HAR §15-212-111. Littering or polluting land area prohibited

(b) No Person shall deposit oil, oily refuse, sludge, chemicals or other hydrocarbons on state property except in specially designated collection points. These items may not be left in or near standard refuse containers or anywhere else on harbors property. Penalties including but not limited to the revocation of mooring permits and the right to use the facilities, may be revoked. [Eff Dec 03 2008] (Auth: HRS §206E-4) (Imp: HRS §206E-4) HAR §15-212-112 Littering or polluting waters prohibited No person shall place, throw, deposit, or discharge, or cause to be placed, thrown, deposited, or discharged into the waters of Kewalo Basin any litter, or other gaseous, liquid or solid materials which render the water unsightly, noxious or otherwise unwholesome so as to be detrimental to the public health and welfare, or a navigational hazard. No person shall discharge oil sludge, oil refuse, fuel oil or molasses either directly or indirectly, or pump bilges or ballast tanks containing other than clean water into the waters of Kewalo Basin. [Eff Dec 03 2008] (Auth: HRS §206E-4) (Imp: HRS §206E-4) Oil Disposal Instructions Kewalo Basin Harbor, Oahu, Hawaii page 4 4.0 ENFORCEMENT Violations will be investigated by the HCDA, its Harbor Agent, and Harbor Patrol mad violators will be cited and permits revoked. Eye witness reports and surveillance devices such as video cameras will be used to identity violators and other noncompliance with Kewalo Basin rules. Public participation is intended to raise public consciousness of water quality issues and create a sense of responsibility for water quality, to lessen the likelihood that informed, members of the public will commit actions which may lead to water quality degradation. Public awareness of storm water quality issues may invite comment by informed members which leads to a better and more effective plan, and better implementation. Harbors Division has invited public involvement/participation during the previous NGPC term by posting the Storm Water Management Plan to the Harbors Division website. Currently HCDA will do the same and post this revised SWMPP on the HCDA website. On the TSI and during annual compliance inspection, HCDA will inform the tenants and the public the location of the SWMPP on the HCDA website and ask them to provide comments to the program and plan. Comments received will be replied to and posted on the website. Effectiveness of the TSI mailing and compliance inspections will be assessed by the responses provided by the tenant public, and comments received by HCDA. ATTACHMENT H Example Revocable Lease Lease Agreement Addendum 1 Environmental Compliance - Lessee’s Duties ADDENDUM 1 ENVIRONMENTAL COMPLIANCE – LESSEE’S DUTIES A. Definitions. For purposes of this Lease, Lessee agrees and understands that the following terms shall have the following meanings: “Environmental Laws” shall mean all federal, state and local laws of every nature including statutes, ordinances, rules, regulations, codes, notices, standards, directives of every kind, guidelines, permits, licenses, authorizations, approvals, interpretations of the foregoing by any court, legislative body, agency or official, judicial decisions, orders, rulings or judgments, or rules of common law which currently are in effect or which may come into effect through enactment, issuance, promulgation, adoption or otherwise, which in any way pertain to, relate to, or have any relevance to the environment, health or safety. These environmental laws include, but are not limited to, regulations and orders of the federal Environmental Protection Agency and of the State of Hawaii Department of Health. “Hazardous Substance” shall mean and include any chemical, substance, organic or inorganic material, controlled substance, object, condition, waste, living organism, or combination thereof which is, may be, or has been determined by proper state or federal authority under any environmental law to be, hazardous to human health or safety or detrimental to the environment. This term shall include, but not be limited to, petroleum hydrocarbons, asbestos, radon, polychlorinated biphenyls (PCBs), methane, and other materials or substances that are regulated by state or federal authorities. B. Lessee’s Activities and Duties. 1. Compliance with Environmental Laws. Lessee agrees, at its sole expense and cost, to comply with all environmental laws that apply to the leased premises during the term of this lease, and Lessee’s occupancy of, and activities on, the leased premises. This duty shall survive the expiration or termination of this lease which means that the Lessee’s duty to comply with environmental laws shall include complying with all environmental laws, regulations and orders that may apply, or be determined to apply, to the occupancy and activities of the Lessee on the leased premises after the expiration or termination of this lease. Failure of the Lessee to comply with any environmental laws shall constitute a breach of this lease for which the Lessor shall be entitled, in its discretion, to terminate this lease and take any other action at law or in equity it deems appropriate. Lessee shall conform its operations with 49 CFR, Part 195 (Pipeline Safety), and shall install Time Domain Reflectivity (TDR) cable leak detection and monitoring equipment, which meet or exceed industry standards, adjacent to the fuel pipelines and related facilities, to provide an indication of any leak occurrence from any fuel pipeline or containment device. In addition, the Lessee shall install a secondary containment wall/vaulting to prevent releases into the environment. The Lessee shall also develop, implement, and follow a written integrity management program that addresses the risks of each pipeline, and provides for periodic assessment of the integrity of each pipeline through internal inspection, pressure testing, or other equally effective assessment means, on a regular basis. 