HomeMy WebLinkAboutSite Certifications - 09/15/2023Page 1
OVERALL SITE and DRAINAGE CERTIFICATION
Commercial, Multi-Family and Subdivision Certification Form and Checklist
Project Name:
Date:
Building Permit Numbers:
(Commercial or multi-family)
Per the requirement in Fort Collins Stormwater Criteria Manual (FCSCM) Chapter 3, Section 3.0 to certify as-
built construction to the approved drainage and grading plans, please fill in all applicable items in this
Certification Form for Commercial, Multi-Family and Overall Single Family sites. NOTE: several items must be
verified during construction. A copy of the approved grading plan must be submitted with the as-built grading
plan. (As-built elevations must be written in red next to the approved elevations.)
•Use “Yes” for items completed as described.
•Use “N/A” for items that are not applicable to the site being certified.
•If any blanks are “No,” attach an explanation referencing the item number below.
Attach an explanation or description of the as-built condition for any items listed or for anything not listed but
shown on the approved construction plans.
Provide an as-built redline or Mylar drawing with the following:
I.Water Quality and Quantity Detention Basin - FCSCM Ch. 6 and 7
For multiple detention basins on a site, provide the following for each basin separately:
A. Volume: As-built topographic verification is attached at 1-foot (or less) contour intervals and
volume verification calculations for the water quality capture volume and the 100-year detention storage
volume.
1. Detention basin topography was prepared by a professional land surveyor registered in the state
of Colorado.
2.Both proposed and as-built contours are shown on the same plan sheet (dashed lines for
proposed and solid lines for as-built).
3.All critical spot elevations as shown on the approved construction plans have been verified and
the as-built elevations are shown on the plan sheet.
4.Stage-storage-discharge tables are provided on a separate document.
5.Verification that designed drain time is in compliance with Colorado Revised Statute § 37-92-
602(8) is attached and has been uploaded to the Statewide Compliance Portal
(tinyurl.com/COCompliancePortal) for approval. Uploaded documents must include:
a.The cover sheet from the approved drainage report
b.The stamped certification page from the approved drainage report
c.As-built topographic survey
d.Stamped certification page from the Overall Site & Drainage Certification
e.PDF output from the Stormwater Detention and Infiltration Design Data Speadsheet
11/19
Wes Lamarque
9/15/2023
Page 2
B.Water Quality and Quantity Detention Basin Grading: Attached is as-built verification that there is
a minimum 2% positive fall into the concrete trickle pans or flow-line(s) from all areas in the bottom of
the detention pond. If there is a “soft pan” in the flow-line, all areas still must meet the minimum 2%
grade requirement.
1.Low Flow: Choose one of the following detention basin low flow options as applicable:
a. Turf swale for low flow path in detention basin.
There is a minimum 2% grade in the flow-line(s) of the detention basin. The flattest as-built grade
is .
b.Concrete pan for low flow in detention basin.
There is a concrete pan installed that meets the grades as shown on the approved construction
plans. (Show as-built spot elevations.)
c.Soft pan for low flow in detention basin.
•Verify and document the soft pan material gradation, trench width and depth - to be verified
during construction by engineer. Picture documentation is preferred or engineer’s statement of
visual inspection and compliance. (Choose one below.)
o There is a soft pan with an underdrain installed that meets the design on the approved
construction plans. (Show the underdrain grades, bedding material, geotextile, spot elevations,
bends, cleanouts, etc.)
o There is soft pan installed without an underdrain but there is a type A or B soil. The soil
type must be documented by supplying verification from a registered professional geotechnical
engineer.
NOTE: Spot elevations are to be within 0.2 ft. +/-.
2. Side Slopes: The as-built side slopes of the detention basin have been calculated and are shown.
Indicate the side slope with an arrow and a numerical value (e.g., 6.25:1). The maximum slope allowed
is 4:1. Small areas of 3:1 may be acceptable, but slopes steeper than 3:1 must be stabilized or re-
graded. Provide documentation if a variance was granted for steeper slopes during the design process.
3.Spillway: The following items must be field verified:
a.The location of the spillway is indicated on the as-built plan.
b.The width of the spillway is indicated on the as-built plan.
c.The elevation(s) of the spillway is shown on the as-built plan.
d.A concrete ribbon defines the location and grade of the spillway.
e.There is downstream scour protection in the spillway as per the construction plans. Indicate
type: (riprap size “D50” gradation and bedding type, geotextile, buried
riprap with inches of bury, etc.).
f.There are no obstructions in the spillway, such as trees, bushes, sidewalks, landscape
features, rocks, etc.
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Page 3
4.Outlet Structure:
a.The orifice plate for the approved release rate is installed with the correct size and location of
the orifice.
b.The orifice plate for the water quality outlet is installed with the correct hole size, number of
rows and columns of holes.
c.The bottom hole on both the water quality and quantity outlets are at the bottom of the plate
so no water ponds in front of the plate.
d.The well screen is the correct material and is installed as shown on the construction plans.
e.100-year overflow grate elevation is . (Elev. A on detail D-46)
f.The top elevation of the water quality capture volume is . (Elev. B on detail
D-46)
g.Overflow grate is made of the correct material, has the correct bar spacing, is hinged at the
top and bolted at the bottom.
h.The bottom of the outlet box has no obstructions or misalignments that will cause it to retain
runoff water and is sloped at 2% towards outlet.
II.Channels/Swales - FCSCM Ch. 8, Sec. 2.0 and Ch. 9, Sec. 5.0
A. Capacity: The as-built capacity of all the major channels and swales has been verified. They meet
or exceed capacity requirements shown in the approved drainage study for this project.
1.All swales are located within the drainage easements as shown on the construction plans.
