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SEDIMENTATION INSPECTION REPORT (City of Winston-Salem/Forsyth Count
Winston-Salem Field Operations Department Permit #: EN2100063
Erosion Control Division
P.O. Box 2511 Date: 4-5-2022
Winston-Salem, NC 27.102
Report by: Ronnie Holbrook
Revised 3-3-22 Phone: [phone]
Project: 2636 Audubon Drive Location 2636 Audubon 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: 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. 8.4.6 (G) ; & G.S. 113A-57 (4) and 15A N.C.A.M.0107(c)]
( }--- Failure to follow approved plan, [UDO SecX4.19 (A); & G.S. 113A-61.11
( )-- Failure to submit revised plan, [UDO Sec. 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 Sec. 8.4.6 (D) (1) (b); & 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. 8.4.6 (D) (1) (a); & G.S. 113A-57(3)]
( )--- Failure to take all reasonable measures, [UDO Sec. 8.4.4 (B); & 15A N.C.A.CAB0105]
( )--- 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, c); & G.S. 113A-57(2) or 15A N.C.A.C. 4B.0124(d)]
Unprotected exposed slopes, [ UDO Sec. 8A.6 (B) (1) (0; & G.S. 113A-57(2)]
Failure to install and maintain erosion control measures, [UDO Sec. 8.4.12; & 15A N.C. A.C. 43.0113]
Failure to keep current self -inspection records, [G.S. 113A-54.1 & 15A NCAC 04B. 0131]
Other (describe):
7. Contact made with (name): Trent Adams Title —
S. Contact Method: phone # (X) email (X) fax # O letter(} person( }
9. Corrective actions needed:
None at this time.
10. Comments: O No devices in place O Additional devices needed O Devices need maintenance O Devices in & functioning
() No seeding noted () Partially seeded () Areas seeded (No ) Off -site sedimentation (Yes ) Project in compliance
The site is completed per the approved Erosion Control plan.
11. Others present:
Office use only: Cityworks O Excel O Financially responsible contact ()