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Home My WebLink AboutPermit File BLD-2021-1022 2213 12th Street (3)�ko 'Co"R � FIELD Storm Water Minimum Requirements #2 ENGINEERING DEPARTMENT 904 G`h Street Anacortes, WA 98221 Official Use Only: (information to Inspectors) Required Storm Water Facility and other related requirements: w%"v.anacorteswa. ov C154 Concrete washout will be required, or trucks to be returned to yard or cleaning. Project Address:5�— Parcel Number: Permit Number: FRONT OF REPORT Submittal Checklist: Submittal Date: 12 Revision Number: Acceptance Date (COA): 12/21/2021 Reviewer: Rob F. o TAB 1 - Drainage Analysis — Minimum Requirement #2 a APPENDIX 1 - Survey performed by a Professional Land Surveyor o APPENDIX 2 - Model Soil Management Plan for BMP T5.13 o APPENDIX 3 - Determining Construction Site Sediment Damage Potential (Appendix 7) o APPENDIX 4 - Site Plan with all applicable information (Minimum Size 11x17 — 30 scale) o APPENDIX 5 - Documented Site Photos (North, South, East and West) Proiect Description: (What is it you are looking to do? Provide details regarding, but not limited to, Lot SF, Home SF, Now and Replaced Hard Surface) Existing Site Conditions Summary: (Additionally, provide information on previous permits, if any, like Grade and Fill, Clear and Grade, topography, vegetation, drainage, Critical Areas adjacent to the site and hay it may affect this project if soils are disturbed, Soils Type (Included in Solis Analysis Report}, Erosion Problem Areas, Construction PhasinglSequence ) ,W Version Date: December 19, 2018 13 ElemeMs of SWPPP (Construction Stormwater Pollution Prevention Plan) Please check off boxes to show that each element has been read and understood. Provide details where applicable and if certain aspects are unnecessary or exempt, clearly justify. Details of the 13 Elements and the correlating BMPs are listed Above from the 2014 Stormwater Management Manual for Western Washington (SWMMW W). A link is provided on the City of Anacortes website, under Planning, Community, &Economic Development Department, as well as under Stormwater on the Engineering Division of Public Work's page. Owner Name: �n � W; „ �r�-c.r 5 on Site Address: 2 2 r 3 17_ '� S�-. //;; � Prepared By:� n,,. Qua c� L.e�� U/an'nnl Co1.Y-Fr��-1� �� L � �� The Stormwater checklist or building permit determined that: r�The 13 elements must be addressed ❑ These elements must be addressed for construction activity adding under for construction activity adding 2,000 2,000 sq. ft. of hard surface area. sq. ft. or more of hard surface area. This means that an attached narretive and site plan are required with this document. Under each element, explain the best management practices (BMPst used or iustifv reasoning for those that will not be used. If needed. please attach a narrative to further explain plans or justification. ELEMENT 1: Preserve Vegetation/Mark Clearing Limits 9' Before beginning land disturbing activities, including clearing and grading, clearly mark all cleadng limits, sensitive areas and their buffers, and trees that are to be preserved within the constuction area. La' Retain the duff layer, native top soil, and natural vegetation in an undisturbed state to the maximum degree practical. AJo M4\ � C (cti� nGG�SSAry C)�St� ✓ L.r C t.iP 4c 4� c 5 W� C<r•-c r+�ro t c-r � �C� P�n��7 Version Date: December 19, 2018 Develoaed Conditions Summary: (Additionally, to be shown on the site plan. Identify cut and fill areas, proposed slopes of all hard surfaces , proposed contours) Ns c 1, w -, a. s /-ti h.- n-, a.�le I G �.' � t-.'„�r�_�r,,� Site Sediment Transport Score: ��Total Points (High\Low) (See Determining Construction Site Sediment Damage Potential (Appendix 7) Complete the Applicability Requirements —Flow Chart (Figure I-2.4.1 Attached, Figure I-2.4.2 Attached and Figure I-2.5.1 Attached) - Highlight the path and attach DOE Stormwater Management Manual Minimum Requirements: (MR#1 to MR#5 only). Refer to the 2012 Department of Ecology Manual, as amended in 2014 for further required information. Version Date: December 19, 2018 Stark Here Cores the site have 35% Yes see Redeveapment Minimum or more of existing Requirements and Flow Chart impervious coverage? (Fpure I-2.4.2). No Ooes the project woven 3, acres or more of vegetatan to Does the project result in lawn ar landscaped areas, a 5.000 square feet, or o woven 2.5 acres or more of greater, of new plus native vegetation b pasture? replaced hard wrface area? NO Yes Yes Does the project result in 2.000 square feet, or greater, of new plus replaced hard wrface area? Yes No