2.Longitudinal slopes and side-slopes (cross-sections) have been verified. Design criteria requires
longitudinal slopes of 2% min. (on vegetated swales) and side-slopes no steeper than 4:1. If these
criteria are not met, the certification engineer will write a justification and propose mitigation for each
instance or have the issues corrected. If variances to these criteria have previously been approved and
are shown on the construction plans, no justification is needed.
3.As-built spot elevations on channels/swales are shown that correspond to spot elevations
shown on the approved construction plans.
4.All permanent erosion control measures are installed as shown on the approved construction
plans (e.g., drop structures, riprap, TRMs, etc.). (Include pictures and verification of the materials used
as part of this verification.)
5.All pans, curbs, storm pipes or other appurtenances appropriately tie into each other in the
system. (Pictures at tie-in points suggested.)
6.The minimum freeboard is provided for all channels and swales as shown on the approved
construction plans or as identified in the approved drainage study. (Show the freeboard provided on
the cross-sections as on the construction plan set or attached as separate documentation.)
7.The low flow portion of all channels or swales is clear of obstructions. (No landscaping, trees,
shrubs, sod, etc. infringe on the low flow portion of channels or swales.)
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Page 4
III.Storm Pipes (aka storm drains) - FCSCM Ch. 9, Sec. 4.0
A. Storm Drain Pipe Capacity: The as-built capacity of all pipes installed on this project has been
verified and meets or exceeds the capacity requirements shown in the approved drainage study for this
project.
1.All storm drain pipe sizes and materials have been verified and are in conformance with the
approved construction plans. (Indicate on the plan and profile sheets that they have been verified.)
Material and size substitutions must be approved prior to installation. If a pipe size or material was
changed during construction, the certification engineer must attach the approval documents or supply
them with this certification. Approval documents must include a calculation documenting the capacity
equivalency (equal or greater) of the substituted size.
2.The longitudinal slope of the pipe is as shown on the approved construction plans. The
acceptable minimum slope is 0.4%. All slopes flatter than the designed slope on the construction plans
must be justified with capacity calculations on an attached sheet.
3.The as-built invert elevations have been verified and are shown on the plan and profile sheets of
the approved construction plans.
B.Storm Drain Pipe Installation Requirements: All pipes are installed in accordance with the
approved construction plans and construction specifications.
1.The minimum cover requirements for all pipes have been met as shown on the approved
construction plans. These will be called out in critical locations.
2.All encasements and clearances as specified on the approved construction plans have been met.
3.Any specific joint types or construction methods specified on the approved construction plans
have been met. (List on a separate sheet and attach to this certification.)
IV.Concrete Pans - FCSCM Ch. 8, Sec. 2.0
A. Construction/Installation: All concrete pans have been constructed in accordance with the
approved construction plans.
1.The concrete pans are the correct size/width as shown on the approved construction plans.
2.The longitudinal slopes of the pans are as shown on the approved construction plans. The
certification engineer must justify or mitigate longitudinal slopes less than the minimum of 0.4% unless
a flatter slope was approved and is shown on the approved construction plans. Provide mitigation or
justification by separate document.
3.The cross-section of the pan is as shown on the construction plans. (Specifically, the pan cross-
section is “V” shaped and meets the side slope shown on the detail.)
4.The concrete pans are a minimum of 6 inches thick without reinforcement and a minimum of 4
inches thick with a minimum of 6X6-W14xW14 reinforcement per detail D20B and D20C. (Provide
documentation of the reinforcement used if different than shown on the details or on the approved
construction plans.)
5.The spot elevations shown on the concrete pan(s) have been verified and are shown on the as-
built drawings.
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Page 5
V. Storm Drain Inlets - FCSCM Ch. 9, Sec. 3.0
A. Construction/Installation: All storm drain inlets have been constructed in accordance with the
approved construction plans and construction specifications.
1.The size and type of inlets are consistent with the inlets shown on the approved construction
plan. Indicate by writing “Verified” on each inlet on the plan sheet or list on a separate document the
inlet number(s), type and size (length). If the inlet installed is other than the one on the approved
construction plan detail sheet, provide the name and source of the detail with justification for equal or
better capacity.
2.The size of the inlet opening is consistent with the approved detail. (Check height and width.)
3.The elevation of the grate (if applicable) is at the elevation shown on the street profile or as
indicated by a spot elevation on the construction plans.
4.The as-built invert elevations of all pipes entering and leaving the inlet are shown on the plan
and profile sheets within construction tolerance of 0.2 feet. If substantially different, provide
justification and capacity calculations to show the capacity is not affected or propose mitigation.
5.The as-built size of the inlet box is as shown on the construction plans or an explanation or
justification is attached.
6.All Type C, R, 13 and 16 inlet covers are stenciled or stamped with the following designation (or
an equivalent): NO DUMPING – DRAINS TO POUDRE RIVER.
VI.Culverts - FCSCM Ch. 9, Sec. 4.0
A. Construction/Installation: All culverts have been constructed and/or installed in accordance with
the approved construction plans and construction specifications.
1.All culvert sizes have been verified as indicated on the as-built construction plans as correct.
2.The culvert material type for all culverts installed is as on the approved construction plans and is
indicated on the as-built plans.
3.The as-built invert “in and out” elevations have been verified and are indicated on the as-built
construction plans.
4.The culvert headwalls or wing walls have been installed as shown on the approved construction
plans. Headwalls or wing walls may be needed in the as-built conditions onsite if the slopes adjacent to
the culvert are greater than 4:1. Please note areas needing stabilization in the certification narrative.
An alternative to consider is a turf reinforcement mat (TRM).
VII.Sub-Drains
A. Construction/Installation: All sub-drains shown on the construction plans have been installed in
accordance with those plans and the construction specifications. Sub-drains installed with the sanitary
sewer are to be verified on the sanitary sewer plan and profile sheets of the construction plans. (NOTE:
Indicate any sub-drains installed after the plans were approved on the as-built plans.)
