NCC243228_ESC Approval Submitted_20241021

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ENGINEERING
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�SrgR�,sHEo��ry� Tim Lowe, PE, County Engineer
May 8, 2024
RE:GP#62-32 and LNDP-23-00078.The Proximity Blue Clay
The Proximity Blue Clay
102 Autumn Hall Drive,Suite 210
Wilmington, NC 28403
Dear Calvin Wells:
This office has reviewed the erosion and sedimentation control plan. We find the plan to be acceptable
and hereby issue this land-disturbing permit for both the rough grading phase and the final commercial
construction.Please read the permit conditions carefully,return the signed permit to our office and keep
the copy for your records. A copy of the enclosed land-disturbing permit must be posted at the job site.
This letter gives the notice required by GS 113A-61.1(a) and the New Hanover County Erosion and
Sedimentation Control Ordinance Article VIII Section 8.21 of our right of periodic inspection to ensure
compliance with the approved plan.
As of April 1, 2019, all new construction activities are required to complete and submit an electronic
Notice of Intent (eN01) form requesting a Certificate of Coverage (COC) under the NCG010000
Construction General Permit. After the form is reviewed and found to be complete,you will receive a link
with payment instructions for the applicable annual permit fee. After the fee is processed, you will
receive the COC via email. As the Financially Responsible Party shown on the FRO form submitted for this
project,you MUST obtain the COC prior to commencement of any land disturbing activity. The eN01 form
and fee details may be accessed at deq.nc.gov/NCG01. Please direct questions about the eN01 form
to the Stormwater Program staff in the Raleigh central office. If the owner/operator of this project
changes in the future,the new responsible party must obtain a new COC.
A copy of the enclosed land-disturbing permit, a copy of the approved erosion and sedimentation control
plan as well as any approved deviations, records of inspections made during the previous 12 months with
the States Certificate of Compliance (COC) number on the report, and a rain gauge must be posted at the
job site as required by 15A NCAC 46 .0118(a), the NCGO1 permit, and the New Hanover County Erosion
and Sedimentation Control Ordinance Article VIII Section 8.19(o).
The land disturbing fee of$7,662 is due to be paid to New Hanover County Engineering prior to Issuance
of the Certificate of Occupancy or Certificate of Completion.

Page 2 of 2
A preconstruction meeting is optional prior to land-disturbing activity on this project. Please contact me
at [phone] if you would like to schedule this meeting in our office. If you choose not to have a
preconstruction meeting,you must contact us with the date the land-disturbing activity will take place
onsite and again once the initial erosion control measures are installed.
New Hanover County's Erosion and Sedimentation Control Program is performance-oriented, requiring
protection of existing natural resources and adjoining properties. If,following the commencement of this
project, it is determined that the erosion and sedimentation control plan is inadequate to meet the
requirements of the Sedimentation Pollution Control Act of 1973 (North Carolina General Statutes 113A-
51 through 66), and the New Hanover County Erosion and Sedimentation Control Ordinance Article VIII
Section 8.19 (f), this office may require revisions to the plan and its implementation of the revisions to
ensure compliance with the Act and Ordinance.
This land-disturbing permit will expire within 1 year following the date of approval, if no land- disturbing
activity has been undertaken,as required by the New Hanover County Erosion and Sedimentation Control
Ordinance Article VIII Section 8.18 (d). If no activity takes place within one year after work has begun
onsite,the permit will expire. Please contact this office to reactivate a permit that has expired.
Acceptance and approval of this erosion control plan is conditioned upon your compliance with Federal
and State water quality laws, regulations and rules and local city or county ordinances or rules.This land-
disturbing permit approval does not supersede any other permits or approvals. It is the owner's
responsibility to have all the permits and approvals that are required, prior to beginning construction.
Please note this approval is based in part on the accuracy of the information provided in the Financially
Responsibility Form,which you provided.You are required to file an amended form if there is any change
in the information included on the form.
