APPENDIX_J_-_MS4_Annual_Report.pdf

This report is being submitted on behalf of an individual MS4.

This report is being submitted on behalf of a Single Entity

This is a joint report being submitted on behalf of a coalition.

Name of Single Entity

This cover page must be completed by the report preparer.

Joint reports require only one cover page.

Name of MS4

MS4 Annual Report Cover Page

Choose one:

Name of Coalition

Provide SPDES ID of each permitted MS4 included in this report. Use page 2 if needed.

SPDES ID

OR

SPDES ID

SPDES ID

SPDES ID SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

Cover Page 1 of 2

MCC form for period ending March 9, Fill in SPDES ID in upper right hand corner.

SPDES ID SPDES ID

OR

(Per Part II.E of GP-0-10-002)

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

3258632975

MS4 Annual Report Cover Page

Provide SPDES ID of each permitted MS4 included in this report.

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID SPDES ID SPDES ID

SPDES ID SPDES ID SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

Cover Page 2 of 2

MCC form for period ending March 9, SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID

SPDES ID SPDES ID

SPDES ID SPDES IDSPDES ID

9714632978

Indicate whether this MCC form is being submitted to certify endorsement or acceptance of:

An Annual Report for a single MS4

A Single Entity (Per Part II.E of GP-0-10-002)

A Joint Report

MS4 Municipal Compliance Certification(MCC) Form

SPDES ID

Each MS4 must submit an MCC form.

If Joint Report, enter coalition name:

Joint reports may be submitted by permittees with legally binding agreements.

Section 1 - MCC Identification Page

Name of MS4

MCC Page 1

MCC form for period ending March 9, 3855151783

For each contact, select all that apply:

Principal Executive Officer/Chief Elected Official

Duly Authorized Representative

Local Stormwater Public Contact

Stormwater Management Program (SWMP) Coordinator

Report Preparer

MS4 Municipal Compliance Certification(MCC) Form

First Name

SPDES ID

Title

Last NameMI

Address

City State Zip eMail

Phone

Section 2 - Contact Information

Contact information must be provided for each of the following positions as indicated below:

1. Principal Executive Officer, Chief Elected Official or other qualified individual (per GP-0-08-002 Part VI.J).

3. The Local Stormwater Public Contact (required per GP-0-08-002 Part VII.A.2.c & Part VIII.A.2.c).

4. The Stormwater Management Program (SWMP) Coordinator (Individual responsible for coordination/implementation of SWMP).

5. Report Preparer (Consultants may provide company name in the space provided).

A separate sheet must be submitted for each position listed above unless more than one position is filled by the same individual. If one individual fills multiple roles, provide the contact information once and check all positions that apply to that individual.

Name of MS4

MCC Page 2

MCC form for period ending March 9, County

Important Instructions - Please Read

2. Duly Authorized Representative (Information for this contact must only be submitted if a Duly Authorized Representative is signing this form)

If a new Duly Authorized Representative is signing this report, their contact information must be provided and a signature authorization form, signed by the Principal Executive Officer or Chief Elected Official must be attached.

5690581587

If Yes, complete information below.

Submit a separate sheet for each partner. Information provided in other formats will not be accepted. If your MS4 cooperated with a coalition, submit one sheet with the name of the coalition. It is not necessary to include a separate sheet for each MS4 in the coalition.

If No, proceed to Section 4 - Certification Statement.

MS4 Municipal Compliance Certification (MCC) Form

Partner/Coalition Name (con't.)

SPDES ID

Address

City State Zip eMail

Phone

Section 3 - Partner Information

SPDES Partner ID - If applicable

Yes No

What tasks/responsibilities are shared with this partner (e.g. MM1 School Programs or Multiple Tasks)?

MM1

MM2

MM3

MM4

MM5

MM6

Did your MS4 work with partners/coalition to complete some or all permit requirements during this reporting period? Yes No

Additional tasks/responsibilities

Watershed Improvement Strategy Best Management Practices required for MS4s in impaired watersheds included in GP-0-08-002 Part IX.

