Spreadsheet: 0f53bc9f-48f2-48fe-b305-e01e3646ffbe
Sheet: Sheet1

 |  | N.C. Department of Environment & Natural Resources
 |  | Division of Water Quality
 |  | [NAME]
 |  | Stage One Adaptive Management Program for Existing Development
 |  | Annual Report Aug. 13, 2011—Oct. 30, 2012
Reports, supplemental forms and MS4 maps should be emailed to: [EMAIL] and [EMAIL]
SECTION I
Local Government Name:
County:
EXISTING WATER QUALITY PROGRAMS
Water Supply Watershed?
Phase II?
*NOTE: Phase II communities are only required to complete Section I and Section VI of this form.
DOES A THIRD PARTY SUCH AS A CONSULTING FIRM, PARTNER LOCAL GOVERNMENT OR OTHER GROUP SATISFY ANY OF YOUR PROGRAM OBLIGATIONS? IF SO, PLEASE PROVIDE THAT INFORMATION BELOW.
If yes, identify below party and the program element they implement:
Name
Element(s) they implement:
Contact Person
Address
City |  | State |  | Zip
Telephone |  | Fax
[NAME]
Are legal agreements in place to establish these responsibilities?
LOCAL GOVERNMENT CONTACT INFORMATION
Provide the following information for the person/position responsible for day-to-day implementation and oversight of your local government's Stage One Adaptive Management Program for Existing Development.
Contact Person
Address
City |  | State |  | Zip
Telephone |  | Fax
[NAME]
OVERVIEW OF ANNUAL REPORT REQUIREMENTS
Session Law 2009-216 requires local governments in the Jordan Lake watershed to submit a Stage One Adaptive Management Program report annually to the N.C. Department of Environment and Natural Resources, Division of Water Quality.  Stage One Adaptive Management Program for Existing Development Requirements: 1. Public education program to inform the public of the impacts of nutrient loading and measures implemented to reduce nutrient loading from stormwater runoff. 2. Mapping program that includes major components of the municipal separate storm sewer system, including the location of major outfalls and names and locations of waters that receive discharges from those outfalls, land use types and location of sanitary sewers. 3. Program to identify and remove illegal discharges. 4. Program to ensure maintenance of best management practices implemented. 5. Program to identify opportunities for retrofits and other projects to reduce nutrient loading existing development.  Phase II Stormwater Programs The Department will accept implementation of other stormwater program(s) in meeting all but one of the Stage One program requirements. Measures 1-4 are already required by NPDES Phase II stormwater permits. Therefore, Phase II communities are only required to complete Section I of this form and Section VI of this form, a report on the identification of retrofit opportunities and other load-reducing measures from existing development.   Best Management Practices Local governments must identify and submit a table of the best management practices, or BMPs, that are being implemented for each of the program’s five measures. This form provides tables for reporting BMPs.
SECTION II:  PUBLIC EDUCATION PROGRAM
Objectives for Public Education and Outreach Program 1. Distribute educational materials to the community. 2. Conduct public outreach activities. 3. Raise public awareness on causes and impacts of stormwater runoff. 4. Inform public on steps they can take to reduce stormwater runoff pollution. 5. Provide opportunities for public participation in program development and implementation.
[NAME] and Education Program: Year Two
Provide information for all BMPs that apply per your approved program.
BMP Implemented |  | Implementation details
Develop Public Education Program: List components of program.
Educational website: Provide link.
Development of Educational Materials: Describe materials developed or produced.
Distribution of Educational Materials: Provide number of items distributed and to whom.
Media Campaign: Provide details of radio or TV spots aired.
[NAME]: List  activities that targeted this audience, providing date, materials distributed, and number attending.
Public Meetings and/or Events: Provide dates, number attending,target audience and topics presented.
Community Volunteer Program:Provide details of local water quality volunteer programs and/or events.
Establish Citizens' Group: Provide date established, name of group and focus of work.
Annual Outreach Program Coordination Meeting: List date and group(s) represented at meeting.
SECTION III:  MAPPING PROGRAM
Objectives for Mapping Program: Maintain an inventory of major outfalls and stormwater drainage components.
BMP Implemented
Stormwater and sanitary sewer system map and major outfall inventory.
*ELECTRONIC FILE OR [NAME] OF MAP MUST BE SUBMITTED WITH ANNUAL REPORT.*
Please use the space below to provide the following information that is required as part of this annual report:   1. Mapping program objectives as per your approved program. 2. Specific details of how map was developed, activities and progress over the past year. 3. Status of mapping program as compared to your approved program.
