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INDIaNa CleaN maRINa pRogRam DesIgNatIoN CheCklIst
State Form 53567 (4-08)

Indiana Department of Natural Resources Lake Michigan Coastal Program Coastal Nonpoint Coordinator 1600 North 25 East Chesterton, IN 46304 Telephone: (219) 921-0863

INSTRUCTIONS: 1. Use this checklist to conduct a self assessment of your facility and determine if your marina qualifies for Indiana Clean Marina status. The checklist and page numbers referenced with each question correspond to the Indiana Clean Marina Guidebook available at www.IN.gov/dnr/lakemich. Please refer to the guidebook as you answer the questions in the checklist. 2. Fill in the information requested below. Then Numeric Values for Best Management Practices proceed to pages 2-13. Each best management practice (BMP) is assigned a numeric 0 = Required by regulation or law value depending on environmental impact. 1 = Low direct impact in maintaining water quality No points are awarded for BMPs required 3 = Moderate impact in maintaining water quality by regulation or law. Some questions do not 5 = High impact in maintaining water quality have a numeric value because they are leadin questions for related questions that follow. For each question, determine if your facility is currently implementing that BMP. If the answer is yes, write down the available points for that BMP in the "Yes" column. If the answer is no, place a check in the "No" column for that BMP. The "Not Applicable" column is provided so options that do not apply to your marina will not count against you during scoring. For BMPs that do not apply to your marina, write down the available points for that BMP in the "Not Applicable" column. Sum up the points awarded under the "Yes" and "Not Applicable" columns. Record these values in the spaces provided for "Awarded Points" and "Not Applicable Points" at the end of each section (e.g., Storm Water Run-Off) and also in the Point Summary on page 13. 3. Complete the "Comments" section on pages 12-13 if you need to explain any answers or request clarification for any particular best management practice. Please reference the question number. 4. Use the equation at the bottom of page 13 to calculate your cumulative score. Then call the coastal nonpoint coordinator at (219) 921-0863 to discuss your results. NOTE: If you previously qualified for "Clean Marina" status and are currently applying for your annual redesignation, place a check in the "New Best Management Practice?" column for any new best management practices you have added since your previous designation. Mail a copy of the updated checklist and a letter stating your marina still meets the requirements included in the checklist to the above address.
Name of Facility Type of Facility

G Marina (no boatyard)

G Marina (with boatyard)

G Other (e.g., boatyard)

Name of Owner or Manager Address (number and street) City Telephone Number State E-mail Address ZIP Code

Page 1 of 13

INDIANA DEPARTMENT OF NATURAL RESOURCES Lake Michigan Coastal Program State Form 53567 (4-08)

Indiana Clean Marina Program Designation Checklist Page 2 of 13

Indiana Clean Marina Program Designation Checklist
Storm Water Run-Off 1. Permits are required for Standard Industrial Code (SIC) 3732 and some SIC 4493 marinas. If your marina meets these requirements, do you have a National Pollutant Discharge Elimination System permit? See pages 33-38*. 2. Do you allow boat hull maintenance at your marina? This includes services conducted by marina staff, outside contractors, and patrons. You cannot answer "Not Applicable." If "No," proceed to question 12. 3. Do you have designated boat hull maintenance areas away from the water's edge or within a building? See pages 33-38*. 4. Are these areas marked with signage or identified in marina rules for patron usage? See pages 33-38*. 5. Are these areas located on impervious surfaces such as concrete or asphalt? See pages 33-38*. 6. If work areas cannot be located indoors or on impervious surfaces, do you require the use of a tarp? See pages 33-38*. 7. Do you offer/provide tarps to patrons for hull maintenance? See pages 33-38*. Available Points 0 Yes No New Best Not Management Applicable Practice?

