Erosion and Water Pollution Inspection Checklist
Use this checklist to systematically assess sites for erosion and water pollution risks, document observations, and recommend corrective actions.
Site Name or Location
*
Inspector Full Name
*
First Name
Last Name
Inspection Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Weather Conditions During Inspection
Clear
Cloudy
Rainy
Windy
Other
Observed Erosion Conditions
*
Rows
Not Present
Minor
Moderate
Severe
Sheet erosion
1
2
3
4
Rill erosion
5
6
7
8
Gully erosion
9
10
11
12
Slope failure
13
14
15
16
Streambank erosion
17
18
19
20
Water Pollution Indicators Observed
Turbid/discolored water
Floating debris
Oil sheen
Odor
Algae bloom
Other (describe below)
Overall Severity of Erosion and Water Pollution Risks
*
Low
1
2
3
4
High
5
1 is Low, 5 is High
Corrective Actions Taken or Recommended
Is Follow-Up Inspection Required?
*
Yes
No
Next Follow-Up Date (if required)
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Additional Notes or Observations
Submit Inspection
Should be Empty: