Stormwater Infrastructure Certification

Stormwater Infrastructure Certification

TO BE COMPLETED BY DESIGN ENGINEER AND RETURNED PRIOR TO ISSUANCE OF CERTIFICATE OF OCCUPANCY

 

Property Location

Address:

Permit Number:

Location Description:

Parcel Size (acre):

Contact Information

Owner

Name

Company

Address

City, State, Zip

Phone

Email

Design Engineer

Name

Company

Address

City, State, Zip

Phone

Email

Requirements for Approval

ücompleted

State Water Rights Reporting documentation provided to Public Works

 

As-Built Drawings provided to Public Works

 

Video Inspection of all installed pipes performed, provided to Public Works

 

Operation and Maintenance Plan provided to Public Works

 

Signed Maintenance Agreement provided to Public Works

 

I hereby certify that the stormwater and drainage facilities for the above referenced project have been constructed and operate in conformance with the approved design. Further I certify that any deviation from the design has been documented and approved, in writing, by the City of Glendale and that said documentation has been provided to the City of Glendale.

Signature:                                                                    Date:

Affix Professional Engineer Seal






Water Quality Design Standard (check all that apply)

WQCV

Pollutant Removal

Runoff Reduction

Regional WQCV Control Measure

Regional WQCV Facility

Constrained Site

Permanent BMP Type (check all that apply)

Extended Detention Basin

Sand Filter

Bioretention

Constructed Wetland Pond

Retention Pond

Constructed Wetland Channel

Grass Buffer

Green Roof

Grass Swale

Underground





Stormwater Collection System (if additional space is needed complete additional form and attach)

Pipe System

Size (in):

Length (ft):

Invert Depth (ft):

Material:

Size (in):

Length (ft):

Invert Depth (ft):

Material:

Size (in):

Length (ft):

Invert Depth (ft):

Material:

Surface System (gutters, pans, channels, chases, etc.)

Width(ft):

Depth(ft):

Max. Longitudinal Slope(%):

Material:

Width(ft):

Depth(ft):

Max. Longitudinal Slope(%):

Material:

 

Flood Control

As Designed / As Constructed

100 Year Volume (CF):

100 Year WSEL:

10 Year Volume (CF):

10 Year WSEL:

 

Water Quality

As Designed / As Constructed

WQCV (CF):

WQCV WSEL:

EURV (CF):

EURV WSEL:

 

Stormwater Facility

As Designed / As Constructed

10 Year Orifice Elevation:

Top of Pond Outlet Elevation:

100 Year Restriction Plate Orientation:

Total Pond Volume (CF):

Overflow Elevation Width:

Overflow Elevation Depth:

Trickle Channel Longitudinal Slope (%):

Trickle Channel Cross Sectional Area (ft2):