NCS000434_Archdale Self Audit_Wells_20201026

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DR, A T PHP''\SE II S�Ji 54 AU01 T T EIRA FLAT
FOR PERT-VU ITS ISSUED PRIOR TO 2019
Edit yellow Mg-' hH0b3dft'EM5 Ito ICE
MUNICIPAL SEPARATE STORM SEWER SYSTEM (MS4)
PROGRAM AUDIT REPORT
NPDES PERMIT NO. NCSOOOXXX
CITY, NORTH CAROLINA
Address
Audit Date: DATE
Report Date: DATE
North Carolina Department of Environmental Quality
Division of Energy, Mineral & Land Resources Stormwater Program
512 N. Salisbury Street, 9th floor
1612 Mail Service Center
Raleigh, NC 27699-1612

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
I\) 0-�, -,�s
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19 r i�C�✓C'�r`ii'r. (Tl 7r1
(This page intentionally left blank)
Audit Date: XXX

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
TABLE OF CONTENTS
1
Audit Details ..........................................................................................................
PermitteeInformation..................................................................................................................................2
SupportingDocuments..................................................................................................................................3
Program Implementation, Documentation & Assessment...........................................................................4
Public Education and Outreach.....................................................................................................................8
Public Involvement and Participation.........................................................................................................11
Illicit Discharge Detection and Elimination (IDDE)......................................................................................13
Construction Site Runoff Controls.......................................:.......................................................................16
Post -Construction Site Runoff Controls...............................................................................................
Pollution Prevention and Good Housekeeping for Municipal Operations.................................................25
Total Maximum Daily Loads(TMDLs)..........................................................................................................28
Site Visit Evaluation: Municipal Facility No. 1 ........................................................................
.............**.••.••30
Site Visit Evaluation: Municipal Facility No. 2.............................................................................................32
Site Visit Evaluation: MS4 Outfall No. 1 ...............................................................................................
......34
Site Visit Evaluation: MS4 Outfall No. 2......................................................................................................36
Site Visit Evaluation: Construction Site No. 1............................................................................................
..38
Site Visit Evaluation: Construction Site No. 2................................................................................
..............40
Site Visit Evaluation: Post -Construction Stormwater Control Measure No. 1............................................42
Site Visit Evaluation: Post -Construction Stormwater Control Measure No. 2............................................44
Appendix A: Supporting Documents
Appendix B: Photograph Log
DISCLAIMER
This audit consists of an evaluation of program compliance with the issued permit and implementation of
the approved Stormwater Management Plan. This audit report does not include a review of all program
components, and program deficiencies in addition to those noted may be present. The permittee is
required to assess program progress and permit compliance, and to implement the approved Stormwater
Management Plan in accordance with the issued permit.
Audit Date: XXX ii

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
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Audit Date: XXX

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Audit Details
Audit ID Number: Audit Date(s): i ��1
NCS000XXX_City MS4 Audit_2019MODAY t1
Minimum Control Measures Evaluated:
❑ Program Implementation, Documentation & Assessment
❑ Public Education & Outreach
❑ Public Involvement & Participation
❑ Illicit Discharge Detection & Elimination
❑ Construction Site Runoff Controls — No delegated Sediment and Erosion Control Program
❑ Construction Site Runoff Controls — Delegated Sediment and Erosion Control Program
❑ Post -Construction Site Runoff Controls
❑ Pollution Prevention and Good Housekeeping for Municipal Operations
❑ Total Maximum Daily Loads (TMDLs)
Field Site Visits:
❑ Municipal Facilities. Number visited: C coy : ii;'�rr:•
❑ MS4 OutfaIIs. Number visited: `:'':o0s_` F1.• i i:erri.
❑ Construction Sites. Number visited: ._tn i.'r`r,•
❑ Post -Construction Stormwater Runoff Controls. Number visited: _­I!ijose ail i s.•
❑ Other: Numbervisited: Choose an ',eF"..
❑ Other: Number visited: i:hoose an ltenl.
Name, Title
Audit Report Author:
Inspector(s) Conducting Audit
Signature �tGt f f �/I Ax:: , OAS"
Audit Report Author:
Date:
Date
Organization
t W' 4 t"I
Audit Date(s): DATE
Page 1 of 47

M54 Permit Audit Report
City, NO NPDES Permit No. NCSOOOXXX
Permittee Information
MS4 Permittee Name:
Permit Effective Date:
Permit Expiration Date:
City, State, ZIP: GPI I\L 7 7-�
L
Date of Last MS4 Inspection/Audit:
Co-permittee(s), if applicable:
Permit Owner of Record:
S-�&r-�-- VJc� (� (0 ,rcu?I�71.�
Primary MS4 Representatives Participating in Audit
Name, Title
Organization '
MS4 Receiving Waters
Waterbody
Classification
Impairments
j
)Lr t ii,,
Audit Date(s): DATE Page 2 of 47

MS4 Permit Audit Report
.-:,... nir, mmnrc n-,-.,-,;+ ni nircnnnvvv
Audit Date(s): DATE
rage 3 ul 4/

