Form 605-006 - Annual Comprehensive Site Compliance Evaluation Report (Page 4 of 4) in pdf

Exhibit 5 Annual Comprehensive Site Compliance Evaluation Report - Instructions

Instructions for Completing the Annual Comprehensive Site Compliance Evaluation Report

Form 605-006, Storm Water Discharges Associated with Industrial Activity

When to File an ACSCER Form:

How to complete the Comprehensive Site Compliance

Permittees who are presently covered under an issued

Evaluation Report Part B (see Section 4.2.17)

OPDES general permit for storm water discharges associated

1. Inspect all areas where materials or activities are

with

industrial

activity

must

submit

Annual

exposed to storm water, and areas where spills and

Comprehensive Site Compliance Evaluation Report by

leaks have occurred within the past 3 years.

March 1

of each year, beginning in 2012. This is in lieu of

2. Report industrial material, residue or trash on the

filing analytical benchmark discharge monitoring reports. If

ground that could contaminate or be washed away.

you need assistance or have questions, contact the Storm

3. Prevent leaks or spills from industrial equipment,

Water Program of the Environmental Complaints & Local

drums, barrels, tanks, etc.

Services of the DEQ at (405) 702-6100.

4. Prevent offsite tracking of industrial material or

Section I: Permit Information:

sediment.

Enter the existing OPDES General Storm Water Multi-

5. Prevent tracking or blowing of raw, final, or waste

Sector Industrial Permit number assigned to the facility

material from areas of no exposure to exposed areas.

identified in Section II.

6. Include evidence of, or potential for pollutants

Section II. Facility Operator Information:

entering the drainage system.

Give the legal name of the person, firm, public organization

Corrective Actions (see Part 4.2.17.3):

or any other entity that owns or operates the facility

1. Review to determine if revisions/modifications to

described in this application. The name of the operator may

eliminate problems or meet the effluent limits in this

or may not be the same name as the facility. The operator of

permit;

the facility is the legal entity that controls the facility's

operation, rather than the plant or site manager.

2. Document your discovery of any of the conditions

listed in Part 4.2.17.3.a and b within 24 hours and any

Section III: Facility/Site Location Information:

corrective actions to be taken to eliminate or further

Enter the facility’s official or legal name and complete

investigate the deficiency within 14 days of such

address, telephone, city, state, and ZIP code. If the facility

discovery.

lacks a street address, indicate the latitude and longitude of

3. Complete the corrective action report with the

the facility to the nearest 15 seconds.

information included in Part 4.2.17.3.d..

Section IV: Certification

The ACSCER form must be signed by a responsible party

Reporting is required by March 1

of the year

such as the owner or an officer, such as: president, vice

beginning in 2012.

president, secretary, and treasurer of either a corporation,

company, trust, partnership, or sole proprietorship by a

Where to file an ACSCER :

general partner or the proprietor. For a municipality, state,

DEQ - ECLS

Federal, or other public facility: by either a principal

Storm Water Program

executive officer or ranking elected official.

P.O. Box 1677

Oklahoma City, Oklahoma 73101-1677

Form 605-006 - Annual Comprehensive Site Compliance Evaluation Report Page 4

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