Minimum Control Measure 6. Stormwater Management for Municipal Operations
If submitting this form as part of a joint report on behalf of a coalition leave SPDES ID blank.
Name of MS4/Coalition
SPDES ID
The information in this section is being reported (check one):
On behalf of an individual MS4
On behalf of a coalition
How many MS4s contributed to this report?
Street Maintenance......................................................
Bridge Maintenance....................................................
Winter Road Maintenance..........................................
Salt Storage.................................................................
Solid Waste Management...........................................
New Municipal Construction and Land Disturbance..
Right of Way Maintenance.........................................
Marine Operations......................................................
Hydrologic Habitat Modification................................
Parks and Open Space.................................................
Municipal Building.....................................................
Stormwater System Maintenance................................
Vehicle and Fleet Maintenance...................................
Other...........................................................................
1. Choose/list each municipal operation/facility that contributes or may potentially contribute
Pollutants of Concern to the MS4 system. For each operation/facility indicate whether the
operation/facility has been addressed in the MS4's/Coalition's Stormwater Management
Program(SWMP) Plan and whether a self-assessment has been performed during the
reporting period. A self-assessment is performed to: 1) determine the sources of pollutants
potentially generated by the permittee's operations and facilities; 2) evaluate the
of existing programs and 3) identify the municipal operations and facilities
that will be addressed by the pollution prevention and good housekeeping program, if it's
not done already.
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
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Operation/Activity/Facility Addressed in SWMP?
Operation/Activity/Facility
performed within the past 3
years?
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
MCM 6 Page 1 of 3
This report is being submitted for the reporting period ending March 9,
6894134836