SAMPLE: fictional site, people and data. For illustration only. Not a real inspection report.
Construction Stormwater Inspection Report
Georgia NPDES General Permit GAR100001 (stand-alone construction) · Part IV.D.4 inspection
Report # SAMPLE-0928-01 Prepared with the Georgia Stormwater Log (prototype)
Project / facility
Magnolia Ridge, Lot 14 (fictional)
Site location
Sample Lane, Canton, GA · Cherokee County (fictional address)
Primary permittee
Pinecrest Sample Homes LLC (fictional)
NOI / permit
GAR100001 · GEOS submittal # 0000000 (sample)
Disturbed acreage
0.62 ac (sampling not required: under 5 ac)
Receiving water
Sample Creek (fictional)
Construction phase IV.D.4.a.(6)
Intermediate(☐ Initial ☒ Intermediate ☐ Final)
Weather at inspection
Clear, 64°F, soils damp
1. Inspection details Part IV.D.4.a.(3) and (6)
Inspection type
Post-rain inspection (storm of 0.5 in or more). Per the permit, this inspection also resets the 7-day inspection frequency.
Qualifying storm
Ended Fri 9/25/2026, 6:15 PM · 0.60 in recorded at the on-site rain gauge
Deadline applied
The storm ended after 5:00 PM on a Friday and the site does not work weekends, so the inspection was due by the end of the next business day and/or working day, whichever occurs first: Mon 9/28/2026.
Date and time of inspection IV.D.4.a.(6)
Mon 9/28/2026, 8:10–8:55 AM ✓ within deadline
Certified personnel making the inspection IV.D.4.a.(6)
Jordan Avery (fictional) · GSWCC Level IA Card # 00000-SAMPLE, exp. 12/2027 (optional field, recommended good practice; the permit requires the name)
Next 7-day inspection due
Mon 10/5/2026 (7 calendar days from this post-rain inspection)
The permit requires rainfall to be measured and recorded within disturbed, not-yet-stabilized areas every 24 hours, except any non-working Saturday, non-working Sunday and non-working federal holiday.
3. Areas inspected Part IV.D.4.a.(1) and (3)
Area
Inspected
Result
(a) Disturbed areas of the site
Yes
See BMP findings
(b) Material storage areas exposed to precipitation
Yes
No issues: lumber covered, no bagged materials exposed
(c) Structural control measures
Yes
See BMP findings
Accessible discharge locations/points (effectiveness in preventing significant impacts to receiving waters)
Yes
Discharge at rear swale clear. No sediment observed leaving site.
Petroleum storage/handling areas: spills or leaks (daily item)
Yes
No leaks observed at fuel can storage
Construction exit: off-site sediment tracking (daily item)
Yes
Tracking observed onto street (see #3 below)
4. Major observations and BMP findings Part IV.D.4.a.(6)
#
BMP / location (per ES&PC Plan)
Status
Observation
1
Sd1 silt fence (Type S), rear lot line
Not maintained
~10 ft section undermined at low point. Sediment at about 1/2 the fence height upslope.
2
Inlet protection (Sd2), curb inlet at lot frontage
Stone voids filled with mud. Tracking onto Sample Lane.
4
Temporary seeding/mulch (Ds2), side slopes
OK
Coverage ~70%, establishing. No rills.
5
Concrete washout, NE corner
OK
Lined, under 50% full.
Incidents of BMPs not properly installed and/or maintained as described in the Plan: #1, #2, #3 (identified as required by Part IV.D.4.a.(6)). Because incidents were found, the "no incidents" compliance certification below does not apply to this report.
5. Actions taken / required Part IV.D.4.a.(5)
#
Corrective action
Plan revision needed?
Due (≤ 7 calendar days)
Completed
1
Re-trench and re-stake undermined silt fence section. Remove accumulated sediment.
No
10/5/2026
9/29/2026 · J. Avery
2
Clean out inlet protection. Replace filter fabric.
No
10/5/2026
9/28/2026 · J. Avery
3
Top-dress construction exit with stone; sweep street.
No
10/5/2026
9/28/2026 · J. Avery
Per Part IV.D.4.a.(5), the Plan shall be revised as appropriate within 7 calendar days of the inspection, and changes implemented as soon as practical but within 7 calendar days.
6. Certification and signature Part V.G.2
"I certify under penalty of law that this report and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that certified personnel properly gather and evaluate 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. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations."
When no incidents are found, the report must instead contain a certification that the BMPs are in compliance with the Erosion, Sedimentation and Pollution Control Plan (Part IV.D.4.a.(6)). The log adds this automatically when every BMP is marked OK.
Sam Pinecrest
Signature: permittee or duly authorized representative (Part V.G.2)