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
E. HAZARDS
F. CORRECTIVE ACTIONS*
G. PHOTOGRAPHS
A. INLETS (If not piped, identify as overland flow)
B. PRETREATMENT
C. FACILITY
NOTE TO INSPECTOR: All personnel entering any confined spaces must take appropriate safety measures and follow applicable OSHA regulations.
Owner Phone Number: ______________________________________________________
Site Conditions: ___________________________________________________________________________________________________________________________________________
STORMWATER MANAGEMENT FACILITY MAINTENANCE INSPECTION CHECKLIST
FILTERS
Circle Type: F-1: Suface Sand Filter F-2: Underground Sand Filter F-3: Perimeter Sand Filter F-4: Organic Filter F-5: Pocket Sand Filter
D. OVERFLOW/OUTLET STRUCTURE
Overall Drainage Area Conditions:
P Job Number: ____________________________________________________________
Inspector: ________________________________________________________________
Date of Inspection: _________________________________________________________
MSD BMP Inspection Checklist Form. Rev 2013