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Appendix A
Primary Contact Name: __________________________________________________________
Work Phone: ______________________________Home Phone: _________________________
Mobile Phone: _________________________________________________________________
Secondary Contact Name: ________________________________________________________
Work Phone: ______________________________Home Phone: _________________________
Mobile Phone: _________________________________________________________________
Property sits on _________acres of land
The facility is open _____________ months of the year, typically operating ____________hours
per day, ___________days per week, and maintains a staff of approximately _________ people.
Facilities and Equipment: Place an X beside all that apply.
wet slips
___ how many?
dry slips
___ how many?
maintenance buildings
___ how many?
fork lift travel lift ships store
picnic area non-commercial
fuel pump
commercial fuel dock
restrooms laundry facilities pumpout station
offices hydraulic trailer pavilion
other structures and
equipment
Services: Place an X beside all that apply
general maintenance sanding commissioning
plumbing winterization electrical
pressure washing refrigeration cleaning and waxing
air conditioning repair
and service
engine repair/tuning carpentry
propeller repairs blister repair oil changes
fiberglass parts cleaning rigging
painting canvas blasting
other services: ______________________________________________________________
Stormwater Pollution Prevention Plan 3