Storm Water Pollution Prevention Plan Template (SWPPP)

LINK to WORD Version of Template

SWPPP Template – Michigan DEQ

FACILITY NAME:

 

_________________________________________________

 

 

STORM WATER POLLUTION PREVENTION PLAN (SWPPP)

 

DEQ SWPPP Template (Revised 9/13/2012)


TABLE OF CONTENTS

 

1.0            General Facility Information

2.0            Storm Water Pollution Prevention Team

3.0            Site Map

4.0            Significant Materials

4.1            Inventory of Exposed Significant Materials

4.2            Description of Industrial Activities & Significant Material Storage Areas

4.3            List of Significant Spills

4.4            Summary of Sampling Data

5.0            Non-Structural Controls

5.1       Preventative Maintenance Program

5.2       Comprehensive Site Inspection

5.3       Housekeeping Procedures

5.4       Material Handling & Spill Prevention / Clean-Up Procedures

5.5       Soil Erosion & Sedimentation Control Measures

5.6       Employee Training Program

5.7       TMDL Requirements

5.8       List of Significant Materials Still Present

6.0            Structural Controls

7.0            Non-Storm Water Discharges

8.0            Annual Review

9.0            Certified Storm Water Operator Update

10.0         Record Keeping

11.0         SWPPP Certification

12.0         Figure 1 – Facility Site Map

13.0         Table 1 – Significant Material Inventory and Description of Industrial Activity or Significant Material Storage Areas

14.0         Table 2 – List of Significant Spills

15.0         Table 3 – Description of Preventative Maintenance / Routine Housekeeping Inspections

16.0         Table 4 – Material Handling & Spill Prevention / Clean-Up Procedures

17.0         Table 5 – Spill Kit Inventory

18.0         Table 6 – Structural Controls used at the Facility

19.0         Preventative Maintenance Inspection Form

20.0         Comprehensive Site Inspection Form

21.0         Housekeeping Inspection Form

22.0         Employee Training Form

23.0         Annual SWPPP Review Form

24.0         DEQ Spill or Release Report

25.0         Sample Site Map

26.0         Sample Table 1

 

1.0          GENERAL FACILITY INFORMATION

Name of Facility:

Facility Address:

Standard Industrial Classification (SIC) Code:

Owner or Authorized Representative:

Facility Contact

Name:

Title:

Telephone:

Mailing Address:

Certified Storm Water Operator

Name & Certification Number:

Permit Information

Certificate of Coverage Number:

Effective Date of Coverage:

Receiving Waters:

 

Brief Industrial Activity Description

 

 

 

 

2.0          STORM WATER POLLUTION PREVENTION TEAM

The storm water pollution prevention team is responsible for developing, implementing, maintaining, and revising this SWPPP.  The members of the team and their primary responsibilities (i.e. implementing, maintaining, record keeping, submitting reports, conducting inspections, employee training, conducting the annual compliance evaluation, testing for non-storm water discharges, signing the required certifications) are as follows:

Add additional spaces as necessary

NAME & TITLE RESPONSIBILITY

 

3.0          SITE MAP

Preparing a site map or sketch is the first step in assessing the facility. (See the DEQ Industrial Certified Operator Training Manual for additional information)

The facility’s site map includes all applicable items listed in the permit, which include:

SEE FIGURE 1 FOR FACILITY SITE MAP

1)     Buildings and other permanent structures

2)     Storage or disposal areas for significant materials

3)     Secondary containment structures and descriptions of what they contain in the primary containment structures

4)     Storm water discharge outfalls (numbered or other wise labeled for reference)

5)     Location of storm water and non-storm water inlets contributing to each outfall (catch basins, roof drains, conduits, drain tiles, detention pond riser pipes, sump pumps, etc.) (numbered or other wise labeled for reference

6)     Location of NPDES permitted discharges other than storm water

7)     Outlines of the drainage areas contributing to each outfall

8)     Structural runoff controls or storm water treatment facilities

9)     Areas of vegetation (with brief description such as lawn, old field, marsh, wooded, etc.)

