Quarterly Routine Inspection Form – Lamar, CO

Note: Qualified facility personnel shall perform a routine inspection of all facility areas during operation where industrial materials or activities are exposed to stormwater, and assess how well stormwater BMPs are operating. Inspections will occur at least each quarter. Qualified facility personnel are those who possess the knowledge and skills to assess conditions and activities that could impact facility stormwater quality, and who can also evaluate the effectiveness of BMPs implemented. At least one member of the Stormwater Management Plan Administrator Team shall participate in visual inspections. See Appendix 4 for a listing of the Stormwater Management Administrator Team Members.

"*" indicates required fields

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Routine Inspection Form

Inspection Frequency: Quarterly

Date*

MM slash DD slash YYYY

Time*

Hours

Minutes

AM/PM

Temperature (℉)*

Precipitation*

One inspection during precipitation per year

Sky Conditions*

Wind Conditions*

Inspections Results*

Check all that apply

All industrial materials and/or activities exposed to stormwater, associated stormwater controls, and BMPs were observed and functioning properly. No improvements are needed at this time.

Verified descriptions of potential pollutant sources required under this permit are accurate.

Observed previously unidentified discharges of pollutants (explain below and complete a Non-compliance Notification Form and Preventative/Corrective Maintenance Program Form).

Observed presence of floating materials, visible oil sheen, discoloration, turbidity, odor, etc. in the stormwater discharge.

Observed condition of and around stormwater outfalls, including flow dissipation measures to prevent scouring.

Observed presence of illicit discharges, such as domestic wastewater, non-contact cooling water or process wastewater (including leachate).

Observed control measures needing maintenance or repairs (explain below and complete a Preventive/Corrective Maintenance Form).

Observed failed control measures that need replacement (explain below and complete a Preventive/Corrective Maintenance Form).

Observed incidents of noncompliance (explain below and complete a Non-compliance Notification Form).

Observed the need for additional control measures (explain below and complete a Preventive/Corrective Maintenance Form).

Site map or SWMP requires update(s) to reflect current conditions (explain below).

No inspection this period. Facility is inactive and/or unstaffed and there are no exposed materials or activities.

Explanation*

Required field – please provide details or enter NA if not appliable. Complete additional forms as needed.

Compliance Certification:

“I verify that, to the best of my knowledge and belief, that if any corrective action items were identified during the inspection, those corrective actions are complete, and the site is currently in compliance with the permit.”

Inspected By:*

First Last Title

Signature*

Complete additional forms as necessary.
Complete and attach a BMP Inspection Form.
Store completed forms in Appendix 12.

BMP Inspection Form

Areas of Industrial Materials or Activities Exposed to Stormwater

Inbound Scale; Truck Loading/Unloading Areas

Inspected?*

Yes

Are BMPs Appropriate, Effective, and Operating?*

Yes

Is Corrective Action needed?*

Yes

Retention Stormwater Puddling Area

Inspected?*

Yes

Are BMPs Appropriate, Effective, and Operating?*

Yes

Is Corrective Action needed?*

Yes

Heavy Iron Storage Pile; Gauge Metals & White Goods Storage Pile

Inspected?*

Yes

Are BMPs Appropriate, Effective, and Operating?*

Yes

Is Corrective Action needed?*

Yes

Vehicle Dismantling Area

Inspected?*

Yes

Are BMPs Appropriate, Effective, and Operating?*

Yes

Is Corrective Action needed?*

Yes

Equipment Storage Area

Inspected?*

Yes

Are BMPs Appropriate, Effective, and Operating?*

Yes

Is Corrective Action needed?*

Yes

Nonferrous Storage Area

Inspected?*

Yes

Are BMPs Appropriate, Effective, and Operating?*

Yes

Is Corrective Action needed?*

Yes

250-Gallon Diesel Fuel AST

Inspected?*

Yes

Are BMPs Appropriate, Effective, and Operating?*

Yes

Is Corrective Action needed?*

Yes

Car Storage Area

Inspected?*

Yes

Are BMPs Appropriate, Effective, and Operating?*

Yes

Is Corrective Action needed?*

Yes

Describe any incidents of noncompliance observed:*

Required field – please provide details or enter NA

Describe any additional control measures needed to comply with the permit requirements:*

Required field – please provide details or enter NA

Use this space for any additional notes or observations from the inspection:*

Required field – please provide details or enter NA

Complete a Corrective Action Form as necessary.
Store completed forms in Appendix 12.