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Public Works, Sewer and Water

Regular Meeting

Verona, WI · April 11, 2022

AgendaMinutes

Minutes

CITY OF VERONA MINUTES PUBLIC WORKS/SEWER & WATER COMMITTEE MONDAY, APRIL 11, 2022 1. The meeting was called to order by Mr. Touchett at 5:18pm. 2. Roll Call: Present: Evan Touchett, Mara Helmke, Chad Kemp. Also present: Theran Jacobson, Director of Public Works; Carla Fischer, AECOM, City Engineer. 3. MOVED by Touchett, seconded by Kemp, to approve the minutes of the March 14, 2022, meeting of the Public Works/Sewer and Water Committee. Motion carried 3-0. 4. MOVED by Touchett, seconded by Helmke, to recommend awarding Project 2022-108, Wildcat Way water main project, to Maddrell Excavating, LLC of Brodhead, WI, in the amount not to exceed $267,751.59. Motion carried 3-0. Touchett noted he thinks Jacobson smartly times public works project bids. 5. MOVED by Touchett, seconded by Helmke, to recommend approving change order No. 6 for Project 2018-108, Eastside Interceptor replacement project, in the amount not to exceed $6,906.00. Motion carried 3-0. 6. MOVED by Touchett, seconded by Kemp, to recommend approving change order No. 7 for Project 2018-108, Eastside Interceptor replacement project, in the amount not to exceed $17,795.20. Motion carried 3-0. 7. Fischer provided an overview of the Municipal Separate Storm Sewer System annual report for 2021. City staff provided supporting documentation to AECOM who formalizes the 2021 annual report for the maintenance activities on the storm water utility. The report was submitted to the Wisconsin Department of Natural Resources on March 31, 2022 and is required to be presented to the committee. The report summarizes the following activities: • Public education and outreach  Presentations prepared and executed by Marty Cieslik, Construction Manager, now retired. AECOM is now facilitating the future presentations with new topics to be determined. Presentations will be recorded and available virtually. • Storm sewer outfall illicit discharge inspections and documentation  These inspections determine if there are any unknown or unanticipated flows in the storm sewer system during dry weather to find a cross connection. There are no known cross connections or unanticipated flows resulting from the inspections. There are known cooling water discharges from industrial sources that are documented. • Construction permits issued and inspections  Issuance of erosion control permits and inspection report • Street & curb side material management  Sweeping  Material collection and usage • Updated mapping  Addition of storm water management assets (pipe and treatment facilities) MOVED by Touchett, seconded by Kemp to approve submittal of the Municipal Separate Storm Sewer System (MS4) 2021 annual report to the WI DNR. Motion carried 3-0. 8. MOVED by Touchett, seconded by Kemp adjourn at 5:47pm. Motion carried 3-0. Note: These minutes were prepared by Theran Jacobson, Director of Public Works. These minutes are based on the notes of the recorder and are subject to change at a subsequent meeting.

Agenda

CITY OF VERONA AMENDED PUBLIC WORKS/SEWER & WATER COMMITTEE AGENDA MONDAY, APRIL 11, 2022 5:15 P.M. VERONA CITY CENTER, ROOM D122 111 LINCOLN STREET VERONA, WI 53593 Agenda Items 1. Call to order. 2. Roll call. 3. Approval of the minutes of the March 14, 2022 meeting of the Public Works/Sewer and Water Committee. 4. Discussion and action regarding awarding Project 2022-108, Wildcat Way water main project. 5. Discussion and action regarding Change order no. 6 for Project ID 2018-108 Eastside Interceptor replacement project. 6. Discussion and action regarding Change order no. 7 for Project ID 2018-108 Eastside Interceptor replacement project. 7. Discussion and action regarding Municipal Separate Storm Sewer System (MS4) 2021 annual report. 8. Adjourn. Evan Touchett Chairperson Notice is hereby given that a majority of the City Council may be present at the meeting of the Public Works/Sewer & Water Committee to gather information about a subject over which they have decision-making responsibility. POSTED: Verona City Hall Verona Library Miller’s Market ALL AGENDAS ARE POSTED ON THE CITY’S WEBSITE AT www.ci.verona.wi.us IF YOU NEED AN INTERPRETER, MATERIALS IN ALTERNATIVE FORMATS, OR OTHER ACCOMMODATION TO ACCESS THE MEETINGS, PLEASE CONTACT THE CITY CLERK AT 845-6495 AT LEAST 48 HOURS PRECEDING THE MEETING. EVERY REASONABLE EFFORT WILL BE MADE TO ACCOMMODATE YOUR REQUEST. CITY OF VERONA MINUTES PUBLIC WORKS/SEWER & WATER COMMITTEE MONDAY, MARCH 14, 2022 1. The meeting was called to order by Mr. Touchett at 5:16pm. 2. Roll Call: Present: Evan Touchett, Mara Helmke. Chad Kemp arrived at 5:22pm. Also present: Theran Jacobson, Director of Public Works; Carla Fischer, AECOM, City Engineer. 3. MOVED by Touchett, seconded by Helmke, to approve the minutes of the February 14, 2022 meeting of the Public Works/Sewer and Water Committee. Motion carried 2-0. 4. MOVED by Touchett, seconded by Helmke, to recommend awarding Project 2022-101, Verona Asphaltic Street Rehabilitation to Wolf Paving & Excavating of Madison, WI, in the amount not to exceed $195,990.00. Motion carried 3-0. 5. MOVED by Touchett, seconded by Kemp, to recommend awarding contract for Project 2022-102, Verona Pavement Surface Treatment to Scott Construction of Lake Delton, WI in the amount not to exceed $173,482.50. Motion carried 3-0. 6. MOVED by Touchett, seconded by Kemp adjourn at 5:28pm. Motion carried 3-0. Note: These minutes were prepared by Theran Jacobson, Director of Public Works. These minutes are based on the notes of the recorder and are subject to change at a subsequent meeting. Meeting Date: April 11, 2022 PW/S&W Committee Memo Public Works/Sewer & Water Committee Listed below is an explanation of the items on the Public Works/Sewer & Water Committee agenda. Item (4) Awarding Project 2022-108, Wildcat Way Water Main Project Four (4) bids were received and are listed below in order lowest to highest: • Maddrell Excavating, LLC of Brodhead, WI in the amount of $267,751.59. • Parisi Construction Co. Inc. of Verona, WI in the amount of $283,140.29. • E & N Hughes Co. Inc. of Monroe, WI in the amount of $293,379.30. • Speedway Sand & Gravel Inc of Middleton, WI in the amount of $399,876.54. The engineer’s estimate with contingencies was $263,767.80. The item of 10-Inch Ductile Iron Water Main was the main factor in the difference in the engineer’s estimate and the contractor’s bids. Current supply chain issues are believed to be the main contributors to this cost difference. Maddrell Excavating, LLC has successfully completed a number of other utility projects throughout the City of Verona; most recently the 2021 N. Main Water Main Replacement, the 2020 annual pond dredging, and the 2018 S. Shuman & W. Park Lane replacement. Based on past work performed in the City of Verona and references checked, Public Works Staff is of the opinion that Maddrell Excavating has the personnel, equipment and financial assets necessary to complete the 2022-108, Wildcat Way Water Main