1.The size of the sub-drains are as approved on the construction plans and are indicated on the as-
built plans.
2.The type of sub-drain, in particular the perforated and non-perforated sections of the drain, are
as indicated on the approved construction plans.
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Page 6
3.The cover requirements per the construction plans are provided.
4.The cleanouts have been installed at the locations shown on the construction plans and are
accessible for cleaning. (Cleanouts can be buried a maximum of 6 inches deep with their locations
marked.)
5.The backfill materials for sub-drains are as shown on the approved construction plans. (This
includes the type, depth and width.)
6.The geo-textile liner completely wraps the sub-drain and the permeable backfill material unless
shown otherwise on the approved construction plans. (Sub-drain pipe wrapped in a sock filter material
is accepted only if approved prior to installation.)
VIII.Curb Cuts
A. Construction: All curb cut openings are constructed in accordance with the approved construction
plans and construction specifications.
1.The size (width) of the curb cut opening is as shown on the approved construction plans.
2.The curb cut openings tie into a downstream swale, pipe, or other appurtenances with a smooth
transition and there no obstructions such as riprap or sod impeding the flow downstream of the curb
cut.
IX.Sidewalk Culverts & Chases
A. Construction/Installation: All sidewalk culverts have been installed at the locations shown on the
approved construction plans.
1.The size (width and length) of the culverts are as shown on the approved construction plans.
2.The cover plate is a minimum 5/8-inch galvanized plate bolted to a galvanized angle iron per the
detail shown on the approved construction plans or per the City’s detail.
3.The sidewalk culvert invert “in and out” elevations have been verified and are indicated on the
as-built plans.
4.The sidewalk culvert opening is as shown on the approved construction plans or per the City’s
detail.
5.There is a smooth transition both on the inlet and outlet ends of the sidewalk culvert with no
obstructions such as riprap or sod impeding the flow into or out of the sidewalk culvert.
X. Site Grading - FCSCM Ch. 8
A. Construction: All common open spaces have been graded in accordance with the approved
construction plans.
1.The grading on all common open spaces bordering private lots has been verified as correct and
the as-built rear lot corner elevations have been shown on the as-built plans.
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Page 7
2.The as-built contours for “overlot grading” are shown on the as-built construction plans for all
common open spaces, tracts, outlots, etc. If not in compliance, please attach a narrative describing the
situation for noncompliance and when it may be corrected. An escrow for overlot grading may be
required. (NOTE: Residential Lot Grading Certification is a separate process from this Overall Site
Certification. It is understood that residential lots will be brought to final grade once the foundation is
backfilled so they may be lower than the plan shows at this Overall Site Certification stage.)
3.All turf reinforcement mats (TRMs) have been installed as shown on the approved construction
plans and the slopes are stabilized.
XI.Permanent Erosion Control BMPs - FCSCM Ch. 9, Sec. 7.0
A. Construction: All permanent erosion control BMPs have been installed per the approved
construction plans.
1.All riprap has been installed in the locations and sizes indicated on the approved construction
plans.
2.All fabric has been installed in the locations and sizes indicated on the approved construction
plans.
a.All fabric was installed per the details on the approved construction plans.
XII.Post-Construction Site Cleanup - FCSCM Ch. 3, Sec. 2.0
A. Construction: All construction debris and obstructions of any kind have been removed from
drainage paths.
1.All construction debris has been removed except in staging area(s).
2.All ruts have been smoothed out in all construction areas.
3.All areas needing reseeding have been identified and future stabilization goals have been
coordinated with the Erosion Control Inspector and in accordance with FCSCM Vol.2 Chapter 12. Note
the area needing stabilization in the narrative.
XIII.Certification of LID and Water Quality Facilities - FCSCM Ch. 7
A.Attached are the During Construction Inspection Checklist for Low Impact Development (LID) and
other items to be verified during construction, along with pictures and other required documentation.
B.Attached is verification of the rain garden and/or sand filter flat surface area(s) and ponding
volume(s). This verification includes survey of critical elevations.
C.Attached is verification of the underground infiltration required volume(s), weir elevations,
orifices, inspection ports and filtering fabric. This verification includes survey of critical elevations.
D.All visible LID design features were verified as part of the engineer's site visit.
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11/19 Page 8
XIV.Certification of Other Permanent BMPs
A.The construction of other permanent BMPs not specifically addressed in this certification is in
accordance with the approved plan. This may include grade control structures, rundowns, bridges, stream
access/improvements, etc.
Please specify other permanent BMPs included on this site:
XV. Certification and Erosion Control Measures - FCSCM Ch. 3
A. All temporary erosion control measures shall be removed upon stabilization. If at the time of preparing
this certification there are any erosion control measures still remaining on the site, please note them in
the narrative and verify that they need to remain at this time. If in doubt as to the need for any control
measure, please consult with the Erosion Control Inspector at erosion@fcgov.com.
XVI.Statement of Compliance - FCSCM Ch. 3
A. This certification is signed and stamped. By signing this form, the engineer(s) attests that he/she has
visited and observed the site, and to the best of his/her knowledge, the as-built conditions of the drainage
facilities are as described in the above form and in the enclosed as-built plans.
B.Failure to properly disclose all known information could result in the rejection of this certification and
prevent the release of any and all Stormwater Utility permit holds on Building Permits and/or Certificates
of Occupancy within this development.
XVII. Signature and Stamp by a Colorado-Registered Professional Engineer
Engineer’s contact information:
Name:
Email:
Phone:
Company:
Address:
PE Stamp
01/13/2023
X
X
X
X
X
X
X
X
STAGE STORAGE TABLE
ELEV
AREA
(sq. ft.)
