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Construction Site Inspection Report Form Appendix G
ll<BVYORKSTAIT
DEP.-IRThl.ENT Of .EN\<1RON!IIENT,'\L CONSERVATION
Dl\'li,lON Of WAT.ER
~ ~,1=
""-- New York State Department of Enviroomental Conservation
Construction Site Inspection Report for SPDES MS4 General Penni! GP--0-24-001
Pro)eci N ame: o.ate:
Pro)!C! Loca'llon: weather.
Permit ' (II' any'): NYR I c ontacted: OYe& ONo Enby Time: I Exft Tkne:
Mame ot S:POES Pi:-rm1ttee: Jn s ~ T)'pe: ~NOT =, COnv,t)IOl
PhOf!e Number{&):: a comp113nce a 1terierra1
OM!le Re~&enlallve(s) ana COfn?.Jny(s}: MS.s Operator Name:
MS~ Pe~ ; ro: NYR2M
SPDES Authority
YN No HfA Citation
I. a a □ ooes me proj ect nave pama coverage? GP-0-20-001: I.A& II, B
2. a □ □ 1, a CtJPY 01 the NOi and AcknowIeogment Leter .n'a!la06e oo see a.nd acceU111Ie ror 'Mwlng? GP-0·20-001: lt D.2
3. a a □ 1, a copy 01 the MS4 S\V?PP Accepunce Foml avaua1:iIe on site anef accest=ID!e ror 'lle-..,.lng? GP-0-20-0J1: I1.D.2
4. a a □ t5 an up-1t><1a~ copy or lhe signed SY/PPP re1a.l'!e:t at ttte cons.iructlon st:e ?" GP-0-20-0J1: ll.0 .2. & II A.4
s. a a □ 1, a copy 01 the SPOf S ~ eral Permit r euIoe<1 at the conslt\lclloo sue? GP-0+20-t'<l1: ll.0 .2
•• a a □ Does Ine NOi accura:ety ri.pon •'!ne mrnbel or acres l o ce alsturtiecr? GP-0·20-001: ll.B..4
:SWPPP coottDt
Yea NO NIA Citation
1. a a □ Does .ne S\V?PP aescrlbe a.tWJ fOffltll'y me ero&IOC'I and &ed!ment con:rot measures to r,e emproye<I? GP-0-20-0:11: ID.6.1.e
•• a a □ Doe6 the S\VPP-P pro\ildie .an rnspecllon sehedtlle ana m.1In1enance re~lranenl5 ror the E&SC measurK? GP-0-20-0:11: IU.6.1.1
9. a a □ Doe6 the SWPP-P aesct10e .lf'l(I klentl!y the slormwa:e, m.3tl~menl pracik:es 10 be- employea? GP-0-20-0:>1: IH.6.2
10. a a □ Does the- S\VPP-P kJenuty tne- contraC:o,{s} and SUbcontrac1or(s} te&pon$1))Ie- tor e-acn measure-? GP-0-20-001: IU.A.6
11. a a □ o oes Ihe S\VPPP raen1lf)' a1Iea.st one 1ra1neo InaI-ri0w I erom t-acn cootractof(s) ana &UDOOntractor(s) companies? GP-0-20-001: IU.A.6
12. a a □ Does t~ S\V?PP l'ICIUde aitne necK&ary C«tl1actor certtteanoo Sbtemen.a ana Signatures? GP--0-20·001: IO.A.6
u . a a □ I&UV! SWPPP ~ e<I 1:/'f the- pennltlee? GP-0-20-0:11: VIUt.2
14. a □ a 1, 'il'Le SWPPP pre,pare<1 by a qt.UlllleO prote6S(onal (Jr po61:-cons:lrucifon stormwal er management requlrea)? GP-0-20-0J1: IH.A.3
,s. □ □ a Do !Tie SM.?s con10nn 10 ltle E.nnanceo Pll06p(lorus Removat su.:,oaras (pn1ec".s rn TMDt wa~enneos)? GP--0-20·0-J1: IU.6.3
Recortt1.aeptng
YN No NfA Citation
16. a □ a Are- ,e,r-inspec:ions per1orme<1 as requr ed oy me perm!I (weekly, o, twice -.-eet ly tor >S au es ail.Wbed} ? GP-0·20-0-J1:Iv .c .2.a. & o
11. □ a a Are me serr-insp?Cbons performe<1 and 6lgne<1 1:>y a quai!le<1 '1&pector ana retaIne<1 on &t:e? GP-0-20·t'<'J1:II.C.2.,IV.C.6 & VILH.3
18. a □ a Do the cr.rallfled ~ specto(s reports lneluele ltle mtntmin f'!POrtlf'.19 req.-emems? GP-0-20-0:11: IV.C.~
19. a □ a Do hspecton reports klenlll'y con?cit,•e mus\#e& trot n.ave not tieen 1mpr,emen1e<1 or arE reclM'flng? GP-0-20-0J1: IV.C.5
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