NCC205716_NOT Closeout Documents_20211001

SEDIMENTATION INSPECTION REPORT (City of Winston-Salem/Forsyth County)
Winston-Salem Field Operations Department Permit #: EN2000193
Erosion Control Division
P.O. Box 2511 Date: 9-30-2021
Winston-Salem, NC 27102
Report by: Ronnie Holbrook
Revised 1-1-20 Phone: [phone]
Project: I Bullard Place Location: 1 2413 Grand Pine Lane
1. Pictures: ("x" One) Yes: No: X
2. Potential for NPDES Violation: ("x" One) Yes: No: x Describe:
3. Weather and soil conditions: Sunnv/Diy 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 See. 8.4.6 (G) ; & G.S. 113A-57 (4) and 15A N.C.A.C4B.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. 4B.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 See. 8.4.6 (D) (1) (a); & G.S. 113A-57(3)]
( )--- Failure to take all reasonable measures, [UDO See. 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 See. 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 current self -inspection records, [G.S. 113A-54.1 & 15A NCAC 0413. 0131]
Other (describe):
7. Contact made with (name): Whitney Title
8. Contact Method: phone # () email (x) fax # () letter () 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 ) Devices in & functioning
( ) No seeding noted ( ) Partially seeded O Areas seeded ( ) Off -site sedimentation (Yes ) Project in compliance
The site is in compliance all lots are constructed per plan. Prior to finagling the grading permit, you will need to terminate
the NCGO1 permit coverage. Please go to the following web address to apply hLtps:Hedocs.deg.nc.gov/Forms/NCGOI-
Termination. And use the inspection report for the supporting documentation.
11. Others present: