HomeMy WebLinkAboutCDP 10-12; SMERUD RESIDENCE; SWPP ASSESSMENT; 2011-02-10c'r ;o--
0* lip Tier 2 Construction SWPPP Site Assessment Form
Project ID:
Project Information:
Project Name: R\ctO 5'MER'J 13 ELSMESCG
Project Address/Location, I uE.NPi \/ t 'i-i; IA) A"/
Responsible Parties/Contact Information:
Name of Preparer: RG merr S U K J4)
Qualification of Preparer (Registration/Certification): RC. a830 7.
.'
Address: l't R\GWT ?(SI
City/State/Zip Code: C.Ag(.,.S A 0, CA )Z p
PhoneNumber: 110O - ODo) O705B(V)
Name of Owner/Owner's Agent: 1ç(CAR.t) SMR D
Address: C8 3 frôe. 5 VLAc
City/State/ZipCode: cot4OitO1 CA 2OZS
Phone Number: '7 0-47A - JJOL
Name of Emergency Contact: Ri 5w. U D (during construction)
Address: Z83 P(oRs5 ]7L.-Ac
City/State/ZipCode: S0N(t)O CA )1OZ.'?
Phone Number: 77 (Q -_11 r 17b (
Pagel of 10
Tier 2 Site Assessment Form 3/24/08
Site and Construction Activity Description:
Construction Start Date: 'ii End Date: 5(15 J
If work begins in rainy season or extends into rainy season, explain how project work can be
scheduled can be altered to avoid rainy season impacts or to lessen exposure of site during rainy
season:
' lMTt}O 76H4V r)4€
UMtERR604O UTILITIES COMPL'r'cJ EOR 'T
FARY 'SEASOM IIEGNS
Grading Quantities: Cut: .C) CY; Fill: 34 C) CY; Import: 30 CY;
Export: e__CY
Any Stockpile Proposed? No If yes, then estimate quantity: CY
Estimated duration of stockpile: .i. A. Months
Soils types: 1Lrf t)
Does site contain apreponderance of soils with USDA-NRC S erosion factor kf greater than or
equal to 0.4? 140
Is a staging area proposed (yes/no)? ()
If yes, then where is it located?
Is concrete washout required (yes/no)? VETS
Where is it located? IN FRCt Q
Any existing site contamination (yes/no)? Na
Where is it located?
Any vehicle storage, maintenance or fueling area proposed (yes/no)?
Where is it located?
Any de-watering operation proposed (yes/no)? t4
Where is it located?
Any other special operations proposed that may impair water quality (yes/no)?
What and where?
Page2 of 10
Tier 2 Site Assessment Form 3/24/08
.0 Watershed Basin project drains to: I'uena Vista Lagoon 0 Agua Hedionda Lagoon
[1 Encinas Creek 0 Batiquitos Lagoon 0 Pacific Ocean
Is project drainage tributary to a CWA section 303(d) listed water body impaired for sediment
(includes Buena Vista and Agua Hedionda Lagoons) (yes/no): '1E.3
If yes, describe additional controls that will be used on project site to mitigate for sediment
impairments (if any):
zluv rEACS5i S1P.Av) WATTLE-5 k
EKTRAKCe ARt ALL ?OD, ITS IS
'LL 13A31 CALL/ FLA'r SO a1ôs0
rtL i ETL' KEDOCSTD .
Is project inside or within 200 feet of an Environmentally Sensitive Area (yes/no):
If yes, describe additional controls that will be used on project site to mitigate for potential storm
water impacts (if any):
.00
Are any agency permits required (yes/no)? N 0
Check off permit types required: 0 Army Corps 404 permit
O Regional Board Water Quality 401 Certification 0 Coastal Commission Certification
o U.S. Fish and Wildlife Section 7 0 Fish and Game Stream Alteration Agreement
0 Other list:
Page3 of 10
Tier 2 Site Assessment Form 3/24108
List materials that will be used on construction site and their handling and storage requirements
Material Characteristics/Toxicity Handling requirements
CEt13 s1ucco
PLAdE QN PA UelS T44 1E.
VLS\c. c(N€P.. tuj
co g ccQ.T LAJ44OUT AR\
?AtZ TO
iiii ce.ou cOj1ACT
__ EA PRoVtD M
coci1OJ D€8i
If any toxic or hazardous materials are proppsed, then a spill prevention plan is required. Is a
spill prevention plan required (yes/no)? t\
If yes, attach spill prevention plan.
Perceived Threat to Storm Water Quality rating:
Using the Construction Threat Assessment Worksheet (attached as Appendix C to Section 3
(Construction SWPPP Standards and Requirements) of the City Storm Water Standards Manual,
determine the projects Perceived Threat to Storm Water Quality rating.
The Construction Threat to Storm Water Quality rating for this project is: U High 1/Medium
Signature of Plan Preparer:
Signature:
Print Nam
Date: zjio) 11
Title: C;'q)L Ik)EU. Q
T?C Z8OZ
Attachments:
U Storm Water Compliance Form - Tier 2
U Spill Prevention Plan
U Hydrology and/or hydraulic study
U Solis and/or geotechnical report(s)
U Other. List:
Page4 of 10
Tier 2 Site Assessment Form 3/24108
0 BMP Selection:
The following tables are provided to help identify and select appropriate site specific BMPs for
the proposed project. Review the list of potential site construction activities and site conditions
described along the left hand column of each sheet. Then, for each activity or site condition that
is included in the proposed project, pick one or more of the BMPs described at the top of the
form and place an X(s) in the box(es) that form(s) an intersection between the activity/site
condition row and BMP column(s).
All structural (physical facility) BMP's should be shown on the site plan in the Construction
SWPPP drawing set. Any proposed no-structural BMP should be noted in the Special Notes on
the Construction SWPPP drawing set.
S
Page5 of 10
Tier 2 Site Assessment Form 3/24/08
I
R = 0 :3 0) 0
= Cu cu Ca - ca — C -.- - = -. a. Q. C) . ç) CD CD CD o >5ö-u LAJ 5 rr >C)ca) (0>
(J)
x
CD
— ~ CD R. CD Cu a -'Q >
4'
EC-1 Scheduling
EC-2 Preservation of
- - Existing Vegetation - --
EC-3 Hydraulic Mulch
EC-4 Hydroseeding
m
EC-5 Soil Binders Is
EC-6 Straw Mulch 0
0'
EC-7 Geotextiles & Mats
EC-8 Wood Mulching 2.
EC-9 Earth Dikes and ic Drainage Swales 0
------------- Cl)
EC-lO Velocity Dissipation
EC-1 I Slope Drains
EC-12 Streambank
Stabilization
EC-I3 Polyacrylamide
m
ic WE-1 Wind Erosion Control
cn.
CD
0
0
0000mCnQDCn-G)O
C) 0
o CD
- o -
CD
.>
(D(D M
- 0 .
0) 4' 4,
SE-1 Silt Fence
SE-2 Sediment Basin
SE-3 Sediment Trap
(D
SE-4 Check Dam CL
3 ----
-------
* SE-5 Fiber Rolls
C)
SE-6 Gravel Bag Berm o
Street Sweeping and SE -7 Vacuuming
IMI
----
SE-8 Sandbag Barrier
----
------- ______
SE-9 Straw Bale Barrier Cl)
r Storm Drain Inlet
T SE-1 0 Protection
SE-il Chemical Treatment
CD 00
0
a;
C) ()
0 1> CI)
U) ' — -' -'
ww-<0LA.
a ' CD
-
i.
CL C)
0 . 0 4,
w-.
