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HomeMy WebLinkAboutNCS000247_Winston-Salem MS4 Self Audit Template Transmittal_20220405From:Powell, Jeanette To:keithh1@cityofws.org Cc:Clark, Paul Subject:NCS000247: Winston-Salem MS4 Self-Audit Template Transmittal Date:Tuesday, April 5, 2022 2:03:00 PM Attachments:NCS000247_Winston-Salem MS4 Self Audit Template_20220405.docx As explained in the March 15, 2022 email to the Phase I MS4s, please see the attached self-audit template for the City of Winston-Salem MS4 permit number NCS000247. The city should complete the self-audit and submit the results to NCDEQ on or before close of business on Friday, May 6, 2022. If you have any questions, please contact either myself or your MS4 Auditor, Paul Clark, who is cc’d on this email. Regards, J Jeanette Powell MS4 Program Coordinator 919-707-3620 Jeanette.Powell@ncdenr.gov North Carolina Department of Environmental Quality Division of Energy, Mineral & Land Resources Stormwater Program 512 N. Salisbury Street, 6th Floor 1612 Mail Service Center Raleigh, NC 27699-1612 Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties. https://deq.nc.gov/sw MUNICIPAL SEPARATE STORM SEWER SYSTEM (MS4) PHASE I PROGRAM SELF-AUDIT REPORT NPDES PERMIT NO. NCS000247 CITY OF WINSTON-SALEM, NORTH CAROLINA Address Self-Audit Date: DATE Report Date: DATE insert City logo here NCS000247_Winston-Salem 2022 MS4 Self-Audit ii * A Duly Authorized Representative can be the Mayor, City Manager, or an authorized person or position. To be authorized, a Delegation of Signature Authority Form signed by the Mayor or City Manager must be on file with the Department. Self-Audit Certification By my signature below, I certify, under penalty of law, that I am a Duly Authorized Representative* and this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations. Name: Title: Signature: Date: NCS000247_Winston-Salem 2022 MS4 Self-Audit iii TABLE OF CONTENTS Self-Audit Details ..................................................................................................................................... 1 Permittee Information ............................................................................................................................. 2 List of Supporting Documents .................................................................................................................. 3 Program Implementation, Documentation & Assessment ........................................................................ 4 Public Education and Outreach ................................................................................................................ 7 Public Involvement and Participation....................................................................................................... 9 Illicit Discharge Detection and Elimination (IDDE) .................................................................................. 11 Construction Site Runoff Controls .......................................................................................................... 13 Post-Construction Site Runoff Controls .................................................................................................. 14 Pollution Prevention and Good Housekeeping for Municipal Operations ............................................... 18 Program to Monitor and Evaluate Stormwater Discharges to Municipal Systems ................................... 21 Water Quality Assessment and Monitoring............................................................................................ 23 Site Visit Evaluation: Municipal Facility No. 1 ......................................................................................... 24 Site Visit Evaluation: Municipal Facility No. 2 ......................................................................................... 26 Site Visit Evaluation: MS4 Outfall No. 1 .................................................................................................. 28 Site Visit Evaluation: MS4 Outfall No. 2 .................................................................................................. 30 Site Visit Evaluation: Construction Site No. 1 ......................................................................................... 32 Site Visit Evaluation: Construction Site No. 2 ......................................................................................... 34 Site Visit Evaluation: Post-Construction Stormwater Control Measure No. 1 .......................................... 36 Site Visit Evaluation: Post-Construction Stormwater Control Measure No. 2 .......................................... 38 Appendix A: Supporting Documents DISCLAIMER This audit consists of an evaluation of program compliance with the issued permit and implementation of the approved Stormwater Management Plan. This audit report does not include a review of all program components, and program deficiencies in addition to those noted may be present. The permittee is required to assess program progress and permit compliance, and to implement the approved Stormwater Management Plan in accordance with the issued permit. NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 1 of 40 Self-Audit Details Audit ID Number: NCS000247_Winston -Salem 2022 MS4 Self-Audit Self-Audit Date(s): Minimum Control Measures Evaluated: ☒ Program Implementation, Documentation & Assessment ☒ Public Education & Outreach ☒ Public Involvement & Participation ☒ Illicit Discharge Detection & Elimination ☒ Construction Site Runoff Controls ☒ Post-Construction Site Runoff Controls ☒ Pollution Prevention and Good Housekeeping for Municipal Operations ☒ Program to Monitor and Control Pollutants ☒ Water Quality Assessment & Monitoring Field Site Visits: ☐ Municipal Facilities. Number visited: Choose an item. ☐ MS4 Outfalls. Number visited: Choose an item. ☐ Construction Sites. Number visited: Choose an item. ☐ Post-Construction Stormwater Runoff Controls. Number visited: Choose an item. ☐ Other: ________________________________. Number