harris county storm water quality management plan · storm water quality management plan ... storm...

7015 Fairbanks N. Houston Rd. ∙ Houston, TX 77040. ∙ 713-937-7602 www.parkusa.com _________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Storm Water Quality Management Plan SWQMP- Harris Co Form- 2017.doc

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Documents for Obtaining:

Harris County

Storm Water Quality Management Plan For

(Site name)

(HOUSTON), Texas

Storm Water Quality Management Plan Prepared For:

(Name)

(Address)

Storm Water Quality Management Plan Prepared By:

(Printed Name)

(License Number)

(Address)

(Phone Number) Engineer’s Seal & Signature

(Note: Plans submitted to the Harris County as part of a storm water quality permit application must be sealed by a Professional Engineer licensed to practice engineering in Texas)

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Storm Water Quality Management Plan Harris County, Texas

Project Information:

Site Name:

Address/Location:

Permittee Information:

Name:

Contact:

Address:

Phone:

Prepared By:

Name:

Address:

Phone:

Email:

1.0 Site Description

A. Site Location

(Provide a description of site location. (Jurisdiction (e.g., in the City of Houston,and unincorporated Harris County), name of the MUD if applicable, street address,latitude/longitude, subdivision name if applicable, direction from intersections orlandmarks, etc.)

B. Owner Information

The owner of the property is: (or)

The property is leased to: (if applicable)

This plan is for the proposed New Development or Substantial Re-development (circle one) area of ____ acres as part of the _____ acres total tract located at (your facility location), Houston, Texas. All management of storm water runoff and quality control should follow the BMP as outlined below:

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1.1 Storm Water Quality Management Plan

The SWQMP functions as a mitigation plan for the potential impacts of pollution in storm water discharge from the normal operating activities of a site for the life of the development. This plan will contain a site description, planned controls and procedures for maintenance and inspection.

1.2 Site Description

A. Site LocationB. Names, addresses and phone numbers of owner and contact person/sC. Type of development or substantial redevelopmentD. Nature of Activities (including Standard Industrial Classification Code)E. Give existing NPDES storm water permit numbers or provide a copy of the NOI or

NPDES permit application. If these are unavailable, present a statement of intent tofile NOI or NPDES (Note! Copy of NOI or NPDES must be submitted whenavailable).

F. Estimates of the total site area and the total area affected by the development.G. Site map (s) showing:

1. Vicinity map2. Areas of development3. Areas not to be developed4. Drainage areas and their acreage, patterns and approximate slopes anticipated

after development (describe outfalls)5. Wetlands and surface waters6. Locations and listing of activities which may generate pollutants and potential

discharge, including hazardous materials treatment, storage or disposal facilities,parking areas, loading areas, etc.

7. Locations of any existing structural and non-structural controls8. Locations where storm water is discharged to the MS4 and the name of the MS4

operator.

1.3 Controls

A. Non-Structural Controls (Describe non-structural BMPs and how they will beused at the site if applicable)

An operational and/or maintenance practice will be applied to prevent or reduce apotential storm water run-off contact with pollution causing activities.

1. Litter Control. Consistent removal of litter from developed areas before runoff orwind moves these materials to receiving waters.

2. Cleaning & Maintenance. Consistent cleaning of oil spill and other liquidpollutants from vehicle parking areas to reduce pollutants in receiving waters.

3. Landscaping. Lawn care and landscaping practices using native, lowmaintenance species, where feasible, to reduce water and fertilization. Grassclippings will not be swept or blown into storm sewers or interceptors.

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4. Chemicals. Proper applications of fertilizers and pesticides will be used tominimize the potential of storm water pollution.

B. Structural Controls (Describe structural BMPs like retention or detention ponds, etc.in addition to StormTrooper® example below) Park StormTrooper® Storm WaterInterceptor,713-937-7602, 800-256-8041 (Harris County, NewDevelopment/Significant Redevelopment Table 3, 4.4.2 Oil/Grit Separator) is thestructural control to be installed in the storm water lateral connection pipe,approximately __’ deep with __” inlet pipe into the control manhole and __” outletpipe __’ to main storm drainage MS4 (see site map for locations).

1.4 Maintenance

A. A lawn maintenance company will perform regular lawn and detention pondmaintenance, including removal of clippings and parking lot debris. Typically, thiswill be every week in warmer months and every two to three weeks in cooler months.

