Information
-
Audit Title
-
Client / Site
-
Conducted on
-
Prepared by
-
Location
-
Personnel
1. General
-
A. Facility's overall appearance is good i.e., entrance, buildings, landscaping, direction/speed signs, other. ("Broken Window" Effect)
-
Score
- 0/5
- 1/5
- 2/5
- 3/5
- 4/5
- 5/5
-
Responsible Department
-
Priority
-
Corrected by next inspection?
-
B. Stored materials are neat and orderly.
-
Score
-
Responsible Department
-
Priority
-
Corrected by next inspection?
-
C. Facility is free of general trash or other inappropriate debris on ground.
-
Score
-
Responsible Department
-
Priority
-
Corrected by next inspection?
-
D. Facility storage areas are free of unusable materials and other debris.
-
Score
-
Responsible Department
-
Priority
-
Corrected by next inspection?
-
E. All trash cans and dumpsters are equipped with lids.
-
Score
-
Responsible Department
-
Priority
-
Corrected by next inspection?
-
F. Proposition 65 signs are posted throughout the site as required
-
Score
-
Responsible Department
-
Priority
-
Corrected by next inspection?
-
G. No odor, noise, or other potential nuisance issues are observed.
-
Score
-
Responsible Department
-
Priority
-
Corrected by next inspection?
-
H. No apparent inconsistencies with the site-specific permits or other regulatory requirements (e.g. Use permit, WDR records, etc.), not listed below.
-
Score
-
Responsible Department
-
Priority
-
Corrected by next inspection?
-
I. Site staff demonstrates good understanding of roles, responsibilities, and environmental requirements.
-
Score
- 0/8
- 1/8
- 2/8
- 3/8
- 4/8
- 5/8
- 6/8
- 7/8
- 8/8
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
J. Site management conducts regular environmental training with crew (tailgates, Take 5s, on-the-job, etc.)
-
Score
- 0/5
- 1/5
- 2/5
- 3/5
- 4/5
- 5/5
-
Responsible Department
-
Priority
-
Completed by next inspection?
2. Air
-
A. Dust Control Plan is maintained on site and current.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
B. Air permits are posted on site and any required records are current.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
C. Opacity limits (dust from equipment and fugitive dust sources) are in compliance at time of inspection.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
D. Dust and other emissions controls are being utilized and/or maintained.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
E. Project is free of visible track out, on public roads, during inspection.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
F. No unpermitted or improperly permitted equipment are observed on site.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
3. Hazardous Materials & Waste Storage
-
A. All waste and hazardous materials are stored in a contained, designated area.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
B. Containers, secondary containments, storage areas, and staging areas are free of spills and leaks.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
C. Containers are sealed with lids, bungs, etc. and valves are closed.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
D. Containers are properly labeled.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
E. Containment structures are in good condition with closed valves.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
F. Spill clean-up response tools and materials are maintained near material storage areas.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
G. Waste is removed in a timely manner: (90 days LQG; 180 days SQG; 1 year Universal Waste.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
H. Hazardous Materials Plan and required records are maintained and current.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
I. Spill Response Procedures and Communication Protocol are current and prominently posted in handling and storage areas.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
4. Storm Water
-
A. Storm water runoff and collection ponds are free of visible pollutants and debris.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
B. BMPs are in place, in good condition, and free of sediment buildup.
-
Score
- 0/6
- 1/6
- 2/6
- 3/6
- 4/6
- 5/6
- 6/6
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
C. Inactive DSAs are covered.
-
Score
- 0/5
- 1/5
- 2/5
- 3/5
- 4/5
- 5/5
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
D. Stockpiles, cold mix, equipment, and other potential pollutants are maintained away from discharge points and drainage paths are protected.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
E. No unauthorized non-storm water discharges appear to have occurred.
-
Score
-
Responsible Department
-
Priority
-
Completed by next inspection?
-
F. Storm Water Pollution Plan and required records (NOI, inspections, training records, etc.) are maintained onsite.
-
Score
- 0/6
- 1/6
- 2/6
- 3/6
- 4/6
- 5/6
- 6/6
-
Responsible Department
-
Priority
-
Completed by next inspection?
Other
-
Additional Comments
-
Environmental Team Recommendations/Feedback
Sign Off
-
On site representative
-
Auditor's signature