Name of MS4

MCC Page 3

Partner/CoalitionName

Legally Binding Agreement in accordance with GP-0-08-002 Part IV.G.?

MCC form for period ending March 9, 4643023765

MS4 Municipal Compliance Certification(MCC) Form

Date

Section 4 - Certification Statement

"I 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, the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations."

This form must be signed by either a principal executive officer or ranking elected official, or duly authorized representative of that person as described in GP-0-08-002 Part VI.J.

First Name MI Last Name

Title

Signature

Send completed form and any attachments to the DEC Central Office at:

MS4 Permit Coordinator Division of Water 4th Floor 625 Broadway Albany, New York 12233-3505

Name of MS4

MCC Page 4

MCC form for period ending March 9, (Clearly print title of individual signing report)

3165331518

1. Has this MS4/Coalition produced any reports documenting water quality trends related to stormwater? If not, answer No and proceed to Minimum Control Measure One.

The information in this section is being reported (check one):

On behalf of an individual MS4 On behalf of a coalition

MS4 Annual Report Form

SPDES ID

How many MS4s are contributed to this report?

Water Quality Trends

Name of MS4/Coalition

Yes No

If Yes, choose one of the following

Report(s) attached to the annual report

Web Page(s) where report(s) is/are provided below

URL

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Please provide specific address of page where report(s) can be accessed - not home page.

Water Quality Trends Page 1 of 1

URL

URL

URL

This report is being submitted for the reporting period ending March 9, 1100364151

MS4 Annual Report Form

Minimum Control Measure 1. Public Education and Outreach

Construction Sites

General Stormwater Management Information

Household Hazardous Waste Disposal

Illicit Discharge Detection and Elimination

Infrastructure Maintenance

Smart Growth

Storm Drain Marking

Green Infrastructure/Better Site Design/Low Impact Development

Other:

Pesticide and Fertilizer Application

Pet Waste Management

Recycling

Riparian Corridor Protection/Restoration

Trash Management

Vehicle Washing

Water Conservation

Wetland Protection

None

Check all topics that were included in Education and Outreach during this reporting period:

1. Targeted Public Education and Outreach Best Management Practices

Other

2. Specific audiences targeted during this reporting period:

Public Employees

Residential

Businesses

Restaurants

Other:

Contractors

Developers

General Public

Industries

Agricultural

The information in this section is being reported (check one):

On behalf of an individual MS4 On behalf of a coalition

How many MS4s contributed to this report?

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

MCM 1 Page 1 of 4

Other

4286299954

Construction Site Operators Trained

Direct Mailings

Kiosks or Other Displays

List-Serves

Mailing List

Newspaper Ads or Articles

Public Events/Presentations

School Program

TV Spot/Program

Printed Materials:

Other:

Web Page:

MS4 Annual Report Form

SPDES ID

3. What strategies did your MS4/Coalition use to achieve education and outreach goals during this reporting period? Check all that apply:

# Trained

# Mailings

# Locations

# In List

# In List

# Days Run

Locations (e.g. libraries, town offices, kiosks)

# Attendees

# Attendees

# Days Run

Total # Distributed

URL

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

MCM 1 Page 2 of 4

Provide specific web addresses - not home page. Continue on next page if additional space is needed.

URL

7870299956

3. Web Page con't.: Provide specific web addresses - not home page.

URL

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

MCM 1 Page 3 of 4

URL

URL

URL

URL

URL

URL

0704299955

4. Evaluating Progress Toward Measurable Goals MCM 1

Use this page to report on your progress and project plans toward achieving measurable goals identified in your Stormwater Management Program Plan (SWMPP), including requirements in Part III.C.1. Submit additional pages as needed.

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

MCM 1 Page 4 of 4

This report is being submitted for the reporting period ending March 9, A. Briefly summarize the Measurable Goal identified in the SWMPP in this reporting period.

