schwabe, williamson wyatt~...draft dust control plan exhibit a-s please include these in the record...
TRANSCRIPT
SCHWABE WILLIAMSON amp WYATT~ ATTORNEYS AT LAW
360 SW Bond Street Suite 500 Bend OR 97702 I Phone 5417494044 I Fax 541 330 1153 I wwwschwabe com
TIAM LEWIS
Direct Line 54 I -749-4048
E-Mail tlewisschwabecom
January 6 2016
By HAND DELIVERY
Will Groves Senior Planner Deschutes County Community Development Department 117 NW Lafayette Avenue Bend OR 97703
Re Lower Bridge Road LLC AppealExhibit List County File Nos 247-1S-00194-CU and 247-1S-00019S-TP Our File No 116094-1S07S2
Dear Will
Enclosed are Applicants Exhibits as follows for the Appeal hearing before the Board
1 Revised TP Exhibit A-I
2 FIRM Map on Property Exhibit A-2
3 Rimrock Setback Drawings Exhibit A-3
4 Typical Lot Layouts Exhibit A-4
S Draft Dust Control Plan Exhibit A-S
Please include these in the record for the above-referenced matter
TMLls Enclosures
PORT LA ND OR 503222998 1 I SALEM OR 5035404262 I BEN D OR 5417494044 I EUGENE OR 54 1 6863299 SEATT LE WA 206622 17 11 I VANCOUVER VA 360694755 1 I WASHINGTO N DC 202488 4302
PDX I 1 6094 1 50752TML 17413630 1
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LOCAL PRIVA TE ROADS TYPICAL SECTON
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APPUCANrowNER LOWER BRIDGE ROAD LlC 205CAST 11TH ST SUlTE QOO VANCOVIR WA
DAGOSTIOO PAf(I(fR LLC 051278 KING JEROBOIIMAVE BEND CREGON 91702
CURRENT ZONING R(JRI( RESOEfflIAl ZOfE RR- 10 FlOOo PtA1N ZONE FP
roTAL LOTS 19 RESIDENTIAl LOTS I PRMUE ROAD TRACT 1 COMON AREA TRACTS 5 OPEN SP~CE TRACTS
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FRE PROTECTION REO~tOD RURAL FIRE PROTECTION DISTRICT
PROJECT AREA SUMMARY
LOWER BRIDGE ROAD LLC PLANNED DEVELOPMENT TENTA TVE PLAN
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PROPOSED fRlvnE ROADS RJTEiT10N AREAS RlGHTQF-WAY AREA
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TENTA TlVE SUBDIVISION PLAN A SUBDIVISION OF PARCELS 2 AND 3 OF MINOR PARTITION MP-80-96
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LOWER BRIDGE ROAD LLC LOWER BRIDGE PLANNED DEVELOPMENT
RIMROCK AND SETBACK EXHIBIT MAP
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TYPICAL ON-SITE SEWAGE DISPOSAL
NOTES
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MINIMUM REQUIRED SEPARATION IS 10
MINIMUM REQUIRED SEPARATIOl IS 100 (IfSl
MfNlMUM SIDE YARD SETBACKS ARE 20 (7W+ SETBACK SHOWN)
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Lower Bridge Road Residential Development Dust Control Plan
Construction Demoition Excavation Extraction and Other Earthmoving Activities require the owner or operator of a construction project to submit a Dust Control Plan to the Lower Bridge Road Subdivision Homeowners Association (LBR HOA) if at any time the project involves
Residential development Subdivision infrastructure construction andor Moving depositing or relocating of more than 10 cubic yards of bulk native soil or imported fill materials
A Dust Control Plan identifies the fugitive dust sources at the construction site and describes all of the dust control measures to be implemented before during and after any dust generating activity for the duration of the project The LBR HOA will review and approve conditionally approve or disapprove the Dust Control Plan within 30 days of submittal Construction activities shall not commence until the Dust Control Plan has been approved or conditionally approved An owner or operator must aliso provide written notification to the LBR HOA via fax email or mail within 10 days prior to the commencement of earthmoving activities A copy of the approved Dust Control Plan must be retained at the project site and made available upon request by LBR HOA Oregon Department of Environmental Ouamy (DEO) or Deschutes County representatives
Regardless of whether a HOA-approved Dust Control Plan is in place or not the owner or operator is required to comply with all requirements of applicable DEQ and Deschutes County Rules and Regulations at all times
Submit the Dust Control Plan to the LBR HOA office listed below
Lower Bridge Road Homeowners Association PO Box TBO Terrebonne OR 97XXX Phone Number (541) XXX-XXXX Email address FAX Number (541) XXX-XXXX
6291 5 NE 181h SL Ste 1 Bend OR 97701 pi 5413824707 f 154138381 18 wallacegroup-inccom
Exhibit A-5 Page 1 of 13
Dust Control Plan Section 1- General Information - Page 1
1-A Project Name and Location
Project Name
ProjectAddress
City
Section(s) County
Township
Range
Expected ConstructionStart Date End Date
1-8 Contacts
Report the names addresses and phone numbers of persons and owners or operators responsible for the preparation submittal and implementation of the Dust Control Plan and responsible for the dust generating operation and dust control applications I
Property Owner - shy ~ ( ~ j
Address
City State Zip ~ - Phone ~ Email ~
~- Developer ~ I - -)
Address V ~~ ~ ~
City State Zip
Contact Person - ~ )1 gt
V _
Phone Email ~ shy - shy
General Contractor c --~
Address -
City State Zip ~
Contact Person
Phone Email
This Dust Control Plan was prepared by
Name Title
Company Name
Address
City State Zip
Phone Email
o I would like additional information about opportunities to reduce water usage on the project site
62915 NE 18 St Sle 1 Bend OR 97701 P I 54 13824707 f I 541383 811 8 wal lacegroup-inccom
Exhibit A-5 Page 2 of 13
Section 1 - General Information - Page 2
Project Name
1-C Contractors
Provide the names addresses and phone numbers of the contractors involved in dust generating activities or performing dust control as part of this project
1
2 (
3 )
J -c 4 ~ -shy -~~
1-0 Who will have the primary responsibility for implementIng this Dust Control Plan
D Property Owner D Developer D GeneralPrime
D Sub-Contractor(s) D Other J --shy- )
Primary Project Contact -~ v
Title ( - ~
Company Name --shy Address ~
~
City State Zip ~ c -1
On-Site Phone - ~ Fax
Mobile Phone Emai
- - j
1-E Provide a brief description of the projects operations
62 15 NE 18 St Ste I Bend OR 9770 1 P 154 13824 707 f I 5413838 11 8 wa llacegroLlp-inccom
Exhibit A-5 Page 3 of 13
Dust Control Plan Section 2-Plot Plan - Page 1
Project Name
2-A Plot Plan
A plot plan identifies the type and location of each project Attach appropriately sized maps with the project boundaries outlined or use the space in sections 2-B or 2-C to draw a plot plan Attached maps may include tract maps site maps and topographic maps Use the checklist below to make sure all areas have been identified on the I t Ian
Identify the relative locations of actual and potential sources of fugitive dust emissions
Bulk material handling and storage areas
Paved and unpaved access roads haul roads traffic areas and equipment
storage yards Exit points where carryout and tracks onto paved public
roads may occur Water supply locations if water application will be used for controlling visible dust emissions Other
2-B Draw Plot Plan (if one is not attached) Include a North Arrow
Plot plan is attached (Skip to 3-A)
62915 NE 18rn St Sle 1 Bend OR 97701 P 1541 3824707 f 1541 383 8118 wallacegroup-inccom
Exhibit A-5 Page 4 of 13
Dust Control Plan Section 3 - Fugitive Sources - Page 1
Project Name
3-A Disturbed Surface Area
Report the total area of land surface to be disturbed the estimates daily throughput volume of earthmoving in cubic yards and the total area inacres ofthe entire project site
Total area of land surface to be disturbed Acres
Daily maximum throughput volume of earthmoving Cubic Yards
Daily average throughput volume of earthmoving Cubic Yards
Total area of entire project site Acres
Total disturbed areas that will be left inactive for more than seven days shy Acres ~
3-8 Dust Generating Activity Dates ( ~ ~
The expected start and completion dates of dust generating activities and soil disturbance activities to be performed on site For phased projects it may be necessary to report expected start and completion dates separately
Expected start date ~~
Completion Date
Phase ProjectStart-A -
Completion-A
Phase Project Start shy B ~ Completion- B J
Phase Project Start- C Completion -C
t I ~V L
62915 NE 181h Sl Ste 1 Bend OR 97701 P I 541 ~382470 7 f 154 138381 18 wallacegroup-inccom
Exhibit A-5 Page 5 of 13
Section 3 - Fugitive Sources - Page 2
Project Name
3-C Sources of Fugitive Dust
This section describes the minimum requirements for limiting visible dust emissions from activities that cause fugitive dust emissions Check at least one box under each category
Structu raiD e m olition
No demolitions are planned for this project
Asbestos NESHAP notification and fees have been submitted to the I-()l
Water will be applied to the following areas for the duration of the demolition activities bull 8uilding exteriorsurfaces bull Unpaved surface areas where equipment will operate bull Razed building materials and bull Water or dust suppressants will be applied to unpaved surface areas within 100 feet of
structure during demolition
Pre-Activity
Not applicable for this project (Please explain why in Section 3-E)
The site will be pre-watered and work will be phased to reduce the amount of disturbed surface area at anyone time (Complete Section 4-A)
Active Operations Water will be applied to dry areas during leveling grading trenching and earthmoving activities (Complete Section 4-A) Wind barriers will be constructed and maintained and water or dust suppressants will be applied to the disturbed surface areas (Complete Sections 4-A or 4-8 and 4-C)
Inactive Operations including after work hours weekends and holidays
Not applicable for this project (Please explain why in Section 3-E) Water or dust suppressants wiU be applied on disturbed surface areas to form a visible crust and vehicle access will be restricted to maintain the visible crust (Complete Section 4shyA or 4-8 and 4-C)
Temporary stabilization of areas that remains unused for seven or more days Not applicable for this project (Please explain why in Section3-E)
Vehicular access will be restricted and water or dust suppressants will be applied and maintained at all un- vegetated areas (Complete Section 4-A or 4-8 and4-C) Vegetation will be reestablished on all previously disturbed areas (Complete Section 4shy
C) Gravel will be applied and maintained at all previously disturbed areas (Complete
Section 4-C) Previously disturbed areas will be paved (Complete Section 4-C)
Unpaved Access and Haul Roads Traffic and Equipment Storage Areas Not applicable for this project (Please explain why in Section3-E)
Apply water or dust suppressants to unpaved haul and access roads (Complete Section 4-A or4-8) Water or dust suppressants will be applied to vehicle traffic and equipment storage areas (Complete Section 4-A or4-8)
62915 NE 181h SL Ste 1 Bend OR 97701 P I 5413824707 t I 5413838118 wallacegroup-inccom
Exhibit A-5 Page 6 of 13
Section 3 - Fugitive Sources - Page 3
3-D Bulk Materials
Outdoor Handling of Bulk Materials
No bulk materials will be handled during this
project
Water or dust suppressants will be applied when handling bulk materials Wind barriers with less than 50 percent porosity will be installed and maintained and water or dust suppressants will be applied
Outdoor Storage of Bulk Materials
No bulk materials will be stored during this project
Water or dust suppressants will be applied to storage piles Storage piles will be covered with tarps plastic or other suitable material and anchored in such a manner that prevents the cover from being removed by wind action A three-sided structure laquo 50 porosity) will be used that is at least as high as the storage piles
On-Site Transporting of Bulk Materials
No bulk materials will be transported on the project site
Vehicle speed will be limited on the work site All haul trucks will be loaded such that the freeboard is not less than six inches when transported across any paved public access road A sufficient amount of water will be applied to the top of the load to limit visible dust
emissions Haul trucks will be covered with a tarp or other suitable cover
Off-Site Transporting of Bulk Materials No bulk materials will be transported to or from the project site
The following practices wi be performed (complete Section 5-8) o The ipterior of emptied truck cargo compartments will be cleaned or covered before leaving
the site o Spillage or loss of bulk materials from holes or other openings in the cargo compartments
floor sides and tailgates will be prevented o Haul trucks will be covered with a tarp or other suitable cover or will be loaded such that the
freeboard is not less than six inches when transported on any paved public access road to or from the project site and a sufficient amount of water will be applied to the top of the load to limit visible dust emissions
Outdoor Transport using a Chute or Conveyor
No chutes or conveyors will be used
Ch ute orconveyorwill befully enclosed
Water spray equipment will be used to sufficiently wet the materials
Transported materials will be washed or screened to remove fines (PM1 0 or smaller)
3-E Comments
62915 NE 18 th St Ste 1 Bend OR 97701 P 154 13824707 1 1541383 8118 wallacegroup-inc com
Exhibit A-5 Page 7 of 13
Section4- DustControl Methods-Page 1
Project Name
4-A Water Application
Complete this section if water application will be used as a control method for limiting visible dust emissions and stabilizing surface areas Check and answer everything that applies to the project
Water Application Equipment
Sprinklers Describe the activities that will utilize sprinklers
Minimum treated area Square FeetAcres
Maximum treated area Square FeetAcres
Minimum waterflow rate ____Gallonsminute Duration ____-=-----shy_____
Water Truck Water Trailer Water Wagon Other __
Describe the activities that will utilize this equipment
Number of application equipment available
poundpplication equipmentcapacity
Water Supply Include the relative locations of these sources on the plot plan in Section 2
Fire hydrants
Number of hydrants available On-Site____ Off-Site____
Approval granted by the owner or public agency to use their fire hydrants for this
project
Owner or Agency
Contact
Storage tanks Number and capacity
______Wells
Phone No
Number andflow rate
Approval granted by the owner or public agency to use their water source for this project
Owner or Agency
Contact ______________Phone No
629 15 NE 18fh St Ste 1 Bend OR 97701 p i 541 3824707 f 154 1383811 8 wallacegroup-inccom
Exhibit A-5 Page 8 of 13
Section 4 - Dust Control Methods- Page 2
Project Name
4-8 Dust Suppressant Products
Complete this section if a dust suppressant product will be used These materials include but are not limited to hygroscopic suppressants (road salts) adhesives petroleum emulsions polymer emulsions and bituminous materials (road oils)
Coov this oaae if more than QrrELdust suoore-SSantoroduct will bpoundLused
D Not Applicable Only water application will be the control method used Skip t04-C
Application Area shy
Product Name ( Contractors Name
) ~ Phone No
Application Rate Gallons of undiluted material per mile or acre treated
Application Frequency Applicationsperweek month year ~
Application Equipment
Number of Application Equipment Available gtj
Application EquipmentCapacity Attach each of the following information that fully describes this product Use the checklist below to make sure all information is submitted with this plan
Product Specifications (MSDS Product Safety Data Sheet etc)
Manufacturers Usage Instructions (method frequency and intensity of application) Env~ronmental impacts and approvals or certifications related to the appropriate and safe use for qround appJication
62915 NE 18111 St Ste 1 Bend OR 97701 pi 541 3824707 f 154 13838118 wallacegroup-inccom
Exhibit A-5 Page 9 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
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LOCAL PRIVA TE ROADS TYPICAL SECTON
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PROJECT AREA SUMMARY
LOWER BRIDGE ROAD LLC PLANNED DEVELOPMENT TENTA TVE PLAN
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TENTA TlVE SUBDIVISION PLAN A SUBDIVISION OF PARCELS 2 AND 3 OF MINOR PARTITION MP-80-96
PLANNED DEVELOPMENT SCHUTH
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Exhibit A-2 Page 1 of 1
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Exhibit A-3 Page 1 of 2
LOWER BRIDGE ROAD LLC LOWER BRIDGE PLANNED DEVELOPMENT
RIMROCK AND SETBACK EXHIBIT MAP
LEGEND
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NOTES
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MINIMUM REQUIRED SEPARATION IS 10
MINIMUM REQUIRED SEPARATIOl IS 100 (IfSl
MfNlMUM SIDE YARD SETBACKS ARE 20 (7W+ SETBACK SHOWN)
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Lower Bridge Road Residential Development Dust Control Plan
Construction Demoition Excavation Extraction and Other Earthmoving Activities require the owner or operator of a construction project to submit a Dust Control Plan to the Lower Bridge Road Subdivision Homeowners Association (LBR HOA) if at any time the project involves
Residential development Subdivision infrastructure construction andor Moving depositing or relocating of more than 10 cubic yards of bulk native soil or imported fill materials
A Dust Control Plan identifies the fugitive dust sources at the construction site and describes all of the dust control measures to be implemented before during and after any dust generating activity for the duration of the project The LBR HOA will review and approve conditionally approve or disapprove the Dust Control Plan within 30 days of submittal Construction activities shall not commence until the Dust Control Plan has been approved or conditionally approved An owner or operator must aliso provide written notification to the LBR HOA via fax email or mail within 10 days prior to the commencement of earthmoving activities A copy of the approved Dust Control Plan must be retained at the project site and made available upon request by LBR HOA Oregon Department of Environmental Ouamy (DEO) or Deschutes County representatives
Regardless of whether a HOA-approved Dust Control Plan is in place or not the owner or operator is required to comply with all requirements of applicable DEQ and Deschutes County Rules and Regulations at all times
Submit the Dust Control Plan to the LBR HOA office listed below
Lower Bridge Road Homeowners Association PO Box TBO Terrebonne OR 97XXX Phone Number (541) XXX-XXXX Email address FAX Number (541) XXX-XXXX
6291 5 NE 181h SL Ste 1 Bend OR 97701 pi 5413824707 f 154138381 18 wallacegroup-inccom
Exhibit A-5 Page 1 of 13
Dust Control Plan Section 1- General Information - Page 1
1-A Project Name and Location
Project Name
ProjectAddress
City
Section(s) County
Township
Range
Expected ConstructionStart Date End Date
1-8 Contacts
Report the names addresses and phone numbers of persons and owners or operators responsible for the preparation submittal and implementation of the Dust Control Plan and responsible for the dust generating operation and dust control applications I
Property Owner - shy ~ ( ~ j
Address
City State Zip ~ - Phone ~ Email ~
~- Developer ~ I - -)
Address V ~~ ~ ~
City State Zip
Contact Person - ~ )1 gt
V _
Phone Email ~ shy - shy
General Contractor c --~
Address -
City State Zip ~
Contact Person
Phone Email
This Dust Control Plan was prepared by
Name Title
Company Name
Address
City State Zip
Phone Email
o I would like additional information about opportunities to reduce water usage on the project site
62915 NE 18 St Sle 1 Bend OR 97701 P I 54 13824707 f I 541383 811 8 wal lacegroup-inccom
Exhibit A-5 Page 2 of 13
Section 1 - General Information - Page 2
Project Name
1-C Contractors
Provide the names addresses and phone numbers of the contractors involved in dust generating activities or performing dust control as part of this project
1
2 (
3 )
J -c 4 ~ -shy -~~
1-0 Who will have the primary responsibility for implementIng this Dust Control Plan
D Property Owner D Developer D GeneralPrime
D Sub-Contractor(s) D Other J --shy- )
Primary Project Contact -~ v
Title ( - ~
Company Name --shy Address ~
~
City State Zip ~ c -1
On-Site Phone - ~ Fax
Mobile Phone Emai
- - j
1-E Provide a brief description of the projects operations
62 15 NE 18 St Ste I Bend OR 9770 1 P 154 13824 707 f I 5413838 11 8 wa llacegroLlp-inccom
Exhibit A-5 Page 3 of 13
Dust Control Plan Section 2-Plot Plan - Page 1
Project Name
2-A Plot Plan
A plot plan identifies the type and location of each project Attach appropriately sized maps with the project boundaries outlined or use the space in sections 2-B or 2-C to draw a plot plan Attached maps may include tract maps site maps and topographic maps Use the checklist below to make sure all areas have been identified on the I t Ian
Identify the relative locations of actual and potential sources of fugitive dust emissions
Bulk material handling and storage areas
Paved and unpaved access roads haul roads traffic areas and equipment
storage yards Exit points where carryout and tracks onto paved public
roads may occur Water supply locations if water application will be used for controlling visible dust emissions Other
2-B Draw Plot Plan (if one is not attached) Include a North Arrow
Plot plan is attached (Skip to 3-A)
62915 NE 18rn St Sle 1 Bend OR 97701 P 1541 3824707 f 1541 383 8118 wallacegroup-inccom
Exhibit A-5 Page 4 of 13
Dust Control Plan Section 3 - Fugitive Sources - Page 1
Project Name
3-A Disturbed Surface Area
Report the total area of land surface to be disturbed the estimates daily throughput volume of earthmoving in cubic yards and the total area inacres ofthe entire project site
Total area of land surface to be disturbed Acres
Daily maximum throughput volume of earthmoving Cubic Yards
Daily average throughput volume of earthmoving Cubic Yards
Total area of entire project site Acres
Total disturbed areas that will be left inactive for more than seven days shy Acres ~
3-8 Dust Generating Activity Dates ( ~ ~
The expected start and completion dates of dust generating activities and soil disturbance activities to be performed on site For phased projects it may be necessary to report expected start and completion dates separately
Expected start date ~~
Completion Date
Phase ProjectStart-A -
Completion-A
Phase Project Start shy B ~ Completion- B J
Phase Project Start- C Completion -C
t I ~V L
62915 NE 181h Sl Ste 1 Bend OR 97701 P I 541 ~382470 7 f 154 138381 18 wallacegroup-inccom
Exhibit A-5 Page 5 of 13
