Stormwater Good Housekeeping

• Document No.

• Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Housekeeping

• Dust/ Gas/ Fumes/ Mist

  Safe

  At Risk

  N/A

• Chemical Spills

  Safe

  At Risk

  N/A

• Diesel Fuel Tank

  Safe

  At Risk

  N/A

• Gasoline Fuel Tank

  Safe

  At Risk

  N/A

• Storage Bins

  Safe

  At Risk

  N/A

• Oustside Storage

  Safe

  At Risk

  N/A

• Inside Storage Area

  Safe

  At Risk

  N/A

• Garbage Dumpster

  Safe

  At Risk

  N/A

• Dumpster Cover

  Safe

  At Risk

  N/A

• Employee Parking

  Safe

  At Risk

  N/A

• Inlets/Drains

  Safe

  At Risk

  N/A

• Environmental Hazards

  Safe

  At Risk

  N/A

• Flammables/ Explosives in Area

  Safe

  At Risk

  N/A

• Wet/ Slippery Surfaces

  Safe

  At Risk

  N/A

CORRECTIVE ACTIONS

• Enter any corrective actions necessary

JOB NOTES

INSPECTION COMPLETED BY

• Name:

  Sign

• Name:

  Sign