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D� SH DDT D OF 3 JEFFERS❑N TOWNSHIP,, GUILF❑RD CO, THOMASVILLE, NC 27360 COLFAX, NC 27235
N 336-472-2378 336-456-3798
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RISER STRUCTURE
SKIMMER (SIZE `AR.
STEEL POSTS (QUANTITY VAR.)
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STANDARD . � IISSIIPATOIR
OR
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ERGENCY SPIILL A
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ANTI -SEEP STABILIZED
COLLAR OUTLET
NOTES
1-SEED AND PLACE MATTING FOR EROSION CONTROL ON INTERIOR AND EXTERIOR SIDESLOPES.
. INSTALL MINIMUM OF 3 COIR FIBER, BAFFLES IN ACCORDANCE WITH PRACTICE STANIDARD 6.65.
. INSTALL SKIMMER AND COUPLING TO RISER STRUCTURE OR DIRECTLY INTO EMBANKMENT 1 FT FROM BOTTOM( OF BASIN.
4. THE ARM PIPE SHALL HAVE A MINIMUM LENIOTH OF 6 FT BETWEEN( THE SKIMMER, AND COUPLING.
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238 CEDAR LODGE ROAD
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PHILLIP SHU, P.E. Se ASSOC.
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P.O. BOX 459
COLFAX, NC 27235
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email: [e-mail]

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PART I I 1
SELF -INSPECTION, REDORDKE EPING AID a FPORTI NiG
PART 111
SELF. I NSRECTI 0 Na p EEOp a KEIEPI.I 6 AND REPORTI NIG
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S E LF- I N WECTI ONO FR ECO R 0 KEEP IN f-3 AND q Er O RT M-3
SECTI O1 A: SE LE-1NISpECT`ON
Self -in 5pection5 a re requir-d d Wring nomall Mine55 ho ur-j in accord ante Sri ,,h tte table
blow - VVhe ri adrse w eathe r or ske cord It'ions wo ul d eaaw 1 he �a N t� of 11re I rispim in r-
personn el to be in jeopa rdyr the in s pection may bo delay@ d u n --il the n-oxt b usi ness dayr O'n
which it i5 We to perforn t e i 15 pe�liz?n . In addit;o nj Me n a Ltor m MM Of eq w-a to C
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Iwhrte
hours rrF a rain
1 denrriptian, ouicirbrr ;iFA d;vh- rl r.nn-prtw attimi; laism. ;i"
acres' bier
cvmt i 1.0 hnch in
2. Rmwrch; of the= i".Ared rejor.s ba the appro piiate U%dsi or-
;4 hour%
M1rgrinal OFFr,.� iper Pwr lll, 5rrri n C, tr.m of Fhi% prrML
MI Grind
After g3h pilaw
1. The phag? of uadhe tlrr;.allation of perimeter E
IM1111AUM
-00.9ta dim$
rhemm -flmlir6q aMd aeubbnoL Iffit.dlacon 81 Stag
n ay
arm -tame iaiA camPledDr ai all lar d-1xurNrg
mHyItyl, enir trunk h m reda6-elinprimrt: pq Ipmjnent
gAlk nd caved.
2. DxL rrtrti'.aikm tWi the reaured ground suiblizailon
measuresUwe been p Fm 1d&c wrthIn t�e required
it rrefnime or am a�iLwapce that MeV All hie Or sad as
16dn As OdkNt1c.
NM: The ra i n i nspfaion mwu the req uired 7 nalencla r day inspect ion requirement.
SECT ION 0: RE -CORD H E E PING
1. E&5 C F Iiii n Doc une rMlation
?h -2 a pp rove d E&SE plan a s -we II as any a p proved deviat ion she II bc kcpt Dn the s i- T�
a pp rove d EEC pl are mWsz. be kn at up -to-dale through ou L the coverage under thti is perm I-.
