SW4120101_HISTORICAL FILE_20120218

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW /�loSIJIB/
T
DOC TYPE
❑ CURRENT PERMIT
❑ APPROVED PLANS
L�. HISTORICAL FILE
DOC DATE
IQ6/ �, g
YYYYMMDD

North Carolina Secretary of State
Page I of I
North Gar3lina
Elaine F. Marshall DEPARTMENT OFTF-{E
Secretary SECRETARYOF STATE
PO Box 29622 Raleigh, NC 27626-0622 [phone]
Date: 2/18/2012
Click here to:
View Document Filings I Sign Up for E-Notifications
Pre -populated Annual Report Fillable PDF Form I File an Annual Report
Corporation Names
Name Name Type
NC CORNERSTONE TRIAD LEGAL
REALTY, LLC
Limited Liability Company Information
SO SI D:
1124339
Status:
Current -Active
Effective Date:
11/18/2009
Annual Report Due Date:
Citizenship:
DOMESTIC
State of Inc.:
NC
Duration:
PERPETUAL
Annual Report Status:
CURRENT
Registered Agent
Agent Name: TERRELL, GRACE E.
Office Address: 1701 WESTCHESTER DRIVE, SUITE 850
HIGH POINT NC 27262
Mailing Address: 1701 WESTCHESTER DRIVE, SUITE 850
HIGH POINT NC 27262
Principal Office
Office Address: 1701 WESTCHESTER DRIVE, SUITE 850
HIGH POINT NC 27262
Mailing Address: 1701 WESTCHESTER DRIVE, SUITE 850
HIGH POINT NC 27262
Officers
This website is provided to the public as a part of the Secretary of State Knowledge Base (SOSKB) system. Version:
2167
http://www.secretary.state.nc.us/corporations/Corp.aspx?PitemId=9256490 2/ 18/2012

#RANCH
Owner/Developer
Cornerstone Healthcare of Asheboro
136 N. Park Street
Asheboro, NC 27203
Contact: Project Engineer
Phone: [phone]
Prepared By:
SUMMEY ENGINEERING ASSOCIATES, PLLC
ENGINEERING • LAND PLANNING • CONSULTING
P.O. BOX 968
ASHEBORO, NC 27204
Phone: [phone] Fax: [phone] \�,o�` CAR�'�ii,
E-mail: [e-mail]
February, 2012
7 -
/VGrNEE
S U 4NIM���������.

Stormwater Project Narrative
Cornerstone Health Care
Park Street
Randolph County - Asheboro, NC
The purpose of this narrative is to briefly describe the development of a new Healthcare Facility located on a 1.4
acre parcel near Downtown Asheboro, NC near the intersection of Park Street & Sunset Avenue. The site is
undeveloped.
The property consists of woods, grass & undergrowth.
This stormwater management plan is the result of the site being Tipped into the NPDES Phase li regulations and
as a result must comply with the Post Construction Rules.
The property is to be cleared, grubbed and graded for the construction of a new doctors office with associated
parking.
The plan for this project is to treat all new Impervious area with a Sand Filter Device.
The existing 1.40 acre site is vacant and the existing topography slopes from the North East to the South West
corner of the property.
The proposed development consists of clearing, grubbing & grading the existing building and paved areas
totaling 1.17 acres of Impervious Area.
Due to the nature of the development, we propose to use a Sand Filter to capture and treat the stormwater and
slow it down before leaving the site. The device is designed to capture the first one inch of runoff and slowly
release the flows over time into the ground and under drain system.
The site has been approved by the City of Asheboro Planning and Engineering Departments and the NCDENR-
Division of Land Quality. Please see the attached plans, calculations and details for more information.
26,14 7
1z
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ADS, Inc. Drainage Handbook Hydraulics ♦ 3-5
Figure 3-9
Discharge Rates for ADS Corrugated Pipe with Smooth Interior Liner'
1000.00
500.01
400.01
300.0(
200.0(
100.00
50.0
40.0
30.0
20.0
u
C t0.00
a
u
3
0
LL 5.01
4.01
3.O1
2.0(
1.0c
0.51
0.41
0.31
0.2(
SA .Ns
0.1 c
40 fps (12.2mfs)
25 fps (10.7mis)
31 fps (9.4mfs)
27 fps (8,2m1s)
25 fps (7.6m1s)
23 fps (7.0mis}
21 fps (6.4misy
19 fps (5.8mis)
17 fps (5.2mis)
15 fps (4.6mfs)
13 fps (4,0m1s)
10 fps (3.Omis)
9 fps (2.7m1s)
8 fps (2.4mis)
9 e- zP e-
o o a o
Q M C
p O o 0 o
Slope of pipe in feet per 100ft (%slope►
1CfS = 0.02832 m'/s
lftls = 0.30480 m!s
1%=0.01fvft
1. Applicable products: N-12®, MEGA GREEN, N-12 STIB, N-12 WT[B, N-12 HP, SaniTltJ, SaniTite HP, N-12
Low Head
Note: Based on a design Manning's "n" of 0.012.
Solid lines indicate pipe diameters. Dashed lines indicate approximate flow velocity.
Redeveloped from FHWA HDS 3 - Design Charts for Open -Channel Flow2
© ADS, [nc., July 2010

