11.24. Environmental Checklist for Modot Facilities

11.24. Environmental Checklist for MoDOT Facilities

Surveys are conducted of all maintenance facilities to establish compliance with federal, state and local environmental regulations. The form used to conduct these surveys covers areas of concern.

District____

1-Facility

Name: ______Date: ______/______/______

Address: ______City: ______Zip: ______

2-Drinking Water

Private System _____ Distance to Public system ______miles

Public System _____ Name: ______

Backflow Preventer where needed: Yes______No ______

Comment: ______

3-Sewage system

Private System: _____ Lagoon: _____ Tile field: _____ Working? ______

Distance to public system______miles Name: ______

Public System: ______Name: ______

Floor Drains Yes ___ No ____ (If yes) Connected to sewer ____ Tile field____

Daylight to ditch _____ Drains: plugged _____ covered _____

Comments: ______

4-Salt Storage

Type of Salt Building: Fabric ____ Dome _____ Bay _____ (# bays) _____

Gabriel _____ Outside pile _____ (covered? No ____Yes____

Type of cover ______)

Storage Building Condition: ______

Salt Basin ______Salt Pond ______(needed yes ____ no ____)

Salt Damage Yes____ No____ if yes----Onsite: ____ Offsite: ____

Damage result of Storage _____ salt pond_____ accident ____

Result of Past ______Current ______problems

Claim paid or land bought Yes _____ No _____

Comment: ______

5-Hazardous Material Storage

Evidence of Leaks or Spills Yes ____ No _____ (ongoing Yes ____ No ____)

Incompatible Chemicals stored separately Yes ____ No _____

Containers Properly Labeled Yes ____ No _____

Comments: ______

Closed ____ Open _____

Parts Cleaner Closed _____ Open _____ Brand ______

Recycled ____ Filtered ____

Old Lead Acid Batteries Yes ____ No _____ (properly stored Yes ____ No ___

Comment: ______

______

______

6-Gasoline, Diesel Fuel, Oil, Asphalt, and Used Oil

Tank Number & Size (gallons): Gasoline (___)______, Diesel (___)______

Kerosene (___)______Asphalt (___)______(in service Yes ___

No___) Used Oil (___)______Other ______

Containment: Largest tank plus %10 Yes ____ No _____ Some ______

Total Tanks/containers over 1,320 gallons Yes ____ No _____

(containers under 55 gallons not counted in total)

List Tanks that need containment: ______

______

______

SPCC plan Yes _____ No _____ In the works ______

Containers Labeled Yes ____ No ____ Need ______

New Oil In containment Yes ____ No____

Floor Drains if present plugged Yes ____ No ____

connect to oil/water separator Yes ____ No ____

Used Oil in containment Yes____ No____ Tank or drum size ______gal.

Used Oil Heater used at site Yes ____ No ____

If not for heat, disposal method ______

Cost per gallon ______Company ______

Comments: ______

7-Solid Waste Management

Waste Tires Hauled by Corrections Yes ____ No ____ (company)______

No. Stored on site ______More than 25 under cover Yes ____ No ____

Types of Waste Segregated Yes ____ No ____

Street Sweepings stored at site Yes ____ No ____ Disposal Method ______

Landfill Name & Location ______

Oil Filter Disposal: Landfill ______Recycle _____ Company ______

Comments: ______

8-Neighboring Environmental Concerns

One Mile – NPL Site ______, RCRA site ______

Landfill site______

Adjoining Property – UST ______, RCRA site ______,

Discharge to site ______, Storage Tanks ______,

Drums ______, Stressed Vegetation ______Pits/Ponds ______,

Lagoons ______, Septic Waste ______, Wells ______,

Property use for (i.e. residential, industrial or rural)______

9-Comments

Inspector Sign: ______Date: ______