19980260 Ver 4_NPDES 9-23-19_20191009

INSPECTION RECORD FOR ACTIVITIES UNDER STORMWATER GENERAL PERMIT NCGO10000
SELF -INSPECTION RECORD FOR LAND DISTURBING ACTIVITIES PER § 113A-54.1
RESPONSE FOR EROSION CONTROL FORM 1675
PROJECT LOCATION WINSTON SALEM, NO TIP/"S# u 579D.
LEVEL H SUPERVISOR Dillon Johnson COUNTY FOR--Li—
CONTRACTOR FLATIRON - BLYTHE DEVELOPMENT, A JOINT VENTURE
All erosion and sedimentation control measures and stormwater discharge outfalls must be inspected once per seven calendar days AND
within 24 hours of a rainfall of 0.5 inch or greater per 24 hour period. Additional monitoring MAY be required at the discretion of DWR
if the receiving stream is 303(d) listed for turbidity AND the project has had documented problems managing turbidity. Permittee must
keep a record of inspections. Attach Multi Precipitation Estimator (MPE) rainfall data for weekly period. If using on site rain gage,
complete daily rainfall measurement. See the most recent `Applicable Requirements' document for more information.
(htti)://www.nedot.gov/doh/oi)erations/dpchief en /roadside/fieldo s/downloads/Files/NCG01GuidanceandFA s2015. d .
Day
Date
Rain
Amt(in)
Notes
1
9l2312019
0 11
INSPECTION
9 19re4/2o19
�19/2512019
9
Th
F
912612019
9/2112019
I O
0 II
Sat
9/28/2019
.965
Sun
sr2sr2o1s
a
Phase of Grading
lace a check in the box of the current project phaso
Installation of perimeter erosion and sediment control measures
X
Clearing and grubbing of existing ground cover
X
Cam letion of any phase of grading of slopes or fills
Installation of storm drainage facilities
X
Completion of construction or development
Establishment of permanent around cover sufficient to restrain erosion
Has all land disturbing activity been completed? (Y/N) N
Has the final permanent ground cover been completed and established? (Y/N) N
By this signature, I certify (in accordance with Part H Section B, 10 of the NCG010000 permit)
that this report is accurate and complete to the best of my knowledge:
Cert. bevel 11 Sup k visor Cert. #
NCDO"f Cer . evel II Representative Cert. 4
Exceptions to standard monitoring requirements
Idle projects: Idle projects must be inspected once every 14
calendar days and after 0.5" of rain in a 24 hour period. Idle
projects are projects that have not been completed but where
no construction activity occurs for 21 calendar days or more
AND the entire project has been adequately stabilized with
temporary vegetation pursuant to DEMLR guidelines. See
`Applicable Requirements' for exceptions.
Completed projects: Completed projects are those projects
where work has been completed and you're waiting for the
permanent vegetation to establish (i.e. waiting for the grass to
grow). Completed projects must be inspected once every 30
calendar days AND after 0.5" of rain in a 24 hour period. The
reduced monitoring can begin once construction has been
completed, and erodible slopes have been sufficiently
stabilized to restrain erosion by application of permanent
ground cover varieties and installation of temporary ground
cover to include appropriate erosion control matting and/or
other approved mulch materials.
Form should not be signed until the week is complete and ALL
corrective actions have been completed in the 24 hour and/or 5
day time periods.

