SW8010220_Current Permit_20190923

ROY COOPER
covemor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Director
September 23, 2019
Carteret General Hospital Corporation
Attn: Richard A. Brvenik, President
NORTH CAROLINA
EAYk rtmental Quality
PO Drawer 1619
Morehead City, NC 28557
Subject: Stormwater Management Permit No. SW8 010220
Carteret General Hospital
High Density Commercial Project
Carteret County
Dear Mr. Brvenik:
The Wilmington Regional Office received a complete, modified State Stormwater Management
Permit Application for Carteret General Hospital on September 4, 2019. Staff review of the
modified plans and specifications has determined that the project, as proposed, will comply with
the Stormwater Regulations set forth in Title 15A NCAC 2H.1000 (1995 Rules) as amended by
Session Law (SL) 2008-211 and as subsequently amended on January 1, 2019 (2017 Rules). We are
forwarding modified Permit No. SW8 010220 dated September 5, 2017, for the construction,
operation and maintenance of the stormwater control measures (SCMs), built -upon areas, as well
as the stormwater collection system and/or vegetated conveyance system associated with the
subject project. Please replace the previously approved plan sheets with the attached modified and
approved versions Please replace the previous application (SWU-101), infiltration basin supplement,
and infiltration basin operation and maintenance agreement with the attached modifled versions
This permit shall be effective from the date of issuance until July 23, 2025 and shall be subject to
the conditions and limitations as specified therein, and does not supersede any other agency permit
that may be required. Please pay special attention to the permit conditions regarding the operation
and maintenance of the SCMs, stormwater collection system, and/or vegetated conveyances; the
limitation of built -upon area; modification of the project; the procedures for changing ownership of
and/or transferring the permit; and the need to renew the permit. Please also pay attention to the
permit conditions that requires the recordation of deed restrictions and protective covenants,
easements, and the maintenance agreement, which must all be provided along with certification
upon completion of the project. Failure to comply with these requirements will result in future
compliance problems.
The following modifications are included and covered by this permit:
1. Increasing the drainage area and built -upon area to the previously approved infiltration
basin. These additional areas are subject to the 2017 rules. The increased runoff requires
the infiltration basin size to increase, requiring the infiltration basin to meet the 2017
minimum design criteria (MDC).
2. The approved plan set includes the following versions: July 23, 2001, May 22, 2014, and
September 5, 2017. Portions of the July 2001 plans are no longer applicable or in effect as
documented in the September 5, 2017 plans. The currently permitted layout is shown in
the September 23, 2019 plans. Details are provided in Attachment B.
North Carolina Department of Environmental Quality I Division of Energy, Mineral and Land Resources
_E �� Wilmington Regional Office 1 127 Cardinal Drive Extension I Wilmington, North Carolina 28405
N.H
°ij""'°B"'°""0i0 910.796.7215

If any parts, requirements, or limitations contained in this permit are unacceptable, you have the
right to request an adjudicatory hearing by filing a written petition with the Office of Administrative
Hearings (OAH). The written petition must conform to Chapter 150B of the North Carolina General
Statutes, and must be filed with the OAH within thirty (30) days of receipt of this permit. You
should contact the OAH with all questions regarding the filing fee (if a filing fee is required) and/or
the details of the filing process at 6714 Mail Service Center, Raleigh, NC 27699-6714, or via
telephone at 919-431-3000, or visit their website at www.NCOAH.com. Unless such demands are
made this permit shall be final and binding.
If you have any questions, or need additional information concerning this matter, please contact
Christine Hall in the Wilmington Regional Office at [phone].
Sincerely,
.Tracy Davis, P.E., Director
Division of Energy, Mineral and Land Resources
Enclosures: Attachment A - Designer's Certification Form
Attachment B - Impervious Area Allocation
GDS/kpj: G:\\\Stormwater\Permits & Projects\2001\010220 HD\2019 09 permit 010220
cc: Ginger Y. Turner, P.E., Stroud Engineering
Town of Morehead City Building Inspections
Carteret County Engineering
Wilmington Regional Office Stormwater File

rz
State Stormwater Management Systems
Permit No. SW8 010220
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY COMMERCIAL DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of
North Carolina as amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Carteret General Hospital Corporation
Carteret General Hospital
3500 Arendell Street, Morehead City, Carteret County
FOR THE
construction, operation and maintenance of one (1) infiltration basin, seven (7) areas of
permeable pavement (some treating additional BUA), and the redevelopment of 72,475 square
feet of existing BUA, in compliance with the provisions of Title 15A NCAC 2H .1000 (1995
Rules) and as amended by Session Law (SL) 2008-211 and as subsequently amended on
January 1, 2017 (2017 Rules) (collectively, the "stormwater rules') and the approved
stormwater management plans, application, supplement(s), specifications, and other supporting
data (the "approved plans and specifications") as attached and/or on file with and approved by
the Division of Energy, Mineral and Land Resources (the "Division" or "DEMLR") and
considered an enforceable part of this permit.
This permit shall be effective from the date of issuance until July 23, 2025, and shall be subject
to the following specified conditions and limitations:
I. DESIGN STANDARDS
This permit is effective only with respect to the nature and volume of stormwater
described in the approved plans and specifications.
2. The tract is a combination of pre-1988 existing built -upon area (BUA), previously
permitted BUA that is being removed and replaced, redeveloped BUA, and proposed
new BUA. There is 347,387 sf of pre-1988 existing BUA within the main campus (called
DA-1) and there is 72,475 sf of existing BUA within the west campus (called DA-2) that
is being redeveloped. The design premise is to treat the amount of BUA that exceeds
what previously existed, after considering what has been removed, what is proposed,
and any BUA credit for the use of permeable pavement. Details are provided in
Attachment B.
3. This stormwater system has been approved for the management of stormwater runoff as
described in Attachment B.
4. The runoff from all BUA within the permitted drainage areas of this project must be
directed into the appropriate permitted stormwater control system. Each of the permitted
BMP's is limited to treating only that amount of BUA listed on the application and in the
approved calculations. The BUA for future development within DA-10 is as shown in
Attachment B.
Page 1 of 6

