Reach ID Description Stream! Location Photo...Photo Inventory (By Camera) Project: This field sheet...

Photo Inventory(By Camera)

Project: This field sheet is to be completed AS photos are taken in the field. The intent is toGrou v I . force us to organize pictures taken on a camera basis. Fill out one sheet per camera

(add sheets as needed). Only fill in Date/Reach/Location ID when you start in aCamera: 0 6 O new spatial or temporal location.

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Project:This field sheet is to be completed AS photos are taken in the field. The intent is to

Grou ‘s force us to organize pictures taken on a camera basis. Fill out one sheet per camera

(add sheets as needed). Only fill in Date/Reach/Location ID when you start in a

Camera: 1O new spatial or temporal location.

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Project: This field sheet is to be completed AS photos are taken in the field. The intent is toGrou force us to organize pictures taken on a camera basis. Fill out one sheet per camera

(add sheets as needed). Only fill in Date/Reach/Location ID when you start in aCamera: - new spatial or temporal location.

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Project: L ii tr This field sheet is to be completed AS photos are taken in the field. The intent is toGrou force us to organize pictures taken on a camera basis. Fill out one sheet per camera

(add sheets as needed). Only fill in Date/Reach/Location if) when you start in aCamera:

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Comments:

(BACK)


Project: This field sheet is to be completed AS photos are taken in the field. The intent is toGrou force us to organize pictures taken on a camera basis. Fill out one sheet per camera

(add sheets as needed). Only fill in Date/Reach/Location ID when you start in aCamera:

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Comments:

(BACK)

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Project:

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This field sheet is to be completed AS photos are taken in the field. The intent is toforce us to organize pictures taken on a camera basis. Fill out one sheet per camera(add sheets as needed). Only fill in DatefReachlLocation ID when you start in anew spatial or temporal location.

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This field sheet is to be completed AS photos are taken in the field. The intent is toforce us to organize pictures taken on a camera basis. Fill out one sheet per camera(add sheets as needed). Only fill in Date/ReachlLocation ID when you start in anew spatial or temporal location.

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Project: H This field sheet is to be completed AS photos are taken in the field. The intent is toforce us to organize pictures taken on a camera basis. Fill out one sheet per cameraGroup: b /M P I (add sheets as needed). Only fill in Date/ReachlLocation ID when you stan in a

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Project: IThis field sheet is to be completed AS photos are taken in the field. The intent is to

Group: , / 44 force us to organize pictures taken on a camera basis. Fill out one sheet per cameraI (add sheets as needed). Only fill in Date/ReachlLocation ID when you start in aCamera:

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Project: ‘3J’( This field sheet is to be completed AS photos are taken in the field. The intent is toGroun j( force us to organize pictures taken on a camera basis. Fill out one sheet per camera

(add sheets as needed). Only fill in Date/Reach/Location ID when you start in aCamera: new spatial or temporal location.

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Project: This field sheet is to be completed AS photos are taken in the field. The intent is toGroun H i-J 2 force us to organize pictures taken on a camera basis. Fill out one sheet per camera

(add sheets as needed). Only fill in DateJReachfLocation ID when you start in aCamera: F0 new spatial or temporal location.

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This field sheet is to be completed AS photos are taken in the field. The intent is toforce us to organize pictures taken on a camera basis. Fill out one sheet per camera(add sheets as needed). Only fill in Date/Reach/Location ID when you start in anew spatial or temporal location.

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(BACK)


Project: CThis field sheet is to be completed AS photos are taken in the field. The intent is to

Groun force us to organize pictures taken on a camera basis. Fill out one sheet per camera1 (add sheets as needed). Only fill in Date/ReachlLocation ID when you start in a

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Project: This field sheet is to be completed AS photos are taken in the field. The intent isGroun force us to organize pictures taken On a camera basis. Fill out one sheet per camera

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Hotspot Site Investigation us!RTERSHED: Qon\o SURWATERSHED: iJ\ AJ UNIQUE SITE ID: S —

- TE: O/9/____ ASSESSED By: CAMERA ID: Pic#: —

MG: LAT° ‘ lLLONGC S ‘“1 LMK#

A. SITE DATA AND BASIC CLASSIFICATION

Name and Address: + 5 Category: El Commercial El Industrial MiscellaneousNof i-U. 0c e gaLV c Institutional El Municipal El Golf Course, Transport-Related El Marina

/ El Animal FacilitySIC code (if available): Basic Description of Operation:

NPDES Status: El Regulated n%4DEx*El Unregulated } Unknown

B. VEHICLE OPERATIONS El N/A (Skip to pan C) I Observed Pollution Source?BI. Types of vehicles: Fleet vehicles C School buses El Other:

112. Approximate number of vehicles: / (-1

113. Vehicle activities (circle all that apply): Maintained Repaired Recycled Fueled Washed114. Are vehicles stored andior repaired outside? J Y El N El Can’t TellAre these vehicles lacking runoff diversion methods? Y El N El Can’t Tell115. Is there evidence of spills/leakage from vehicles? El Y El N Can’t Tell

B6. Are uncovered outdoor fueling areas present? El Y N El Can’t Tell

B7. Are fueling areas directly connected to storm drains? El Y N El Can’t TellB8. Are vehicles washed outdoors? El Y fl N Can’t TellDoes the area where vehicles are washed discharge to the storm drain? El Y El N El Can’t Tell

OUTDOOR MATERIALS El N/A (Skip to part 13) Observed Pollution Source?i. Are loading/unloading operations present? 1Y El N El Can’t TellIf yes, are they uncovered and draining towards a storm drain inlet? El Y El N 21’ Can’t TellC2. Are materials stored outside? V El N El Can’t Tell If yes, are they El Liquid El Solid Description:Where are they stored? 30 grass/dirt area El concrete/asphalt El bermed area

C3. Is the storage area directly or indirectly connected to storm drain (circle one)? El Y El N Can’t Tell 0C4. Is staining or discoloration around the area visible? Ely El N Can’t Tell 0CS. Does outdoor storage area lack a cover? Y El N El Can’t Tell

C6. Are liquid materials stored without secondary containment? El Y El N Can’t Tell 0C7. Are storage containers missing labels or in poor condition (rusting)? El Y EiN El Can’t Tell 0D. WASTE MANAGEWNT El N/A (Skip to pan E) Observed Pollution Source?DI. Type of waste (check all that apply): El Garbage Construction materials El Hazardous materials 0D2. Dumpster condition (check all that app, No cover/Lid is open El Damaged/poor condition ElLeaking or

evidence of leakage (stains on ground) [ OverfiowinD3. Is the dumpster located near a storm drain inlet? El Y N Can’t Tell

If yes, are runoff diversion methods (berms, curbs) lacking? El Y El N Can’t Tell

E. PHYSICAL PLANT JZN/A (Skip to part F) Observed Pollution Source?

El. Building: Approximate age: yrs. Condition of surfaces: El Clean El Stained El Dirty El Damaged 0Evidence that maintenance results in discharge to storm drains (staining/discoloration)? El Y El N El Don’t know Q

*Jndex: 0 denotes potential pollution source; L._J denotes confirmed polluter (evidence was seen)

A-5

Hotspot Site Investigation

E3. Do downspouts discharge to impervious surface? El Y EN El Don’t know Q None visibleAre downspouts directly connected to storm drains? El Y [1 N El Don’t know

E4. Evidence of poor cleaning practices for construction activities (stains leading to storm drain)? Y El N Can’t Tell

F. TURF/LANDSCAPING AREAS N/A (skip to pan G) Observcd Pollution Source?Fl. % of site with: Forest canopy % Turf grass % Landscaping Bare Soil 0F2. Rate the turf management smtus: El High El Medium El Low 0F3. Evidence of permanent irrigation or “non-target” irrigation ElY El N El Can’t Tell 0F4. Do landscaped areas drain to the storm drain system? El Y El N El Can’t Tell 0F5. Do landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? El Y El N El Can’t Tell 0G. STORM WATER INFRASTRUCTURE LI N/A (skip to pan H) Observed Pollution Source? LiGl. Are storm water treatment practices present? El Y El N El Unknown If yes, please describe: 0G2. Are private storm drains located at the facility? El Y El N El Unknown

Is trash present in gutters leading to storm drains? If so, complete the index below.

Index Rating for Accumulation in GuttersClean Filthy

Sediment Eli El2 El3 El4 El5Organicmaterial Eli El2 El3 El4 El5Litter Eli El2 El3 El4 Els

G3. Catch basin inspection — Record SSD Unique Site ID here: Condition: El Dirty El CleanH. INITJAL HOTSPOT STATUS - INDEX RESULTS

E2. Parking Lot: Approximate age 7 yrs. Condition: CleanSurface material Q Paved/Concrete ZGravel ,Permeable

HSI

El Stained El Dirty El Breaking up

El Don’t know

El Not a hotspot (fewer than 5 circles and no boxes checked) Potential hotspot (5 to 10 circles but no boxes checked)El Confirmed hotspot (10 to 15 circles and/or 1 box checked) El Severe hotspot (>15 circles and/or 2 or more boxes checkedFollow-up Action:

El Refer for immediate enforcementEl Suggest follow-up on-site inspectionqTest for illicit dischargej?J Include in future education effortEl’Check to see if hotspot is an NPDES non-filer

Onsite non-residential retrofitEl Pervious area restoration; complete PAA sheet and record

Unique Site ID here:

_______________________

El Schedule a review of storm water pollution prevention plan

Notes:

A-6

Hotspot Site Investigation us!HATERSHED: V’\,&i SUEWATERSHED: UNIQUE SITE ID: 4—1s I -Uw@ - ot

SE: fo/J$ I p ASSESSED By: J CAMERA ID: Pic#: ‘1 —

MAPGRID: LAT l]fo 2°’frLONG73°‘9 ‘7’T LMK#A. SITE DATA AND BASIC CLASSIFICATION

Name and Address: f\A i.r ka- c Category: fi Commercial Industrial Miscellaneousfi Institutional fi Municipal fi Golf Course

. p C Transport-Related fi Marinat’Ji\L4 SCV\ -‘---\ fi Animal Facility

SIC codet(ifavailable): Basic Description of Operation:

NPDES Status: fi Regulated 4r .-4&4tç INDEx*flUnregulated_QUnknown

B. VEHICLE OPERATIONS fi N/A (Skip to part_C)I_btiservea Pollution Source? :••

Bi. Types of vehicles: ,21 Fleet vehicles fi School buses U Other:HZ. Approximate number of vehicles:

B3. Vehicle activities (circle all that apply): Maintained Repaired Recycled Fueled Washed Stored 0B4. Are vehicles stored and/or repaired outside? C Y fi N Can’t TellAre these vehicles lacking runoff diversion methods? fly fi N Can’t TellBS. Is there evidence of spills/leakage from vehicles? fly N Can’t Tell 0B6. Are uncovered outdoor fueling areas present? fi Y U N fi Can’t Tell 0B7. Are fueling areas directly connected to storm drains? fi y fi N E Can’t Tell 0B8. Are vehicles washed outdoors? flY fi N Can’t TellDoes the area where vehicles are washed discharge to the storm drain? fi y C N Can’t Tell

OUTDOOR MATERIALS C N/A (Skip to part D) Observed Pollution Source?Ci. Are loading/unloading operations present? Y fi N fi Can’t TellIf yes, are they uncovered and draining towards a storm drain inlet? fi y fi N Can’t Tell

C2. Are materials stored outside? y fi N fi Can’t Tell If yes, are they U Liquid C Solid Description:Where are they stored? fi grass/dirt area fi concrete/asphalt U bermed area

C3. Is the storage area directly or indirectly connected to storm drain (circle one)? C Y U N Can’t Tell 0C4. Is staining or discoloration around the area visible? U Y C N 0 Can’t Tell QCS. Does outdoor storage area lack a cover? JZJ y U N fi Can’t Tell

C6. Are liquid materials stored without secondary containment? C Y fi N Can’t Tell QCl. Are storage containers missing labels or in poor condition (rusting)? C Y U N Can’t Tell 0a WASTE MANAGEMENT C N/A (Skip to part F) Observed Pollution Source?

- -

Dl. Type of waste (check all that apply): U Garbage Construction materials C Hazardous materials

D2. Dumpster condition (check all that apply): fi No cover/Lid is open U Damaged/poor condition fiLeaking orevidence of leakage (stains on ground) C Overflowing

D3. Is the dumpster located near a storm drain inlet? C y fi N-fl Can’t TellIf yes, are runoff diversion methods (berms, curbs) lacking? C Y C N Can’t Tell

-

F. PHYSICAL PLANT N/A (Skip to part F) Observed Pollution Source? HJ

El. Building: Approximate age: yrs. Condition of surfaces: C Clean U Stained U Dirty U Damaged 0Evidence that maintenance results in discharge to storm drains (staining/discoloration)? fi Y C N C Don’t know Q

*Index: 0 denotes potential pollution source; L__---J denotes confirmed polluter (evidence was seen)

A-5

Hotspot Site Investigation JJ

C Stained C Dirty C Breaking up

C Don’t know

E2. Parking Lot: Approximate ageH 0 yrs. Condition: CleanSurface material C Paved/Concrete Gravel Permeable

E3. Do downspouts discharge to impervious surface? C Y LI N C Don’t know Q None visibleAre downspouts directly connected to storm drains? C Y Li N j] Don’t know

E4. Evidence of poor cleaning practices for construction activities (stains leading to storm drain)? LI Y C N 0 Can’t Tell 0F. TURF/LANDSCAPING AREAS Jl N/A (skip to pan G) I Observed Pollution Source? IFl. T0 of site with: Forest canopy .__% Turf grass % Landscaping % Bare Soil % 0F2. Rate the turf management status: C High C Medium Low 0F3. Evidence of permanent irrigation or “non-target” irrigation Y C N C Can’t Tell 0F4. Do landscaped areas drain to the storm drain system? C Y C N Can’t Tell 0F5. Do landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? C Y C N Can’t Tell 0G. STORM WATER INFRASTRUCTURE N/A (skip to part H) Observed Pollution Source? LJGl. Are storm water treatment practices present? C Y C N C Unknown If yes, please describe: 0G2. Are private storm drains located at the facility? C Y C N C Unknown



Sediment Ci C2 C3 C4 COrganic material Cl C 2 C 3 C4 C 5Litter Cl 02 C3 C4 CS

G3. Catch basin inspection— Record SSD Unique Site ID here: Condition: C Dirty C CleanH. INITIa HOTSPOT STATUS - INDEX RESULTS

C Not a hotspot (fewer than 5 circles and no boxes checked) JJ Potential hotspot (5 to 10 circles but no boxes checked)C Confirmed hotspot (10 to 15 circles andJor I box checked) C Severe hotspot (>15 circles and/or 2 or more boxes checlFollow-up Action:

C Refer for immediate enforcementj Suggest follow-up on-site inspectionC Test for illicit dischargeC Include in future education effort

Check to see if hotspot is an NPDES non-filerC Onsite non-residential retrofitC Pervious area restoration; complete PAA sheet and record


_____________________

C Schedule a review of storm water pollution prevention plan

Notes:

ct—\ pj?O5 p/v

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46


HTTERSHED: eeq’L SuBWATERSHED: LA V-ut2D UNIQUESITEID: Ff51— LAL”& —0?.TE:jk/Jti/ lv ASSESSEDBY: ,-tg CAMERiW: A dc) Pic#: q— 12.

MAPGRID: LAT’4(° 7-1 -1L(2 LONG L5°_(ç-i7.. LMK#A. SITE DATA AND BASIC CT,ASSIFICATION

Name and Address: Category: LI Commercial Industrial MiscellaneousC-IbJED-JY-JL LI Institutional Municipal LI Golf Course

-,,

LI Transport-Related LI Marina/‘et-i ç&_t:

LI Animal FacilitySIC code (if available) Basic Description of Operation:

NPDES Status: LI Regulated INDEXtLI Unregulated ,{3J Unknown

B. VEHICLE OPERATIONS LI N/A (Skip to part C) I Observed Pollution Source?81. Types of vehicles: LI Fleet vehicles LI School buses LI Other:B2. Approximate number of vehicles:

B3. Vehicle activities (circle all that apply). Maintained Repaired Recycled Fueled Washed Stored 0B4. Are vehicles stored andJor repaired outside? LI Y N LI Can’t TellAre these vehicles lacking runoff diversion methods? DY LI N LI Can’t Tell85. Is there evidence of spills/leakage from vehicles? LIV LI N LI Can’t Tell 0B6. Are uncovered outdoor fueling areas present? LI Y LI N LI Can’t Tell 0B7. Are fueling areas directly connected to storm drains? LI Y LI N LI Can’t Tell 088. Are vehicles washed outdoors? LI Y LI N LI Can’t TellDoes the area where vehicles are washed discharge to the storm drain? LI Y LI N LI Can’t Tell

OUTDOOR MATERIALS LI N/A (Skip to part D) I Observed Pollution Source?Ut. Are loading/unloading operations present? 1Y LI N LI Can’t TellIf yes, are they uncovered and draining towards a storm drain inlet? S Y LI N LI Can’t Tell

C2. Are materials stored outside? I’Y LI N, LI Can’t Tell If yes, are they LI Liquid LI Solid Description:Where are they stored? LI grass/dirt area concrete/asphalt LI bermed area

C3. Is the storage area directly or indirectly connected to storm drain (circle one)? Y LI N LI Can’t Tell 0C4. Is staining or discoloration around the area visible? LI Y N LI Can’t Tell QC5. Does outdoor storage area lack a cover? Y LI N LI Can’t Tell 0C6. Are liquid materials stored without secondary containment? LI Y LI N 121 Can’t Tell 0C7. Are storage containers missing labels or in poor condition (rusting)? LI V ‘N LI Can’t Tell 0IX WASTE MANAGETWNT LI N/A (Skip to part E) I Observed Pollution Source?—- -

Dl. Type of waste (check all rhat apply): Garbage Construction materials LI Hazardous materials ©D2. Dumpster condition (check all that apply): 1No coverlLid is open LI Damaged/poor condition LILeakiog or

evidence of leakage (stains on ground) LI OverflowingD3. Is the dumpster located near a storm drain inlet? Y LI N LI Can’ijell

If yes, are runoff diversion methods (berms, curbs) lacking? DY IL1 N LI Can’t Tell

E. PHYSJCAL PLANT LI N/A (Skip to part F) Observed Pollution Source?

El. Building: Approximate age: <,‘9 yrs. Condition of surfaces: Clean LI Stained LI Dirty LI Damaged 0Evidence that maintenance results in discharge to storm drains (staining/discoloration)? LI Y N LI Don’t know Q

tJyidex: 0 denotes potential pollution source; L_i denotes confirmed polluter (evidence was seen)

A-5


E2. Parking Lot: Approximate age yrs. Condition: Clean El Stained Q Dirty El Breaking upSurface material Paved/Concrete fl Gravel Q Permeable El Don’t know

E3. Do downspouts discharge to impervious surface? Y El N C Don’t know Q None visibleAre downspouts directly connected to storm drains? El Y N []Don’t know

E4. Evidence of poor cleaning practices for construction activities (stains leading to storm drain)? El Y N El Can’t Tell

F. TURF/LANISCAPJNG AREAS [1 N/A (skip to pan G) I Observed Pollution SFl. % of site with; Forest canopy ].Q_% Turf grass 30 % Landscaping 2% Bare Soil ?_1%F2. Rate the turf management status: High El Medium El Low

F3. Evidence of permanent irrigation or “non-target” irrigation DY flN Can’t Tell

F4. Do landscaped areas drain to the storm drain system? Y El N El Can’t Tell

F5. Do landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? El YJ N Can’t Tell

G. STORM WATER INFRASTRUCTURE Li N/A (skip to part H) I Observed Pollution Source?Gl. Are storm water treatment practices present? J] Y El N El Unknown If yes, please describe:

__________________

0G2. Are private storm drains located at the facility? Y El N El Unknown

J5 trash present in gutters leading to storm drains? If so, complete the index below.


Sediment 03 04 ElsOrganicmaterial J1 ‘El2 03 04 05Litter El 02 03 04 05

G3. Catch basin inspection — Record SSD Unique Site ID here: Condition: El Dirty El CleanH. INITIAL HoTsvoT STATUS - INDEX RESULTS

El Not a hotspot (fewer than 5 circles and no boxes checked) El Potential hotspot (5 to 10 circles but no boxes checked)El Confirmed hotspot (10 to 15 circles and/or I box checked) El Severe hotspot (>15 circles and/or 2 or more boxes checked’Follow-up Action:

El Refer for immediate enforcementEl Suggest follow-up on-site inspectionEl Test for illicit dischargeEl Include in future education effortEl Check to see if hotspot is an NPDES non-filerEl Onsite non-residential retrofitEl Pervious area restoration; complete PAA sheet and record


_____________________


Notes:

HSI

A-6

Streets and Storm Drains SSDWATERSHED: ‘-u SUBWATERSHED: A W 13 UNIQUE SITE ID:4c L’ - ut-ig- c /DATE: JPJJY/ 10 ASSESSED By: CAMERA ID:

MAPGRID RAININLAST24HOURS DY N PIC# 1- toA. LOCATION

Al. Street names or neighborhood surveyed:

A2. Adjacent land use: fl Residential Commercial Industrial InstitutionalMunicipal Transport-Related

A3. Corresponding HSI or NSA field sheet? If so, circle HSI or NSA and record its Unique Site ID here ?-iS kB. STREET CONDITIONS

B1.RoadType: Arterial Q Collector ,JEJ Local 0 Alley 0 Other:

B2. Condition of Pavement: $J New C Good 0 Cracked Q BrokenB3. Is on-street parking permitted fly N If yes, approximate number of cars per block:

B4. Axe large cul-de-sacs present? . Y Q N

B5. Is trash present in curb and gutter? If so, Index Rating for Accumulation in Guttersuse the index to the right to record amount. Clean Filthy

Sedimentr Di 03 Q4 05

OrganicMaterial Di 03 04 05Litter ui 02 [13 04 05

C. STORM DRAIN INLETS AND CATCH BASINSCl. Type of storm drain conveyance: 0 open 0 enclosedC2. Percentage of inlets with catch basin storage:Sample 1-2 catch basins per NSI4JHSILatitudeLongitude

LMK #Picture # I CCurrent Condition [1 Wet Dry 0 Wet DryCondition of Inlet . DClear flObstructed I Clear flObstructedLitter Accumulation [1Y N DY NOrganics Accumulation DY 0 N I DY D NSediment Accumulation DY 0 N DY NSediment Depth (in feet) ft. ft.Water Depth -S ft. ft.Evidence of oil and grease dY E N DY 0 NSulfur smell DY N DY C NAccessible to vacuum truck Y [1 N Y fi ND. NON-RESIDENTIAL PARKENG LOT (>2 acres)

Dl. Approximate size: 2— acres

D2. Lot Utilization: 0 Full About half full [1 Empty

D3. Overall condition of Pavement: Smooth (no cracks) 0 Medium (few cracks) 0 Rough (many cracks)0 Very Rough (numerous cracks and depressions)

D4. Is lot served by a storm water treatment practice? Y [1 N If yes, describe: 5’- L5;J

D5. On-site retrofit potential: 0 Excellent [1 Good fi Poor ‘/

A-9

Streets and Storm Drains SSDE. MUNICEPAL POLLUTANT REDUCTION STRATEGIES

El. Degree of pollutant accumulation in the system: D High fl Medium fl Low Q None

E2. Rate the feasibility of the following pollution prevention strategies:

Street Sweeping: U High U Moderate U Low

Storm Drain Stenciling: High U Moderate U Low

Catch Basin Clean-outs: U High U Moderate Q Low

Parking Lot Retrofit Potential: U High U Moderate U Low

CATCH BASIN SKETCIS#1 #2 4

rr /

C

/ /( / / /J?iiniC/;/7,<? /

c , çP

/)7 /

- —_J

/ 2’n AtA-2hf/./

/ çz v s 7/?.&A-A.JNotes:

A-i 0

Neighborhood Source Assessment

IAT51IED: ( Ic SunWATERSHED: (A ‘—j UNIQUE SITE ID: /JS,k— Li. LOJ3 — C’DATE: (12/HI 1? ASSESSED By: c- *$ CAMERA ID: Pic#: /3 -

A. NMGIDIORROOD CHARACTERJZATION

Neighborhood/Subdivision Name: AJov 41n too

If unknown, address (orstreets) surveyed:Ij1c Dr - 10c61 cktk

Neighborhood Area (acres)

Homeowners Association? 9 N 9 Unknown If yes, name and contact information:

____________________________

Residential (circle average single family lot size):

_______________________________

9 Single Family Attached (Duplexes, Row Homes) <½ ‘/ ¼ V3 ½ acre Multifamily (Apts. Townbomes4condos9 Single Family Detached <¼ ¼ ½ 1 >1 acre 9 Mobile Home ParkEstimated Age of Neighborhood: 2—0 years Percent of Homes with Garages: \CO % With Basements j,% INDEX*Sewer Service? fly N

Index of Infill, Redevelopment, and Remodeling No Evidence 9 <5% of units 9 5-10% 9 >10% Qecqittpqrc ntobsen%dfor eacoflhefollos4ng indkgtors,

. . .. . i PercEntage ConiinentsiNotesJepefI4znon appkcabilsiy and/or site complexityB. YAm AND LAwr CONDITIONS

Bi. % of lot with impervious cover ‘3 082. % of lot with grass cover

‘ 0B3. % of lot with landscaping (e.g., mulched bed areas) ‘tO.84. % of lot with bare soil Q

*Note: B] through B4 nuts! total 100%

B5. % of lot with forest canopy

86. Evidence of permanent irrigation or “non-target” irrigation 0High: Q

87. Proportion of total neighborhood turf lawns with following Med: Sbmanagement status:

Low:

B8. Outdoor swimming pools? FE.Y fiN 9 Can’t Tell Estimated #

B9. Junk or trash in yards? fl N9 Can’t Tell 0C. DRIVEWAYS, SIDEWALKS, AND Cu1u3sCI. % of driveways that are impervious 9 N/A 0C2. Driveway Condition Clean 9 Stained 9 Dirty 9 Breaking up 0C3.Aresidewa&spresent?QYNIfyes,aretheyononesideofstreetQoralongbothsidesfl

9 Spotless 9 Covered with lawn clippings/leaves 9 Receiving ‘non-target’ irrigation QWhat is the distance between the sidewalk and street? ft. 0Is pet waste present in this area? 9 Y 9 N 9 N/A Q

c4.Iscurbandgutterpresent?gYLIN ys!!tPLpRlx:9 Clean and Dry 9 Flowing or standing water 9 Long-term car parking N Sediment 09 Organic matter, leaves, lawn clippings 9 Trash, litter, or debris 9 Overhead tree canopy* INDEX: 0 denotes potential poLlution source; 0 denotes a neighborhood restoration opportunity

A-3

fi Better management of common space?

o Pond retrofit?

fi Multi-family Parking Lot Retrofit?

O Other action(s)

____________________

NSA Pollution Severity Index

fi Severe (More than 10 circles checked)

C High (5 to 10 circles checked)Moderate (Fewer than 5 circles checked)

fi None (No circles checked)

Neighborhood Restoration Opportunity Index

fi High (More than 5 diamonds checked)

0 Moderate (3-5 diamonds checked)Low (Fewer than 3 diamonds checked)

Neighborhood Source Assessment fJSAP. RoOFTops

Di. Downspouts are directly connected to storm drains or sanitary sewer 0Di Downspouts are directed to impervious surface

D3. Downspouts discharge to pervious area 5o fti ti( ((*

04. Downspouts discharge to a cistern, rain barrel. etc. 9Wore: CI through C4 should total 100%

05. Lawn area present downgradient of leader for rain garden? Y ON I 0E. Co!,1I’.loN AREAS

El. Storm drain inlets? Y Q Njyes, are they stenciled? 0 Y Q N Condition: fi Clean Dirty 0Catch basins inspected? ElY fi N If yes, include Unique Site ID from SSD sheet: SSn- it’P -02_ Q

E2. Storm water pond? Y fi N Is it a wet pond or fi dry pond? Is it overgrown? fi Y NWhat is the estimated pond area? 0<1 acre 0 about 1 acre t?1> 1 acre 1 i

E3. Open Space?Y fi N If yes, is pet waste present? fly N dumping? fly N aBuffers/floodplain_present:_“Y_0 N If yes, is encroachment evident? Ø’Y fi N k__C.

F. INITIAL NEIGRBOIWOOD ASSESSMENT AND RECOMMENDATIONS

B9sed on field observations, this neighborhood has sigyificant indicators for the following: (check all that apply)Nutrients fi Oil and Grease 0 Trash/Litter Bacteria 0 Sediment fi Other

Recommended ActionsSpecific Action

O Onsite retrofit potential?

o Better lawn/landscaping practice?

