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3.08.2022 Forest Terrace TESC
TA 3/08/2022 NATIONAL STORM WATER QUALITY PROGRAM SITE INSPECTION REPORT (SIR) For use on most PulteGroup Sites as of 01/01/2016 Community Name: Forest Terrace, 2611 Union Ave NE, Renton, WA 98059 WAR-310059 (Include Site Name, City, State, Zip Code and NPDES/Construction Storm Water Permit Number) Master Site List ID: 1419 Inspection performed by: Tom Shugrue, WaterTechNW, CESCL #81901 (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) ☒ Routine Inspection ☐ Storm-Event Related ☐ Final Site Inspection ☐Other: Construction entrance, terraced lots, perimeter protection I. SWPPP – Respond to all Questions Item Yes No A. Was the SWPPP accessible at the time of the inspection? ☒ ☐ B. Is the SSWR correctly identified in the SWPPP? ☒ ☐ C. Does the SWPPP reflect the current stage of development including a current BMP Site Map? ☒ ☐ D. Have all SIR Action Items identified on the preceding reports been resolved? ☒ ☐ E. Is NSQP Signage posted and in compliance with NSQP requirements? ☒ ☐ II. Estimated date of most recent Storm Event that triggered an Inspection: 2/28/2022; 1.60” Provide rainfall information as required by the Applicable Permit 0.20” III. Site BMP Inspection Not Item SWPPP Items Applicable Acceptable Action Item Assigned To 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) ☒ ☐ ☐ 6 Silt Fence ☐ ☒ ☐ 7 Berms, Dikes, Straw Wattles ☐ ☒ ☐ 8 Detention Basins/Sediment Traps ☐ ☒ ☐ 9 Stockpiles Protected / Stabilized ☐ ☐ ☒ contractor 10 Storm Water Inlet Protection ☐ ☐ ☒ contractor Housekeeping/Trade Compliance 11 Waste and Trash Management ☐ ☒ ☐ 12 Spill and Leak Prevention ☐ ☒ ☐ 13 Sanitary Stations ☐ ☒ ☐ 14 Concrete and Construction Washouts ☐ ☒ ☐ 15 Material Use and Potential ☒ ☐ ☐ Contaminate Storage 16 Equipment Storage and Maintenance ☐ ☒ ☐ 17 Construction Exits and Entrances ☐ ☒ ☐ PROPRIETARY COMPANY MATERIAL Not If “No,” then an Action Item is required. Describe all Action Items on the reverse side of this sheet. (Section IV) (Based on the storm-event related Inspection Frequency required by the Applicable Permit) 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. © PulteGroup, Inc. 2016 Standard SIR 2016 PROPRIETARY COMPANY MATERIAL NOTE 2016 Protocol: Maximum of one SSWR per permit. Item SWPPP Items (continued) Applicable Acceptable Action Item Assigned To 18 Dust Control ☐ ☒ ☐ 19 Street Sweeping [TS1] ☐ ☒ ☐ Other 20 Non-storm water flow ☐ ☒ ☐ 21 Site’s weathering of Storm Events ☐ ☒ ☐ 22 Site discharge points ☐ ☒ ☐ 23 BMP provider performance ☐ ☒ ☐ 24 No construction stormwater discharge ☐ ☒ ☐ 25 ☐ ☐ ☐ IV. Action Items V. Responsive Action Completion Item Location and Responsive Action to be taken Date Noted Date of Completion Initials 9 Cover stockpiles IF inactive > 2 days 3/08 10 Install catch basin inserts interior roadways 3/08 Attach additional sheet(s) of SIR addendum if 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. SIR must be reviewed and signed below by SSWR – Not Delegable: Certified By: (Third Party Inspector if required by the Applicable Permit Tom Shugrue CESCL 81901; 206 972 3720 Inspector – Print Name 3/08/2022 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 Certified By: (SSWR – Must be a PulteGroup Employee) Site Storm Water Representative – Print Name and Title ite Storm Water Representative Signature (Use Ink) Date 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.