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<br />ANNUAL REPORT for 2008 <br /> <br />MUNICIPAL SEPARATE STORM SEWER SYSTEMS (MS4s) <br />Reporting period January 1, 2008 to December 31, 2008 <br />Due June 30, 2009 <br /> <br />USE OF THIS FORM IS MANDATORY By completing this Annual Report form, you are providing the Minnesota <br />Pollution Control Agency (MPCA) with a summary of your status of compliance with permit conditions, including an <br />assessment of the appropriateness of your identified best management practices (BMPs) and progress towards achieving <br />your identified measurable goals for each of the minimum control measures as required by the MS4 Permit. If an MS4 <br />determines that program status or compliance with the permit can not be adequately reflected within the structure of this <br />form additional explanation and/or information may be referenced in an attachment. This form has significant limitations <br />and provides only a snap shot of MS4 compliance with the conditions in the Permit. After reviewing the information <br />MPCA staff may need to contact the MS4 to clarify or seek additional information. MPCA enforcement policy is to <br />provide the opportunity to respond to any alleged violations before any enforcement action is taken. <br /> <br />Submit your annual report by June 30, 2009 to: <br /> <br />Minnesota Pollution Control Agency <br />Municipal Division <br />520 Lafayette Road North <br />St. Paul, MN 55155-4194 <br /> <br />This Annual Report may be submitted electronically via email to the MPCA MS4 Program mailbox: <br />ms4permitla),pca.state.mn.us. If submitting electronically, this form must be sent via email from the person that is duly <br />authorized to sign this form under the Owner/Operator Certification section. A confirmation email will be sent in <br />response to electronic submissions. If you would like to obtain an electronic copy of the MS4 Annual Report for 2008 <br />orm, please visit: www.pca.state.mn.us/water/stormwater/stormwater-ms4.html. <br /> <br />fyou have further questions, please contact one of these MPCA staff members (call toll-free 800-657-3864). Note new <br />numbers effective November 2008: <br />. Keith Cherryholmes 651-757-2270 <br />. Joyce Cieluch 218-846-7387 <br />. Scott Fox 651-757-2368 <br />. Amy Garcia 651-757-2377 <br /> <br />City of Centerville <br />Name ofMS4 <br />Dallas Larson <br />Name of Contact Person <br />651-429-3232 <br /> <br />Telephone (including area code) <br />1880 Main Street <br />Mailing Address <br />Centerville <br />City <br /> <br />dlarson@centervillemn.com <br />Email Address <br /> <br />MN <br />State <br /> <br />55038 <br />ZIP code <br /> <br />wq-strm4-06 <br /> <br />Page I of7 <br />1 <br /> <br />12/08 <br />