Compliance Evaluation Inspection – Industrial Stormwater Discharges SCDHEC Inspector:____________________________________________________________ Inspection Date _______________ Start Time______________ End Time______________ SWP3 Preparation Date __ __/ __ __ / __ __ __ __ Facility Name Site Address Site County Facility Phone _________________________________________________________________ ________________________, City _______________ State ____ Zip ________ _______________, NPDES No._______________________ ________________________________________________________ Owner _________________________________________________________________ Owner Address ________________________, City _______________ State ____ Zip ________ Name and Phone Number of On Site Representative _________________________ ___________________ Name Phone *****************Please verify that names and addresses are correct in EFIS.******************* Provide a general description of the nature of the industrial activities at the facility (Ref 5.1.2b). __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Site Permanently Closed? No Yes Is site eligible for NOT? No Yes At the time of inspection, had a Notice of Intent been submitted? No Yes Is the correct SIC Code <________> listed in EFIS for this permit? No Yes If the SIC Code is not correct, what is it? If applicable, explain below why it has changed. __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ A) SWP3 Details Was there an updated SWP3 on site to review? Yes No Yes No R.61-9.122.41(k) & 5.1.7 R.61-9.122.41(k) & 5.1.7 Is the Plan Signed? Is the Plan Certified? Page 1 of 6 No Yes B) Field Observation Details Yes No Yes Yes Yes Yes Yes Yes Yes Yes No No No No No No No No PCA 48-1-90.a Did you observe a significant off-site impact? Impacted public streets or highways? Impacted adjacent property? Impacted an area stream, lake or river? NA NA NA NA NA NA NA NA 2.1.2.3 2.1.2.3 2.1.2.3 2.1.2.3 2.1.2.3 2.1.2.3 2.1.2.3 2.1.2.5 Were receiving areas maintained? Were shipping areas maintained? Were process areas maintained? Were storage areas maintained? Were fueling areas maintained? Were maintenance areas maintained? Were the drainage structures maintained? Was erosion controlled? Were there any deficiencies noted during Field Observations? No Yes Pertinent Field Observation Notes: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ C) Pollution Prevention Team Details Yes No Yes No Yes No 5.1.1 Does the plan identify team member(s) by name or title? 5.1.1 Does the plan identify each team member's responsibilities? 5.1.1 Do the team's responsibilities address all aspects of the SWP3? 3.4.A Were there any deficiencies with Pollution Prevention Team? No Yes Pollution Prevention Team Notes: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Page 2 of 6 D) Site Map Details Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No No No No No No No No No No No No No No 5.1.2 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 5.1.2 5.1.2 5.1.2 5.1.2 5.1.2 5.1.2 5.1.2 5.1.2 5.1.2 5.1.2 5.1.2 5.1.2 5.1.2 5.1.2 5.1.2 Does the SWP3 have a general location map for this facility? For each question listed below, Does the Site Map indicate the… Siize of the property in acres Location of structures and impervious surfaces Direction of stormwater flow (using arrows) Locations of all existing structural control measures Identify receiving waters, and if they are impaired or if a TMDL is assigned All storm water conveyances (pipes, ditches) Locations of potential pollutant sources Locations of past significant spills or leaks Locations of stormwater monitoring points Storm water inlets and outfalls with unique IDs Outline of area draining to each outfall MS4, where your stormwater discharges to them Location and description of non-stormwater discharges Locations of fueling stations, equipment maintenance, loading and unloading, etc. Location and source of run-on of pollutants from adjacent property Were there any deficiencies with the site map? No Yes Site Map Details Notes: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ E) Potential Pollutant Sources Details For each question listed below, Does the Plan… Yes No NA 5.1.3.1 List industrial activities exposed to stormwater? Yes No NA 5.1.3.2 List an inventory of potential pollutants exposed to rain now or in the past 3 years? Yes No NA 5.1.3.3 Identify where leaks/spills could occur to SW discharges & outfall that may be affected? Yes No NA 5.1.3.3 Identify the leaks/spills that did occur during the past 3 years? Yes No NA 5.1.3.5 Identify the location of any salt storage piles? Yes No NA 5.1.3.6 Include a summary of discharge sampling data? Yes No NA 5.1.3.4 Was a Non-Storm Water (SW) Discharge Evaluation completed? Regarding this evaluation, Yes No NA 5.1.3.4.a. Was the date of the Non-Stormwater Discharge Evaluation identified? Yes No NA 5.1.3.4.b. Included a description of the evaluation criteria that was used? Yes No NA 5.1.3.4 c. Included a list of the outfalls or onsite drainage points that were observed? Yes No NA 5.1.3.4.d. Included a list of the different types of non-SWdischarge(s) and source locations? Yes No NA 5.1.3.4.e. Included a description of the action(s) taken, such as a list of control measures used to eliminate unauthorized discharge(s), if any were identified. Were there any deficiencies with Potential Pollutant Sources? Page 3 of 6 No Yes Potential Pollutant Sources Notes: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ F) Measures and Controls Details Yes Yes Yes Yes No