Form CEM-20EE "Swppp Attachment Ee - Stormwater Sampling Locations" - California

What Is Form CEM-20EE?

This is a legal form that was released by the California Department of Transportation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2012;
  • The latest edition provided by the California Department of Transportation;
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Download a fillable version of Form CEM-20EE by clicking the link below or browse more documents and templates provided by the California Department of Transportation.

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Download Form CEM-20EE "Swppp Attachment Ee - Stormwater Sampling Locations" - California

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STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
SWPPP ATTACHMENT EE
STORMWATER SAMPLING LOCATIONS
Page 1 of 6
CEM-20EE (NEW 9/2012)
PROJECT INFORMATION NAME AND SITE ADDRESS
CONTRACT NUMBER/CO/RTE/PM
PROJECT SITE RISK LEVEL
Risk Level 1
PROJECT IDENTIFIER NUMBER
Risk Level 2
Risk Level 3
STORMWATER SAMPLING LOCATIONS
Project Site Non-Visible Pollutant Sampling Locations
SWPPP Table 700.2.2.3.2.1 & Table 700.2.2.3.2.2
Location
Uncontaminated
Location
Pollutant
Pollutant
Water Quality
No.
Location
Source
Indicator Constituent
No.
Instruction: Include the following Table for all Risk Levels.
Project Site Drainage Areas
SWPPP Table Table 700.1.1.1
Drainage
Location
Drainage
Disturbed
Percentage of
Area
Area
Soil Area
Drainage
No.
(acres)
(acres)
Area that is
Disturbed Soil
Area
(%)
For individuals with sensory disabilities, this document is available in alternate formats. For information, call (916) 445-1233,
ADA Notice
TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
SWPPP ATTACHMENT EE
STORMWATER SAMPLING LOCATIONS
Page 1 of 6
CEM-20EE (NEW 9/2012)
PROJECT INFORMATION NAME AND SITE ADDRESS
CONTRACT NUMBER/CO/RTE/PM
PROJECT SITE RISK LEVEL
Risk Level 1
PROJECT IDENTIFIER NUMBER
Risk Level 2
Risk Level 3
STORMWATER SAMPLING LOCATIONS
Project Site Non-Visible Pollutant Sampling Locations
SWPPP Table 700.2.2.3.2.1 & Table 700.2.2.3.2.2
Location
Uncontaminated
Location
Pollutant
Pollutant
Water Quality
No.
Location
Source
Indicator Constituent
No.
Instruction: Include the following Table for all Risk Levels.
Project Site Drainage Areas
SWPPP Table Table 700.1.1.1
Drainage
Location
Drainage
Disturbed
Percentage of
Area
Area
Soil Area
Drainage
No.
(acres)
(acres)
Area that is
Disturbed Soil
Area
(%)
For individuals with sensory disabilities, this document is available in alternate formats. For information, call (916) 445-1233,
ADA Notice
TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
SWPPP ATTACHMENT EE
STORMWATER SAMPLING LOCATIONS
Page 2 of 6
CEM-20EE (NEW 9/2012)
PROJECT NAME
CONTRACT NUMBER/CO/RTE/PM
PROJECT IDENTIFIER NUMBER
STORMWATER SAMPLING LOCATIONS CONTINUED
Instruction: Include the following Table for all Risk Levels when dewatering will be performed on the project site. Delete the Table if there is no dewatering
planned for the project site.
Project Site Dewatering Sampling Locations
SWPPP Table 700.2.3.3.2.1
Location
Location
Dewatering
Pollutant From
Water Quality
No.
Permit?
Construction
Indicator Constituent
Activity
YES
NO
YES
NO
YES
NO
Instruction: Include the following Table for all Risk Levels when there is a potential for impounded stormwater that will have to be discharged from the project site.
Project Site Potential Impounded Stormwater Sampling Locations
(SWPPP Table 700.2.3.3.2.2)
Location
Location
Dewatering
Pollutant From
Water Quality
No.
Permit?
Construction
Indicator Constituent
Activity
YES
NO
YES
NO
YES
NO
Instruction: Include the following Table for all Risk Levels when there are dewatering activities or a potential for impounded stormwater that will have to be
discharged from the project site and there is a high risk receiving water.
Project Site Potential Dewatering/Impounded Stormwater Sampling Locations and Receiving Water Sampling Locations
(SWPPP Table 700.2.3.3.2.3)
Dewatering/
Location
Receiving
Location
Impounded
Water
Stormwater
Location
Location
No.
No.
For individuals with sensory disabilities, this document is available in alternate formats. For information, call (916) 445-1233,
ADA Notice
TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
SWPPP ATTACHMENT EE
