Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Month
- January
- February
- March
- April
- May
- June
- July
- August
- September
- October
- November
- December
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SIC
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INDUSTRY SECTOR
- M
- N
- E
- F
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- Y
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(g) Periodic Inspections-Qualified personnel, who are familiar with industrial activities performed at the facility, shall conduct periodic inspections to determine the effectiveness of the Good Housekeeping, Spill Prevention and Response Measures, Erosion Control Measures, Maintenance Programs for Structural Controls, Best Management Practices, and Employee Training Program. Periodic inspections must be conducted on a frequency of once per quarter or monthly, unless otherwise specified in Part V of this permit, relating to Specific Requirements for industrial activities. The inspection must be documented through the use of a checklist that is developed to include each of the controls and measures that are evaluated. When revisions or additions to the SWP3 are recommended as result of inspections, a summary description of these proposed changes must be attached to the checklist. The summary must identify any necessary time frames required to the proposed changes. The periodic inspections checklists must be made readily available for inspection and review by authorized TCEQ personnel upon request.
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AREAS NEEDING ATTENTION FOR NEXT PERIOD
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Add media
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GOOD HOUSEKEEPING MEASURES
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Are areas clean and organized?
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Are areas clean and orderly? (ie. Trash containers, storage areas, outdoor processing, and loading docks)
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Are there any trash, debris, or staining present at the outfall?
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Are there any other areas that need attention?
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SPILL PREVENTION & RESPONSE MEASURES
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Waste containers provided and used?
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Are all drums, tanks or containers clearly labeled?
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Are there any hazardous materials present? If so, are they clearly labeled?
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Is the spill response posted?
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Are materials and equipment available for spill cleanup?
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Are leaks and spills noted?
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Has there been any significant spills or leaks? If so, has appendix 7 been updated?
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Is secondary containment provided around liquid storage areas?
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Is equipment monitored for leaks and spills? If so, is there a log available?
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EROSION CONTROL MEASURES
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Is vegetation in good condition?
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Is paving adequate?
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Are there any other structural controls needed or in need of attention?
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Was any other erosion noted?
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Are there any other signs of erosion noted at the outfalls?
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MAINTENANCE PROGRAMS FOR STRUCTURAL CONTROLS
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Are oil/water separators use? If so, are they maintained?
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Are catch basins used? If so are they maintained?
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Are sediment ponds used? If so, are they maintained?
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Are grass swales used? If so, are they maintained?
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Are berms used? If so, are they maintained?
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Are fluid storage areas covered?
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Any other structural controls used? If so, are they maintained?
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BEST MANAGEMENT PRACTICES
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Are all BMP's required by the SWP3 being implemented?
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Are additional BMP's needed?
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Have there been any changes in operation that require changes to the SWP3?
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Is the SWP3 up to date?
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Are the maps current?
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Was Visual sample collected this quarter? If so, are the results available in the SWP3?
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Was the Benchmark sample collected? If so, are the results available in the SWP3?
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Was the annual twelve metals collected? If so, are they results available in the SWP3?
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Is the NOI/permit available in the SWP3?
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Is the Pollution Prevention Team correct in the plan?
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Are there any non-storm water discharges? If so, has the SWP3 been updated?
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Is the certification page signed by the proper signatory and available in the SWP3?
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EMPLOYEE TRAINING
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Has employee training been conducted? If not, when is it scheduled? If so, is the content of the training in the SWP3?
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REPORT CERTIFICATION
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This certification is that the information in this report is correct.
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"I certify under penalty of law this document and all attachments were prepared under my direction and supervision under accordance with a system designed to ensure that qualified personnel properly gathered and evaluated the information submitted? Based on my inquiry of the person or person who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations"
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SWP3 Inspector
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Do not sign this certification if there is any noncompliance or corrective action issues identified within this Periodic Site Evaluation
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"I certify under penalty of law this document and all attachments were prepared under my direction and supervision under accordance with a system designed to ensure that qualified personnel properly gathered and evaluated the information submitted? Based on my inquiry of the person or person who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations"
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SWP3 Inspector