No No No 5.1.5.1 5.1.5.1 5.1.5.1 5.1.5.1 Yes No 2.1.2.6 Does the plan describe the housekeeping procedures? Was the preventative maintenance program adequate? Were the spill prevention and response procedures adequate? Was the employee training effort adequate? (e.g. all employees trained along with specific training for Pollution Prevention Team members on inspections, reporting, etc.) Is stormwater runoff management adequate? (Divert, infiltrate, reuse, reduce?) Were there any deficiencies with Measures and Controls? No Yes Measures and Controls Notes: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ G) Facility Inspections a) Routine Facility Inspections Yes No 4.1.1 Yes No 4.1.1 4.1.2 Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Are routine facility inspections conducted at least once/quarter? Was at least one inspection conducted when stormwater discharge was occurring? Routine inspection documentation must include the following: a) Inspection date and time; b) Name and signature of inspector; c) Weather info and description of any discharge at time of inspection; d) Any previously unidentified discharges of pollutants from site; e) Any control measures needing maintenance or repair; f) Any failed control measures that need replacement; g) Any incidents of noncompliance observed; h) Any additional control measures needed to comply with permit; Were there any deficiencies with Routine Facility Inspections? No Yes Routine Facility Inspections Notes: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Page 4 of 6 b) Quarterly Visual Assessments Yes No 4.2.1 4.2.2 Yes Yes Yes Yes Yes Yes Yes No No No No No No No N/A Are stormwater sample visual assessments conducted at least once/quarter? Note* - Visual assessment of sample must be made in a clean, clear, glass or plastic container. Sample must be collected during first 30 minutes of discharge. Quarterly visual assessment documentation must include the following: a) Sample location. b) Collection date and time, and visual assessment date and time. c) Name and signature of person(s) collecting the sample and performing assessment. d) Nature of the discharge (e.g. runoff, snowmelt). e) Observation results (e.g. color, odor, solids present, foam, oil sheen, etc) f) Probable source of any observed contamination. g) If applicable, why it was not possible to collect sample during first 30 minutes. Were there any deficiencies with Quarterly Visual Assessments? No Yes Quarterly Visual Assessment Notes __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ c) Comprehensive Site Inspections Yes No 4.3.1 4.3.2 Yes Yes Yes Yes No No No No Yes Yes Yes Yes No No No No Are annual comprehensive inspections conducted at this facility? What was the most recent inspection date? _______________ Comprehensive site inspection documentation must include the following: a) Date of inspection. b) Name and title of personnel making the inspection. c) Findings from inspection of areas identified in Part 4.3.1(e) of the Permit. d) Observations related to implementation of control measures including: - previously unidentified discharges - previously unidentified pollutants in discharges - evidence of pollutants discharging from facility outfalls and condition of outfall, including energy dissipation to prevent scouring. - additional control measures needed e) Any SWPPP revisions needed as a result of the inspection. f) Any incidents of noncompliance or certification that the facility is in compliance. g) Certification statement from Appendix B of General Permit. h) Review of DHEC approved TMDLs. Were there any deficiencies with the Comprehensive Site Inspections? No Yes Comprehensive Site Inspections Notes __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Page 5 of 6 H) Discharges to Impaired Waters a) 303d Listed Waters 6.2.4.2a Yes No Yes No N/A Yes No N/A Does the facility discharge to an impaired water that does not have an established TMDL? (i.e. Is the receiving water body or downstream water on the 303d list?) Has the facility monitored (at least 1/year) at each outfall for the pollutant of concern? Note: This monitoring does not apply after 1 year if the pollutant of concern is not detected above natural background levels in the stormwater discharge. If monitoring does not detect the pollutant above natural background levels, has the facility provided written documentation with the SWPPP that the pollutant is not present or not expected to be present in the facility’s stormwater discharge? Were there any deficiencies regarding the 303d Listed Waters? No Yes 303d Listed Waters Notes __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ b) Established Total Maximum Daily Load 6.2.4.2b Yes No Does the facility discharge to a receiving water body which has an approved TMDL? Yes No N/A Has the facility conducted monitoring for the pollutant of concern listed in the TMDL? Note: The facility must conduct sampling for the TMDL pollutant no less than 4 times during the 12 month period after coverage under the permit or after the required annual review of the TMDL list. If monitoring does not detect the pollutant of concern then sampling for that pollutant may be discontinued. If the pollutant is detected and the appropriate water quality standard is not met, monitoring must continue. Progress toward the pollutant reduction goal of the TMDL must be demonstrated. Were there any deficiencies regarding TMDLs? No Yes Established Total Maximum Daily Load Notes __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Page 6 of 6