DEPTH
(ft)
AVG END
INC.
VOL.
(cu. ft.)
AVG END
TOTAL
VOL.
(cu. ft.)
CONIC
INC.
VOL.
(cu. ft.)
CONIC
TOTAL
VOL.
(cu. ft.)
4,883.400 36.39 N/A N/A 0.00 N/A 0.00
4,883.600 1,183.44 0.200 121.98 121.98 95.16 95.16
4,883.800 1,580.28 0.200 276.37 398.35 275.42 370.57
4,884.000 1,697.52 0.200 327.78 726.13 327.71 698.28
4,884.200 1,822.34 0.200 351.99 1078.12 351.91 1050.20
4,884.400 1,953.31 0.200 377.57 1455.69 377.49 1427.68
4,884.600 2,088.89 0.200 404.22 1859.90 404.14 1831.83
RAIN GARDEN 1
STAGE STORAGE ANALYSIS
FORT COLLINS, CO
EAST PARK DISTRICT MAINTENANCE FACILITY
E N G I N E E R N GI
EHTRON R N
6/20/22
P:\1748-002\DRAINAGE\DRNGCERT\1748-002 STAGE STORAGE.DWG
( IN FEET )
1 inch = ft.
Feet01010
10
20 30
NORTH
RAIN GARDEN 1 AS-BUILT PROPERTIES
PROPERTY DESIGN AS-BUILT
FLAT AREA (SF)1378.0 1580.28
TOTAL VOLUME (CF)1692.0 1859.9
WQCV (CF)1421.0 1629.75
ELEVATION AT WQCV (FT)4884.5 4884.5
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SD SD SD SD SD SD SD SD SD SD
STAGE STORAGE TABLE
ELEV
AREA
(sq. ft.)
DEPTH
(ft)
AVG END
INC. VOL.
(cu. ft.)
AVG END
TOTAL VOL.
(cu. ft.)
CONIC
INC. VOL.
(cu. ft.)
CONIC
TOTAL
VOL.
(cu. ft.)
4,881.800 12.46 N/A N/A 0.00 N/A 0.00
4,882.000 462.76 0.200 47.52 47.52 36.74 36.74
4,882.000 255.42 0.000 0.00 47.52 0.00 36.74
4,882.200 1,362.02 0.200 161.74 209.27 147.15 183.89
4,882.400 1,558.51 0.200 292.05 501.32 291.83 475.73
4,882.600 1,665.86 0.200 322.44 823.76 322.38 798.10
4,882.800 1,903.53 0.200 356.94 1180.69 356.67 1154.78
RAIN GARDEN 2
STAGE STORAGE ANALYSIS
FORT COLLINS, CO
EAST PARK DISTRICT MAINTENANCE FACILITY
E N G I N E E R N GI
EHTRON R N
6/20/22
P:\1748-002\DRAINAGE\DRNGCERT\1748-002 STAGE STORAGE.DWG
( IN FEET )
1 inch = ft.
Feet02020
20
40 60
NORTH
RAIN GARDEN 2 AS-BUILT PROPERTIES
PROPERTY DESIGN AS-BUILT
FLAT AREA (SF)1195.0 1362.0
TOTAL VOLUME (CF)1570.0 1154.78
WQCV (CF)548.0 548.0
ELEV. AT WQCV (FT)4883.0 4882.8
X
X
STAGE STORAGE TABLE
ELEV
AREA
(sq. ft.)
DEPT
H
(ft)
AVG END
INC. VOL.
(cu. ft.)
AVG END
TOTAL
VOL.
(cu. ft.)
CONIC
INC.
VOL.
(cu. ft.)
CONIC
TOTAL VOL.
(cu. ft.)
4,877.200 1.97 N/A N/A 0.00 N/A 0.00
4,877.400 12.35 0.200 1.43 1.43 1.28 1.28
4,877.600 28.90 0.200 4.13 5.56 4.01 5.29
4,877.800 60.03 0.200 8.89 14.45 8.71 14.00
4,878.000 176.26 0.200 23.63 38.08 22.61 36.61
4,878.200 470.81 0.200 64.71 102.79 62.34 98.95
4,878.400 923.05 0.200 139.39 242.17 136.87 235.83
4,878.600 1,532.10 0.200 245.52 487.69 242.96 478.78
4,878.800 2,271.44 0.200 380.35 868.04 377.94 856.72
4,879.000 3,037.72 0.200 530.92 1398.96 529.06 1385.78
4,879.200 3,703.29 0.200 674.10 2073.06 673.00 2058.78
4,879.400 4,232.34 0.200 793.56 2866.62 792.97 2851.76
4,879.600 4,717.76 0.200 895.01 3761.63 894.57 3746.33
4,879.800 5,118.32 0.200 983.61 4745.24 983.34 4729.67
4,880.000 5,446.09 0.200 1056.44 5801.68 1056.27 5785.94
4,880.200 5,770.03 0.200 1121.61 6923.29 1121.46 6907.39
4,880.400 6,096.98 0.200 1186.70 8110.00 1186.55 8093.94
4,880.600 6,426.93 0.200 1252.39 9362.39 1252.25 9346.19
4,880.800 6,759.89 0.200 1318.68 10681.07 1318.54 10664.73
4,881.000 7,095.86 0.200 1385.58 12066.65 1385.44 12050.17
4,881.200 7,434.83 0.200 1453.07 13519.71 1452.94 13503.11
4,881.400 7,776.81 0.200 1521.16 15040.88 1521.04 15024.15
4,881.600 8,121.79 0.200 1589.86 16630.74 1589.74 16613.88
4,881.800 8,469.78 0.200 1659.16 18289.90 1659.04 18272.92
4,882.000 8,820.77 0.200 1729.06 20018.95 1728.94 20001.85
4,882.200 9,174.77 0.200 1799.55 21818.50 1799.44 21801.29
4,882.400 9,531.78 0.200 1870.66 23689.16 1870.54 23671.83
DETENTION POND 1
STAGE STORAGE ANALYSIS
FORT COLLINS, CO
EAST PARK DISTRICT MAINTENANCE FACILITY
E N G I N E E R N GI
EHTRON R N
6/20/22
P:\1748-002\DRAINAGE\DRNGCERT\1748-002 STAGE STORAGE.DWG
( IN FEET )
1 inch = ft.
