Stormwater Quality Design Manual (May 2007) - City of Sacramento ...

Sacramento County Supplemental Application:Preliminary Stormwater Quality Compliance FormThis form is provided for example purposes only.Check with your local permitting agency for copies of forms and procedures appropriate for your project site.1) Project InformationApplicant Name:_____________________Phone Number: ______________________Address:______________________________________________________________________Project Contact:______________________Phone Number:_______________________Project name:________________________Assessor Parcel Number(s):____________Site Address:______________________________________________________________Project Category (check all that apply): Refer to Design Manual Table 3-2 for Priority Project CategoriesResidential (Single Family)Residential (Multi-Family)Retail Gasoline OutletRestaurantHillside DevelopmentParking LotCommercial DevelopmentAutomotive Repair ShopIndustrial DevelopmentStreet/RoadProject Gross Acres:_____________________Existing Impervious Surface Area:________Project Net Acres:_____________________Proposed Impervious Surface Area:__________Watershed or receiving water:______________2) Source Controls (check source control measure or applicable pollutant sources, check Design ManualChapter 4 for more information on source control measures)Refer to Design Manual Table 3-2 for RequirementsStorm Drain Message and SignageFueling AreasLoading/Unloading AreasOutdoor Storage AreasOutdoor Work AreasVehicle/Equipment Wash AreasWaste Management AreasOther Describe______________________________________3) Runoff Reduction MeasuresRefer to Design Manual Table 3-2 for RequirementsWill runoff reduction measures be utilized for this project? Yes NoIf yes, check selectec runoff reduction measures below; attach completed Runoff Reduction worksheets(Design Manual Appendix D).Alternative Driveway DesignDisconnected Roof DrainsDisconnected PavementGreen RoofInterceptor TreesPorous PavementOther Describe____________________________________4) Stormwater Quality Treatment RequirementsRefer to Design Manual Table 3-2 for RequirementsIs treatment required? Yes No If no, form is complete with signature. If yes, complete this section.Indicate No. of drainage sheds for the site: ________Early consideration of stormwater quality during site planning may reduce the overall cost of treatmentcontrols. Runoff reduction methods and innovative design options can reduce the size of treatmentoptions. In addition, early consideration allows for non-proprietary treatment options that cansignificantly reduce construction and maintenance costs.