State Stormwater Management Systems
Permit No. SW8 010220
5. The following design criteria have been permitted for the infiltration basin (DA-10) under
the 2017 MDC and must be provided in the system at all times and maintained at design
condition:
a. Drainage Area, acres: 1.39
Onsite, subject to 1995 Rules, ft2: 54,871
Onsite, subject to 2017 Rules, ft2: 5,867
Offsite, ft2: 0
b. Total Impervious Surfaces, ft2: 48,196
Onsite, subject to 1995 Rules, ft2: 43,644
Onsite, subject to 2017 Rules, ft2: 4,552
Offsite, ft2: 0
C. Design Storm
subject to 1995 Rules, inch: 1.5
subject to 2017 Rules, inch: 3.66
d. Basin Depth, feet: 1.85
e. Bottom Elevation, FMSL: 22.9
f. Bottom Surface Area, ft2. 2,902
g. Bypass Weir Elevation, FMSL: 24.75
h. Permitted Storage Volume, W: 6,845
k. Type of Soil: Wando
I. Expected Infiltration Rate, in/hr: 4
M. Seasonal High Water Table, FMSL: 21.4
n. Time to Draw Down, hours: 7
o. Receiving Stream/River Basin: Bogue Sound / WOK03
P. Stream Index Number: 20-36-(8.5)
q. Classification of Water Body: "SA HQW"
6. The peak flow from the 10-year storm event from the infiltration basin drainage area
shall not cause erosion downslope of the stormwater outlet discharge point.
7. Pretreatment devices have been provided to prevent clogging the infiltration basin. This
project uses a sump in the existing control box for pretreatment.
8_ A 72,475 ft2 portion of DA-2 (West Campus) is excluded from State Stormwater
permitting requirements under the following conditions:
a. The project must be constructed as shown on the plans submitted to this Office;
b. The currently proposed built -upon area is as shown on Attachment B within DA-2.
The existing built -upon area of 72,475 square feet is not required to be treated. The
excess is proposed to be treated by permeable pavement designed to infiltrate (DA-
3, DA-4, DA-5, DA-6, DA-7 and DA-8), and;
c. The runoff from the existing BUA of 72,475 square feet is proposed to continue to
sheet flow over grassed areas to existing drainage outlets, which provides equal
protection of surface waters as the existing stormwater control, which is sheet flow
over impervious surfaces to existing drainage outlets.
Page 2 of 6

State Stormwater Management Systems
Permit No. SW8 010220
9. The following design criteria have been approved for the permeable pavement areas,
and shall be installed and maintained at design condition:
DA3
DA4
DA5
DA6
DA7
DA8
DA9
a
HSG
-
A/B
A/B
A/B
A/B
A/B
A/B
A/B
b
Drainage Area
SF
2502
2016
6604
4648
6700
5999
44800
c
PP Area
SF
2502
2016
3008
3008
3008
3008
22400
d
Effective BUA
SF
625.5
504
752
752
752
752
5600
e
Adjacent BUA
SF
0
0
3008
1640
3008
2991
22400
f
Design Storm
in
1.5
1.5
1.5
1.5
1.5
1.5
1.5
10 yr 24 hr IDS (P)
in
6.87
6.87
6.87
6.87
6.87
6.87
6.87
h
Infiltration Rate
In/hr
5
5
5
5
5
5
3
i
DwqAg re ate Depth
in
12
12
12
12
12
12
12
J
Volume Treated
CF
1001
806
1203
1203
1203
1203
8960
k
Dwq Ponding Time
days
.06
.06
.13
.10
.13
.12
.21
II. SCHEDULE OF COMPLIANCE
The stormwater management system shall be constructed in its entirety, vegetated as
required, and operational for its intended use prior to the construction of any built -upon
surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of the
system will be repaired immediately.
3. The facilities shall be constructed in accordance with the conditions of this permit, the
approved plans and specifications, and other supporting data.
4. If the stormwater system was used as an Erosion Control device, it must be restored to
design condition prior to operation as a stormwater treatment device, and prior to
occupancy of the facility. The drainage area must be stabilized prior to the construction
of the permeable pavement. During site construction, drainage from unstabilized areas
of the project must be diverted away from the permeable pavement and into suitable
erosion control measures.
5. The permittee shall at all times provide the operation and maintenance necessary to
assure that all components of the permitted stormwater system function at design
condition. The approved Operation and Maintenance Agreement is incorporated by
reference into this permit and must be followed in its entirety and maintenance must
occur at the scheduled intervals.
6. Records of maintenance activities must be kept for each permitted BMP. The reports will
indicate the date, activity, name of person performing the work and what actions were
taken.
Page 3 of 6