B. The perimeter of the site will be inspected at least once weekly for wind blowndebris.

C. Dumpster Trash will be picked up on a weekly schedule including cleaning ofdumpster area.

D. Any oil or chemical related spills will be cleaned up immediately and disposed of perlocal, county and TCEQ regulations.

1.5 Inspections

A. A qualified employee or manager will perform recorded inspections quarterly or afterany major storm event, following StormTrooper® Inspection Guidelines andMonitoring Report. Inspections reports will be kept in a secure location available forreview by local inspectors.

B. Management will contract a professional engineer registered by the State of Texasto perform an annual inspection and complete the Annual Structural ControlCertification for SWQP Renewal Form. This will be submitted along with renewalfees and any pumping truck manifests.

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1.6 Sizing of StormTrooper® Based on Harris County guidelines

If the interceptor is subject to rainwater discharge, it should be considered stormwater (regardless if the final discharge is draining into the sanitary sewer or storm sewer). The StormTrooper® stormwater interceptor is selected based on anticipated flow rate (gpm) of the storm sewer.

Using the “First Flush Principle” is the acceptable means of determining treated stormwater flow rates. The initial runoff flow will be more polluted than the stormwater that runs off later, after the rainfall has “cleansed” the catchment area. The stormwater containing this high initial pollutant load will be treated with the StormTrooper® stormwater interceptor. Studies have found that significant concentration pollutant loads are retained when at least 90% of the storm events are treated.2

To determine the flow rate of the StormTrooper® stormwater interceptor, the flow rate of the first flush is estimated. An accepted practice is to calculate the drainage using the Rational Method for estimating design peak discharge from a small watershed.2

Q = A x C x I x 449

gpm

1,164 gpm or 2.59 cfsQ = gpm

gpm

Q = 12 x .80 x .27 x 449

This example recommends the Model

rated for 1,375 gpm (or 3.06 cfs).StormTrooper SWST-25

Solution:The City of Houston requires Stormwater treatment of at least 80% of annual stormwaterevents; or Treated Intensity Factor of I=.27

Example:A common application is stormwater run-off from a 12 acre commercial building site. The stormwater run-off consists of trace amounts of oil, litter, and road grime. Using the Rational Method, and an average Runoff Coefficient of C=.80, the treated flow rate is calculated:

AacreQ =

gpmx C

Formula:Multiply the number of Acresthe following equation to obtain the treated flow rate:

x I x 449Where:

A = Drainage Area (acres)C = Runoff CoefficientI = Treated Rainfall Intensity

449 = Conversion from cfs to gpm

Q = Treated Flow Rate (gpm)

2

A. Actual Sizing Calculations for the site located at .

Outfall #1

A Area

(acres)

C Runoff

Coefficient

I Rainfall Intensity

Qcfs Flowrate

(cfs)

Qgpm Flowrate

(gpm)

StormTrooper Model

(see Table 1 for required size)

x x = x 449 =

2 Storm Water Quality Management Guidance Manual 2001, City of Houston/Harris County Flood Control District/Texas Dept of Transportation Stormwater Management Joint Task Force

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B. Table 1: StormTrooper Size Table for Typical Stormwater Treatment Flow Rates

Cylindrical Designs Rectangular Designs

Model No Gallons GPM CFS Model No. Gallons GPM CFS

SwST-05C 500 300 0.67 SwST-10 1000 650 1.45 SwST-06C 600 400 0.89 SwST-15 1500 875 1.95 SwST-08C 800 500 1.11 SwST-20 2000 1125 2.51 SwST-10C 1000 650 1.45 SwST-25 2500 1375 3.06 SwST-15C 1500 875 1.95 SwST-30 3000 1600 3.56 SwST-20C 2000 1125 2.51 SwST-35 3500 1775 3.95 SwST-25C 2500 1375 3.06 SwST-40 4000 1950 4.34 SwST-30C 3000 1600 3.56 SwST-45 4500 2150 4.79 SwST-35C 3500 1775 3.95 SwST-50 5000 2350 5.23 SwST-40C 4000 1950 4.34 SwST-60 6000 2675 5.96 SwST-45C 4500 2150 4.79 SwST-70 7000 3000 6.68 SwST-50C 5000 2350 5.23 SwST-80 8000 3325 7.41 SwST-60C 6000 2675 5.96 SwST-90 9000 3625 8.07

