E & S Inspection Report- AGC

• Project Name

• AFE

• Contractor

• Conducted on

  Date

• Inspected By

• Personnel Present

• Note: Include all information pertinent to Environmental inspection at the time this inspection is conducted. Include entire permitted project name, full inspector name and signature. Attach pictures as necessary. (Do not use symbols in "Project Name" such as # @ $ (/), etc.)

• Answer Every Item Below. If an item is not applicable or "not present", mark as N/A. If a BMP is Insufficient, Mark as AT RISK and Make Repairs within 7 days.

Inspection Type

• Routine

• Post Rain Event

Current Weather On Site- check all that apply

• Sunny

• Overcast/Cloudy

• Snow/Ice Covered

Site Access

• Rock Construction Entrance(s)

  Safe

  At Risk

  N/A

• Off-Site Vehicle Tracking

  Safe

  At Risk

  N/A

• Dust Control

  Safe

  At Risk

  N/A

• Cross-drain Culvert(s)

  Safe

  At Risk

  N/A

• Check Dam(s)<br> Overflow point installed?

  Safe

  At Risk

  N/A

• Road Surface Slope

  Safe

  At Risk

  N/A

• Drainage Dips

  Safe

  At Risk

  N/A

• Road-Side Ditches

  Safe

  At Risk

  N/A

• Wing Ditches/Turnouts

  Safe

  At Risk

  N/A

Vegetation/Soil Management

• Topsoiling<br> Segregated? Mulched <4days? Contained?<br>

  Safe

  At Risk

  N/A

• Seedbed Preparation<br>

  Safe

  At Risk

  N/A

• Vegetated Buffer Zones

  Safe

  At Risk

  N/A

• Hydro-Seeding

  Safe

  At Risk

  N/A

• Seed Tags From Seed Bags Must Be Kept in Project's E & S Folder

• Vegetation Percentage- Enter a Value (0 for active sites)

Slope Stabilization

• Water Bars<br>

  Safe

  At Risk

  N/A

• Soil Roughening or Tracking<br> Tracked perpendicular to slope?

  Safe

  At Risk

  N/A

• Brush Piles<br> Windrowed to Downhill Side?

  Safe

  At Risk

  N/A

• Mulching

  Safe

  At Risk

  N/A

• ECB's, ECRM's, TRMs<br> Straw/Curlex/Geotextile

  Safe

  At Risk

  N/A

• Straw/Hay Bales<br> Replace/Remove <3 months

  Safe

  At Risk

  N/A

• Silt Fencing

  Safe

  At Risk

  N/A

• Silt Sock/ Compost Sock

  Safe

  At Risk

  N/A

• Off-Site/Up Drainage Diverted?

  Safe

  At Risk

  N/A

• Trench Breakers (Ditch Plugs)

  Safe

  At Risk

  N/A

• On-Site Erosion

  Safe

  At Risk

  N/A

Creek/Stream Crossing

• Stream Bank Stabilization <br>

  Safe

  At Risk

  N/A

• ECB's, ECRM's, TRMs<br> Straw/Curlex/Geotextile

  Safe

  At Risk

  N/A

• Rip-Rap Installation

  Safe

  At Risk

  N/A

• Straw/Hay Bales<br> Replace/Remove <3 months

  Safe

  At Risk

  N/A

• Silt Sock/ Compost Sock

  Safe

  At Risk

  N/A

• Active Stream Crossing to Minimum Spec

  Safe

  At Risk

  N/A

• Silt Fencing

  Safe

  At Risk

  N/A

• Upstream Water Quality

  Safe

  At Risk

  N/A

• Downstream Water Quality

  Safe

  At Risk

  N/A

• Instream Sedimentation Accumulation?

  Safe

  At Risk

  N/A

• Mat Bridges<br> Above flow/ Geo Base With Side Boards

  Safe

  At Risk

  N/A

• Flume Pipe<br>

  Safe

  At Risk

  N/A

• Mulching<br> (No Mulch Inside Controls)

  Safe

  At Risk

  N/A

• Check Dams (not in flowing stream)<br>

  Safe

  At Risk

  N/A

• Wetlands Topsoil Stockpiled >50ft Away? <br> Trench Spoil on Geo Material?

  Safe

  At Risk

  N/A

CPF and Well Pads

• Sediment Basins

  Safe

  At Risk

  N/A

• Straw/Hay Bales<br> Replace/Remove <3 months

  Safe

  At Risk

  N/A

• Silt Sock/ Compost Sock

  Safe

  At Risk

  N/A

• Silt Fencing

  Safe

  At Risk

  N/A

• ECB's, ECRM's, TRMs<br> Straw/Curlex/Geotextile

  Safe

  At Risk

  N/A

• Sediment Traps

  Safe

  At Risk

  N/A

• Interceptor Swales (drainage ditches)

  Safe

  At Risk

  N/A

• Spillways, Outlets & Overflows

  Safe

  At Risk

  N/A

Bore Site

• Perimeter Sediment Barrier

  Safe

  At Risk

  N/A

• Generator/ Pump Containment

  Safe

  At Risk

  N/A

• Bore Mud Pit Cuttings Contained Slurry Disposal

  Safe

  At Risk

  N/A

• Unplanned Inadvertent Returns

  Safe

  At Risk

  N/A

General Housekeeping

• Solid Waste Handling

  Safe

  At Risk

  N/A

• Fuel/Chemical Handling

  Safe

  At Risk

  N/A

Summary

• Repairs/Maintenance Needed?

  Safe

  At Risk

  N/A

• Repairs/ Maintenance Performed <7 Days of Last Inspection?

  Safe

  At Risk

  N/A

• Observations/Comments:

• Sketch

  Drawing

• E & S Inspector Signature: (required)

  Sign