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STORMWATER MANAGEMENT PLAN
ACTIVITY LOG
IDATE [DESCRIPTION OF ACTIVITY I
STORMWATER MANAGEMENT PLAN
ACTIVITY LOG
STORMWATER FIELD IMPECTION LOG (CDOT FORM ##1176)
COLORADO DEPARTMENT OF TRANSPORTATION
STORMWATER FIELD INSPECTION REPORT AND WEEKLY MEETING NOTES -
.ACTIVE CONSTRUCTION
(1) Project Name:
(2) Project Contractor. (3) SWMP Administrator:
Erosion Control Inspector:
(4/ COOT Project Engineer/CDOT Designee:
(5) Other Attendee(s) (Name and Title):
(6) COOT Project Number.
(7) Project Code (Sub Account #):
(8) COPS-SCP Certification#:
(9) COOT Region:
(10) Date of Project Inspection:
(11) Weather at Time of Inspection:
(12) REASON FOR INSPECTION ! EXCLUSION
❑ Routine Inspection: (minimum every 7 Calendar Days)
Cl Runoff Event: (Post -storm event inspections must be conducted within 24 hours after the end of any precipitation or snowmelt event that causes
surface erosion. If no construction activities will occur following a storm event, post -storm event inspections shall be conducted prior to re -commencing
construction activities, but no later than 72 hours following the storm event. The occurrence of any such delayed inspection must be documented in the
inspection record.) Routine inspections still must be conducted every 7 calendar days.
Storm Start Date: Approximate End Time of Storm (hrs):
❑ Third Party Request:
❑ Winter Conditions Inspections Exclusion: Inspections are not required at sites where construction activities are temporarily halted, snow cover
exists over the entire site for an extended period, and melting conditions posing a risk of surface erosion do not exist. This exception is
applicable anal ++ during the period where melting conditions do not exist, and applies to the routine 7-day inspections, as well as the post -storm -event
inspections. if visual inspection of the site verifies that all of these conditions are satisfied, document the conditions in section 18 (General Notes) and
proceed to section 19 (Inspection Certification). Documentation must include: dates when snow cover occurred, date when construction activities
ceased, and date when melting conditions began.
❑ Other:
(111 SWMP MANAGEMENT
'Yes
No
NA
Reason for N/A
a Is the SWMP notebook located on site?
b Are changes to the SWMP documents noted and approved?
c Are the inspection reports retained in the SWMP notebook?
d Are corrective actions from the last inspection completed?
e Is the Spill Response Plan updated in the SWMP notebook?
f Is a list of 2otential pollutants updated in the SWMP notebook?
11A1 rtIRRFNT MNSTRUCTION ACTIVITIES
b Estimate of disturbed area at the time
of theInsroection
use quidance found in 208.04 e :
Acres
Notes
TemporarV Stabilization.
Interim Stabilization
Permanent Stabilization Completed
c Has the SWMP Phased BMP Implementation Matrix been updated? ❑ Yes ❑ No
WFFKI Y MFFTINr, NOTFS
Page 1 of 5 CDOT Form #1176 2/16
(16) CONSTRUCTION SITE ASSESSMENT & CORRECTIVE ACTIONS "Off site Pollutant Discharges area Violation of the Permit and Reason for Immediate Project Suspension -
The Construction Site Boundary/Limits of Construction (LOC) , all disturbed areas, material and/or waste storage areas that are exposed to precipitation, discharge
locations, and locations wherevehicles access the site shall be inspected for evidence of, or the potential for, pollutants leaving the LOC, entering the stormwater
drainagesystem, or discharging to State waters. If there is evidence of sediment or other pollutants discharging from the site, see section 17 (Construction Site
Assessment).
All erosion and sediment control practices identified in the SWMP shall be evaluated to ensure that they are maintained and operating correctly. Identify the
condition of the BMP, using more than one letter if necessary: (1) Incorrect Installation; (M) Maintenance is needed; (F) BMP failed to operate; (A) Additional BMP is
needed; (R) Remove BMP. Keep copies of this blank page for additional room if needed.
Continuous maintenance is required on all BMPs. BMPs that are not operating effectively, have proven to be Inadequate, or have failed must be addressed
as soon as possible, immediately in most cases.
Location
BMP
Condition
Comments:
Description of Corrective Action and Preventative Measure Taken
Date
Completed
& Initials
17) CONSTRUCTION SITE A5SE55MEN I :—OFF SITE POLLUTANT UI5CKARGES AKm A VIOLA IJUN ur Inc rrKryn i Alvu ncAoviv unw—wim—
(a) Is there evidence of discharge of sediment or other pollutants from the site? ❑ Yes ❑ No
'If yes, explain the discharge and (he corrective actions in section 16 (Construction Site Assessment & Corrective Actions) or section 18 (General Notes).