10)  Areas of exposed and/or erodible soils

11)  Impervious surfaces (roofs, asphalt, concrete, etc.)

12)  Name and location of receiving waters

13)  Areas of known or suspected impacts on surface waters as designated under Par 201 (Environmental Response) of the Michigan Act.

4.0          SIGNIFICANT MATERIALS

Definition:  Significant materials are any material which could degrade or impair water quality, including but not limited to:

  •  Raw Materials
  • Fuels
  • Solvents
  • Detergents
  • Plastic pellets
  • Finished materials (i.e. metallic products)
  • Hazardous Substances designated under section 101(14) of Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), see 40CFR372.65
  • Any chemical the facility is required to report pursuant to section 313 of the Emergency Planning and Community Right-to-Know Act (EPCRA)
  • Polluting Materials – Oil and any material, in solid or liquid form, identified as polluting material under the Part 5 Rules (Rules 324.2001 through 324.2009 of the Michigan Administrative Code)
  • Hazardous Wastes as defined in Part 111 of the Michigan Act
  • Fertilizers
  • Pesticides
  • Waste Products (i.e. ashes, slag, sludge, plant waste, animal waste)

 During the significant materials identification phase, all sources of potential storm water contamination need to be identified.  Both the inside and outside of the facility must be inventoried to determine the materials and practices that may be sources of contamination to storm water runoff. Note the identification phase must address residual contaminants which may be found on items stored outside.

4.1       Inventory of Exposed Significant Materials

 The permit requires a general inventory of significant materials that could enter storm water.  For each material listed the SWPPP shall include the ways in which each type of material has been or has reasonable potential to become exposed to storm water (e.g. spillage during handling; leaks from pipes, pumps, or vessels; contact with storage piles, contaminated materials or soils; waste handling and disposal; deposits from dust or overspray; etc.). In addition, the SWPPP must identify the inlet(s) spilled significant materials may enter and the outfall(s) through which the spilled significant material may be discharged.

SEE TABLE 1 FOR SIGNIFICANT MATERIAL INVENTORY

 4.2       Description of Industrial Activities & Significant Material Storage Areas

The permit requires industrial facilities to evaluate the reasonable potential for contribution of significant materials to storm water runoff from at least the following areas or activities:
1)     Loading, unloading, and other material handling operations

2)     Outdoor storage including secondary containment structures

3)     Outdoor manufacturing or processing activities

4)     Significant dust or particulate generating processes

5)     Discharge from vents, stacks, and air emission controls

6)     On-site waste disposal practices

7)     Maintenance and cleaning of vehicles, machines, and equipment

8)     Areas of exposed and/or erodible soils

9)     Sites of Environmental Contamination listed under Part 201 (Environmental Response) of the Michigan Act

10)  Areas of significant material residues

11)  Areas where animals congregate (wild or domestic) and deposit wastes

12)  Other areas where storm water may contact significant materials

For each applicable item, the permit requires a written description of the specific activity or storage area.  Along with the written description of the activities or storage areas, a description of the significant materials associated with those items must be included.

SEE TABLE 1 FOR INDUSTRIAL ACTIVITY AND SIGNIFICANT MATERIAL STORAGE AREA DESCRIPTIONS

4.3            List of Significant Spills

The permit requires a list of significant spills and significant leaks of polluting materials that occurred at areas that are exposed to precipitation or that otherwise discharge to a point source at the facility. The listing shall include spills that occurred over the three years prior to the effective date of a certificate of coverage authorizing discharge under the General Permit.  The listing shall include the date, volume, exact location of release, and actions taken to clean up the material and/or prevent exposure to storm water runoff or contamination of surface waters of the state.  Any release that occurs after the SWPPP has been developed shall be controlled in accordance with the SWPPP and is cause for the SWPPP to be updated as appropriate within 14 calendar days of obtaining knowledge of the spill or loss.  (If there have been no spills of polluting materials, state that in this section.)