- -
C,)
- - -
TR.1 Stabilized Construction ....(
Ingress/Egress C)
TR- 2 Stabilized Construcion
Roadway o
TR-3 Ingress/Egress Tire
Wash
9 omoom o.Qono.Q) U
-
'
-
1
omoQ0g
NS-1 Water Conservation Practices
NS-2 Dewatering Operations
NS-3 Paving and Grinding Operations
NS-4 Temporary Stream Crossing Z
NS-5 Clear Water Diversion
NS-6 Illicit Connection/Discharge
NS-7 Potable Water/Irrigation
NS-8 Vehicle and Equipment Cleaning
NS-9 Vehicle and Equipment Fueling
___ ------------- ________
NS-10 Vehicle and Equipment Maintenance CD
___ ------------- 3
NS-1 I Pile Driving Operations
NS-I2 Concrete Curing
1 NS-I3 Concrete Finishing
NS-14 Material and Equipment Use
NS-I5 Demolition Adjacent to Water
NS-16 Temporary Batch Plants
S S
OHC)Q)
-'
(D r øO.CD ) -•r- 50O5 -, (I) _D) CDOOOD >C) C)
g)o)CD o
3 rL Cn
5
wcnoimcncn -uOOor-
0 cfl_
co CD
0 CD
g
(0
CD
W g 0)
5 CL a U3 0
o
(0 U3 (D -n
WM-1 Material Delivery and Storage
WM-2 Material Use co
WM-3 Stockpile Management
- - fu
WM-4 Spill Prevention and Control
03
WM-5 Solid Waste Management
Om --
WM-6 Hazardous Waste Management W CL
WM-7 Contaminated Soil Management
go
j ) WM-8 Concrete Waste Management
WM-9 Sanitary! Septic Waste Management
0 ---
WM-1O Liquid Waste Management
Tier 2 Construction SWPPP Required Elements Checklist
Required Elements Required
Project
Preparer
for Verification
Construction SWPPP Drawing Set
1. Standard Storm Water Pollution Prevention Notes
General Site Management Requirements Notes
Rainy Season Site Management Requirements Notes
Erosion Control Hydroseeding, Planting and Irrigation Notes
Special site specific notes
2. City SWMP identification number affixed for high priority projects
3. Construction Threat to Storm Water Quality rating (high or medium
inspection frequency required?)
4. Regional Water Board WDID Number shall be affixed for small linear
utility projects as appropriate
5. Project Location
6. Legend
7. Description of work
Quantities (cut, fill, import, export)
Area of disturbance
Site conditions description
1) Soils type
8. Benchmark Information
9. Preparer's signature and seal as appropriate
10. City title block
11. Emergency contact name, company and phone number
12. Water shed project drains to listed
13. Site Plan
Existing topographic and cultural features of site and immediate
vicinity as appropriate
Scale and north arrow
Project boundary and property lines
Proposed grading contours and slopes clearly shown
quired Elements Checklist 3/24/08
C E. Staging areas, equipment storage, refueling, stockpiling and
maintenance areas identified
F. Storm drain inlets, open channels and natural drainages and
watercourses that flow onto or drain off of the project site clearly
delineated
G. Potential source points of pollutants (fueling locations, waste
container areas, wash racks, hazardous materials storage, etc)
H. Site access locations
I. Proposed BMPs - location and description
Perimeter controls
Erosion controls
Sediment controls
Tracking controls
Non-storm water management controls
Waste management and materials pollution controls
Additional controls (as needed)
Advanced treatment methods (as needed)
J. Toxic or hazardous material contamination or spill areas
K. Existing site BMP installations
14. BMP detail drawings as needed
Construction SWPPP Supplemental Documentation
Storm Water Compliance Form for a Tier 2 Construction SWPPP
completed and signed
Tier 2 Site Assessment Form completed and signed
Hydrology and hydraulic calculations (as needed for sediment
basins and sizing of drainage swales to handle drainage during
construction
Soils report (as needed when proposed BMP installation may affect
ground water, slope stability or other geotechnical site condition)
Page 2 of 2
Tier 2 Required Elements Checklist 3/24/08
C
0 Tier 2 Construction SWPPP Review Checklist
PROJECT ID NO.PROJECT NAME________________________________
PLANCHECKER DRAWING NO. DATE_____
1st
Chk
2nd
Chk
3rd
Chk
Mylar Comments
SS SS.SS
tONSTRUCTION SWPPPDRAWING
1. ALL SHEETS
A. Medium (to be reviewed at time of submission of final
plan check)
24"x36 mylar film with title block (Alternative
medium may be approved by Deputy City
Engineer or designee)
No sticky-back, glued or taped on or together
sections
Drawing with waterproof ink or photographically
reproduced
B. Drafting
Signed by the Qualified SWPPP Preparer
Marked with the name, address & telephone
number of the Qualified SWPPP Preparer
preparing the plan & date of preparation
Consecutively numbered & the total number of
sheets shown
Lettered in a neat & legible style no lettering
smaller than 1I8
Title with the name & discretionary permit
number of the City approval
Prepared to appropriate Scale(s)
Drawn as separate plans from Grading Plans,
Building Plans or Improvement Plans S
Use standard plans & details to maximum extent
Clearly designate between existing conditions &
work proposed
Scale noted, north arrow & bar scale provided
No duplication of any section or detail letter
designation.
