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Minnesota Pollution MS4 Annual Report for 2012 Control Agency Control R Municipal Separate Storm Sewer Systems (MS4s) 52 Paul, MN 551 oad Road North 4 orth Reporting period January 1, 2012 to December 31, 2012 Due June 30, 2013 Doc Type: Permitting Annual Report Instructions: By completing this mandatory MS4 Annual Report form, you are providing the Minnesota Pollution Control Agency (MPCA) with a summary of your status of compliance with permit conditions, including an assessment of the appropriateness of your identified best management practices (BMPs) and progress towards achieving your identified measurable goals for each of the minimum control measures as required by the MS4 Permit. If a permittee determines that program status or compliance with the permit can not be adequately reflected within the structure of this form additional explanation and /or information may be referenced in an attachment This form has significant limitations and provides only a snap shot of MS4 compliance with the conditions in the permit. After reviewing the information, MPCA staff may need to contact the permittee to clarify or seek additional information. Submittal: This MS4 Annual Report must be submitted electronically to the MPCA using the submit button at the end of the form, from the person that is duly authorized to certify this form. All questions with an asterisk ( *) are required fields (these fields also have a red border), and must be completed before the form will send. A confirmation e-mail will be sent in response to electronic submissions. If you have further questions, please contact one of these MPCA staff members (toll -free 800 - 657 - 3864): • Scott Fox 651- 757 -2368 scott.foxAstate.mn.us • Claudia Hochstein 651- 757 -2881 claudia.hochstein(a)state.mn.us • Cole Landgraf 651- 757 -2880 cole.landaraf(astate.mn.us • Dan Miller 651- 757 -2246 daniel.miller(cDstate.mn.us • Rachel Stang/ 651 - 757 -2879 rachel.stangl(a-state.mn.us General Contact Information ( *Required fields) *Name of MS4: ' CL r' ' &,AL.-I *Contact name: A.1 L.aavj *Mailing address: I rq-D /yyH.y�. Si *City: ca'Jl JL u - *State: {M N *Zip code:: _ .r6VjY *Phone (including area code): ('46 - 3 ?. 3 *E -mail: �gISar - Cel (1-0". c,a/n Minimum Control Measure 1: Public Education and Outreach [V.G.1 ] ( *Required fields) A. The permit requires each permittee to implement a public education program to distribute educational materials to the community or conduct equivalent outreach activities about the impacts of stormwater discharges on water bodies and steps that the public can take to reduce pollutants in stormwater runoff. [Part V.G.1.a] Note: Please indicate which of the following distribution methods you used. Indicate the number distributed in the spaces provided (enter "0" if the method was not used or "NA" if the data does not exist): Circulation/ Media type Number of media Number of times published Audience Example: Brochures: 3 different brochures published 5 times about 10,000 Brochures: 6 Newsletter: (1 Posters: 0 Newspaper articles: 6 Utility bill inserts: rd Radio ads: r) Television ads: Cable Access Channel: Other: Other: Other: www.pca.state.mn.us 651 - 296 -6300 800 -657 -3864 TTY 651- 282 -5332 or 800 - 657 -3864 Available in alternative formats wq- strm4 -06 • 112312013 Page 1 of 5 2