State Stormwater Management Systems
Permit No. SW8 010220
7 Upon completion of the project, the permittee shall determine whether or not the project
is in compliance with the permitted plans and take the necessary following actions:
a. If the permittee determines that the project is in compliance with the permitted plans,
then within 45 days of completion, the permittee shall submit to the Division one hard
copy and one electronic copy of the following:
i. The completed and signed Designer's Certification provided in Attachment
A noting any deviations from the approved plans and specifications.
Deviations may require approval from the Division;
ii. A copy of the recorded maintenance agreement,
iii. Unless already provided, a copy of the recorded deed restrictions and
protective covenants; and
iv. A copy of the recorded plat delineating the public rights -of -way, dedicated
common areas and/or permanent recorded easements, when applicable.
b. If the permittee determines that the project is not in compliance with the
permitted plans, the permittee shall submit an application to modify the permit
within 30 days of completion of the project or provide a plan of action, with a
timeline, to bring the site into compliance.
8. Access to the stormwater facilities shall be maintained in an unobstructed manner and
via appropriate easements at all times.
9. No person or entity, including the permittee, shall alter any component shown in the
approved plans and specifications. Prior to the construction of any modification to the
approved plans, the permittee shall submit to the Director, and shall have received
approval for modified plans, specifications, and calculations including, but not limited to,
those listed below:
a. Any modification to the approved plans and specifications, regardless of size
including the stormwater control measures, built -upon area, details, etc.
b. Redesian or addition to the aDDroved amount of built -upon area or to the drainaae
area.
c. Further development, subdivision, acquisition, lease or sale of any, all or part of the
project area as reported in the approved plans and specifications.
d. Altering, modifying, removing, relocating, redirecting, regrading or resizing of any
component of the approved stormwater control measure, stormwater collection
system and/or vegetative conveyance system shown on the approved plan.
e. The construction of any allocated future BUA.
f. The construction of any permeable pavement for BUA credit that was not included in
the approved plans and specifications.
g. The construction of any #57 stone area, public trails, or landscaping material to be
considered a permeable surface that were not included in the approved plans and
specifications.
h. Other modifications as determined by the Director.
10. Prior to transfer of the permit, the stormwater facilities will be inspected by Division
personnel. The project and the stormwater facility must be in substantial compliance with
all permit conditions. Any items not in substantial compliance must be repaired, replaced
or restored to design condition prior to the transfer. Records of maintenance activities
performed to date will be required.
11 The Director may notify the permittee when the permitted site does not meet one or
more of the minimum requirements of the permit. Within the time frame specified in the
notice, the permittee shall submit a written time schedule to the Director for modifying
the site to meet minimum requirements. The permittee shall provide copies of revised
plans and certification in writing to the Director that the changes have been made.
III. GENERAL CONDITIONS
Any individual or entity found to be in noncompliance with the terms and conditions of
this permit or with the stormwater rules, is subject to enforcement action by the Division,
in accordance with North Carolina General Statute 143, Article 21.
Page 4 of 6

State Stormwater Management Systems
Permit No. SW8 010220
2. The issuance of this permit does not preclude the Permittee from complying with any
and all statutes, rules, regulations, or ordinances, which may be imposed by other
government agencies (local, state, and federal) having jurisdiction.
3. If the facilities fail to perform satisfactorily the Permittee shall take immediate corrective
action, including those as may be required by this Division, such as the construction of
additional or replacement stormwater management systems. Additional or replacement
stormwater management systems shall receive a permit from the Division prior to
construction.
4. This permit is not transferable to any person or entity except after notice to and approval
by the Director. The permittee shall submit a completed and signed Name/Ownership
Change Form, accompanied by the supporting documentation as listed on the form, to
the Division at least 60 days prior to any one or more of the following events:
a. An ownership change including the sale or conveyance of the project area in whole
or in part;
b. The sale or conveyance of the common areas to a Homeowner's or Property
Owner's Association, subject to the requirements of Session Law 2011-256;
c. Bankruptcy;
d. Foreclosure;
e. Dissolution of the partnership or corporate entity;
f. A name change of the current permittee;
g. A name change of the project;
h. A mailing address change of the permittee;
5. The permittee is responsible for compliance with all permit conditions until such time as
the Division approves the transfer request. Neither the sale of the project, in whole or in
part, nor the conveyance of common area to a third party constitutes an approved
transfer of the stormwater permit.
6. The permittee grants DENR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted stormwater
management facility.
7. The permit issued shall continue in force and effect until the permittee files a request
with the Division for a permit modification, transfer, renewal, or rescission; however,
these actions do not stay any permit conditions.
8. Approved plans, application documents, supplements, calculations, operation and
maintenance agreement, and specifications for this project are incorporated by reference
and are enforceable parts of the permit. A copy of this permit, application, supplements,
operation and maintenance agreement, and approved plans and specifications shall be
maintained on file by the permittee.
9. Unless specified elsewhere, permanent seeding requirements for the stormwater
controls must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
10. The issuance of this permit does not prohibit the Director from reopening and modifying
the permit, revoking and reissuing the permit, or terminating the permit as allowed by the
laws, rules and regulations contained in Session Law 2008-211, Title 15A NCAC
2H.1000, and NCGS 143-215.1 et. al.
11. A permit renewal request must be submitted at least 180 days prior to the expiration
date of this permit. The renewal request must include the appropriate application,
documentation and the processing fee as outlined in Title 15A NCAC 02H.1045(3).
Page 5 of 6

State Stormwater Management Systems
Permit No. SW8 010220
Permit modified and reissued this the 23rd day of September 2019
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
S. Daniel Smofi, Director
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Page 6 of 6

Attachment A
State Stormwater Management Systems
Permit No. SW8 010220
Carteret General Hospital
Stormwater Permit No. SW8 010220
Carteret County
Designer's Certification
I, , as a duly registered in the State
of North Carolina, having been authorized to observe (periodically/weekly/full time) the
construction of the project,
(Project)
for (Project Owner) hereby state that, to the best of
my abilities, due care and diligence was used in the observation of the project construction such
that the construction was observed to be built within substantial compliance and intent of the
approved plans and specifications.
The checklist of items on page 2 of this form is a part of this Certification.
Noted deviations from approved plans and specifications:
Signature
Registration Number
Date
SEAL
cc: NCDEQ-DEMLR Regional Office
Town of Morehead City Building Inspections
Page 1 of 2

State Stormwater Management Systems
Permit No. SW8 010220
General Certification Requirements:
1. The drainage area to the system contains approximately the permitted acreage.
2. The drainage area to the system contains no more than the permitted amount of
built -upon area.
3. All the built -upon area associated with the project is graded such that the runoff
drains to the system.
4. All roof drains are located such that the runoff is directed into the system.
5. All slopes are grassed with permanent vegetation.
6. Vegetated slopes are no steeper than 3:1.
7. The inlets are located per the approved plans and do not cause short-circuiting of
the system.
8. The permitted amounts of surface area and/or volume have been provided.
9. All required design depths are provided.
10. All required parts of the system are provided.
11. The required dimensions of the system are provided, per the approved plan.
12. All components of the stormwater control measure are located in either recorded
common areas, or recorded easements.
Infiltration System Certification Requirements:
The bypass structure weir elevation is per the approved plan.
2. The bypass structure is located per the approved plans.
3. A trash rack is provided on the bypass structure.
Permeable Pavement Certification Requirements:
1. The soil subgrade slope under the permeable pavement has the appropriate
slope.
2. The base material under the permeable pavement areas is a washed aggregate.
4. Except for the incidental, unavoidable runoff from the stable vegetated areas
shown on the approved plans, runoff from adjacent pervious areas has been
prevented from reaching the permeable pavement.
5. A capped observation was installed at the low point in each permeable pavement
system or terraced area as shown on the approved plans.
6. Edge restraints have been installed around the perimeter of the permeable
interlocking concrete pavers and/or concrete grid pavers.
8. After installation, the permeable pavement was protected from sediment
deposition until the site was completed and stabilized. An in -situ infiltration
permeability test has been conducted to confirm.
Page 2 of 2