Describe Recommended Actions:

SGq<k\C Q’CV’t 2/

c cç

Initial Assessment

NOTES:

A-4

Streets and Storm Drains SSDWATERSHED: 2-w-ocL SUBWATERSHED: UA US-’ UNIQUE SITE ID: SS D -

U’LA -o2DATE: ?/)4/ / o ASSESSED By: L,- t3 CAMERA ID:

MAPGRID RAININLAST24HOURS [1Y N Pic# ;i’ /1 ‘7jj j.j.A LOCATION

/

Al. Street names or neighborhood surveyed:k3cv+kr4 Nv.t

A2. Adjacent land use: Residential [1Commercial [1 Industrial [1 InstitutionalC Municipal U Transport-Related

A3. Corresponding HSI orNSA field sheet? If so, circle 1151 or NSA and record its Unique Site ID here jt4-lAWR--OL

B. STREET CONIMTIONS

Bi. Road Type: [1 Arterial [1 Collector Local [1 Alley [1 Other:

B2. Condition of Pavement: [1 New Good C Cracked [1 Broken83. Is on-street parking permitted [1 Y N If yes, approximate number of cars per block:

84. Are large cul-de-sacs present? j Y [1 N

85. Is trash present in curb and gutter? If so, Index Rating for Accumulation in Guttersuse the index to the right to record amount. Clean Filthy

Sedimentj Dl 03 [14 [15Organic Matej4J [1 1 2 [1 3 0 4 [1 5

Litter; 1 [12 [13 [14 [15C. STORM DRAIN INLETS AM) CATCH BASINS’Cl. Type of storm drain conveyance: C open enclosed [1 mixedC2. Percentage of inlets with catch basin storage: JQL_ [1 N/ASample 1-2 catch basins per NSAJHSI C3. Catch basin #1 C4. Catch basin #2Latitude .ELL° 40 74) ‘ Mi

• Longitude 3.° i” I IIfl30 ?u I

LMK #Picture#Current Condition Wet [1 Dry [1 Wet DryCondition of Inlet ØClear DObstructed liJClear DObstructedLitter Accumulation N DY I NOrganics Accumulation DY N [1y NSediment Accumulation DY N [1y NSediment Depth (in feet) ft. ft.Water Depth ft. ft.Evidence of oil and grease ElY N Dy NSulfur smell Y El N NAccessible to vacuum truck [Y [1 N Y [1 Nth NON-RESIDENTIAL PARKING LOT (>2 acres) AJDl. Approximate size: acres

P2. Lot Utilization: [1 Full [1 About half full [1 Empty

P3. Overall condition of Pavement: [1 Smooth (no cracks) [1 Medium (few cracks) [1 Rough (many cracks)[1 Very Rough (numerous cracks and depressions)

D4. Is lot served by a storm water treatment practice? [1 Y [1 N If yes, describe:

S/p f c tt J

21

P5. On-site retrofit potential: DExcellent [1Good [1Poor

A-9

Streets and Storm Drains ssDE. MUNIcIPAL POLLUTANT REDUCTION STRATEGIES

El. Degree of pollutant accumulation in the system: El High El Medium Low Q None , ILWV

E2. Rate the feasibility of the following pollution prevention strategies:Street Sweeping: High El Moderate fl LowStorm Drain Stenciling: High fl Moderate fl LowCatch Basin Clean-outs: High Moderate El LowParking Lot Retrofit Potential: El High [J Moderate Low

CATCH BASIN SKETCHES#1 #2

aCV

6*-Notes:

(I\ ry, stNtv c

c6_’ ‘ c’

A-b


WATERSHED: la SUEWATERSHETh C UNIQUE SITE ID: [‘ISA — 5 C —oD&TE:Jt)/r/ , ASSESSEDBY: k,—t CAMER4ID: PJc#:233I,A. NnonBoIwooD CHARACTERIZATION

Neighborhood/Subdivision Name: r*c1 e S - Neighborhood Area (acres)If unknown, address (or streets) surveypd:

(>c 51 £ r.rcUId4 ak

Homeowners Association? fl Y Unknown If yes, name and contact information:Residential (circle average single family lot size):

C Single Family Attached (Duplexes, Row Homes) <¼ Vs ¼ ‘/3 ¼ acre Multifamily (Apts, Townhomes, Condos)Single Family Detached <¼ 1 >1 acre C Mobile Home Park

Estimated Age of Neighborhood: SO years Percent of Homes with Garages: 7Z% With Basements JPP% INDEX*Sewer Service?, Y C N SQvJty fr4v tJOlt 0Index of Infill, Redevelopment, and Remodeling C No Evidence <5% of units Q 5-10% 1 >10% Q

Recordpercent observedfor each ofthe following indicators,. - .. -

. -- Percentage Comments/Notadgpend,nLon appjtcabthty and/or sjte complexity

B. YARD AND LAWN CoNIa’noNsBI. % of lot with impervious cover oB2. % of lot with grass cover 5 O 0B3. % of lot with landscaping (e.g., mulched bed areas) / 0 LB4. % of lot with bare soil 0

*Note: B] through B4 must total 100%

BS. % of lot with forest canopy 20 9jvipnmtuc \‘t€a5 0B6. Evidence of permanent irrigation or “non-target” irrigation

High: jQ QB7. Proportion of total neighborhood turf lawns with following Med: .Qmanagement status:

Low: 0

B8. Outdoor swimming pools? flY N fl Can’t Tell Estimated # QB9. Junk or trash in yards? flY ND Can’t Tell 0C. DRIVEWAYS, SIDEWALKS, AND CunsCl. % of driveways that are impervious fi N/A I / 00C2. Driveway Condition Clean fi Stained fi Dirty C Breaking up QC3. Are sidewalks present? UYN If y are they on one side of streetCor along both sides

fi Spotless fi Covered with lawn clippings/leaves C Receiving ‘non-target’ irrigation QWhat is the distance between the sidewalk and street? ft. -

Is pet waste present in this area? C Y C N C N/A 0If yes, checkall thntapply: O’I4

POrganic matter, leaves, lawn clippings C Trash, litter, or debris Overhead tree canopy

‘*INTJEx: 0 denotes potential pollution source; 0 denotes a neighborhood restoration opportunity

A-3

Neighborhood Source Assessment PtSA

11 ROOFTOPS

Dl. Downspouts are directly connected to storm drains or sanitary sewer 2.6 octJ.\. • 002. Downspouts are directed to impervious surface 1 003. Downspouts discharge to pervious area 7 1204. Downspouts discharge to a cistern, rain barrel. etc. 0

*Note: Cl through C4 should total 100%

05. Lawn area present downgradient of leader for rain garden? Y LiN 4E. CoMloN AREAS

El. Storm drain inlets? Y Li N If yes, are they stenciled? Lii’ Li N Condition: Li Clean Li Dirty <C>Catch basins inspected? ‘Y Li N If yes, include Unique Site ID from SSD sheet: S S L 0 0

E2. Storm water pond? Y Li N Is it a wet ponA.or Li dry pond? Is it overgrown? Y Li N +What is the estimated pond area? Li <1 acre .l5about 1 acre Li> 1 acre

NOTES

E3. Open Space? Li Y If yes, is pet waste present? Li Y Li N dumping? Li Y Q N QBuffers/floodplain present: Li Y Li N If yes, is encroachment evident? Lii’ Li N

F. INITIAL NEIGHBORHOOD ASSESSMENT AND RECOMMENDATIONS

Based on field observations, this neighborhood has significant indicators for the following: (check all that apply)Li Nutrients Li Oil and Grease Li Trash/Litter Li Bacteria Li Sediment Li Other

______________________


Li Onsite retrofit potential?

Li Better lawn/landscaping practice?

Li Better management of common space?Pond retrofit?

Li Multi-family Parking Lot Retrofit?

Li Other action(s) —____________________


o&

cv-’

1’ i/ Pi k ‘rc

Initial Assessment


Li Severe (More than 10 circles checked)

Li High (5 to 10 circles checked)

Li Moderate (Fewer than 5 circles checked)None (No circles checked)


Li High (More than 5 diamonds checked)Moderate (3-5 diamonds checked)

Li Low (Fewer than 3 diamonds checked)

A-4

Streets and Storm Drains SSDWATERSHED: Q046tk_ SUBWATERSHED: ¶.L— UNIQUESITEID: SS — lSLoeDATE: 10/19/ O ASSESSED By: /4 g: CAMERA ID:

MAPGEmI

RAININLASTZ4IIOVRS ElY N PiC# 21 3A. LOCATION

Al. Street names neighborhood surve ‘ed:Cvev / r

A2. Adjacent land use: Residential El Commercial El Industrial El InstitutionalEl Municipal El Transport-Related

A3. Corresponding Ff51 or NSA field sheet? If so, circle HSI or NSA and record its Unique Site ID here IJ5A ISL Of

B. STREET CONDITIONS

Bl. Road Type: Q Arterial El Collector Local El Alley El Other:

B2. Condition of Pavement: El New El Good Cracked El BrokenB3. Is on-street parking permitted Y El N If yes, approximate number of cars per block: 7.__B4. Are large cul-de-sacs present? El Y.K N evô - Th ç ‘L 5BS. Is trash present in curb and gutter? If so, Index Rating for Accumulation in Guttersuse the index to the right to record amount. Clean Filthy

Sediment El I El3 El4Organic MateriaJ El 1 El 2 El 3 El 5

Litterf 1 El2 El3 El4 ElsC. STORM DRAIN INLETS AND CATCH BASINSCl. Type of storm drain conveyance: El open El enclosed mixedC2. Percentage of inlets with catch basin storage: N/A f [{/ ISample 1-2 catch basins per NSA!HSI C3. Catch basin #1 C4. Catch basin #2Latitude .Y.L0 UI —o t II

Longitude .22 13 ‘42 \ —oLMK# N /Picture # 1&I N /Current Condition El Wet Dry ‘\ El Wet ElDryCondition of Inlet ElClear Obstructed \ElClearElObsfxuctedLitter Accumulation Y El N DY: El NOrganics Accumulation [Y El N ElVN El NSediment Accumulation ElY N ,CY Q NSediment Depth (in feet) k&ec ft. /7 ft.Water Depth ft. / ‘ft.Evidence of oil and grease DY N / ElY El N\Sulfur smell ElY IX] N [JY fl NAccessible to vacuum truck Y El N ( / ElY El ND. ? ON-RESIDENTIAL PARKING LOT (>2 acres) pi fpDl. Approximate size: acres

D2. Lot Utilization: El Full About half full El Empty

D3. Overall condition of Pavement: El Smooth (no cracks) El Medium (few cracks) El Rough (many cracks)El Very Rough (numerous cracks and depressions)

D4. Is lot served by a storm water treatment practice? ElY El N If yes, describe:D5. On-site retrofit potential: El Excellent El Good El Poor

A-9

Streets and Storm Drains SSDE. Murgcjppj. POLLUTANT REDUCTION STRATEGIESEl. Degree of pollutant accumulation in the system: High El Medium LI Low fl NoneE2. Rate the feasibility of the following pollution prevention strategies:

Street Sweeping: High El Moderate LowStorm Drain Stenciling: High Moderate LI LowCatch Basin Clean-outs: High Moderate LowParking Lot Retrofit Potential: Q High Q Moderate Low

CATCH BASIN SKETCHES41

-Q

)r \QJt

.1/

/ 7— ‘t -i

-Q

Notes:

A-i 0

Retrofit Reconnaissance Investigation J?JJ

WATERSHED: k j SUBWATERSI-IED: I S L UNIQUE SITE ID: ERI -— Cl

DATE: j )icf )‘o ASSESSEDRY: CAMERAID: PICTURES: —?C]

GPSID: LMKID: LAT:L-H°)[37L’ LONG:731j 9i-Sin DESCRIPTION

Name: 17CbZQ 5+’tk ti4-L-,4tAddress: ?‘3 Gt9 S ,x,4U DrOwnership: Public ‘Private UnknownIf Public, Government Jurisdiction: Local fl State DOT fl Other:__________________________

Corresponding USSPJ’USA Field Sheet? Yes fl No If yes. Unique Site ID: tJSA \ Cl

Proposed Retrofit Location:Storage On-SiteE Existing Pond Above Roadway Culvert Hotspot Operation D Individual Rooftop

Selow Outfall In Conveyance System Small Parking Lot fl Small Impervious AreaIn Road ROW Near Large Parking Lot Individual Street fl Landscape / Hardscape

fl Other:__________________________________ fl Underground fl Other:__________________

DRAINAGE AREA TO PROPOSED RETROFIT

Drainage Area Drainage Area Land Use:Imperviousness Residential fl InstitutionalImpervious Area z SFH (< 1 ac lots) fl Industrial

H SFH (> I ac lots) Transport-RelatedNotes:- HTownhouses HParkr4

OMulti-Family H Undevelopedo4bY S°Jfe Commercial H Other:____________

EXISTING STORMWATER MANAGEMENT

Existing Stormwater Practice: Yes No H PossibleIf Yes, Describe:

1I

-

Describe Existing Site Conditions, Including Existing Site Drainage and Conveyance:

L\A. 0 CL tVst & I ---\ ctX \p’ I ¶ww95-,.,\ t

%—

Existing Head Available and Points Where Measured:

Page 1 of 4 Unique Site ID:______

Retrofit Reconnaissance Investigation 1Jaj

PROPOSED RETROFIT

Purpose of Retrofit:LI Water Quality LI Recharge Channel Protection LI Flood ControlLI Demonstration / Education ,fj Repair LI Other:___________________________________________

Retrofit Volume Computations - Target Storage: Retrofit Volume Computations - Available Storage:

Proposed Treatment Option:LI Extended Detention LI Wet Pond LI Created Wetland jBioretentionLI Filtering PracUce LI Infiltration Swale LI Other:_____________________________________

Describe Elements of Proposed Retrofit, Including Surface Area, Maximum Depth of Treatment, and Conveyance:

SITE CONSTRAINTS

Adjacent Land Use: Access;j} Residential LI Commercial LI Institutional LI No ConstraintsLI Industrial LI Transport-Related LI Park Constrained due toLI Undeveloped LI Other:_________________________ LI Slope LI SpacePossible Conflicts Due to Adjacent Land Use? LI Yes LI No LI Utilities LI Tree ImpactsIf Yes, Describe: LI Structures LI Property Ownership

LI Other:__________________________

Conflicts with Existing Utilities: Potential Permitting Factors:LI None Dam Safety Permits Necessary LI Probable LI Not ProbableLI Unlaiown Impacts to Wetlands LI Probable LI Not ProbableYes Possible Impacts to a Stream LI Probable LI Not ProbableLI LI Sewer Floodplain Fill LI Probable LI Not ProbableLI LI Water Impacts to Forests LI Probable LI Not ProbableLI LI Gas Impacts to Specimen Trees LI Probable LI Not ProbableLI LI Cable How many?_____________LI LI Electric Approx. DBH____________LI LI Electric to StreetlightsLI Overhead Wires Other factors:_________________________________________________LI LI Other:

Soils:Soil auger test holes: LI Yes LI NoEvidence of poor infiltration (clays, fines): LI Yes LI NoEvidence of shallow bedrock: LI Yes LI NoEvidence of high water table (gleying, saturation): LI Yes LI No


Retrofit Reconnaissance Investigation RJ{I

is L —‘

A-’ a”

- —--H jmL.

_—:z—-—1 Ii_i

rnv/o\’p

C’”

\

N

Nud \-J

C,’)/

S.,


Retrofit Reconnaissance Investigation JZJJ

DESIGN OR DELIVERY NOTES

\

>\

FOLLOW-UP NEEDED TO COMPLETE FIELD CONCEPT

Confirm property ownership J Obtain existing stormwater practice as-builtsE Confirm drainage area Obtain site as-builtsE Confirm drainage area impervious cover Obtain detailed topography- Confirm volume computations Obtain utility mappingE Complete concept sketch Confirm storm drain invert elevations

fl Confirm soil typesOther;

INITIAL FEASIBILITY AND CONSTRUCTION CONSIDERATIONS

v I- -‘r

SdçkJ d-1 F&WtV (1

SITE CANDIDATE FOR FURTHER INVESTIGATION: YES []No fl MAYBEIs SITE CANDIDATE FOR EARLY ACTION PROJECT(S): YES No LI MAYBEIF NO, SITE CANDIDATE FOR OTHER RESTORATION PROJECT(S) []YES [J No []MAYBE

IF YES, TYPE(S)

H

- -C

Page 4 of 4 Unique Site ID:_______


WATERSHED: (2qv0.0cjc. SUBWATERSHED: ç L. UNIQuESITEID: 1L -d 7—DATE: j,fjl/ 1 0 ASSESSED By: )c&A p, CAMERA ID: A z-- Pic#: (712 -57A. NEIGHBORHOOD CHARACTERIZATION

Neighborhood/Subdivision Name: I p Ja Pr,-Q— Neighborhood Area (acres)If unknown, address (or streets) surveyed:

Homeowners Association? C Y JZJ N Q Unknown If yes, name and contact information:Residential (circle average single family lot size):

C Single Family Attached (Duplexes, Row Homes) <‘/8 ‘/s ¼ V3 V3 acre Q Multifamily (Apts, Townhomes. Condos)Single Family Detached <¼ ½ I >1 acre U Mobile Home Park

Estimated Age of Neighborhood: ?O years Percent of Homes with Garages: % With Basements INDEX*Sewer Service? Y U N kurv La(g5 cf’rt a4 0Index of Infill, Redevelopment, and Remodeling Q No Evidence C <5% of units U 5-10%J >10%

J?ecordpercent obsenedfor eackof thefollowing indicators,Percenta e Comments/Notesdepending on applicability and/or site compiesity g

B. YARD AND LAWN CoNDmoNsRI. % of lot with impervious cover SOB2. % of lot with grass cover ftQ 0B3. % of lot with landscaping (e.g., mulched bed areas) L/9B4. % of lot with bare soil O 0

sjvote: 81 through 84 must total 100%

B5. % of lot with forest canopy 4 0 0B6. Evidence of permanent irrigation or “non-target” irrigation 0 0

High:jA QB7. Proportion of total neighborhood turf lawns with following Med: LQ_

management status:Low: 5Q

B8. Outdoor swimming pools? DY N fl Can’t Tell Estimated # 0B9. Junk or trash in yards? C Y N fl Can’t Tell [ 0C. DRIVEWAYS, SIDEWALKS, AND CURBS

CI. % of driveways that are impervious U N/A I 0 0C2. Driveway Condition C Clean Stained C Dirty Breaking up 0C3. Are sidewalks present? Y JJ N If yes, are they on one side of street U or along both sides U

U Spotless U Covered with lawn clippings/leaves U Receiving ‘non-target’ irrigation QWhat is the distance between the sidewalk and street? ft.

Is pet waste present in this area? U Y El N U N/A 0c4.Iscurbandgutterpresent? QNlfyes,checkalithatapply:

Q Clean and Dry U Flowing or standing water Q Long-term car parking SedimentOrganic matter, leaves, lawn clippings U Trash, litter, or debris Overhead tree canopy

* INDEX: 0 denotes potential pollution source; 0 denotes a neighborhood restoration opportunity

A-3

Neighborhood Source Assessment fJSJ4rD.

Dl. Downspouts are directly connected to storm drains or sanitary sewer cD cO 002. Downspouts are directed to impervious surface

03. Downspouts discharge to pervious area

04. Downspouts discharge to a cistern, rain barrel, etc.

Wore; Cl through C4 should total 100%

05. Lawn area present downgradient of leader for rain garden? Y N J ‘D 7 JK. COMMON AREAS

i.Storndraininlets?,EYUNyes,arethytenc1XYUNCondition:CCleanDirty

Catch basins inspected? Y U N If yes, include Unique Site ID from SSD sheet: S5t)—SL U L£2. Storm water pond? Y U N Is it a ‘wet pond or U dry pond? Is it overgrown? U YØ N

What_is_the_esti*iated_pond_area?_U_<1_acre__U_about 1 acre_E1>_1_acre( Lt_i-

£3. Open Space? U Y N If yes, is pet waste present? UY UN dumping? U Y U N QBuffers/floodplain present: Q Y N If yes, is encroachment evident? U Y Q N

F. INITIAL NEIGHBORHOOD ASSESSMENT AND RECOMMENDATIONS

Based on field observations, this neighborhood has significant indicators for the following: (check all that apply)U Nutrients U Oil and Grease Q Trash/Litter U_BacteriaJ Sediment U Other

______________________

Recommended Actions Describe Recommended Actions:Specific Action

U Onsite retrofit potential?

U Better lawn/landscaping practice?

U Better management of common space?

U Pond retrofit?

U Multi-family Parking Lot Retrofit?

U Other action(s)

Initial Assessment


U Severe (More than 10 circles checked)LJ,A-Iigh (5 to 10 circles checked)

Moderate (Fewer than 5 circles checked)

U None (No circles checked)

Neighborhood Restoration Opportunity IndexHigh (More than 5 diamonds checked)

Moderate (3-5 diamonds checked)

U Low (Fewer than 3 diamonds checked)

NOTES:

A-4

Streets and Storm Drains SSDWATERSHED: epcock SUBWATERSHED: IL.- UNIQUESITEID: SSD—( S L—°2-DATE: 10/ jL1 I 0 ASSESSED By: CAMERA ID:

MAPGRID RAININLAST24HOURS DY N Pic# LJ-

47

A. LOCATION

Al. Street names or neighborhood surveyed:Lokn)cje p6.t

A2. Adjacent land use: Residential D Commercial 0 Industrial 0 InstitutionalQ Municipal D Transport-Related

A3. Corresponding 1151 or NSA field sheet? If so, circle 1151 or NSA and record its Unique Site ID here A1c4 - ISB. STREET CONDJTIONS

BI. Road Type: 9 Arterial )SCollector Local C Alley 9 Other:

B2. Condition of Pavement: J New 9 Good Cracked I3BrokenB3. Is on-street parking permitted Y 9 N If yes, approximate number of cars per block:

[ii. Are large cul-de-sacs present? 9 1’ N


Sediment Dl 92 94 95Organic Material 9 1 93 95

Litter 91 93 94 95C. STORM DRAJN INLETS AND CATCH BASINSCl. Type of storm drain conveyance: 9 open enclosed 9 mixedC2. Percentage of inlets with catch basin storage: .JI2L..... 9 N/ASample 1-2 catch basins per NSA/HS1 C3. Catch basin #1 C4. Catch basin #2Latitude .!J.L° !3 (2/G ft

Longitude jj.° LI q —o

LMK#Picture# (4Current Condition 9 Wet ‘Dry C Wet DryCondition of Inlet Clear 9Obstructed LjClear ObstructedLitter Accumulation 9y 0 N DY 13 NOrganics Accumulation Dy J N 12Y 9 NSediment Accumulation 9y N- Y 9 NSediment Depth (in feet) ft. ft.Water Depth ft. ft.Evidence of oil and grease DY N QY rNSulfur smell DY N 9Y NAccessible to vacuum truck 1Y 9 N Y Q NB. NON-RESIDENTIAL PARKING LoT (>2 acres) Hf ADl. Approximate size: acres

D2. Lot Utilization: 9 Full 9 About half full 9 Empty

D3. Overall condition of Pavement: 9 Smooth (no cracks) 9 Medium (few cracks) 9 Rough (many cracks)9 Very Rough (numerous cracks and depressions)

D4. Is lot served by a storm water treatment practice? C Y 9 N If yes, describe:D5. On-site retrofit potential: 9 Excellent 9 Good 9 Poor

A-9

Streets and Storm Drains SSDK MUMCIPAL POLLUTANT REDUCTION STRATEGIES

El. Degree of pollutant accumulation in the system: Q High Medium Low El NoneE2. Rate the feasibility of the following pollution prevention strategies:

Street Sweeping: C High 12f Moderate C LowStorm Drain Stenciling: High C Moderate C LowCatch Basin Clean-outs: C High Moderate C LowParking Lot Retrofit Potential: C High C Moderate C Low

CATCH BASIN SKETCHES#1 I#2 \QP Z.

7 ::rr-——-—r——--’I I L

: I

/ .:;.

J\) J: ..

j I

..

Notes:

rL:r cr

A- 10

Retrofit Reconnaissance Investigation J4{I 1WATERSHED: SUDWATERSHED: [ UNIQUE SITE iTh R1ZI —I SL- 62DATE: ASSESSED By: €, CAMERA ID: PICTURES: 52 — 3GPSfl): LMKID: LAT: LONG:

SITE DESCRIPTION

Name:Address; t/p k443L_ — 1¾JwLj

Ownership: 5 Public 5 Private Unknown cc_it oo\

If Public, Government Jurisdiction: 5 Local 5 State 5 DOT 5 Other:__________________________

Corresponding USSPJUSA Field Sheet? 5 Yes No If yes, Unique Site ID;___________________

Proposed Retrofit Location:Storage On-Site5 Existing Pond 5 Above Roadway Culvert 5 Hotspot Operation Individual Rooftop5 Below Outfall In Conveyance System Small Parking Lot j, Small Impervious Area5 In Road ROW J Near Large Parking Lot 5 Individual Street Landscape / Hardscape5 Other;________________________________ 5 Underground 5 Other;_________________


Drainage Area Drainage Area Land Use:Imperviousness 5 Residential InstitutionalImpervious Area 5 SFH (< 1 ac lots) Li Industrial

5 SFH (> I ac lots) 5 Transport-RelatedNotes:5 Townhouses 5 Park5 Multi-Family 5 Undeveloped

5 Commercial 5 Other;______________

EXISTING STORMWATER’M&NAGEMENT

Existing Stormwater Practice: 5 Yes 5 No PossibleIf Yes, Describe:

6oct •fl-t.f it o-’ O’v\ •tt£ouvA Cf ,jsA c& oP r:- C

I U


E:° c_Lv



PROPOSED RETROFIT

Retrofit Reconnaissance Investigation

Purpose of Retrofit:jiWater Quality H Recharge H Channel Protection Flood ControlH Demonstration / Education H Repair H Other:__________________________________________


Proposed Treatment Option:H Extended Detention H Wet Pond FJCreated Wetland BioretentionH Filtering Practice H Infiltration H Swale H Other:__________________________________


‘—Jc Cc OSi7

SITE CONSTRAINTS

Adjacent Land Use: Access:H Residential H Commercial H Institutional H No ConstraintsH Industrial H Transport-Related H Park Constrained due toH Undeveloped H Other:_________________________ H Slope H SpacePossible Conflicts Due to Adjacent Land Use? H Yes H No H Utilities H Tree ImpactsIf Yes, Describe: H Structures H Property Ownership

H Other:__________________

Conflicts with Existing Utilities; Potential Pennitting Factors:H None Dam Safety Permits Necessary H Probable H NotProbableH Unknown Impacts to Wetlands H Probable H Not ProbableYes Possible Impacts to a Stream H Probable H Not ProbableH H Sewer Floodplain Fill H Probable H Not ProbableH H Water Impacts to Forests H Probable H Not ProbableH H Gas Impacts to Specimen Trees H Probable H Not ProbableH H Cable How many?_____________H H Electric Approx. DBH____________H H Electric to StreetlightsH Overhead Wires Other factors:_________________________________________________H H Other:

Soils:Soil auger test holes: H Yes H NoEvidence of poor infiltration (clays, fines): H Yes H NoEvidence of shallow bedrock: H Yes H NoEvidence of high water table (gleying, saturation): H Yes H No



SKETCH

Page 3 of 4

E?/u bt ri C—

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\ / -

N -

cc

Unique Site ID:______

Retrofit Reconnaissance Investigation ItIZI


—

cri ro- S

uJL cloj foVL

€f-— oc 6Y °‘


Confirm property ownership Obtain existing stormwater practice as-builtsConfirm drainage area Obtain site as-builtsConfirm drainage area impervious cover C Obtain detailed topographyConfirm volume computations C Obtain utility mapping

C Complete concept sketch C Confirm storm drain invert elevationsC Confirm soil types

C Other:


SITE CANDIDATE FOR FURTHER INVESTIGATION: YES []No [1 MAYBEIS SITE CANDIDATE FOR EARLY ACTION: PROJECT(S): C YES fl No C MAYBEII? NO, SITE CANDIDATE FOR OThER RESTORATION PROJECT(S) YES El No fl MAYBE

IF YES, TYPE(S):


Retrofit Reconnaissance Investigation JZ]TJ

DATE:

GPS ID:

CAMEit4 ID: A5VO PICTURES: (LjASSESSED By: fr r’ ,LMKID: ILAT:WD1[tcl1ILoNG:23oV *1

WATERSHED: SURWATERSHED: M r F- UNIQUE SITE ID: Rfij -MPR-6

SITE DESCifiPTI0N

Name: v (I Li’C4v11

Address: Qvj {-t3 Sfrpt’V/ ?)—

Ownership: Public Q Private fl Unknown 1’—v C p’’v% iIf Public, Government Jurisdiction: Local E State fl DOT D Other;__________________________

Corresponding USSRiUSA Field Sheet? fl Yes No If yes, Unique Site ID:__________________

Proposed Retrofit Location:Storage On-Sitefl Existing Pond D Above Roadway Culvert E Hotspot Operation LJ Individual RooftopE Below Outfall In Conveyance System E Small Parking Lot Small Impervious Areafl In Road ROW Near Large Parking Lot fl Individual Street Landscape / Hardscapefl Other:__________________________________ E Underground Other:___________________


Drainage Area Drainage Area Land Use:Imperviousness Residential InstitutionalImpervious Area SFH (< 1 ac lots) D Industrial

E SFH (> I ac lots) U Transport-RelatedNotes:El Townhouses fl Parkfl MuLti-Family U Undeveloped

U Commercial El Other:______________


Existing Stormwaler Practice: fl Yes No U PossibleIf Yes, Describe:

—t Lbc - L9L rDo4 Jrc •C4 oji


V ¶

‘ ) 7 )i ‘ C


F’s C? *- i0 Dir Jt\ 4VVTh(5

Page 1 of 4 Unique Site ID:

Retrofit Reconnaissance Investigation riiltiPROPOSED RETROFIT

Purpose of Retrofit:,N Water Quality I23 Recharge fl Channel Protection L51 Flood Control

Demonstration! Education Repair E Other:___________________________________________

Retrofit Volume Computations - Target Storage: Retrofit Volume Computations -. Available Storage:

Proposed Treatment Option:fl Extended Detention fl Wet Pond fl Created Wetland 3 BioretentionE Filtering Practice fl Infiltration JSJ Swale fl Other:_____________________________________


SITE CONSTRMNTS

Adjacent Land Use: Access:fl Residential Commercial Qj Institutional J No Constraintsfl Industrial jTransport4{elated Park ‘Constrained due tofl Undeveloped Other:_________________________ D Slope 1 SpacePossible Conificts Due to Adjacent Land Use? E Yes No fl Utilities fl Tree ImpactsIf Yes, Describe: E structures H Property Ownership

Other:_______________________

Conflicts with Existing Utilities: Potential Permitting Factors:H None Dam Safety Permits Necessary H Probable Not Probablefl Unknown Impacts to Wetlands Probable Not ProbableYes Possible Impacts to a Stream H Probable Not Probable

Sewer Floodplain Fill H Probable Not ProbableH fl Water Impacts to Forests H Probable Not ProbableH H Gas Impacts to Specimen Trees H Probable J Not Probable

H Cable How many?____________H ISI Electric Approx. DEH____________H H Electric to StreetlightsH Overhead Wires Other factors:_________________________________________________H H Other:



SKETCH

? rc) Q 4

Page 3 of 4

Retrofit Reconnaissance Investigation I{Jtj

7-

Cl

7-/_ /1 ‘V2/7 Pr? —

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Unique Site ID:

Retrofit Reconnaissance Investigation RJ?J


tr?.t ‘‘&Q.

