Project Name:
Location:
Date of Inspection: Start/End Time:
Inspectors Name:
Inspectors Title:
Inspectors Contact Information:
Describe present phase of construction:
Type of Inspection:
 Regular  Pre-storm event  During storm event  Post-storm event
General InformatIon
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):
Weather at time of this inspection?
 Clear Cloudy  Rain  Sleet  Fog  Snowing  High Winds
 Other: Temperature:
Have any discharges occurred since the last inspection? Yes No
If yes, describe:
Are there any dischar
ges at the time of inspection? Yes No
If yes, describe:
Weather InformatIon
“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 qualied personnel properly gathered and
evaluated the information submitted. Based on my inquiry of the person or persons who manage the 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 am aware that there are signicant penalties for submitting
false information, including the possibility of ne and imprisonment for knowing violations.”
Signature of Inspector Printed Name and Title Date
CertIfICatIon Statement
Stormwater Construction Site
Inspection Report
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overall SIte ISSueS
Below are some general site issues that should be assessed during inspections. Customize this list as needed for
conditions at your site.
BMP/activity Implemented? Maintenance
Required?
Corrective Action Needed
and Notes
1. All inactive slopes and disturbed
areas have been stabilized.
Yes No Yes No
2. Are natural resource areas (e.g.,
streams, wetlands, mature trees, etc.)
protected with barriers or similar
BMPs?
Yes No Yes No
3. Are all sanitary waste recepticles
placed in secondary containment and
free of leaks?
Yes No Yes No
4. Are perimeter controls and sedi-
ment barriers adequately installed
(keyed into substrate) and main-
tained?
Yes No Yes No
5. Are discharge points and receiv-
ing waters free of any sediment
deposits?
Yes No Yes No
6. Are storm drain inlets properly
protected?
Yes No Yes No
7. Is the construction exit preventing
sediment from being tracked into the
street?
Yes No Yes No
8. Is trash/litter from work areas col-
lected and placed in covered dump-
sters?
Yes No Yes No
9. Are washout facilities (e.g., paint,
stucco, concrete) available, clearly
marked, and maintained?
Yes No Yes No
10. Are vehicle and equipment fuel-
ing, cleaning, and maintenance areas
free of spills, leaks, or any other
deleterious material?
Yes No Yes No
11. Are materials that are poten-
tial stormwater contaminants stored
inside or under cover?
Yes No Yes No
12. Are non-stormwater discharges
(e.g., wash water, dewatering) prop-
erly controlled?
Yes No Yes No
13. (Other) Yes No Yes No
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