SwST-100 10000 3900 8.69 SwST-110 11000 4175 9.30 SwST-120 12000 4425 9.86 SwST-130 13000 4725 10.52 SwST-140 14000 4950 11.02 SwST-150 15000 5200 11.58

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1.7 StormTrooper® Specifications

A: General:

1. A Stormwater Interceptor shall be provided and installed as indicated on plans. Systemshall be Park Environmental Equipment Company, StormTrooper® Model SwST-XX.The system shall be installed in strict accordance with the manufacturer'srecommendations. Manufacturer shall have been in business for 10 years in the designand manufacturing of wastewater products. Manufacturer shall provide a one-yearlimited warranty. Manufacturer shall provide proof of third party testing by anindependent applied engineering and physical sciences testing organization.

2. The Stormwater Interceptor shall be provided with installation, operation & maintenancemanuals that contain clear and concise descriptions.

3. Contractor shall submit required copies of manufacturer's equipment specification forengineer's review. Shop drawings shall include the following:

a) Detailed manufacturer's data including installation plan/elevation drawings, rebarlayout drawings, buoyancy calculations, and site specific coalescing plateperformance analysis for TSS & TPH, all certified by a registered professionalengineer.

b) Manhole frame/cover specifications.c) Joint Sealant specifications.d) Coatings and/or concrete additives specifications.

4. Stormwater Interceptor design shall conform to criteria set forth by the InternationalAssociation of Plumbing and Mechanical Officials (IAPMO), the American PetroleumInstitute, and all other governing state and local code requirements.

5. Contractor shall field verify all dimensions for piping inverts and interceptor excavationdepth.

B: Materials:

1. Concrete: The Stormwater Interceptor tank shall be constructed of precast concretehaving a 28 day minimum compressive strength of 4500 PSI using a Type I PortlandCement.

2. Steel Reinforcement: The Stormwater Interceptor shall be designed for H-20-44 trafficloading as defined by AASHTO 14th ED. 1989 using a 30% impact factor. Structuralreinforcement placement shall be in accordance to ACI. All reinforcement steel shallcomply with ASTM A615 grade 60 or ASTM A706 Grade 60. Bar bending shall complywith latest ACI standards. Lifting inserts to be installed for handling and be installed permanufacturer's requirements.

3. Manhole Access: Interceptor shall have adequate manhole access covers and framesto permit access for cleaning all areas of the interceptor. Each manhole access shall beminimum 24” diameter clear opening. Cast iron frame and covers shall conform toASTM A48-83 Class 30. Fabricated steel access covers shall be ASTM A36 steelconstruction and hot-dipped galvanized after fabrication. All access covers shall betraffic duty. Access covers shall be placed at grade elevation by using concreteextensions.

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4. Pipe Material: All pipe and fittings shall be of materials approved by engineer.

5. Coalescing Media: The oil coalescing media pak shall be fabricated of an oleophillicpolypropylene plastic material and assembled into modules with 304 stainless steelmaterials. Media assembly shall be self-cleaning and removable.

6. The Stormwater Interceptor shall be equipped with a system to control by-pass manholeto control unusually high rainfall. The control manhole system shall prevent re-suspension and scouring of the storm water interceptor. The control by-pass systemshall be equipped with an adjustable weir and stainless steel debris screen.

C: Interceptor Performance:

1. The interceptor shall be sized to treat the flow generated by the design rainfall intensityof the Harris County area, which is based on 0.27-inch per hour. Using 0.27-inch perhour rainfall intensity, the rational formula (Q=CIA) shall be used to determine thedesign flow rate for impervious (C=0.80) commercial drainage areas.

2. The Interceptor shall be capable containing and treating a wide variety of concentrationand loads of floatable and non floatable constituents such sand, sediments, oil, grease,grit and trash debris to the acceptable loadings of EPA and local authorities.

3. Influent Characteristics - The interceptor shall be designed for intermittent and variableflows of water, oil, or any combination of non-emulsified sediment/oil/water mixturesranging from zero to 2,400 gpm (adjust number accordingly). Operating temperaturesof the influent storm water shall range from 40F to 60F. The specific gravities of thehydrocarbons shall range from .68 to .95 at operation temperature and have aconcentration of 400 PPM or less.

4. Effluent Characteristics – The total petroleum hydrocarbon (TPH) concentration of theinterceptor effluent shall not exceed 10 mg/l. The system shall be capable of removinga minimum of 80% of the total suspended solids (TSS).