2. Hazardous Substances. Lessee shall not use, store, treat, dispose, discharge, release, generate, create, or otherwise handle any Hazardous Substance, or allow the same by any third person, on the leased premises (with the exception of the intended routine management of the petroleum products within the proposed pipeline) without first obtaining the written consent of the Lessor and complying with all environmental laws, including giving all required notices, reporting to, and obtaining permits from, all appropriate authorities, and complying with all provisions of this lease. 3. Notice to Lessor. Lessee shall keep Lessor fully informed at all times regarding all environmental law related matters affecting the Lessee or the leased premises. This duty shall include, without limited the foregoing duty, providing the Lessor with a current and complete list and accounting of all hazardous substances of every kind which are present on or about the leased premises and with evidence that the Lessee has in effect all required and appropriate permits, licenses, registrations, approvals and other consents that may be required of or by federal and state authorities under all environmental laws. This duty shall also include providing immediate written notice of any investigation, enforcement action, remediation, or other regulatory action, order of any type, or any legal action, initiated, issued, or any indication of an intent to do so, communicated in anyway to the Lessee by any federal or state authority, or individual, which relates in any way to any environmental law, or any hazardous substance, and the Lessee or the leased premises. As part of this written notice to the Lessor, the Lessee shall also immediately provide the Lessor with copies of all written communications from individuals, or state and federal authorities, including copies of all correspondence, claims, complaints, warnings, reports, technical data and any other documents received or obtained by the Lessee. At least thirty days prior to termination of this lease, or termination of the possession of the leased premises by Lessee, Lessee shall provide the Lessor with written evidence satisfactory to the Lessor that Lessee has fully complied with all environmental laws, including any orders issued by any governmental authority to the Lessee that relate to the leased premises. 4. Notice to Authorities. Lessee shall provide written notice to the Environmental Protection Agency and the State of Hawaii Department of Health at least sixty days prior to the termination of this lease, or sixty days prior to Lessee’s termination of possession of the leased premises, whichever occurs first, that Lessee intends to vacate the leased premises and terminate its operations on those leased premises. Lessee shall allow the agents or representatives of said authorities access to the leased premises at any and all reasonable times for the purpose of inspecting the leased premises, and taking samples of any material for inspection or testing for compliance with any environmental laws. Lessee shall provide copies of said written notices to Lessor at the time said notices are provided to said authorities. 5. Disposal/Removal. Except for materials that are lawfully sold in the ordinary course of the Lessee’s business, Lessee shall cause any hazardous substances to be removed from the leased premises for disposal, and to be transported from the leased premises solely by duly licensed hazardous substances transporters, to duly licensed facilities for final disposal as required by all applicable environmental laws. Lessee shall provide Lessor with copies of documentary proof, including manifests, receipts, or bills of lading, which reflect that said hazardous substances have been properly removed and disposed of in accordance with all environmental laws. 6. Environmental Investigations and Assessments. The Lessee, at its sole cost and expense, shall cause to be conducted such investigations and assessments of the leased premises to determine the presence of any hazardous substance on, in, or under the leased premises as may be directed from time to time by the Lessor, in its sole discretion, or by any federal or state authority. The extent and number of any environmental investigations and assessments shall be determined by the Lessor or the federal or state authority directing said investigations and assessments to be conducted. Lessee shall retain a competent and qualified person or entity that is satisfactory to the Lessor or governmental authority, as the case may be, to conduct said investigations and assessments. Lessee shall direct said person or entity to provide the Lessor or governmental authority, if so requested, with testable portions of all samples of any soils, water, ground water, or other material that may be obtained for testing, and provide to the Lessor and the governmental authority written results of all tests on said samples upon completion of said testing. 7. Remediation. In the event that any hazardous substance is used, stored, treated, disposed on the premises, handled, discharged, released, or determined to be present on the leased premises, Lessee shall, at its sole expense and cost, remediate the leased premises of any hazardous substances, and dispose/remove said hazardous substance in accordance with paragraph 4. This duty to remediate includes strictly complying with all environmental laws and directives to the Lessee to remediate said hazardous substance from the Lessor. This duty to remediate shall include replacement of any materials, such as soils, so removed with material that is satisfactory to the Lessor and governmental authority, as the case may be. In the event Lessee does not remediate the leased premises to the same condition as it existed at the commencement of the lease, as determined by the Lessor, Lessee understands and agrees that Lessor may exercise its rights under the paragraph entitled Lessor’s Right to Act, and until such time as the remediation is complete to the satisfaction of the Lessor, Lessee shall be liable for lease rent in the same manner and amount as if the lease had continued in effect during the period of remediation. 