(b) Has sediment or other pollutants discharging from the site reached State waters? ❑ Yes ❑ No
'If yes. see subsection 208.03 c and -Pa rt II A.2 and 3 of the p ermit for re p a rt inq reciuirements_
GENERAL NOTES
INSPECTION CERTIFICATION
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assurethat qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted Is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations.
Contractors SWMP Administrator
Print Name: Signature Required:
Contractors Erosion Control Inspector (If Needed)
Date:
Print Name: Signature Required:
Contractors Superintendent/Approved Designee
Dale:
Print Neme: Signature Required:
CDOT Project Englneer/CDOT Designee
Date:
Print Name: Signature Required:
(20) COMPLIANCE CERTIFICATION
Corrective action(s) has been taken, or where a report does not identify any incidents requiring corrective action, the report shall contain a signed statement
indicating the site is in compliance with the permit to the best of the signer's knowledge and belief.
Contractors SWMP Administrator
Print Name: Signature Required:
CDOT Project Engineer/CDOT Designee (Signature Required) Date:
Print Name: Slgnalwe Required:
Stormwater Management Field Inspection Report Instructions
State waters are defined to be any and all surface and subsurface waters which are contained in or flow through the state,
ncluding, streams, rivers, lakes, drainage ditches, storm drains, ground water, and wetlands, but not including waters in sewage
Systems, waters in treatment works or disposal systems, waters in potable water distribution systems, and all water withdrawn for
,until use and treatment have been completed. (Per subsection 107.25 and 25-8-103 (19) CRS)
(3) SWMP Administrator and Erosion Control Inspector: Indicate the name(s) of the individual responsible for
mplementing, maintaining and revising the SWMP. An Erosion Control Inspector(s) may be required see 208.03(c)2. for
,equirements.
(4) CDOT Project Engineer/CDOT Designee: Indicate the name of the CDOT representative performing the inspection with
the SWMP Administrator/Erosion Control Inspector(s). This person should be the Project Engineer or an authorized
representative.
(9) CDPS-SCP Certification #: Indicate the Colorado Discharge Permit System (CDPS) Stormwater Construction Permit (SCP)
(for Stormwater Discharges Associated with Construction Activities) certification number, issued by CDPHE, for the project which
the report is being completed. Certification number can be found on the first page of the SCP.
(12) Reason(s) for Inspection I Exclusion: Indicate the purpose for the inspection or exclusion. These inspections are
required to comply with the CDOT Specifications and the CDPS-SCP.
:1 Routine Inspections. These inspections are required at least every 7 calendar days during active construction. Suspended
projects require the 7 calendar day inspection unless snow cover exists over the entire site for an extended period of time, and
melting conditions do not exist (see, Winter Conditions Inspections Exclusions).
Z) Runoff Event Inspection for Active Sites. See page 1 for definition.
❑ Third Party Request. Indicate the name of the third party requesting the inspection and, if known, the reason the request was
made.
❑ Winter Conditions Inspections Exclusions. See page 1 for definition. An inspection does not need to be completed, but use
this form to document the conditions that meet the Exclusion.
❑ Other. Specify any other reason(s) that resulted in the inspection.
/ - SWMP Management: Review the SWMP records and documents and use a ✓ to answer the question. To comply with
U,OT Standard Specifications and the CDPS-SCP, all of the items identified must be adhered to. If No is checked, indicate the
necessary corrective action in section 16 (Construction Site Assessment & Corrective Actions).
(a) Is the SWMP notebook located on site? A copy of the SWMP notebook must be retained on site, unless another location,
specified by the permit, is approved by the Division.
(b) Are changes to the SWMP documents noted and approved? Indicate all changes that have been made to any portion of the
SWMP notebook documents during construction. Changes shall be dated and signed at the time of occurrence. Amendments
may include items listed in subsection 208.03(d).
(c) Are the inspection reports retained in the SWMP notebook? The SWMP Administrator shall keep a record of inspections.
Inspection reports must identify any incidents of non-compliance with the terms and conditions of the CDOT specifications or the
CDPS-SCP. Inspection records must be retained for three years from expiration or inactivation of permit coverage.
(d) Are corrective actions from the last inspection completed? Have corrective actions from the last inspection been addressed?