Sand Filter Selection Worksheet
t (days)? 1.66
k (ft/day)? 3.5
110 (inlhr)? 6.85
df min (ft)? 2
«« Time to Drain Filter
«« Coefficient of Sand Permeability
«« Rainfall Intensity
«« Minimum Allowable Filter Depth
Filter
#
Ad
Drainage
Area (Ac)
Imp. Area
(ac)
% Imp.
RIO
Coeff.
"C"
Rv
Rd
WQV
W)
WQVadj
= (0,75) x
WQV
S 5
Sed.
Basin
(Min.)
1
1.17
0.89
75.98
0.77
0.73
1 1.0
3,1163
2,337.5
205.7
#DIVIO!
##1###
#DIVIO!
#DIVIO!
#DIV/01
#DIVIO!
#;####
#DIVIO!
#DIV/O!
#DIVIO!
#DIVIO!
##I;4`l#
#DIV10!
#DIVIO!
#DIVIO!
#DIVIO!
#DIVIO!
#DIVIO!
#DIVI01
#DIVIO!
###
#DIVIO!
#DIVIO!
#DIVIO!
#DIV/01
#####
#DIVIO!
#DIV/O!
#DIV/0!
#DIVIO!
#####
#DIVIO!
#DIVIO!
#DIVIO!
#DIVIO!
#
#DIVIO!
#DIVIO!
#DIVIO!
Rv = Volumetric Runoff Coefficient (0.05+(0.009x(%Imp)) (Unitless)
Rd = Design Storm Rainfall Depth (1" INC Piedmont or 1.5' NC Coast) (in.)
WQV = (Rv x Ad x 43,560 x Rd)112
As = Sedimentation Basin Area (sf)
As (Minimum) = 0.066 x WQV: Minimum Sedimentation Basin Area (sf)
df: Depth of Sand Filter Bed (ft)
k: Coefficient of Permeability for the Sand Filter (3.5 ftlday)
t: Time Required to Drain the WQV Through the Sand Filter (day). Should be 40 Hours (1.66 days).
hMaxFilter = WQVadjl(As + Af): Maximum Bead On Sand Filter - between 2 and 6 feet
hA = hMaxFilter 12 (ft)
Af = Sand Filter Area (sf)
Af (Minimum) = (WQV x df)1 (1c x t x (hA + df)): Minimum Filter Bed Area (sf)
MaxFilter
Drainage Area
1.17
0.00
0.00
0. 00
0.00
0.00
0,00
0.00
0.00
0.5
�67�5#1
�
0��
iREF!
#
f#R�F!�
#REF!
#REF!
#REF!
0.0
1.0
2337.5
0.0
#REF!
#REF!
#REF!
#REF!
#REF!
0.0
1.5
1558T4�
t00M
,#REF!'.
]
#REF!
#REF!
#REF!
0.0
2.0
1168.8
0.0
#REF!
#REF!
#REF!#M
#REF!
#REF!
0.0
2.5
t9_2MOIN
0.0
L#REFIl
#REF!
[#.REFl]
#REF!
PWR,.EFI
#REF!
- 0..0. -
3.0
779.2
=010M
#REF!
#REF!
##REFI"
#REF!
#REF!
WXRG
0.0
3.5
667.9
0.0
#REF!
[#_REFIT
#REF!
#REF!
#REF!
#REF!
EM
4.0
584.4
1 0.0
#REF!
#REF!
#REF!
#REF!
#REF!
#REF!
0.0
4.5
519.5
OI<0
RE
#REF!
#REFI
I #REF!
I #REF!
WREF
Filter 1 Ac
hMaxFilter WQV adj As + Af Af (min.)
(ft) (cf) (so (sf]
0.5
2,337.51
4675A
476.8
1.0
2,337.5
2337.5
429.2
1.5
2,337.5
1558.4
390.1
2.0
2,337.5
1168.8
357.6
2.5
2,337.5
935.0
330.1
3.0
2,337.51
779,21
306.5
3.5
2,337.5
667.9
286.1
4.0
2,337.5
584.4
268.2
4.5
2,337.5
519.51
252.4
11/2/2011 Sand Filter-1-As

Contour
Contour
Area
(sq ft)
incr
Vol
(cu ft)
Accum
Vol
(cu ft)
810.50
1099.00
811.00
1307.00
601.5
601.5
812.00
1768.00
1537.5
2139.0
813.00
2285.00
2026.5
4165.5
814.00
2862.00
2573.5
6739.0
815.00
1 3483.00
1 3172.5
9911.5
Doi. z 81y.5 -c EW,er,er-e-.�j 5po11w".
, (m - -� :q c�
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4" P -4C Yc rr act i� pes .
Arco",,
a
4 'NC V•!eki 7-PAC c 6, 15 cTs
� 325 [ } w• �'S �rS
()•1,5 5 &CC S� 'Z.� k�3 U
Page 1

Patterson, Robert
From:
Patterson, Robert
Sent:
Tuesday, February 14, 2012 9:41 AM
To:
'Mack Summey'
Cc:
Homewood, Sue
Subject:
RE: SIA14120101 - Cornerstone Healthcare of Asheboro - Additional Information Request
Mack,
Got your message this morning about the add. info. being sent today. I'll put in a 5 day extension to cover it.
Thanks
Robert
From: Patterson, Robert
Sent: Tuesday, February 14, 2012 8:50 AM
To: 'Mack Summey'
Cc: Homewood, Sue
Subject: FW: SW4120101 - Cornerstone Healthcare of Asheboro - Additional Information Request
Importance: High
Mack,
This add. info. was due yesterday, but I never received it. Do you need an extension? Otherwise, I will have to return
the project as incomplete. Please let me know by the end of today. If you need an extension, please specify the date
you plan to provide the information.
Thanks.
Robert D. Patterson, PE
Frvironrnental F;ngineer
NCDIENR I DWQ I Storniwater Permitting
1617 Mail Service Center, Raleigh, NC 27699-1617 M1 iil I 512 N. Salisbury St, Raleigh, NC 27604 1 91h Floor 1,oc0i>n &, Parents
[phone] Phone [phone] F.r_K I Robert. Pattersoncr,ncdcnr.Rov Elmail j htt ortal.ncdenr.or web w ws I su Websilt!
6,A Before printing this email, plcrvse consider your budget and the environment.
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties unless the content is
exempt by statute or other regulation.
From: Patterson, Robert
Sent: Friday, January 13, 2012 8:06 AM
To: 'Mack Summey'
Cc: Homewood, Sue;'[e-mail]'
Subject: SW4120101 - Cornerstone Healthcare of Asheboro - Additional Information Request
Mack,
Please see attached. An original is also in the mail. Let me know if you have any questions.
Thanks
Robert D. Patterson, PG
Environmental Engineer

NCDENR I DWQ I Stormwater Permitting
1617 Mail Service Center, Raleigh, NC 27699-1617 Mail 1 512 N. Salisbury St, Raleigh, NC 27604 1911, Floor Location &, Parcels
[phone] Phone [phone] Fa:x I Robert. Patterson ancdenr. ov Email I htti)://portal,ncdenr.orp/weblwg/ws/su Website
rA Before printing this email, please consider your budget and the environment.
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties unless the content is
exempt by statute or Other Fegulat}on.