Section 3 - Fugitive Sources - Page 2
Project Name
3-C Sources of Fugitive Dust
This section describes the minimum requirements for limiting visible dust emissions from activities that cause fugitive dust emissions Check at least one box under each category
Structu raiD e m olition
No demolitions are planned for this project
Asbestos NESHAP notification and fees have been submitted to the I-()l
Water will be applied to the following areas for the duration of the demolition activities bull 8uilding exteriorsurfaces bull Unpaved surface areas where equipment will operate bull Razed building materials and bull Water or dust suppressants will be applied to unpaved surface areas within 100 feet of
structure during demolition
Pre-Activity
Not applicable for this project (Please explain why in Section 3-E)
The site will be pre-watered and work will be phased to reduce the amount of disturbed surface area at anyone time (Complete Section 4-A)
Active Operations Water will be applied to dry areas during leveling grading trenching and earthmoving activities (Complete Section 4-A) Wind barriers will be constructed and maintained and water or dust suppressants will be applied to the disturbed surface areas (Complete Sections 4-A or 4-8 and 4-C)
Inactive Operations including after work hours weekends and holidays
Not applicable for this project (Please explain why in Section 3-E) Water or dust suppressants wiU be applied on disturbed surface areas to form a visible crust and vehicle access will be restricted to maintain the visible crust (Complete Section 4shyA or 4-8 and 4-C)
Temporary stabilization of areas that remains unused for seven or more days Not applicable for this project (Please explain why in Section3-E)
Vehicular access will be restricted and water or dust suppressants will be applied and maintained at all un- vegetated areas (Complete Section 4-A or 4-8 and4-C) Vegetation will be reestablished on all previously disturbed areas (Complete Section 4shy
C) Gravel will be applied and maintained at all previously disturbed areas (Complete
Section 4-C) Previously disturbed areas will be paved (Complete Section 4-C)
Unpaved Access and Haul Roads Traffic and Equipment Storage Areas Not applicable for this project (Please explain why in Section3-E)
Apply water or dust suppressants to unpaved haul and access roads (Complete Section 4-A or4-8) Water or dust suppressants will be applied to vehicle traffic and equipment storage areas (Complete Section 4-A or4-8)
62915 NE 181h SL Ste 1 Bend OR 97701 P I 5413824707 t I 5413838118 wallacegroup-inccom
Exhibit A-5 Page 6 of 13
Section 3 - Fugitive Sources - Page 3
3-D Bulk Materials
Outdoor Handling of Bulk Materials
No bulk materials will be handled during this
project
Water or dust suppressants will be applied when handling bulk materials Wind barriers with less than 50 percent porosity will be installed and maintained and water or dust suppressants will be applied
Outdoor Storage of Bulk Materials
No bulk materials will be stored during this project
Water or dust suppressants will be applied to storage piles Storage piles will be covered with tarps plastic or other suitable material and anchored in such a manner that prevents the cover from being removed by wind action A three-sided structure laquo 50 porosity) will be used that is at least as high as the storage piles
On-Site Transporting of Bulk Materials
No bulk materials will be transported on the project site
Vehicle speed will be limited on the work site All haul trucks will be loaded such that the freeboard is not less than six inches when transported across any paved public access road A sufficient amount of water will be applied to the top of the load to limit visible dust
emissions Haul trucks will be covered with a tarp or other suitable cover
Off-Site Transporting of Bulk Materials No bulk materials will be transported to or from the project site
The following practices wi be performed (complete Section 5-8) o The ipterior of emptied truck cargo compartments will be cleaned or covered before leaving
the site o Spillage or loss of bulk materials from holes or other openings in the cargo compartments
floor sides and tailgates will be prevented o Haul trucks will be covered with a tarp or other suitable cover or will be loaded such that the
freeboard is not less than six inches when transported on any paved public access road to or from the project site and a sufficient amount of water will be applied to the top of the load to limit visible dust emissions
Outdoor Transport using a Chute or Conveyor
No chutes or conveyors will be used
Ch ute orconveyorwill befully enclosed
Water spray equipment will be used to sufficiently wet the materials
Transported materials will be washed or screened to remove fines (PM1 0 or smaller)
3-E Comments
62915 NE 18 th St Ste 1 Bend OR 97701 P 154 13824707 1 1541383 8118 wallacegroup-inc com
Exhibit A-5 Page 7 of 13
Section4- DustControl Methods-Page 1
Project Name
4-A Water Application
Complete this section if water application will be used as a control method for limiting visible dust emissions and stabilizing surface areas Check and answer everything that applies to the project
Water Application Equipment
Sprinklers Describe the activities that will utilize sprinklers
Minimum treated area Square FeetAcres
Maximum treated area Square FeetAcres
Minimum waterflow rate ____Gallonsminute Duration ____-=-----shy_____
Water Truck Water Trailer Water Wagon Other __
Describe the activities that will utilize this equipment
Number of application equipment available
poundpplication equipmentcapacity
Water Supply Include the relative locations of these sources on the plot plan in Section 2
Fire hydrants
Number of hydrants available On-Site____ Off-Site____
Approval granted by the owner or public agency to use their fire hydrants for this
project
Owner or Agency
Contact
Storage tanks Number and capacity
______Wells
Phone No
Number andflow rate
Approval granted by the owner or public agency to use their water source for this project
Owner or Agency
Contact ______________Phone No
629 15 NE 18fh St Ste 1 Bend OR 97701 p i 541 3824707 f 154 1383811 8 wallacegroup-inccom
Exhibit A-5 Page 8 of 13
Section 4 - Dust Control Methods- Page 2
Project Name
4-8 Dust Suppressant Products
Complete this section if a dust suppressant product will be used These materials include but are not limited to hygroscopic suppressants (road salts) adhesives petroleum emulsions polymer emulsions and bituminous materials (road oils)
Coov this oaae if more than QrrELdust suoore-SSantoroduct will bpoundLused
D Not Applicable Only water application will be the control method used Skip t04-C
Application Area shy
Product Name ( Contractors Name
) ~ Phone No
Application Rate Gallons of undiluted material per mile or acre treated
Application Frequency Applicationsperweek month year ~
Application Equipment
Number of Application Equipment Available gtj
Application EquipmentCapacity Attach each of the following information that fully describes this product Use the checklist below to make sure all information is submitted with this plan
Product Specifications (MSDS Product Safety Data Sheet etc)
Manufacturers Usage Instructions (method frequency and intensity of application) Env~ronmental impacts and approvals or certifications related to the appropriate and safe use for qround appJication
62915 NE 18111 St Ste 1 Bend OR 97701 pi 541 3824707 f 154 13838118 wallacegroup-inccom
Exhibit A-5 Page 9 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
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LOWER BRIDGE ROAD LLC dLOWER BRIDGE PLANNED DEVELOPMENT or OF DESCHUTES COUNTY FLOOD PLAIN ZON
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Exhibit A-2 Page 1 of 1
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Exhibit A-3 Page 1 of 2
LOWER BRIDGE ROAD LLC LOWER BRIDGE PLANNED DEVELOPMENT
RIMROCK AND SETBACK EXHIBIT MAP
LEGEND
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Exhibit A-3 Page 2 of 2
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TYPICAL ON-SITE SEWAGE DISPOSAL
NOTES
6 amp amp
MINIMUM REQUIRED SEPARATION IS 10
MINIMUM REQUIRED SEPARATIOl IS 100 (IfSl
MfNlMUM SIDE YARD SETBACKS ARE 20 (7W+ SETBACK SHOWN)
~ -~~
40
--shy
TYPICAL ON-SITE SEWAGE DISPOSAL SU8SURFACE
~Ntshyoe( 0 bull - IeCl)JC)gtlt CUWa
(20 SHOWN TO PROPERTY LINE 15 TO PUE)
SEPARATION SHOWN)
APPROXIMATE LIMITS OF EXISTING RI M ROCK OlITRCOPPfNGS (OR SLOPES GREATER THAN 45deg) AN]) CORRESPONDING 5u RJMROCK SETBACK LIMITS
SCALE 0 20 40 80
~ ( FEET )
Ishy(E
1 INCH =40 FT
~ 00JJ
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SU8SURFACE e ~ampl~g ~ U I1lA8S0RP nON FIELD
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rYPICAl ON - SIrE SEWAGE DISPOSAL SUBSURFACE REPlACEMENr AREA
FT~( MINIMUM REQUIRED SEPARATION IS 100 ( 120 SEPARATION SHOWN)
I rYPICAl ON - Si rE SEWAGE I ~DISPOSAL SUBSURFACE MINIMUM SIDE YARD SETBACKS ARE 20I I ABSORPriON FIELD (60plusmn SETBACK S HO~)
I 5 PUE
1-1 I JPPROXIMATE LIMITS OF EXISTING RIMROCK OUTRCO PPrNGS (OR
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-5-~
(~r~I 20 I I ) SLOPES GREATER THAN 45) AND CORRESPONDING 50 RIMROCK
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Lower Bridge Road Residential Development Dust Control Plan
Construction Demoition Excavation Extraction and Other Earthmoving Activities require the owner or operator of a construction project to submit a Dust Control Plan to the Lower Bridge Road Subdivision Homeowners Association (LBR HOA) if at any time the project involves
Residential development Subdivision infrastructure construction andor Moving depositing or relocating of more than 10 cubic yards of bulk native soil or imported fill materials
A Dust Control Plan identifies the fugitive dust sources at the construction site and describes all of the dust control measures to be implemented before during and after any dust generating activity for the duration of the project The LBR HOA will review and approve conditionally approve or disapprove the Dust Control Plan within 30 days of submittal Construction activities shall not commence until the Dust Control Plan has been approved or conditionally approved An owner or operator must aliso provide written notification to the LBR HOA via fax email or mail within 10 days prior to the commencement of earthmoving activities A copy of the approved Dust Control Plan must be retained at the project site and made available upon request by LBR HOA Oregon Department of Environmental Ouamy (DEO) or Deschutes County representatives
Regardless of whether a HOA-approved Dust Control Plan is in place or not the owner or operator is required to comply with all requirements of applicable DEQ and Deschutes County Rules and Regulations at all times
Submit the Dust Control Plan to the LBR HOA office listed below
Lower Bridge Road Homeowners Association PO Box TBO Terrebonne OR 97XXX Phone Number (541) XXX-XXXX Email address FAX Number (541) XXX-XXXX
6291 5 NE 181h SL Ste 1 Bend OR 97701 pi 5413824707 f 154138381 18 wallacegroup-inccom
Exhibit A-5 Page 1 of 13
Dust Control Plan Section 1- General Information - Page 1
1-A Project Name and Location
Project Name
ProjectAddress
City
Section(s) County
Township
Range
Expected ConstructionStart Date End Date
1-8 Contacts
Report the names addresses and phone numbers of persons and owners or operators responsible for the preparation submittal and implementation of the Dust Control Plan and responsible for the dust generating operation and dust control applications I
Property Owner - shy ~ ( ~ j
Address
City State Zip ~ - Phone ~ Email ~
~- Developer ~ I - -)
Address V ~~ ~ ~
City State Zip
Contact Person - ~ )1 gt
V _
Phone Email ~ shy - shy
General Contractor c --~
Address -
City State Zip ~
Contact Person
Phone Email
This Dust Control Plan was prepared by
Name Title
Company Name
Address
City State Zip
Phone Email
o I would like additional information about opportunities to reduce water usage on the project site
62915 NE 18 St Sle 1 Bend OR 97701 P I 54 13824707 f I 541383 811 8 wal lacegroup-inccom
Exhibit A-5 Page 2 of 13
Section 1 - General Information - Page 2
Project Name
1-C Contractors
Provide the names addresses and phone numbers of the contractors involved in dust generating activities or performing dust control as part of this project
1
2 (
3 )
J -c 4 ~ -shy -~~
1-0 Who will have the primary responsibility for implementIng this Dust Control Plan
D Property Owner D Developer D GeneralPrime
D Sub-Contractor(s) D Other J --shy- )
Primary Project Contact -~ v
Title ( - ~
Company Name --shy Address ~
~
City State Zip ~ c -1
On-Site Phone - ~ Fax
Mobile Phone Emai
- - j
1-E Provide a brief description of the projects operations
62 15 NE 18 St Ste I Bend OR 9770 1 P 154 13824 707 f I 5413838 11 8 wa llacegroLlp-inccom
Exhibit A-5 Page 3 of 13
Dust Control Plan Section 2-Plot Plan - Page 1
Project Name
2-A Plot Plan
A plot plan identifies the type and location of each project Attach appropriately sized maps with the project boundaries outlined or use the space in sections 2-B or 2-C to draw a plot plan Attached maps may include tract maps site maps and topographic maps Use the checklist below to make sure all areas have been identified on the I t Ian
Identify the relative locations of actual and potential sources of fugitive dust emissions
Bulk material handling and storage areas
Paved and unpaved access roads haul roads traffic areas and equipment
storage yards Exit points where carryout and tracks onto paved public
roads may occur Water supply locations if water application will be used for controlling visible dust emissions Other
2-B Draw Plot Plan (if one is not attached) Include a North Arrow
Plot plan is attached (Skip to 3-A)
62915 NE 18rn St Sle 1 Bend OR 97701 P 1541 3824707 f 1541 383 8118 wallacegroup-inccom
Exhibit A-5 Page 4 of 13
Dust Control Plan Section 3 - Fugitive Sources - Page 1
Project Name
3-A Disturbed Surface Area
Report the total area of land surface to be disturbed the estimates daily throughput volume of earthmoving in cubic yards and the total area inacres ofthe entire project site
Total area of land surface to be disturbed Acres
Daily maximum throughput volume of earthmoving Cubic Yards
Daily average throughput volume of earthmoving Cubic Yards
Total area of entire project site Acres
Total disturbed areas that will be left inactive for more than seven days shy Acres ~
3-8 Dust Generating Activity Dates ( ~ ~
The expected start and completion dates of dust generating activities and soil disturbance activities to be performed on site For phased projects it may be necessary to report expected start and completion dates separately
Expected start date ~~
Completion Date
Phase ProjectStart-A -
Completion-A
Phase Project Start shy B ~ Completion- B J
Phase Project Start- C Completion -C
t I ~V L
62915 NE 181h Sl Ste 1 Bend OR 97701 P I 541 ~382470 7 f 154 138381 18 wallacegroup-inccom
Exhibit A-5 Page 5 of 13
Section 3 - Fugitive Sources - Page 2
Project Name
3-C Sources of Fugitive Dust
This section describes the minimum requirements for limiting visible dust emissions from activities that cause fugitive dust emissions Check at least one box under each category
Structu raiD e m olition
No demolitions are planned for this project
Asbestos NESHAP notification and fees have been submitted to the I-()l
Water will be applied to the following areas for the duration of the demolition activities bull 8uilding exteriorsurfaces bull Unpaved surface areas where equipment will operate bull Razed building materials and bull Water or dust suppressants will be applied to unpaved surface areas within 100 feet of
structure during demolition
Pre-Activity
Not applicable for this project (Please explain why in Section 3-E)
The site will be pre-watered and work will be phased to reduce the amount of disturbed surface area at anyone time (Complete Section 4-A)
Active Operations Water will be applied to dry areas during leveling grading trenching and earthmoving activities (Complete Section 4-A) Wind barriers will be constructed and maintained and water or dust suppressants will be applied to the disturbed surface areas (Complete Sections 4-A or 4-8 and 4-C)
Inactive Operations including after work hours weekends and holidays
Not applicable for this project (Please explain why in Section 3-E) Water or dust suppressants wiU be applied on disturbed surface areas to form a visible crust and vehicle access will be restricted to maintain the visible crust (Complete Section 4shyA or 4-8 and 4-C)
Temporary stabilization of areas that remains unused for seven or more days Not applicable for this project (Please explain why in Section3-E)
Vehicular access will be restricted and water or dust suppressants will be applied and maintained at all un- vegetated areas (Complete Section 4-A or 4-8 and4-C) Vegetation will be reestablished on all previously disturbed areas (Complete Section 4shy
C) Gravel will be applied and maintained at all previously disturbed areas (Complete
Section 4-C) Previously disturbed areas will be paved (Complete Section 4-C)
Unpaved Access and Haul Roads Traffic and Equipment Storage Areas Not applicable for this project (Please explain why in Section3-E)
Apply water or dust suppressants to unpaved haul and access roads (Complete Section 4-A or4-8) Water or dust suppressants will be applied to vehicle traffic and equipment storage areas (Complete Section 4-A or4-8)
62915 NE 181h SL Ste 1 Bend OR 97701 P I 5413824707 t I 5413838118 wallacegroup-inccom
Exhibit A-5 Page 6 of 13
Section 3 - Fugitive Sources - Page 3
3-D Bulk Materials
Outdoor Handling of Bulk Materials
No bulk materials will be handled during this
project
Water or dust suppressants will be applied when handling bulk materials Wind barriers with less than 50 percent porosity will be installed and maintained and water or dust suppressants will be applied
Outdoor Storage of Bulk Materials
No bulk materials will be stored during this project
Water or dust suppressants will be applied to storage piles Storage piles will be covered with tarps plastic or other suitable material and anchored in such a manner that prevents the cover from being removed by wind action A three-sided structure laquo 50 porosity) will be used that is at least as high as the storage piles
On-Site Transporting of Bulk Materials
No bulk materials will be transported on the project site
Vehicle speed will be limited on the work site All haul trucks will be loaded such that the freeboard is not less than six inches when transported across any paved public access road A sufficient amount of water will be applied to the top of the load to limit visible dust
emissions Haul trucks will be covered with a tarp or other suitable cover
Off-Site Transporting of Bulk Materials No bulk materials will be transported to or from the project site
The following practices wi be performed (complete Section 5-8) o The ipterior of emptied truck cargo compartments will be cleaned or covered before leaving
the site o Spillage or loss of bulk materials from holes or other openings in the cargo compartments
floor sides and tailgates will be prevented o Haul trucks will be covered with a tarp or other suitable cover or will be loaded such that the
freeboard is not less than six inches when transported on any paved public access road to or from the project site and a sufficient amount of water will be applied to the top of the load to limit visible dust emissions
Outdoor Transport using a Chute or Conveyor
No chutes or conveyors will be used
Ch ute orconveyorwill befully enclosed
Water spray equipment will be used to sufficiently wet the materials
Transported materials will be washed or screened to remove fines (PM1 0 or smaller)
3-E Comments
62915 NE 18 th St Ste 1 Bend OR 97701 P 154 13824707 1 1541383 8118 wallacegroup-inc com
Exhibit A-5 Page 7 of 13
Section4- DustControl Methods-Page 1
Project Name
4-A Water Application
Complete this section if water application will be used as a control method for limiting visible dust emissions and stabilizing surface areas Check and answer everything that applies to the project
Water Application Equipment
Sprinklers Describe the activities that will utilize sprinklers
Minimum treated area Square FeetAcres
Maximum treated area Square FeetAcres
Minimum waterflow rate ____Gallonsminute Duration ____-=-----shy_____
Water Truck Water Trailer Water Wagon Other __
Describe the activities that will utilize this equipment
Number of application equipment available
poundpplication equipmentcapacity
Water Supply Include the relative locations of these sources on the plot plan in Section 2
Fire hydrants
Number of hydrants available On-Site____ Off-Site____
Approval granted by the owner or public agency to use their fire hydrants for this
project
Owner or Agency
Contact
Storage tanks Number and capacity
______Wells
Phone No
Number andflow rate
Approval granted by the owner or public agency to use their water source for this project
Owner or Agency
Contact ______________Phone No
629 15 NE 18fh St Ste 1 Bend OR 97701 p i 541 3824707 f 154 1383811 8 wallacegroup-inccom
Exhibit A-5 Page 8 of 13
Section 4 - Dust Control Methods- Page 2
Project Name
4-8 Dust Suppressant Products
Complete this section if a dust suppressant product will be used These materials include but are not limited to hygroscopic suppressants (road salts) adhesives petroleum emulsions polymer emulsions and bituminous materials (road oils)
Coov this oaae if more than QrrELdust suoore-SSantoroduct will bpoundLused
D Not Applicable Only water application will be the control method used Skip t04-C
Application Area shy
Product Name ( Contractors Name
) ~ Phone No
Application Rate Gallons of undiluted material per mile or acre treated
Application Frequency Applicationsperweek month year ~
Application Equipment
Number of Application Equipment Available gtj
Application EquipmentCapacity Attach each of the following information that fully describes this product Use the checklist below to make sure all information is submitted with this plan
Product Specifications (MSDS Product Safety Data Sheet etc)
Manufacturers Usage Instructions (method frequency and intensity of application) Env~ronmental impacts and approvals or certifications related to the appropriate and safe use for qround appJication
62915 NE 18111 St Ste 1 Bend OR 97701 pi 541 3824707 f 154 13838118 wallacegroup-inccom
