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CITY OF SANTA ANA <br />PUBLIC WORKS AGENCY <br />20 Civic Center Plaza • M-22 <br />Santa Ana, California 92702 <br />www.santa-ana.org <br />(714)647-5659 <br />CITY OF SANTA ANA <br />Planning and Building Agency <br />Approved <br />FOR PERMIT ISSUANCE <br />Master <br />Date: <br />WATER QUALITY MANAGEMENT PLAN (WQMP) CHECKLIST <br />Proj ect Title and Address: Dr Ka /g 0-Frn If I. _.Pm4o / (7-t% re d-_O -S • BA6401 S-6 A <br />Select the type of construction that applies to your parking lot project then follow the arrows to determine if the <br />project is subject to WQMP requirements. Submit the completed checklist to the Public Works Agency. <br />Construction of a Addition or Redevelopment to <br />new parking lot an existing parkin! lot <br />Enter surface area <br />(square -feet) of new <br />parking lot, including <br />drive aisles, exposed to <br />stormwater runoff in <br />Box 1 below. <br />Does the project result in the <br />addition of new impervious surface' <br />to the existing parking lot area <br />(i.e. increased parking area)? <br />Yes j JIL No <br />Enter surface area (square -feet) of <br />parking lot addition, including <br />drive aisles, exposed to stormwater <br />runoff in Box 2 below. <br />sq-ft I Yes <br />Does the project consist of a "grind <br />and overlay" and/or "slurry seal" <br />treatment to the existing parking <br />lot surface? <br />l 7sq-ft No WQMP ■ <br />Required' <br />'Impervious surface is a surface that prohibits stormwater infiltration into the ground Checkbox <br />00 <br />'Native soil is the soil below any existing engineered fill or base material <br />'Project is considered routine maintenance <br />No <br />If the sum of the values entered into Box 1, 2, and 3 is greater than or equal to 5,000 r <br />square -feet, the project is subject to WQMP requirements and will require a grading <br />permit. Public Works Agency — Development Engineering staff review and approve No WQMP ❑ <br />WQMPs and grading plans. Grading permits may also be required for routine Required' <br />maintenance projects, subject to the discretion of the Public Works Agency. Checkbox <br />1 certify that the above information is true and accurate to the best of my knowledge. ) am aware that City <br />staff may conduct inspections of the project during construction and if staff determine the project is in fact <br />subject to WQMP requirements, a Stop Work Order and/or Administrative Citation(s) with Administrative <br />Fine(s) may be issued t e contractor and property owner, and a WQMP will be required for the project. <br />Signature Print Name: 794 j2,k,s JZ Date:�5 <br />No <br />Is native soil' being <br />exposed, surface <br />material changing (i.e. <br />asphalt to concrete), or <br />grade/drainage patterns <br />changing? <br />i Yes <br />Enter surface area <br />(square -feet) of <br />redeveloped parking lot, <br />including drive aisles, <br />exposed to stormwater <br />runoff in Box 3 below. <br />3 <br />sq-ft <br />May 2022 Page 2 of 2 <br />