Attachment B - SW8 010220 - Carteret General Hospital - 9/23/19
Main Campus
West Campus
Impervious
Allocation
impervious Treatment
Impervious
Allocation
Impervious Treatment
PermPave
I Infil Basin
Permeable Pavement
Drainage Area Number
1
_9­7
10
2
3
4
5
6
7
8
Impervious Treatment Required
(=Total lmpervloua Area - E ftdng/vre-1588)
74,586
14,021
Total Impervious Area
421,973
86,496
Existing/Pre-1988 Impervious Area Total
347,387
72,475
impervious Allocation
345,7771
28,0001
48,1961
70,439
626
5041
4,3481
2,3921
4,4441
3,743
Onsite Buildings
45,690
0
0
0
0
0
0
0
0
0
Onsite Streets
0
0
0
0
0
0
0
0
0
0
Onsite Parking
32,254
0
31018
20,240
0
0
3,596
1,640
3,692
2,991
Onsite Sidewalks
6,460
0
0
0
0
0
0
0
0
0
Other Onsite
245
0
0
0
0
0
0
0
0
0
Future Available Inside the Infil Basin (DA10)
01
0
1,534
0
01
0
01
0
0
0
Offsite
01
0
0
0
0
0
0
0
0
0
Existing/Pre-1988
El
261,128
22,400
43,644
50,199
0
0
0
0
0
0
Total Perm Pave Surface Area
01
22,400
0
0
2,502
2,016
3,008
3,008
3,008
3,008
25% Counted as Impery
5,600
0
0
626
504
752
752
752
752
Impervious Treated
76,196
14,785
2g,000 48,196
626 504 3,760 2,392 3,760
3,743
Impervious Not Treated
Im rvAllocation-Im rvArea Treated
01,
0
0
0
0
588
0
684
0
Future Impervious Available)
Im erv­rreated - ImpervRequired)
765
1The tract is a combination of pre-1988 existing built -upon area (BUA), previously permitted BUA that is being removed and replaced, redeveloped BUA, and proposed
new BUA. The design premise is to treat the amount of BUA that exceeds what previously existed, after considering what has been removed, what is proposed, and any
BUA credit for the use of permeable pavement. Two areas are the project are considered separately:
Main Campus (DA1): There is 347,387sf of pre-1988, existing BUA within this area. Drainage areas 9 and 10 provide treatment for impervious built in excess of
347,387sf which is tracked as "Impervious Treated". The "Future Impervious Available" is the amount of excess treatment that has been provided and is therefore
available for future use anywhere inside the Main Campus. (There is also an infiltration basin that has been overdesigned with 1,534sf of impervious in excess of the
'future impervious available". The infiltration basin's impervious must be used in the drainage area of the infiltration basin.)
West Campus (DA2): There is 72,475sf of pre-1988, existing BUA within this area. Drainage areas 3, 4, 5, 6, 7, and 8 provide treatment for impervious built in excess of
72,475sf which is tracted as "Impervious Treated". The "Future Impervious Available" is the amount of excess treatment that has been provided and is therefore
available for future use anywhere inside the West Campus.

DEMLR USE ONLY
Date . ecei ed
Fee Paid
Permit Number
/&
om�
s of 0doo
STORMWATER PERMITTING FORM 7:
MINOR MODIFICATION
Standard Permitting Program — No Pee for Minor Modification
Express Permitting Program — See Express Fee Schedule
Only complete applications packages will be accepted and reviewed. This form and the required items (with
original signatures) must be sent to the appropriate DEMLR Regional Office, which can be determined by locating
the project on the interactive online map at. http://deg.nc.gov/contact/regional-offices.
This form is to only to be used by the current pennittee to notify the Division of a minor
modification. Pursuant to Rule 15A NCAC 02H .1002, a minor modification is a change to the project that.-
1) does not increase the net built -upon area; and/or
2) does not change the size or design of the SCM(s).
A. GENERAL INFORMATION
1. State Stormwater Permit Number: SW8 010220
2. Current Permit Holder's Company Name/Organization: Carteret General Hospital Corporation
3. Signing Official's Name: Richard A. Brvenik
4. Signing Official's Title:
President
5. Mailing Address: P.O. Drawer 1619
City: Morehead City State: NC ZIP: 28557
6. Street Address (if different): 3500 Arendell Street
City: Morehead City State: NC Zip: 28557
7. Phone: ( ) 252-499-6094 Email: [e-mail]
8. Describe the minor modifications that you are requesting, including any revised BUA allocations (attach
additional pages or supporting tables similar to Section IV.10 of the original application, if needed):
Removed spaces 56-61 north (not constructed) of the Central Energy Plant. Proposing the installation of a concrete
pad (35' x T) to install a mechanical unit. The mechanical unit will be enclosed and pervious gravel installed around
the unit per G.S. 143-214.7(b2). Proposed impervious removed and relocated within Drainage Area 1.
B. SUBMITTAI REQUIREMENTS
Please mark "Y" to confirm the items are included with this form. Please mark X" if previously provided. if not
applicable or not available, please mark N/A.:
Y _ 1. Two hard copies (with original signatures) and one electronic copy of this completed form.
Y 2. Two hard copies and one electronic copy of the revised plan sheets (must be a revision of the
originally approved plan sheets).
N/A 3. If there is reallocation of lot BUA, a copy of the revised recorded deed restrictions and protective
covenants OR the proposed recorded deed restrictions and protective covenants documenting
the changes and a signed agreement to provide the final recorded document.
N/A 4. If applicable, the appropriate Express review fee.
. '. $`tw.
Stormwater Permit Form 7: Minor Modification Page 1 of 2 BY. July 14, 2017