O\OPO\ o fnJ‘3 S


fl Confirm property ownership Obtain existing stormwater practice as-bniitsfl Confirm drainage area L] Obtain site as-builtsfl Confirm drainage area impervious cover Obtain detailed topographyfl Confirm volume computations ‘Obtain utility mappingL Complete concept sketch Confirm stonn drain invert elevations

L Confirm soil typesEl Other:

INITJAL FEASIBILITY AND CONSTRUCTION CONSIDERATIONS

- —

SITE CANDIDATE FOR FURthER INVESTIGATION: I YES [J No fl MAYBEIS SITE CANDIDATE FOR EARLY ACTION PROJECT(S): [1 YES ] No [J MAYBEIF NO, SITE CANDIDATE FOR OTHER RESTORATION PROJECT(S): YES J] No [I MAYBE

IF YES, TYPE(S)


If unknown, address (or streets) surveyed:‘di


Homeowners Association? Y J N {Jnknown If yes, name and contact information:Residential (circle average single family lot size):

Single Family Attached (Duplexes, Row Homes) <¼ ¼ ¼ ‘/3 ¼ acre Multifamily (Apts, Townhomes, Condos)Single Family Detached <¼ ¼ ½ 1 acre Q Mobile Home Park

Estimated Age of Neighborhood: cC) years Percent of Homes with Garages: .iL% With Basements /.E% JNDEX*Sewer Service? Y N 0Index of Inf,ll, Redevelopment, and Remodeling Q No Evidence <5% of units Q 5-10% >10% Q

Recordpercent observedfor each ofthefollowing indicators,. - .. . . - - Percentage Comments/NotesdependznLon applicabilny and/or site complexityB. YARD AND LAWN CoNornoNs

BI. % of lot with impervious cover

B2. % of lot with grass cover .4,..C)t ‘• 0B3. % of lot with landscaping (e.g., mulched bed areas) / 1 0B4. % of lot with bare soil Q 0

*Note: B1 through B4 must total 100%


B6. Evidence of permanent irrigation or “non-target” irrigation 0High:

B7. Proportion of total neighborhood turf lawns with following Med: 70management status:

Low: 2fl-

B8. Outdoor swimming pools? Y ON Li Can’t Tell Estimated # 0B9. Junk or trash in yards? Li Y N Q Can’t Tell 0C. DRIVEWAYS, SIDEWALKS, AN]) CURBs

Cl. % of driveways that are impervious fl N/A IC2. Driveway Condition Q Clean Li Stained Li Dirty Breaking up 0

Spotless Covered with lawn clippings/leaves fl Receiving ‘non-target’ irrigation QWhat is the distance between the sidewalk and street? ñ.

Is pet waste present in this area? Y [] N [] N/A 0CNlfyes,jckallthatapply:

Li Clean and Dry Li Rowing or standing water Li Long-term car parking Li Sediment 0Organic matter, leaves, lawn clippings Li Trash, litter, or debris Overhead tree canopy


WATERSHED: SURWATERSIJED: UNIQUE SITEID: /J,a-’ P1?— oDATE: if2/j/J.a ASSESSED By: 77E”9 C.MER4 ID: PJC#: ‘

A. NMGImORHO0D CHARACTERIZATION 9L/_ ‘5Neighborhood/Subdivision Name: i,L-n 77 r\Ø / 4— c I-1- 1 1 Neighborhood Area (acres)

A-3


D. RoorfoPs

Dl. Downspouts are directly connected to storm drains or sanitary sewer /t/o 0 002. Downspouts are directed to impervious surface


04. Downspouts discharge to a cistern, rain barrel, etc.sNote: Cl ilit-ough C4 should total 100%

05. Lawn area present downgradient of leader for rain garden? Y QN I 0E. COMMON Aiwis

-tCatch basins inspected? Q Y fl N If yes, include Unique Site ID from SSD sheet: 0

£2. Storm water pond? Y Q N Is it a D wet pond or D dry pond? Is it overgrown? C Y E1 NWhat_is_the_estimated_pond_area?_C_<I_acre__Q_about_I acre > acre 4r_j,)_-

£3. Open Space? C Y SJ If yes, is pet waste present? Y -1 dumping? C Y C N 0Buffers/floodplain present: C Y N If yes, is encroachment evident? Cv C N

F. INIma NExGaBoim000 ASSESSMENT AND RECOMMEATIONS

Based on field observations, this neighborhood has significant indicators for the following: (check all that apply)F7J Nutrients C Oil and Grease C TrashlLitter C Bacteria C Sediment C Other


C Onsite retrofit potential?Better lawn/landscaping practice?

C Better management of common space?

C Pond retrofit?

C Multi-family Parking Lot Retrofit?

C_Other_action(s)________________________________Initial Assessment


Csevere (Morethanlocircleschecked)High (5 to 10 circles checked)Moderate (Fewer than5 circles checked)

C None (No circles checked)


C High (More than 5 diamonds checked)

C Moderate (3-5 diamonds checked)Low (Fewer than 3 diamonds checked) — — —

NOTES;

A-4

Streets and Storm Drains SSD

WATERSHED: - SUBWATERSHED: LY2 UNIQUE SITE ID: ç,_(fr’p o(

DATE: jt2/V6’/ 16’(O ASSESSED By: CAMERA ID:

MAPGRID RAININLAST24HOURS fly fiN PIc# ?l— 3A. LOCATION

Al. Street names or neighborhood sijryed:

A2. Adjacent land use: Residential fi Commercial fi Industrial fi Institutionalfi Municipal fi Transport-Related

A3. Corresponding HSI or NSA field sheet? If so, circle HSI or NSA and record its Unique Site ID here

______________


Dl. Road Type: fi Arterial [1 Collector [Xl Local [1 Alley fi Other.

B2. Condition of Pavement: fi New fi Good Cracked fi Broken

B3. Is on-street parking permitted Y fi N If yes, approximate number of cars per block:

B4. Are large cul-de-sacs present? Y fi N


Sediment El fl3 fl4 fl5OrganicMaterial El fi 2 fi 3 fi 5

Litter Ii fl2 fl3 fl4 1:5C. STORM DRAIN INLETS AND CATCH BASINS

Cl. Type of storm drain conveyance: 1: open enclosed El mixed

C2. Percentage of inlets with catch basin storage: fi N/A

Sample 1-2 catch basins per NSA/IISI C3. Catch basin #1 C4. Catch basin #2

Latitude r .........° ‘ —o

Longitude :(-v7F;,: G’ , —oLMK# Ct

Picture# ,z_.Current Condition Wet LDry J2 Wet U Dry

Litter Accumulation IKjY 13J NOrganics Accumulation f2IY fi NSediment Accumulation j2lY E N

. .Sediment Depth (in feet)Water Depth - 41 SEvidence of oil and greaseSulfur smell ElY 1: NAccessible to vacuum truck ElY fi N

‘Y NENEN

ft.y_S ft.

j N‘Y fli’iYfiN

Condition of Inlet fiClear flObstructed fiClear LiObstructed

ft.ft.

P. NON-RESIDENTIAL PARKING LOT (>2 acres)

Dl. Approximate size:

__________

acres

D2. Lot Utilization: fi Full fi About half fUll fi Empty

D3. Overall condition of Pavement: fi Smooth (no cracks) fi Medium (few cracks) fi Rough (many cracks)El Very Rough (numerous cracks and depressions)

D4. Is lot served by a storm water treatment practice? fi Y fi N If yes, describe:

__________________________

D5. On-site retrofit potential: fi Excellent fi Good fi Poor

A-9

—0


1

ID. MUNICIPAL POLLUTANT REDUCTION STRATEGIES

El. Degree of pollutant accumulation in the system: D High Medium LI Low fl None

E2. Rate the feasibility of the following pollution prevention strategies:Street Sweeping: High El Moderate fl LowStorm Drain Stenciling: High H Moderate LowCatch Basin Clean-outs: H High Moderate El LowParking Lot Retrofit Potential: El High El Moderate El Low


Notes:

Ig /c2

A-i 0

Hotspot Site Investigation fjSJ

UNIQUE SITE 113: (->j -flpT’--c 1Pic#:

LMK#

cit’ •tj7713

13C j4.CXt’

plitc CI45

MAP GRID:

I “4TERSflED: JD SURWATERSHED: AAj”(

-

.TE:JQ/j551 (C? ASSESSEDBY: CAMERAJTh CMo-iLAT jj’j2L1 i Z’LONG 7OJL.3L?tI


Name and Address: 7 OCt Category: Commercial El Industrial Miscellaneous[3 Institutional El Municipal El Golf CourseEl Transport-Related El Marina

El Animal FacilitySIC code (if available): Basic Description of Operation:

NEDES Status: El Regulated (Yp&,c ThcZ.L( INDEX*El Unregulated El Unknown

B. VEHICLE OPERATIONS jt’4/A (Skip to pan C) I Observed Pollution Source? LLSLJRi. Types of vehicles: El Fleet vehicles El School buses El Other:B2. Approximate number of vehicles:

83. Vehicle activities (circle all that apply): Maintained Repaired Recycled Fueled Washed Stored 0Ba. Are vehicles stored and/or repaired outside? El Y 9 N El Can’t TellAre_these_vehicles_lacking runoff diversion_methods?_El_Y__El_N__El_Can’t_TellB5. Is there evidence of spills/leakage from vehicles? El Y El N El Can’t Tell 0B6. Are uncovered outdoor fueling areas present? El Y El N El Can’t Tell 0B7. Are fueling areas directly connected to storm drains? El Y El N El Can’t Tell 0BS. Are vehicles washed outdoors? El Y El N El Can’t TellDoes the area where vehicles are washed discharge to the storm drain? El Y El N El Can’t Tell

OUTDOOR MATERIALS SN/A (Skip to pan D) Observed Pollution Source?I. Are loading/unloading operations present? Y El N El Can’t Tel]If yes, are they uncovered and draining towards a storm drain inlet? El Y N El Can’t Tell

C2. Are materials stored outside? ElY ,N El Can’t Tell If yes, are they El Liquid El Solid Description:Where are they stored? El grass/dirt area El concrete/asphalt El bermed area

C3. Is the storage area directly or indirectly connected to storm drain (circle one)? El Y El N El Can’t Tell 0C4. Is staining or discoloration around the area visible? El Y El N El Can’t Tell 0CS. Does outdoor storage area lack a cover? El Y El N El Can’t Tell 0C6. Are liquid materials stored without secondary containment? El Y El N El Can’t Tell QCl. Are storage containers missing labels or in poor condition (rusting)? El Y El N El Can’t Tell QB. WASTE MANAGEMENT El N/A (Skip to panE) I Observed Pollution Source?Dl. Type of waste (check all that apply): Garbage El Construction materials El Hazardous materials 0D2. Dumpster condition (check all that apply): El No cover/Lid is open El Damaged/poor condition Leaking or

evidence of leakage (stains on ground) El OverflowingD3. Is the dumpster located near a storm drain inlet? Y El N El Can’t Tell

If yes, are runoff diversion methods (berms, curbs) lacking? Y El N El Can’t Tell

E. PHYSICAL PLANT El N/A (Skip to pan F,) Observed Pollution Source?

El. Building: Approximate age: ‘70 yrs. Condition of surfaces: Clean El Stained El Dirty El Damaged 0

IEvidence that maintenance results in discharge to storm drains (staining/discoloration)? El Y N El Don’t know Q

*thdex: 0 denotes potential pollution source; LEEI denotes confirmed polluter (evidence was seen)

Hotspot Site Investigation HSI

E2. Parking Lot: Approximate age ‘2D yrs. Condition: Clean Stained El Dirty Q Breaking upSurface material Paved/Concrete El Gravel El Permeable Q Don’t know 0

E3.Do downspouts discharge to impervious surface?flN El Don’t know El None visibleAre downspouts directly connected to storm drains? Y El N El Don’t know

E4. Evidence of poor cleaning practices for construction activities (stains leading to storm drain)? El Y El N fl Can’t Tell 0F. TURF/LANDSCAPING AREAS LI N/A (skip to pan G) I Observed Pollution Source?Fl. Sb of site with: Forest canopy 2P% Turf grass tO % Landscaping j% Bare Soil ._%

F2. Rate the turf management status: El High Medium Q Low

F3. Evidence of permanent irrigation or “non-target” irrigation El Y El N Can’t Tell

F4. Do landscaped areas drain to the storm drain system? LY El N El Can’t Tell

F5.Do landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? El Y N El Can’t Tell

G. STORM WATER INFRASTRUCTURE El N/A (skip to part H) I Observed Pollution Source?GI. Are storm water treatment practices present? El Y N El Unknown If yes, please describe:

G2. Are private storm drains located at the facility? Y El N El UnknownIs trash present in gutters leading to storm drains? If so, complete the index below.


Sediment Eli El3 El4 Els -

Organicmaterial l El2 El3 El4 El5Litter 1 El2 El3 El4 Els

G3. Catch basin inspection — Record SSD Unique Site ID here: Condition: El Dirty El CleanH. INITIAL HOTSPOT STATUS - INDEX RESULTS

El Not a hotspot (fewer than 5 circles and no boxes checked) j Potential hotspot (5 to 10 circles but no boxes checked)El Confirmed hotspot ( 10 to 15 circles and/or 1 box checked) El Severe hots iot (>15 circles and/or 2 or more boxes checkedFollow-up Action:



_____________________

fl Schedule a review of storm water pollution prevention plan

Notes:

A-6

Streets and Storm Drains SSDWATERSHED: SunWATERSHED: MPALtT’ UNIQUE SITE JD:t55.y.fljcy(

DATEL)jj/“J ASSESSEDBY: t’ CAMERAJD:

MAPGRID RAIN INLAST24HOURS DY IN PIc# /00— (04A.LOCATION ‘7.ocj 4 ‘ I-b’11 7Zee,-lAJ. Street names or neighborhood surv yed:

A2. Adjacent land use: Residential ,Commercial D Industrial D Institutional0 Municipal D Transport-Related

A3. Corresponding 1151 or NSA field sheet? If so, circle 1151 or NSA and record its Unique Site ID here ffi7.’-DIB. STREET CONDITIONS

BI. Road Type: 0 Arterial Collector D Local DAiley D Other: C0t82. Condition of Pavement: 0 New Good Cracked BrokenB3. Is on-street parking permitted fl Y N If yes, approximate number of cars per block:

B4. Are large cul-de-sacs present? D Y N


Sediment Di 3 04 05OrganicMaterial Di 02 D4 D5

Litter []i 02 03 04 05C. STORM DRAIN INLETS AND CATCH BASINSCI. Type of storm drain conveyance: open enclosed mixedCi Percentage of inlets with catch basin storage: D N/ASa,nple 1-2 catch basins per NSAJHSI C3. Catch basin #1 C4. Catch basin #2Latitude .L° I1.1Y3 L° tg77.çLongitude 110 /9J’M

“ 11° i’-4, C) c2_LMK#Picture# I 00 V ICurrent Condition Wet 0 Dry IJ Wet 0 DryCondition of Inlet WClear DObstructed DClear ObstructedLitter Accumulation DY N DY NOrganics Accumulation DY N Y C NSediment Accumulation DY N DY NSediment Depth (in feet) 0 ft. 0 ft.Water Depth Q..2— ft. ft.Evidence of oil and grease DY N DY NSulfur smell DY N DY E NAccessible to vacuum truck Y 0 N DY ND. NON-RESIDENTIAL PARKING LOT (>2 acres)

Dl. Approximate size: 2 acres

D2.Lot Utilization: Full D About half full D Empty

D3.Overall condition of Pavement: 0 Smooth (no cracks) Medium (few cracks) 0 Rough (many cracks)0 Very Rough (numerous cracks and depressions)

D4. Is lot served by a storm water treatment practice? DY N If yes, describe:• 115. On-site retrofit potential: D Excellent 0 Good Poor

A-9

E. MUMCIPAL POLLUTANT REDUCTION STRATEGIES


El. Degree of pollutant accumulation in the system: El High Medium El Low El NoneE2. Rate the feasibility of the following pollution prevention strategies:

Street Sweeping: El High Moderate El LowStorm Drain Stenciling: El High El Moderate LowCatch Basin Clean-outs: El High Moderate El LowParking Lot Retrofit Potential: El High El Moderate Low

CATCH BASIN ETCIS// #2

Notes:

t

cY

A-i 0

Streets and Storm Drains SSDWATERSHED: 77 SUBWATERSHED: UNIQUE SITE ID: 57)— lAP ‘-C)1DATE: 4jj4/jQ ASSESSED By: CAMERA ID:

MAPGRID RAININLAST24HOURS LIY N fZ— /0

A. LOCATION

Al. Street names or peighborho d surve ed::?fvM9 f1ll La

AZ. Adjacent land use: LI Residential LI Commercial LI Industrial LI InstitutionaljJ Municipal LI Transport-Related

A3. Corresponding 1151 or NSA field sheet? If so, circle 115! or NSA and record its Unique Site ID here


RI. Road Type: LI Arterial Collector LI Local LI Alley LI Other:

B2. Condition of Pavement: lJ New LI Good LI Cracked LI BrokenB3. Is on-street parking permitted LI Y N If yes, approximate number of cars per block:

r B4. Are large cul-de-sacs present? LI Y [1 N


Sediment LII LI2 LI4 LI5OrganicMaterial LII LI2 LI4 LIS

Litter LIi LI2 LI3 LI4 LI5C. STORM DRAIN INLETS AND CATCH BASINS

Cl. Type of storm drain conveyance: LI open enclosed LI mixedC2. Percentage of inlets with catch basin storage: L?tL..... LI N/ASample 1-2 catch basins per NSAJHSI 7&sQ0t3. Catch basin #1 j1t;t. I0°C4. Catch basin #2Latitude .aLc 7/. 17 iL° * 11r1’O6Longitude a° 9 I jO /‘—Lc2s °

LMK#

Pictureff (O(---(oCurrent Condition LI Wet Dry LI Wet DryCondition of Inlet KCIear LIobstructed Clear LIObstructedLitter Accumulation LIV N lY NOrganics Accumulation N Y LI NSediment Accumulation Y LI N Y LI NSediment Depth (in feet) 7 ft. -2 ft.Water Depth ft. j’)-? ft.Evidence of oil and grease LIY N LIY R NSulfur smell DV EEl N LIY NAccessible to vacuum truck VJy LI N EY Li ND. NON-RESIDENTIAL PARKING LOT (>2 acres)Dl. Approximate size: acres

D2. Lot Utilization: LI Full LI About half full LI Empty

D3. Overall condition of Pavement: LI Smooth (no cracks) LI Medium (few cracks) LI Rough (many cracks)LI Very Rough (numerous cracks and depressions)

D4. Is tot served by a storm water treatment practice? LI Y LI N If yes, describe:

[ D5. On-site retrofit potential: LI Excellent LI Good LI Poor

A-9


#1

V

E. MuMCIPa POLLUTANT REDUCTION STRATEGIESEl. Degree of pollutant accumulation in the system; fl High Q Medium C Low Q NoneE2. Rate the feasibility of the following pollution prevention strategies;

Street Sweeping; C High I7J Moderate Q LowStorm Drain Stenciling; High C Moderate LowCatch Basin Clean-outs: High C Moderate LowParking Lot Retrofit Potential; C High C Moderate Low

CATCH BASIN SKETCHES

#2

/Vi

Notes:

A-i 0

Hotspot Site Investigation IjI“4TERSHED: SUEWATERSHED: ,t4pr UNIQUE SITEID:

JE: t°/J/jQ ASSESSED By: CAMERA ID: Pic#: j5r—iOyMAP GRID: LATI4I I_ ILONGI’O ;q ‘j4’ LMK#A. SITE DATA AND BASIC CLASSIFICATION

Name and Address: Category: Commercial Industrial Miscellaneous‘iS ii Jr Q Institutional Municipal fl Golf Course

JItY flCJL.’L 1Transport-Related Marina

A SP7 C’ t’ttW (Cl? Animal FacilitySIC code (if available): Basic Description of Operation:

NFDES Status: Regulated INDEX*Q Unregulated fl Unknown

B. VEHICLE OPERATIONS .N/A (Skip to part C) I Observed Pollution Source?Bl. Types of vehicles: EJ Fleet vehicles School buses Other:B2. Approximate number of vehicles;

83. Vehicle activities (circle all that apply). Maintained Repaired Recycled Fueled Washed StoredB4. Are vehicles stored and/or repaired outside? Q Y Q N Q Can’t TellAre these vehicles lacking runoff diversion methods? C Y Q N C Can’t TellB5. Is there evidence of spills/leakage from vehicles? fl Y N C Can’t Tell

86. Are uncovered outdoor fueling areas present? C Y C N C Can’t Tell

B7. Are fueling areas directly connected to storm drains? C Y C N C Can’t TellB8. Are vehicles washed outdoors? Y C N C Can’t TellDoes the area where vehicles are washed discharge to the storm drain? C Y C N C Can’t Tell

OUTDOOR MATERIALS C NIA (Skip to part D) I Observed Pollution Source?Cl. Are loading/unloading operations present? Y C N C Can’t TellIf yes, are they uncovered and draining towards a storm drain inlet? C Y C N Can’t Tell

C2. Are materials stored outside? V C N C Can’t Tell If yes, are they C Liquid Solid Description; &s5 rWhere are they stored? C grass/dirt area concrete/asphalt C bermed area CctCcX’’1

C3. Is the storage area directly or indirectly connected to storm drain (circle one)? C V C N Can’t Tell 0C4. Is staining or discoloration around the area visible? C V C N Can’t Tell 0Cs. Does outdoor storage area lack a cover? Y C N C Can’t Tell

C6. Are liquid materials stored without secondary containment? C Y N C Can’t Tell 0C7. Are storage containers missing labels or in poor condition (rusting)? C V C N Can’t Tell 00. WASTE MANAGEMENT C N/A (Skip to part E) Observed Pollution Source?Dl. Type of waste (check all that apply): Garbage C Construction materials C Hazardous materials Q02. Dumpster condition (check aK that apply): C No cover/Lid is open Damaged/poor condition CLeaking or

evidence of leakage (stains on ground) C Overflowing cq% .itz,LjD3. Is the dumpster located near a storm drain inlet? C Y N Can’t Tell

If yes, are runoff diversion methods (berms, curbs) lacking? Li Y C N C Can’t Tell

E. PHYSICAL PLANT C N/A (Skip to part F) Observed Pollution Source? L.

El. Building: Approximate age: yrs. Condition of surfaces: C Clean Stained C Dirty C Damaged 0Evidence that maintenance results in discharge to storm drains (staining/discoloration)? C V C N s-Don’t know 0

*Index: 0 denotes potential pollution source; denotes confirmed polluter (evidence was seen)

A-5


£2. Parking Lot: Approximate age tO yrs. Condition: Clean Stained El Dirty El Breaking up —

Surface material Paved/Concrete El Gravel El Permeable El Don’t knowE3.Do downspouts discharge to impervious surface? El Y N LI Don’t know El None visible— Are downspouts directly connected to storm drains? Y El N El Don’t knowE4. Evidence of poor cleaning practices for construction activities (stains leading to storm drain)? El Y El N El Can’t Tell

F. TURF/LANISCAPING AREAS El N/A (skip to pan G) I Observed Pollution Source?Ft. % of site with: Forest canopy ZS% Turf grass 2 O % Landscaping Bare Soil

Fl Rate the turf management status: El High Medium El Low

F3. Evidence of permanent irrigation or “non-target” irrigation ElY El N Can’t Tell

F4. Do landscaped areas drain to the storm drain system? Y El N El Can’t Tell

F5. Do landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? El Y El N Can’t Tell

G. STORM WATER INFRASTRUCTURE El N/A (skip to part H) I Observed Pollution Source?GI. Are storm water treatment practices present? ElY Q N Unknown If yes, please describe:

__________________

G2. Are private storm drains located at the facility? Y El N El UnknownIs trash present in gutters leading to storm drains? If so, complete the index below.


Sediment Eli 03 El4 05Organic material El 1 02 El 3 04 05Litter Eli 03 04 05

G3. Catch basin inspection — Record SSD Unique Site ID here:

________

Condition: El Dirty El CleanIJ.JNITIAL HOTSPOT STATUS - INDEX RESULTS

Not a hotspot (fewer than 5 circles and no boxes checked) El Potential hotspot (5 to 10 circles but no boxes checked)El Confirmed hotspot (10 to 15 circles and/or 1 box checked) El Severe hotsoot (>15 circles and/or 2 or more boxes checkedFollow-up Action:

El Refer for immediate enforcementEl Suggest follow-up on-site inspectionEl Test for illicit dischargeEl Include in future education effortEl Check to see if hotspot is an NPDES non-filerQ Onsite non-residential retrofitEl Pervious area restoration; complete PAA sheet and record


_____________________


Notes:

A-6

Hotspot Site Investigation EISJ“4TERSHED: I SUBWATERSHED: 4(7T UNIQUE SITE ID: 16!-.ucp’r-ot

.TE:jQjl.I IC ASSESSED By: 1Z CAMERAID: twc Pic#: Ioq—((l’FMAPGmD: LATqf141)LONG1tFO $4 ‘2t” LMK#


Name and Address: rgffTh.ci’fL Category: U Commercial Industrial Miscellaneoust’ A 4 U Institutional v Municipal U Golf Courses /, rcr2;?;r 1AJ2

4-. [J Transport-Related U Marinafli tr’—(a-- c-it4io- U Animal Facility

SIC code (if available): Basic Description of Operation:

NPDES Status: U Regulated INDEX*U Unregulated U Unknown

B. VEHICLE OPERATIONS U N/A (Skip to part C) I Observed Pollution Source?RI. Types of vehicles: U Fleet vehicles School buses U Other:

Ri Approximate number of vehicles: /&

B3 Vehicle activities (cii cle all that apply) Ma1iiiiièiERepaLra Recycled tueJdWihd siTha’

B4. Are vehicles stored and/or repaired outside? Y U N U Can’t Tell .t,&L-tad Ct4

Are_these_vehicles_lacking_runoff diversion_methods?_U_Y__0_N__U_Can’t Tell

85. Is there evidence of spills/leakage from vehicles? U Y U N J Can’t Tell Q86. Are uncovered outdoor fueling areas present? U N U Can’t Tell 0B7. Are fueling areas directly connected to storm drains? U Y U N Can’t Tell 0B8. Are vehicles washed outdoors? U Y U N Can’t Tell Zas1Does the area where vehicles are washed discharge to the storm drain? Y U N U Can’t Tell

OUTDOOR PVLATERIALS N/A (Skip to part D) Observed Pollution Source’LI. Are loading/unloading operations present? U Y U N U Can’t TellIf yes, are they uncovered and draining towards a storm drain inlet? U Y U N U Can’t Tell

C2. Are materials stored outside? U “ U N U Can’t Tell If yes, are they U Liquid U Solid Description:Where are they stored? U grass/dirt area U concrete/asphalt U bermed area

C3. Is the storage area directly or indirectly connected to storm drain (circle one)? U Y U N U Can’t Tell 0C4. Is staining or discoloration around the area visible? U Y U N U Can’t Tell QC5. Does outdoor storage area lack a cover? U Y U N U Can’t Tell QC6. Are liquid materials stored without secondary containment? U Y U N U Can’t Tell QC7. Are storage containers missing labels or in poor condition (rusting)? U Y U N U Can’t Tell 0U. WASTE MANAGEMENT 0 N/A (Skip to part F) ‘Lc44jt 4Ajt,- Observed Pollution Source?Dl. Type of waste (check all that apply): U Garbage U Construction materials U Hazardous materials 0D2. Dumpster condition (check all that apply): U No cover/Lid is open U Damaged/poor condition ULeaking or

evidence of leakage (stains on ground) U OverflowingD3. Is the dumpster located near a storm drain inlet? U Y U N El Can’t Tell

If yes,_are_runoff diversion_methods_(berms._curbs)_lacking?_U_Y__U_N__U_Can’t_Tell

E. PHYSICAL PLANT U N/A (Skip to part F) Observed Pollution Source?

El. Building: Approximate age: ‘Z-L yrs. Condition of surfaces: Clean U Stained U Dirty U Damaged 0Evidence that maintenance results in discharge to storm drains (staining/discoloration)? U Y U N Don’t know Q

*Jjldex: 0 denotes potential pollution source; L-_---J denotes confirmed polluter (evidence was seen)

$5


E2. Parking Lot: Approximate age yrs. Condition: Clean 0 Stained Dirty 0 Breaking upSurface material Paved/Concrete Gravel Permeable fl Don’t know

E3. Do downspouts discharge to impervious surface? 0 Y fl N 0 Don’t know,

None visibleAre downspouts directly connected to storm drains? C Y 0 N 0 Don’t know

Evidence of poor cleaning practices for construction activities (stains leading to storm drain)? 0 Y 0 N fl Can’t TellE4.

F2. Rate the turf management status: 0 High 0 Medium

F3. Evidence of permanent irrigation or “non-target” irrigation

F4. Do landscaped areas drain to the storm drain system?

G. ST0IM WATER INFRASTRUCTURE N/A (skip to part H)

0

0F. TURF/LANDSCAPING ARE4s El N/A (skip to part G) I Observed Pollution Source?1Fl. % of site with: Forest canopyEk% Turf grass LU; % Landscaping Bare Soil

C Low

Y ON DCan’tTell

DY QN DCan’tTell

F5. Do landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? Y flN C Can’t Tell

I Observed PollutionGI. Are storm water treatment practices present? C Y N C Unknown If yes, please describe:

G2. Are private storm drains located at the facility? Y C N C UnknownIs trash present in gutters leading to storm drains? If so, complete the index below.


