SWPPP D J 2015 COMPLETED BY AKT P E S · The CMU Campus is located within sections 22 and 27 in...
Transcript of SWPPP D J 2015 COMPLETED BY AKT P E S · The CMU Campus is located within sections 22 and 27 in...
STORM WATER POLLUTION PREVENTION PLAN CENTRAL MICHIGAN UNIVERSITY CAMPUS
MOUNT PLEASANT, MICHIGAN
SWPPP DATE: JANUARY 2015 COMPLETED BY: AKT PEERLESS ENVIRONMENTAL AND ENERGY SERVICES
CONTENTS
SECTION PAGE 1.0 GENERAL FACILITY INFORMATION ....................................................................................1 2.0 OVERVIEW ..........................................................................................................................2
2.1 INTRODUCTION ............................................................................................................2 2.2 OBJECTIVES ..................................................................................................................2 3.0 FACILITY DESCRIPTION .......................................................................................................2
3.1 FACILITY LAYOUT ..........................................................................................................2 3.2 FACILITY OPERATIONS ..................................................................................................7 3.3 WATER SUPPLY AND SANITARY DISCHARGE ...............................................................10 3.4 STORM WATER DISCHARGE .........................................................................................10 3.5 STORM WATER POLLUTION PREVENTION TEAM ........................................................10 4.0 POTENTIAL SOURCES OF POLLUTANTS .............................................................................10
4.1 SITE MAP ......................................................................................................................10 4.2 INVENTORY OF EXPOSED MATERIALS ..........................................................................11 4.3 PAST SPILL OR LEAKS ....................................................................................................12 4.4 SUMMARY OF SAMPLING DATA ..................................................................................12
5.0 BEST MANAGEMENT PRACTICES .......................................................................................13
5.1 NON‐STRUCTURAL CONTROLS .....................................................................................13 5.2 STRUCTURAL CONTROLS ..............................................................................................13 5.3 MATERIAL HANDLING ..................................................................................................15 5.4 SPILL PREVENTION AND RESPONSE .............................................................................16 5.5 EMPLOYEE TRAINING ...................................................................................................17
6.0 EVALUATION OF NON‐STORM WATER DISCHARGES .......................................................17 7.0 RECORD KEEPING AND REPORTING ..................................................................................18
7.1 ANNUAL REPORT ...........................................................................................................18 7.2 RECORD KEEPING AND REPORTING FORMS .................................................................18 7.3 RECORD KEEPING AND REPORTING SCHEDULE ............................................................19 8.0 CERTIFICATION OF SWPPP .................................................................................................20 9.0 PLAN EVALUATION AND UPDATE ......................................................................................21
CONTENTS (cont.)
APPENDICES Appendix A .......................Campus Maps Appendix B .......................Record Keeping and Reporting Forms Preventative Maintenance, Good Housekeeping, & Routine Inspection Semi‐Annual Comprehensive Inspection Employee Training Form Storm Water Training Outline Significant Spill Report Annual Plan Review
1
1.0 GENERAL FACILITY INFORMATION Name of Facility: Central Michigan University Campus Facility Address: 1720 S. East Campus Drive Mt. Pleasant, Michigan 48859 Facility Contact: Name: Jeff Suty Title: Environmental Administrator Telephone: 989‐774‐2770 Fax: 989‐774‐1303 Mailing Address: Central Michigan University Smith 103 Mount Pleasant, Michigan 48859 Certified Storm Water Operator: Mark S. Blanzy Certification Number: 07936 Certification Expiration Date: 2016 Primary SIC Code: 611310 Receiving Water: Chippewa River‐via storm drains and
overland flow Emergency Contact: Name: Jeff Suty Telephone: Cell Phone: (517) 525‐8636 Office Phone: (989) 774‐2770
2
2.0 OVERVIEW 2.1 INTRODUCTION
This Storm Water Pollution Prevention Plan (SWPPP) covers the operations at the Central Michigan University (CMU) Campus in Mount Pleasant, Michigan. This SWPPP describes this facility and its operations, identifies potential sources of storm water pollution at the facility, recommends appropriate best management practices (BMPs) or pollution control measures to reduce the discharge of pollutants in storm water runoff, and provides for periodic a review of the SWPPP. 2.2 OBJECTIVES
The goal of the storm water permit program is to improve the quality of surface waters by reducing the amount of pollutants potentially contained in the storm water runoff being discharged. The objective of this SWPPP is three‐fold:
1. Identify potential sources of storm water pollution at the CMU Campus. 2. Describe BMPs which are to be used at CMU Campus. 3. Provide other elements such as a facility inspection program, a site compliance
evaluation program, as well as a record keeping and reporting program that will help CMU Campus comply with the terms and conditions of the storm water discharge regulations.
