NCC240176_MODIFICATION Supporting Doc (CLOSEOUT LOT 558)_20241107

SEDIMENTATION INSPECTION REPORT (City of Winston-Salem/Fors th Count
Winston-Salem Field Operations Department Permit#: EN240070
Erosion Control Division
P.O. Box 2511 Date: 11-6-2024
Winston-Salem,NC 27102
Report by: Ronnie Holbrook
Revised 3-3-22 Phone:1 336-590-6038
Project: Lot 558 Brookberry Location: 1016 Wood Duck Ln
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, [LIDO Sec.8.4.6(G);&G.S.113A-57(4)and 15A N.C.A.C413.0107(c)]
()--- Failure to follow approved plan,[UDO Sec.8.4.19(A);&G.S.113A-61.1]
()--- Failure to submit revised plan,[UDO Sec.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, [LIDO Sec.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, [LIDO Sec.8.4.6(D)(1)(a);&G.S.113A-57(3)]
()--- Failure to take all reasonable measures, [LIDO Sec.8.4.4(B);&15A N.C.A.C.4130105]
()--- Inadequate buffer zone, [LIDO Sec.8.4.6(A);&G.S.113A-57(1)]
()--- Graded slopes and fills too steep,[LIDO Sec.8.4.6(B)(1)(a,b,c);&G.S.113A-57(2)or 15A N.C.A.C.413.0124(d)]
()--- Unprotected exposed slopes, [UDO Sec.8.4.6(B)(1)(1);&G.S.113A-57(2)]
()--- Failure to install and maintain erosion control measures, [LIDO Sec.8.4.12;& 15A N.C.A.C.413.0113]
()--- Failure to keep current self-inspection records, [G.S.113A-54.1&15A NCAC 048.0131]
()--- Other(describe):
7. Contact made with(name): Justin Reece Title Contractor
8. Contact Method: phone#() email(X) fax#() letter() person()
9. Corrective actions needed:
NO CORRECTIVE ACTIONS.
10. Comments:O No devices in place O Additional devices needed O Devices need maintenance O Devices in&functioning
()No seeding noted()Partially seeded O Areas seeded(NO)Off-site sedimentation(YES)Project in compliance
THIS PROJECT HAS BEEN COMPLETED AND IS STABLE.YOU WILL NOW NEED TO TERMINATE THE
NCGO1 PERMIT COVERAGE. PLEASE GO TO THE FOLLOWING WEB ADDRESS TO APPLY:
https:Hedocs.deg.nc.gov/Fonns/NCGOI-Termination. AND USE THIS INSPECTION REPORT FOR SUPPORTING
DOCUMENTATION.
11. Others present:
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Office use only: Cityworks (X) Excel O Financially responsible contact ()

Modification Confirmation
[e-mail] <[e-mail]>
Wed 3/13/2024 7:33 AM
To:Justin Reece <[e-mail]>
Cc:[e-mail] <[e-mail]>;Justin Reece <[e-mail]>;
Alex Mitchell <[e-mail]>
This e-mail is to notify you that the modification information for COC No. NCC240176 for the
project Brookberry Lot 554 that you submitted on 3/12/2024 has been added to the permit file
records as of 3/13/2024.
Modification Reason: Additional Lots/Outparcels Approved - E&SC Revised
Additional Details (if provided): Site Name: Brookberry Lot 558
Address: 1016 Wood Duck LN Winston-Salem, NC 27106
Lot # 558
Parcel ID # 5896-23-6062
Site Contact: Justin Reece [phone]
You can find all Construction COC Permit files in our Document Repository here.
Questions? Please contact The NC Stormwater Program at [phone].
Be sure to add [e-mail] to your contacts to avoid future e-mails about this
application from going into Spam filters.
The NC DEMLR Stormwater Program
512 N. Salisbury Street, Archdale Building 6th Floor, 1612 Mail Service Center, Raleigh, NC 27699-1612
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