Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

General Information

  • Inspection Date?

  • MB Kahn Inspector

  • Sub Inspector

Weather Information

  • Has it Rained since the last inspection?

  • If yes, provide:

  • Approximate Rainfall (in):

  • Weather at time of inspection?

  • Temperature of the day?

Items

  • Unless noted, all previous deficiencies were corrected.

  • For specific locations, reference Appendix B: EP-02 Erosion & Settlement Control located in MB Kahn's Environmental Management Plan.

  • Do any catch basins need corrective action?

  • Corrective action includes but is not limited to: remove gutter buddy install silt bag, clean out leaves and settlement/dirt, replace gutter buddy and silt bag

  • If yes, which ones?

  • If needed, provide pictures below:

  • Do any curb inlets need corrective action?

  • Corrective action includes but is not limited to: remove gutter buddy, clean out leaves and settlement/dirt, replace gutter buddy

  • If yes, which ones?

  • If needed, provide pictures below:

BMPs inspection

  • All inactive slopes and disturbed areas have stabilized?

  • Are natural resource areas (streams, wetlands, mature trees, etc) protected with barriers or similar BMPs?

  • Are all sanitary waste replaces placed in secondary containment and free of leaks?

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

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

  • Are storm drain inlets properly protected?

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

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

  • Are washout facilities (paint, stucco, and concrete) available, clearly marked, and maintained?

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

  • Are materials that are potential storm water contaminants stored inside or under cover?

  • Are non-stormwater discharges (was water or dewatering) properly controlled?

Signatures

  • Inspector

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.