visited: Choose an item. ☐ Other: ________________________________. Number visited: Choose an item. Auditors Name Title Audit Report Author ___________________________________ __ ___ Name _____________________________________ _____ Title ___________________________________ _____ Date ___________________________________ _____ Signature Audit Report Author ___________________________________ __ ___ Name _____________________________________ _____ Title ___________________________________ _____ Date ___________________________________ _____ Signature NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 2 of 40 Audit Report Author ___________________________________ __ ___ Name _____________________________________ _____ Title ___________________________________ _____ Date ___________________________________ _____ Signature Audit Report Author ___________________________________ __ ___ Name _____________________________________ _____ Title ___________________________________ _____ Date ___________________________________ _____ Signature Permittee Information MS4 Permittee Name: Permit Effective Date: Permit Expiration Date: Mailing Address: Date of Last MS4 Inspection/Audit: Permit Owner of Record: Primary MS4 Representatives Participating in Audit Name Title NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 3 of 40 List of Supporting Documents Item Number Document Title Document Format (web link, e- file, etc.) NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 4 of 40 Program Implementation, Documentation & Assessment Staff Interviewed: (Name, Title, Role) Permit Citation Program Requirement Status Supporting Doc No. II.A. Program Implementation The permittee maintained adequate legal mechanisms, such as regulations, ordinances, policies and procedures to implement all provisions of the Stormwater Management Plan (SWMP). Choose an item. --- The permittee implemented provisions of the Stormwater Management Plan and evaluated the performance and effectiveness of the program components annually. Choose an item. --- The permittee maintained written procedures for implementing the six minimum control measures, which identify specific action steps, schedules, resources and responsibilities. Choose an item. --- The permittee is current on payment of invoiced administering and compliance monitoring fees (see stormwater e-payments on https://deq.nc.gov/sw). Choose an item. --- Comments III. Program Documentation The permittee maintained documentation of all program components including, but not limited to, inspections, maintenance activities, educational programs, monitoring and sampling, implementation of BMPs, enforcement actions and other stormwater activities. Choose an item. --- Documentation is kept on-file by the permittee for a period of five (5) years. Choose an item. --- The permittee’s Stormwater Management Plan is reviewed and updated as necessary, but at least on an annual basis. Choose an item. --- Comments IV.B. Annual Reporting The permittee submitted annual reports to the Department by October 31st of each calendar year for the previous fiscal year's activities (from July 1st to June 30th). Choose an item. --- The Annual Reports included appropriate information to accurately describe the progress, status, and results of the permittee’s Stormwater Management Plan, including, but not limited the following: NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 5 of 40 Program Implementation, Documentation & Assessment a. A detailed description of the status of implementation of the Stormwater Management Plan. This includes information on development and implementation of each major component of the Stormwater Management Plan for the past year and schedules and plans for the year following each report. Choose an item. --- b. A description and justification of any proposed changes to the Stormwater Management Plan. This includes descriptions and supporting information for the proposed changes and how these changes will impact the Stormwater Management Plan (results, effectivene ss, implementation schedule, etc.). Choose an item. --- c. Documentation of any necessary changes to programs or practices for assessment of management measures implemented through the Stormwater Management Plan. Choose an item. --- d. A summary of data accumulated as part of the Stormwater Management Plan throughout the year along with an assessment of what the data indicates. Choose an item. --- e. An assessment of compliance with the permit, information on the establishment of appropriate legal authorities, inspections, and enforcement actions. Choose an item. --- f. Discussion of program funding. Choose an item. --- Comments IV.D. Other Information The Permittee maintained a record of any illicit discharge that reaches waters of the state and may cause or contribute to a violation of the water quality standards or constitute an imminent threat to health or the environment. Choose an item. --- The record includes dates, identification of possible responsible parties, causes, and any action taken by the permittee or the responsible party. Choose an item. --- Discharges that constitute an imminent threat to health or the environment were reported within 24 hours by phone or e-mail to the Division Regional Office during business hours, or to the NC Division of Emergency Management State Operations Center hotline outside of business hours. Choose an item. --- Comments NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 6 of 40 Program Implementation, Documentation & Assessment Additional Comments: NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 7 of 40 Public Education and Outreach Staff Interviewed: (Name, Title, Role) Permit Citation Program Requirement Status Supporting Doc No. II.B.2.a. Target Pollutants & Sources The permittee described the target pollutants and target pollutant sources that the public education program is designed to address and why they are an issue. Choose an item. --- Comments II.B.2.b. Target Audiences The permittee described the target audiences likely to