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HomeMy WebLinkAboutM_Appendix_A_TIR_Worksheet_210420_v1CITY OF RENTON SURFACE WATER DESIGN MANUAL 2017 City of Renton Surface Water Design Manual 12/12/2016 8-A-1 REFERENCE 8-A TECHNICAL INFORMATION REPORT (TIR) WORKSHEET Part 1 PROJECT OWNER AND PROJECT ENGINEER Part 2 PROJECT LOCATION AND DESCRIPTION Project Owner _____________________________ Phone ___________________________________ Address __________________________________ _________________________________________ Project Engineer ___________________________ Company _________________________________ Phone ___________________________________ Project Name __________________________ CED Permit # ________________________ Location Township ________________ Range __________________ Section _________________ Site Address __________________________ _____________________________________ Part 3 TYPE OF PERMIT APPLICATION Part 4 OTHER REVIEWS AND PERMITS  Land Use (e.g., Subdivision / Short Subd.)  Building (e.g., M/F / Commercial / SFR)  Grading  Right-of-Way Use  Other _______________________  DFW HPA  COE 404  DOE Dam Safety  FEMA Floodplain  COE Wetlands  Other ________  Shoreline Management  Structural Rockery/Vault/_____  ESA Section 7 Part 5 PLAN AND REPORT INFORMATION Technical Information Report Site Improvement Plan (Engr. Plans) Type of Drainage Review (check one): Date (include revision dates): Date of Final:  Full  Targeted  Simplified  Large Project  Directed __________________ __________________ __________________ Plan Type (check one): Date (include revision dates): Date of Final:  Full  Modified  Simplified __________________ __________________ __________________ REFERENCE 8: PLAN REVIEW FORMS AND WORKSHEET TECHNICAL INFORMATION REPORT (TIR) WORKSHEET 12/12/2016 2017 City of Renton Surface Water Design Manual 8-A-2 Part 6 SWDM ADJUSTMENT APPROVALS Type (circle one): Standard / Blanket Description: (include conditions in TIR Section 2) ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Approved Adjustment No. ______________________ Date of Approval: _______________________ Part 7 MONITORING REQUIREMENTS Monitoring Required: Yes / No Start Date: _______________________ Completion Date: _______________________ Describe: _________________________________ _________________________________________ _________________________________________ Re: SWDM Adjustment No. ________________ Part 8 SITE COMMUNITY AND DRAINAGE BASIN Community Plan: ____________________________________________________________________ Special District Overlays: ______________________________________________________________ Drainage Basin: _____________________________________________________________________ Stormwater Requirements: _____________________________________________________________ Part 9 ONSITE AND ADJACENT SENSITIVE AREAS  River/Stream ________________________  Lake ______________________________  Wetlands ____________________________  Closed Depression ____________________  Floodplain ___________________________  Other _______________________________ _______________________________  Steep Slope __________________________  Erosion Hazard _______________________  Landslide Hazard ______________________  Coal Mine Hazard ______________________  Seismic Hazard _______________________  Habitat Protection ______________________  _____________________________________ REFERENCE 8-A: TECHNICAL INFORMATION REPORT (TIR) WORKSHEET TECHNICAL INFORMATION REPORT (TIR) WORKSHEET 2017 City of Renton Surface Water Design Manual 12/12/2016 Ref 8-A-3 Part 10 SOILS Soil Type ______________________ ______________________ ______________________ ______________________ Slopes ________________________ ________________________ ________________________ ________________________ Erosion Potential _________________________ _________________________ _________________________ _________________________  High Groundwater Table (within 5 feet)  Other ________________________________  Sole Source Aquifer  Seeps/Springs  Additional Sheets Attached Part 11 DRAINAGE DESIGN LIMITATIONS REFERENCE  Core 2 – Offsite Analysis_________________  Sensitive/Critical Areas__________________  SEPA________________________________  LID Infeasibility________________________  Other________________________________  _____________________________________ LIMITATION / SITE CONSTRAINT _______________________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________  Additional Sheets Attached Part 12 TIR SUMMARY SHEET (provide one TIR Summary Sheet per Threshold Discharge Area) Threshold Discharge Area: (name or description) Core Requirements (all 8 apply): Discharge at Natural Location Number of Natural Discharge Locations: Offsite Analysis Level: 1 / 2 / 3 dated:__________________ Flow Control (include facility summary sheet) Standard: _______________________________ or Exemption Number: ____________ On-site BMPs: _______________________________ Conveyance System Spill containment located at: _____________________________ Erosion and Sediment Control / Construction Stormwater Pollution Prevention CSWPP/CESCL/ESC Site Supervisor: _____________________ Contact Phone: _________________________ After Hours Phone: _________________________ REFERENCE 8: PLAN REVIEW FORMS AND WORKSHEET TECHNICAL INFORMATION REPORT (TIR) WORKSHEET 12/12/2016 2017 City of Renton Surface Water Design Manual 8-A-4 Part 12 TIR SUMMARY SHEET (provide one TIR Summary Sheet per Threshold Discharge Area) Maintenance and Operation Responsibility (circle one): Private / Public If Private, Maintenance Log Required: Yes / No Financial Guarantees and Liability Provided: Yes / No Water Quality (include facility summary sheet) Type (circle one): Basic / Sens. Lake / Enhanced Basic / Bog or Exemption No. _______________________ Special Requirements (as applicable): Area Specific Drainage Requirements Type: SDO / MDP / BP / Shared Fac. / None Name: ________________________ Floodplain/Floodway Delineation Type (circle one): Major / Minor / Exemption / None 100-year Base Flood Elevation (or range): _______________ Datum: Flood Protection Facilities Describe: Source Control (commercial / industrial land use) Describe land use: Describe any structural controls: Oil Control High-Use Site: Yes / No Treatment BMP: _________________________________ Maintenance Agreement: Yes / No with whom? _____________________________________ Other Drainage Structures Describe: REFERENCE 8-A: TECHNICAL INFORMATION REPORT (TIR) WORKSHEET TECHNICAL INFORMATION REPORT (TIR) WORKSHEET 2017 City of Renton Surface Water Design Manual 12/12/2016 Ref 8-A-5 Part 13 EROSION AND SEDIMENT CONTROL REQUIREMENTS MINIMUM ESC REQUIREMENTS DURING CONSTRUCTION  Clearing Limits  Cover Measures  Perimeter Protection  Traffic Area Stabilization  Sediment Retention  Surface Water Collection  Dewatering Control  Dust Control  Flow Control  Control Pollutants  Protect Existing and Proposed BMPs/Facilities  Maintain Protective BMPs / Manage Project MINIMUM ESC REQUIREMENTS AFTER CONSTRUCTION  Stabilize exposed surfaces  Remove and restore Temporary ESC Facilities  Clean and remove all silt and debris, ensure operation of Permanent BMPs/Facilities, restore operation of BMPs/Facilities as necessary  Flag limits of sensitive areas and open space preservation areas  Other _______________________ Part 14 STORMWATER FACILITY DESCRIPTIONS (Note: Include Facility Summary and Sketch) Flow Control Type/Description Water Quality Type/Description  Detention  Infiltration  Regional Facility  Shared Facility  On-site BMPs  Other ________________ ________________ ________________ ________________ ________________ ________________  Vegetated Flowpath  Wetpool  Filtration  Oil Control  Spill Control  On-site BMPs  Other ________________ ________________ ________________ ________________ ________________ ________________ ________________ Part 15 EASEMENTS/TRACTS Part 16 STRUCTURAL ANALYSIS  Drainage Easement  Covenant  Native Growth Protection Covenant  Tract  Other ____________________________  Cast in Place Vault  Retaining Wall  Rockery > 4′ High  Structural on Steep Slope  Other _______________________________ REFERENCE 8: PLAN REVIEW FORMS AND WORKSHEET TECHNICAL INFORMATION REPORT (TIR) WORKSHEET 12/12/2016 2017 City of Renton Surface Water Design Manual 8-A-6 Part 17 SIGNATURE OF PROFESSIONAL ENGINEER I, or a civil engineer under my supervision, have visited the site. Actual site conditions as observed were incorporated into this worksheet and the attached Technical Information Report. To the best of my knowledge the information provided here is accurate. ____________________________________________________________________________________ Signed/Date