Sediment flI 02 03 04 05Organic material Ci C2 03 04 05Litter Ci 02 03 04 05

G3. Catch basin inspection — Record SSD Unique Site ID here: Condition: C Dirty Q CleanH. INITIAL HOTSPOT STATUS - INI)EX RESULTS

Not a hotspot (fewer than S circles and no boxes checked) 0 Potential hotspot (5 to 10 circles but no boxes checked)C Confirmed hotspot ( 10 to 15 circles and/or I box checked) C Severe hotsnot (>15 circles and/or 2 or more boxes checkedFollow-up Action:

C Refer for immediate enforcementC Suggest follow-up on-site inspectionC Test for illicit dischargeo Include in future education effortO Check to see if hotspot is an NPDES non-filerC Onsite non-residential retrofitC Pervious area restoration; complete PAA sheet and record


_______________________


Notes:

‘is

A-6


WATERSHED: 4 SUEWATERSHEU: AA Pt UNIQUE SITE ID: 1kj’9A k)1- c> IDATE: JQJS/ jo ASsESSEDBY: CAMERAJD: J Pic#: irV//L7A. NEIGHBORHOOD CHARACTERIZATION

Neighborhood/Subdivision Name: 14e We Qcc-1.t5 Neighborhood Aiea (acres)If unknown, address (or streets) surveyed:

Homeowners Association? Y fl N Q Unknown If yes, name and contact information:Residential (circle average single family lot size):

Single Family Attached (Duplexes, Row Homes) <Vs <1j) ¼ 1/3 V3 acre Multifamily (Apts, Townhomes, Condos)fl Single Family Detached <¼ 1/4 ½ 1 >1 acre C Mobile Home ParkEstimated Age of Neighborhood: t years Percent of Homes with Garages: / &( % With BasementsL% INDEX*Sewer Service? Y Q N

Index of Infill. Redevelopment, and Remodeling No Evidence <5% of units

Recoipercen.t obtervedfor eqckoftlzefollojping indicators,1ependingon applicabitily and/or siltcomplexity

B. VASn AI’D LAWN CoNurnoNs

---

Bl. % of lot with impervious cover

82. % of lot with grass cover

B3. % of lot with landscapisg (e.g., mulched bed areas)

84. % of lot with bare soil

*Note: 81 through 84 must total 100%

85. % of lot with forest canopy

B6. Evidence of permanent irrigation or “non-target” irrigation

87. Proportion of total neighborhood turf lawns with followingmanagement status:

88. Outdoor swimming pools? DY N fl Can’t Tell Estimated 4*

89. Junk or trash in yards? C Y ND Can’t Tell

C. DmvEwAYs, SIDEwALKs, AND CURBS

Cl. % of driveways that are impervious N/A /00

C2. Driveway Condition Clean C Stained C Dirty C Breaking up

C3.Aresidewalkspresent?YNIfyes,aretheyononesideofstreetora]ongboth sides CC Spotless C Covered with lawn clippings/leaves C Receiving ‘non-target’ irrigation 0

What is the distance between the sidewalk and street? ft.

Is pet waste present in this area? C Y C N C N/A 0e.s.checkalithatapply:

Clean and Dry Flowing or standing water PL?!:m car parking C Sediment. 0

C Organic matter, leaves, lawn clippings C Trash, litter, or debris C Overhead tree canopy 0* INDEX: 0 denotes potential pollution source; 0 denotes a neighborhood restoration opportunity

A-3

NSA Pollution Severity IndexSevere (More than 10 circles checked)

El High (5 to 10 circles checked)JModerate (Fewer than 5 circles checked)

El None (No circles checked)


El High (More than 5 diamonds checked)

El Moderate (3-5 diamonds checked)SLow (Fewer than 3 diamonds checked)

Neighborhood Source Assessment NSAD. ROOrros

Dl. Downspouts are directly connected to storm drains or sanitary sewer 1 O) 2 • ®02. Downspouts are directed to impervious surface A,!03. Downspouts discharge to pervious area /1104. Downspouts discharge to a cistern, rain barrel, etc. /1

Wote: Cl through C4 should total 100%

05. Lawn area present downgradient of leader for rain garden? Y CN IE. COMMON AREAS

El. Storm drain inlets? ‘EJ Y Q N If yes, are they stenciled? Ely N Condition: Q Clean El Dirty

Catch basins inspected? El Y El N If yes, include Unique Site ID from SSD sheet: 0E2. Storm water pond? Y Q N Is it a El wet pond or Idry pond? Is it overgrown? El Y 12 N

What is the estimated pond area? <1 acre El about I acre Q> I acre rvuv,s- i,’i,J

Buffers/floodplain present: El Y El N If yes, is encroachment evident? El Y El N

F. INITLAL NEIGHBORHOOD ASSESSMENT AND RECOMMENDATIONS

Based on field observations, this neighborhood has significant indicators for the following: (check all that apply)Nutrients Oil and Grease El Trash/Litter Bacteria El Sediment El Other


El Onsite retrofit potential?Better lawn/landscaping practice? .

El Better management of common space?Pond retrofit?

El Multi-family Parking Lot Retrofit?

El Other action(s)

Initial Assessment


V

NOTES:

A-4


WATERSHED: A4?1 SUBWATERSHED: UNIQUE SITE m:DATE: JQ//2fJu ASSESSEDRY: --r7Pf3 CAMERAID: (o%//•v. PICTURES:IZ/ /,c1

GPS1D: LMKID: LAT:HJ72Zc LONG:t’uiJ:C

SITE DESCRIPTION

Name:Address: (e 4-tv4” V- ( F -

Ownership: Public El Private El UnknownIf Public, Government Jurisdiction: El Local El State DOT El Other:__________________________

Corresponding USSRUSA Field Sheet? El Yes El No If yes, Unique Site ID:___________________

Proposed Retrofit Location:Storage On-SiteEl Existing Pond El Above Roadway Culvert El Hotspot Operation El Individual RooftopEl Below Outfall El In Conveyance System El Small Parking Lot El Small Impervious Area

In Road ROW Near Large Parking Lot El Individual Street El Landscape / HardscapeEl Other:__________________________________ El Underground El Other:__________________


Drainage Area 1-- - Drainage Area Land Use:Imperviousness 4Z--(z / % El Residential El InstitutionalImpervious Area El SFH (< 1 ac lots) El Industrial

El SFH (> I ac lots) ] Transport-RelatedNotes:El Townhouses El ParkEl Multi-Family El Undeveloped

El Commercial El Other:


Existing Stormwater Practice: El Yes El No El PossibleIf Yes, Describe:

I,cct /Cv -CkC


7! 2


- CJ t’


PROPOSED RETROFIT

Retrofit Reconnaissance Investigation flJ4f

Purpose of Retrofit:Water Quality LI Recharge LI Channel Protection LI Flood Control

LI Demonstration / Education LI Repair LI Other:___________________________________________


Proposed Treatment Option:LI Extended Detention LI Wet Pond LI Created Wetland BioretentionLI Filtering Practice LI Infiltration j1 Swale LI Other:_____________________________________


J/CS( Cte m

SITE CONSTRAINTS

Adjacent Land Use: Access:LI Residential LI Commercial LI Institutional LI No ConstraintsLI Industrial Transport-Related LI Park Constrained due to /LI Undeveloped LI Other:_________________________ LI Slope SpacePossible Conificts Due to Adjacent Land Use? LI Yes LI No Utilities .f- Tree ImpactsIf Yes, Describe: LI Structures LI Property Ownership

LI Other:__________________

Conflicts with Existing Utilities: Potential Permitting Factors:LI None Dam Safety Permits Necessary LI Probable LI NotProbableLI Unknown Impacts to Wetlands LI Probable LI Not ProbableYes Possible Impacts to a Stream LI Probable LI Not ProbableLI LI Sewer Floodplain Fill LI Probable LI Not ProbableLI LI Water Impacts to Forests LI Probable LI Not ProbableLI LI Gas Impacts to Specimen Trees LI Probable LI Not ProbableLI C Cable I-low many?LI JJ Electric Approx. DBH____________LI E Electric to StreetlightsLI Overhead Wires Other factors:_________________________________________________LI LI Other:




SKETCH Kf\ -MPr--ö)

Ay

/

I..

JI

I) I


Retrofit Reconnaissance Investigation fZJ?J


£-k_ ?vVk rCA /H:J UL

I c7C -cC — Jc


Confwm property ownership fl Obtain existing stormwater practice as-builtsSConfuin drainage area Obtain site as-builts

Confirm drainage area impervious cover Obtain detailed topographyC Confirm volume computations Obtain utility mapping

Complete concept sketch Confirm storm draIn invert elevationsConfirm soil types

C Other:


SITE CANDIDATE FOR FURThER TN VESTIGATION: [] YES [] No H MAmIs SITE CANDIDATE FOR EARLY ACTION PROJECT(S): YES No H MAYBEIF NO, SITE CANDIDATE FOR OTHER RESTORATION PROJEcT(s) YES LI No MAYBE

IF YES, TYPE(S)


Streets and Storm Drains SSDWATERSHED: Pq SUEWATERSHED: UNIQUE SITE ID:DATE: jj 147 (& ASSESSED By: rm,zç CAMERA ID:

MAPGRID RAIN INLAST24HOURS Dy ON Pic# (2-i — iLA. LOCATION


A2. Adjacent land use: Residential Commercial Q Industrial InstitutionalMunicipal Q Transport-Related

A3. Corresponding HSI or NSA field sheet? If so, circle HSI or NSA and record its Lnique Site ID here ‘


81. Road Type: U Arterial Collector C Local U Alley Other:

B2. Condition of Pavement: New D Good Cracked Broken83. Is on-street parking permitted DY N If yes, approximate number of cars per block:

B4. Are large cul-de-sacs present? Y Q N 41/AB5. Is trash present in curb and gutter? If so, Index Rating for Accumulation in Guttersuse the index to the right to record amount. Clean Filthy

Sediment Dl 02 03 04 05OrganicMaterial Di 02 03 04 Os

Litter Dl []3 04 OsC. STORM DRAIN INLETS AND CATCH BAsINsCL Type of storm drain conveyance: U open enclosedC2. Percentage of inlets with catch basin sto’Sample 1-2 catch basins per NSAIHSILatitude

Longitude

LMK #

Picture# /7.-)

Current Condition Wet 0 Dry U Wet DryCondition of Inlet OClear EObstructed Clear OObstructedLitter Accumulation DY N DY NOrganics Accumulation Y C N DY C NSediment Accumulation EY C N DY U NSediment Depth (in feet) 2 ft. ..i - ft.Water Depth OS ft. ft.Evidence of oil and grease DY N DY NSulfur smell DY N DY ONAccessible to vacuum truck P DY C N DY fl ND. NON-RESIDENTIAL PARKING LOT (>2 acres)

Dl. Approximate size: acres

D2. Lot Utilization: U Full About half full Empty

D3. Overall condition of Pavement: C Smooth (no cracks) C Medium (few cracks) Rough (many cracks)0 Very Rough (numerous cracks and depressions)

D4. Is lot served by a storm water treatment practice? C Y N If yes, describe:‘ D5. On-site retrofit potential: Excellent 1 Good Q Poor

A-9

Streets and Storm Drains SSDE. MUNICWAL POLLUTANT REDUCTION STRATEGIES

El. Degree of pollutant accumulation in the system: High Q Medium Low fl NoneE2. Rate the feasibility of the following pollution prevention strategies:

Street Sweeping: High Moderate LowStorm Drain Stenciling: C High IJ Moderate LowCatch Basin Clean-outs: High Moderate C LowParking Lot Retrofit Potential: jJ High Q Moderate Q Low


C /

LI?

.1.

Notes:

VT I,

A-i 0


WATERSHED: SURWATERSHED: f( 21 UNIQUE SITE ID: tL ir—- c>’DATE: ic/i41 IC’ ASSESSEDBY: T7lZi CAMERATh: O I PIC#:/7c7_)3

A. NEloaBolul000 CHARACTERIZATION

Neighborhood/Subdivision Name: ‘re I(’r ‘ kh Tz,( 7 ti— Neighborhood Area (acres)

If unknown, address (or streets) surveyed;

Homeowners Association? Y N El Unimown If yes, name and contact information;Residential (cu-tie average singtefamily lot size):

El Single Family Attached (Duplexes, Row Homes) <¼ ‘h ¼ l, V3 acre El Multifamily (Apts, Townhomes, Condos)_Single Family_Detached <¼ ¼__½(Tci)_acre Q_Mobile Home_ParkEstimated Age of Neighborhood: 5C years Percent of Homes with Garages: % With Basements INDEX*

wer Service? El y N

Index of Infill, Redevelopment, and Remodeling El No Evidence <5% of units El 5-10% El >10% Q?ecordjnrcent observedfor each ofthefo,flØving indicators,

/ ependingon applicability an?/Jr sill complexity I

B. YARD AN]) LAwN CoNurnoNs

Bi. % of lot with impervious cover

B2. % of lot with grass cover

B3. % of lot with landscaping (e.g., mulched bed areas)

B4. % of lot with bare soil

*Note: Dl through B4 must total 100%


B6. Evidence of permanent irrigation or “non-target” irrigation

B7. Proportion of total neighborhood turf lawns with followingmanagement status:

B8. Outdoor swimming pools? IZIY EN El Can’t Tell Estimated #

B9. Junk or trash in yards? El Y N El Can’t Tell

C. DRIVEWAYS, SIDEWALKS, AND CulussCl. % of driveways that are impervious El N/A

C2. Driveway Condition Clean El Stained El Dirty El Breaking up QC3. Are sidewalks present? ElY N If yes, are they on one side of streetEl or along both sides Q

El Spotless El Covered with lawn clippings/leaves El Receiving ‘non-target’ irrigation QWhat is the distance between the sidewalk and street? ft.

Is pet waste present in this area? El Y El N El N/A 0C4. Is curb andgutterpresent? ElY N yçpply:

El Clean and Dry El Flowing or standing water El Long-term car parking SedimentOrganic matter, leaves, lawn clippings El Trash, litter, or debris 0 Overhead tree canopy 4

* INDEX: 0 denotes potential pollution source; K> denotes a neighborhood restoration opportunity

1’

A-3

Neighborhood Source Assessment NSA


ElElElElCEl

Initial Assessment


El Severe (More than 10 circles checked)

C High (5 to 10 circles checked)Moderate (Fewer than 5 circles checked)

El None (No circles checked)


El High (More than S diamonds checked)

C Moderate (3—S diamonds checked)Low (Fewer than 3 diamonds checked)

D. Roorrors

Dl. Downspouts are directly connected to storm drains or sanitary sewer (7 3’ 0D2. Downspouts are directed to impervious surface ?n t’,,i

D3. Downspouts discharge to pervious area 9’() %P4. Downspouts discharge to a cistern, rain barrel, etc.

kNote: C] through C4 should total 100%

PS. Lawn area present downgradient of leader for rain garden? 0. Y CN 0E. COMMON AREAS

XN ondition:ElCleanCDirty 0Catch basins inspected? Y El N If yes, include Unique Site ID from SSD sheet: ‘.‘1PT2 0

EL Storm water pond? C Y N Is it a C wet pond or C dry pond? Is it overgrown? C 1’ N 4What is the estimated pond area? Q <1 acre C about I acre C > 1 acre

E3. Open Space? Y C N If yes, is pet waste present? C Y N dumping? C Y 0 N 0Buffers/floodplain present: C Y C N If yes, is encroachment evident? C Y C N

F. INITIAL NEIGUBO1W000 ASSESSMENT AND RECOMMENDATIONS

8sed on field observations, this neighborhood has significant indicators for the following: (check all that apply)Nutrients C Oil and Grease C Trash/Litter C Bacteria Sediment C Other


Onsite retrofit potential?Better lawn/landscaping practice?Better management of common space?Pond retrofit?

Multi-family Parking Lot Retrofit?Other action(s)

NOTES:

A-4


Cl. Type of storm drain conveyance: C open 0 enclosedC2. Percentage of inlets with catch basin storage:Sample 1-2 catch basins per NSA/HSILatitude

Longitude

WATERSHED: TEQ SUBWATERSHED: -(77Y UNIQUE SITE ID: j,5>q7 cDATE: .c/K4____ ASSESSED By: CAMERA ID:

MAPGRID RAININLAST24IIOURS flY fiN P# )t’1 3_A. LOCATION

Al. Street names or neighborhood surysred:Zj P4 (Cd za

A2. Adjacent land use: Residential fi Commercial fi Industrial fi InstitutionalC Municipal C Transport-Related

A3. Corresponding HSI or NSA field sheet? If so, circle FISI or NSA and record its Unique Site ID here

B. STREET CONrnTIONS

Bi. Road Type: 0 Arterial fi Collector Local C Alley C Other:

B2. Condition of Pavement: 0 New fi Good E Cracked fi Broken83. Is on-street parking permitted Y 0 N If yes, approximate number of cars per block: (D84. Are large cul-de-sacs present? 0 Y 0 N


Sediment flu 03 04 05OrganicMaterial 01 fl2 03 04 05

Litter i fl2 03 04 05C. STORM DRAIN INLETS AND CATCH BASINS

LMK#Picture# Ui-Current Condition C Wet Dry 0 Wet DryCondition of Inlet OClear fiObstructed fiClear ObstructedLitter Accumulation fly fi N fly fi NOrganics Accumulation Y 0 N 0 NSediment Accumulation flY fi N EJY 0 NrSediment Depth (in feet) / T ft —7 ft.Water Depth (2 ft. C’ ft.Evidence of oil and grease fly fi N fly NSulfur smell fly fi N fly fi NAccessible to vacuum truck flY fi N fi ND. NON-RESIDENTIAL PARKING LOT (>2 acres)


D2. Lot Utilization: fi Full fi About half full fi Empty

D3. Overall condition of Pavement: fi Smooth (no cracks) fi Medium (few cracks) C Rough (many cracks)fi Very Rough (numerous cracks and depressions)

D4. Is lot served by a storm water treatment practice? fly fi N if yes, describe:

E D5. On-site retrofit potential: fi Excellent fi Good fi Poor

A-9

Streets and Storm Drains SSDE. MIJNICWAL POLLUTANT REDUCTION STRATEGIES

El. Degree of pollutant accumulation in the system: D High fl Medium fl Low C NoneE2. Rate the feasibility of the following pollution prevention strategies:

Street Sweeping: High Moderate LowStorm Drain Stenciling: High Moderate fl LowCatch Basin Clean-outs: High C Moderate C LowParking Lot Retrofit Potential: Q High C Moderate C Low

CATCH BASIN SKETCHES#1

I 7 t/ q / i-i a/

/t> A

Lr

Notes:

A-i 0


WATERSHED: - SUB WATERSHED: UIF i- UNIQUE SITE ID:- tj?p-I- -Cf

DATE: jflj //4/ ig U ASSESSED By: ‘i- Z CAMERA ID: Pjc#:

A. NEIGHBORHOOD CHARACTERIZATION /33- flcZNeighborhood/Subdivision Name: /c4 /adIf unknown, address (or streets) surveyed:


_______

Sewer Service? Y fi N

Index of Infill, Redevelopment, and Remodeling

Recor4 percent obseedfor each of thejdepending on applicabilit

B. YARD AND LAwN CoNornoNS

111. % of lot with impervious cover 30 J_BZ. % of lot with grass cover

B3. % of lot with landscaping (e.g., mulched bed areas)

114. % of lot with bare soil CNote: Bi through B4 must total 100%


116. Evidence of permanent irrigation or “non-target” irrigation 7.CHigh:

117. Proportion of total neighborhood turf lawns with following Med: J53management status:Low: sü

BS. Outdoor swimming pools? flY fiN Can’t Tell Estimated #

119. Junk or trash in yards? flY [jfl Nfl Can’t Tell

C. DRIVEWAYS, SIDEWALKS, AN]) CURBS

CI. % of driveways that are impervious fi N/A J

fi Spotless fi Covered with lawn clippings/leaves 9 Receiving ‘non-target’ irrigationWhat is the distance between the sidewalk and street?

______

ft.

Is pet waste present in this area? fi Y 9 N fi N/A

yes,checkalithatappiy:

fi Clean and Dry fi Flowing or standing water fi Long-term car parking fi SedimentOrganic matter, leaves, lawn clippings fi Trash, litter, or debris fi Overhead tree canopy

Homeowners Association? fi y N fi Unknown If yes, name and contact information:

_____________________________


_______________________________

9 Single Family Attached (Duplexes, Row Homes) <¼ I/a ¼ ¼ ¼ acre 9 Multifamily (Apts, Townhomes. Condos)Single Family Detached <¼ ¼ >1 acre fi Mobile Home Park

Estimated Age of Neighborhood: gO years Percent of Homes with Garages:

_____%

With Basements

C2. Driveway Condition Clean fi Stained fi Dirty fi Breaking up

00

000


0

A-3

NOTES:

Neighborhood Source Assessment NSAft RooFrops

Dl. Downspouts are directly connected to storm drains or sanitary sewer 0 0D2. Downspouts are directed to impervious surface

Di Downspouts discharge to pervious area

1)4. Downspouts discharge to a cistern, rain barrel, etc.SNore: CI through C’4 should total 100%

D5. Lawn area present downgradient of leader for rain garden? Y QN I I 0’E. CcnnloN AREASEl. Storm drain inlets? 3Y Li N If yes, are they stenciled? Li Y N Condition: Li Clean Dirty 0’

Catch basins inspected? Y Li N If yes, include Unique Site ID from SSD sheet: 5ct-tflR -ci Q£2. Storm water pond? Li Y N Is it a Li wet pond or Li dry pond? Is it overgrown? DY Li N

What is the estimated pond area? Li <1 acre Li about 1 acre Li > 1 acre

£3. Open Space? DY N If yes, is pet waste present? Li Y Li N dumping? Li Y Li N QBuffers/floodplain present: Y Li N If yes, is encroachment evident? Li Y Li N

F. INITIAL NEIGHBORHOOD ASSESSMENT AND RECOMMENDATIONSBased on field observations, this neighborhood has significant indicators for the following: (check all i/jar apply)

Nutrients Li Oil and Grease Li Trash/Litter Li Bacteria Li Sediment Li Other


Li Onsite retrofit potential?

Li Better lawn/landscaping practice?

Li Better management of common space?

Li Pond retrofit?

Li Multi-family Parking Lot Retrofit?

Li Other action(s)

Initial Assessment—

—


Li Severe (Morethan 10 circles checked)

Li High (5 to 10 circles checked) iLi Moderate (Fewer than 5 circles checked)None (No circles checked)


Li High (More than 5 diamonds checked)

Li Moderate (3-5 diamonds checked)SLow (Fewer than 3 diamonds checked)

— — — — —

\J1Z%

A-4

Streets and Storm Drains SSDWATERSHED: SUEWATERSHED: )7 1-f- UNIQUE SITE ID: scv uu— olDATE: iflJcfL/ to ASSESSED By: pp CAwWRA ID:

M.4PGRID j RAININLAST24HOURS ElY N Pic# \‘3.;— 13 (,

A. LOCATION

Al. Street names or neighborhood surveyed:3AJ324 &

A2. Adjacent land use: Residential El Commercial El Industrial El Institutionalfi Municipal fi Transport-Related

A3. Corresponding HSI or NSA field sheet? If so. circle HSI or NSA and record its Unique Site ID here

B. STREET C0rQWTIONS

Bi. Road Type: El Arterial fi Collector Local El Alley El Other:

B2. Condition of Pavement: El New Good El Cracked El BrokenB3. Is on-street parking permitted Y fi N If yes, approximate number of cars per block:

B4. Are large cul-de-sacs present? El Y N

B5. Is trash present in curb and gutter? If so, 1 Index Rating for Accumulation in Guttersuse the index to the right to record amount. Clean Filthy

Sediment El I El3 Q4 ElsOrganicMaterial Eli El2 J3 El4 El5

Litter l El2 El3 fl4 []5C. STORM DRAIN INLETS AND CATCH BASINSCl. Type of storm drain conveyance: El open enclosed El mixedC2. Percentage of inlets with catch basin storage: El N/ASample 1-2 catch basins per NSAJHS1 C3. Catch basin #1 C4. Catch basin #2Latitude j° I&102/ .th.° ,6b2—Q”Longitude 1° ID

“ Z.o f(, tj ‘3LMK #Picture # f5Current Condition El Wet Dry El Wet DryCondition of Inlet Clear flObstructed fiClear ObstructedLitter Accumulation flY N El NOrganics Accumulation W El N Y El NSediment Accumulation jY El N RY El NSediment Depth (in feet) — i—i.. ft. I - ft.Water Depth 0 ft. (2 ft.Evidence of oil and grease ElY N El NSulfur smell ElY N NAccessible to vacuum truck [ Y El N Y El Nft NON-RESIDENTIAL PARKING LOT (>2 acres)


P2. Lot Utilization: El Full El About half full El Empty

P3. Overall condition of Pavement: El Smooth (no cracks) El Medium (few cracks) El Rough (many cracks)El Very Rough (numerous cracks and depressions)

P4. Is lot served by a storm water treatment practice? El Y El N If yes, describe:PS. On-site retrofit potential: El Excellent El Good El Poor

A-9

[MUN1CIPAL POLLUTANT REDUCTION STRATEGIES


El. Degree of pollutant accumulation in the system: fl High V] Medium fl Low fl NoneE2. Rate the feasibility of the following pollution prevention strategies:

Street Sweeping: fl High Moderate LowStorm Drain Stenciling: High Q Moderate Q LowCatch Basin Clean-outs: High H Moderate H LowParking Lot Retrofit Potential: H High Q Moderate Low


#2

A

Notes:

J

#1

pr

A-i 0

Hotspot Site Investigation iisiRZTERSHED: SUBWATERSHED: “TIjP.. J UNIQTJESITEID: i/-’fliL2.,- ‘(

TE:j/fl/ in U ASSESSEDBY: Vy CAMERAID: (U PIc#:,3 7.jc4._MAP GRID LATIIIO ) (.4, 01ç ftLoNGo /0. l’ LMK#

A. SUE DATA AND BASIC CLASSIFICATION

Name and Address: -j-4 T:ti Category: LI Commercial LI Industrial Miscellaneous

j Institutional Municipal LI Golf Course- LI Transport-Related LI Marina

LI Animal FacilitySIC code (if available): Basic Description of Operjijon:NPDES Status: LI Regulated r4kJtZtL ‘4’ce&4i

LI Unregulated LI Unknown

B. VEHICLE OPERATIONS 1519 N/A (Skip to part C)

BI. Types of vehicles: LI Fleet vehicles LI School buses LI Other:B2. Approximate number of vehicles:

B3. Vehicle activities (circle all that apply): Maintained Repaired Recycled Fueled Washed StoredB4. Are vehicles stored andlor repaired outside? LI Y LI N LI Can’t TellAre these vehicles lacking runoff diversion methods? LIY LI N LI Can’t TellB5. Is there evidence of spills/leakage from vehicles? LIY LI N LI Can’t Tell

B6. Are uncovered outdoor fueling areas present? LI V LI N LI Can’t Tell

B7. Are fueling areas directly connected to storm drains? LI Y LI N LI Can’t TellB8. Are vehicles washed outdoors? LI V LI N LI Can’t TellDoes the area where vehicles are washed dischar2e to the storm drain? LI Y LI N LI Can’t Tell

UTDOOR MATERIALS 5fl N/A (Skip to part D) Observed Pollution Source?Ci. Are loading/unloading operations present? LI Y LI N LI Can’t TellIf yes, are they uncovered and draining towards a storm drain inlet? LI Y LI N LI Can’t Tell

C2. Are materials stored outside? LI V LI N LI Can’t Tell If yes, are they LI Liquid LI Solid Description:Where are they stored? LI grass/dirt area LI concrete/asphalt LI bermed area

C3. Is the storage area directly or indirectly connected to storm drain (circle one)? LI Y LI N LI Can’t Tell 0C4. Is staining or discoloration around the area visible? LI Y LI N LI Can’t Tell QCS. Does outdoor storage area lack a cover? LI Y LI N LI Can’t Tell 0C6. Are liquid materials stored without secondary containment? LI Y LI N LI Can’t Tell 0C7. Are storage containers missing labels or in poor condition (rusting)? LI V LI N LI Can’t Tell 0U. WASTE MANAGEMENT M N/A (Skip to pan E) Observed Pollution Source?.*Di. Type of waste (check all that apply): LI Garbage LI Construction materials LI Hazardous materials 002. Dumpster condition (check all that apply): LI No cover/Lid is open LI Damaged/poor condition LIteaking or

evidence of leakage (stains on ground) LI OverflowingD3. Is the dumpster located near a storm drain inlet? LI Y LI N LI Can’t Tell

If yes, are runoff diversion methods (berms, curbs) lacking? LI V LI N LI Can’t Tell--

E. PHYSICAL PLANT LI N/A (Skip to part F) Observed Pollution Source? -__JEl. Building: Approximate age: yrs. Condition of surfaces: LI Clean Stained LI Dirty LI Damaged 0Evidence that maintenance results in discharge to storm drains (staining/discoloration)? LI Y N LI Don’t know 0

*Thdex: 0 denotes potential pollution source; L__i denotes confirmed polluter (evidence was seen)

45


E2. Parking Lot: Approximate age ‘-10 yrs. Condition: El Clean Stained El Dirty El Breaking upSurface material Paved/Concrete El Gravel El Permeable El Don’t know

El Do downspouts discharge to impervious surface? El Y EEl N El Don’t know El None visibleAre downspouts directly connected to storm drains? El Y []N El Don’t know

E4. Evidence of poor cleaning practices for construction activities (stains leading to storm drain)? El Y El N El Can’t Tell

F. TURF/LANI)scM’IrcG A1uAS El WA (skip to pan G) I Observed Pollution SoiFl. % of site with: Forest canopy .L4LTo Turf grass 6O % Landscaping ±CI% Bare Soil LL%F2. Rate the turf management status: High El Medium El Low

F3. Evidence of permanent irrigation or “non-target” irrigation 0 Y El N El Can’t Tell

F4. Do landscaped areas drain to the storm drain system? Q Y El N El Can’t Tell

F5. Do landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? L Y QN El Can’t Tell

G. STORM WATER INFRASTRUCTURE El N/A (skip to part H) I Observed Pollution So’GI. Are storm water treatment practices present? ElY El N El Unknown If yes, please describe:

G2. Are private storm drains located at the facility? El Y El N El UnknownIs trash present in gutters leading to storm drains? If so, complete the index below.