3.0 FACILITY DESCRIPTION 3.1 FACILITY LAYOUT
The CMU Campus is located within sections 22 and 27 in Mount Pleasant (T14N, R4E), Isabella County, Michigan. The property is located in the southern portion of the city of Mount Pleasant. The campus consists of over 100 structures (including buildings and parking lots) and is comprised of over 800 acres. The location of the property is depicted on the Campus Map and Site Maps depicting the layout of the campus and areas subject to storm water consideration are presented in Appendix A. This SWPPP will identify areas of the campus with geographical descriptions for ease of use. The following tables summarize the geographical areas of the CMU campus:
3
Northwest Campus
Building Name Functionality Potential Storm Water
Exposure
Barnes Hall Residence Halls Dumpsters, Grease Bins
Calkins Hall Residence Halls Dumpsters
Larzelere Hall Residence Halls Dumpsters
Northwest Apartments Apartment Complex Dumpsters
Robinson Hall Residence Halls Dumpsters
Robinson Dining Commons Dining Hall Dumpsters, Grease Bins
Trout Hall Residence Halls Dumpsters
Grawn Hall Academic/Administrative Dumpsters
Powers Hall Academic/Administrative Dumpsters
Auction Building/Pole Barn Storage Dumpster
Salt Storage Building Storage See Section 3.2
North Art Studio Academic/Administrative Dumpster
Ronan Hall Academic/Administrative Dumpster
Wightman Hall Academic/Administrative Dumpsters
Bovee University Center Academic/Administrative Dumpsters, Grease Bins
General Counsel Building Academic/Administrative See Section 3.2
Warriner Hall Academic/Administrative Dumpsters
Northeast Campus
Building Name Functionality Potential Storm Water
Exposure
University Art Gallery Academic/Administrative Dumpsters
Health Professions Building Academic/Administrative Dumpsters
Finch Hall/ Field House Academic/Administrative Dumpsters
Park Library Academic/Administrative Dumpsters
Sloan Hall Academic/Administrative Dumpsters
Smith Hall Academic/Administrative Dumpsters
Rowe Hall Academic/Administrative Dumpsters
4
Northeast Campus
Building Name Functionality Potential Storm Water
Exposure
Carlin Alumni House Academic/Administrative Dumpsters
Special Olympics Building Academic/Administrative Dumpsters
Foust Hall Academic/Administrative Dumpsters
West Campus
Building Name Functionality Potential Storm Water
Exposure
Beddow Hall Residence Halls Dumpsters
Campbell Hall Residence Halls Dumpsters
Carey Hall Residence Halls Dumpsters, Grease Bins
Cobb Hall Residence Halls Dumpsters
Kesseler Hall Residence Halls Dumpsters
Kulhavi Hall Residence Halls Dumpsters
Merrill Hall Residence Halls Dumpsters, Grease Bins
Troutman Hall Residence Halls Dumpsters
Wheeler Hall Residence Halls Dumpsters
Anspach Hall Academic/Administrative Dumpsters
Dow Science Complex (West and East)
Academic/Administrative Dumpsters
Education and Human Service Building (West and East)
Academic/Administrative Dumpsters
Pearce Hall Academic/Administrative Dumpsters
5
East Campus
Building Name Functionality Potential Storm Water
Exposure
Emmons Hall Residence Halls Dumpsters
Herrig Hall Residence Halls Dumpsters
Saxe Hall Residence Halls Dumpsters
Fabiano Hall Residence Halls Dumpsters
Sweeney Hall Residence Halls Dumpsters
Thorpe Hall Residence Halls Dumpsters
Woldt Hall Residence Halls Dumpsters, Grease Bins
Celani Hall Residence Halls Dumpsters
Brooks Science Hall Academic/Administrative Dumpsters
Dow Science Complex (West and East)
Academic/Administrative Dumpsters
ET Building/ IET Facility Academic/Administrative Dumpsters
Education and Human Service Building (West and East)
Academic/Administrative Dumpsters
Moore Hall and Bush Theatre
Academic/Administrative Dumpsters
Music Building Academic/Administrative Dumpsters
CMU Welcome Center Academic/Administrative Dumpsters
Combined Services Building Academic/Administrative See Section 3.2
Police Station Academic/Administrative Dumpsters
Public Broadcasting Academic/Administrative Dumpsters
Power House Academic/Administrative See Section 3.2
6
Southwest Campus
Building Name Functionality Potential Storm Water
Exposure
Kewadin Village Residence Halls Dumpsters
Bennett Track Athletic Fields/Stadiums Dumpsters
Bennett Soccer Field Athletic Fields/Stadiums Dumpsters
Field Hockey Stadium Athletic Fields/Stadiums Dumpsters
Indoor Athletic Complex Academic/Administrative Dumpsters
McGuirk Arena (Southwest and Southeast)
Athletic Fields/Stadiums Dumpsters
Rose‐Ryan Student Activity Center (Southwest and Southeast)
Academic/Administrative See Section 3.2
Theunissen Stadium Athletic Fields/Stadiums Dumpsters
Varsity Softball Field Athletic Fields/Stadiums Dumpsters
Center for Applied Research and Technology (CART)
Academic/Administrative Dumpsters
Wellness Central Academic/Administrative Dumpsters
Grounds/Storage Academic/Administrative See Section 3.2
Grounds South Academic/Administrative See Section 3.2
Ground/CHIP Facility Academic/Administrative See Grounds South (Section 3.2)
Southeast Campus
Building Name Functionality Potential Storm Water
Exposure
Rose‐Ryan Student Activity Center (Southwest and Southeast)
Academic/Administrative Dumpsters
Bennett Track Athletic Fields/Stadiums Dumpsters
Bennett Soccer Field Athletic Fields/Stadiums Dumpsters
Field Hockey Stadium Athletic Fields/Stadiums Dumpsters
Kelly/Shorts Stadium Athletic Fields/Stadiums Dumpsters
7
Southeast Campus
Building Name Functionality Potential Storm Water Exposure
Indoor Athletic Complex Academic/Administrative Dumpsters
McGuirk Arena (Southwest and Southeast)
Athletic Fields/Stadiums Dumpsters
Rose‐Ryan Student Activity Center (Southwest and Southeast)
Academic/Administrative Dumpsters
Varsity Softball Field Athletic Fields/Stadiums Dumpsters
Charter Schools Academic/Administrative Dumpsters
3.2 FACILITY OPERATIONS
The property is utilized by CMU as its main campus. Site development and use includes classroom buildings, administrative buildings, facility maintenance buildings, athletic fields, dormitories, open green spaces, exterior equipment storage, vehicle fueling, medical offices, power plant operation, etc. The following section identifies areas within the CMU Campus that has significant storm water exposures. Grounds South Grounds South is located on the southern portion of the CMU Campus. Portions of the Grounds South facility contains asphalt, concrete, and gravel parking/storage areas. Exterior portions of Grounds South are used for various equipment storage including, but not limited to:
Signposts Fence posts Light posts Masonry bricks Concrete blocks Wood chips Sand Gravel Pad‐mounted electrical transformers (unused) Used heating, ventilation and air conditioning equipment Trash compactor 6,000‐gallon above ground storage tank (AST) containing Ice Ban Snow plows Picnic tables Metal recycling dumpster Wood recycling dumpster Paper recycling dumpster
8
Main Structure (Grounds South) The main structure is used for administrative, vehicle storage, and equipment repair operations. General chemical storage within the building includes:
Paint‐5 to 10 gallons‐various sized containers
Lubricants‐up to 20 gallons‐various sized containers
Ammonia‐up to 10 gallons‐various sized containers
Degreaser‐up to 10 gallons‐various sized containers
Engine Coolant‐up to 100 gallons‐various sized containers
Salt Rinse‐up to 10 gallons‐various sized containers
Automotive Battery‐up to 50 batteries
Hydraulic Fluid‐up to 20 gallons‐various sized containers
Transmission Fluid‐up to 50 gallons‐various sized containers
Windshield Washer Fluid‐up to 20 gallons‐various sized containers
New Oil‐up to 400‐gallons‐range from 1‐quart to 55‐gallon drums
Used Oil‐up to 550‐gallons‐Underground Storage Tank (UST)
Automotive Tires‐varies
Metal Bar Stock‐varies
Parts Cleaner Solvent‐up to 10 gallons Material Storage Building (Grounds South) The material storage building is for athletic field equipment, vehicle storage, and miscellaneous storage. General chemical/material storage within the building includes:
Clay‐packaged in 50 pound bags‐approximately 50 bags
Field Marker Chalk‐packaged in 50 pound bags‐approximately 50 bags
Infield Gravel‐packaged in 50 pound bags‐approximately 100 bags Combined Services Building Combined Services Building is located on the eastern portion of the CMU Campus. The Combined Services Building is used for administrative purposes, as well as for maintenance and warehousing purposes. General chemical storage within the building includes:
Paint‐up to 500 gallons‐various sized containers
Solvent‐up to 100 gallons‐various sized containers
Varnish/stain‐up to 100 gallons‐various sized containers
Trowel Grout‐up to 50 gallons‐various sized containers A fenced in area is located on the southern portion of the building. The fenced in area contains a hopper used to collect saw dust from an interior ventilation/exhaust system. The hopper contains a locking lid mechanism. Other storage within the fenced in area include scrap metal, wood storage, and metal sign storage.
