Agda Pkt 2025.12.08 Joint SA PFA

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Worksheet G (For municipal staff use only) G-1 Yes No Name of Reviewer: G-2 Yes No If yes, then add site to Staff’s Monthly Rainy Season Construction Site Inspection List G-3 Yes No If yes, then add site to Staff’s Lists for Construction and O&M inspections (C.3 and C.3.h) Operations and Maintenance (O&M) Submittals G-4 Stormwater Treatment Measure and/HM Control Owner or Operator’s Information: Name: Address: Phone:Email: The following questions apply to C.3 Regulated Projects and Hydromodification Management Projects. Yes No N/A G-4.1 Was maintenance plan submitted? G-4.2 Was maintenance plan approved? G-4.3 Was maintenance agreement submitted? (Date executed:) ► Attach the executed maintenance agreement as an appendix to this checklist. G-5 Annual Operations and Maintenance (O&M) Submittals (for municipal staff use only): G-6 Comments (for municipal staff use only): ► Applicant must call for inspection and receive inspection at completion of installation of treatment measures and/or hydromodification management controls including any pervious pavement areas of 3,000 sq.ft. or more. For C.3 Regulated Projects and Hydromodification Management Projects, indicate the dates on which the Applicant submitted annual reports for project O&M: Alternative Certification: Were the treatment and/or HM control sizing and design reviewed by a qualified third-party professional that is not a member of the project team or agency staff? High Priority Site: High Priority Sites can include those located in or within 100 feet of a sensitive habitat, an Area of Special Biological Significance (ASBS), a body of water, or on "hillside projects" disturbing >=5,000 sq.ft. of land and with steep slopes (of >=15% - see cell I.A.5 - or as identified by municipal criteria or map). These sites are subject to monthly inspections from Oct 1 to April 30. See MRP Provision C.6.e.ii.(2)(b) and C.6.e.ii.(2)(c). Inspections of Sites with Pervious Pavement: Regulated projects that are installing 3,000 sq.ft. or more of pervious pavement (see cell I.B.1.g) (excluding private-use patios in single family homes, townhomes, or condominiums) must have the pavement system inspected by the jurisdiction upon completion of the installation and the site must be added to the jurisdiction’s list of sites needing inspections at least once every five years – see provision C.3.h. Pervious pavement systems include pervious concrete, pervious asphalt, pervious pavers and grid pavers etc. and are described in the C3 Regulated Projects Guide downloadable at: www.flowstobay.org/newdevelopment. 7.A. - Page 66 of 121 72