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Program Implementation, Documentation & Assessment
Staff Interviewed:
(Name, Title, Role)
Permit Citation
Program Requirement
Status
Supporting
Doc No.
The permittee maintained adequate funding and staffing to implement and manage,%
Staffing and
the provisions of the Stormwater Plan and meet all requirements of the permit.
Funding
The Stormwater Plan identifies a specific position(s) responsible for the overall
:-loose
C�"',
coordination, implementation, and revision to the Plan.
Responsibilities for all components of the Stormwater Plan are documented and
o :sew
position(s) assignments provided.y,,
The permittee is current on payment of invoiced administering and compliance
S?
monitoring fees (see stormwater e-payments on DEMLR MS4 web page).
1 r
Comments (Briefly describe funding mechanism, number of staff, etc.)
II.A.2 Stormwater
The permittee evaluated the performance and effectiveness of the program
noose
Plan
Implementation
components at least annually.
R'6
and Evaluation
If yes, the permittee used the results of the evaluation to modify the program
choo�
components as necessary to accomplish the intent of the Stormwater Program.
anl' m.
`
Did the permitted MS4 discharges cause or contribute to non -attainment of an
01pose
applicable water quality standard?
If yes, did the permittee expand or better tailor its BMPs accordingly to address
Choose
the non -attainment?
an it ern.
Comments
I
Audit Date(s): DATE Page 4 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Program Implementation, Documentation & Assessment
II.A.3z
Keeping the
The permittee kept the Stormwater Plan up to date.
Stormwater Plan
Up to Date
C,ous�
`Z/
The permittee notified DEMLR of any updates to the Stormwater Plan.
„
Comments (Indicate the date of latest Stormw ter Plan and describe the natyre_of any u dates, if applicable).
°
Cur, e r Jej
II.A.4 AvailabilityC'il+;o
The permittee kept an up-to-date version of its Stormwater Plan available to the
c'—L,7�
of the Stormwater
Division and the public online.
"y'�i Jam'
_ VI
Plan
The online materials included ordinances, or other regulatory mechanisms, or a list
identifying the ordinances, or other regulatory mechanisms, providing the legal
authority necessary to implement and enforce the requirements of the permit.
Comments (Note what materials are available on line)
II.A.3 & II.A.5
Stormwater Plan
Did DEMLR require a modification to the Stormwater Plan?
1i+ors
Modifications
If yes, did the permittee complete the modifications in accordance with the
-` moose
established deadline?
ar: i': _Mi.
Comments (Note date of DEMLR notification, modifications required, and date modifications were completed, as applicable)
ILA.6Sharing
Responsibility
itt
Are any control measures implemented by an entity other than the permittee?
Dose
Cjc?c_,.2_
If yes, is there a written agreement in place?
Comments (List the specific control measures implemented by others that do not have adequate written agreements, if
applicable)
II.A.7
The permittee maintained written procedures for implementing the six minimum
=h ose
Sq t;
Written
control measures.
an
Procedures
Written procedures identified specific action steps, schedules, resources and
,� � aose
"{?fin•
responsibilities for implementing the six minimum measures.
a
...I.. W nnnlirnhip)
Comments (List the specific minimum measures tnar oo nor nave uaryuu« VVIN&&­ 1
Audit Date(s): DATE Page 5 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Program Implementation, Documentation & Assessment
III. A
The permittee maintained documentation of all program components including, but
Program
g
not limited to, inspections, maintenance activities, educational programs,
6• c'=
Documentation
implementation of BMPs, enforcement actions etc., on file for a period of five years.
Comments (List the specific program components that do not have adequate documentation on file and why, if applicable)
III_B
The permittee submitted annual reports to the Department within twelve months
Annual Report
from the effective date of the permit (See Section 111.B. for the annual reporting
/
Submittal
period specific to this MS4).'
"
The permittee submitted subsequent annual reports every twelve months from the
scheduled date of the first annual report submittal.
The Annual Reports included appropriate information to accurately describe the progress, status, and results
of the permittee's Stormwater Plan, including, but not limited the following:
1. A detailed description of the status of implementation of the Stormwater Plan
as a whole. This will include information on development and implementation
of each major component of the Stormwater Plan for the past year and
,
schedules and plans for the year following each report.
2. An adequate description and justification of any proposed changes to the
Stormwater Plan. This will include descriptions and supporting information for
Chow^
the proposed changes and how these changes will impact the Stormwater
, '' H.e; n.
Plan (results, effectiveness, implementation schedule, etc.).
4
3. Documentation of any necessary changes to programs or practices for
�.
assessment of management measures implemented through the Stormwater
y(
Plan.
4. A summary of data accumulated as part of the Stormwater Plan throughout
Chaose
the year along with an assessment of what the data indicates in light of the
Stormwater Plan.
5. An assessment of compliance with the permit, information on the
'i"1,05'
establishment of appropriate legal authorities, inspections, and enforcement
actions.
' —`>
Comments (Note dates that annual reports cover under current permit and generally describe report deficiencies, if any)
IV.B
Annual Reporting
The Annual Reports document the following:
1. A summary of past year activities, including where applicable, specific
100sc
quantities achieved and summaries of enforcement actions.
C !L, ate,
C
2. A description of the effectiveness of each program component.
,Choose
3. Planned activities and changes for the next reporting period, for each
Choose
program component or activity.
a i ba'N.
Audit Date(s): DATE Page 6 of 47

MS4 Permit Audit Report
City, NO NPDES Permit No. NCSOOOXXX
Program Implementation, Documentation & Assessment
r�1C J.S
4. Fiscal analysis. r�;4
Comments (Note dates that annual reports cover under current permit and generally describe report deficiencies, if any)
Audit Date(s): DATE Page 7 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Public Education and Outreach
Staff Interviewed:
(Name, Title, Role)
Permit Citation
Program Requirement
Status
Supporting
Doc No.
II.B.2.a
Goals and
The permittee defined goals and objectives of the Local Public Education and
Objectives
Outreach Program based on community wide issues.
;
Comments (Generally describe process for establishing goals/objectives)
�rwl�
L
II.B.2.b
The permittee maintained a description of the target pollutants and/or stressors and
.r:o::s
Target Pollutants
likely sources.
?�i rr
Do
/
Comments (List target pollutants, note any that are missing or not appropriate)
II.B.2.c
The permittee identified, assessed annually and updated the description of the target
C : CS-2
Target Audiences
audiences likely to have significant storm water impacts and why they were selected.
Comments (Describe any changes made, if applicable)
Audit Date(s): DATE Page 8 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Public Education and Outreach
II.B.2.d Residential The permittee described issues, such as pollutants, the likely sources of those
pollutants, potential impacts, and the physical attributes of stormwater runoff in
and Industrial/ p ltt
p
Commercial Issues their education/outreach program.
Comments (Generally describe the residential/industrlial/commerciaal issues addressed)
l�5 l'�.1' ✓C�L"L�v IN'� t� �� � I J'' � ilCr� t�'`�17�/�'' 1
IJ J
II.B.2.e The permittee promoted and maintained an internet web site designed to convey the oo
Informational
Web Site ,.
program's message.
Comments (list web page address and general contents, or attach screen shot of landing page)
'�(.""
v
JI D J
I1.B.2.f The permittee distributed stormwater educational material to appropriate target
Public Education ,( I.
groups.
Materials
Comments (List distributed materials and quantity, message, distribution mechanism, target audience for each if not included in
program documentation/annual reporting)
n
I`2 Y,n_1111 i �C:' r� .jL y >�C
� � v
II•B•2�., The permittee promoted and maintained a stormwater hotline/helpline for the OC oose r�
Hotline/Help Line purpose of public education and outreach.
Comments (Note hotline contact information and methods) for advertising its
C-j\ p k©c'e—
Car, �c�5 ,�425 iu v:, r��� r�
I•B•2•h The permittee's outreach program, including those elements implemented locally or Choose
through a cooperative agreement, included a combination of approaches designed to
reach the target audiences.
Audit Date(s): DATE Page 9 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Public Education and Outreach
Public Education
and Outreach For each media, event or activity, including those elements implemented locally or
c Program through a cooperative agreement the permittee estimated and recorded the extent �r;se
of exposure.
Comments (Generally describe approaches, extent of exposure. Note any cooperating entities, agreements and scope of services,
or reference comments in Section II.A.6. above.)
Additional
Comments:
y1�s"—v.`It� ef`vC��"tit�T1 r4�! —iiy t�"�wrz��t CW�LhCf��"
Audit Date(s): DATE Page 10 of 47