Patterson, Robert
From:
Sent:
To:
Cc:
Subject:
Importance:
Tracking:
Mack,
Patterson, Robert
Tuesday, February 21, 2012 2:48 PM
'Mack Summey'
Homewood, Sue; Bennett, Bradley
FW: SW4120101 - Cornerstone Healthcare of Asheboro - Return
High
Recipient Delivery Read
'Mack Summey'
Homewood, Sue Delivered: 2/21/2012 2:48 PM Read: 2/21/2012 3:11 PM
Bennett, Bradley Delivered: 2/21/2012 2:48 PM
The mail had not gone out yet, so I was able to pull this one out. Please have the add. info, requested submitted by
tomorrow, or I'll have to return it. Please note that for future projects, if add, info. is not received by the stipulated
date, it will be automatically returned the morning of the following day with no additional reminders from the original
add. info, request letter.
Thanks.
Robert D. Patterson, PE
Fnvirotitnental Engineer
WDENR I DWQ I St:orinwater Permitting
1617 Mail See sce Center, Raleigh. NC 27699-1617 M dl 1 512 N. Salisbury St. Rale.igfi, NC. 27604 1 91h Floor Location t , Porccls
[phone] Phonr, 1 [phone] Vzi.x I Robe rt. Patterson0,nedenr.gov IE nia.fl I httl)://portal.ilcdenj-.oi-g/web/wq/ws/su Wel)site
bA Beliore prinling thii email. please cow ides sour budget and the environment.
E-mail correspondence to and from this address may be subject to the worth Carolina Public Records Law and may be disclosed to third parties unless the content is
exempt by statute or other regulation.
From: Patterson, Robert
Sent: Tuesday, February 21, 2012 1:04 PM
To: 'Mack Summey'
Subject: RE: SW4120101 - Cornerstone Healthcare of Asheboro - Return
Mack — I never received anything.
Robert
From: Mack Summey [mailto:mack(@asheboro.com]
Sent: Tuesday, February 21, 2012 12:59 PM
To: Patterson, Robert
Cc: Homewood, Sue
Subject: RE: SW4120101 - Cornerstone Healthcare of Asheboro - Return
Hi Robert
You should have it by now, we put it in the mail..........
Thanks!
Mack

'h�
H. Mack Summey, Jr., PE
Summey Engineering Associates, PLLC
Engineering-- Land Planning - Consulting
P.D. Box 968
Asheboro, NC 27204
Office - 336-328-0902
Fax - 336-328-0922
Email: [e-mail]
SEA, PLLC. COMPUTER FILE DISCLAIMER
Any computer files included with this transmittal are for informational purposes only. Their content can be considered accurate at the time of delivery, but is subject
to change, in the future, without notice. These files are not to be interpreted as final engineering drawings and are not to be used for property acquisition or project
construction. flue to constant updates and revisions to computers and software packages, SEA, PLLC does not guarantee that these files can be opened or read by the
recipient. Furthermore, SEA, PLLC policy does not permit the internal conversion of files to alternate software packages or operating systems. These activities, if
necessary, shall be the responsibility of the recipient. By opening this file, the recipient understands that SEA, PLLC does not authorize in any way that drawing is
accurate for construction material quantity takeoffs or for survey staking.
From: Patterson, Robert [maiIto: robert.patterson(a)ncdenr.pov]
Sent: Tuesday, February 21, 2012 12:34 PM
To: Mack Summey
Cc: Homewood, Sue
Subject: RE: SW4120101 - Cornerstone Healthcare of Asheboro - Return
Mack,
Please'see the attached return letter. I have put the original in the mail. Please let me know if you have any questions.
Thanks.
Robert D. Patterson, PE
lsnvirotantcntal Engineer
NCI ENR I DWQ I Storrawiter Pcrniitting
1617 Mail Service Center, Raleigh, NC 27699-1617 Mail 1 512 N, Salisbury St, Raleigh. NC 27604 1 91' Floor Location cS, F'sarceh,
(919) 807.,6375 .F'honc 1 (9:19) 807-649 Fcax I Robert.Pattersol>(ir?nccicnr.eov i?rnail I httiz://port.al-nc.dejir.ory/web/wg/ws/su WOasitr-
�,A13efi rc printing, this email. please COusicler?our budget and the environment.
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties unless the content is
exempt by statute or other regulation.
From: Mack Summey [[e-mail]]
Sent: Tuesday, February 14, 2012 11:02 AM
To: Patterson, Robert
Cc: Homewood, Sue
Subject: RE: SW4120101 - Cornerstone Healthcare of Asheboro - Additional Information Request
Hi Robert
As per my voicemail, we have the updated form so I will put this info in the mail today.
Thank you very much!
Mack
H. Mack Summey, Jr., PE
Summey Engineering Associates, PLLC