8. Restoration and Surrender of Premises. The Lessee hereby agrees to restore the leased premises, at its sole cost and expense, including the soil, water and structures on, in, or under the leased premises to the same condition as the premises existed at the commencement of this lease, fair wear and tear to the structures excepted. In the event Lessee does not restore the leased premises to the same condition as it existed at the commencement of the lease, as determined by the Lessor, Lessee understands and agrees that Lessor may exercise its rights under the paragraph entitled Lessor’s Right to Act, and until such time as the restoration is complete to the satisfaction of the Lessor, Lessee shall be liable for lease rent in the same manner and amount as if the lease had continued in effect during the period of restoration. 9. Lessor’s Right to Act. In the event Lessee fails for any reason to comply with any of its duties under this lease or under any environmental laws within the time set for doing so, or within a reasonable time as determined by the Lessor, Lessor shall have the right, but not the obligation, in its sole discretion, to perform those duties, or cause them to be performed. Lessee hereby grants access to the leased premises at all reasonable hours to the Lessor, its agents, and anyone designated by the Lessor in order to perform said acts and duties. Any cost, expense, or liability of any type that may be incurred by the Lessor in performing said acts or duties shall be the sole responsibility of the Lessee, and Lessee hereby agrees to pay for those costs and expenses, and indemnify the Lessor for any liability incurred. This obligation shall extend to any costs and expenses incident to enforcement of Lessor’s right to act, including litigation costs, attorneys fees, and the costs and fees for collection of said cost, expense or liability. 10. Release and Indemnity. Lessee hereby agrees to release the Lessor, its officers, agents, successors, and assigns from any liability of any kind, including, but not limited to, any liability for any damages, penalties, fines, judgments, or assessments that may be imposed or obtained by any person, agency, or governmental authority against the Lessee by reason of any hazardous substance that may be present by whatever means on, in or under the leased premises. The Lessee hereby agrees to indemnify, defend with counsel suitable to the Lessor, and hold harmless the Lessor from any liability that may arise in connection with, or by reason of, any occurrence involving any hazardous substance that may be alleged to be connected or related in any way with the leased premises, the Lessor’s ownership of the premises, or this lease, including the presence of any hazardous substance on the leased premises. 11. Surety/Performance Bond for Cleanup/Restoration. At its sole cost and expense, Lessee shall provide the Lessor with a Bond, or other security satisfactory to Lessor, in the amount of $100,000.00 to assure removal of any hazardous substances, and the remediation and restoration of the leased premises during the term of, and at the conclusion of the lease so as to comply with the terms of this lease to the satisfaction of the Lessor, and in order to comply with environmental laws. Lessee shall provide written evidence that said Bond or security has been secured by the Lessee, which evidence shall indicate the term during which said Bond or other security shall irrevocably remain in effect. 12. Insurance. Effective at the commencement of this lease, Lessee shall obtain and keep in force a comprehensive liability and property damage policy of insurance issued by an insurer licensed to do business in the State of Hawaii, with limits of indemnity coverage no less than $1,000,000. Said policy of insurance shall provide coverage for personal injury or damage to property caused by hazardous substances or any occurrence that may constitute a violation of any environmental law by the Lessee. Said policy of insurance shall name the Lessor as an additional insured. Lessee shall provide proof of said insurance satisfactory to the Lessor which shall include, at a minimum, the coverage provided, and the term during which said policy shall be effective. ATTACHMENT I Kewalo Basin Mooring and Commercial Fishing Permits Excerpt from Standard Revocable Permit Environmental Compliance - Permittee’s Duties 26. SPECIAL TERMS AND CONDITIONS. ENVIRONMENTAL COMPLIANCE – PERMITTEE’S DUTIES A. Definitions. For purposes of this Revocable Permit, Permittee agrees and understands that the following terms shall have the following meanings: “Environmental Laws” shall mean all federal, state and local laws of every nature including statutes, ordinances, rules, regulations, codes, notices, standards, directives of every kind, guidelines, permits, licenses, authorizations, approvals, interpretations of the foregoing by any court, legislative body, agency or official, judicial decisions, orders, rulings or judgments, or rules of common law which currently are in effect or which may come into effect through enactment, issuance, promulgation, adoption or otherwise, which in any way pertain to, relate to, or have any relevance to the environment, health or safety. These environmental laws include, but are not limited to, regulations and orders of the federal Environmental Protection Agency and of the State of Hawaii Department of Health. “Hazardous Substance” shall mean and include any chemical, substance, organic or inorganic material, controlled substance, object, condition, waste, living organism, or combination thereof which is, may be, or has been determined by proper state or federal authority under any environmental law to be, hazardous to human health or safety or detrimental to the environment. This term shall include, but not be limited to, petroleum hydrocarbons, asbestos, radon, polychlorinated biphenyls (PCBs), methane, and other materials or substances that are regulated by state or federal authorities. B. Permittee’s Activities and Duties. 