Information

  • Document No.

  • Project Name:

  • Conducted on

Section 1 - General Information:

  • Project Name:

  • Address:
  • Site Contact:

  • Contact Phone:

  • Type of Inspection:

  • Inspector Name(s):

Section 2 - Additional Information:

  • Permit Number:

  • Weather:

  • Date of Last Rainfall:

  • Duration

  • Approximate Rainfall

  • Other individuals present besides the Inspector?

  • Individual:

  • Individual
  • Name:

  • Title:

  • Contact Information:

Section 3 - Documentation

  • SWPPP Reviewed?

  • SWPPP Document Onsite?

  • City NOI in the SWPPP?

  • State NOI in the SWPPP?

  • SWPPP site plan / Erosion Control Plan Onsite?

  • Has the SWPPP been updated to reflect the current site conditions (modifications dated & initialed on the site map, new BMPs, details and specifications, etc.)

  • Last updated?

  • Operator to update the Erosion Control Plan.

  • Site plan depicts each of the following items:

  • Location of Site BMPs

  • Location of Potential Discharges (fueling areas, trash containers, port-a-potty, concrete washout, etc)

  • Amendment Log

  • Other

  • Require ECP from Operator.

  • SWPPP Document not reviewed.

  • Comments:

Section 4 - Site Inspection Check if there are any Deficiences. Include Photos and Description of any Deficiencies.

Erosion Controls

  • Perimeter Control - Silt Fence, Vegetative Buffer, Cut Back Curb, Etc.

  • Comments

  • Add media

  • Site Stabilization

  • Comments

  • Add media

  • Dust Control

  • Comments

  • Add media

  • Other

  • Comments

  • Add media

  • Erosion Control Comments

Sediment Controls

  • Inlet Protection

  • Comments

  • Add media

  • Sediment Basin

  • Comments

  • Add media

  • Construction Entrance

  • Comments

  • Add media

  • Other

  • Comments

  • Add media

  • Sediment Control Comments

Housekeeping

  • Trash Control

  • Comments

  • Add media

  • Port a Potty

  • Comments

  • Add media

  • Chemicals Storage and Leak Controls

  • Comments

  • Add media

  • Concrete Washout

  • Comments

  • Add media

  • Other

  • Comments

  • Add media

  • Housekeeping Comments

Section 6 - Inspection Summary

  • Inspection result:

  • Summary of actions to be taken:

  • Follow-up date

  • Additional photo

Signature

  • 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 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.

  • Inspector Signature -

  • Date:

  • Operator Signature -

  • Date:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.