SEE TABLE 2 FOR A LISTING OF SIGNIFICANT SPILLS

 

4.4            Summary of Sampling Data

The permit requires a summary of existing storm water discharge sampling data (if available) describing pollutants in storm water discharges associated with industrial activity at the facility.  The summary shall be accompanied by a description of the suspected sources of the pollutants detected.  (If there is no storm water discharge sampling data, state that in this section.)

Add additional spaces as necessary

SUMMARY OF SAMPLING   EVENTS:  

 

5.0          NON-STRUCTURAL CONTROLS

Non-structural controls are practices that are relatively simple, fairly inexpensive, and applicable to a wide variety of industries or activities.  Non-structural controls are intended to reduce the amount of pollution getting into the surface waters of the state and are generally implemented to address the problem at the source.  They do not require any structural changes to the facility.  These are typically everyday types of activities undertaken by employees at the facility.  Many facilities may already have nonstructural controls in place for other reasons.  The permit requires that the SWPPP shall, at a minimum, include each of the following non-structural controls.

5.1       Preventative Maintenance Program (Routine Inspection Program)

The permit requires a description of a program for routine preventive maintenance which includes inspection and maintenance of storm water management and control devices (e.g. cleaning of oil/water separators and catch basins) as well as inspecting and testing plant equipment and systems to uncover conditions that could cause breakdowns or failures resulting in discharges of pollutants to surface waters.  A log of the inspection and corrective actions shall be maintained on file and shall be retained for three years. The Preventative Maintenance Inspection Form is in Section 19.0.  (See the DEQ Industrial Certified Operator Training Manual for additional information.  If this requirement is addressed in other facility procedures, reference those procedures here.)

SEE TABLE 3 FOR PREVENTATIVE MAINTENANCE / ROUTINE HOUSEKEEPING INSPECTION PROGRAM

5.2            Comprehensive Site Inspection

The permit requires a schedule for comprehensive site inspection to include but not be limited to, the areas and equipment identified in the preventive maintenance program and good housekeeping procedures. The inspection shall also include a review of the routine preventive maintenance reports, good housekeeping inspections reports, and any other paperwork associated with the SWPPP.  The comprehensive site inspection shall be conducted by the Certified Storm Water Operator quarterly.  The permittee may request Department approval of an alternate schedule for comprehensive site inspections.  A report of the comprehensive site inspection results shall be prepared and retained for three years.  The report shall identify any incidents of non-compliance with the SWPPP or this permit.  If there are no reportable incidents of non-compliance, the report shall contain a certification that the facility is in compliance with this permit. The Comprehensive Site Inspection Form is in Section 20.0.

 

COMPREHESIVE SITE INSPECTION SCHEDULE:  

 

 

COMPREHENSIVE SITE INSPECTION DESCRIPTION:  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.3            Housekeeping Procedures

 

The permit requires that the SWPPP include a description of good housekeeping procedures to maintain a clean, orderly facility.  Housekeeping procedures are intended to reduce the potential for significant materials to come in contact with storm water.  The Housekeeping Inspection Form is in Section 21.0.  (See the DEQ Industrial Certified Operator Training Manual for additional information.)

 

SEE TABLE 3 FOR PREVENTATIVE MAINTENANCE / ROUTINE HOUSEKEEPING INSPECTION PROGRAM

 

HOUSEKEEPING   PROCEDURE DESCRIPTION:  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.4       Material Handling & Spill Prevention / Clean-Up Procedures

 

The permit requires a description of material handling procedures and storage requirements for significant materials.  Equipment and procedures for cleaning up spills shall be identified in the SWPPP and made available to the appropriate personnel.  The procedures shall identify measures to prevent spilled materials or material residues on the outside of the containers from being discharged into storm water.

