20170239 Ver 2_11.9.20 thru 11.15.20_Signed_20210506

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Erosion control maintenance.
Erosion control inspection.
Erosion control maintenance.
Erosion control maintenance.
Erosion control inspection. (No inspection 11/12 due to sa
Erosion control maintenance.
No work project wide.
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Pollutants** Deposited*** Clarsty
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Station Number
Permit Site 1: 07-1
Permit Site 1: 07-6
Permit Site 1: 07-7
Permit Site 1: 07-12
PermitSite 1: 07-13
Permit Site 1: 07-15
Permit Site 2: 08-1
Permit Site 2: 08-3
Permit Site 2: 08-4
Permit Site 2: 08-6
Permit Site 2: 08-13
Permit Site 3: 08-7
Permit Site 3: 08-8
Permit Site 3: 08-14
P ermit Site 3: 08-15
P ermit Site 3: 08-16
P ermit Site 3: 08-17
P ermit Site 3: 08-18
P ermit Site 5: 08-10
P ermit Site 5: 08-12
P ermit Site 5: 08-19
P ermit Site 5: 08-20
P ermit Site 5: 08-21
(Permit Site 5: 08-22
P ermit Site 5: 08-23
P ermit Site 5: 08-24
P ermit Site 6: 09-01
P ermit Site 6: 09-02
P ermit Site 6: 09-03
P ermit Site 6: 09-04
P ermit Site 6: 09-05
P ermit Site 6: 09-06
P ermit Site 6: 09-07
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Repair/maintenance to rock check dam.
No action taken
No action taken
Repair/maintenance to silt fence outlet.
No action taken
No action taken
Repair/maintenance to silt fence outlet.
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P ermit Site 7: 09-10
P ermit Site 7: 09-11
Permit Site 7: 10-01
Permit Site 7: 10-02
P ermit Site 7: 10-03
Permit Site 7: 10-04
Permit Site 7: 10-05
Permit Site 7: 10-06
Permit Site 7: 10-07
Permit Site 7: 10-08
Permit Site 7: 10-09
Permit Site 7: 10-10
Permit Site 7: 10-11
Permit Site 7: 10-12
Permit Site 7: 10-13
Permit Site 7: 10-14
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P ermit Site 8: 11-01
P ermit Site 8: 11-02
P ermit Site 8: 11-09
P ermit Site 8: 11-10
P ermit Site 8: 11-11
P ermit Site 8: 11-12
P ermit Site 8: 11-13
Permit Site 9: 11-14
Permit Site 10: 12-1
Permit Site 10: 12-2
P ermit Site 10: 12-3
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Maintenance to rock check dam.
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Station Number
P ermit Site 11: 12-8
P ermit Site 11: 12-9
P ermit Site 11: 12-10
P ermit Site 11: 12-11
P ermit Site 11: 12-12
Permit Site 11: 12-13
Permit Site 11: 12-14
Permit Site 11: 12-15
Permit Site 11: 12-16
Permit Site 11: 12-17
Permit Site 11: 12-18
Permit Site 12: 14-1
Permit Site 12: 15-1
Permit Site 12: 15-2
Permit Site 12: 15-3
Permit Site 12: 15-4
Permit Site 13: 15-5
Permit Site 13: 15-6
Permit Site 13: 15-7
Permit Site 13: 15-8
Permit Site 13: 15-9
P ermit Site 14: 15/27-1
P ermit Site 14: 15/27-2
P ermit Site 14: 15/27-3
P ermit Site 14: 15/27-4
P ermit Site 14: 15/27-5
P ermit Site 15: 16-01
P ermit Site 15: 16-02
P ermit Site 15: 16-03
P ermit Site 15: 16-04
P ermit Site 16: 27-06
P ermit Site 16: 27-07
P ermit Site 16: 27-08
Permit Site 16: 27-09
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Permit Site 20: 31-8 Silt fence outlet maintenance. U 11/14/20 N N N
Permit Site 20: 31-9 No action taken NA NA A N N
Permit Site 20: 31-10 IIIMIIII_IS
Permit Site 20: 31-11
Permit Site 20: 31-12
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'Permit Site 16: 27-11
Permit Site 16: 27-13
