Monthly storm water inspection

• Audit title

• Location
  Address

• Conducted on

  Date

General information

• Facility name - Continental BP Palatka
  

• NPDES Tracking number - FLR05G022

• Date

• Inspector's name

• Inspector's title

• Inspector's contact info

• Inspector's qualifications (Or reference SWPPP)

Weather information

• Weather at time of inspection?

  Select clear cloudy rain sleet fog snow high winds other

  • clear
  • cloudy
  • rain
  • sleet
  • fog
  • snow
  • high winds
  • other

• Other:

• Temperature

• Have any previously unidentified discharges of pollutants occurred since the last inspection? <br>If yes describe.

  yes

  no

• Are any discharges occurring at the time of inspection? <br>If yes describe.

  yes

  no

Control measures

• Is outfall #1 operating effectively?

  Yes

  No

  N/A

• If no, In need of Maintenance, Repair or Replacement?

  Maintenenace

  Repair

  Replace

• Corrective action needed and notes

• Is outfall #2 operating effectively?

  Yes

  No

  N/A

• If no, In need of Maintenance, Repair or Replacement?

  Maintenenace

  Repair

  Replace

• Corrective action needed and notes

• Is outfall #3 operating effectively?

  Yes

  No

  N/A

• If no, In need of Maintenance, Repair or Replacement?

  Maintenenace

  Repair

  Replace

• Corrective action needed and notes

Areas of industrial Materials or Activities exposed to storm water.

• Material loading and unloading and storage areas inspected?

  Yes

  No

  N/A

• Controls adequate?

  Yes

  No

  N/A

• Corrective action needed and notes

• Equipment operations and maintenance areas inspected?

  Yes

  No

  N/A

• Controls adequate?

  Yes

  No

  N/A

• Corrective action needed and notes

• Fueling areas inspected?

  Yes

  No

  N/A

• Controls adequate?

  Yes

  No

  N/A

• Corrective action needed and notes

• Outdoor vehicle and equipment washing areas inspected?

  Yes

  No

  N/A

• Controls adequate?

  Yes

  No

  N/A

• Corrective action needed and notes

• Waste handling and disposal areas inspected?

  Yes

  No

  N/A

• Controls adequate?

  Yes

  No

  N/A

• Corrective action needed and notes

• Erodible/Construction areas inspected?

  Yes

  No

  N/A

• Controls adequate?

  Yes

  No

  N/A

• Corrective action needed and notes

• Dust generation and vehicle tracking areas inspected?

  Yes

  No

  N/A

• Controls adequate?

  Yes

  No

  N/A

• Corrective action needed and notes

• Other areas inspected?

  Yes

  No

  N/A

• Area description

• Controls adequate?

  Yes

  No

  N/A

• Corrective action needed and notes

Non-compliance

• Describe any incidents of non-compliance observed and not described above.

Additional control measures

• Describe any additional control measures needed to comply with the permit requirements.

Notes

• Any additional notes or observations from the inspection.

Certification Statement

• I certify under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering 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.

• Print name and title

• Signature

  Sign

• Date

  Date