IVIS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
+ Public Involvement and Participation
Staff Interviewed:
(Name, Title, Role)
Permit Citation
Program Requirement
Status
Supporting
Doc No.
II.C.2.a Volunteer
Community
The permittee included and promoted volunteer opportunities designed to promote
�>
Involvement
ongoing citizen participation.
Program
Comments (Note opportunities promoted and date(s) of volunteer events)
{— p
�� � C� �'7' C-'�m.�JI l,,�ai� ���,. L� =�:�� rJ t/� ��", Cd J„^'l c- ti/
T�t��,� A✓�C�i (�=
�r,r•.` !-�� {'n C J-� (`. � � `.arc% �\`T � �✓'r
C.��
5CA, 0
ILC.2.b
Mechanism for
The permittee provided and promoted a mechanism for public involvement that
_,
- goose
✓��
Public
provides for input on stormwater issues and the stormwater program.i��nr^
•
Involvement
Comments (Note mechanism(s) for input and how promoted)
��c—t'bJe. f �'.t*tc'%Z+�`� �t7 V�, ��:a✓�"� C'i Je''�j�J
II.C.2.c
The permittee promoted and maintained a hotline/helpline for the purpose of public
Cizc se
Hotline/Help Line
involvement and participation.
a
Comments (Note hotline contact information and how it is promoted)
I�
n r C711, %V)O
Audit Date(s): DATE
Page 11 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Public Involvement and Participation
Additional
Comments:
Audit Date(s): DATE Page 12 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Illicit Discharge Detection and Elimination (IDDE)
Staff Interviewed:
(Name, Title,
Role)
Status Supporting
Permit Citation Program Requirement Doc No.
071
IDDE Program The permittee maintained a written IDDE Program. ,.. -n
If yes, the written program includes provisions for program assessment and
4 oG5e
evaluation and integrating program.''
Comments (Note any deficiencies)
II.D.2.b
Legal Authorities
Comments
The permittee maintained an IDDE ordinance or other regulatory mechanism(s) that
provides the legal authority to prohibit illicit connections and discharges to the MS4.;rirr.
If yes, the ordinance applies throughout the corporate limits of the permittee.
[Permit Part I.D]
II.D.2.c
The permittee maintained a current map showing major outfalls and receiving
C' oose
Storm Sewer
streams.
System Map
�..>>ni•('CL ,��,
c-r\
Comments
CO %-`
1
i�r' „
r�ii;
ri: ": rX_ 'tr;r4_,.
II.D.2.d • Choose
The permittee maintained a program for conducting dry weather flow field
C1
Dry Weather Flow observations in accordance with written procedures.
Program
Comments (Generally summarize program, including frequency of observations and # or % of outfalls screened)
Audit Date(s): DATE Page 13 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Fllicit Discharge Detection and Elimination (IDDE)
II.D.2.e
Investigation
The permittee maintained written procedures for conducting investigations of
he^ce
Procedures
identified illicit discharges.
Comments (Generally describeprocedures are documented)
`what
c-�
II.D.2.f
For each case of an illicit discharge or potential illicit discharge, the permittee documented and tracked the
Track and
following:
Document
Investigations
1. The date(s) the illicit discharge was observed
2. The results of the investigation
se
:Z'nn'.
3. Any follow-up of the investigation
i�
j;n o Sn
4. The date the investigation was closed
Comments (Note whether a standard inspection form is utilized to capture consistent information and a tracking mechanism is
used) T 1 ,
i_41v�.ic
II.D.2.s Employee
Training
The permittee implemented and documented a training program for appropriate
municipal staff who, as part of their normal job responsibilities, may come into
�J0
r
contact with or otherwise observe an illicit discharge or illicit connection.
Comments (Generally describe the staff training program, including frequency and which staff are trained)
�V� (°E?l,J jn,.�:'"'L• c�.S LJCLi� C��Ci
jj
,V'% j V IJ ` ► -V%+ M
Public
Public Education
The permittee informed public employees of hazards associated with illegal
ii
3ose
dischar es and im ro er dis osal of waste.
g p p p
The permittee informed businesses of hazards associated with illegal discharges and
('hoase
improper disposal of waste.
^�,j��
The permittee informed the general public of hazards associated with illegal
1-I Dose
discharges and improper disposal of waste.
aiti�.
Comments (Note how each sector was informed, if applicable)
��C�:i�s I_?r, ,�,/��✓\ dt%Z�CS C� f1;�;,t-t-a'1. 1--�Z. ��S:..tl�,��S
Audit Date(s): DATE Page 14 of 47

MS4 Permit Audit Report
City, NO NPDES Permit No. NCSOOOXXX
Illicit Discharge Detection and Elimination (IDDE)
II•D•2•i The permittee promoted, publicized, and facilitated a reporting mechanism for the 'r
Public Reporting public to report illicit discharges.
Mechanism
The permittee promoted, publicized, and facilitated a reporting mechanism for staff > >
to report illicit discharges.
The permittee established and implemented response procedures for citizen ro
requests/reports.
Comments (Generally describe reporting mechanisms and how promoted/publicized/facilitated/established) i
�220 'T�� r��r�+r %\ t�•on�
ILD.2.1 The permittee implemented a mechanism to track the issuance of notices of violation _^�' -s=
Enforcement and enforcement actions administered by the permittee.
If yes, the mechanism includes the ability to identify chronic violators for
initiation of actions to reduce noncompliance. y
Comments (Generally describe the established tracking mechanism, if applicable)
Audit Date(s): DATE rdge 13 ui �►i

