Form 3400-187 - Construction Site Inspection Report
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1
2CONSTRUCTION SITE INSPECTION REPORT
State of Wisconsin
Department of Natural Resources
Form 3400-187 (rev. 9/04)
Page 1 of 2
dnr.wi.gov
Notice: Use of this specific form is voluntary, but the information contained on this form must be collected and kept by the permittee under s. NR
216.48(4), Wis. Adm. Code, for a construction site covered under the General WPDES Construction Site Storm Water Discharge Permit, Permit
No. WI-0067831-2. This form is provided for the convenience of the permittee to meet the requirements of s. NR 216.48(4), Wis. Adm. Code.
Multiple copies of this form may be made to compile the inspection report.
Inspections of implemented erosion and sediment control best management practices must be performed weekly and within 24 hours after a
precipitation event 0.5 inches or greater which results in runoff.
Weekly written reports of all inspections conducted by or for the permittee must be maintained throughout the period of general permit coverage.
The information maintained in accordance with s. NR 216.48 (4) must be submitted to the Department upon request.
Name of Permittee:
Construction Site Name (Project):
Construction Site ID No.:
Location:
County:
Contractor:
Field Office Phone:
Note: Weekly inspection reports, along with erosion control and stormwater management plans, are required to be
maintained on site and made available upon request.
Date of inspection (mm/dd/yy):
Type of inspection:
Weekly
Precipitation Event
________________
Other (specify) ____________________________________
Time of inspection:
Start:
a.m./p.m.
Name(s) of individual(s) performing inspection:
End:
a.m./p.m.
Weather:
Description of present phase of construction:
Comments/Recommendations about the overall effectiveness of the erosion
Not
and sediment control measures.
Modifications Required
Yes
No
Applicable
Note: For each item checked "Yes", complete the follow-up information on
page 2.
Ditch Checks
Erosion Control Plan
Erosion Mat
Grading Practices
Inlet Protection
Mulch
Offsite Sediment
Permanent Seeding
Schedule / Phasing
Silt Fence
Silt Screen
Sod
Stabilized Outlet
Temp. Diversion Channel
Temp. Settling Basin
Temporary Seeding
Tracking Pads
Turbidity Barrier
Other (specify) __________
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