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CHEMINFO<br />

Sample Daily Record-keeping Form <strong>for</strong> Fugitive Dust Abatement<br />

Project Name:__________________ Project Location:__________________ Date:___________________<br />

Each time you visually check an area <strong>for</strong> dust control measure implementation, write <strong>the</strong> time in <strong>the</strong> shaded box at <strong>the</strong><br />

top <strong>of</strong> <strong>the</strong> table and write a “Y”, “N” or “NA”, in <strong>the</strong> boxes below your recorded time. Use <strong>the</strong> “Comments” column<br />

to record o<strong>the</strong>r pertinent in<strong>for</strong>mation (e.g., describe <strong>the</strong> corrective action taken).<br />

1. Be<strong>for</strong>e Dust Generation Operations Occur<br />

Pre-watering to depth <strong>of</strong> cuts?<br />

Pre-watering storage piles?<br />

Work phased/disturbance minimized?<br />

Water trucks being operated?<br />

Water trucks being filled?<br />

O<strong>the</strong>r (specify in Comments column)<br />

2. During Dust Generating Operations<br />

Is visible dust present?<br />

Applying water?<br />

Applying dust suppressant(s) o<strong>the</strong>r than water?<br />

Fences 3’-5’ with 50% porosity intact?<br />

Shut down operations?<br />

Checked control measures be<strong>for</strong>e leaving <strong>the</strong><br />

work site <strong>for</strong> <strong>the</strong> day?<br />

O<strong>the</strong>r (specify in Comments column)<br />

3. Unpaved Haul/Access Roads<br />

Is visible dust present?<br />

Vehicles travelling less than 15 miles per hour<br />

(24 kilometers per hour)?<br />

Is road visibly moist?<br />

Is road covered with gravel, recycled asphalt or<br />

o<strong>the</strong>r suitable material?<br />

Applying dust suppressant(s) o<strong>the</strong>r than water?<br />

O<strong>the</strong>r (specify in Comments column)<br />

4. Loading, Unloading and Storage Piles<br />

Is visible dust present?<br />

Pre-watering material?<br />

Water being applied during loading/unloading?<br />

O<strong>the</strong>r (specify in Comments column)<br />

5. Trackout/Access Points<br />

Is trackout control device intact?<br />

Cleaned-up trackout?<br />

O<strong>the</strong>r (specify in Comments column)<br />

6. Temporary Site Stabilization<br />

Applying water?<br />

Applying dust suppressant(s) o<strong>the</strong>r than water?<br />

O<strong>the</strong>r (specify in Comments column)<br />

Total Number <strong>of</strong> Litres Applied:_________ Responsible Person’s Signature and Title:________________<br />

<strong>Best</strong> <strong>Practices</strong> <strong>for</strong> <strong>the</strong> <strong>Reduction</strong> <strong>of</strong> <strong>Air</strong> <strong>Emissions</strong> <strong>From</strong> <strong>Construction</strong> and Demolition Activities 42<br />

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