DHEC Form 1356 "Erosion Prevention and Sediment Control Monthly Report for Sites Greater Than 10 Acres" - South Carolina

What Is DHEC Form 1356?

This is a legal form that was released by the South Carolina Department of Health and Environmental Control - a government authority operating within South Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2008;
  • The latest edition provided by the South Carolina Department of Health and Environmental Control;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of DHEC Form 1356 by clicking the link below or browse more documents and templates provided by the South Carolina Department of Health and Environmental Control.

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Download DHEC Form 1356 "Erosion Prevention and Sediment Control Monthly Report for Sites Greater Than 10 Acres" - South Carolina

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Erosion Prevention and Sediment Control Monthly Report
for Sites Greater than 10 Acres
1)
Permit Number (Report will NOT be accepted without permit number.): SCR10_____________________________
2)
Inspection Month: _________________________
3) Total Rainfall for Inspection Month ___________(inches)
4)
Project Name: ____________________________
5) County: ______________________________________
6)
Inspector Name: __________________________
7) Inspector Phone Number: ________________________
8)
Inspector Address: ____________________________________________________________________________
9)
Inspector Qualifications: _______________________________________________________________________
10) Check deficiencies noted during this reporting month: o  Re-vegetation o  Ponds
o  Basins/Swales
o  Rip rap/Channels
o  Silt Fence
o  Debris
o  Entrance/Exit o  Phasing/Sequencing
o  Stabilization
o  Idle-14 days
o  More BMPS needed
o  Other ____________________________________________________________________________________
11) Any off-site sediment / impacts: o  In streams or waterways
o  On public roads
o  On Private Property
12) Name, address, and phone numbers of parties responsible for above deficiencies:
13) Were all deficiencies reported last month corrected? o  Yes
o  No
a) if Yes, please provide the date and nature of action taken to correct deficiencies: _________________________
___________________________________________________________________________________________
b) if No, please provide information why the deficiencies were not corrected: ______________________________
___________________________________________________________________________________________
----------------------------------------------------------------------------------------------------------------------------------------------------------------
14) Certification and Signature:
“I certify under penalty of law that 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 fine
and imprisonment for knowing violations.”
Permittee or Delegated Signature: ____________________________________________________________________
Permittee or Delegated Printed Name: ________________________________________________________________
Permittee or Delegated Person’s Telephone Number: _____________________________________________________
----------------------------------------------------------------------------------------------------------------------------------------------------------------
Submit this report by the 28
day of the month following the month during which the inspections were done to:
th
SC DHEC Bureau of Water – WPC, 2600 Bull Street, Columbia, SC 29201
or Fax to (803) 898-4215
Note: Copies of inspection reports are not required unless requested by the Department
SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
DHEC 1356 (03/2008)
Erosion Prevention and Sediment Control Monthly Report
for Sites Greater than 10 Acres
1)
Permit Number (Report will NOT be accepted without permit number.): SCR10_____________________________
2)
Inspection Month: _________________________
3) Total Rainfall for Inspection Month ___________(inches)
4)
Project Name: ____________________________
5) County: ______________________________________
6)
Inspector Name: __________________________
7) Inspector Phone Number: ________________________
8)
Inspector Address: ____________________________________________________________________________
9)
Inspector Qualifications: _______________________________________________________________________
10) Check deficiencies noted during this reporting month: o  Re-vegetation o  Ponds
o  Basins/Swales
o  Rip rap/Channels
o  Silt Fence
o  Debris
o  Entrance/Exit o  Phasing/Sequencing
o  Stabilization
o  Idle-14 days
o  More BMPS needed
o  Other ____________________________________________________________________________________
11) Any off-site sediment / impacts: o  In streams or waterways
o  On public roads
o  On Private Property
12) Name, address, and phone numbers of parties responsible for above deficiencies:
13) Were all deficiencies reported last month corrected? o  Yes
o  No
a) if Yes, please provide the date and nature of action taken to correct deficiencies: _________________________
___________________________________________________________________________________________
b) if No, please provide information why the deficiencies were not corrected: ______________________________
___________________________________________________________________________________________
----------------------------------------------------------------------------------------------------------------------------------------------------------------
14) Certification and Signature:
“I certify under penalty of law that 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 fine
and imprisonment for knowing violations.”
Permittee or Delegated Signature: ____________________________________________________________________
Permittee or Delegated Printed Name: ________________________________________________________________
Permittee or Delegated Person’s Telephone Number: _____________________________________________________
----------------------------------------------------------------------------------------------------------------------------------------------------------------
Submit this report by the 28
day of the month following the month during which the inspections were done to:
th
SC DHEC Bureau of Water – WPC, 2600 Bull Street, Columbia, SC 29201
or Fax to (803) 898-4215
Note: Copies of inspection reports are not required unless requested by the Department
SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
DHEC 1356 (03/2008)
Erosion Prevention and Sediment Control Monthly Report
for Sites Greater than 10 Acres
INSTRUCTIONS
Purpose: To satisfy the reporting requirements of the South Carolina NPDES General Permit for Storm Water Discharges
from Large and Small Construction Sites, Permit # SCR100000, Part 3.10H.
Who will complete the form: Developers, contractors, and inspectors engaged in the sediment and erosion control in-
dustry.
1.
Permit Number
: Enter the permit number. The permit number always starts with SCR and can be found on the
permit coverage approval letter sent to the permittee. Do not enter any other numbers such as file numbers or job
numbers. Do not submit without the SCR number.
2.
Inspection Month
: Enter the month and year in which the inspections were performed.
3.
Total Rainfall
: Enter the total inches of rainfall for the permitted site during the month when the inspections took
place.
4.
Project Name
: Enter the facility or site name listed on the permit coverage approval letter sent to the permittee.
5.
County
: Enter the county where the site is located
6.
Inspector Name
: Enter the name of the person performing the inspections.
7.
Inspector Phone Number
: Enter the inspector’s phone number.
8.
Inspector Address
: Enter the inspector’s address.
9.
Inspector Qualifications
: Enter the CEPSCI certification number of the inspector, PE registration number, or other
qualifications acceptable to the SC DHEC.
10.
Summary of deficiencies noted during the inspection
: Summarize and enter all sediment and erosion deficiencies
found at the site during the inspections. Check all of the items that apply.
11.
Off-site Impact:
If sediment was found off-site, put a check-mark beside each area the sediment impacted.
12.
Name, address, and phone numbers of parties responsible for above deficiencies
: Enter the name, address,
and phone numbers for the person/company responsible for the deficiencies listed in your summary.
13.
Were the deficiencies reported last month corrected
: If there were any deficiencies noted in last month’s report
that were not corrected, put a check mark beside “No”. If all deficiencies were corrected, check “Yes”.
a) Date and nature of action taken to correct deficiencies: If deficiencies from previous month were
corrected, list corrective actions and dates performed.
b)
Explain why deficiencies were not corrected. If deficiencies were not corrected, explain what prevented
deficiencies from being corrected.
14.
Certification and Signature
: The report has to be signed by the Permitee or the person delegated to sign the reports,
printed name, and a contact number is required.
Office Mechanisms and filing: The form must be filed with the Bureau of Water, Water Pollution Control Division, by the
28
day of the month following the month during which the inspections were done. The report will be filed in the Bureau of
th
Water’s file room and will be retained for three years after the Department receives an approvable Notice of Termination
from the permit holder.
DHEC-1356 (03/2008)
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