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HomeMy WebLinkAbout20140090 Ver 3_NPDES Inspection Form 4-26-17_2017050306/2016 SPPPFORM30 INSPECTION RECORD FOR ACTIVITIES UNDER STORMWATER GENERAL PERMIT NCGO10000 SELF-INSPECTION RECORD FOR LAND DISTURBING ACTIVITIES PER § 113A-541 RESPONSE FOR EROSION CONTROL FORM 1675 PROJECT LOCATION Winston-Salem, NC TIP/WBS# U-2579U LEVEL II SUPERVISOR Roger McNeill COUNTY Forsyth CONTRACTOR DRAGADOS-USA 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. (http://www.ncdot.�ov/doh/operations/dp chief en�/roadside/fieldops/downloads/Files/NCGO1GuidanceandFAQs2015.pdt). Rainfall Day Date Amount Notes Site 1 Site 2 Site 3 0 4/24/17 2.567 2.335 2.382 TO 4/25/17 1.524 1.539 1.602 � 4/26/17 0.012 0.012 0.012 Th 4/27/17 0 �� � 4/28/17 0354 0.28 0307 Sat 4/29/17 000 Sun 4/30/17 ��� Phase of Grading (Place a check in the box of the current project phase) Tnstallation ofi perimeter erosion and sediment control measures Y Clearing and grubbing of existing ground cover Y Completion of any phase of grading of slopes or fills Installation of storm drainage facilities Y Completion of construciion or development Establishment of permanent ground 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 II Section B, 10 of the NCGO10000 permit) that this report is accurate and complete to the best of my knowledge: Cert. Level II Supervisor Cert. # NCDOT Cert. Level II Representative Cert. # 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 vegetakion 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 consCruction 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. 06/2016 SPPPFORM30 StOPrilWateP D1SCIlarge OUtfa11S �SDO� (Required to list during each inspection) Sheet 1 Of Jr Visible Sedimentation and Stream Turbidity Inspection Station Number Priority Date **Other ***Sediment **�*Stream Date Corrective Actions Taken * Corrected pollutants Deposited C�ar�ty 4/26/17 # 12 Y1 LT 28+00 BASIN 5.3B OUTLET FALL NO NO NO 4/26/17 #13 Y1 LT 33+50 ROCK OUTLET NO NO NO 4/26/17 #14 Y1 LT 42+50 BASIN 5.16C OUTFALL NO NO NO 4/26/17 #18 Yi RPD LT19+00 5.26C OUTFALL NO NO NO 4/26/17 #380 Y1- 41 +50 5.15B OUTFALL NO NO NO 4/26/17 #20 Yi RPD LT17+00 SITE 2 OUTLET NO NO NO 4/26/17 #35 Y1- RPD 501+00 BASIN 6.5B OUTFALL NO NO NO 3/2/17 #44 Y1 RPA 501+00 BASIN 6.4F OUTFALL NO NO NO 4/26/17 #45 Y1 RPA 502+00 BASIN 6.7B OUTFALL NO NO NO 4/26/17 #53 Y1 RPA 502+00 ROCK OUTLET NO NO NO 4/26/17 #62 Y1-RPA 507+00 ROCK OUTLET NO NO NO 4/26/17 #63 L-LINE 507+00 ROCK OUTLET NO NO NO 4/26/17 #90 L-LINE 523+00 ROCK OUTLET NO NO NO 4/26/17 #94 L-LINE 523+00 ROCK OUTLET NO NO NO 4/26/17 #95 L-LINE 523+00 ROCK OUTLET NO NO NO 4/26/17 #100 L-LINE 525+00 CFW OUTLET NO NO NO 4/26/17 #102 L-LINE 525+00 ROCK OUTFALL NO NO NO 4/26/17 #103 L-LINE 526+00 CFW OUTFALL NO NO NO 4/26/17 #104 L-LINE 526+00 CFW OUTFALL NO NO NO 4/26/17 #108 L-LINE 526+00 ROCK OUTFALL