{"id":19694,"date":"2025-10-09T07:32:58","date_gmt":"2025-10-09T14:32:58","guid":{"rendered":"https:\/\/myehsportal.com\/?page_id=19694"},"modified":"2025-10-09T07:54:16","modified_gmt":"2025-10-09T14:54:16","slug":"visual-assessment-form-pueblo-co","status":"publish","type":"page","link":"https:\/\/myehsportal.com\/es\/visual-assessment-form-pueblo-co\/","title":{"rendered":"Quarterly Visual Assessment Form &#8211; Pueblo, CO"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_30' ><div id='gf_30' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Quarterly Visual Assessment Monitoring Form &#8211; Pueblo, CO<\/h2>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_30'  action='\/es\/wp-json\/wp\/v2\/pages\/19694#gf_30' data-formid='30' novalidate>\n        <div id='gf_progressbar_wrapper_30' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>6<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_16' style='width:16%;'><span>16%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_30_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_30' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_30_101\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p style=\"text-align:left; margin:0 0 10px 0;\">\n  <span style=\"font-family:Tahoma, Arial, Helvetica, sans-serif; font-size:14px; font-weight:400;\">\n    Complete All Form Fields.\n  <\/span>\n<\/p>\n<\/div><div id=\"field_30_1\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_1'>Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_1' id='input_30_1' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_30_1_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_30_1_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_30_1' class='gform_hidden' value='https:\/\/myehsportal.com\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_30_114\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Inspected By:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name has_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_30_114'>\n                            \n                            <span id='input_30_114_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_114.3' id='input_30_114_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_30_114_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_30_114_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_114.6' id='input_30_114_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_30_114_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            <span id='input_30_114_8_container' class='name_suffix  gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_114.8' id='input_30_114_8' value=''   aria-required='false'     \/>\n                                                    <label for='input_30_114_8' class='gform-field-label gform-field-label--type-sub '>Title<\/label>\n                                                <\/span>\n                        <\/div><\/fieldset><fieldset id=\"field_30_124\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Discharge\/Outfall Applicability<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_30_124'>Note: If a facility does not discharge or have designated outfalls, a stormwater monitoring inspection shall be conducted to verify the absence of discharge.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_124'>\n\t\t\t<div class='gchoice gchoice_30_124_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_124' type='radio' value='This facility does not discharge or have designated outfalls.'  id='choice_30_124_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_30_124\"   \/>\n\t\t\t\t\t<label for='choice_30_124_0' id='label_30_124_0' class='gform-field-label gform-field-label--type-inline'>This facility does not discharge or have designated outfalls.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_124_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_124' type='radio' value='This facility has outfalls and\/or discharge may occur.'  id='choice_30_124_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_124_1' id='label_30_124_1' class='gform-field-label gform-field-label--type-inline'>This facility has outfalls and\/or discharge may occur.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_30_127\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Assessment Instructions<\/h3><\/div><div id=\"field_30_95\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Visual assessments shall be made of samples collected in a clean, clear glass or plastic container in a well-lit area within the first 30 minutes (or as soon thereafter as practical) of when the runoff begins discharging from the facility. All samples shall be collected from a storm event that produces measurable discharge and that occurs at least 72 hours from the previously measurable storm event. The 72-hour storm interval is waived when the preceding measurable storm did not yield a \nmeasurable discharge, or if the facility documents that less than a 72-hour interval is representative for local storm events during \nthe sampling period. Samples shall be discarded following evaluation.<\/div><div id=\"field_30_14\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_30_30\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-checkbox gfield--width-full body .gform_wrapper input[type=&#039;radio&#039;], input[type=&#039;checkbox&#039;] { width: inherit!important; } gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Visual Assessment Conditions<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_30_30'>Check all that apply<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_30_30'><div class='gchoice gchoice_30_30_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.1' type='checkbox'  value='Stormwater monitoring inspection conducted in lieu of visual assessment; no discharge from the facility was identified.'  id='choice_30_30_1'   aria-describedby=\"gfield_description_30_30\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_30_30_1' id='label_30_30_1' class='gform-field-label gform-field-label--type-inline'>Stormwater monitoring inspection conducted in lieu of visual assessment; no discharge from the facility was identified.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_30_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.8' type='checkbox'  value='No storm event resulted in measurable discharge during the quarter.'  id='choice_30_30_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_30_2' id='label_30_30_2' class='gform-field-label gform-field-label--type-inline'>No storm event resulted in measurable discharge during the quarter.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_30_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.2' type='checkbox'  value='No measurable discharge occurred during daylight hours during the quarter.'  id='choice_30_30_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_30_3' id='label_30_30_3' class='gform-field-label gform-field-label--type-inline'>No measurable discharge occurred during daylight hours during the quarter.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_30_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.7' type='checkbox'  value='Adverse weather prevented sample collection and examination (explain below).'  id='choice_30_30_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_30_4' id='label_30_30_4' class='gform-field-label gform-field-label--type-inline'>Adverse weather prevented sample collection and examination (explain below).<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_30_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.3' type='checkbox'  value='Sample collected appeared to contain contamination (explain probable sources below).'  id='choice_30_30_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_30_5' id='label_30_30_5' class='gform-field-label gform-field-label--type-inline'>Sample collected appeared to contain contamination (explain probable sources below).