Feet02020
20
40 60
NORTH
DETENTION POND 1 - AS-BUILT PROPERTIES
PROPERTY DESIGN AS-BUILT
VOLUME AT CREST (AC*FT)0.56 0.543
100-YR VOLUME (AC*FT)0.56 0.543
WQCV (AC*FT)N/A N/A
OUTLET INVERT ELEV. (FT)4877.80 4877.76
ELEVATION AT WQCV (FT)N/A N/A
POND CREST ELEV. (FT)4882.51 4882.40
SPILLWAY ELEV. (FT)4882.50 4882.59
1/19 Page 1 of 2
DURING CONSTRUCTION INSPECTION CHECKLIST
To be completed by Construction Superintendent
This checklist is to be completed during construction and included with the Overall Site and Drainage Certification.
• Use “Yes” for items completed as described.
• Use “N/A” for items that are not applicable to the site being certified.
• If any blanks are “No,” attach an explanation referencing the item number below.
Project Name: East Park Maintenance Date: 10.29.2022
Building Permit Numbers: B2107049
I. Compaction
A. Yes All berms and embankments meet the compaction requirements as specified in the project geotechnical report or comply with the
City’s standard, which is “soils should be compacted within a moisture content range of 2% below to 2% above optimum moisture content
and compacted to 95% of the Maximum Standard Proctor Density (ASTM D698).” Compaction requires verification during construction.
Provide testing log from contractor/engineer.
II. Storm Drain Pipe Installation Requirements
A. Yes The pipe trenches have been compacted in accordance with Section 02225-3.07.A.1. of the Fort Collins Development Construction
Standards for Water, Wastewater, Stormwater (e.g., the trenches in the roadways are to be 95% of maximum density and all other areas
are to be at 90%, both in accordance with ASTM D698).
III. Energy Dissipation and Erosion Protection - FCSCM Chapter 9, Section 7.0
A. Riprap
1. N/A The riprap bedding is a granular bedding of the gradation and thickness indicated on the approved construction plans.
2. N/A A filter fabric was installed instead of granular bedding and is the material shown on the approved construction plans or was an
approved equal. Provide documentation for an approved equal.
3. N/A The riprap is the gradation shown on the approved construction plans with a D50 of .
4. N/A The riprap thickness is as shown on the approved construction plans and extends to the horizontal limits shown.
5. N/A The riprap is buried to the depth indicated on the approved construction plans. (A minimum of 6 inches of soil is required.)
B. Permanent Erosion Control Fabric - FCSCM Vol.1, Ch.7
1. N/A All fabric was installed per manufacturer’s specifications.
1/19 Page 2 of 2
IV. Other Permanent BMPs
A. N/A All cut-off walls have been installed in accordance with the approved construction plans. (Cut-off walls are required for irrigation ditch
crossings of storm drain pipes.)
V. Extended Detention Basins
A. N/A Installation of this facility was verified via inspection by a City-Stormwater Inspector at the point of installation of the water quality
control box(es). Provide date of inspection and name of inspector:
Included certification sheet(s):
Please check the appropriate box(es) for the Low Impact Development
(LID) facilities found on this site and complete the corresponding
certification sheets.
☐ Permeable Interlocking Concrete Pavers
☒ Bioretention Cells (Rain Gardens)
☐ Sand Filters
☐ Vegetated Buffers
☐ Underground Infiltration
☐ Other LID – For certification of Dry Wells, Tree Filters,
Constructed Wetland Channels & Ponds, etc., contact City Staff
to determine requirements to exhibit the LID facility has been
constructed and functions as intended per the approved
drainage report.
*Please provide photographic documentation of the installation of all
stages of all LID facilities.
**Please contact the City Stormwater Inspector at
stormwaterinspection@fcgov.com to discuss inspection requirements
for each LID facility and request inspections.
***All facilities being certified must be “clean” – free of sediment &
construction debris – prior to certification or acceptance of the facility.
Completed by:
Name: Jeremy Zirbel
Title: Superintendent
Email: jzirbel@fransenpittman.com
Phone: 7207740600
Company: Fransen Pittman
Address: 522 Main St.
Windsor Co 80550
1/19 Page 1 of 2
Permeable Interlocking Concrete Pavers
Item/Activity Yes No N/A Submittal Requirements Submitted?/Response
Stormwater Inspection
Pre-construction meeting was held with City-Stormwater
Inspector to discuss installation, inspection, checklist, and
protection from sedimentation
☐ ☐ ☒
Record date, inspector name, meeting
location (i.e. DCP, initial erosion control
inspection, etc.)
