Program for Residents
ANNUAL REPORT DATA SUMMARY SHEET
Program for Illicit Discharges/Illegal Connections
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Co-permittee:
(City Name)
|Incident Response |
|Illicit Discharges | | |
| |Total number of reports of illicit discharges | |
| | | |
| |Number of reports that were responded to* | |
| | | |
| |Number of these reports that were identified as actual illicit discharges | |
| | | |
| |Number of actual illicit discharges where the incident was cleaned up/referred to another agency**/ followed up/education | |
| | | |
|Illicit Connections | | |
| |Total number of illicit connections identified | |
| | | |
| |Total number of illicit connections eliminated | |
* SMP Performance Criteria: Co-permittees will investigate 90% of reported illicit discharge/dumping incidents.
** SMP Performance Criteria: When appropriate or necessary, Co-permittees will refer documented non-stormwater discharges/connections or dumping to the appropriate agency for investigation, containment, and cleanup.
|Definitions/Reporting Criteria |
|Report |Includes all complaints, referred complaints and/or reports received by telephone, email, fax or website, etc. |
|Illicit Discharge |Shall mean any discharge to the storm drain system or an upstream flow, which is a tributary to the storm drain system that is not |
| |composed entirely of stormwater except discharges pursuant to a NPDES permit and discharges that are exempt or conditionally exempt in |
| |accordance with any applicable order of the RWQCB-LA. For more information, please see pages 7-2 through 7-4 of the SMP. |
|Illicit Connection |Shall mean any man-made conveyance or drainage system pipeline, graded channel, conduit, inlet or outlet, or condition of property |
| |whether on the surface or subsurface through which the discharge of any pollutant to the storm drain system occurs or may occur. The |
| |term illicit connection shall not include connections to the storm drain system that are authorized by a Co-permittee with jurisdiction|
| |over the system at the location at which the connection is made. |
Completed by: Date: Phone:
ANNUAL REPORT DATA SUMMARY SHEET
Program for Illicit Discharges/Illegal Connections
[pic]
Co-permittee:
(City Name)
|Source Determination |
|Probable Cause | | |
| |Total number of actual illicit discharges/dumping that resulted from an accident | |
| | | |
| |Total number of actual illicit discharges/dumping that resulted from cleaning activities | |
| | | |
| |Total number of actual illicit discharges/dumping that resulted from a spill/overflow | |
| | | |
| |Total number of actual illicit discharges/dumping that resulted from unknown cause | |
| | | |
| |Total number of actual illicit discharges/dumping that resulted from other | |
| | | |
| |Sum of above | |
| |(should match number of actual illicit discharges on page 1) | |
|Please briefly describe actions taken to prevent similar discharges from occurring: |
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|Probable Cause Definitions |
|Accident |An unpreventable or chance happening that occurs unexpectedly, without deliberate plan or cause. |
|Cleaning Activities |Any activity intended to wash, tidy up, or make clean. |
|Spill/Overflow |A preventable release of material; may be the result of poor maintenance or negligence. |
|Unknown |Cause is unidentified; unable to determine origin. |
|Other |Any remaining incidents that do not fit into the above mentioned categories. |
Completed by: Date: Phone:
ANNUAL REPORT DATA SUMMARY SHEET
Program for Illicit Discharges/Illegal Connections
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Co-permittee:
(City Name)
|Source Determination con’t. |
|Type of | | |
|Material |Number of actual illicit discharges/dumping that involved hazardous material | |
| | | |
| |Number of actual illicit discharges/dumping that involved sewage | |
| | | |
| |Number of actual illicit discharges/dumping that involved wastewater | |
| | | |
| |Number of actual illicit discharges/dumping that were building materials | |
| | | |
| |Number of actual illicit discharges/dumping that were landscape debris | |
| | | |
| |Number of actual illicit discharges/dumping that were animal wastes | |
| | | |
| |Number of actual illicit discharges/dumping that were litter/trash | |
| | | |
| |Number of actual illicit discharges/dumping that were other | |
| | | |
| | | |
| |Sum of above | |
| |(should match number of actual illicit discharges on page 1) | |
|Type of Material Definitions |
|Hazardous Material |By-products of society that can pose a substantial or potential hazard to human health or environment when improperly managed. |
| |Posses at least one of the four following characteristics (ignitability, corrosivity, reactivity, or toxicity), or identified as a |
| |listed waste (e.g. oil, used anti-freeze, hydraulic fluid). |
|Sewage |The waste and wastewater produced by residential and commercial sources and discharged into sewers, includes the sludge produced by |
| |Publicly Owned Treatment Works. |
|Wastewater |The spent or used water from a home, community, farm or industry that contains dissolved or suspended matter. |
|Building Materials |Any debris associated with construction activities used to construct a building and/or stand/alone facility, such as plaster, |
| |dry-wall, nails, wood, etc. |
|Landscape Debris |Excessive eroded soils, sediment and/or organic materials |
|Animal wastes |Discharge from confinement facilities, kennels, pens, recreational facilities, stables, show facilities, and residential yards. |
|Litter/Trash |Synthetic consumer by-products |
|Other |Any remaining materials that do not fit into the above mentioned categories. |
Completed by: Date: Phone:
ANNUAL REPORT DATA SUMMARY SHEET
Program for Illicit Discharges/Illegal Connections
[pic]
Co-permittee:
(City Name)
|Source Type | | |
| |Number of actual illicit discharges/dumping that originated from a residential source | |
| | | |
| |Number of actual illicit discharges/dumping that originated from an industrial/commercial source | |
| | | |
| |Number of actual illicit discharges/dumping that came originated a Co-permittee facility | |
| | | |
| |Number of actual illicit discharges/dumping that originated from construction activities | |
| | | |
| |Number of actual illicit discharges/dumping that originated from an unknown source | |
| | | |
| |Sum of above | |
| |(should match number of actual illicit discharges on page 1) | |
| Source Type Definitions |
|Residential |Discharge generated from residential activities; can include solid waste (trash, discarded appliances), automotive |
| |maintenance/cleaning by-products (oil, transmission fluid), home repair/remodel waste (paint, plaster) and yard trimmings. |
|Industrial/Commercial |Discharge of all solid and unwanted materials emanating from a business or industrial facility/operation; may be liquid, sludge, |
| |solid or hazardous. |
|Co-permittee Facility |Discharge of effluent or waste from a Co-permittee owned facility (includes corporate yards, and waste water treatment plants); |
| |may be composed of domestic wastewaters and/or industrial discharges. |
|Construction Activities |Discharge of building materials, dredging materials (including sediment), tree stumps, and rubble from construction and |
| |demolition of homes, commercial buildings and other structures and pavements. May contain lead, asbestos, or other hazardous |
| |material. |
|Unknown |Any discharge from city streets and adjacent domestic or commercial properties that could carry pollutants of various kinds into |
| |the storm drains and receiving waters that cannot be traced to source or does not fit into the above mentioned categories. |
Completed by: Date: Phone:
ANNUAL REPORT DATA SUMMARY SHEET
Program for Illicit Discharges/Illegal Connections
[pic]
Co-permittee:
(City Name)
|Enforcement Program |
|Enforcement Actions |Total number of enforcement actions taken | |
| | | |
| |Total number of warnings issued | |
| | | |
| |Total number of Notice of Violations issued | |
| | | |
| |Total number of Legal Actions taken | |
|Stormwater Quality Staff Training |
|Number of staff targeted for stormwater training |
| |
|Percentage of Targeted Staff Trained* |
* SMP Performance Criteria: Co-permittees will train 90% of targeted employees by January 27, 2001 and annually thereafter. Training will include education in illicit discharge/dumping and illegal connections identification, investigation, reporting and/or cleanup.
|Definitions/Reporting Criteria |
|Warning |This is the first level of enforcement. This enforcement is generally limited to problems that are relatively minor and will be |
| |resolved immediately and cooperatively upon notification. This notification can be either verbal or written. |
|Notice of Violation |This is the second level of enforcement. This enforcement is used when a warning fail to achieve compliance for minor problems that are|
| |repeated, and for moderate level problems that will be resolved cooperatively but may require an extended period of time to achieve |
| |desired compliance. The NOV will identify the objectives that are not being met and/or the local requirements that have not been |
| |achieved and will indicate that continued noncompliance may result in additional enforcement actions. The NPV will provide a compliance|
| |date. |
|Legal Action |This is the third level of enforcement. This enforcement is used when prior efforts have failed to achieve compliance for major |
| |problems that are repeated, for any violation that may pose an immediate and/or significant threat to the public or the environment, or|
| |when problems are the result of deliberate, intentional, and/or criminal acts or failures to act. Legal actions usually involve the |
| |judicial system. |
Completed by: Date: Phone:
OPTIONAL GUIDANCE MATERIAL FOR CO-PERMITTEE DOCUMENTATION PURPOSES (for your files only)
Program for Illicit Discharges/Illegal Connections
[pic]
Co-permittee:
(City Name)
|Incident Report* |
|Incident Date |Source Name |Source Address |
| | | |
| | | |
| | | |
|( Incident was an illicit discharge/dumping |
|Date of Initial Inspection |Date of Follow-up/Education |
| | |
| | |
| | |
|Type of Material |Source Type |Probable Cause |
| | | |
|( Hazardous ( Building Materials |( Residential |( Accident |
|( Sewage ( Landscape Debris |( Industrial/Commercial |( Cleaning Activities |
|( Wastewater ( Animal Wastes |( Co-permittee Facility |( Spill/Overflow |
|( Litter/Trash ( Other |( Construction |( Unknown |
| |( Unknown |( Other |
|Actions taken to prevent similar discharges from occurring |
| |
| |
| |
| |
| |
|Date of Conclusion |Date of Cleanup/Removal |
| | |
| | |
| | |
|( Incident was referred to other agency |Type of Enforcement Action taken (if appropriate) |
| | |
|( Incident was cleaned up/terminated |( Warning |
| |( Notice of violation |
|( Follow-up/education conducted |( Legal Action |
| | |
|( Enforcement action taken | |
* SMP Performance Criteria: Co-permittees will investigate 90% of reported illicit discharge/dumping incidents.
Completed by: Date: Phone:
OPTIONAL GUIDANCE MATERIAL FOR CO-PERMITTEE DOCUMENTATION PURPOSES (for your files only)
Program for Illicit Discharges/Illegal Connections (cont.)
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Co-permittee:
(City Name)
Co-permittee Illicit Discharge/Dumping Database*
Co-permittee Type of Material Source Type
Insert Co-permittee Name Choice of: Choice of:
Hazardous Material Residential
Sewage Industrial/Commercial
Wastewater Co-permittee Facility
Building Materials Construction
Landscape Debris Unknown
Animal Wastes
Litter/Trash
Other
Date of Initial Inspection Date of Follow-up Inspection Date of Conclusion/Clean
DATE DATE up/Removal/Follow
up/Education
DATE
Probable Cause Enforcement Action Taken
Choice of: Choice of:
Accident Not applicable
Cleaning Activities Warning Issued
Spill/Overflow Notice of Violation Issued
Unknown Legal Action Taken
Other
* SMP Performance Criteria: Co-permittees will provide a summary of records on illicit discharges and connections, which includes type of material, type of source, date of initial inspections, enforcement action taken, date of follow-up inspection, date of conclusion/clean up/removal/ follow up/education, annually as part of the Annual Storm Water Report and Assessment.
Completed by: Date: Phone:
OPTIONAL GUIDANCE MATERIAL FOR CO-PERMITTEE DOCUMENTATION PURPOSES (for your files only)
Program for Illicit Discharges/Illegal Connections (cont.)
[pic]
Co-permittee:
(City Name)
|Stormwater Quality Staff Training |
|Number of staff targeted for stormwater training |
| |
|Total Trained* |
| | |
|Staff Training Sessions |
|Date |Number Trained |Topics Covered |
| | |( General Stormwater |
| | |( Inspections |
| | |( Illicit Discharge Response |
| | |( General Stormwater |
| | |( Inspections |
| | |( Illicit Discharge Response |
| | |( General Stormwater |
| | |( Inspections |
| | |( Illicit Discharge Response |
| | |( General Stormwater |
| | |( Inspections |
| | |( Illicit Discharge Response |
| | |( General Stormwater |
| | |( Inspections |
| | |( Illicit Discharge Response |
| | |( General Stormwater |
| | |( Inspections |
| | |( Illicit Discharge Response |
| | |( General Stormwater |
| | |( Inspections |
| | |( Illicit Discharge Response |
| | |( General Stormwater |
| | |( Inspections |
| | |( Illicit Discharge Response |
* SMP Performance Criteria: Co-permittees will train 90% of targeted employees by January 27, 2001 and annually thereafter. Training will include education in illicit discharge/dumping and illegal connections identification, investigation, reporting and/or clean up.
Completed by: Date: Phone:
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