Your cooperation is appreciated,
Galen M Jamison, PE
Chief Project Engineer
Enclosures: Land-Disturbing Permit
NCG01 Fact Sheet and Self Inspection & Monitoring Form

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Permit for a Land-Disturbing Activity
New Hanover County
Department of Engineering
230 Government Center Drive -Suite 160
Wilmington, North Carolina 28403
[phone]
As authorized by the New Hanover County Erosion and Sedimentation Control Ordinance
This permit issued to The Proximity Blue Clay, LLC authorizes the development of 25.54 acres of land at
3600 Block of Blue Clay Road for The Proximity Blue Clay, LLC in New Hanover County. The permit issued on May
8, 2024, is subject to compliance with the application and site drawings, all applicable regulations and special
conditions, notes set forth below and includes the original rough grading permit as well as this permit for the
subdivision construction. Any plan modifications must be approved by this office prior to field changes.
It is understood by the applicant that a representative of New Hanover County's Engineering Department
may inspect the site at any time following the issuance of this Permit. A copy of the approved Soil Erosion
Control Plan as well as any approved deviations, this permit, a rain gauge, the Certificate of Coverage (COC)
number from the State and copies of the Combined Self-Monitoring and Self-Inspection Reports must be
available at all times at the site.
Failure to execute the provisions of this permit and the approved Soil Erosion Plan, or any other provisions
of the New Hanover County Soil Erosion and Sedimentation Control Ordinance, may result in immediate legal
action by the County to the limits prescribed by the Ordinance. If the measures outlined on the approved Soil
Erosion Control Plan and this Permit prove insufficient, additional Erosion Control measures can and will be
required which in turn will be considered provisions of this Permit. This Permit does not preclude any other
permits or approvals necessary for beginning or completing this development. Approval of an erosion control
plan is conditioned on the applicant's compliance with Federal and State laws, regulations, and rules. It is the
Permittee's responsibility to obtain all necessary permits and approvals and to ensure the information given for
this permit is accurate and updated if ownership or the financially responsible party changes.
SPECIAL CONDITIONS
(THESE CONDITIONS MUST BE FOLLOWED IN ADDITION TO THE PLANS AND SPECIFICATIONS)
*All the soil erosion control measures will be installed as the site is cleared and maintained throughout
construction.
*Note the required separate NCGO1 permit that requires concrete washouts and other NCGO1 regulations.
*In issuing this permit New Hanover County has relied on the representations of the permit applicant. The County
has no jurisdiction to determine any contested property rights or ownership.

(Continued) - Page Two GP#62-23 & LNDP-23-00078
*Tree Removal Permits and/or Approvals are required from the City of Wilmington and/or New Hanover
County PRIOR to clearing of the site.
*Silt fence stakes must be steel and will be placed six feet apart without wire reinforcement or eight feet apart
with wire reinforcement. Silt fence is not allowed as inlet protection.
*This permit does not preclude any permits or approvals which may be necessary such as City of Wilmington or
New Hanover County, NC DEMLR, C.A.M.A., and/or the US Army Corps. of Engineers, DEM Solid Waste or any
other agencies or approvals that may be necessary.
*No sediment shall leave the site in suspension of water.
*If plan revisions are necessary, you must submit a copy to this office for approval prior to any field changes.
*If soil is brought onto this site or removed from this site, it must come from or be taken to an approved or
permitted site, to be identified to this office prior to being brought onsite or removal from the site.
*All City and/or County and State drainage and stormwater requirements will be adhered to.
*If these measures fail to adequately control erosion, more restrictive measures will be required.
*If any phase of grading ceases for more than 90 calendar days, the site will be temporarily stabilized.
*All slopes must be stabilized within 21 calendar days of any phase of activity.
The approval of an erosion control plan is conditioned on the applicant's compliance with Federal and State
Water Quality laws, regulations, and rules.
