HomeMy Public PortalAboutImpervious Area Disconnection Storm Credit Checklist - Facility ChecklistNOTE: 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 ITEMS RATING COMMENTS
Excessive trash/debris?0 1 2 3 N/A
Bare/exposed soil?0 1 2 3 N/A
Evidence of erosion?0 1 2 3 N/A
Excessive landscape waste/yard clippings?0 1 2 3 N/A
Inflow points (e.g. downspouts, curb cuts, edge of pavement, level
spreader) provide stable conveyance into facility 0 1 2 3 N/A
Runoff enters pervious area as sheet flow?0 1 2 3 N/A
Level spreader functional? (if applicable)0 1 2 3 N/A
Excessive trash/debris/sediment accumulation at inflow points?0 1 2 3 N/A
Evidence of erosion at/around inflow points?0 1 2 3 N/A
Downspouts or surface impervious area drains to the receiving pervious area?0 1 2 3 N/A
Receiving pervious areas are in good condition?0 1 2 3 N/A
Excessive trash/debris/sediment accumulation in pervious area?0 1 2 3 N/A
Evidence of standing water?
(Ponding, Noticeable Odors, Water Stains, Algae)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
Vegetation 0 1 2 3 N/A
a. Presence of invasive species/weeds 0 1 2 3 N/A
b. Dead vegetation/exposed soil?0 1 2 3 N/A
Complaints from local residents? (describe if any)0 1 2 3 N/A
Any public hazards observed? (describe if any)0 1 2 3 N/A
Encroachment on facility or easement by buildings or other structures?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 during inspection.
CORRECTIVE ACTIONS
RECOMMENDED TO
OWNER COMPLETED AT TIME OF INSPECTION
Please attach photographs, with descriptions, showing current condition of the system and any defeciencies noted in this inspection.
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.
D. HAZARDS
C. FACILITY (PERVIOUS AREA RECEIVING RUNOFF)
Overall Drainage Area Conditions:
E. CORRECTIVE ACTIONS*
F. PHOTOGRAPHS
B. INFLOW POINTS (i.e. downspouts, paved area)
STORMWATER MANAGEMENT FACILITY MAINTENANCE INSPECTION CHECKLIST
IMPERVIOUS AREA DISCONNECTION STORM CREDIT
NOTE TO INSPECTOR: All personnel entering any confined spaces must take appropriate safety measures and follow applicable OSHA regulations.
A. CONTRIBUTING DRAINAGE AREA
Circle Type: SCDN: Disconnect Non Rooftop SCDR: Disconnect Rooftop
P Job Number: ____________________________________________________________
Inspector: ________________________________________________________________
Date of Inspection: _________________________________________________________
Owner Phone Number: ______________________________________________________
Site Conditions: ___________________________________________________________________________________________________________________________________________
MSD BMP Inspection Checklist Form. Rev 8/1/2016