B. Briefly summarize the observations that indicated the overall effectiveness of this Measurable Goal.

C. How many times was this observation measured or evaluated in this reporting period?

(ex.: samples/participants/events)

D. Has your MS4 made progress toward this Measurable Goal during this reporting period?

Yes No

E. Is your MS4 on schedule to meet the deadline set forth in the SWMPP? Yes No

F. Briefly summarize the stormwater activities planned to meet the goals of this MCM during the next reporting cycle (including an implementation schedule).

6932504403

Minimum Control Measure 2. Public Involvement/Participation

1. What opportunities were provided for public participation in implementation, development, evaluation and improvement of the Stormwater Management Program (SWMP) Plan during this reporting period? Check all that apply:

Cleanup Events

Comments on SWMP Received

Community Hotlines

Community Meetings

Plantings

Storm Drain Markings

Stakeholder Meetings

Volunteer Monitoring

Other:

# Events

# Comments

Phone # ( ) -

# Attendees

Sq. Ft.

# Drains

# Events

# Attendees

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

How many MS4s contributed to this report?

The information in this section is being reported (check one):

On behalf of an individual MS4 On behalf of a coalition

MCM 2 Page 1 of 6

Phone # ( ) - Phone # ( ) - Phone # ( ) - Phone # ( ) - Phone # ( ) -

Phone # ( ) - Phone # ( ) - Phone # ( ) - Phone # ( ) -

Phone # ( ) -

2. Was public notice of availability of this annual report and Stormwater Management Program (SWMP) Plan provided?

List-Serve

Newspaper Advertising

TV/Radio Notices

Other:

Web Page URL:

# In List

# Days Run

# Days Run

Enter URL(s) on the following two pages.

Yes No

4961183103

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

2. URL(s) con't.:

Please provide specific address(es) where notice(s) can be accessed - not home page.

MCM 2 Page 2 of 6

URL

URL

URL

URL

URL

URL

URL

1693183102

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

2. URL(s) con't.:

Please provide specific address(es) where notices can be accessed - not home page.

MCM 2 Page 3 of 6

URL

URL

URL

URL

URL

URL

URL

3714183108

3. Where can the public access copies of this annual report, Stormwater Management Program SWMP) Plan and submit comments on those documents?

City

Department

Address

Zip

Phone

City

Address

Zip

Phone

City

Address

Zip

Phone

MS4/Coalition Office

Library

Other

Web Page URL:

eMail

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

Please provide specific address of page where report can be accessed - not home page.

MCM 2 Page 4 of 6

Annual Report SWMP Plan Comments

Annual Report SWMP Plan Comments

Annual Report SWMP Plan Comments

Annual Report SWMP Plan Comments

Comments

Enter address/contact info and select radio button to indicate which document is available and whether comments may be submitted at that location. Submit additional pages as needed.

5441172015

5.a. Was an Annual Report public meeting held in this reporting period?

If Yes, what was the date of the meeting?

If No, is one planned?

MS4 Annual Report Form

SPDES ID

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

Yes No

Yes No

MCM 2 Page 5 of 6

6. Were comments received during this reporting period?

If Yes, attach comments, responses and changes made to SWMP in response to comments to this report.

Yes No

If submitting a report for single MS4, answer 5.a.. If submitting a joint report, answer 5.b..

5.b. Was an Annual Report public meeting held for all MS4s contributing to this report during this reporting period?

If No, is one planned for each?

Yes No

Yes No

This report is being submitted for the reporting period ending March 9, 4.a. If this report was made available on the internet, what date was it posted?

Leave blank if this report was not posted on the internet. / /

4.b. For how many days was/will this report be posted?

0614183104

7. Evaluating Progress Toward Measurable Goals MCM 2

Use this page to report on your progress and project plans toward achieving measurable goals identified in your Stormwater Management Program Plan (SWMPP), including requirements in Part III.C.1. Submit additional pages as needed.

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

MCM 2 Page 6 of 6

This report is being submitted for the reporting period ending March 9, A. Briefly summarize the Measurable Goal identified in the SWMPP in this reporting period.

