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J atEO S)q� <br />Minnesota Pollution Control Agency i0 Minnesota Pollution <br />�y�ry PRO' NPDES /SDS Small MS4 Report Form Control Agency <br />L <br />The purpose of this report is to contribute information to an evaluation of the NPDES small municipal separate storm sewer <br />system (MS4) permit program. Consistent with 40 CFR §122.37 the U.S. Environmental Protection Agency is assessing the <br />status of the program nation -wide. A "no" answer to a question does not necessarily mean noncompliance with your permit or <br />with the federal regulations. In order to establish the range of variability in the program it is necessary to ask questions along a <br />fairly broad performance continuum. Your permitting authority may use some of this information as one component of a <br />compliance evaluation. <br />1. MS4 Information <br />City of Centerville <br />Name of MS4 <br />Dallas <br />Larson Administrator <br />Name of Contact Person (First) <br />(Last) (Title) <br />(651) 429 -3232 <br />dlarson @centervillemn.com <br />Telephone (including area code) <br />Email <br />1880 Main Street <br />® No <br />Mailing Address <br />❑ No <br />Centerville <br />MN 55038 <br />City <br />State ZIP code <br />What size population does your MS4 serve? 3900 <br />What is the reporting period for this report? (mm /dd/yyyy) From 01/01/2009 t 01/01/2010 <br />2. Water Quality Priorities <br />A. Does your MS4 discharge to waters listed as impaired on a state 303(d) list? ® Yes ❑ No <br />B. If yes, identify each impaired water, the impairment, whether a TMDL has been approved by EPA for each, and whether <br />the TMDL assigns a wasteload allocation to your MS4. Use a new line for each impairment, and attach additional pages as <br />necessary. <br />Impaired Water Impairment Approved TMDL TMDL assigns WLA to MS4 <br />Clearwater Creek Aquatic macroinvertebrate & ❑ Yes ® No ❑ Yes ❑ No <br />MN07010206519 <br />fish bioassessments <br />❑ Yes <br />❑ No <br />❑ Yes <br />❑ No <br />Centerville Lake <br />Nutrient/Eutrophication <br />❑ Yes <br />® No <br />❑ Yes <br />❑ No <br />MNO2- 0006 -00 <br />biological indicators <br />❑ Yes <br />❑ No <br />❑ Yes <br />❑ No <br />George Watch Lake <br />❑ Yes <br />® No <br />❑ Yes <br />❑ No <br />MNO2- 0005 -00 <br />❑ Yes <br />❑ No <br />❑ Yes <br />❑ No <br />Peltier Lake <br />❑ Yes <br />® No <br />❑ Yes <br />❑ No <br />MNO2- 0004 -00 <br />❑ Yes <br />❑ No <br />❑ Yes <br />❑ No <br />C. What specific sources contributing to the impairment(s) are you targeting in your stormwater program? <br />construction sites <br />D. Do you discharge to any high - quality waters (e.g., Tier 2, Tier 3, outstanding natural resource 0 yes ® No <br />waters, or other state or federal designation)? <br />E. Are you implementing additional specific provisions to ensure their continued integrity? ❑ Yes W3 No <br />