have significant stormwater impacts and why they were selected. Choose an item. --- Comments II.B.2.c. Informational Web Site The permittee promoted and maintained an internet web site designed to convey the program’s message. Choose an item. --- Comments II.B.2.d. Public Education Materials The permittee distributed general stormwater educational material to appropriate target groups as likely to have a significant stormwater impact. Choose an item. --- Comments II.B.2.e. Stormwater Hotline The permittee promoted and maintained a stormwater hotline(s) or helpline(s) for the public to request information about stormwater, public involvement & participation, and to report illicit connections & discharges, etc. Choose an item. --- Comments II.B.2.f. Public Education & Outreach The permittee’s outreach program, including those elements implemented locally or through a cooperative agreement, include a combination of approaches designed to reach the target audiences. Choose an item. --- NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 8 of 40 Public Education and Outreach Program Implementation For each media, event or activity, including those elements implemented locally or through a cooperative agreement, the permittee estimated and recorded the extent of exposure. Choose an item. --- Comments Additional Comments: NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 9 of 40 Public Involvement and Participation Staff Interviewed: (Name, Title, Role) Permit Citation Program Requirement Status Supporting Doc No. II.C.2.a. Volunteer Community Involvement Program The permittee include d and promoted volunteer opportunities designed to promote ongoing citizen participation. Choose an item. --- Comments II.C.2.b. Mechanism for Public Involvement The permittee provided and promoted a mechanism for public involvement that provides for input on stormwater issues and the stormwater program. Choose an item. --- Comments II.C.2.c. Hotline/Help Line The permittee promoted and maintained a hotline/helpline for the public to request information about stormwater, public involvement & participation, and to report illicit connections & discharges, etc. Choose an item. --- Comments II.C.2.d. Public Comment The permittee made the most recent Stormwater Management Plan available for public review and comment. Choose an item. --- Comments II.C.2.e. Public Notice The permittee complied with State, Tribal and local public notice requirements when implementing the public involvement / participation program. Choose an item. --- Comments NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 10 of 40 Public Involvement and Participation Additional Comments: NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 11 of 40 Illicit Discharge Detection and Elimination (IDDE) Staff Interviewed: (Name, Title, Role) Permit Citation Program Requirement Status Supporting Doc No. II.D.2.a. Legal Authorities The permittee maintained adequate ordinances or other legal authorities to prohibit illicit connections and discharges and enforce the approved IDDE Program. Choose an item. --- Comments II.D.2.b. MS4 Mapping The permittee maintained a current map showing major outfalls and receiving streams. Choose an item. --- Comments II.D.2.c. Dry Weather Flow Program The permittee maintained written procedures and/or Standard Operating Procedures (SOPs) for detecting and tracing the sources of illicit discharges. Choose an item. --- The permittee maintained written procedures and/or Standard Operating Procedures (SOPs) for removing the sources or reporting the sources to the State to be properly permitted. Choose an item. --- The permittee maintained written procedures and/or SOPs that specify a timeframe for monitoring and how many outfalls and the areas that are to be targeted for inspections. Choose an item. --- Comments *Major outfalls are discharges from > 36” diameter pipes or drainage areas of > 50 acres. In areas zoned for industrial activity, major outfalls are > 12” or drainage area > 2 acres. II.D.2.d. Employee Training The permittee conducted training for appropriate municipal staff on detecting and reporting illicit connections and discharges. Choose an item. --- Comments II.D.2.e. Public Reporting The permittee maintained and publicized reporting mechanism(s) for the public to report illicit connections and discharges. Choose an item. --- NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 12 of 40 Illicit Discharge Detection and Elimination (IDDE) Comments II.D.2.f. Documentation The permittee documented the date of investigations, any enforcement action(s) or remediation that occurred. Choose an item. --- Comments Additional Comments: NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 13 of 40 Construction Site Runoff Controls Staff Interviewed: (Name, Title, Role) Program Delegation Status: The permittee has a delegated Sediment and Erosion Control Program to implement the North Carolina Sedimentation Pollution Control Act (SPCA) of 1973 and Chapter 4 of Title 15A of the North Carolina Administrative Code. The delegated or authorized Sediment and Erosion Control Program effectively meets the NPDES MS4 MEP standard for Construction Site Runoff Controls by permitting and controlling development activities disturbing one or more acres of land surface and those activities less than one acre that are part of a larger common plan of development as authorized under the Sediment Pollution Control Act of 1973 and Chapter 4 of Title 15A of the North Carolina Administrative Code. Permit Citation Program Requirement Status Supporting Doc No. II.E.2.a. Delegated SPCA Program The permittee implements a delegated program in compliance with the Sediment Pollution Control Act of 1973 and Chapter 4 of Title 15A of the North Carolina Administrative Code within the city’s jurisdictional area. Choose an item. --- Comments (Note date of last SPCA delegated program review by NCDEQ-DEMLR staff and result) II.E.2.c. Reporting Mechanism The permittee provided and promoted a means for the public to notify the appropriate