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STATE&'CALIFORNIA•DEPARTMENT OF TRANSPORTATION <br /> BMP TAILGATE MEETING REPORT <br /> NPDE-S0001 (REV 1012017) <br /> ACTION AND DISTRIBUTION: <br /> First line supervisor conducts meeting, completes, and signs form <br /> First line supervisor retains and posts a,copy <br /> `3: First Iine.supervisor forwards a copy to second line supervisor for review and signature <br /> 4. Second fine supervisor signs and returns the copy to first line supervisor to file in FPPP binder and forwards the copy to the <br /> Maintenance Storm Water Coordinator <br /> REGION OFFICENARD <br /> Spray Lodi <br /> DATE OF MEETING COST CENTER <br /> 11/20/2017 102608 <br /> ATTENDANCE: <br /> Employee Name(Print) Employee Signature Employee Name(Print) Employee Signature <br /> U1 tst u° <br /> �a <br /> T aso rV WeApel <br /> BMPs Discussed(List): <br /> Nonlandscaped Chemical Vegetation Control <br /> r <br /> Suggestions for BMP Improvements <br /> Environmental Concerns Discharge of the following materials into the storm water drainage system or watercourse- <br /> -Fuel <br /> •Sediment <br /> ,Non-storm water <br /> •Vehicle fluids <br /> -Pesticides <br /> Supervisor's Comments <br /> FIRST LIJN�SUPERVISOR (Pr' t) SECOND LINE SUPERVISOR (Print) <br /> /7 i_7) � <br /> FIRST LINE SUP ISOR(Signature r. DATE SECOND LINE SUPERVISOR (Signature) DATE <br /> Forward competed copy to the District Maintenance Storm Water coordinator Post completed copy in crew room or FPPP book, <br /> keep copies for minimum of three(3)years. <br /> ADA Notice For individuals with sensory disabilities, this document is available in alternate formats. For alternate format information, contact the Forms <br /> Management Unit at(916)445-1233,TTY 711,or write to Records and Forms Management, 1120 N Street, MS-89,Sacramento,CA 95814. <br />