Site Information

Environmental Site Visit

  • Facility Name:

  • Add media

  • Areas covered by inspection:

  • Document No.

  • Conducted on

  • Inspection Completed on:

  • ESH Team member(s) completing inspection:

  • Facility Personnel accompanying ESH Team:

  • Do any open items remain from the previous inspection?

  • Open Item Document Number:

  • Was the inspection Report reviewed with the Plant Manager (or designee) prior to leaving the Facility?

  • Please sign as receipt of the attached inspection.

  • Cut and Paste E-mail return receipt if forwarded after leaving the facility.

Water

Water

  • Water inspection Items:

  • Water Inspection Item
  • Location?

  • Describe the item?

  • Photographs:

  • Is this a repeat item?

  • Date of Previous inspection

  • Is this an action item?

  • Corrective Action:

  • Date Corrective Action is to be completed?

Air

Air

  • Air inspection Items:

  • Air Inspection Item
  • Location?

  • Describe the item?

  • Photographs:

  • Is this a repeat item?

  • Date of Previous inspection

  • Is this an action item?

  • Corrective Action:

  • Date Corrective Action is to be completed?

SPCC

SPCC

  • Has annual training been completed for current year?

  • Date of training?

  • Date of last training?

  • SPCC Inspection Items:

  • SPCC Inspection Item
  • Location?

  • Describe the item?

  • Photographs:

  • Is this a repeat item?

  • Date of Previous inspection

  • Is this an action item?

  • Corrective Action:

  • Date Corrective Action is to be completed?

SWPPP

SWPPP

  • Has annual training been completed for current year?

  • Date of training?

  • Date of last training?

  • SWPPP Inspection Items:

  • SWPPP Inspection Item
  • SWPPP Inspection Items:

  • SWPPP Inspection Item
  • Location?

  • Describe the item?

  • Photographs:

  • Is this a repeat item?

  • Date of Previous inspection

  • Is this an action item?

  • Corrective Action:

  • Date Corrective Action is to be completed?

Waste

Waste

  • Waste Inspection items:

  • Waste Inspection Item
  • Location?

  • Describe the item?

  • Photographs:

  • Is this a repeat item?

  • Date of Previous inspection

  • Is this an action item?

  • Corrective Action:

  • Date Corrective Action is to be completed?

Permits

Permitting, documentation, and other.

  • Permitting, Documentation, and other inspection items:

  • Other Inspection Item
  • Location?

  • Describe the item?

  • Photographs:

  • Is this a repeat item?

  • Date of Previous inspection

  • Is this an action item?

  • Corrective Action:

  • Date Corrective Action is to be completed?

Best Management Practices

Best Management Practices

  • Best Management Practices in use:

  • BMP item
  • Location?

  • Describe the item?

  • Photographs:

Comments

Additional Comments:

  • Are there any additional comments:

  • Additional Comments:

  • Add media

Evaluation by facility:

  • Would you like to comment on this inspection method:

  • On a scale of 1 to 10, 10 being the most useful, how would you rate this inspection method?

  • On a scale of 1 to 10, 10 being the most useful, how would you rate you Environmental Manager?

  • On a scale of 1 to 10, 10 being the most useful, how would you rate communication with your Environmental Manager?

  • Additional Comments:

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.