Sub-surface inspection(s): Installation of this facility was
verified via inspection by a City-Stormwater Inspector at the
point of installation of the outlet, underdrain, geomembrane
layer, and sub-base courses (per design in Final Plan
Documents)
☐ ☐ ☒
Record date(s) of inspection and
inspector’s name
Surface inspection(s): Installation of this facility was verified via
inspection by a City-Stormwater Inspector at the point of
installation of the pavers and joint fill material
☐ ☐ ☒
Record date(s) of inspection and
inspector’s name
Excavation
Heavy equipment did not encroach into the excavated area
(prevents over-compaction) ☐ ☐ ☒
Bottom of cell was “ripped” after excavation ☐ ☐ ☒ Provide photographs before and after
“ripping”
Bottom surface of cell is flat and level ☐ ☐ ☒ Provide photograph
Impermeable Liner
Impermeable liner meets design specifications ☐ ☐ ☒ Provide specifications of delivered
material
Impermeable liner is attached to concrete perimeter wall ☐ ☐ ☒ Provide photograph
Impermeable liner is buried with no exposure ☐ ☐ ☒
Any penetrations of the impermeable liner have been sealed
and checked for water-tightness ☐ ☐ ☒ Provide photograph (if necessary)
Edge Restraint and Concrete Cut-Off Wall
The required edge restraint meets design specifications ☐ ☐ ☒ Provide specification of installation
Concrete cut-off wall meets design specifications for: ☐ ☐ ☒ Provide specification of installation
- Dimensions ☐ ☐ ☒
- Reinforcement ☐ ☐ ☒
- Footings ☐ ☐ ☒
Underdrain System
Underdrain pipe meets design specifications ☐ ☐ ☒ Provide photograph
At least one cleanout is provided per underdrain lateral ☐ ☐ ☒ Provide photograph
1/19 Page 2 of 2
Cleanout pipe is solid (not perforated/slotted) ☐ ☐ ☒ Provide photograph
Cleanout covers are installed and watertight ☐ ☐ ☒ Provide photograph
Verify the underdrain is NOT wrapped in geotextile fabric ☐ ☐ ☒ Provide photograph
Verify there is no orifice plate on the underdrain outfall ☐ ☐ ☒ Provide photograph
Underdrain integrity tested after backfilling using TV and/or
water test ☐ ☐ ☒ Provide documentation of test results
Aggregate
Sub-base Course(e.g., #2/4):
- Has 90% fractured faces
- Is thoroughly washed (virtually free of fine sediment)
- Is installed to the required design depth
☐ ☐ ☒
Provide load ticket, photographs, and
record depth installed
Basecourse (e.g., #57):
- Has 90% fractured faces
- Is thoroughly washed (virtually free of fine sediment)
- Is installed to the required design depth
☐ ☐ ☒
Provide load ticket, photographs, and
record depth installed
Leveling Course / Joint Fill (e.g., crushed #89):
- Has 90% fractured faces
- Is thoroughly washed (virtually free of fine sediment)
- Is dry screened
- Is installed to the required design depth and to the top
of the paver joints
☐ ☐ ☒
Provide load ticket, photographs, and
record depth installed
Aggregate materials are installed and compacted according to
manufacturer’s and/or design specifications ☐ ☐ ☒ Provide photographs and documentation
of compaction
Protection During Construction
PICP area is protected from construction site sediment,
including runoff from the upstream catchment and
construction equipment traffic ☐ ☐ ☒
Specify how the area was covered and/or
otherwise protected to prevent
construction runoff from entering the
pavement
Close Out
Cracked/broken paver units have been removed and replaced ☐ ☐ ☒
Paver height offsets are no more than 1/4” between adjacent
units & surface contains no deformations
(depressions/settlement) exceeding 1/2"
☐ ☐ ☒
Upstream catchment is stabilized prior to diverting runoff into
PICP system ☐ ☐ ☒
1/19 Page 1 of 3
Bioretention Cells (Rain Gardens)
Item/Activity Yes No N/A Submittal Requirements Submitted?/Response
Stormwater Inspection
Pre-construction meeting was held with City-Stormwater
Inspector to discuss installation, inspection, checklist, and
protection from sedimentation
☒ ☐ ☐
Record date, inspector name, meeting
location (i.e. DCP, initial erosion control
inspection, etc.)
Martha Cruse-
12.13.2021
Underdrain and basecourse inspection(s): Installation of this
facility was verified via inspection by a City-Stormwater
Inspector at the point of installation of the outlet, underdrain,
geomembrane layer, and base course (per design in Final Plan
Documents)
☒ ☐ ☐
Record date(s) of inspection and
inspector’s name
09.12.2022 Adam
Camp
Pea gravel and BSM inspection(s): Installation of this facility
was verified via inspection by a City-Stormwater Inspector at
the point of installation of the pea gravel and bioretention
sand media
☒ ☐ ☐
Record date(s) of inspection and
inspector’s name
09.13.2022 Adam
Camp
Excavation
Heavy equipment did not encroach into the excavated area
(prevents over-compaction) ☐ ☐ ☐
Bottom of cell was “ripped” after excavation ☐ ☐ ☒ Provide photographs before and after
“ripping”
Bottom surface of cell is flat and level ☒ ☐ ☐ Provide photograph
Excavated area is protected/surrounded by sediment/runoff
control measures during construction ☒ ☐ ☐ Provide photograph
Intake
Upstream catchment drains to inlet/bioretention cell per plan
and flows are fully captured ☒ ☐ ☐
Forebay
Forebay is installed according to design specifications ☒ ☐ ☐ Provide photograph
There is a minimum 3” drop at the forebay entrance ☒ ☐ ☐ Provide photograph
Forebay will drain fully and not hold standing water ☒ ☐ ☐
Outlet Structure/Overflow
Emergency overflow elevation is confirmed
☒ ☐ ☐
Measure and record distance from
overflow to top of media filter; provide
photograph