9
General Counsel Building The General Counsel Building is located on the northeastern portion of the CMU Campus. The General Counsel Building is used for administrative purposes and vehicle fueling purposes. General chemical storage within the building includes:
Gasoline‐10,000‐gallon UST
Diesel fuel‐6,000‐gallon UST Two fuel dispensers are located to the west of the General Counsel Building. Salt Storage Building The Salt Storage Building is located on the northwestern portion of the CMU Campus. The Salt Storage Building consists of a three‐sided pole‐barn structure used for road salt and sand storage. The building has a 300 ton capacity. Power House The power house is located on the eastern portion of the CMU Campus. The power house building is used as the central energy facility for the entire CMU Campus. Energy sources include biomass and natural gas. General chemical storage within the building includes:
Diesel fuel‐20,000‐gallon UST (exterior)
Gasoline‐up to 300‐gallons‐various sized containers/machines
Sulfuric acid‐up to 2,000‐gallons
Hydraulic oil‐up to 55‐gallons
Turbine oil‐up to 300‐gallons/machines
Lubricants‐up to 100‐gallons No significant storage of materials occur on the exterior portion of the Power House, with the exception of the diesel fuel UST and the wood unloading area on the eastern portion of the building. Rose Ryan Hall The Rose Ryan Hall Building is located on the south‐central portion of the CMU Campus. The building consists of an activity center used for student athletic events. The structure has a number of exercise areas and a pool. General chemical storage within the building includes:
Sodium hypochlorite‐dry in boxes
Hydrochloric acid‐approximately twenty, 1‐gallon containers
Ice melt‐in 50 pound bags
Bicarbonate of Soda‐200 pounds in various size bags
Calcium chloride‐on 50 pound bag These chemicals are utilized for maintaining appropriate water quality of the swimming pool in the building.
10
3.3 WATER SUPPLY AND SANITARY DISCHARGE
The campus is provided with municipal water and sanitary sewer services. 3.4 STORM WATER DISCHARGE
Storm water runoff within paved parking areas generally discharge into storm water drains located throughout the CMU Campus. All other storm water discharges at the site occur due to overland flow. See Appendix A for locations of campus wide outfalls and storm water drains. 3.5 STORM WATER POLLUTION PREVENTION TEAM
The storm water pollution prevention team is responsible for developing, implementing, maintaining, and revising this SWPPP. The members of the team are familiar with the management and operations of CMU. The members of the team and their primary responsibilities are as follows:
Name Responsibilities
Mark S. Blanzy‐CMU Implementing and maintaining BMPs, keeping and submitting required records and reports, conducting annual inspections, conducting site compliance evaluations, training employees, and signing the SWPPP.
General Site Employees Assisting with the implementation and maintenance of BMPs, assistance in conducting annual inspections, assistance in conducting annual site evaluations, as well as day‐to‐ day operations.
Jeff Carr‐AKT Peerless General support
4.0 POTENTIAL SOURCES OF POLLUTANTS 4.1 SITE MAP
A map of the campus facility presented in Appendix A shows the following features:
Property boundaries
Facility buildings
Outside storage areas for significant materials
Storm drain inlets and outfalls
Anticipated storm water flow patterns
Drainage areas
Areas of vegetation
Parking lots
Locations where the following activities are exposed to storm water:
‐ Wood/sand/gravel/salt storage
‐ Loading/unloading areas
11
‐ General traffic areas by automobiles and trucks
‐ Waste container storage areas
‐ Bulk receiving areas
‐ Fuel tank storage and dispensing area 4.2 INVENTORY OF EXPOSED MATERIALS Significant materials used and stored at the facility, and the potential methods of exposure to storm water, are presented in the following table.
Material(s) Areas/Processes Potential For and Methods of
Exposure Outfall Number
Metal storage Grounds South Low potential for exposure. Physical weathering, unlikely to contribute pollutants to storm water.
8,9
Trash Compactor Grounds South
Moderate potential for exposure. Contribute to pollutants to storm water if free liquids or electronic equipment are introduced to compactor.
8,9
Bricks/blocks Grounds South Low potential for exposure. Physical weathering, unlikely to contribute pollutants to storm water.
8,9
Wood chips Grounds South High potential for exposure. Sediments within overland flow, exposure to storm water.
8,9
Sand/gravel Grounds South High potential for exposure. Sediments within overland flow, exposure to storm water.
8,9
Recycling containers (wood, paper, metal)
Grounds South Low potential for exposure. Unlikely to contribute pollutants to storm water.
8,9
6,000‐gallon AST‐Ice Ban
Grounds South High potential for exposure. Leaks or spills.
8,9
General unloading areas
Grounds South High potential for exposure. Leaks or spills.
8,9
550‐gallon UST Grounds South High potential for exposure. Leaks or spills.
8,9
Interior fuel/chemical storage
Grounds South Low potential for exposure. Unlikely to contribute pollutants to storm water.
8,9
Pool chemicals, ice Rose‐Ryan Hall Low potential for exposure. Unlikely 7
12
Material(s) Areas/Processes Potential For and Methods of
Exposure Outfall Number
melt to contribute pollutants to storm water.
