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.............................................................................................................................................................................. <br />ATTY/AGR.2017.203/Lane Partners, LLC - STMMA <br />Proprietary Media Filter Inspection <br />and Maintenance Checklist <br />Property Address: <br />Treatment Measure No.: Date of Inspection: <br />Inspector(s): <br />Deflect Conditions When Maintenance Is Maintenance <br />Needed Needed?(Y/N) <br />1. Sediment, trash Sediment, trash and debris <br />and debris accumulated in the sedimentation <br />accumulation basin, riser pipe and filter bed. Filter <br />does not drain as specified. <br />2. Standing water Non-proprietary media filter does not <br />drain within five days after rainfall. <br />3. Mosquitoes Evidence of mosquito larvae in non- <br />proprietary media filter. <br />4. Filter bed Overall media depth 300 millimeters <br />(12 inches) or less. <br />5. Miscellaneous Any oondltion not covered above that <br />needs attention in order for the non- <br />proprietary media filter to function as <br />designed. <br />Property Owner: <br />Type of Inspection: Monthly Pre -Wet Season <br />After heavy runoff End of Wet Season <br />Other: <br />Comments (Describe maintenance Results Expected When <br />completed and if needed maintenance was Maintenance Is Performed <br />not conducted, note when it will be done) <br />Proprietary Media Filter Maintenance Plan - Page 3 <br />Sediment, trash and debris removed <br />from sedimentation basin, riser pipe <br />and filter bed and disposed of <br />properly. Filter drains per design <br />specifications. <br />Clogs removed from sedimentation <br />basin, riser pipe and filter bed. Filter <br />drains per design specifications. <br />Clogs removed from sedimentation <br />basin, riser pipe and filter bed. Filter <br />drains per design specifications. <br />Media depth restored to 450 <br />millimeters (18 inches). <br />Meet the design specifications. <br />