Construction Activities Drive-by inspection

Salt Lake City Public Utilities - Stormwater Program Construction Activities Inspection

• Document No.

• Project Name:

• Conducted on

  Date

Section 1 - General Information:

• Address:
  Address

• Operator:

• Site Contact:

• Contact Phone:

• Contact Email::

• Inspector Name(s):

  Select Greg Archuleta Jason Draper Anthony Garcia Other

  • Greg Archuleta
  • Jason Draper
  • Anthony Garcia
  • Other

Section 2 - Additional Information:

• Permit Number:

• Receiving Waters:

• Weather:

  Sunny

  Cloudy

  Raining

  Snowing

  Other

Section 3 - Site Inspection Check items inspected and any deficiencies. Include Photos and Description of any Deficiencies.

Erosion Controls

• Perimeter Control - Silt Fence, Vegetative Buffer, Cut Back Curb, Etc.

• Comments

• Add media

  Media

• Site Stabilization

• Comments

• Add media

  Media

• Dust Control

• Comments

• Add media

  Media

• Other

• Comments:

• Add media

  Media

• Erosion Control Comments

• Add media

  Media

Sediment Controls

• Inlet Protection

• Comments

• Add media

  Media

• Sediment Basin

• Comments

• Add media

  Media

• Construction Entrance

• Comments

• Add media

  Media

• Other

• Comments

• Add media

  Media

• Sediment Control Comments

• Add media

  Media

Housekeeping

• Trash Control

• Comments

• Add media

  Media

• Port a Potty

• Comments

• Add media

  Media

• Chemicals Storage and Leak Controls

• Comments

• Add media

  Media

• Concrete Washout

• Comments

• Add media

  Media

• Other

• Comments

• Add media

  Media

• Housekeeping Comments

• Add media

  Media

Section 5 - Inspection Summary

• Inspection result:

  No Deficiencies Observed

  Deficiencies Observed

• Summary of actions to be taken:

• Follow-up date

  Date

• Additional photo

  Media

• Comment

• I certify under penalty of 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 properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system or those 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.

• Inspector Signature -

  Sign

• Date:

  Date