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HomeMy WebLinkAbout5.17.2021 Forest Terrace TESCPROPRIETARY COMPANY MATERIAL NOTE 2016 Protocol: 5�17�202I Maximum of one SSWR per permit. *PulteGroup NATIONAL STORM WATER QUALITY PROGRAM SITE INSPECTION REPORT (SIR) For use on most PulteGroup Sites as of 01/01/2016 Community Name: (Include Site Name, City, State, Zip Code andNPDES/Construction Storm Water Permit Number) Master Site List ID: 1419 Inspection performed by: Andrew Glandon WaterTechNW CESCL #82522 (Print Name, Company, and Title / Qualifications ) Stages of Construction: (check all that apply) ® Land Development ❑ Inactive ❑ Vertical Construction ❑ Post -Construction Type of Inspection: (check all that apply) N Routine Inspection ❑ Storm -Event Related ❑ FinaI Site Inspection ❑ Other: Vault slopes, off site utilities, I. SWPPP —Respond to all Questions Item Yes NQ If "No," then an A. Was the SWPPP accessible atthe timeof the ins ection? p _ _ Action Item ® ❑ is required. B. Is the SSWR correctly identified in the SWPPP? ® ❑ C. Does the SWPPP reflect the current stage of development Describe all Action includinga current BMP Site Ma p? Items on the reverse ® ❑ side of this sheet. D. Have all SIR Action Items identified on thepreceding reports beenresolved? N ❑ (section Iv) E. Is NSQP Signage posted and in compliance with NSQP requirements? ® ❑ H. Estimated date of most recent Storm Event that triggered an Inspection: 2/22/2021; 0.50" Provide rainfall information as required by the Applicable Permit 0.00" (Based on the storm -event related Inspection M. Site BMP Inspection Not Frequency required by the Applicable Permit) Item SWPPP Items Applicable Acceptable A_---.. Erosion Control 1 Protection of Disturbed Areas ❑ ® ❑ 2 Slope Protection ❑ ® ❑ 3 Vegetation/Revegetation ❑ ® ❑ 4 Velocity Reduction Devices/ Outlet ❑ ® ❑ Protection Sediment Control 5 Check Dams (rock, gravel, other) N ❑ ❑ 6 Silt Fence ❑ ® ❑ 7 Berms, Dikes, Straw Wattles ❑ ® ❑ 8 Detention Basins/Sediment Traps ❑ ® ❑ 9 Stockpiles Protected / Stabilized ❑ ® ❑ 10 Storm Water Inlet Protection ❑ N ❑ Housekeeping/Trade Compliance 11 Waste and Trash Management ❑ N ❑ 12 Spill and Leak Prevention ❑ N ❑ 13 Sanitary Stations ❑ N ❑ 14 Concrete and Construction Washouts ❑ N ❑ 15 Material Use and Potential ® ❑ ❑ Contaminate Storage 16 Equipment Storage and Maintenance ❑ ® ❑ 17 Construction Exits and Entrances ❑ ® ❑ All capitalized terms are defined in the glossary of the NSQP Handbook. Complete all Sections of this Report. Any information added after the signature date must be initialed and dated. This report must be signed by the SSWR, dated and retained with the SWPPP. 0 PulteGroup, Inc. 2016 PROPRIETARY COMPANY MATERIAL Standard SIR 2016 Item 18 p Other 20 21 22 23 24 25 IV. SWPPP_Items (continuedj Dust Control Street Sweeping)Tsli Not Applicable Acceptable El IR Action Item Assianed To ■❑ Non -storm water flow ❑ ® ❑ Site's weathering of Storm Events ❑ ® ❑ Site discharge points ❑ ® ❑ BNO provider performance ❑ ® ❑ No construction storrnwater discharge ❑ ® ❑ ❑ ❑ ❑ Action Items V. Responsive Action Completion Item Location and Responsive Action to betaken Date Noted Date of Com letlon Initial$ Attach additional sheets) of SIR addendum ij necessary SIR must be reviewed and signed below by SSWR — Not Delegable: I certify under penalty of law that Sections I-V of this document and all attachments were prepared by me or under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the 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 fine and imprisonment for knowing violations. Certification applies to the area under the supervision of the SSWR signing this report. In 1U U,3 . IJG A G V 1G VYCl! A�AIi a1i11G4 IUG1V rr u' 00 ►► x% — 1 Certified By: (SSWR — Must be a PulteGroup Employee) L 'K/U Cr 9�n f - �4iv/�rils Site Storm Water Representative —Print Name and Title z ite Storm Water Representative Signature (Use Ink) Date I Certified By: (Third Party Inspector if required by theAppiicablePermit Andrew Glandon CESCL 82522; 425 890 4858 Inspector — Print Name L �lG 5/17/2021 Inspector Signature (Use Ink) Date VI. Justification for non -completion of Responsive Actions. Describe why any Responsive Actions were not corrected within the permit required time period (if applicable). Attach additional sheet(s) if necessary All capitalized terms are defined in the glossary of the NSQP Handbook. Complete all Sections of this Report. Any information added after the signature date must be initialed and dated. This report must he signed by the SSWR, dated and retained with the SWPPP.