*Note the required rates for seed, lime, fertilizer, and mulch in your seeding specifications.
*Enclosed is a Combined Self-Monitoring and Self-Inspection Form that meets the requirements of both the
NPDES Stormwater Permit for Construction Activities, NCG 010000 reporting and the Land Resources Self-
Inspection Program that satisfies the requirements of the Sedimentation Pollution Control Act. These are
mentioned below with specific requirements for each program. These reports are the responsibility of the
property owner. They require a rain gauge onsite, inspections and reporting every 7 calendar days and within
24 hours of every 1.0-inch rain per 24-hour period and at specific phases of construction. Additional copies of
this Combined Construction Inspection Report can be found at https://www.deq.nc.gov/about/divisions/energy-
mineral-and-land-resources/stormwater/stormwater-program/npdes-construction-program. . Reports must be
available onsite at all times. If you have questions, please contact New Hanover County Engineering (910) 798-
7139 or the Land Quality Section at the NC DEMLR Regional office at [phone].
*Note the NPDES information from the State for sites disturbing 1 acre or more and the reporting
requirements. All NEW projects permitted after August 3, 2011, must include the following surface water
withdrawal locations and stabilization requirement designations on the plan in order to qualify for coverage
under the most recent NPDES Construction General Permit. All settling basins must have outlet structures that
withdraw water from the surface, with the exception of basins or traps that have a drainage area of less than 1
acre. The NPDES permit also requires ground cover within 14 calendar days on disturbed flat areas and ground
cover within 7 calendar days on all areas within HQW Zones, perimeter dikes, swales, ditches, perimeter slopes
and all slopes steeper than 3:1. Exceptions include slopes that are 10 feet or less in length and not steeper than
2:1 which must be stabilized within 14 calendar days and slopes greater than 50 feet which must be stabilized
within 7 calendar days. It requires inspections of all erosion control measures and reporting every 7 days and
within 24 hours of every 1.0-inch rain event in a 24-hour period. This permit also includes other new
requirements which are listed in the text of the NPDES Stormwater Discharge Permit for Construction Activities
and are included with the original copy of each land-disturbing permit.

(Continued) - Page Three GP#62-23 & LNDP-23-00078
*As of April 1, 2019, all new construction activities are required to complete and submit an electronic Notice of
Intent (eNOI) form requesting a Certificate of Coverage (COC) under the NCG010000 Construction General
Permit. After the form is reviewed and found to be complete, you will receive a link with payment instructions for
the applicable annual permit fee of$120. After the fee is processed, you will receive the COC via email. As the
Financially Responsible party shown on the FRO form submitted for this project, you MUST obtain the COC prior
to commencement of any land disturbing activity. The eNO1 form and fee details may be accessed at
deq.nc.gov/NCG01. Please direct questions about the eNO1 form to the stormwater Program staff in the Raleigh
central office. If the owner/operator of this project changes in the future, the new responsible party must obtain
a new COC. Once the project is stabilized and receives the final land-disturbance inspection, you should file a
Notice of Termination (NOT) with the State to final out the project.
*Note the Land Resources Self Inspection Program Requirements. This program is separate from the NPDES
reporting and requires inspection and documentation after each phase of construction. These phases include:
Installation of perimeter erosion control measures, Clearing and Grubbing of existing ground cover, Completion
of any phase of grading of slopes or fills, Installation of storm drainage facilities, Completion of construction or
development, Establishment of permanent ground cover sufficient to restrain erosion and any Deviation from
the approved plan.
*Pre-construction meetings are optional but highly recommended. Contact Beth E. Wetherill at [phone]
to set up a meeting prior to land-disturbing activity onsite. If you do not choose to have a preconstruction
meeting prior to starting work on site, you should contact us when activity begins and again when the initial
measures have been installed.
This Permit will expire one year from date of issue Acknowledgment of receipt of Permit
if no construction activity begins on site. This permit
may not be amended or transferred to another party
without approval of this office.
