NCC205640_NOT Closeout Documents_20210902

SEDIMENTATION INSPECTION REPORT (City of Winston-Salem/Forsyth County)
Winston-Salem Field Operations Department Permit #: EN2000176
Erosion Control Division
P.O. Box 2511 Date: 8-20-21
Winston-Salem, NC 27102
Report by: David Evans, CESSWI
Revised 1-1-20 Phone: [phone]
Project: I CULVER RESTAURANT Location: FAIRLAWN DR.
1. Pictures: ("x" One) Yes: No: X
2. Potential for NPDES Violation: ("x" One) Yes: No: X Describe:
3. Weather and soil conditions: Sun/clouds 88d damp 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. 8.4.6 (G) ; & G.S. 113A-57 (4) and 15A N.C.A.C4B.0107(e)]
Q--- 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)]
O--- Insufficient measures to retain Sediment on Site, [UDO Sec. 8.4.6 (D) (1) (a); & G.S. 113A-57(3)]
O--- 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) (t); & 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 cw
Other (describe):
rent self -inspection records, [G.S. 113A-54.1 & 15A NCAC 0413. 0131]
7. Contact made with (name): Dave Herron Title CONTRACTOR
8. Contact Method: phone # [phone]) email(X—[e-mail]) letter O person ( )
9. Corrective actions needed:
10. Comments: () No devices in place () Additional devices needed ( ) Devices need maintenance (Some) Devices in & functioning
() No seeding noted ( ) Partially seeded (X ) Areas seeded (NO) Off -site sedimentation (X) Project in compliance
Site stable with landscaping, building, & parking lot. No erosion problems. Permanent ground cover sufficient
to restrain erosion has been established. No additional self -monitoring or self -inspections are required.
Project is in compliance and released under the SPCA. Termination of coverage under the NPDES General
Stormwater Permit for Construction Activities (NCG01) must be requested by the permittee via a Notice of
Termination (NOT). The NOT is available at: hops://edocs.deg.nc.aov/Forms/NCG01-Termination. Please
note that this correspondence must be uploaded as part of completing the NOT process.
Office use only: Cityworks ( ) Final ( ) [white notebook] Excel ( ) Financially responsible contact ( ) ARCGIS ()