Interior chemical/paint storage
Combined Services Building Low potential for exposure. Unlikely to contribute pollutants to storm water.
3,4
Scrap metal/wood Combined Services Building Low potential for exposure. Unlikely to contribute pollutants to storm water.
3,4
Saw dust hopper Combined Services Building High potential for exposure. Leaks or spills.
3,4
10,000‐gallon UST‐gasoline
6,000‐gallon UST‐diesel fuel
General Counsel Building High potential for exposure. Leaks or spills.
17
Salt/Sand Storage Salt Storage Building High potential for exposure. Sediments within overland flow, exposure to storm water.
1,2,17
20,000‐gallon UST‐diesel fuel
Power House High potential for exposure. Leaks or spills.
3,4
Wood unloading area Power House High potential for exposure. Leaks or spills.
3,4
General unloading area Power House High potential for exposure. Leaks or spills.
3,4
Interior fuel/chemical storage
Power House Low potential for exposure. Unlikely to contribute pollutants to storm water.
3,4
Dumpster Campus wide Low potential for exposure. Unlikely to contribute pollutants to storm water.
Varies
4.3 PAST SPILLS OR LEAKS
No reportable spills or leaks of significant materials have occurred at the facility within the past three years.
4.4 SUMMARY OF SAMPLING DATA
Not applicable.
13
5.0 BEST MANAGEMENT PRACTICES The following storm water management controls, or BMPs, will be implemented to minimize the potential of pollutants to enter the storm water discharged from the CMU Campus. 5.1 NON‐STRUCTURAL CONTROLS
Non‐structural controls are practices that are specifically intended to reduce the amount of pollution getting into surface waters. They are generally implemented to address the problem at the source. The following non‐structural controls have been selected for implementation:
Preventive Maintenance
Preventive maintenance is designed to identify potential sources of pollution or sedimentation before they impact storm water run off. The following equipment and activities are included in the preventive maintenance program.
Material/Equipment Preventive Activity Frequency
Metal storage Inspect and maintain all equipment to minimize the potential for physical weathering/oxidation.
Bi‐weekly observations by employees
Bricks/blocks Inspect and maintain all equipment to minimize the potential for physical weathering.
Bi‐weekly observations by employees
Wood chips/sand/gravel Inspect storage area. Sweep dust, chips, and sediment into storage area.
Daily observations by employees
Recycling containers Inspection doors and closing mechanisms. Inspect for physical weathering.
Inspect at time of removal
Loading areas Inspection loading/unloading areas on a regular basis to identify potential hazards which may result in spills/leaks.
Employee oversight during loading activities
6,000‐gallon AST‐Ice Ban Inspect valves, piping, and tanks. Cleanup spills, replaceworn valves/piping. Store in low traffic areas.
Daily observations by employees
Employee oversight during filling activities
550‐gallon UST‐used oil Automatic tank gauging and automatic line leak detectors.
Employee oversight during removal
activities
Saw dust hopper Inspection doors and closing mechanisms. Inspect for physical weathering.
Inspect at time of removal
10,000‐gallon UST‐gasoline
6,000‐gallon UST‐diesel fuel Automatic tank gauging and interstitial monitoring.
Employee oversight during filling activities
Salt/Sand Storage Inspect storage area. Sweep dust and sediment into storage area, beyond curbing.
Daily observations by employees
20,000‐gallon UST‐diesel fuel Automatic tank gauging and interstitial monitoring. Employee oversight during filling activities
14
Material/Equipment Preventive Activity Frequency
Campus wide, parking areas, walk ways
Repair areas of disturbed soil. Inspect for erosion, spills, releases, and sheens. Remove excessive sediment, debris, general refuse to minimize exposure to storm water drains.
Bi‐weekly observations by employees
Good Housekeeping Practices
Good housekeeping practices are designed to maintain a clean and orderly work environment. Consistency in storing and using significant materials will enable employees to follow procedures designed to minimize the potential for impact on storm water runoff. The following practices are included in campus wide good housekeeping routine.
Good Housekeeping Practices Frequency
Routinely inspect for leaks or spills. Loading/unloading events or every 2
weeks
Ensure spill clean up procedures are understood by employees. 6 months
Ensure that all chemical substances are properly labeled. Delivery of materials or
every 2 weeks
Keep equipment paths and work areas clear of chemicals and product. 2 weeks
Make cleanup equipment easily accessible to employees and post cleanup methods in visible areas.
2 weeks
Sedimentation Control Measures
Sedimentation control measures are designed to reduce the amount of sedimentation deposited to storm water runoff. Surface treatments are one way to minimize the transport of sediment from a property in a rain event. The campus consists of paved, gravel, and vegetated surfaces. Rain gardens, vegetation buffers and soil percolation will filter storm water run off, removing particulates and sediment. In addition, paved spillways and riprap outlet protection will protect against sedimentation due to high‐velocity water flow. Exposed soil will be kept to a minimum. No soil erosion and sedimentation is expected to originate from the site. Soil which becomes exposed by erosion or surface disturbance caused by operations will be immediately repaired.
Routine Inspections
As described above, preventive maintenance, housekeeping, and sedimentation control are important elements of the non‐structural controls at the facility. Inspection of the potential sources of pollution will identify breakdowns before storm water runoff is impacted. Routine inspections of the facility will be conducted at a minimum of at least every 2 weeks. The results
15
of the inspections will be recorded on the Preventative Maintenance, Good Housekeeping, and Routine Inspection form contained in Appendix B. The completed forms will be kept on file with the SWPPP for a minimum of 3 years.
Semi‐annual Comprehensive Inspections
Regular inspections of the facility and its operations can identify potential problems before they occur. Comprehensive inspections of the facility, including equipment and plant areas, will be conducted at least every six months. The comprehensive inspection provides a basis for determining the overall effectiveness of the SWPPP. The comprehensive inspection should determine if the controls currently in place are adequate and working properly. The results of the inspections will be recorded on the Comprehensive Inspection form contained in Appendix B. These completed forms will be kept on file with the SWPPP for at least 3 years. The comprehensive inspections will be completed in April and October, annually. 5.2 STRUCTURAL CONTROLS
Structural controls are permanent devices that are designed to control storm water flow, minimize sedimentation, and prevent pollution from entering the waters of the State. Spill covers should be placed over storm water drains during loading/unloading of oils, lubricants, salt/sand/gravel, gasoline, diesel fuel, etc. Sediment covers should be placed within storm water drains where overland drainage is rapid with minor sediment. Covers should be cleaned and maintained as needed. Curbing should be placed in the area of the salt and sand storage building. The building currently contains a curb; however, the curb is in poor condition and is unlikely to maintain materials during a storm event. Sand and gravel storage on grounds south should be placed within storage bins with curbing. Spill kits should be located in areas of fueling, significant chemical storage, loading, and unloading areas throughout the campus. Spill kits should contain, at a minimum, multiple socks, pads, suits, gloves, goggles, and disposable bags. Inventory should be replaced after use. Maintain lids/locking mechanisms on all dumpsters throughout the campus. No liquid disposal should occur within dumpsters. The following is an inspection and maintenance schedule for the structural controls at the property. Note that these items are included in routine and/or comprehensive inspections.