Is a description of the corrective action(s), the date(s) of the corrective action(s), and the measure(s) taken to prevent future
violations (including changes to the SWMP, as necessary) documented?
(e) Is a Spill Response Plan retained in the SWMP notebook? Subsection 208.06(c) requires that a Spill Response Plan be
developed and implemented to establish operating procedures and that the necessary employee training be provided to
minimize accidental releases of pollutants that can contaminate stormwater runoff. Records of spills, leaks or overflows that
result in the discharge of pollutants must be documented and maintained. Information that should be recorded for all
occurrences include the time and date, weather conditions, reasons for spill, etc. Some spills may need to bereported to the
Water Quality Control Division immediately.
(f) Is a list of potential pollutants retained at the site? Subsection 107.25(b)6 requires the Erosion Control Supervisor to identify
and describe all potential pollutant sources, including materials and activities, and evaluate them for the potential to contribute
pollutants to stormwaterdischarge.
(g)lf NA ischecked for any of the items (a) through (f), indicate why in the space provided, if additional space is needed
indicate in section 18 (General Notes).
Page 4 of 5 CDOT Form #1176 2/16
Stormwater Management Field Inspection Report Instructions (continued)
(14) Current Construction Activities:
(a) Provide a short description of the current construction activities/phase at the project site; include summary of grading
activities, installation of utilities, paving, excavation, landscaping, etc.
stimate of disturbed area at the time of the inspection, use guidance found in 208.04 (e). Estimate the acres of disturbed
area at the time of the inspection. Include clearing, grading, excavation activities, areas receiving overburden (e.g.
stockpiles), demolition areas and areas with heavy equipment/vehicle traffic, installation of new or improved haul roads and
access roads, staging areas, borrow areas and storage that will disturb existing vegetative cover.
(c)Has the Phased BMP Implementation Matrix on the SWMP been updated? As part of the inspection the Phased BMP
Implementation matrix for both the structural and non-structural BMPs found at the beginning of the SWMP sheets must be
reviewed to ensure that "In use on site" box is checked for BMPs currently use at the time of the inspection.
(15) Weekly Meeting Notes: The SWMP Administrator shall take notes of water quality comments and action items at
each weekly meeting. At the meeting the following shall be discussed and documented:
(1) Requirements of the SWMP.
(2) Problems that may have arisen in implementing the site specific SWMP or maintaining BMPs.
(3) Unresolved issues from inspections and concerns from last inspection
(4) BMPS that are to be installed, removed, modified, or maintained.
(5) Planned activities that will effect stormwater in order to proactively phase BMPs.
(6) Recalcitrant inspection findings
(16) Construction Site Assessment & Corrective Actions: Inspect the construction site and indicate where BMP feature(s)
identified in section 13 (SWMP Management), require corrective action. Erosion and sediment control practices identified in the
SWMP shall be evaluated to ensure that they are operating correctly.
- Location. Site location (e.g., project station number, mile marker, intersection quadrant, etc.).
- BMP. Indicate the type of BMP at this location that requires corrective action (e.g., silt fence, erosion logs, soil retention
blankets, etc.).
- Condition. Identify the condition of the BMP, using more than one letter (identified in section 16) if necessary.
- Description of Corrective Action and Preventative Measure Taken. Provide the proposed corrective action needed to bring
' -rea or BMP into compliance. Once corrective actions are completed, state the measures taken to prevent future violations
G_,ensure that the BMPs are operating correctly, including the required changes made to the SWMP.
- Date Completed & Initials. Date and initial when the corrective action was completed and the preventative measure statement
finished.
(17) Construction Site Assessment: Was there any off site discharge of sediment at this site since the last inspection?
(a) Is there evidence of discharge of sediment or other pollutants from the site? Off site pollutant discharges are a violation
of the permit. The construction site perimeter, all disturbed areas, material and/or waste storage areas that are exposed to
precipitation, discharge locations, and locations where vehicles access the site shall be inspected for evidence of, or the
potential for, pollutants leaving the construction site boundaries, entering the stormwater drainage system, or discharging to
State water.
(b) Has sediment or other pollutants discharging from the site reached State waters? Off site pollutant discharges are a
violation of the permit. If off site discharge has occurred, explain the discharge and the corrective actions in section 16
(Construction Site Assessment & Corrective Actions) or section 18 (General Notes).
(18) General Notes: Indicate any additional notes that add detail to the inspection; this may include positive practices noted on
the project.
(19) Inspection Certification: In accordance with Part I, F.1.c of the CDPS-SCP, all reports for submittal shall be signed and
certified for accuracy.
