Fillable City of Milpitas Stormwater Requirements C.3 Data Form (California)

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City of Milpitas Stormwater Requirements C.3 Data Form (California)

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City of Milpitas - SCVURPPP C.3. Data Form
Page 1 of 4
12/2013
City of Milpitas – Stormwater Requirements C.3 Data Form
Santa Clara Valley Urban Run-Off Pollution Prevention Program
1. Project Information
Project Name: ____________________________________APN # _________________________
Project Address:
Cross Streets:
Applicant/Developer Name:
Project Phase(s): ______of______ Engineer:
Project Type (Check all that apply): New Development Redevelopment
Residential Commercial Industrial Mixed Use Public Institutional
Restaurant Uncovered Parking Retail Gas Outlet Auto Service (SIC code) _______
Other ________________________________________
Project Description: _______________________________________________________________
Project Watershed/Receiving Water (creek, river, or bay):_______________________________
Which Projects Must Comply with Stormwater Requirements?
All projects that create and/or replace 10,000 sq. ft. or more of impervious surface on the project site must
fill out this worksheet and submit it with the development project application.
All restaurants, auto service facilities, retail gasoline outlets, and uncovered parking lot projects
(stand-alone or part of another development project, including the top uncovered portion of parking
structures) that create and/or replace 5,000 sq. ft. or more of impervious surface on the project site must also
fill out this worksheet.
Interior remodeling projects, routine maintenance or repair projects such as re-roofing and re-paving, and
single family homes that are not part of a larger plan of development are NOT required to complete this
worksheet.
What is an Impervious Surface?
An impervious surface is a surface covering or pavement that prevents the land’s natural ability to absorb and
infiltrate rainfall/stormwater. Impervious surfaces include, but are not limited to rooftops, walkways, paved
patios, driveways, parking lots, storage areas, impervious concrete and asphalt, and any other continuous
watertight pavement or covering. Pervious pavement, underlain with pervious soil or pervious storage
material (e.g., drain rock), that infiltrates rainfall at a rate equal to or greater than surrounding unpaved areas
OR that stores and infiltrates the water quality design volume specified in Provision C.3.d of the Municipal
Regional Stormwater Permit (MRP) is not considered an impervious surface.
For More Information
For more information regarding selection of Best Management Practices for stormwater pollution prevention
or stormwater treatment
in Santa Clara County
:
http://www.scvurppp
-
w2k.com/c3_han
dbook_2012.shtml
(5013-5014, 5541, 7532-7534, 7536-7539)
City of Milpitas - SCVURPPP C.3. Data Form
Page 2 of 4
12/2013
2. Project Size
a. Total Site Area:
____________________acre
b. Total Site Area Disturbed: __________________ acre
(including clearing, grading, or excavating)
Existing Area (ft
2
)
Proposed Area (ft
2)
Total Post-Project
Area (ft
2
)
Replaced New
Impervious Area
Roof
Parking
Sidewalks and Streets
c. Total Impervious Area
d. Total new and replaced impervious area
Pervious Area
Landscaping
Pervious Paving
Other (e.g. Green Roof)
e. Total Pervious Area
f. Percent Replacement of Impervious Area in Redevelopment Projects (Replaced Total Impervious Area ÷
Existing Total Impervious Area) x 100% = _______________________%
3. State Construction General Permit Applicability:
a. Is #2.b. equal to one acre or more?
Yes, applicant must obtain coverage under the State Construction General Permit (i.e.,
file a Notice of Intent and prepare a Stormwater Pollution Prevention Plan) (see
www.swrcb.ca.gov/water_issues/programs/stormwater/construction.shtml for details).
No, applicant does not need coverage under the State Construction General Permit.
4. MRP Provision C.3 Applicability:
a. Is #2.d. equal to 10,000 sq. ft. or more, or 5,000 sq. ft. or more for restaurants, auto service
facilities, retail gas outlets, and uncovered parking?
Yes, C.3. source control, site design, and treatment requirements apply.
No, C.3. source control and site design requirements may apply – check with local agency
b. Is #2.f. equal to 50% or more?
Yes, C.3. requirements (site design, source control, as appropriate, and stormwater
treatment) apply to entire site.
No, C.3. requirements only apply to impervious area created and/or replaced.
5. Hydromodification Management (HM) Applicability:
a. Does project create and/or replace one acre or more of impervious surface AND is the total