Overflow inlet elevation is set above bioretention media per
plan ☒ ☐ ☐ Provide photograph
1/19 Page 2 of 3
Overflow inlet invert elevation is at least 3 inches below
containment wall/berm (to direct overflow into inlet) ☒ ☐ ☐
Measure and record distance between
inlet and top of containment wall/berm;
provide photograph
Overflow path and check dams, if used, are armored to protect
from erosion and maintain elevations ☒ ☐ ☐ Provide photograph
Impermeable Liner
Impermeable liner meets design specifications ☒ ☐ ☐ Provide specifications of delivered
material
Impermeable liner is appropriately anchored ☒ ☐ ☐ Provide photograph
Impermeable liner is buried with no exposure ☒ ☐ ☐
Any penetrations of the impermeable liner have been sealed
and checked for water-tightness ☒ ☐ ☐ Provide photograph (if necessary)
Underdrain System
Underdrain pipe meets design specifications ☒ ☐ ☐ Provide photograph
At least one cleanout is provided per underdrain lateral ☒ ☐ ☐ Provide photograph
Cleanout pipe is solid (not perforated/slotted) ☒ ☐ ☐ Provide photograph
Cleanout covers are installed and watertight ☒ ☐ ☐ Provide photograph
Verify the underdrain is NOT wrapped in geotextile fabric ☒ ☐ ☐ Provide photograph
Verify there is no orifice plate on the underdrain outfall ☒ ☐ ☐ Provide photograph
Underdrain integrity tested after backfilling using TV and/or
water test ☐ ☐ ☐ Provide documentation of test results
Filter Media and Aggregate
Reservoir aggregate layer (ASTM #57 or #67):
- meets design specifications
- is installed to the required design depth
☒ ☐ ☐
Provide load ticket, photographs, and
record depth installed
Diaphragm aggregate layer (“Pea Gravel” with gradation ASTM
#8, #89, or #9):
- meets design specifications
- is installed to the required design depth
☒ ☐ ☐
Provide load ticket, photographs, and
record depth installed
Bioretention Sand Media (BSM) composition:
- meets design specifications
- is installed to the required design depth
☒ ☐ ☐
Provide load ticket, photographs, and
record depth installed
BSM was “machine mixed” by supplier prior to delivery ☒ ☐ ☐ Provide load ticket
BSM is installed flat and level ☒ ☐ ☐ Provide photograph
Other Structural Components
Containment wall/berm is continuous and level ☒ ☐ ☐
Landscaping
1/19 Page 3 of 3
Verify final landscaping is free of sod ☒ ☐ ☐ If sod is used, it must be shown to be
“sand-grown”
Final landscaping (non-floatable mulch) is flat and level ☒ ☐ ☐ Provide photograph
Vegetation is planted according to landscape design
specifications and final landscaping plan ☒ ☐ ☐ Provide photograph
Verify that weed barrier is NOT installed ☒ ☐ ☐
Temporary irrigation installed
☒ ☐ ☐
If N/A, then verify that permanent
irrigation is installed to establish/maintain
vegetation
Close Out
Upstream catchment stabilized prior to diverting runoff into
bioretention cell ☒ ☐ ☐
1/19 Page 1 of 1
Vegetated Buffers
Item/Activity Yes No N/A Submittal Requirements Submitted?/Response
Construction
Buffer area was sectioned off to eliminate site disturbance and
compaction during construction ☐ ☐ ☒ Provide photograph(s)
Level spreader has been installed per plan (if applicable) ☐ ☐ ☒ Provide photograph
Soils in the buffer area have been amended ☐ ☐ ☒ Record soil amendment certification with
Environmental & Regulatory Affairs
Vegetation is planted according to landscape design
specifications and final landscaping plan ☐ ☐ ☒ Provide photograph
1/19 Page 1 of 3
Sand Filters
Item/Activity Yes No N/A Submittal Requirements Submitted?/Response
Stormwater Inspection
Pre-construction meeting was held with City-Stormwater
Inspector to discuss installation, inspection, checklist, and
protection from sedimentation
☐ ☐ ☒
Record date, inspector name, meeting
location (i.e. DCP, initial erosion control
inspection, etc.)
Underdrain and basecourse inspection(s): Installation of this
facility was verified via inspection by a City-Stormwater
Inspector at the point of installation of the outlet, underdrain,
geomembrane layer, and base course (per design in Final Plan
Documents)
☐ ☐ ☒
Record date(s) of inspection and
inspector’s name
Pea gravel and filter media inspection(s): Installation of this
facility was verified via inspection by a City-Stormwater
Inspector at the point of installation of the pea gravel and filter
media
☐ ☐ ☒
Record date(s) of inspection and
inspector’s name
Excavation
Heavy equipment did not encroach into the excavated area
(prevents over-compaction) ☐ ☐ ☒
Bottom of cell was “ripped” after excavation ☐ ☐ ☒ Provide photographs before and after
“ripping”
Bottom surface of cell is flat and level ☐ ☐ ☒ Provide photograph
Excavated area is protected/surrounded by sediment/runoff
control measures during construction ☐ ☐ ☒ Provide photograph
Intake
Upstream catchment drains to inlet/sand filter per plan and
flows are fully captured ☐ ☐ ☒
Forebay (If Applicable)
Forebay is installed according to design specifications ☐ ☐ ☒ Provide photograph
There is a minimum 3” drop at the forebay entrance ☐ ☐ ☒ Provide photograph
Forebay will drain fully and not hold standing water ☐ ☐ ☒
Outlet Structure/Overflow
Overflow inlet elevation is set above sand filter media per plan
(typically 1 to 3 feet) ☐ ☐ ☒ Provide photograph
Overflow inlet invert elevation is at least 3 inches below
containment wall/berm (to direct overflow into inlet) ☐ ☐ ☒
Measure and record distance between
inlet and top of containment wall/berm;
provide photograph
1/19 Page 2 of 3
Overflow path and check dams, if used, are armored to protect
