Monthly Visual Observation
This checklist is for monthly visual observations of drainage areas potentially impacting stormwater, as per the General Permit No. CAS000001 for Storm Water Discharges Associated with Industrial Activities, Section XI.A.
MaintainX
08/09/2025
Monthly Visual Observation
This checklist is for monthly visual observations of drainage areas potentially impacting stormwater, as per the General Permit No. CAS000001 for Storm Water Discharges Associated with Industrial Activities, Section XI.A.
Facility Name:
Facility Location:
Month/Year:
Date:
Inspector(s):
Weather conditions:
Description of any discharges occurring at the time of the inspection (landscape watering, fire system testing, etc.):
Description of any discharges occurring at the time of the inspection (landscape watering, fire system testing, etc.):
ALL ACTIVITIES/AREAS:
Drip pans or absorbent pads are placed under equipment/vehicles that are leaking or which are likely to leak to collect leaks or spills
Storm drains are free of debris, trash, sediment, oil, vehicle fluids, or other visible pollutants and are not clogged. Materials are stored away from the storm drains.
Paved areas are free of visible contaminants (significant staining, chemical residue, spent absorbent materials, etc.)
Spill response kits are stocked with appropriate equipment, located in appropriate areas and are easily accessible.
The site is free of loose trash, excessive landscape debris, paper scraps, etc.
The roof and roof drains are free of paper scraps and other debris.
Has a reportable release occurred since last inspection? If so, has the SWPPP been updated to document this event?
Corrective actions listed on last inspection form have been addressed or are in place
GENERAL / RECYCLED WASTE DUMPSTERS
The area around the dumpsters is free of loose trash, debris, paper
The dumpsters are not leaking.
TRUCK LOADING AND UNLOADING AREAS
The truck loading and unloading areas are free of paper scraps, trash, debris, and is free of significant oil staining.
A spill kit is located in proximity to the truck loading and unloading areas
SCRAP METAL/EQUIPMENT STORAGE
Scrapped equipment and scrap metal parts are not resting directly on the ground and are covered.
There are no visible pollutants (oil, grease, rust, etc.) on the ground around the scrap metal storage area.
Oil has been drained from scrap equipment prior to outdoor storage, as applicable.
Scrap equipment and scrap metal is stored in the designated location
EMPTY TOTE STORAGE
Containers are completely empty, free of surface residue, and the drain valves are in the closed position.
The empty totes are labeled as “EMPTY” or otherwise marked.
The area is free of trash and other debris
PALLET STORAGE
Pallets are neatly stacked and free of residual material (oil, grease, ink, etc.)
The pallet storage area is free of wood scraps, trash, and other debris.
STARCH AND CAUSTIC UNLOADING AREA
22.The starch and caustic loading ports are locked when not in use
A spill bucket is placed under the fill port when actively filling (if activity is not occurring during the inspection, check NA)
The starch and caustic fill ports are labeled
A spill kit is located in proximity to the loading area
The area is free of residual material (starch, caustic, debris, etc.)
DIESEL FUELING (GENERATOR)
The diesel tank and generator area are free of staining, leaks, debris, etc.
A spill kit is located in close proximity to the diesel fueling area.
ROOF / CYCLONE
The roof, cyclone, and roof drains are free of paper scraps, dust, and other debris.
NON-STORM WATER DISCHARGES
Materials and/or wastes are stored away from fire hydrant flushing areas.
Materials and/or wastes are stored away from the fire system riser discharge area.
There are no unauthorized non-storm water discharges or indications of prior unauthorized non-storm water discharges (i.e., staining, residue, etc.).
SPECIFIC BMPS/CONDITIONS – List specific issues and area noted in the previous inspection(s)
NA – Not Applicable
Other notes/comments/observations:
If it is determined during the Monthly Visual Observation Inspection that modifications to the best management practices are necessary or that control measures are not being properly implemented and maintained, the selection, design, installation, and implementation of the best management practices must be reviewed and/or revised to ensure that the condition is eliminated and will not be repeated.