 

The SWPPP may include, by reference, requirements of either a Pollution Incident Prevention Plan (PIPP) prepared in accordance with the Part 5 Rules (Rules 324.2001 through 324.2009 of the Michigan Administrative Code); a Hazardous Waste Contingency Plan (HWCP) prepared in accordance with 40CFR264 and 265 Subpart D, as required by Part 111 of the Michigan Act; or a Spill Prevention Control and Countermeasure (SPCC) plan prepared in accordance with 40CFR112.

 

THE FOLLOWING PLANS   ARE ON FILE   AT THE FACILITY:  

 

 

Spills and leaks together are the largest industrial source of storm water pollution.  Thus, this SWPPP specifies material handling procedures and storage requirements for significant materials.  Equipment and procedures necessary for cleaning up spills and preventing the spilled materials from being discharged have also been identified.  All employees have been made aware of the proper procedures.  (See the DEQ Industrial Certified Operator Training Manual for additional information.)

 

SEE TABLE 4 FOR MATERIAL HANDLING & SPILL PREVENTION / CLEAN-UP PROCEDURES

 

SEE TABLE 5 FOR SPILL KIT INVENTORY

 

5.5        Soil Erosion & Sedimentation Control Measures

The permit requires the identification of areas which, due to topography, activities, or other factors, have a high potential for significant soil erosion.  Areas commonly prone to soil erosion are: gravel lots, bare earth or gravel at material handling areas around storm water inlets, areas with concentrated storm water runoff into streams or ditches, and access roads over open streams or ditches. Control measures must be implemented in areas prone to soil erosion and sedimentation.  (More information on soil erosion and sedimentation control may be obtained from the DEQ, Water Bureau District Office.)

Add additional spaces as necessary

AREA OF CONCERN: CONTROL MEASURE:

 

5.6       Employee Training Program

The permit requires a description of employee training programs have been implemented to inform appropriate personnel at all levels of responsibility of the components and goals of the SWPPP.  Recent modifications to the General Permits have included a requirement for annual employee training.  The SWPPP shall identify periodic dates for such training.  DEQ recommends that employees are trained at the time of hire, then annually. An employee training video is available at the DEQ website:  http://www.michigan.gov/deq/0,1607,7-135-3308_3333_4168—,00.html

Employee training will be a major component in ensuring the success of the facility’s SWPPP. The more knowledgeable all employees are about the facility’s SWPPP and what is expected of them, the greater the chance that the plan will be effective. The following is a description of the employee training programs to be implemented to inform appropriate personnel at all levels of responsibility of the components and goals of the SWPPP (i.e. good housekeeping practices, spill prevention and response procedures, waste minimization practices, informing customers of facility policies, etc.).  The Employee Training Form is in Section 22.0.

EMPLOYEE TRAINING   DESCRIPTION & FREQUENCY:  

 

 

 

 

 

 

 

 

 

 

 

 

5.7       TMDL Requirements

 

The permit requires that if there is a Total Maximum Daily Load (TMDL) established by the Department for the receiving water, which restricts the discharge of any of the identified significant materials or constituents of those materials, then the SWPPP shall identify the level of control for those materials necessary to comply with the TMDL.

 

The TMDL means the amount of pollutant load a water body, such as a lake or stream, can assimilate and still meet water quality standards.  If a receiving water body does not meet the water quality standards for a specific pollutant, the DEQ will establish the appropriate daily maximum load for that pollutant to allow the water body to again meet water quality standards.  If a permitted facility is expected to discharge that specific pollutant in its storm water to that water body, the General Permit requires the facility to list actions it will take to meet that TMDL requirement.  For example, if the TMDL calls for storm water dischargers to reduce their phosphorus inputs by 50%, the permittee would need to identify phosphorus sources at their facility and estimate their current annual load.  The permittee must list actions to reduce storm water phosphorus discharges from their facility by 50%.

 

See the DEQ website for additional TMDL information at:  http://www.michigan.gov/deq/0,1607,7-135-3313_3686_3728-12464–,00.html

 

IS THERE A TMDL REQUIREMENT FOR THE RECEIVING WATER?

