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~ Alameda Countywide Clean Water Program EXH I 8 IT Q Municipality: _________________ _ <br />clean water Standard Stormwater Treatment BMP Inspection Report Form Facility has closed, or Facility Information has changed: 0 yes 0 no Date: ____________________ _ <br />Reason for Inspection: D First Inspection D Routine Inspection D Response to Complaint 0 Follow-up I Follow-up Inspection Due: <br />NAME OFFACILITY: SITE ADDRESS: ID#: <br />CONTACT NAME: I PHONE: BUSINESS TYPE! ACTNITY: I SIC: Map Code: <br />Is the property owner different than the facility owner? D yes D no I If yes, complete the following: I NAME: I CONTACT: I PHONE· I <br />MAILINGADDRESS: TITLE: . L . ocatton: <br />ls the BMP Operator different than the facility owner? D yes D no If yes, complete the following: <br />NAME: <br />MAILING ADDRESS: <br />CONTACT: <br />TITLE: I PHONE: <br />Needed maintenance noted for the TreatmentBMPs below shall be completed within 30 days and notification of correction faxed, emailed or mailed to the oversight agency. <br />Treatment BMP Type <br />(Numbers in parentheses <br />correspond to fact sheets in <br />CASQA's New Development <br />Handbook) <br />Vegetated Swale (TC-30) <br />Extended Detention Basin <br />(TC-22) <br />Bioretention Facility (TC-32)/ <br />Flow-Through Planter <br />Vortex Separator(MP-51) <br />Infiltration Basin (TC-11) <br />Water Quality Inlets -Oil/ <br />grit/water Separator (TC-50} <br />Media Filters -Sand Filters <br />(TC-40) <br />Drain Inserts (MP-52) <br />Pervious Paving (SD-20) -Note <br />pavement type in Comments <br />Drain Inlet Signage (SD-13) <br />j <br />~ ] <br />c.. " ~ Q <br />~ ! > "' <br />0 "' z ?< <br />"' "' "' 0 = :i:: "' --c:: .E " --0 ~ ~ <br />] <br />"' g <br />]~ <br />N C:: "' .... :i:: t!l <br />.... <br />0 "° c:: c:: <br />0 ·-·en ~ <br />0 0 .... <> ~ C'll <br />t:· T <I· : <br />I <br />I > <I /I > I < :I <br />"' -> c:: ·-" g; El <br />8:;:; <br />>< " ~ C'll <br />~ <br />§ . ., <br />:;:; <br />8~ ,..._ <br />".J:J ;§ :~ <br />' <br />._ .... , ..... , <br />.::)!.:((}f:tt <br />1S ... ":::: E cs <br />"C'll Ee -~1 <br />;:i:"' = E ~8 <br />.;; 16 e a E-< <> <br />i'l~ "° 0 "',,. E " "' ., o~ <br />1-::>:::.::,·.'.'. <br />., <br />":::: c:: 6·,g ~:;:; <br />"c:: :S8 <br />if :::: <.!l~ ;~ <br />"§ .; <br />"' B "., <br />C'll "° <br />Needed Maintenance <br />-~ <br />~ .3 .. <br />8 <br />! :::: <br />~ <br />] <br />C'll <br />~ <br />5 <br />1i <br />-~ = "' ~o <br />0 1;l <br />:::!! ..:1 <br />.~ -.; = $ <br />"' ~ <br />;:i: ~ <br />0 .... -c.. i:... C'll <br />l5 <br />~ <br />~ <br />:::: § <br />0 ·= >"' ·u; Q) <br />~ ~ ..:1 ;> <br />-~ .5 "$. .,o <br />"°"' "'v ;> .... <br />.... " 0 > 0 0 i:i..U <br />.,g 0 ~§ c:: ~ <br />.§ -~ -~ -~ <br />h Q,) = ~ l'l~S'Cl~~ "'d d) 0 ~ "c:I ~Q u ;> 0 <br />I I I I I I <br />l><.i <br />;.:··: <br />I I l:c<<I <br />I I I <br />I ·.-..:>r;>: <br />COMMENTS/REMARKS/REQUIREMENTS: Stormwater treatment BMP destroyed or eliminated? D yes D no Maintenance required in storm drain system? 0 yes D no <br />Pervious Pavement Type(s}: D porous concrete D porous asphalt 0 concretefstone pavers 0 grid pavers 0 grid pavers with turf <br />Number ofBMP Brochures Distributed Describe: <br />PRIORITY FORRE-INSPECTION: D I.First 0 2.Second D 3.Third <br />ENFORCEMENT: DNone D Verbal Notice 0 WarningNotice D AdministrativeAction 0 Administrative Action w/ Penalty &/or Cost Recovery <br />*"'d.. = !1) <br />CD ·-0 ~ ~ ~ f: 0 ~ ::s u ~!1 ~Cf.l <br />1:1 ~-=a:= ~ = OJ)~ a cu ~~th~.£~ >o c.o> ~> ~~ <~ ~~ <br />·::·'.:::-.c•:1 <br />I . <br />.. ~· .. <br />D See attached for more comments. <br />D Legal Action <br />O&M Representative: Inspector: __________________________________ _