Extension Project. Item (5) Change order no. 6 for Project ID 2018-108 Eastside Interceptor Replacement. Change order no. 6 for the Eastside Interceptor Project is for additional work required as part of Project A, which is a City of Verona and MMSD facilitated and financed project component. The change order is to add additional bid items to complete the work and improve drainage conditions along the Badger Mill Creek Corridor: • Storm sewer adjacent to the Ice Age Trail on the north side of Badger Mill Creek. o Removed and replaced a CMP culvert estimated to be installed in the 1960s that was unknown to any project staff until encountered in the field. • Repaired an existing sanitary manhole that was a source of inflow and infiltration. The contract notes are as follows: • Contract award value = $7,761,804.60 • Previous change orders = $288,893.50 (add) • Change order No. 6 = $6,906.00 (add) Page 1 / 2 Meeting Date: April 11, 2022 PW/S&W Committee Memo • Contract value after incorporating this change order = $8,057,604.10 Staff recommends approval of change order no. 6. Item (6) Change order no. 7 for Project ID 2018-108 Eastside Interceptor Replacement. Change order no. 7 for the Eastside Interceptor Project is for additional work required as part of Project A, which is a City of Verona and MMSD facilitated and financed project component. The change order is to add additional bid items to complete the work along the Badger Mill Creek Corridor, this work is all under Project B which is work facilitated and financed by Dane County: • Work included transporting stockpiled trees from streambank work to a location outside of the project limits for County use at a later date. o It is anticipated that the County will be re-using the material as mulch. The contract notes are as follows: • Contract award value = $7,761,804.60 • Previous change orders = $295,799.50 (add) • Change order No. 7 = $17,795.20 (add) • Contract value after incorporating this change order = $8,075,399.30 Staff recommends approval of change order no. 7. Item (7) Municipal Separate Storm Sewer System (MS4) 2020 annual report. City staff has prepared the 2021 annual report for the maintenance activities on the storm water utility. The report was submitted to the Wisconsin Department of Natural Resources on March 31, 2022 and is to be presented to the committee. The report summarizes the following activities: • Public education and outreach • Storm sewer outfall illicit discharge inspections and documentation • Construction permits issued and inspections • Street & curb side material management • Updated mapping Included in the packet is the executive summary submitted to the WDNR which lists all the attachments included with the report. Page 2 / 2 City of Verona Public Works Department 410 Investment Court Verona, WI 53593 Phone: (608) 845-6695 Fax: (608) 845-5761 Email: theran.jacobson@ci.verona.wi.us April 4, 2022 Verona City Council Members 111 Lincoln Street Verona, WI 53593 Subject: Letter of Recommendation 2022‐108, Wildcat Way Water Main Extension Project Dear Council Members: In accordance with the Official Notice to Bidders, the office of the Public Works Director accepted sealed bids for the above named project until 11:00 a.m. local time on March 22, 2022. Following the close of bidding, the bids received were publicly opened virtually via Zoom and read aloud. Staff has reviewed the bids received. A copy of the Bid Tabulation is attached. Four (4) bids were received and are listed below in order lowest to highest:  Maddrell Excavating, LLC of Brodhead, WI in the amount of $267,751.59.  Parisi Construction Co. Inc. of Verona, WI in the amount of $283,140.29.  E & N Hughes Co. Inc. of Monroe, WI in the amount of $293,379.30.  Speedway Sand & Gravel Inc of Middleton, WI in the amount of $399,876.54. The engineer’s estimate with contingencies was $263,767.80. The item of 10‐Inch Ductile Iron Water Main was the main factor in the difference in the engineer’s estimate and the contractor’s bids. Current supply chain issues are believed to be the main contributors to this cost difference. Maddrell Excavating, LLC has successfully completed a number of other utility projects throughout the City of Verona; most recently the 2021 N. Main Water Main Replacement, the 2020 annual pond dredging, and the 2018 S. Shuman & W. Park Lane replacement. Based on past work performed in the City of Verona and references checked, Public Works Staff is of the opinion that Maddrell Excavating has the personnel, equipment and financial assets necessary to complete the 2022‐108, Wildcat Way Water Main Extension Project. I would therefore recommend that the City of Verona accept the bid of Maddrell Excavating for the 2022‐108, Wildcat Way Water Main Extension Project and recommend awarding a contract to Maddrell Excavating in the amount of $267,751.59. Project ID 2022‐108 I will be pleased to answer any questions concerning the recommendations set forth. Thank you in advance for your cooperation. Sincerely, Theran P. Jacobson, P.E. Public Works Director Drafted / reviewed by: EAS/tpj S:\PROJECTS\2022-108_WILDCAT WAY WATER MAIN CONNECTION\DESIGN - PERMITTING - BIDDING\BIDDING\LETTER OF RECOMMENDATION\2022-108, WILDCAT WAY WATER MAIN EXTENSION LETTER OF RECOMMENDATION_2022-04-01.DOCX Project ID 2022‐108 BID TABULATION BID TABULATION 2022-108, Wildcat Way Water Main Extension Project CITY OF VERONA, WISCONSIN Bid Date: 22-Mar-22 11:00 Bid Time 2022-108, Wildcat Way Water Main Extension Project For City of Verona, Wisconsin Engineers Estimate Maddrell Excavating LLC Parisi Construction, LLC E & N Hughes Co. Inc. Speedway Sand & Gravel Inc Item Description Quantity Units Unit Price Total Unit Price Total Unit Price Total Unit Price Total Unit Price Total 1201.0100.S Clearing and Grubbing 10 STA $ 900.00 $ 9,000.00 $ 500.00 $ 5,000.00 $ 1,700.00 $ 17,000.00 $ 1,913.00 $ 19,130.00 $ 1,663.60 $ 16,636.00 1204.0170 Removing Fence 88 LF $ 3.00 $ 264.00 $ 20.00 $ 1,760.00 $ 8.00 $ 704.00 $ 13.00 $ 1,144.00 $ 22.50 $ 1,980.00 1465.0120.S Remove and Replace Asphaltic Driveway and Dense Graded Base 45 SY $ 200.00 $ 9,000.00 $ 150.00 $ 6,750.00 $ 140.00 $ 6,300.00 $ 73.00 $ 3,285.00 $ 110.00 $ 4,950.00 1606.0200 Riprap Medium 15 CY $ 75.00 $ 1,125.00 $ 65.00 $ 975.00 $ 98.00 $ 1,470.00 $ 103.00 $ 1,545.00 $ 74.00 $ 1,110.00 1616.0206.S Fence Chain Link Security 6-FT 88 LF $ 50.00 $ 4,400.00 $ 65.00 $ 5,720.00 $ 86.00 $ 7,568.00 $ 16.00 $ 1,408.00 $ 78.00 $ 6,864.00 1619.1000 Mobilization 1 LS $ 35,000.00 $ 35,000.00 $ 31,500.00 $ 31,500.00 $ 67,000.00 $ 67,000.00 $ 11,650.00 $ 11,650.00 $ 39,310.00 $ 39,310.00 1625.0100 Topsoil, 6-Inch 4237 SY $ 5.50 $ 23,303.50 $ 0.25 $ 1,059.25 $ 3.00 $ 12,711.00 $ 2.70 $ 11,439.90 $ 1.00 $ 4,237.00 1628.0100.S Temporary Waterway Crossing 1 LS $ 4,000.00 $ 4,000.00 $ 250.00 $ 250.00 $ 500.00 $ 500.00 $ 7,383.00 $ 7,383.00 $ 2,950.00 $ 2,950.00 1628.1504 Silt Fence 1000 LF $ 2.00 $ 2,000.00 $ 2.50 $ 2,500.00 $ 2.30 $ 2,300.00 $ 3.80 $ 3,800.00 $ 1.95 $ 1,950.00 1628.2008 Erosion Mat Urban Class I Type B 4200 SY $ 2.00 $ 8,400.00 $ 1.95 $ 8,190.00 $ 2.10 $ 8,820.00 $ 2.30 $ 9,660.00 $ 1.85 $ 7,770.00 1628.2021 Erosion Mat Class II Type C 37 SY $ 6.00 $ 222.00 $ 9.00 $ 333.00 $ 8.30 $ 307.10 $ 18.70 $ 691.90 $ 5.00 $ 185.00 1628.7504 Temporary Ditch Checks 50 LF $ 10.00 $ 500.00 $ 10.00 $ 500.00 $ 13.00 $ 650.00 $ 32.60 $ 1,630.00 $ 7.50 $ 375.00 1630.0100.S Flood Plain Seed Mix 1 LB $ 200.00 $ 200.00 $ 600.00 $ 600.00 $ 670.00 $ 670.00 $ 116.00 $ 116.00 $ 586.00 $ 586.00 1630.0175 Seeding Mixture No. 75 26 LB $ 40.00 $ 1,040.00 $ 105.00 $ 2,730.00 $ 82.00 $ 2,132.00 $ 41.00 $ 1,066.00 $ 101.93 $ 2,650.18 1630.0200.S Sterile Cover Crop 28 LB $ 15.00 $ 420.00 $ 20.00 $ 560.00 $ 36.00 $ 1,008.00 $ 14.75 $ 413.00 $ 18.00 $ 504.00 1643.5000 Traffic Control 1 LS $ 1,000.00 $ 1,000.00 $ 1,500.00 $ 1,500.00 $ 520.00 $ 520.00 $ 1,740.00 $ 1,740.00 $ 3,800.00 $ 3,800.00 1645.0120 Geotextile Type HR 30 SY $ 4.00 $ 120.00 $ 7.00 $ 210.00 $ 5.70 $ 171.00 $ 1.85 $ 55.50 $ 6.00 $ 180.00 1650.1000 Construction Staking Project 1 LS $ 5,000.00 $ 5,000.00 $ 3,350.00 $ 3,350.00 $ 3,100.00 $ 3,100.00 $ 6,150.00 $ 6,150.00 $ 3,000.00 $ 3,000.00 1690.1000 Sawing Pavement 60 LF $ 3.00 $ 180.00 $ 5.00 $ 300.00 $ 10.25 $ 615.00 $ 4.00 $ 240.00 $ 9.00 $ 540.00 2204.1215.S Remove and Reset 15-Inch Reinforced Concrete Pipe and Apron Endwall 1 LS $ 4,500.00 $ 4,500.00 $ 2,750.00 $ 2,750.00 $ 4,700.00 $ 4,700.00 $ 2,550.00 $ 2,550.00 $ 3,400.00 $ 3,400.00 2612.0106.S Remove and Reinstall Pipe Underdrain 6-Inch 25 LF $ 10.00 $ 250.00 $ 15.00 $ 375.00 $ 34.25 $ 856.25 $ 61.00 $ 1,525.00 $ 25.00 $ 625.00 3209.3000 Trench Backfill (Water Main) 34 TF $ 32.00 $ 1,088.00 $ 0.01 $ 0.34 $ 0.01 $ 0.34 $ 46.00 $ 1,564.00 $ 29.20 $ 992.80 3801.0110 10-Inch Dia. Ductile Iron Water Main 1064 LF $ 80.00 $ 85,120.00 $ 163.00 $ 173,432.00 $ 115.00 $ 122,360.00 $ 167.00 $ 177,688.00 $ 253.07 $ 269,266.48 3803.0106 Water Valve and Valve Box (6-inch) 1 EA $ 2,800.00 $ 2,800.00 $ 2,475.00 $ 2,475.00 $ 3,200.00 $ 3,200.00 $ 1,994.00 $ 1,994.00 $ 3,073.00 $ 3,073.00 3803.0110 Water Valve and Valve Box (10-inch) 1 EA $ 4,100.00 $ 4,100.00 $ 2,950.00 $ 2,950.00 $ 5,000.00 $ 5,000.00 $ 3,657.00 $ 3,657.00 $ 4,750.00 $ 4,750.00 3804.0106 Hydrant Lead, 6-Inch 6 LF $ 75.00 $ 450.00 $ 95.00 $ 570.00 $ 150.00 $ 900.00 $ 120.00 $ 720.00 $ 121.88 $ 731.28 3805.0100.S Fire Hydrant 1 EA $ 6,000.00 $ 6,000.00 $ 5,850.00 $ 5,850.00 $ 5,800.00 $ 5,800.00 $ 6,196.00 $ 6,196.00 $ 7,321.00 $ 7,321.00 3806.1000 Insulation, Polystyrene 128 SF $ 8.00 $ 1,024.00 $ 4.00 $ 512.00 $ 6.70 $ 857.60 $ 3.00 $ 384.00 $ 6.60 $ 844.80 3807.0110 Connect to Existing Water Main (10-Inch) 2 EA $ 3,000.00 $ 6,000.00 $ 1,850.00 $ 3,700.00 $ 2,500.00 $ 5,000.00 $ 4,382.00 $ 8,764.00 $ 3,835.00 $ 7,670.00 3809.0406 Remove Water Valve (6-Inch) 1 EA $ 800.00 $ 800.00 $ 350.00 $ 350.00 $ 180.00 $ 180.00 $ 1,930.00 $ 1,930.00 $ 400.00 $ 400.00 3809.0410 Remove Water Valve (10-Inch) 1 EA $ 1,000.00 $ 1,000.00 $ 350.00 $ 350.00 $ 180.00 $ 180.00 $ 1,930.00 $ 1,930.00 $ 400.00 $ 400.00 3809.0500 Remove Hydrant 1 EA $ 1,500.00 $ 1,500.00 $ 650.00 $ 650.00 $ 560.00 $ 560.00 $ 1,930.00 $ 1,930.00 $ 825.00 $ 825.00 Bid Total $ 219,806.50 $ 267,751.59 $ 283,140.29 $ 293,379.30 $ 399,876.54 Contingency 20% $ 43,961.30 Bid Bond 5% 5% 5% 5% Total w. Contingency $ 263,767.80 * - Apparent Low Bidder 2022-108, WIldcat Way Water Main Extension Bid Tab.xlsx CHANGE ORDER NO. 6 Owner City of Verona Date 01/28/2022 Project East Side Interceptor/MMSD Pump Station 17 Force Main Relief Owner’s Contract No. 2018-108 Contractor Minger Construction Companies, Inc. Date of Contract Start October 13, 2020 You are directed to make the following changes in the Contract Documents. These changes will be incorporated into the Project A portion of the contract. These additions will be paid for solely by the City of Verona. Adding Items Item Number Description Quantity Unit Unit Price Amount 2204.1221 (CO.06.01) Removing Storm Sewer 21-inch and less 30 LF $ 12.00 $ 360.00 2521.1024 (CO.06.02) Apron Endwalls for Culvert Pipe Steel 24-Inch 2 EA $ 1,101.00 $ 2,202.00 2608.3024 (CO.06.03) Storm Sewer Pipe Class III-A 24-Inch 40 LF $ 58.60 $ 2,344.00 CO.06.04 Existing MH SA 3177 Leak Repair 1 LS $ 2,000.00 $ 2,000.00 Total Net Change = $6,906.00 Reason for Change Order: Added Items: CO.06.01 Through CO.06.03 = Added items to fix drainage issue north of Badger Mill Creek east of Ice Age Trail creek crossing. Removed existing CMP culvert placed in the 1960’s that was plugged and damaged. Replaced with new pipe and endwalls and area graded to drain to new pipe. CO.05.15 = Added item to fix leak in existing MH SA3177. This was the existing manhole that the new ESI was connected to at Bruce Street. Leak present in previously abandoned pipe penetration. Leak was causing a significant amount of groundwater to enter the sanitary sewer system. CONTRACT PRICE CONTRACT TIMES (Calendar Days) To substantial To final completion completion Original: $7,761,804.60 Original Completion Date: 11/12/2021 11/19/2021 Previous C.O.s (ADD/DEDUCT): $288,893.50 Previous C.O.s (ADD/DEDUCT): N/A N/A This C.O. (ADD/DEDUCT): $6,906.00 This C.O. (ADD/DEDUCT): N/A N/A Contract Price with all REVISED: N/A N/A approved Change Orders: $8,057,604.10 Revised Completion Date: N/A N/A It is agreed by the Contractor that this Change Order includes any and all costs associated with or resulting from the change(s) ordered herein, including all impact, delays, and acceleration costs. Other than the dollar amount and time allowance listed above, there shall be no further time or dollar compensation as a result of this Change Order. THIS DOCUMENT SHALL BECOME AN AMENDMENT TO THE CONTRACT AND ALL STIPULATIONS AND COVENANTS OF THE CONTRACT SHALL APPLY HERETO. 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BOX 236 PHONE: 952-368-9200 FAX: 952-368-9311 T&M Work Daily Billing Breakdown (Direct Costs) Date: 3.18.22 Project: Verona Eastside Interceptor Description of Extra Work: Estimate to move left over Trees From Dane County Work Mobilize 245 2/23/22 - 2/24/22 - De-Mobilize 2/22/22 - Excavator with Continue Finish Moving 245 Excavator Begin Moving Thumb & Moving Logs/Brush with Thumb & Logs/Brush Offroad Truck Logs/Brush Clean up Site Offroad Truck Date: Hourly Rate (Straight Labor Costs Time) Hours Hours Hours Hours Hours Hours Total Cost $ - Truck Driver $ 87.43 7.00 7.00 $ 1,224.02 Foreman - Tim P $ 113.79 11.00 11.00 11.00 $ 3,755.07 $ - $ - $ - $ - Total Labor Cost Without Markup $ 4,979.09 Labor Markup (15%) $ 746.86 Total Labor Cost With Markup $ 5,725.95 Equipment Costs Lowboy Tractor Trailer $ 120.00 7.00 7.00 $ 1,680.00 245 Excavator $ 115.00 11.00 11.00 11.00 $ 3,795.00 30 Ton Off-Road Haul Truck $ 115.00 11.00 11.00 11.00 $ 3,795.00 Foreman Truck $ 30.00 11.00 11.00 11.00 $ 990.00 Cat 299 Skid Loader $ 47.00 5.00 $ 235.00 Total Equipment Cost Without Markup $ 10,495.00 Equipment Markup (15%) $ 1,574.25 Total Equipment Cost With Markup $ 12,069.25 Material Costs Quantity Unit Unit Price $ - $ - $ - $ - $ - Total Material Cost Without Markup $ - Subcontractor Markup (15%) $ - Total Material Cost With Markup $ - Subcontractor Costs Quantity Unit Unit Price $ - $ - Total Material Cost Without Markup $ - Subcontractor Markup (5%) $ - Total Material Cost With Markup $ - Summary Total Labor Cost $ 5,725.95 Total Equipment Cost $ 12,069.25 Total Material Cost $ - Total Subcontractor Cost $ - Total Cost of Extra Work $ 17,795.20 Submittal of Annual Reports and Other Compliance Documents for Municipal Separate Storm Sewer System (MS4) Permits NOTE: Missing or incomplete fields are highlighted at the bottom of each page. You may save, close and return to your draft permit as often as necessary to complete your application. After 120 days your draft is deleted. Form 3400-224(R8/2021) Reporting Information : Will you be completing the Annual Report or other submittal type? Annual Report Other Project Name: 2021 Annual Report County: Dane Municipality: Verona City Permit Number: S058416 Facility Number: 30911 Reporting Year: 2021 Is this submittal also satisfying an Urban Nonpoint Source Grant funded deliverable? Yes No Required Attachments and Supplemental Information Please complete the contents of each tab to submit your MS4 permit compliance document. The information included in this checklist is necessary for a complete submittal. A complete and detailed submittal will help us review about your MS4 permit document. To help us make a decision in the shortest amount of time possible, the following information must be submitted: Annual Report Review related web site and instructions for Municipal storm water permit eReporting [Exit Form] Complete all required fields on the annual report form and upload required attachments Attach the following other supporting documents as appropriate using the attachments tab above Public Education and Outreach Annual Report Summary Public Involvement and Participation Annual Report Summary Illicit Discharge Detection and Elimination Annual Report Summary Construction Site Pollution Control Annual Report Summary Post-Construction Storm Water Management Annual Report Summary Pollution Prevention Annual Report Summary Leaf and Yard Waste Management Municipal Facility (BMP) Inspection Report Municipal Property SWPPP Municipally Property Inspection Report Winter Road Maintenance Storm Sewer Map Annual Report Attachment Storm Water Quality Management Annual Report Attachment TMDL Attachment Storm Water Consortium/Group Report Municipal Cooperation Attachment Other Annual Report Attachment Attach the following permit compliance documents as appropriate using the attachments tab above Storm Water Management Program Public Education and Outreach Program Public Involvement and Participation Program Illicit Discharge Detection and Elimination Program Construction Site Pollutant Control Program Post-Construction Storm Water Management Program Pollution Prevention Program Municipal Storm Water Management Facility (BMP) Inventory Municipal Storm Water Management Facility (BMP) Inspection and Maintenance Plan Total Maximum Daily Load documents (*If applicable, see permit for due dates.) TMDL Mapping* TMDL Modeling* TMDL Implementation Plan* Fecal Coliform Screening Parameter * Fecal Coliform Inventory and Map (S050075-03 general permittees Appendix B B.5.2 – document due to the department by March 31, 2022) Fecal Coliform Source Elimination Plan (S050075-03 general permittees Appendix B - document due to the department by October 31,2023) Sign and Submit form Form 3400-224 (R8/2021) Municipal Contact Information- Complete Notice: Pursuant to s. NR 216.07(8), Wis. Adm. Code, an owner or operator of a Municipal Separate Storm Sewer System (MS4) is required to submit an annual report to the Department of Natural Resources (Department) by March 31 of each year to report on activities for the previous calendar year (“reporting year”). This form is being provided by the Department for the user’s convenience for reporting on activities undertaken in each reporting year of the permit term. Personal information collected will be used for administrative purposes and may be provided to the extent required by Wisconsin’s Open Records Law [ss. 19.31-19.39, Wis. Stats.]. Note: Compliance items must be submitted using the Attachments tab. Municipality Information Name of Municipality Verona City Facility ID # or (FIN): 30911 Check to update mailing address information Updated Information: Mailing Address: 111 Lincoln St Mailing Address 2: City: Verona State: Wisconsin Zip Code: 53593 xxxxx or xxxxx-xxxx Primary Municipal Contact Person (Authorized Representative for MS4 Permit) The “Authorized Representative” or “Authorized Municipal Contact” includes the municipal official that was charged with compliance and oversight of the permit conditions, and has signature authority for submitting permit documents to the Department (i.e., Mayor, Municipal Administrator, Director of Public Works, City Engineer). Select to create new primary contact First Name: Theran Last Name: Jacobson Select to update current contact information Title: Director of Public Works Mailing Address: 410 Investment Ct Mailing Address 2: City: Verona State: WI Zip Code: 53593 xxxxx or xxxxx-xxxx Phone Number: 608-845-6695 Ext: xxx-xxx-xxxx Email: theran.jacobson@ci.verona.wi.us Additional Contacts Information (Optional) I&E Program IDDE Program IDDE Response Procedure Manual Municipal-wide Water Quality Plan Individual with responsibility for: Ordinances (Check all that apply) Pollution Prevention Program Post-Construction Program  Winter roadway maintenance First Name: Brian Last Name: Peterson Title: Str. Superintendent Mailing Address: 410 Investment Court Mailing Address 2: City: Verona State: WI Zip Code: 53593 xxxxx or xxxxx-xxxx Phone Number: 608-845-6695 Ext: xxx-xxx-xxxx Email: brian.peterson@ci.verona.wi.us I&E Program  IDDE Program  IDDE Response Procedure Manual Individual with responsibility for: Municipal-wide Water Quality Plan (Check all that apply) Ordinances  Pollution Prevention Program  Post-Construction Program Winter roadway maintenance First Name: Carla Last Name: Fischer Title: City Engineer Mailing Address: 1350 Deming Way Mailing Address 2: Ste 100 City: Middleton State: WI Zip Code: 53562 xxxxx or xxxxx-xxxx Phone Number: 603-828-8128 Ext: xxx-xxx-xxxx Email: carla.fischer@aecom.com I&E Program  IDDE Program  IDDE Response Procedure Manual Municipal-wide Water Quality Plan Individual with responsibility for: Ordinances (Check all that apply) Pollution Prevention Program Post-Construction Program Winter roadway maintenance First Name: Kyle Last Name: Neeve Title: Engineer Mailing Address: 1350 Deming Way Mailing Address 2: Ste 100 City: Middleton State: WI Zip Code: 53562 xxxxx or xxxxx-xxxx Phone Number: 608-828-8172 Ext: xxx-xxx-xxxx Email: kyle.neeve@aecom.com 1. Does the municipality rely on another entity to satisfy some of the permit requirements? Yes No  Public Education and Outreach Madison Area Storm Water Partnership (MAMSWaP)  Public Involvement and Participation MAMSWaP  Illicit Discharge Detection and Elimination AECOM  Construction Site Pollutant Control AECOM  Post-Construction Storm Water Management AECOM Pollution