1. Compliance with Environmental Laws. Permittee agrees, at its sole expense and cost, to comply with all environmental laws that apply to the premises during the term of this Revocable Permit, and Permittee’s occupancy of, and activities on, the premises. This duty shall survive the expiration or termination of this Revocable Permit which means that the Permittee’s duty to comply with environmental laws shall include complying with all environmental laws, regulations and orders that may apply, or be determined to apply, to the occupancy and activities of the Permittee on the premises after the expiration or termination of this Revocable Permit. Failure of the Permittee to comply with any environmental laws shall constitutes a breach of this Revocable Permit for which the State shall be entitled, in its discretion, to terminate this Revocable Permit and take any other action at law or in equity it deems appropriate. 2. Hazardous Substances. Permittee shall not use, store, treat, dispose, discharge, release, generate, create, or otherwise handle any Hazardous Substance, or allow the same by any third person, on the premises without first obtaining the written consent of the State and complying with all environmental laws, including giving all required notices, reporting to, and obtaining permits from, all appropriate authorities, and complying with all provisions of this Revocable Permit. 3. Notice to the State. Permittee shall keep the State fully informed at all times regarding all Environmental law related matters affecting the Permittee or the premises. This duty shall include, without limit to the foregoing duty, providing the State with a current and complete list and accounting of all hazardous substances of every kind which are present on or about the premises and with evidence that the Permittee has in effect all required and appropriate permits, licenses, registrations, approvals and other consents that may be required of or by federal and state authorities under all environmental laws. This duty shall also include providing immediate written notice of any investigation, enforcement action, remediation or other regulatory action, order of any type, or any legal action, initiated, issued, or any indication of an intent to do so, communicated in anyway to the Permittee by any federal or state authority or individual which relates in any way to any environmental law or any hazardous substance and the Permittee or the premises. This written notice to the State shall include the Permittee immediately providing the State with copies of all written communications from individuals or state and federal authorities, including copies of all correspondence, claims, complaints, warnings, reports, technical data and any other documents received or obtained by the Permittee. At least thirty (30) days prior to termination of this Revocable Permit, or termination of the possession of the premises by Permittee, which ever shall first occur, Permittee shall provide the State with written evidence satisfactory to the State that Permittee has fully complied with all environmental laws, including any orders issued by any governmental authority to the Permittee that relate to the premises. 4. Notice to Authorities. Permittee shall provide written notice to the Environmental Protection Agency and the State of Hawaii Department of Health at least sixty (60) days prior to the termination of this Revocable Permit, or sixty (60) days prior to Permittee’s termination of possession of the premises, whichever occurs first, the fact that Permittee intends to vacate the premises and terminate its operations on those premises. Permittee shall allow the agents or representatives of said authorities access to the premises at any and all reasonable times for the purpose of inspecting the premises and taking samples of any material for inspection or testing for compliance with any environmental laws. Permittee shall provide copies of said written notices to the State at the time said notices are provided to said authorities. 5. Disposal/Removal. Except for materials that are lawfully sold in the ordinary course of the Permittee’s business and for which the Permittee has obtained all required authorizations from appropriate authorities including the prior written permission of the State to have said substance on the premises, Permittee shall cause any hazardous substances to be removed from the premises for disposal. This duty shall include the transportation of said hazardous substance from the premises solely by duly licensed hazardous substance transporters to duly licensed facilities for final disposal as required by all applicable environmental laws. Permittee shall provide the State with copies of documentary proof, including manifests, receipts or bills of lading, which reflect that said hazardous substances have been properly removed and disposed of in accordance with all environmental laws. 6. Environmental Investigations and Assessments. The Permittee, at its sole cost and expense, shall cause to be conducted such investigations and assessments of the premises to determine the presence of any hazardous substance on, in, or under the premises as may be directed from time to time by the State, in its sole discretion, or by any federal or state authority. The extent and number of any environmental investigations and assessments shall be determined by the State or the federal or state authority directing said investigations and assessments to be conducted. Permittee shall retain a competent and qualified person or entity that is satisfactory to the State or governmental authority, as the case may be, to conduct said investigations and assessments. Permittee shall direct said person or entity to provide the State or governmental authority, if so requested, with testable portions of all samples of any soils, water, ground water or other material that may be obtained for testing and provide directly to the State and the governmental authority at the sole expense of the Permittee written results of all tests on said samples upon completion of said testing. 