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Construction Site Runoff Controls
Staff Interviewed:
(Name, Title, Role)
Program Delegation Status:
M The permittee has a delegated Sediment and Erosion Control Program and implements the North Carolina
Sedimentation Pollution Control Act (SPCA) of 1973 components of this minimum measure (complete the permit
citation and SPCA citation sections).
❑ The permittee does not have a delegated Sediment and Erosion Control Program and relies on DEMLR to comply
with the North Carolina Sedimentation Pollution Control Act (SPCA) of 1973 components of this minimum measure
(complete only the permit citation section).
Permit Citation Program Requirement Status
supporting
Doc No.
II.E.3 Construction
Site Runoff Controls The permittee provides and promotes a means for the public to notify the
Bose
(NPDES Permit No. appropriate authorities of observed erosion and sedimentation problems (e.g.,
NCS000435] promoting the existence of the DEQ DEMLR "Stop Mud" hotline).
Comments (Describe how provided and promoted)
SPCA Citation
Delegated Program Requirement
Status
Supporting
Doc No.
113A-60 Local
erosion and
The permittee has adopted an ordinance or other regulatory mechanism to enforce
��'ioose
sedimentation
the erosion and sedimentation control program.
ar,
control programs (a)
If yes, the ordinance meets or exceeds the minimum requirements of the
aose
SPCA.
If yes, the ordinance applies throughout the corporate limits of the permittee.
t I'ioose
[Permit Part I.D]
ai1.
G
Comments (Provide regulatory mechanism reference or Supporting Documentation number)
§ 113A-60 Local
erosion and
The permittee collects a fee paid by each person who submits an erosion and
��i�aoSe
sedimentation
sedimentation control plan.
al°
control programs (d)
Audit Date(s): DATE Page 16 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Construction Site Runoff Controls
Comments (indicate th
1A-60 Local
erosion and
sedimentation
control programs (e)
e
Has the permittee determined that a person engaged in a land -disturbing activity
has failed to comply with an approved erosion and sedimentation control plan?
If yes, has the permittee referred any such matters to the North Carolina
Ch
Sedimentation Control Commission for inspection and enforcement?
Comments
�.[j:1—. 1 ����L'T'c h ;{ ��r�m� ✓ ��.�:�t?- V.-7 5—L Y9C7'� ,� �Cvth�' '1
SzLe..
�— -�t,Z l r�i✓� c�.�rp �-�v� � ��.- a 5 y
The permittee reviews each erosion and sedimentation control plan submitted to
113A-61 Local
approval of erosion
them and notifies the person submitting the plan that it has been approved,
and sedimentation
approved with modification, or disapproved within 30 days of receipt.
control plans
The permittee only approves an erosion and sedimentation control plan upon
determining that it complies with all applicable State and local regulations.
The permittee has disapproved of an erosion and sedimentation control plan in
-h; o.-;m
order to protect riparian buffers along surface waters.-
If yes, the permittee notified the Director of the Division of Energy,
I��(1 JCy
Mineral, and Land Resources within 10 days of the disapproval.
Comments . L �� I e\ L-l� c� e
L XC.Ji'_F tt ) . � O e."/j{
§ 113A-61.1
Inspection of land -
disturbing activity;
notice of violation
(a)
Comments
The certificate of approval of each erosion and sedimentation control plan oS2
approved by the permittee includes a notice of the right to inspect.,r .
The permittee provides for inspection of land -disturbing activities to ensure C,i 10cse
compliance with the SPCA and to determine whether the measures required in an AU n.
erosion and sedimentation control plan are effective. l
nE_'J
Audit Date(s): DATE Page 17 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Construction Site Runoff Controls
§ 113A-61.1
When the permittee determines that a person engaged in land -disturbing activity
Inspection of land-
has failed to comply with the SPCA, the Permittee immediately issues a notice of
disturbing activity,
violation upon that person.
notice of violation
�c)
Each notice of violation issued by the permittee specifies the date by which the
person must comply.
Irp
Each notice of violation issued by the permittee informs the person of the actions
S;'
that need to be taken to comply.
�We-_
Comments
113A-64 Penalties
Does the permittee issue civil penalties as part of the erosion and sedimentation
program?
Comments (indicate when/why a civil penalty is issued, and the amount, if applicable).
V + �)
Audit Date(s): DATE Page 18 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Post -Construction Site Runoff Controls
Staff Interviewed:
(Name, Title, Role)
Audit Date(s): DATE Page 19 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Post -Construction Site Runoff Controls
Implementation (check all that apply):
❑ The permittee implements the components of this minimum measure.
❑ The permittee relies upon another entity to implement the components of this minimum measure: name of entity
AT The permittee implements the following deemed -compliant program(s), which meet NPDES MS4 post -construction
requirements for the areas where implemented and in compliance with the specific program requirements as provided in 15A
NCAC and noted below (Complete Session Law 2006-246 section below):
❑ Water Supply Watershed I (WS-1) —15A NCAC 213.0212
❑ Water Supply Watershed II (WS-II) —15A NCAC 2B .0214
❑ Water Supply Watershed III (WS-III) —15A NCAC 213.0215
❑ Water Supply Watershed IV (WS-IV) —15A NCAC 213.0216
❑ Freshwater High Quality Waters (HQW) —15A NCAC 2H .1006
❑ Freshwater Outstanding Resource Waters (ORW) —15A NCAC 2H .1007
❑ Neuse River Basin Nutrient Sensitive (NSW) Management Strategy —15A NCAC 26 .0235
❑ Tar -Pamlico River Basin Nutrient Sensitive (NSW) Management Strategy —15A NCAC 2B .0258
❑ Randleman Lake Water Supply Watershed Nutrient Management Strategy-15A NCAC 213.0251
❑ Universal Stormwater Management Program —15A NCAC 2H .1020
Ordinance(s) (check all that apply):
The permittee utilizes the following ordinances and/or regulatory authority to fulfill post construction minimum measure program
requirements throughout the MS4 permitted area (check all that apply):
❑ DEQ model ordinance
.® MS4 designed post -construction practices that meet or exceed 15A NCAC 02H .1000.
N DEQ approved comprehensive watershed plan
❑ DEQ approved ordinance for a deemed -compliant Program (see list above)
Instructions:
For MS4s not implementing a S.L. 2006-246 deemed -compliant program, complete only the Permit Citation section below.
For MS4s implementing a S.L. 2006-246 deemed -compliant program, complete the Session Law 2006-246 section below. If the MS4