04/2019 SP--FORM30
StOmwater'�>fscharg Clu>'aals {ID, Visible Sedimentation-
-N Shee 2 ;;
(I2equ>llred to last du117 4 eat ll-inspectiq>) u�f and S#ream Turbidity
Inspection
Date
Station Number.
Corrective Actions Takeu
Priority*
Date
Corrected
Other
Pollutants*.:
Sediment
Deposited"*
Stream
Clarity.*
9/23/2019
BID 5.10B
Installed
N
N
N
9/23/2019
BID 5.11B
Installed
N
N
N
9/23/2019
BID 5.12CG
Installed
N
N
N
9/23/2019
BID 5.13CG
Installed
N
N
N
9/23/2019
BID 5.14CG
Installed
N
N
N
9123/2019
BID 5.15CG
Installed
N
N
N
9/23/2019
BID 5. I6CG
Installed
N
N
N
9/23/2019
BID 5.18CG
Installed
N
N
N
9/23/2019
BID 5.19CG
Installed
N
N
N
9/23/2019
BID 6.1B
Installed
N
N
N
9/23/2019
BID 6.313
Installed
N
N
N
9/23/2019
BID 6.4CG
Installed
N
N
N
9/23/2019
BID 6513
Installed
N
\'
N
9/23/2019
BID 7.1B
Installed
N
N
N
9/23/2019
BID 7.3CG
Installed
N
N
N
9/23/2019
BID 7.4CG
Installed
N
N
N
9/23i2019
BID 8.1CG
Installed
N
N
N
9/23/2019
BID 8.2CG
installed
N
N
N
9/23/2019
BID 9.1CG
Installed
N
N
N
9/23/2019
BID 9.2CG
Installed
N
N
N
9/2312019
BID 9.3CG
Installed
N
N
N
9/23/2019
BID 10.5E
Installed
N
N
N
9/23/2019
BID 10,6E
Installed
N
N
N
9/2312019
BID 10.8F
Installed
N
N
N
9/2312019
BID 10.9F
Installed
N
N
N
9/23/2019
BID IO.IOB
Installed
N
N
N
9/23/2019
BID 11.3B
Installed
N
N
N
9/23/2019
BID 11.5E
Installed
N
N
N
9/23/2019
BID 11.7CG
Installed
N
N
N
9/23/2019
BID 11,8E
Installed
N
N
N
9/23/2019
BID 26.1 B
Installed
N
N
N
9/23/2019
BID 26.213
Installed
N
N
N
9/23/2019
BID 26.313
Installed
N
N
N
9/23/2019
811) 26.4CG
Installed
N
N
N
9/23/2019
BID 28.5F
Installed
N
N
N
9/23/2019
BID 28.6F
Installed
N
N
N
*R=Routine; needs
attention within 5
days; U=Urgent,
needs attention
within 24 hrs.
**Is there evidence of other pollutants discharging from site
such as oil sheen, discoloration, cement wastes, sanitary waste,
fertilizers, or fuel or storage leakage? (Y/N)
**If Other Pollutants is marked Yes describe extent of discharge
g
and list the corrective actions taken.
***Is there "any visible sediment. deposited in a stream, wetland,
buffer or:adjacent propertyT (YIN)
*** Contact DWQ/DLR-LQ within 24 hours if visible sediment
is deposited in surface waters or wetlands.
****Is there Any visible
decrease in stream clarity.
(increase turbidity -
cloudy) because of
discharge? (YIN)
NOTE: Any erosion control device that is damaged that has the potential to lose sediment and/or pollution offsite and/or into surface waters should be treated as "URGENT"

04/2019 Sr^''FORM30
5tormwater Disehalrge Outfalls (SDO) Utsible sedilnentation
(Required to list during each inspection) aztdStream Tu'rliidi. ty
Inspection
Date
Station.NumberCorrective
Actions Taken , > .
Prioritty�
hate
Corrected'
other
Pollutants".
Sediment
. Deposited"**
Stream
Clarity*. �* '
9/2312019
BID 28.7E
Installed
N
N
N
9/23/2019
BID 30.3E
Installed
N
N
N
9/23/2019
BID 30.417
Installed
N
N
N
9/23/2019
BID 30.5F
Installed
N
N
N
9/23/2019
BID 30.6P
Installed
N
N
N
9/23/2019
BID 31.1 B
Installed
N
N
N
9/23/2019
BID 31.2B
Installed
N
N
N
9/23/2019
BID 31.3B
Installed
N
N
N
9/23/2019
STA - 67+65 Rt 192'
Installed
N
N
N
9/23/2019
STA - 67+95 Rt 80'
Installed
N
N
N
9/23/2019
STA - 68+30 Rt 37'
Installed
N
N
N
9123/2019
STA - 68+50 Lt 72'
Installed
N
N
N
9/23/2019
STA - 68+55 Lt 60'
HWC - Installed
N
N
N
9/23/2019
STA - 69+15 Lt 172'
HWC - Installed
N
N
N
9/23/2019
STA - 69+25 Lt 202'
HWC - Installed
N
N
N
9/23/2019
STA - 69+35 Lt 219'
HWC - Installed
N
N
N
9/23/2019
STA - 69+80 Lt 188'
HWC - Installed
N
N
9/23/2019
STR 1026
Pipe outlet - Installed
N
N
N
9/23/2019
STA - 356+30 Rt 17'
HWC - Installed
N
N
N
9/23/2019
STA - 356+35 Rt 26'
HWC - Installed
N
N
N
9/23/2019
STA - 405+75 Rt 240'
Permanent Ditch - Installed
N
N
N
9/23/2019
YI RPA 20+20 Rt 110'
1IWC - Installed
N
N
N
9/23/2019
YI RPA 20+20 Rt 36'
HWC - Installed
N
N
N
9/23/2019
Yl RPA 20+50 Rt 91'
HWC - InstaIled
N
N
N
9/23/2019
Yl RPA 20+15 Lt 44'
HWC - InstaIled
N
N
N
9/23/2019
YI RPA 20+00 Lt 57'
HWC - Installed
N
N
N
9/23/2019
Yi LPD 5+05 Lt 77'
HWC - Installed
N
N
N
9/23/2019
Y1 LPD 4+85 Lt 17'
HWC - Installed
N
N
N
9/23/2019
YI LPD 5+50 Lt 5'
HWC - Installed
N
N
N
9/23/2019
Y I RPD 25+90 Rt 52'
HWC - InstalIed
N
N
N
9/23/2019
Y1 RPD 25+95 Lt 55'
HWC - Installed
N
N
N
9/23/2019
Yl RPD 26+00 Lt 117'
HWC - Installed
N
N
N
9/2312019
Yl RPD 26+10 Lt 1 17'
HWC - Installed
N
N
N
N
N
N
N
N
N
N
N
N
*R=Routine, needs
attention within 5
days; U=Urgent,
needs attention
within 24 hrs.
**ls there evidence of other pollutants discharging from site
such as oil sheen, discoloration, cement wastes, sanitary waste;
fertilizers, or fuel or storage leakage? (YIN)
**If Other Pollutants is marked Yes, describe extent of discharge
n
and list the corrective actions taken. '
***Is there any visible sediment deposited in a stream, wetland,:,
buffer or adjacent property? (Y/N) .
*x*.Contact DWQ/DI,R-LQ within 24 hours if visible sediment
is in surface waters or=wetlands.
****Is there any visible
decrease in stream,clarity
(increase turb dity-
cloudy) because of a
discharge? (YIN)
NOTE: Any erosion control device that is damaged that has the potential to lose sediment and/or pollution offsite and/or into surface waters should be treated as "URGENT"

04/2019 SPA'— ORM30
NOTE: Any erosion control device that is damaged that has the potential to lose sediment and/or pollution offsite and/or into surface waters should be treated as "URGENT"

DOT Precip Res,", For Project Winston DEF
https://climate.ncsu.edu/dot/p- ',ct_more_query.php
Multi -Sensor Precipitation Estimates
.�. (M PE)
r 7 O
OI,RAH�" �r
MPE home Map My Projects My Alerts More MPE Data User Acct Status NC CRONOS State Climate Office Contact
Project Precipitation Time Series for Winston DEF
Date Range: 2019-09-23 thru 2019-09-29
Project: Winston DEF
Observation
University Pkwy
(old DOT Yard)
Germanton Rd
Old Hollow Rd
Baux Mtn Rd
Davis Rd
Dippen Rd
L sta. 400
Date & Time
36.230926°N,
36.19847°N,
36.191274°N,
36.180289°N,
36.165017°N,
36.162432°N,
36.157971°N,
(EST)
-80.280589°E
-80.253883°E
-80.242678°E
-80.222719°E
-80.203091'E
-80.194357°E
-80.187804°E
(inches)
(inches)
(inches)
(inches)
(inches)
(inches)
(inches)
2019-09-23
0
0
0
0
0
0
0
07:00:00
2019-09-24
0
0
0
0
0
0
0
07:00:00
2019-09-25
0
0
0
0
0
0
0
07:00.00
2019-09-26
0
0
0
0
0
0
D
07:00:00
2019-09-27
0
0
0
0
0
0
p
07:00:00
2019-09-28
07:00:00
0.965
0.866
0.866
Q.856
0.331
0.331
0,331
2019-09-29
0
0
0
0
0
0
0
07:00:00
TOTAL
0.965
0.866
0.866
0,866
0.331
0.331
0.331
1 of 1
10/2/2019, 3:55 PM

PERMANENT SEEDING
L-LINE
9/23/2019
126+00
LEFT
75
601.00
72.5
43572.50
1.00
131+00
70
43572.50
I 1.00
Y3RPB
9/25/2019
24+00
LEFT
55
467.00
57.5
26852.50
0.62
_
28+00
60
26852.50
0.62
Y3RPB
9/25/2019
24+00
RIGHT
56
645.00
57
36765.00
0.84
30+00
58
36765.00
0.84
I
L-LINE
9/25/2019
114+00
LEFT
50
1275.00
52.5
66937.50
1.54
126+00
55
66937.50
1.54

TEMPORARY SEEDING

MATTING
MATTING
STATION LOCATION LENGTH WIDTH AVG. AREA [SF] AREA [SY] DATE MATTED
WIDTH
126+00
]
75
L-LT
601.00
72.5
43572.5
4841.39
131+00
70.,.:
115+90
41.:..
I
I
L-LT
860.00
44.5
38270
4252.22
124+501
48
1J
I
I
I
SUBTOTAL
81842.5
9093.61
I
I
SUBTOTAL 0 0.00
9/23/19 & 9/25/19 1
1

s�>
RESPONSE FOR EROSION CONTROL — INSPECTOR'S DAILY REPORT
I. _
O * w
27.00
511 n
9/26/2019
Temporary Sift Fence
LF
Matting for Erosion Control
Sy
7,000.00
9/23/19 & 9/26/19
Perm. Seed and Mulch
AC
4.00
9/23/19 & 9/26/19
Temp. Mulching
AC
4.00
9/26/2019
Temp. Seed
LB
200.00
9/26/2019
Temp. Fertilizer
TN
0.80
9/26/2019
Response for Erosion Control
EA
1.00
9/26/2019