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SAMPLE ANNUAL REPORT <br />Treatment Measure Operation and Maintenance <br />Inspection Report to the <br />City Engineer <br />City of San Leandro <br />835 East 14th Street <br />San Leandro, CA 94577 <br />This report and attached inspection checklists document the inspection and maintenance conducted for the <br />identified stormwater treatment measure(s) subject to the Maintenance Agreement between the City and the <br />property owner during the annual reporting period indicated below. <br />I. Property Information: <br />Property Address or APN: 2001 Williams Street, San Leandro, CA <br />Property Owner: DCT Williams Street LLC <br />077 A-0700-022-00 <br />II. Contact Information: <br />Name of person to contact regarding this report:._T"'-e""rr""'i'-'A'-=ll""'en'"'------------------- <br />Phone number of contact person: (949) 219-1242 Email: tallen@dctindustrial.com <br />Address to which correspondence regarding this report should be directed: <br />12 Corporate Plaza, Suite 150. Newport Beach, CA 92660 <br />Ill. Reporting Period: <br />This report, with the attached completed inspection checklists, documents the inspections and maintenance <br />of the identified treatment measures during the time period from January 1 to December 31 , ___ . <br />IV. Treatment Measure Information: <br />The following stormwater treatment measures (identified treatment measures) are located on the property <br />identified above and are subject to the Maintenance Agreement: <br />Identifying Type of Treatment Measure Location of Treatment Measure on the <br />Number of Property <br />Treatment <br />Measure <br />11 <br />K:IOAK_LDEV\197051001 -Williams Street-OCT San Leandro\KHA Reports & Documents\Stormwater\O&M\O&M Agreement_Williams.doc