Prevention 2. Has there been any changes to the municipality’s participation in group efforts towards permit compliances (i.e., the municipality has added or dropped consortium membership)? Yes No Form 3400-224 (R8/2021) Minimum Control Measures- Section 1 : Complete 1. Public Education and Outreach a. Complete the following information on Public Education and Outreach Activities related to storm water. Select the Delivery Mechanism that best describes how the topics were conveyed to your population. Use the Add Event to add additional entries. Event Start Date 1/12/2021 Project/Event Name Where Does Verona's Water Come From and Where Does It Go Delivery Mechanism Educational activity* *Active Estimated People Regional Effort Topics Covered Target Audience Reached (Optional) (Optional) Illicit discharge detection and elimination  General Public 1 - 10 Yes No Household hazardous waste disposal/pet Public Employees waste management/vehicle washing  Residents  Yard waste management/pesticide and Businesses fertilizer application Contractors  Stream and shoreline management Developers  Residential infiltration Industries Construction sites and post-construction Other storm water management  Pollution prevention Green infrastructure/low impact development Other: Event Start Date 2/2/2021 Project/Event Name Verona's Storm Water Quality Delivery Mechanism Educational activity* *Active Estimated People Regional Effort Topics Covered Target Audience Reached (Optional) (Optional) Illicit discharge detection and elimination  General Public 1 - 10 Yes No Household hazardous waste disposal/pet Public Employees waste management/vehicle washing  Residents  Yard waste management/pesticide and Businesses fertilizer application Contractors Stream and shoreline management Developers Residential infiltration Industries Construction sites and post-construction Other storm water management  Pollution prevention Green infrastructure/low impact development Other: Event Start Date 3/23/2021 Project/Event Name Stormwater Basin Management Strategies Delivery Mechanism Educational activity* *Active Estimated People Regional Effort Topics Covered Target Audience Reached (Optional) (Optional) Illicit discharge detection and elimination  General Public 1 - 10 Yes No Household hazardous waste disposal/pet Public Employees waste management/vehicle washing  Residents  Yard waste management/pesticide and Businesses fertilizer application Contractors Stream and shoreline management Developers Residential infiltration Industries Construction sites and post-construction Other storm water management  Pollution prevention Green infrastructure/low impact development Other: Event Start Date 4/13/2021 Project/Event Name The Lincoln Street Basin Delivery Mechanism Educational activity* *Active Estimated People Regional Effort Topics Covered Target Audience Reached (Optional) (Optional) Illicit discharge detection and elimination  General Public 1 - 10 Yes No Household hazardous waste disposal/pet Public Employees waste management/vehicle washing  Residents  Yard waste management/pesticide and Businesses fertilizer application Contractors Stream and shoreline management Developers  Residential infiltration Industries Construction sites and post-construction Other storm water management  Pollution prevention Green infrastructure/low impact development Other: Event Start Date 4/26/2021 Project/Event Name Storm Water Pond Treatment Delivery Mechanism Educational activity* *Active Estimated People Regional Effort Topics Covered Target Audience Reached (Optional) (Optional) Illicit discharge detection and elimination  General Public 1 - 10 Yes No Household hazardous waste disposal/pet Public Employees waste management/vehicle washing  Residents  Yard waste management/pesticide and Businesses fertilizer application Contractors Stream and shoreline management  Residential infiltration Developers Construction sites and post-construction Industries storm water management Other  Pollution prevention Green infrastructure/low impact development Other: Event Start Date 9/21/2021 Project/Event Name 23 Prairie Oaks Detention Basin Clean-Out Project Delivery Mechanism Educational activity* *Active Estimated People Regional Effort Topics Covered Target Audience Reached (Optional) (Optional) Illicit discharge detection and elimination  General Public 1 - 10 Yes No Household hazardous waste disposal/pet Public Employees waste management/vehicle washing  Residents  Yard waste management/pesticide and Businesses fertilizer application Contractors Stream and shoreline management Developers  Residential infiltration Industries Construction sites and post-construction Other storm water management  Pollution prevention Green infrastructure/low impact development Other: Event Start Date 10/5/2021 Project/Event Name Using Alum Flocculants to Treat Strom Water Ponds to Control Phosphorous Delivery Mechanism Educational activity* *Active Estimated People Regional Effort Topics Covered Target Audience Reached (Optional) (Optional) Illicit discharge detection and elimination  General Public 1 - 10 Yes No Household hazardous waste disposal/pet Public Employees waste management/vehicle washing  Residents  Yard waste management/pesticide and Businesses fertilizer application Contractors Stream and shoreline management Developers Residential infiltration Industries  Construction sites and post-construction Other storm water management  Pollution prevention Green infrastructure/low impact development Other: Event Start Date 12/14/2021 Project/Event Name How is storm water different from our drinking water and wastewater Delivery Mechanism Educational activity* *Active Estimated People Regional Effort Topics Covered Target Audience Reached (Optional) (Optional) Illicit discharge detection and elimination  General Public 1 - 10 Yes No Household hazardous waste disposal/pet Public Employees waste management/vehicle washing  Residents  Yard waste management/pesticide and Businesses fertilizer application Contractors Stream and shoreline management Developers Residential infiltration Industries Construction sites and post-construction Other storm water management  Pollution prevention Green infrastructure/low impact development  Other: place holder b. Brief explanation on Public Education and Outreach reporting. Limit response to 250 characters and/or attach supplemental information on the attachments page. See Public Education & Outreach 2021 Summary for details (attachment). Each of the event presentation is included in the attachments. Form 3400-224 (R8/2021) Minimum Control Measures - Section 2 : Complete 2. Public Involvement and Participation a. Permit Activities. Complete the following information on Public Involvement and Participation Activities related to storm water. Select the Delivery Mechanism that best describes how the permit activities were conveyed to your population. Use the Add Event to add additional entries. Event Start Date 2/22/2021 Project/Event Name City Council Meetings Delivery Mechanism Government Event (Public Hearing, Council Meeting, etc) Estimated People