7. Remediation. In the event that any hazardous substance is used, stored, treated, disposed on the premises, handled, discharged, released, or determined to be present on the premises, or to have migrated from the premises, Permittee shall, at its sole expense and cost, remediate the premises, or any location off the premises to which it is determined that the hazardous substance has migrated, of any hazardous substances. Said duty to remediate includes the removal and disposal of said hazardous substances in accordance with paragraph 5. This duty to remediate includes strictly complying with all environmental laws and directives to remediate said hazardous substance issued from the State or any federal or State governmental authority charged with enforcing the Environmental laws. This duty to remediate shall include replacement of any materials, such as soils, removed with material that is satisfactory to the State and governmental authority, as the case may be. 8. Restoration and Surrender of Premises. The Permittee hereby agrees to restore the premises, at its sole cost and expense, including the soil, water and structures on, in, or under the premises, to the same condition as the premises existed at the commencement of this Revocable Permit, fair wear and tear to the structures excepted. In the event Permittee does not restore the premises to the same condition as it existed at the commencement of the Revocable Permit, as determined by the State, the Permittee understands and agrees that the State may exercise its rights under the paragraph entitled State’s Right to Act, and until such time as the restoration is complete to the satisfaction of the State, Permittee shall be liable for Revocable Permit rent in the same manner and amount as if the Revocable Permit had continued in effect during the period of restoration. 9. State’s Right to Act. In the event the Permittee fails for any reason to comply with any of its duties under this Revocable Permit or under any environmental laws within the time set for doing so, or within a reasonable time as determined by the State, the State shall have the right, but not the obligation, in its sole discretion, to perform those duties, or cause them to be performed. Permittee hereby grants access to the premises at all reasonable hours to the State, its agents and anyone designated by the State in order to perform said acts and duties. Any cost, expense or liability of any type that may be incurred by the State in performing said acts or duties shall be the sole responsibility of the Permittee and Permittee hereby agrees to pay for those costs and expenses and indemnify the State for any liability incurred. This obligation shall extend to any costs and expenses incident to enforcement of State’s right to act, including litigation costs, attorneys fees and the costs and fees for collection of said cost, expense or liability. 10. Release and Indemnity. Permittee hereby agrees to release the State, its officers, agents, successors and assigns from any liability of any kind, including, but not limited to, any liability for any damages, penalties, fines, judgments or assessments that may be imposed or obtained by any person, agency or governmental authority against the State and/or the Permittee by reason of any hazardous substance that may be present by whatever means on, in or under the premises. The Permittee hereby agrees to indemnify, defend with counsel suitable to the State, and hold harmless the State from any liability that may arise in connection with, or by reason of, any occurrence involving any hazardous substance that may be alleged to be connected or related in any way with the premises, the State’s ownership of the premises, or this Revocable Permit, including the presence of any hazardous substance on the premises. Permittee understands and agrees that any assessments, fines or penalties that may be assessed against the Permittee or the State by reason of any environmental law violation concerning the premises shall be paid, complied with, and in every way satisfied by the Permittee and not the State. 11. Surety/Performance Bond for Cleanup/Restoration. At its sole cost and expense, Permittee shall provide the State with a Bond, or other security satisfactory to State, in the amount of $ N/A to assure removal of any hazardous substances and the remediation and restoration of the premises during the term of, and at the conclusion of the Revocable Permit so as to comply with the terms of this Revocable Permit to the satisfaction of the State and in order to comply with environmental laws. Permittee shall provide written evidence that said Bond or security has been secured by the Permittee which evidence shall indicate the term during which said Bond or other security shall irrevocably remain in effect. 12. Insurance. Effective at the commencement of this Revocable Permit, Permittee shall obtain and keep in force a comprehensive liability and property damage policy of insurance issued by an insurer licensed to do business in the State of Hawaii with limits of indemnity coverage no less than $500,000.00. Said policy of insurance shall provide coverage for personal injury and damage to property caused by hazardous substances or any occurrence that may constitute a violation of any environmental law by the Permittee or the State. Said policy of insurance shall name the State as an additional insured. Permittee shall provide proof of said insurance satisfactory to the State which shall include, at a minimum, the coverage provided and the term during which said policy shall be effective. ATTACHMENT J Site Investigation Sheet 1 of 2 Kewalo Basin Small MS4 Site Investigation Sheet (SIS) File No.: GPS Coordinates: Storm Drains: ID #(s): Date: Time: Photos: (roll, frame, other description) Reason for Investigation: Complaint Debris Inspection Referral Survey Response Other: Inspector(s): 1. 2. 