Sediment Eli El2 El3 El4 El5Organicmaterial Eli El2 El3 El4 ElsLitter ElI El2 El3 El4 Els

G3. Catch basin inspection — Record SSD Unique Site ID here: Condition: El Dirty El CleanH. INITIa UOTSPOT STATUS - INDEX RESULTS

Not a hotspot (fewer than 5 circles and no boxes checked) El Potential hotspot (5 to 10 circles but no boxes checked)El Confirmed hotspot (10 to IS circles and/or I box checked) El Severe hotspot (>15 circles and/or 2 or more boxes checkedFollow-up Action:


Unique Site 1D here:

_____________________


Notes: !

V A.4LWt6I

-

A-6


WATERSHED: SUB WATERSHED: UNIQUE SITE ID: 41$ 4—iL it -o /DATEHO/1l/ lb C ASSESSEDBY: CAMER.41D: Pxc#: NO,u rA. NEJGIiB0RH00D CHARACTERIZATION

Neighborhood/Subdivision Name: v.tncr’r.L ff64..it Neighborlwod Area (acres)If unkjiown, address (or streets) surveyed:

Homeowners Association? El Y El N Unknown If yes, name and contact information: C’44CC


________________________

Single Family Attached (Duplexes. Row Homes) <Vs ¼(()’/c ¼ acre El Multifamily (Apts, Townhomes, Condos)Q Single Family Detached <¼ ¼ ½ 1 >1 acre El Mobile Home ParkEstimated Age of Neighborhood: 40 years Percent of Homes with Garages: With Basements ._.% INDEX*Sewer Service? El Y El N 0Index of Infill, Redevelopment, and Remodeling Q No Evidence El <5% of units El 5-10% >l0% Q

Recordpercent observedfor each ofthefollowing indicators,Percenta e Comments/Notes4epending on applicability and/or site cpinpkxity

B. YARD AND LAwN CoNornoNs

Bi. % of lot with impervious cover Lf C82. % of lot with grass cover C.1 0 083. % of lot with landscaping (e.g., mulched bed areas) /G 084. % of lot with bare soil / 0 0


85. % of lot with forest canopy 6 0 C)86. Evidence of permanent irrigation or “non-target” irrigation £ i Q 0

High:L QB7. Proportion of lotal neighborhood turf lawns with following Med: .b.Q.management status:

Low: flL

B8. Outdoor swimming pools? ElY N El Can’t Tell Estimated 4* 089. Junk or trash in yards? Q Y N El Can’t Tell 0C. DRIVEWAYS, SmEwaKs, AND CuRes

Cl. % of driveways that are impervious El N/A

C2. Driveway Condition Clean Stained El Dirty El Breaking up

C3.Are sidewalks present? ElY N If yes, are they on one side of streetElor along both sides ElEl Spotless El Covered with lawn clippings/leaves El Receiving ‘non-target’ irrigation Q

What is the distance between the sidewalk and street? ft. C) --

Is pet waste present in this area? El Y El N El N/A 0y1scc!lltkaLppIy:

El Clean and Dry El Flowing or standing water El Long-term car parking El Sediment 0Organic matter, leaves, lawn clippings El Trash, litter, or debris El Overhead tree canopy 0

* INDEX: 0 denote-s potential pollution source; C) denotes a neighborhood restoration opportunity

A-3

Neighborhood Source Assessment I IWSA.D. RooFToPs

Dl. Downspouts are directly connected to storm drains or sanitary sewer (3 ‘G 0D2. Downspouts are directed to impervious surface ‘3ofr

D3. Downspouts discharge to pervious area

D4. Downspouts discharge to a cistern, rain barrel, etc. (‘7*Note: CI through C4 should total 100%

05. Lawn area present downgradient of leader for rain garden? Y UN IE COMMON AREAS

El. Storm drain inlets? U Y If yes, are they stenciled? U Y Q N Condition: U Clean U DirtyCatch basins inspected? Q Y U N If yes, include Unique Site ID from SSD sheet: 0

E2. Storm water pond? U Y U N Is it a Q wet pond or U dry pond? Is it overgrown? U Y U NWhat is the estimated pond area? U <1 acre U about I acre U> 1 acre

E3. Open Space? Y U N If yes, is pet waste present? U Y U N dumping? U Y U N 0

Buffers/floodplain present: U Y N If yes, is encroachment evident? U Y U N

F INITIAL NEIGHBORHOOD ASSESSMENT AND RECOMMENDATIONSBased on field observations, this neighborhood has significant indicators for the following: (check all that apply)

Nutrients U Oil and Grease U Trash/Litter Bacteria Sediment U Other

Recommended Actions Describe Recommended Actions:

Uof potential?. tfr it

Better lawn/landscaping practice?Better management of common space?

fl Pond retrofit?

U Multi-family Parking Lot Retrofit?

U Other action(s)

Initial Assessment


USevere (Morethanl0circleschecked)

U High (5 to 10 circles checked)

jModerate (Fewer than 5 circles checked)



U High (More than S diamonds checked)

U Moderate (3-5 diamonds checked)

Low (Fewer than 3 diamonds checked)

__________

NOTES:

A-4

r..cu H-cJ

Homeowners Association? Y N Q Unknown If yes, name and contact information:Residential (circle average single family lot size):

_______________________________

fl Single Family Attached (Duplexes, Row Homes) <¼ ‘/ ¼ V, 1/3 acre Multifamily (Apts, Townhomes. Condos)Single Family Detached ¼ ½ 1 >1 acre Q Mobile Home Park

Estimated Age of Neighborhood: years Percent of Homes with Garages: % With Basements ._.% INDEX*Sewer Service? DY N

Index of Infill, Redevelopment, and Remodeling D No Evidence D <5% of units C 5-10% Q >10% QRecorctpercent obsen’edfor eackoftlzefoilowrng indicators,

pcrcaii e CnnmentsINotesAepending on applicability and/or site complexity-

B. YARD AND L&’w’ CONDITIONS

81. % of lot with impervious cover Z7j)

BZ. % of lot with grass cover U 083. % of lot with landscaping (e.g., mulched bed areas) / 0 0B4. % of lot with bare soil C

*Note: Dl through B4 must total 100%

B5. % of lot with forest canopy 086. Evidence of permanent irrigation or “non-target” irrigation /0 O

High:JB7. Proportion of total neighborhood turf lawns with following Med:

management status:Low:

B8. Outdoor swimming pools? DYJN C Can’t Tell Estimated # CB9. Junk or trash in yards? DY N C Can’t Tell QC. DRIVEWAYS, SmEwAUCS, AND CuRBS

CL % of driveways that are impervious C N/A /6 d

C2. Driveway Condition Clean C Stained C Dirty C Breaking up 0C3. Are sidewalks present? C Y Q N If yes, are they on one side of street C or along both sides C

C Spotless C Covered with lawn clippings/leaves C Receiving ‘non-target’ irrigation QWhat is the distance between the sidewalk and street? ft. 0Is pet waste present in this area? C Y N C N/A Q

C4.Iscurbandgutterpresent?t DN yes,checkalithatapply:

I Clean and Dry C Flowing or standing water C Long-term car parking C Sediment QC_Organic matter, leaves, lawn clippings Q Trash, litter, or debris C Overhead tree canopy* INDEX: 0 denotes potential pollution source; 0 denotes a neighborhood restoration opportunity

••t)


WATERSHED: SUEWATERSHED: t UNIQUE SITE ID: IJ9,>A L) 02.-DATE: O/K6/____ ASSESSED By: J>T> r CAMERA ifi: &j F Prc#:A. NEIGHBORHOOD CHARACTERIZATION

Neighborhood/Subdivision Name: TZe Et / c_\c LbIf unknown, address (or streets) surveyed:


_______

A-3

Specific Action

El Onsite retrofit potential?

El Better Iawnllandscaping practice?

El Better management of common space?

o Pond retrofit?

El Multi-family Parking Lot Retrofit?

o Other action(s)

________________________________


El Severe (More than 10 circles checked)

o High (5 to 10 circles checked)Moderate (Fewer than 5 circles checked)

O None (No circles checked)


0 High (More than 5 diamonds checked)

Q Moderate (3-5 diamonds checked)Low (Fewer than 3 diamonds checked)


p_RoonovsDl. Downspouts are directly connected to storm drains or sanitary sewer

—

92. Downspouts are directed to impervious surface


04. Downspouts discharge to a cistern, rain barrel, etc.*Nore: Ci through C’4 should total 100%

95. Lawn area present downgradient of leader for rain garden? 0 Y ON I 0E. Cow%loN AREAS

El. Storm drain inlets? El Y El N If yes, are they stenciled? El Y El N Condition: El Clean El Dirty 0Catch basins inspected? DY El N If yes, include Unique Site ID from SSD sheet: 0

£2. Storm water pond? El Y El N Is it a El wet pond or El dry pond? Is it overgrown? Ely N C)What is the estimated pond area? El <1 acre El about I acre El> 1 acre

£3. Open Space? DY El N If yes, is pet waste present? 0 El N dumping? El Y El N

Buffers/floodplain present: El Y El N If yes, is encroachment evident? El Y El N

F. INITIAL NEIGHBORHOOD ASSESSMENT AN]) RECOMMENDATIONS

Recommended Actions

Based on field observations, this neighborhood has significant indicators for the following: (check all flint apply)El Nutrients El Oil and Grease El TrashlLitter El Bacteria El Sediment El Other

______________________

0


Initial Assessment

NOTES:

A-4

Hotspot Site Investigation IISI“kTERSHED: j%) ç SUBWATERSHED: L P L UNIQUE SITE ID: 1-44) —

STE: 4Jjjtl/ Jo ASSESSED By: (LM [ CAMERA IT): Pic#: L/3 /V5MAPGRID: LATJL0 1$ 1,luLONG7.0 It ‘31’e2- LMK#A. SrEE DATA AND BASIC CLASSIFICATION

Name and Address: S’I N vtk El Commercial Industrial Miscellaneous$s. El Institutional El Municipal El Golf Course

I El Transport-Related El Marinak El Animal FacilitySIC doàe (if available): Basic Description of Operation:

NPDES Status: Regulated A k o&c ç--iINDEX°El Unregulated El Unknown

B. VEffiCLE OPERATIONS El N/A (Skip to part C) I Observed Pollution Source?Bi. Types of vehicles: Fleet vehicles El School buses El Other:

B2. Approximate number of vehicles: / 1)-

B3. Vehicle activities (circle all that apply): Maintained Repaired Recycled Fueled Washed 4Stor

B4. Are vehicles stored andlor repaired outside? Y El N C Can’t TellAre_these_vehicles_lacking runoff diversion_methods?_El_Y__El_N___Can’t Tell

B5. Is there evidence of spills/leakage from vehicles? El Y El N Can’t Tell 0B6. Are uncovered outdoor fueling areas present? El Y N El Can’t Tell 0B7. Are fueling areas directly connected to storm drains? El Y El N’ Can’t Tell 0B8. Are vehicles washed outdoors? El Y N El Can’t TellDoes the area where vehicles are washed discharge to the storm drain? El Y El N El Can’t Tell

9UTDOOR MATERIALS El N/A (Skip to part D) Observed Pollution Source?Ci. Are loading/unloading operations present? Y El N El Can’t TellIf yes, are they uncovered and draining towards a storm drain inlet? El Y El N El Can’t Tell

C2. Are materials stored outside? V EjN El Can’t Tell If yes, are they El Liquid JJ Solid Description:Where are they stored? El grass/dirt area concrete/asphalt El bermed area tçç -Vs L ,ro’\i-5 j”—s G-’--,C3. Is the storage area directly or indirectly connected to storm drain (circle one)? Y El N El Can’t Tel.4ct QC4. Is staining or discoloration around the area visible? El Y El N Can’t Tell £(? 0Cs. Does outdoor storage area lack a cover? %J Y El N El Can’t Tell 0C6. Are liquid materials stored without secondary containment? El Y N El Can’t Tell QC7. Are storage containers missing labels or in poor condition (rusting)? El V El N Can’t Tell 0D. WASTE MANAGErcr Q N/A (Skip to part I Observed Pollution Source’Dl. Type of waste (check all that apply): , Garbage Construction materials El Hazardous materials

D2. Dumpster condition (check all that apply): El No cover/Lid is open El Dmaged/poor condition ElLeaking orevidence_of leakage_(stains_on_ground)_El_Overflowing _If_COy-c_ftCt to_ftdkbL-s

D3. Is the dumpster located near a storm drain inlet? El Y El N El Can’t TellIf yes,_are runoff diversion_methods_(berms,_curbs)_lacking?_El_Y__El_N__El_Can’t Tell

E. PHYSICAL PLsNT Q N/A (Skip to part F) Observed Pollution Source?

El. Building: Approximate age: yrs. Condition of surfaces: Clean El Stained El Dirty El Damaged 0Evidence that maintenance results in discharge to storm drains (staining/discoloration)? El V El N El Don’t know 0

tlndex: 0 denotes potential pollution source; L__J denotes confirmed polluter (evidence was seen)

45


E2. Parking Lot: Approximate age yrs. Condition: Q Clean Stained 0 Dirty M’Breaking upSurface material Q Paved/Concrete Gravel Permeable Don’t know

EibJownspouts discharge to impervious surface? C Y Q N Q Don’t know None visibleAre downspouts directly connected to storm drains? DY C N C Don’t know

E4. Evidence of poor cleaning practices for construction activities (stains leading to storm drain)? DY N Can’t Tell

F. TURF/LANDSCAPING AREAS N/A (skip to part G) I Observed Pollution Source?Fl. % of site with: Forest canopy Turf grass % Landscaping % Bare Soil

F2.Rate the turf management status: C High C Medium Low

F3. Evidence of permanent irrigation or “non-target” irrigation C V C N C Can’t Tell

F4. Do landscaped areas drain to the storm drain system? C Y C N C Can’t Tell

F5.Do landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? C Y C N Q Can’t Tell

G. STORM WATER INFRASTRUCTURE C N/A (skip to part H) I Observed Pollution SourcGI. Are storm water treatment practices present? E:Jv N C Unknown If yes, please describe:

G2. Are private storm drains located at the facility? ‘Y C N C UnknownIs trash present in gutters leading to storm Srains? If so, complete the index below.


Sediment Ci C2 C3 04 05Organic material Cl C2 03 04 05Litter Ci C2 C3 04 Cs

G3. Catch basin inspection— Record SSD Unique Site ID here: Condition: C Dirty C CleanH. INITIAL IIOTSPOT STATUS - INDEX RESULTS

O Not a hotspot (fewer than 5 circles and no boxes checked) Potential hotspot (5 to 10 circles but no boxes checked)O Confirmed hotspot (10 to 15 circles and/or I box checked) C Severe hotsuot (>15 circles and/or 2 or more boxes checked’Follow-up Action:

C Refer for immediate enforcemento Suggest follow-up on-site inspectiono Test for illicit discharge

Include in future education effortO Check to see if hoEspot is an NPDES non-filerJ Onsite non-residential retrofitC Pervious area restoration; complete PAA sheet and record


_____________________


Notes:

HSI

A-6

Streets and Storm Drains SSD 1WATERSHED: nu SUBWATERSHED: L’O fL UNIQUE SITE ID: 5S — UP (L0(DATE: (0 /(‘j/ (t) ASSESSED BY: (jA CAMERA ID:

MAPGRID RAININLAST24HOURS Dy 121N Pic# jtjt —Hi- ; /,/A.LOCATION

Al. Street names or neighborhood sur eyed:a4OAJ t // *(tojL

A2. Adjacent land use: Residential E Commercial a Industrial EJ InstitutionalD Municipa] C Transport-Related

A3. Corresponding HSI or NSA field sheet? If so, circle HSI or NSA and record its Unique Site ID here 5l-

B. STREET Cor’wITIoNs

RI. Road Type:D Arterial fl Collector ,‘Local fl Alley Other:

132. Condition of Pavement: Q New Good Cracked Q Broken133. Is on-street parking permitted ØY C N If yes, approximate number of cars per block:

B4. Are large cul-de-sacs present? Y N

135. Is trash present in curb and gutter? If so, Index Rating for Accumulation in Guttersuse the index to the right to record amount. Clen Filthy

Sediment 02 03 04 05Organic Material LII 2 03 Q4

Litter Ql f2 03 04 OsC. STORM DRAIN INLETS AM) CATCH BASINsCl. Type of storm drain conveyance: 0 open 0 enclosed LI mixedC2. Percentage of inlets with catch basin storage: Q N/ASample 1-2 catch basins per NSAJHSI C3. Catch basin #1 C4. Catch basin #2Latitude H it t 3Longitude flj ii Itt-” Iko if fLyLMK#Picture# (L-fG, /6/’Current Condition LI Wet Dry Q Wet DryCondition of Inlet OClear WObstructed — LC1ear CObstructedLitter Accumulation MY C N DY W NOrganics Accumulation DY N DY NSediment Accumulation Y C N DY 0 NSediment Depth (in feet) ft. ft.Water Depth ft. ft.Evidence of oil and grease DY N Y 0 NSulfur smell Y N UY NAccessible to vacuum truck ZJY fl N Y fl NP. NoN-RESIDENTIAL PARKING LOT (>2 acres) /\I/,bDl. Approximate size: acres

P2. Lot Utilization: Li Full fl About half full fl Empty

P3. Overall condition of Pavement: 0 Smooth (no cracks) LI Medium (few cracks) LI Rough (many cracks)0 Very Rough (numerous cracks and depressions)

04. Is lot served by a storm water treatment practice? Y fl N If yes, describe:P5. On-site retrofit potential: fl Excellent C Good Poor

A-9

Streets and Storm Drains SSDE. MuNIcwa POLLUTANT REDUCTION STRATEGIES

El. Degree of pollutant accumulation in the system: Q High J Medium Li Low C NoneEl Rate the feasibility of the following pollution prevention strategies:

Street Sweeping: High C Moderate LI LowStorm Drain Stenciling: High LI Moderate C LowCatch Basin Cleanouts: High C Moderate LowParking Lot Retrofit Potential: Q High Q Moderate Low

CATCH BASIN SKETCHES -

#1 VJ( #2

—— .tIsi

r /f4nt Vo ({tL(

I

Notes:

A-i 0


(4 j SURWATERSHEI); 14 UNIQUE SITE ID: f-(,i— L. P&— 021

STE: jj/4/ ASSESSED By: CAMERA ID: Pxc#:j14 J7L.MAPGIUD: LATt0 j( 31..LONG:ao II lLui1 LMK#A. SITE DATA AND BASIC CLASSIFICATION

Name and Address: £tv t Ai Uadt44,A/ Category: El Commercial El Industrial MiscellaneousI j(• ( J’T’ Jnstitutional El Municipal fl Golf Course14

El Transport-Related LI MarinaEl Animal Facility


NI DES Status: El Regulated kciv\tm.cINDEX°El Unregulated ‘] Unknown

B. VEHICLE OPERATIONS El N/A (Skip to part C) j Observed Pollution Source? L2LJBi. Types of vehicles: EJFleet vehicles El School buses El Other:

B2. Approximate number of vehicles: cB3. Vehicle activities (circle all that apply): Recycled FueledB4. Are vehicles stored and/or repaired outside? DTT El Can’t TellAre these vehicles lacking runoff diversion methods? Y El N El Can’t TellB5. Is there evidence of spills/leakage from vehicles? Y El N El Can’t Tell

B6. Are uncovered outdoor fueling areas present? El Y N El Can’t Tell

B7. Are fueling areas directly connected to storm drains? El Y El N El Can’t Tell A/IAB8. Are vehicles washed outdoors? Y El N El Can’t Tell Y’ tkP* -

Does the area where vehicles ary washed discharge to the storm drain? 1’ El N L] Can’t Tell d-e LI

OUTDOORMATERIALS N/A (Skip to part D) Observed Pollution Source?

CI. Are loading/unloading operations present? El Y El N El Can’t TellIf yes, are they uncovered and draining towards a storm drain inlet? El Y El N El Can’t Tell

C2. Are materials stored outside? El Y El N El Can’t Tell If yes, are they El Liquid El Solid Description:Where are they stored? El grass/dirt area El concrete/asphalt fl bermed area

C3. Is the storage area directly or indirectly connected to storm drain (circle one)? El Y El N El Can’t Tell 0C4. Is staining or discoloration around the area visible? El Y El N El Can’t Tell 0CS. Does outdoor storage area lack a cover? El Y El N El Can’t Tell QC6. Are liquid materials stored wit/jour secondary containment? El Y El N El Can’t Tell QC7. Are storage containers missing labels or in poor condition (rusting)? El Y El N El Can’t Tell 0D. WASTE I1ANAGEMENT N/A (Skip to part E) I Observed Pollution Source?Dl. Type of waste (check all that apply): El Garbage El Construction materials El Hazardous materials 0D2. Dumpster condition (check all that apply): El No cover/Lid is open El Damaged/poor condition ElLeaking or

evidence of leakage (stains on ground) El OverflowingD3. Is the dumpster located near a storm drain inlet? El Y El N El Can’t Tell

If yes, are runoff diversion methods (berms, curbs) lacking? El Y El N El Can’t Tell

E. PHYSICAL PLANT El N/A (Skip to part F) Observed Pollution Source?

• El. Building: Approximate age: yrs. Condition of surfaces: El Clean Stained El Dirty El Damaged 0Evidence that maintenance results in discharge to storm drains (staining/discoloration)? Y El N El Don’t know Q

*Jndex: 0 denotes potential pollution source; L_i denotes confirmed polluter (evidence was seen)

45

5hJ\ p4cWi tQfr

- *\\\Qfc\ A’\ 4 V—


E2. Parking Lot: Approximate age ‘-K) yrs. Condition: fi CleanSurface material Paved/Concrete Grave1 fl_Permeable

o Stained Dirty Breaking up

fi Don’t know 0E3. Do downspouts discharge to impervious surface? Y fi N 0 Don’.know 0 None visible

Are downspouts directly connected to storm drains? 0 Y N 0 Don’t know£4. Evidence of poor cleaning practices for construction activities (stains leading to storm drain)? Y fi N 0 Can’t Tell •F. TURF/LANDSCAPING AREAS ‘N/A (skip to pan G) I Observed Pollution Source? IFl. % of site with: Forest canopy Turf grass % Landscaping Bare Soil 0F2. Rate the turf management status: fi High fi Medium fi Low 0F3. Evidence of permanent irrigation or “non-target” irrigation 0 Y fi N fi Can’t Tell QF4. Do landscaped areas drain to the storm drain system? fi Y fi N fi Can’t Tell 0F5. IJo landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? fi Y fi N EJ Can’t Tell 0G. STORM WATER INFRASTRUCTURE fi N/A (skip to part H) I Observed Pollution Source? LXJGi. Are storm water treatment practices present? LI Y N 0 Unknown If yes, please describe: 0G2. Are private storm drains located at the facility? fly N 0 Unknown?-u o4- $-t( k )QL



Sediment 03 04Organic material fil fl2 03 fl4Litter flu fl2 fl3 04 05

G3. Catch basin inspection — Record SSD Unique Site ID here: Condition: fi Dirty fi CleanH. INITIAL HOTSPOT STATUS - INDEX RESULTS

O Not a hotspot (fewer than 5 circles and no boxes checked) Potential hotspot (5 to 10 circles but no boxes checked)Confirmed hotspot (10 to 15 circles and/or 1 box checked) fi Severe hotsoot (>15 circles and/or 2 or more boxes checked

Follow-up Action:

fi Refer for immediate enforcementO Suggest follow-up on-site inspectionO Test for illicit dischargeO Include in future education efforto Check to see if hotspot is an NPDES non-filerO Onsite non-residential retrofitfi Pervious area restoration; complete PAA sheet and record


_______________________

fi Schedule a review of storm water pollution prevention plan

Notes:

\tQL 4GD

A-6

Retrofit Reconnaissance Investigation IR1

URWATERSHED: LV IC UNIQUE SITE ID:T?cPWATERSHED:

DATE: /

GPSJD: LMKID:

SITE DESCRIPTION

Name: /(CAc ( Z4Address:

Ownership: Public LI Private LI UnknownIf Public, Government Jurisdiction: Local LI State LI DOT LI Other:__________________________

Corresponding USSRUSA Field Sheet? LI Yes No If yes, Unique Site ID:__________________

Proposed Retrofit Location:Storage On-SiteLI Existing Pond LI Above Roadway Culvert LI I-Iotspot Operation LI Individual RooftopLI Below Outfall LI In Conveyance System LI Small Parking Lot LI Small Impervious AreaLI In Road ROW [1 Near Large Parking Lot LI Individual Street LI Landscape! Hardscape

Other: 4t tt;A kc-i LI Underground LI Other:__________________


Drainage Area Drainage Area Land Use:Imperviousness LI Residential LI InstitutionalImpervious Area LI SFH (< 1 ac lots) LI Industrial

—‘- LI SFH (> 1 ac lots) LI Transport-RelatedNotes: /fr X’f- C

‘ LI Townhouses LI Park:4 v i-CO1. ;ttV.. i-s--L LI Multi-Family LI Undeveloped

LI Commercial LI Other:_______________

EXISTING STORM WATER MANAGEMENT

Existing Stormwater Practice: LI Yes No LI PossibleIf Yes, Describe:


;U’4&)ljtX cL’j Utfl4 ftcce4-$/cm”- cc/ztfr

,air-t- 4c&L0?c-tet

Ut., II


; f- r:


PRoposIn RETROFIT


Purpose of Retrofit:Water Quality H Recharge H Channel Protection H Flood Control

[)J Demonstration / Education H Repair H Other: O!,.-e,.a


Proposed Treatment Option:H Extended Detention H Wet Pond Created Wetland H BioretentionH Filtering Practice H Infiltration Li Swale H Other:_____________________________________

Describe Elements of Proposed Retrofit, Including Surface Area, Maximum Depth of Treatment, and Conveyance:- (,c/j1J{? ._c___--c

-

-— -CCC

SITE CONSTRAINTS

Adjacent Land Use: Access:H Residential Commercial H Institutional H No Constraints

Industrial H Transport-Related H Park Constrained due toH Undeveloped Other: ñ%4i H Slope H SpacePossible Conflicts Due to Adjacent Land Use? H Yes H No Utilities H Tree ImpactsIf Yes, Describe: 4”E Structures H Property Ownership

I71L4/ C’ Other.___________________‘- p

Conflicts with Existing Uliities: Potential Permitting Factors:H None Dam Safety Permits Necessary H Probable Not ProbableH Unknown Impacts to Wetlands Probable H Not ProbableYes Possible Impacts to a Stream fl Probable Not ProbableH H Sewer Floodplain Fill 1 Probable H Not ProbableH H Water Impacts to Forests H Probable Not ProbableH H Gas Impacts to Specimen Trees H Probable Not ProbableH H Cable I-low many?H H Electric Approx. DBH______________H Electric to Streethghts

Overhead Wires Other factors:_________________________________________________H H Other:




SKETCH

U

I s—

N

ILvc





LI Confirm property ownership LI Obtain existing stormwater practice as-builtsLI Confirm drainage area LI Obtain site as-builtsLI Confirm drainage area impervious cover LI Obtain detailed topographyLI Confirm volume computations LI Obtain utility mappingLI Complete concept sketch LI Confirm storm drain invert elevations

LI Confirm soil typesLI Other:


SITE CANDIDATE FOR FURTHER INVESTIGATION: LI YES LI No LI r&AmEIs SITE CANDIDATE FOR EARLY ACTION PROJECT(S): LI YES LI No LI MAYBEIF NO, SITE CANDIDATE FOR OTHER RESTORATION PROJECT(S) LI YES LI No LI MAYBE

IF YES, TYPE(S)



WATERSHED:0eçtMocL I SuBWATERSHED: tP C. UNIQUE SITE ID: pJ SA — LI’ g. a,DATE: jnj_iii I 0 ASSESSED By: CAMERA ID: Pic#: j7—f—fA. NEIGHBORHOOD CHARACTERIZATION

Neighborhood/Subdivision Name: A P/cUP /nA’th 4. Neighborhood Area (acres)If unknown, address (or streets) surveyed:

Homeowners Association? LI Y Q N LI Unknown If yes, name and contact information:Residential (circle average single family lot size):

LJ,single Family Attached (Duplexes, Row Homes) <V V3 ¼ /3 V3 acre ‘Multifamily (Apts, Townhomes, Condos)1J Single Family Detached <¼ ¼ ½ I >1 acre LI Mobile Home ParkEstimated Age of Neighborhood:I2oq9ears ) Perciof Homes with Garages: 4 % With Basements fl% IIEX*Sewer Service? ‘Y LI N

Index of Infill. Redevelopment, and Remodeling No Evidence LI <5% of units

Recorjjiercent observedfor each ofthefollowing indkators,epending on applicability and/or site complexity

B. YARD AND LAwN CONDITIONS

UI. % of lot with impervious cover

B2. % of lot with grass cover

83. % of lot with landscaping (e.g., mulched bed areas)

84. % of lot with bare soil


85. % of lot with forest canopy

86. Evidence of permanent irrigation or “non-target” irrigation

B7. Proportion of total neighborhood turf lawns with followingmanagement status:

88. Outdoor swimming pools? LIY MN LI Can’t Tell

89. Junk or trash in yards? ‘Y LI NC Can’t Tell

C. DRIVEWAYS, SIDEWALKS, om CuRBs

Cl. % of driveways that are impervious LI N/A

C2. Driveway Condition LI Clean LI Stained Dirty Breaking up

C3. Are sidewalks present? ] Y LI N If yes, are they on one side of street LI or along both sidesLI Spotless LI Covered with lawn clippings/leaves LI Receiving ‘non-target’ irngation Q

What is the distance between the sidewalk and street? 1— ft. 0Is pet waste present in this area? LI Y N LI N/A Q

p

LI Organic matter, leaves, lawn clippings Trash, litter, or debris LI Overhead tree canopy

73


43


LI Onsite retrofit potential?

