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Page 2 of 12

General Project Information

The submitted Erosion Prevention and Sediment Control Plan must have the following components:

Do not combine plan sheets or submit plans unrelated to EPSC!

Low (K< 0.22) Moderate K(0.22<K<0.37) High (K>0.37)

Discharge Area SummaryFor each drainage area with disturbance of 0.5 acres or more, complete a line below.

DrainageArea

DisturbanceArea (acres)

Weighted Soil K1

<.18, .18-.37 or >.37Average Slope %

<5, 5-15 or >15Risk2

L, M or HEPSC3

A, B and/or C

Page 3 of 12

1 L AB10

Page 4 of 12

Standard: Temporary Stabilization and Vegetation EstablishmentCheck all that apply

Project Name: Designer Name:

Practice Description

SurfaceRoughening

Mulching

Temporary &PermanentPlantings

SoilAmendments

RolledErosionControlProducts

ConstructionRoadStabilization

Other Describe all other specified Temporary Stabilization and VegetationEstablishment Practices:

14 Hay

2 Tons

Urban

Fertilizer based on soil test

NAG S150BN

Standard: Limiting DisturbanceCheck all that apply

Project Name: Designer Name:

Practice Description

LimitConcurrentDisturbance

Phasing

Limits ofDisturbance(LOD)

Type of barrier within 50 feet of waters of the state (including wetlands):

Other barrier type(s) called out on plans:

Other Describe all other specified Limiting Disturbance practices:

Page 5 of 12

5

Page 6 of 12

Standard: Runoff ControlCheck all that apply

Project Name: Designer Name:

Practice Description

Fiber Roll

Water Bar

Check Dam

Diversion

Earth Dike

TemporarySwale

PerimeterSwale

Page 7 of 12

Standard: Slope ProtectionCheck all that apply

Project Name: Designer Name:

Practice Description

Rip Rap

Retaining Wall

Brush Layer

Live Fascine

Branch Packing

Standard: Flow ProtectionCheck all that apply

Grassed Waterway

Lined Outlet/Lined Waterway

Rock Outlet Protection

Grade StabilizationStructure

Paved Flume

Page 8 of 12

Standard: Large and Small Sediment ControlCheck all that apply

Project Name: Designer Name:

Practice Description

Silt Fence

Excavated StormDrain Inlet Protection

Fabric Drop InletProtection

Stone and DropBlock InletProtection

StabilizedConstructionEntrance

Debris Basin

Rock Dam

Sediment Trap

Temporary SedimentBasin

1

Page 9 of 12

Standard: Small Area Sediment Control – Sediment TrapsCheck all that apply

Project Name: Designer Name:

Practice Description

Pipe OutletSediment Trap

Grass OutletSediment Trap

Catch BasinSediment Trap

Stone OutletSediment Trap

Riprap OutletSediment Trap

Temporary Sediment Basin SummaryCheck all that apply – Complete one sheet per Sediment Basin

Project Name: Designer Name:

Drainage Area #: Sediment Basin #: Drainage Area Size (acres):

Total Required Storage:cubic feet

Total Storage Available:cubic feet

Class:1 2

Standard:

Class 1 Class 2

Page 10 of 12

Plans include:

78,510 18,348

1 1 21.7

Temporary Sediment Basin DesignComplete one sheet per Sediment Basin – See Directions Below (page 12)

Drainage Area #: Sediment Basin #: Drainage Area Size (acres):

BASIN SIZE DESIGN

larger

DESIGN OF SPILLWAYS & ELEVATIONS

Note

ANTI-SEEP COLLAR/ SEEPAGE DIAPHRAGM DESIGN:

DEWATERING ORIFICE SIZING

Page 11 of 12

(2) 6.5" orifice sized for 24-hrextended detention

21.7 2,9081,454

3873.66

0.49 0.32

82.72

21.7 4.3482.72

3048

12

Additional storage volume

5.66 4 0.5 463 66 1.5

1 1 21.7