Engineering - Land Planning - Consulting
P.O. Box 968
Asheboro, NC 27204
Office - 336-328-0902
Fax - 336-328-0922
Email: [e-mail]
SEA PLLC COMPUTER FILE DISCLAIMER
Any computer files included with this transmittal are for informational purposes only. Their content can be considered accurate at the time of delivery, but is subject
to change, in the future, without notice. These files are not to be interpreted as final engineering drawings and are not to be used for property acquisition or project
construction. Due to constant updates and revisions to computers and software packages, SEA, PLLC does not guarantee that these files can be opened or read by the
recipient. Furthermore, SEA, PLLC policy does not permit the internal conversion of files to alternate software packages or operating systems. These activities, if
necessary, shall be the responsibility of the recipient. By opening this file, the recipient understands that SEA, PLLC does not authorize in any way that drawing is
accurate for construction material quantity takeoffs or for survey staking.
From: Patterson, Robert [maiIto: robert.pattersonC&ncdenr.gov]
Sent: Tuesday, February 14, 2012 8:50 AM
To: Mack Summey
Cc: Homewood, Sue
Subject: FW: SW4120101 - Cornerstone Healthcare of Asheboro - Additional Information Request
Importance: High
Mack,
This add. info. was due yesterday, but I never received it. Do you need an extension? Otherwise, I will have to return
the project as incomplete. Please let me know by the end of today. If you need an extension, please specify the date
you plan to provide the information.
Thanks.
Robert. D. Pattel-soT1, PF,
Environinrnta1 Engirieer
NCDF;NR I DWQ I Storinwaler Permitting
1617 Mail Service Center, R,alcigh, NC 27699-1617 Ml�ri1 1 512 N. 4ulisbtity 5t, Raleigh, NC 27604 1 911, Moor L€x;Mion li, Mircels
[phone] Phony 1 [phone] lax I Robert. Pat ter'sOrt(&necleiir. gov Kiruail I lrtt ):1. /poruil.necjenr.org/webJwgJws/su Wrh zit(�
h,A 13cturc printing this entail, please consider your budget and the envirunnlent.
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties unless the content is
exempt by statute or other regulation.
From: Patterson, Robert
Sent: Friday, January 13, 2012 8:06 AM
To: 'Mack Summey'
Cc: Homewood, Sue;'craig,[e-mail]'
Subject: SW4120101 - Cornerstone Healthcare of Asheboro - Additional Information Request
Mack, -
Please see attached. An original is also in the mail. Let me know if you have any questions.
Thanks.
Robert D. Pit.€:t:e:.rsori, PE
f;rvironrnew al l,ngstice r
NCD NR I F)WO 15torrnwater Pernaittirag
1617 Mail Sctvice Gcnter, Raleigh, NC 27699-1617 Mail 1 512 N. Sn1isbui'y Sl, Raleigh, NC 27604 1 911, Moor 1:ocs,trion &.l�'itvicels

t . 1
[phone] l'ttone 1 (9 191807-6494 T<<)-+t I Robert. Patt(,rson(ir!ncdelr.gv_ Lwail j httv: / [c)grt.jl.ricdenr.ot webJwq/ws1su Website.
�.A Betsirc printing this email. pleaw consider ytncr budgo and the en irommcnt.
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disciosed to third parties unless the content is
exempt by statute or other regulation.
No virus found in this message.
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° 19@2QVR� swYlzo2or
1 �'1
JAN 6 2012
DENR -WA
k7lATER QUALITY
NDSM STaRMWATERCFI
Stormwater Design Calculations
for
Cornerstone Healthcare
City of Asheboro
Randolph County, North Carolina
SEA PROJECT NO. E-2106
Owner/Developer
Cornerstone Healthcare of Asheboro
134 N. Park Street
Asheboro, NC 27203
Contact: Project Engineer
Phone: [phone]
Prepared By:
SUMMEY ENGINEERING ASSOCIATES, PLLC
ENGINEERING - LAND PLANNING - CONSULTING
P.O. BOX 968
ASHEBORO, NC 27204
Phone: [phone] / Fax: [phone]
E-mail: [e-mail]
December, 2011

Stormwater Project Narrative
Cornerstone Health Care
Park Street
Randolph County - Asheboro, NC
The purpose of this narrative is to briefly describe the development of a new Healthcare Facility located on a 1.4
acre parcel near Downtown Asheboro, NC near the intersection of Park Street & Sunset Avenue. The site is
undeveloped.
The property consists of woods, grass & undergrowth.
This stormwater management plan is the result of the site being Tipped into the NPDES Phase It regulations and
as a result must comply with the Post Construction Rules.
The property is to be cleared, grubbed and graded for the construction of a new doctors office with associated
parking.
The plan for this project is to treat all new Impervious area with a Sand Filter Device.
The existing 1.40 acre site is vacant and the existing topography slopes from the North East to the South West
corner of the property.
The proposed development consists of clearing, grubbing & grading the existing building and paved areas
totaling 1.17 acres of Impervious Area.
Due to the nature of the development, we propose to use a Sand Filter to capture and treat the stormwater and
slow it down before leaving the site. The device is designed to capture the first one inch of runoff and slowly
release the flows over time into the ground and under drain system.
The site has been approved by the City of Asheboro Planning and Engineering Departments and the NCDENR-
Division of Land Quality. Please see the attached plans, calculations and details for more information.
�� � •.•QF�55.1 •. /
26447
•�//��igCklS IU `M�-l\\\\�.