5. The Interceptor manufacturer shall provide recommended maintenance and operationsinstructions that comply with EPA, county and local monitoring requirements.

D: Installation:

1. The Interceptor shall be installed in strict accordance with the manufacturer'srecommendations and according to plans and specifications. The manufacturer shallhave representation during the setting procedure to insure proper installation.

2. The Stormwater Interceptor shall be installed on level, undisturbed soil or an approvedcompact fill with a load bearing capacity of minimum 2000 PSF.

3. The interceptor shall be backfilled after placement with an approved backfill material.Backfill of all sides of structure shall be performed simultaneously to prevent unbalancedlateral pressures during construction.

4. All joints shall be made watertight. Manufacturer shall seal joints with a plastic flexiblegasket conforming to AASHTO M-198-75 for bitumen gasket.

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5. All interceptor inlet/outlet/vent piping shall be installed in accordance to manufacturer’srecommendations and project specifications.

6. Interceptor shall be filled with clean water prior to start-up of system. Followmanufacturer’s recommendations for testing and start-up.

1.8 Maintenance

A preventative maintenance cleanout schedule is the most valuable tool for maintaining the proper operation of Park StormTrooper®. Interceptor maintenance costs will be greatly reduced if a good housekeeping plan for the property is developed i.e., trash pickup, lawn maintenance, dumpster control, etc.

Typically, regulatory entities require the manufacturer to recommend routine maintenance. ParkUSA recommends StormTrooper should be inspected after any major storm event or at least quarterly (see Table 3). StormTrooper should be completely pumped out when sediment or oil levels reach the capacities listed in Table 2. Most authorities with annual renewal programs require pump out at least once a year. Monitoring results should be recorded and submitted annually along with any pump out manifests and a PE stamped certification that the system is in operation per the original design. All documents are helpful in obtaining an annual permit renewal.

A. Maintenance Procedures

1. Easiest observation and maintenance is best accomplished during non-flow (dryweather) conditions 3-4 days after the most recent rain.

2. Remove the control manhole basin cover. Remove and observe optional inflowprotectors. Observe for trash and debris and remove if necessary. Trash is typicallycollected in the control manhole. This is the most important maintenance requirement.Failure to remove trash and debris from the control manhole could be problematic toentire system.

3. Remove interceptor covers or open hatchway to observe conditions. Remove optionalhatchway safety net (“HatchNet”) if applicable. If absorbent pillows are utilized, observetheir condition. Uniform browning or gray color of the pillow means they should bereplaced. Observe baffle debris screen and clean if necessary.

4. Coalescing media (white plates) is provided for added treatment of Total PetroleumHydrocarbons (TPH) and removal of the finer Total Suspended Solids (TSS).Coalescing media give the environmentally conscience user assurance that effluentstormwater will leave owner’s property with contaminate loadings lower than 10 mg/l.

5. Coalescing plates are self-cleaning and seldom require maintenance unless broken orcrushed. Do not walk on or stand on plate packs. Call Park Environmental Equipment(800-256-8041), for assistance if coalescing media is damaged.

6. Check of the depth (level) of oil and sediment with a tank sampler device designed forthis purpose. Two examples listed below may be purchased via Internet. Checkwww.pollardwater.com (Sludge Judge) and www.carpco.com (Discrete SludgeSampler). See Figure 1.

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http://www.pollardwater.com/

http://www.carpco.com/



7. Find your StormTrooper® Model Number on Table 2 below. The model number listsrecommended maximum capacities of oil and sediment. Vacuum service should beconsidered when capacities exceed these recommended levels.

Table 2: Recommended Service Levels

Rectangular Designs Cylindrical Designs Model

Number Oil

Depth Sediment

Depth Model

Number Oil

Depth Sediment

Depth SwST-10 12” 12” SwST-05C 12” 12” SwST-15 12” 12” SwST-06C 12” 12” SwST-20 12” 12” SwST-08C 12” 12” SwST-25 12” 12” SwST-10C 12” 12” SwST-30 12” 12” SwST-15C 12” 12” SwST-35 12” 12” SwST-20C 12” 12” SwST-40 12” 12” SwST-25C 12” 12” SwST-45 12” 12” SwST-30C 12” 12” SwST-50 12” 12” SwST-35C 12” 12” SwST-60 12” 12” SwST-40C 12” 12” SwST-70 12” 12” SwST-45C 12” 12” SwST-80 12” 12” SwST-50C 12” 12” SwST-90 12” 12” SwST-60C 12” 12” SwST-100 12” 12” SwST-110 12” 12” SwST-120 12” 12” SwST-130 12” 12” SwST-140 12” 12” SwST-150 12” 12”