T� f8 118*1r jZ lttM� rtdjn,Mg ti5 t188 E Ala r, thlll bt kiyPt i5m e nd Ayin iIZ614 fir
Fri$ ic�p F0 01 tim-es 4�4 ri rig horrriil Wsiqleg 111ggIrs1
M Each Bw mea&ure has been Installed
no krs r qq ;i,8rtiifiw noy qIqyi@ti:#pm jhq
to 6on% drnemigr15 a nO relative -eleyi�om
s hnwn 611 the appmysd E &SC C Iarti_
DocyrrwentatIcn RegLirennents
with I and dat-e ezrh c& 5c measwrq on � copy
-Qf 1h Q p pPrQvv0 EAM pl.Pri gr QQm PMQ, Mg
� nd 5 gn a a i rispe0o n rewt Chest i5i� eacll�
E&SeC measur-2 shin on the a ppmvM E
plan_ This dncUrni�rkra dcin i5 required u pun the
irpifaal imta II ation gf the E&�YC rnea�ure� yr if
ale EMI SC measures a re mDdi Eyed after i 11tia1
i sra IM18 A.
h} A phase of gr3 d i ng ha i teen cam pl@UcL Initia I and date a raper of the approved E&+C
plan 4i-r complete, date and slgn an ins titer~
report tv indicate =plef un of the
�;?mtru;tign phaw.
(0 Ground corer is IvEated and i nslalMel
'in accaFda rice with the approved E&SE
On.
[d} The mai ntarmrice acid rapzir
requireme rrEs -�air all E&SC mea s u ms
laawa been peerfarrned_
(e) Corrective actioin haw men taken
t4a EIL 51� n1 eaw Fes.
initia I and date a napy cif the approved EIS
plan or �arlmplete, date -and S iEn an impe,-0on
report w inriicare L`rnpliarlr-P frith a RprL�uuc
gmu red cower specitica ions..
Corn plater date and LWn an in peclian repaf i -
knItla I and dare a Mpy of the appFoved F
pLan -or complete, dgt a and slon a n. iinspe�ctiion
MpVM �q ink q 1hq Vpan p4ettpr, Vf the
corrective action.
Z, add Itional amumentati cn to be Kept an Mu
I n add ition to the EW-, pl a n doru menti abcrve, the talllmuiing items seal I be kepi on the
s,le and a-yaL a ble fo r inspectors at all tl mes Burl mg norm al buslri= haw r$r u1n k= the
cfy'slo rt pry Ides a site-t f Ic mirriplion Wed on uniquQ s4e cvhd Itaons that rna W
t hi g r gaftmir nt n6t practical:
0) Tb h Gerieral Perri- i I. a5 WCII a5 the Ce ftlfiClate lof C-OwM ffe, afti�r it I$ ru kd_
a) fiords of in:spectiors made during the previliou5 twelve rnonrlih& T ne permittee shall
record the required obse rvatiori$ on the 145 Rearm flecord Fora prawadeJ by the
CjI e,. I it r I opettllori fi�rrn that irW Lullle� III t Nt e-�tiuitle4 Oefthteu. W� of
eltetroini ca I Iy-ava i la b1i� rgcQr& in lie u of r;ie ri�Wired pope r copies w111 Oe aff a d if
shown to p rnvid@ eq ual access a nd util ity a & th@ hard ca pry reru rds-
3. Documentation to be Rimta i Fled for Three Years
All data use d to coal plete t Fie a-N 01 and all insoectlon recu rds shall be malpr`rtainedl for a Pe nod
of three years of ter project car"r pleflon a rid m dde aw-ilablo up0l 1 req Dent, NO CFR 12.2.411
TIAR7 I r., S 1=1 DN C;' I 1 141
DIR i;W DOWN O F 5EDI M FIST DA51 N b FOE M Al NTEN A NNE OR E L05 F OUT
Sedirn-ent ba-sIns a red tra ps that r�oelve runoff fro m dr'ai rage Dress err u rte E cn> ar more 5h. a IJ uw outlet 3tr>uEture$ that withdraw wale r from the Surface when the$e de'wiLC5 nod to be d rawn down
foe Maiht�narpoe or c1#le out urllem th Infta:;i bl c_ Thi� drtL+miMtxs 1-P �1�icl� it f:� ei81 Wiih4 M withdraw mtD r tmm the tarfttj� shall b8 ram (For oedmpNp kilmeL with aW r &-d c5Id vmatM t� .
