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AMinnesota Pollution Control Agency 520 Lafayette Road North 5t. Paul, MN 5 515 5 -419 4 Attachment A MS4 Annual Report for 2013 Municipal Separate Storm Sewer Systems [Ml Reporting period January 1, 2013 to December 31, 2013 Due June 30, 2014 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 ofyour status of compliance with permit conditions, including an assessment ofthe appropriateness ofyour identified best management practices (BMPs) and progress towards achieving your identified measurable goals for each ofthe minimum control measures as required by the MS4 Permit (permit). If a permittee determines that program status or compliance with the permit can not be adequately reflected within the structure ofthis form additional explanation and/or information may be referenced in an attachment. This form has limitations and provides only a snap shot of your 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 ofthe form, from the person that is duly authorized to certify this form. Al questions with an asterisk ( *) are required fields (these fields also have a red border), and must be completed before the form will send. A manual confirmation e-mail will be sent in response to electronic submissions. If you do not receive an e-mail confirmation within two business days, please contact the program staff below. (If the submit button does work for you, you can save a copy ofthe form to a location on your computer where you will easily be able to retrieve it. You will then have to attach the form separately to an e-mail once you are within your Internet mail.) If you have further questions, please contact one of these MPCA staff members (toll -free 800 -657- 3864): • Scott Fox 651- 757 -2368 scott.fox(o)state.mnms • Claudia Hochstein 651- 757 -2881 claudia.hochstein(o)state.mnms • Cole Landgraf 651- 757 -2880 cole. Ian dgraW_state.mn.us • Dan Miller 651- 757 -2246 daniel.miller(o)state.mn.us • Rachel Stang/ 651- 757 -2879 rachel.stanal(o)state.mn.us General Contact Information ( *Required fields) *NameofMS4: Citvof Roseville *Contact name: *Mailing address: 2660 Civic Center Drive *City: Roseville *State: MN *Zip code: 55113 *Phone (including area code). 651- 792 -7049 *E -mail: ryan .iohnson(o)ci.roseville.mn.us Minimum Control Measure 1: Public Education and Outreach [V.G. 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: Indicate which ofthe 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): Mediatype Number of media Number of times published Circulation/ Audience Example, Brochures: 3 dAferent brochures published 5 times about 10,000 Brochures: Newsletter: 7 6 times a year 17,600 Posters: Newspaper articles: 9 1 per week Utility bill inserts: Radio ads: Television ads: 9 1 per week Cable Access Channel: 9 ro rams 100 PSAs Other: City Bulletin Board 15 Slides Other: Roseville U 11 Other: www.pca.state.mn.us 651- 296 -6300 800 1 M651- 282- 5332or800 -657 -3864 • Available in alternative formats vq-strm4 -06 • 12119113 Prge 1 of5