16
Structural Control Activity Frequency
Curbing Observe for damage or blockage Formal inspection every 6 months.
Spill kits Present with necessary contents Formal inspection every 6 months.
Retention areas/ditches Observe and remove sediment/refuse buildup. Evaluate and encourage healthy vegetative growth.
Formal inspection every 6 months. Repair as necessary.
Diversions berms Observe for erosion and damage. Observe foroverflow of materials (i.e. sand, salt, etc.)
Formal inspection every 6 months. Replace annually or as necessary.
Fueling stations Report malfunctions
Formal inspection every 6 months. Integrity testing per manufacturer recommendations (est. every 10 years or >).
Dumpsters Observe lid present and in working condition.Formal inspection every 6 months. Replace or repair as necessary.
5.3 MATERIAL HANDLING
General Material Handling
General material handling at the subject property involves the delivery of various materials. Loading of sand/gravel/salt should be limited to fixed location. Filling and waste oil removal from on‐site USTs should be conducted by licensed waste haulers. Utilize interior storage areas as much as possible. Minimize the time stored material on exterior portions of the property during loading/unloading events. Avoid stored chemicals in high traffic areas, install crash posts, avoid stacking materials too high, avoid storage liquid near drains, and maintain adequate isle space within buildings where possible.
5.4 SPILL PREVENTION AND RESPONSE PROCEDURES
Spills and leaks are the largest industrial source of storm water pollution. Thus, this SWPPP specifies material handling procedures and storage requirements for significant materials. Equipment and procedures necessary for cleaning up spills and preventing the spilled materials from being discharged have also been identified. All employees have been made aware of the proper procedures. The following procedures have been developed for spill response for CMU Campus:
1. Put on the appropriate personal protection equipment (gloves, goggles).
2. Stop the flow of material from the source by up righting fallen containers, closing valves, or using plugs or patches.
3. Place absorbent material to intercept or contain spilled substance and reduce contaminant run off from the site. If necessary, place additional booms across storm water spillways.
4. Maintain fire extinguishers at easily accessed locations. In the event of a combustible material spill, keep an extinguisher on hand during clean up.
17
5. Notify one of the following facility representatives:
CMU Environmental Administrator: Jeff Suty
Storm Water Operator: Name
If necessary, contact MDEQ Storm Water representative: Keith Noble (989‐686‐8025)
6. If release to waters of the state contact Pollution Emergency Alerting System 1‐800‐292‐4706 (within Michigan) or 1‐517‐373‐7660 (outside of Michigan).
7. Containerize and dispose of absorbent material and any impacted soil into a disposal bag or a 55‐gallon drum, pending characterization.
8. Characterize and dispose of impacted water if spill reaches storm water retention/ detention pond.
Upon notification of the spill, the Certified Storm Water Operator will complete a Significant Spill Report form (Appendix B). Depending on the quantity and location of the spill, certain state or federal release reporting requirements may need to be met. Any materials used from the spill control kits will be reordered and replaced. 5.5 EMPLOYEE TRAINING
Employee training will be a major component in ensuring the success of this SWPPP. The more knowledgeable all employees are about the facility’s SWPPP and what is expected of each individual; the greater the chance the plan will be successful. In general, employee training will be conducted after the time of hire and annually. The following is a description of the employee training programs to be implemented to inform appropriate personnel at all levels of responsibility of the components and goals of the SWPPP.
Topic Employees Frequency
Preventive maintenance All Upon initial hiring, updates as necessary, and annually during yearly startup meeting(s).
Good housekeeping practices All Upon initial hiring, updates as necessary, and annually during yearly startup meeting(s).
Spill response procedures – general awareness
All Upon initial hiring, updates as necessary, and annually during yearly startup meeting(s).
A general outline of the employee training is included in Appendix B. 6.0 EVALUATION OF NON‐STORM WATER DISCHARGES
By signing this plan, the Certified Industrial Storm Water Operator certifies that the storm water drainage system at this facility has been tested or evaluated for the presence of non‐storm water discharges either personally, or under their direction and supervision. To the best
18
of their knowledge and belief, the information submitted is true, accurate, as well as complete, and at the time this plan was completed, no unauthorized discharges were present. The Certified Industrial Storm Water Operator is aware that there are significant penalties for submitting false information, including the possibility of fine or imprisonment for known violations. 7.0 RECORD KEEPING AND REPORTING
The property is exempt from complying with Part I.B of Michigan’s National Pollutant Discharge Elimination Systems (NPDES) general permit for storm water discharge due to the site’s Standard Industrial Classification (SIC) Code; however, this SWPPP is voluntary and shall be followed as if it were required by law. The permit requires that records of all preventive maintenance routine inspections, the semi‐annual comprehensive site inspections, records of employee training sessions, and the annual report be retained at the CMU Campus for at least three years after the permit coverage expires. These records will be made available, upon request, to a representative of the MDEQ. 7.1 ANNUAL REPORT
The SWPPP will be reviewed annually and updated as necessary. The updated report will be retained on site. An annual review form is attached in Appendix B. 7.2 RECORD KEEPING AND REPORTING FORMS
A master copy of the following record keeping and reporting forms are provided in Appendix B:
Preventive Maintenance, Good Housekeeping, and Routine Inspection Semi‐Annual Comprehensive Inspection Employee Training Form Employee Training Outline Significant Spill Report Annual SWPPP Review Form
19
7.3 RECORD KEEPING AND REPORTING SCHEDULE
The following schedule displays the work activity, employee training, inspections, and plan review activities at the subject property. Note that the dates shown below are approximate and some variation may occur based on seasonality and market conditions.