 

 

 

Below is the identification of actions to limit the discharge of significant materials in order to comply with TMDL requirements:

 

Add additional spaces as necessary

TMDL POLLUTANT: BEST MANAGEMENT   PRACTICES IMPLEMENTED ONSITE:

 

 

5.8            List of Significant Materials Still Present

 

The permit requires the identification of significant materials expected to be present in storm water discharges following implementation of non-structural preventative measures and source controls.  Non-structural controls are used to reduce pollutants at the source before they can get into the storm water runoff.  In some cases, these types of controls will not be enough.  A list of significant materials expected to be present in storm water discharges after implementation of nonstructural controls must be included in the SWPPP.  The materials listed below will be addressed through the use of structural controls. (If there will be no significant materials present after the implementation of non-structural controls, state that in this section.)

 

Add additional spaces as necessary

SIGNIFICANT   MATERIAL & LOCATION: PLANNED CONTROL   MEASURE: IMPACTED OUTFALL:

 


6.0          STRUCTURAL CONTROLS

 

 

The permit requires that where implementation of non-structural controls does not control storm water discharges in accordance with water quality standards, the SWPPP shall provide a description of the location, function, and design criteria of structural controls for prevention and treatment.

 

Structural controls may be necessary:

 

1)     To prevent uncontaminated storm water from contacting or being contacted by significant materials; or

 

2)     If preventive measures are not feasible or are inadequate to keep significant materials at the site from contaminating storm water.  Structural controls shall be used to treat, divert, isolate, recycle, reuse, or otherwise manage storm water in a manner that reduces the level of significant materials in the storm water and provides compliance with the Water Quality Standards

 

Examples of structural controls:

 

ü  Signs and Labels

ü  Safety Posts

ü  Fences

ü  Security Systems

ü  Temporary and Permanent Coverings

ü  Storm Water Conveyances

ü  Diversion Dikes

ü  Grading

ü  Paving

ü  Curbing

ü  Drip Pans

ü  Secondary Containment

ü  Catch Basin Inserts

ü  Detention and Retention Ponds

ü  Vegetative Filters

ü  Sand Filters

ü  Oil/Water Separators

 

These types of controls are physical features that control and prevent storm water pollution.  They can range from preventive measures to collection structures to treatment systems. Structural controls will typically require construction of a physical feature or barrier.  Below is a description of the structural controls used at the facility. (See the DEQ Industrial Storm Water Operator Training Manual for additional details on structural controls.  If no structural control measures are needed at the facility, state that in this section.)

 

SEE TABLE 6 FOR A LIST OF STRUCTURAL CONTROLS USED AT THE FACILITY

 

7.0          NON-STORM WATER DISCHARGES

 

 

The permit requires that all discharge locations be evaluated for the presence of non-storm water discharges.  Any unauthorized storm water discharges must be eliminated, or covered under another NPDES permit.

 

Storm water shall be defined to include all of the following non-storm water discharges provided pollution prevention controls for the non-storm water component are identified in the SWPPP:

 

1)     Discharges from fire hydrant flushing

2)     Potable water sources including water line flushing

3)     Fire system test water

4)     Irrigation drainage

5)     Lawn watering

6)     Routine building wash down which does not use detergents or other compounds

7)     Pavement wash waters where contamination by toxic or hazardous materials have not occurred (unless all contamination by toxic or hazardous materials have been removed) and where detergents are not used

8)     Air conditioning condensate

9)     Springs

10)  Uncontaminated ground water

11)  Foundations or footing drains where flows are not contaminated with process materials such as solvents

 

Discharges from fire fighting activities are authorized by the permit, but are exempted from the requirement to be identified in the SWPPP.

 

The table below specifies what non-storm water discharges occur at the facility.

