2014-05-27_PWETC_AgendaPacket - Laserfiche WebLink

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F. *For each BMP below, indicate the total number within your MS4, how many of each BMP type were inspected and the percent inspected during the reporting period. Enter "0" if your MS4 does not contain BMPs or none were inspected. Enter "NA" if the data does not exist: Structure /Facility type *Total number I *Number inspected I *Percentage *Outfalls to receiving waters: 371 114 30.7 *Sediment basins/ponds: 0 0 0 *Total 371 117 30.7 G. Of the BMPs inspected in F.. above, did you include any privately owned BMPs in that number? ❑ Yes No H. If yes in G.. above, how many: Section 7: Impaired Waters Review ( *Required fields) The permit requires any permittee whose MS4 discharges to a Water of the State, which appears on the current U. S. Environmental Protection Agency (EPA) approved list of impaired waters under Section 303(d) of the Clean Water Act, review whether changes to the SWPPP may be warranted to reduce the impact of your discharge [Part IV.D]. A. *Does your MS4 discharge to any waters listed as impaired on the state 303 (d) list? ® Yes ❑ No B. *Have you modified your SWPPP in response to an approved Total Maximum Daily Load (TMDL)? ❑ Yes ❑X No If yes, indicate for which TMDL: Section 8: Additional SWPPP Issues ( *Required fields) A. *Did you make a change to any BMPs or measurable goals in your SWPPP since your last report? [Part VI.D.3.] B. If yes, briefly list the BMPs or any measurable goals using their unique SWPPP identification numbers that were modified in your SWPPP, and why they were modified: (Attach a separate sheet if necessary) C. *Did you rely on any other entities (MS4 permittees, consultants, or contractors) to implement any portion of your SWPPP? [Part VI.D.4] If yes, please identify them and list activities they assisted with: Owner or Operator Certification ( *Required fields) ❑ Yes ❑X No ❑ Yes ❑X No The person with overall administrative responsibility for SWPPP implementation and permit compliance must certify this MS4 Annual Report. This person must be duly authorized and should be either a principal executive (i.e., Director of Public Works, City Administrator) or ranking elected official (i.e., Mayor, Township Supervisor). ❑ *Yes - / certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete (Minn. R. 7001.0070). / am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment (Minn. R. 7001.0540). *Name of certifying official: *Title: *Date: w ww. pca. state. mn. us wq- strm4 -06 • 12119113 (mmiddiyyyy) 651- 296 -6300 800 - 657 -3864 TTY 651- 282 -5332 or 800 - 657 -3864 • Available in alternative formats Page 5 of 5