Does the project have land tlisturbing activities of 7,000 Yef square feet or greater? �No Minbnum Requirement N2 applies. Figure I-2.4.1 Flow Chart for Determining Requirements for New Development DEP�RTM ENT OF RevKed .tune 2g 15 ECOLOGY �iease see nrtp:�MNw ecy.wa govrcopyrprtt.nrmrfor copyngnt nonce lnclWing penntulons, .'atl at washing[on nitatpn MllaDlltty. YlO dlbClamer. All Minimum Requirements appy to Me new and replaced hard surfaces and converted vegetation areas. Minimum Requirements #1 through N5 appy to the new and replaced hard surfaces and the land disturbed. Minimum Requirements #1 through N5 appy to the new and replaced hard surfaces and the land disturbed. verson uate: uecemoer tor, �uta TAB 2 (MINIMUM REQUIREMENT #2) 1-2.5.2 Minimum Requirement #2 —Construction Stormwater Pollution Prevention Plan (SWPP) - All projects are required to complete Minimum Requirement 2. - Refer to the 13 Elements of the SWPP (See document below, complete and attach) - See attached Table 4.1.1, Table 4.2.1 and Table - Provide Engineering Calculations as an attachment for Sediment Ponds\Traps, Diversions, Waterways and Runoff/Stormwater Detention Calculations. Version Date: December 19, 2018 Ta61e 4.1.1 Source [ontrol BMP'B by SW PPP FlPment Element el flenunl03 Ebrrem/5 Elemem gfi Ebmenl e9 Ebnun1 e11 EMIreMe12 Elemem MJ BMPorEbmem Heme Prererve EaublleM1 gYbgke Purecr Control Meinuin NmegelM1a Proucl Low VegmnbnR.lmh Conarrunbn Sob Sbpes Pollutmla BMPe Pulecl Inpen BMPC101:Pmarving Neutral WgmMlon ✓ BMP CLOT BWhr Zones ✓ ✓ BMP C103: Nigh KlblEry Pketk er Yalel ✓ ✓ Fence BMP CtOg: Mebgbetl Conahuclbn ✓ Enlrmce/EW BMP C106: Wheel Wmh ✓ BMP C10]: Cenmm�bn RoetllPmbOp ✓ Nee gubglzetlen BMP C130: Temporeryentl Perrlmem ✓ ✓ gaeCing BMP C131: MukM1mg -✓ ✓ BMP C133: Nab ntl BleNeu ✓ ✓ BMP CI3I: Plmgc Covering ✓ BMP C13d: gotltlkg ✓ BMP C130: Topeollhy lCemposrhg ✓ BMP CiM: PolyecrylrAtla M goll Erosbn ✓ Prmedbn BMP CIJO: Surlse Roughening ✓ ✓ BMP CIN: GrtlkM Teases ✓ ✓ BMP CidO: Busl Control ✓ BMPC150: Mmarbb On Hentl ✓ ✓ BMP [151: Concrma HentllNg ✓ BMP C153: Sencmlilg antl SUHacbg ✓ PoOmbn Pmvantlon BMP CiSI: Mmerbl OeOvery,Surege entl ✓ ConWnnlenl BMP C151: Concurs Wuhout Nee ✓ BMP C1fip. CeM1060 Erabn antl ✓ ✓ seamemc°mYn.ea BMP [1fiI: Schetlu0ng ✓ Version Date: December 19, 2018 Table 4.2.1 Runoff Conveyance and Treatment BMP's by SWPPP Element EYmaAEf Ia.n.Nw BamMFE EbmeNA eemnew BensMq FbmmtOM EbaeMwT BMP ar EbnsN Nnm � GMEroI fmYll Probct PfvtaU EbblMs CsntnN CarM1clDr �t t'� PbalRNsn MdMMr Slopac 0.nln lrMh C � „ PaiMib VhbrlM I cTpO: FYrtePbr DM aW 8r�b ✓ ✓ P C7At: GrawUrotl Charuab ✓ P C9PT: Chaa[I LNiq ✓ v tm�: wwrea. ✓ ✓ BMP C]IN: Pd1O BIOM DANa ✓ BMvcam: aoea.r»naha - ✓ BMPCA UVN BpnMw ✓ bMP CaA: Checl Dais ✓ ✓ BMI GIW: TrlapJa OEI Oqs IDacicalEv ✓ J Encavntl Check Dn� BMP Cab: OuNN Pnbatios � ✓ BMP CYYB: 91pM Dnln Inbt ProbegaF ✓ BMP Cf31: Mud�Bsrbr ✓ ✓ BMP C73L DnwlFFbr BcrM ✓ BMP CTSk SEt Pecro ✓ ✓ BMP CP]k WpabYtl Bblp ✓ ✓ BMP C]f6: Wdbc ✓ MP C]Sk W DIMIw Flltstion ✓ � � � — `_ MP C71k 6vtlimont Trap ✓ ✓ � BMP C3N: Tampersry 6nd•1MM PaM ✓ ✓ BMP CMP. COrrtructlOn SIOmMbf CMxtlelTnMmN `� ernr cxucwalrucuon atoDatar � FMrNIOP ✓ BMP CTft HbD pH MWraRatlan W11P Dr ✓ BMP Ct6b: pN tanbdftt Hlph pH PYbI ✓ Version Date: December 19, 2018 ELEMENT 2: Establish Construction Access s� Limit construction vehicle access and exit to one route, if possible. B' Stabilize access points with a patl of quarry spalls, crushed rock, or other equivalent BMPs, to minimize tracking onto roads. � Locate wheel wash or fire baths on site, if the stabilized construction entrance is not effective in preventing tracking sediment onto roads. ty If sediment is tracked off site, clean the affected roadway thoroughly at the end of each day, or more frequently as necessary (ex: wet weather). Remove sediment from roads by shoveling, sweeping, or pick up and transport the sediment to a controlled sediment disposal area. 4V Conduct street washing only after sediment is removed in accordance with the above bullet. C3�Control street wash wastewater by pumping back on site or otherwise preventing it from discharging into systems tributary to waters of the State. �1.��r .Sh`+� u1�.t.i-c 'Lty a ...clrt �- .L. -A�c« e , !F� Sd-.� 5 � � a. A.�a,.,ir., _ 1r.'rt Sa-w-t-� dL� m c �- Lc� �' •�� ✓r!