Activity Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Employee Training
Routine Inspections
Comprehensive Inspection
Annual Plan Review
20
8.0 CERTIFICATION OF THE SWPPP The permit requires the SWPPP shall be signed by the storm water certified operator and by either the permittee or an authorized representative. The SWPPP shall be retained on‐site at the facility which generates the storm water discharge. I certify under penalty of law that this SWPPP has been developed in accordance with good engineering practices. To the best of my knowledge and belief, the information submitted is true, accurate, and complete. In addition, at the time this plan was completed no unauthorized discharges were present. I am aware that there are significant penalties for submitting false information, including the possibility of fine or imprisonment for known violations. (Signature of Certified Operator) (Operator ID: 07936) Mark S. Blanzy (Printed Name) (01/2015) (CMU Campus Representative) (01/2015) Jeff Suty (Printed Name) (Environmental Administrator) (Signature of SWPPP Author) (01/2015) Jeff Carr (Printed Name) (Environmental Consultant)
21
9.0 PLAN EVALUATION AND UPDATE This SWPPP will be evaluated and updated on an annual basis. Plan updates will be based on information obtained from the routine inspections, semi‐annual comprehensive inspections, and record keeping and reporting procedures prescribed herein. Completed and scheduled evaluations are included in the following table:
Evaluation and Update Conducted by
January 2015 – Initial Plan Jeff Carr / AKT Peerless Environmental
APPENDIX A:
Campus Maps
CMU RESEARCHCORPERATION
DEERFIELD
ABEL
CO
URT
RESEARCHLAB
CMEMITSUBAELLIS
WELLNESSCENTRAL
THREE LEAVES DRIVE
OLD
MIS
SIO
N
LOT60
FAIRFIELDINN
UN
IVER
SITY
PAR
K DR
IVEWEST CAMPUS DRIVE
SOU
TH M
ISSI
ON
CAMPUS DRIVE
LOT
LOT 64KELLY/SHORTS
STADIUM
GROUNDSSOUTH &
TV TOWER
CHIPFACILITY
LOT 70
THEUNISSENSTADIUM
LOT 67
LOT 65
CRAW
FORD
INTRAMURALFIELDS
BROOMFIELD
HIS HOUSECHRISTIANCHURCH
LOT 62WC
COMMUTER
BENNETTTRACK
HOCKEYFIELD
ROSE RYAN HALLLOT61
EAST CAMPUS DRIVE
DEM
ING
EDGE
WO
OD
STO
CKM
AN
LOT42
LOT41 KULH
AVI
WHEELER
COBB
KESSELERCAMPBELL
CCOMMUTER
LOT22F
FACULTY/STAFF
LOT 23
LIBRARY DRIVE
ANSPACH DRIVE
ANSPACH
DOWSCIENCE
LOT30
PEARCE
OTTAWA COURTLOT 48
LOT 49
WASHINGTONAPARTMENTS
FLOT 56
OJIBWAY COURT
LOT 37
LOT 44
ISABELLABANK & TRUST
LOT 68
DENISON
MARGOJONKER
STADIUM
LOT 69
WEST CAMPUS DRIVE
63
LOT57EVENT
CENTER
CAREYDINING
KEWADINVILLAGE
SAC
LOT40
LOT 62EC
COMMUTER
LOT39
LOT43C
INDOORATHLETICCOMPLEX
LOT22
BROOMFIELD
CARE
Y
TROUTMAN
EDUCATION ANDHUMAN SERVICES
BUILDING
BROOKS
LOT 45
LOT 38LOT 47
LOT 46
FABIANO
CELANI
HERRIG
LOT 53
LOT 52LOT 55
PUBLICBROADCASTING
CENTER
127
BUSI
NES
S LO
OP
SAXE
LOT50
EMMONS
WOLDT
WOLDTDINING
LOT 51
MER
RILL
DIN
ING
MERRILL SWEENEY
THORPEBEDDOW
LOT54
LOT34
IET
CALU
MET
CO
URT
POWERHOUSE
CSB
DATACENTER
LOT 33S
LOT 33N
LOT 32
BUSH THEATER&
MOORE HALL
MUSIC
PARKLIBRARY
BOTANICALGARDENS
LOT 27
LOT28
LOT 18
LOT29
FOUST
FINCH
LOT 12
LOT 20
COLLEGEOF
MEDICINE
HEALTH PROF.
LOT 11CHIPPEWA TRAIL
LOT 8LOT 8
SLOAN
LOT 14
LOT 19
SPECIALOLYMPICS
ROWE
LOT
13
ALUMNIHOUSEGRADUATE HOUSING
LOT7
LOT9
LOT10
LOT 6
LOT 15
LOT3
SMITH
GRAW
N
RONAN
WARRINER
PRESTON
FRAN
KLIN
EAST
CAM
PUS
DRIV
E
SOU
TH M
ISSI
ON
BARN
ES
UNIVERSITYART GALLERY
LOT 16
SEFWIGHTMAN
NORTHART
WESTLOT 4HOPKINS
CALKINS ROBINSON
ROBINSONDINING
LARZELERETROUT
MEN
OM
INEE
ALGO
NQ
UIN
LOT2
LOT 1
AUCTIONBUILDINGNORTHWEST
APRTMENTS
LOT 1C
LOT1B
LOT 1A
DOU
GLAS
MAI
N
UN
IVER
SITY
LAN
SIN
G
FAN
CHER
ARN
OLD
BELLOWS
LOT21
LOT31
CENTRAL MICHIGAN UNIVERSITY CAMPUSMT. PLEASANT, MICHIGANPROJECT NUMBER : 7354F
CAMPUS MAP DRAWN BY:
DATE:OGO
12/30/2014
FIGURE 1
7003500SCALE: 1" = 700'
ILLINOIS MICHIGAN OHIO GEORGIA
www.aktpeerless.com
STORAGE
POW
ERHOU
SE
WO
LDT
LOT 34
PARKING
LOT 35
PARKING
LOT 54
PARKING
LOT 51
PARKING
EAST CAMPUS DRIVE
WO
OD
HOPPER
WO
OD
LOADIN
G
COM
BINED
SERVICESEN
GINEERIN
GTECHN
OLO
GYBU
ILDING
20,000 GALLONDIESEL UST
PREDICTED DIRECTION
OF
STORM
WATER SHEET FLO
W
CENTRAL MICHIGAN UNIVERSITY CAMPUSMT. PLEASANT, MICHIGANPROJECT NUMBER : 7354F
COMBINED SERVICES AND POWERHOUSE DRAWN BY:
DATE:
OGO
12/30/2014
FIGURE 2
80400SCALE: 1" = 80'
ILLINOIS MICHIGAN OHIO GEORGIA
www.aktpeerless.com
= STORM
LINE
LEGEN
D
CST STO
RAGE
HEAVY EQU
IP.STO
RAGE
GARAGEFACILITY
CHIP
MO
VING
GROU
NDS
PBSSTO
RAGE
STORAGE
BIOLO
GY
MAT'L/
SUPPLY
BUILDIN
G
LOT 69
PARKING
LOT 68
PARKING
CAMPU
SW
ESTDRIVE
ANN ARBOR R.R.