 

Add additional spaces as necessary

NON-STORM WATER   DISCHARGE: POLLUTION   PREVENTION CONTROLS: IMPACTED OUTFALL:

 


8.0          ANNUAL REVIEW

 

 

The permit requires that the permittee shall review the SWPPP annually after it is developed and maintain written summaries of the reviews.  Based on the review, the permittee shall amend the SWPPP as needed to ensure continued compliance with the terms and conditions of the permit.  The annual review is to be retained on site for three years and depending on the general permit is required to be submitted to the DEQ district office on or before January 10th of each year.  The Annual Review Report Form is in Section 23.0.

 

9.0          CERTIFIED STORM WATER OPERATOR UPDATE

 

 

The permit requires that if the Certified Storm Water Operator is changed or an additional Certified Storm Water Operator is added, the permittee shall provide the name and certification number of the new Certified Storm Water Operator to the Department.  If a facility has multiple Certified Storm Water Operators, the name and certification number of the Certified Storm Water Operators shall be included in the SWPPP.

 

10.0     RECORD KEEPING

 

 

The permit requires that the permittee shall maintain records of all SWPPP related inspection and maintenance activities.  Records shall also be kept describing incidents such as spills or other discharges that can affect the quality of storm water runoff.  All such records shall be retained for three years.  The following records are required by the permit:

 

ü  Routine preventive maintenance inspection reports

ü  Routine good housekeeping inspection reports

ü  Comprehensive site inspection reports

ü  Employee training records

ü  Written summaries of the annual SWPPP review

 

11.0     SWPPP CERTIFICATION

 

 

The permit requires that the SWPPP shall be reviewed and signed by the Certified Storm Water Operator(s) and by either the permittee or an authorized representative in accordance with 40CFR122.22.  The SWPPP shall be retained on-site at the facility which generates the storm water discharge.

 

I certify under penalty of law that the storm water drainage system in this SWPPP has been tested or evaluated for the presence of non-storm water discharges either by me, or under my direction and supervision.  I certify under penalty of law that this SWPPP has been developed in accordance with the General Permit and with good engineering practices.  To the best of my knowledge and belief, the information submitted is true, accurate, and complete.  At the time this plan was completed no unauthorized discharges were present.  I am aware that there are significant penalties for submitting false information, including the possibility of fine or imprisonment for knowing violations.

 

Permittee or   Authorized Representative
Printed   Name & Title: 
Signature   & Date: 

 

Certified Storm   Water Operator
Printed   Name & Certification Number: 
Signature   & Date: 


12.0 FIGURE 1 – FACILITYSITEMAP


13.0 TABLE 1 – SIGNIFICANT MATERIAL INVENTORYANDDESCRIPTION OF INDUSTRIAL ACTIVITY OR SIGNIFICANT MATERIAL STORAGE AREAS

Instructions – The intent of this table is to ensure that facilities comply with Part I, Section C.1.b. of their industrial storm water permit. See sample table in Section 26 for reference. Fill out the applicable areas or activities in the corresponding sections. Add more lines as needed. Once you have described the area or activity, list the significant materials that are associated with the areas or activities, the exposure methods, and evaluate the level of exposure. Once that is completed indicate the inlet(s) and outfall(s) that would be impacted if significant materials were discharged from the areas or activities described.

 

Section   Listed in General Permit Storage   Areas / Activity Areas Significant   Materials Exposure   Method Reasonable   Potential Evaluation (high,medium,low) Inlet(s) Outfalls(s)
1) Loading, unloading, and   other material handling operations  

 

 

 

 

 

2) Outdoor storage including   secondary containment structures  

 

 

 

 

 

 

13.0 TABLE 1 CONTINUED

 

Section   Listed in General Permit Storage   Areas / Activity Areas Significant   Materials Exposure   Method Reasonable   Potential Evaluation (high,medium,low) Inlet(s) Outfalls(s)
3) Outdoor manufacturing or   processing activities  

 

 

 

 

 

4) Significant dust or   particulate generating processes  

 

 

 

 

 

5) Discharge from vents,   stacks, and air emission controls  

 

 

 

 

 

 

13.0 TABLE 1 CONTINUED

 