- nF� f�T ELEMENT 3: Control Flow Rates � Protect properties and waterways downstream of development sites from erosion and the associated discharge of turbid waters due to increases in the velocity and peak volumetric flow rate of stormwater runoff from the project site. � Where necessary to comply with the bullet above, construct stormwater retention or detention facilities as one of the first steps in grading. Assure that detention facilities function properly before constructing site improvement (e.g. impervious surfaces). B' If permanent infiltration ponds are used for Flow cenVol during construction, protect these facilities from siltation during the constmction phase. �/5! th' v r�+dJ[e5 � 9n rl (, ,eS .S S '/: lac c a� ,fl, S �Fhzu �. {-t.i_ �..'FLL. kcr_p S..'4 �-Sf„iAa-.cam io .. ;.: .� Version Date: December 19, 2018 ELEMENT 4: Install Sediment Controls rY Design, install, and maintain effective erosion controls and sediment controls to minimize the discharge of pollutants. L� Construct sediment control BMPs (sediment ponds, traps, filters, etc.) as one of the first steps in greding. These BMPs shall be functional before other land disturbing activities take place. L� Minimize sediment discharges from the site. The design, installation and maintenance of erosion and sediment controls must address factors such as the amount, frequency, intensity and duration of precipitation, the nature of resulting stormwater runoff, and soil charactedstirs, including the range of soil particle sizes expected to be present on the site. �J Direct stormwater runoff from disturbed areas through a sediment pond or other appropriate sediment removal BMP, before the runoff leaves a construction site or before discharge to an infiltration facility. Runoff from fully stabilized areas may be discharged without a sediment removal BMP, but must meet the flow control performance standard in Element #3, bullet #1. Ei Locate BMPs intended to trap sediment on-ske in a manner to avoid interference with [he movement of juvenile salmonids attempting to enter offchannel areas or drainages. [� Provide and maintain natural buffers around surtace waters, direct stormwater to vegetated areas to increase sediment removal, and maximize stormwater infiltration. ✓� Where feasible, design outlet structures that withdraw impounded stormwater from the surtace to avoid discharging sediment that is still suspended lower in the water column. _yL4. L✓<r)JZiS SmeJR�wS .b S.'/��,...ce t,.Lv �GrJe r) ,o /c�c I ELEMENT 5: Stabilize Soils � Stabilize exposed and unworked soils by application of effective BMPs that prevent erosion. Applicable BMPs include, but are not limited to: temporary and permanent seeding, sodding, mulching, plastic covedng, erosion control fabrics and matting, soil application of polyacrylamide (PAM), the early application of gravel base early on areas to be paved, and dust control. Control stormwater volume and velocity within the site to minimize soil erosion. d Control stormwater discharges, including both peak flow rates and total stormwater volume, to minimize erosion at outlets and to minimize downstream channel and stream bank erosion. � Soils must not remain exposed and unworked for more than the time periods set forth below to prevent erosion. o During the dry season (May 1 —Sept 30): 7 days o During the wet season (Oct 1 —Apr 30): 2 days Stabilize soils at the end of the shift before a holiday or weekend'rf needed based on the weather forecast. ❑' Stabilize soil stockpiles from erosion, protect with sediment trapping measures, and where possible, be Version Date: December 19, 2018 located away from storm drain inlets, waterways, and drainage channels. d Minimize the amount of soil exposed during construction activity. [3� Minimize the disturbance of steep slopes. [.Y Minimize soil compaction and, unless infeasible, preserve topsoil. ELEMENT 6: Protect Slopes B' Design and construct cut -and -fill slopes in a manner to minimize erosion. Applicable practices include, but are not limited to, reducing continuous length of slope with terracing and diversions, reducing slope steepness, and roughening slope surfaces (6r: track walking). Divert off -site stormwater (run-on) or ground water away from slopes and disturbed areas with interceptor dikes, pipes, and/or swales. Off -site stormwater should be managed separately from stormwater generated on the site. � At the top of slopes, collect drainage in pipe slop drains or protected channels to prevent erosion. o "Temporary pipe slope drains must handle the peak volumetric flow rate calculated using a 10- minute time step from a Type 1A, 10-year, 24-hour frequency storm for the developed cendition. Alternatively, the 10-year, 1-hour flow rate predicted/indicated by an approved continuous runoff model, increased by a factor of 1.8, may be used. The hydrologic analysis must use the existing land cover condition for predicting flow