PREDICTED DIRECTION OF
STORM W
ATER SHEET FLOW
USED TRAN
SFORM
ERSAN
DHVAC EQ
UIPM
ENT
EQU
IPMEN
TSTO
RAGE
GRASS AND TREES
USED O
IL UST
TRASHCO
MPACTO
R
CENTRAL MICHIGAN UNIVERSITY CAMPUSMT. PLEASANT, MICHIGANPROJECT NUMBER : 7354F
GROUND SOUTH DRAWN BY:
DATE:
OGO
12/30/2014
FIGURE 3
80400SCALE: 1" = 80'
ILLINOIS MICHIGAN OHIO GEORGIA
www.aktpeerless.com
= STORM
LINE
LEGEN
D
BROO
KS BUILDIN
G
HAZARDOU
SW
ASTE BUILDIN
G
PREDICTED DIRECTION
OF
STORM
WATER SHEET FLO
W
CENTRAL MICHIGAN UNIVERSITY CAMPUSMT. PLEASANT, MICHIGANPROJECT NUMBER : 7354F
HAZARDOUS WASTE STORAGE AND GREENHOUSE DRAWN BY:
DATE:
OGO
12/30/2014
FIGURE 4
30150SCALE: 1" = 30'
ILLINOIS MICHIGAN OHIO GEORGIA
www.aktpeerless.com
= STORM
LINE
LEGEN
D
LOT 21
PARKING
LOT 31
PARKING
WEST CAMPUS DRIVE
ANN ARBOR RR
PREDICTED DIRECTION
OF
STORM
WATER SHEET FLO
W
CENTRAL MICHIGAN UNIVERSITY CAMPUSMT. PLEASANT, MICHIGANPROJECT NUMBER : 7354F
HAZARDOUS WASTE STORAGE AND GREENHOUSE DRAWN BY:
DATE:
OGO
12/30/2014
FIGURE 5
30150SCALE: 1" = 30'
ILLINOIS MICHIGAN OHIO GEORGIA
www.aktpeerless.com
GIRLS VARSITY
SOFTBALL FIELD
ROSE-RYAN
HALL
STUDEN
T ACTIVITY CENTER
EVENTS
CENTER
LOT 61
PARKING
LOT 62 W
ESTPARKIN
G
BROO
MFIELD RO
AD
RETENTIO
N PO
ND
PREDICTED DIRECTION
OF
STORM
WATER SHEET FLO
W
CENTRAL MICHIGAN UNIVERSITY CAMPUSMT. PLEASANT, MICHIGANPROJECT NUMBER : 7354F
ROSE RYAN HALL AND STUDENT ACTIVITY CENTER DRAWN BY:
DATE:
OGO
12/30/2014
FIGURE 6
100500SCALE: 1" = 100'
ILLINOIS MICHIGAN OHIO GEORGIA
www.aktpeerless.com
= STORM
LINE
LEGEN
D
SALT STORAGE
LOT 1 PO
LE BARN
LOT 1
PARKING
LOT 2
PARKING
ANN ARBOR RR
PREDICTED DIRECTION
OF
STORM
WATER SHEET FLO
W
CENTRAL MICHIGAN UNIVERSITY CAMPUSMT. PLEASANT, MICHIGANPROJECT NUMBER : 7354F
AUCTION BUILDING DRAWN BY:
DATE:
OGO
12/30/2014
FIGURE 7
40200SCALE: 1" = 40'
ILLINOIS MICHIGAN OHIO GEORGIA
www.aktpeerless.com
= STORM
LINE
LEGEN
D
SALT STORAGE
LOT 1 PO
LE BARN
LOT 1
PARKING
LOT 2
PARKING
LOT 21
PARKING
LOT 31
PARKING
ANN ARBOR RR
WEST CAMPUS DRIVE
ANN ARBOR RR
PREDICTED DIRECTION
OF
STORM
WATER SHEET FLO
W
PREDICTED DIRECTION
OF
STORM
WATER SHEET FLO
W
CENTRAL MICHIGAN UNIVERSITY CAMPUSMT. PLEASANT, MICHIGANPROJECT NUMBER : 7354F
SITE LOCATION MAP DRAWN BY:
DATE:
OGO
12/30/2014
FIGURE 8
3001500SCALE: 1" = 300'
ILLINOIS MICHIGAN OHIO GEORGIA
www.aktpeerless.com
STORAGE
BROO
KS BUILDIN
G
HAZARDOU
SW
ASTE BUILDIN
G
POW
ERHOU
SE
WO
LDT
LOT 21
PARKING
LOT 31
PARKING
LOT 34
PARKING
LOT 35
PARKING
LOT 54
PARKINGLO
T 51PARKIN
G
Visitors P
arking (40 S
talls)
BROO
MFIELD RO
AD
EAST CAMPUS DRIVE
WO
OD
HOPPER
WO
OD
LOADIN
G
COM
BINED
SERVICES
WEST CAMPUS DRIVE
ANN ARBOR RR
ENGIN
EERING
TECHNO
LOGY
BUILDIN
G
20,000 GALLONDIESEL UST
PREDICTED DIRECTION
OF
STORM
WATER SHEET FLO
W
PREDICTED DIRECTION
OF
STORM
WATER SHEET FLO
W
PREDICTED DIRECTION
OF
STORM
WATER SHEET FLO
W
CENTRAL MICHIGAN UNIVERSITY CAMPUSMT. PLEASANT, MICHIGANPROJECT NUMBER : 7354F
SITE LOCATION MAP DRAWN BY:
DATE:
OGO
12/30/2014
FIGURE 9
3001500SCALE: 1" = 300'
ILLINOIS MICHIGAN OHIO GEORGIA
www.aktpeerless.com
GIRLS VARSITY
SOFTBALL FIELD
CST STO
RAGE
ROSE-RYAN
HALL
STUDEN
T ACTIVITY CENTER
EVENTS
CENTER
HEAVY EQU
IP.STO
RAGE
GARAGEFACILITY
CHIP
MO
VING
GROU
NDS
PBSSTO
RAGE
STORAGE
BIOLO
GY
MAT'L/
SUPPLY
BUILDIN
G
LOT 61
PARKING
LOT 62 W
ESTPARKIN
G
LOT 69
PARKING
LOT 68
PARKING
BROO
MFIELD RO
AD
CAMPU
SW
ESTDRIVE
ANN ARBOR R.R.