Permit No.
(to be provided by DWQ)
III. REQUIRED ITEMS CHECKLIST
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal
package will result in a request for additional information. This will delay final review and approval of the project. Initial
in the space provided to indicate the following design requirements have been met. If the applicant has designated an agent,
the agent may initial below. If a requirement has not been met, attach justification.
Initials Page/ Plan
Sheet No.
L R1S 3
1. Plans (1" - 50' or larger) of the entire site with labeled drainage area boundaries
- System dimensions (length, width, and depth) for both the sedimentation chamber and the filter
chamber,
Maintenance access,
- Flow splitting device,
- Proposed drainage easement and public right of way (ROW),
- Design at ultimate build -out,
Off -site drainage (if applicable), and
�L� 3
Boundaries of drainage easement.
2. Plan details (1" = 30' or larger) for the sand filter showing:
- System dimensions (length, width, and depth) for both the sedimentation chamber and the
chamber,
Maintenance access,
- Flow splitting device,
- Vegetative filter strip dimensions and slope (if SA waters),
- Proposed drainage easement and public right of way (ROW),
Design at ultimate build -out,
- Oft -site drainage (if applicable), and
- Boundaries of drainage easement.
fht5� C 3
3. Section view of the sand filter (1" = 20' or larger) showing:
- Depth(s) of the sedimentation chamber and sand filter chamber,
- Depth of sand filter media,
filter
- Connection between the sedimentation chamber and the sand filter chamber and weir elevation,
- SHWT elevation,
- Outlet pipe, and
- Clearance from the surface of the sand filter to the bottom of the roof of the underground structure (if
applicable).
Fknt<s� 4. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. The
results of the soils report must be verified in the field by DWQ, by completing & submitting the soils
investigation request form, County soil maps are not an acceptable source of soils information.
)'JAtfJ 5. Supporting calculations (including drainage calculations)
NMS 6. Signed and notarized operation and maintenance (0&M) agreement
r-uk.5� _W A 7. A copy of the deed restrictions (if required).
Form SW401-Sand Filter-Rev.5 2009Sept17 Part III, Page 1 of 1

RANDOLPH COUNTY REGISTER OF DEEDS - UNOFFICIAL RECORD Page 101 2
E>Lty F"?,y6DD.D0
70101222000, 8521 6 DEED
5k:RE2213 Pgq:lasa
20221 MO 03:30:30 Pa 112
��1�11j 1 IWIN IIIII �1111110
NORTH CAROLINA GENERAL WARRAN'T'i' DEED
Purchase rice:S300,000.00 Revenue Stamps: S600.00
Mail t rantee: 1701 Wc-3tchester Dr., High Point, NC 27262
Prep
by: Smith, Alexander & Morgan, L.L.P., Attorneys, Asheboro, North Carolina 27203
THIS DEED is made this 20c' day of Decernber 2010, by and between the following
Grantor and Grantee:
Grantor: IIIGHLINE IMPORTS OF NORTH CAROLINA, LLC
106 S. Park Street
Asheboro, NC 27203
Grantee: CORNERSTONE TRIAD REALTY, LLC
1701 Westchester Drive
High Point, NC 27262
The designation Grantor and Grantee as used herein shall include said parties, their heirs.
successors, and assigns, and shall signify either singular, plural, masculine, feminine or neuter as
required by context.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of
which is hereby acknowledged, has and by these presents does grant, bargain, sell and convey
unto the Grantee in fee simple that certain lot or parcel of land situated in Asheboro
Township, Randolph County, North Carolina, which is more particularly described as follows:
BEING ALL of Tract No. 2 (consisting of 1.418 acres),of a Recombination Survey
for Ifighline Imports of North Carolina, LLC as shown on plat recorded in Plat
Book 127, Page 99, Randolph County Registry.

RANDOLPH COUNTY HEGISTER OF DEEDS - UNOFFICIAL RECORD Page 2 of 2
E2?131069 V1 IIIIIIIIIiNII[III
arzx+a +mca 212
[,'or back reference sec: D"Ll recorded in Deed Book 2062, Page 1646, Randolph
County Registry.
The above described property is not the primary residence of the Grantor.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and
appurtenances thereto belonging to the Grantee in fee simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple,
has the right to convey the same in fee simple, that title is marketable and free and clear of all
encumbrances, and that Grantor will warrant and defend the title against the lawful claims ot'all
persons whomsoever.
IN WfI NESS WHEREOF, the Grantors have hereunto set their hands and seals the day and year
first above written.
Highline Imports of Forth Carolina, LLC
BY: {SEAL)
E ' . nzlnw, Menlher/Manager
NORTH CAROLINA, RAN'DOLPH COUNTY.
1, Sharon A. Crose , it Notary Public of the County and Stale aforesaid, certify that Eric d,
Kodun, MemberlManager of Highline Imports of North Carolina, LLC, a North Carolina
Limited Liability Company, Grantors, personally appeared before me this day and
acknowledged the execution of the foregoing instrument. Witness my hand and official stamp or
seal, this�day of December. 2010.
My commission expires: May 5, 2013 J
Notary Public

RANDOLPH COUNTY REGISTEi1 OF DEEDS . UNOFFICIAL RECORD Page I of 2
RFILED K,i,t, n Lo—
igiltar Of D-1 R-1010 rOMC
R OOrtli 1g .ru SF 2.0D
N� Raal Elale E rn:7400. e0
22IC1222000186910 DEED
8k:R1E2213 Yy186a
1212212019 00: 3L.30 pl tr2
�111111101111011111giliii�
NORTH CAROLINA GENERAL WARRANTY DEED
I'urcha rice:$300,000.00 Revenue Stamps: S600.00
Mail t grantee: 1701 Westchester Dr., High Point, NC 27262
Prepay by: Smith, Alexander & Morgan, L.L.P., Attorneys, Asheboro, North Carolina 27203
THIS DEED is made this 20'h day of December 2010. by and between the following
Grantor and Grantee:
Grantor: HIGHLINE IMPORTS OF NORTH CAROLINA. LLC
106 S. Park Street
Ashehoro, YC 272113
Grantee: CORNERSTONE TRIAD REALTY, LLC
1701 Westchester Drive
High PDint, NC 27262
The designation Grantor and Grantee as used herein shall include said panics, their heirs,
successors, and assigns, and shall signify either singular, plural, masculine, feminine or neuter as
required by context.
WITNESSETH, that the Grantor, for u valuable consideration paid by the Grantee, the receipt of
which is hereby acknowledged, has and by these presents does grant, bargain, sell and convey
unto the Grantee in fee simple that certain lot or parcel of land situated in Asheboro
Tuwnship, Randolph County, North Carolina, which is more particularly described as follows:
BEING ALL of Tract No. 2 (consisting of 1,418 acres)of a Recombination Survey
for Highline Imports of North Carolina, LLC as shown on plat recorded in Plat
Book 127, Page 99, Randolph County Registry,