Exhibit A-5 Page 9 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
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h=~- (Mj [ L-~o l LOWER BRIDGE PLANNED DEVELOPMENT Jll~ ~J~ _ ~ RIMROCK AND SETBACK EXHIBIT MAP m- -- I I_-+-tltlft I IA0t5n~o) Dtl 00 QIIItCQIf
middot0 11 1
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Exhibit A-3 Page 1 of 2
LOWER BRIDGE ROAD LLC LOWER BRIDGE PLANNED DEVELOPMENT
RIMROCK AND SETBACK EXHIBIT MAP
LEGEND
l ~-0 -
~IIO-tl cJI1Il1 ~-n)lNJI1 IiOJI1N~I JIf
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Exhibit A-3 Page 2 of 2
~ Qa CIl
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~
TYPICAL ON-SITE SEWAGE DISPOSAL
NOTES
6 amp amp
MINIMUM REQUIRED SEPARATION IS 10
MINIMUM REQUIRED SEPARATIOl IS 100 (IfSl
MfNlMUM SIDE YARD SETBACKS ARE 20 (7W+ SETBACK SHOWN)
~ -~~
40
--shy
TYPICAL ON-SITE SEWAGE DISPOSAL SU8SURFACE
~Ntshyoe( 0 bull - IeCl)JC)gtlt CUWa
(20 SHOWN TO PROPERTY LINE 15 TO PUE)
SEPARATION SHOWN)
APPROXIMATE LIMITS OF EXISTING RI M ROCK OlITRCOPPfNGS (OR SLOPES GREATER THAN 45deg) AN]) CORRESPONDING 5u RJMROCK SETBACK LIMITS
SCALE 0 20 40 80
~ ( FEET )
Ishy(E
1 INCH =40 FT
~ 00JJ
JlUa ltllU oa eta ~ lU lU ltt 0 ~~I-- gtshy9 5 0 5et U J Ishy~ -eshy ~ lU 0~ J ~ a J- (3o et shyJ co uI ffi ~ 8 ~ ~ 0J
~ ~~ ~~~ ~
~ ~ ~~g~ (3 ~ c b ~ ~ ~
SU8SURFACE e ~ampl~g ~ U I1lA8S0RP nON FIELD
~ tgt
REPLACEMENT AREA oc or V)
Q lt0 ~
~ ~ lt
112 I~ 1 ~ ~ ~
II ~ ~I ~ I
I 1 I
- -
I
rYPICAl ON - SIrE SEWAGE DISPOSAL SUBSURFACE REPlACEMENr AREA
FT~( MINIMUM REQUIRED SEPARATION IS 100 ( 120 SEPARATION SHOWN)
I rYPICAl ON - Si rE SEWAGE I ~DISPOSAL SUBSURFACE MINIMUM SIDE YARD SETBACKS ARE 20I I ABSORPriON FIELD (60plusmn SETBACK S HO~)
I 5 PUE
1-1 I JPPROXIMATE LIMITS OF EXISTING RIMROCK OUTRCO PPrNGS (OR
I
-5-~
(~r~I 20 I I ) SLOPES GREATER THAN 45) AND CORRESPONDING 50 RIMROCK
8 I +--1101-shy I I I Ittr rli
I I I I I IPOrENTlAl l
REPLACEMENTI t I AREA I I I I I I I I I
I I I TII 1 If I I ~~~~
sectamp
------POrENriAlI EXEMPT PRIVA rE II fER WEll lOCA n ON
25
--- (
- PROPOSEDI
I PROPERry PROPOSED -----LINE LOr LINE I
)1 6
13 ~6~ I f A(middot~ - shy
SFTBACK I1 MITS
IRACT c OPEN SPACE
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Lower Bridge Road Residential Development Dust Control Plan
Construction Demoition Excavation Extraction and Other Earthmoving Activities require the owner or operator of a construction project to submit a Dust Control Plan to the Lower Bridge Road Subdivision Homeowners Association (LBR HOA) if at any time the project involves
Residential development Subdivision infrastructure construction andor Moving depositing or relocating of more than 10 cubic yards of bulk native soil or imported fill materials
A Dust Control Plan identifies the fugitive dust sources at the construction site and describes all of the dust control measures to be implemented before during and after any dust generating activity for the duration of the project The LBR HOA will review and approve conditionally approve or disapprove the Dust Control Plan within 30 days of submittal Construction activities shall not commence until the Dust Control Plan has been approved or conditionally approved An owner or operator must aliso provide written notification to the LBR HOA via fax email or mail within 10 days prior to the commencement of earthmoving activities A copy of the approved Dust Control Plan must be retained at the project site and made available upon request by LBR HOA Oregon Department of Environmental Ouamy (DEO) or Deschutes County representatives
Regardless of whether a HOA-approved Dust Control Plan is in place or not the owner or operator is required to comply with all requirements of applicable DEQ and Deschutes County Rules and Regulations at all times
Submit the Dust Control Plan to the LBR HOA office listed below
Lower Bridge Road Homeowners Association PO Box TBO Terrebonne OR 97XXX Phone Number (541) XXX-XXXX Email address FAX Number (541) XXX-XXXX
6291 5 NE 181h SL Ste 1 Bend OR 97701 pi 5413824707 f 154138381 18 wallacegroup-inccom
Exhibit A-5 Page 1 of 13
Dust Control Plan Section 1- General Information - Page 1
1-A Project Name and Location
Project Name
ProjectAddress
City
Section(s) County
Township
Range
Expected ConstructionStart Date End Date
1-8 Contacts
Report the names addresses and phone numbers of persons and owners or operators responsible for the preparation submittal and implementation of the Dust Control Plan and responsible for the dust generating operation and dust control applications I
Property Owner - shy ~ ( ~ j
Address
City State Zip ~ - Phone ~ Email ~
~- Developer ~ I - -)
Address V ~~ ~ ~
City State Zip
Contact Person - ~ )1 gt
V _
Phone Email ~ shy - shy
General Contractor c --~
Address -
City State Zip ~
Contact Person
Phone Email
This Dust Control Plan was prepared by
Name Title
Company Name
Address
City State Zip
Phone Email
o I would like additional information about opportunities to reduce water usage on the project site
62915 NE 18 St Sle 1 Bend OR 97701 P I 54 13824707 f I 541383 811 8 wal lacegroup-inccom
Exhibit A-5 Page 2 of 13
Section 1 - General Information - Page 2
Project Name
1-C Contractors
Provide the names addresses and phone numbers of the contractors involved in dust generating activities or performing dust control as part of this project
1
2 (
3 )
J -c 4 ~ -shy -~~
1-0 Who will have the primary responsibility for implementIng this Dust Control Plan
D Property Owner D Developer D GeneralPrime
D Sub-Contractor(s) D Other J --shy- )
Primary Project Contact -~ v
Title ( - ~
Company Name --shy Address ~
~
City State Zip ~ c -1
On-Site Phone - ~ Fax
Mobile Phone Emai
- - j
1-E Provide a brief description of the projects operations
62 15 NE 18 St Ste I Bend OR 9770 1 P 154 13824 707 f I 5413838 11 8 wa llacegroLlp-inccom
Exhibit A-5 Page 3 of 13
Dust Control Plan Section 2-Plot Plan - Page 1
Project Name
2-A Plot Plan
A plot plan identifies the type and location of each project Attach appropriately sized maps with the project boundaries outlined or use the space in sections 2-B or 2-C to draw a plot plan Attached maps may include tract maps site maps and topographic maps Use the checklist below to make sure all areas have been identified on the I t Ian
Identify the relative locations of actual and potential sources of fugitive dust emissions
Bulk material handling and storage areas
Paved and unpaved access roads haul roads traffic areas and equipment
storage yards Exit points where carryout and tracks onto paved public
roads may occur Water supply locations if water application will be used for controlling visible dust emissions Other
2-B Draw Plot Plan (if one is not attached) Include a North Arrow
Plot plan is attached (Skip to 3-A)
62915 NE 18rn St Sle 1 Bend OR 97701 P 1541 3824707 f 1541 383 8118 wallacegroup-inccom
Exhibit A-5 Page 4 of 13
Dust Control Plan Section 3 - Fugitive Sources - Page 1
Project Name
3-A Disturbed Surface Area
Report the total area of land surface to be disturbed the estimates daily throughput volume of earthmoving in cubic yards and the total area inacres ofthe entire project site
Total area of land surface to be disturbed Acres
Daily maximum throughput volume of earthmoving Cubic Yards
Daily average throughput volume of earthmoving Cubic Yards
Total area of entire project site Acres
Total disturbed areas that will be left inactive for more than seven days shy Acres ~
3-8 Dust Generating Activity Dates ( ~ ~
The expected start and completion dates of dust generating activities and soil disturbance activities to be performed on site For phased projects it may be necessary to report expected start and completion dates separately
Expected start date ~~
Completion Date
Phase ProjectStart-A -
Completion-A
Phase Project Start shy B ~ Completion- B J
Phase Project Start- C Completion -C
t I ~V L
62915 NE 181h Sl Ste 1 Bend OR 97701 P I 541 ~382470 7 f 154 138381 18 wallacegroup-inccom
Exhibit A-5 Page 5 of 13
Section 3 - Fugitive Sources - Page 2
Project Name
3-C Sources of Fugitive Dust
This section describes the minimum requirements for limiting visible dust emissions from activities that cause fugitive dust emissions Check at least one box under each category
Structu raiD e m olition
No demolitions are planned for this project
Asbestos NESHAP notification and fees have been submitted to the I-()l
Water will be applied to the following areas for the duration of the demolition activities bull 8uilding exteriorsurfaces bull Unpaved surface areas where equipment will operate bull Razed building materials and bull Water or dust suppressants will be applied to unpaved surface areas within 100 feet of
structure during demolition
Pre-Activity
Not applicable for this project (Please explain why in Section 3-E)
The site will be pre-watered and work will be phased to reduce the amount of disturbed surface area at anyone time (Complete Section 4-A)
Active Operations Water will be applied to dry areas during leveling grading trenching and earthmoving activities (Complete Section 4-A) Wind barriers will be constructed and maintained and water or dust suppressants will be applied to the disturbed surface areas (Complete Sections 4-A or 4-8 and 4-C)
Inactive Operations including after work hours weekends and holidays
Not applicable for this project (Please explain why in Section 3-E) Water or dust suppressants wiU be applied on disturbed surface areas to form a visible crust and vehicle access will be restricted to maintain the visible crust (Complete Section 4shyA or 4-8 and 4-C)
Temporary stabilization of areas that remains unused for seven or more days Not applicable for this project (Please explain why in Section3-E)
Vehicular access will be restricted and water or dust suppressants will be applied and maintained at all un- vegetated areas (Complete Section 4-A or 4-8 and4-C) Vegetation will be reestablished on all previously disturbed areas (Complete Section 4shy
C) Gravel will be applied and maintained at all previously disturbed areas (Complete
Section 4-C) Previously disturbed areas will be paved (Complete Section 4-C)
Unpaved Access and Haul Roads Traffic and Equipment Storage Areas Not applicable for this project (Please explain why in Section3-E)
Apply water or dust suppressants to unpaved haul and access roads (Complete Section 4-A or4-8) Water or dust suppressants will be applied to vehicle traffic and equipment storage areas (Complete Section 4-A or4-8)
62915 NE 181h SL Ste 1 Bend OR 97701 P I 5413824707 t I 5413838118 wallacegroup-inccom
Exhibit A-5 Page 6 of 13
Section 3 - Fugitive Sources - Page 3
3-D Bulk Materials
Outdoor Handling of Bulk Materials
No bulk materials will be handled during this
project
Water or dust suppressants will be applied when handling bulk materials Wind barriers with less than 50 percent porosity will be installed and maintained and water or dust suppressants will be applied
Outdoor Storage of Bulk Materials
No bulk materials will be stored during this project
Water or dust suppressants will be applied to storage piles Storage piles will be covered with tarps plastic or other suitable material and anchored in such a manner that prevents the cover from being removed by wind action A three-sided structure laquo 50 porosity) will be used that is at least as high as the storage piles
On-Site Transporting of Bulk Materials
No bulk materials will be transported on the project site
Vehicle speed will be limited on the work site All haul trucks will be loaded such that the freeboard is not less than six inches when transported across any paved public access road A sufficient amount of water will be applied to the top of the load to limit visible dust
emissions Haul trucks will be covered with a tarp or other suitable cover
Off-Site Transporting of Bulk Materials No bulk materials will be transported to or from the project site
The following practices wi be performed (complete Section 5-8) o The ipterior of emptied truck cargo compartments will be cleaned or covered before leaving
the site o Spillage or loss of bulk materials from holes or other openings in the cargo compartments
floor sides and tailgates will be prevented o Haul trucks will be covered with a tarp or other suitable cover or will be loaded such that the
freeboard is not less than six inches when transported on any paved public access road to or from the project site and a sufficient amount of water will be applied to the top of the load to limit visible dust emissions
Outdoor Transport using a Chute or Conveyor
No chutes or conveyors will be used
Ch ute orconveyorwill befully enclosed
Water spray equipment will be used to sufficiently wet the materials
Transported materials will be washed or screened to remove fines (PM1 0 or smaller)
3-E Comments
62915 NE 18 th St Ste 1 Bend OR 97701 P 154 13824707 1 1541383 8118 wallacegroup-inc com
Exhibit A-5 Page 7 of 13
Section4- DustControl Methods-Page 1
Project Name
4-A Water Application
Complete this section if water application will be used as a control method for limiting visible dust emissions and stabilizing surface areas Check and answer everything that applies to the project
Water Application Equipment
Sprinklers Describe the activities that will utilize sprinklers
Minimum treated area Square FeetAcres
Maximum treated area Square FeetAcres
Minimum waterflow rate ____Gallonsminute Duration ____-=-----shy_____
Water Truck Water Trailer Water Wagon Other __
Describe the activities that will utilize this equipment
Number of application equipment available
poundpplication equipmentcapacity
Water Supply Include the relative locations of these sources on the plot plan in Section 2
Fire hydrants
Number of hydrants available On-Site____ Off-Site____
Approval granted by the owner or public agency to use their fire hydrants for this
project
Owner or Agency
Contact
Storage tanks Number and capacity
______Wells
Phone No
Number andflow rate
Approval granted by the owner or public agency to use their water source for this project
Owner or Agency
Contact ______________Phone No
629 15 NE 18fh St Ste 1 Bend OR 97701 p i 541 3824707 f 154 1383811 8 wallacegroup-inccom
Exhibit A-5 Page 8 of 13
Section 4 - Dust Control Methods- Page 2
Project Name
4-8 Dust Suppressant Products
Complete this section if a dust suppressant product will be used These materials include but are not limited to hygroscopic suppressants (road salts) adhesives petroleum emulsions polymer emulsions and bituminous materials (road oils)
Coov this oaae if more than QrrELdust suoore-SSantoroduct will bpoundLused
D Not Applicable Only water application will be the control method used Skip t04-C
Application Area shy
Product Name ( Contractors Name
) ~ Phone No
Application Rate Gallons of undiluted material per mile or acre treated
Application Frequency Applicationsperweek month year ~
Application Equipment
Number of Application Equipment Available gtj
Application EquipmentCapacity Attach each of the following information that fully describes this product Use the checklist below to make sure all information is submitted with this plan
Product Specifications (MSDS Product Safety Data Sheet etc)
Manufacturers Usage Instructions (method frequency and intensity of application) Env~ronmental impacts and approvals or certifications related to the appropriate and safe use for qround appJication
62915 NE 18111 St Ste 1 Bend OR 97701 pi 541 3824707 f 154 13838118 wallacegroup-inccom
Exhibit A-5 Page 9 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
LOWER BRIDGE ROAD LLC LOWER BRIDGE PLANNED DEVELOPMENT
RIMROCK AND SETBACK EXHIBIT MAP
LEGEND
l ~-0 -
~IIO-tl cJI1Il1 ~-n)lNJI1 IiOJI1N~I JIf
1lDJIIiO I~~ lQ~ fwN __ bullbull AIJQolk-vnmiddot
PoG~_ UIr Nltftl UlwoWl II~ I IIII1~
l-uwn ~
~lUTIIU)lfj1i-aurJIII 4IIlYOXrt~~ ~GUT1Itn lUlC Y1)
~-m bullbull ~ ~UMm
_ I
Exhibit A-3 Page 2 of 2
~ Qa CIl
~ ~ CIl
~
TYPICAL ON-SITE SEWAGE DISPOSAL
NOTES
6 amp amp
MINIMUM REQUIRED SEPARATION IS 10
MINIMUM REQUIRED SEPARATIOl IS 100 (IfSl
MfNlMUM SIDE YARD SETBACKS ARE 20 (7W+ SETBACK SHOWN)
~ -~~
40
--shy
TYPICAL ON-SITE SEWAGE DISPOSAL SU8SURFACE
~Ntshyoe( 0 bull - IeCl)JC)gtlt CUWa
(20 SHOWN TO PROPERTY LINE 15 TO PUE)
SEPARATION SHOWN)
APPROXIMATE LIMITS OF EXISTING RI M ROCK OlITRCOPPfNGS (OR SLOPES GREATER THAN 45deg) AN]) CORRESPONDING 5u RJMROCK SETBACK LIMITS
SCALE 0 20 40 80
~ ( FEET )
Ishy(E
1 INCH =40 FT
~ 00JJ
JlUa ltllU oa eta ~ lU lU ltt 0 ~~I-- gtshy9 5 0 5et U J Ishy~ -eshy ~ lU 0~ J ~ a J- (3o et shyJ co uI ffi ~ 8 ~ ~ 0J
~ ~~ ~~~ ~
~ ~ ~~g~ (3 ~ c b ~ ~ ~
SU8SURFACE e ~ampl~g ~ U I1lA8S0RP nON FIELD
~ tgt
REPLACEMENT AREA oc or V)
Q lt0 ~
~ ~ lt
112 I~ 1 ~ ~ ~
II ~ ~I ~ I
I 1 I
- -
I
rYPICAl ON - SIrE SEWAGE DISPOSAL SUBSURFACE REPlACEMENr AREA
FT~( MINIMUM REQUIRED SEPARATION IS 100 ( 120 SEPARATION SHOWN)
I rYPICAl ON - Si rE SEWAGE I ~DISPOSAL SUBSURFACE MINIMUM SIDE YARD SETBACKS ARE 20I I ABSORPriON FIELD (60plusmn SETBACK S HO~)
I 5 PUE
1-1 I JPPROXIMATE LIMITS OF EXISTING RIMROCK OUTRCO PPrNGS (OR
I
-5-~
(~r~I 20 I I ) SLOPES GREATER THAN 45) AND CORRESPONDING 50 RIMROCK
8 I +--1101-shy I I I Ittr rli
I I I I I IPOrENTlAl l
REPLACEMENTI t I AREA I I I I I I I I I
I I I TII 1 If I I ~~~~
sectamp
------POrENriAlI EXEMPT PRIVA rE II fER WEll lOCA n ON
25
--- (
- PROPOSEDI
I PROPERry PROPOSED -----LINE LOr LINE I
)1 6
13 ~6~ I f A(middot~ - shy
SFTBACK I1 MITS
IRACT c OPEN SPACE
~ ~n ~I _ ~
EIIOBQJlIfI
~ tgt tJ
~ I shy2 UJ
~ a~ I shy0-() 0 iii
j ul J ~ a -JI Q it Gl d Q
ctQCjJ I- ~ ~
UJ ~ -- ~ tgt
()21- S ~ 9 SOlshy ctll-J 0 a to UJ - ct () - ~ Q laquo
- ()o ct a - ~ ~ 0 c ~ 0 - 0
- u deg I ~ ~ ltXl Q
~ ~ ~~ ~~i - 8 ~~~g~
~ i o~ q G ~ ~ 1u ltq QlIJ lII Q
Q Q Jocc l o c oq u Q
( SHpoundpoundI 1 of 1
I
~ ~
wallaceGROUP
Lower Bridge Road Residential Development Dust Control Plan
Construction Demoition Excavation Extraction and Other Earthmoving Activities require the owner or operator of a construction project to submit a Dust Control Plan to the Lower Bridge Road Subdivision Homeowners Association (LBR HOA) if at any time the project involves
Residential development Subdivision infrastructure construction andor Moving depositing or relocating of more than 10 cubic yards of bulk native soil or imported fill materials
A Dust Control Plan identifies the fugitive dust sources at the construction site and describes all of the dust control measures to be implemented before during and after any dust generating activity for the duration of the project The LBR HOA will review and approve conditionally approve or disapprove the Dust Control Plan within 30 days of submittal Construction activities shall not commence until the Dust Control Plan has been approved or conditionally approved An owner or operator must aliso provide written notification to the LBR HOA via fax email or mail within 10 days prior to the commencement of earthmoving activities A copy of the approved Dust Control Plan must be retained at the project site and made available upon request by LBR HOA Oregon Department of Environmental Ouamy (DEO) or Deschutes County representatives
Regardless of whether a HOA-approved Dust Control Plan is in place or not the owner or operator is required to comply with all requirements of applicable DEQ and Deschutes County Rules and Regulations at all times
Submit the Dust Control Plan to the LBR HOA office listed below
Lower Bridge Road Homeowners Association PO Box TBO Terrebonne OR 97XXX Phone Number (541) XXX-XXXX Email address FAX Number (541) XXX-XXXX
6291 5 NE 181h SL Ste 1 Bend OR 97701 pi 5413824707 f 154138381 18 wallacegroup-inccom
Exhibit A-5 Page 1 of 13
Dust Control Plan Section 1- General Information - Page 1
1-A Project Name and Location
Project Name
ProjectAddress
City
Section(s) County
Township
Range
Expected ConstructionStart Date End Date
1-8 Contacts
Report the names addresses and phone numbers of persons and owners or operators responsible for the preparation submittal and implementation of the Dust Control Plan and responsible for the dust generating operation and dust control applications I
Property Owner - shy ~ ( ~ j
Address
City State Zip ~ - Phone ~ Email ~
~- Developer ~ I - -)
Address V ~~ ~ ~
City State Zip
Contact Person - ~ )1 gt
V _
Phone Email ~ shy - shy
General Contractor c --~
Address -
City State Zip ~
Contact Person
Phone Email
This Dust Control Plan was prepared by
Name Title
Company Name
Address
City State Zip
Phone Email
o I would like additional information about opportunities to reduce water usage on the project site
62915 NE 18 St Sle 1 Bend OR 97701 P I 54 13824707 f I 541383 811 8 wal lacegroup-inccom
Exhibit A-5 Page 2 of 13
Section 1 - General Information - Page 2
Project Name
1-C Contractors
Provide the names addresses and phone numbers of the contractors involved in dust generating activities or performing dust control as part of this project
1
2 (
3 )
J -c 4 ~ -shy -~~
1-0 Who will have the primary responsibility for implementIng this Dust Control Plan
D Property Owner D Developer D GeneralPrime
D Sub-Contractor(s) D Other J --shy- )
Primary Project Contact -~ v
Title ( - ~
Company Name --shy Address ~
~
City State Zip ~ c -1
On-Site Phone - ~ Fax
Mobile Phone Emai
- - j
1-E Provide a brief description of the projects operations
62 15 NE 18 St Ste I Bend OR 9770 1 P 154 13824 707 f I 5413838 11 8 wa llacegroLlp-inccom
Exhibit A-5 Page 3 of 13
Dust Control Plan Section 2-Plot Plan - Page 1
Project Name
2-A Plot Plan
A plot plan identifies the type and location of each project Attach appropriately sized maps with the project boundaries outlined or use the space in sections 2-B or 2-C to draw a plot plan Attached maps may include tract maps site maps and topographic maps Use the checklist below to make sure all areas have been identified on the I t Ian
Identify the relative locations of actual and potential sources of fugitive dust emissions
Bulk material handling and storage areas
Paved and unpaved access roads haul roads traffic areas and equipment
storage yards Exit points where carryout and tracks onto paved public
roads may occur Water supply locations if water application will be used for controlling visible dust emissions Other
2-B Draw Plot Plan (if one is not attached) Include a North Arrow
Plot plan is attached (Skip to 3-A)
62915 NE 18rn St Sle 1 Bend OR 97701 P 1541 3824707 f 1541 383 8118 wallacegroup-inccom
Exhibit A-5 Page 4 of 13
Dust Control Plan Section 3 - Fugitive Sources - Page 1
Project Name
3-A Disturbed Surface Area
