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WATER PROTECTION (REVIEW)
FILE CLOSEOUT AT TIME OF ENGINEERING APPROVAL/DENIAL
IMAGING CENTER INSTRUCTIONS
CHECKLIST
The Lead Engineer is to complete this form within 30 days of final action of WPO plan; place the completed
form in the WPO folder and forward to the Imaging Center for digital closeout into LaserFiche. Once items
have been placed in LaserFiche,Imaging Center staff will forward back to the Engineering Department. •
WPO# Rq.r;-- 2C PROJECT TITLE 4—t�L��y �S► GQ�
FULL NAME OF ENGINEER A,s( 6cee,e, FINAL ACTION DATE: 512114
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CountyView —
1 n Li s of Disturbance Area(Ac)updated
Status/Status Date updated
Hardcopy — File Folder Closeout: All items listed should be placed in project folder, in reverse
chronological order(latest on top).
Please check each item included in this folder. To indicate that an item.is not applicable to this file, place an"N/A"
next to the check box. The Lead Reviewer/Engineer has the discretion'to';include any item deemed necessary to
provide clarity to the file, please indicate that item on the"Other"lines provided.
Digital Closeout Instructions: Below each item please indicate if Imaging Center is to scan the document;
or, if the document is already in digital format, can be saved to LaserFiche. Pleaseprovide the digital location
(path/name)of the document in the space provided.
!
/
r--�y'Applicati signature copy)
Scan ❑ Saved location
EtApprove S Plan(signed, or stamped"Approved"with Engineer name)
i:K.
Scan ❑ Saved location :.
❑ Approved Mitigation Plan(stamped "Approved":with Engineer name)
Scan • ❑ Saved location :,, >:;_: •
Approved M Plan(stamped"Approved"with Eiigipeer.name)
Scan ❑ Saved location
❑ Army Corp Approval
❑ Scan • ❑ Saved location
❑ VDOT Approval
❑ ..Scan ❑ Saved location
❑ Calculations
❑ Scan _: f i Saved location
Bond Esti equest
Scan
n Saved location
❑ Bond Estimate Calculated
❑ Scan n Saved location
❑ O• ther(Please explain)
❑ Scan ❑ Saved location
❑ O• ther(Please explain)
n Scan n Saved location
•
I ❑ A• t the Engineer's discretion, copies of unapproved plans/plats may be placed in the file if they lend clarity to the
review at a later date. If such nlanc arp inrrinrl, ri