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Fillable Printable Standard Construction Activity Inspection Form

Fillable Printable Standard Construction Activity Inspection Form

Standard Construction Activity Inspection Form

Standard Construction Activity Inspection Form

1
STANDARD INSPECTION FORM
GENERAL PERMIT FOR STORMWATER ASSOCIATED WITH CONSTRUCTION ACTIVITY
General Information
Project Name
Permittee
NOI #
Date of Inspection
Start Time End Time
Inspector’s Name(s)
Green Card Certification #
Inspector’s Contact Information
Describe present phase of
construction
Clearing/Grubbing Rough Grading Infrastructure Demolition
Building Construction Final Grading Final Stabilization
Notes:
Type of Inspection:
Weekly routine Pre-storm event During storm event Post-storm event Due to a discharge of
significant amounts of sediment
Has there been a storm event since the last inspection? Yes No
If yes, provide:
Storm Start Date & Time:
Storm Duration (hrs):
Approximate Amount of Precipitation (in):
Permit Coverage and Plans
Subject
Status
Corrective Action Needed and Notes
Date Corrected
1 Was an NOI submitted for all
disturbed acres?
Yes
No
2 Is the permittee listed above still in
control of permitted activities at the
site? (If no, submit a Transfer of
Authorization form to MDE)
Yes
No
3 Do the approved plans reflect current
site conditions?
Yes
No
4 Are the approved E&S and SWM
plans maintained at the site?
Yes
No
5 Have the E&S or SWM plan approvals
expired?
Yes
No
5 Are all inspection reports and
enforcement actions on file at the site?
Yes
No
6 Is the site permanently stabilized,
temporary erosion and sediment
controls are removed or set to be
removed, and stormwater discharges
from construction activity are
eliminated?
Yes
No
7 If #6 is Yes, has a Notice of
Termination been submitted to MDE?
Yes
No
2
Permit Coverage and Plans
Subject
Status
Corrective Action Needed and Notes
Date Corrected
8 Are all discharges composed entirely
of stormwater or as authorized by the
permit?
Yes
No
Discharge of significant amounts of sediment
Subject Status Notes
Is there evidence of the discharge of
significant amounts of sediment to surface
waters, or conveyance systems leading to
surface waters?
Yes
No
A discharge of significant amounts of sediment may be indicated by (but is not limited to) observations of the following. Note
whether any are observed during this inspection:
1 Earth slides or mud flows Yes
No
2 Concentrated flows of stormwater
such as rills, rivulets or channels that
cause erosion when such flows are not
filtered, settled or otherwise treated to
remove sediment
Yes
No
3 Turbid flows of stormwater that are
not filtered, settled or otherwise
treated to reduce turbidity
Yes
No
4 Deposits of sediment at the
construction site in areas that drain to
unprotected stormwater inlets or catch
basins that discharge directly to
surface waters
Yes
No
5 Deposits of sediment from the
construction site on public or private
streets outside of the permitted
construction activity
Yes
No
6 Deposits of sediment from the
construction site on any adjacent
property outside of the permitted
construction activity
Yes
No
7 Discharges from the construction site
to municipal conveyances, curbs and
gutters, or streams running through or
along the site where visual
observations show that the discharges
differ from ambient conditions in
terms of turbidity so as to indicate
significant amounts of sediment
present in them
Yes
No
3
BMPs
BMP/activity
(some recommended
items to check included
below)
Installed
/Imple-
mented?
Maintenance
Required?
Location Corrective Action Needed and Notes
(note any BMPs required by plans but not yet installed)
Date
Correction
Completed
1 Temporary stabilization
- within 7 or 14 days in
accordance with
26.17.01.07(B)(3)(e)(iv)
Yes
No
Yes
No
2 Permanent stabilization
- within 7 or 14 days in
accordance with
26.17.01.07(B)(3)(e)(iv)
Yes
No
Yes
No
3 Stockpile protection
- check for stabilization,
silt fence or other
controls
Yes
No
Yes
No
4 Are natural resource
areas (e.g., streams,
wetlands, mature trees,
etc.) protected with
barriers or similar
BMPs?
Yes
No
Yes
No
5 Silt fence
- check for proper
installation including
toeing in, stakes and
supports, gaps and tears,
and sediment buildup
Yes
No
Yes
No
6 Check dams, dikes, and
diversion ditches
Yes
No
Yes
No
7 Storm drain inlet
protection
- check for gaps, tears,
sediment buildup
Yes
No
Yes
No
4
BMPs
BMP/activity
(some recommended
items to check included
below)
Installed
/Imple-
mented?
Maintenance
Required?
Location Corrective Action Needed and Notes
(note any BMPs required by plans but not yet installed)
Date
Correction
Completed
8 Construction entrance
- check for trackout, soil
buildup on entrance
Yes
No
Yes
No
9 Sediment basins/traps
- check for sediment
buildup, erosion, proper
outlet structures
Yes
No
Yes
No
10 Outfall protection
- check for erosion,
sediment
Yes
No
Yes
No
11 Is trash/litter from work
areas collected and
placed in covered
dumpsters?
Yes
No
Yes
No
12 Are washout facilities
(e.g., paint, stucco,
concrete) available,
clearly marked, and
maintained?
Yes
No
Yes
No
13 Are vehicle and
equipment fueling,
cleaning, and
maintenance areas free of
spills, leaks, or any other
deleterious material?
Yes
No
Yes
No
14 Are materials that are
potential stormwater
contaminants stored
inside or under cover?
Yes
No
Yes
No
5
BMPs
BMP/activity
(some recommended
items to check included
below)
Installed
/Imple-
mented?
Maintenance
Required?
Location Corrective Action Needed and Notes
(note any BMPs required by plans but not yet installed)
Date
Correction
Completed
15 Are non-stormwater
discharges (e.g., wash
water, dewatering)
properly controlled?
Yes
No
Yes
No
16 (Other)
Yes
No
Yes
No
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