from erosion and maintain elevations ☐ ☐ ☒ Provide photograph
Impermeable Liner (If Applicable)
Impermeable liner meets design specifications ☐ ☐ ☒ Provide specifications of delivered
material
Impermeable liner is appropriately anchored to the perimeter
wall ☐ ☐ ☒ Provide photograph
Impermeable liner is buried with no exposure ☐ ☐ ☒
Any penetrations of the impermeable liner have been sealed
and checked for water-tightness ☐ ☐ ☒ Provide photograph (if necessary)
Underdrain System
Underdrain pipe meets design specifications ☐ ☐ ☒ Provide photograph
At least one cleanout is provided per underdrain lateral ☐ ☐ ☒ Provide photograph
Cleanout pipe is solid (not perforated/slotted) ☐ ☐ ☒ Provide photograph
Cleanout covers are installed and watertight ☐ ☐ ☒ Provide photograph
Verify the underdrain is NOT wrapped in geotextile fabric ☐ ☐ ☒ Provide photograph
Verify there is no orifice plate on the underdrain outfall ☐ ☐ ☒ Provide photograph
Underdrain integrity tested after backfilling using TV and/or
water test ☐ ☐ ☒ Provide documentation of test results
Filter Media
Filter media composition (e.g. ASTM C 33 Sand):
- meets design specifications
- is installed to the required design depth
☐ ☐ ☒
Provide load ticket, photographs, and
record depth installed
Pea gravel layer:
- meets design specifications
- is installed to the required design depth
☐ ☐ ☒
Provide load ticket, photographs, and
record depth installed
Filter Media is installed flat and level ☐ ☐ ☒
Other Structural Components
Containment wall/berm is continuous and level ☐ ☐ ☒
Landscaping
Verify final landscaping is free of sod ☐ ☐ ☒ If sod is used, it must be shown to be
“sand-grown”
Final landscaping (non-floatable mulch) is flat and level ☐ ☐ ☒ Provide photograph
Vegetation is planted according to landscape design
specifications and final landscaping plan ☐ ☐ ☒ Provide photograph
Verify that weed barrier is NOT installed ☐ ☐ ☒
1/19 Page 3 of 3
Temporary irrigation installed
☐ ☐ ☒
If N/A, then verify that permanent
irrigation is installed to establish/maintain
vegetation
Close Out
Upstream catchment stabilized prior to diverting runoff into
sand filter cell ☐ ☐ ☒
1/19 Page 1 of 2
Underground Infiltration
Item/Activity Yes No N/A Submittal Requirements Submitted?/Response
Stormwater Inspection
Manufacturer’s representative pre-construction meeting: A
pre-construction meeting was completed with the
manufacturer’s representative and installers
☐ ☐ ☒
Record date and who was present at the
meeting
Pre-construction meeting was held with City-Stormwater
Inspector to discuss installation, inspection, checklist, and
protection from sedimentation
☐ ☐ ☒
Record date, inspector name, meeting
location (i.e. DCP, initial erosion control
inspection, etc.)
Inspection(s): Installation of this facility was verified via
inspection by a City-Stormwater Inspector at the point at which
the chambers had been laid/prior to backfilling.
Correct fabric placement was confirmed.
☐ ☐ ☒
Record date(s) of inspection and
inspector’s name
Excavation
Heavy equipment did not travel across underground cell area
during excavation (prevents over-compaction) ☐ ☐ ☒
Bottom of cell was “ripped” after excavation ☐ ☐ ☒ Provide photographs before and after
“ripping”
Bottom of cell is flat and level, or graded per approved grading
plans ☐ ☐ ☒ Provide photograph
Non-woven fabric is installed per manufacturer’s specifications
and was not damaged during construction (around system) ☐ ☐ ☒ Provide photograph
Woven fabric is installed per manufacturer’s specifications and
was not damaged during construction (beneath chambers) ☐ ☐ ☒ Provide photograph
Excavated area is protected/surrounded by sediment/runoff
control BMPs during construction ☐ ☐ ☒ Provide photograph
Impermeable Liner
Impermeable liner meets design specifications ☐ ☐ ☒ Provide specifications of delivered
material
Impermeable liner is not exposed ☐ ☐ ☒
Any penetrations of the impermeable liner have been sealed
and checked for water-tightness. ☐ ☐ ☒ Provide photograph (if necessary)
Aggregate
Foundation and embedment materials are installed and
compacted according to design and manufacturer’s
specifications
☐ ☐ ☒
Provide load ticket and photograph(s)
Underdrain System
1/19 Page 2 of 2
Underdrain pipe meets design specifications ☐ ☐ ☒ Provide photograph
At least one cleanout is provided per underdrain lateral ☐ ☐ ☒ Provide photograph
Cleanout pipe is solid (not perforated/slotted) ☐ ☐ ☒ Provide photograph
Cleanout covers are installed and watertight ☐ ☐ ☒ Provide photograph
Verify the underdrain is NOT wrapped in geotextile fabric ☐ ☐ ☒ Provide photograph
Verify there is no orifice plate on the underdrain outfall ☐ ☐ ☒ Provide photograph
Underdrain integrity tested after backfilling using TV and/or
water test ☐ ☐ ☒ Provide documentation of test results
Manifold system
Overflow weir elevation is set at/above water quality storm
elevation ☐ ☐ ☒ Record weir elevation on survey
Maintenance access is provided for each Isolator Row ☐ ☐ ☒
At least one inspection port has been provided for each Isolator
Row (located in middle third of each row) ☐ ☐ ☒
Upstream catchment drains to inlet/intake properly ☐ ☐ ☒
Underground Detention Chambers
All chambers were installed per approved Utility Plans and
manufacturer’s specifications ☐ ☐ ☒ Photograph
Close Out
Upstream catchment is stabilized prior to diverting runoff into
Underground Detention system ☐ ☐ ☒
All Isolator Rows, chambers, and pipes are cleaned and
sediment/debris has been removed ☐ ☐ ☒
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