does not implement a deemed -compliant program throughout the entire MS4 permitted area, then complete the Permit Citation
section below for the permitted area(s) not covered under the S.L. 2006-246 deemed -compliant program.
Session Law 2006- supporting
246 Program Requirement Status Doc No.
Audit Date(s): DATE Page 20 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Post -Construction Site Runoff Controls
Deemed -Compliant
The permittee implements deemed -compliant Program requirements in
Program(s)
accordance with the applicable 15A NCAC rules.,
,
Je�L_. l l
The permittee implements deemed -compliant Program requirements throughout
the entire MS4 area (if not, also complete the Permit Citation section below.)
The permittee applies deemed -compliant Program requirements to all federal,
state and local government projects within the permitted MS4 area who do not
have their own NPDES stormwater permit.
The permittee included deemed -compliant Program reporting in their MS4 Annual
Reports.
Pe
The permittee included deemed -compliant Program implementation in their
Stormwater Management Plan.
g
Comments
Status
Supporting
Permit Citation
Program Requirement
Doc No.
II.F.2.a
The permittee maintained an ordinance or other regulatory mechanism designed .,.Choose
Legal Authority
to meet the objectives of the Post -Construction Site Runoff Controls Stormwater �.,tn
Management Program.
If yes, the ordinance applies throughout the corporate limits of the permittee \ U
(Verify permit coverage area listed in Part I.D of permit and modifyv
accordingly).
The permittee has the authority to review designs and proposals for new � ; . 00S
development and redevelopment to determine whether adequate Stormwater 4e
control measures will be installed, implemented, and maintained.
The permittee has the authority to request information such as stormwater plans,
inspection reports, monitoring results, and other information deemed necessary to `: ,Oase
evaluate compliance with the Post -Construction Stormwater Management e
Program.
The permittee has the authority to enter private property for the purpose of �:I_ aos�
inspecting at reasonable times any facilities, equipment, practices, or operations Y
related to Stormwater discharges.
Comments (if the permittee relies upon another entity, specifically note the legal authority that allows that entity to implement
the program within the M54 area)
II.F.2.b
Stormwater Control
Chcosa
The permittee utilizes strategies which include SCMs appropriate for the MS4. GI�r�
Measures (SCMs)
I]OQS`
SCMs comply with 15A NCAC 02H .1000.
Audit Date(s): DATE Page 21 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Post -Construction Site Runoff Controls
Lummenrs
L_
II.F.2.c
The permittee conducted site plan reviews of all new development and
Plan Reviews
redeveloped sites that disturb greater than or equal to one acre (including sites
that disturb less than one acre that are part of a larger common plan of,
development or sale).
If yes, the site plan reviews addressed how the project applicant meets the
. 0 S 0
performance standards.
a•.�
If yes, the site plan reviews addressed how the project will ensure long-term
te r' Sc
maintenance.
Comments
-TK(
11
:toaJ""51'i�
II.F.2.d
The permittee maintained an inventory of projects with post -construction
Inventory of Projects
structural stormwater control measures installed and implemented at new
�i10
C
development and redeveloped sites.
The inventory included both public and private sector sites located within the
permittee's corporate limits that are covered by its post -construction ordinance
YAD
requirements.
` 1.
Comments f,
CADO �' Vic?,df`. iI'Yj Lj'2�
II.F.2.e
Deed Restrictions
The permittee provided mechanisms such as recorded deed restrictions and
�.
and Protective
protective covenants that ensure development activities will maintain the project
0052
„
Covenants
consistent with approved plans.
ar, is rn.
Comments
II.F.2.f
The permittee implemented or required an operation and maintenance plan for
-Choose
Mechanism to
the long-term operation of the SCMs required b the program.
g p q y p g
a`�
J
Require Long-term
Operation and
The operation and maintenance plan required the owner of each SCM to perform
iaose
Maintenance
and maintain a record of annual inspections of each SCM.
a ;(ft?n.
Annual inspection of permitted structural SCMs are required to be performed by a
'.Cboose
qualified professional.��
Comments
Audit Date(s): DATE Page 22 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Post -Construction Site Runoff Controls
II.F.2.g The permittee conducted and documented inspections of each project site covered
Inspections of under performance standards, at least one time during the permit term (Verify this
modify
Structural is a permit condition in Part II.F.2.g of permit and fY accordingly),
Stormwater Control Before issuing a certificate of occupancy or temporary certificate of occupancy, the
Measures permittee conducted a post -construction inspection to verify that the permittee's t ,,
performance standards have been met or a bond is in place to guarantee
condition in Part II.F.2.g of permit and modify
completion(Verify this is a permit cond 9
accordingly.
The permittee developed and implemented a written inspection program for SCMs ;•, J
installed pursuant to the post -construction program(Verify this is a permit ,
condition in Part II.F.2.g of permit and modify accordingly.
The permittee documented and maintained records of inspections..
The permittee documented and maintained records of enforcement actions. tt,,_
T'.
Comments
a
II.F.2.h The permittee made available through paper or electronic means, ordinances,
Educational post -construction requirements, design standards checklists, and other materials
Materials and appropriate for developers. +� ;
Training for Note: New materials may be developed by the permittee, or the permittee may use.r3
Developers materials adopted from other programs and adapted to the permittee's new
development and redevelopment program.
Comments (If the permittee has adopted materials from other programs, indicate here which materials they are using)
�v� o. A Y%(21
II.F.2.i Enforcement
Comments
II.F.3.b
New Development
Comments
The permittee tracked the issuance of notices of violation and enforcement
actions.
If yes, the tracking mechanism included the ability to identify chronic violators
for initiation of actions to reduce noncompliance.
The permittee fully complies with post construction program requirements on its
own publicly funded construction projects.
f o0Sr`
"moose
0Osf
Audit Date(s): DATE Page 23 of 47