Owner
By (please print)
Galen M Jamison, PE
Chief Project Engineer
Signature

Fact Sheet on the New NCG01 Permit
April 2019
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The NC Construction General Permit (also known as"NCG01")was renewed on April 1,2019.The updated permit
does not significantly change the measures that are required to be implemented on construction sites. However,
there are some organizational and technical updates to the permit as described below. Most notably,there is a new
process in which construction sites will obtain official coverage under an NCG01 permit through an electronic
process. DEMLR worked with a broad team of stakeholders to make all of these updates. If you have questions,
contact Annette Lucas at [e-mail] or(919) 707-3639.
Organizational Updates Acronyms to Know
The new permit: COC: Certificate of Coverage, proof of coverage under an NCG01 permit
• Repeats state requirements for E&SC DEMLR: NC Division of Energy, Mineral, and Land Resources
Plans and organizes them with federal E&5C: Erosion &Sedimentation Control
construction activity requirements; a-NOI: Notice of Intent, application form for the NCGO1 permit
• Is clearly organized by topic; and e-NOT: Notice of Termination,form for closing out the NCGO1 permit
• Has less text and more tables. SWPPP: Stormwater Pollution Prevention Plan, required by the NCG01
Technical Updates
The new permit:
• Requires that the E&SC Plan meet
SWPPP requirements (p. 2); r*`rF '�
• Provides a list of items that must be
included in the SWPPP, such as the
construction sequence, plans,
calculations, etc. (p. 2-4);1
• Has updated language on bypasses and
AO-
upsets that is tailored to construction -
activities (p. 10);
• Puts all timeframes for inspections,
record-keeping and reporting in The NCGO1 Process
"calendar days" for clarity and The new NCGO1 applies to permits approved on or after April 1,2019.
consistency(p. 11 14);Z Permittees will no longer receive a copy of the NCGO1 permit in the mail
• Changes the inspection frequency with their E&SC Plan approvals and be considered as covered under the
(during business hours)to at least permit. Federal rules require that DEMLR receive an NOI on each
once per 7 calendar days and after construction project and issue each construction project its own COC.
every storm > 1.0 inch (previously 0.5
inch);3 and Under the new NCG01 process, construction sites will continue to
• Excludes weekends, state and federal receive approval for E&SC Plans from either DEMLR or the delegated
holidays from normal business hours local E&SC program just like before. After receiving E&SC Plan approval,
unless construction activities take permittees will officially obtain coverage under the NCG01 by
place (p. 23). completing an e-NOI (available at deq.nc.gov/NCG01). The e-NOI will
only take about 20 minutes to fill out and submit on-line.
1 This list is based on website guidance
by the DEMLR Sediment Program. Initially,there will be no charge associated with applying for an NCGO1
2 The number of calendar days was permit but on or around June 1, 2019, DEMLR will begin charging a $100
selected to be as equivalent as annual general permit fee as required per§143-215.3D.
possible with the previous permit. DEMLR is working on creating a single application form that will allow an
3 The intent is to provide predictability applicant to simultaneously apply for an E&SC permit and an NCGO1
to the inspection schedule. COC.That effort is part of a larger Permit Transformation project at
DEMLR.

Q&A About the New NCGO1 Permit
Why do construction sites have to do this extra application step? How does the new NCGO1 affect the
DEMLR is required by the EPA to issue a specific COC to every construction delegated local E&SC Programs?
site that disturbs one acre or more. DEMLR is working to create a form Local programs will continue to review
that combines the E&SC plan approval and e-NOI processes, but that will and approve E&SC plans. However,
take more time. For now, DEMLR has created an efficient e-NOI process. they will no longer send copies of the
NCGO1 with E&SC Plan approvals.
