Stormwater Pollution Prevention Program (Swppp) Template (Page 10 of 30) in pdf

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Instructions:

• List the waterbody(s) that would receive stormwater from your site, including streams, rivers, lakes, coastal

waters, and wetlands. Describe each as clearly as possible, such as Mill Creek, a tributary to the Potomac

River, and so on.

• Indicate the location of all waters, including wetlands, on the site map.

• Note any stream crossings, if applicable.

• List the storm sewer system or drainage system that stormwater from your site could discharge to and the

waterbody(s) that it ultimately discharges to.

• If any of the waterbodies above are impaired and/or subject to Total Maximum Daily Loads (TMDLs),

please list the pollutants causing the impairment and any specific requirements in the TMDL(s) that are ap-

plicable to construction sites. Your SWPPP should specifically include measures to prevent the discharge

of these pollutants.

Name of Watershed: _________________________________________________________________________

Receiving Waterbody: ______________________________________________________ Class ____________

Distance from project outfall to receiving water: __________ feet

Type of outfall: ______________________

How will velocity be reduced at the outfall? ______________________________________________________

: If outfall discharges to more than one receiving water body, attach information for each outfall. If dis-

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charge is to a sinkhole, list groundwater as the receiving water and submit a Sinkhole Evaluation report.

Description of storm sewer/drainage system: ______________________________________________________

__________________________________________________________________________________________

Will work be done in a Jurisdictional stream or creek?

Yes

If so, what steps will be taken to address the impact of construction? _____________________________

____________________________________________________________________________________

: A Limited Stream Assessment must be submitted if work is done in the stream buffer.

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: Include a copy of the 404/401 Permit or Nationwide Permit

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Are there any impaired waters on the site?

Yes

If so, what is the name of the waterbody and list the impairment: ________________________________

___________________________________________________________________________________

: For a list of impaired waters, please visit

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If the above answer is yes, has a Total Maximum Daily Load (TMDL) been developed?

Yes

If a TMDL has been developed, list any specific reqirements that are applicable to the construction site.

____________________________________________________________________________________

Stormwater Pollution Prevention Program (Swppp) Template Page 10