Swppp Construction Inspection Report Form – Fill Out and Use This PDF

STATE OF ALASKA

DEPARTMENT OF TRANSPORTATION AND PUBLIC FACILITIES

SWPPP CONSTRUCTION SITE INSPECTION REPORT

Detailed instructions for completing this form can be found on the Alaska Construction Forms website:

http://dot.alaska.gov/stwddes/dcsconst/index.shtml

						1.0 General Information
1.1	Project Name
1.2	Project Number						1.3 Location
1.4	NOI Tracking No.		Contractor’s:					DOT&PF’s:
1.5a Date of Inspection								1.5b Start/End Times:
1.6	Inspectors’ Names		Contractor:					DOT&PF:
1.7	Inspectors’ Titles		Contractor:					DOT&PF:
1.8	Inspectors’		Contractor:					DOT&PF:
Contact Information
1.9a AK-CESCL Cert. No.					Contractor:				DOT&PF:
1.9b AK-CESCL Exp. Date					Contractor:				DOT&PF:

1.10 Describe construction activities

2.0Weather Information

2.1Describe the weather since the last inspection, or start of construction activities if first Inspection.

Check all appropriate boxes.
Clear	Cloudy	Rain	Sleet	Fog	Snow	High Winds	Other:

2.2 Storm events. Complete storm event information if there were any storm events since the last inspection.

Storm event: a rainfall event that produces more than 0.5 inch of precipitation in 24 hours and that is separated from the previous storm event by at least 3 days of less than 0.1 inch of rain per day, CGP C16.

Estimated

Start Date:

Estimated

Duration (#days):

Approximate

Amount of

Precipitation (in):

Form 25D-100 (6/2021)	Page 1 of 7	Project Number:
		Inspection Date:

3.0 Overall Site Issues

For complete instructions, please see instructions on Constructions Forms web page, by separate form

•Overall Site Issue -- These are general site issues that must be assessed during inspections.

•Implemented? – If a BMP should be installed at the time of the inspection and you marked “No” in the “BMP Installed” column, then you must check “Yes” in the “BMP Action Required?” column. If there is good reason to mark “no” in the “BMP Installed” column (such as the BMP is no longer needed and was removed) then you can mark “no” in the “BMP Action Required?” column and explain in the “Comments” column.

•Corrective Action Required? - When maintenance or some other corrective action is required, check “Yes” in this column.

•Corrective Action Required, Complete by Date - When a corrective action is required, before certifying the report, fill in the date when the corrective action can reasonably be expected to be completed. When a corrective action is NOT required, leave the “Complete by Date” blank.

•If Corrective Action is required, describe Action and Location – Anytime you check “Yes” in the “Corrective Action Required?” column, you must fill in the “Describe Corrective Action and Location” column as well.

•Corrective Action Log - When a Corrective Action is required as noted in this report, you must also enter all the information for this action in the Corrective Action Log and document on the Log the actual date of completed correction.

				Corrective		If Corrective Action is
	Overall Site Issue	Response		Action		required, describe	Comments
				Required?		Action and Location
3.1	Have stabilization			Yes	No
	measures been
	initiated on slopes	Yes	No	Complete by
	and disturbed areas
				Date:
	not actively being
	worked?
3.2	Are natural resource
	areas (e.g., streams,
	wetlands, mature			Yes	No
	trees, etc.) required	Yes	No
	by the SWPPP to be			Complete by
	delineated in the			Date:
	field, identified with
	barriers or markings?
3.3	Are perimeter			Yes	No
	controls and sediment
	barriers adequately	Yes	No	Complete by
	installed (keyed into
				Date:
	substrate) and
	maintained?
3.4	Are storm drain inlets			Yes	No
	properly protected?
		Yes	No	Complete by
				Date:
3.5	Are the construction			Yes	No
	exits preventing
	sediment from being	Yes	No	Complete by
	tracked into the			Date:
	street?
3.6	Is trash/litter from
	work areas collected			Yes	No
	and disposed of	Yes	No
	properly?			Complete by
				Date:

Form 25D-100 (6/2021)	Page 2 of 7	Project Number:
		Inspection Date:

				Corrective		If Corrective Action is
	Overall Site Issue	Response		Action		required, describe	Comments
				Required?		Action and Location
3.7	Are washout facilities			Yes	No
	(e.g., paint, concrete)
	available, clearly	Yes	No	Complete by
	marked, and
				Date:
	maintained?
3.8	Are vehicle and
	equipment fueling,			Yes	No
	cleaning, and
	maintenance areas	Yes	No	Complete by
	free of spills, leaks,			Date:
	or any other potential
	pollutants?
3.9	Are materials that are
	potential stormwater			Yes	No
	contaminants stored	Yes	No
	inside or under			Complete by
	cover?			Date:
3.10	Are non-stormwater			Yes	No
	discharges (e.g., wash
	water, dewatering)	Yes	No	Complete by
	properly controlled?			Date:
3.11	Has Spill Response			Yes	No
	kit been used since
	the last inspection?	Yes	No	Complete by
				Date:
3.12	Is the SWPPP Main			Yes	No
	Entrance Signage
	legible and does it	Yes	No	Complete by
	contain the correct			Date:
	information?
3.13	Are erodible			Yes	No
	stockpiles properly
	covered and have a	Yes	No	Complete by
	perimeter control?
				Date:
3.14	Are any additional			Yes	No
	BMPs needed?
		Yes	No	Complete by
				Date:
3.15	(Other)			Yes	No
		Yes	No	Complete by
				Date:

Form 25D-100 (6/2021)	Page 3 of 7	Project Number:
		Inspection Date:

•BMP Identifier -- This column is a mandatory entry used to help correspond BMPs with the site map. Number the structural and non-structural BMPs identified in your SWPPP on your site map and list them below (add as many BMPs as necessary on the continuation sheets).

•BMP and Location - Describe and give the location of the structural and non-structural BMPs identified in your SWPPP in the BMP column below (Include areas that are required to be inspected by the CGP, such as material storage areas that are exposed to precipitation.)

•BMP Installed? – If a BMP should be installed at the time of the inspection and you marked “No” in the “BMP Installed” column, then you must check “Yes” in the “BMP Action Required?” column. If there is good reason to mark “no” in the “BMP Installed” column (such as the BMP is no longer needed and was removed) then you can mark “no” in the “BMP Action Required?” column and explain in the “Comments” column.

•BMP Action Required? - If a BMP needs repair, modification, replacement, maintenance or a new BMP is needed or a SWPPP amendment is needed, then a BMP Action is required.

•BMP Action Required, Complete by Date - Before certifying the report, fill in the date when the BMP Action can reasonably be expected to be completed. When a BMP Action is NOT required, leave the “Complete by Date” blank.

•If BMP Action is required, describe Action and Location – Anytime you check “Yes” for “BMP Action Required,” then you must also fill in the “Describe BMP Action and Location” column.

•Corrective Action Log - When a BMP Action is required as noted in this report, you must also enter all the information for this action in the Corrective Action Log, and document on the Log the actual date of completing correction.