Rule 13 Annual Report {51278}

Rule 13 - MS4 ANNUAL REPORT State Form 51278 (R6 / 7-12) INDIANA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT For questions regarding this form, contact: IDEM Office of Water Quality , Storm Water Program MS4 Coordinator 100 North Senate Avenue, Room 1255 MC 65-42 Indianapolis, IN 46204-2251 Telephone: (317) 234-1601 or (800) 451-6027, ext. 41601 (within Indiana) Web Access: http://www.IN.gov/idem/4900 NOTE: Annual reports must be submitted to the Indiana Department of Environmental Management. Failure to submit the annual report is considered noncompliance with your permit. For the first five (5)-year permit term, this completed form must be submitted by 1 year from the SWQMP ­ Part C submittal date and, thereafter, 1 year from the previous report (i.e., in years two (2) through five (5) of permit coverage). In the second and subsequent five (5)-year permit terms, this completed form must be submitted in years two (2) and four (4) of permit coverage. Please type or print in ink. Please answer all questions thoroughly and return the form by the due date. Return this form and any required attachments to the IDEM Storm Water Program, MS4 Coordinator at the address listed in the box on the upper-right. Five Year Permit Term Reporting Year 1st Permit Term Second and subsequent five (5) Year Permit Terms Permit Year 1 2 3 4 5 MS4s in their first permit term must submit reports annually. MS4s that are in subsequent permit terms must submit in years 2 and 4 of the permit term. PART A: GENERAL INFORMATION ­ MS4 OPERATOR Type of MS4: City Town County 1. Permit Number: 2. MS4 Entity: INR 0 4 0 (Name of permit holder) Non-traditional 3. MS4 Operator: 4. Mailing Address: , IN ZIP: County: 5. Email Address: PART B: GENERAL INFORMATION ­ MS4 COORDINATOR 6. MS4 Coordinator (please print): 7. Person's Title: 8. Mailing Address: Page 1 of 6 American LegalNet, Inc. www.FormsWorkFlow.com  , IN ZIP: 9. Telephone Number: 10. E-mail Address: PART C: GENERAL INFORMATION ­ REPORT PREPARER 11. Name: (Provide this information if someone other than MS4 Operator or Coordinator completed this report.) 12. Affiliation with the MS4: 13. Mailing Address: , IN ZIP: 14. Telephone Number: 15. E-mail Address: Extension: Page 2 of 6 American LegalNet, Inc. www.FormsWorkFlow.com PART D: PROGRAM MANAGEMENT 327 IAC 15-13-18 16. Provide a summary of the following program management activities performed during the reporting period: a) b) If this is a co-permit, list all permittees and operators responsible for permit implementation for each entity. Identify changes to the MS4 area boundaries, including areas added to or lost to the MS4 area via annexation or other similar means. Provide a current map (8.5" X 11" or 8.5" X 14") Identify follow-up or additional water quality characterizations completed during the reporting period if applicable. Provide updated receiving water information completed during the reporting period if applicable. Identify funding sources (utility fees, grants, enforcement fines etc) utilized for MS4 program implementation during this reporting period. Provide a list of new active industrial sites identified during this reporting period. Provide a list of facilities owned and operated by the MS4 that require Rule 6 (industrial storm water) permits. Provide a summary of complaints received and follow-up investigation results related to storm water quality issues during this reporting period. Other: c) d) e) f) g) h) i) PART E: PUBLIC EDUCATION AND OUTREACH - MINIMUM CONTROL MEASURE 17. Identify the best management practices (BMPs) for public education and outreach included in your Storm Water Quality Management Plan (SWQMP) Part C and then respond to the following: a) Identify progress made towards development and implementation of each BMP for this minimum control measure (MCM) including timetables and measurable goals during this reporting period. Describe implementation problems encountered and changes made due to ineffectiveness or infeasibility during this reporting period. Describe program BMPs that went beyond those identified in the SWQMP. Identify storm water BMPs installed or initiated for this MCM during this reporting period. Describe program implementation partnerships and explain successes and barriers during this reporting period. Other: b) c) d) e) f) Page 3 of 6 American LegalNet, Inc. www.FormsWorkFlow.com PART F: PUBLIC PARTICIPATION AND INVOLVEMENT - MINIMUM CONTROL MEASURE 18. Identify the best management practices for public participation and involvement included in your SWQMP Part C and then respond to the following: a) Identify progress made towards development and implementation of each BMP for this MCM including timetables and measurable goals during this reporting period. Describe implementation problems encountered and changes made due to ineffectiveness or infeasibility during this reporting period. Describe program BMPs that went beyond those identified in the SWQMP. Identify storm water BMPs installed or initiated for this MCM during this reporting period. Describe program implementation partnerships and explain successes and barriers during this reporting period. Other: b) c) d) e) f) PART G: ILLICIT DISCHARGE DETECTION AND ELIMINATION - MINIMUM CONTROL MEASURE 19. Identify the best management practices for illicit discharge detection and elimination (IDDE) included in your SWQMP Part C and then respond to the following: a) Identify progress made towards development and implementation of each BMP for this MCM including timetables and measurable goals during this reporting period (mapping, screening, etc.). Describe implementation problems or challenges encountered, particularly as it relates to mapping and screening of outfalls during this reporting period. Identify changes made to the IDDE Plan during this reporting period if applicable. Identify updates or revisions to IDDE ordinance or other regulatory mechanism made during this reporting period. Describe level of mapping and screening completed to date. If there are unmapped or unscreened outfalls, provide a plan and a timetable for completion. Other: b) c) d) e) f) Page 4 of 6 American LegalNet, Inc. www.FormsWorkFlow.com PART H: CONSTRUCTION SITE STORM WATER RUN-OFF CONTROL - MINIMUM CONTROL MEASURE 20. List the best management practices for the construction site storm water run-off program identified in your SWQMP Part C and then respond to the following: a) Identify progress made towards development and imple