RANDOLPH COUNTY REGISTER OF DEEDS - UNOFFICIAL RECORD Page 2 of 2
�!RV213� IM9 2l 'dIIIYIllll�ll�lllll
RE�213 10EG ill
For back reference see Deed recorded in Deed Book 2062. Page 1646. Randolph
County Rebristry.
The above described property is not the primary residence of the Grantor.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and
appurtenances thereto belonging to the Grantee in Fee simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple,
has the right to convey the same in fee simple, that title is marketable and free and clear of all
encumbrances, and that Grantor will warrant and defend the title against the lawful claims of all
persons whomsoever.
IN WITNESS WHEREOF, the Grantors have hereunto set their hands and seals the day and year
first above written.
Highline Imports of North Carolina, LLC
BY: {SEAL}
E ' ozlow, Member .Manager
NORTH CAROLINA, RANDOLPH COUNTY.
I, Sharon A. Grose , a Notary Public of the County and State aforesaid, certify that Eric J.
Kucluw, Mvoilrer/Nlaougur of Highliue Imports of North Carolina, LLC, a North Carolina
Limited Liability Company, Grantors, personally appeared before me this day and
acknowledged the execution of the foregoing instrument. Witness my hand and official stamp air
seal, this_.lp 06 day of December, 2010,
My commission expires: May 5, 2013 L
Notary Public

Scott F. Cole
Licensed Soil Scientist
312 Copple's Road Ext.
Asheboro, NC 27205-0711
336.460.4554
Summey Engineering Associates
Attn: Mr. Mack Summcy
1342 E. Salisbury Street
Asheboro, NC 27203
July 11, 2011
Re: Identification of the seasonal high-water table for a proposed bio-cell at 136 South Park Street, Asheboro, NC
(Central Carolina Women's Center of Asheboro, NC).
Mr. Summey,
Per your request, soil conditions were evaluated within the footprint of the proposed bio-cell on the above -referenced
property to determine the depth of the seasonal high-water table. Work was conducted to satisfy requirements set forth in
the North Carolina Division of Water Quality Stortnivater Best Managernerrt Practices Manual. Samples were collected
with hand augers.
The seasonal high-water table is determined by a field evaluation for soil wetness conditions. Soil wetness conditions are
determined by the presence of colors with a chroma of 2 or less (in Munsell color notation) in mottles or the horizon
matrix. Colors of chroma 2 or less due to relic minerals from the parent material (underlying rock) are not considered as
indicators for soil wetness conditions.
RESULT'S
Multiple borings were evaluated within the proposed footprint of the bio-cell (approximate surface elevation 814'). The
seasonal high-water table was not observed within 8' (elevation 806') of the surface.
I am pleased to be of service in this matter and can be contacted at your convenience should you have questions
concerning information within this report.
Thank you,
Sco t Ij. Cole
North Carolina Licensed Soil Scientist
SOILS,
r(j
01)
D
Ir
WO

Scott F. Cole
Licensed Soil Scientist
312 Copple's Road Ext.
Asheboro, NC 27205-0711
336.460.4554
Summey Engineering Associates
Attn: Mr. Mack Summey
1342 E. Salisbury Street
Asheboro, NC 27203
July 11, 2011
Re: Identification of the seasonal high-water table for a proposed bio-cell at 136 South Park Street, Asheboro, NC
(Central Carolina Women's Center of Asheboro, NC).
Mr. Summey,
Per your request, soil conditions were evaluated within the footprint of the proposed bio-cell on the above -referenced
property to determine the depth of the seasonal high-water table. Work was conducted to satisfy requirements set forth in
the North Carolina Division of Water Quality Stormwater Best Management Practices Manual. Samples were collected
with hand augers.
The seasonal high-water table is determined by a field evaluation for soil wetness conditions. Soil wetness conditions are
determined by the presence of colors with a chroma of 2 or less (in Munsell color notation) in mottles or the horizon
matrix. Colors of chroma 2 or less due to relic minerals from the parent material (underlying rock) are not considered as
indicators for soil wetness conditions.
RESULTS
Multiple horings were evaluated within the proposed footprint of the bio-cell (approximate surface elevation 814'). The
seasonal high-water table was not observed within 8' (elevation 806') of the surface.
I am pleased to be of service in this matter and can be contacted at your convenience should you have questions
concerning information within this report.
Thank you,
Sco F. Cole" .
North Carolina Licensed Soil Scientist
SDK
i63
Z1
rt

Sand Filter Selection Worksheet C&&er-s-U4�
t (days)?
1.66
«« Time to Drain Filter
k (ft/day)?
3.5
«« Coefficient of Sand Permeability
110 (inlhr)?
6.85
«« Rainfall Intensity
df min (ft)?
2
«« Minimum Allowable Filter Depth
Filter
#
Ad
Drainage
Area (Ac)
Imp. Area
(ac)
% Imp.
RIO
Coeff.
"C
RV
Rd
WQV
(cif)
WQVadj
= (0.75) x
WQV
S S
Sed.
Basin
(Min.)
1
1.17
0.89
75.98
0.77
0.73
1.0
3,116.7
2,337.5
205.7
#DIVIO!
#DIVIO!
#DIV/O!
#DIVIO!
#DIVIO!
#####
#DIVIO!
#DIVIO!
#DIVIO!
#DIVIO!
##
#DIVIO!
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#####
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#####
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#####
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#####
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#DIVIO!
#DIVIO!
Rv = Volumetric Runoff Coefficient (0.05+(0.009x(%Imp)) (Unitless)
Rd = Design Storm Rainfall Depth (1" NC Piedmont or 1.5" NC Coast) (in.)
WQV = (Rv x Ad x 43,560 x Rd)112
As = Sedimentation Basin Area (sf)
As (Minimum) = 0.066 x WQV: Minimum Sedimentation Basin Area (sf)
df: Depth of Sand Filter Bed (ft)
k: Coefficient of Permeability for the Sand Filter (3.5 fUday)
t: Time Required to Drain the WQV Through the Sand Filter (day). Should be 40 Hours (1.66 days).
hMaxFilter = WQVadj1(As + Af): Maximum Head On Sand Filter - between 2 and 6 feet
hA = hMaxFilter 1 2 (ft)
Af = Sand Filter Area (sf)
Af (Minimum) _ (WQV x df)1 (k x t x (hA + df)): Minimum Filter Bed Area (sf)
h MaxFilterl Drainage Area
1.17
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.5
L467151
t30M
ULR E F,J!j
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0.0
1.0
2337.5
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0.0
3.5
667.9
0.0
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j#R, EFJ
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K0*0
4.0
584.4
0.0
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0.0
4.5
519.5
010
#REF!
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a 0
Filter 1 Ac
�7
hMaxFilter WQV adj As + Af Af (min.)
N (cf) (sf) (sf)
0.5
2,337.5
4675.1
476.8
1.0
2,337.5
2337.5
429.2
1.5
2,337.5
1558.4
390.1
2.0
2,337.5
1168.8
357.6
2.5
2,337.5
935.0
330.1
3.0
1 2,337.51
779.2
306.5
3.5
2,337.5
667.9
286.1
4.0
2,337.5
584A
268.2
4.5
2,337.5
519.51
252.4
11/2/2011 Sand Filter-1.xls