NON-STORM WATER DISCHARGES
Authorized non-storm water discharges (NSWDs), sources, and associated BMPs implemented must be observed monthly to ensure compliance with Sections IV.B.3 and XI.A.1.a.ii of the General Permit. The following NSWDs have been identified at the facility: fire system risers, fire hydrants. If no authorized non-storm water discharges occurred during the month, enter “NONE” in the first empty cell and cross out the remaining empty cells.
NON-STORM WATER DISCHARGES 1
Observer Name, Title, Initials
EXAMPLE J. Smith, Maintenance Manager
Date & Time of Authorized NSWD
EXAMPLE August 13, 1:30pm
Name and Location of Authorized NSWD
EXAMPLE Fire system risers, west side
Describe Characteristics of NSWD Indicate whether authorized NSWD is clear, cloudy, or discolored, causing staining, contains floating objects or an oil sheen, has odors, etc.
EXAMPLE Initial discharge was cloudy with some odor (musty), eventually clear with no odor
Are the BMPs listed in Table 5 implemented and sufficient? If “NO”, describe corrective action
EXAMPLE Some pallets were stored in from of the riser discharge point. Pallets were moved away prior to flushing. Will evaluate attaching a hose to the riser discharge and directing the water to a landscaped area.
NON-STORM WATER DISCHARGES 2
Observer Name, Title, Initials
EXAMPLE J. Smith, Maintenance Manager
Date & Time of Authorized NSWD
EXAMPLE August 13, 1:30pm
Name and Location of Authorized NSWD
Describe Characteristics of NSWD Indicate whether authorized NSWD is clear, cloudy, or discolored, causing staining, contains floating objects or an oil sheen, has odors, etc.
EXAMPLE Initial discharge was cloudy with some odor (musty), eventually clear with no odor
Are the BMPs listed in Table 5 implemented and sufficient? If “NO”, describe corrective action
EXAMPLE Some pallets were stored in from of the riser discharge point. Pallets were moved away prior to flushing. Will evaluate attaching a hose to the riser discharge and directing the water to a landscaped area.
NON-STORM WATER DISCHARGES 3
Observer Name, Title, Initials
EXAMPLE J. Smith, Maintenance Manager
Date & Time of Authorized NSWD
Name and Location of Authorized NSWD
Describe Characteristics of NSWD Indicate whether authorized NSWD is clear, cloudy, or discolored, causing staining, contains floating objects or an oil sheen, has odors, etc.
EXAMPLE Initial discharge was cloudy with some odor (musty), eventually clear with no odor
Are the BMPs listed in Table 5 implemented and sufficient? If “NO”, describe corrective action
EXAMPLE Some pallets were stored in from of the riser discharge point. Pallets were moved away prior to flushing. Will evaluate attaching a hose to the riser discharge and directing the water to a landscaped area.
CORRECTIVE ACTIONS
CORRECTIVE ACTIONS 1
Item Number
Description of Deficiency
Action Taken / Suggested Action To Be Taken
Responsible Individual(s) / Department
Date Corrective Action Initiated
Date Corrective Action Completed or Expected to be Completed
Update SWPPP?
CORRECTIVE ACTIONS 2
Item Number
Description of Deficiency
Action Taken / Suggested Action To Be Taken
Responsible Individual(s) / Department
Date Corrective Action Initiated
Date Corrective Action Completed or Expected to be Completed
Update SWPPP?
CORRECTIVE ACTIONS 3
Item Number
Description of Deficiency
Action Taken / Suggested Action To Be Taken
Responsible Individual(s) / Department
Date Corrective Action Initiated
Date Corrective Action Completed or Expected to be Completed
Update SWPPP?
CORRECTIVE ACTIONS 4
Item Number
Description of Deficiency
Action Taken / Suggested Action To Be Taken
Responsible Individual(s) / Department
Date Corrective Action Initiated
Date Corrective Action Completed or Expected to be Completed
Update SWPPP?
Inspector Information
Print Name and Title
Signature of Inspector
Click here to sign
Date:
Source: MaintainX (Community Member)