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STATE OF CALIFORNIA•DEPARTMENT OF TRANSPORTATION <br /> BMP TAILGATE MEETING REPORT <br /> NPDE-50001 (REV 10/2017) <br /> ACTION AND DISTRIBUTION: <br /> " First line supervisor conducts meeting, completes, and signs form <br /> iC First line supervisor retains and posts a copy <br /> 3. First line supervisor forwards a copy to second line supervisor for review and signature <br /> 4. Second line 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 OFFICEIYARD <br /> Spray Lodi <br /> DATE OF MEETING COST CENTER <br /> 12/18/2017 102608 <br /> ATTENDANCE: <br /> Employee Name(Print) Employee Signature Employee Name(Print) Employee Signature <br /> V azoN r,�)e-be,' Wd, <br /> BMPs Discussed (List): <br /> Nonlandscaped Chemical Vegetation Control <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 LINE SUPERVISOR(Print) SECOND LINE SUPERVISOR(Print) <br /> FIRST LINE SUP RVISO (Signature) DAT SECOND LINE <br /> SUPERVISOR(Signature) DATE <br /> Forward completed 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 />