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STATE OF CALIFORNIA•DEPARTMENT OF TRANSPORTATION , EMP TAILGATE MEETING REPORT NPDES-001 (REV 1012017) ACTION AND DISTRIBUTION: First line supervisor conducts meeting, completes, and signs form I i First line supervisor retains and posts a copy First line supervisor forwards a copy to second line supervisor for review and signature 4. Second line supervisor signs and returns the copy to first line supervisor to file in FPPP binder and forwards the copy to the Maintenance Storm Water Coordinator REGION OFFICENARD Mountain Lodi DATE OF MEETING COST CENTER 06/04/2018 Spray 102608 ATTENDANCE: Employee Name(Print) Employee Signature Employee Name(Print) Employ Sig ture 5c 0 �~ l=rq rats W BMPs Discussed (List): C FAMILY B-21 yr Suggestions for BMP Improvements C FAMILY—SLOPE/DRAINS/VEGETATION: Nonlandseaped Chemical Vegetation Control Discharge of the following materials into the storm water drainage system or watercourse:FUEL,SEDIMENT,NON-STORM WATER, VEHICLE FLUIDS, PESTICIDES. Supervisor's Comments Identify drain inlets and watercourses,both upstream and downstream of the activity site.Protect the drain inlets,storm water drainage systen) and watercourses from discharges of potential pollutants.Calibrate the spray rig to ensure accurate application of pesticides.Minimize the use of pesticides in or near storm water drainage system or watercourses. FIRS INE SUPERVISOR(Print) SECONQ LINE SUPERVISOR(Print) FIRPT-.LINE SU ERVISOR (Signature) DATE SECONDLINESUPERVISOR (Signature) DATE Forward completed copy to the District Maintenance Storm Water coordinator Post completed copy in crew room or FPPP book, keep copies for minimum of three(3)years. ADA Notice For individuals with sensory disabilities,this document is availaNe in alternate formats, For alternate format information, contact the Forms Management Unit at(916)445-1233,TTY 711,or write to Records and Forms Management,1120 N Street,MS-89,Sacramento,CA 95814.