Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

General Information

  • Project Name - Anaheim Regional Transportation Intermodal Center (ARTIC)

  • WDID # - No WDID #

  • Location - Anaheim, CA

  • Inspector's Name and Title: Jason Gilles - Safety Manager

  • Inspector's Contact Information: Jason.Gilles@clarkconstruction.com - Cell: (714)448-3595

  • Inspector's Qualifications: QSP # 23411

  • Date of Inspection and Start Time

  • Describe present phase of construction and site conditions and additional information

  • Type of Inspection

Weather Information

  • Has there been a storm event since the last inspection?<br>If yes please provide Storm event info below (next 3 fields)

  • Storm Start Date and Time

  • Storm Duration (hrs):

  • Approx. Amount of Precipitation

  • Weather at time of inspection:

  • Temperature (F)

  • Other Weather Information:

  • Have any discharges occurred since the last inspection? <br>If yes, describe or comment:

  • Are there any discharges at the time of inspection?<br>If yes, describe:

Site-Specific BMP's

Wind Screen

  • BMP Installed?

  • BMP Maintenance Required?

Construction Entrances

  • BMP Installed?

  • BMP Maintenance Required?

Fiber Rolls

  • BMP Installed?

  • BMP Maintenance Required?

Gravel Bags

  • BMP Installed?

  • BMP Maintenance Required?

Portable Toilets

  • BMP Installed?

  • BMP Maintenance Required?

Materials Yard

  • BMP Installed?

  • BMP Maintenance Required?

Stockpile BMP's

  • BMP Installed?

  • BMP Maintenance Required?

Overall Site Issues

Are all slopes and disturbed areas not actively being worked properly stabilized?

  • Implemented?

  • Maintenance Required?

Are natural resource areas (e.g., streams, wetlands, mature trees, etc.) protected with barriers or similar BMP's?

  • Implemented?

  • Maintenance Required?

Are perimeter controls and sediment barriers adequately installed (keyed into substrate) and maintained?

  • Implemented?

  • Maintenance Required?

Are discharge points and receiving waters free of any sediment deposits?

  • Implemented?

  • Maintenance Required?

Are storm drain and inlets properly protected? (On and off site drains)

  • Implemented?

  • Maintenance Required?

Is/Are the construction exits preventing sediment from being tracked into the street?

  • Implemented?

  • Maintenance Required?

Is trash/litter from work areas collected and placed in covered dumpsters?

  • Implemented?

  • Maintenance Required?

Are washout facilities (e.g., paint, stucco, concrete) available, clearly marked, and maintained?

  • Implemented?

  • Maintenance Required?

Are vehicle and equipment fueling, cleaning, and maintenance areas free of spills, leaks, or any other deleterious materials?

  • Implemented?

  • Maintenance Required?

Are construction materials that are potential stormwater contaminants stored inside or under cover?

  • Implemented?

  • Maintenance Required?

Are non-stormwater discharges (e.g., wash water, dewatering) properly controlled?

  • Implemented?

  • Maintenance Required?

Surplus BMP's?

  • Implemented?

  • Maintenance Required?

SWPPP documentation and Wall Map up to date?

  • Implemented?

  • Maintenance Required?

Certification Statement

  • "I certify under penalty of the law that this document and all attachments were prepared under my direction/ or supervision in accordance with a system designed to assure that qualified personnel gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations."

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