CONTROL MANHOLEObserve and RemoveExcess Trash & Debris

INTERCEPTOR SECTIONCheck Depths of Oil &Sediment with SamplerDevice. Schedule VacuumTruck Service if Needed

Sediment

Figure. 1 StormTrooper® Inspection

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B. Vacuum Truck Recommendations

1. Typically, the vacuum truck will skim off the oil and other floatables. In most geographicareas the sediment can be disposed of in a sanitary landfill once dewatered. Pollutantsare not allowed to be discharged back into the sanitary or storm sewer systems.

Sediment

Figure. 2 StormTrooper® Maintenance

2. After cleaning via vacuum truck, refill the StormTrooper® with water to the topcoalescing media plate. Replace the absorbent pillows if utilized. Replace manholecovers, safety nets and inflow protectors (if provided). Close and latch hatchway.

3. After cleanout is accomplished, obtain a copy of the service truck manifest. Update theStormTrooper® Monitoring/Maintenance Report and attach a copy of the manifest to thereport.

C. Safety and Environmental Considerations

1. All normal safety precautions should be taken with this equipment to prevent accidentsand fires. Normal fire prevention measures must be taken to prevent fire danger fromthe separated oil.

2. Care should be taken to keep the area around the interceptor clean to preventaccidents.

3. Dispose of the separated oil properly, preferably by recycling.

4. The atmosphere inside the Park Environmental Equipment StormTrooper® is a confinedspace and may be hazardous. Entry is not recommended without proper equipment.Follow OSHA confined space entry requirements.

5. SAFETY AND ENVIRONMENTAL PROTECTION ARE THE RESPONSIBILITY OFTHE USER. PARK EQUIPMENT CO. ASSUMES NO LIABILITY FOR MISUSE OFTHIS SEPARATOR OR FOR USE OUTSIDE THE PARAMETERS FOR WHICH IT ISDESIGNED.

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Appendix A

Documentation

NPDES or TPDES Permit or NOI Maintenance and Inspection Schedule

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NPDES or TPDES Permit or NOI (Insert NPDES or TPDES permit or NOI)

EXAMPLE

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PERMITTEE CERTIFICATION OF STORM WATER QUALITY MANAGEMENT REQUIREMENTS

I, (Name), acting as (Position) for (Permittee's Name), Permittee, certify under penalty Of law that the proposed development is subject to storm water quality requirements. It is my duty to see that all storm water quality features be placed in accordance with construction drawings approved by (the City of Houston, Harris County, ... etc.). Once storm water quality features are in place, it is my responsibility that all features be inspected either yearly or at the frequency outlined in the Storm Water Quality Management Plan For (Site Name). Also, all storm water quality features will be maintained in accordance with the above-mentioned report for the property known as (Site Name) at (Address or Location).

Signature: ____________________________________ Date: _______________

(Printed Name): ________________________________________

(Permittee's Name): ________________________________________

(Address): ________________________________________

(Phone Number): ________________________________________

State of Texas

County of__________________________________

Before me, a notary is day personally appeared _________________________________________ known to me (or proved to me on the oath of ___________________________) to be the person whose name is subscribed to foregoing instrument and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed. Given under my hand and seal of office this___________day of ________________,___________.

____________________ Notary Public's Signature

STORM WATER QUALITY MANAGEMENT PLAN ENGINEER'S CERTIFICATION

(NOTE: Engineer's Certification is required for SWQMPs submitted to Harris County for a Harris County Storm Water Quality Permit.

I, _________________________________ (Name), a registered ___________________ (Engineer) duly licensed to practice in the State of Texas do hereby certify that the information presented in this document was prepared under my direction and supervision and complies with the Regulations of Harris County, Texas for Storm Water Quality Management and the Storm Water Quality Management Guidance Manual, Any parts of the design/sizing of the permanent storm water quality feature(s) that do not meet the current minimum design criteria contained within the Regulations and Manual as noted below.

(Describe any exceptions to the criteria here.)