Report the total area of land surface to be disturbed the estimates daily throughput volume of earthmoving in cubic yards and the total area inacres ofthe entire project site
Total area of land surface to be disturbed Acres
Daily maximum throughput volume of earthmoving Cubic Yards
Daily average throughput volume of earthmoving Cubic Yards
Total area of entire project site Acres
Total disturbed areas that will be left inactive for more than seven days shy Acres ~
3-8 Dust Generating Activity Dates ( ~ ~
The expected start and completion dates of dust generating activities and soil disturbance activities to be performed on site For phased projects it may be necessary to report expected start and completion dates separately
Expected start date ~~
Completion Date
Phase ProjectStart-A -
Completion-A
Phase Project Start shy B ~ Completion- B J
Phase Project Start- C Completion -C
t I ~V L
62915 NE 181h Sl Ste 1 Bend OR 97701 P I 541 ~382470 7 f 154 138381 18 wallacegroup-inccom
Exhibit A-5 Page 5 of 13
Section 3 - Fugitive Sources - Page 2
Project Name
3-C Sources of Fugitive Dust
This section describes the minimum requirements for limiting visible dust emissions from activities that cause fugitive dust emissions Check at least one box under each category
Structu raiD e m olition
No demolitions are planned for this project
Asbestos NESHAP notification and fees have been submitted to the I-()l
Water will be applied to the following areas for the duration of the demolition activities bull 8uilding exteriorsurfaces bull Unpaved surface areas where equipment will operate bull Razed building materials and bull Water or dust suppressants will be applied to unpaved surface areas within 100 feet of
structure during demolition
Pre-Activity
Not applicable for this project (Please explain why in Section 3-E)
The site will be pre-watered and work will be phased to reduce the amount of disturbed surface area at anyone time (Complete Section 4-A)
Active Operations Water will be applied to dry areas during leveling grading trenching and earthmoving activities (Complete Section 4-A) Wind barriers will be constructed and maintained and water or dust suppressants will be applied to the disturbed surface areas (Complete Sections 4-A or 4-8 and 4-C)
Inactive Operations including after work hours weekends and holidays
Not applicable for this project (Please explain why in Section 3-E) Water or dust suppressants wiU be applied on disturbed surface areas to form a visible crust and vehicle access will be restricted to maintain the visible crust (Complete Section 4shyA or 4-8 and 4-C)
Temporary stabilization of areas that remains unused for seven or more days Not applicable for this project (Please explain why in Section3-E)
Vehicular access will be restricted and water or dust suppressants will be applied and maintained at all un- vegetated areas (Complete Section 4-A or 4-8 and4-C) Vegetation will be reestablished on all previously disturbed areas (Complete Section 4shy
C) Gravel will be applied and maintained at all previously disturbed areas (Complete
Section 4-C) Previously disturbed areas will be paved (Complete Section 4-C)
Unpaved Access and Haul Roads Traffic and Equipment Storage Areas Not applicable for this project (Please explain why in Section3-E)
Apply water or dust suppressants to unpaved haul and access roads (Complete Section 4-A or4-8) Water or dust suppressants will be applied to vehicle traffic and equipment storage areas (Complete Section 4-A or4-8)
62915 NE 181h SL Ste 1 Bend OR 97701 P I 5413824707 t I 5413838118 wallacegroup-inccom
Exhibit A-5 Page 6 of 13
Section 3 - Fugitive Sources - Page 3
3-D Bulk Materials
Outdoor Handling of Bulk Materials
No bulk materials will be handled during this
project
Water or dust suppressants will be applied when handling bulk materials Wind barriers with less than 50 percent porosity will be installed and maintained and water or dust suppressants will be applied
Outdoor Storage of Bulk Materials
No bulk materials will be stored during this project
Water or dust suppressants will be applied to storage piles Storage piles will be covered with tarps plastic or other suitable material and anchored in such a manner that prevents the cover from being removed by wind action A three-sided structure laquo 50 porosity) will be used that is at least as high as the storage piles
On-Site Transporting of Bulk Materials
No bulk materials will be transported on the project site
Vehicle speed will be limited on the work site All haul trucks will be loaded such that the freeboard is not less than six inches when transported across any paved public access road A sufficient amount of water will be applied to the top of the load to limit visible dust
emissions Haul trucks will be covered with a tarp or other suitable cover
Off-Site Transporting of Bulk Materials No bulk materials will be transported to or from the project site
The following practices wi be performed (complete Section 5-8) o The ipterior of emptied truck cargo compartments will be cleaned or covered before leaving
the site o Spillage or loss of bulk materials from holes or other openings in the cargo compartments
floor sides and tailgates will be prevented o Haul trucks will be covered with a tarp or other suitable cover or will be loaded such that the
freeboard is not less than six inches when transported on any paved public access road to or from the project site and a sufficient amount of water will be applied to the top of the load to limit visible dust emissions
Outdoor Transport using a Chute or Conveyor
No chutes or conveyors will be used
Ch ute orconveyorwill befully enclosed
Water spray equipment will be used to sufficiently wet the materials
Transported materials will be washed or screened to remove fines (PM1 0 or smaller)
3-E Comments
62915 NE 18 th St Ste 1 Bend OR 97701 P 154 13824707 1 1541383 8118 wallacegroup-inc com
Exhibit A-5 Page 7 of 13
Section4- DustControl Methods-Page 1
Project Name
4-A Water Application
Complete this section if water application will be used as a control method for limiting visible dust emissions and stabilizing surface areas Check and answer everything that applies to the project
Water Application Equipment
Sprinklers Describe the activities that will utilize sprinklers
Minimum treated area Square FeetAcres
Maximum treated area Square FeetAcres
Minimum waterflow rate ____Gallonsminute Duration ____-=-----shy_____
Water Truck Water Trailer Water Wagon Other __
Describe the activities that will utilize this equipment
Number of application equipment available
poundpplication equipmentcapacity
Water Supply Include the relative locations of these sources on the plot plan in Section 2
Fire hydrants
Number of hydrants available On-Site____ Off-Site____
Approval granted by the owner or public agency to use their fire hydrants for this
project
Owner or Agency
Contact
Storage tanks Number and capacity
______Wells
Phone No
Number andflow rate
Approval granted by the owner or public agency to use their water source for this project
Owner or Agency
Contact ______________Phone No
629 15 NE 18fh St Ste 1 Bend OR 97701 p i 541 3824707 f 154 1383811 8 wallacegroup-inccom
Exhibit A-5 Page 8 of 13
Section 4 - Dust Control Methods- Page 2
Project Name
4-8 Dust Suppressant Products
Complete this section if a dust suppressant product will be used These materials include but are not limited to hygroscopic suppressants (road salts) adhesives petroleum emulsions polymer emulsions and bituminous materials (road oils)
Coov this oaae if more than QrrELdust suoore-SSantoroduct will bpoundLused
D Not Applicable Only water application will be the control method used Skip t04-C
Application Area shy
Product Name ( Contractors Name
) ~ Phone No
Application Rate Gallons of undiluted material per mile or acre treated
Application Frequency Applicationsperweek month year ~
Application Equipment
Number of Application Equipment Available gtj
Application EquipmentCapacity Attach each of the following information that fully describes this product Use the checklist below to make sure all information is submitted with this plan
Product Specifications (MSDS Product Safety Data Sheet etc)
Manufacturers Usage Instructions (method frequency and intensity of application) Env~ronmental impacts and approvals or certifications related to the appropriate and safe use for qround appJication
62915 NE 18111 St Ste 1 Bend OR 97701 pi 541 3824707 f 154 13838118 wallacegroup-inccom
Exhibit A-5 Page 9 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
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TYPICAL ON-SITE SEWAGE DISPOSAL
NOTES
6 amp amp
MINIMUM REQUIRED SEPARATION IS 10
MINIMUM REQUIRED SEPARATIOl IS 100 (IfSl
MfNlMUM SIDE YARD SETBACKS ARE 20 (7W+ SETBACK SHOWN)
~ -~~
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TYPICAL ON-SITE SEWAGE DISPOSAL SU8SURFACE
~Ntshyoe( 0 bull - IeCl)JC)gtlt CUWa
(20 SHOWN TO PROPERTY LINE 15 TO PUE)
SEPARATION SHOWN)
APPROXIMATE LIMITS OF EXISTING RI M ROCK OlITRCOPPfNGS (OR SLOPES GREATER THAN 45deg) AN]) CORRESPONDING 5u RJMROCK SETBACK LIMITS
SCALE 0 20 40 80
~ ( FEET )
Ishy(E
1 INCH =40 FT
~ 00JJ
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SU8SURFACE e ~ampl~g ~ U I1lA8S0RP nON FIELD
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rYPICAl ON - SIrE SEWAGE DISPOSAL SUBSURFACE REPlACEMENr AREA
FT~( MINIMUM REQUIRED SEPARATION IS 100 ( 120 SEPARATION SHOWN)
I rYPICAl ON - Si rE SEWAGE I ~DISPOSAL SUBSURFACE MINIMUM SIDE YARD SETBACKS ARE 20I I ABSORPriON FIELD (60plusmn SETBACK S HO~)
I 5 PUE
1-1 I JPPROXIMATE LIMITS OF EXISTING RIMROCK OUTRCO PPrNGS (OR
I
-5-~
(~r~I 20 I I ) SLOPES GREATER THAN 45) AND CORRESPONDING 50 RIMROCK
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REPLACEMENTI t I AREA I I I I I I I I I
I I I TII 1 If I I ~~~~
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------POrENriAlI EXEMPT PRIVA rE II fER WEll lOCA n ON
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Lower Bridge Road Residential Development Dust Control Plan
Construction Demoition Excavation Extraction and Other Earthmoving Activities require the owner or operator of a construction project to submit a Dust Control Plan to the Lower Bridge Road Subdivision Homeowners Association (LBR HOA) if at any time the project involves
Residential development Subdivision infrastructure construction andor Moving depositing or relocating of more than 10 cubic yards of bulk native soil or imported fill materials
A Dust Control Plan identifies the fugitive dust sources at the construction site and describes all of the dust control measures to be implemented before during and after any dust generating activity for the duration of the project The LBR HOA will review and approve conditionally approve or disapprove the Dust Control Plan within 30 days of submittal Construction activities shall not commence until the Dust Control Plan has been approved or conditionally approved An owner or operator must aliso provide written notification to the LBR HOA via fax email or mail within 10 days prior to the commencement of earthmoving activities A copy of the approved Dust Control Plan must be retained at the project site and made available upon request by LBR HOA Oregon Department of Environmental Ouamy (DEO) or Deschutes County representatives
Regardless of whether a HOA-approved Dust Control Plan is in place or not the owner or operator is required to comply with all requirements of applicable DEQ and Deschutes County Rules and Regulations at all times
Submit the Dust Control Plan to the LBR HOA office listed below
Lower Bridge Road Homeowners Association PO Box TBO Terrebonne OR 97XXX Phone Number (541) XXX-XXXX Email address FAX Number (541) XXX-XXXX
6291 5 NE 181h SL Ste 1 Bend OR 97701 pi 5413824707 f 154138381 18 wallacegroup-inccom
Exhibit A-5 Page 1 of 13
Dust Control Plan Section 1- General Information - Page 1
1-A Project Name and Location
Project Name
ProjectAddress
City
Section(s) County
Township
Range
Expected ConstructionStart Date End Date
1-8 Contacts
Report the names addresses and phone numbers of persons and owners or operators responsible for the preparation submittal and implementation of the Dust Control Plan and responsible for the dust generating operation and dust control applications I
Property Owner - shy ~ ( ~ j
Address
City State Zip ~ - Phone ~ Email ~
~- Developer ~ I - -)
Address V ~~ ~ ~
City State Zip
Contact Person - ~ )1 gt
V _
Phone Email ~ shy - shy
General Contractor c --~
Address -
City State Zip ~
Contact Person
Phone Email
This Dust Control Plan was prepared by
Name Title
Company Name
Address
City State Zip
Phone Email
o I would like additional information about opportunities to reduce water usage on the project site
62915 NE 18 St Sle 1 Bend OR 97701 P I 54 13824707 f I 541383 811 8 wal lacegroup-inccom
Exhibit A-5 Page 2 of 13
Section 1 - General Information - Page 2
Project Name
1-C Contractors
Provide the names addresses and phone numbers of the contractors involved in dust generating activities or performing dust control as part of this project
1
2 (
3 )
J -c 4 ~ -shy -~~
1-0 Who will have the primary responsibility for implementIng this Dust Control Plan
D Property Owner D Developer D GeneralPrime
D Sub-Contractor(s) D Other J --shy- )
Primary Project Contact -~ v
Title ( - ~
Company Name --shy Address ~
~
City State Zip ~ c -1
On-Site Phone - ~ Fax
Mobile Phone Emai
- - j
1-E Provide a brief description of the projects operations
62 15 NE 18 St Ste I Bend OR 9770 1 P 154 13824 707 f I 5413838 11 8 wa llacegroLlp-inccom
Exhibit A-5 Page 3 of 13
Dust Control Plan Section 2-Plot Plan - Page 1
Project Name
2-A Plot Plan
A plot plan identifies the type and location of each project Attach appropriately sized maps with the project boundaries outlined or use the space in sections 2-B or 2-C to draw a plot plan Attached maps may include tract maps site maps and topographic maps Use the checklist below to make sure all areas have been identified on the I t Ian
Identify the relative locations of actual and potential sources of fugitive dust emissions
Bulk material handling and storage areas
Paved and unpaved access roads haul roads traffic areas and equipment
storage yards Exit points where carryout and tracks onto paved public
roads may occur Water supply locations if water application will be used for controlling visible dust emissions Other
2-B Draw Plot Plan (if one is not attached) Include a North Arrow
Plot plan is attached (Skip to 3-A)
62915 NE 18rn St Sle 1 Bend OR 97701 P 1541 3824707 f 1541 383 8118 wallacegroup-inccom
Exhibit A-5 Page 4 of 13
Dust Control Plan Section 3 - Fugitive Sources - Page 1
Project Name
3-A Disturbed Surface Area
Report the total area of land surface to be disturbed the estimates daily throughput volume of earthmoving in cubic yards and the total area inacres ofthe entire project site
Total area of land surface to be disturbed Acres
Daily maximum throughput volume of earthmoving Cubic Yards
Daily average throughput volume of earthmoving Cubic Yards
Total area of entire project site Acres
Total disturbed areas that will be left inactive for more than seven days shy Acres ~
3-8 Dust Generating Activity Dates ( ~ ~
The expected start and completion dates of dust generating activities and soil disturbance activities to be performed on site For phased projects it may be necessary to report expected start and completion dates separately
Expected start date ~~
Completion Date
Phase ProjectStart-A -
Completion-A
Phase Project Start shy B ~ Completion- B J
Phase Project Start- C Completion -C
t I ~V L
62915 NE 181h Sl Ste 1 Bend OR 97701 P I 541 ~382470 7 f 154 138381 18 wallacegroup-inccom
Exhibit A-5 Page 5 of 13
Section 3 - Fugitive Sources - Page 2
Project Name
3-C Sources of Fugitive Dust
This section describes the minimum requirements for limiting visible dust emissions from activities that cause fugitive dust emissions Check at least one box under each category
Structu raiD e m olition
No demolitions are planned for this project
Asbestos NESHAP notification and fees have been submitted to the I-()l
Water will be applied to the following areas for the duration of the demolition activities bull 8uilding exteriorsurfaces bull Unpaved surface areas where equipment will operate bull Razed building materials and bull Water or dust suppressants will be applied to unpaved surface areas within 100 feet of
structure during demolition
Pre-Activity
Not applicable for this project (Please explain why in Section 3-E)
The site will be pre-watered and work will be phased to reduce the amount of disturbed surface area at anyone time (Complete Section 4-A)
Active Operations Water will be applied to dry areas during leveling grading trenching and earthmoving activities (Complete Section 4-A) Wind barriers will be constructed and maintained and water or dust suppressants will be applied to the disturbed surface areas (Complete Sections 4-A or 4-8 and 4-C)
Inactive Operations including after work hours weekends and holidays
Not applicable for this project (Please explain why in Section 3-E) Water or dust suppressants wiU be applied on disturbed surface areas to form a visible crust and vehicle access will be restricted to maintain the visible crust (Complete Section 4shyA or 4-8 and 4-C)
Temporary stabilization of areas that remains unused for seven or more days Not applicable for this project (Please explain why in Section3-E)
Vehicular access will be restricted and water or dust suppressants will be applied and maintained at all un- vegetated areas (Complete Section 4-A or 4-8 and4-C) Vegetation will be reestablished on all previously disturbed areas (Complete Section 4shy
C) Gravel will be applied and maintained at all previously disturbed areas (Complete
Section 4-C) Previously disturbed areas will be paved (Complete Section 4-C)
Unpaved Access and Haul Roads Traffic and Equipment Storage Areas Not applicable for this project (Please explain why in Section3-E)
Apply water or dust suppressants to unpaved haul and access roads (Complete Section 4-A or4-8) Water or dust suppressants will be applied to vehicle traffic and equipment storage areas (Complete Section 4-A or4-8)
62915 NE 181h SL Ste 1 Bend OR 97701 P I 5413824707 t I 5413838118 wallacegroup-inccom
Exhibit A-5 Page 6 of 13
Section 3 - Fugitive Sources - Page 3
3-D Bulk Materials
Outdoor Handling of Bulk Materials
No bulk materials will be handled during this
project
Water or dust suppressants will be applied when handling bulk materials Wind barriers with less than 50 percent porosity will be installed and maintained and water or dust suppressants will be applied
Outdoor Storage of Bulk Materials
No bulk materials will be stored during this project
Water or dust suppressants will be applied to storage piles Storage piles will be covered with tarps plastic or other suitable material and anchored in such a manner that prevents the cover from being removed by wind action A three-sided structure laquo 50 porosity) will be used that is at least as high as the storage piles
On-Site Transporting of Bulk Materials
No bulk materials will be transported on the project site
Vehicle speed will be limited on the work site All haul trucks will be loaded such that the freeboard is not less than six inches when transported across any paved public access road A sufficient amount of water will be applied to the top of the load to limit visible dust
emissions Haul trucks will be covered with a tarp or other suitable cover
Off-Site Transporting of Bulk Materials No bulk materials will be transported to or from the project site
The following practices wi be performed (complete Section 5-8) o The ipterior of emptied truck cargo compartments will be cleaned or covered before leaving
the site o Spillage or loss of bulk materials from holes or other openings in the cargo compartments
floor sides and tailgates will be prevented o Haul trucks will be covered with a tarp or other suitable cover or will be loaded such that the
freeboard is not less than six inches when transported on any paved public access road to or from the project site and a sufficient amount of water will be applied to the top of the load to limit visible dust emissions
Outdoor Transport using a Chute or Conveyor
No chutes or conveyors will be used
Ch ute orconveyorwill befully enclosed
Water spray equipment will be used to sufficiently wet the materials
Transported materials will be washed or screened to remove fines (PM1 0 or smaller)
3-E Comments
62915 NE 18 th St Ste 1 Bend OR 97701 P 154 13824707 1 1541383 8118 wallacegroup-inc com
Exhibit A-5 Page 7 of 13
Section4- DustControl Methods-Page 1
Project Name
4-A Water Application
Complete this section if water application will be used as a control method for limiting visible dust emissions and stabilizing surface areas Check and answer everything that applies to the project
Water Application Equipment
Sprinklers Describe the activities that will utilize sprinklers
Minimum treated area Square FeetAcres
Maximum treated area Square FeetAcres
Minimum waterflow rate ____Gallonsminute Duration ____-=-----shy_____
Water Truck Water Trailer Water Wagon Other __
Describe the activities that will utilize this equipment
Number of application equipment available
poundpplication equipmentcapacity
Water Supply Include the relative locations of these sources on the plot plan in Section 2
Fire hydrants
Number of hydrants available On-Site____ Off-Site____
Approval granted by the owner or public agency to use their fire hydrants for this
project
Owner or Agency
Contact
Storage tanks Number and capacity
______Wells
Phone No
Number andflow rate
Approval granted by the owner or public agency to use their water source for this project
Owner or Agency
Contact ______________Phone No
629 15 NE 18fh St Ste 1 Bend OR 97701 p i 541 3824707 f 154 1383811 8 wallacegroup-inccom
Exhibit A-5 Page 8 of 13
Section 4 - Dust Control Methods- Page 2
Project Name
4-8 Dust Suppressant Products
Complete this section if a dust suppressant product will be used These materials include but are not limited to hygroscopic suppressants (road salts) adhesives petroleum emulsions polymer emulsions and bituminous materials (road oils)
Coov this oaae if more than QrrELdust suoore-SSantoroduct will bpoundLused
D Not Applicable Only water application will be the control method used Skip t04-C
Application Area shy
Product Name ( Contractors Name
) ~ Phone No
Application Rate Gallons of undiluted material per mile or acre treated