MS4 Permit Audit Report
City, NO NPDES Permit No. NCSOOOXXX
Post -Construction Site Runoff Controls
II.F.3.c
Nutrient Sensitive
Does the MS4 have areas drainingto Nutrient Sensitive Waters NSW
(NSW) to
15A NCAC 02H .0150?
71
Waters
If yes, does the permittee use SCMs that reduce nutrient loading in order to
meet local program requirements.
If yes, does the permittee also still incorporate the stormwater controls
l:it, li:;:: s
required for the project's density level.
If yes, does the permittee also require documentation where it is not feasible to
use SCMs that reduce nutrient loading.
Comments (Provide reference for local requirements)
esigd D
Design Volume
The permittee ensured that the design volumes of SCMs take into account the
C:�aoose
runoff at build out from all surfaces draining to the system.
�,; ,et ,
Where "streets" convey stormwater, the permittee designed SCMs to be sized to
treat and control stormwater runoff from all surfaces draining to the SCM including
- `
streets, driveways, and other impervious surfaces.
Comments
Audit Date(s): DATE Page 24 of 47

MS4 Permit Audit Report
r^�r„ rur• r%IPnFC Permit Nn Nccnnmay
n..11nnrl (znnri Nnimi-kpPning for Municipal Operations
Staff Interviewed:
(Name, Title, Role)
Permit Citation
Status Supporting
Program Requirement Doc No.
II.G.2.a
The permittee maintained a current inventory of facilities and operations owned _ c
Facility Inventory
and operated by the permittee with the potential for generating polluted Jti�
.._., ,.
stormwater runoff.
Comments (Note number of facilities, typical inventory data and any facilities that are not inventoried that should be)
y � ���! � �� i L � i.n)% 4�C_'_ � 0 � ` � � L• �G�, C, �sr2 ,` ,�, �' rZ ! r? c:- ti_ `�,.
II.G.2.b
The permittee maintained and implemented an O&M program for municipally
oo; _,
Operation and
owned and operated facilities with the potential for generating polluted
�Cl
-
Maintenance (O&M)
stormwater runoff.
for Facilities
,Ci-
If yes, the O&M program specifies the frequency of inspections.
If yes, the O&M program specifies the frequency of routine maintenance
requirements.
If yes, the permittee evaluated the O&M program annually and updated it as
Cho0S
J
necessary.
Comments
II.G.2.c
Spill Response
The permittee had written spill response procedures for municipal operations.
Pr' inns`
Procedures
Comments
II.G.2.d Streets,
The permittee evaluated existing and new BMPs that reduce polluted stormwater
ICI oos:
Roads, and Public
runoff from municipally -owned streets, roads, and public parking lots within its
aa-
1� : are/
corporate limits annually.
4
rage c5 or 41
Audit Date(s): DATE

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Pollution Prevention and Good Housekeeping for Municipal Operations
Parking Lots
Maintenance
If yes, the permittee evaluated the effectiveness of existing and new BMPs
/ o-),=
based on cost and the estimated quantity of pollutants removed.
`
Comments
II.G.2.f
O&M for Catch
The permittee maintained and implemented an 0&M program for the stormwater
Basins and
sewer system including catch basins and conveyance systems that it owns and
"
Conveyance Systems
maintains.
Comments (Briefly describe O&M program)
II•G•2.g
The permittee maintained a current inventory of municipally -owned or operated
Structural
structural stormwater controls installed for compliance with the permittee's post-
Stormwater Controls
construction ordinance.
Comments (Describe inventory information and number of controls in inventory)
II.G.2.h
The permittee maintained and implemented an O&M program for municipally -
O&M for Structural
owned or maintained structural stormwater controls installed for compliance with
Stormwater Controls
the permittee's post -construction ordinance. If yes, then:
"
The 0&M program specified the frequency of inspections and routine
Se
maintenance requirements.
ayi-IS,,
The permittee documented inspections of all municipally -owned or maintained
Chaose
structural stormwater controls.
yml S_ �
The permittee inspected all municipally -owned or maintained structural
1100se
stormwater controls in accordance with the schedule developed by permittee.
a M•
The permittee maintained all municipally -owned or maintained structural
-ih0ose
stormwater controls in accordance with the schedule developed by permittee.
a,
The permittee documented maintenance of all municipally -owned or
Choose
maintained structural stormwater controls.
a i 13
Comments
II.G.2.i
The permittee ensured municipal employees are properly trained in pesticide,
0osc
;
herbicide and fertilizer application management.
a --:ec?n.
Je?i,' ,
Audit Date(s): DATE Page 26 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
. m&4 r_r%r%A uni makppning for Municipal Operations
ruHULIU" L.v.. M..M ---- I- -
Pesticide, Herbicide
The permittee ensured contractors are properly trained in pesticide, herbicide and
h
and Fertilizer
fertilizer application management."
Application
Management
The permittee ensured all permits, certifications, and other measures for
applicators are followed.
Comments
y c , �A i
�l �: c.`.
The permittee implemented an employee training program for employees involved
j: i10:'D e
II•G•2•i
Staff Training
in implementing pollution prevention and good housekeeping practices..
i
Comments
Cam,
II.G.2.k
The permittee described and implemented measures that prevent or minimize
0 Fe
Vehicle and
contamination of stormwater runoff from all areas used for vehicle and equipment
Equipment Cleaning
cleaning.
Comments
I
Audit Date(s): DATE Page 27 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Total Maximum Daily Loads (TMDLs) -�:� �� )�.
Staff Interviewed:
(Name, Title, Role)
Program Status:
❑ The permittee is not subject to an approved TMDL (skip the rest of this section).
❑ The permittee is subject to an approved TMDL for: name of parameter(s) and date(s) approved
There ❑ is ❑ is not a Waste Load Allocation (WLA) in the approved TMDL (If there is a WLA, then complete items H.H.1-5
below. If there is not a WLA, skip to item H.H.6 below)
Permit Citation
Program Requirement
Status supporting
Doc No.
II.H.3 TMDLs
Within 12 months of final TMDL approval, the permittee's annual reports included
a description of existing
p g programs, controls, partnerships, projects and strategies to
address impaired waters.
"'' rn,.
Within 12 months of final TMDL approval, the permittee's annual reports provided
a brief explanation as to how the programs, controls, partnerships, projects and
^ i` `Se
strategies address impaired waters.
air i-eni.
II.H.4 TMDLs Within 24 months of final TMDL approval, the permittee's annual reports included
an assessment of whether additional structural and/or non-structural BMPs are no"
necessary to address impaired waters. ani`�r"•
Within 24 months of final TMDL approval, the permittee's annual reports included
a brief explanation as to how the programs, controls, partnerships, projects and (.Ilvc)s^c
strategies address impaired waters. a ' i`er"•
Comments
II.H.5 TMDLs Within 36 months of final TM DL approval, the permittee's annual reports included
C`i I {'
a description of activities expected to occur and when activities are expected to
occur.
an fi; OGIT
Audit Date(s): DATE Page 28 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Total Maximum Daily Loads (TMDLs) KYA
Comments
H.H.6 TMDLs If there is no Waste Load Allocation in the approved TMDL, the permittee
evaluated strategies and tailored and/or expanded BMPs within the scope of the
six minimum measures to enhance water quality recovery strategies in the jar; ,err
watershed(s) to which the TMDL applies.
The permittee described strategies and tailored and/or expanded BMPs in their o =s
Stormwater Management Plan and annual reports ='
Comments
Audit Date(s): DATE Page 29 of 47