<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_30_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.4' type='checkbox'  value='Sample was collected at least 72 hours from previously measurable event.'  id='choice_30_30_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_30_6' id='label_30_30_6' class='gform-field-label gform-field-label--type-inline'>Sample was collected at least 72 hours from previously measurable event.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_30_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.5' type='checkbox'  value='Sample was collected within 72 hours of previously non-measurable storm event (explain below).'  id='choice_30_30_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_30_7' id='label_30_30_7' class='gform-field-label gform-field-label--type-inline'>Sample was collected within 72 hours of previously non-measurable storm event (explain below).<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_30_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.6' type='checkbox'  value='Sample was collected within 72 hours of a measurable event (representative of area, explain below).'  id='choice_30_30_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_30_8' id='label_30_30_8' class='gform-field-label gform-field-label--type-inline'>Sample was collected within 72 hours of a measurable event (representative of area, explain below).<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_30_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.9' type='checkbox'  value='Sample was not collected within the first 30 minutes of discharge (explain below).'  id='choice_30_30_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_30_9' id='label_30_30_9' class='gform-field-label gform-field-label--type-inline'>Sample was not collected within the first 30 minutes of discharge (explain below).<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_30_138\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_138'>Explanation<\/label><div class='gfield_description' id='gfield_description_30_138'>Complete only if applicable.<\/div><div class='ginput_container ginput_container_text'><input name='input_138' id='input_30_138' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_138\"    aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_30_137' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_30_2' class='gform_page pagebreak' data-js='page-field-id-137' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_30_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_30_82\" class=\"gfield gfield--type-section gfield--input-type-section gsection bold-label field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Outfall 1 (O1\/S1)<\/h3><\/div><div id=\"field_30_139\" class=\"gfield gfield--type-section gfield--input-type-section gsection bold-label field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Discharge Appearance<\/h3><\/div><div id=\"field_30_130\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_130'>O1\/S1 &#8211; Color<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_30_130'>Provide details or enter NA<\/div><div class='ginput_container ginput_container_text'><input name='input_130' id='input_30_130' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_130\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_30_131\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_131'>O1\/S1 &#8211; Odor<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_30_131'>Provide details or enter NA<\/div><div class='ginput_container ginput_container_text'><input name='input_131' id='input_30_131' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_131\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_30_133\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_133'>O1\/S1 &#8211; Clarity<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_30_133'>Provide details or enter NA<\/div><div class='ginput_container ginput_container_text'><input name='input_133' id='input_30_133' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_133\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_30_132\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_132'>O1\/S1 &#8211; Solids<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_30_132'>Floating, settled, or suspended or enter NA<\/div><div class='ginput_container ginput_container_text'><input name='input_132' id='input_30_132' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_132\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_30_135\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >O1\/S1 &#8211; Foam<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_30_135'>Select No if not applicable<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_135'>\n\t\t\t<div class='gchoice gchoice_30_135_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_135' type='radio' value='Yes'  id='choice_30_135_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_30_135\"   \/>\n\t\t\t\t\t<label for='choice_30_135_0' id='label_30_135_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_135_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_135' type='radio' value='No'  id='choice_30_135_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_135_1' id='label_30_135_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_30_136\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >O1\/S1 &#8211; Oil Sheen<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_30_136'>Select No if not applicable<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_136'>\n\t\t\t<div class='gchoice gchoice_30_136_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_136' type='radio' value='Yes'  id='choice_30_136_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_30_136\"   \/>\n\t\t\t\t\t<label for='choice_30_136_0' id='label_30_136_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_136_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_136' type='radio' value='No'  id='choice_30_136_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_136_1' id='label_30_136_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_30_134\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_134'>Other<\/label><div class='ginput_container ginput_container_text'><input name='input_134' id='input_30_134' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_30_140' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_30_140' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_30_3' class='gform_page pagebreak' data-js='page-field-id-140' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_30_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_30_141\" class=\"gfield gfield--type-section gfield--input-type-section gsection bold-label field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Outfall 2 (O2\/S2)<\/h3><\/div><div id=\"field_30_142\" class=\"gfield gfield--type-section gfield--input-type-section gsection bold-label field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Discharge Appearance<\/h3><\/div><div id=\"field_30_143\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_143'>O2\/S2 &#8211; Color<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_30_143'>Provide details or enter NA<\/div><div class='ginput_container ginput_container_text'><input name='input_143' id='input_30_143' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_143\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_30_144\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_144'>O2\/S2 &#8211; Odor<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_30_144'>Provide details or enter NA<\/div><div class='ginput_container ginput_container_text'><input name='input_144' id='input_30_144' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_144\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_30_145\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_145'>O2\/S2 &#8211; Clarity<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_30_145'>Provide details or enter NA<\/div><div class='ginput_container ginput_container_text'><input