B. Briefly summarize the observations that indicated the overall effectiveness of this Measurable Goal.

C. How many times was this observation measured or evaluated in this reporting period?

(ex.: samples/participants/events)

D. Has your MS4 made progress toward this measurable goal during this reporting period?

Yes No

E. Is your MS4 on schedule to meet the deadline set forth in the SWMPP?

Yes No

F. Briefly summarize the stormwater activities planned to meet the goals of this MCM during

2013032775

Auto Recyclers

Building Maintenance

Churches

Commercial Carwashes

Commercial Laundry/Dry Cleaners

Construction Vehicle Washouts

Cross-Connections

Distribution Centers

Food Processing Facilities

Garbage Truck Washouts

Hospitals

Improper RV Waste Disposal

Industrial Process Water

Other:

Sewersheds:

Landscaping (Irrigation)

Marinas

Metal Plateing Operations

Outdoor Fluid Storage

Parking Lot Maintenance

Printing

Residential Carwashing

Restaurants

Schools and Universities

Septic Maintenance

Swimming Pools

Vehicle Fueling

Vehicle Maint./Repair Shops

None

MS4 Annual Report Form

SPDES ID

Minimum Control Measure 3. Illicit Discharge Detection and Elimination

1. Enter the number and approx. percent of outfalls mapped:

3.a.What types of generating sites/sewersheds were targeted for inspection during this reporting period?

2. How many of these outfalls have been screened for dry weather discharges during this reporting period (outfall reconnaissance inventory)?

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

The information in this section is being reported (check one):

On behalf of an individual MS4 On behalf of a coalition

How many MS4s contributed to this report?

MCM 3 Page 1 of 4

7368169291

7. Has the storm sewershed mapping been completed in this reporting period?

If No, approximately what percent was completed in this reporting period?

Yes No

8. Is the above information available in GIS?

Is this information available on the web?

If Yes, provide URL(s):

Yes No

URL

MS4 Annual Report Form

SPDES ID

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

Yes No

Please provide specific address of page where map(s) can be accessed - not home page.

MCM 3 Page 2 of 4

3.b.What types of illicit discharges have been found during this reporting period?

5. How many illicit discharges have been confirmed during this reporting period?

6. How many illicit discharges/illegal connections have been eliminated during this reporting period?

Broken Lines From Sanitary Sewer

Cross Connections

Failing Septic Systems

Floor Drains Connected To Storm Sewers

Illegal Dumping

Other:

Industrial Connections

Inflow/Infiltration

Pump Station Failure

Sanitary Sewer Overflows

Straight Pipe Sewer Discharges

None

4. How many illicit discharges/potential illegal connections have been detected during this reporting period?

URL

5953169299

9. Has an IDDE law been adopted for each traditional MS4 and/or have IDDE procedures been approved for all non-traditional MS4s contributing to this report?

10. If Yes, has every traditional MS4 contributing to this report certified that this law is equivalent to the NYS Model IDDE Law?

11. What percent of staff in relevant positions and departments has received IDDE training?

MS4 Annual Report Form

SPDES ID

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

Yes No

Yes No NT

MCM 3 Page 3 of 4

URL

URL

URL

8. URL(s) con't.:

Please provide specific address of page where map(s) can be accessed - not home page

URL

URL

5820169292

12. Evaluating Progress Toward Measurable Goals MCM 3

Use this page to report on your progress and project plans toward achieving measurable goals identified in your Stormwater Management Program Plan (SWMPP), including requirements in Part III.C.1. Submit additional pages as needed.

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

MCM 3 Page 4 of 4

This report is being submitted for the reporting period ending March 9, A. Briefly summarize the Measurable Goal identified in the SWMPP in this reporting period.

B. Briefly summarize the observations that indicated the overall effectiveness of this Measurable Goal.

C. How many times was this observation measured or evaluated in this reporting period?

(ex.: samples/participants/events)

D. Has your MS4 made progress toward this measurable goal during this reporting period?

Yes No

E. Is your MS4 on schedule to meet the deadline set forth in the SWMPP?

Yes No

F. Briefly summarize the stormwater activities planned to meet the goals of this MCM during

9126383899

1a. Has each MS4 contributing to this report adopted a law, ordinance or other regulatory mechanism that provides equivalent protection to the NYS SPDES General Permit for Stormwater Discharges from Construction Activities?

