Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Section 1 - General Information

  • Inspector Name(s):

  • Reason for inspection

  • Permit #:

  • Permit Signatory:

  • Present at inspection?

  • Were any other individuals present besides the Inspector?

  • Individual:

  • Individual
  • Name:

  • Title:

  • Contact Information:

  • Last inspected by:

  • Were any recommendations or deficiencies noted in previous inspection?

  • Recommendations/Deficiencies noted:

  • Corrective actions taken by IU:

  • Date of last inspection:

  • Date Facility went into operation?

  • Date of initial discharge to POTW:

  • Date of last application/BMR

  • Is this a new CIU (i.e. less than 6 months)?

  • Date of 90 day, if new CIU.

  • Plant Layout/Schematic on file at POTW?

  • Request Plant Layout / Schematic from Permittee.

  • When was the file received?

  • Schematic depicts each of the following items:

  • Location and fate of process discharges (sewer laterals, holding tanks, outfalls, leach fields)

  • All internal and external drains (floor drains, plumbing drains, overflow pipes)

  • Permit monitoring locations

  • All tanks and vessels (day tanks, liquid storage, dry chemicals, fuels, waste holding)

  • Secondary containment tanks, walls and other systems

  • Comments:

  • SIU Permit Signatory:

  • Present at Inspection?

Section 2 - Product or Service Information

  • Brief description of manufacturing or service activity at this facility:

  • SIC Codes:

  • NAIC Codes:

  • Has production rate been affected since the last inspection?

  • How has production rate been affected?

  • Decrease in production.

  • By what percent?

  • Increase in production.

  • By what percent?

  • Industrial Category:

  • Applicable Standards:

  • List products manufactured, indicating the appropriate production units. (Skip if not applicable):

  • Product
  • Product

  • Units

  • List type and amount of raw materials utilized, indicating the appropriate units:

  • Raw Material
  • Material

  • Units

  • Are there any by-products?

  • Please describe:

  • Comments:

Section 3 - Production Information

  • Total hours per day of operation

  • Employees / Schedule:

  • Shift
  • Number of full-time employees:

  • Number of part-time employees:

  • Hours of operation

  • Days of operation:

  • Describe schedule.

  • Is production seasonal?

  • Indicate periods of maximum and minimum production.

  • Do scheduled shutdowns occur?

  • List time period(s):

  • Total days of production for the latest calendar year:

  • Are expansion plans scheduled within the next three (3) years?

  • Which changes are anticipated?

  • New products

  • Same products, additional capacity

  • New facility

  • Expansion of current facility

  • Relocation of facility

  • Relocating within SLC sewer district?

  • Proposed new facility address:

  • Comments:

Section 4 - Water Use Information

  • Water supply information:

  • Public Source

  • Enter SLCDPU Billing Account Number:

  • Surface Water

  • What is the source?

  • What is the flow in GPD?

  • Well Water

  • What is the flow in GPD?

  • Other

  • Specify:

  • What is the flow in GPD?

  • List total average daily plant water use (Gallons):

  • Does usage vary widely during the production day?

  • List maximum periods:

  • Is a boiler in use at the facility?

  • What is the blowdown frequency and quantity?

  • Are corrosion or biological inhibiting chemicals added to facility water systems which are discharged to the sewer?

  • Are raw water treatment processes employed?

  • Water softener

  • Reverse Osmosis (RO)

  • Deionizing System (DI)

  • Other

  • Describe:

  • Is any residue/regenerant disposed to sewer (e.g., reverse osmosis reject)?

  • List type and quantity:

Section 5 - Wastewater Discharge Information

  • Is facility connected to the SLC sanitary sewer system?

  • Sewer Account and/or Service ID Number:

  • What type of system is utilized for wastewater discharge?

  • Does the facility have more than one sanitary sewer connection to the public sewer?

  • How many connections?

  • Is sanitary waste discharged separately to the POTW from process waste?

  • Does IU discharge industrial/process wastewater to the POTW?

  • List sources of industrial/process wastewater discharged to the POTW:

  • source
  • Source:

  • Volume currently discharged:

  • Batch or continuous?

  • Treated prior to discharge?

  • Authorized in Permit?

  • Are any of the process discharges regulated by Federal Categorical Standards?

  • List processes and standards:

  • Does IU conduct process or equipment washes?

  • What days and times do washes normally occur?

  • Describe:

Section 5 (a) - Waste Streams

  • Are waste streams separated at the facility?

  • Is a piping diagram available on site?

Section 5 (b) - Pretreatment

  • Pretreatment System(s) in use?

  • Indicate system(s) used:

  • Dissolved Air floatation (DAF)

  • Chlorination

  • Flow Equalization

  • Grease, Oil, & Sand Interceptor

  • Ion Exchange

  • Flocculation / Precipitation

  • Air Stripping

  • Chemical Precipitation

  • Filtration

  • Grease/Oil Separation

  • Grit Removal

  • Reverse Osmosis

  • Centrifuge

  • Cyanide Destruction

  • Neutralization, pH Control

  • Screening

  • Solvent Separation

  • Sedimentation

  • Evaporation

  • Cyclone

  • Ozonation

  • Other

  • Describe:

  • Comments:

  • Describe the process flow. (Be specific):

  • Does the City have a copy of the Process Flow Diagram (PFD)?

  • Draw, or have the Permitee draw a basic sketch of the process flow.

  • Does the pretreatment system provide "continuous" or "batch" treatment?

  • How many batches are treated per week?

  • Average quantity per batch:

  • Is there a full-time wastewater treatment operator(s)?

  • Provide name, title, and training received:

  • Are all wastewater treatment units in service?

  • Is there a wastewater treatment operations & maintenance manual?

  • Is there a spare parts inventory of critical parts?

  • Which parts?

  • Are there any bypasses?

  • Describe bypass:

  • Potential pollutants:

  • List existing and proposed engineering and operational controls:

  • Are air pollution control devices employed?

  • Describe location:

  • Is a wastewater stream generated?

  • Potential pollutants:

  • Discharge or disposal method:

Section 5 (c) - Pollutants

  • Could pollutants potentially be contained in the wastewater?

  • Check all potential pollutants:

  • Acids and Acidic Waste

  • Alkali and Caustic Wastes

  • Pickling Wastes

  • Metal Cleaning and Preparation Wastes

  • Metal Finishing Wastes

  • Electroplating Wastes

  • Photographic Wastes

  • Latex Wastes

  • Paints and Pigments

  • Glues

  • Inks and Printing Wastes

  • Dyes, Coloring Agents

  • Waxes

  • Soaps, Surfactants, Detergents

  • Oils

  • Fats and Grease

  • Aldehydes, Ketones

  • Ethers

  • Organic Acids

  • Pesticides, Herbicides, Rodenticide

  • Phenol Containing Wastes

  • Benzene and Benzene Derivatives

  • Organic Solvents, Thinners

  • Halogenated Organic Compounds

  • Hot Wastes

  • Radioactive Wastes

  • Other

  • Specify:

  • Which of the above-noted pollutants come into direct contact with water that is discharged to the POTW?

  • Is Permittee subject to any Best Management Practices (BMPs)?

  • Are BMP Requirements implemented appropriately?

  • Comments:

Section 6 - Stored Chemical & Waste Production

  • Are liquid chemicals used/stored in quantities of 55 gallons or more and/or dry chemicals in quantities of 500 pounds or more?

  • List each chemical and amount stored/used:

  • Chemical
  • Chemical name:

  • Amount currently stored:

  • Quantity used:

  • Time frame for quantity used:

  • Does the City have a copy of the chemical inventory?

  • Obtain a copy of the chemical inventory.

  • Comments:

Section 6 (a) - Spill Control

  • Does facility have a written Spill/Slug Discharge Control Plan?

  • Is the Plan Adequate?

  • List Plan deficiencies:

  • Is a copy of the Plan on file at POTW?<br>

  • When was the Plan submitted?

  • Are notification procedures posted in the plant?

  • Describe any spill control methods or facilities:

  • Are employees trained in spill response procedures?

  • Are employees properly trained to handle hazardous waste and other chemicals?

  • Name and title of person responsible for chemicals:

  • Is heavy equipment serviced or cleaned on your property (forklifts, cranes, trucks, etc.)?