113"x4"8"
8"
PREDICTED DIRECTION OF
STORM W
ATER SHEET FLOW
USED TRAN
SFORM
ERSAN
DHVAC EQ
UIPM
ENT
EQU
IPMEN
TSTO
RAGE
GRASS AND TREES
USED O
IL UST
TRASHCO
MPACTO
R
RETENTIO
N PO
ND
PREDICTED DIRECTION
OF
STORM
WATER SHEET FLO
W
CENTRAL MICHIGAN UNIVERSITY CAMPUSMT. PLEASANT, MICHIGANPROJECT NUMBER : 7354F
SITE LOCATION MAP DRAWN BY:
DATE:
OGO
12/30/2014
FIGURE 10
4002000SCALE: 1" = 400'
ILLINOIS MICHIGAN OHIO GEORGIA
www.aktpeerless.com
APPENDIX B:
Record Keeping and Reporting Forms
PREVENTIVE MAINTENANCE, GOOD HOUSEKEEPING, and ROUTINE INSPECTION
Preventative maintenance involves the regular inspection, testing, and cleaning of the facility equipment, vehicles, and operation systems. These inspections will help uncover conditions that could lead to breakdowns. The routine inspection will be performed at a minimum of approximately every 2 weeks during the production seasons. It is anticipated that formal inspections will not be conducted during the months without production. Retain records of inspection for at least 3 years.
Date: Time
Inspected by (printed):
Signature:
Areas Inspected Observations Actions Taken
Loading areas
Fueling area
Parking areas
Grounds (in general)
Routine Inspection (continued) Other Observations
SEMI‐ANNUAL COMPREHENSIVE INSPECTION
The comprehensive inspection provides a basis for determining the overall effectiveness of the SWPPP. The comprehensive inspection should determine if the controls currently in place are adequate and working properly. This inspection must be conducted at 6 month intervals. Retain records of inspection for at least 3 years. The comprehensive inspection will be performed in April and October each year.
Date: Time
Inspected by (printed):
Signature:
Areas Inspected Observations Actions Taken
Evaluate routine inspection results
Evaluate and update employee training, as necessary
Storm water outfalls
Property boundaries
Grounds (in general)
Parking lots, curbing, spillways, and paved areas
General refuse dumpsters
Bulk storage / receiving areas
Comprehensive Inspection continued
Areas Inspected Observations Actions Taken
On‐site equipment, storage, use, and maintenance areas
Fueling area
Chemical storage areas
Berms
Retention areas and rain gardens
EMPLOYEE TRAINING
In order for the SWPPP to be effective, the employee should be informed about storm water treatment and control measures at the facility. Refer to the Storm Water Training Outline included in the SWPPP for a general list of topics covered during the training.
Date of Session: Time:
Trainer: (Printed) (Signature)
Attendees (name, printed): Signature:
Topics Covered:
Storm Water Training Outline CMU Campus
Mt. Pleasant, Michigan Training outline generally follows MDEQ Storm Water Employee Training Video, which may or may not be shown. Training will be conducted at time of hire and annually. Based on knowledge and experience, trainer may elect to focus on select topics. Overview of Storm Water Program and Storm Water Pollution Prevention Plan (SWPPP)
Goal of Storm Water Program – To reduce pollution entering Michigan’s waters by
implementing controls designed to prevent the contamination of storm water runoff.
Hydrologic Cycle – Water always moving.
Natural – Infiltrate ground, evaporate, or gather in surface water
Manmade activities alter natural pattern.
Industrial activities add pollutants to rain and snow melt when storm water comes in
contact in material/pollutants.
Discuss Storm Water Plan at the facility (SWPPP). Written plan unique and specific to this
facility. Something MDEQ can hold us to.
Goal of SWPPP is to prevent contamination of storm water. Keep storm water from coming
in contact with polluting materials.
Big part of plan is map. Review map for facility.
Discuss point source discharge and receiving waters at our facility
Materials that can degrade and impact water quality; examples:
Soil Salt Raw Materials Fuels Wood and metal chips Plastic Waste/scrap materials
Discuss specific polluting materials at this facility. Which are exposed to storm water?
Materials outside and inside are both evaluated and important. Discuss how materials
inside can be spilled or tracked outside.
Non‐structural Controls important to everyday employees:
1) Preventative Maintenance – inspection cleaning, and testing. Often includes identifying
equipment/item, tasks involved, and frequency e.g. detention pond, inspect for sheen,
outfalls, clear debris, daily observations by employees.
Discuss site specific items.
2) Good Housekeeping – Maintain a good and orderly work environment.
Discuss good housekeeping at site.
3) Routine Inspections – Certified operator conducts. Checking on maintenance and
housekeeping activities. Formal documented inspection every two weeks.
Discuss any past or reoccurring issues.
Material handling and storage procedures. Proper handling and storage can minimize
potential for accidental release.
Discuss how proper loading and unloading procedures minimize spills.
Common sense storage – Avoid storing liquids near drains, stacking materials too high,
barrier posts, adequate isle space, avoid traffic areas, install secondary containment.
Spill Prevention and Response
Preventing spill is more economical than cleaning up after the fact. Spill kits – describe what have on‐site and where. Response plan, where located, discuss procedures, safety Emergency Phone #s
SIGNIFICANT SPILL REPORT
Date of Occurrence:
Discovered by Whom:
Location:
Material Type & Volume:
Cause of Spill:
Corrective Action Taken:
Agencies/Persons Contacted:
Signature:
ANNUAL PLAN REVIEW
Date of Review:
Reviewer:
Signature:
Results of Review (update entire plan if necessary): Date of Review:
Reviewer:
Signature:
Results of Review (update entire plan if necessary): Date of Review:
Reviewer:
Signature:
Results of Review (update entire plan if necessary): Date of Review:
Reviewer:
Signature:
Results of Review (update entire plan if necessary):