Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

General Information

  • Select date

  • Site location

  • Type of inspection

  • Weather at the time of inspection:

  • Are there any discharges at the time of inspection?

  • Do you suspect that discharges may have occurred since the last inspection?

Inspection Details

  • Are all slopes and topsoil stockpiles not actively being worked properly stabilized?

  • Are natural and sensitive resources protected with barriers or similar BMP's?

  • Are perimeter controls and sediment barrier (silt fences, wattles) installed, functional, and maintained?

  • Are discharge points and receiving waters free of sediment deposits?

  • Is sediment being controlled in site and not allowed onto public traveled streets?

  • Is trash/litter/recyclables properly stored and collected in appropriate areas?

  • Are vehicle and equipment fueling, cleaning, lubing, and maintenance areas free of spills, leaks, or any other deleterious material?

  • Is secondary containment adequate, installed, and maintained around required fuel tanks and drums?

  • Are nonstormwater discharges (wash water, dewatering) properly controlled?

  • If there is any visible erosion evidence, are functional BMP's in place?

  • Are stockpiles stabilized and/or protected per permit requirements?

Corrective Actions

  • Enter any corrective actions that will be undertaken.

  • Add media


  • I fully understand that this document is an inspection required by our stormwater pollution prevention plan, and applicable local, state and federal permits. I comply that the information provided from me is true and done to the best of my ability.

  • Add signature

  • Select date

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.