Environmental Inspection Checklist - Capay

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1. General

• A. Facility's overall appearance is good i.e., entrance, buildings, landscaping, direction/speed signs, other. ("Broken Window" Effect)

  Yes

  No

  N/A

• Score

  Select 0/5 1/5 2/5 3/5 4/5 5/5

  • 0/5
  • 1/5
  • 2/5
  • 3/5
  • 4/5
  • 5/5

• Responsible Department

• Priority

  High

  Medium

  Low

• Corrected by next inspection?

  Yes

  No

  N/A

• B. Stored materials are neat and orderly.

  Yes

  No

  N/A

• Score

  0/3

  1/3

  2/3

  3/3

• Responsible Department

• Priority

  High

  Medium

  Low

• Corrected by next inspection?

  Yes

  No

  N/A

• C. Facility is free of general trash or other inappropriate debris on ground.

  Yes

  No

  N/A

• Score

  0/3

  1/3

  2/3

  3/3

• Responsible Department

• Priority

  High

  Medium

  Low

• Corrected by next inspection?

  Yes

  No

  N/A

• D. Facility storage areas are free of unusable materials and other debris.

  Yes

  No

  N/A

• Score

  0/3

  1/3

  2/3

  3/3

• Responsible Department

• Priority

  High

  Medium

  Low

• Corrected by next inspection?

  Yes

  No

  N/A

• E. All trash cans and dumpsters are equipped with lids.

  Yes

  No

  N/A

• Score

  0/1

  1/1

• Responsible Department

• Priority

  High

  Medium

  Low

• Corrected by next inspection?

  Yes

  No

  N/A

• F. Proposition 65 signs are posted throughout the site as required

  Yes

  No

  N/A

• Score

  0/1

  1/1

• Responsible Department

• Priority

  High

  Medium

  Low

• Corrected by next inspection?

  Yes

  No

  N/A

• G. No odor, noise, or other potential nuisance issues are observed.

  Yes

  No

  N/A

• Score

  0/2

  1/2

  2/2

• Responsible Department

• Priority

  High

  Medium

  Low

• Corrected by next inspection?

  Yes

  No

  N/A

• H. No apparent inconsistencies with the site-specific permits or other regulatory requirements (e.g. Use permit, WDR records, etc.), not listed below.

  Yes

  No

  N/A

• Score

  0/4

  1/4

  2/4

  3/4

  4/4

• Responsible Department

• Priority

  High

  Medium

  Low

• Corrected by next inspection?

  Yes

  No

  N/A

• I. Site staff demonstrates good understanding of roles, responsibilities, and environmental requirements.

  Yes

  No

  N/A

• Score

  Select 0/8 1/8 2/8 3/8 4/8 5/8 6/8 7/8 8/8

  • 0/8
  • 1/8
  • 2/8
  • 3/8
  • 4/8
  • 5/8
  • 6/8
  • 7/8
  • 8/8

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• J. Site management conducts regular environmental training with crew (tailgates, Take 5s, on-the-job, etc.)

  Yes

  No

  N/A

• Score

  Select 0/5 1/5 2/5 3/5 4/5 5/5

  • 0/5
  • 1/5
  • 2/5
  • 3/5
  • 4/5
  • 5/5

• Responsible Department

  Sign

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

2. Air

• A. Dust Control Plan is maintained on site and current (if necessary).

  Yes

  No

  N/A

• Score

  0/1

  1/1

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• B. Air permits are posted on site and any required records are current

  Yes

  No

  N/A

• Score

  0/4

  1/4

  2/4

  3/4

  4/4

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• C. Opacity limits (plants and fugitive dust sources) are in compliance at time of inspection.

  Yes

  No

  N/A

• Score

  0/4

  1/4

  2/4

  3/4

  4/4

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• D. Dust and other emissions controls are being utilized and/or maintained.

  Yes

  No

  N/A

• Score

  0/4

  1/4

  2/4

  3/4

  4/4

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• E. Facility is free of visible track out, on public roads, during inspection.

  Yes

  No

  N/A

• Score

  0/3

  1/3

  2/3

  3/3

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• F. No unpermitted or improperly permitted equipment are observed on site.

  Yes

  No

  N/A

• Score

  0/4

  1/4

  2/4

  3/4

  4/4

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

3. Hazardous Materials & Waste Storage

• A. All waste and hazardous materials are stored in a contained, designated area.

  Yes

  No

  N/A

• Score

  0/2

  1/2

  2/2

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• B. Containers, piping, secondary containment a, loading areas, and storage areas are free of spills and leaks.

  Yes

  No

  N/A

• Score

  0/4

  1/4

  2/4

  3/4

  4/4

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• C. Containers are sealed with lids, bungs, etc. and valves are closed.

  Yes

  No

  N/A

• Score

  0/2

  1/2

  2/2

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• D. Containers are properly labeled.

  Yes

  No

  N/A

• Score

  0/4

  1/4

  2/4

  3/4

  4/4

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• E. Containment structures are in good condition with closed valves.

  Yes

  No

  N/A

• Score

  0/1

  1/1

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• F. Hoses are free from visible leakage and stored inside containment structure.

  Yes

  No

  N/A

• Score

  0/1

  1/1

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• G. Storage tank areas have security fencing or other security measures implemented.

  Yes

  No

  N/A

• Score

  0/1

  1/1

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• H. Spill clean-up response tools are materials are maintained near material storage areas.

  Yes

  No

  N/A

• Score

  0/1

  1/1

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• I. Waste is removed in a timely manner: (90 days LQG; 180 days SQG; 1 year Universal Waste.

  Yes

  No

  N/A

• Score

  0/2

  1/2

  2/2

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• J. Waste manifest copies are sent to and retained in a central location in accordance with the established protocol.

  Yes

  No

  N/A

• Score

  0/1

  1/1

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• K. Hazardous Materials Plan, SPCC Plan, and required records are maintained and current.

  Yes

  No

  N/A

• Score

  0/4

  1/4

  2/4

  3/4

  4/4

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• L. Spill Response Procedures and Communication Protocol are current and prominently posted in handling and storage areas.

  Yes

  No

  N/A

• Score

  0/2

  1/2

  2/2

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

4. Storm Water

• A. Storm water runoff and collection ponds are free of visible pollutants and debris.

  Yes

  No

  N/A

• Score

  0/4

  1/4

  2/4

  3/4

  4/4

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• B. BMPs are in place, in good condition, and free of sediment buildup.

  Yes

  No

  N/A

• Score

  0/4

  1/4

  2/4

  3/4

  4/4

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• C. The iterative storm water management process is apparent (e.g. BMPs are improved in response to storm water sampling results).

  Yes

  No

  N/A

• D. Stockpiles, cold is, equipment, and other potential pollutants are maintained away from discharge points and drainage paths are protected.

  Yes

  No

  N/A

• Score

  0/2

  1/2

  2/2

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• E. No unauthorized non-storm water discharges are apparent.

  Yes

  No

  N/A

• Score

  0/2

  1/2

  2/2

• Responsible Department

• Priority

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

• F. Storm Water Pollution Prevention Plan (SWPPP) and required records (NOI, inspections, etc.) are maintained and current.

  Yes

  No

  N/A

Other

• Additional Comments

• Environmental Team Recommendations/Feedback

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• On site representative

  Sign

• Auditor's signature

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