Form 3400-187: Construction Site Inspection Report

Notice: This form was developed in accordance with s. NR 216.48 Wis. Adm. Code for WPDES permittees' convenience; however, use of this specific form is voluntary. Multiple copies of this form may be made to compile the inspection report. Inspections of the construction site and implemented erosion and sediment control best management practices (BMPs) must be performed weekly and within 24 hours after a rainfall event 0.5 inches or greater.

Enter the Construction Site Name and Location (Project, Municipality, and County), the Site/Facility ID No. (FIN), the Onsite Contact/Contractor and the Onsite Phone/Cell.

Enter the Date of inspection and the Time of inspection.

For the Time of inspection, enter Start and End, each with am or pm.

Type of inspection: Weekly, Precipitation Event or Other (specify).

Under Weather/Site Conditions, enter the Temp. in °F, the Last Rainfall Depth in inches and the Last Rainfall Date.

Antecedent Soil Moisture: Dry, Variable or Wet.

Frozen or snow covered: Frozen, Frozen (Thaw predicted in next week) or Melting Snow/slush.

Describe current phase of construction.

Enter the Scheduled Final Stabilization Date for Universal Soil Loss Equation (USLE). The Universal Soil Loss Equation (USLE) model and the Construction Site Soil Loss and Sediment Discharge Guidance are available at: http://dnr.wi.gov/topic/stormwater/standards/const_standards.html

Project on Schedule? Yes No. 2 If the project is not on schedule then the soil loss summary for the project should be reviewed and schedule, plan or practices modified accordingly.

Enter the Name(s) of individual(s) performing inspection and the Inspector Phone/Cell.

I certify that the information contained on this form is an accurate assessment of site conditions at the time of inspection: Inspector Signature, Date.

Inspection Questions: Yes No (Identify Actions Required): Location/Comments: Actions Completed by Date & Initials.

1. Is the erosion control plan accessible to operators? Provide onsite copy.

2. Is the permit certificate posted where visible? Post certificate.

3. Is the current phase of construction on sequence with the site- specific erosion and sediment control plan, including installation/stabilization of ponds and ditches? Add sediment control. Install missing ditch/pipe/pond Stabilize bare soil.

4. Are all erosion and sediment control BMPs shown on plan properly installed and in functional condition? Repair. Modify.

5. Is inlet protection properly installed and functioning in all inlets likely to receive runoff from the site? Clean. Replace. Install.

6. Is the air free of fugitive dust resulting from construction activity and bare soil exposure? Apply water. Apply dust control product.

7. Is the public right of way curb line free of tracked soil and accumulation? Install tracking pad Widen/lengthen pad Amend stone/Add geotextile Install wheel washing station Close entrance/exit Limit traffic across disturbed areas Sweep road and curb line

8. Are wetlands, lakes, streams, ditches, or storm sewers downstream of the site free of sedimentation and turbid water leaving the site? Repair/Replace erosion control Add sediment controls Modify operations. Contact DNR to verify extent of cleanup required. 3 If sediment discharge enters a wetland or waterbody, the permittee should consult with DNR staff to determine if sediment cleanup and/or additional control measures are required.

9. Is dewatering and/or vehicle and equipment washing being done in a manner that prevents erosion and sediment discharge? Install treatment train Install energy dissipation Modify discharge location Modify intake to reduce sediment

10. Are soil stockpiles existing for more than 7 days covered and stabilized? Seed Install mat/mulch/polymer Cover with tarp/plastic sheeting

11. Are downstream channels and other downhill areas protected from scour and erosion? Install energy dissipation at outfall Install ditch checks. Install slope interruption. Install onsite detention.

12. Are good housekeeping practices or treatment controls in place to prevent the discharge of chemicals, cement, trash, and other materials into wetlands, waterways, storm sewers, ditches, or drainage-ways? Properly dispose of trash Provide concrete washout station. 4 The permittee shall notify the DNR immediately via the spills hotline at (800)943-0003 of any release or spill of a hazardous substance to the environment in accordance with s. 292.11, Wis. Stats., and ch. NR 706, Wis. Adm. Code.

13. Is the plan reflective of current site operations and does it address all erosion and sediment control issues identified during the inspection? Revise sequence Revise sediment control BMP Revise erosion control BMP Revise post-construction storm water BMP

14. Are all areas where construction has temporarily ceased (and will not resume for more than 2 weeks) temporarily stabilized? Topsoil & seed Install mat/mulch/polymer Cover with tarp/plastic sheeting

15. Are all areas at final grade permanently vegetated or stabilized with other treatments? Topsoil & seed Install mat/mulch/polymer Sod Install stone base

16. Have temporary sediment controls been removed in areas of the site that meet the permit definition of 'final stabilization'? Water to establish vegetation Repair or reseed areas Remove temporary practices.