NO NO NO 4/26/17 #109 L-LINE 526+00 ROCK OUTFALL Site 7- Silt loss, less than 5 allon bucket U 4/30/17 NO YES NO 4/26/17 #110 L-LINE 528+00 ROCK OUTFALL NO NO NO 4/26/17 #111 L-LINE 528+00 ROCK OUTFALL NO NO NO 4/26/17 #115 L-LINE 528+00 CFW OUTFALL NO NO NO 4/26/17 #125 L-LINE 544+00 ROCK OUTFALL NO NO NO 4/26/17 #137 L-LINE 556+00 ROCK OUTFALL NO NO NO 4/26/17 #138 L-LINE 557+00 ROCK OUTFALL NO NO NO 4/26/17 #152 L-LINE 560+00 ROCK OUTFALL Site 9— Silt loss, less than 5 allon bucket U 4/30/17 NO YES NO 4/26/17 #153 L-LINE 560+00 BASIN 10.12B NO NO NO 4/26/17 #157 L-LINE 560+00 BASIN 10.10B NO NO NO 4/26/17 #177 L-LINE 526+00 BASIN 11.4C OUTFALL NO NO NO 4/26/17 #178 L-LINE 567+00 CFW OUTFALL NO NO NO 4/26/17 #185 L-LINE 568+00 CFW OUTFALL NO NO NO 4/26/17 #186 L-LINE 569+00 BASIN 11.3 OUTLET NO NO NO * R=Routine, **Is there evidence of other pollutants discharging from �**Is there any visible sediment deposited in a stream, wetland, ****Is there any needs attention site such as oil sheen, discoloration, cement wastes, buffer or adjacent property? (Y/N) visible decrease in within 5 days; sanitary waste, fertilizers, or fuel or storage leakage? (Y/N) ��� Contact DWQ/DLR-LQ within 24 hours if visible sediment is stream clarity U=Urgent, needs **If Other Pollutants is marked Yes, describe extent of deposited in surface waters or wetlands. (increase turbidity- attention within discharge and list the corrective actions taken. cloudy) because of a 24 hrs. discharge? (Y/N) NOTE: Any erosion control device thaC is damaged that has Che potenCial to lose sediment and/ar pollutants offsite and/or into surface waters should be treated as "URGENT". 06/2016 SPPPFORM30 StOPrilWateP D1SCIlarge OUtfa11S �SDO� (Required to list during each inspection) Sheet 2 of 5 Visible 5edimentation and Stream Turbidity Inspection Station Number Priority Date �*Other ***Sediment ****Stream Date Corrective Actions Taken * Corrected Pollutants Deposited Ctar;ty 4/26/17 #252 Y4 RPD 19+50 BASIN 15.11 F OUTFALL NO NO NO 4/26/17 #253 L-LINE 620+00 BASIN 15.4C OUTFALL NO NO NO 4/26/17 #254 Y4 RPBD 24+50 BASIN 15.12B OUTFALL NO NO NO 4/26/17 #255 Y1 RPBD 26+00 CFW OUTFALL NO NO NO 4/26/17 #256 Yi RPBD 26+00 CFW OUTFALL NO NO NO 4/26/17 #257 L-LINE 628+00 BASIN 15.8B — 15.9B NO NO NO 4/26/17 #258 L-LINE 628+00 CFW OUTFALL NO NO NO 4/26/17 #259 L-LINE 628+00 CFW OUTFALL NO NO NO 4/26/17 #260 Y4 CD 33+00 CFW OUTFALL NO NO NO 4/26/17 #261 Y4 RPA 16+00 CFW OUTFALL NO NO NO 4/26/17 #262 RPA 16+00 BASIN 15.7B NO NO NO 4/26/17 #263 Y4 RPA BASIN 15.10B NO NO NO 4/26/17 #264 Y4 RPA 18+00 CFW OUTFALL NO NO NO 4/26/17 #265 Y4 CD 33+50 CFW OUTFALL NO NO NO 4/26/17 #266 Y4 CD 33+50 CFW OUTFALL NO NO NO 4/26/17 #267 Y4 CD 33+50 CFW OUTFALL NO NO NO 4/26/17 #268 L-LINE 628+00 BASIN 16.10B NO NO NO 4/26/17 #269 L-LINE 628+50 CFW OUTFALL NO NO NO 4/26/17 #270 L-LINE 628+00 BASIN 15.15 B NO NO NO 4/26/17 #271 Y4 RPBD 26+50 CFW OUTFALL NO NO NO 4/26/17 #293 Y4 LPB 25+00 BASIN 16.14B NO NO NO 4/26/17 #312 Y4 RPBD 33+00 CFW OUTFALL NO NO NO 4/26/17 #313 Y3 RPBD 34+00 CFW OUTFALL NO NO NO 4/26/17 #314 Y4 RPBD 37+00 CFW OUTFALL NO NO NO 4/26/17 #315 Y4 RPA 27+00 ROCK OUTLET NO NO NO 4/26/17 #316 Y4 RPA 28+00 ROCK OUTLET NO NO NO 4/26/17 #317 Y4 RPA 31+00 ROCK OUTLET NO NO NO 4/26/17 #318 Y4 RPA 32+00 ROCK OUTLET NO NO NO '� R=Routine, needs **Is there evidence of other pollutants discharging from ***Is there any visible sediment deposited in a stream, wetland, ****Is there any attention within 5 site such as oil sheen, discoloration, cement wastes, buffer or adjacent property? (Y/N) visible decrease in days; U=Urgent, sanitary waste, fertilizers, or fuel or storage leakage? (Y/N) "*� Contact DWQ/DLR-LQ within 24 hours if visible sediment is stream clarity needs attention **If Other Pollutants is marked Yes, describe extent of deposited in surface waters or wetlands. (increase turbidity- within 24 hrs. discharge and list the corrective actions taken. cloudy) because of a discharge? (Y/N) NOTE: Any erosion control device that is damaged that has the potenCial to lose sediment and/ar pollutants offsite and/or into surface waters should be treated as "URGENT". 06/2016 SPPPFORM30 StOPrilWateP D1SCIlarge OUtfa11S �SDO� (Required to list during each inspection) Sheet 3 of 5 Visible 5edimentation and Stream Turbidity Inspection Station Number Priority Date �*Other ***Sediment ****Stream Date Corrective Actions Taken * Corrected Pollutants Deposited Ctar;ty 4/26/17 #323 L-LINE 661+00 ROCK OUTLET NO NO NO 4/26/17 #324 L-LINE 661+20 ROCK OUTLET NO NO NO 4/26/17 #325 L-LINE 661+90 ROCK OUTLET NO NO NO 4/26/17 #326 L-LINE 662+50 ROCK OUTLET NO NO NO 4/26/17 #327 L-LINE 663+00 ROCK OUTLET NO NO NO 4/26/17 #328 L-LINE 663+80 ROCK OUTLET NO NO NO 4/26/17 #329 L-LINE 664+50 ROCK OUTLET NO NO NO 4/26/17 #330 L-LINE 665+00 ROCK OUTLET NO NO NO 4/26/17 #331 L-LINE 665+50 ROCK OUTLET NO NO NO 4/26/17 #332 L-LINE 666+50 ROCK OUTLET NO NO NO 4/26/17 #333 L-LINE 666+50 ROCK OUTLET NO NO NO 4/26/17 #334 L-LINE 667+50 ROCK OUTLET Basin 18.3 Silt loss, less than 5 allon bucket U 4/27/17 NO YES NO 4/26/17 #335 L-LINE 665+75 ROCK OUTLET NO NO NO 4/26/17 #336 L-LINE 665+00 ROCK OUTLET NO NO NO 4/26/17 #337 L-LINE 664+25 ROCK OUTLET NO NO NO 4/26/17 #338 L-LINE 663+50 ROCK OUTLET NO NO NO 4/26/17 #339 L-LINE 662+90 ROCK OUTLET NO NO NO 4/26/17 #340 L-LINE 662+50 ROCK OUTLET NO NO NO 4/26/17 #341 L-LINE 661+90 ROCK OUTLET NO NO NO 4/26/17 #342 L-LINE 661+50 ROCK OUTLET NO NO NO 4/26/17 #343 L-LINE 661+00 ROCK OUTLET NO NO NO 4/26/17 #344 L-LINE 660+50 ROCK OUTLET NO NO NO 4/26/17 #345 L-LINE 660+00 ROCK OUTLET NO NO NO 4/26/17 #346 L-LINE 669+20 ROCK OUTLET NO NO NO 4/26/17 #347 L-LINE 658+50 ROCK OUTLET NO NO NO 4/26/17 #348 L-LINE 659+50 ROCK OUTLET NO NO NO 4/26/17 #349 L-LINE 659+80 ROCK