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EROSION CONTROL SUPPLEMENTAL INFORMATION FORM <br /> INSPECTION PLAN REQUIREMENTS <br /> 1. Routine Inspections: <br /> • Once every seven days during active construction <br /> • Within 24 hours of a half inch or more precipitation <br /> 2. Completed Field Inspection Reports: <br /> • Reports available within 24 hours of request until MCWD determines project is complete& <br /> stabilized <br /> Failure to submit requested inspection information will result in a site inspection and may be subject to <br /> reimbursement for MCWD staff time. <br /> Who will inspect your site regularly? <br /> NAME: David Klema ORGANIZATION: <br /> PHONE: 617-461-2395 ALTERNATE PHONE: 203-841-3492 <br /> EMAIL: david.klema@gmail.com <br /> Where is the concrete washout location? <br /> 8 OFF SITE OR CONTAINED ON TRUCK <br /> ❑ INDICATED ON SITE PLAN(with required impermeable liner) <br /> ❑ N/A <br /> What is the final stabilization method? <br /> (seed, sod,etc.): Seed, sod <br /> 6 inches of topsoil must be added/replaced prior to final stabilization <br /> Will protective fencing for retained vegetation be installed? <br /> ❑ YES <br /> El NOT APPLICABLE <br /> ❑ OTHER(describe) <br /> I certify that I am familiar with the requirements of the MCWD Erosion Control Rule and that the <br /> proposed activity will be conducted in compliance with this rule. <br /> David Klema Digitally signed by David Nlema <br /> Date:2018.06.1512:02:2805i00 6/15/16 <br /> Signature of Applicant or Authorized Agent Date <br /> \Jj) WATERSHED MINNEHAHADISTRICCREEK <br /> T <br /> DUALITY OF WATER,DUALITY OF LIFE <br />