1b.Has each Town, City and/or Village contributing to this report documented that the law is equivalent to a NYSDEC Sample Local Law for Stormwater Management and Erosion and Sediment Control through either an attorney cerfification or using the NYSDEC Gap Analysis Workbook?

If Yes, Towns, Cities and Villages provide date of equivalent NYS Sample Local Law.

Yes No

2. Does your MS4/Coalition have a SWPPP review procedure in place? Yes No

3. How many Construction Stormwater Pollution Prevention Plans (SWPPPs) have been reviewed in this reporting period?

4. Does your MS4/Coalition have a mechanism for receipt and consideration of public comments related to construction SWPPPs?

If Yes, how many public comments were received during this reporting period?

Yes No NT

5. Does your MS4/Coalition provide education and training for contractors about the local SWPPP process? Yes No

09/2004 03/2006 NT

MS4 Annual Report Form

Minimum Control Measures 4 and 5.

Construction Site and Post-Construction Control

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

The information in this section is being reported (check one):

On behalf of an individual MS4 On behalf of a coalition

How many MS4s contributed to this report?

SPDES ID

MCM 4/5 Page 1 of 2

This report is being submitted for the reporting period ending March 9, Yes No NT

5624056356

6. Identify which of the following types of enforcement actions you used during the reporting period for construction activities, indicate the number of actions, or note those for which you do not have authority:

Notices of Violation

Stop Work Orders

Criminal Actions

Termination of Contracts

Administrative Fines

Civil Penalties

Administrative Orders

Enforcement Actions or Sanctions

Other

No Authority

No Authority

No Authority

No Authority

No Authority

No Authority

No Authority

No Authority

MCM 4/5 Page 2 of 2

3951056357

Minimum Control Measure 4. Construction Site Stormwater Runoff Control

1. How many construction projects have been authorized for disturbances of one acre or more during this reporting period?

2. How many construction projects disturbing at least one acre were active in your jurisdiction during this reporting period?

3. What percent of active construction sites were inspected during this reporting period?

4. What percent of active construction sites were inspected more than once?

5. Do all inspectors working on behalf of the MS4s contributing to this report use the NYS Construction Stormwater Inspection Manual?

MS4 Annual Report Form

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

SPDES ID

The information in this section is being reported (check one):

On behalf of an individual MS4 On behalf of a coalition

How many MS4s contributed to this report?

MCM 4 Page 1 of 3

Yes No NT

6. Does your MS4/Coalition provide public access to Stormwater Pollution Prevention Plans (SWPPPs) of construction projects that are subject to MS4 review and approval?

If your MS4 is Non-Traditional, are SWPPPs of construction projects made available for public review?

If Yes, use the following page to identify location(s) where SWPPPs can be accessed.

Yes No NT

This report is being submitted for the reporting period ending March 9, NT

NT

Yes No

9445612573

6. con't.:

SPDES ID

City

Department

Address

Zip

Phone

City

Address

Zip

Phone

City

Address

Zip

Phone

URL

MS4/Coalition Office

Library

Other

Web Page URL(s):

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

MCM 4 Page 2 of 3

Please provide specific address where SWPPPs can be accessed - not home page.

Submit additional pages as needed.

URL

7482169883

7. Evaluating Progress Toward Measurable Goals MCM 4

Use this page to report on your progress and project plans toward achieving measurable goals identified in your Stormwater Management Program Plan (SWMPP), including requirements in Part III.C.1. Submit additional pages as needed.

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

MCM 4 Page 3 of 3

This report is being submitted for the reporting period ending March 9, A. Briefly summarize the Measurable Goal identified in the SWMPP in this reporting period.