OUTLET NO NO NO 4/26/17 #350 L-LINE 660+00 ROCK OUTLET NO NO NO 4/26/17 #314A Y4 RPA 24+50 ROCK OUTLET NO NO NO 4/26/17 #351 L-LINE 522+00 BASIN 7.3B NO NO NO 4/26/17 #352 L-LINE 524+00 BASIN 7.5B NO NO NO 4/26/17 #353 L-LINE 522+00 BASIN 7.2B NO NO NO * R=Routine, needs **Is there evidence of other pollutants discharging from �**Is there any visible sediment deposited in a stream, wetland, ****Is there any attention within 5 site such as oil sheen, discoloration, cement wastes, buffer or adjacent property? (Y/N) visible decrease in days; U=Urgent, sanitary waste, fertilizers, or fuel or storage leakage? (Y/N) *** Contact DWQ/DLR-LQ within 24 hours if visible sediment is stream clarity needs attention **If Other Pollutants is marked Yes, describe extent of deposited in surface waters or wetlands. (increase turbidity- within 24 hrs. discharge and list the corrective actions taken. cloudy) because of a discharge?(Y/N) NOTE: Any erosion control device that is damaged that has the potenCial to lose sediment and/ar pollutants offsite and/or into surface waters should be treated as "URGENT". 06/2016 SPPPFORM30 StOrrilWateP D1SCIlarge OUtfS11S �SDO� (Required to list during each inspection) Sheet 4 of 5 Visible 5edimentation and Stream Turbidity Inspection Station Number Priority Date �'�Other **'�Sediment T�*'�Stream Date Corrective Actions Taken * Corrected Pollutants Deposited Ctar;ty 4/26/17 #228 Y4 RPBD 18+00 CFW OUTFALL NO NO NO 4/26/17 #319 Y6 20+00 ROCK OUTLET NO NO NO 4/26/17 #320 Y6 21+00 ROCK OUTLET NO NO NO 4/26/17 #321 Y6 22+00 ROCK OUTLET NO NO NO 4/26/17 #322 L-LINE 660+75 ROCK OUTLET NO NO NO 4/26/17 #225 L-LINE 614+00 BASIN 15.1 OUTFALL NO NO NO 4/26/17 #226 L-LINE 612+00 BASIN 15.3B OUTFALL NO NO NO 4/26/17 #227 Y4 RPBD 16+00 BASIN 15.3B OUTFALL NO NO NO 4/26/17 SITE 5 LEFT ROCK OUTLET NO NO NO 4/26/17 SITE 14 L-LINE LEFT ROCK OUTLET NO NO NO 632+00 4/26/17 Borrow Pit #2 Right ROCK OUTLET NO NO NO Northeast Side 4/26/17 Borrow Pit #2 Northeast ROCK OUTLET NO NO NO Side at Basin #2 4/26/17 Borrow Pit #2 ROCK OUTLET NO NO NO Northwest side Basin #1 4/26/17 Borrow Pit #2 Basin #1 ROCK OUTLET NO NO NO 4/26/17 Borrow Pit #1 Outlet of ROCK OUTLET NO NO NO Basin 1 4/26/17 Borrow Pit #1 SE ROCK OUTLET NO NO NO Corner 4/26/17 SDO @ Basin 10.2 ROCK OUTLET NO NO NO 4/26/17 SDO @ Site 4 ROCK OUTLET Silt loss, less than 5 allon bucket U 4/30/17 NO YES NO 4/26/17 Site 10 ROCK OUTLET NO NO NO 4/26/17 SDO 667+50 Site 18 ROCK OUTLET NO NO NO 4/26/17 BASIN 16.15F 15A ROCK OUTLET NO NO NO 4/26/17 L-LINE 595+00 BASIN 13.3 Silt loss, less than 5 allon bucket U 4/26/17 NO YES NO 4/26/17 L-LINE 616+00 RIGHT ROCK OUTLET Culvert outlet Silt loss, less than 5 allon bucket U 4/29/17 NO YES NO 4/26/17 Y4 RPB 22+00 ROCK OUTLET BASIN 28.1 Silt loss, less than 5 allon bucket U 4/26/17 NO YES NO � R=Routine, needs **Is there evidence of other pollutants discharging from *�*Is there any visible sediment deposited in a stream, wetland, ****Is there any attention within 5 site such as oil sheen, discoloration, cement wastes, buffer or adjacent property? (Y/N) visible decrease in days; U=Urgent, sanitary waste, fertilizers, or fuel or storage leakage? (Y/N) *�* Contact DWQ/DLR-LQ within 24 hours if visible sediment is stream clarity needs attention **If Other Pollutants is marked Yes, describe extent of deposited in surface waters or wetlands. (increase turbidity- within 24 hrs. discharge and list the corrective actions taken. cloudy) because of a discharge? (Y/N) NOTE: Any erosion control device that is damaged that has the potenCial to lose sediment and/ar pollutants offsite and/or into surface waters should be treated as "URGENT". 06/2016 SPPPFORM30 StOrrilWateP D1SCIlarge OUtfS11S �SDO� (Required to list during each inspection) Sheet 5 of 5 Visible 5edimentation and Stream Turbidity Inspection Station Number Priority Date �'�Other **'�Sediment T�*'�Stream Date Corrective Actions Taken * Corrected Pollutants Deposited Ctar;ty 4/26/17 #355 L-LINE 528+00 BASIN 8.1 B NO NO NO 4/26/17 #356 L-LINE 526+00 BASIN 8.2B NO NO NO 4/26/17 #357 L-LINE 556+50 BASIN 10.4B NO NO NO 4/26/17 #358 L-LINE 556+00 BASIN 10.6B NO NO NO 4/26/17 #359 L-LINE 562+00 BASIN 11.5B NO NO NO 4/26/17 #360 L-LINE 574+35 BASIN 12.4C Silt loss, less than 5 allon bucket U 4/27/17 NO YES NO 4/26/17 #361 L-LINE 605+00 BASIN 14.3B NO NO NO 4/26/17 #362 L-LINE 606+50 BASIN 14.4B NO NO NO 4/26/17 #363 Y1 128+00 BASIN 2.8F NO NO NO 4/26/17 #364 Yi 19+50 BASIN 20,1 B NO NO NO 4/26/17 #365 Y1 21+50 BASIN 20.5G NO NO NO 4/26/17 #366 Y1 42+00 BASIN 5.18C NO NO NO 4/26/17 #367 L-LINE 666+75 BASIN 17.1 B NO NO NO 4/26/17 #368 LINE 528+50 BASIN 8.3F NO NO NO 4/26/17 #369 Y4 107+50 BASIN 28.6B NO NO NO 4/26/17 #370 Y4 107+75 BASIN 28.7B NO NO NO 4/26/17 #371 Y4 121+00 BASIN 28.10C NO NO NO 4/26/17 #372 L-LINE 528+50 BASIN 8.3F NO NO NO 4/26/17 #1 Y1 27+00 RT ROCK OUTLET NO NO NO 4/26/17 #7 Y1 41+50 RT ROCK OUTLET NO NO NO 4/26/17 #373 Y4 36+50 BASIN 27.4B NO NO NO 4/26/17 #374 Y4 66+50 BASIN 27.5B NO NO NO 4/26/17 #375 Y4 73+00 BASIN 27.10B, BASIN 27.11 B, BASIN 27.13B NO NO NO 4/26/17 #376 Y4 105+00 ROCK OUTLET SITE 27A NO NO NO 4/26/17 #377 Y4 107+00 ROCK OUTLET 27B Silt loss, less than 5 allon bucket U 4/29/17 NO NO NO 4/26/17 #7 L-LINE 476+50 ROCK OUTLET NO NO NO 4/26/17 #10 Y1 41+50 ROCK OUTLET NO NO NO 4/26/17 #223 L-LINE 606+00 ROCK OUTLET NO NO NO 4/26/17 #378 L-LINE 556+00 LT ROCK OUTLET — HAUL ROAD NO NO NO 4/26/17 #354 L-LINE 523+00 BASIN 7.4B NO NO NO 4/26/17 611+00 Ri ht ROCK OUTLET NO NO NO * R=Routine, needs **Is there evidence of other pollutants discharging from *��Is there any visible sediment deposited in a stream, wetland, ****Is there any attention within 5 site such as oil sheen, discoloration, cement wastes, buffer or adjacent property? (Y/N) visible