Regional Effort Topics Covered Target Audience Reached (Optional) (Optional) MS4 Annual Report General Public 1 - 10 Yes No  Storm Water Management Program Public Employees Storm Water related ordinance  Residents Other: Businesses Contractors Developers Industries Other Event Start Date 4/7/2021 Project/Event Name Plan Commission meetings Delivery Mechanism Government Event (Public Hearing, Council Meeting, etc) Estimated People Regional Effort Topics Covered Target Audience Reached (Optional) (Optional) MS4 Annual Report General Public 1 - 10 Yes No  Storm Water Management Program Public Employees Storm Water related ordinance  Residents Other: Businesses Contractors Developers Industries Other Event Start Date 1/11/2021 Project/Event Name Public Works Committee Meetings Delivery Mechanism Government Event (Public Hearing, Council Meeting, etc) Estimated People Regional Effort Topics Covered Target Audience Reached (Optional) (Optional) MS4 Annual Report General Public 1 - 10 Yes No  Storm Water Management Program Public Employees Storm Water related ordinance  Residents Other: Businesses Contractors Developers Industries Other b. Volunteer Activities. Complete the following information on Public Involvement and Participation Activities related to storm water. Select the Delivery Mechanism that best describes how volunteer activities were conveyed to your population. Use the Add Event to add additional entries. Event Start Date 1/23/2021 NA (Individual Permittee). Project/Event Name Sugar River Wetlands Restoration Days Delivery Mechanism Other hands-on event Estimated People Regional Effort Topics Covered Target Audience Reached (Optional) (Optional) 11-50 Yes No Volunteer Opportunity  General Public Public Employees Residents Businesses Contractors Developers Industries Other c. Brief explanation on Public Involvement and Participation reporting. Limit response to 250 characters and/or attach supplemental information on the attachments page. A summary of Verona’s Public Involvement and Participation is included as an attachment. The agendas and minutes for the Public Works Committee, Common Council, and Plan Commission meetings are included as attachments. Form 3400-224 (R8/2021) Minimum Control Measures - Section 3 : Complete 3. Illicit Discharge Detection and Elimination a. How many total outfalls does the municipality have? Unsure 15 b. How many outfalls did the municipality evaluate as part Unsure 10 of their routine ongoing field screening program? c. From the municipality's routine screening, how many Unsure 0 were confirmed illicit discharges? d. How many illicit discharge complaints did the Unsure 0 municipality receive? e. From the complaints received, how many were Unsure 0 confirmed illicit discharges? f. How many of the identified illicit discharges did the Unsure 0 municipality eliminate in the reporting year (from both routine screening and complaints)? (If the sum of 3.c. and 3.e. does not equal 3.f., please explain below.) g. How many of the following enforcement mechanisms did the municipality Unsure use to enforce its illicit discharge ordinance? Check all that apply and enter the number of each used in the reporting year.  Verbal Warning 0  Written Warning (including email) 0  Notice of Violation 0  Civil Penalty/ Citation 0 Additional Information: h. Brief explanation on Illicit Discharge Detection and Elimination reporting. If you marked Unsure for any questions above, justify the reasoning. Limit response to 250 characters and/or attach supplemental information on the attachments page. Verona's consultant AECOM performs annual dry weather monitoring to check for Illicit Discharge, see attachment for the reports AECOM prepared in 2021. Form 3400-224 (R8/2021) Minimum Control Measures - Section 4 : Complete 4. Construction Site Pollutant Control a. How many total construction sites with one acre or more Unsure 20 of land disturbing construction activity were active at any point in the reporting year? b. How many construction sites with one acre or more of Unsure 19 land disturbing construction activity did the municipality issue permits for in the reporting year? c. How many erosion control inspections did the municipality Unsure 57 complete in the reporting year (at sites with one acre or more of land disturbing construction activity)? d. What types of enforcement actions does the municipality have available Unsure to compel compliance with the regulatory mechanism? Check all that apply and enter the number of each used in the reporting year. No Authority  Verbal Warning 2  Written Warning (including email) 8  Notice of Violation 0  Civil Penalty/ Citation 0  Stop Work Order 0 Forfeiture of Deposit Other - Describe below e. Brief explanation on Construction Site Pollutant Control reporting . If you marked Unsure for any questions above, justify the reasoning. Limit response to 250 characters and/or attach supplemental information on the attachments page. A summary of Construction Site Pollutant Control activities is included as an attachment. The sites inspected during 2021 are listed in the attachment. Form 3400-224 (R8/2021) Minimum Control Measures - Section 5 : Complete 5. Post-Construction Storm Water Management a. How many sites with new structural storm water Unsure 9 management facilities* have received local approval ? *Engineered and constructed systems that are designed to provide storm water quality control such as wet detention ponds, constructed wetlands, infiltration basins, grassed swales, permeable pavement, catch basin sumps, etc. b. Does the permittee have procedures for inspecting and Yes No Unsure maintaining private storm water facilities? c. If Yes, how many privately owned storm water Unsure 26 management facilities were inspected in the reporting year ? Inspections completed by private landowners should be included in the reported number. d. What types of enforcement actions does the municipality have available Unsure to compel compliance with the regulatory mechanism? Check all that apply and enter the number of each used in the reporting year. No Authority  Verbal Warning 0  Written Warning (including email) 0  Notice of Violation 0 Civil Penalty/ Citation Forfeiture of Deposit Complete Maintenance Bill Responsible Party Other - Describe below e. Brief explanation on Post-Construction Storm Water Management reporting . If marked 'Unsure' on any questions above, justify your reasoning. Limit your response to 250 characters and/or attach supplemental information on the attachments page. A summary of the private storm water sites inspected during 2021 is included as an attachment. Form 3400-224 (R8/2021) Minimum Control Measures - Section 6 : Complete 6. Pollution Prevention Storm Water Management Facility Inspections Not Applicable a. Enter the total number of municipally owned or operated Unsure 60 structural storm water management facilities ? b. How many new municipally owned storm water management Unsure 0 facilities were installed in the reporting year ? c. How many municipally owned storm water management facilities Unsure 50 were inspected in the reporting