B. Briefly summarize the observations that indicated the overall effectiveness of this Measurable Goal.

C. How many times was this observation measured or evaluated in this reporting period?

(ex.: samples/participants/events)

D. Has your MS4 made progress toward this measurable goal during this reporting period?

Yes No

E. Is your MS4 on schedule to meet the deadline set forth in the SWMPP?

Yes No

F. Briefly summarize the stormwater activities planned to meet the goals of this MCM during

7935007876

Minimum Control Measure 5. Post-Construction Stormwater Management

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

SPDES ID

The information in this section is being reported (check one):

On behalf of an individual MS4 On behalf of a coalition

How many MS4s contributed to this report?

Alternative Practices

Filter Systems

Infiltration Basins

Open Channels

Ponds

Wetlands

Other

Inventoried

Inspections

# Times Maintained

2. Do you use an electronic tool (e.g. GIS, database, spreadsheet) to track post-construction BMPs, inspections and maintanance? Yes No

1. How many and what type of post-construction stormwater management practices has your MS4/Coalition inventoried, inspected and maintained in this reporting period?

MCM 5 Page 1 of 3

3. What types of non-structural practices have been used to implement Low Impact Development/Better Site Design/Green Infrastructure principles?

Building Codes

Overlay Districts

Zoning

None

Watershed Plans

Other:

Municipal Comprehensive Plans

Open Space Preservation Program

Local Law or Ordinance

Land Use Regulation/Zoning

Other Comprehensive Plan

1048119251

5. What percent of municipal officials/MS4 staff responsible for program implementation attended training on Low Impace Development (LID), Better Site Design (BSD) and other Green Infrastructure principles in this reporting period?

4a. Are the MS4s contributing to this report involved in a regional/watershed wide planning effort?

MS4 Annual Report Form

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

SPDES ID

MCM 5 Page 2 of 3

This report is being submitted for the reporting period ending March 9, Yes No

4b. Does the MS4 have a banking and credit system for stormwater management practices?

Yes No

4c. Do the SWMP Plans for each MS4 contributing to this report include a protocol for evaluation and approval of banking and credit of alternative siting of a stormwater management practice?

Yes No

4d. How many stormwater management practices have been implemented as part of this system in this reporting period?

9091119257

6. Evaluating Progress Toward Measurable Goals MCM 5

Use this page to report on your progress and project plans toward achieving measurable goals identified in your Stormwater Management Program Plan (SWMPP), including requirements in Part III.C.1. Submit additional pages as needed.

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

MCM 5 Page 3 of 3

This report is being submitted for the reporting period ending March 9, A. Briefly summarize the Measurable Goal identified in the SWMPP in this reporting period.

B. Briefly summarize the observations that indicated the overall effectiveness of this Measurable Goal.

C. How many times was this observation measured or evaluated in this reporting period?

(ex.: samples/participants/events)

D. Has your MS4 made progress toward this measurable goal during this reporting period?

Yes No

E. Is your MS4 on schedule to meet the deadline set forth in the SWMPP?

Yes No

F. Briefly summarize the stormwater activities planned to meet the goals of this MCM during

1610116332

Minimum Control Measure 6. Stormwater Management for Municipal Operations

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

SPDES ID

The information in this section is being reported (check one):

On behalf of an individual MS4 On behalf of a coalition

How many MS4s contributed to this report?

Street Maintenance Bridge Maintenance Winter Road Maintenance Salt Storage Solid Waste Management New Municipal Construction and Land Disturbance..

Right of Way Maintenance Marine Operations Hydrologic Habitat Modification Parks and Open Space Municipal Building Stormwater System Maintenance Vehicle and Fleet Maintenance Other

1. Choose/list each municipal operation/facility that contributes or may potentially contribute Pollutants of Concern to the MS4 system. For each operation/facility indicate whether the operation/facility has been addressed in the MS4's/Coalition's Stormwater Management Program(SWMP) Plan and whether a self-assessment has been performed during the reporting period. A self-assessment is performed to: 1) determine the sources of pollutants potentially generated by the permittee's operations and facilities; 2) evaluate the effectiveness of existing programs and 3) identify the municipal operations and facilities that will be addressed by the pollution prevention and good housekeeping program, if it's not done already.