Application Frequency Applicationsperweek month year ~
Application Equipment
Number of Application Equipment Available gtj
Application EquipmentCapacity Attach each of the following information that fully describes this product Use the checklist below to make sure all information is submitted with this plan
Product Specifications (MSDS Product Safety Data Sheet etc)
Manufacturers Usage Instructions (method frequency and intensity of application) Env~ronmental impacts and approvals or certifications related to the appropriate and safe use for qround appJication
62915 NE 18111 St Ste 1 Bend OR 97701 pi 541 3824707 f 154 13838118 wallacegroup-inccom
Exhibit A-5 Page 9 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
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rYPICAl ON - SIrE SEWAGE DISPOSAL SUBSURFACE REPlACEMENr AREA
FT~( MINIMUM REQUIRED SEPARATION IS 100 ( 120 SEPARATION SHOWN)
I rYPICAl ON - Si rE SEWAGE I ~DISPOSAL SUBSURFACE MINIMUM SIDE YARD SETBACKS ARE 20I I ABSORPriON FIELD (60plusmn SETBACK S HO~)
I 5 PUE
1-1 I JPPROXIMATE LIMITS OF EXISTING RIMROCK OUTRCO PPrNGS (OR
I
-5-~
(~r~I 20 I I ) SLOPES GREATER THAN 45) AND CORRESPONDING 50 RIMROCK
8 I +--1101-shy I I I Ittr rli
I I I I I IPOrENTlAl l
REPLACEMENTI t I AREA I I I I I I I I I
I I I TII 1 If I I ~~~~
sectamp
------POrENriAlI EXEMPT PRIVA rE II fER WEll lOCA n ON
25
--- (
- PROPOSEDI
I PROPERry PROPOSED -----LINE LOr LINE I
)1 6
13 ~6~ I f A(middot~ - shy
SFTBACK I1 MITS
IRACT c OPEN SPACE
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Lower Bridge Road Residential Development Dust Control Plan
Construction Demoition Excavation Extraction and Other Earthmoving Activities require the owner or operator of a construction project to submit a Dust Control Plan to the Lower Bridge Road Subdivision Homeowners Association (LBR HOA) if at any time the project involves
Residential development Subdivision infrastructure construction andor Moving depositing or relocating of more than 10 cubic yards of bulk native soil or imported fill materials
A Dust Control Plan identifies the fugitive dust sources at the construction site and describes all of the dust control measures to be implemented before during and after any dust generating activity for the duration of the project The LBR HOA will review and approve conditionally approve or disapprove the Dust Control Plan within 30 days of submittal Construction activities shall not commence until the Dust Control Plan has been approved or conditionally approved An owner or operator must aliso provide written notification to the LBR HOA via fax email or mail within 10 days prior to the commencement of earthmoving activities A copy of the approved Dust Control Plan must be retained at the project site and made available upon request by LBR HOA Oregon Department of Environmental Ouamy (DEO) or Deschutes County representatives
Regardless of whether a HOA-approved Dust Control Plan is in place or not the owner or operator is required to comply with all requirements of applicable DEQ and Deschutes County Rules and Regulations at all times
Submit the Dust Control Plan to the LBR HOA office listed below
Lower Bridge Road Homeowners Association PO Box TBO Terrebonne OR 97XXX Phone Number (541) XXX-XXXX Email address FAX Number (541) XXX-XXXX
6291 5 NE 181h SL Ste 1 Bend OR 97701 pi 5413824707 f 154138381 18 wallacegroup-inccom
Exhibit A-5 Page 1 of 13
Dust Control Plan Section 1- General Information - Page 1
1-A Project Name and Location
Project Name
ProjectAddress
City
Section(s) County
Township
Range
Expected ConstructionStart Date End Date
1-8 Contacts
Report the names addresses and phone numbers of persons and owners or operators responsible for the preparation submittal and implementation of the Dust Control Plan and responsible for the dust generating operation and dust control applications I
Property Owner - shy ~ ( ~ j
Address
City State Zip ~ - Phone ~ Email ~
~- Developer ~ I - -)
Address V ~~ ~ ~
City State Zip
Contact Person - ~ )1 gt
V _
Phone Email ~ shy - shy
General Contractor c --~
Address -
City State Zip ~
Contact Person
Phone Email
This Dust Control Plan was prepared by
Name Title
Company Name
Address
City State Zip
Phone Email
o I would like additional information about opportunities to reduce water usage on the project site
62915 NE 18 St Sle 1 Bend OR 97701 P I 54 13824707 f I 541383 811 8 wal lacegroup-inccom
Exhibit A-5 Page 2 of 13
Section 1 - General Information - Page 2
Project Name
1-C Contractors
Provide the names addresses and phone numbers of the contractors involved in dust generating activities or performing dust control as part of this project
1
2 (
3 )
J -c 4 ~ -shy -~~
1-0 Who will have the primary responsibility for implementIng this Dust Control Plan
D Property Owner D Developer D GeneralPrime
D Sub-Contractor(s) D Other J --shy- )
Primary Project Contact -~ v
Title ( - ~
Company Name --shy Address ~
~
City State Zip ~ c -1
On-Site Phone - ~ Fax
Mobile Phone Emai
- - j
1-E Provide a brief description of the projects operations
62 15 NE 18 St Ste I Bend OR 9770 1 P 154 13824 707 f I 5413838 11 8 wa llacegroLlp-inccom
Exhibit A-5 Page 3 of 13
Dust Control Plan Section 2-Plot Plan - Page 1
Project Name
2-A Plot Plan
A plot plan identifies the type and location of each project Attach appropriately sized maps with the project boundaries outlined or use the space in sections 2-B or 2-C to draw a plot plan Attached maps may include tract maps site maps and topographic maps Use the checklist below to make sure all areas have been identified on the I t Ian
Identify the relative locations of actual and potential sources of fugitive dust emissions
Bulk material handling and storage areas
Paved and unpaved access roads haul roads traffic areas and equipment
storage yards Exit points where carryout and tracks onto paved public
roads may occur Water supply locations if water application will be used for controlling visible dust emissions Other
2-B Draw Plot Plan (if one is not attached) Include a North Arrow
Plot plan is attached (Skip to 3-A)
62915 NE 18rn St Sle 1 Bend OR 97701 P 1541 3824707 f 1541 383 8118 wallacegroup-inccom
Exhibit A-5 Page 4 of 13
Dust Control Plan Section 3 - Fugitive Sources - Page 1
Project Name
3-A Disturbed Surface Area
Report the total area of land surface to be disturbed the estimates daily throughput volume of earthmoving in cubic yards and the total area inacres ofthe entire project site
Total area of land surface to be disturbed Acres
Daily maximum throughput volume of earthmoving Cubic Yards
Daily average throughput volume of earthmoving Cubic Yards
Total area of entire project site Acres
Total disturbed areas that will be left inactive for more than seven days shy Acres ~
3-8 Dust Generating Activity Dates ( ~ ~
The expected start and completion dates of dust generating activities and soil disturbance activities to be performed on site For phased projects it may be necessary to report expected start and completion dates separately
Expected start date ~~
Completion Date
Phase ProjectStart-A -
Completion-A
Phase Project Start shy B ~ Completion- B J
Phase Project Start- C Completion -C
t I ~V L
62915 NE 181h Sl Ste 1 Bend OR 97701 P I 541 ~382470 7 f 154 138381 18 wallacegroup-inccom
Exhibit A-5 Page 5 of 13
Section 3 - Fugitive Sources - Page 2
Project Name
3-C Sources of Fugitive Dust
This section describes the minimum requirements for limiting visible dust emissions from activities that cause fugitive dust emissions Check at least one box under each category
Structu raiD e m olition
No demolitions are planned for this project
Asbestos NESHAP notification and fees have been submitted to the I-()l
Water will be applied to the following areas for the duration of the demolition activities bull 8uilding exteriorsurfaces bull Unpaved surface areas where equipment will operate bull Razed building materials and bull Water or dust suppressants will be applied to unpaved surface areas within 100 feet of
structure during demolition
Pre-Activity
Not applicable for this project (Please explain why in Section 3-E)
The site will be pre-watered and work will be phased to reduce the amount of disturbed surface area at anyone time (Complete Section 4-A)
Active Operations Water will be applied to dry areas during leveling grading trenching and earthmoving activities (Complete Section 4-A) Wind barriers will be constructed and maintained and water or dust suppressants will be applied to the disturbed surface areas (Complete Sections 4-A or 4-8 and 4-C)
Inactive Operations including after work hours weekends and holidays
Not applicable for this project (Please explain why in Section 3-E) Water or dust suppressants wiU be applied on disturbed surface areas to form a visible crust and vehicle access will be restricted to maintain the visible crust (Complete Section 4shyA or 4-8 and 4-C)
Temporary stabilization of areas that remains unused for seven or more days Not applicable for this project (Please explain why in Section3-E)
Vehicular access will be restricted and water or dust suppressants will be applied and maintained at all un- vegetated areas (Complete Section 4-A or 4-8 and4-C) Vegetation will be reestablished on all previously disturbed areas (Complete Section 4shy
C) Gravel will be applied and maintained at all previously disturbed areas (Complete
Section 4-C) Previously disturbed areas will be paved (Complete Section 4-C)
Unpaved Access and Haul Roads Traffic and Equipment Storage Areas Not applicable for this project (Please explain why in Section3-E)
Apply water or dust suppressants to unpaved haul and access roads (Complete Section 4-A or4-8) Water or dust suppressants will be applied to vehicle traffic and equipment storage areas (Complete Section 4-A or4-8)
62915 NE 181h SL Ste 1 Bend OR 97701 P I 5413824707 t I 5413838118 wallacegroup-inccom
Exhibit A-5 Page 6 of 13
Section 3 - Fugitive Sources - Page 3
3-D Bulk Materials
Outdoor Handling of Bulk Materials
No bulk materials will be handled during this
project
Water or dust suppressants will be applied when handling bulk materials Wind barriers with less than 50 percent porosity will be installed and maintained and water or dust suppressants will be applied
Outdoor Storage of Bulk Materials
No bulk materials will be stored during this project
Water or dust suppressants will be applied to storage piles Storage piles will be covered with tarps plastic or other suitable material and anchored in such a manner that prevents the cover from being removed by wind action A three-sided structure laquo 50 porosity) will be used that is at least as high as the storage piles
On-Site Transporting of Bulk Materials
No bulk materials will be transported on the project site
Vehicle speed will be limited on the work site All haul trucks will be loaded such that the freeboard is not less than six inches when transported across any paved public access road A sufficient amount of water will be applied to the top of the load to limit visible dust
emissions Haul trucks will be covered with a tarp or other suitable cover
Off-Site Transporting of Bulk Materials No bulk materials will be transported to or from the project site
The following practices wi be performed (complete Section 5-8) o The ipterior of emptied truck cargo compartments will be cleaned or covered before leaving
the site o Spillage or loss of bulk materials from holes or other openings in the cargo compartments
floor sides and tailgates will be prevented o Haul trucks will be covered with a tarp or other suitable cover or will be loaded such that the
freeboard is not less than six inches when transported on any paved public access road to or from the project site and a sufficient amount of water will be applied to the top of the load to limit visible dust emissions
Outdoor Transport using a Chute or Conveyor
No chutes or conveyors will be used
Ch ute orconveyorwill befully enclosed
Water spray equipment will be used to sufficiently wet the materials
Transported materials will be washed or screened to remove fines (PM1 0 or smaller)
3-E Comments
62915 NE 18 th St Ste 1 Bend OR 97701 P 154 13824707 1 1541383 8118 wallacegroup-inc com
Exhibit A-5 Page 7 of 13
Section4- DustControl Methods-Page 1
Project Name
4-A Water Application
Complete this section if water application will be used as a control method for limiting visible dust emissions and stabilizing surface areas Check and answer everything that applies to the project
Water Application Equipment
Sprinklers Describe the activities that will utilize sprinklers
Minimum treated area Square FeetAcres
Maximum treated area Square FeetAcres
Minimum waterflow rate ____Gallonsminute Duration ____-=-----shy_____
Water Truck Water Trailer Water Wagon Other __
Describe the activities that will utilize this equipment
Number of application equipment available
poundpplication equipmentcapacity
Water Supply Include the relative locations of these sources on the plot plan in Section 2
Fire hydrants
Number of hydrants available On-Site____ Off-Site____
Approval granted by the owner or public agency to use their fire hydrants for this
project
Owner or Agency
Contact
Storage tanks Number and capacity
______Wells
Phone No
Number andflow rate
Approval granted by the owner or public agency to use their water source for this project
Owner or Agency
Contact ______________Phone No
629 15 NE 18fh St Ste 1 Bend OR 97701 p i 541 3824707 f 154 1383811 8 wallacegroup-inccom
Exhibit A-5 Page 8 of 13
Section 4 - Dust Control Methods- Page 2
Project Name
4-8 Dust Suppressant Products
Complete this section if a dust suppressant product will be used These materials include but are not limited to hygroscopic suppressants (road salts) adhesives petroleum emulsions polymer emulsions and bituminous materials (road oils)
Coov this oaae if more than QrrELdust suoore-SSantoroduct will bpoundLused
D Not Applicable Only water application will be the control method used Skip t04-C
Application Area shy
Product Name ( Contractors Name
) ~ Phone No
Application Rate Gallons of undiluted material per mile or acre treated
Application Frequency Applicationsperweek month year ~
Application Equipment
Number of Application Equipment Available gtj
Application EquipmentCapacity Attach each of the following information that fully describes this product Use the checklist below to make sure all information is submitted with this plan
Product Specifications (MSDS Product Safety Data Sheet etc)
Manufacturers Usage Instructions (method frequency and intensity of application) Env~ronmental impacts and approvals or certifications related to the appropriate and safe use for qround appJication
62915 NE 18111 St Ste 1 Bend OR 97701 pi 541 3824707 f 154 13838118 wallacegroup-inccom
Exhibit A-5 Page 9 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
~ ~
wallaceGROUP
Lower Bridge Road Residential Development Dust Control Plan
Construction Demoition Excavation Extraction and Other Earthmoving Activities require the owner or operator of a construction project to submit a Dust Control Plan to the Lower Bridge Road Subdivision Homeowners Association (LBR HOA) if at any time the project involves
Residential development Subdivision infrastructure construction andor Moving depositing or relocating of more than 10 cubic yards of bulk native soil or imported fill materials
A Dust Control Plan identifies the fugitive dust sources at the construction site and describes all of the dust control measures to be implemented before during and after any dust generating activity for the duration of the project The LBR HOA will review and approve conditionally approve or disapprove the Dust Control Plan within 30 days of submittal Construction activities shall not commence until the Dust Control Plan has been approved or conditionally approved An owner or operator must aliso provide written notification to the LBR HOA via fax email or mail within 10 days prior to the commencement of earthmoving activities A copy of the approved Dust Control Plan must be retained at the project site and made available upon request by LBR HOA Oregon Department of Environmental Ouamy (DEO) or Deschutes County representatives
Regardless of whether a HOA-approved Dust Control Plan is in place or not the owner or operator is required to comply with all requirements of applicable DEQ and Deschutes County Rules and Regulations at all times
Submit the Dust Control Plan to the LBR HOA office listed below
Lower Bridge Road Homeowners Association PO Box TBO Terrebonne OR 97XXX Phone Number (541) XXX-XXXX Email address FAX Number (541) XXX-XXXX
6291 5 NE 181h SL Ste 1 Bend OR 97701 pi 5413824707 f 154138381 18 wallacegroup-inccom
Exhibit A-5 Page 1 of 13
Dust Control Plan Section 1- General Information - Page 1
1-A Project Name and Location
Project Name
ProjectAddress
City
Section(s) County
Township
Range
Expected ConstructionStart Date End Date
1-8 Contacts
Report the names addresses and phone numbers of persons and owners or operators responsible for the preparation submittal and implementation of the Dust Control Plan and responsible for the dust generating operation and dust control applications I
Property Owner - shy ~ ( ~ j
Address
City State Zip ~ - Phone ~ Email ~
~- Developer ~ I - -)
Address V ~~ ~ ~
City State Zip
Contact Person - ~ )1 gt
V _
Phone Email ~ shy - shy
General Contractor c --~
Address -
City State Zip ~
Contact Person
Phone Email
This Dust Control Plan was prepared by
Name Title
Company Name
Address
City State Zip
Phone Email
o I would like additional information about opportunities to reduce water usage on the project site
62915 NE 18 St Sle 1 Bend OR 97701 P I 54 13824707 f I 541383 811 8 wal lacegroup-inccom
Exhibit A-5 Page 2 of 13
Section 1 - General Information - Page 2
Project Name
1-C Contractors
Provide the names addresses and phone numbers of the contractors involved in dust generating activities or performing dust control as part of this project
1
2 (
3 )
J -c 4 ~ -shy -~~
1-0 Who will have the primary responsibility for implementIng this Dust Control Plan
D Property Owner D Developer D GeneralPrime
D Sub-Contractor(s) D Other J --shy- )
Primary Project Contact -~ v
Title ( - ~
Company Name --shy Address ~
~
City State Zip ~ c -1
On-Site Phone - ~ Fax
Mobile Phone Emai
- - j
1-E Provide a brief description of the projects operations
62 15 NE 18 St Ste I Bend OR 9770 1 P 154 13824 707 f I 5413838 11 8 wa llacegroLlp-inccom
Exhibit A-5 Page 3 of 13
Dust Control Plan Section 2-Plot Plan - Page 1
Project Name
2-A Plot Plan
A plot plan identifies the type and location of each project Attach appropriately sized maps with the project boundaries outlined or use the space in sections 2-B or 2-C to draw a plot plan Attached maps may include tract maps site maps and topographic maps Use the checklist below to make sure all areas have been identified on the I t Ian
Identify the relative locations of actual and potential sources of fugitive dust emissions
Bulk material handling and storage areas
Paved and unpaved access roads haul roads traffic areas and equipment
storage yards Exit points where carryout and tracks onto paved public
roads may occur Water supply locations if water application will be used for controlling visible dust emissions Other
2-B Draw Plot Plan (if one is not attached) Include a North Arrow
Plot plan is attached (Skip to 3-A)
62915 NE 18rn St Sle 1 Bend OR 97701 P 1541 3824707 f 1541 383 8118 wallacegroup-inccom
Exhibit A-5 Page 4 of 13
Dust Control Plan Section 3 - Fugitive Sources - Page 1
Project Name
3-A Disturbed Surface Area
Report the total area of land surface to be disturbed the estimates daily throughput volume of earthmoving in cubic yards and the total area inacres ofthe entire project site
Total area of land surface to be disturbed Acres
Daily maximum throughput volume of earthmoving Cubic Yards
Daily average throughput volume of earthmoving Cubic Yards
Total area of entire project site Acres
Total disturbed areas that will be left inactive for more than seven days shy Acres ~
3-8 Dust Generating Activity Dates ( ~ ~
The expected start and completion dates of dust generating activities and soil disturbance activities to be performed on site For phased projects it may be necessary to report expected start and completion dates separately
Expected start date ~~
Completion Date
Phase ProjectStart-A -
Completion-A
Phase Project Start shy B ~ Completion- B J
Phase Project Start- C Completion -C
t I ~V L
62915 NE 181h Sl Ste 1 Bend OR 97701 P I 541 ~382470 7 f 154 138381 18 wallacegroup-inccom
Exhibit A-5 Page 5 of 13
Section 3 - Fugitive Sources - Page 2
Project Name
3-C Sources of Fugitive Dust
This section describes the minimum requirements for limiting visible dust emissions from activities that cause fugitive dust emissions Check at least one box under each category
Structu raiD e m olition
No demolitions are planned for this project
Asbestos NESHAP notification and fees have been submitted to the I-()l
Water will be applied to the following areas for the duration of the demolition activities bull 8uilding exteriorsurfaces bull Unpaved surface areas where equipment will operate bull Razed building materials and bull Water or dust suppressants will be applied to unpaved surface areas within 100 feet of
structure during demolition
Pre-Activity
Not applicable for this project (Please explain why in Section 3-E)
The site will be pre-watered and work will be phased to reduce the amount of disturbed surface area at anyone time (Complete Section 4-A)
Active Operations Water will be applied to dry areas during leveling grading trenching and earthmoving activities (Complete Section 4-A) Wind barriers will be constructed and maintained and water or dust suppressants will be applied to the disturbed surface areas (Complete Sections 4-A or 4-8 and 4-C)
Inactive Operations including after work hours weekends and holidays
Not applicable for this project (Please explain why in Section 3-E) Water or dust suppressants wiU be applied on disturbed surface areas to form a visible crust and vehicle access will be restricted to maintain the visible crust (Complete Section 4shyA or 4-8 and 4-C)
Temporary stabilization of areas that remains unused for seven or more days Not applicable for this project (Please explain why in Section3-E)
