Submitreport
to:
CityofLynchburg
525TaylorStreet
Lynchburg,Virginia24501
Attn:StormwaterBMP
434‐455‐4250
INFILTRATIONPRACTICES:O&MCHECKLIST–VirginiaStormwaterManagementHandbook,Chapter9‐C.9.0.
InspectionDate
Project SitePlan/PermitNumber
Location DateBMPPlacedinService
DateofLastInspection Inspector
Owner/Owner’sRepresentative
As‐BuiltPlansavailable: Y/N
FacilityType:Level1____________________________Level2
FacilityLo
cation:
Surface
Underground
FiltrationMedia:
Nofiltration(e.g.,drywell,
permeablepavement,infiltration
facility,etc.
Sand
BioretentionSoil
Peat
Other:_____________________
HydraulicConfiguration:
On‐linefacility
Off‐linefacility
TypeofPre‐TreatmentFacility:
Sedimentforebay(aboveground)
Sedimenta
tionchamber
Plungepool
Stonediaphragm
Grassfilterstrip
Grasschannel
Other:_____________________
Ideally, infiltration facilities should be inspected annually. Spill Prevention measures should be used around
infiltration facilities when handling substances that contaminate stormwater. Releases of pollutants should be
correctedassoonasid
entified.