C. CONTACT INFORMATION
The Design Professional who is authorized to provide information on the Applicant's behalf:
Design Professional's Name: Ginger Y. Turner, PE
Consulting Firm: The Cullipher Group, PA
Mailing Address: 151 -A Highway 24
City: Morehead City State: NC Zip: 28557
Phone: ( 252 ) 499-2166 Fax: ( )
Email:: ginger(Ptcgpa.com
2. [OPTIONAL] If you would like to designate another person to answer questions about the project:
Name & Title:
Organization:
Mailing Address:
City: State: Zip:
Phone: ( ) Fax: ( )
Email:
D. CERTIFICATION OF PERMITTEE
Richard A. Brvenik, President
I, Carteret General Hospital Corporation, the current permittee, certify that I have authorized the minor modifications listed
in Section A and shown in the attached revised plan sheets. I further attest that this information is accurate and
complete to the of my knowledge.
Signature: Date: ZY
I, 5. K U l e M a-e k , a Notary Public for the State of LIP 66 --
County of (-y►f, '+r i 'P 74-- ,do hereby certify that kiC- I
personally appeared before me this the 9- day of X014 20_L4L_, and
acknowledge the due execution of the forgoing instrument. Witness 4y hand and official seal,
(.Notary Seal)
EGEIV '.
Notary Signature .-4 , JUL 10 2019
My commission expires a Vc9 4 / 2-0 2 2-
Bv:
Stormwater Permit Form 7: Minor Modification Page 2 of 2 Oct 6, 2017

DEMLR USE ONLY
Date 4e(JivecV
Fee Paid
Permit Number
.� 24D32Z1
S D/D z 04
Applicable RuIe . Coastal SW - A0,15 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ Mgmt Plan: 11
State of North Carolina
Depart.-ent of Envi-r-anment and Natural Res—.11rceu
Division of Energy, Mineral and Land Resources
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original
I. GENERAL INFORMATION
1. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Carteret General Hospital
2. Location of Project (street address):
3500 Arendell Street
City:Morehead City County:Carteret Zip:28557
3. Directions to project (from nearest major intersection):
From the intersection of US Hwy 70 and NC Hwy 24 take US Hwy 70 East approximtely 2.5 miles to
35th Street. Carteret General Hospital located on the left.
4. Latitude:34° 43' 33" N Longitude:76° 45' 18" W of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ❑New ®Modification ❑ Renewal w/ Modificationt
tRenewals with modifications also requires SWU 102 - Renewal Application Form
b. If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number SW8 010220 , its issue date (if known)7-23-01/9-17-13 , and the status of
construction: ❑Not Started ❑Partially Completed* ® Completed* *provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ®High Density ❑Drains to an Offsite Stormwater System ❑Other
3. If this application is being submitted as the result of a previously returned application or a letter from
DEMLR requesting a state stormwater management permit application, list the stormwater project number,
if assigned, and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major ❑Sedimentation/Erosion Control: _
❑NPDES Industrial Stormwater ❑404/401 Permit: Proposed Impacts
ac of Disturbed Area
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:
5. Is the project located within 5 miles of a public airport? ®No
If yes, see S.L. 2012-200, Part VI: httl2://portal.ticdenr.org/web/Ir/rules-and-regulat
AUG 0 7 2017
tBY:
Form SWU-101 Version Oct. 31, 2013 Page 1 of 6

III. CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicant/Organization: Carteret County General Hospital Corporation
Signing Official & Title: Richard A. Brvenik, President
b. Contact information for person listed in item la above:
Street Address: 3500 Arendell Street
City: Morehead City State: NC Zip: 28557
Mailing Address (if applicable): P.O. Drawer 1619
City: Morehead City State: NC Zip: 28557
Phone: (252 ) 808-6094 Fax: ( )
Email: [e-mail]
c. Please check the appropriate box. The applicant listed above is:
® The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Owner/Organization:
Signing Official & Title:
b. Contact information for person listed in item 2a above:
Street Address:
City: State: Zip:
Mailing Address (if applicable):
City: State: Zip:
Phone: ( Fax:
Email:
3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other
person who can answer questions about the project:
Other Contact Person/
Signing Official & Title:,
b. Contact information for person listed in item 3a above: M WN 0 % 2017
Mailing
City: State:
Phone: ( ) Fax:
Email:
4. Local jurisdiction for building permits: Town of Morehead City
Point of Contact: Phone #: [phone]
Form SWU-101 Version Oct. 31, 2013 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Previously permitted and constructed infiltration basin as well as installation of pervious pavement to
maintain the net effective BUA
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 ❑ Ph II - Post Construction
3. Stormwater runoff from this project drains to the White Oak River basin.
4. Total Property Area:17.05 acres 5. Total Coastal Wetlands Area: acres
6. Total Surface Water Area: acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area+: 17.05 acres
+ Total project area shall be calculated to exclude the following: the normal pool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NHVV) line or Mean High Water
(MHK9 line, and coastal wetlands landwardfrom the NHW (or MHM line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal wetlands landward of the NHW (or MHM line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 72.25 %
9. How many drainage areas does the project have?10 (For high density, count 1 for each proposed engineered
stormwater BMP. For low density and other projects, use 1 for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as be1Qw. ,
88 Nlai ✓+ �,Wn5 TY'e 8$ West West Ca vqp vs
Basin Information
Drainage Area _
Drainage Area 1
Drainage Area _
Drama a Area 2
Receiving Stream Name
Bogue Sound
Bogue Sound
Bogue Sound
Bogue Sound
Stream Class *
SA;HQW
SA;HQW
SA;HQW
SA;HQW
Stream Index Number *
20-36-(8.5)
20-36-(8.5)
20-36-(8.5)
20-36-(8.5)
Total Drainage Area (sf)
609,964
609,964
132,949
112,789
On -site Drainage Area (sf)
609,964
609,964
132,949
112,789
Off -site Drainage Area (sf)
0
0
0
0
Proposed Impervious Area** s
0
90,010
0
0
% Impervious Area" (total
56.95 %
1 72.07%
54.51 %
87.69 %
Impervious"* Surface Area
Drainage Area _
DiamageAreal
Drama Area _
Draina a Area 2
On -site Buildings/Lots (so
45,690
On -site Streets (sf)
On -site Parking (sf)
36,326
48,709
On -site Sidewalks (sf)
6,460
Other on -site (sf)
Future (sf)
1,534
Off -site (sf)
Existing BUA*** (so
347,387
1 349,572
1 72,475
50,199
Total (sf):
347,387
1 439,582
1 72,475
1 98,908
* Stream Class and Index Number can be determined at: htW.Zportal.ncdenr.org/webAvq&s/csu/classifications
** Impervi.ous area is defined as the built upon area including, but not limited to, bui
sidewalks, gravel areas, etc.
*** Report only that amount of existing B UA that will remain after development. Do report any existing B that
is to be removed and which will be replaced by new BUA. AUS 0 7
Form SWU-101 Version Oct. 31, 2013 Page 3 of 6
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'11. How was the off -site impervious area listed above determined? Provide documentation. N/A
Proiects in Union County: Contact DEMLR Central Office staff to check if the project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per 15A NCAC 02B.0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BUT specified for this project. The latest versions of the forms can be downloaded
from htti)://vortal.ncdenr.orL,/web/wo/ws/su/bmio-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Energy, Mineral and
Land Resources (DEMLR). A complete package includes all of the items listed below. A detailed application
instruction sheet and BMP checklists are available from
httpl/Rortal.ncdenr.org web/wg/ws/su/statesw/forms docs. The complete application package should be
submitted to the appropriate DEMLR Office. (The appropriate office may be found by locating project on the
interactive online map athig2://12ortal.ncdenr.org/web/wg/ws/­su/mal2s.)
Please indicate that the following required information have been provided by initialing in the space provided
for each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions
for each submitted application package from http://12ortal.ncdenr.org/web/wq/ws/su/statesw/forms docs.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants N
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreements) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
htlp://www.enyhelp.org/12ages/onestol2exl2ress.html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/managementfor
the project. This is required in addition to the brief summary provided in the Project
Information, item 1.
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the 1/2
mile radius on the map.
7. Sealed, signed and dated calculations (one copy).
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including: �—
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater con- .
m. Wetlands delineated, or a note on the plans that none exist. (Must be define y a
qualified person. Provide documentation of qualifications and identify the sokioo l Lu
Mil
made the determination on the plans. UW
n. Existing drainage (including off -site), drainage easements, pipe sizes, runo culations.
o. Drainage areas delineated (included in the main set of plans, not as a separate ar"Me t)
Form SWU-101 Version Oct. 31, 2013 Page 4 of 6

p. Vegetated buffers (where required).
Copy of any applicable soils report with the associated SHWT elevations (Please identify
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"xll" copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DEMLR to verify the SHWT prior
to submittal, [phone].)
10. A. copy of the most c»rrer_t property deed. Deed book: 25110531019102710271109 Page No: ' n
280,218,285,17,16,68 'ou-SL � aL-�+a�..+(
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per 15A NCAC 21-1.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
hgp:/ /www.secretary.state.nc.us/Corl2orations/CSearch.mpx
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from http://portal.ncdenr.org/web/lr/state-stormwater-
forms docs. Download the latest versions for each submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DEMLR, and that they will be recorded prior to the sale of any lot.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting Engineer: Ginger Y. Turner, PE
Consulting Firm: Stroud Engineering, PA
Mailing Address: 107 B Commerce Street
City: Greenville State: NC Zip: 27858
Phone: ( 252 ) 756-9352 ext 233 Fax: ( 252 ) 756-2345
Email: [e-mail]
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or type name of person listed in Contact Information, item 2a) , certify that I
own the property identified in this permit application, and thus give permission to (print or type name of person
listed in Contact Information, item 1 a) with (print or type name of organization listed in
Contact Information, item 1a) to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the stormwater system.CC
GCEIVE
AUG 0 7 Ulf
Form SW-101 Version Oct. 31, 2013 Page 5 of 6 �"

