2. Introduction
   This WQMP template shall be used for projects that create and/or replace between 2500 and 5000 square feet of impervious surface; and for detached single family residence projects that create or replace ≥ 2500 sq. ft., and are not part of a larger plan of development consistent with Section E.12.b of the MS4 Permit. Do not be confuse this template with the “Regulated Project” WQMP template or the Phase I WQMP for the Santa Ana Watershed area of San Bernardino County.
6. Project Name:
8. Project Owner Contact
10. First Name*
11. Last Name*
13. Address1*
15. Address2
17. City*
18. State*
19. Zip*
21. Contact Email*
22. Contact Phone*
24. Permit Application Number*
25. Tract/Parcel Map Numbers*
27. Additional Information/Comments
31. Description of Project*
33. Provide Summary of Conceptual Project Site Design Conditions*
35. Project Information
    Projects must provide all information requested below. The information provided for a Preliminary WQMP should give sufficient detail to identify the major proposed site design measures that impact site planning. The Final Project WQMP must identify all site design measures and source control BMPs incorporated into the final site design, and provide other detailed information as described herein. This information will document the project’s site design measures, source control BMPs, and establish performance criteria and long term maintenance responsibilities for the project.
37. Property Ownership/Management
    Describe the ownership/management of all portions of the project and site. State whether any infrastructure will transfer to public agencies (City, County, Caltrans, etc.) after project completion. State if a homeowners or property owners association will be formed and be responsible for the long-term maintenance of project stormwater facilities. Describe any lot-level stormwater features that will be the responsibility of individual property owners.
39. Development Project Type: *

    1. Non Regulated Project (Project Total Square Feet >2,500 but <5,000 sq.)
40. Project Area (ft2): *
42. Number of Dwelling Units*
43. SIC Code*
45. Is Project going to be phased? (If yes, ensure that the WQMP evaluates each phase as a distinct DA, requiring LID BMPs to address runoff at time of completion. *

    1. Yes
    2. No
49. Property Ownership/Management*
    In the space above, describe property ownership/management responsible for long-term maintenance of the site design.
53. Site and Watershed Description
    Describe project site conditions relevant to the selection of Site Design Measures through an analysis of the physical conditions and limitations of the site. Identify distinct drainage areas (DA) that collect flow from each portion of the site and describe how runoff from each DA is conveyed to the site outlet(s). A map presenting the DAs must be included as an appendix to the WQMP. Small sites may have only one DA.
55. Site Coordinates: Latitude*
    Take GPS measurement at approximate centroid of site.
56. Site Coodinates: Longitude*
    Take GPS measurement at approximate centroid of site.
57. Thomas Bros Map Page*
58. San Bernardino County Climate Region*

    1. Desert
60. Does the site have more than one drainage area (DA)?
    -- Select One --YesNo (in the space below, upload a conceptual schematic describing DAs and hydrologic feature connecting DAs to the site outlets)
61. 
63. Schematic Upload
64. Conveyance
    In the spaces below, briefly describe on-site drainage features to convey runoff that is not retained within a DA.
66. DA Flows to Outlet 1*
    Provide a brief description.
67. DA Flows to Outlet 2*
    Provide a brief description.
71. Site Design Measures and Source Control BMPs
    Site design measures are project design methods that help reduce runoff generation and transport of pollutants offsite. Projects must evaluate site conditions such as soil type(s), existing vegetation, and flow paths, which will influence the overall site design.
73. Narrative - Site Design Practices *
    Please provide a narrative of site design practices utilized or rationale for not using practices.
74. Narrative - Design Practices Incorporation*
    Please provide a narrative of how site plan incorporates preventive site design practices.
76. Site Plan Layout Upload*
    Include an attached Site Plan layout which shows how preventative site design practices are included in the WQMP.
80. MS4 Permit Section E.12: Site Design Measures*

    Projects shall implement one or more of the following site design measures to reduce project site runoff. ROOFTOP REQUIRED.