authorities of observed erosion and sedimentation problems. Choose an item. --- Comments II.E.2.d. Coordination with DEMLR The permittee coordinated the approval of the construction site runoff control with DEMLR for new development and redevelopment projects to be built within the permittee’s planning jurisdiction by entities with eminent domain authority. Choose an item. --- Comments Additional Comments: NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 14 of 40 Post-Construction Site Runoff Controls Staff Interviewed: (Name, Title, Role) Program Implementation (check all that apply): ☐ The permittee implements the components of this minimum measure. ☐ The permittee relies upon another entity to implement the components of this minimum measure: list name of entity ☐ The permittee implements the following Qualifying Alternative Program(s), which meet NPDES MS4 post-construction requirements in the areas where they are implemented and in compliance with the specific program requirements as provided in 15A NCAC and noted below: ☐ Water Supply Watershed I (WS-I) – 15A NCAC 2B .0212 (Eff. March 1, 2019 15A NCAC 02B .0620 - .0624) ☐ Water Supply Watershed II (WS-II) – 15A NCAC 2B .0214 (Eff. March 1, 2019 15A NCAC 02B .0620 - .0624) ☐ Water Supply Watershed III (WS-III) – 15A NCAC 2B .0215 (Eff. March 1, 2019 15A NCAC 02B .0620 - .0624) ☐ Water Supply Watershed IV (WS-IV) – 15A NCAC 2B .0216 (Eff. March 1, 2019 15A NCAC 02B .0620 - .0624) ☐ Freshwater High Quality Waters (HQW) – 15A NCAC 2H .1006 ☐ Freshwater Outstanding Resource Waters (ORW) – 15A NCAC 2H .1007 ☐ Neuse River Basin Nutrient Sensitive (NSW) Management Strategy – 15A NCAC 2B .0235 ☐ Tar-Pamlico River Basin Nutrient Sensitive (NSW) Management Strategy – 15A NCAC 2B .0258 ☐ Randleman Lake Water Supply Watershed Nutrient Management Strategy – 15A NCAC 2B .0251 ☐ Universal Stormwater Management Program – 15A NCAC 2H .1020 Regulatory Authority: The permittee utilizes the following ordinances and/or regulatory authority to fulfill post construction minimum measure program requirements (check all that apply): ☐ DEQ model ordinance ☐ MS4 designed post-construction practices that meet or exceed 15A NCAC 02H .1000 ☐ DEQ approved comprehensive watershed plan ☐ DEQ approved Qualifying Alternative Program listed above Program Requirement Status Supporting Doc No. The permittee implements the Qualifying Alternative Program requirements checked above in accordance with the applicable 15A NCAC rules. Choose an item. --- NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 15 of 40 Post-Construction Site Runoff Controls 02H .1017 Qualifying Alternative Program(s) The permittee cumulatively implements the Qualifying Alternative Program requirements checked above throughout the entire MS4 permitted area. Choose an item. --- If response is no or partial, the permittee implements MS4 post- construction requirements in accordance with 15A NCAC 02H .1017(3) – (14) throughout the balance of the MS4 permitted area. Choose an item. --- Comments Permit Citation Program Requirement Status Supporting Doc No. II.F.2.a. Legal Authority The permittee maintained an ordinance or similar regulatory mechanism that authorizes a program to address stormwater runoff from new development and redevelopment to the extent allowable under State law. Choose an item. --- Comments II.F.2.b. Stormwater Control Measures (SCMs) The permittee maintains strategies that include a combination of structural and/or non-structural SCMs in concurrence with the legal authorities above (II.F.2.a.). Choose an item. --- The permittee provides a mechanism to require long-term operation and maintenance of structural SCMs. Choose an item. --- The permittee requires annual inspection reports of permitted structural SCMs performed by a qualified professional. Choose an item. --- The permittee implements SCM requirements that are at least as stringent as the minimum requirements in 15A NCAC 02H .1000. Choose an item. --- Comments II.F.2.c. Deed Restrictions and Protective Covenants The permittee provides mechanisms such as recorded deed restrictions, plats, and/or protective covenants so that development activities maintain the project consistent with approved plans. Choose an item. --- Comments NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 16 of 40 Post-Construction Site Runoff Controls II.F.2.d. Operation and Maintenance Plans The developer provides the permittee with an operation and maintenance plan for the stormwater system, indicating the operation and maintenance actions that shall be taken, specific quantitative criteria used for determining when those actions shall be taken, and who is responsible for those actions. Choose an item. --- The plans clearly indicate the steps that shall be taken and who shall be responsible for restoring a stormwater system to design specifications if a failure occurs. Choose an item. --- The plans include a legally enforceable acknowledgment by the responsible party. Choose an item. --- Development is maintained consistent with the requirements in the approved plans. Choose an item. --- Modifications to those plans must be / are approved by the Permittee. Choose an item. --- Comments II.F.2.e. Educational Materials and Training The permittee provided educational materials and training for developers. Choose an item. --- Comments II.F.4. Sensitive Receiving Waters The permittee applies additional requirements to projects draining to SA waters by requiring SCMs that result in the highest degree of fecal coliform die-off and controls sources of fecal coliform to the maximum extent practicable in accordance with 15A NCAC 02H .1017(9) Not Applicable --- The permittee applies additional requirements to projects draining to Trout waters by requiring SCMs that avoid a sustained increase in receiving water temperature in accordance with 15A NCAC 02H .1017(9) Not Applicable --- The permittee implements an approved locally implemented Nutrient Management Strategy that addresses post-construction runoff and the provisions of that Strategy