Form 3400-176A - 3400-176a-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Facility Name and Mailing Address, if different from the site location. Ensure all details are accurate for proper documentation.
3. Fill in the City, State, and ZIP Code fields to specify your facility's location.
4. Provide the Name of Person Conducting Inspection along with the Inspection Date and Employer information.
5. Record the Outfall Number as referenced in your site map, followed by the Time of Rainfall Event.
6. Describe the Outfall type (e.g., ditch, concrete pipe) and note the Time of Visual Inspection. Optionally, include Amount of Rainfall at that time.
7. In the observations section, detail any visual indicators such as color, odor, and clarity. Use a glass jar for sampling if needed.
8. Document any visible pollution findings and suggest Best Management Practices to mitigate issues. Include comments summarizing your observations.
9. If an outfall was not evaluated this quarter, provide a brief explanation in the designated area.
10. Attach relevant photos that depict observations made during inspections for comprehensive documentation.

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