3322 BROADWAY COMPASS HEALTH 2025-10-03

Construction Stormwater Site Inspection Form Project Name Permit # Inspection Date Name of Certified Erosion Sediment Control Lead (CESCL) or qualified inspector if less than one acre Print Name: Approximate rainfall amount since the last inspection (in inches): Approximate rainfall amount in the last 24 hours (in inches): Current Weather Clear ❑ Cloudy ❑ Mist ❑ Rain ❑ Wind ❑ Fog ❑ A. Type of inspection: Weekly ❑ Post Storm Event ❑ Other B. Phase of Active Construction (check all that apply): Pre Construction/installation of erosion/sediment controls Concrete pours Offsite improvements C. Questions: Time Clearing/Demo/Grading Infrastructure/storm/roads Vertical Utilities Construction/buildings Site temporary stabilized Final stabilization 1. Were all areas of construction and discharge points inspected? Yes No 2. Did you observe the presence of suspended sediment, turbidity, discoloration, or oil sheen Yes No 3. Was a water quality sample taken during inspection? (refer to permit conditions S4 & S5) Yes No 4. Was there a turbid discharge 250 NTU or greater, or Transparency 6 cm or less?* Yes No 5. If yes to #4 was it reported to Ecology? Yes No 6. Is pH sampling required? pH range required is 6.5 to 8.5. Yes No If answering yes to a discharge, describe the event. Include when, where, and why it happened; what action was taken, and when. *If answering yes to # 4 record NTU/Transparency with continual sampling daily until turbidity is 25 NTU or less/ transparency is 33 cm or greater. Sampling Results: Date: Parameter Method (circle one) Result Other/Note NTU cm pH Turbidity tube, meter, laboratory pH Paper, kit, meter Page 1