No numeric value

5

1

3

1

1

* Indiana Clean Marina Guidebook www.IN.gov/dnr/lakemich

INDIANA DEPARTMENT OF NATURAL RESOURCES Lake Michigan Coastal Program State Form 53567 (4-08)

Indiana Clean Marina Program Designation Checklist Page 3 of 13

Indiana Clean Marina Program Designation Checklist
Storm Water Run-Off (continued) 8. Do you require enclosed spray booths or tarps for sand blasting and sanding that is done outdoors? See pages 33-38*. 9. Do you offer/provide sanders equipped with vacuums to collect hull paint sandings? See pages 33-38*. 10. Do you have a regular maintenance schedule to clean hull maintenance areas? See pages 33-38*. 11. Do you provide patrons and contractors with a list of "yard rules?" See pages 33-38*. 12. Do you have vegetated buffers between impervious surfaces and the marina basin? See pages 33-38*. 13. Do you direct run-off from roofs or other impervious surfaces into vegetated areas? See pages 33-38*. 14. Do you have any mechanical or treatment devices that treat storm water (e.g., filters, oil/water separators, etc.)? See pages 33-38*. 15. Do you have practices in place to control pet waste? See page 47*. 16. Do you discourage patrons from feeding geese, ducks, and sea-gulls at the marina? See page 48*. Available Points 3 Yes No New Best Not Management Applicable Practice?

3

3

1

3

3

3

5 5

Available Awarded Points Points 40 * Indiana Clean Marina Guidebook www.IN.gov/dnr/lakemich

Not Applicable Points

INDIANA DEPARTMENT OF NATURAL RESOURCES Lake Michigan Coastal Program State Form 53567 (4-08)

Indiana Clean Marina Program Designation Checklist Page 4 of 13

Indiana Clean Marina Program Designation Checklist
Fueling Stations 17. A marina that has the capacity to store greater than an aggregate of 1,320 gallons of petroleum above ground or more than 42,000 gallons underground is required to have a spill prevention, control, and countermeasure (SPCC) plan. If your marina falls under these guidelines, do you have an SPCC plan? See pages 111-114*. 18. If you are not legally required to have an SPCC plan under these guidelines, do you still have an SPCC plan or similar plan in place? See pages 111-114*. 19. Are your fueling stations situated in such a way that an accidental spill can be easily contained? See pages 39-42*. 20. Do you train staff in spill prevention, containment, and cleanup procedures? See pages 39-42*. 21. Do you have spill containment equipment available at fuel docks? See pages 39-42*. 22. Do you have oil absorbent pads available at the fuel dock to clean up small drips and spills? See pages 39-42*. 23. Do you have special fueling docks for personal watercraft to help drivers refuel without spilling? See pages 39-42*. Available Points 0 Yes No New Best Not Management Applicable Practice?

5

3

5

5

3

5

* Indiana Clean Marina Guidebook www.IN.gov/dnr/lakemich

INDIANA DEPARTMENT OF NATURAL RESOURCES Lake Michigan Coastal Program State Form 53567 (4-08)

Indiana Clean Marina Program Designation Checklist Page 5 of 13

Indiana Clean Marina Program Designation Checklist
Fueling Stations (continued) 24. Do you require boaters fueling personal watercraft or other vessels at your marina to use a designated fueling station or upland location away from the water? See pages 39-42*. 25. Do you regularly inspect, maintain, and replace fuel hoses, pipes and tanks for fueling stations as necessary? See pages 39-42*. 26. Do you have signs at the fuel dock that explain how to prevent spills while fueling as well as spill reporting procedures? See pages 39-42*. Available Points 3 Yes No New Best Not Management Applicable Practice?

0

1

Available Awarded Points Points 30

Not Applicable Points

* Indiana Clean Marina Guidebook www.IN.gov/dnr/lakemich

INDIANA DEPARTMENT OF NATURAL RESOURCES Lake Michigan Coastal Program State Form 53567 (4-08)

Indiana Clean Marina Program Designation Checklist Page 6 of 13

Indiana Clean Marina Program Designation Checklist
Sewage Facilities 27. A marina located on the state's navigable waters that can accommodate boats equipped with a marine sanitation device must provide pumpouts or enter into a binding agreement with another marina or similar facility along the waterway to provide pumpout services to your patrons. Can your marina accommodate boats equipped with marine sanitation devices? See pages 43-48*. You cannot answer "Not Applicable." If "Yes," please proceed to question 28. If "No," please proceed to question 33. If you are not legally required to implement this measure but are doing so, proceed to question 28. 28. Do you have pumpout or dump stations available at your marina or a contractual agreement with another marina to provide these services to your patrons even though you are not legally required to? See pages 43-48*. 29. Are the station locations well marked by signage and instructions for correct operation posted? See pages 43-48*. 30. Does marina staff assist boaters with pumpout operation? See pages 43-48*. 31. Do you have a regular maintenance schedule to keep pumpout stations clean and in service? See pages 43-48*. * Indiana Clean Marina Guidebook www.IN.gov/dnr/lakemich Available Points 0 Yes No New Best Not Management Applicable Practice?

