Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

General Information

  • NPDES Tracking No.

  • Inspection Type

Weather Information

  • Has there been a storm since the last inspection?

  • Wind at time of inspection?

  • Precipitation at time of inspection?

  • Sky at time of inspection?

  • Have any discharges occurred since the last inspection?<br>If yes, describe in comments below.

  • Are there any discharges at time of inspection? <br>If yes , describe in comments below.

Site specific BMP'S

  • South silt fence

  • North silt fence

  • East silt fence

  • West silt fence

  • Inlet protection

  • Erosion control blanket

Overall site issues

  • Are slopes and disturbed areas not actively being worked properly stabilized?

  • Are natural resources areas (e.g., streams,wetlands, mature trees, etc.) protected with barriers or similar BMP'S?

  • Are perimeter controls and sediment barriers adequately installed (keyed into substrate) and main tainted?

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

  • Are Storm drain inlets properly protected?

  • Is the construction exit preventing sediment from being tracked into the street?

  • Is trash/litter from work areas collected and placed in covered dumpsters?

  • Are washout facilities (e.g., paint, stucco, concert) available, clearly marked, and maintained?

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

  • Are materials that are potential storm water contaminants store inside or undercover?

  • Other.

  • Are non-storm water discharges (e.g., wash water, dewatering) properly controlled?

  • Name and title

"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, the information submitted is, to the nest 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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