name='input_145' id='input_30_145' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_145\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_30_146\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_146'>O2\/S2 &#8211; Solids<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_30_146'>Floating, settled, or suspended or enter NA<\/div><div class='ginput_container ginput_container_text'><input name='input_146' id='input_30_146' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_146\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_30_148\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >O2\/S2 &#8211; Foam<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_30_148'>Select No if not applicable<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_148'>\n\t\t\t<div class='gchoice gchoice_30_148_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_148' type='radio' value='Yes'  id='choice_30_148_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_30_148\"   \/>\n\t\t\t\t\t<label for='choice_30_148_0' id='label_30_148_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_148_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_148' type='radio' value='No'  id='choice_30_148_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_148_1' id='label_30_148_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_30_147\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >O2\/S2 &#8211; Oil Sheen<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_30_147'>Select No if not applicable<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_147'>\n\t\t\t<div class='gchoice gchoice_30_147_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_147' type='radio' value='Yes'  id='choice_30_147_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_30_147\"   \/>\n\t\t\t\t\t<label for='choice_30_147_0' id='label_30_147_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_147_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_147' type='radio' value='No'  id='choice_30_147_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_147_1' id='label_30_147_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_30_149\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_149'>Other<\/label><div class='ginput_container ginput_container_text'><input name='input_149' id='input_30_149' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_30_92' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_30_92' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_30_4' class='gform_page pagebreak' data-js='page-field-id-92' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_30_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_30_151\" class=\"gfield gfield--type-section gfield--input-type-section gsection bold-label field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Outfall 3 (O3\/S3)<\/h3><\/div><div id=\"field_30_152\" class=\"gfield gfield--type-section gfield--input-type-section gsection bold-label field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Discharge Appearance<\/h3><\/div><div id=\"field_30_153\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_153'>O3\/S3 &#8211; Color<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_30_153'>Provide details or enter NA<\/div><div class='ginput_container ginput_container_text'><input name='input_153' id='input_30_153' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_153\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_30_154\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_154'>O3\/S3 &#8211; Odor<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_30_154'>Provide details or enter NA<\/div><div class='ginput_container ginput_container_text'><input name='input_154' id='input_30_154' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_154\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_30_155\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_155'>O3\/S3 &#8211; Clarity<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_30_155'>Provide details or enter NA<\/div><div class='ginput_container ginput_container_text'><input name='input_155' id='input_30_155' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_155\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_30_156\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_156'>O3\/S3 &#8211; Solids<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_30_156'>Floating, settled, or suspended or enter NA<\/div><div class='ginput_container ginput_container_text'><input name='input_156' id='input_30_156' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_156\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_30_157\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >O3\/S3 &#8211; Foam<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_30_157'>Select No if not applicable<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_157'>\n\t\t\t<div class='gchoice gchoice_30_157_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_157' type='radio' value='Yes'  id='choice_30_157_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_30_157\"   \/>\n\t\t\t\t\t<label for='choice_30_157_0' id='label_30_157_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_157_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_157' type='radio' value='No'  id='choice_30_157_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_157_1' id='label_30_157_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_30_158\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >O3\/S3 &#8211; Oil Sheen<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_30_158'>Select No if not applicable<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_158'>\n\t\t\t<div class='gchoice gchoice_30_158_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_158' type='radio' value='Yes'  id='choice_30_158_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_30_158\"   \/>\n\t\t\t\t\t<label for='choice_30_158_0' id='label_30_158_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_158_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_158' type='radio' value='No'  id='choice_30_158_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_158_1' id='label_30_158_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_30_159\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_159'>Other<\/label><div class='ginput_container ginput_container_text'><input name='input_159' id='input_30_159' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_30_150' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_30_150' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_30_5' class='gform_page pagebreak' data-js='page-field-id-150' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_30_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_30_161\" class=\"gfield gfield--type-section gfield--input-type-section gsection bold-label field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Outfall 4 (O4\/S4)<\/h3><\/div><div id=\"field_30_162\" class=\"gfield gfield--type-section gfield--input-type-section gsection bold-label field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Discharge Appearance<\/h3><\/div><div id=\"field_30_163\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_163'>O4\/S4 &#8211; Color<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_30_163'>Provide details or enter NA<\/div><div class='ginput_container ginput_container_text'><input name='input_163' id='input_30_163' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_163\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_30_164\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_164'>O4\/S4 &#8211; Odor<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_30_164'>Provide details or enter NA<\/div><div class='ginput_container ginput_container_text'><input name='input_164' id='input_30_164' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_164\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_30_165\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_165'>O4\/S4 &#8211; Clarity<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_30_165'>Provide details or enter NA<\/div><div