5

1

3

5

INDIANA DEPARTMENT OF NATURAL RESOURCES Lake Michigan Coastal Program State Form 53567 (4-08)

Indiana Clean Marina Program Designation Checklist Page 7 of 13

Indiana Clean Marina Program Designation Checklist
Sewage Facilities (continued) 32. Do you keep log sheets of pumpout station maintenance? See pages 43-48*. 33. Do you provide clean, wellmaintained public restrooms that are in convenient locations and well marked? See pages 43-48*. Available Points Yes No New Best Not Management Applicable Practice?

5

5

Available Awarded Points Points 24

Not Applicable Points

Solid Waste 34. Do you provide trash receptacles in convenient locations for marina patrons? See pages 49-52*. 35. Are the trash receptacles covered? See pages 49-52*. 36. Are the trash receptacles inspected daily? See pages 49-52*. 37. Do you have recycling facilities available for marina patrons? See pages 49-52*. 38. Do you recycle winter storage shrink wrap? See pages 49-52*. 39. Do you promote used fishing line collection or recycling? See pages 49-52*.

Available Points 5

Yes

No

New Best Not Management Applicable Practice?

3 3 3

3 3

Available Awarded Points Points * Indiana Clean Marina Guidebook www.IN.gov/dnr/lakemich 20

Not Applicable Points

INDIANA DEPARTMENT OF NATURAL RESOURCES Lake Michigan Coastal Program State Form 53567 (4-08)

Indiana Clean Marina Program Designation Checklist Page 8 of 13

Indiana Clean Marina Program Designation Checklist
Fish Waste 40. Do you allow fish cleaning at the marina? You cannot answer "Not Applicable." If "No," proceed to question 44. 41. Do you prohibit boaters from disposing fish waste in the marina basin? See pages 53-54*. 42. Do you prohibit boaters from cleaning fish at the docks? See pages 53-54*. 43. Do you have a designated fish cleaning station that is clearly marked? See pages 53-54*. Available Points No numeric value 0 Yes No New Best Not Management Applicable Practice?

3

5

Available Awarded Points Points 8

Not Applicable Points

Liquid Materials 44. Do you allow boat maintenance (such as, but not limited to, changing of oil, antifreeze, etc.) at your marina? This includes services conducted by marina staff, outside contractors, and patrons. You cannot answer "Not Applicable." If "Yes," please continue to question 45. If "No," proceed to question 50. 45. Do you have an emergency spill response plan? See pages 115-123*. * Indiana Clean Marina Guidebook www.IN.gov/dnr/lakemich

Available Points No numeric value

Yes

No

New Best Not Management Applicable Practice?

5

INDIANA DEPARTMENT OF NATURAL RESOURCES Lake Michigan Coastal Program State Form 53567 (4-08)

Indiana Clean Marina Program Designation Checklist Page 9 of 13

Indiana Clean Marina Program Designation Checklist
Liquid Materials (continued) 46. Do you train employees in spill response? See pages 115-123*. 47. Do you have and maintain appropriate storage areas for materials such as antifreeze, solvents, oil, and paints? See pages 55-57*. 48. Do you recycle liquid materials? See pages 55-57*. 49. Do you provide educational material to patrons and contractors, if applicable, on proper disposal of liquid materials? See pages 55-57*. Available Points Yes No New Best Not Management Applicable Practice?

5

5

3 3

Available Awarded Points Points 20

Not Applicable Points

Petroleum Control
50. Do you prohibit the use of detergents to dissipate fuel spills on the water? See pages 59-60*. 51. Do you provide educational materials to patrons that promote engine and bilge maintenance? See Appendix K on page 175*.

Available Points 3

Yes

No

New Best Not Management Applicable Practice?

