Title Page
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Conducted on
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Prepared by
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Facility Name
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Weather
Quarterly / Comprehensive Site Inspection
OVERALL PLANT OUTSIDE AREAS
All areas
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Spilled materials
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Grassed areas
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Bare spots or soil erosion
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Catch Basins and Drains or Storm Water Pits
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Debris or clogging
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Areas where spills have occurred in the past
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Signs of spillage
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Material storage areas
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Spill potential
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Storm Water Infiltration Basins
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Condition / Empty?
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Old equipment & metal recycling areas
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Spill potential
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Shipping & Receiving areas
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Potential contaminants
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Vehicle holding / storage areas
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Leaks, stains, housekeeping
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Outfalls
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Clear of debris,plant material,culverts
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Outfalls
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ID / Dry Weather flow
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Corroded drums or drums without plugs or covers
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Spill potential
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
No open containers, drums, totes, etc.
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Spill potential
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Corroded or damaged tanks, tank supports, tank drain valves
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Signs of leakage
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Corroded or leaking pipes
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Signs of leakage
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Leaking or improperly closed valves and valve fitting
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Spill potential
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Leaking pumps or hose connections
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Spill potential
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Electrical Transformers
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Signs of leakage
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Hydraulic Systems
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Signs of leakage
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
All areas
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Wind blown dry material
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Facility fencing, security, lighting
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Intact and working
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Manure
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Excessive accumulation
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Live Haul Trailers (Empty/Loaded)
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Stored in proper location
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Loaded trailers (Offal / Dresshaul)
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Stored in proper location
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Wind blown dry materials
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Excessive accumulation
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Spill kits
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Adequately provisioned
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
ABOVEGROUND STORAGE TANKS
Containment structures
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Signs of cracks, damage or leakage
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Valves, fill lines, vents, connections, loading areas
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Signs of leakage
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Aboveground storage tanks
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Signs of leakage
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
SHIPPING / RECEIVING AREAS
Shipping & receiving areas
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Signs of spillage
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Drainage facilities
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Blockage or debris
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Curbing or other stromwater diversion structures
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Damage
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
ROOF AREAS
All plant roofs
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Materials exhausted through vents
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
RECORDS REVIEW
Storm Water Plan
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Up to date and accurate
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Monitoring Data
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Visuals / Analytical
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Training Records
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Current
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Spill Records
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Current
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
Inspection Records
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Current
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COMMENTS/ACTION NEEDED
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Responsible Person
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Corrective Action Taken
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Date Resolved