fulfill the MS4 post-construction requirement. Choose an item. --- Comments II.F.5. Permittee Projects The permittee meets the requirements of the post-construction program for construction projects that are performed by, or under contract for, the permittee. Choose an item. --- NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 17 of 40 Post-Construction Site Runoff Controls Comments II.F.6. SCM Design Volume The permittee requires that the water quality design volume of SCMs account for the runoff at build out from all surfaces draining to the system. Choose an item. --- Comments II.F.7. Linear Transportation Projects The permittee fulfills the post-construction minimum control measure requirements for non-NCDOT linear transportation projects if they are designed, constructed, and conveyed as set forth in 15A NCAC 02H .1001(1)(c): (i) Constructed to NCDOT standards and in accordance with the NCDOT BMP Toolbox; (ii) Conveyed to NCDOT or other public entity and regulated in accordance with that entity’s NPDES MS4 Permit; and (iii) The project is not part of a common plan of development. Choose an item. --- Comments Additional Comments: NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 18 of 40 Pollution Prevention and Good Housekeeping for Municipal Operations Staff Interviewed: (Name, Title, Role) Permit Citation Program Requirement Status Supporting Doc No. II.G.2.a. Municipal Facility Inventory The permittee maintained an inventory of municipal facilities and operations owned and operated by the permittee that have been determined by the permittee to have significant potential or generating polluted stormwater runoff. Choose an item. --- The permittee maintained an inventory of municipally-owned structural SCMs. Choose an item. --- Comments II.G.2.b. Inspection and Maintenance for Municipal Facilities The permittee implemented an inspection and maintenance program for facilities and operations owned and operated by the permittee for potential sources of polluted runoff, including stormwater controls and conveyance systems. Choose an item. --- The inspection program evaluates pollutant sources, documents deficiencies, plans corrective actions, implements appropriate controls, and documents the accomplishment of corrective actions. Choose an item. --- The maintenance program includes maintenance activities and procedures aimed at preventing or reducing pollutants generated from municipal facilities and operations. Choose an item. --- Comments II.G.2.c. Site Pollution Prevention Plans for Municipal Facilities The permittee maintained and implemented Site Pollution Prevention Plans for municipal facilities owned and operated by the permittee that have been determined by the permittee to have significant potential for generating polluted stormwater runoff that has the goal of preventing or reducing pollutant runoff. Choose an item. --- Comments NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 19 of 40 Pollution Prevention and Good Housekeeping for Municipal Operations II.G.2.d. Spill Response Procedures for Municipal Facilities The permittee maintained spill response procedures for municipal facilities and operations owned and operated by the permittee that have been determined by the permittee to have significant potential for generating polluted stormwater runoff. Choose an item. --- Comments II.G.2.e. Vehicle and Equipment Cleaning Areas The permittee described measures that prevent or minimize contamination of the stormwater runoff from all areas used for vehicle and equipment cleaning, including fire stations that have more than three fire trucks and ambulances. Choose an item. --- The permittee performs all cleaning operations indoors, covers the cleaning operations, ensures wash water drains to the sanitary sewer system, collects wash water and stormwater run-on from the cleaning areas and provide s treatment or recycling, or other equivalent measures Choose an item. --- The permittee, if sanitary sewer is not available to the facility and cleaning operations take place outdoors, ensures wash water drains to an SCM for treatment, or else the cleaning operations take place on or drain directly to grassed or graveled areas to prevent point source discharges of wash water into the storm drains or surface waters. Choose an item. --- The permittee, where cleaning operations cannot be performed as described above and when operations are performed in the vicinity of a storm drainage collection system, covers the drain(s) with a portable drain cover during cleaning activities, and any excess standing water is removed and properly handled prior to removing the drain cover. Choose an item. --- The permittee facilities that have three or fewer fire trucks and ambulances attempt to comply with the above requirements; however, those that cannot comply with these requirements due to existing limitations incorporate structural measures during facility renovation to the extent practicable. Choose an item. --- Comments II.G.2.f. Streets, Roads and Public Parking Lot Maintenance The permittee implements BMPs to reduce polluted stormwater runoff from municipally-owned streets, roads, and public parking lots within the corporate limits. Choose an item. --- Comments NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 20 of 40 Pollution Prevention and Good Housekeeping for Municipal Operations II.G.2.g. Inspection and Maintenance for Municipal SCMs and MS4 The permittee maintained and implemented an inspection and maintenance program for structural stormwater control measures (SCMs) owned and operated by the municipality. Choose an item. --- The permittee maintained and implemented an inspection and maintenance program for the municipal storm sewer system (including catch basins, the conveyance system and SCMs). Choose an item. --- Comments II.G.2.h. Staff Training The permittee maintained a training plan that indicates when, how often, and who is required to be trained and what they are to be trained on. Choose an item. --- The permittee implemented a training plan that