NCC200261_NOT Closeout Documents_20210729

SEDIMENTATION INSPECTION REPORT (Village of Clemmons)
Winston-Salem Field Operations Department Permit #: EN1900163
Erosion Control Division
P.O. Box 2511 Date: 5-13-2021
Winston-Salem, NC 27102
Report by: KENT WALL
Revised 7-1-19 Phone: [phone]
Project CLEMMONS MEDICAL OFFICE ocation 3311 JESSIE VILLAGE DR
1. Pictures: ("x" One) Yes: No: X
2. Potential for NPDES Violation: ("x" One) Yes: No: X Describe:
3. Weather and soil conditions: PT CLOUDY / DRY Initial inspection: ("x" One) Yes: No: X
4. Is site currently under notice of violation? ("x" One) Yes: No: X
5. Is the site in compliance with S.P.C.A. and rules? ("x" One) Yes: X No: If no, check violations below:
6. Violations: ("X" all applicable sections)
( )--- No approved plan, [UDO Sec. 4-7 (G) ; & G.S. 113A-57 (4) and 15A N.C.A.C4B.0107(c)]
( )--- Failure to follow approved plan, [UDO Sec.4-20.1; & G.S. 113A-61.1]
( )--- Failure to submit revised plan, [UDO Sec. 4-18.2; & G.S. 113A-54.1(b) and 15A N.C.A.C. 4B.0118(a)]
( )--- Failure to provide adequate groundcover, [UDO Sec. 4-7 (D)(1); & G.S. 113A-57(3); & 15A N.C.A.C. 4B.0007(b) or 15A N.C.A.C.
4B.0124(e)]
( )--- Insufficient measures to retain sediment on site, [UDO Sec. 4-7 (D)(1); & G.S. 113A-57(3)]
( )--- Failure to take all reasonable measures, [UDO Sec. 4-5.2; & 15A N.C.A.C.4B0105]
( )--- Inadequate buffer zone, [UDO Sec. 4-7 (A); & G.S. 113A-57(1)]
( )--- Graded slopes and fills too steep, [UDO Sec. 4-7 (B); & G.S. 113A-57(2) or 15A N.C.A.C. 4B.0124(d)]
Unprotected exposed slopes, [ UDO Sec. 4-7 (D)(2); & G.S. 113A-57(2)]
Failure to install and maintain erosion control measures, [UDO Sec. 4-13; & 15A N.C.A.C. 4B.0113]
Failure to keep current self -inspection records, [G.S. 113A-54.1 & 15A NCAC 04B. 0131]
Other (describe):
7. Contact made with (name): MATT BAKER Title
8. Contact Method: phone # O email (X) fax # O letter O person ( )
9. Corrective actions needed:
CORRECTIVE ACTIONS ARE NOT REQUIRED.
10. Comments: O 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 (YES) Project in compliance
THIS PROJECT HAS BEEN FINISHED AND IS STABLE.
PLEASE APPLY FOR NOTICE OF TERMINATION OF THE NCGO1 CERTIFICATE OF COVERAGE (COC).
ONCE YOU OBTAIN TERMINATION OF THE COC, WE CAN CLOSE THE GRADING PERMIT.
11. Others present:
Office use only: Cityworks (X) Final ( ) [white notebook] Excel ( ) Financially responsible contact ( )