Yes No Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No Yes No

Yes No

Yes No Yes No

Operation/Activity/Facility Addressed in SWMP?

Self-Assessment Operation/Activity/Facility performed within the past 3 years?

Yes No

Yes No

Yes No

Yes No

Yes No Yes No

Yes No

Yes No

Yes No Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

MCM 6 Page 1 of 3

6894134836

Parking Lots Swept

Streets Swept

Catch Basins Inspected and Cleaned Where Necessary

Post Construction Control Stormwater Management Practices

Phosphorus Applied In Chemical Fertilizer

Nitrogen Applied In Chemical Fertilizer

Pesticide/Herbicide Applied

MS4 Annual Report Form

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

SPDES ID

2. Provide the following information about municipal operations good housekeeping programs:

Inspected and Cleaned Where Necessary

# Acres

# Miles

# Lbs.

# Lbs.

# Acres .

3. How many stormwater management trainings have been provided to municipal employees during this reporting period?

4. What was the date of the last training?

5. How many municipal employees have been trained in this reporting period?

6. What percent of municipal employees in relevant positions and departments receive stormwater management training?

MCM 6 Page 2 of 3

This report is being submitted for the reporting period ending March 9, (Number of acres X Number of times swept)

(Number of miles X Number of times swept)

(Number of acres to which pesticide/herbicide was applied X Number of times applied to the nearest tenth.)

6445134838

7. Evaluating Progress Toward Measurable Goals MCM 6

Use this page to report on your progress and project plans toward achieving measurable goals identified in your Stormwater Management Program Plan (SWMPP), including requirements in Part III.C.1. Submit additional pages as needed.

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

MCM 6 Page 3 of 3

This report is being submitted for the reporting period ending March 9, A. Briefly summarize the Measurable Goal identified in the SWMPP in this reporting period.

B. Briefly summarize the observations that indicated the overall effectiveness of this Measurable Goal.

C. How many times was this observation measured or evaluated in this reporting period?

(ex.: samples/participants/events)

D. Has your MS4 made progress toward this measurable goal during this reporting period?

Yes No

E. Is your MS4 on schedule to meet the deadline set forth in the SWMPP?

Yes No

F. Briefly summarize the stormwater activities planned to meet the goals of this MCM during

7123078468

Answer

1,2,3,4,5,6,7a-d,8a,8b,9 1,2,3,4,7a-d,8a,8b,9 1,2,77a-d,8a,8b,9

1,6,7a-d,8a,9 1,6,7a-d,8a,9 1,6,7a-d,8a,9

1,4,6,7a-d,8a,9 1,4,6,7a-d,8a,9 1,4,6,7a-d,8a,9

1,4,7a-d,9,10,11,12 1,4,7a-d,9,10,11,12 1,4,7a-d,9

1,4,7a-d,8a,9,10,11,12 1,4,7a-d,8a,9,10,11,12 1,4,7a-d,8a,9

1,4,6,7a-d,8a,9 1,4,6,7a-d,8a,9 1,4,6,7a-d,8a,9

1,2,3,4,7a-d,9,10,11,12 1,2,3,4,7a-d,9,10,11,12 1,2,3,4,7a-d,9

(POC)

Phosphorus Phosphorus Phosphorus

Phosphorus Phosphorus Phosphorus

Phosphorus Phosphorus Phosphorus

Pathogens Pathogens Pathogens

Pathogens and Nitrogen Pathogens and Nitrogen Pathogens and Nitrogen

Phosphorus Phosphorus Phosphorus

Pathogens Pathogens Pathogens

If No, estimate what percentage of the conveyance system has been mapped so far.

