Contractor Field Assistant

Erosion and Sediment Control Best Management Practices Inspected

id	BMP	GPS (Lat/Lon)	Location Description	BMP Maintenance or Corrective Action	Image

Additional Quantities or Additional Best Management Practices Needed

id	BMP	GPS (Lat/Lon)	Location Description	BMP Maintenance or Corrective Action	Image

Temporarily or Permanently Suspended Construction Activities

id	BMP	GPS (Lat/Lon)	Location Description	BMP Maintenance or Corrective Action	Image

Compliance Evaluation

With the maintenance and improvement actions noted, the areas inspected will meet the intent of the Erosion and Sediment Control Plan and INDOT contract documents and specifications related to temporary erosion and sediment control.

The areas inspected are not meeting the intent and are in potential noncompliance with the Erosion and Sediment Control Plan and/or INDOT contract documents and specifications related to temporary erosion and sediment control. There is off site sedimentation and/or a high potential for off-site sedimentation on this project.

Potential Noncompliance Issues

id	BMP	GPS (Lat/Lon)	Location Description	BMP Maintenance or Corrective Action	Image

Overview

Inspection Certification

Inspector Name:	Company:	Title:	Date:
I certify that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is to the best of my knowledge and belief, true, accurate and complete.
Inspector (Type Full Name):
I concur with the inspector. I do not concur with the inspector.

(1) Diversion Interceptor	(8) Check Dam, Traversable	(15) Filter Berm	(22) Concrete Washout	(29) Dewatering
(2) Temporary Seeding	(9) Slope Drain	(16) Filter Sock	(23) Secondary Spill Containment	(30) Rock Chute
(3) Permanent Sod or Seed	(10) Splash Pad	(17) Turbidity Curtain	(24) Other (must take a picture)	(31) Dust Control
(4) Mulch (hydraulic or bonded fiber mulch)	(11) Sediment Trap	(18) Surface Roughening	(25) Earthwork (slope)	(32) Riprap Ditch
(5) Straw Mulch (blown/laid)	(12) Sediment Basin	(19) Vegetative Filter Strip	(26) Earthwork (ditch bottom)	(33) Notice of Termination
(6) Manufactured Surface Protection Products	(13) Retention Pond	(20) Inlet Protection	(27) Cofferdam
(7) Check Dam	(14) Silt Fence	(21) Construction entrance/exit	(28) Pump Around

BMP Type	GPS(Lat,Lon)