class='ginput_container ginput_container_text'><input name='input_165' id='input_30_165' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_165\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_30_166\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_166'>O4\/S4 &#8211; Solids<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_30_166'>Floating, settled, or suspended or enter NA<\/div><div class='ginput_container ginput_container_text'><input name='input_166' id='input_30_166' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_166\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_30_168\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >O4\/S4 &#8211; Foam<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_30_168'>Select No if not applicable<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_168'>\n\t\t\t<div class='gchoice gchoice_30_168_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_168' type='radio' value='Yes'  id='choice_30_168_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_30_168\"   \/>\n\t\t\t\t\t<label for='choice_30_168_0' id='label_30_168_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_168_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_168' type='radio' value='No'  id='choice_30_168_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_168_1' id='label_30_168_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_30_167\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >O4\/S4 &#8211; Oil Sheen<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_30_167'>Select No if not applicable<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_167'>\n\t\t\t<div class='gchoice gchoice_30_167_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_167' type='radio' value='Yes'  id='choice_30_167_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_30_167\"   \/>\n\t\t\t\t\t<label for='choice_30_167_0' id='label_30_167_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_167_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_167' type='radio' value='No'  id='choice_30_167_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_167_1' id='label_30_167_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_30_169\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_169'>Other<\/label><div class='ginput_container ginput_container_text'><input name='input_169' id='input_30_169' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_30_160' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_30_160' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_30_6' class='gform_page pagebreak' data-js='page-field-id-160' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_30_6' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_30_100\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full bold-text gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p style=\"text-align:left; margin:0 0 14px 0;\">\n  <span style=\"font-family:Tahoma, Arial, Helvetica, sans-serif; font-size:16px; font-weight:700;\"><strong>Certification Statement<\/strong>\n  <\/span>\n<\/p><\/div><div id=\"field_30_26\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >\u201cI 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 contained therein. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information contained 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.\u201d<\/div><fieldset id=\"field_30_115\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Inspected By:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name has_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_30_115'>\n                            \n                            <span id='input_30_115_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_115.3' id='input_30_115_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_30_115_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_30_115_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_115.6' id='input_30_115_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_30_115_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            <span id='input_30_115_8_container' class='name_suffix  gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_115.8' id='input_30_115_8' value=''   aria-required='false'     \/>\n                                                    <label for='input_30_115_8' class='gform-field-label gform-field-label--type-sub '>Title<\/label>\n                                                <\/span>\n                        <\/div><\/fieldset><div id=\"field_30_28\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-full max-width: 100%; gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_28'>Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><input type='hidden' value='' name='input_28' id='input_30_28_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_30_28_Container' class='gfield_signature_container ginput_container' style='height:180px; width:300px; ' ><canvas id='input_30_28' width='300' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/myehsportal.com\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;'><\/canvas><\/div><div id='input_30_28_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id = 'input_30_28_resetbutton' src='data:image\/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' \/ ><\/div><input type='hidden' id='input_30_28_data' name='input_30_28_data' value=''><\/div><\/div><div id=\"field_30_29\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"text-align: center;\">\n  Complete a Corrective Action Form as necessary. <br>\n  Store completed forms in Appendix 13.\n<\/div><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_30' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='submit' id='gform_submit_button_30' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_30' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_30' id='gform_theme_30' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_30' id='gform_style_settings_30' value='{&quot;inputPrimaryColor&quot;:&quot;#204ce5&quot;}' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_30' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='30' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='W8NjLiTRaPHQDfTMkFz97Yr1K+TB2ydG1mt0oy3NjxGb2YK6JJCRMaozWbA\/6L6ZwIfizeya0RbZKllrI\/4xSATM8l2ukxpRUNDE8TW+Gxq1IJo=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_30' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_30' id='gform_target_page_number_30' value='2' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_30' id='gform_source_page_number_30' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n             <\/div><\/div>\n                        <\/form>\n                        <\/div><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\n gform.initializeOnLoaded( function() {gformInitSpinner( 30, 'https:\/\/myehsportal.com\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_30').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_30');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_30').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){jQuery('#gform_wrapper_30').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_30').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_30').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/ jQuery(document).scrollTop(jQuery('#gform_wrapper_30').offset().top - mt); }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_30').val();gformInitSpinner( 30, 'https:\/\/myehsportal.com\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [30, current_page]);window['gf_submitting_30'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_30').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_30').offset().top - mt);jQuery(document).trigger('gform_confirmation_loaded', [30]);window['gf_submitting_30'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_30').text());}else{jQuery('#gform_30').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"30\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = 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