MS4 Description NYC EOH Watershed

Traditional Land Use Traditional Non-Land Use Non-Traditional

Onondaga Lake Watershed Traditional Land Use Traditional Non-Land Use Non-Traditional

Greenwood Lake Watershed Traditional Land Use Traditional Non-Land Use Non-Traditional

Oyster Bay Traditional Land Use Traditional Non-Land Use Non-Traditional

Peconic Estuary Traditional Land Use Traditional Non-Land Use Non-Traditional

Oscawana Lake Watershed Traditional Land Use Traditional Non-Land Use Non-Traditional

LI 27 Embayments Traditional Land Use Traditional Non-Land Use Non-Traditional

Additional Watershed Improvement Strategy Best Management Practices

MS4 Annual Report Form

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

SPDES ID

The information in this section is being reported (check one):

On behalf of an individual MS4 On behalf of a coalition

How many MS4s contributed to this report?

Check NA

10,11,12 5,10,11,12 3,4,5,10,11,12

2,3,4,5,8b,10,11,12 2,3,4,5,8b,10,11,12 2,3,4,5,8b,10,11,12

2,3,5,8b,10,11,12 2,3,5,8b,10,11,12 2,3,5,8b,10,11,12

2,3,5,6,8a,8b 2,3,5,6,8a,8b 2,3,4,5,8a,8b,10,11,12

2,3,5,6,8b 2,3,5,6,8b 2,3,4,5,8b,10,11,12

2,3,5,8b,10,11,12 2,3,5,8b,10,11,12 2,3,5,8b,10,11,12

5,6,8a,8b 5,6,8a,8b 5,6,8a,8b,10,11,12

MS4s must answer the questions or check NA as indicated in the table below.

1. Does your MS4/Coalition have an education program addressing impacts of phosphorus/nitrogen/pathogens on waterbodies? Yes No N/A

2. Has 100% of the MS4/Coalition conveyance system been mapped in GIS?

Estimate what percentage was mapped in this reporting period.

Yes No N/A

If N/A, go to question 3.

Additional BMPs Page 1 of 3

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If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

SPDES ID

4. Estimate the percentage of on-site wastewater treatment systems that have been inspected and maintained or rehabilitated as necessary in this reporting period? %

5. Has your MS4/Coalition developed a program that provides protection equivalent to the NYSDEC SPDES General Permit for Stormwater Discharges from Construction Activities (GP-0-08-001) to reduce pollutants in stormwater runoff from construction activities that disturb five thousand square feet or more?

6. Has your MS4/Coalition developed a program to address post-construction stormwater runoff from new development and redevelopment projects that disturb greater than or equal to one acre that provides equivalent protection to the NYS DEC SPDES General Permit for Stormwater Discharges from Construction Activities (GP-0-08-001), including the New York State Stormwater Design Manual Enhanced Phosphorus Removal Standards?

7a. Does your MS4/Coalition have a retrofitting program to reduce erosion or phosphorus/nitrogen/pathogen loading?

Yes No N/A

Yes No N/A

Yes No N/A

Additional BMPs Page 2 of 3

This report is being submitted for the reporting period ending March 9,

3. Does your MS4/Coalition have a Stormwater Conveyance System (infrastructure) Inspection and Maintenance Plan Program? Yes No N/A

7b.How many projects have been sited in this reporting period?

7c. What percent of the projects included in 7b have been completed in this reporting period?

7d.What percent of projects planned in previous years have been completed? %

No Projects Planned

8a.Has your MS4/Coalition developed and implemented a turf management practices and procedures policy that addresses proper fertilizer application on municipally owned lands?

8b.Has your MS4/Coalition developed and implemented a turf management practices and procedures policy that addresses proper disposal of grass clippings and leaves from municipally owned lands?

Yes No N/A

Yes No N/A

2244042255

If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.

Name of MS4/Coalition

SPDES ID

11. Does your MS4/Coalition have a pet waste bag program?

12. Does your MS4/Coalition have a program to manage goose populations?

Yes No N/A

Yes No N/A

Additional BMPs Page 3 of 3

This report is being submitted for the reporting period ending March 9,

9. Has your MS4/Coalition developed and implemented a program of native planting?

10. Has your MS4/Coalition enacted a local law prohibiting pet waste on municipal properties and prohibiting goose feeding?

Yes No N/A

Yes No N/A

2404042253