Vehicular access will be restricted and water or dust suppressants will be applied and maintained at all un- vegetated areas (Complete Section 4-A or 4-8 and4-C) Vegetation will be reestablished on all previously disturbed areas (Complete Section 4shy
C) Gravel will be applied and maintained at all previously disturbed areas (Complete
Section 4-C) Previously disturbed areas will be paved (Complete Section 4-C)
Unpaved Access and Haul Roads Traffic and Equipment Storage Areas Not applicable for this project (Please explain why in Section3-E)
Apply water or dust suppressants to unpaved haul and access roads (Complete Section 4-A or4-8) Water or dust suppressants will be applied to vehicle traffic and equipment storage areas (Complete Section 4-A or4-8)
62915 NE 181h SL Ste 1 Bend OR 97701 P I 5413824707 t I 5413838118 wallacegroup-inccom
Exhibit A-5 Page 6 of 13
Section 3 - Fugitive Sources - Page 3
3-D Bulk Materials
Outdoor Handling of Bulk Materials
No bulk materials will be handled during this
project
Water or dust suppressants will be applied when handling bulk materials Wind barriers with less than 50 percent porosity will be installed and maintained and water or dust suppressants will be applied
Outdoor Storage of Bulk Materials
No bulk materials will be stored during this project
Water or dust suppressants will be applied to storage piles Storage piles will be covered with tarps plastic or other suitable material and anchored in such a manner that prevents the cover from being removed by wind action A three-sided structure laquo 50 porosity) will be used that is at least as high as the storage piles
On-Site Transporting of Bulk Materials
No bulk materials will be transported on the project site
Vehicle speed will be limited on the work site All haul trucks will be loaded such that the freeboard is not less than six inches when transported across any paved public access road A sufficient amount of water will be applied to the top of the load to limit visible dust
emissions Haul trucks will be covered with a tarp or other suitable cover
Off-Site Transporting of Bulk Materials No bulk materials will be transported to or from the project site
The following practices wi be performed (complete Section 5-8) o The ipterior of emptied truck cargo compartments will be cleaned or covered before leaving
the site o Spillage or loss of bulk materials from holes or other openings in the cargo compartments
floor sides and tailgates will be prevented o Haul trucks will be covered with a tarp or other suitable cover or will be loaded such that the
freeboard is not less than six inches when transported on any paved public access road to or from the project site and a sufficient amount of water will be applied to the top of the load to limit visible dust emissions
Outdoor Transport using a Chute or Conveyor
No chutes or conveyors will be used
Ch ute orconveyorwill befully enclosed
Water spray equipment will be used to sufficiently wet the materials
Transported materials will be washed or screened to remove fines (PM1 0 or smaller)
3-E Comments
62915 NE 18 th St Ste 1 Bend OR 97701 P 154 13824707 1 1541383 8118 wallacegroup-inc com
Exhibit A-5 Page 7 of 13
Section4- DustControl Methods-Page 1
Project Name
4-A Water Application
Complete this section if water application will be used as a control method for limiting visible dust emissions and stabilizing surface areas Check and answer everything that applies to the project
Water Application Equipment
Sprinklers Describe the activities that will utilize sprinklers
Minimum treated area Square FeetAcres
Maximum treated area Square FeetAcres
Minimum waterflow rate ____Gallonsminute Duration ____-=-----shy_____
Water Truck Water Trailer Water Wagon Other __
Describe the activities that will utilize this equipment
Number of application equipment available
poundpplication equipmentcapacity
Water Supply Include the relative locations of these sources on the plot plan in Section 2
Fire hydrants
Number of hydrants available On-Site____ Off-Site____
Approval granted by the owner or public agency to use their fire hydrants for this
project
Owner or Agency
Contact
Storage tanks Number and capacity
______Wells
Phone No
Number andflow rate
Approval granted by the owner or public agency to use their water source for this project
Owner or Agency
Contact ______________Phone No
629 15 NE 18fh St Ste 1 Bend OR 97701 p i 541 3824707 f 154 1383811 8 wallacegroup-inccom
Exhibit A-5 Page 8 of 13
Section 4 - Dust Control Methods- Page 2
Project Name
4-8 Dust Suppressant Products
Complete this section if a dust suppressant product will be used These materials include but are not limited to hygroscopic suppressants (road salts) adhesives petroleum emulsions polymer emulsions and bituminous materials (road oils)
Coov this oaae if more than QrrELdust suoore-SSantoroduct will bpoundLused
D Not Applicable Only water application will be the control method used Skip t04-C
Application Area shy
Product Name ( Contractors Name
) ~ Phone No
Application Rate Gallons of undiluted material per mile or acre treated
Application Frequency Applicationsperweek month year ~
Application Equipment
Number of Application Equipment Available gtj
Application EquipmentCapacity Attach each of the following information that fully describes this product Use the checklist below to make sure all information is submitted with this plan
Product Specifications (MSDS Product Safety Data Sheet etc)
Manufacturers Usage Instructions (method frequency and intensity of application) Env~ronmental impacts and approvals or certifications related to the appropriate and safe use for qround appJication
62915 NE 18111 St Ste 1 Bend OR 97701 pi 541 3824707 f 154 13838118 wallacegroup-inccom
Exhibit A-5 Page 9 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
Dust Control Plan Section 1- General Information - Page 1
1-A Project Name and Location
Project Name
ProjectAddress
City
Section(s) County
Township
Range
Expected ConstructionStart Date End Date
1-8 Contacts
Report the names addresses and phone numbers of persons and owners or operators responsible for the preparation submittal and implementation of the Dust Control Plan and responsible for the dust generating operation and dust control applications I
Property Owner - shy ~ ( ~ j
Address
City State Zip ~ - Phone ~ Email ~
~- Developer ~ I - -)
Address V ~~ ~ ~
City State Zip
Contact Person - ~ )1 gt
V _
Phone Email ~ shy - shy
General Contractor c --~
Address -
City State Zip ~
Contact Person
Phone Email
This Dust Control Plan was prepared by
Name Title
Company Name
Address
City State Zip
Phone Email
o I would like additional information about opportunities to reduce water usage on the project site
62915 NE 18 St Sle 1 Bend OR 97701 P I 54 13824707 f I 541383 811 8 wal lacegroup-inccom
Exhibit A-5 Page 2 of 13
Section 1 - General Information - Page 2
Project Name
1-C Contractors
Provide the names addresses and phone numbers of the contractors involved in dust generating activities or performing dust control as part of this project
1
2 (
3 )
J -c 4 ~ -shy -~~
1-0 Who will have the primary responsibility for implementIng this Dust Control Plan
D Property Owner D Developer D GeneralPrime
D Sub-Contractor(s) D Other J --shy- )
Primary Project Contact -~ v
Title ( - ~
Company Name --shy Address ~
~
City State Zip ~ c -1
On-Site Phone - ~ Fax
Mobile Phone Emai
- - j
1-E Provide a brief description of the projects operations
62 15 NE 18 St Ste I Bend OR 9770 1 P 154 13824 707 f I 5413838 11 8 wa llacegroLlp-inccom
Exhibit A-5 Page 3 of 13
Dust Control Plan Section 2-Plot Plan - Page 1
Project Name
2-A Plot Plan
A plot plan identifies the type and location of each project Attach appropriately sized maps with the project boundaries outlined or use the space in sections 2-B or 2-C to draw a plot plan Attached maps may include tract maps site maps and topographic maps Use the checklist below to make sure all areas have been identified on the I t Ian
Identify the relative locations of actual and potential sources of fugitive dust emissions
Bulk material handling and storage areas
Paved and unpaved access roads haul roads traffic areas and equipment
storage yards Exit points where carryout and tracks onto paved public
roads may occur Water supply locations if water application will be used for controlling visible dust emissions Other
2-B Draw Plot Plan (if one is not attached) Include a North Arrow
Plot plan is attached (Skip to 3-A)
62915 NE 18rn St Sle 1 Bend OR 97701 P 1541 3824707 f 1541 383 8118 wallacegroup-inccom
Exhibit A-5 Page 4 of 13
Dust Control Plan Section 3 - Fugitive Sources - Page 1
Project Name
3-A Disturbed Surface Area
Report the total area of land surface to be disturbed the estimates daily throughput volume of earthmoving in cubic yards and the total area inacres ofthe entire project site
Total area of land surface to be disturbed Acres
Daily maximum throughput volume of earthmoving Cubic Yards
Daily average throughput volume of earthmoving Cubic Yards
Total area of entire project site Acres
Total disturbed areas that will be left inactive for more than seven days shy Acres ~
3-8 Dust Generating Activity Dates ( ~ ~
The expected start and completion dates of dust generating activities and soil disturbance activities to be performed on site For phased projects it may be necessary to report expected start and completion dates separately
Expected start date ~~
Completion Date
Phase ProjectStart-A -
Completion-A
Phase Project Start shy B ~ Completion- B J
Phase Project Start- C Completion -C
t I ~V L
62915 NE 181h Sl Ste 1 Bend OR 97701 P I 541 ~382470 7 f 154 138381 18 wallacegroup-inccom
Exhibit A-5 Page 5 of 13
Section 3 - Fugitive Sources - Page 2
Project Name
3-C Sources of Fugitive Dust
This section describes the minimum requirements for limiting visible dust emissions from activities that cause fugitive dust emissions Check at least one box under each category
Structu raiD e m olition
No demolitions are planned for this project
Asbestos NESHAP notification and fees have been submitted to the I-()l
Water will be applied to the following areas for the duration of the demolition activities bull 8uilding exteriorsurfaces bull Unpaved surface areas where equipment will operate bull Razed building materials and bull Water or dust suppressants will be applied to unpaved surface areas within 100 feet of
structure during demolition
Pre-Activity
Not applicable for this project (Please explain why in Section 3-E)
The site will be pre-watered and work will be phased to reduce the amount of disturbed surface area at anyone time (Complete Section 4-A)
Active Operations Water will be applied to dry areas during leveling grading trenching and earthmoving activities (Complete Section 4-A) Wind barriers will be constructed and maintained and water or dust suppressants will be applied to the disturbed surface areas (Complete Sections 4-A or 4-8 and 4-C)
Inactive Operations including after work hours weekends and holidays
Not applicable for this project (Please explain why in Section 3-E) Water or dust suppressants wiU be applied on disturbed surface areas to form a visible crust and vehicle access will be restricted to maintain the visible crust (Complete Section 4shyA or 4-8 and 4-C)
Temporary stabilization of areas that remains unused for seven or more days Not applicable for this project (Please explain why in Section3-E)
Vehicular access will be restricted and water or dust suppressants will be applied and maintained at all un- vegetated areas (Complete Section 4-A or 4-8 and4-C) Vegetation will be reestablished on all previously disturbed areas (Complete Section 4shy
C) Gravel will be applied and maintained at all previously disturbed areas (Complete
Section 4-C) Previously disturbed areas will be paved (Complete Section 4-C)
Unpaved Access and Haul Roads Traffic and Equipment Storage Areas Not applicable for this project (Please explain why in Section3-E)
Apply water or dust suppressants to unpaved haul and access roads (Complete Section 4-A or4-8) Water or dust suppressants will be applied to vehicle traffic and equipment storage areas (Complete Section 4-A or4-8)
62915 NE 181h SL Ste 1 Bend OR 97701 P I 5413824707 t I 5413838118 wallacegroup-inccom
Exhibit A-5 Page 6 of 13
Section 3 - Fugitive Sources - Page 3
3-D Bulk Materials
Outdoor Handling of Bulk Materials
No bulk materials will be handled during this
project
Water or dust suppressants will be applied when handling bulk materials Wind barriers with less than 50 percent porosity will be installed and maintained and water or dust suppressants will be applied
Outdoor Storage of Bulk Materials
No bulk materials will be stored during this project
Water or dust suppressants will be applied to storage piles Storage piles will be covered with tarps plastic or other suitable material and anchored in such a manner that prevents the cover from being removed by wind action A three-sided structure laquo 50 porosity) will be used that is at least as high as the storage piles
On-Site Transporting of Bulk Materials
No bulk materials will be transported on the project site
Vehicle speed will be limited on the work site All haul trucks will be loaded such that the freeboard is not less than six inches when transported across any paved public access road A sufficient amount of water will be applied to the top of the load to limit visible dust
emissions Haul trucks will be covered with a tarp or other suitable cover
Off-Site Transporting of Bulk Materials No bulk materials will be transported to or from the project site
The following practices wi be performed (complete Section 5-8) o The ipterior of emptied truck cargo compartments will be cleaned or covered before leaving
the site o Spillage or loss of bulk materials from holes or other openings in the cargo compartments
floor sides and tailgates will be prevented o Haul trucks will be covered with a tarp or other suitable cover or will be loaded such that the
freeboard is not less than six inches when transported on any paved public access road to or from the project site and a sufficient amount of water will be applied to the top of the load to limit visible dust emissions
Outdoor Transport using a Chute or Conveyor
No chutes or conveyors will be used
Ch ute orconveyorwill befully enclosed
Water spray equipment will be used to sufficiently wet the materials
Transported materials will be washed or screened to remove fines (PM1 0 or smaller)
3-E Comments
62915 NE 18 th St Ste 1 Bend OR 97701 P 154 13824707 1 1541383 8118 wallacegroup-inc com
Exhibit A-5 Page 7 of 13
Section4- DustControl Methods-Page 1
Project Name
4-A Water Application
Complete this section if water application will be used as a control method for limiting visible dust emissions and stabilizing surface areas Check and answer everything that applies to the project
Water Application Equipment
Sprinklers Describe the activities that will utilize sprinklers
Minimum treated area Square FeetAcres
Maximum treated area Square FeetAcres
Minimum waterflow rate ____Gallonsminute Duration ____-=-----shy_____
Water Truck Water Trailer Water Wagon Other __
Describe the activities that will utilize this equipment
Number of application equipment available
poundpplication equipmentcapacity
Water Supply Include the relative locations of these sources on the plot plan in Section 2
Fire hydrants
Number of hydrants available On-Site____ Off-Site____
Approval granted by the owner or public agency to use their fire hydrants for this
project
Owner or Agency
Contact
Storage tanks Number and capacity
______Wells
Phone No
Number andflow rate
Approval granted by the owner or public agency to use their water source for this project
Owner or Agency
Contact ______________Phone No
629 15 NE 18fh St Ste 1 Bend OR 97701 p i 541 3824707 f 154 1383811 8 wallacegroup-inccom
Exhibit A-5 Page 8 of 13
Section 4 - Dust Control Methods- Page 2
Project Name
4-8 Dust Suppressant Products
Complete this section if a dust suppressant product will be used These materials include but are not limited to hygroscopic suppressants (road salts) adhesives petroleum emulsions polymer emulsions and bituminous materials (road oils)
Coov this oaae if more than QrrELdust suoore-SSantoroduct will bpoundLused
D Not Applicable Only water application will be the control method used Skip t04-C
Application Area shy
Product Name ( Contractors Name
) ~ Phone No
Application Rate Gallons of undiluted material per mile or acre treated
Application Frequency Applicationsperweek month year ~
Application Equipment
Number of Application Equipment Available gtj
Application EquipmentCapacity Attach each of the following information that fully describes this product Use the checklist below to make sure all information is submitted with this plan
Product Specifications (MSDS Product Safety Data Sheet etc)
Manufacturers Usage Instructions (method frequency and intensity of application) Env~ronmental impacts and approvals or certifications related to the appropriate and safe use for qround appJication
62915 NE 18111 St Ste 1 Bend OR 97701 pi 541 3824707 f 154 13838118 wallacegroup-inccom
Exhibit A-5 Page 9 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
Section 1 - General Information - Page 2
Project Name
1-C Contractors
Provide the names addresses and phone numbers of the contractors involved in dust generating activities or performing dust control as part of this project
1
2 (
3 )
J -c 4 ~ -shy -~~
1-0 Who will have the primary responsibility for implementIng this Dust Control Plan
D Property Owner D Developer D GeneralPrime
D Sub-Contractor(s) D Other J --shy- )
Primary Project Contact -~ v
Title ( - ~
Company Name --shy Address ~
~
City State Zip ~ c -1
On-Site Phone - ~ Fax
Mobile Phone Emai
- - j
1-E Provide a brief description of the projects operations
62 15 NE 18 St Ste I Bend OR 9770 1 P 154 13824 707 f I 5413838 11 8 wa llacegroLlp-inccom
Exhibit A-5 Page 3 of 13
Dust Control Plan Section 2-Plot Plan - Page 1
Project Name
2-A Plot Plan
A plot plan identifies the type and location of each project Attach appropriately sized maps with the project boundaries outlined or use the space in sections 2-B or 2-C to draw a plot plan Attached maps may include tract maps site maps and topographic maps Use the checklist below to make sure all areas have been identified on the I t Ian
Identify the relative locations of actual and potential sources of fugitive dust emissions
Bulk material handling and storage areas
Paved and unpaved access roads haul roads traffic areas and equipment
storage yards Exit points where carryout and tracks onto paved public
roads may occur Water supply locations if water application will be used for controlling visible dust emissions Other
2-B Draw Plot Plan (if one is not attached) Include a North Arrow
Plot plan is attached (Skip to 3-A)
62915 NE 18rn St Sle 1 Bend OR 97701 P 1541 3824707 f 1541 383 8118 wallacegroup-inccom
Exhibit A-5 Page 4 of 13
Dust Control Plan Section 3 - Fugitive Sources - Page 1
Project Name
3-A Disturbed Surface Area
Report the total area of land surface to be disturbed the estimates daily throughput volume of earthmoving in cubic yards and the total area inacres ofthe entire project site
Total area of land surface to be disturbed Acres
Daily maximum throughput volume of earthmoving Cubic Yards
Daily average throughput volume of earthmoving Cubic Yards
Total area of entire project site Acres
Total disturbed areas that will be left inactive for more than seven days shy Acres ~
3-8 Dust Generating Activity Dates ( ~ ~
The expected start and completion dates of dust generating activities and soil disturbance activities to be performed on site For phased projects it may be necessary to report expected start and completion dates separately
Expected start date ~~
Completion Date
Phase ProjectStart-A -
Completion-A
Phase Project Start shy B ~ Completion- B J
Phase Project Start- C Completion -C
t I ~V L
62915 NE 181h Sl Ste 1 Bend OR 97701 P I 541 ~382470 7 f 154 138381 18 wallacegroup-inccom
Exhibit A-5 Page 5 of 13
Section 3 - Fugitive Sources - Page 2
Project Name
3-C Sources of Fugitive Dust
This section describes the minimum requirements for limiting visible dust emissions from activities that cause fugitive dust emissions Check at least one box under each category
Structu raiD e m olition
No demolitions are planned for this project
Asbestos NESHAP notification and fees have been submitted to the I-()l
Water will be applied to the following areas for the duration of the demolition activities bull 8uilding exteriorsurfaces bull Unpaved surface areas where equipment will operate bull Razed building materials and bull Water or dust suppressants will be applied to unpaved surface areas within 100 feet of
structure during demolition
Pre-Activity
Not applicable for this project (Please explain why in Section 3-E)
The site will be pre-watered and work will be phased to reduce the amount of disturbed surface area at anyone time (Complete Section 4-A)
Active Operations Water will be applied to dry areas during leveling grading trenching and earthmoving activities (Complete Section 4-A) Wind barriers will be constructed and maintained and water or dust suppressants will be applied to the disturbed surface areas (Complete Sections 4-A or 4-8 and 4-C)
Inactive Operations including after work hours weekends and holidays
Not applicable for this project (Please explain why in Section 3-E) Water or dust suppressants wiU be applied on disturbed surface areas to form a visible crust and vehicle access will be restricted to maintain the visible crust (Complete Section 4shyA or 4-8 and 4-C)
Temporary stabilization of areas that remains unused for seven or more days Not applicable for this project (Please explain why in Section3-E)
Vehicular access will be restricted and water or dust suppressants will be applied and maintained at all un- vegetated areas (Complete Section 4-A or 4-8 and4-C) Vegetation will be reestablished on all previously disturbed areas (Complete Section 4shy
C) Gravel will be applied and maintained at all previously disturbed areas (Complete
Section 4-C) Previously disturbed areas will be paved (Complete Section 4-C)
Unpaved Access and Haul Roads Traffic and Equipment Storage Areas Not applicable for this project (Please explain why in Section3-E)
Apply water or dust suppressants to unpaved haul and access roads (Complete Section 4-A or4-8) Water or dust suppressants will be applied to vehicle traffic and equipment storage areas (Complete Section 4-A or4-8)