MS4 Permit Audit Report
City, NO NPDES Permit No. NCSOOOXXX
Site Visit Evaluation: Municipal Facility No. 1
Facility Name:
Date and Time of Site Visit:
Facility Address:
Facility Type (Vehicle Maintenance, Landscaping, etc.):
Name of MS4 inspector(s) evaluated:
Most Recent MS4 Inspection (List date and name of inspector):
Name(s) and Title(s) of Facility Representative(s) Present During the Site Visit:
Name
Title
Observations
Facility Documentation/Training
Does the facility have a Stormwater Pollution Prevention Plan (SWPPP) or similar document? Is it facility -specific?
What type of stormwater training do facility employees receive? How often?
t-0�r�v�—y c5'�t�'� '��vCC�iiC✓�
`J
Inspector Training/Knowledge
What type of stormwater training does the MS4 inspector receive? How often?
Did the MS4 inspector appear knowledgeable about Permit requirements for pollution prevention and good housekeeping?
Did the MS4 inspector appear knowledgeable about stormwater pollution prevention and good housekeeping?
Inspection Procedures
Does the MS4 inspector's process include the use of a checklist or other standardized form?
Does the MS4 inspector's process include taking photos?
Does the MS4 inspector's process include reviewing the facility's SWPPP (or similar document)?
Audit Date(s): DATE Page 30 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Site Visit Evaluation: Municipal Facility No. 1
Does the MS4 inspector's process include walking the entire facility and inspecting all points of discharge?
*�D
Did the MS4 inspector miss any obvious areas of concern? If so, explain:
�V 0
Does the MS4 inspector's process include presenting the inspection findings to the facility contact?
IyQ�
Inspection Results
Did the facility inspection result in any corrective actions to be implemented? if so, for what issue(s)?
If compliance corrective actions were identified, what timeline for correction/follow-up was provided?
Notes/Comments/Recommendations
Audit Date(s): DATE Page 31 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Site Visit Evaluation: Municipal Facility No. 2
Facility Name:
Date and Time of Site Visit:
Facility Address:
Facility Type (Vehicle Maintenance, Landscaping, etc.):
Name of MS4 inspector(s) evaluated:
Most Recent MS4 Inspection (Date and Entity):
Name(s) and Title(s) of Facility Representative(s) Present During the Site Visit:
Name
Title
Observations
Facility Documentation/Training
Does the facility have a Stormwater Pollution Prevention Plan (SWPPP) or similar document? Is it facility -specific?
What type of stormwater training do facility employees receive? How often?
Inspector Training/Knowledge
What type of stormwater training does the MS4 inspector receive? How often?
Did the MS4 inspector appear knowledgeable about Permit requirements for pollution prevention and good housekeeping?
Did the MS4 inspector appear knowledgeable about stormwater pollution prevention and good housekeeping?
Inspection Procedures
Does the MS4 inspector's process include the use of a checklist or other standardized form?
Does the MS4 inspector's process include taking photos?
Does the M54 inspector's process include reviewing the facility's SWPPP (or similar document)?
Audit Date(s): DATE Page 32 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Site Visit Evaluation: Municipal Facility No. 2
Does the MS4 inspector's process include walking the entire facility and inspecting all points of discharge?
Did the MS4 inspector miss any obvious areas of concern? If so, explain:
Does the MS4 inspector's process include presenting the inspection findings to the facility contact?
Inspection Results
Did the facility inspection result in any corrective actions to be implemented? If so, for what issue(s)?
If compliance corrective actions were identified, what timeline for correction/follow-up was provided?
Notes/Comments/Recommendations
Audit Date(s): DATE Page 33 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Site Visit Evaluation: MS4 Outfall No. 1
Outfall ID Number:
Date and Time of Site Visit: '
Outfall Location:
Outfall Description (Pipe Material/Diameter, Culvert, etc.):
Receiving Water:
Is Flow Present? If So, Describe (Color, Approximate Flow Rate,
Sheen, Odor, Floatables/Debris, etc.):
Most Recent Outfall Inspection/Screening (Date):
Days Since Last Rainfall:
Inches:
Name of MS4 Inspector(s) evaluated:
Observations
Inspector Training/Knowledge
What type of stormwater training does the MS4 inspector receive? How often?
Did the MS4 inspector appear knowledgeable about illicit discharge indicators and investigations?
Inspection Procedures
Does the inspector's process include the use of a checklist or other standardized form?
Does the inspector's process include taking photos?
Did the MS4 inspector miss any obvious potential illicit discharge indicators or maintenance issues? If so, what were they?
Audit Date(s): DATE Page 34 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Site Visit Evaluation: MS4 Outfall No. 1
Inspection Results
Did the outfall inspection result in any work orders or maintenance requests? If so, for what issue(s)?
will a follow-up outfall inspection be conducted? If so, for what reason?
Notes/Comments/Recommendations
Audit Date(s): DATE Page 35 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Site Visit Evaluation: MS4 Outfall No. 2
Outfall ID Number:
Date and Time of Site Visit:
Outfall Location:
Outfall Description (Pipe Material/Diameter, Culvert, etc.):
Receiving Water:
Is Flow Present? If So, Describe (Color, Approximate Flow Rate,
Sheen, Odor, Floatables/Debris, etc.):
Most Recent Outfall Inspection/Screening (Date):
Days Since Last Rainfall:
Inches:
Name of MS4 Inspector(s):
Observations
Inspector Training/Knowledge
What type of stormwater training does the MS4 inspector receive? How often?
Did the MS4 inspector appear knowledgeable about illicit discharge indicators and investigations?
Inspection Procedures
Does the inspector's process include the use of a checklist or other standardized form? Obtain copy.
Does the inspector's process include taking photos?
Did the MS4 inspector miss any obvious potential illicit discharge indicators or maintenance issues? If so, what were they?
Audit Date(s): DATE Page 36 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Site Visit Evaluation: MS4 ®utfall No. 2
Inspection Results
Did the outfall inspection result in any work orders or maintenance requests? If so, for what issue(s)?
Will a follow-up outfall inspection be conducted? If so, for what reason?
Notes/Comments/Recommendations
Audit Date(s): DATE Page 37 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Site Visit Evaluation: Construction Site No. 1
Site/Project Name:
Date and Time of Site Visit: "
Site/Project Address:
Operator:
Project Type (Commercial, Industrial, Residential, CIP, Roadway,
etc.):
NCG Permit ID Number:
Disturbed Acreage:
Recent Enforcement Actions (Include Date):
Name of MS4 Inspector(s) evaluated:
Name(s) and Title(s) of Site Representative(s) Present During the
Site Visit:
Name
Title
Observations
Site Documentation/Training
Does the site have a Stormwater Pollution Prevention Plan (SWPPP) or similar document? Is it site -specific?
l
Does the site have approved erosion and sedimentation control plans onsite? Are they representative of current site conditions?
What type of stormwater training do site employees receive? How often?
Inspector Training/Knowledge
What type of stormwater training does the MS4 inspector receive? How often?
Did the MS4 inspector appear knowledgeable about MS4 and NCGO10000 requirements for construction sites?
Did the MS4 inspector appear knowledgeable about erosion and sedimentation control/stormwater pollution prevention BMPs?
Audit Date(s): DATE Page 38 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Site Visit Evaluation: Construction Site No. 1
Inspection Procedures
Does the MS4 inspector's process include the use of a checklist?
Does the MS4 inspector's process include taking photos?
Does the MS4 inspector's process include reviewing approved plans (erosion and sedimentation control and/or SWPPP)?
Does the MS4 inspector's process include walking the entire site and inspecting all points of discharge?
Did the MS4 inspector miss any obvious violations? If so, explain:
Does the MS4 inspector's process include presenting the inspection findings to the site contact in writing?
Does the MS4 inspector's process include providing construction stormwater educational materials to the site contact?
Compliance/Enforcement
What, if any, enforcement actions (verbal warnings, NOV, etc.) did the inspection result in?
If compliance issues were identified, what timeline for correction/follow-up was provided?
Notes/Comments/Recommendations
Audit Date(s): DATE Page 39 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Site Visit Evaluation: Construction Site No. 2
Site/Project Name:
Date and Time of Site Visit:
Site/Project Address:
Operator:
Project Type (Commercial, Industrial, Residential, CIP, Roadway,
etc.):
NCG Permit ID Number:
Disturbed Acreage:
Recent Enforcement Actions (Include Date):
Name of MS4 Inspector(s) evaluated:
Name(s) and Title(s) of Site Representative(s) Present During the Site Visit:
Name
Title
Observations
Site Documentation/Training
Does the site have a Stormwater Pollution Prevention Plan (SWPPP) or similar document? Is it site -specific?
Does the site have approved erosion and sedimentation control plans onsite? Are they representative of current site conditions?
What type of stormwater training do site employees receive? How often?
Inspector Training/Knowledge
What type of stormwater training does the MS4 inspector receive? How often?
Did the MS4 inspector appear knowledgeable about M54 and NCG010000 requirements for construction sites?
Did the MS4 inspector appear knowledgeable about erosion and sedimentation control/stormwater pollution prevention BMPs?
Audit Date(s): DATE Page 40 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Site Visit Evaluation: Construction Site No. 2
Inspection Procedures
Does the MS4 inspector's process include the use of a checklist? Obtain copy.
Does the MS4 inspector's process include taking photos?
Does the MS4 inspector's process include reviewing approved plans (erosion and sedimentation control and/or SWPPP)?
Does the MS4 inspector's process include walking the entire site and inspecting all points of discharge?
Did the MS4 inspector miss any obvious violations? If so, explain:
Does the MS4 inspector's process include presenting the inspection findings to the site contact in writing?
Does the M54 inspector's process include providing construction stormwater educational materials to the site contact?
Compliance/Enforcement
What, if any, enforcement actions (verbal warnings, NOV, etc.) did the inspection result m?
If compliance issues were identified, what timeline for correction/follow-up was provided?
Notes/Comments/Recommendations
Audit Date(s): DATE Page 41 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Site Visit Evaluation: Post -Construction Stormwater Control Measure No. 1
Site Name:
Date and Time of Site Visit:
Site Address:
SCM Type:
Most Recent MS4 Inspection (Include Date and Entity):
Name of MS4 Inspector(s) evaluated:
Most Recent MS4 Enforcement Activity (Include Date):
Name(s) and Title(s) of Site Representative(s) Present During the
Site Visit:
Name
Title
Observations
Site Documentation
Does the site have an operation and maintenance plan?
Does the site have records of annual inspections? Are they performed by a qualified individual?
Inspector Training/Knowledge
What type of stormwater training does the MS4 inspector receive? How often?
Did the MS4 inspector appear knowledgeable about MS4 requirements for post -construction site runoff controls?
Did the MS4 inspector appear knowledgeable about post -construction BMPs (general purpose/function, components, O&M
requirements, etc.)?
Inspection Procedures
Does the MS4 inspector's process include the use of a checklist or other standardized form? What format?
Does the MS4 inspector's process include taking photos?
Does the MS4 inspector's process include reviewing the site's operation and maintenance plan and records of annual inspections?
r
Audit Date(s): DATE Page 42 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Site Visit Evaluation: Post -Construction Stormwater Control Measure No. 1
Does the MS4 inspector's process include walking the entire site and inspecting all points of discharge?
Did the MS4 inspector miss any obvious operation and maintenance deficiencies? If so, explain:
Does the MS4 inspector's process include presenting the inspection findings to the site contact in writing?
Compliance/Enforcement
What, if any, enforcement actions (verbal warnings, NOV, etc.) did the inspection result in?
If compliance issues were identified, what timeline for correction/follow-up was provided?
Notes/Comments/Recommendations
Audit Date(s): DATE rage 4s or 4i