rates from tributary areas outside the project limits. For tributary areas on the project site, the analysis must use the temporary or permanent project land cover condition, whichever will produce the highest flow rates. If using the Western Washington Hydrology Model (W WHM) to predict flows, bare soil areas should be modeled as "landscaped" area. o Where 15-minute time steps are available in an approved continuous runoff model, they may be used directly without a correction factor. Place excavated material on the uphill side of trenches, consistent with safety and space considerations. [� Place check dams at regular intervals within constructed channels that are cut down a slope. B' Consider soil types and its potential for erosion. G3� Stabilize soils on slopes, as specked in Element 5. C� BMP combinations are the most effective method of protecting slopes with disturbed soils. Ex: Use both mulching and straw erosion control blankets. Version Date: December 19, 2018 ELEMENT 7: Protect Drain Inlets td Protect all stone drain inlets made operable during construction so that stormwater runoff does not enter the conveyance system without first being filtered or treated to remove sediment. Ci�Clean or remove and replace inlet protection devices when sediment has filled one-third of the available storage (unless a different standard is specified by the product manufacturer). [T� Where possible, protect all existing storm drain inlets so that stormwater runoff does not enter the conveyance system without first being filtered or treated to remove sediment. t7 Keep all approach roads clean. Do not allow sediment and street wash water to enter storm drains without prior and adequate treatment unless treatment is provided before the storm drain discharges to waters of the State. G✓ Inlets should be inspected weekly at a minimum and daily during storm events. ELEMENT 8: Stabilize Channels and Outlets ®' Design, conshuct, and stabilize all on -site conveyance channels to prevent erosion from the following expected peak flows: o 'Channels must handle same peak volumetric flow rate as temporary pipe slope drains listed in Element 6, above. Q Provide stabilization, including armoring material, adequate to prevent erosion of outlets, adjacent streambanks, slopes, and downstream reaches at the outlets of all conveyance systems. 9' The best method for stabilizing channels is to completely line the channel with a blanket product first, then add check dams as necessary to function as an anchor and to slow the flow of water. Version Date: December 19, 2018 ELEMENT 9: Control Pollutants C' Design, install, implement, and maintain effective pollution prevention measures to minimize the discharge of pollutants. P' Handle and dispose of all pollutants, including waste materials and demolition debris that occur on -site in a manner that does not cause contamination of stormwater. a Provide cover, containment, and protection from vandalism for all chemicals, liquid products, petroleum products, and other materials that have the potential to pose a threat to human health or the environment. On -site fueling tanks must include secondary containment. Secondary containment means placing tanks or containers within an impervious structure capable of containing 110 % of the volume contained in the largest tank within the containment structure. Double -walled tanks do not / require additional secondary containment. 6 Conduct maintenance, fueling, and repair of heavy equipment and vehicles using spill prevention and control measures. Clean contaminated surfaces immediately following any spill incident. [� Discharge wheel wash or dre bath wastewater to a separate on -site treatment system that prevents discharge to surface water, such as closed -loop recirculation or upland land application, or to the sanitary sewer, with local sewer district approval. Wheel wash or tire bath wastewater should not include wastewater from concrete washout areas. [+� Apply fertilizers and pesticides in a manner and at application rates that will not result in loss of chemical to stormwater runoff. Follow manufacturers' label requirements for application rates and procedures. B Use BMPs to prevent contamination of stormwater runoff by pH-mod'rfying sources. The sources for this contamination include, but are not limited to: bulk cement, cement kiln dust, fly ash, new concrete washing and curing waters, waste streams generated from concrete grinding and sawing, exposed aggregate processes, dewatering concrete vaults, concrete pumping, and mixer washout waters. Adjust the pH of stormwater if necessary to prevent