3. PROPERTY INFORMATION Site Address: TMK: Site Land Use: Tenant’s Name: Owner’s Mailing Address: WEATHER Raining Sunny Cloudy High Wind Moderate Wind Calm Precipitation in last 24 hours? Yes No Unknown 48 hours? Yes No Unknown 72 hours? Yes No Unknown DOT DRAINAGE CONVEYANCE AFFECTED Catch basin Grated inlet Box culvert Pipe culvert Drain manhole Inlet structure Outlet structure Ditch Other: Dimensions of Conveyance: Conveyance Material: Concrete Metal Other: DESCRIPTION OF DISCHARGE Illicit Discharge Suspected? Yes No Possibly If yes, basis (Check all that apply): Dry weather flow Color Sheen Odor Solids Abnormal temperature Is there visible flow into HCDA’s drainage system? Yes No Estimated Rate of Flow: gallons/minute Source of discharge visually identified? Yes No If yes, describe source: PERSON CONTACTED ON-SITE Name: Title: Company: Phone No.: DESCRIPTION OF CONNECTION Approved Facility? Yes No If yes, attach approval documentation. Illegal Connection Suspected? Yes No Size of pipe: Other type of connection (describe): FOLLOW-UP REQUIRED Harbor Agent Notification Warning letter Follow-up Inspection Other: Construction Permit Issued? Yes No If yes, Permit No.: Date Issued: Affected Operator’s or Existing or 2 of 2 (continued) MS4 Site Investigation Sheet COMMENTS/SKETCH: COMMENTS: SKETCH ATTACHMENT K Kewalo Basin Private Drain Connection Application Executive Director Department of Business, Economic Development & Tourism Hawaii Community Development Authority 677 Ala Moana Boulevard, Suite 1001 Honolulu, Hawaii 96813 Dear Madam/Sir: Subject: Application for a New/Existing/Temporary Private Storm Drain Connection (s) to Hawaii Community Development Authority Kewalo Basin Separate Storm Sewer System Pursuant to Hawaii Administrative Rules (HAR), Chapter 11-55, Appendix K, applicant hereby requests a license for a private storm drain connection(s) to the Kewalo Basin separate storm sewer system. I. Project Information: Project Title:______________________________________________________________ Street Address: ____________________________________________________________ Tax Map Key: Total Area: ____________________ II. Brief Description of Connection(s) serving this property. For each connection, provide size, inflow type, flow rate, and location. (Attach 3 copies of the drainage plan showing the location of the drain connection(s).) III. Pursuant to Section II – of the City and County of Honolulu Storm Water Quality of the Rules Related to Storm Drainage Standard (see also City and County of Honolulu Revised Ordinance of Honolulu, Section 14.12-12) the follow is required: A. For development/redevelopment projects with a total area of one acre and less than five acres, list permanent post construction Best Management Practices (BMP) including maintenance schedule. (Attach 2 copies of the permanent post construction BMP plan, if not shown on the drainage plan.) B. For nonresidential subdivision development/redevelopment projects with total area of 5 acres or more and residential subdivision development projects with total area of 10 acres or more, attach 2 copies of the Storm Water Quality Report. Executive Director Page 2 of 3 IV. The following information are related to activities that could affect the quality of storm water discharged from the property: A. North American Industry Classification System (NAICS) Code. (List as many activities and codes as applicable, i.e. Private Household - 8141.) NAICS codes can be found at www.census.gov/epcd/naics/framesrc.htm. B. Does your property/facility discharge runoff associated with "industrial activity"? C. Is your property/facility presently covered by a National Pollutant Discharge Elimination System (NPDES) permit? If yes, attach a copy of the NPDES permit including effluent limitation. V. Type of discharge and total estimated quantity or flow rate (CFS: cubic feet per second, GPD: gallons per day, etc.): [ ] Storm Water Runoff, CFS [ ] Roof Drain, CFS [ ] Swimming Pool Drain, CFS [ ] Groundwater Seepage, CFS/GPD [ ] Non-Contact Cooling Water, CFS/GPM (Heating, Ventilating, and Air Conditioning (HVAC) Once-Through Condenser Water) [ ] Uncontaminated HVAC Cooling Tower Water, CFS/GPM [ ] Landscape Irrigation Water, CFS/GPD [ ] Unpolluted Process Water, CFS/GPM [ ] Treated Process Water, CFS/GPM [ ] Decorative Pool, CFS/GPD [ ] Other Runoff, CFS (give description) Executive Director Page 3 of 3 VI. Construction Schedule for New Connection (s): Work will start: Work will start: VII. Person to contact in the event the licensee is subject to enforcement action for any violations of the conditions of HAR, Chapter 11-55, Appendix K: Name:___________________________________________________________________ Title:____________________________________________________________________ Address: _________________________________________________________________ Telephone Number: ________________________________________________________ Very truly yours, Owner/Lessee (Signature) Date Print Name Title Company ATTACHMENT L Construction BMP Plan Checklist CONSTRUCTION ACTIVITIES BEST MANAGEMENT PRACTICE PLAN CHECKLIST Applicant Name: Date: Project Name: TMK: Site Location: Existing and Proposed Site Features Yes No N/A The following site features should be included on the plans, if deemed necessary based on project type, size, and scope. Existing and proposed topography and features Preliminary location, size in square feet, and limits of disturbance Location of existing and proposed roads, curbs, gutters, storm drains, inlets, buildings, signs, sidewalks, traffic signals, light standards, guardrails, and other structures Location of internal swales and ditches, and other drainage facilities Flow paths for both existing and proposed topography Maps of predominant soils from USDA soil surveys Boundaries of existing predominant vegetation and proposed limits of clearing and grubbing Existing and proposed utilities and easements Preliminary location and dimensions of proposed channel modifications, such as bridge or culvert crossings If the project or site includes, is adjacent to, or otherwise may impact any of the following, they should be shown on the plans. Perennial and intermittent streams or other surface water Location and boundaries of resource protection areas such as wetlands, lakes, ponds, and other setbacks (e.g., stream buffers, drinking water well setbacks, septic setbacks) Location of floodplain/floodway limits and relationship of site to upstream and downstream properties and drainages The limits of the existing and proposed maps and plans shall extend past the project limits if any existing condition has an impact to the project. Include future projects that have the potential to start prior to the subject project. Stream flow velocity for stream work Identify non-storm water potential pollutants on site? Scheduling Yes No N/A Schedule that includes sequencing of construction activities with the implementation of construction site BMPs is provided? Shows