NCC191814_NOT Closeout Documents_20210218

SEDIMENTATION INSPECTION REPORT (City of Winston-Salem/Forsyth County)
Winston-Salem Field Operations Department Permit #: EN1900070
Erosion Control Division
P.O. Box 2511 Date: 12-16-20
Winston-Salem, NC 27102
Report by: David Evans, CESSWI
Revised 1-1-20 Phone: [phone]
Locatio Project:
DOLLAR GENERAL —MOTOR RD. 1771 MOTOR RD.
1. Pictures: ("a'' One) Yes: No: X
2. Potential for NPDES Violation: ("a'' One) Yes: No: X Describe:
3. Weather and soil conditions: Rain 36d wet Initial inspection: ("a'' One) Yes: No: X
4. Is site currently under notice of violation? ("a'' One) Yes: No: X
5. Is the site in compliance with S.P.C.A. and rules? ("X7 One) Yes: X No: If no, check violations below.
6. Violations: ("X" all applicable sections)
( )--- No approved plan, [UDO See. 8.4.6 (G) ; & G.S. 113A-57 (4) and 15A N.C.A.C413.0107(e)]
( )--- Failure to follow approved plan, [UDO See.8.4.19 (A); & G.S. 113A-61.1]
( )--- Failure to submit revised plan, [UDO See. 8.4.17 (B) (5); & G.S. 113A-54.1(b) and 15A N.C.A.C. 413.0118(a)]
( )--- Failure to provide adequate groundcover, [UDO See. 8.4.6 (D) (1) (b); & G.S. 113A-57(3); & 15A N.C.A.C. 413.0007(b) or 15A
N.C.A.C. 413.0124(e)]
( )--- Insufficient measures to retain sediment on site, [UDO Sec. 8.4.6 (D) (1) (a); & G.S. 113A-57(3)]
( )--- Failure to take all reasonable measures, [UDO Sec. 8.4.4 (B); & 15A N.C.A.C.4130105]
( )--- Inadequate buffer zone, [UDO See. 8.4.6 (A); & G.S. 113A-57(1)]
( )--- Graded slopes and fills too steep, [UDO Sec. 8.4.6 (B) (1) (a, b, e); & G.S. 113A-57(2) or 15A N.C.A.C. 413.0124(d)]
( )--- Unprotected exposed slopes, [ UDO See. 8.4.6 (B) (1) (1); & G.S. 113A-57(2)]
( )--- Failure to install and maintain erosion control measures, [UDO See. 8.4.12; & 15A N.C.A.C. 413.0113]
( )--- Failure to keep current self -inspection records, [G.S. 113A-54.1 & 15A NCAC 048. 0131]
( )--- Other (describe):
7. Contact made with (name): BRAD HILL itle
8. Contact Method: phone # O email (([e-mail]) letter O person ( )
9. Corrective actions needed:
10. Comments: (X) No devices in place O Additional devices needed O Devices need maintenance O Devices in & functioning
O No seeding noted () Partially seeded (X) Areas seeded (NO) Off -site sedimentation (X) Project in compliance
Site stable. Building done.
Please submit for Notice of Termination [N.O.T.] from State for your NPDES permit and upload documentation when
received, to IDT plan review file for this project.
It. Others present.
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Office use only: Cityworks O Final ( ) [white notebook] Excel ( ) Financially responsible contact ( ) ARCGIS ()