indicates when, how often, and who is required to be trained and what they are to be trained on. Choose an item. --- Comments Additional Comments: NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 21 of 40 Program to Monitor and Evaluate Stormwater Discharges to Municipal Systems Staff Interviewed: (Name, Title, Role) Permit Citation Program Requirement Status Supporting Doc No. II.H.2.a. Industrial Facility Inventory The permittee maintained an inventory of permitted hazardous waste treatment, disposal, and recovery facilities, industrial facilities that are subject to Section 313 of Title III of the Superfund Amendments and Reauthorization Act of 1986 (SARA). Choose an item. --- The permittee maintained an inventory of industrial facilities identified with an industrial activity (as defined in 40 CFR 122.26) permitted to discharge storm water to the permittee’s MS4. Choose an item. --- Comments II.H.2.b. Inspection Program The permittee identified priorities and inspection procedures. At a minimum, priority facilities include those identified above (subsection II.H.2.a). Choose an item. --- Comments II.H.2.c. Industrial Facility Evaluation The permittee evaluated control measures implemented at permitted hazardous waste treatment, disposal, and recovery facilities, industrial facilities that are subject to Section 313 of Title III of the Superfund Amendments and Reauthorization Act of 1986 (SARA). For the purpose of this permit, the Permittee is authorized to inspect the permitted hazardous waste treatment, disposal, and recovery facilities as an authorized representative of the Director. Choose an item. --- The permittee evaluated control measures implemented at industrial facilities identified with an industrial activity permitted to discharge storm water to the permittee’s MS4. For the purposes of this permit, industrial activities shall mean all permitted industrial activities as defined in 40 CFR 122.26. Choose an item. --- For permitted industrial facilities, the permittee established procedures for reporting deficiencies and non-compliance to the permitting agency. Choose an item. --- NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 22 of 40 Program to Monitor and Evaluate Stormwater Discharges to Municipal Systems Where compliance with an existing industrial stormwater permit does not result in adequate control of pollutants to the MS4, the permittee recommends and documents the need for permit modifications or additions to the permit issuing authority. Choose an item. --- The permittee evaluated control measures implemented at industrial facilities identified as an illicit discharge under the IDDE Program. Choose an item. --- Comments Additional Comments: NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 23 of 40 Water Quality Assessment and Monitoring Staff Interviewed: (Name, Title, Role) Permit Citation Program Requirement Status Supporting Doc No. II.I.2.a. Water Quality Assessment and Monitoring Plan The permittee maintained a Water Quality Assessment and Monitoring Plan. Choose an item. --- The Water Quality Assessment and Monitoring Plan includes a schedule for implementing the proposed assessment and monitoring activities. Choose an item. --- Comments II.I.2.b. Water Quality Monitoring The permittee maintained and implemented the Water Quality Assessment and Monitoring Plan submitted to DEMLR. Choose an item. --- The Division waived the requirement to maintain a Water Quality Assessment and Monitoring Plan. Choose an item. --- Comments Additional Comments: NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 24 of 40 Site Visit Evaluation: Municipal Facility No. 1 Facility Name: Date and Time of Site Visit: Facility Address: Facility Type (Vehicle Maintenance, Landscaping, etc.): Name of MS4 inspector(s) evaluated: Most Recent MS4 Inspection (List date and name of inspector): Name(s) and Title(s) of Facility Representative(s) Present During the Site Visit: Name Title Observations Facility Documentation/Training Does the facility have a Stormwater Pollution Prevention Plan (SWPPP) or similar document? Is it facility-specific? What type of stormwater training do facility employees receive? How often? Inspector Training/Knowledge What type of stormwater training does the MS4 inspector receive? How often? Did the MS4 inspector appear knowledgeable about Permit requirements for pollution prevention and good housekeeping? Did the MS4 inspector appear knowledgeable about stormwater pollution prevention and good housekeeping? Inspection Procedures Does the MS4 inspector’s process include the use of a checklist or other standardized form? Does the MS4 inspector’s process include taking photos? Does the MS4 inspector’s process include reviewing the facility’s SWPPP (or similar document)? NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 25 of 40 Site Visit Evaluation: Municipal Facility No. 1 Does the MS4 inspector’s process include walking the entire facility and inspecting all points of discharge? Did the MS4 inspector miss any obvious areas of concern? If so, explain: Does the MS4 inspector’s process include presenting the inspection findings to the facility contact? Inspection Results Did the facility inspection result in any corrective actions to be implemented? If so, for what issue(s)? If compliance corrective actions were identified, what timeline for correction/follow-up was provided? Notes/Comments/Recommendations NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 26 of 40 Site Visit Evaluation: Municipal Facility No. 2 Facility Name: Date and Time of Site Visit: Facility Address: Facility Type (Vehicle Maintenance, Landscaping, etc.): Name of MS4 inspector(s) evaluated: Most Recent MS4 Inspection (Date and Entity): Name(s) and Title(s) of Facility Representative(s) Present During the Site Visit: Name Title Observations Facility Documentation/Training Does the facility have a Stormwater Pollution Prevention Plan (SWPPP) or similar document? Is it facility-specific? What type of stormwater training do facility employees receive? How