decrease in days; U=Urgent, sanitary waste, fertilizers, or fuel or storage leakage? (Y/N) '�'�* Contact DWQ/DLR-LQ within 24 hours if visible sediment is stream clarity needs attention **If Other Pollutants is marked Yes, describe extent of deposited in surface waters or wetlands. (increase turbidity- within 24 hrs. discharge and list the corrective actions taken. cloudy) because of a discharge? (Y/N) NOTE: Any erosion control device thaC is damaged that has Che potenCial to lose sediment and/ar pollutants offsite and/or into surface waters should be treated as "URGENT". 06/2016 SPPPFORM30 Erosion & Sedimentation Control Devices Sheet 1 of 4 (Required to list all devices that need maintenance) Inspection Station Number Corrective Actions Taken priority Date Date * Corrected Yl to Y2 (W. MOUNTAIN ST.) 4/26/17 Y1 Clean all pipe inlets R 4/29/17 4/26/17 Basin 5.14 and Basin 5.15 Clean rock in between basins R 4/30/17 4/26/17 STR 1 Clean straw off drop box inlet protection in front of structure R 4/27/17 4/26/17 Below STR 1 Clean overburdened rock checks in ditch line below structure R 4/27/17 4/26/17 STR 1 Replace rock on drop box beside structure - South side R 5/1/17 4/26/17 Basin 6.5 Clean out basin R 5/1/17 4/26/17 Site 4 Silt loss, less than 5 gallon bucket U 4/30/17 4/26/17 501+00 Left Repair rill erosion R 5/1/17 4/26/17 Y1 Detour - Y3 Repair drop boxes, slope drains and rock checks as needed — Work in progress, delayed by R paving and additional rain 4/26/17 Basin 6.1 Outlet Repair CWD at outlet R 4/30/17 4/26/17 501+00 Right Clean pipe outlet R 4/30/17 4/26/17 Basin 2.3 Clean basin inlets R 5/2/17 4/26/17 Y1 33+00 and 36+00 Right Repair rill erosion R 5/2/17 4/26/17 Batch Plant Basin Rework basin R 5/1/17 *R=Routine, needs attention within 5 days; U=Urgent, needs attention within 24 hours. NOTE: Any erosion control device that is damaged that has the potential to lose sediment and/ar pollutants offsiCe andlor into surface waters should be treated as "URGENT". 06/2016 SPPPFORM30 Erosion & Sedimentation Control Devices Sheet 2 of 4 (Required to list all devices that need maintenance) Inspection Station Number Corrective Actions Taken priority Date Date * Corrected Y2 — Y3 (WALKERTOWN-GUTHRIE RD. TO W. MOUNTAIN ST.) 4/26/17 524+50 Repairberm R 4/30/17 4/26/17 Site 7 Silt loss, less than 5 gallons U 4/30/17 4/26/17 Basin 8.2B Clean out basin and SDO U 4/30/17 4/26/17 Basin 8.1B Clean wattles at inlet to basin R 4/30/17 4/26/17 Bridge 4 Repair rill erosion under bridge approach R 4/30/17 4/26/17 558+00 Repair rill erosion R 5/1/17 4/26/17 Site 9 Silt loss, less than 5 gallons U 4/26/17 4/26/17 Site 9 Rework SDO at site R 4/28/17 4/26/17 Site 9 Overburdened silt fence, remove silt R 4/28/17 4/26/17 Basin 11.6 Clean out basin and pipe inlet R 4/26/17 Y3 Clean pipeinlet R S/1/17 4/26/17 Bridges 5& 6 Repair rill erosion and slope drain at bridge