As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
lease agreement, or pending sale, responsibility for compliance with the DEMLR Stormwater permit reverts back
to me, the property owner. As the property owner, it is my responsibility to notify DEMLR immediately and
submit a completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater
treatment facility without a valid permit. I understand that the operation of a stormwater treatment facility
without a valid permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement
action including the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature: Date:
a Notary Public for the State of County of
do hereby certify that
personally appeared
before me this _ day of and acknowledge the due execution of the application for
a stormwater permit Witness my hand and official seal,
SEAL
My commission
X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact Information, item 1a) Richard A. Brvenik, President
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormwater rules under 15A NCAC 2H .1000 d any other applicable state stormwater r quirements.
Signature:—F z� , � n // - / f Date: t �
I, h� y2 % �l `A V - ! n e-e , a Notary Public for the State of /YXA �/ ', County of
(i1 t�" do hereby certify thatpersonally appeared
before me this &day of JU11 I , and acknowledgge the due execution of the application for
a stormwater permit. Witness my hand and official seal, Aao 'X • C&I C.Q.
,001!
111111///��°
40
CS �i
NOTARY
a-
-s PUBLIC
.n v�
ym COU.�O`�•
SEAL
My commission expires afi—z:e'? !''dl
Form SWU-101 Version Oct. 31, 2013 Page 6 of 6
ECEIVE
AUG 0 T 2017
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n,Ooeration'& Maintenance Agreement
Project Name:
Project Location:
Carteret General Hospital
3500 Arendell Street, Morehead City
Cover PpjLe
Maintenance records shall be kept on the following BMP(s). This maintenance record shall be kept in a log in a known set
location. Any deficient BMP elements noted in the inspection will be corrected, repaired, or replaced immediately. These
deficiencies can affect the integrity of structures, safety of the public, and the pollutant removal efficiency of the BMP(s).
The BMP(s) on this project include (check all that apply & c4
Bioretention Cell
Quantity:
Dry Detention Basin
Quantity:
Grassed Swale
Quantity:
Green Roof
Quantity:
Infiltration Basin
Quantity:
Infiltration Trench
Quantity:
Level SpreaderNFS
Quantity:
Permeable Pavement
Quantity:
Proprietary System
Quantity:
Rainwater Harvesting
Quantity:
Sand Filter
Quantity:
Stormwater Wetland
Quantity:
Wet Detention Basin
Quantity:
Disconnected Impervious Area
Present:
User Defined BMP
Present:
ing O&M tables wil
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
I be added automatically):
NE corner of project
Areas on main and west campus
I acknowledge and agree by my signature below that I am responsible for the performance of the maintenance procedures listed
for each BMP above, and attached O&M tables. I agree to notify NCDENR of any problems with the system or prior to any
changes to the system or responsible party.
* Responsible Party:
Title & Organization:
Street address:
City, state, zip:
Phone number(s):
Email:
Signature:
1, Dal
County of
personally appeared before me this
Richard A. Brvenik
President, Carteret County General Hospital Corporation
3500 Arendell Street
Morehead City, NC 28557
252-808-6094
[e-mail]
Date: 71
, a Notary Public for the State of NO
, do hearby certify that ffic lar 14. 6�
ie? -7 day of C J01,� O� ) / -] and
acknowledge the due execution of the Operations and Maintenance =ent
.
I
Witness my hand and official seal,
O
NOTARY
, PUBLIC c
My commission expires
ECEIVE
AUG 0 7 2017
BY:
STORM-EZ
Version 1.4 O&M Manual
7/26/2017
Page 1 of 3

Infiltrati�ln S tem Maintenance Re ui�rements
Important maintenance procedures:
- The drainage area will be carefully managed to reduce The sediment load to The infiltration basin.
_ Immediately after the infiltration basin is established, the vegetation will be watered twice weekly if needed until
the plants become established (commonly six weeks).
No portion of the infiltration basin will be fertilized after the initial fertilization that is required to establish the
vegetation.
- The vegetation in and around the basin will be maintained at a height of approximately six inches.
After the infiltration basin is established, it shall be inspected once a quarter and within 24 hours after every storm event
greater than 1.0 inches (or 1.5 inches if in a Coastal County). Records of operation and maintenance shall be kept in a known
set location and shall be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall be repaired immediately.
BMP element:
Potential problem:
How to remediate the problem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to remove the gully, and then plant a
infiltration basin
erosive gullies have formed.
ground cover and water until it is established. Provide lime and a one-
time fertilizer application.
The inlet device: pipe or
The pipe is clogged (if
Unclog the pipe. Dispose of the sediment off -site.
Swale
applicable).
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to smooth it over and provide erosion
swale (if applicable).
control devices such as reinforced turf matting or riprap to avoid future
problems with erosion.
The forebay
Sediment has accumulated
Search for the source of the sediment and remedy the problem if
and reduced the depth to
possible. Remove the sediment and dispose of it in a location where
75% of the original design
it will not cause impacts to streams or the BMP.
depth.
Erosion has occurred or
Provide additional erosion protection such as reinforced turf matting or
riprap is displaced.
riprap if needed to prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by hand. If pesticides are used, wipe
them on the plants rather than spraying.
The main treatment area
A visible layer of sediment
Search for the source of the sediment and remedy the problem if
has accumulated.
possible. Remove the sediment and dispose of it in a location where
it will not cause impacts to streams or the BMP. Replace any media
that was removed in the process. Revegetate disturbed areas
immediately.
Water is standing more than
Replace the top few inches of filter media and see if this corrects the
5 days after a storm event.
standing water problem. If so, revegetate immediately. If not, consult
an appropriate professional for a more extensive repair.
Weeds and noxious plants
Remove the plants by hand or by wiping them with pesticide (do not
are growing in the main
spray).
treatment area.
The embankment
Shrubs or trees have started
Remove shrubs or trees immediate)
E
to grow on the embankment."
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
BY: -
needs repair.
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose of the sediment off -site.
The outlet device is damaged
Repair or replace the outlet device.
The receiving water
Erosion or other signs of
Contact the local NC Department of Environment and Natural
damage have occurred at the
Resources Regional Office.
outlet.
STORM-EZ 7/26/2017
Version 1.4 O&M Manual Page 2 of 3

Permeable Pavement Maintenance Re uirements
At all times, the pavement shall be kept free of:
Debris and particulate matter through frequent blowing that removes such debris, particularly during the fall and
- spring.
- Piles of soil, sand, mulch, building materials or other materials that could deposit particulates on the pavement.
- Piles of snow and ice.
- Chemicals of all kinds, including deicers.
The permeable pavement will be inspected once a quarter. Records of operation and maintenance will be kept in a known set
location and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall be repaired immediately.
BMP element:
Potentialproblem:
How to remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
permeable pavement
Areas of bare soil and/or
erosive gullies
Regrade the soil if necessary to remove the gully, then plant ground
cover and water until established.
A vegetated area drains
toward the pavement.
Regrade the area so that it drains away from the pavement, then plant
ground cover and water until established.
The inlet device
The pipe is clogged.
Unclog the pipe. Dispose of the sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged.
Erosion is occurring in the
Regrade the swale if necessary to smooth it over and provide erosion
swale.
control devices such as reinforced turf matting or riprap to avoid future
problems with erosion.
Stone verge is clogged or
Remove sediment and replace with clean stone,
covered in sediment (if
applicable).
The surface of the
Trash/debris present
Remove the trash/debris.
permeable pavement
Weeds
Do not pull the weeds (may pull out media as well). Spray them with ,a
systemic herbicide such as glyphosate and then return within the
week to remove them by hand. (Another option is to pour boiling water
on them or steam them.
Sediment
Vacuum sweep the pavement.
Rutting, cracking or slumping
Consult an appropriate professional.
or damaged structure
Observation well
Water present more than five
days after a storm event
Clean out clogged underdrain pipes. Consult an appropriate
professional for clogged soil subgrade.
Educational sign
Missing or is damaged.
Replace the sign.
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose of the sediment off -site.
The outlet device is damaged
Repair or replace the outlet device.
The receiving water
Erosion or other signs of
Contact the local NC Department of Environment and Natural
damage have occurred at the
Resources Regional Office.
outlet.
} zi�l� .
AUG 200
BY:
STORM-EZ 7/26/2017
Version 1.4 O&M Manual Page 3 of 3