year? d. What elements are looked at during inspections (250 character limit)? Vegetation, discharge structures, inflow structures, basins are photographed from set locations e. How many of these facilities required maintenance? Unsure 10 f. Brief explanation on Storm Water Management Facility inspection reporting. If you marked Unsure for any questions above, justify the reasoning. Limit response to 250 characters and/or attach supplemental information on the attachments page. Public Works Yards & Other Municipally Owned Properties (SWPPP Plan Review) Not Applicable g. How many municipal properties require a SWPPP? Unsure 3 h. How many inspections of municipal properties have been Unsure 3 conducted in the reporting year? i. Have amendments to the SWPPPs been made? Yes No Unsure j. If yes, describe what changes have been made. Limit response to 250 characters and/or attach supplemental information on the attachment page: k. Brief explanation on Storm Water Pollution Prevention Plan reporting. If you marked Unsure for any questions above, justify the reasoning. Limit response to 250 characters and/or attach supplemental information on the attachments page. Collection Services - Street Sweeping / Cleaning Program Not Applicable l. Did the municipality conduct street sweeping/cleaning during the reporting year? Yes No Unsure m. If known, how many tons of material was removed? Unsure 813 n. Does the municipality have a low hazard exemption for this Yes No material? o. If street cleaning is identified as a storm water best management practice in the pollutant loading analysis, was street cleaning completed at the assumed frequency? Yes - Explain frequency No - Explain Not Applicable Collection Services - Catch Basin Sump Cleaning Program Not Applicable p. Did the municipality conduct catch basin sump cleaning during the reporting year? Yes No Unsure q. How many catch basin sumps were cleaned in the reporting year? 12 Unsure r. If known, how many tons of material was collected?  Unsure s. Does the municipality have a low hazard exemption for this Yes No material? t. If catch basin sump cleaning is identified as a storm water best management practice in the pollutant loading analysis, was cleaning completed at the assumed frequency? Yes- Explain frequency No - Explain Not Applicable Collection Services - Leaf Collection Program Not Applicable u. Does the municipality conduct curbside leaf collection? Yes No Unsure v. Does the municipality notify homeowners about pickup? Yes No Unsure w. Where are the residents directed to store the leaves for collection? Pile on terrace  Pile in street Bags on terrace Unsure Other - Describe x. What is the frequency of collection? bi-weekly during the growing season & weekly during the fall y. Is collection followed by street sweeping/cleaning? Yes No Unsure z. Brief explanation on Collection Services reporting. If you marked Unsure for any questions above, justify the reasoning. Limit response to 250 characters and/or attach supplemental information on the attachments page Winter Road Management Not Applicable *Note: We are requesting information that goes beyond the reporting year, answer the best you can. aa. How many lane-miles of roadway is the municipality 71 Unsure responsible for doing snow and ice control? ab. Provide amount of de-icing products used by month last winter season? Solids (tons) (ex. sand, or salt-sand) Product Oct Nov Dec Jan Feb Mar Salt 0 0 260 450 230 450 Liquids (gallons) (ex. brine) Oct Nov Dec Jan Feb Mar Brine 0 0 2875 1775 3150 0 ac. Was salt applying machinery calibrated in the reporting Yes No Unsure year? ad. Have municipal personnel attended salt reduction strategy Yes No Unsure training in the reporting year? Training Date Training Name # Attendance 10/6/2021 "Brine 101" By Be Salt Wise 20 ae. Brief explanation on Winter Road Management reporting. If you marked Unsure for any questions above, justify the reasoning. Limit response to 250 characters and/or attach supplemental information on the attachments page Training went over how to incorporate salt brine into winter maintenance. Internal (Staff) Education & Communication af. Has training or education been held for municipal or other Yes No Unsure personnel involved in implementing each of the pollution prevention program elements ? If yes, describe what training was provided (250 character limit): When: How many attended: ag. Describe how the municipality has kept the following local officials and municipal staff aware of the municipal storm water discharge permit programs and its requirements. Elected Officials Public Works Committee meetings, City Council meetings, Plan Commission meetings Municipal Officials Technical Review Committee meetings - provide recommendations to Plan Commission Appropriate Staff ( such as operators, Department heads, and those that interact with public) Staff Meetings ah. Brief explanation on Internal Education reporting. If you marked Unsure for any questions above, justify the reasoning. Limit response to 250 characters and/or attach supplemental information on the attachments page. Form 3400-224 (R8/2021) Minimum Control Measures - Section 7 : Complete 7. Storm Sewer System Map a. Did the municipality update their storm sewer map this year? Yes No Unsure If yes, check the areas the map items that got updated or changed:  Storm water treatment facilities  Storm pipes Vegetated swales Outfalls Other - Describe below b. Brief explanation on Storm Sewer System Map reporting. If you marked Unsure for an question for any questions above, justify the reasoning. Limit response to 250 characters and/or attach supplemental information on the attachments page. Storm Sewer map is included as an attachment Form 3400-224 (R8/2021) Final Evaluation - Complete Fiscal Analysis Complete the fiscal analysis table provided below. For municipalities that do not break out funding into permit program elements, please enter the monetary amount to your best estimate of what funding may be going towards these programs. Annual Budget Budget Source of Funds Expenditure Reporting Year Upcoming Reporting Year Year Element: Public Education and Outreach 15019 17100 17200 Storm water utility Element: Public Involvement and Participation 828 1300 1500 Storm water utility Element: Illicit Discharge Detection and Elimination 5766 3900 4000 Storm water utility Element: Construction Site Pollutant Control 31756 7900 40600 Storm water utility Element: Post-Construction Storm Water Management 136135 12500 140000 Permit fee and/or deposit/escrow Element: Pollution Prevention 419238 494200 495000 Storm water utility Other (describe) Storm Sewer System Map 5870 12000 12000 Storm water utility Other (describe) Storm Water Quality Management 13517 10250 2500 Storm water utility Other (describe) Basin Maintenance (vegetation burns & pond treatments) 41251 0 13000 Storm water utility Please provide a justification for a "0" entered in the Fiscal Analysis. Limit response to 250 characters. Water Quality a: Were there any known water quality improvements in the receiving waters to which the municipality’s