Signature: _________________________________ Date: _________________________

(Printed Name): ___________________________

(License Number): ___________________________

(Address): _________________________________________________________

(Phone Number): ___________________________

________________________ Engineer's Seal and Signature

Project Name: ____________________________________________________

Project Description: ____________________________________________________

Project Location: ____________________________________________________

p:\watershed protection\stormwater group\plan review\forms\2015 draft changes\swq as-built certificate 3.20.15.docx Revised 10/04/05

STORMWATER QUALITY PERMIT AS-BUILT CERTIFICATE

I, ____________________________________, a registered Professional Engineer (Name)

duly licensed to practice in the State of Texas do hereby certify that the

____________________________________________________, constructed at (Storm Water Quality Features) ______________________________________________, under Permit Number (Project Named on Permit)

_______________________, were completed in accordance with the drawings and (Storm Water Quality Permit#)

specifications on file with the Harris County Engineering Department.

S E A L __________________

Signature Date

__________________ Mailing Address

__________________ City, Zip

__________________ Phone No.

P:\WATERSHED PROTECTION\Stormwater Group\PLAN REVIEW\Forms\2015 Draft Changes\01b Annual Permitee Certification Form 3.20.15.docx

ANNUAL PERMITTEE CERTIFICATION OF PROPER OPERATION

I, ________________________, acting as __________________________ (Name) (Position)

for ________________________________, permittee, certify under penalty of (Permittee’s Name)

law that the Storm Water Quality Management Plan in effect for ______________

_______________________________________________________________, (Development Named on Permit)

under Storm Water Quality Permit No. ________________________, has been(SWQ Permit No.)

complied with according to the provisions contained therein.

___________________________ _______________________ (Signature) (Date)

___________________________ _______________________ (Printed Name) (Phone Number)

Permittee’s Name: _____________________________________________

Address: ____________________________________________________

City, State, and Zip: ____________________________________________

Phone No. ___________________________________________________

State of Texas § County of Harris §

Before me, a notary public, on this day personally appeared _______________________ _________________________ known to me (or proved to me on the oath of _________________________) to be the person whose name is subscribed to the foregoing instrument and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed.

Given under my hand and seal of office this _____ day of _____________, _________.

_______________________________________ SEAL Notary Public

Form SWQ 01-005

P:\WATERSHED PROTECTION\Stormwater Group\PLAN REVIEW\Forms\2015 Draft Changes\01c Annual Engineer Certification Form 3.20.15.docx

ANNUAL PROFESSIONAL ENGINEER INSPECTION CERTIFICATION

I, ___________________________, a registered Professional Engineer (Name)

duly licensed to practice in the State of Texas do hereby certify that on ___________________, the _______________________________________

(Inspection Date) [Structural Control(s)]

designed and constructed as part of Storm Water Quality Permit Number

_________________, conformed to the plans and technical specifications (SWQ Permit No.)

contained in the approved civil engineering drawings and Storm Water

Quality Management Plan on file with the Harris County Engineering

Department, Permit Office.

_________________________________ _______________________ Signature Date

_________________________________ Mailing Address

_________________________________ S E A L City, Zip

_________________________________ Phone No.

Form SWQ 01-006



Table 3: StormTrooper® Interceptor Monitoring / Maintenance Report

Year: Company Name: Address: City/State/Zip: Contact Phone: Contact Name: StormTrooper® Model GPM

Quarterly Record Keeping Maintenance Activity Mar June Sept Dec

Non-Structural Controls Manhole Debris Cleaned Interceptor Debris Cleaned Hose Off Inside Walls Debris Screens Cleaned Mowing of Stormtrooper

Structural Controls Oil Depth Solids Depth Pumped Out

Inspections Quarterly Annually

“X” identifies the months in which the activity will be performed (at a minimum). *Provided to residents at move-in and available at community locations.**Sediment removed from basin per chart on Table 2 (page 11) or at least one year from move-in of location

I certify that I supervised or performed StormTrooper® monitoring per local codes and manufacturer’s recommended monitoring and maintenance procedures on the dates listed above.

Signed: ____________________________ Owner or Owner Representative

Print Name: ____________________________

Date Submitted: ____________________________

Note: The property must submit for permit renewal yearly. For permit renewal, you will be notified by the regulatory agency to submit this inspection report along with an Annual Review of Monthly StormTrooper® Monitoring, Maintenance and Operation signed and stamped by a professional engineer licensed in the State of Texas.