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SUMMEY ENGINEERING ASSOCIATES, PLLC I Project: Cocne(S.�n-0— I Job No: f-2)0 (�'
1342 E. Salisbury St. 336-328-0902
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[e-mail]
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UNITED STATES
DEPARTMENT OF THE INTERIOR
GEOLOGICAL SURVEY
M
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h��+S Cmfrol by U5a5 end N0VN0AA
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taken 1969. fie d checked 1970
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Tlvxn- may a pr otli.yprd�yl ". 0,a baRl Imb
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STATE OF NORTH CAROLINA
DEPARTMENT OF NATURAL AND ECONOMIC RESOURCES
RALEIOH, NORTH CAROLINA
SCALE 12400D
p +�1
CC)NTOUR INTERVAL 10 FEET
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Prym.ry hrghwey, Llghldury road. hard c,
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NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Gover I for
Dr. Craig Gaccione
Cornerstone Healthcare of Asheboro
237-A N. Fayetteville Street
Asheboro, NC 27203
Subject: Stormwater Permit Applic;
Cornerstone Healthcare of
Application Return #1282
Randolph County L
Dear Dr. Gaccione:
Division of Water Quality
Charles Wakild, P.E. Dee Freeman
Director Secretary
February 21, 2012
pio-T ww/t-/V�
Return
boro - SW4120101
A review of your Stormwater Management Permit Application indicates that as of this date, information
requested on January 13, 2012,.has not been received in this Office within the stipulated timeframe. Per DWQ
requirements and policies, this Office is hereby returning the subject application as incomplete. The $505.00
application fee has been forfeited and a new fee will need to be provided if you choose to resubmit this
application in the future. Any original signed documents are enclosed.
Until a State Stormwater Permit is issued for this project, the construction of any impervious surfaces,
other than a construction entrance under an approved Sedimentation Erosion Control Plan, is a
violation of NCGS 143-215.1 and is subject to enforcement action pursuant to NCGS 143-215.6A.
If you have any questions concerning this matter, please contact me at [phone], or
[e-mail].
Sincerely,
Robert D. Patterson, PE
Environmental Engineer
DWQ Stormwater Permitting Unit
Enclosures
cc: Mr. Mack Summey, Jr., PE - Summey Engineering Associates, PLLC
Winston-Salem Regional Office - Sue Homewood
SPU files
Wetlands and Stormwater Branch
1617 Mail Service Center, Ralegh, North Carolina 27699-1617
Location: 512 N. Salisbury St Raleigh, North Carolina 27604
Phone: [phone] FAX. [phone]
Internet www ncwaterquality.org
An Equal Opportunily 1 Affirmative Action Employer
NorthCarolina
Natumllty

Summey Engineering Associates, PLLC
SEA Engineering - Land Planning - Consulting
PLLC 1'0 Box 968 — Asheboro, NC 27204
[phone] I Fax: [phone] [e-mail]
asheboro.com
TRANSMITTAL
January 5, 2012
To: Attn: Robert Patterson Cornerstone Healthcare
NCDENR — DWO Stormwater
512 N. Salisbury St.
Raleigh NC 27604-1170
SEA Job No. E-2106
We are sending you attached the following items:
❑
Shop Drawings
❑
Samples ❑ Copy of Letter
❑
Prints
❑
Specifications ❑ Other
®
Plans
❑
Disk
# CopiesCopiesj
Drawin #
Description
Disposition
For your review:
1 Check
$505.00 Stormwater Review
2 copies
Calculations
2 sets
Plans
Remarks
c: File
Please let me know if anything else is needed.
Thanks,
H. Mack Summey, Jr.
JAN 6 2012
DENR -WATER QUALITY
"E DSAND STORMWATER RRANrk
By: H. Mack Summey, Jr.

