Stormwater Pollution Prevention Program (Swppp) Template Page 7
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30S
1. S
e
, a
, & P
eCtion
ite
valuation
SSeSSment
lanning
1.1 P
/S
I
rojecT
ITe
nformaTIon
Project/Site Name: __________________________________________________________________________
Project Street/Location: ______________________________________________________________________
City:____________________________________________ State: ___________ Zip: ___________________
County or Similar Subdivision: ________________________________________________________________
Latitude/Longitude:
Latitude:
___ ___
___ ___` ___ ___``
0
Longitude:
___ ___
___ ___` ___ ___``
0
Is this project considered a federal facility?
Yes
No
State Operating Permit needed?
Yes
No
NPDES project or permit tracking number: _______________________________________________________
1.2 c
I
/r
P
onTacT
nformaTIon
eSPonSIble
arTIeS
General Contractor: _________________________________________________________________________
General Contractor Contact: __________________________________________________________________
Address: __________________________________________________________________________________
City: ____________________________________________
State: _____________ Zip: ______________
Phone: _______________________________________ Fax:_______________________________________
E-mail: ___________________________________________________________________________________
Erosion Control Inspector: ____________________________________________________________________
Company: _________________________________________________________________________________
Address: __________________________________________________________________________________
City: ____________________________________________
State: _____________ Zip: ______________
Phone: _______________________________________ Fax:_______________________________________
E-mail: ___________________________________________________________________________________
24-Hour Contact: ___________________________________________________________________________
Contact Name: _____________________________________________________________________________
Phone: ____________________________________________________________________________________
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