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HARRIS COUNTY

10555 Northwest Frwy Ste 120 Houston TX 77092-8615 SWQ 01-001 (713) 956-3000

L:\WATERSHED PROTECTION\Stormwater Group\PLAN REVIEW\Forms\2011 Draft Changes\SWQ Permit App 05.10.11.docx

STORM WATER QUALITY PERMIT APPLICATION

1. APPLICANT & OWNER INFORMATION (Please print or type)Applicant Name___________________________________________________________Phone__________________________Fax_______________________

Applicant Mailing Address ___________________________________________City ________________________ State _______Zip_______________

Property Owner Name_______________________________________________________________________________________________________________

Property Owner’s Mailing Address ________________________________________City ______________________ State_______ Zip_____________

Property Owner E-mail_______________________________________________Phone______________________________Fax_____________________

2. PERMIT STATUS (Check only one per form)[ ] New Permit, Provide HC Project # ________________ [ ] Renewal [ ] Amendment [ ] Transfer Provide Permit No. _________________[ ] Master Permit, Provide Permit No.’s to be Consolidated: _______________________________________________________________________________

3. LOCATION OF PROPERTY

Subdivision/Project Name___________________________________________________________Sec___________Blk_________Lot_________Res________

Street Address_________________________________________________ City ______________________________ State _________ Zip ________________

Acreage ___________________Survey Name __________________________________________________________ Abstract Number__________________

Property Tax Account Number _________________________ - _________________________ -_________________________-_________________________

4. RECEIVING STREAMHCFCD Name and Unit No.: _________________________________________________________________________________________________________

5. PERMANENT STORM WATER QUALITY FEATURE

[ ] Dry w/ Detention [ ] Dry 10/100 Yr Trash Basin [ ] Oil/Grit/Trash Separator(s) [ ] Vegetative Filter Strip(s)

[ ] Wet w/ Detention [ ] Wet 10/100 Yr Trash Basin [ ] Trash Separator(s) [ ] Grassy Swale(s)

[ ] Inlet Inserts [ ] Low-Impact Development [ ] Combination [ ] Other-Explain: _______________________________

6. DEVELOPMENT TYPE

[ ] New Development [ ] Significant Re-Development [ ] Existing Development

7. MUNICIPAL SEPARATE STORM SEWER TYPE[ ] Detention Pond [ ] Flood Control Ditch [ ] Open Ditch [ ] Storm Sewer

8. STORM WATER QUALITY FEATURE OWNERSHIP TRANSFER INFORMATION (If Applicable)Upon Completion, Ownership of the Permanent Storm Water Quality Feature Will be Transferred To: _________________________________________[ ] Property Owner (if other than current) [ ] HCFCD [ ] MUD [ ] Home Owner’s Assoc.

FOR NEW PERMIT: Attach 1 copy of the Approved Plan Set (if approved before 11/1/2009), the original SWQ Affidavit, a copy of the NOI, and the fees. FOR PERMIT RENEWAL: Attach both completed original Annual Certification Forms and the fee. Additional information and forms: http://hcpid.org/permits/swq_welcome.html All development must be completed in accordance with the Regulations of Harris County, Texas for Storm Water Quality Management.

The Applicant hereby acknowledges and agrees to be strictly bound to Commissioners’ Court of Harris County in ensuring that all provisions, conditions and requirements attached to the issuance of the Storm Water Quality permit(s) under the Regulations of Harris County, Texas for Storm Water Quality Management will be faithfully and fully complied with.

The permit applicant understands and agrees that the County Engineer may make scheduled or unscheduled inspections of the property upon the issuance of the permit. The applicant acknowledges that the Permanent Storm Water Quality Feature must receive a Final Inspection before a Certificate of Compliance can be issued. If the permit applicant is a corporation, partnership or other legal entity other than a natural person, then the undersigned acting as the authorized representative of said entity will be responsible for ensuring the entity’s compliance with all provisions, conditions and requirements of the Storm Water Quality Permit.

I, ___________________________________________________________________, the undersigned have carefully reviewed this application and my answers to all questions. To the best of my knowledge, the answers are all true and correct.

SIGNATURE of Applicant/Agent or Attorney__________________________________________________________________ Date____________________

Receiving Plan checking Cashier Date Application Received Applicant No. Planchecker SWQ #

Request No. Approved By

Property No. Date

Clerk & Date Viol No. Receipt No.