Section   Listed in General Permit Storage   Areas / Activity Areas Significant   Materials Exposure   Method Reasonable   Potential Evaluation (high,medium,low) Inlet(s) Outfalls(s)
6) On-site waste disposal   practices  

 

 

 

 

 

7) Maintenance and cleaning of   vehicles, machines and equipment  

 

 

 

 

 

8) Areas of exposed and/or   erodible soils  

 

 

 

 

 

 

13.0 TABLE 1 CONTINUED

 

Section   Listed in General Permit Storage   Areas / Activity Areas Significant   Materials Exposure   Method Reasonable   Potential Evaluation (high,medium,low) Inlet(s) Outfalls(s)
9) Sites of Environmental   Contamination listed under Part 201  
 
 
10) Areas of significant   material residues  
 
 
11) Areas where animals   congregate (wild or domestic) and deposit wastes  
 
 
12) Other areas where storm   water may contact significant materials  
 
 

 

 

 

14.0   TABLE 2 – LIST OF SIGNIFICANT SPILLS

 

Location   & Date Material   & Volume Corrective   Actions Taken
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


15.0   TABLE 3 – DESCRIPTION OF PREVENTATIVE MAINTENANCE / ROUTINE HOUSEKEEPING INSPECTIONS

 

Description of Area   or Equipment Tasks Frequency
 
 
 
 
 
 
 
 
 
 


16.0   TABLE 4 – MATERIAL HANDLING & SPILL PREVENTION / CLEAN-UP PROCEDURES

 

Potential   Spill Area Material   Handling & Storage Procedures Spill   Response Procedures & Equipment
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


17.0   TABLE 5 – SPILLKITINVENTORY

List the spill response equipment that will be maintained in each location or locker (refer to MSDSs to determine recommended clean-up methods and supplies):

 

Person responsible for maintaining this inventory: _______________________________

 

Locker number or   location Absorbents (pads,   booms, kitty litter, etc.) Tools (shovels,   brooms, squeegees, etc.) Personal Protective   Equipment (rubber gloves, boots, masks, etc.) Other Supplies   (warning tape, labels, markers, MSDSs, etc.)
           
           
           
           

 

Label each spill kit with the words “SPILLKIT” and the necessary emergency telephone number(s) or pager number(s) of persons to be contacted in case of a spill or leak that is beyond the training and equipment available on or near each spill locker:

 

Facility Responsible Person/Phone Number: ____________________________________________­

Spill Response Contractor (if any)/Phone Number: _______________________________________

DEQ District Office Phone Number:  ___________________________________________________

DEQ 24-Hour Emergency Spill Reporting Hot-Line: 1-800-292-4706

 

Stencil the following warning on each spill kit:

 

“WARNING: NEVER HOSE DOWN A SPILL!

CLEAN IT UP PROMPTLY AND DISPOSE OF THE WASTE PROPERLY.”


18.0   TABLE 6 – STRUCTURAL CONTOLS USED AT THE FACILITY

 

Description of Structural   Control Location of Structural   Control Significant Materials   intended to be managed
 

 

 

 

 

 

 

 

 

 

 

 

 

 


19.0   PREVENTATIVE MAINTENANCE INSPECTIONFORM

 

Date: Time:

 

Inspector
Print: Signature:

 

Areas Inspected Observation Corrective Actions Taken

 


20.0   COMPREHENSIVESITEINSPECTIONFORM

 

Date: Time:

 

Certified Operator
Print: Signature:

 

Compliance Certification   Statement
Based on   the results of this inspection the facility is in compliance with the general   permit and the SWPPP:   _____YES    _____NO

 

Areas Inspected Observation Corrective Actions Taken


21.0   HOUSEKEEPING INSPECTIONFORM

 

Date: Time:

 

Inspector
Print: Signature:

 

Areas Inspected Observation Corrective Actions Taken


22.0   EMPLOYEE TRAININGFORM

 

 

Date of   Session:

 

Trainer
Print: Signature:

 

Topics   Covered: 

 

 

Attendee Name Attendee Signature

 


23.0   ANNUAL SWPPP REVIEW REPORT FORM

 

Facility   Information
Designated Name: Certificate of Coverage No.:
Facility   Contact Information
Name: Telephone No.:
Email Address: Certification No:
Backup   Facility Contact Information
Name: Telephone No.:
Email Address: Certification No:
Certified   Operator Information
Name: Telephone No.:
Email Address: Certification No:

 

SWPPP Review Checklist

 

1)   Facility general information is current and accurate Yes No
2)   Site map is current and accurate Yes No
3)   Significant material inventory is current and accurate Yes No
4)   New exposures, processes and related controls have been documented   appropriately in the SWPPP Yes No NA
5)   Spills have been recorded and reported as appropriate Yes No NA
6)   Employee SWPPP training was conducted and documented Yes No
7)   Records of routine preventative maintenance and housekeeping inspections are   available in the SWPPP file Yes No
8)   Comprehensive site inspections have been completed, certified and filed in   the SWPPP file Yes No
9)   Corrective actions noted in the inspection reports have been completed Yes No
10)   SWPPP has been reviewed and signed by the Certified Storm Water Operator and   the Permittee or designated representative Yes No

 

Additional Comments (use additional sheets if necessary): 

 

 

 

I certify that the   above information is correct
Name: Signature   / Date:

 

SUBMIT THIS FORM TO THE DISTRICT OFFICE IDENTIFIED ON YOUR CERTIFICATE OF COVERAGE ON OR BEFORE JANUARY 10TH OF EACH YEAR


24.0   DEQ SPILL OR RELEASE REPORT

 

 

 

 


25.0   SAMPLE SITE MAP

 

 


25.0   SAMPLE SITE MAP CONTINUED

 

 


25.0   SAMPLE SITE MAP CONTINUED

 

 


26.0   SAMPLE TABLE 1

 

Section   Listed in General Permit Storage   Areas / Activity Areas Significant   Materials Exposure   Method Reasonable   Potential Evaluation (high,medium,low) Inlet(s) Outfalls(s)
1) Loading, unloading, and   other material handling operations 1) Boat maintenance area  Oil, battery acid, diesel fuel, gasoline, and other   fluids Spillage during material handling activities High A,B 1
2) Outdoor storage including   secondary containment structures 1) Boat storage area NA Outdoor storage Low B 1
2)  Equipment   storage area Grease, hydraulic oil Outdoor storage Medium B 1
3) Rack storage Rusting of metal Outdoor storage Low C 2
3) Outdoor manufacturing or   processing activities NA
4) Significant dust or   particulate generating processes 1) Boat hull sanding  Paint dust, fiberglass dust Outdoor maintenance activities High C 2
5) Discharge from vents,   stacks, and air emission controls NA
6) On-site waste disposal   practices 1) Dumpster staging area  General refuse Spillage during loading and unloading High C 2
2) Slip owner sewage pump out Raw sewage and grey water Spillage during unloading High A 1
7) Maintenance and cleaning of   vehicles, machines and equipment 1) Boat / vehicle maintenance  Diesel, gasoline, coolant, grease, oil, waste water Maintenance activities conducted outdoors High C 2
2) Boat washing  Sediment, paint, waste water Washing activities conducted outdoors High C 2

 

26.0   SAMPLE TABLE 1 CONTINUED

 

Section   Listed in General Permit Storage   Areas / Activity Areas Significant   Materials Exposure   Method Reasonable   Potential Evaluation (high,medium,low) Inlet(s) Outfalls(s)
8) Areas of exposed and/or   erodible soils 1) Gravel lot Sediment Erosion during rain events Medium D 2
9) Sites of Environmental   Contamination listed under Part 201 NA
10) Areas of significant   material residues NA
11) Areas where animals   congregate (wild or domestic) and deposit wastes NA
12) Other areas where storm   water may contact significant materials NA
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