often? Inspector Training/Knowledge What type of stormwater training does the MS4 inspector receive? How often? Did the MS4 inspector appear knowledgeable about Permit requirements for pollution prevention and good housekeeping? Did the MS4 inspector appear knowledgeable about stormwater pollution prevention and good housekeeping? Inspection Procedures Does the MS4 inspector’s process include the use of a checklist or other standardized form? Does the MS4 inspector’s process include taking photos? Does the MS4 inspector’s process include reviewing the facility’s SWPPP (or similar document)? NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 27 of 40 Site Visit Evaluation: Municipal Facility No. 2 Does the MS4 inspector’s process include walking the entire facility and inspecting all points of discharge? Did the MS4 inspector miss any obvious areas of concern? If so, explain: Does the MS4 inspector’s process include presenting the inspection findings to the facility contact? Inspection Results Did the facility inspection result in any corrective actions to be implemented? If so, for what issue(s)? If compliance corrective actions were identified, what timeline for correction/follow-up was provided? Notes/Comments/Recommendations NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 28 of 40 Site Visit Evaluation: MS4 Outfall No. 1 Outfall ID Number: Date and Time of Site Visit: Outfall Location: Outfall Description (Pipe Material/Diameter, Culvert, etc.): Receiving Water: Is Flow Present? If So, Describe (Color, Approximate Flow Rate, Sheen, Odor, Floatables/Debris, etc.): Most Recent Outfall Inspection/Screening (Date): Days Since Last Rainfall: Inches: Name of MS4 Inspector(s) evaluated: Observations Inspector Training/Knowledge What type of stormwater training does the MS4 inspector receive? How often? Did the MS4 inspector appear knowledgeable about illicit discharge indicators and investigations? Inspection Procedures Does the inspector’s process include the use of a checklist or other standardized form? Does the inspector’s process include taking photos? Did the MS4 inspector miss any obvious potential illicit discharge indicators or maintenance issues? If so, what were they? NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 29 of 40 Site Visit Evaluation: MS4 Outfall No. 1 Inspection Results Did the outfall inspection result in any work orders or maintenance requests? If so, for what issue(s)? Will a follow-up outfall inspection be conducted? If so, for what reason? Notes/Comments/Recommendations NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 30 of 40 Site Visit Evaluation: MS4 Outfall No. 2 Outfall ID Number: Date and Time of Site Visit: Outfall Location: Outfall Description (Pipe Material/Diameter, Culvert, etc.): Receiving Water: Is Flow Present? If So, Describe (Color, Approximate Flow Rate, Sheen, Odor, Floatables/Debris, etc.): Most Recent Outfall Inspection/Screening (Date): Days Since Last Rainfall: Inches: Name of MS4 Inspector(s) evaluated: Observations Inspector Training/Knowledge What type of stormwater training does the MS4 inspector receive? How often? Did the MS4 inspector appear knowledgeable about illicit discharge indicators and investigations? Inspection Procedures Does the inspector’s process include the use of a checklist or other standardized form? Does the inspector’s process include taking photos? Did the MS4 inspector miss any obvious potential illicit discharge indicators or maintenance issues? If so, what were they? NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 31 of 40 Site Visit Evaluation: MS4 Outfall No. 2 Inspection Results Did the outfall inspection result in any work orders or maintenance requests? If so, for what issue(s)? Will a follow-up outfall inspection be conducted? If so, for what reason? Notes/Comments/Recommendations NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 32 of 40 Site Visit Evaluation: Construction Site No. 1 Site/Project Name: Date and Time of Site Visit: Site/Project Address: Operator: Project Type (Commercial, Industrial, Residential, CIP, Road, etc.): NCG Permit ID Number: Disturbed Acreage: Recent Enforcement Actions (Include Date): Name of MS4 Inspector(s) evaluated: Name(s) and Title(s) of Site Representative(s) Present During the Site Visit: Name Title Observations Site Documentation/Training Does the site have a Stormwater Pollution Prevention Plan (SWPPP) or similar document? Is it site-specific? Does the site have approved erosion and sedimentation control plans onsite? Are they representative of current site conditions? What type of stormwater training do site employees receive? How often? Inspector Training/Knowledge What type of stormwater training does the MS4 inspector receive? How often? Did the MS4 inspector appear knowledgeable about MS4 and NCG010000 requirements for construction sites? Did the MS4 inspector appear knowledgeable about erosion and sedimentation control/stormwater pollution prevention BMPs? NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 33 of 40 Site Visit Evaluation: Construction Site No. 1 Inspection Procedures Does the MS4 inspector’s process include the use of a checklist? Does the MS4 inspector’s process include taking photos? Does the MS4 inspector’s process include reviewing approved plans (erosion and sedimentation control and/or SWPPP)? Does the MS4 inspector’s process include walking the entire site and inspecting all points of discharge? Did the MS4 inspector miss any obvious violations? If so, explain: Does the MS4 inspector’s process include presenting the inspection findings to the site contact in writing? Does the MS4 inspector’s process include providing construction stormwater educational materials to the site contact? Compliance/Enforcement What, if any, enforcement actions (verbal warnings, NOV, etc.) did the inspection result in? If compliance issues were identified, what timeline for correction/follow-up was provided? Notes/Comments/Recommendations NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 34 of 40 Site Visit