2. TITLE SHEET
A. Erosion Control Notes Provided
Standard Notes
Supplemental special notes
B. Project Location
Legal description
Assessor's parcel number
Vicinity map (may be waived by Deputy City
Engineer or designee)
C. Legend
1) Symbols per County Standards
'1= Acceptable 7 = Unclear, Provide More Data NIA Not Applicable X Not Acceptable (provide reason for unacceptability In comment section)
her 2 Construction SWPPP checklist 3t24108
Page lof5
17J
S
TIER 2 CONSTRUCTION SWPPP - CHECKLIST DRAWING NO. PAGE: 2 OF5
1st
Chk
2nd
Chk
3rd
Chk
Mylar Comments
Every symbol used on the plans is shown in the
legend
Every symbol description clear & unequivocal
D. Description & Quantities of Work
Quantities for each item constructed or installed
per these plans
Erosion control Structural BMPs
Standard references fisted
E. Site Plan - (certain site plan requirements may be
waived for projects not requiring a
grading plan per the approval of the
Deputy City Engineer or designee)
Full project site area shown (on one sheet if
possible)
Adequate adjacent site area shown to clearly
indicate drainage courses that flow onto or off of
the site
Topography extends minimum 15 beyond limits
of work & over entire property
Existing contours and cultural features
(screened back - 60% matte)
Proposed contours and cultural features
Existing & proposed contours clearly
differentiated
Slope symbols used only on slopes 2:1 or
steeper
Degree of slope shown for all slopes
Fill slopes shaded
Proposed lot lines shown
Existing lot lines shown & dimensioned
Street name or designations
F. Drainage Facilities and Water Courses
Storm drains and inlets existing and proposed
Water courses and natural drainages shown
with arrows indicating direction of flow
Down drains
Paved swales & terrace drains shown with
arrows indicating direction of flow
Existing and proposed basins
G. Detail Drawings (Only when necessary. Generally refer
to CASQA reference drawings)
1) Modifications to standard drawings (CASQA or
others) should be detailed
H. Proposed Storm Water BMPs
BMPs shown in bold ink and clearly visible
BMP notes and identifiers bolded and clearly
shown
Acceptable ? = unclear, Provide More Data NIA Not Applicable X Not Acceptable (provide reason for unacceptablifty In comment section)
her 2 Construction SWPPP Checklist 3t2410 Page 2 of 5
TIER 2 CONSTRUCTION SWPPP - CHECKLIST DRAWING NO. PAGE: 3 0F5
1st 2nd 3rd M)lar Comments Chk Chk Chk
3) Proper CASQA (or other standard) designations
used
4) Perimeter control shown
Flows onto site contained or diverted
around construction area
Flows off-site mitigated through retention,
dissipation or other means
Perimeter sift fencing, fiber rolls or other
sediment control BMP for sloped areas or
areas of sheet flow
5) Erosion control shown
Existing vegetation preserved where
possible
BMP specified for all sloped areas 3:1 or
steeper
Minimize area and duration of exposed
soils
6) Sediment control shown
Basin or other appropriate BMP shown for
flat areas less than 3:1
Onsite and offsite inlets protected with
storm drain inlet protection, gravel bags or
other appropriate BMP
Onsite earth swales and water courses
protected with check dams, gravel bags,
fiber rolls or other appropriate BMP
Additional controls proposed for sites
draining directly to receiving waters
7) Tracking control shown
Umit vehicle and equipment access points
onto site
Stabilized construction entrance called out
on plan
8) Non-Storm Water Management BMP indicated
on plan
Vehicle and equipment fueling and
maintenance areas identified and
protected
Concrete Finishing and curing protections
