INDUSTRIAL STORMWATER INSPECTION LOG

• Document No.

• Audit Title

• Facility Name

• Permit Number

• Conducted on

  Date

• Site Activities

• Current Weather Conditions

• Inspector, Title

• Type of Inspection

  Quarterly

  Run-Off Event

  Storm Event

  Visual Assessment
• Location
  Address

• Location of discharge or samples collected

• Add media

  Media
• Locations
  Address

• I certify that this report is true, accurate, and complete, to the best of my knowledge and belief.

  Sign

• Have observations been made regarding the location of sampling or where stormwater associated with industrial activity is discharged to waters of the state, or to a storm sewer system that drains to waters of the state in accordance with Part I.G.2.a?

  Yes

  No

  N/A

• Have observations been made for the presence of floating materials, visible oil sheen, discoloration, turbidity, odor, etc. in the stormwater discharge(s) per Part I.G.2.b?

  Yes

  No

  N/A

• Have observation been made of the condition of and around stormwater pitfalls, including flow dissipation measures to prevent scouring per Part I.G.2.c?

  Yes

  No

  N/A

• Have observations been made in accordance with Part I.G.2.d of the presence of illicit discharges or other non-permitted discharges?

  Yes

  No

  N/A

• Are all descriptions of potential pollutant sources required under this permit accurate?

  Yes

  No

  N/A

• Has the site map been updated to in the SWMP to reflect the current conditions?

  Yes

  No

  N/A

Rain Event

• Date, time of the start of discharge, time of sampling, duration (in hours) of the rainfall event, and magnitude (in inches) of the storm event sampled

• Duration between the store event and the end of the most recent storm event that produced a discharge

Snowmelt Event

• Date of the sampling event during snowmelt

• Was a grab sample collected? How many?

  Yes

  No

  N/A

• Were the grab samples collected within the first 30 minutes of a measurable storm event?

  Yes

  No

  N/A

• Name and title of personnel collecting the sample

Sample 1

• Location
  Address

• Date collected

  Date

• Nature of discharge

Sample 2

• Location
  Address

• Date collected

  Date

• Nature of discharge

Sample 3

• Location
  Address

• Date collected

  Date

• Nature of discharge

Sample 4

• Location
  Address

• Date collected

  Date

• Nature of discharge

Sample 5

• Location
  Address

• Date collected

  Date

• Nature of discharge

Sample 6

• Location
  Address

• Date collected

  Date

• Nature of discharge

Visual Assessment

• Color

• Odor

• Clarity

• Floating Solids

• Settled Solids

• Suspended Solids

• Foam

• Oil Sheen

• Other obvious indicators of stormwater pollution

Check Dam (N. of Office)

• Is check dam free of damage and signs of erosion?

  Yes

  No

  N/A

Rock Socks (Surrounding N. Dam)

• Are rock socks free of damage and performing their respective duties?

  Yes

  No

  N/A

Check Damn (S. side of parking)

• Is check dam free of damage and signs of erosion?

  Yes

  No

  N/A

Rock Socks (Surrounding S. Dam)

• Are rock socks free of damage and performing their respective duties?

  Yes

  No

  N/A

Tenants

• Is GMCO in compliance with all environmental regulations and expected best management practices?

  Yes

  No

  N/A

• Is Martin Marietta in compliance with all environmental regulations and expected best management practices?

  Yes

  No

  N/A

• Is the pipe fitter company in compliance with all environmental regulations and expected best management practices?

  Yes

  No

  N/A

Retention Pond

• Is the designated outfall into the pond free of debris and waste materials?

  Yes

  No

  N/A

• All drainage paths to pond free of erosion pathways and debris?

  Yes

  No

  N/A

• Is pond free of deficiencies or problems?

  Yes

  No

  N/A

Material Stockpiles

• Are material stockpiles free from signs of weather and water erosion?

  Yes

  No

  N/A

Other

• Are there any other non-compliance issues discovered during the inspection? (No = No discrepancies noted)

  Yes

  No

  N/A