Permit Site 16: 27-14
Permit Site 18: 30-01
Permit Site 18: 30-02
Permit Site 18: 30-03
Permit Site 18: 30-04
Permit Site 18: 30-05
Permit Site 18: 30-06
t Site 18: 30-07
t Site 18: 30-09
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EY 28 (Edgewood Chruch Rd.) Repair/maintenance ditch line EC measures. R 11/17/20
L Line 155+00 RT Clean ditch line free of silt. R 11/19/20
L Line 155+00 RT Pipe inlet protection maintenance. R 11/17/20 II,
L Line 155+00 RT Repair coir fiber wattle. R 11/17/20
L Line 155+00 RT Slope drain protection maintenance. R 11/18/20
P ermit site 12: 157+00 LT Slope drain protection repair. R 11/18/20
P ermit site 12: 157+00 LT Installation of silt fence outlet where slope drain discharges. R 11/18/20
P ermit site 12: 157+00 LT Silt fence maintenance. R 11/18/20
L 157+75 RT Repair silt fence and silt fence outlet around 24" RCP. R 11/15/20
L 157+75 RT Pipe inlet protection maintenance. R 11/15/20
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S ilt fence maintenance.
Silt fence maintenance.
S ilt fence outlet maintenance.
Inlet of 24" RCP: Retrieve silt from inlet of pipe.
Re-coir fiber and seed.
Retrieve silt from JS.
Maintenance to silt fence and silt fence outlets.
Clean rip rap line ditch.
Relieve/repair silt fence.
DI protection maintenance.
Retrieve silt from offsite.
Clean out rip rap line ditch.
Retrieve 57 stone from JS.
S ilt fence outlet repair.
Retrieve silt from offsite.
Silt fence outlet maintenance above outlet of pipe.
Clean silt out of dip hole in front of silt fence outlet.
S lope drain protection/DI protection maintenance.
S lope drain protection/DI protection maintenance.
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P ermit site 7: L 96+00 RT
P ermit site 7: L 97+50 LT
L 81+50 LT
L 108+25 RT
L 108+25 RT
P ermit site 8: L 108+25 LT
P ermit site 8: L 108+25 LT
P ermit site 8: L 108+25 LT
L 111+00 LT
111+00 LT
P ermit site 10: L 126+50 LT
P ermit site 10: L 126+50 LT
Site 10A: L 127+50 LT
S ite 10A: L 127+50 LT
P ermit site 11: L 133+00 LT
P ermit site 11: L 133+50 LT
P ermit site 11: L 134+00 RT
L 134+00 - 143+00 LT
L 134+00 - 143+00 RT
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Repair silt fence outlet.
Repair/maintenance check d
DI protection maintenance.
Retrieve silt from JS.
Repair silt fence where it
Repair silt fence.
Retrieve silt from JS.
Silt fence outlet repair.
Repair silt fence outlet.
Repair silt fence.
Retrieve silt from bank of
.ir silt fence ou
(Where tree has fallen) Re
Repair silt fence.
Repair silt fence outlet.
Repair check dam.
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Station Number
t site 16: Y16RAP 18+00 RT I
t site 16: Y16RAP 18+00 RT
P ermit site 16: Y16RAP 18+00 RT
Y16RPA 26+00 LT
IY20 20+00 RT
Y10 19+50 RT
Y10 26+00 RT
P ermit site 20: Y10 29+00 RT
t site 20: Y10 29+00 RT
Y11 17+00 RT (triple RCP)
Y11 17+00 RT (triple RCP)
Y11 17+00 RT (triple RCP)
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P ermit site 18: Y1C
P ermit site 18: Y1(
Y10 20+00 RT
Y10 20+00 RT
Y10 21+00 RT
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04/2019 : PFORM30
Comments
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
cat
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Standard/Metric Unit
LF M
TN/MTN LF/M
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LB KG
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