post-project impervious area greater than the pre-project (existing) impervious area?
Yes (continue) No – exempt from HM, go to page 3
b. Is the project located in an area of HM applicability (green area) on the HM
Applicability Map? ( www.scvurppp-w2k.com/hmp_maps.htm )
Yes, project must implement HM requirements
No, project is exempt from HM requirements
City of Milpitas - SCVURPPP C.3. Data Form
Page 3 of 4
12/2013
6. Selection of Specific Stormwater Control Measures:
Site Design Measures
Minimize land disturbed
Minimize impervious
surfaces
Minimum-impact street
or parking lot design
Cluster structures/
pavement
Disconnected downspouts
Pervious pavement
Green roof
Microdetention in
landscape
Other self-treating area
Self-retaining area
Rainwater harvesting and
use
(e.g., rain barrel, cistern
connected to roof drains)
1
Preserved open space:
_______ ac. or sq. ft
.(circle one)
Protected riparian and
wetland areas/buffers
(Setback from top of bank:
_______ft.)
Other _______________
Source Control Measures
Alternative building
materials
Wash area/racks, drain to
sanitary sewer
2
Covered dumpster area,
drain to sanitary sewer
2
Sanitary sewer
connection or accessible
cleanout for swimming
pool/spa/fountain
2
Beneficial landscaping
(minimize irrigation, runoff,
pesticides and fertilizers;
promotes treatment)
Outdoor material storage
protection
Covers, drains for loading
docks, maintenance bays,
fueling areas
Maintenance
(pavement
sweeping, catch basin
cleaning, good housekeeping)
Storm drain labeling
Other _______________
Treatment Systems
None (
all impervious surface
drains to self-retaining areas)
LID Treatment
Rainwater harvest and
use
(e.g., cistern or rain barrel
sized for C.3.d treatment)
Infiltration basin
Infiltration trench
Exfiltration trench
Underground detention
and infiltration system
(e.g. pervious pavement drain
rock, large diameter conduit)
Biotreatment
3
Bioretention area
Flow-through planter
Tree box with
bioretention soils
Other _______________
Other Treatment Methods
Proprietary tree box filter
4
Media filter
(sand, compost,
or proprietary media)
4
Vegetated filter strip
5
Dry detention basin
5
Other _______________
Flow Duration Controls for Hydromodification Management (HM)
Detention basin
Underground
tank or vault
Bioretention with outlet
control
Other
_______________
1
Optional site design measure; does not have to be sized to comply with Provision C.3.d treatment requirements.
2
Subject to sanitary sewer authority requirements.
3
Biotreatment measures are allowed only with completed feasibility analysis showing that infiltration and rainwater
harvest and use are infeasible.
4
These treatment measures are only allowed if the project qualifies as a “Special Project”.
5
These treatment measures are only allowed as part of a multi-step treatment process.
City of Milpitas - SCVURPPP C.3. Data Form
Page 4 of 4
12/2013
7. Treatment System Sizing for Projects with Treatment Requirements
Indicate the hydraulic sizing criteria used and provide the calculated design flow or volume:
Treatment System Component Hydraulic Sizing
Criteria Used
3
Design Flow or
Volume
(cfs or cu.ft.)
3
Key: 1a: Volume – WEF Method
1b: Volume – CASQA BMP Handbook Method
2a: Flow – Factored Flood Flow Method
2b: Flow – CASQA BMP Handbook Method
2c: Flow – Uniform Intensity Method
3: Combination Flow and Volume Design Basis
8. Alternative Certification: Was the treatment system sizing and design reviewed by a qualified third-
party professional that is not a member of the project team or agency staff?
Yes No Name of Reviewer: ___________________________________________
9. Operation & Maintenance Information
A. Property Owner’s Name: _________________________________________
B. Responsible Party for Stormwater Treatment/Hydromodification Control O&M:
a. Name: _________________________________________
b. Address: _________________________________________
c. Phone/E-mail: _________________________________________
This section to be completed by City of Milpitas staff.
O&M Responsibility Mechanism
Indicate how responsibility for O&M is assured. Check all that apply:
O&M Agreement
Other mechanism that assigns responsibility (describe below):
________________________________________________________________________________________
________________________________________________________________________________________
Reviewed:
Planning Department Public Works Department
Planning Division: ________ Land Development: ________
Other (Specify): ________ Other (Specify): ________
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City of Milpitas Stormwater Requirements C.3 Data Form (California)

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Completed 3 August 2021

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