violations of the water quality standards. ll Assure that washout of concrete trucks is performed off -site or in designated concrete washout areas only. Do not wash out concrete trucks onto the ground, or into storm drains, open ditches, streets, or streams. Do not dump excess concrete on site, except in designated concrete washout areas. Concrete spillage or concrete discharge to surtace waters of the State is prohibited. Do not use upland land applications for discharging wastewater from concrete washout areas. � Obtain written approval from Ecology and provide to the City before using chemical treatment other than CO2 or dry ice to adjust pH. � Woody debris may be chopped and spread on site. a Conduct oil changes, hydraulic system drain down, solvent and de -greasing cleaning operations, fuel tank drain down and removal, and other activities which may result in discharge or spillage of pollutants to the ground or into stormwater runoff using spill prevention measures, such as drip pans. B� Clean contaminated surfaces immediately following any discharge or spill incident. Emergency repairs may be performed on -site using temporary plastic placed beneath and, if raining, over the vehicle. Version Date: December 19, 2018 ELEMENT 10: Control De -Watering d Discharge foundation, vault, and trench dewatering water, which have characteristics similar to stormwater runoff at the site, into a controlled conveyance system before discharge to a sediment trap or sediment pond. Ci Discharge clean, non -turbid de -watering water, such as well -point ground water, to systems tdbutary to, or directly into surface waters of the State, as spec'rfied in Element 8, provided the de -watering flow does not cause erosion or Flooding of receiving waters or intertere with the operation of the system. Do not route clean dewatering water through stormwater sediment ponds. Note that "surface waters of the State' may exist on a censtruction site as well as off site; for example, a creek mooing through a site. Handle highly turbid or contaminated dewatering water separately from stormwater. [� Other treatment or disposal options may include: 1. Infikration 2. Transport off -site in a vehicle, such as a vacuum Flush truck, for legal disposal in a manner that does not pollute state waters. 3. Ecology -approved on -site chemical treatment or other suitable treatment technologies. 4. Sanitary or combined sewer discharge with local sewer district approval, 'rf there is no other option. 5. Use of a sedimentation bag with ouffall to a ditch or Swale for small volumes of localized dewatering. [�' Construction equipment operation, clamshell digging, concrete (ramie pour, or work inside a cofferdam can create highly turbid or contaminated dewatering water. t� Discharging sediment -laden (muddy) water into waters of the State likely constitutes a violation of water quality standards for turbidity. The easiest way to avoid discharging muddy water is through infiltration and preserving vegetation. ELEMENT 11: Maintain BMPs d Maintain and repair all temporary and permanent erosion and sediment control BMPs as needed to assure continued performance of their intended function in accordance with BMP spec cations. i� Remove all temporary erosion and sediment control BMPs within 30 days aker achieving final site stabilization or after the temporary BMPs are no longer needed. Soma temporary erosion and sediment Version Date: December 19, 2018 control BMPs are bio-degradable and designed to remain in place following construction such as compost socks. � Provide protection to all BMPs installed for the permanent control of stormwater from sediment and compaction. All BMPs that are to remain in place following completion of constroction shall be examined and placed in full operating conditions. If sediment enters the BMPs during construction, it shall be removed and the facility shall be returned to the conditions specified in the construction documents. Remove or stabilize trapped sediment on site. Permanently stabilize disturbed soil resulting from removal of BMPs or vegetation. ELEMENT 72: Manage the Project— Projects subject to Minimum Requirements 1-9 must have a Cert�ed Erosion and Sediment Control Lead (CESCL) for site inspections. Projects subject to Minimum Requirements 1-5 do not require the inspector to be cert'rfied. By the initiation of construction, the SWPPP must idenfrfy the CESCL or inspector, who shall be present on -site or on -call at all times. E� Phase development projects to the maximum degree practicable and take into account seasonal work limits to prevent soil erosion and