R 4/30/17 4/26/17 Basin 12.4B Silt loss, less than 5 gallons U 4/27/17 4/26/17 Basin 12.4B Clean out basin — Work in progress R 4/26/17 All basins Clean basin inlets as needed R 4/26/17 Basin 12.2 Clean outlet at basin R 4/30/17 4/26/17 555+00 - 583+00 Right Clean outlets as needed R 5/1/17 4/26/17 575+00 Right Silt loss, less than 5 gallons U 4/26/17 4/26/17 Site 10 Clean drop boxes at Site R 4/30/17 4/26/17 Site 10 Clean baffle U 4/27/17 4/26/17 Basin 10.10 Clean out basin and SDO — Work delayed due wet conditions on slope R 4/26/17 Basin 10.9 Repair berm R 4/30/17 4/26/17 Basin 10.4 Repair SDO at basin U 4/27/17 NOTE: Any erosion control device that is damaged that has the potential to lose sediment and/ar pollutants offsiCe andlor into surface waters should be treated as "URGENT". 06/2016 SPPPFORM30 *R=Routine, needs attention within 5 da s; U=Ur ent, needs attention within 24 hours. Erosion & Sedimentation Control Devices Sheet 3 of 4 (Required to list all devices that need maintenance) Inspection Station Number Corrective Actions Taken Priority nate Date * Corrected Y3 — Y4 (W. MOUNTAIN 5T. TO BUS. 40) 4/26/17 Basin 30.1B Repair rill erosion in basin weir R 4/27/17 4/26/17 Basin 28.10 Clean SDO, find new low spot R 4/27/17 4/26/17 Basin 28.1 Silt loss behind SDO, less than 5 gallon bucket U 4/26/17 4/26/17 Basin 16.14F (or Basin 16.15F) Erosion in basin R 4/27/17 4/26/17 Site 15 Repair slope drain, rill erosion in slope R 4/27/17 4/26/17 Basin 16.2 Clean dropbox U 4/26/17 4/26/17 Basin 16.7 Repair weir R 4/27/17 4/26/17 Smith Creek Repair silt fence and SDO's R 4/27/17 4/26/17 Basin 15.10 Apply BMP's in area R 4/27/17 4/26/17 Culvert 616+00 Right Silt loss, less than 5 gallon bucket U 4/29/17 4/26/17 Culvert 616+00 Left Repair SDO U 4/29/17 4/26/17 584+00 Right Repair slope drain along MSE wall R 4/27/17 4/26/17 DR 5 Clean checks and wattles R 4/30/17 4/26/17 DR 5, Basin 13.3 Silt loss, less than 5 gallon bucket at end of basin U 4/26/17 4/26/17 606+00 Left Silt loss, less than 5 gallon bucket (erosion at silt fence) U 4/26/17 4/26/17 Basin 14.3 Left Repair weir, add Type 2 R 4/27/17 4/26/17 Basin 15.1 Clean rock checks and inlets R 5/2/17 NOTE: Any erosion control device that is damaged that has the potential to lose sediment and/ar pollutants offsiCe andlor into surface waters should be treated as "URGENT". 06/2016 SPPPFORM30 *R=Routine, needs attention within 5 da s; U=Ur ent, needs attention within 24 hours. Erosion & Sedimentation Control Devices Sheet 4 of 4 (Required to list all devices that need maintenance) Inspection Station Number Corrective Actions Taken Priority nate Date * Corrected Y4 — END OF PROJECT 4/26/17 692+00 Right (end of project) Repair silt fence U 4/27/17 4/26/17 Basin 19.1C Clean rock in temporary diversion leading to basin R 5/1/17 4/26/17 682+50 Right Repair silt fence in this area R 4/27/17 4/26/17 670+00 Right Clean