Better lawnJlandscaping practice?

LI Better management of common space?

LI Pond retrofit?

LI Multi-family Parking Lot Retrofit?Other action(s)

______________________

Initial Assessment


LI Severe (More than 10 circles checked)LIHigh (5 to 10 circles checked)

El Moderate (Fewer than 5 circles checked)

LI None (No circles checked)

Neighborhood Restoration Opportunity IndexHigh (More than 5 diamonds checked)Moderate (3-5 diamonds checked)

LI Low (Fewer than 3 diamonds checked)

Neighborhood Source Assessment J’JS4D. RoOFToPSDl. Downspouts are directly connected to storm drains or sanitary sewer • IP2. Downspouts are directed to impervious surface

P3. Downspouts discharge to pervious area

P4. Downspouts discharge to a cistern, rain barrel, etc.S/Vote: Ci through C4 should total 100%

PS. Lawn area present downgradient of leader for rain garden? LI Y EJN I 0K COMMON AREAS

0-Catch basins inspected? FJY LI N If yes, include Unique Site ID from SSD sheet: 541) L(W-

— 0 7—

E2. Storm water pond? LI Y J3]$4 Is it a LI wet pond or LI dry pond? Is it overgrown? LI Y LI NWhat is the estimated pond area? LI <1 acre LI about I acre LI> 1 acre /

E3. Open Space? 4 Y LI N If yes, is pet waste present? LI Y N dumping? Y LI N V Ck (1k,,. \- }c •Buffers/floodplain present: JSY LI N If yes, is encroachment evident9 Y LI N

F. INITIAL NnGIIB0RN0OD ASSESSMENT AND RECOMMENDATIONS

Based on field observations, this neighborhood has significant indicators for the following’ (check all that apply)LI Nutrients El Oil and Grease LI Trash/Litter LI Bacteria [] Sediment LI Other


NOTES:

44

Streets and Storm Drains SSDWATERSHED: P04- SUBWATERSHED: (.fl UNIQUE SITE ID: b UP/C —O LDATE: jfj il/ I ASSESSED By: CAMERA ID:

M.&PGiu RAININLAST24HOURS fly fiN Pic# ftA. LOCATION


—

ttMfD9

A2. Adjacent land use:_’Residential Li Commercial fi Industrial LilnstitutionalLi Municipal Li Transport-Related

A3. Corresponding HSI or NSA field sheet? If so, circle US! or NSA and record its Unique Site ID here ) SA L9 iB. STREET CONDITIONS

81. Road Type: Li Arterial fiCollector J Local fi Alley fi Other:

__________

B2. Condition of Pavement: New Li Good fi Cracked Li BrokenB3. Is on-street parking permitted ja Li N If yes, approximate number of cars per block:

84. Are large cul-de-sacs present? Li Y


Sediment Lii Li2 fl3 Li4 LisOrganic Material Lii fi 2 Li 3 Li 4 Li 5

Litter flu Li2 Li3 Li4 flsC. STORM DRAIN INLETS AND CATCH BA.S INSCl. Type of storm drain conveyance: Li open jJ enclosed Li mixedC2. Percentage of inlets with catch basin storage: fi N/ASample 1-2 catch basins per NSAJHSI C3. Catch basin #1 C4. Catch basin #2Latitude C Ojl

Longitude .22° 4 I i&,Li’ 73° ‘ /0,5”LMK #Picture# )1-1Current Condition Li Wet Dry Li Wet DryCondition of Inlet LiClear Obstructed Clear LiObstructedLitter Accumulation [2W Li N fly Li NOrganics Accumulation \‘ Li N fly Li NSediment Accumulation Y fi N fly Li NSediment Depth (in feet) — Y ft. ft.Water Depth ‘Y ft. ft.Evidence of oil and grease ]y fi N fly Li NSulfur smell fly N fly fi NAccessible to vacuum truck y Li N fly fi ND. NON-RESIDENTIAL PARKING LOT (>2 acres)


D2. Lot Utilization: Li Full fi About half full Li Empty

D3. Overall condition of Pavement: Li Smooth (no cracks) Li Medium (few cracks) Li Rough (many cracks)fi Very Rough (numerous cracks and depressions)

D4. Is lot served by a storm water treatment practice? Li y Li N If yes, describe:D5. On-site retrofit potential: Li Excellent fi Good Li Poor

$9

Streets and Storm Drains rssnlE. MuMcn’AL POLLUTANT REDUCTION STRATEGIESEl. Degree of pollutant accumulation in the system: ‘high Q Medium Q Low fl NoneE2. Rate the feasibility of the following pollution prevention strategies:

Street Sweeping: 1’High El Moderate Q LowStorm Drain Stenciling: High Moderate LowCatch Basin Clean-outs: ‘High Moderate LowParking Lot Retrofit Potential: El High El Moderate Q Low !‘J l.A

CATCH BASIN SKETCHES#1 #2 -___

C4%K

I%jc\.

Notes:

A-i 0

Hotspot Site Investigation ffHTERSRED: C4 SUBWATERSHED; UNIQUE SITE ID: 1-\si —L2JL- 03i.TE: L2JJjLJ& ASSESSED By: cMt CAMERA ID: PIC#: I ?- q g’o

MAPGRID: LAT9IO IL ‘ M,E’IILONG73OIII3WI LMK#

A. SITE DATA AND BASIC CLASSIFICATIONName and Address: Category: Commercial Industrial Miscellaneous? r A fl Institutional LI Municipal LI Golf CourseI

flTransport-Related LI MarinaLI Animal Facility

SIC code (if available): Basic Description of Operation:1I

?DES Status: Regulated B1 fr1\L\, Pfsth\, c41nt\LI Unrilated LI Unknown

B. VEHICLE OPERATIONS LI N/A (Skip to part C) I Observed Pollution Source?Bi. Types of vehicles: Fleet vehicles LI School buses LI Other: vB2. Approximate number of vehicles: ,- pc’

B3. Vehicle activities (circle all that apply): Maintained Repaired Recycled /Fuel &a1 StoredB4. Are vehicles stored and/or repaired outside? LI Y LI N El Can’t TellAre these vehicles lacking runoff diversion methods? LI Y LI N LI Can’t TellB5. Is there evidence of spills/leakage from vehicles? flY LI N LI Can’t Tell

B6. Are uncovered outdoor fueling areas present? LI Y LI N LI Can’t Tell

B7, Are fueling areas directly connected to storm drains? LI Y LI N LI Can’t TellBS. Are vehicles washed outdoors? LI Y LI N Can’t TellDoes the area where vehicles are washed discharge to the storm drain? LI Y LI N LI Can’t Tell

9UTDOOR MATERIALS LI N/A (Skip to part D) Observed Pollution Source?Cl. Are loading/unloading operations present? ‘Y LI N LI Can’t TellIf yes, are they uncovered and draining towards a storm drain inlet? LI Y LI N Can’t Tell

C2, Are materials stored outside? LI V LI N LI Can’t Tell If yes, are they U Liquid LI Solid Description:Where are they stored? LI grass/dirt area LI concrete/asphalt LI bermed area

C3. Is the storage area directly or indirectly connected to storm drain (circle one)? LI Y LI N LI Can’t Tell

C4. Is staining or discoloration around the area visible? LI Y LI N LI Can’t Tell 0C5. Does outdoor storage area lack a cover? LI Y LI N LI Can’t Tell QC6. Are liquid materials stored without secondary containment? LI Y LI N LI Can’t Tell 0C7. Are storage containers missing labels or in poor condition (rusting)? LI Y LI N LI Can’t Tell 0B. WASTE MANAGEMENT LI N/A (Skip to part E) Observed Pollution Source?Dl. Type of waste (check all that apply): LI Garbage LI Construction materials LI Hazardous materials 0D2. Dumpster condition (check all that apply): fi No cover/Lid is open LI Damaged/poor condition LILeaking or

evidence of leakage (stains on ground) LI OverflowingD3. Is the dumpster located near a storm drain inlet? LI Y LI N fl Can’t Tell

If yes, are runoff diversion methods (berms, curbs) lacking? LI Y LI N LI Can’t Tell

E. PHYSICAL PLANT LI N/A (Skip to part F) Observed Pollution Source? :-

El. Building: Approximate age: yrs. Condition of surfaces: LI Clean LI Stained LI Dirty LI Damaged 0Evidence that maintenance results in discharge to storm drains (staining/discoloration)? LI Y LI N LI Don’t know Q

Clndex: 0 denotes potential pollution source; L_J denotes confirmed polluter (evidence was seen)

A-S


E2. Parking Lot: Approximate age yrs. Condition: El Clean El Stained Dirty El Breaking upSurface material El Paved/Concrete El Gravel Permeable El Don’t know

E3. Do downspouts discharge to impervious surface? Q Q N El Don’t know 0 None visibleAre downspouts directly connected to storm drains? El Y El N El Don’t know

E4. Evidence of poor cleaning practices,r construction activities (stains leading to storm drain)? El Y El N El Can’t Tell 0F. TURF/LANDSCAPING AREAS N/A (skip to pan G) Observed Pollution Source? IFl. % of site with: Forest canopy Turf grass % Landscaping __% Bare Soil 0F2. Rate the turf management status: El High El Medium El Low QF3. Evidence of permanent irrigation or “non-target” irrigation El Y El N Can’t Tell 0F4. Do landscaped areas drain to the storm drain system? El Y El N El Can’t Tell 0F5. Do landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? El Y El N El Can’t Tell 0G. STORM WATER INFRASTRUCTURE El N/A (skip to part H) I Observed Pollution Source?Gl. Are storm water treatment practices present? El Y El N El Unknown If yes, please describe: 0G2. Are privafe Storm drains located at the facility? El Y El N El Unknown



Sediment ElI El2 El3 El4 El5Organic material Eli El2 El3 El4 ElsLitter Eli El2 El3 El4 Els


El Not a hotspot (fewer than 5 circles and no boxes checked) Potential hotspot (5 to 10 circles but no boxes checked)jf Confirmed hotspot ( 10 to 15 circles and/or I box checked) El Severe hots ot(>iscirclesandlor2 or more boxes checked) — —

Followup4ction C’ -‘-‘ r

El Refer for immediate enforcement —

El Suggest follow-up on-site inspectionEl/Test for illicit discharge0 Include in future education effortEl Check to see if hotspot is an NPDES non-filergonsite non-residential retrofit — Soi.j 4&aD Perviousarearestoration;compietePAAsheetandrecôrd

Unique Site ID here:El Schedule a review of storm water pollution prevention plan —

Notes: -

— 4o\ c.O&\\\QS—

¼4s\QqR — c.1 \tcflvJ6?Vti—.

—

r-’ ‘(Q(

otJvrs? t’ c&-

A-6

Hotspot Site Investigation uS!rcTERSHED; f)oocL I SUEWATERSHED: tPf—. UNIQUESITEID: fist LPtL- ot/.TE:// / ASSESSED By: CAMERA ID: Pic#: /7a — / Ic

MAP GRID: LAT3±°.J4Z Ii) “LONG1° I ‘2&F LMK#A. SITE DATA AND BASIC CLASSIFICATION

Name and Address: (i s ¶.\ Category: El Commercial El Industrial MiscellaneouscJ1 çhi El Institutional El Municipal El Golf Course

f. El Transport-Re] ated El MarinaC1O’J t ( ;n -, &i El Animal FacilitySIC code (if available): Basic Description of Operation:

NPDES Status: El Regulated t( S-hxb° 1’INDEX*El Unregulated ØUnknown

B. VEHICLE OPERATIONS El N/A (Skip to part C) I Observed Pollution Source? LtrLJBI. Types of vehicles: ‘Fleet vehicles El School buses El Other:B2. Approximate number of vehicles: —4njc(C t PI4( cpiOLB3. Vehicle activities (circle oil that apply): Maintained Repaired Recycles Fueled Washed Store’B4. Are vehicles stored and/or repaired outside? El Y N El Can’t TellAre these vehicles lacking runoff diversion methods? ElY El N El Can’t TellB5. Is there evidence of spills/leakage from vehicles? ElY El N Can’t Tell

B6. Are uncovered outdoor fueling areas present? EJ Y El N El Can’t Tell

B7. Are fueling areas directly connected to storm drains? El Y N Can’t TellBS. Are vehicles washed outdoors? ElY El N Can’t Tell {c k’rttJ -l. .\V (NDoes the area where vehicles are washed discharge to the storm drain? El Y El N Can’t Tell

‘)UTDOOR MATERIALS El N/A (Skip to part D) j Observed Pollution Source? JZ..CI. Are loadinglunloading operations present? El Y N El Can’t TellIf yes, are they uncovered and draining towards a storm drain inlet? El Y El N El Can’t Tell

C2. Are materials stored outside? Y El NEl Can’t Tell If yes, are they gLiquid El Solid Description: n’sIrtWhere are they stored? El grass/dirt area El concrete/asphalt El bermed area

C3. Is the storage area directly or indirectly cormected to storm drain (circle one)? Y El N El Can’t Tell 0C4. Is staining or discoloration around the area visible? El Y N El Can’t Tell 0CS. Does outdoor storage area lack a cover? IY El N El Can’t Tell QC6. Are liquid materials stored without secondary containment? El Y ,EI N El Can’t Tell 0

LE Are storage containers missing labels or in poor condition (rusting)? El Y N El Can’t Tell QP. WASTE MANAGEMENT El N/A (Skip to part E) Observed Pollution Source?Dl. Type of waste (check all that apply): Garbage El Construction materials El Hazardous materials 0P2. Dumpster condition (check all that apply): El No cover/Lid is open El Damaged/poor condition ElLeaking or

evidence of leakage (stains on ground) El OverflowingD3. Is the dumpster located near a storm drain inlet? El Y El N El Can’t Tell

If yes, are runoff diversion methods (berms, curbs) lacking? El Y El N El Can’t TellE. PHYSICAL PLAET El N/A (Skip to part F) Observed Pollution Source?. NL_El. Building: Approximate age: 31) yrs. Condition of surfaces: ‘Clean El Stained El Dirty El Damaged 0Evidence that maintenance results in discharge to storm drains (staining/discoloration)? El Y El N El Don’t know 0

°Index: 0 denotes potential pollution source; L.J denotes confirmed polluter (evidence was seen)

A-5


£2. Parking Lot: Approximate age yrs. Condition: Clean fl Stained fl Dirty Breaking upSurface material ‘PavedIConcrete 0 Gravel fl Permeable 0 Don’t know 0

£3. Do downspouts discharge to impervious surface? 0 Y 0 N Don’t know 0 None visibleAre downspouts directly connected to storm drains? 0 Y 0 N 0 Don’t know

E4. Evidence of poor cleaning practices for construction activities (stains leading to storm drain)? 0 Y Can’t Tell 0F. TURF/LANDSCAPING AREAS LI N/A (skip to pan G) I Observed Pollution Source?Fl. % of site with: Forest canopy Turf grass ic % Landscaping .L&% Bare SoiLO_% Hgc}Mf2Vv (cl/Cik - SF2. Rate the turf management status: 0 High Medium Q Low / 0F3. Evidence of permanent irrigation or “non-tatget” irrigation 0 Y N 0-Can’t Tell 0F4. Do landscaped areas drain to the storm drain system? 0 Y fl N Can’t Tell 0F5. Do landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? 0 Y Q N Can’t Tell QG. STORIt WATER INFRASTRUCTURE [I N/A (skip to part H) I Observed Pollution Source?Gi. Are storm water treatment practices present? 0 Y N 0 Unknown If yes, please describe: 0G2. Are private storm drains located at the facility? Y Q N 0 Unknown



Sediment 01 02 03 04 05Organic material 01 02 03 04 05Litter 01 02 03 04 05

G3. Catch basin inspection — Record SSD Unique Site ID here: Condition: 0 Dirty Q CleanH. INITIAL HOTSPOT STATUS - INDEX RESULTS

0 Not a hotspot (fewer than S circles and no boxes checked) ,J7 Potential hotspot (5 to 10 circles but no boxes checked)0 Confirmed hotspot (10 to 15 circles and/or I box checked) Q Severe hotspot (>15 circles and/or 2 or more boxes chec]Follow-up Action:0 Refer for immediate enforcement0 Suggest follow-up on-site inspection0 Test for illicit discharge

Include in future education effort7Q Check to see if hotspot is an NPDES non-filer0 Onsite non-residential retrofit0 Pervious area restoration; complete PAA sheet and record


_______________________

0 Schedule a review of storm water pollution prevention plan

Notes:

v—c; t°\\ 5’2L( $‘ç& \LA(

A-6

Name: 4A,*c.wt 1/P’( et-t--at t4Address: k2t- oAR.

Ownership: fl Public l Private UnknownIf Public, Government Jurisdiction: Local State DOT LI Other:__________________________

Corresponding USSRJ’LTSA Field Sheet? Yes fl No If yes, Unique Site ID: i($1 ( 11t ci-iProposed Retrofit Location:Storage On-Site

Existing Pond LI Above Roadway Culvert J Hotspot Operation LI Individual RooftopBelow Outfall J In Conveyance System Small Parking Lot fl Small Impervious Area

LI In Road ROW Near Large Parking Lot Individual Street Landscape / HardscapeLI Other:__________________________________ Underground LI Other:__________________


Drainage Area Drainage Area Land Use:Imperviousness LI Residential LI InstitutionalImpervious Area LI SFH (< I ac lots) LI Industrial

LI SFH (> I ac lots) LI Transport-RelatedNotes:LI Townhouses LI Park

Multi-Family LI UndevelopedCommercial LI Other:


Existing Stormwater Practice: LI Yes LI No LI PossibleIf Yes, Describe:

4at t/L


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1t1 r--j Q/{(Vt.

.\‘

Existing Bead Available and Points Where Measured: (I

I -‘1 j4 /CkW

/4, cuV’rt

/

WATERSHED:.

DATE:

GPS ID:


SITE DESCRIPTION


PROPOSED RETROFIT

Retrofit Reconnaissance Investigation I{Pi

3rpose of Retrofit:

J,4. Water Quality D Recharge LI Channel Protection LI Flood ControlLi Demonstration / Education Repair LI Other:___________________________________________


Proposed Treatment Option:Extended Detention LI Wet Pond LI Created Wetland jj Bioretention

[ Filtering Practice LI Infiltration LI Swale LI Other:_____________________________________


Sin CONSTRAINTS

Adjacent Land Use: Access:LI Residential Commercial LI Institutional LI No ConstraintsLI Industrial LI Transport-Related LI Park Constrained due to

Undeveloped J5J Other:_________________________ LI Slope LI SpacePossible Conflicts Due to Adjacent Land Use? LI Yes LI No LI Utilities LI Tree ImpactsIf Yes, Describe: LI Stnjctures LI Property Ownership

LI Other:_________________

Conflicts with Existing Utilities: Potential Permitting Factors:LI None Dam Safety Permits Necessary LI Probable NotProbableLI Unknown Impacts to Wetlands LI Probable Not ProbableYes Possible Impacts to a Stream LI Probable Not ProbableLI Sewer Floodplain Fill LI Probable Not Probable

Water Impacts to Forests LI Probable Not ProbableLI Gas Impacts to Specimen Trees LI Probable LI Not ProbableLI LI Cable How many?fl j Electric Approx. DBH____________LI Electric to Streetlights

Overhead Wires Other factors:_________________________________________________fl LI Other:

Soils:Soil auger test holes: LI Yes LI NoEvidence of poor infiltration (clays, fines): LI Yes LI NoEvidence of shallow bedrock: LI Yes LI NoEvidence of high water table (gleying, saturation): fl Yes LI No



SKETCH Q—\ ttF 61-

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Page3of4 Ijnique Site

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FOLLOw-UP NEEDED TO COMPLETE FIELD CONCEPT

Confirm property ownership Obtain existing stormwater practice as-builtsConfirm drainage area E Obtain site as-builts

[ Confirm drainage area impervious cover Obtain detailed topographyConfirm volume computations [5J Obtain utility mappingComplete concept sketch Confirm storm drain invert elevations

I Confirm soil typesLI Other:


eU

SITE CANDIDATE FOR FURTHER LNVESTIGATION: DYES LI] No Li MAYBEIs SITE CANDIDATE FOR EARLY ACTION PROJECT(S): DYES [INo Li MAYBEIF NO, SITE CANDIDATE FOR OTHER RESTORATION PROJECT(S) El YES LI] No H MAYBE

IF YES, TYPE(S)



WATERSHED: SUBWATERSHED: tS It. UNIQUE SITE ID: A/c A L2P— —ozDATE: fh ASSESSED By: j.4 f CMER4 ID: Pic#: { 77.2jA. NEIGHBORHOOD CHARACTERIZATION

Neighborhood/Subdivision Name: y}°kt, i-k&vw’q (Lv-v (ii-4- YavL.. Neighborhood Area (acres)

_______

If unknown, address Wr streets) surveyed: cAaU)h 4a4 \w ki 3-1g.

Homeowners Association? Y N J Unknown If yes, name and contact information:

_____________________________

Residential (circle average single fanzilv lot size):

__________________________________

C Single Family Attached (Duplexes, Row Homes) <¼ 1A ¼ ¼ ¼ acre , Multifamily (Apts, Townhomes, Condos)C Single Family Detached <¼ ¼ ½ 1 >1 acre C Mobile Home ParkEstimated Age of Neighborhood: .JS1 years Percent of Homes with Garages: C % With Basements INDEX*Sewer Service? Y C N 0Index of Infill. Redevelopment, and Remodeling E No Evidence C <5% of units C 5-10% >10%

Recordpercent observedfor each ofthefoliowing indicators,. - .. . . Percentage Comments/Notes4ependjng on applscabthly and/or site complexity

B. YARD AND LAWN CONDITIONS

Bi. % of lot with impervious cover

B2. % of lot with grass cover -2-- 9 0B3. % of lot with landscaping (e.g., mulched bed areas)

B4. % of lot with bare soil 0*Note: 81 through 84 must total 100%

B5. % of lot with forest canopy / 1)B6. Evidence of permanent irrigation or “non-target” irrigation 0

High:_.. QB7. Proportion of total neighborhood turf lawns with following Med: J&Qmanagement status:

Low:

BS. Outdoor swimming pools? CY NC Can’t Tell Estimated # QB9. Junk or trash in yards? C Y N C Can’t Tell I 0C. DRIVEWAYS, SIDEWALKS, AND CURBS

Cl. % of driveways that are impervious 4t/A IC2. Driveway Condition C Clean C Stained C Dirty C Breaking up 0C3. Are sidewalks present? iJ Y C N If yes, are they on one side of street C or along both sides C

Spotless C Covered with lawn clippings/leaves C Receiving ‘non-target’ irrigatiOn QWhat is the distance between the sidewalk and street? 4ZL. ft. ‘GIs pet waste present in this aa? C Y ISIN C N/A Q

C4. Is curb and gutterpresent? Y DN If yes, check all that apply:1cleanandDryHo arparn

[ C Organic matter, leaves, lawn clippings C Trash, litter, or debris C Overhead tree canopy* INDEX: 0 denotes potential pollution source; 0 denotes a neighborhood restoration opportunity

A-S

Neighborhood Source Assessment INSJ&rD. ROOFTOPS

DI; Downspotits are directly connected to storm drains or sanitary sewer I &‘O • •02. Downspouts are directed to impervious surface


04. Downspouts discharge to a cistern, rain barrel, etc.

“Note: C] through C4 should total 100%

05. Lawn area present downgradient of leader for rain garden? 0 Y ON I 0E. COMMON AREAS

El. Storm drain inlets? Ø’Y N If yes, are they stenciled? fl YJ9t Condition: Clean 9’Dirty

Catch basins inspected? U Y If yes, include Unique Site ID from SSD sheet: QE2. Storm water pond? U y S’l’ Is it a U wet pond or U dry pond? Is it overgrown? U Y U N

What is the estimated pond area? Q <1 acre U about I acre C > 1 acre

E3. Open Space?,Y U N If yes, is pet waste present? U Y dumping? U Y QBuffers/floodplain present: U Y U N If yes, is encroachment evident? U Y U N

F. INrrIAu NEIGHBORHOOD ASSESSMENT ANT) RECOMMENDATIONS

Based on field observations, this neighborhood has significant indicators for the following: (check all flint apply)U Nutrients U Oil and Grease U Trash/Litter U Bacteria Sediment U Other

Recommended Actions Describe Recommended Actions:Specific Action vvwti4cr yef’° f- 1w1 c“Onsite retrofit potential? L RS.!j p,’,’U Better lawn/landscaping practice?

U Better management of common space? °‘ ‘

U,Pond retrofit? v’O Skr%’ 0Ø’Multi-faniilv Parking Lot Retrofit? - I ‘

U Other action(s) ‘t Yi* VL?JS\j ‘fr —

Initial Assessment — I_ J_ —


Usevere (Morethanlocircleschecked)

U High (5 to 10 circles checked)

,}2fModerate (Fewer than 5 circles checked)



U High (More than 5 diamonds checked)U,,Moderate (35 diamonds checked)

— —

Low (Fewer than 3 diamonds checked) — — — — —

I

NOTES:

44


WATERSHED: SURWATERSHED: ?1? j UNIQUE SITE ifi:

DATE: ASSESSED By: 777? CAMERAW: PICTURES:

GPSTD: LMKID: LAT: HI’e LONG:73°/l’ZQ”

SITE DESCRIPTION

Name: -iL-etAddress:

Ownership: [Public fl Private UnknownIf Public, Government Jurisdiction: Local H State DOT H Other:__________________________

Conesponding USSRJ’LTSA Field Sheet? fl Yes No If yes, Unique Site ID:__________________

Proposed Retrofit Location:Storage On-SiteH Existing Pond H Above Roadway Culvert l-lotspot Operation H Individual RooftopH Below Outfall In Conveyance System H Small Parking Lot H Small Impervious AreaH In Road ROW H Near Large Parking Lot H Individual Street H Landscape / HardscapeH Other:__________________________________ H Underground H Other:__________________


Drainage Area Drainage Area Land Use:lmpei-viousness H Residential LI InstitutionalImpervious Area H SFH (‘C I ac lots) H Industrial

H SFH (> I ac lots) Transport-RelatedNotes: /l,Ctt°”7 H Townhouses H Park- t-t H Multi-Family H Undeveloped‘ ‘ / H Commercial H Other:


Existing Stormwater Practice: Yes H No H PossibleIf Yes, Describe:


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PROPOSED RETROFIT

Purpose of Retrofit:LI Water Quality LI Recharge LI Channel Protection LI Flood ControlLI Demonstration / Education LI Repair LI Other:______________________________________________


Proposed Treatment Option:LI Extended Detention LI Wet Pond LI Created Wetland LI BioretentionLI_Filtering Practice LI Infiltration LI Swale LI Other:_____________________________________


SITE CONSTRAINTS

Adjacent Land Use: Access:LI Residential LI Commercial LI Institutional LI No ConstraintsLI Industrial LI Transport-Related LI Park Constrained due toLI Undeveloped LI Other:_________________________ LI Slope LI SpacePossible Conflicts Due to Adjacent Land Use? LI Yes LI No LI Utilities LI Tree ImpactsIf Yes, Describe: LI Structures LI Property Ownership

LI Other:___________________

Conflicts with Existing Utilities: Potential Permitting Factors:LI None Dam Safety Permits Necessary LI Probable LI Not ProbableLI Unknown Impacts to Wetlands LI Probable LI Not ProbableYes Possible Impacts to a Stream LI Probable LI Not ProbableLI LI Sewer Floodplain Fill LI Probable LI Not ProbableLI LI Water Impacts to Forests LI Probable LI Not ProbableLI LI Gas Impacts to Specimen Trees LI Probable LI Not ProbableLI LI Cable How many?LI LI Electric Approx. DI3H____________LI LI Electric to StreetlightsLI Overhead Wires Other factors:_________________________________________________LI LI Other:




SKETCH- L- o.

c (_-to 2q -

Page 3 of 4 Unique Site ID:’RYT__tAT-03


DESIGN OR DELWERY NOTES


Confirm property ownership Obtain existing stormwater practice as-builtsConfirm drainage area fl Obtain site as-builtsConfirm drainage area impervious cover D Obtain detailed topographyConfirm volume computations fl Obtain utility mapping

E Complete concept sketch fl Confirm storm drain invert elevationsfl Confirm soil types

E Other:


Sin CANDIDATE FOR FURTHER LNVESTIGATION: [J YES []No [J MAYBEIS SITE CANDIDATE FOR EARLY ACTION PROJECT(S): flYES [INo []MAYBEIF NO, SITE CANDIDATE FOR OTHER RESTORATION PROJECT(S) [IYES [1 No [3 MAYBE

IF YES, TYPE(S)


Retrofit Reconnaissance Investigation 1PJ

WATERSHED: SUBWATERSHED: I-. P7Z UNIQUE SITE ID

DATE: ASSESSED BYtJ7’0i CAMER4. ifi: PICTURES:2Qc.