9) Waste Management and Materials Control BMPs
Material Delivery and Storage BMPs indicated
Stockpile management BMPs indicated
Concrete mixer wash out BMP indicated
1. General Site Management
1) All weather access provide to basins and other
BMPs that require cleaning or maintenance
during rainy season
4 Acceptable 7 unclear, Provide More Data NIA Not Applicable X Not Acceptable (provide reason for unacceptability In comment Section)
1'Ier 2 Construction SWPPP checklist 312410$
Page 3 of 5
TIER 2 CONSTRUCTION SWPPP - CHECKLIST DRAWING NO. PAGE: 4 0F5
1st 2nd 3rd M4ar Comments
Chk Chk Chk
24 hour telephone number for emergency
erosion control person and name of specific
individual with authority and responsibility for
erosion control
Schedule for completion of installation of erosion
control facilities
Erosion control planting & method of starting &
maintaining growth (irrigation)
"Weather triggered" action plan for deploying
BMPs with 48 hours of a predicted rain
Description of standby BMP materials plan
J. Project Conditions of Approval (list if applicable.)
2)
3. ADDITIONAL PLAN SHEETS (Additional plan sheets as
required to adequately depict required BMP details or
depict the site plan with an appropriate scale to clearly
show all existing and proposed features)
II SUPLEMENTAL 1304jUMENTA1lON
STORM WATER COMPLIANCE FORM
(properly filled out and signed by Owner or Owner's
Agent including appropriate City approval initial)
COMPLETED SITE ASSESSMENT FORM
SPILL PREVENTION PLAN (as required)
SOILS/GEOTECHNICAL INVESTIGATION REPORT (As
needed for geotechnical safety. Follow format indicated
on Grading Plan Checklist when require
CALCULATIONS
(As needed for projects with sedimentation basins or
significant on-site/off-site drainage flows to determine
sizing of swales and potential for erosive velocities)
A. All
All pages numbered
Total number of pages on each page
Each page labeled with the name address &
telephone number of the preparing firm
Neat & legible
Indexed
In logical order
Cross-referenced to plans
Bound
Sturdy cover
Signed, sealed & dates of preparation and
expiration of registration applied on report cover
or on bound-in cover letter
Cover prominently labeled with subject, name &
number of the discretionary permit for the
project.
'/ Pceptabte ?-Unclear, Provide More Data NIA Not Applicable X Not Acceptable (provide reason for unacceptability In comment section)
Tier 2 construction SWPPP Checklist 3l248
Page 4 of 5
S
TIER 2 CONSTRUCTION SWPPP - CHECKLIST DRAWING NO. PAGE: 5 OF5
1st
Chk
2nd
Chk
3rd
Chk
M'1ar Comments
B. Hydrology Per San Diego County Standards
1) 1984 rainfall intensity curves
2) Appropriate value of C
3) Appropriate design method
U.S. Army Corps of Engineers HEC series
Soil Conservation Service Unit
Hydrography
Rational Method (Q=ClA) (0.5 sq. mile
max)
4) TI correctly completed
5) If correctly completed
6) Tccorrect
7) Six hour/24 intensities correctly balanced
8) Documentation provided or "plain english"
output for computer generated reports
C. Hydraulic
Documentation provided or "plain english"
output for computer generated reports
Clear copies provided or all charts, maps,
nomogrpahs or other graphic used
Cite general formula before inserting specific
values (i.e. Q=AV; 0=2.5 x 18 = 4.75 cfs)
7. ENGINEERS ESTIMATE (Needed only for projects with
grading plans. Follow grading plan checklist
requirements)
•
Additional Comments:
.AccepbIe ?=Unclear, Provide More Data NIA Not Applicable X • Not Acceptable (provide reason for unacceptablifty In comment section)
her 2 Construction SWPPP Checklist 3I248
Page 5 of 5
EN
G
I
N
E
E
R
I
N
G
DEP
A
R
T
M
E
N
T
fl