Non-;urtace withdraW215 frorr1 sedirrlent basins s ha I I be a Ilevved -only wh e n a II of the fol lowi rig 271--eria have bee n mfft:
(a) Tri a E&SC p Ian aurtharity has been provided wittti doe urn er"rtati on of t he non -s u rfare writhd fawa I a rd : h Lz specific ti me periods Dr Condit 1orti5 in wNdh k will cxru r. Th E nor -su rface writ r 1 ri ei.a 1
shall Icit coca Memo& U nd I the& MSC plv� autorfty has a pp rovad t h ese Items..
(kj 1h� vp-ry rf�� wyitN rpw@ I � � �qE rn repqr�iud a.5�in �n kri RptE�O byps' in p�ggrdprii;t wit 4 Rips III, S Qh �, lti�bm (2)(�j �rId fo) Of this pgr _Mr
(r) [ew-�Ibe?iing d im F n rge!L g r8 trenUd with r8 r+ gals to m i-ni m im d i!geMarZe-g 8f pd I uta)m fyoI gtor nwpter tha j5 m mewed fem rho SM i m-�nt MEi n . Ewnmpl a� 8f n p pr8 minte rn Mt ?CIS irlclu d?�
Iprnpe rly sited, des a rred an d rn a intai ned dew2teri ig tarry, we r tanks;., a nd f it zratir n s�5tern s.,
(d) Vege .ate , up La rid am as of the 51tes or a Rropedy d-Es Ign Lid stone pad is u5ad to the extent feasible a` t outlet of the dewaterl ng tree me nt devi re5 de Bribed in Ite rr W a bona,
(e) Velocity di55iRat o n &maces Such a s check da m3, 5ed ime rrt try, wd ripra p are provi&d at t be d'56arp poi nk� of a I I dfmter ng devi U5. an d
(0 iment r ,o�d f r.Dm the wale ri rf trEotment cleylces descrl bed h Item (4 Is disposed of 6 a rna n ne. - t ha- does riot ca use die posit in n [rr mad i me.nt I Mo Fate r� of t6e UnIted States -
SFC-T1(5 N f!: MPOft kNC3
1 L Ocru rnLmc@i� that Mn st M R@bported
Pe rm ittees sha II re pa rt the fa I lawi ng accurre In ie5 :
(o) Visib I@ sed irnLLrt d-apos ition i n a &trearn cf wetland.
(b) 01 wills if=
They are 25 p1 lobs cr rr*rer
T" is `Q IeSS LIa p -25 pllarns b ut cp nnot be rlea red 4p with 'In 24 h owrs,
They courpe shear` co su rFace graters (eqa rdle55 Gf %f-vlu )r or
o T r arLd wr Kel 100 Wirt -of �UMr%ee W (regard I t Of VedtIN-Cm).
1c) ReIemies of h izardous sutistan re5 in excc55 of rep urGable qua rnit c5 u -I de r Section 311
of the E1 ea ri YVater Act (Ref: M CFR 110, 3 and 4E (E R 117.3) or Eerrion 102 of CE RELA
I Fief. 40 CFR 302_4� ar G.S. 143-215,85,
(d) Anticipa I:iypsses and ur1t Micipate if h pasNeN-
(e) N Dn zar>npl iance wit h the rxiridWoriis of this pe rr1 is that may f nd a r pr- hea Ith a r t -le
c ny iron merkt.
2. FLaM rfing Ti rnefrarnes an d Me r I q Li;1111i�Y
After a perrnitlee bewr7i e5 aw�fe of �in DLr ur -e nce t h a 1. m 1uLt be reported, he shaJ, �;Q react
the appvop crate bivis6oin reglom- I off ce within the fir n efrarn-�!; and in acr."01rnu With (ke
othe r rcq Lixernerrls listed Wow. QaurrencQc� outs idD norrr a I busir1v..�s hours may alb be
r iepu r*�d to tea pant' Errwirorl 1 rltal Erne rg�r1 rye te f p f r�r1 el at i�00)
Occurrence I ftgaRirg Tlmeftames I01ter 01wo;+er3+l and other Re0remenis
(al VSih IQ !Wd 1innE y I
dep sition in a
T,M: gjen or wet r•41
j b) 0i I Spills a nd
-P
■
WrrtzhR 24 6a Lrr& arl orall or electrb rric nolMr.a1ioA A.
Wit?xiR I c-aOenaiaf ems, a report than -c*ntains A tiet3�criptian Gf 111-E
5edirrent and attio n5 taken w addre5 5 the Gdy3d of the depu5 thyn.
Nuislon staff mw WolVe the FegIjl Q+)l NF a Wf1ffefk rE1p0 Fl On D
case-Ey-cam basis.
11 the st morn is nran-ped an the KC M; f d) list 8r impaired fcc sedliment-
re Iat� caLmi., the perrrlittEC Ma-f he requirt% to p�riorm additional
moribring lnsp ions or a Qpl�v mona �trlrlpnt priMeot f !:14 ff
determine rhit addimprial requirements are needed tQ assure o mpia nce
with thefectera I ar state im paired wart-eFs cunditkprrs,
s
WY24 bovrJ~ Rn orb nt elea m rmC n01tIka1i0r1. The nrjMCdtW
all I nclu �nf�nn,atl n abut t h� dales time, nAtu re, vo1 J m� end
-hazardous
IQcativ n af tie spill or re "E.
SuhSWPCQG per 11mim
IM11 0 abwl:
It 1 rlt spa
*
A Warf of 1amr renz(aps Ib efiw thIF � + -
bWmses [46 -CPR
The report sha I I Mn€1udle a n eva W-tian of the anticipated quality and
122_41ilmh�3)1
effect of the byp.a%,
To.',Tnanwpa�4
o
!! 24 hourr, an anal or elect ra rre nGlifiialbn_
b$passes [4a CF p
i
MAWr& � ta1ema6r doK a report [bit 'includer, aK evaluar Ion of the
122_411Mri (3) J
9 u a I i4 an r. effect c f the by pass.
■
wwrr z4 bovi:sr ion irti or tiectru ric noldicpliari ,
f f Iorrcern al is me
with the eared Ikloril
*
Wr Wo 7 a�■ iW&K a e4�p&� tKAI: 4:6nt6iepi ik d ri j*iM M IKE
of this perma that
,�ai,ccmplian aer a nd i1s. causes; the period of nPancorkipllarire,
may endan�eir
includ ng e o ft dzte5 a-rd trrnei, and it the nooc rripllance Fhas not
hiral Lh or Fhe
tmmn rorrened, th@ A,-Ar0atk ttnR r1OWMRlignit iS LEXpOCMd 10
eiriv1 mnrrla nt[40
tn�Atl wi!� and :Etag6 tz6 ri or phrm d to reduce, ei'm r nth: ,s6d
UR 121�41(1)pj j
prevent moix uFr-2nc-? ai the noncom plia nce. 140 EfFk 122.4
*
Lilylsl*n staff may wralwe the re3ulremeni for a %uni err repo rl on a
caig@-tv-taw baii5.
' NOR7HPa[aEnvironmerI Q airy
NCG01 SELF -INSPECTION, REC�RDKEEPING AND RI,P0R"1_41NG
EFFECTIVE: 041`0 1 ,`19