Title Page
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Inspector name and title
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Inspection Date
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Location (canal, yard, project)
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Post storm inspection
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14 day inspection
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7 day inspection
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Current weather conditions
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Date since last inspection
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Weather since last inspection - describe
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Duration of storm event (days or hours)
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Date that storm event started
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Approximate Rainfall (inches)
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Did any discharges occur during the storm event? "At risk" implies an issue
Construction Activities
Current Grading Activities
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Describe the current grading activities and document with a photo
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Grading activity 1 name
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Date activity 1 started
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Photo 1
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Stabilization date or projected date
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Grading activity 2 name
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Date activity 2 started
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Photo 2
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Stabilization date or projected date
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Grading activity 3 name
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Date activity 3 started
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Photo 3
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Stabilization date or projected date
Discharges
Discharges noted
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Include any dewatering activities on site
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Any discharges noted?
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Note the location of the discharge, color, etc.
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Photo 1
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Photo 2
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Photo 3
BMPs
BMPs
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Additional BMPs needed. Add photos here
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Add media
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Add media
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Add media
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Add media
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Add media
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Maintenance- any repairs or replacements noted here w photos
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Add media
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Add media
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Add media
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Add media
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Add media
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Add media
Other
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Are Changes to the SWPPP required?
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Inspectors signature
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Signature in accordance with LAR100000 part VI.G
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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 this 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 also certify that a storm water pollution prevention plan, including both construction and post construction controls, has been prepared for the site in accordance with the permit and that such a plan complies with approved State, Tribal and/or local sediment and erosion plans or permits and/or storm water management plans or permits. I am aware that signature and submittal of the NOI is deemed to constitute my determination of eligibility under one or more of the requirements of Permit Part I.A.3.e(1), related to the Endangered Species Act requirements. To the best of my knowledge, I further certify that such discharges and discharge related activities will not have an effect on properties listed or eligible for listing on the National Register of Historic Places under the National Historic Preservation Act, or are otherwise eligible for coverage under Part I.A.3.f of the permit. I am also aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations.
