IPS PPC Location Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Location

• Date inspected

  Date

• Inspector signature

  Sign

Monthly PPC inspection items

• 1. Condition of gravel in yard?

  Safe

  At Risk

  N/A

• 1a. Are there any obvious spills in the yard?

  No

  Yes

• 2. Condition of the storm water retention basin?

  Yes

  No

  N/A

• 2a. Is there any evidence of leaks from the retention basin

  Yes

  No

  N/A

• 2b. Is there any evidence of spills in or near retention basin?

  Yes

  No

  N/A

• 2c. Is there any trash in retention basin?

  Yes

  No

  N/A

• 2d. Is there any type of staining indicating a spill or leak?

  Yes

  No

  N/A

• 3. Are there any compromised or damaged storage containers?

  Yes

  No

  N/A

• 4. Are there any compromised or damaged shipping containers?

  Yes

  No

  N/A

• 5. Are there any overflowing containments or barriers?

  Yes

  No

  N/A

• 6. Are there any corroded or leaking valves or fittings?

  Yes

  No

  N/A

• 7. Is there any evidence of cracks or deterioration to containers and ect?

  Yes

  No

  N/A

• 8. Any other issues that might cause a leak or spill?

  Yes

  No

  N/A

• 9. Any non compliance with no exposure certificate for discharges of storm water?

  Yes

  No

  N/A