  • What provisions are made for disposal of oil, steam cleaning wastes or other wastes?

  • Comments:

Section 6 (b) - Offsite Disposal

  • Are any solid wastes, sludges or other residues generated which require offsite disposal?

  • Provide information for each waste type (Type, Amount Generated, Waste Hauler)

  • Waste type
  • Waste:

  • Amount generated per month GPM:

  • Waste hauler:

  • Disposal location:

  • Hazardous waste?

  • Are all applicable waste manifests and/or shipping records available for review?

  • Comments:

Section 6 (c) - Management of Toxic Organics

  • Is the facility subject to 40 CFR 413 or 433?

  • Has a Toxic Organic Management Plan (TOMP) been submitted and reviewed by the POTW?

  • Is the TTO certification statement being submitted as required?

  • Is the TOMP being implemented and followed as described?

  • How is the TOMP being implemented?

  • Explain: Note deficiencies in TOMP implementation.

  • Are TTOs being monitored?

  • By whom and how often?

  • Which of the required TTOs are being monitored (624, 625, 608, 1613B)?

  • Has a request to utilize alternative TTO monitoring been submitted and reviewed by the POTW?

  • Are the parameters specified by the POTW being monitored?

Section 7 - Self-Monitoring Sampling & Testing

  • Does Industrial User (Permittee) perform all monitoring?

  • Person responsible for sampling:

  • Date IU last sampled wastewater discharge:

  • Type of sample:

  • Composite

  • How many aliquots are being taken?

  • Grab

  • Grab samples are being collected for which of the following?

  • Specify:

  • Are samples properly preserved?

  • Deficiencies observed:

  • Are samples iced or refrigerated as needed?

  • Is pH measured immediately after collection?

  • Measured with a pH meter?

  • How often is the pH meter calibrated?

  • Which buffers are used for calibration?

  • Are calibration logs being kept.

  • Is a continuous recording pH meter used?

  • Are pH records being submitted?

  • Which type of records are being submitted?

  • Is the sampling point identified in the permit being used?

  • Deficiencies observed:

  • Add media

  • Does the IU have written sampling procedures?

  • Do the sampling procedures reference 40 CFR 136?

  • Have the sampling procedures been submitted to the City for approval?

  • Have the procedures been approved?

  • Deficiencies:

  • Are samples being tested by a certified lab?

  • Name of lab:

  • Specify name of lab, and evidence of certification:

  • Contact person:

  • Phone number:

  • Are samples delivered to the lab within holding times?

  • Are 40 CFR 136 procedures being followed?

  • Are self-monitoring reports being submitted according to the permit requirements?

  • Reporting frequency:

  • Are they consistent with results?

  • Sampling frequency:

  • Specify:

  • Did IU monitor for all Permit parameters since the last inspection?

  • Which parameters were not sampled?

  • Has the IU violated any pollutant limits or reporting requirements since the last inspection?

  • Explain:

  • Was the City notified within 24 hours?

  • Was corrective action documented?

  • Was sampling increased in the last reporting period?

Section 8 - Record Keeping

  • Does the Permit require any other reports, such as Zero Discharge Periodic Compliance Reports or TTO certification statements?

  • Have the reports been complete and on time?

  • Has the IU notified the POTW of all sampling (including any non-routine sampling) conducted at the permitted monitoring point?

  • Is the current wastewater discharge control permit on file?

  • Are on-site records maintained and available for review for at least a minimum of five (5) years?

  • Are all reports signed by an authorized representative?

  • Are spill and/or upset/bypass reports being submitted?

  • Comments:

Section 9 - Enforcement

  • Is the IU presently under an informal/formal enforcement action by Salt Lake City?

  • Describe status:

  • Is the IU under a compliance schedule?

  • Are compliance schedule progress reports being submitted?

  • Comments:

Section 10 - Walk Through

  • If visible, are pipes labeled or color coded?

  • Are system alarms or shut off valves in place?

