1. Verify environmental compliance by answering the questions accordingly
2. Add Photos in "Images" and Comments in "Notes" on each question.
3. Add a Corrective Measure in "Action." Provide a description, assign to a member, set priority, and due date
4. Complete the audit by providing a digital signature
5. Share your report by exporting as PDF, Word, Excel or Web Link

15. Environmental - Storm Water

15.1 Is a copy of the stormwater permit located on-site?

15.2 Is a copy of the Storm Water Pollution Prevention Plan (SWPPP) located on-site?

15.3 Is the SWPPP up-to-date? (Note areas which need to be updated.)

15.4 Has employee training been conducted and documented?

15.5 Are inspections being performed and documented according to SWPPP frequency?

15.6 Does the site discharge storm water?

15.7 Have appropriate storm water samples been collected?

15.8 Is the chemical analysis available on-site?

15.9 Have chemical analysis results been submitted to the appropriate regulatory office?

15.10 Are BMP's noted in the SWPPP being followed?

15.11 Is a rain gauge present at the facility and current rainfall information being recorded?

15.12 Are buckets used to catch oil or other open containers covered and/or not exposed to the weather?

15.13 Are storm water discharge locations free of visible silt or other contaminants?

15.14 Is there visible trackout from the facility?

15.15 Is the property and surrounding ditches free of trash and litter?

Overall impression of the Implementation of Supplemental CRH Fundamental # 15. Environmental - Storm Water

16. Environmental - Waste Water

16.1 Is a copy of the NPDES permit on-site?

16.2 Has appropriate sampling been completed?

16.3 Are chemical analysis results within permit allowance?

16.4 Are all controls being properly utilized and not bypassed?

16.5 At sites that do not discharge, are there any areas of concern with the settling ponds?

Overall impression of the Implementation of Supplemental CRH Fundamental # 15. Environmental - Storm Water

17. Environmental - Air

17.1 Is a copy of the air permit on-site?

17.2 Is the facility in compliance with permit conditions? (production limits, hourly limits, temperature readings, etc.)

17.3 If a permit is not required, is appropriate documentation kept on-site? (calculations, rule references, etc.)

17.4 Are sulfur content of fuel records available?

17.5 Is dust controlled on-site? (haul roads, crushers, conveyors, maintenance of other controls, etc.)

17.6 Are Maintenance, Startup, and Shutdown (MSS) Emissions being documented?

17.7 Does facility equipment list match what is being utilized on site? (crushers, engines, conveyors, etc.)

17.8 Are maintenance records for equipment or control equipment available?

17.9 Have all appropriate emission tests (including NSPS "OOO") been performed & documented?

17.10 Are required mix type records maintained on-site?

Overall impression of the Implementation of Supplemental CRH Fundamental # 16. Environmental - Air

18. Environmental - Spill Prevention, Control, and Countermeasures Plan (SPCC)

18.1 If required, is a SPCC maintained on-site?

18.2 Is the information provided in the SPCC current and has it been reviewed in proper intervals (every 5 years)?

18.3 Has annual employee training been conducted and documented?

18.4 Are monthly inspections conducted and documented on-site?

18.5 Is secondary containment drainage log on-site and current?

18.6 Are containment drainage valves closed at the time of inspection?

18.7 Is appropriate secondary containment in place?

18.8 If present on site, are fuel transport tanks emptied or parked in areas that can provide containment?

18.9 Are tanks and drums properly labeled?

18.10 If tanks are not being used, are the tanks empty and marked "Out of Service"?

18.11 Are adequate materials, equipment, & other resources readily available to effectively control a spill?

Overall impression of the Implementation of Supplemental CRH Fundamental # 18. Environmental - Spill Prevention, Control and Countermeasures (SPCC) Plan

19. Environmental - Mining & Dredging

19.1 Is a copy of mining permit or mining authorization on site?

19.2 Are mining practices following applicable mining regulations?

19.3 Are appropriate signs, berms, fences in place?

19.4 If reclamation has started is the reclamation plan being followed?

19.5 Is the site mining in a navigable water, flood plain, or flood way and are all state and federal requirements (404 permits) being met?

Overall impression of the Implementation of Supplemental CRH Fundamental # 19. Environmental - Mining and Dredging

20. Environmental - Good Housekeeping

20.1 Are oil stains from leaks, drips, or small spills present?

20.2 Is used oil managed correctly (burning, labeling, approved haulers, manafests, etc.)?

20.3 Is universal waste handled properly? (batteries, light bulbs, etc.)

20.4 Are part washer solvents, anitfreeze, and other waste materials properly segregated and disposed of?

20.5 Does site appear clean and orderly? (5S, trash/garbage, metal storage, etc.)

20.6 Do floor drains and outfalls have appropriate controls?

20.7 Are SDS available on-site?

Overall impression of the Implementation of Supplemental CRH Fundamental # 20. Environmental - Good Housekeeping

Annual Report Certification

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 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.

Authorized Representative Printed Name, Title and Signature