Information

  • Document No.

  • Audit Title

  • Project Name

  • Location
  • NPDES Tracking Number

  • Date of Inspection

  • Current Weather Condition

  • Site Activities

  • Type of Inspection

  • Amount of precipitation, duration

  • Inspector Name, Title

  • I certify this inspection is accurate and completed as required per the permit.

  • Date of Completed Maintenance

  • I certify the necessary maintenance was completed relative to this inspection and that the project is in compliance with the permit.

Inspection Checklist

  • Is the inspector a qualified person in accordance with Part 4.1.1?

  • Are you conducting a site inspection in accordance with one of the two schedules listed in Part 4.1.2.1 and 4.1.2.2?

  • Is there a properly maintained rain gauge on your site or the equivalent of on Part 4.1.2.2?

  • All earth disturbing areas have perimeter controls?

  • Sediment track-out on streets, paved areas, and sidewalks from vehicle exiting is minimized according to Part 2.1.2.3?

  • Stockpiles located outside natural buffers protected from stormwater in accordance with Part 2.1.2.4?

  • Is dust minimized in accordance with 2.1.2.5?

  • Has the disturbance of steep slopes been minimized in accordance with Part 2.1.2.6?

  • Adequate installation, protection, and maintenance of storm drain inlets in accordance with Part 2.1.2.9?

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

  • Any sweeping/hosing soil or sediment accumulated on pavement into stormwater conveyances?

  • Have soil stabilization measures been initiated if earth-disturbing activities permanently or temporarily ceased within 14 calendar days in accordance with Parts 2.2.1.1 and 2.2.1.2 following the criteria under Part 2.2.2?

  • Are any of the following being generated at the site; concrete wash water, waste water paint clean out, oils, fuels, soaps, solvents, detergents, or other toxic substances prohibited in Part 2.3.1 and are the materials being properly maintained?

  • All pollution prevention controls installed in accordance with Part 2.3.2 are in effective operating condition?

  • If fueling and/or maintaining equipment or vehicles at the site, are effective means of eliminating the discharges of spilled or leaked chemicals being utilized in accordance with Part 2.3.3.1?

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

  • All storage of products, materials, or wastes are in accordance with the specifications in Part 2.3.3.3?

  • Is trash/litter from work areas collected and placed in respective material dumpsters?

  • Are washout facilities available, clearly marked, and maintained?

  • Are there any signs of visible erosion and sedimentation on or adjacent to the project?

  • Have you inspected all areas that have been cleared, graded, or excavated and that have not yet completed stabilization consistent with Part 2.2?

  • Have you inspected all stormwater controls including pollution prevention measures?

  • Have you inspected all material, waste, borrow, or equipment storage and maintenance areas?

  • Have you inspected all areas where stormwater flows within the site?

  • Have you inspected all points of discharge?

  • Have you inspected all locations where stabilization measures have been implemented?

  • If you must declare a portion of the site unsafe to inspect, describe the reasoning.

VTC1

  • Tracking pad in good condition meeting all specs and requirements?

  • Actions Taken, Date, Initials

19.2

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

WD.1

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

WD.2

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

Prowattle Perimeter Fence

  • Is perimeter fence working properly and free of damage?

  • Actions Taken, Date, Initials

16.13

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

16.12

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

16.11

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

VTC7

  • Tracking pad in good condition meeting all specs and requirements?

  • Actions Taken, Date, Initials

WYN.2

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

WYN.3

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

WYN.4

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

HOV.6

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

HOV.1

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

HOV.2

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

HOV.3

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

HOV.4

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

HOV.5

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

VTC4

  • Tracking pad in good condition meeting all specs and requirements?

  • Actions Taken, Date, Initials

WC.1

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

WC.2

  • Is inlet protection working correctly and free of debris or damage?

  • Actions Taken, Date, Initials

Gradient Slopes and Differentials

  • Are all gradient slopes and differentials working properly and meeting specifications?

  • Actions Taken, Date, Initials

Office Rock Socks

  • Are rock socks working properly and free of debris and damage?

  • Actions Taken, Date, Initials

Seed and Mulch

  • Do areas that are seeded and mulched appear to have good coverage and growth?

  • Actions Taken, Date, Initials

Grout Mixer Containment

  • Is the secondary containment around the mixer working sufficiently and containing leaks or spills?

  • Actions Taken, Date, Initials

Eco-Pan

  • Is the Eco-pan being used only to collect debris and not concrete?

  • Actions Taken, Date, Initials

Office Silt Fence

  • Is the silt fence working properly and free of debris and damage?

  • Actions Taken, Date, Initials

Concrete Washout Systems and Eco Pans

  • Are concrete washout systems and eco pans being maintained properly?

  • Actions Taken, Date, Initials

Chestnut Maintenance Yard

  • Are all materials in the maintenance yard being stored properly and is the area free of spills and erosion?

  • Actions Taken, Date, Initials

Other

  • Are there any other concerns or non-compliant observations on site at this time? (No = Maintenance Needed)

  • Actions Taken, Date, Initials

Other

  • Are there any other concerns or non-compliant observations on site at this time? (No = Maintenance Needed)

  • Actions Taken, Date, Initials

Other

  • Are there any other concerns or non-compliant observations on site at this time? (No = Maintenance Needed)

  • Actions Taken, Date, Initials

Other

  • Are there any other concerns or non-compliant observations on site at this time? (No = Maintenance Needed)

  • Actions Taken, Date, Initials

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.