62915 NE 181h SL Ste 1 Bend OR 97701 P I 5413824707 t I 5413838118 wallacegroup-inccom
Exhibit A-5 Page 6 of 13
Section 3 - Fugitive Sources - Page 3
3-D Bulk Materials
Outdoor Handling of Bulk Materials
No bulk materials will be handled during this
project
Water or dust suppressants will be applied when handling bulk materials Wind barriers with less than 50 percent porosity will be installed and maintained and water or dust suppressants will be applied
Outdoor Storage of Bulk Materials
No bulk materials will be stored during this project
Water or dust suppressants will be applied to storage piles Storage piles will be covered with tarps plastic or other suitable material and anchored in such a manner that prevents the cover from being removed by wind action A three-sided structure laquo 50 porosity) will be used that is at least as high as the storage piles
On-Site Transporting of Bulk Materials
No bulk materials will be transported on the project site
Vehicle speed will be limited on the work site All haul trucks will be loaded such that the freeboard is not less than six inches when transported across any paved public access road A sufficient amount of water will be applied to the top of the load to limit visible dust
emissions Haul trucks will be covered with a tarp or other suitable cover
Off-Site Transporting of Bulk Materials No bulk materials will be transported to or from the project site
The following practices wi be performed (complete Section 5-8) o The ipterior of emptied truck cargo compartments will be cleaned or covered before leaving
the site o Spillage or loss of bulk materials from holes or other openings in the cargo compartments
floor sides and tailgates will be prevented o Haul trucks will be covered with a tarp or other suitable cover or will be loaded such that the
freeboard is not less than six inches when transported on any paved public access road to or from the project site and a sufficient amount of water will be applied to the top of the load to limit visible dust emissions
Outdoor Transport using a Chute or Conveyor
No chutes or conveyors will be used
Ch ute orconveyorwill befully enclosed
Water spray equipment will be used to sufficiently wet the materials
Transported materials will be washed or screened to remove fines (PM1 0 or smaller)
3-E Comments
62915 NE 18 th St Ste 1 Bend OR 97701 P 154 13824707 1 1541383 8118 wallacegroup-inc com
Exhibit A-5 Page 7 of 13
Section4- DustControl Methods-Page 1
Project Name
4-A Water Application
Complete this section if water application will be used as a control method for limiting visible dust emissions and stabilizing surface areas Check and answer everything that applies to the project
Water Application Equipment
Sprinklers Describe the activities that will utilize sprinklers
Minimum treated area Square FeetAcres
Maximum treated area Square FeetAcres
Minimum waterflow rate ____Gallonsminute Duration ____-=-----shy_____
Water Truck Water Trailer Water Wagon Other __
Describe the activities that will utilize this equipment
Number of application equipment available
poundpplication equipmentcapacity
Water Supply Include the relative locations of these sources on the plot plan in Section 2
Fire hydrants
Number of hydrants available On-Site____ Off-Site____
Approval granted by the owner or public agency to use their fire hydrants for this
project
Owner or Agency
Contact
Storage tanks Number and capacity
______Wells
Phone No
Number andflow rate
Approval granted by the owner or public agency to use their water source for this project
Owner or Agency
Contact ______________Phone No
629 15 NE 18fh St Ste 1 Bend OR 97701 p i 541 3824707 f 154 1383811 8 wallacegroup-inccom
Exhibit A-5 Page 8 of 13
Section 4 - Dust Control Methods- Page 2
Project Name
4-8 Dust Suppressant Products
Complete this section if a dust suppressant product will be used These materials include but are not limited to hygroscopic suppressants (road salts) adhesives petroleum emulsions polymer emulsions and bituminous materials (road oils)
Coov this oaae if more than QrrELdust suoore-SSantoroduct will bpoundLused
D Not Applicable Only water application will be the control method used Skip t04-C
Application Area shy
Product Name ( Contractors Name
) ~ Phone No
Application Rate Gallons of undiluted material per mile or acre treated
Application Frequency Applicationsperweek month year ~
Application Equipment
Number of Application Equipment Available gtj
Application EquipmentCapacity Attach each of the following information that fully describes this product Use the checklist below to make sure all information is submitted with this plan
Product Specifications (MSDS Product Safety Data Sheet etc)
Manufacturers Usage Instructions (method frequency and intensity of application) Env~ronmental impacts and approvals or certifications related to the appropriate and safe use for qround appJication
62915 NE 18111 St Ste 1 Bend OR 97701 pi 541 3824707 f 154 13838118 wallacegroup-inccom
Exhibit A-5 Page 9 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
Dust Control Plan Section 2-Plot Plan - Page 1
Project Name
2-A Plot Plan
A plot plan identifies the type and location of each project Attach appropriately sized maps with the project boundaries outlined or use the space in sections 2-B or 2-C to draw a plot plan Attached maps may include tract maps site maps and topographic maps Use the checklist below to make sure all areas have been identified on the I t Ian
Identify the relative locations of actual and potential sources of fugitive dust emissions
Bulk material handling and storage areas
Paved and unpaved access roads haul roads traffic areas and equipment
storage yards Exit points where carryout and tracks onto paved public
roads may occur Water supply locations if water application will be used for controlling visible dust emissions Other
2-B Draw Plot Plan (if one is not attached) Include a North Arrow
Plot plan is attached (Skip to 3-A)
62915 NE 18rn St Sle 1 Bend OR 97701 P 1541 3824707 f 1541 383 8118 wallacegroup-inccom
Exhibit A-5 Page 4 of 13
Dust Control Plan Section 3 - Fugitive Sources - Page 1
Project Name
3-A Disturbed Surface Area
Report the total area of land surface to be disturbed the estimates daily throughput volume of earthmoving in cubic yards and the total area inacres ofthe entire project site
Total area of land surface to be disturbed Acres
Daily maximum throughput volume of earthmoving Cubic Yards
Daily average throughput volume of earthmoving Cubic Yards
Total area of entire project site Acres
Total disturbed areas that will be left inactive for more than seven days shy Acres ~
3-8 Dust Generating Activity Dates ( ~ ~
The expected start and completion dates of dust generating activities and soil disturbance activities to be performed on site For phased projects it may be necessary to report expected start and completion dates separately
Expected start date ~~
Completion Date
Phase ProjectStart-A -
Completion-A
Phase Project Start shy B ~ Completion- B J
Phase Project Start- C Completion -C
t I ~V L
62915 NE 181h Sl Ste 1 Bend OR 97701 P I 541 ~382470 7 f 154 138381 18 wallacegroup-inccom
Exhibit A-5 Page 5 of 13
Section 3 - Fugitive Sources - Page 2
Project Name
3-C Sources of Fugitive Dust
This section describes the minimum requirements for limiting visible dust emissions from activities that cause fugitive dust emissions Check at least one box under each category
Structu raiD e m olition
No demolitions are planned for this project
Asbestos NESHAP notification and fees have been submitted to the I-()l
Water will be applied to the following areas for the duration of the demolition activities bull 8uilding exteriorsurfaces bull Unpaved surface areas where equipment will operate bull Razed building materials and bull Water or dust suppressants will be applied to unpaved surface areas within 100 feet of
structure during demolition
Pre-Activity
Not applicable for this project (Please explain why in Section 3-E)
The site will be pre-watered and work will be phased to reduce the amount of disturbed surface area at anyone time (Complete Section 4-A)
Active Operations Water will be applied to dry areas during leveling grading trenching and earthmoving activities (Complete Section 4-A) Wind barriers will be constructed and maintained and water or dust suppressants will be applied to the disturbed surface areas (Complete Sections 4-A or 4-8 and 4-C)
Inactive Operations including after work hours weekends and holidays
Not applicable for this project (Please explain why in Section 3-E) Water or dust suppressants wiU be applied on disturbed surface areas to form a visible crust and vehicle access will be restricted to maintain the visible crust (Complete Section 4shyA or 4-8 and 4-C)
Temporary stabilization of areas that remains unused for seven or more days Not applicable for this project (Please explain why in Section3-E)
Vehicular access will be restricted and water or dust suppressants will be applied and maintained at all un- vegetated areas (Complete Section 4-A or 4-8 and4-C) Vegetation will be reestablished on all previously disturbed areas (Complete Section 4shy
C) Gravel will be applied and maintained at all previously disturbed areas (Complete
Section 4-C) Previously disturbed areas will be paved (Complete Section 4-C)
Unpaved Access and Haul Roads Traffic and Equipment Storage Areas Not applicable for this project (Please explain why in Section3-E)
Apply water or dust suppressants to unpaved haul and access roads (Complete Section 4-A or4-8) Water or dust suppressants will be applied to vehicle traffic and equipment storage areas (Complete Section 4-A or4-8)
62915 NE 181h SL Ste 1 Bend OR 97701 P I 5413824707 t I 5413838118 wallacegroup-inccom
Exhibit A-5 Page 6 of 13
Section 3 - Fugitive Sources - Page 3
3-D Bulk Materials
Outdoor Handling of Bulk Materials
No bulk materials will be handled during this
project
Water or dust suppressants will be applied when handling bulk materials Wind barriers with less than 50 percent porosity will be installed and maintained and water or dust suppressants will be applied
Outdoor Storage of Bulk Materials
No bulk materials will be stored during this project
Water or dust suppressants will be applied to storage piles Storage piles will be covered with tarps plastic or other suitable material and anchored in such a manner that prevents the cover from being removed by wind action A three-sided structure laquo 50 porosity) will be used that is at least as high as the storage piles
On-Site Transporting of Bulk Materials
No bulk materials will be transported on the project site
Vehicle speed will be limited on the work site All haul trucks will be loaded such that the freeboard is not less than six inches when transported across any paved public access road A sufficient amount of water will be applied to the top of the load to limit visible dust
emissions Haul trucks will be covered with a tarp or other suitable cover
Off-Site Transporting of Bulk Materials No bulk materials will be transported to or from the project site
The following practices wi be performed (complete Section 5-8) o The ipterior of emptied truck cargo compartments will be cleaned or covered before leaving
the site o Spillage or loss of bulk materials from holes or other openings in the cargo compartments
floor sides and tailgates will be prevented o Haul trucks will be covered with a tarp or other suitable cover or will be loaded such that the
freeboard is not less than six inches when transported on any paved public access road to or from the project site and a sufficient amount of water will be applied to the top of the load to limit visible dust emissions
Outdoor Transport using a Chute or Conveyor
No chutes or conveyors will be used
Ch ute orconveyorwill befully enclosed
Water spray equipment will be used to sufficiently wet the materials
Transported materials will be washed or screened to remove fines (PM1 0 or smaller)
3-E Comments
62915 NE 18 th St Ste 1 Bend OR 97701 P 154 13824707 1 1541383 8118 wallacegroup-inc com
Exhibit A-5 Page 7 of 13
Section4- DustControl Methods-Page 1
Project Name
4-A Water Application
Complete this section if water application will be used as a control method for limiting visible dust emissions and stabilizing surface areas Check and answer everything that applies to the project
Water Application Equipment
Sprinklers Describe the activities that will utilize sprinklers
Minimum treated area Square FeetAcres
Maximum treated area Square FeetAcres
Minimum waterflow rate ____Gallonsminute Duration ____-=-----shy_____
Water Truck Water Trailer Water Wagon Other __
Describe the activities that will utilize this equipment
Number of application equipment available
poundpplication equipmentcapacity
Water Supply Include the relative locations of these sources on the plot plan in Section 2
Fire hydrants
Number of hydrants available On-Site____ Off-Site____
Approval granted by the owner or public agency to use their fire hydrants for this
project
Owner or Agency
Contact
Storage tanks Number and capacity
______Wells
Phone No
Number andflow rate
Approval granted by the owner or public agency to use their water source for this project
Owner or Agency
Contact ______________Phone No
629 15 NE 18fh St Ste 1 Bend OR 97701 p i 541 3824707 f 154 1383811 8 wallacegroup-inccom
Exhibit A-5 Page 8 of 13
Section 4 - Dust Control Methods- Page 2
Project Name
4-8 Dust Suppressant Products
Complete this section if a dust suppressant product will be used These materials include but are not limited to hygroscopic suppressants (road salts) adhesives petroleum emulsions polymer emulsions and bituminous materials (road oils)
Coov this oaae if more than QrrELdust suoore-SSantoroduct will bpoundLused
D Not Applicable Only water application will be the control method used Skip t04-C
Application Area shy
Product Name ( Contractors Name
) ~ Phone No
Application Rate Gallons of undiluted material per mile or acre treated
Application Frequency Applicationsperweek month year ~
Application Equipment
Number of Application Equipment Available gtj
Application EquipmentCapacity Attach each of the following information that fully describes this product Use the checklist below to make sure all information is submitted with this plan
Product Specifications (MSDS Product Safety Data Sheet etc)
Manufacturers Usage Instructions (method frequency and intensity of application) Env~ronmental impacts and approvals or certifications related to the appropriate and safe use for qround appJication
62915 NE 18111 St Ste 1 Bend OR 97701 pi 541 3824707 f 154 13838118 wallacegroup-inccom
Exhibit A-5 Page 9 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
Dust Control Plan Section 3 - Fugitive Sources - Page 1
Project Name
3-A Disturbed Surface Area
Report the total area of land surface to be disturbed the estimates daily throughput volume of earthmoving in cubic yards and the total area inacres ofthe entire project site
Total area of land surface to be disturbed Acres
Daily maximum throughput volume of earthmoving Cubic Yards
Daily average throughput volume of earthmoving Cubic Yards
Total area of entire project site Acres
Total disturbed areas that will be left inactive for more than seven days shy Acres ~
3-8 Dust Generating Activity Dates ( ~ ~
The expected start and completion dates of dust generating activities and soil disturbance activities to be performed on site For phased projects it may be necessary to report expected start and completion dates separately
Expected start date ~~
Completion Date
Phase ProjectStart-A -
Completion-A
Phase Project Start shy B ~ Completion- B J
Phase Project Start- C Completion -C
t I ~V L
62915 NE 181h Sl Ste 1 Bend OR 97701 P I 541 ~382470 7 f 154 138381 18 wallacegroup-inccom
Exhibit A-5 Page 5 of 13
Section 3 - Fugitive Sources - Page 2
Project Name
3-C Sources of Fugitive Dust
This section describes the minimum requirements for limiting visible dust emissions from activities that cause fugitive dust emissions Check at least one box under each category
Structu raiD e m olition
No demolitions are planned for this project
Asbestos NESHAP notification and fees have been submitted to the I-()l
Water will be applied to the following areas for the duration of the demolition activities bull 8uilding exteriorsurfaces bull Unpaved surface areas where equipment will operate bull Razed building materials and bull Water or dust suppressants will be applied to unpaved surface areas within 100 feet of
structure during demolition
Pre-Activity
Not applicable for this project (Please explain why in Section 3-E)
The site will be pre-watered and work will be phased to reduce the amount of disturbed surface area at anyone time (Complete Section 4-A)
Active Operations Water will be applied to dry areas during leveling grading trenching and earthmoving activities (Complete Section 4-A) Wind barriers will be constructed and maintained and water or dust suppressants will be applied to the disturbed surface areas (Complete Sections 4-A or 4-8 and 4-C)
Inactive Operations including after work hours weekends and holidays
Not applicable for this project (Please explain why in Section 3-E) Water or dust suppressants wiU be applied on disturbed surface areas to form a visible crust and vehicle access will be restricted to maintain the visible crust (Complete Section 4shyA or 4-8 and 4-C)
Temporary stabilization of areas that remains unused for seven or more days Not applicable for this project (Please explain why in Section3-E)
Vehicular access will be restricted and water or dust suppressants will be applied and maintained at all un- vegetated areas (Complete Section 4-A or 4-8 and4-C) Vegetation will be reestablished on all previously disturbed areas (Complete Section 4shy
C) Gravel will be applied and maintained at all previously disturbed areas (Complete
Section 4-C) Previously disturbed areas will be paved (Complete Section 4-C)
Unpaved Access and Haul Roads Traffic and Equipment Storage Areas Not applicable for this project (Please explain why in Section3-E)
Apply water or dust suppressants to unpaved haul and access roads (Complete Section 4-A or4-8) Water or dust suppressants will be applied to vehicle traffic and equipment storage areas (Complete Section 4-A or4-8)
62915 NE 181h SL Ste 1 Bend OR 97701 P I 5413824707 t I 5413838118 wallacegroup-inccom
Exhibit A-5 Page 6 of 13
Section 3 - Fugitive Sources - Page 3
3-D Bulk Materials
Outdoor Handling of Bulk Materials
No bulk materials will be handled during this
project
Water or dust suppressants will be applied when handling bulk materials Wind barriers with less than 50 percent porosity will be installed and maintained and water or dust suppressants will be applied
Outdoor Storage of Bulk Materials
No bulk materials will be stored during this project
Water or dust suppressants will be applied to storage piles Storage piles will be covered with tarps plastic or other suitable material and anchored in such a manner that prevents the cover from being removed by wind action A three-sided structure laquo 50 porosity) will be used that is at least as high as the storage piles
On-Site Transporting of Bulk Materials
No bulk materials will be transported on the project site
Vehicle speed will be limited on the work site All haul trucks will be loaded such that the freeboard is not less than six inches when transported across any paved public access road A sufficient amount of water will be applied to the top of the load to limit visible dust
emissions Haul trucks will be covered with a tarp or other suitable cover
Off-Site Transporting of Bulk Materials No bulk materials will be transported to or from the project site
The following practices wi be performed (complete Section 5-8) o The ipterior of emptied truck cargo compartments will be cleaned or covered before leaving
the site o Spillage or loss of bulk materials from holes or other openings in the cargo compartments
floor sides and tailgates will be prevented o Haul trucks will be covered with a tarp or other suitable cover or will be loaded such that the
freeboard is not less than six inches when transported on any paved public access road to or from the project site and a sufficient amount of water will be applied to the top of the load to limit visible dust emissions
Outdoor Transport using a Chute or Conveyor
No chutes or conveyors will be used
Ch ute orconveyorwill befully enclosed
Water spray equipment will be used to sufficiently wet the materials
Transported materials will be washed or screened to remove fines (PM1 0 or smaller)
3-E Comments
62915 NE 18 th St Ste 1 Bend OR 97701 P 154 13824707 1 1541383 8118 wallacegroup-inc com
Exhibit A-5 Page 7 of 13
Section4- DustControl Methods-Page 1
Project Name
4-A Water Application
Complete this section if water application will be used as a control method for limiting visible dust emissions and stabilizing surface areas Check and answer everything that applies to the project
Water Application Equipment
Sprinklers Describe the activities that will utilize sprinklers
Minimum treated area Square FeetAcres
Maximum treated area Square FeetAcres
Minimum waterflow rate ____Gallonsminute Duration ____-=-----shy_____
Water Truck Water Trailer Water Wagon Other __
Describe the activities that will utilize this equipment
Number of application equipment available
poundpplication equipmentcapacity
Water Supply Include the relative locations of these sources on the plot plan in Section 2
Fire hydrants
Number of hydrants available On-Site____ Off-Site____
Approval granted by the owner or public agency to use their fire hydrants for this
project
Owner or Agency
Contact
Storage tanks Number and capacity
______Wells
Phone No
Number andflow rate
Approval granted by the owner or public agency to use their water source for this project
Owner or Agency
Contact ______________Phone No
629 15 NE 18fh St Ste 1 Bend OR 97701 p i 541 3824707 f 154 1383811 8 wallacegroup-inccom
Exhibit A-5 Page 8 of 13
Section 4 - Dust Control Methods- Page 2
Project Name
4-8 Dust Suppressant Products
Complete this section if a dust suppressant product will be used These materials include but are not limited to hygroscopic suppressants (road salts) adhesives petroleum emulsions polymer emulsions and bituminous materials (road oils)
Coov this oaae if more than QrrELdust suoore-SSantoroduct will bpoundLused
D Not Applicable Only water application will be the control method used Skip t04-C