prevent transporting sediment from the site during censtroction. LK' Inspection and monitoring —Inspect, maintain, and repair all BMPs as needed to assure continued performance of their intended function. L9' Maintain, update, and implement the SWPPP. [3' Clearing and grading activities for developments shall be permitted only if conducted using an approved /site development plan (e.g., subdivision approval). LY From Oct 1 through Apr 30, clearing, grading, and other soil disturbing activities is permitted only if shown that the site operator will prevent silt -laden runoff from leaving the site through a combination of the following: 1. Site conditions including existing vegetative coverage, slope, soil type, and proximity to receiving waters. 2. Limit activities and the extent of disturbed areas. 3. Proposed erosion and sediment control measures. Weather conditions can influence the seasonal limitation on site disturbance. The City of Anacertes has the authority to take enforcement action per AMC 19.76 Stormwater. i� The following activities are exempt from the seasonal clearing and grading limitations: 1. Routine maintenance and necessary repair of erosion and sediment control BMPs; 2. RouBne maintenance of public facilities or existing utility structures that do not expose the sail or result in the removal of the vegetative cover to soil 3. Activities where there is 100%infiltration of surface water runoff within the site in approved and installed erosion and sediment control facilities. Version Date: December 19, 2018 ELEMENT 73: Protect Low Impact Development BMPS t� If implementing any bioretention facilities or rain gardens, refer to the applicable BMP sections of the Manual for requirements. __� ! z —Z-o —'2 I Applicant Signature Date Version Date: December 19, 2018 TAB 5 (MINIMUM REQUIREMENT #5) • Minimum Requirement #5 — On -site Stormwater Management All sites are required to utilize BMP T5.13 —Post Construction Soil Quality and Depth. For each surtace, consider the BMP's in the order listed for that type of surtace. Use the first BMP that is considered feasible. No other on -site Stormwater Management BMP is necessary for that surface. Feasiblity shall be determined by evaluation against: 1. Design criteria, limitations and infeasiblity criteria identified for each BMP in this manual, and; 2. Competing needs criteria listed in Chapter V-5 — On -site Stormwater Management. Lawn and Landscaped Area: • BMP T5.13: Post -Construction Soil Quality and Depth. (Attach Detail in Report) Refer to this site for requirements and specifications. All projects are required to utilize this BMP. httoa/wwwsoilsforsalmon.oralodf/Soil BMP Manual.odf See below for the "Model Soil Management Plan for BMP T5.13" to be submitted with Drainage Report and Application Material. Version Date: December 19, 2018 PRodECT DVFORMATION "Model Soil Management Plan for BMP T5.13" age # _ at_ pages Com lets all information on a e 1' onl site address and a mt[ number on admtmnW a ea. Site Address /Lot No.: Permit Permit Number: Permit Holder: Phone: MatL'ng Address: Conhct Person: Phone: Plan Pre aredB ATTACHMENTS REOUIIOT.D (Check a#'reauired items that are attached to this n(an _ Site Plau ahowiug, to scale: Areas ofmdishnbed native vegetation (uo amendmem required) _New planting beds and turf areas (amendment required) Type of soil improvement proposed for each area Soil test resWts (re aired H ro custom amendment rates) Product test resWts for ro oaed amendments AREA# (should match Area #on Site Plan) PLANTIlVG TYPE _Turf _ UudisNrbed native vegetation _Planting Beds _Other: SQUARE FOOTAGE OF THIS AREA: square feel SCARIFICATION (depth) of scarification needed to achieve fiW�hed total l2" loosened depth. _ Subsoil will be scarified _inches PRE -APPROVED _inches of compost or imported topsoil applied AMENDMENT METHOD: X 3 1 (conversion factor, inches ro cubic yards) PRODUCT: _Topsoil import =cu yards per 1,000 sq. & _Amend wiEa compost X ,000s sq.ft. in this area Stockple and amend cubic yards ofamendment -. -� -. -. -. QUANTITY: CU. YDS. cu. ds. stock tied needed to cover this a ea ro deli aced de th CUSTOM AMENDMENT Athch teat reaWts and calculations. Topsoil import organic matter or mpsoil import PRODUCT: _Topsoil &compost lift _inches X 3 1 - cu. yards / 1,000 sq. ft. _Amend Stockpile and amend X _,000s sq.