Section 10 (a) - Interior Inspection

  • Chemicals/Raw Materials - Storage and Use

  • Deficiencies observed:

  • Add media

  • Describe chemical storage and containment:

  • Chemicals/Raw Materials - Labeling

  • Deficiencies observed:

  • Add media

  • Waste Storage - Containment

  • Deficiencies observed:

  • Add media

  • Describe waste storage and containment:

  • Waste Disposal

  • Deficiencies observed:

  • Add media

  • Floor Drains - Location

  • Deficiencies observed:

  • Add media

  • Describe floor drain location and pollution potential, where applicable:

  • Floor Drains - Protected from Pollutants

  • Deficiencies observed:

  • Add media

  • Mop Water - Proper Disposal

  • Deficiencies observed:

  • Add media

  • Spill Containment Equipment / Spill Kits

  • Deficiencies observed:

  • Add media

  • Describe spill containment equipment:

  • Maintenance shop, storage, garages, etc.

  • Deficiencies observed:

  • Add media

  • Pretreatment Equipment - Maintenance

  • Deficiencies observed:

  • Add media

  • Pretreatment Equipment - Operation

  • Deficiencies observed:

  • Add media

  • Pretreatment Equipment - Authorized

  • Deficiencies observed:

  • Add media

  • MSDS - Complete

  • Deficiencies observed:

  • Add media

  • MSDS - Available

  • Deficiencies observed:

  • Add media

  • Slug/Spill/Emergency Notification Procedures - Posted

  • Deficiencies observed:

  • Add media

  • Lab - Plumbing

  • Deficiencies observed:

  • Add media

  • How does Permittee dispose of lab waste?

  • Lab - Procedures

  • Deficiencies observed:

  • Add media

  • pH meters/ORP Meters - Provided

  • Deficiencies observed:

  • Add media

  • pH meters/ORP Meters - Properly Calibrated / Complete Records

  • Deficiencies observed:

  • Add media

  • pH meters/ORP Meters - Operation & Maintenance

  • Deficiencies observed:

  • Add media

  • Incompatible chemicals - Properly Separated

  • Deficiencies observed:

  • Add media

  • Chemical Containment - Adequate

  • Deficiencies observed:

  • Add media

  • Flammable Cabinet

  • Deficiencies observed:

  • Add media

  • Sampling Points

  • Add media

  • Deficiencies observed:

  • What manufacturing processes were observed/identified?

  • Additional Comments:

Section 10 (b) - Exterior Inspection

  • Perimeter of Building

  • Deficiencies observed:

  • Add media

  • Storm Drains

  • Deficiencies observed:

  • Add media

  • Location of all storm drains:

  • Outside Chemical Storage Areas - Containment

  • Deficiencies observed:

  • Add media

  • Outside Chemical Storage Areas - Covered

  • Deficiencies observed:

  • Add media

  • Grease removal devices

  • Deficiencies observed:

  • Add media

  • Describe each grease removal device:

  • Device
  • Type

  • Number of chambers:

  • Size:

  • Location:

  • Date of most recent cleaning

  • By whom?

  • Cleaning frequency schedule:

  • Monitoring Points

  • Add media

  • Deficiencies observed:

  • Comments:

Section 11 - Inspection Summary

  • Narrative: Describe the pretreatment system at this facility:

  • If needed, draw a sketch of the pretreatment system:

  • Pretreatment system sketch #2:

  • Pretreatment system sketch #3:

  • Wastewater is free from potential of prohibited pollutant discharges listed in 40 CFR 403.5(b)

  • Describe deficiency:

  • Wastewater is free from potential of pollutant discharges not previously noted.

  • Describe deficiency:

  • Wastewater effluent is not being diluted as a substitute for adequate treatment.

  • Describe deficiency:

  • There is no evidence of spill, upset or bypass.

  • Describe deficiency:

  • There is no evidence of unreported violations.

  • Describe deficiency:

  • Note any action items (facility or POTW) and summarize overall observations of the facility:

  • Information/handouts given to industry (titles: RCRA, Local Limits, etc):

  • Inspection result:

  • Summary of all deficiencies:

  • Follow-up date

  • Summary of actions to be taken:

  • Summary of actions to be taken:

  • Reclassification required?

  • Additional photo

  • Additional photo

  • Additional photo

  • Additional photo

  • Additional photo

Section 12 - Signature Block

  • Inspector Signature:

  • Permitee Signature (or authorized representative):

  • Copy of inspection report to be sent to IU?

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