3

Available Awarded Points Points 6 * Indiana Clean Marina Guidebook www.IN.gov/dnr/lakemich

Not Applicable Points

INDIANA DEPARTMENT OF NATURAL RESOURCES Lake Michigan Coastal Program State Form 53567 (4-08)

Indiana Clean Marina Program Designation Checklist Page 10 of 13

Indiana Clean Marina Program Designation Checklist
Boat Cleaning 52. Do you provide educational materials to patrons that promote environmentally-friendly boat cleaning practices? See pages 61-64*. 53. Under the Clean Water Act, the National Pollutant Discharge Elimination System (NPDES) Storm Water Permit Program defines boat wash water as "processed water." Discharge of any processed water by a marina or boatyard is illegal nationwide without a formal permit from U.S. EPA or a state government. This permit requirement does not apply to boat owners who are cleaning their own boats, but it does apply to anyone who professionally cleans boats in a marina. If your marina meets these requirements, do you have an NPDES permit? See pages 61-64*. 54. Do you have measures in place that reduce or prevent wastewater from pressure washing from entering waterways? See pages 61-64*. Available Points 3 Yes No New Best Not Management Applicable Practice?

0

5

Available Awarded Points Points 8

Not Applicable Points

* Indiana Clean Marina Guidebook www.IN.gov/dnr/lakemich

INDIANA DEPARTMENT OF NATURAL RESOURCES Lake Michigan Coastal Program State Form 53567 (4-08)

Indiana Clean Marina Program Designation Checklist Page 11 of 13

Indiana Clean Marina Program Designation Checklist
Public Education 55. Do you post signs or utilize bulletins that address the best management practices outlined in the Indiana Clean Marina Guidebook to promote environmentally-friendly boating practices? See pages 65-68*. 56. Do you actively distribute pamphlets, newsletters, or billing inserts to promote environmentally-friendly boating practices? See pages 65-68*. 57. Do you provide educational materials and documented training opportunities to marina employees that promote environmentallyconscious work habits? See pages 65-68*. 58. Do you insert language in marina contracts that promote compliance with marina best management practices? See pages 171-174*. 59. Do you have best management practice agreements for outside contractors? See pages 171-174*. 60. Are your storm drains marked with a "Dump No Waste" type message? See pages 65-68*. Available Points 3 Yes No New Best Not Management Applicable Practice?

3

5

5

5

5

Available Awarded Points Points 26

Not Applicable Points

* Indiana Clean Marina Guidebook www.IN.gov/dnr/lakemich

INDIANA DEPARTMENT OF NATURAL RESOURCES Lake Michigan Coastal Program State Form 53567 (4-08)

Indiana Clean Marina Program Designation Checklist Page 12 of 13

Indiana Clean Marina Program Designation Checklist
Boat Operation 61. Do you have any areas that are considered "no boating" or "no wake" zones or other restrictions to reduce sediment suspension from prop wash or destruction of shallow water habitat? See pages 69-70*. Available Points 5 Yes No New Best Not Management Applicable Practice?

Available Awarded Points Points 5

Not Applicable Points

Exotic & Nuisance Aquatic Species 62. Do you post signs or utilize bulletins to promote best management practices that can reduce the spread of aquatic invasive species? See pages 71-77*. 63. Do you distribute pamphlets, newsletters, or billing inserts to promote best management practices that can reduce the spread of aquatic invasive species? See pages 71-77*.

Available Points 5

Yes

No

New Best Not Management Applicable Practice?

5

Available Awarded Points Points 10

Not Applicable Points

Comments

* Indiana Clean Marina Guidebook www.IN.gov/dnr/lakemich

INDIANA DEPARTMENT OF NATURAL RESOURCES Lake Michigan Coastal Program State Form 53567 (4-08)

Indiana Clean Marina Program Designation Checklist Page 13 of 13

Comments (continued)

Point Summary
Available Points Storm Water Run-Off Fueling Stations Sewage Facilities Solid Waste Fish Waste Liquid Materials Petroleum Control Boat Cleaning Public Education Boat Operation Exotic & Nuisance Aquatic Species 40 30 24 20 8 20 6 8 26 5 10 Total Available Points 197 Total Awarded Points Total Not Applicable Points Awarded Points Not Applicable Points

Equation for Calculating Your Cumulative Score
Total Awarded Points (Total Available Points ­ Total Not Applicable Points) = Multiply by 100 = Cumulative Score:

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