If an E&SC Plan is approved before April 1,which permit applies? DEMLR will provide sample language to
Projects with already approved E&SC Plans will automatically follow the use in local E&SC Plan approvals to
new NCGO1 permit, but will not need to fill out an e-NOI or pay an annual advise permittees that they must
permit fee. However,the permittees should print the new permit and the submit an e-NOI to DEMLR.
two standard detail sheets and have them on site. •�
Will DEMLR offer tools to help permittees comply with the new NCGO1?
Yes, DEMLR will provide two sample plan sheets at deq.nc.gov/NCGO1 that • -
can be placed into the E&SC plan set.The first covers the site stabilization 1
and materials handling portions of the permit. The second sheet covers A
the inspection, record-keeping and reporting portions of the permit. " 4~�•" r µ '
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How will the new e-NOI submittal and COC process work?
Permittees will apply for E&SC Plan approvals from DEMLR or the local
E&SC program like before.The E&SC approval letter will instruct the
permittee to visit deq.nc.gov/NCGO1 to submit an e-NOI form to DEMLR. Local programs are not required to
The permittee may begin the construction activity after receipt of the COC check if permittees have submitted e
(within three days*).The permittee must print and retain a copy of the NOls to DEMLR. However, if they wish
permit and the COC on site. Initially,the COC will be issued for free but on to do this voluntarily,there will be a
or around June 1, 2019, a $100 annual general permit fee will be charged. tool available on DEMLR's web site for
them to view a list of construction
Who is allowed to submit an e-NOI form? projects that have submitted a-NOIs.
Submittal must be by a responsible corporate officer that owns or
operates the activity, such as a president, secretary,treasurer, or vice When local programs close out an E&SC
president or a manager that is authorized in accordance with IV.B.6 of the Plan, the close-out letter will advise
NCGO1 permit. Additional signatory options are set forth in IV.B.6 of the permittees that they must submit an e
permit. It is possible for consultant to prepare the e-NOI, save it as a draft, NOT. DEMLR will provide sample
and email it to the responsible entity for signature &submittal. language.
Local programs may approve E&SC
What happens to the COC when the construction activity is complete? plans that meet state sediment laws
When a project is complete,the permittees will contact DEMLR or the local and rules even if those plans are not
delegated program to close out the E&SC Plan. After DEMLR or the local compliant with all of the NCGO1
E&SC program inform the permittee of the project close out via inspection requirements. However,their
report,the permittee will visit deq.nc.gov/NCGO1 to submit an e-NOT. permittees will be required to add two
Will there be a grace period for adherence to the new process? plan sheets (which will be provided by
DEMLR does not have the authority to grant a grace period from a DEMLR)to their E&SC Plans to ensure
federally mandated permit. Permittees will be informed of the new that they fully comply with the ground
process via web site, E&SC Plan approval letters and list servs. If a stabilization, materials handling, and
construction activity disturbs one acre or more (or is part of common plan inspection, record keeping and
of development that disturbs one acre or more)fails to submit an e-NOI reporting portion of the NCGO1 permit.
after approval of its E&SC Plan,this is a violation of federal permitting
requirements and the permittee could be subject to a penalty assessment. * Or 24 business hours for a project
approved under the DEMLR Express
review program.

Page 1 of 5
DEMLR Monitoring Form Rev.07012020
INSPECTION AND MONITORING RECORDS FOR ACTIVITIES UNDER STORMWATER GENERAL PERMIT NCG010000
AND SELF-INSPECTION RECORDS FOR LAND DISTURBING ACTIVITIES PER G.S. 113A-54.1
Project Name Land Quality or Local
Program Project/Permit #
Approving Authority Date of Plan Expiration Date,
Approval if applicable
NCG010000 Certificate of
Coverage Number Date of COC Issuance
Coverage under the NCG010000 permit must be renewed annually, if issued after April 1, 2019 until Notice of Termination is filed and approved.