GPSTD: LMKID: LAT: L//O/0,t LONG:

SITE DESCRIPTION

Name: C,. —Address: >

Ownership: El Public Private El UnknownIf Public, Government Jurisdiction: El Local Li State El DOT El Other:__________________________Corresponding USSRJIJSA Field Sheet? El Yes El No If yes, Unique Site ID:__________________

Proposed Retrofit Location;Storage On-SiteEl Existing Pond El Above Roadway Culvert El Hotspot Operation El Individual RooftopEl Below Outfall El In Conveyance System El Small Parking Lot El Small Impervious AreaEl In Road ROW Near Large Parking Lot El Individual Street El Landscape! HardscapeEl Other:________________________________ El Underground El Other:_________________

DRMNAGE AREA TO PROPOSED RETROFIT

Drainage Area Drainage Area Land Use:Imperviousness El Residential El InstitutionalImpervious Area El SFH (< 1 ac lots) El Industrial

El SFH (> 1 ac lots) El Transport-RelatedNotes. o Townhouses El ParkEl Multi-Family El Undeveloped

El Commercial El Other:_______________


Existing Stormwater Practice: Yes El No PossibleIf Yes, Describe:

Aa3%L.fl


‘1 1tCtf %, c 7e’


fit tO\r’-7YQ iw.9.’{&t flA--rf4


PROPOSED RETROFIT

Retrofit Reconnaissance Investigation JZJ4J

Purpose of Retrofit:,P Water Quality El Recharge El Channel Protection El Flood ControlEl Demonstration / Education El Repair El Other:___________________________________________

Retrofit Volume Computations - Target Storage; Retrofit Volume Computations - Available Storage:

Proposed Treatment Option:El Extended Detention El Wet Pond El Created Wetland El BioretentionEl Filtering Practice El Infiltration El Swale El Other:__________________________________


ffcjn-ccAc Zttt 5Z r’

rC’C,é’(

SITE CONSTRAINTS

Adjacent Land Use: Access:El Residential El Commercial El Institutional El No ConstraintsEl Industrial El Transport-Related El Park Constrained due toEl Undeveloped El Other:___________________________ El Slope El SpacePossible Conflicts Due to Adjacent Land Use? El Yes El No El Utilities El Tree ImpactsIf Yes, Describe: El Stmctures Property Ownership

El Other:________________________

Conflicts with Existing Utilities: Potential Permitting Factors:El None Dam Safety Permits Necessary El Probable El Not ProbableEl Unknown Impacts to Wetlands El Probable El Not ProbableYes Possible Impacts to a Stream El Probable El Not ProbableEl El Sewer Floodplain Fill El Probable El Not ProbableEl Water Impacts to Forests El Probable El Not ProbableEl El Gas Impacts to Specimen Trees El Probable El Not ProbableEl El Cable How many?El El Electric Approx. DBH____________El Electric to StreetlightsEl Overhead Wires Other factors:_________________________________________________El El Other:_________________

Soils:Soil auger test holes: El Yes El NoEvidence of poor infiltration (clays, fines): El Yes El NoEvidence of shallow bedrock: El Yes El NoEvidence of high water table (gleying, saturation): El Yes El No



S1TCH


Retrofit Reconnaissance Investigation IIRI1DESIGN OR DELIVERY NOTES

FOLLOW-Up NEEDED TO COMPLETE FIELD CONCEPT

Confirm property ownership LI Obtain existing stormwater practice as-builtsConfirm drainage area Obtain site as-builts

LI Confirm drainage area impervious cover LI Obtain detailed topographyLI Confirm volume computations LI Obtain utility mappingLI Complete concept sketch LI Confirm storm drain invert elevations

LI Confirm soil typesLI Other:


SITE CANDIDATE FOR FURTHER INVESTIGATION: LI YES []No LI MAYBEIS SITE CANDIDATE FOR EARLY ACTION PROJECT(S): LI YES LI No LI MAYBEIF NO, SITE CANDIDATE FOR OTHER RESTORATION PROJECT(S): LI YES LI No LI MAYBE

IF YES, TYPE(S)


Neighborhood Source Assessment INSJ4

WATERSHED: Ppads OvJL SUI3WATERSHED: c/I’ R UNIQUE SITE ID: & - 14’RQ3DATE:lQ/Vl/(d ASSESSEDRY: CAMERAID: I PIC#:j/_1j

A. NEIGImORH0OD CHARACTERIZATION

Neighborhood/Subdivision Name: Neighborhood Area (acres)If unknown, address (or streets) surveyed:

Homeowners Association? Q Y N Unknown If yes, name and contact information:

_____________________________

Residential (circle average single faintly lot size): Vo C -

C Single Family Attached (Duplexes, Row Homes) ‘/ ¼ V, ¼ acre ?vItifamily Apts, Townhomes. Condos)fl Single Family Detached <¼ ¼ ½ 1 >1 acre fl Mobile Home ParkEstimated Age of Neighborhood: 00 years Percent of Homes with Garages:/ C With Basements LO% INDEx*Sewer Service? .KJ”Y fl N 0Index of Infill, Redevelopment, and Remodeling C No Evidence <5% of units 5-10% >10%

Record percent observedfor tack ofEkefollowing indicators,. . .. . . Percentage CommcntslNotesdepending on applicability and/or site complexity

B. YAW) AND LAwI’i CONDITIONS. -BI. % of lot with impervious cover

B2. % of lot with grass cover 0B3. % of lot with landscaping (e.g., mulched bed areas)

B4. % of lot with bare soil Qtvote: B] through B4 must total 100%


B6. Evidence of permanent irrigation or “non-target” irrigation QHigh: Q

B7. Proportion of total neighborhood turf lawns with following Mcd:management status:

Low:

B8. Outdoor swimming pools? DY ØN U Can’t Tell Estimated # QB9. Junk or trash in yards? DY U NC Can’t Tell QC. DRIVEWAYS, SIDEWALKS, Ar’11) CURBS

Cl. % of driveways that are impervious Q N/A IC2. Driveway Condition U Clean C Stained U Dirty ‘Breaking up 0

Spotless U Covered with lawn clippings/leaves U Receiving non-target’ irrigation QWhat is the distance between the sidewalk and street? ‘2.— ft. 0Is pet waste present in this ar5a? Q Y N C N/A Q

C4. Is curb and gutter present? WY CN yes,checkalithat apply:

U Clean and Dry QFlowing SOrganic_matter, leaves, lawn clippings Trash,_litter, or debris U Overhead tree canopy


A-3

NSA Pollution Severity IndexSevere (More than 10 circles checked)

cj. High (5 to 10 circles checked)Moderate (Fewer than 5 circles checked)

0 None (No circles checked)

Neighborhood Restoration Opportunity IndexHigh (More than 5 diamonds checked)Moderate (3-5 diamonds checked)Low (Fewer than 3 diamonds checked)


Crz

fpo UJ/( -

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Neighborhood Source Assessment f’JSt4_IL ROOFTOPS

Dl. Downspouts are directly connected to storm drains or sanitary sewer • •D2. Downspouts are directed to impervious surface

D3. Downspouts discharge to pervious area )D4. Downspouts discharge to a cistern, rain barrel, etc. I

*Nore: Cl through C4 should total 100%

US. Lawn area present downgradient of leader for rain garden? fl Y 0E. COMMON AiuAsEl. Storm drain inlets? ‘Y N If yes, are they stenciled? Q Y Condition: Q Clean tirty

UN

if yes, indude Uque Site ID from SSD sheet SP- —°!. SE2. Storm water pond? Y1 N Is it a wet pond or dry pond? Is it overgrown? U Y U N

What is the estimated pond area? 0 <1 acre U about 1 acre fl > I acreE3. OpenSpace? DY N If yes, is petwastepresent? U Y UN dumping? DY U N

- 0Buffers/floodplain present: DY If yes, is encroachment evident? QY U N

F. INITIAL NUORBOIW000 ASSESSMENT AND RECOMMENI)ATIONS

Based on field observations, this neighborhood has significant indicators for the following: (check all that apply)D Nutrients fl Oil and Grease U Trash/Litter Q Bacteria Q Sediment Q Other


D/Onsite retrofit potential?

Better lawn/landscaping practice?

Q Better management of common space?

O Pond retrofit?

o Multi-family Parking Lot Retrofit?Other action(s)

Initial Assessment

OlE Li

NOTES:

44

Streets and Storm Drains SSDWATERSHED: SUBWATERSHED: tfZ UNIQUE SITE

BATE: tlifiJL ASSESSED By: CAMERA ID:

MAPGRID RAININLAST24H0uRs ElY N Pic# -7(c, it

A. LOCATJONAl. Street names or neighborhood surveyed: -

&-Al Adjacent land use: Residential Commercial Q Industrial Institutional

U Municipal 0 Transport-Related

A3. Corresponding HSI or NSA field sheet? If so, circle HSJ or NSA and record its Unique Site ID here

B. STREET CONIMTIONS

BI. Road Type: Arterial El Collector Local fl Alley El Other:

B2. Condition of Pavement: Q New Good Cracked El BrokenB3. Is on-street parking permitted Y Q N If yes, approximate number of cars per block:

B4. Are large cul-de-sacs present? El Y N

B5. Is trash present in curb and gutter? If so, Index Rating for Accumulation in Guttersuse the index to the right to record amount. I Clean Filthy

SedimJ 01 02 03Organic Material 01 El 2 3 04 05

Litter []1 2 03 04 05C. STORM DRAIN INLETS AND CATCH BASINS

• Cl. Type of storm drain conveyance: El open enclosed El mixedC2. Percentage of inlets with catch basin storage:

— fl N/ASample 1-2 catch basins per NSAJIISI C3. Catch basin #1 C4. Catch basin #2Latitude .fl0 • ‘.

Longitude .11° i 11° ‘CYSLMK#Picture# j/5Current Condition Wet El Dry Wet El DryCondition of Inlet ElClear Obstructed ElClear ObstructedLitter Accumulation 13JY El N SY J NOrganics Accumulation Y El N Y El NSediment Accumulation JY El N JY Q NSediment Depth (in feet) / ft. ft.Water Depth C c ft. 4- 5 ft.Evidence of oil and grease Y El N JY NSulfur smell Ely j N Ely E N

, Accessible to vacuum truck EIY El N ØY ND. NON-RESIDENTIAL PARKING LOT (>2 acres)


D2. Lot Utilization: Full El About half full El Empty

D3. Overall condition of Pavement: El Smooth (no cracks) El Medium (few cracks) El Rough (many cracks)El Very Rough (numerous cracks and depressions)

D4. Is lot served by a storm water treatment practice? El Y El N If yes. describe:

[p On-site retrofit potential: El Excellent El Good El Poor

A-9

E. MUNICIPAL POLLUTANT REDUCTION STRATEGIES


Ei Degree ofppjjitant accumulation in the system High fl Medium fl Low fl NoneE2. Rate the feasibility of the following pollution prevention strategies:

Street Sweeping: El High ModerateStorm Drain Stenciling: High ModerateCatch Basin Clean-outs: El High El ModerateParking Lot Retrofit Potential: Q High El Moderate


— yc&c7t’UJ 4& d

.1 ‘

1%!-t -L--tt2f _//—l.-(tJ-c-l-Y fl-_c c_-e--i_& -

-t %Lt C

#1

El Low

El Low

Low

U Low

#2

eJ

SVc.

- i/ _L,_c-t

Notes:

/

Al )L

A-i 0

If unknown, address (or streets) surveyed:

Neighborhood Source Assessment 1JSA

/ F

Homeowners Association? Li Y N Li Unknown If yes, name and contact information:Residential (circle average single family lot size):

WATERSHED: SURWATERSHED: UNIQUE SITE ID: Aj9t iTSL 03DATE: JC/Jsi/ ( ASSESSED By: CAMERA II): 4oi--1 Pic#:

A. NEIGHBORHOOD CHARACTERIZATION

Neighborhood/Subdivision Name: 4/d,- 5/ Neighborhood Area (acres)

Li Single Family Attached (Duplexes, Row Homes) <‘/s Vs ¼ ‘/3 ‘A acre Li Multifamily (Apts, Townhomes, Condos)Single Family Detached ¼ ½ 1 >1 acre Mobile Home Park

Estimated Age of Neighborhood: && years Percent of Homes with Garages: / C % With Basements % INDEX*Sewer Service? Y Li N Ce-tq-r-d < 0Index of Inf,ll. Redevelopment, and Remodeling No Evidence Q <5% of units 510% Li >10% Q

Recor percent obervedfor eackof the following indkoiors,/‘ . . . . Percentage Comments/Notesiepedsng on app4cpbd#y and/or Ue co,nplèxtjB. YARD AND LAWN CoNDrnoNs

81. % of lot with impervious cover

B2. % of lot with grass cover 1_f 6 0B3. % of lot with landscaping (e.g., mulched bed areas) / 6> 084. % of lot with bare soil t Q


B5. % of lot with forest canopy 7. C86. Evidence of permanent irrigation or “non-target” irrigation (2 0

High:iZ QB7. Proportion of total neighboi-hood turf lawns with following EMed: Qmanagement status:

Low: rc

88. Outdoor swimming pools? LiY N Q Can’t Tell Estimated # 0B9. Junk or trash in yards? YLi N Li Can’t Tell /c-’ 0C DRIVEWAYS, SIDEWALKS, AND CuRDSCl. % of driveways that are impervious J N/A /00C2. Driveway Condition Clean Li Stained Li Dirty Li Breaking up QC3. Are sidewalks present? C Y N If yes, are they on one side of street Li or along both sides Li

Li Spotless Li Covered with lawn clippings/leaves Li Receiving non target irrigation QWhat is the distance between the sidewalk and street? ft. 0Is pet waste present in this area? Li Y Li N Li N/A

Li Clean and Dry Li Flowing or standing water Long-term car parking Li Sediment

Li Organic matter, leaves, lawn clippings Li Trash, litter, or debris Li Overhead tree canopy* INDEX: 0 denotes potential pollution source; 0 denotes a neighborhood restoration opportunity

00

A-3

Neighborhood Source

Dl. Downspouts are directly connected to storm drains or sanitary sewer

02. Downspouts are directed to impervious surface


Assessment INSA.ft Roorrops

00

04. Downspouts discharge to a cistern, rain barrel. etc.*Note: CI through C4 should total 100%

05. Lawn area present downgradient of leader for rain garden? Y QN

E. ConioN AREASEl. Storm drain inlets? Q Y SN If yes, are they stenciled? Y LI N Condition: Clean LI Dirty

Catch basins inspected? fl Y N If yes, include Uique Site ID from SSD sheet: 0£2. Storm water pond? Q yj Is it aD wet pond or Q dry pond? Is it overgrown? QY Q N

What is the estimated pond area? fl <1 acre about I acre > i acre

£3. Open Space? %Y Q N If yes, is pet waste present? C Y N dumping? E Y C N QBuffers/floodplain present: DY N If yes, is encroachment evident? DY C N

F. IMTIAL NEIGHBORHOOD ASSESSMENT AND RECOMMENDATIONSBased on field observations, this neighborhood has significant indicators for the following: (check all that apply)Q Nutrients Oil and Grease C Trash/Litter C Bacteria Sediment C Other


C Onsite retrofit potential?Better lawn/landscaping practice?Better management of common space?

Q Pond retrofit?

C Multi-family Parking Lot Retrofit?

Q Other action(s)


Initial Assessment


o Severe (More than 10 circles checked)

LI High (5 to 10 circles checked)

o Moderate (Fewer than 5 circles checked)

o None (No circles checked)


C High (More than 5 diamonds checked)Moderate (3-5 diamonds checked)

LI Low (Fewer than 3 diamonds checked)

NOTES:

A-4

Hotspot Site Investigation fJSP “TERSHED: SuBWATERSHED: /V)f72... UNIQUESITEID: 1-4G—pg_r-Ci

EE:(0/L4/16 ASSESSEDBY: CAIER4ID: PIC#:223.—7_l7

MAPGRID: LAT/ b’7S”LONG13° U LMK#

A. SITE DATA AND BASIC CLASSifICATION

Name and Address: Category: Commercial El Industrial Miscellaneous

5 t El Institutional El Municipal El Golf Course. fi Transport-Related El Marina

4 fi Animal FacilitySIC code (if available): Basic Description of Operation:

NPDES Sj(us: El Regulated INDEXtJ Unregulated El Unknown

B. VEHICLE OPERATIONS El N/A (Skip to part C) I Observed Pollution Source?

Bi. Types of vehicles: J’Fleet vehicles El School buses El Other:

B2. Approximate number of vehicles: do

B3. Vehicle activities (circle all that apply): Maintained Repaired Recycled Fueled Washed Stored 0B4. Are vehicles stored and/or repaired outside? El Y El N_ Can’t TellAre_these_vehicles_lacking_runoff diversion_methods?_El_Y El_N___Can’t_TellB5. Is there evidence of spills/leakage from vehicles? El Y El N Can’t Tell 0B6. Are uncovered outdoor fueling areas present? El Y U N “Can’r Tell Pv’ai3Lt JJo< 0B7. Are fueling areas directly connected to storm drains? El Y El N ,Ø’Can’t Tell 0B8. Are vehicles washed outdoors? El Y El N Can’t TellDoes the area where vehicles are washed discharge to the storm drain? El Y El N El Can’t Tell

OUTDOOR MATERIALS El N/A (Skip to part D) Observed Pollution Source?tJ. Are loading/unloading operations present? Y El N El Can’t TellIf yes, are they uncovered and draining towards a storm drain inlet? Ely fi N El Can’t Tell

C2. Are materials stored outside? 0 Y El N El Can’t Tell If yes. are they El Liquid Solid Description:Where are they stored? El grass/dirt area concrete/asphalt El bermed area

C3. Is the storage area directly or indirectly connected to storm drain (circle one)? gjy El N fi Can’t Tell 0C4. Is staining or discoloration around the area visible? El y ‘N El Can’t Tell 0Cs. Does outdoor storage area lack a cover? Y El N El Can’t Tell 0C6. Are liquid materials stored without secondary containment? El Y N El Can’t Tell 0C7. Are storage containers missing labels or in poor condition (rusting)? El Y N El Can’t Tell 0D. WASTE MANAGEMENT El N/A (Skip to part H) I Observed Pollution Source? L

Dl. Type of waste (check all that apply): El Garbage El Construction materials El Hazardous materials 0D2. Dumpster condition (check all that apply): El To cover/Lid is open El Damaged/poor condition ElLeaking or

evidence of leakage (stains on ground) El OverflowingD3. Is the dumpster located near a storm drain inlet? El El N El Can’t Tell

If yes, are runoff diversion methods (berms. curbs) lacking? El Y El N El Can’t Tell— -

E. PHYSICAL PLANT El N/A (Skip to part F) Observed Pollution Source?

El. Building: Approximate age: fO yrs. Condition of surfaces: Clean El Stained El Dirty El Damaged 0Evidence that maintenance results in discharge to storm drains (staining/discoloration)? ElY N El Don’t know Q

tlndex: 0 denotes potential pollution source; L denotes confirmed polluter (evidence was seen)

A-5


£2. Parking Lot: Approximate age / 0 yrs. Condition: E Clean LI Stained LI Dirty E Breaking upSurface material Paved/Concrete LI Gravel LI Permeable LI Don’t know

£3. Do downspouts discharge to impervious surface? LI Y N LI Don’t know LI None visibleAre downspouts directly connected to storm drains? - Y LI N LI Don’t know

E3. Evidence of poor cleaning practices for construction activities (stains leading to storm drain)? LI Y 0N LI Can’t Tell

F. TURF/LANDSCAPING AREAS F?] N/A (skip to pan G) I Observed Pollution Source?Fl. % of site with: Forest canopy % Turf grass % Landscaping Bare Soil _% 0F2. Rate the turf management status: LI High Medium LI Low 0F3. Evidence of permanent irrigation or “non-target” irrigation LI Y N LI Can’t Tell 0F4. Do landscaped areas drain to the storm drain system? LI N Can’t Tell 0F5. Do landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? Y N LI Can’t Tell 0G STORM WATER INFRASTRUCTURE LI N/A (skip to pan H) I Observed Pollution Source9 NJGI. Are storm water treatment practices present? LI Y I’N LI Unknown If yes, please describe: 0G2. Are private storm drains located at the facility? Y Q N Unknown



Sediment LIi LI2 LI3 LI4 LIsOrganic material LII LI2 LI 3 LI4 LI 5Litter LII LI2 LI3 LI4 LI5

G3. Catch basin inspection — Record SSD Unique Site ID here: Condition: LI Dirty LI Clean

H. INITIAL HOTSPOT STATUS - INDEX RESULTS

Not a hotspot (fewer than 5 circles and no boxes checked) LI Potential hotspot (5 to 10 circles but no boxes checked)

LI Confirmed hotspot ( 10 to 15 circles and/or I box checked) LI Severe hotspnt (>l5circlesanclfor2 or more boxes checked) — — —

Follow-up Action:

LI Refer for immediate enforcement—

LI Suggest follow-up on-site inspectionU,Test for illicit discharge

Include in future education effortLI Check to see if hotspot is anNPDES non-filer

LI Onsite non-residential retrofitLI Pervious area restoration; complete PAA sheet and record

Unique Site ID here:LI Schedule a review of storm water pollution prevention plan

Notes:

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A-6

Retrofit Reconnaissance Investigation j{j] 1WATERSHED: SUBWATERSHED: UNIQUE SITE m: cjziLAwg_U IDATE: \ 6 ASSESSED By: CAMERA ID: PIcTURES:-ZZr13

GPSLD: LMKID: LAT: UI’ /q 6,1” LONG:13

SITE DESCRIPTION

Name: S2L’Q”j PSt-viM ,t>rznoAddress: oLH 1k’0JY(.t4

Ownership: Public Li Private Li UnknownIf Public, Government Jurisdiction: U Local Li State Li DOT Li Other:__________________________

Corresponding USSR/USA Field Sheet? Li Yes No If yes, Unique Site ID:__________________

Proposed Retrofit Location:Storage On-SiteLi Existing Pond Li Above Roadway Culvert Li Hotspot Operation Li Individual RooftopLi Below Outfall Li In Conveyance System Li Small Parking Lot Small Impervious AreaLi In Road ROW Near Large Parking Lot Li Individual Street Li Landscape / HardscapeLi Other:________________________________ Li Underground Li Other:_________________


Drainage Area Drainage Area Land Use:Imperviousness Li Residential ,PJ InstitutionalImpervious Area Li SFH (< I ac lots) Li Industrial

Li SFH (> 1 ac lots) Li Transport-RelatedNotes:Li Townhouses Li ParkLi Multi-Family Li Undeveloped

Li Commercial Li Other:______________


Existing Stormwater Practice Li Yes No Li PossibleIf Yes, Describe:


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Retrofit Reconnaissance Investigation JJZ_j 1PROPOSED RETROFIT

Purpose of Retrofit:Li Water Quality Recharge Li Channel Protection Li Flood Control

Demonstration / Education Li Repair Li Other:___________________________________________

Retrofit Volume Computatious - Target Storage; Retrofit Volume Computations - Available Storage:

Proposed Treatment Option:Li Extended Detention Li Wet Pond Li Created Wetland BioretentionLi Filtering Practice Infiltration Li Swale Li Other:_____________________________________


SITE CONSTRAINTS

4djacent Land Use:- Access:

,,Zi Residential Li Commercial Li Institutional 0 Li No ConstraintsLi Industrial Li Transport-Related 1 Park Constrained due toLi Undeveloped Li Other:_________________________ Slope Li SpacePossible Conflicts Due to Adjacent Land Use? Li Yes LiNo Li Utilities Tree ImpactsIf Yes, Describe: Li Stnictures Li Property Ownership

Li Other:_________________

Conflicts with Existing Utilities: Potential Permitting Factors:Li None Dam Safety Permits Necessary Li Probable Not Probable

Unknown Impacts to Wetlands Li Probable Not ProbableYes Possible Impacts to a Stream Li Probable Not ProbableLi Li Sewer Floodplain Fill Li Probable Not ProbableLi Li Water Impacts to Forests Li Probable Not ProbableLi Li Gas Impacts to Specimen Trees Probable Li Not ProbableLi Li Cable How many?Li Li Electric Approx. DBH____________Li Li Electric to StreetlightsLi Overhead Wires Other factors:_________________________________________________Li Li Other:

Soils:Soil auger test holes: Li Yes Li NoEvidence of poor infiltration (clays, fines): Li Yes Li NoEvidence of shallow bedrock: Li Yes Li NoEvidence of high water table (gleying, saturation): Li Yes Li No



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O Confirm property ownership Obtain existing stormwater practice as-bufltsØConfinn drainage area Elobtain site as-builtsQ_,Confirm drainage area impervious cover 0 Obtain detailed topography

Confirm volume computations [JObtain utility mappingEi Complete concept sketch 3j Confirm storm drain invert elevations

1YConfirm soil typesfl Other:


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SITE CAMJIDATE FOR FURTHER INVESTIGATION: H YES H No H MAYBEIS SITE CANDIDATE FOR EARLY ACTION PROJECT(S): H YES H No H MAYBEIF NO, SITE CANDIDATE FOR OnwR RESTORATION PROJECT(S) H YES H No LI MAYBE

IF YES, TYPE(S)


Retrofit Reconnaissance Investigation RRI

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WATERSHED:

DATE:

GPS ID:

SITE DESCRIPTION

Name: W0 \L- fv—Address: n44oP ‘icL Ylill ‘R-clOwnership: U Public U Private U UnknownIf Public, Goverm-nent Jurisdiction: U Local U State U DOT U Other:________________________

Con-esponding USSRUSA Field Sheet? U Yes U No If yes, Unique Site ID:___________________

Proposed Retrofit Location:§,rage On-Site

Existing Pond U Above Roadway Culvert U Hotspot Operation tndividual RooftopU Below Outfall U In Conveyance System 1ZSmall Parking Loty, Small Impervious AreaU In Road ROW U Near Large Parking Lot U Individual Stree2. U Landscape / HardscapeU Other:__________________________________ U Underground U Other:___________________


Drainage Area Drainage Area Land Use:Imperviousness U Residential U InstitutionalImpervious Area U SFH (< 1 ac lots) U Industrial

U SFH (> I ac lots) U Transport-RelatedNotes:U Townhouses U ParkU Multi-Family U Undeveloped

U Commercial U Other:_______________


Existing Stormwater Practice: i Yes U No U PossibleIf Yes, Describe:

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Existing Bead Available and Points Where Measured:


Retrofit Reconnaissance Investigation flJ{I

PROPOSED RETROFIT

Purpose of Retrofit:fWater Quality 1{echarge LI Channel Protection j Flood Control1Demonstration / Education Repair LI Other:______________________________________________


Proposed Treatment Option:J Extended Detention Jj,Wet Pond LI Created Wetland BioretentionFiltering Practice Infiltration LI Swale LI Other:_____________________________________


tb1Th

SITE CONSTRAINTS

Adjaccnt Land Use: Access:Residential LI Commercial Institutional LI No Constraints

LI Industrial LI Transport-Related Park Constrained due toLI Undeveloped LI Other:_________________________ LI Slope LI SpacePossible Conflicts Due to Adjacent Land Use? LI Yes 121 No LI Utilities LI’Tree ImpactsIf Yes, Describe: Structures LI Property Ownership

LI Other:__________________

Conflicts with Existing Utilities: Potential Permitting Factors:None Dam Safety Permits Necessary LI Probable LI NotProbable

LI Unlaiown Impacts to Wetlands LI Probable LI Not ProbableYes Possible Impacts to a Stream LI Probable LI Not ProbableLI LI Sewer Floodplain Fill LI Probable LI Not ProbableLI LI Water Impacts to Forests LI Probable LI Not ProbableLI LI Gas Impacts to Specimen Trees LI Probable LI Not ProbableLI LI Cable How many?LI LI Electric Approx. DBH___________LI LI Electric to StreetlightsLI Overhead Wires Other factors:_________________________________________________LI LI Other:_________________


Page 2014 Unique Site ID:______

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D Confirm property ownership Obtain existing stormwater practice as-builtsfl Confirm drainage area D Obtain site as-builtsfl Confirm drainage area impervious cover E Obtain detailed topographyfl Confirm volume computations Li Obtain utility mappingC Complete concept sketch Confirm storm drain invert elevations

U Confirm soil typesOther:


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SITE CANDIDATE FOR FURTHER INVESTIGATION: Li YES Li No Li MAYBEIs SITE CANDIDATE FOR EARLY ACTION PROJECT(S): Li YES Li No Li MAYBEIF NO, SITE CANDIDATE FOR OTHER RESTORATION PROJECT(S) Li YES Li No Li MAYBE

IF YES, TYPE(S)

Page 4 of 4 Unique Site ID: FR


j ASSESSED By: ,vjç CAMERA ID:

GPSLD: ILMKID:

DATE: PIcTURES:2_2

“‘°1’ LONG:7007! ySITE DESCRIPTION

Name: — cu t \&--- Socc,r 4JAddress: êJ\j-R /4-’e cLt,-

WATERSHED: I SUBWATERSHED: 4 H UNIQUE SITE ID: j2jq -u &4 -

Ownership: Public Private fl UnknownIf Public, Government Jurisdiction: Local D State fl DOT U Other:__________________________Coffesponding USSRJUSA Field Sheet? Yes No If yes, Unique Site ID:___________________

Proposed Retrofit Location:Storage On-SiteC Existing Pond C Above Roadway Culvert C Hotspot Operation Individual RooftopC Below Outfall fl In Conveyance System 151 Small Parking Lot C Small Impervious Area

In Road ROW fl Near Large Parking Lot Individual Street C Landscape! HardscapeC Other:________________________________ C Underground C Other:_________________


Drainage Area Drainage Area Land Use:Imperviousness C Residential C InstitutionalImpervious Area C SFH (< 1 ac lots) C Industrial

C SFH (> 1 ac lots) C Transport-RelatedNotes.C Townhouses C ParkC MuLti-Family C Undeveloped

C Commercial C Other:______________


Existing Stormwater Practice: C Yes No C PossibleIf Yes, Describe:


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Page 1 of 4 Unique Site ID:_______

Retrofit Reconnaissance Investigation JZJ{J

PROPOSED RETROFIT

Purpose of Retrofit:Water Quality Recharge LI Channel Protection LI Flood Control

LI Demonstration / Education Repair LI Other:___________________________________________


Proposed Treatment Option:IYJ Extended Detention LI Wet Pond LI Created Wetland LI BioretentionLI Filtering Practice LI Infiltration LI Swale LI Other:_____________________________________


SITE CONSTRAINTS

Adjacent Land Use: Access;LI Residential LI Commercial LI Institutional LI No ConstraintsLI Industrial LI Transport-Related LI Park Constrained due toLI Undeveloped LI Other:_________________________ LI Slope LI SpacePossible Conflicts Due to Adjacent Land Use? LI Yes LI No LI Utilities LI Tree ImpactsIf Yes, Describe: LI Stmctures LI Property Ownership

LI Other:__________________________

Conflicts with Existing Utilities: Potential Permitting Factors:LI None Dam Safety Permits Necessary LI Probable LI NotProbableLI Unknown Impacts to Wetlands LI Probable LI Not ProbableYes Possible Impacts to a Stream LI Probable LI Not ProbableLI LI Sewer Floodplain Fill LI Probable LI Not ProbableLI LI Water Impacts to Forests LI Probable LI Not ProbableLI LI Gas Impacts to Specimen Trees LI Probable LI Not ProbableLI LI Cable How many?____________LI Electric Approx. DBH_____________LI LI Electric to StreetlightsLI Overhead Wire-s Other factors:_________________________________________________LI LI Other:



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Confirm property ownership 0 Obtain existing stormwater practice as-buiittsC Confinn drainage area Obtain site as-builts

Confirm drainage area impen’ious cover Obtain detailed topographyC Confirm volume computations C Obtain utility mappingfl Complete concept sketch Confirm stonn drain invert elevations

Confirm soil typesfl Other:

INITIAL FEASIBJLITY AND CONSTRUCTION CONSIDERATIONS

SITE CM4DIDATE FOR FURTHER INVESTIGATION: H YES H No H MAYBEIS SITE CA.NI)IDATE FOR EARLY ACTION PROJECT(S): H YES H NO H MAYBEIF NO, SITE CANDIDATE FOR OTHER RESTORATION PROJECT(S): H YES H No H MAYBE

IF YES, TYPE(S)


Hotspot Site Investigation [jIsII “4TERSHED: 1f}/1oL)C SUEWATERSHED: fill UNIQUE SITEID:

.TE:ID/24/ /V ASSESSED By: VAw CAMERAID: Pic#: 1n7—- lY1MAPGRID: LAT*jf° jc— t{4LONG11 H iLø LMK#A. SITE DATA AND BASIC CLASSIFICATION

Name and Address: tvA Category: Commercial Industrial Miscellaneousg i çJjxoo Institthional D Municipal D Golf Course

c-i I { D Transport-Related D Marina!‘) lVVOt/i C/X

Animal FacilitySIC code (if available): Basic Description of Opertion:

NPDES Status: D Regulated S?oo\ 4 k, c1coiAjINDEX°0 Unregulated Unknown

B. VEHICLE OPERATIONS Q N/A (Skip to part C) Observed Pollution Source?BI. Types of vehicles: Q Fleet vehicles ‘School buses 0 Other:B2. Approximate number of vehicles: tcB3. Vehicle activities (circle all that apply): Maintained Repaired Recycled Fueled Washed StoredB4. Are vehicles stored and/or repaired outside? Y N C Can’t TellAre these vehicles lacking runoff diversion methods? C Y C N Q Can’t TellB5. Is there evidence of spills/leakage from vehicles? C Y N C Can’t Tell

B6. Are uncovered outdoor fueling areas present? C Y N Can’t Tell

B7. Are fueling areas directly connected to storm drains? Y N C Can’t TellB8. Are vehicles washed outdoors? C Y N C Can’t TellDoes the area where vehicles are washed discharge to the storm drain? C Y C N C Can’t Tell

OUTDOOR MATERLALS C N/A (Skip to part D) Observed Pollution Source?

[ UI. Are loading/unloading operations present? Y C N C Can’t Tell sI If yes, are they uncovered and draining towards a storm drain inlet? Y C N C Can’t Tell

Ci Are materials stored outside? Y C ND Can’t Tell If yes, are they C Liquid Solid Description:Where are they stored? C grass/dirt area ‘concrete/asphalt C bermed area

C3. Is the storage area directly or indirectly connected to storm drain (circle one)? Y C N C Can’t Tell

C4. Is staining or discoloration around the area visible? flY f9’N C Can’t Tell QCS. Does outdoor storage area lack a cover? Y C N C Can’t Tell 0C6. Are liquid materials stored without secondary containment? DY .N C Can’t Tell QC7. Are storage containers missing labeis or in poor condition (rusting)? C Y N C Can’t Tell QD. WASTE MANAGEMENT C N/A (Skip to p9rt if) I Observed Pollution Source?Dl. Type of waste (check all that apply): Garbage Construction materials C Hazardous materials 0D2. Dumpster condition (check all that apply): C No cover/Lid is open C Damaged/poor condition CLeaking or

evidence of leakage (stains on ground) fi OverflowinD3. Is the dumpster located near a storm drain inlet? C Y N C Can’t Tell oIf yes, are runoff diversion methods (berms, curbs) lacking? Dv C N C Can’t Tell

E. PHYSICAL PLANT C N/A (Skip to part F) Observed Pollution Source?

El. Building: Approximate age: yrs. Condition of surfaces: Clean C Stained C Dirty C Damaged 0Evidence that maintenance results in discharge to storm drains (staining/discoloration)? C Y ‘N C Don’t know 0

*hdex: 0 denotes potential pollution source; L__i denotes confirmed polluter (evidence was seen)

A-5

Hotspot Site Investigation IISI‘I

_____

£2. Parking Lot: Appro3imate age yrs. Condition: E Clean Q Stained El Dirty C Breaking upSurface material Paved/Concrete Gravel El Permeable Don’t know

E3.Do downspouts discharge to impervious surface? El Y N El Don’t know None visibleAre downspouts directly connected to storm drains? Y fl N Don’t know

E4. Evidence of poor cleaning practices for construction activities (stains leading to storm drain)? El Y N Can’t Tell 0F. TURF/LANDSCAPING AREAS E] N/A (skip to part G) Observed Pollution Source? IFl. % of site with: Forest canopy Q_% Turf grass Ic % Landscaping Bare Soil

F2. Rate the turf management status: f High El Medium El Low

F3. Evidence of permanent irrigation or “non-target” irrigation Y fl N Can’t Tell

F4. Do landscaped areas drain to the storm drain system? g Y El N El Can’t Tell

F5. Do landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? El Y N E Can’t Tell 0G. STORM WAThR INFRASTRUCTURE El N/A (skip to part H) I Observed Pollution Source? LJGI. Are storm water treatment practices present? El Y N El Unknown If yes, please describe: 0G2. Are private storm drains located at the facility? f1Y El N fl Unknown



Sediment Q2 El3 El4 CsOrganicmaterial [91 [92 [93 [94 05Litter [91 [92 [93 [94 [95

G3. Catch basin inspection— Record SSD Unique Site ID here: Condition: [9 Dirty [9 CleanH. INITIAL HOTSPOT STATUS - INDEX RESULTS

El Not a hotspot (fewer than 5 circles and no boxes checked) Potential hotspot (5 to 10 circles but no boxes checked)[9 Confirmed hotspot (10 to 15 circles andlor I box checked) [9 Severe hots mt (>15 circles and/or 2 or more boxes checkedFollow-up Action:

El Refer for immediate enforcementEl Suggest follow-up on-site inspectionEl Test for illicit discharge

Include in future education effortEl Check to see if hotspot is an NPDES non-filer

Onsite non-residential retrofitEl Pervious area restoration; complete PAA sheet and record


_____________________


Notes:

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A-6


I ‘4TERSHED: SUBWATERSHED; . UNIQUE SITE ID:—

IA PJE:IL’/-iO/t U ASSESSEDBY: cAMERAm: Pic#: 224—7--1-

MAYGRID: LATQI0 (- I LMK#

A. SITE DATA AND BASIC CLASSIFICATIONName and Address: Category: Commercial 9 Industrial Miscellaneous

- —--t - 9 Institutional 9 Municipal U Golf Courser’

- 9 Transport-Related U Marina0 Animal Facility

SIC code (iavailable): Basic Description of Operation: -NPDES Status: 9 Regulated .\[L- L .1 )dL itJLa— (if JNDEX*N Unregulated 9 Unknown

B. VEHICLE OPERATIONS N/A (Skip to part C) I Observed Pollution Source?Bi. Types of vehicles: 9 Fleet vehicles 9 School buses 9 Other:B2. Approximate number of vehicles:

$3. Vehicle activities (circle all that apply): Maintained Repaired Recycled Fueled Washed Stored 0B4. Are vehicles stored and/or repaired outside? 9 Y 9 N 9 Can’t TellAre_these_vehicles_lacking_runoff diversion_methods?_C_Y__9_N__fl_Can’t_TellB5. Is there evidence of spills/leakage from vehicles? C Y 9 N 0 Can’t Tell 0B6. Are uncovered outdoor fueling areas present? 0 Y 0 N 0 Can’t Tell 0B7. Are fueling areas directly connected to storm drains? 0 Y 9 N 0 Can’t Tell QBS. Are vehicles washed outdoors? 9 Y 9 N C Can’t TellDoes the area where vehicles are washed discharge to the storm drain? 9 Y 9 N 9 Can’t Tell

OUTDOOR MATERIALS 9’N/A (Skip to part D) Observed Pollution Source?Cl. Are loading/unloading operations present? 0 Y 0 N 0 Can’t TellIf yes, are they uncovered and draining towards a storm drain inlet? 0 Y 0 N 0 Can’t Tell

C2. Are materials stored outside? U Y 0 NQ Can’t Tell If yes, are they 0 Liquid 0 Solid Description:Where are they stored? 9 grass/dirt area 9 concrete/asphalt 9 bermed area

C3. Is the storage area directly or indirectly connected to storm drain (circle one)? 0 Y 9 N 0 Can’t Tell 0C4. Is staining or discoloration around the area visible? 9 Y 9 N 0 Can’t Tell 0CS. Does outdoor storage area lack a cover? 9 Y 9 N 9 Can’t Tell QC6. Are liquid materials stored without secondary containment? 9 Y 9 N 0 Can’t Tell 0C7. Are storage containers missing labels or in poor condition (rusting)? C Y 9 N 9 Can’t Tell QB. WASTE MANAGEMENT 9 N/A (Skip to part E) Observed Pollution Source?Dl. Type of waste (check all i/tat apply): .Garbage 9 Construction materials 9 Hazardous materials 0D2. Dumpster condition (check all that apply): 9 No cover/Lid is open 9 Damaged/poor condition 9Leaking or

evidence of leakage (stains on ground) 9 Overflowing G,rpD3. Is the dumpster located near a storm drain inlet? C Y 0 N El Can’t Tell

If yes, are runoff diversion methods (berms, curbs) lacking? C Y 9 N 9 Can’t Tell

E. PHYSICAL PLANT 9 N/A (Skip to part F) Observed Pollution Source?

El. Building: Approximate age: / yrs. Condition of surfaces: Clean 9 Stained 9 Dirty DamagedEvidence that maintenance results in discharge to storm drains (staining/discoloration)? 9 Y 9 N 9 Don’t know Q

*Index: 0 denotes potential pollution source; L_._ denotes confirmed polluter (evidence was seen)

A-5


E3. Do downspouts discharge to impervious surface? El Y DN El Don’t know El None visibleAre downspouts directly connected to storm drains? Y El N El Don’t know

E4. Evidence of poor cleaning practices for construction activities (stains leading to storm drain)? ElY ZN El Can’t Tell

F. TURF/LANTSCAPING AREAS El N/A (skip to pan G) Observed Pollution Source?Fl. % of site with: Forest canopy _5Z% Turf grass YV % Landscaping Bare Soil _2_%F2. Rate the turf management status: [2] High El Medium El Low

F3. Evidence of permanent irrigation or “non-target” irrigation El Y El N E Can’t Tell

F4. Do landscaped areas drain to the storm drain system? J2] Y El N El Can’t Tell

F5. Do landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? El Y, N El Can’t Tell

G. STORM WATER INFRASTRUCTURE El N/A (skip to part H) I Observed Pollution SoiGl. Are storm water treatment practices present? Y El N El Unknown If yes, please describe: A±± r \irSj

G2. Are private storm drains located at the facility? El Y El N El UnknownI



Sediment ElI El2 El3 El4 El5Organic material Eli El 2 El3 El4 fl5Litter Eli El2 El3 El4 Els


El Not a hotspot (fewer than 5 circles and no boxes checked) Potential hotspot (5 to 10 circles but no boxes checked)El Confirmed hotspot (10 to 15 circles and/or I box checked) El Severe hotsuot (>15 circles and/or 2 or more boxes checked’Follow-up Action:



_____________________


Notes:

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E2. Parking Lot: Approximate age I 0 yrs. Condition: El CleanSurface material ,EJ Paved/Concrete El Gravel El Permeable

HSI

El Stained El Dirty Breaking up

El Don’t know

A-6


“.TERSHED: SUB WATERSHED; /A UNIQUE SITE ID: t-\S I /vi p> R —6 ‘-

..TE:]J2/?AI10 ASSESSED By: Y-A14 CAMERAJD: Pic#: ?_t? —3c tj

MAPGRID: LAT±IL° 5 I ZZ1tLoNG1’o ii ‘4’ LMK#A. SrFE DATA AND BASIC CLASSIFICATION

Name and Address: Nc Category: Commercial fl Industrial Miscellaneous

4 i a c-kr Sc’i “- i;- Institutional Municipal Golf CourseC Transport-Related H Marina

cS.’4rr Co H Animal FacilitySIC code (if available): Basic Description of Operation:

NPDES Status: Regulated INDEX*H Unregulated Unknown

B. VEHICLE OPERATIONS C N/A (Skip to part C) I Observed Pollution Source?Bl. Types of vehicles: Fleet vehicles School buses H Other:

B2. Approximate number of vehicles:

B3. Vehicle activities (circle all that apply): Maintained Repaired Recycled Fueled Washed Stored) 0B4. Are vehicles stored andlor repaired outside? H Y Q N C Can’t TellAre these vehicles lacking runoff diversion methods? Y H N Can’t TellB5. Is there evidence of spills/leakage from vehicles? H Y N 5J Can’t Tell 0B6. Are uncovered outdoor fueling areas present? H Y N H Can’t Tell 0B7. Are fueling areas directly connected to storm drains? H Y JZI N H Can’t Tell 0B8. Are vehicles washed outdoors? H Y Q N Can’t TellDoes the area where vehicles are washed discharge to the storm drain? H Y H N Q Can’t Tell

: OUTDOOR MATERIALS U N/A (Skip to part D) Observed Pollution Source? --

Cl. Are loading/unJoading operations present? Y H N H Can’t TellIf yes, are they uncovered and draining towards a storm drain inlet? Y H N Can’t Tell -

• C2. Are materials stored outside? J Y Q N Can’t Tell If yes, are they H Liquids Solid Description: (ochL4#JWhere are they stored? H grass/dirt area concrete/asphalt H bermed area

C3. Is the storage area directly or indirectly connected to storm drain (circle one)? Y H N H Can’t Tell

C4. Is staining or discoloration around the area visible? H Y N H Can’t Tell 0Cs. Does outdoor storage area lack a cover? Y H N Can’t Tell

C6. Are liquid materials stored without secondary containment? U Y U N H Can’t Tell 0Cl. Are storage containers missing labels or in poor condition (rusting)? H Y N H Can’t Tell 0D. WASTE MANAGEMENT H N/A (Skip to part I Observed Pollution Source?DI. Type of waste (check all that apply): Garbage Construction materials H Hazardous materials 0D2. Dumpster condition (check all that apply): H No cover/Lid is open H Damaged/poor condition flLeaking or

evidence of leakage (stains on ground) Overflowing ° ‘

D3. Is the dumpster located near a storm drain inlet? H Y H N Can’t TellIf yes,_are runoff diversion_methods_(berms,_curbs)_lacking?_H_Y__H_N___Can’t_Tell

E. PHYSICAL PLANT H N/A (Skip to partF,l Observed Pollution Source’

El. Building: Approximate age: /6’ yrs. Condition of surfaces: .D Clean Stained H Dirty H DamagedEvidence that maintenance results in discharge to storm drains (staining/discoloration)? H Y N H Don’t know Q

*Jndex: 0 denotes potential pollution source; L____J denotes confirmed polluter (evidence was seen)

A-5


El Do downspouts discharge to impervious surface? Y [EJ N 0 Don’t know 0 None visibleAre downspouts directly connected to storm drains? Y Q N 0 Don’t know

E4. Evidence of poor cleaning practices for construction activities (stains leading to storm drain)? 0 Y N 0 Can’t Tell 0F. TURE/LANrSCAPING AREAs 0 N/A (skip to part G) I Observed Pollution Source?1Fl. To of she with; Forest canopy i_To Turf grass C % Landscaping Q% Bare SoiLa% 0F2. Rate the turf management status: High 0 Medium 0 Low SF3. Evidence of permanent irrigation or “non-target” irrigation Y 0 N Can’t Tell CF4. Do landscaped areas drain to the storm drain system? Y N 0 Can’t Tell

ES. Do landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? 0 Y N 0 Can’t Tell 0G. STORM WATER INFRASTRUCTURE El N/A (skip to part H) I Observed Pollution Source? LGI. Are storm water treatment practices present? Y N C Unknown If yes. please describe: &;‘ 0G2. Are private storm drains located at the facility? Y C N Q Unknown



Sediment 02 03 04 05Organicmaterial Ci 02 03 04 05Litter 1 02 03 04 05

G3. Catch basin inspection — Record SSD Unique Site ID here: Condition: C Dirty 0 CleanH. INITIAL HOTSPOT STATUS - INDEX RESULTS

- [EJNot a hotspot (fewer than 5 circles and no boxes checked) 0 Potential hotspot (5 to 10 circles but no boxes checked)C Confirmed hotspot (10 to 15 circles andlor I box checked) C Severe hots )ot (>15 circles and/or 2 or more boxes checkedFollow-up Action:

0 Refer for immediate enforcemento Suggest follow-up on-site inspection0 Test for illicit discharge

Include in future education effortC Check to see if hotspot is an NPDES non-filerC Onsite non-residential retrofitC Pervious area restoration; complete PAA sheet and record


_____________________

Q Schedule a review of storm water pollution prevention plan

Notes:

C’’Ct1 9i..A 14no U\i-ipAc s

EZ. Parking Lot: Approximate age /0 yrs. Condition: 4J Clean Q Stained C Dirty C Breaking upSurface material Paved/Concrete C Gravel C Permeable C Don’t know 0

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Hotspot Site Investigation [Is! 14TERSHED: ?Qtrjni,c . SUBWATERSHED: (J1. I uNIQUESITEm: —6--LvJ—O2..

SE: h2/%o/ ID ASSESSED By: CAMERA ID: Pic#: 3o 5: y73rMAPGRID: LATHIO 1 ‘ (t.CTILONG’130/ •({(5 LMK#A. SITE DATA AND BASIC CLASSIFICATION

Name and Address: Category: , Commercial El Industrial Miscellaneous- El Institutional El Municipal El Golf Course

j El Transport Related Q Marinat* C *‘‘.. ) LA U El Animal Facility


NPDES Status: El Regulated 0 riwo v (U—c- Ct A CIOINDEX°Unregulated El Unknown

B. VEHICLE OPERATIONS ‘N/A (Skip to pan C) I Observed Pollution Source’.BI. Types of vehicles: El Fleet vehicles El School buses El Other:B2. Approximate number of vehicles:

B3. Vehicle activities (circle all that apply): Maintained Repaired Recycled Fueled Washed StoredB4. Are vehicles stored and/or repaired outside? C Y El N El Can’t TellAre these vehicles lacking runoff diversion methods? El Y El N El Can’t TellBS. Is there evidence of spills/leakage from vehicles? El Y El N El Can’t Tell

B6. Are uncovered outdoor fueling areas present? El Y El N El Can’t Tell

B7. Are fueling areas directly connected to storm drains? El Y El N El Can’t TellB8. Are vehicles washed outdoors? El Y El N El Can’t TellDoes the area where vehicles are washed discharge to the storm drain? El Y El N El Can’t Tell

OUTDOOR MATERIALS El N/A (Skip to pan D) Observed Pollution Sourc&(21. Are loading/unloading operations present? El Y N El Can’t TellIf yes, are they uncovered and draining towards a storm drain inlet? El Y El N El Can’t Tell

C2. Are materials stored outside? Y El N El Can’t Tell If yes, are they El Liquid Solid Description:Where are they stored? El grass/dirt area El concrete/asphalt El bermed area 1;- e-

C3. Is the storage area direcüor indirectly connected to storm drain (circle one)? Y El N El Can’t Tell 0C4. Is staining or discoloration around the area visible? El ‘i’ El N El Can’t Tell 0CS. Does outdoor storage area lack a cover? El Y El N El Can’t Tell 0C6. Are liquid materials stored without secondary containment? El Y El N El Can’t Tell 0C7. Are storage containers missing labels or in poor condition (rusting)? El Y El N El Can’t Tell 0U. WASTE MANAGEMENT El N/A (Skip to pan Observed Pollution Source’Dl. Type of waste (check all that apply): 1 Garbage El Consrruction materials El Hazardous materials 0D2. Dumpster condition (check all that apply): El No cover/Lid is open El Damaged/poor condition ElLeaking or

evidence of leakage (stains on ground) El Overflowing U,-°’DD3. Is the dumpster located near a storm drain inlet? Y El N El Can’t Tell

If yes, are runoff diversion methods (berms, curbs) lacking? El Y N El Can’t Tell

E. PHYSICAL PLANT El N/A (Skip to part F) I Observed Pollution Source?:.

El. Building: Approximate age: 50 yrs. Condition of surfaces: Clean El Stained El Dirty El Damaged 0Evidence that maintenance results in discharge to storm drains (staining/discoloration)? El Y N El Don’t know Q

°Index: 0 denotes potential pollution source; L__J denotes confirmed polluter (evidence was seen)

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Follow-up Action:Refer for immediate enforcement

El Suggest follow-up on-site inspectionQ Test for illicit dischargeØ Include in future education effortfl Check to see if hotspot is an NPDES non-filerfl Onsite non-residential retrofit

Pervious area restoration; complete PAA sheet and recordUnique Site ID here:

_____________________

Schedule a review of storm water pollution prevention plan

Notes:

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E2.Parking Lot: Approximate age yrs. Condition: CleanSurface material Paved/Concrete El Gravel fl Permeable

El Stained El Dirty Breaking upDon’t know 0

E3. Do downspouts discharge to impervious surface? Y El N LI Don’t know Q None visibleAre_downspouts_directly_connected_to_storm_drains? _Y__LI_N___Don’t_know 5o

E4. Evidence of poor cleaning practices for construction activities (stains leading to storm drain)? flY N El Can’t Tell 0F. TURF/LANDSCAPING AREAS N/A (skip to pan G) I Observed Pollution Source? IFL % of site with: Forest canopy Turf grass % Landscaping Bare Soil 0F2. Rate the turf management status: U High Q Medium C Low 0F3. Evidence of permanent irrigation or “non-target” irrigation fl Y C N U Can’t Tell 0F4. Do landscaped areas drain to the storm drain system? U Y C N U Can’t Tell 0F5. Do landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? U Y fi N Can’t Tell 0G. STORM WATER INFRASTRUCTURE U N/A (skip to part H) Observed Pollution Source?GI. Are storm water treamient practices present? LI” jJ N LI Unknown If yes, please describe: 0G2. Are private storm drains located at the facility? El Y N LI Unknown

Is u-ash present in gutters leading to storm drains? If so, complete the index below.


Sediment Lii 02 U3 USOrganic material 01 02 03 CsLitter fll 03 04 US

G3. Catch basin inspection — Record SSD Unique Site ID here: r-’ / / Condition: 0 Dirty U CleanH. INITIAL HOTSPOT STATUS - INDEX RESULTS

JZ Not a hotspot (fewer than 5 circles and no boxes checked) C Potential hotspot (5 to 10 circles but no boxes checked)C Confirmed hotspot (10 to 15 circles and/or 1 box checked) U Severe hotspot (>15 circles and/or 2 or more boxes checked)

A-6

Hotspot Site Investigation JJIHSTERSHED: lttQu Nt•J°’- C SURWATERSHED: LA/J1 J UNIQUE SITE m: Pci -.

•TE:/2cI o ASSESSEDBY: kMj? C.4MEIt&ID: Pic#: f2- —

MAPGRID: LATL0 13’ •31/tLONG7S0 j(z5ff LMK#


Name and Address: Category: [Commercial El Industrial Miscellaneous

“

Institutional fl Municipal El Golf Courset 5 Transport-Related Marina

El Animal FacilitySIC code (if available): Basic Description of Operation:

NPDES Status: J3”Regulated Qfl 3 II%])EX*El Unregulated El Unknown -.

B. VEHICLE OPERATIONS El N/A (Skip to part C) I

BI. Types of vehicles: Fleet vehicles El School buses El Other:

B2. Approximate number of vehicles: ‘Z-O

B3. Vehicle activities (circle all that apply): Maintained Repaired Recycled Fueled Washed Stored114. Are vehicles stored and/or repaired outside? ,1J Y C N El Can’t TellAre these vehiqles lacking runoff diversion methods? Y El N El Can’t Tell

B5. Is there evidence of spit lsfleakage from vehicles? El Y N El Can’t Tell

B6. Are uncovered outdoor fueling areas present? ElY [N El Can’t Tell flb\it è\B7. Are fueling areas directly connected to storm drains? Y El N El Can’t Tell118. Are vehicles washed outdoors? El Y N Can’t tellDoes the area where vehicles are washed discharge to the storm drain? El Y El N El Can’t Tell

OUTDOOR MATERIALS El N/A (Skip to pan D) Observed Pollution Source?CI. Are loading/unloading operations present? El Y El N Can’t TellIf yes, are they uncovered and draining towards a storm drain inlet? El Y El N 1Can’t Tell

C2. Are materials stored outside?)’Y El N El Can’t Tell If yes, are they Liquid El Solid Description: 51 L_Where are they stored? El grass/dirt area El concrete/asphalt bermed area — c1

(,L,:k” 4-,

C3. Is the storage area directly or indirectly connected to storm drain (circle one)? El Y N El Can’t Tell

C4. Is staining or discoloration around the area visible? El 1’ El N•

Can’t Tell

CS. Does outdoor storage area lack a cover? JI Y El N El Can’t Tell

C6. Are liquid materials stored without secondary containment? El Y N El Can’t Tell -“-—------.

C7. Are storage containers missing labels or in poor condition (rusting)? El Y N El Can’t Tell

P. WASTE MANAGEMENT ,El N/A (Skip to part E) I Observed Pollution Source?Dl. Type of waste (check all that apply): El Garbage El Construction materials El Hazardous materials 0P2. Dumpster condition (check all that apply): El No cover/Lid is open El Damaged/poor condition ElLeaking or

evidence of leakage (stains on ground) El OverfiowinP3. Is the dumpster located near a storm drain inlet? El Y N El Can’t Tell

If yes, are runoff diversion methods (berms, curbs) lacking? El Y El N. El Can’t Tell . —

E. PHYSICAL PLANT El N/A (Skip to part F) Observed Pollution Source? - -

El. Building: Approximate age: ‘7,0 yrs. Condition of surfaces: Clean El Stained El Dirty El Damaged 0Evidence that maintenance results in discharge to storm drains (staining/discoloration)? El Y El N El Don’t know Q

°Index: 0 denotes potential pollution source; denotes confirmed polluter (evidence was seen)

00000

A-S

Hotspot Site Investigation [

_______

£2. Parking Lot: Approximate age ?LO yrs. Condition: Clean LI Stained LI Dirty LI Breaking upSurface material Paved/Concrete LI Gravel LI Permeable LI Don’t know

E3.Do downspouts discharge to impervious surface? LI Y Q N Don’t know LI None visibleAre downspouts directly connected to storm drains? LI Y LI N Don’t know

£4. Evidence of poor cleaning practices for construction activities (stains leading to storm drain)? LI Y N LI Can’t Tell

F. TURF/LANDSCAPING AREAS fZ] N/A (skip to part G) I Observed Pollution Source?Ft. % of site with: Forest canopy Turf grass % Landscaping Bare Soil QF2. Rate the turf management status: LI High LI Medium LI Low 0F3. Evidence of permanent irrigation or “non-target” irrigation LI Y LI N LI Can’t Tell 0F4. Do landscaped areas drain to the storm drain system? LI Y LI N LI Can’t Tell 0F5. Do landscape plants accumulate organic matter (leaves, grass clippings) on adjacent impervious surface? LI Y N LI Can’t Tell 0

G2. Are private storm drains located at the facility? Y Q N LI Unknown rIs trash present in gutters leading to storm drains0 If so complete the index below


Sediment LIi LI2 LI3 LI4 LISOrganic material LII LI2 LI3 LI4 CsLitter flI fl2 LI3 LI4 LIS

G3._Catch_basin_inspection — Record_SSD_Unique_Site_ID_here:_________ Condition:_LI_Dirty__LI_CleanH. INITIAL HOTSPOT STATUS - INDEX RESULTS

LI Not a hotspot (fewer than 5 circles and no boxes checked) Potential hotspot (5 to 10 circles but no boxes checked)LI Confirmed hotspot ( 10 to 15 circles and/or 1 box checked) LI Severe hotsnot (>15 circles and/or 2 or more boxes checke&Follow-up Action:

fi Refer for immediate enforcementLI Suggest follow-up on-site inspectionLI Test for illicit dischargeLI Include in future education effort

Check to see if hotspot is an NPDES non-filero Onsite non-residential retrofitLI Pervious area restoration; complete PAA sheet and record


_____________________

Schedule a review of storm water pollution prevention plan

Notes:

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G. STORM WATER INFRASTRUCTURE LI N/A (skip to part H)

Gl. Are storm water treamient practices present? LI Y N Unknown If yes, please describe: L ..1—- c o

I Observed Pollution Source?

C

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A-6

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