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Industrial & Commercial Stormwater Evaluation Program Facility Survey
Please complete the survey questions below. If you have any questions please contact Mr. Ty Fukuroku, of Maui Highways at (808) 873-3535 or at his email address,
ty.h.fukuroku@hawaii.gov
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Facility Owner's Name & Location Address:
*
Your answer
Contact Name for Scheduling & Obtaining Access to Facility:
*
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Facility Contact's Email Address & Phone Number:
*
Your answer
Facility's Standard Industrial Classification (SIC) Code:
Your answer
Select all that are applicable about your facility's on-site activities:
On-Site Vehicle Fueling
Maintenance and or Cleaning of Vehicles / Equipment Parts Conducted On-Site
Vehicle, Equipment, or Supplies Washing On-Site
Painting Activities Conducted On-Site
Loading / Unloading Docks On-Site
Outdoor Above Ground Liquid Storage Tanks On-Site
Industrial Waste Produced or Handled On-Site
Raw Materials, Parts, or Products Stockpiled Outdoors On-Site
If required does the facility have any of the following documents:
National Pollution Discharge Elimination System (NPDES) Permit
Storm Water Pollution Control Plan (SWPCP)
Spill Prevention, Control, and Countermeasure (SPCC) Plan
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