PART 1A: Rainfall Data PART 1 B: Phase(s) of the Plan
Rain Amount (inches) Check ALL applicable box(es) that apply to X
Daily Rainfall Required. If no rain, completed &current phases
indicate with a "zero" Initial installation of erosion and sediment control measures
M Clearing and grubbing of existing ground cover
T Completion of any grading that requires ground cover
W Completion of all land-disturbing activity, construction or development
Th Permanent ground cover sufficient to restrain erosion has been established
F
Sat (Inspection Optional)
Sun (Inspection Optional)
Are there any site or project conditions that limit
completion of inspection?
If yes, explain conditions and areas of site that were
inaccessible.

Page 2 of 5
DEMLR Monitoring Form Rev. 07012020
PART 2: STORMWATER PLANS AND CONTROLS: For each question below, mark the corresponding box as Yes, No or N/A. For all items marked "No", note
in Part 3A the Reference letter and provide the Corrective Action and location of the deficiency, the original date noted, and the date it was noted as being
corrected. NOTE: Reference letters may be used multiple times.
Reference Part 2A: Storm Water Plans and Related Documents Yes No N/A
A Is the approval letter or certificate, COC and a copy of the NPDES Construction General Permit (CGP) on site?
(Readily available electronic copy of CGP is acceptable)
B Is the approved plan on site and current?
Reference Part 2B: Stormwater Pollutant Controls Yes No N/A
C Are erosion and sediment controls that are shown on the approved plan installed and operating properly with
no repairs needed?
D Are stormwater controls that are shown on the approved plan installed and operating properly with no repairs
needed?
E Vehicle Tracking: Are construction entrances operating properly with no repairs needed?
F Soil Stabilization: Are areas of the site where construction activities have ceased been properly stabilized
within the required timeframes?
G Are earthen stockpiles stabilized or otherwise protected from sediment loss, and located at least 50 feet away
or downhill from drain inlets and surface waters?
Reference Part 2C: Non-Storm Water Pollutant Controls Yes No N/A
H Concrete, stucco, paint, etc. washouts: Are washouts installed, properly located, posted and operating with no
repairs needed?
Solid & hazardous wastes: Are trash, debris, and hazardous materials properly managed?
Sanitary waste: Are portable toilets properly located and operating with no visible repairs needed?
K Equipment and stored fluids: Are fuels, lubricants, hydraulic fluids, etc. contained so as not to enter surface
and ground waters?
Report oil spills and the release of hazardous substances to the appropriate DEQ Regional Office via phone call or email
within 24 hours of discovery. https://deq.nc.gov/contact/regional-offices
For any items listed in the section below, a full description of sedimentation is required in Part 3A. This includes, but may not be limited to: location, estimated
amount of sediment that has left the site and/or entered waters, apparent causes of the sediment loss, and what corrective actions need to be taken to prevent
this from recurring.
Reference Part 2D: Sedimentation Yes No N/A
L Are sediment or other pollutants noted beyond the approved or permitted limits of disturbance?
M Are BMPs detected as releasing sediment or other pollutants into receiving waters?
Report visible sedimentation into streams or wetlands to the appropriate DEQ Regional Office via phone call or email
within 24 hours of discovery. https://deq.nc.gov/contact/regional-offices

Page 3 of 5
DEMLR Monitoring Form Rev. 07012020
PART 3A: EROSION AND SEDIMENTATION CONTROL MEASURES: Measures must be inspected at least ONCE PER 7 CALENDAR DAYS AND WITHIN 24
HOURS OF A RAINFALL EVENT EQUAL TO OR GREATER THAN 1.0 INCH PER 24 HOUR PERIOD. Add rows as needed.