AT4 .;YAV
MC®EN R
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Mr. H. Mack Summey, Jr., PE
Summey Engineering Associates, PLLC
P.O. Box 968
Asheboro, NC 27204
Dear Mr. Summey:
Division of Water Quality
Charles Wakild, PE
Director
January 13, 2012
Subject: Request for Additional Information
Stormwater Project No. SW4120101
Cornerstone Healthcare of Asheboro
Randolph County
Dee Freeman
Secretary
The Division of Water Quality Central Office received a Stormwater Management Permit Application
for the subject project on January 6, 2012. A preliminary review of that information has determined
that the application is not complete. The following information is needed to continue the stormwater
review:
1. An old version of SWU-101 was submitted. Please be sure to always use the most recent
version of any forms.
2. The blank field for the applicant's name was left blank on Sections IX. and X. of SWU-101.
3. Please provide the correct legal name of the applicant in 111,1.a. of SWU-101. The name
provided, Cornerstone Healthcare of Asheboro, is not shown as a valid entity on the NC
Secretary of State (SOS) website.
4. The person signing for applicant and owner must have the proper signature authority to do
so as per 15A NCAC 02H .1003(e) and VI.11. of SWU-101. Dr. Craig Gaccione is not listed
as a member/manager of Cornerstone Triad Realty, LLC on the NC SOS website. Also, his
title was not provided in I11.1.a. and 111.2.a, of SWU-101. Although VI.11. was initialed on
SWU-101, the supporting documentation was not found in the submitted application
package.
5. The NC SOS shows that a letter, dated December 9, 2011, was sent to the owner stating
the possible administrative dissolution of Cornerstone Triad Realty, LLC. Please provide
information as to whether this was resolved. DWQ cannot issue a permit to a company not
in good standing with the NC SOS.
6. There is concern with the potential for erosion into the sand filter from along the un-curbed
edge of the pavement just upslope of the BMP.
7. The supplement form shows the top elevation of the sediment chamber berm at 313.5', but
the plans show it at 315.0, The berm on the plans needs to be lowered to below the
emergency spillway elevation. Lowering it to the elevation stated on the supplement would
accomplish this.
Wetlands and Stormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone]
Internet: www rlwaterquality.orcd
An Equal Dpp000nily 1 Affirmative Action Employer
Aturally
nehCarohna

Mr. H. Mack Summey, Jr., PE
SW4120101 — Cornerstone Healthcare of Asheboro
January 12, 2012
8. The sediment chamber area (As) shown on the supplement form appears to be too small,
and not consistent with the plans and calculations. Please clarify.
9. The Hmax on the supplement form shows 3', but the plans show a max head of 4' (814.5-
810.5=4). Please clarify.
10. Please show the supporting calculations for the drawdown time provided.
11. Please show a stage -storage table that supports the stated provided volume of 8,366 cf.
12. Although it is stated no offsite flow drains to the proposed BMP, it appears from the grading
plan that a portion of Park St. will drain into the site. Please verify and revise as needed.
Please note that this request for additional information is in response to a preliminary review. The
requested information -should be received by this Office prior to February 13, 2012, or the application
will be returned as incomplete. The return of a project will necessitate resubmittal of all required
items, including the application fee.
If you need additional time to submit the information, please mail or fax your request for a time
extension to the Division at the address and fax number at the bottom of this letter. The request must
indicate the date by which you expect to submit the required information. The Division is allowed 90
days from the receipt of a completed application to issue the permit.
The construction of any impervious surfaces, other than a construction entrance under an approved
Sedimentation Erosion Control Plan, is a violation of NCGS 143-215.1 and is subject to enforcement
action pursuant to NCGS 143-215.6A.
All revised original signed documents must be returned or new originals must be provided. Copies are
not acceptable. Any revised calculations or plans must be sealed, signed, and dated; and have a
revision date shown. Please reference the State assigned project number SW4120101 on all
correspondence. If you have any questions concerning this matter please feel free to call me at (919)
807-6375, or at [e-mail].
Sincerely,
Robert D. Patterson, PE
Environmental Engineer
Stormwater Permitting Unit
cc: SW4120101 File
ec: Dr. Craig Gaccione — Cornerstone Healthcare of Asheboro
Sue Homewood — Winston-Salem Regional Office
Page 2 of 2

A&7M r
State of North Carolina
tSFCR1aine r. NlarsRYOFr,I' Department of the Secretary of State
sr.curi'rnitY of srA rI:
December 9, 2011
Cornerstone Triad Realty, LLC
Grace E. Terrell , Agent
1701 Westchester Drive, Suite 850
High Point, NC 27262
Cher': L. Myvrs
DIRFCr4R OF CPRPQRA HONS
NOTICE OF GROUNDS FOR ADMINISTRATIVE DISSOLUTION OF: Cornerstone Triad Realty, LLC
Recently, this office conducted its periodic internal review of annual reports filed in this office for Limited
Liability Companies in North Carolina. Unfortunately, the review indicates that the above referenced limited
liability company is delinquent in filing two (2) annual rcport(s) and consequently, is not in compliance with
the North Carolina Limited Liability Company Act.
The Secretary of State is authorized by N.C.G.S. 57C-6-03 to administratively dissolve a limited liability
company if grounds for dissolution exist. Failure to file the annual report is grounds for Administrative
Dissolution, This Notice is the first step of the dissolution process. In order to prevent administrative
dissolution, the limited liability company must File the appropriate annual report(s), or show to the
Corporation's Division of the Secretary of State within sixty (60) days from the date of this Notice that each
ground determined does not exist.
Determining Annual Reports Due
A list of your annual reports submitted to date is viewable by clicking the link to the Corporations Division
web page at www.sosnc.com. Search for your company by name and then click "File Annual Report Online".
From this page you will be able to see both, if an annual report was submitted but not deemed in "file" status
due to an error that to date has not been corrected and determine how many annual reports are required. The
due date for filing a Limited Liability Companys annual report is April 15. One report is required for each year
beginning the year after the year of creation.
Onling—Filing
Utilize the above link to the entity's profile page, then click "File an Annual Report" at the top of the page and
follow the directions. The fee is $200.00 plus a $2.00 transaction fee. Please keep in mind that these filing
fees are neither retained nor spent by the Secretary of State's Office, instead they are deposited with the State
Treasurer and are expended by the General Assembly of North Carolina.
Paper Filing
You may also print a pre -populated form at the web address stated above by clicking "Print a Pre -Populated
Annual Report Form". Changes can be made on the fillable pdf prior to printing the report. Mail the report
and fees to the address at the bottom of the form. The fee is $200.00.
If you have any concerns or experience technical difficulty with the filing process, please contact our staff at
[phone] or send an email to [e-mail]
Respectfully,
The Corporations Division
r'o 13o.N' 29622
RALI;ICI I, NORTII CAROLINA 27626-0622