(20) Compliance Certification: In accordance with Part I, D.6.b.2.viii of the CDPS-SCP, compliance shall be certified through
signature.
Page 5 of 5 CDOT Form #1176 2/16
i
DAILY STORMWATER LOG (CDOT FORM # 1388)
COLORADO DEPARTMENT OF TRANSPORTATION
Stormwater Management Field Daily Inspection Report
In accordance with the Project Special Provision daily stormwater compliance inspections are required on all projects holding a
Colorado Discharge Permit System — Stormwater Construction Permit (CDPS-SCP).
form is to be used as the daily diary to evaluate BMPs used during construction activities.
See the instructions for more information.
Date:
Project number:
Sub -account number:
The entire site shall be inspected to determine whether BMPs are being implemented and maintained in accordance with the
project's site specific SWMP and the CDPS-SCP. The SWMP Administrator or Erosion Control Inspector (ECI) or
Superintendent shall identify if additional BMPs are needed, can be removed, or need maintenance. The condition of the
currently used BMPs shall be recorded, using one or more of the following letters: (1) Incorrect Installation; (M) Maintenance is
needed; (F) BMP failed to operate; (A) Additional BMP is needed; (R) Remove BMP. Only BMPs with the conditions above
need be recorded. (Use the extra page at the end of this form if needed.)
The Project Engineer will approve and the Superintendent shall direct the work associated with any BMPs identified in this daily
log to ensure compliance with the site specific SWMP and the CDPS=SCP.
CDPS-SCP States: "BMPs that are not operating effectively, have proven,to be inadequate, or have failed must be
addressed as soon as possible, immediately in most cases."
Location
BMP Type
Condition
Notes/Comments
Date
Completed
& Initials
** ALL BMPS ARE IN OPERATING CONDITION AND NO MAINTENANCE IS NEEDED.
(initial the box to the right when this applies)
Comments/General notes:( attach photos if necessary)
Inspection signature: SWMP Administrator or ECI or Superintendent
Name:(Print) Signature: Date signed:
PAGE 1 OF 3 CDOT Form #1388 2116
Stormwater Management Field Daily Inspection Report Instructions
Inspect all erosion and sediment control BMPs throughout the entire construction site — observe, record, and determine their
effectiveness. If additional BMPs are needed or any BMP is not operating effectively, it shall be recorded on this form and
P,Idressed immediately.
Location: Record the site location (e.g., project station number, mile marker, intersection quadrant, etc.).
BMP Type: Indicate the type of BMP at this location that requires attention (e.g., silt fence, erosion logs, soil retention blankets,
etc.).
Condition: Identify the condition of the BMP, using one or more of the following letters: (1) Incorrect Installation, (M) Maintenance
is needed (i.e., sediment needs to be removed), (F) BMP Failed to operate, (A) Additional BMP is needed, (R)
Remove the BMP.
"` If all BMPs are in operating condition and no BMP maintenance is needed, sign and initial the box to the right of the
statement.
Notes/Comments: Provide the proposed corrective action needed to bring the area or BMP into compliance.
Date Completed & initials: Date and initial when the corrective action was completed.
Inspection Signature: Sign the form when the inspection has been completed.
Place the completed daily stormwater log sheet(s) in the SWMP Notebook.
PAGE 2 OF 3 CDOT Form #1388 2116
COLORADO DEPARTMENT OF TRANSPORTATION
Stormwater Management Field Daily Inspection Report, ADDITIONAL PAGE
Date: 1 Project number: i Sub -account number: I
e entire site shall be inspected to determine whether BMPs are being implemented and maintained in accordance with the
project's site specific SWMP and the CDPS-SCP. The SWMP Administrator or Erosion Control Inspector (ECI) or
Superintendent shall identify if additional BMPs are needed, can be removed, or need maintenance. The condition of the
currently used BMPs shall be recorded, using one or more of the following letters: (1) Incorrect Installation; (M) Maintenance is
needed; (F) BMP failed to operate; (A) Additional BMP is needed; (R) Remove BMP. Only BMPs with the conditions above need
be recorded.
The Project Engineer will approve and the Superintendent shall direct the work associated with any BMPs identified in this daily
log to ensure compliance with the site specific z5vvivir and the Uur0-0t_1r.
CDPS-SCP States: "BMPs that are not operating effectively, have proven to be inadequate, or have failed must be
addressed as soon as possible, immediately in most cases."
Location
BMP Type
Condition
Notes/Comments
Date
Completed
& Initials
PAGE 3 OF 3 CDOT Form #1388 2116