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
Site Visit Evaluation: Post -Construction Stormwater Control Measure No. 2
Site Name:
Date and Time of Site Visit:
Site Address:
SCM Type:
Most Recent MS4 Inspection (Include Date and Entity):
Name of MS4 Inspector(s) evaluated:
Most Recent MS4 Enforcement Activity (Include Date):
Name(s) and Title(s) of Site Representative(s) Present During the Site Visit:
Name
Title
Observations
Site Documentation
Does the site have an operation and maintenance plan?
Does the site have records of annual inspections? Are they performed by a qualified individual?
Inspector Training/Knowledge
What type of stormwater training does the MS4 inspector receive? How often?
Did the MS4 inspector appear knowledgeable about MS4 requirements for post -construction site runoff controls?
Did the MS4 inspector appear knowledgeable about post -construction BMPs (general purpose/function, components, 0&M
requirements, etc.)?
Inspection Procedures
Does the MS4 inspector's process include the use of a checklist or other standardized form? What format?
Does the MS4 inspector's process include taking photos?
Does the MS4 inspector's process include reviewing the site's operation and maintenance plan and records of annual inspections?
Audit Date(s): DATE Page 44 of 47

MS4 Permit Audit Report
City_ NC- NPDES Permit No. NCSOOOXXX
Site Visit Evaluation: Post -Construction Stormwater Control Measure No. 2
Does the MS4 inspector's process include walking the entire site and inspecting all points of discharge?
Did the MS4 inspector miss any obvious operation and maintenance deficiencies? If so, explain:
Does the MS4 inspector's process include presenting the inspection findings to the site contact in writing?
Compliance/Enforcement
What, if any, enforcement actions (verbal warnings, NOV, etc.) did the inspection result in?
If compliance issues were identified, what timeline for correction/follow-up was provided?
Notes/Comments/Recommendations
Audit Date(s): DATE Page 45 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
APPENDIX A: SUPPORTING DOCUMENTS
Audit Date(s): DATE Page 46 of 47

MS4 Permit Audit Report
City, NC: NPDES Permit No. NCSOOOXXX
APPENDIX B: PHOTOGRAPH LOG
Audit Date(s): DATE Page 47 of 47