Application Area shy
Product Name ( Contractors Name
) ~ Phone No
Application Rate Gallons of undiluted material per mile or acre treated
Application Frequency Applicationsperweek month year ~
Application Equipment
Number of Application Equipment Available gtj
Application EquipmentCapacity Attach each of the following information that fully describes this product Use the checklist below to make sure all information is submitted with this plan
Product Specifications (MSDS Product Safety Data Sheet etc)
Manufacturers Usage Instructions (method frequency and intensity of application) Env~ronmental impacts and approvals or certifications related to the appropriate and safe use for qround appJication
62915 NE 18111 St Ste 1 Bend OR 97701 pi 541 3824707 f 154 13838118 wallacegroup-inccom
Exhibit A-5 Page 9 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
Section 3 - Fugitive Sources - Page 2
Project Name
3-C Sources of Fugitive Dust
This section describes the minimum requirements for limiting visible dust emissions from activities that cause fugitive dust emissions Check at least one box under each category
Structu raiD e m olition
No demolitions are planned for this project
Asbestos NESHAP notification and fees have been submitted to the I-()l
Water will be applied to the following areas for the duration of the demolition activities bull 8uilding exteriorsurfaces bull Unpaved surface areas where equipment will operate bull Razed building materials and bull Water or dust suppressants will be applied to unpaved surface areas within 100 feet of
structure during demolition
Pre-Activity
Not applicable for this project (Please explain why in Section 3-E)
The site will be pre-watered and work will be phased to reduce the amount of disturbed surface area at anyone time (Complete Section 4-A)
Active Operations Water will be applied to dry areas during leveling grading trenching and earthmoving activities (Complete Section 4-A) Wind barriers will be constructed and maintained and water or dust suppressants will be applied to the disturbed surface areas (Complete Sections 4-A or 4-8 and 4-C)
Inactive Operations including after work hours weekends and holidays
Not applicable for this project (Please explain why in Section 3-E) Water or dust suppressants wiU be applied on disturbed surface areas to form a visible crust and vehicle access will be restricted to maintain the visible crust (Complete Section 4shyA or 4-8 and 4-C)
Temporary stabilization of areas that remains unused for seven or more days Not applicable for this project (Please explain why in Section3-E)
Vehicular access will be restricted and water or dust suppressants will be applied and maintained at all un- vegetated areas (Complete Section 4-A or 4-8 and4-C) Vegetation will be reestablished on all previously disturbed areas (Complete Section 4shy
C) Gravel will be applied and maintained at all previously disturbed areas (Complete
Section 4-C) Previously disturbed areas will be paved (Complete Section 4-C)
Unpaved Access and Haul Roads Traffic and Equipment Storage Areas Not applicable for this project (Please explain why in Section3-E)
Apply water or dust suppressants to unpaved haul and access roads (Complete Section 4-A or4-8) Water or dust suppressants will be applied to vehicle traffic and equipment storage areas (Complete Section 4-A or4-8)
62915 NE 181h SL Ste 1 Bend OR 97701 P I 5413824707 t I 5413838118 wallacegroup-inccom
Exhibit A-5 Page 6 of 13
Section 3 - Fugitive Sources - Page 3
3-D Bulk Materials
Outdoor Handling of Bulk Materials
No bulk materials will be handled during this
project
Water or dust suppressants will be applied when handling bulk materials Wind barriers with less than 50 percent porosity will be installed and maintained and water or dust suppressants will be applied
Outdoor Storage of Bulk Materials
No bulk materials will be stored during this project
Water or dust suppressants will be applied to storage piles Storage piles will be covered with tarps plastic or other suitable material and anchored in such a manner that prevents the cover from being removed by wind action A three-sided structure laquo 50 porosity) will be used that is at least as high as the storage piles
On-Site Transporting of Bulk Materials
No bulk materials will be transported on the project site
Vehicle speed will be limited on the work site All haul trucks will be loaded such that the freeboard is not less than six inches when transported across any paved public access road A sufficient amount of water will be applied to the top of the load to limit visible dust
emissions Haul trucks will be covered with a tarp or other suitable cover
Off-Site Transporting of Bulk Materials No bulk materials will be transported to or from the project site
The following practices wi be performed (complete Section 5-8) o The ipterior of emptied truck cargo compartments will be cleaned or covered before leaving
the site o Spillage or loss of bulk materials from holes or other openings in the cargo compartments
floor sides and tailgates will be prevented o Haul trucks will be covered with a tarp or other suitable cover or will be loaded such that the
freeboard is not less than six inches when transported on any paved public access road to or from the project site and a sufficient amount of water will be applied to the top of the load to limit visible dust emissions
Outdoor Transport using a Chute or Conveyor
No chutes or conveyors will be used
Ch ute orconveyorwill befully enclosed
Water spray equipment will be used to sufficiently wet the materials
Transported materials will be washed or screened to remove fines (PM1 0 or smaller)
3-E Comments
62915 NE 18 th St Ste 1 Bend OR 97701 P 154 13824707 1 1541383 8118 wallacegroup-inc com
Exhibit A-5 Page 7 of 13
Section4- DustControl Methods-Page 1
Project Name
4-A Water Application
Complete this section if water application will be used as a control method for limiting visible dust emissions and stabilizing surface areas Check and answer everything that applies to the project
Water Application Equipment
Sprinklers Describe the activities that will utilize sprinklers
Minimum treated area Square FeetAcres
Maximum treated area Square FeetAcres
Minimum waterflow rate ____Gallonsminute Duration ____-=-----shy_____
Water Truck Water Trailer Water Wagon Other __
Describe the activities that will utilize this equipment
Number of application equipment available
poundpplication equipmentcapacity
Water Supply Include the relative locations of these sources on the plot plan in Section 2
Fire hydrants
Number of hydrants available On-Site____ Off-Site____
Approval granted by the owner or public agency to use their fire hydrants for this
project
Owner or Agency
Contact
Storage tanks Number and capacity
______Wells
Phone No
Number andflow rate
Approval granted by the owner or public agency to use their water source for this project
Owner or Agency
Contact ______________Phone No
629 15 NE 18fh St Ste 1 Bend OR 97701 p i 541 3824707 f 154 1383811 8 wallacegroup-inccom
Exhibit A-5 Page 8 of 13
Section 4 - Dust Control Methods- Page 2
Project Name
4-8 Dust Suppressant Products
Complete this section if a dust suppressant product will be used These materials include but are not limited to hygroscopic suppressants (road salts) adhesives petroleum emulsions polymer emulsions and bituminous materials (road oils)
Coov this oaae if more than QrrELdust suoore-SSantoroduct will bpoundLused
D Not Applicable Only water application will be the control method used Skip t04-C
Application Area shy
Product Name ( Contractors Name
) ~ Phone No
Application Rate Gallons of undiluted material per mile or acre treated
Application Frequency Applicationsperweek month year ~
Application Equipment
Number of Application Equipment Available gtj
Application EquipmentCapacity Attach each of the following information that fully describes this product Use the checklist below to make sure all information is submitted with this plan
Product Specifications (MSDS Product Safety Data Sheet etc)
Manufacturers Usage Instructions (method frequency and intensity of application) Env~ronmental impacts and approvals or certifications related to the appropriate and safe use for qround appJication
62915 NE 18111 St Ste 1 Bend OR 97701 pi 541 3824707 f 154 13838118 wallacegroup-inccom
Exhibit A-5 Page 9 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
Section 3 - Fugitive Sources - Page 3
3-D Bulk Materials
Outdoor Handling of Bulk Materials
No bulk materials will be handled during this
project
Water or dust suppressants will be applied when handling bulk materials Wind barriers with less than 50 percent porosity will be installed and maintained and water or dust suppressants will be applied
Outdoor Storage of Bulk Materials
No bulk materials will be stored during this project
Water or dust suppressants will be applied to storage piles Storage piles will be covered with tarps plastic or other suitable material and anchored in such a manner that prevents the cover from being removed by wind action A three-sided structure laquo 50 porosity) will be used that is at least as high as the storage piles
On-Site Transporting of Bulk Materials
No bulk materials will be transported on the project site
Vehicle speed will be limited on the work site All haul trucks will be loaded such that the freeboard is not less than six inches when transported across any paved public access road A sufficient amount of water will be applied to the top of the load to limit visible dust
emissions Haul trucks will be covered with a tarp or other suitable cover
Off-Site Transporting of Bulk Materials No bulk materials will be transported to or from the project site
The following practices wi be performed (complete Section 5-8) o The ipterior of emptied truck cargo compartments will be cleaned or covered before leaving
the site o Spillage or loss of bulk materials from holes or other openings in the cargo compartments
floor sides and tailgates will be prevented o Haul trucks will be covered with a tarp or other suitable cover or will be loaded such that the
freeboard is not less than six inches when transported on any paved public access road to or from the project site and a sufficient amount of water will be applied to the top of the load to limit visible dust emissions
Outdoor Transport using a Chute or Conveyor
No chutes or conveyors will be used
Ch ute orconveyorwill befully enclosed
Water spray equipment will be used to sufficiently wet the materials
Transported materials will be washed or screened to remove fines (PM1 0 or smaller)
3-E Comments
62915 NE 18 th St Ste 1 Bend OR 97701 P 154 13824707 1 1541383 8118 wallacegroup-inc com
Exhibit A-5 Page 7 of 13
Section4- DustControl Methods-Page 1
Project Name
4-A Water Application
Complete this section if water application will be used as a control method for limiting visible dust emissions and stabilizing surface areas Check and answer everything that applies to the project
Water Application Equipment
Sprinklers Describe the activities that will utilize sprinklers
Minimum treated area Square FeetAcres
Maximum treated area Square FeetAcres
Minimum waterflow rate ____Gallonsminute Duration ____-=-----shy_____
Water Truck Water Trailer Water Wagon Other __
Describe the activities that will utilize this equipment
Number of application equipment available
poundpplication equipmentcapacity
Water Supply Include the relative locations of these sources on the plot plan in Section 2
Fire hydrants
Number of hydrants available On-Site____ Off-Site____
Approval granted by the owner or public agency to use their fire hydrants for this
project
Owner or Agency
Contact
Storage tanks Number and capacity
______Wells
Phone No
Number andflow rate
Approval granted by the owner or public agency to use their water source for this project
Owner or Agency
Contact ______________Phone No
629 15 NE 18fh St Ste 1 Bend OR 97701 p i 541 3824707 f 154 1383811 8 wallacegroup-inccom
Exhibit A-5 Page 8 of 13
Section 4 - Dust Control Methods- Page 2
Project Name
4-8 Dust Suppressant Products
Complete this section if a dust suppressant product will be used These materials include but are not limited to hygroscopic suppressants (road salts) adhesives petroleum emulsions polymer emulsions and bituminous materials (road oils)
Coov this oaae if more than QrrELdust suoore-SSantoroduct will bpoundLused
D Not Applicable Only water application will be the control method used Skip t04-C
Application Area shy
Product Name ( Contractors Name
) ~ Phone No
Application Rate Gallons of undiluted material per mile or acre treated
Application Frequency Applicationsperweek month year ~
Application Equipment
Number of Application Equipment Available gtj
Application EquipmentCapacity Attach each of the following information that fully describes this product Use the checklist below to make sure all information is submitted with this plan
Product Specifications (MSDS Product Safety Data Sheet etc)
Manufacturers Usage Instructions (method frequency and intensity of application) Env~ronmental impacts and approvals or certifications related to the appropriate and safe use for qround appJication
62915 NE 18111 St Ste 1 Bend OR 97701 pi 541 3824707 f 154 13838118 wallacegroup-inccom
Exhibit A-5 Page 9 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
Section4- DustControl Methods-Page 1
Project Name
4-A Water Application
Complete this section if water application will be used as a control method for limiting visible dust emissions and stabilizing surface areas Check and answer everything that applies to the project
Water Application Equipment
Sprinklers Describe the activities that will utilize sprinklers
Minimum treated area Square FeetAcres
Maximum treated area Square FeetAcres
Minimum waterflow rate ____Gallonsminute Duration ____-=-----shy_____
Water Truck Water Trailer Water Wagon Other __
Describe the activities that will utilize this equipment
Number of application equipment available
poundpplication equipmentcapacity
Water Supply Include the relative locations of these sources on the plot plan in Section 2
Fire hydrants
Number of hydrants available On-Site____ Off-Site____
Approval granted by the owner or public agency to use their fire hydrants for this
project
Owner or Agency
Contact
Storage tanks Number and capacity
______Wells
Phone No
Number andflow rate
Approval granted by the owner or public agency to use their water source for this project
Owner or Agency
Contact ______________Phone No
629 15 NE 18fh St Ste 1 Bend OR 97701 p i 541 3824707 f 154 1383811 8 wallacegroup-inccom
Exhibit A-5 Page 8 of 13
Section 4 - Dust Control Methods- Page 2
Project Name
4-8 Dust Suppressant Products
Complete this section if a dust suppressant product will be used These materials include but are not limited to hygroscopic suppressants (road salts) adhesives petroleum emulsions polymer emulsions and bituminous materials (road oils)
Coov this oaae if more than QrrELdust suoore-SSantoroduct will bpoundLused
D Not Applicable Only water application will be the control method used Skip t04-C
Application Area shy
Product Name ( Contractors Name
) ~ Phone No
Application Rate Gallons of undiluted material per mile or acre treated
Application Frequency Applicationsperweek month year ~
Application Equipment
Number of Application Equipment Available gtj
Application EquipmentCapacity Attach each of the following information that fully describes this product Use the checklist below to make sure all information is submitted with this plan
Product Specifications (MSDS Product Safety Data Sheet etc)
Manufacturers Usage Instructions (method frequency and intensity of application) Env~ronmental impacts and approvals or certifications related to the appropriate and safe use for qround appJication
62915 NE 18111 St Ste 1 Bend OR 97701 pi 541 3824707 f 154 13838118 wallacegroup-inccom
Exhibit A-5 Page 9 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
Section 4 - Dust Control Methods- Page 2
Project Name
4-8 Dust Suppressant Products
Complete this section if a dust suppressant product will be used These materials include but are not limited to hygroscopic suppressants (road salts) adhesives petroleum emulsions polymer emulsions and bituminous materials (road oils)
Coov this oaae if more than QrrELdust suoore-SSantoroduct will bpoundLused
D Not Applicable Only water application will be the control method used Skip t04-C
Application Area shy
Product Name ( Contractors Name
) ~ Phone No
Application Rate Gallons of undiluted material per mile or acre treated
Application Frequency Applicationsperweek month year ~
Application Equipment
Number of Application Equipment Available gtj
Application EquipmentCapacity Attach each of the following information that fully describes this product Use the checklist below to make sure all information is submitted with this plan
Product Specifications (MSDS Product Safety Data Sheet etc)
Manufacturers Usage Instructions (method frequency and intensity of application) Env~ronmental impacts and approvals or certifications related to the appropriate and safe use for qround appJication
62915 NE 18111 St Ste 1 Bend OR 97701 pi 541 3824707 f 154 13838118 wallacegroup-inccom
Exhibit A-5 Page 9 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
Section 4 - Carry-Out and Track-Out - Page 3
Project Name
4-C Other Dust Control Methods
Check below the other types of dust control methods that will be employed at the construction site
o Physical barriers for restricting unauthorized vehicleaccess Fences Gates Posts Berms Concrete Barriers
Other
Wind barriers Describe __________________________
Re-establish vegetation for temporarily stabilizing previously disturbed surfaces
Explain_____________~___----~__----------o Apply and maintain gravel
On haul roads On access roads At equipment storage yards o At vehicle traffic areas For temporarily stabilizing previously disturbed areas
Explain------------------------------------------7---- shyApply pavement
o Explain________=-------___~-=-------------
Other
4-0 Contingencies
Contingencies to be implemented if application equipment becomes inoperable more equipment is needed to effectively control fugitive dust emissions during active and inactive periods accessibility limitations occur at the water sources or staff is not available to operate the application equipment Describe the contingencies that will be in place and when they will be implemented Attach any additional information if needed
4-E Record keeping Records and any other supporting documents for demonstrating compliance with dust control must be maintained by the owneroperator for those days when a control measure is implemented
62915 NE 181 81 8te L Bend OR 97701 P 1541382470 t 1541 3838118 wal lacegroup-inccom
Exhibit A-5 Page 10 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-A Treatments for Preventing Track-Out
Select the control devices that will be used for preventing track-out from occurring onto paved public roads Track-out is any material that adheres to vehicle tires and is deposited onto a paved public road or the paved shoulder of a paved public road Check one or a combination that will apply to this project
Grizzly Rails pipes or grates used to dislodge debris off of vehicles before exiting the site Extends from the intersection with the paved public road surface for the full width of the unpaved exit surface for a distance of at least 25 feet
Describe
Gravel Pad A layer of washed gravel at least one (1) inch or larger in diameter three (3) inches deep and extends from the intersection with the public paved road surface for the full width of the unpaved exit surface for a distance of at least 50 feet
Gravel Size ____lnches
Pad Width Feet Length____Feet Depth ____Inches
Paved Surface Extends from the intersection with the paved public road surface for the full width of the unpaved access road for at least 100 feet to allow mud and dirt to drop off of vehicles before exiting the site
Width Feet Length Feet
Mud and dirt deposits accumulating on paved interior roads will be removed with sufficient frequency but not less frequently than once per week
Clean-up Frequency
Wheel Washer Uses water to dislodge debris from tires and vehicle undercarriage
Describe ____---------_ ---==----=---_____________________
Other
62915 NE 18 81 Ste 1 Bend OR 977 01 p i 54 13824707 f 15413838118 wallacegroup-inccom
Exhibit A-5 Page 11 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
Section 5 - Carry-Out and Track-Out - Page 2
Project Name
5-8 Treatments for Preventing Carry-Out
Report the required treatments that will be used for preventing carry-out from occurring on paved public roads Carry-out occurs when materials from emptied or loaded haul trucks vehicles or trailers falls onto a paved public road or paved shoulder of a paved public road
No haul trucks will be routinely entering or leaving the project site
Emptied Haul Trucks Interior cargo compartments will be cleaned before leaving the project site
Cargo com partment will be covered with a tarp or suitable cover before leaving the project site
Loaded Haul Trucks Spillage or loss of materials from holes or other opening in the cargo compartment will be prevented when material is transported onto any paved public access road S~ct one or both of the required applications
H~ trucks will be loaded such that the freeboard is not less than six inches with water applied to tHe top of the load before leaving the project site
Cargo compartment and load will be covered with a tarp or suitable cover before leaving the project site
Other
5-C Record keeping for Cleanup of Carry-Out and Track-Out
Records and any other support-
ing documents for demonstrating compliance with carry-out and track-out must be maintained by the owneroperator
62915 NE 181h Sl Ste 1 Bend OR 9770 1 P I 54 13824707 f I 541 3838118 wallacegroup-inccorn
Exhibit A-5 Page 12 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13
Section 6 - Certification - Page 1
Project Name
6-A Certification
The owner principle operator or the individual implementing must certify the plan I certify that all information contained herein and information submitted in the attachments to this document are true and correct
Date
Email Cell Number
Print Name
Signature
Phone Number
6291 5 NE 18th St Ste 1 Bend OR 9770 1 P 1541382 4707 f I 541383811 8 waltacegroup-inc com
Exhibit A-5 Page 13 of 13