how the rainy season relates to soil-disturbing and re- stabilization activities? Schedule includes detail on the implementation and deployment of soil stabilization, sediment control, non-storm water management, waste management and pollution control, and inspection and maintenance BMPS? If the project is performed in multiple phases, are the phase-specific BMPs that take into account phase-specific potential pollutants? Construction Site BMPs Soil Stabilization Practices Plans address or include the following practices and situations? Preservation of existing vegetation? Stabilized construction entrance? Protection of stockpiles? Bank stabilization? Topsoil management? Mulching, seeding, and/or planting with installation/application procedures and requirements? Velocity reduction devices in flow paths? Geotextiles, plastic covers, turf reinforce mats, and/or erosion control blankets/mats, with installation/application procedures and requirements? Temporary drains, swales, earth dikes, and/or lined ditches? Slope drains, subsurface drains? Top and toe of slope diversion ditches/berms? Sediment Control Practices Plans address or include the following practices and situations? Location of potential sediment sources? Does on-site drainage enter into off-site drainage? Dust fence? Silt fence, wattles, and matting rolls? Watering? Soil binders, including acrylic polymers? Storm drain inlet protection? Sediment Control Practices (Continued) Yes No N/A Temporary sediment basin? Sediment trap? Flared culvert end sections? Outlet protection? Temporary stream crossing? Slope roughening/terracing/rounding? Entrance/Exit equipment tire wash? Sand bag barrier? Brush or rock filter? Shoveling, sweeping, and disposing? Non-Storm Water Management Practices Plans address or include the following practices and situations? Employee training? Vehicle and equipment cleaning, refueling, and maintenance? Dewatering operations? Paving operations? Concrete washout procedure? Structure construction and painting? Water conservation? Good housekeeping practices? Waste Management and Pollution Control Practices Plans address or include the following practices and situations? Material delivery and storage? Material use? Spill prevention control? Waste disposal? Solid waste management? Hazardous waste management with designated and prohibited storage areas? Sanitary/Septic waste management? Liquid waste management with storage containment devices? Contaminated soil management? Concrete waste management? Fertilizer management? Herbicide and fungicide management? Pesticide application? Inspection and Maintenance Responsibility Yes No N/A Plans address of include the following practices and situations? Long-term inspection entity identified? Long-term operation and maintenance identified? Minimum frequency and maintenance described? Record keeping? Schedule and/or triggers for inspection of BMP measures? Rain gauge? Incident reporting? OTHER PERMITS, REPORTS, AND PLANS Review this section to assess if the project requires any other possible permits, reports, or plans that include or impact BMPs. If none are required, check N/A above. NPDES Form C for Construction Activities is provided, if required? NPDES Form F for Hydrotest Waters discharge is provided, if required? NPDES Form G for Dewatering discharge is provided, if required? 401 Water Quality Certification (WQC) is provided, if required? 404 Department of the Army (DA) Permit is provided, if required? Coastal Zone Management (CZM) Permit is provided, if required? Special Management Area (SMA) permit is provided, if required? Drainage report is provided, if required? Grading permit with temporary erosion control plan is provided? (if project requires City and County approval and meets requirements) If multiple permits or approvals are required for the project, are BMPs consistent in all permits and plans? Reviewed by Name & Title: Signature: Date: ATTACHMENT M CCH Construction Site BMPs Weekly Checklist Storm Water Management Program Plan Attachment M ATTACHMENT N NPDES Construction BMP Inspection Worksheet NPDES Industrial Storm Water Worksheet (Construction) National Database Information Inspection Type NPDES ID Number Inspec tion Date Inspector Type (circle one) EPA State EPA Oversight Facility Type (circle one) Commercial/ Industrial Residential Municipal General Inspector Name Telephone Entr y Tim e Exit T ime Signature Facility Location Information Name/Location/ Mailing Address GPS Coordinates Latitude Longitude Receiving Water(s) Disturbed Area Start Da te Stop D ate Contact Information Name(s) Telephone Name(s) and Role(s) of All Parties Meeting the Definition of Operator Facility Contact Authorized Official(s) Site Information: (circle all that apply) Nature of Project Residential Commercial/ Industrial Roadway Private Federal State/ Municipal Other Construction Stage Clearing/ Grubbing Rough Grading Infrastructure Building Const. Final Grading Final Stabilization NPDES Industrial Storm Water Worksheet (Construction) Basic Permit Information Permit Coverage ESO Element 3 & 4 Y N Permit Type General Individual Permit notice/sign visibly posted including: copy of NOI, contact name & phone number, location of SSBMP ESO Element 41 Y N NOI D ate If applicable, is waiver certification & approval on file? Y N Basic SSBMP Information SSBMP Prep ared & Ava ilable ESO Element 5 & 30 Y N SSBMP Con tents Satis facto ry ESO Elements 5 - 31 Y N SSBMP Implementation Satisfactory ESO Elements 32 - 48 Y N SSBMP D ate Intentionally left blank SSBMPP Review (can be completed in office) General Notes: Is there a SSBMP? ESO Element 5 Y N SSBMP completed prior to NOI submission? ESO Element 6 Y N Copy of permit language? ESO Element 25 Y N Is SSBMP c onsisten t with state/tribal/local regulations and permits? ESO Element 26 Y N SSBMP u pdated to incorpo rate changes to State, Tribal, Local erosion plans? ESO Element 27 Y N Hav e cop ies of inspe ction repo rts/a ll other documentation been retained as part of the SSBMP for 3 years from date permit coverage expires? ESO Element 28 Y N Is a copy of the SSBMP on site or made available? ESO Element 30 Y N Did all “operators” sign/certify he SSBMP? ESO Element 31 Y N t NPDES