[t in this area _ Ica. yds. stockpiled) =cubic yards of amendment -. -, -. -. -+ QUAN'l11'Y: CU. YDS. MULCH ,000 sq.ft PRODUCT: X 62 (conversion, ro give 2 inch mulch depth) =cubic yards ofmulch -. -. � � -. � QUANTITY: LTJ. YDS. TOTAL AMENDMENT/TOPSOHJMULCH FOR ALL AREAS co late on a e 1 onl , totalin a[I areas/ a sin this Plan ❑ Product#I: ❑ uanfi u. da. Version Date: December 19, 2018 ❑ Teat ReaWts: % o snit matter C:N ntlo Q5:1 mulch, or <35:1 for native lams "stable^ es/no ❑ ProduM #2: ❑ Qoantlty: cu. yds. ❑ Test Reaolts: % or anic matter C:N ratio a5:1 ex mulch, or <35:1 for natve lams "stable" es/no ❑ Product #3: ❑ Qaautity: cw yds. ❑ Test Results: % or anic matter C:N ntlo <Z5:1 exce t mulch, or <35:1 for native lams) "stable^ es/no Date: Inspector: Approved: Revisions Required: Dete: Inspector. Approved: Revisions Required: APPENDIX 1 -Survey performed by a Professional Land Surveyor Version Date: December 19, 2018 1 . 1 '+ 11`II 111 • • ` MAMBO IF t r a r• K T For ffir "Now F 1 eItFA 4 AM 04 _ J 1a 1 1 1 1 l + Few Or v Aw — i If F4 y hv,, Ate_ ^I a _.� V OF IF OF .d IF OF F 0 OFF leek m1bF OF s _ M1w I OF ALL 0, — ,. ~— 4 �� a -_ - - _ 9_ - �' _ - / - n �r S l V. New OF, 1 OF Fee, IF ry . rI. i. „-- .-. ,-. - A as �- a OF IN, OF IF el. 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V "�{� .� •Y� � �..� � '� yam, a y i _ ;;� - ;,�,�� ; .� ty,�.y:,�� g� �t �� •�t dl��jr ,y•� � ��'� ��T. 7� ,?"� ` n s "�<�✓ ` e� '.r ��1 � . 1 ��, aAt �,� �. �i��J !��.�� " r,v, -Y,4 ',sf' � .+��ii/ t �` .il ..t •f�,L�+• � ��+ :y"�`' y _"4•;— �N�� y-rd � �3. ']. � 7�� T �i�. .I �� 1. •a. 4( .� ._t IJ �,�. 11;� � � �JP't� .`F,;11:, ff'' /� ,,� � � � �� ... .� - ; . fl J � �� y�,'�I �� .. � *.� �• � 'i _�� ' �y� <: • •. �` `. ;, i M � .. ,. APPENDI% 2 —Model Soil Management Plan for BMP T5.13 Note: Document is provided under Minimum Requirement 5 in this document Version Date: December 19, 2018 APPENDIX 3 —Determining Construction Site Sediment Damage Potential (Appendix 7— NPDES Phase II Permit) Note: See attached Version Date: December 19, 2018 Western Washington Phase ]IStormwater Permit i. APPENDIX 7 —Determining Construction Site Sediment Damage Potential The following rating system allows objective evaluation of a particular development sde's potential to discharge sediment. Permittees may use the rating system below or develop alternative process designed to identify site -specific features which indicate that the site must be inspected prior to clearing and construction. Any alternative evaluation process must be documented and provide for equivalent environmental review. Step one is to determine if there is a sedimenVerosion sensitive feature downstream of the development site. If there is such a site downstream complete step two, assessment of hydraulic nearness. If there is a sedimenUerosion sensitive feature and it is hydraulically near the site then go to step three to determine the construction site sediment transport potential. STEP 1 — SedimenflErosion Sensitive Feature Identification Sediment/erosion sensitive features are areas subject to sign'rficant degradation due to the effect of sediment deposition or erosion. Special protection must be provided to protect them. Sedimentlerosion sensitive features include but are not limited to: i. Salmonid bearing fresh water streams and their tributaries or freshwater streams that would be Salmonid beadng if not for anthropogenic barriers; ii. Lakes; iii. Category I, II, and III wetlands; iv. Marine near -shore habitat; v. Sites containing contaminated soils where erosion could cause dispersal of contaminants; and vi. Steep slopes (25 % or greater) associated with one of the above features. Identify any sediment/erosion sensitive features, and proceed to step two. If there are none the assessment is complete. STEP 2 —Hydraulic Nearness Assessment Version Date: December 19, 201 B Sites are hydraulically near a feature'rf the pollutant load and peak quantity of runoff from the site will not be naturally attenuated before entering the feature. The conditions that render a site hydreulirally near to a feature include, but are not limited to, the following: i. The feature or a buffer to protect the feature is within 200 feet downstream of the site. ii. Runoff from the site is tight -lined to the feature or flows to the feature through a channel or ditch. August 1, 2013, Modified January 16, 2015 Appendix 7- Determining Sediment Damage Potential Page 1 of 3 Version Date: December 19, 2018 A site is not hydraulically near a feature if one of the following takes place to provide attenuation before runoff from the sRe enters the feature: iv. Sheet flow through a vegetated area with dense ground cover v. Flow through a wetland not included as a sensitive feature vi. Flow through a significant shallow or adverse slope, not in a conveyance channel, between the site and the sensitive