    1. Stream Setbacks and Buffers - a vegetated area including trees, shrubs, and herbaceous vegetation, that exists or is established to protect a stream system, lake, reservoir, or coastal estuarine area;
    2. Soil Quality Improvement and Maintenance - improvement and maintenance soil through soil amendments and creation of microbial community;

    1. Tree Planting and Preservation - planting and preservation of healthy, established trees that include both evergreens and deciduous, as applicable;
    2. Rooftop and Impervious Area Disconnection - rerouting of drainage pipes from rooftops and impervious areas to drain stormwater to permeable areas instead of the storm sewer; Required for all projects

    1. Porous Pavement - pavement that allows runoff to pass through it, thereby reducing the runoff from a site and surrounding areas and filtering pollutants;
    2. Green Roofs - a vegetative layer grown on a roof (rooftop garden); not recommended

    1. Arid, Region Rock-lined Swale – an open-channel management practice designed specifically to treat and attenuate storm water runoff;
    2. Rain Barrels and Cisterns - system that collects and stores storm water runoff from a roof or other impervious surface; not recommended
84. Site Design Measure Descriptions
    In the spaces below, provide description of proposed implementation/rationale for no implementation. Only complete spaces for your site's proposed plan.
86. Stream Setbacks and Buffers
    A vegetated area including trees, shrubs, and herbaceous vegetation, that exists or is established to protect a stream system, lake, reservoir, or coastal estuarine area.
87. Soil Quality Improvement and Maintenance
    Improvement and maintenance soil through soil amendments and creation of microbial community.
89. Tree Planting and Preservation
    Planting and preservation of healthy, established trees that include both evergreens and deciduous, as applicable.
90. Rooftop and Impervious Area Disconnection*
    Rerouting of rooftop drainage pipes to drain rainwater to rain barrels, cisterns, or permeable areas instead of the storm sewer. Required for all projects.
92. Porous Pavement
    Pavement that allows runoff to pass through it, thereby reducing the runoff from a site and surrounding areas and filtering pollutants.
93. Green Roofs
    A vegetative layer grown on a roof (rooftop garden); not recommended.
95. Arid Region Rock-Lined Swales
    Open-channel management practice designed specifically to treat and attenuate storm water runoff.
96. Rain Barrels and Cisterns
    System that collects and stores storm water runoff from a roof or other impervious surface.
98. SMARTS Post Construction Calculator
    Post Construction Calculator

    Project proponents shall use the State Water Board SMARTS Post-Construction Calculator, or equivalent, to quantify the runoff reduction resulting from implementation of site design measures.
100. None of the above site measures are appropriate for this Project.

     1. None Applicable

     If none of the above site design measures are applicable or appropriate, provide proposed alternative BMP/approach and supporting rationale below.
102. Alternative
103. Rationale
105. Minimum Source Control BMPs
     Projects with pollutant-generating activities and sources are required to implement standard permanent and/or operation source control measures as applicable. Form 4.2-1 and 4.2-2 are used to describe specific source control BMPs used in the Site Design WQMP, or to explain why specific BMPs are not applicable. Table 7-3 of the TGD for WQMP provides a list of applicable source control BMP for projects with specific types of potential pollutant sources or activities. The source control BMPs in this table must be implemented for projects with these specific types of potential pollutant sources or activities. The site owner shall review the source control BMP requirements for development projects, and the specific BMPs required for this project as specified in Forms 4.2-1 and 4.3-2. All applicable non-structural and structural source control BMPs shall be implemented in the project.
107. CASQA Stormwater BMPs
     Stormwater Handbook

     The identified list of source control BMPs correspond to the CASQA Stormwater BMP Handbook for New Development and Redevelopment may be found at the link above.
109. Source Control Measures
     Projects with pollutant-generating activities and sources as described below shall implement all applicable standard permanent and/or operational source control measures to minimize pollutant discharges for these sources. Source Control Measures for the following pollutant generating activities and sources shall be designed consistent with recommendations from the CASQA Stormwater BMP Handbook for New Development and Redevelopment or equivalent manual, and include:
111. Accidental Spills or Leaks*

     Spill contingency plan; cleanup materials on site.

     1. Yes
     2. No
Leave This Blank:


113. 1. Receive an email copy of this form.
114. Email address

     This field is not part of the form submission.

115. Submit

* indicates a required field