STORMWATER SAMPLING LOCATIONS
Page 3 of 6
CEM-20EE (NEW 9/2012)
PROJECT NAME
CONTRACT NUMBER/CO/RTE/PM
PROJECT IDENTIFIER NUMBER
STORMWATER SAMPLING LOCATIONS CONTINUED
Instruction: Include the following Table for Risk Level 2 and Risk Level 3 projects. Delete the Table for Risk Level 1 projects.
Project Site Discharge Sampling Locations for Turbidity and pH
SWPPP Table 700.2.4.3.2.1
Location
Location
Drainage
Disturbed
Percentage
Are there
No.
Area
Soil Area
of Drainage
construction
(acres)
(acres)
Area that is
activities that
Disturbed
may affect pH
Soil Area
of stormwater
(%)
discharges?
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
Instruction: Include the following Table for Risk Level 2 and Risk Level 3 when project site has discharge locations that discharge directly to a receiving water.
Delete the Table for Risk Level 1 projects.
Receiving Water Sampling Locations for Turbidity and pH When Project Site Discharges Directly To The Receiving
Water
SWPPP Table 700.2.4.3.2.2
Location
Location
Drainage
Disturbed
Percentage
Are there
No.
Area
Soil Area
of Drainage
construction
(acres)
(acres)
Area that is
activities that
Disturbed
may affect pH
Soil Area
of stormwater
(%)
discharges?
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
For individuals with sensory disabilities, this document is available in alternate formats. For information, call (916) 445-1233,
ADA Notice
TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
SWPPP ATTACHMENT EE
STORMWATER SAMPLING LOCATIONS
Page 4 of 6
CEM-20EE (NEW 9/2012)
PROJECT NAME
CONTRACT NUMBER/CO/RTE/PM
PROJECT IDENTIFIER NUMBER
STORMWATER SAMPLING LOCATIONS CONTINUED
Instruction: Include the following Table for all Risk Levels. Delete the Table for Risk Level 1 projects if there are no project site run-on locations.
Project Site Run-on Sampling Locations
SWPPP Table 700.2.4.3.2.4
Location
Location
Run-on May
Is there any
Are there
Identified
No.
Affect Water
off-site disturbed
any off-site
Potential Off-site
Quality
soil area that
pollutants
Pollutants
Discharged
could affect
identified
at Project
run-on water
that could
Site
quality at
affect run-on
Discharge
this location?
water quality
Location No.
at this location?
YES
YES
NO
NO
YES
YES
NO
NO
YES
YES
NO
NO
YES
YES
NO
NO
YES
YES
NO
NO
Instruction: Include the following Table for all Risk Level 3 projects. Delete the Table for Risk Level 1 and Risk Level 2 projects.
Receiving Water Sampling Locations
SWPPP Table 700.2.4.3.2.5
Location
Location
Project Site Discharge
Do discharges from this
No.
Location No.
project site discharge
location reach
receiving water?
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
For individuals with sensory disabilities, this document is available in alternate formats. For information, call (916) 445-1233,
ADA Notice
TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
SWPPP ATTACHMENT EE
STORMWATER SAMPLING LOCATIONS
Page 5 of 6
CEM-20EE (NEW 9/2012)
PROJECT NAME
CONTRACT NUMBER/CO/RTE/PM
PROJECT IDENTIFIER NUMBER
STORMWATER SAMPLING LOCATIONS CONTINUED
Instruction: Include the following Table when the RWQCB has requested specific water quality standard monitoring of project site discharge locations.
Stomwater Discharge Locations Required To Be Monitored By RWQCB
SWPPP Table 700.5.3.2.1
Location
Location
Water Quality
Is there potential site run-on
No.
Standard(s)
that may affect water
quality standard(s)?
YES
NO
YES
NO
YES
NO
YES
NO
Instruction: Include the following Table when the RWQCB has requested specific water quality standard monitoring of receiving waters.
Receiving Water Sampling Locations Required To Be Monitored By RWQCB
SWPPP Table 700.2.4.3.2.5
Location
Location
Water Quality
No.
Standard(s)
Instruction: Include the following Table when the project receives run-on with the potential to combine with stormwater discharges locations or receiving waters
that require RWQCB specified water quality monitoring.
Run-on Locations With Potential To Combine With Stormwater Discharges Required To Be Monitored By RWQCB
SWPPP Table 700.2.5.3.2.4
Location
Location
Water Quality
No.
Standard(s)
For individuals with sensory disabilities, this document is available in alternate formats. For information, call (916) 445-1233,
ADA Notice
TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
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