SECTION IV:  ILLICIT DISCHARGE DETECTION AND ELIMINATION PROGRAM
Objectives for Illicit Discharge Detection and Elimination: 1. Develop and implement program to detect and eliminate illicit discharges. 2. Detect and eliminate illicit discharges. 3. Address significant contributors of pollutants. 4. Inform municipal employees, businesses and public of hazards associated with illegal discharges and improper waste disposal.
Provide information for all BMPs that are part of your approved program.
BMP Implemented
Establish appropriate legal authorities to enforce program.
Implement illicit discharge detection procedures.
Municipal employee training on illicit discharges.
Public and business sector education.
Mechanism for public to report illicit discharges.
SECTION V:  BEST MANAGEMENT PRACTICES MAINTENANCE PROGRAM
Objectives for a Best Management Practices (BMP) Maintenance Program: 1. Prevent or reduce stormwater pollution. 2. Provide mechanism to require long-term operation and maintenance of BMPs. 3. Ensure controls are in place to minimize water quality impacts 4. Evaluate operation and maintenance management agreements. 5. Allow local government to enter property for inspection purposes. 6. Allow local government to be reimbursed for operation and maintenance they are required to perform.
Provide information for all BMPs that are part of your approved program.
BMP Implemented
Local government BMP Operation and Maintenance program.
Mechanism to require annual inspections of structural BMPs.
BMP Operation and Maintenance training program for employees and the public.
Mechanism/program to require and maintain inventory of structural BMPs.
Mechanism to require annual review of the BMP Operation and Maintenance program.
SECTION VI:  OPPORTUNITIES FOR RETROFITS TO REDUCE NUTRIENT LOADING
Opportunities for Retrofits to Reduce Nutrient Loading Local government must develop a program to identify opportunities for retrofit projects to reduce nutrient loading from existing developed lands. The program must include a process to identify and prioritize locations for such projects. Retrofit opportunities will be considered acceptable if all of the following conditions have been investigated: 1. The proposed retrofit clearly has the potential to reduce nitrogen or phosphorus loading to the receiving water. 2. The watershed is clearly contributing nitrogen or phosphorus loading above background levels. 3. Landowner where retrofit is proposed agrees to retrofit installation on property. 4. There is adequate space and access for the retrofit. 5. It is technically practical to install a retrofit at that location.  The minimum number of retrofit opportunities each local government is required to identify is based on population. For those communities that are not completely located within the [NAME] watershed, the number of retrofits can be based on the estimated population within the watershed. The local government will have to provide the data to support the population estimate used.   Table 1 below shows the minimum requirements for identifying retrofit opportunities on an annual basis based upon local governments’ population in the watershed. Sites may be carried over to meet the minimum requirements for up to two subsequent years provided that: 1. BMPs/retrofits have not been implemented. 2. The site continues to meet the criteria stated above on an annual basis.
Table 1: Minimum Retrofit Requirements
Population in Watershed |  | Minimum Number of Existing Development  Nutrient Load-Reducing Projects
Less than 15,000 |  | 1
15,000 - 30,000 |  | 2
30,000 - 60,000 |  | 3
60,000+ |  | 4
Data Collection and Notification Each retrofit opportunity must include data describing the location, type of retrofit proposed, property owner, as well as basic information about the watershed and receiving waters. Table 2 below provides a format for submitting this information. Local governments that must submit more than one retrofit should use the Supplemental Retrofit Form (Attachment A) to submit information on additional projects. That form is available for download at www.jordanlake.org.
Table 2: Retrofit Opportunity Table
Location description, including directions from a major highway
Type and description of retrofit opportunity.
Current property owner
Is the property owner willing to cooperate?
Land area available for retrofit (sq. ft)
Accessibility to retrofit site
Drainage area size (acres)
Land use in drainage area (percent of each type of land use)
Average slope in drainage area (%)
Environmentally sensitive areas in drainage area such as wetlands, riparian buffers, endangered or threatened species.
Approximate annual nitrogen and phosphorus loading from drainage area (lbs/acre/year) *
Potential nitrogen reduction (lbs/ac/yr)*
Potential phosphorus reduction (lbs/ac/yr)*
Estimated cost of retrofit
Receiving water
DWQ classification of receiving water
Use support rating for receiving water
Other retrofit information you may wish to provide