Evaluation: Construction Site No. 2 Site/Project Name: Date and Time of Site Visit: Site/Project Address: Operator: Project Type (Commercial, Industrial, Residential, CIP, Road, etc.): NCG Permit ID Number: Disturbed Acreage: Recent Enforcement Actions (Include Date): Name of MS4 Inspector(s) evaluated: Name(s) and Title(s) of Site Representative(s) Present During the Site Visit: Name Title Observations Site Documentation/Training Does the site have a Stormwater Pollution Prevention Plan (SWPPP) or similar document? Is it site-specific? Does the site have approved erosion and sedimentation control plans onsite? Are they representative of current site conditions? What type of stormwater training do site employees receive? How often? Inspector Training/Knowledge What type of stormwater training does the MS4 inspector receive? How often? Did the MS4 inspector appear knowledgeable about MS4 and NCG010000 requirements for construction sites? Did the MS4 inspector appear knowledgeable about erosion and sedimentation control/stormwater pollution prevention BMPs? NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 35 of 40 Site Visit Evaluation: Construction Site No. 2 Inspection Procedures Does the MS4 inspector’s process include the use of a checklist? Does the MS4 inspector’s process include taking photos? Does the MS4 inspector’s process include reviewing approved plans (erosion and sedimentation control and/or SWPPP)? Does the MS4 inspector’s process include walking the entire site and inspecting all points of discharge? Did the MS4 inspector miss any obvious violations? If so, explain: Does the MS4 inspector’s process include presenting the inspection findings to the site contact in writing? Does the MS4 inspector’s process include providing construction stormwater educational materials to the site contact? Compliance/Enforcement What, if any, enforcement actions (verbal warnings, NOV, etc.) did the inspection result in? If compliance issues were identified, what timeline for correction/follow-up was provided? Notes/Comments/Recommendations NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 36 of 40 Site Visit Evaluation: Post-Construction Stormwater Control Measure No. 1 Site Name: Date and Time of Site Visit: Site Address: SCM Type: Most Recent MS4 Inspection (Include Date and Entity): Name of MS4 Inspector(s) evaluated: Most Recent MS4 Enforcement Activity (Include Date): Name(s) and Title(s) of Site Representative(s) Present During the Site Visit: Name Title Observations Site Documentation Does the site have an operation and maintenance plan? Does the site have records of annual inspections? Are they performed by a qualified individual? Inspector Training/Knowledge What type of stormwater training does the MS4 inspector receive? How often? Did the MS4 inspector appear knowledgeable about MS4 requirements for post-construction site runoff controls? Did the MS4 inspector appear knowledgeable about post-construction BMPs (general purpose/function, components, O&M requirements, etc.)? Inspection Procedures Does the MS4 inspector’s process include the use of a checklist or other standardized form? What format? Does the MS4 inspector’s process include taking photos? Does the MS4 inspector’s process include reviewing the site’s operation and maintenance plan and records of annual inspections? NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 37 of 40 Site Visit Evaluation: Post-Construction Stormwater Control Measure No. 1 Does the MS4 inspector’s process include walking the entire site and inspecting all points of discharge? Did the MS4 inspector miss any obvious operation and maintenance deficiencies? If so, explain: Does the MS4 inspector’s process include presenting the inspection findings to the site contact in writing? Compliance/Enforcement What, if any, enforcement actions (verbal warnings, NOV, etc.) did the inspection result in? If compliance issues were identified, what timeline for correction/follow-up was provided? Notes/Comments/Recommendations NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 38 of 40 Site Visit Evaluation: Post-Construction Stormwater Control Measure No. 2 Site Name: Date and Time of Site Visit: Site Address: SCM Type: Most Recent MS4 Inspection (Include Date and Entity): Name of MS4 Inspector(s) evaluated: Most Recent MS4 Enforcement Activity (Include Date): Name(s) and Title(s) of Site Representative(s) Present During the Site Visit: Name Title Observations Site Documentation Does the site have an operation and maintenance plan? Does the site have records of annual inspections? Are they performed by a qualified individual? Inspector Training/Knowledge What type of stormwater training does the MS4 inspector receive? How often? Did the MS4 inspector appear knowledgeable about MS4 requirements for post-construction site runoff controls? Did the MS4 inspector appear knowledgeable about post-construction BMPs (general purpose/function, components, O&M requirements, etc.)? Inspection Procedures Does the MS4 inspector’s process include the use of a checklist or other standardized form? What format? Does the MS4 inspector’s process include taking photos? Does the MS4 inspector’s process include reviewing the site’s operation and maintenance plan and records of annual inspections? NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 39 of 40 Site Visit Evaluation: Post-Construction Stormwater Control Measure No. 2 Does the MS4 inspector’s process include walking the entire site and inspecting all points of discharge? Did the MS4 inspector miss any obvious operation and maintenance deficiencies? If so, explain: Does the MS4 inspector’s process include presenting the inspection findings to the site contact in writing? Compliance/Enforcement What, if any, enforcement actions (verbal warnings, NOV, etc.) did the inspection result in? If compliance issues were identified, what timeline for correction/follow-up was provided? Notes/Comments/Recommendations NCS000247_Winston-Salem 2022 MS4 Self-Audit Page 40 of 40 APPENDIX A: SUPPORTING DOCUMENTS