Erosion and Sedimentation Control Measures Date
Ins ected Inspection Describe Actions Needed Previous
p Date Action(s)
Measure ID or Location and Description Reference(s) Operating Corrective actions should be performed as soon as possible Observed
Properly? and before the next storm event as
(Y/N) Corrected
Report unanticipated bypasses, or non-compliance conditions that may endanger health or the environment, to the appropriate DEQ Regional Office
via phone call or email within 24 hours of discovery. https://deq.nc.gov/contact/regional-offices
PART 3B: STORMWATER DISCHARGE OUTFALLS (SDOs): SDOs must be inspected at least ONCE PER 7 CALENDAR DAYS AND WITHIN
24 HOURS OF A RAINFALL EVENT EQUAL TO OR GREATER THAN 1.0 INCH PER 24 HOUR PERIOD. Add rows as needed.
Stormwater Discharge Outfalls Inspected Date
Any Visible Any Increase Any Inspection Previous
Stormwater Sedimentation in Stream Visible Any visible oil Date Action(s)
Discharge Describe Actions Needed Observed
in Streams, Turbidity Erosion sheen, floating or
Outfall Wetlands or from below suspended solids or Corrective actions should be performed as soon as possible and as
ID or Outside Site Discharge? SDO? discoloration? (Y/N) before the next storm event Corrected
Location Limits? (Y/N) (Y/N) (Y/N)

Page 4 of 5
DEMLR Monitoring Form Rev.07012020
PART 3C: GROUND STABILIZATION: Must be recorded, at a minimum, after each phase. Add rows as needed.
Site area description and location where Time Have Temporary Is Ground Date
construction activities have temporarily Limit for stabilization or Cover Original Describe Actions Needed Previous
or permanently ceased Ground measures Permanent Sufficient Inspection Corrective actions should be performed as Action(s)
Cover been Stabilization to Restrain Date Observed
(see table installed? (T/P) Erosion? soon as possible and before the next as
below) (Y/N) (Y/N) storm event Corrected
GROUND STABILIZATION TIMEFRAMES
Site Area Description Stabilization Timeframe Variations
Perimeter dikes, swales and slopes 7 Days None _
High Quality Water(HQW)Zones 7 Days None
Slopes Steeper than 3:1 7 Days 7 days for perimeter dikes, swales, slopes and HWQ zones
14 days for slopes 10 ft or less in length and not steeper than 2:1
10 days for Falls Lake Watershed
Slopes 3:1 to 4:1 14 Days 7 days for perimeter dikes, swales, slopes and HWQ zones
7 days for slopes greater than 50 ft in length
10 days for Falls Lake Watershed
All other areas with slopes flatter than 4:1 14 Days 7 days for perimeter dikes, swales, slopes and HWQ zones
10 days for Falls Lake Watershed

Page 5 of 5
DEMLR Monitoring Form Rev.07012020
PART 3D: NEW OR REVISED MEASURES: Erosion and sedimentation control measures omitted or installed, at a minimum since the last inspection, shall be
documented here or by initialing and dating each measure or practice shown on a copy of the approved erosion and sedimentation control plan. Alterations and
relocations of measures shall also be documented if they significantly deviate from the approved plan. The removal of measures should also be documented.
List dimensions of measures such as Sediment Basins and Dissipator Pads. Add rows as needed. Corrective actions should be included in Part 3A.
Measure ID or Location and Description Proposed Actual Significant Date measure Installed (I)
Dimensions(ft.) Dimensions(ft.) Deviation* observed as Altered (A)
from Plan? installed, altered, Relocated (R)
(Y/N) relocated or Removed (X)
removed
*Significant deviation means any omission, alteration or relocation of an erosion or sedimentation control measure that prevents it from performing as intended.
PART 4: Signature of Inspector
Financially Responsible County
Party(FRP)/Permittee
INSPECTOR Name Employer
Inspector Type(Mark) X Address
FRP/Permittee
Agent/Designee Phone Number Email Address
By this signature, I certify in accordance with the NCG010000 permit&G.S. 11I3A-54.1 that this report is accurate and complete to the best of my knowledge.
Financially Responsible Party/ Permittee or Agent/ Designee Date &Time of Inspection