rock checks R 5/1/17 4/26/17 669+50 Right Clean rock checks and silt in ditch, repair ditch line R 5/1/17 4/26/17 Basin 18.3 Silt loss, less than 5 gallon bucket U 4/27/17 4/26/17 667+50 Right Clean silt from SDO's R 5/1/17 4/26/17 Basin 17.6 Clean debris from skimmer orifice, add stake and rope to skimmer R 5/1/17 4/26/17 664+00 - 666+50 Left Clean rock checks leading beside driveway R S/1/17 4/26/17 Basin 16.29F Rebuild dam, repair basin walls — Work in progress, wet conditions delayed work R 4/26/17 Basin 16.29F Clean silt out of basin R 4/30/17 4/26/17 Basin 16.29F Replace rear baffles, uncover slope drain inlet, rebuild inlet protection at slope drains R 4/26/17 Basin 16.29F Replace pipe inlet protection on 42" bore and jack pipe at end of basin R 4/30/17 4/26/17 Basin 16.20 Silt loss, less than 5 gallon bucket at SDO's at end of basin U 4/29/17 4/26/17 Site 27A Clean and rework SDO's, remove silt U 4/29/17 4/26/17 Site 27B Restart pump U 4/27/17 4/26/17 Y4 EB 74+00 - 78+00 Clean rock checks, repair erosion in ditch as needed (Ditch leading to Basin 27.10) R 5/3/17 4/26/17 Site 24, Y4 65+50 - 68+50 Clean rock checks in ditch leading to Site 24 R 5/2/17 4/26/17 Site 24, Y4 65+50 Rework SDO at stream beside steel bore and jack pipe R 5/2/17 4/26/17 Basin 27.13 Clean debris and silt from slope drain at rear of basin R 5/3/17 4/26/17 Basin 27.13 Rebuild berm at rear of basin, rebuild larger berm R 5/3/17 4/26/17 Basin 27.10 Clean slope drain inlet at rear of basin R 5/3/17 4/26/17 Basin 27.11 Clean slope drain inlet above basin R S/3/17 4/26/17 Y5 Detour 14+00 - 15+50 Left Clean rock checks, replace filter stone R S/2/17 4/26/17 Y5 Detour 15+50 Left Clean pipe inlet protection R 5/2/17 4/26/17 Y5 Detour 27+00 - 30+00 Right Clean rock checks in ditch, replace filter stone R S/2/17 *R=Routine, needs attention within 5 days; U=Urgent, needs attention within 24 hours. NOTE: Any erosion control device that is damaged that has the potential to lose sediment and/ar pollutants offsiCe andlor into surface waters should be treated as "URGENT". 06/2016 SPPPFORM30 RESPON5E FOR EROSION CONTROL - INSPECTOR'S DAILY REPORT SUBSTITUTE FORM 1675 Pay Item 5tandard/Metric Unit Quantity Comments Temporary Silt Fence LF M Specia] Sediment Control Fence TN/MTN LF/M Temporary Mulching AC HA Seed - Temporary Seeding LB KG Fertilizer - Temporary Seeding TN MTN Matting for Erosion Control SY M� Coir Fiber Mat SY M� Coir Fiber Baffles LF M Perm. Soil Reinforcement Mat SY M� Seeding and Mulching AC HA Seed - Repair Seeding LB KG Fertilizer - Repair Seeding TN MTN Seed for Supplemental Seeding LB KG Fertilizer Topdressing TN MTN Response for Erosion Control EA EA Safety/Highly Visible Fencing LF M We agree that this is the work to be performed. We agree that this work was performed. NCDOT Representative: NCDOT Representative: Prime Representative: Prime Representative: Date Date