Industrial Storm Water Worksheet (Construction) Site Description Notes: SSBMP identifies potential sources of pollution? ESO Element 7 Y N SSBMP identifies all operators and their areas of control? ESO Element 8 Y N Is there a site description? ESO Element 9 Y N Nature/sequence of construction activity? ESO Element 9A - 9B Y N Total area of site and total area to be disturbed? ESO Element 9C Y N Is there a general location map? ESO Element 9D Y N Is there a site map? ESO Element 9E Y N Drainag e patterns/outfalls on site map? ESO Element 9F Y N Y N Y N Y N Y N Name of Receiving water(s) or MS4 listed? Y N Note: Indicate whether receiving water is 303(d) listed. Area of soil disturbance on site map? ESO Element 9F Location of major structural controls on site map? ESO Element 9F Location of storm water disc harges to a surface water on site map? ESO Element 9F Location of materials or equipment storage on site map (on-site or off- site)? ESO Element 9F Location/description industrial activities? ESO Element 9G Y N NPDES Industrial Storm Water Worksheet (Construction) Site Description Notes: Does the SSBMP include dates of major grading ativities, temporary/permanent construction cessation, and initiation of stabilization practices? ESO Element 14 Y N Endangered Species Documentation? ESO Element 23 Y N Controls to R educe Po llutants Notes: Doe s the SSBMP includ e a de scrip tion o f all pollut ion co ntrol m eas ures (BM Ps) th at will be implem ented to control pollutants in storm water discharges, including sequence and which operator responsible for implementation? ESO Element 10 A - C Y N Does the SSBMP include a description of interim a nd perm anent stabilization practices (e.g., seeding, mulching, riprap for the site)? ESO Element 11; 12 Y N Does the SSBMP identify the contractor(s) and timing by which stabilization practices will be implemented? ESO Element 13 Y N Does the SSBMP include a description of structural practices (e.g., vehicle track-o ut, silt fences, sediment traps, storm drain inlet protection) for the site? ESO Element 15 Y N Does the SSBMP identify the contractor(s) and timing by which structural practices will be implemented? ESO Element 10B - 10C Y N Does the SSBMP identify storm water manage ment m easures to address s torm wate r runo ff on ce th e con struc tion is com pleted (e.g ., retention po nds, velo city dissipation controls)? ESO Element 16 Y N NPDES Industrial Storm Water Worksheet (Construction) Controls to R educe Po llutants Notes: Does SSBMP describe measures to prevent discharge of dredge/fill materials to waters of the U.S .? Does site have 4 04 perm it? ESO Element 17 Y N Does SSBMP d escribe mea sures to minimize off-site vehicle tracking and generation of dust? ESO Element 18 Y N Does SSBMP describe controls for pollutants from storage of construction or waste materials? ESO Element 19 Y N Does the SSBMP describe controls for pollutants from non-construction activities? ESO Element 20 Y N Does SSBMP identify allowable non-storm water discharges? ESO Element 21 Y N Does SSBMP ensure implementation of pollution prevention measures for non-storm water discharges? ESO Element 22 Y N Is SSBMP revised when BMPs added/modified within 7 days after inspection reveals problems? ESO Element 29 Y N Inspections Notes: Inspections performed once every 7 days, or every 14 days within 24 hours of a rain event greater 0 .5"? ESO Element 32 Y N Inspections performed by qualified pers onn el? ESO Element 33 Y N All disturbed areas and/or used for storage and exposed to rain inspected? ESO Element 34 Y N All pollution co ntrol me asures inspecte d to ensure proper operation? ESO Element 35 Y N NPDES Industrial Storm Water Worksheet (Construction) Inspections Notes: All dis cha rge lo catio ns ins pec ted if accessible, or if not accessible, are nearby downstream locations inspected? ESO Element 36; 37 Y N Entrance/exit inspected for off-site tracking? ESO Element 38 Y N Inspection report contain all required items and certified? ESO Element 39; 40 Y N Notes on SWPPP Review Site Description: NPDES Industrial Storm Water Worksheet (Construction) SSBMP Implementation (complete in field) Stabilization Practices List and describe stabilization practices ESO Element 43, 48 (e.g., seeding, mulching, geotextiles, sod stabilization) NPDES Industrial Storm Water Worksheet (Construction) Stabilization Practices Are stabilization measures initiated no more than 14 days after tem porary or permanent construction cessation? ESO Element 46 (e.g., indicate “yes” or “no”; if “yes”, how long without stabilization measures?) NPDES Industrial Storm Water Worksheet (Construction) Structural Practices List and describe structural controls ESO Element 42, 43, 47 (e.g., silt fences, hay bales, storm drain inlet protection, sedimentation pond, rip rap, check dam, diversion structure, off-site vehicle track-out) Non-Structural Practices Street Cleaning ESO Element 44 (e.g., describe measures taken to remove offsite accumulation of sediment) NPDES Industrial Storm Water Worksheet (Construction) Non-Structural Practices Good Housekeeping & Waste Disposal Practices ESO Element 45 (e.g., describe measures taken to prevent litter and debris from becoming a pollutant source) Equipment Wash/ Maintenance Area ESO Elements 43 (provide brief description) Concrete Washout Areas ESO Elements 43 (provide brief description) NPDES Industrial Storm Water Worksheet (Construction) Miscellaneous Evidence of Sediment Deposition to Surface Waters *ESO Eligibility - if “yes,” site not eligible for ESO (e.g., significant turbidity observed in a receiving water body) Pollution prevention measures for non- storm water discharges? *ESO Eligibility - If evidence of non-allowable non-storm water discharges, site not eligible for ESO (provide brief description and determine whether/if non-storm water discharges allowable) Has implementation of additional/modified BMPs been comp leted befo re next anticipated storm even t? ESO Element 43.C.1 (provide brief description) NPDES Industrial Storm Water Worksheet (Construction) Notes on SSBMP Implementation NPDES Industrial Storm Water Worksheet (Construction) Photograph Log 1. *Insert additional rows as needed