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APPENDIX A Interim Discharge Prevention Plan Daily Inspection Report Inspections must be conducted by a person with the knowledge and skills to assess conditions and activities that could impact stormwater quality at the facility, and evaluate the effectiveness of best management practices required by this permit. Retain a copy of the completed and signed form in accordance with Permit Condition S9.C. FACILITY NAME: Nelson Petroleum, Inc. INSPECTION TIME: DATE: WEATHER INFORMATION: • Description of Weather Conditions (e.g., sunny, cloudy, raining, snowing, etc.): • Was stormwater (e.g., runoff from rain or snowmelt) flowing at outfalls and/or discharge areas shown on the Site Map during the inspection: ❑ Yes ❑ No ❑ Comments: I. POTENTIAL POLLUTANT SOURCE AREA INSPECTION AND BEST MANAGEMENT PRACTICES EVALUATION SWPPP and Site Map: Have a copy of the SWPPP and site map Yes No Findings and Remedial Action Documentation: with you during the inspection so that you can ensure they are Describe any findings below and the schedule for current and accurate. Use it as an aide in recording the location of remedial action completion including the date any issues you identify during the inspection. initiated and date completed or expected to be • Is the Site Map current and accurate? completed. • Is the SWPPP inventory of activities, materials and products current? Any new potential pollutant sources must be added to the map and reflected in the SWPPP Facility Assessment & Tables 2, 2A, 3 an 5.