feature. Identify any of the sedimentlerosion sensitive features from step one that are hydraulically near the site, and proceed to step three. If none of the sedimentlerosion senstive features are hydraulically near the site, the assessment is complete. vii. STEP 3 —Construction Site Sediment Transoort Potential Using the worksheet below, determine the total points for each development site. Assign points based on the most cdticel condition that affects 10 % or more of the site. If soil testing has been performed on site, the results should be used to determine the predominant soil type on the site. Otherwise, soil information should be obtained from the county soil survey to determine Hydrologic Soil Group (Table of Engineering Index Properties for step 1.D) and Erosion Potential (Table of Water Features for step 1.E) When using the county soil survey, the dominant soil type may be in question, particularly when the site falls on a boundary between two soil types or when one of two soil types may be present on a site. In this case, the soil type resulting in the most points on the rating system will be assumed unless site soil tests indicate that another soil type dominates the site. Use the point score from Step 3 to determine whether the development site has a high potential for sediment transport off of the site. Total Score Transoort Rating <100 Low ❑100 High A high transport rating indicates a higher risk that the sde will generate sediment contaminated runoff. Construction Site Sediment Transport Potential Worksheet A. Existing slope of site (average, weighted by aerial extent): Points 2% or less ...0 >2-5% ........................................ ------..............................................5 >5-10%0----•..............................................................................•--...'15 >10-15% ........... ..................................................................•-•--.....30 >15%n........................ .................... ....... ............................. ............. 50 B. Site Area to be cleared andlor graded: <5,000 sq. ft.................................................................................. 5,000 sq. ft. —1 acre ........ ............................................................. 30 > 1 acres.......................................................................................50 C. Quantity of cut and/or fill on site, <500 cubic yards............................................................................0 500 — 5,000 cubic yards................................................................... 5 >5,000—10,000 cubic yards .... ............. .................. ...................... 10 >10,000 — 20,000 cubic yards.......................................................25 >20,000 cubic yards.....................................................................40 D. Runoff potential of predominant soils (Natural _Resources Conservation. Service): Hydrologic soil group A ............. ............. .......... ............................... ❑ Hydrologic soil group B................................ ................... .............. Hydrologic soil group C. .......... .............................................. —..... 0 Hydrologic soil group D.................................................................40 E. Erosion Potential of predominant soils (Unified Classification Stem) GW, GP, SW, SP soils..........................................................................:.0 Dual classifications (GW-GM, GP -GM, GW-GC, GP -GC, SW-SM, SW -SC, SP-SM, SP-SC) ..........................10 GM, GC, SM, SC soils..................................................................20 ML, CL, MH, CH soils ................................................... F. Surface or Groundwater entering site identified and intercepted :1:.........40 Yes.........................................................................................• •-----�o No....... ......... ......................................... .....................................25 G. Depth of cut or height of fill >10 feet: Yes...............................................................................................25 No ......................................................................................................... 10 H. Clearing and grading will occur in the wet season [October 1 — May 1]: 50 No.......... ....................................................................... kJ TOTAL POINTS .............................................. .............................................. ' 85 1 If no surface or groundwater enters site, give 0 points.