storm sewer system directly discharges to? Yes No Unsure If Yes, explain below: b : Were there any known water quality degradation in the receiving waters to which the municipality’s storm sewer system directly discharges to? Yes No Unsure If Yes, explain below: c: Have any of the receiving waters that the municipality discharges to been added to the impaired waters list during the reporting year? Yes No Unsure d: Has the municipality evaluated their storm water practices to reduce the pollutants of concern? Yes No Unsure Storm Water Quality Management a. Has the municipality completed or updated modeling in the reporting year (relating to developed urban area performance standards of s. NR 151.13(2)(b)1., Wis. Adm. Code)? Yes No b. If yes, enter percent reduction in the annual average mass discharging from the entire MS4 to surface waters of the state as compared to implementing no storm water management controls: Total suspended solids (TSS) Total phosphorus (TP) Additional Information Based on the municipality’s storm water program evaluation, describe any proposed changes to the municipality’s storm water program. If your response exceeds the 250 character limit, attach supplemental information on the attachments page. Form 3400-224 (R8/2021) Requests for Assistance on Understanding Permit Programs Would the municipality like the Department to contact them about providing more information on understanding any of the Municipal Separate Storm Sewer Permit programs? Please select all that apply: Public Education and Outreach Public Involvement and Participation Illicit Discharge Detection and Elimination Construction Site Pollutant Control Post-Construction Storm Water Management Pollution Prevention Storm Water Quality Management Storm Sewer System Map Water Quality Concerns Compliance Schedule Items Due MS4 Program Evaluation Form 3400-224(R8/2021) Required Attachments and Supplemental Information Any other MS4 program information for inclusion in the Annual Report may be attached on here. Use the Add Additional Attachments to add multiple documents. Upload Required Attachments (15 MB per file limit) - Help reduce file size and trouble shoot file uploads *Required Item Note: To replace an existing file, use the 'Click here to attach file ' link or press the to delete an item. Storm Sewer System Map Verona_MAMSWaP_2021.pdf File Attachment Attach - Other Supporting Documents AR_EO PublicEducationandOutreach2021Summary.pdf File Attachment AR_EO 01VeronawaterresourceJanuary2021.pdf File Attachment AR_EO 02VeronaStormWaterQuality02-02-2021.pdf File Attachment AR_EO 03BasinManagementStrategiesMarch232021.pdf File Attachment AR_EO 04StormWaterBasinVegetaionBurnsMarch-Apirl2021.pdf File Attachment AR_EO 05LincolnStBasin04-13-2021.pdf File Attachment AR_EO 06StormWaterPondTreatmentApril262021.pdf File Attachment AR_EO 0723PrairieOaksClean-outSept2021.pdf File Attachment AR_EO 08UsingAlumFlocculantsupdatedfromOctober52021.pdf File Attachment AR_EO 09VeronawaterresourceNovember2021.pdf File Attachment AR_EO 10StormWaterBasicsDecember2021.pdf File Attachment AR_IP PublicInvolvementandParticipation2021Summarry.pdf File Attachment AR_IP 2021PublicWorksMinuteswstormwater.pdf File Attachment AR_IP 2021CommonCouncilMinuteswithStormWater.pdf File Attachment AR_IDDE IllicitDischargeDetectionElimination2021Summary.pdf File Attachment AR_CSPC ConstructionSiteErosionControl2021Summary.pdf File Attachment AR_PCSSW Post-ConstructionStormWaterManagement2021Summary.pdf File Attachment AR_PP PollutionPrevention2021Summary.pdf File Attachment AR_PP StreetSweeping2021Summary.pdf File Attachment AR_LeafYardMgmt LeafYardWasteCollection2021Summary.pdf File Attachment AR_Other MAMSWaP_Notes.pdf File Attachment AR_IP 2021PlanCommissionMinutes.pdf File Attachment AR_IP 2021CommonCouncilAgendas.pdf File Attachment AR_IP PWSW2021Agenda.pdf File Attachment AR_SWQM StormWaterQualityManagementReport.pdf File Attachment AR_SWQM StormWaterQualityManagementReportSummary.pdf File Attachment (To remove items, use your cursor to hover over the attachment section. When the drop down arrow appears, select remove item) Attach - Permit Compliance Documents EO_Program 2021-IE-Work-Plan-FINAL.pdf File Attachment PCSSW_Program CityofVeronaSWPPP_Combined_reduced.pdf File Attachment IDDE_Program Verona_IDDE_Plan.pdf File Attachment IP_Program PublicInvolvementandParticipationPlan2021.pdf File Attachment PP_BMPInventory BasinMaintenancePlan2022-2025.pdf File Attachment CS_Program ConstructionSitePollutantControl.pdf File Attachment PCSSW_Program PostConstructionStormWaterManagement.pdf File Attachment EO_Program IE-WPDES-2022AnnualWorkPlan_22_03_30.pdf File Attachment PP_BMPInventory VeronaSWBasins2021-December2021.pdf File Attachment EO_Program PublicEducationandOutreachPlan2021.pdf File Attachment (To remove items, use your cursor to hover over the attachment section. When the drop down arrow appears, select remove item) Form 3400-224(R8/2021) Sign and Submit Your Application Steps to Complete the signature process 1. Read and Accept the Terms and Conditions 2. Press the Submit and Send to the DNR button NOTE: For security purposes all email correspondence will be sent to the address you used when registering your WAMS ID. This may be a different email than that provided in the application. For information on your WAMS account click HERE . Terms and Conditions Certification: I hereby certify that I am an authorized representative of the municipality covered under Verona City MS4 Permit for which this annual report or other compliance document is being submitted, and that the information contained in this submittal and all attachments were gathered and prepared under my direction or supervision. Based on my inquiry of the person or persons under my direction or supervision involved in the preparation of this document, to the best of my knowledge, the information is true, accurate, and complete. I further certify that the municipality’s governing body or delegated representatives have reviewed or been apprised of the contents of this annual report. I understand that Wisconsin law provides severe penalties for submitting false information. Signee (must check current role prior to accepting terms and conditions) Authorized municipal contact using WAMS ID. Delegation of Signature Authority ( Form 3400-220 ) for agent signing on the behalf of the authorized municipal contact. Agent seeking to share this item with authorized municipal contact (authorized municipal contact must get WAMS id and complete signature). Name: Theran Jacobson Title: Director of Public Works Authorized Signature. Signed by : i:0#.f|wamsmembership|theran5veronadpw on 2022-03-31T08:19:34  I accept the above You have already signed and submitted this application to the DNR. Please contact terms and conditions. the Wisconsin DNR for assistance. After providing the final authorized signature, the system will send an email to the authorized party and any agents. This email will include a copy to the final read only version of this application.

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