INDUSTRIAL USER COMPLIANCE INSPECTION
CHECKLIST
Inspection Date:
A.
Time:
BACKGROUND INFORMATION
Facility Name:
Address:
Metro Connector:
Name of Responsible Official:
Title:
Phone Number:
Name of Contact:
Title:
Phone Number:
Personnel Present at Inspection:
Industry (Name and Title):
Connector:
Metro:
B.
FACILITY INFORMATION
Industrial Category:
Applicable Federal Regulations:
Permit Effective/Expiration Dates:
Briefly describe the processes used at this facility:
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Note any changes in the processes or wastestreams from those described in the BMR or
previous inspections. Draw a new process diagram, including wastestreams, indicating
any changes. If no change, indicate "NONE."
Were these changes reported to the Connector and Metro?
Yes
No
N/A
Yes
No
N/A
THURS
FRI
Do these changes affect the applicable federal regulations?
(If yes, explain)
C.
SHIFT INFORMATION
Shifts Normally Worked:
SUN
MON
TUES
WED
1st
2nd
3rd
Shift Times:
Average Number of Employees
per shift:
1st
1st
2nd
2nd
3rd
3rd
Normal Operating Months:
full year
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or
JFMAMJJASOND
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SAT
D.
FLOW DATA
Regulated or process Flow Rates:
Avg. Daily Flow
Max. Daily Flow
gpd
gpd
How were these flows measured?
Non-Regulated or Non-Process Flow Rates:
Avg. Daily Flow
Max. Daily Flow
gpd
gpd
How were these flows measured?
E.
SAMPLING
(Explain any NO answers)
Are sampling facilities in satisfactory condition?
Yes
No
Does only regulated process flow pass through the designated sampling points?
Yes
No
IF NO SELF MONITORING REQUIRED, SKIP TO SECTION F.
Is the I.U. performing the minimum amount of sampling as required by the Permit?
Yes
No
Are all samples taken at the designated sampling points? (Inspector should require I.U.
to identify sampling points)
Yes
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No
Are sample types (composite, grab) taken as specified in the discharge permit?
Yes
No
If the discharge is in violation of permit limits, is increased sampling being performed?
Yes
No
N/A
Are samples representative of the discharge during normal operating conditions?
Yes
No
Are samples collected according to accepted sampling procedures?
Yes
No
Yes
No
Yes
No
Do sample test procedures conform to 40 CFR 136?
Is this documented?
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F.
LABORATORY FACILITIES
Is an onsite laboratory used?
Yes
No
Yes
No
Parameters:
Is an offsite laboratory used?
Parameters:
Name of Offsite Laboratory:
Phone:
Contact:
G.
ACCIDENTAL DISCHARGE
Has the I.U. posted a notice advising whom to call in the event of an accidental
discharge?
Yes
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No
H.
PRETREATMENT SYSTEM
Briefly describe the pretreatment system: (IF NONE, INDICATE "NONE," AND SKIP TO
SECTION I)
Is the pretreatment system batch or continuous?
Is there a full time Waste Treatment Operator?
Is he/she certified?
Yes
No
Are all treatment units in service?
Yes
If not, how is the waste being treated?
Yes
No
Certification Level:
No
Is there an O&M manual for the Pretreatment System?
Yes
No
Yes
No
Yes
No
Is there a contingency plan for emergencies relating
to the Pretreatment System?
Can the Pretreatment System be bypassed?
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Are there any sludges produced from the pretreatment process?
(IF NO, SKIP TO SECTION I)
Yes
No
No
N/A
If the sludges produced are hazardous, are they disposed
of via a RCRA manifest?
(If no, explain)
Yes
I.U. ID Number:
Hauler:
Hauler ID Number:
Frequency:
Disposal Site:
Quantities:
If the sludges produced are not hazardous, how are the sludges disposed of?
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I.
TOXIC ORGANIC MANAGEMENT PLAN
IF THE INDUSTRIAL USER IS NOT REGULATED BY CATEGORICAL STANDARDS, OR IF
THE CATEGORICAL STANDARD DOES NOT CONTAIN LIMITS FOR TTOs, SKIP TO
SECTION J.
Does the I.U. monitor for TTOs, submit the TTO certification statement contained in its
permit with each PCR, or monitor alternative parameters (i.e. oil & grease)?
If the I.U. has certified that TTOs are not present in the wastestream, have they submitted
a Toxic Organic Management Plan?
(If no, explain)
Yes
No
Has this plan been implemented?
(If no, explain)
Yes
No
Describe any deficiencies.
List any organic chemicals found onsite which should be covered by the TTO plan.
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J.
SPILL PREVENTION PLAN
Does the industry's permit require a Spill Prevention Plan?
Yes
No
Yes
No
N/A
Yes
No
N/A
Has a Spill Prevention Plan been submitted?
(If no, explain)
Has the Spill Prevention Plan been implemented?
(If no, explain)
Describe any deficiencies in the Plan or its implementation.
Describe any site conditions which should be covered by a Spill Prevention Plan.
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K.
RECORDS MAINTENANCE
Are records onsite and available for inspection?
Yes
No
Are all records pertaining to monitoring kept for a minimum of three years?
Yes
No
Compare industrial user records with connector/Metro records.
discrepancies.
Describe any
Do the monitoring records contain the following information: (IF NO SELF-MONITORING,
SKIP TO SECTION L).
Sample Date?
Sample Location?
Sample Type?
Sample Time?
Sampler Name?
Date analysis was performed?
Lab performing analysis?
Analytical methods used?
Results of analysis?
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
No
No
If the industry performs any onsite sample analysis (e.g., pH) for reporting purposes, are
maintenance, calibration and equipment records kept for all sampling and measuring
equipment or devices?
Yes
No
N/A
Yes
No
N/A
If applicable, are the following records available:
1. Wastewater flow data or water meter readings?
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2. Production data?
Yes
No
N/A
Yes
No
N/A
3. Batch discharge information?
4. Chart recordings of explosion hazard, and/or discharge flow and/or power supply
monitoring?
Yes
No
N/A
Yes
No
N/A
Yes
No
N/A
Yes
No
N/A
5. pH chart recordings?
6. Material waste profiles, income logs and source lists?
7. Records of visual oil and grease observations?
8.
A listing of the volume and character of wastewater transported to the industrial
treatment plant from spills and wrecks?
Yes
9.
No
N/A
Receipts of all perchloroethylene or "perc"-containing products purchased and
disposed?
Yes
No
N/A
Yes
No
N/A
Yes
No
10. Records of removed substances?
Are the records adequate?
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L.
COMPLIANCE INSPECTION MONITORING RESULTS
Was a sample collected during the inspection?
(IF NO, SKIP TO SECTION M)
Yes
Grab Sample?
No
Yes
No
Yes
No
Yes
No
Parameters:
Composite Sample?
Flow Proportioned?
Parameters:
Describe how and where (monitoring point number) the sample was collected. Include
sampling and flow monitoring equipment used, custody procedures, field preservation,
etc.
Sample split with IU?
Yes
Attach a copy of the following forms to this inspection report:
Chain or Custody Form
Laboratory Analysis Report
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No
M.
ENFORCEMENT
Is the IU presently under an informal/formal enforcement action by the Control Authority?
Yes
If yes, describe status:
N.
OTHER FINDINGS
O.
INDUSTRY CONCERNS
P.
SLUG PLAN REVIEW
Q.
POLLUTION PREVENTION MEASURES
INSPECTOR(S)
Signature:
Date:
Signature:
Date:
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No