PROJECT:_____________________________________________

CONTRACTOR PROJECT MANAGER:____________________________________________

MNDOT INSPECTOR:______________________	Date/Time:_______________ Weather:_______________

Rainfall amount within last 24 hours:____________

NOTE: - ANY CONDITIONS RESULTING IN NON-EFFECTIVE OR POTENTIALLY INSUFFICIENT POLLUTION PREVENTION MUST BE CORRECTED IN A TIMELY MANNER AND IN ACCORDANCE WITH REGULATORY REQUIREMENTS

INSPECTION REQUIREMENT	IMPLEMENTED?	MAINTENANCE REQUIRED?	CORRECTIVE ACTION REQUIRED AND NOTES
Is there compliance with the pollution prevention plan details in the contract documents?	Y N N/A	Y N
Are contractor initiated changes to the pollution prevention plans effective?	Y N N/A	Y N
Are the construction site vehicle exits free of off-site sediment tracking?	Y N N/A	Y N
Are the silt fences and bio-logs installed and properly functioning?	Y N N/A	Y N
Is there any evidence of sediment escaping the immediate construction site?	Y N N/A	Y N
Is effective dewatering in-place as needed?	Y N N/A	Y N
Is the concrete wash-out area effectively used and maintained?	Y N N/A	Y N
Is there any evidence of waste products being disposed of in an improper manner?	Y N N/A	Y N
Are perimeter controls and sediment barriers adequately installed and maintained?	Y N N/A	Y N
Are inlet protection devices and sediment traps effectively functioning?	Y N N/A	Y N
Are slopes, stockpiles, and disturbed areas stabilized within the time periods allowed?	Y N N/A	Y N
Are surface waters and other sensitive areas fully protected?	Y N N/A	Y N
Are temporary and permanent sediment basins functioning properly?	Y N N/A	Y N
Are planned infiltration areas being protected from sediment and compaction?	Y N N/A	Y N
Is trash on the site being collected properly?	Y N N/A	Y N