SwBD low -ate
Permit No.
(to be provided by DWQ)
A& --AA
STORMWATER MANAGEMENT
PERMIT APPLICATION FORM
WDENR 401 CERTIFICATION APPLICATION FORM
PERMEABLE PAVEMENT SUPPLEMENT
This form must be completely filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
!. PROJECT INFORMATION
Project Name
Carteret Genera! Hospital
Contact Person
Richard A. Brvenik, President
Phone Number
252-808-6094
Date
2-Apr
Drainage Area
3
II. DESIGN INFORMATION
Solis Report Summary
Hydrologic soil group (HSG) of subgrade
A
Infiltration rate
5.00 in/hr
Pavement Design Summary
BUA Credit for Permeable Pavement Footprint:
Permeable Pavement (PP) design type
Infiltration - HSG A/B 75% BUA Credit
SA of PP being proposed (AP)
2,502 ft2
Resulting BUA counted as impervious for main application form
626 ftz
Adjacent BUA directed to PP (AJ
0 ftz OK
Ratio of A. to AP
0.00 (unitless)
Flow from pervious surfaces is directed away from PI'?
Yes OK
Design rainfall depth
1.5" in
Permeable pavement surface course type
PICP
Layer 1- Washed aggregate size (ex. No. 57)
No. 57
Layer 1- Aggregate porosity (n)
0.40 (unitless) OK
Layer 2 - Washed aggregate size (ex. No. 57)
No. 4
Layer 2 - Aggregate porosity (n)
0.40 (unitless) OK
Minimum total aggregate depth for design rainfall (DN,q)
3.8 in
Drawdown/infiltration time for DWq
0.3 days OK
How is 10-yr, 24-hr storm handled?
infiltrated
Aggregate depth to infiltrate 10-yr, 24-hr storm (Dlo)
-42.8 in
Drawdown/infiltration time of 10-yr, 24-hr storm
0.29 days
Actual provided total aggregate depth
12.0 in OK
Top of aggregate base layer elevation
25.90 fmsl
Storage elevation of design rainfall depth
25.22 fmsl
Overflow elevation
NA fmsl
Bottom elevation at subgrade
24.90 fmsl #REF!
SHWT elevation
22.50 fmsl
Underdrain diameter
NA in
JEE IVUE-
APR 2 4%
BY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 1 of 3

Permit No.
(to be provided by DWQ)
Detention Systems (skip for infiltration systems)
Diameter of orifice
in
Coefficient of discharge (Co)
(unitless)
Driving head (Ho)
ft
Storage volume discharge rate (through discharge orifice)
ft3/sec
Storage volume drawdown time
days
Pre -development 1-yr, 24-hr peak fiow
ft3/sec
Past -development 1-yr, 24 hr peak flow
ft3/sec
Additional Information
Slope of soil subgrade at bottom of permeable pavement
0.50
%
OK
Slope of the permeable pavement surface
0.50
%
OK
Construction sequence minimizes compaction to soils?
Yes
OK
Subsoil preparation specified (must select one)
scarified
Meets industry standards for structural requirements?
Yes
OK
Washed stone is specified for the aggregate?
Yes
OK
Required signage specified on plans?
Yes
OK
Number of observation wells provided
1
OK
Distance to structure
45.00
ft
Distance to surface waters
1,400.00
ft
OK
Distance to water supply well(s)
NA
ft
OK
V FIE
APR 2 8 20%
BY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 2 of 3

Permit No.
(fo 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 beer. met, attach justification.
1. Plans (1" = 50' or larger) of the entire site showing:
- Design at ult;mate build -out,
Off -site drainage (if applicable),
Delineated drainage basins (include Rational C coefficient per
basin),
Location of permeable pavement,
Roof and other surface flow directed away from permeable
pavement,
- Location of the permeable pavement sign(s).
2. Section view of the permeable pavement (1" = 20' or larger)
showing:
All layers (including details about the surface course), and
SHWT
3. A detail of what the permeable pavement sign.
a. A site specific soils report that is based upon an actual field
investigation, soil borings, and Infiltration tests within the
footprint of the proposed permeable pavement. The soils
investigation shall state the infiltation rate, SHWT elevation, and
information about any confining layers. County soil maps are not
an acceptable source of soils information.
(Projects in the WiRO - The results of the soils report must be
verified in the field by DWQ, by completing & submitting the soils
investigation request form.)
5. A construction sequence that shows how the permeable
pavement will be protected from sediment until the entire
drainage area is stabilized.
6. The supporting calculations.
7. A copy of the signed and notarized operation and maintenance
(O&M) agreement.
8. A copy of the deed restrictions (if required).
Pagel Plan Sheet No.
Sheets C-2, C-8, C-9, C-10, C-11
Sheet C-12
Sheet C-12
Attached
Sheet C-15
— Attached
Attached
N/A
APR 2 8 20%
BY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 3 of 3

r-
Permit No.
(to be provided by DWQ)
�OF �V ATE,9 pG
A�
,....► o STORMWATER MANAGEMENT PERMIT APPLICATION FORM
NCDENR 401 CERTIFICATION APPLICATION FORM
PERMEABLE PAVEMENT SUPPLEMENT
This form must be completely filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
I. PROJECT INFORMATION
Project Name
Carteret General Hospital
Contact Person
Richard A. Brvenik, President
Phone Number
252-808-6094
Date
2-Apr
Drainage Area
4
11. DESIGN INFORMATION
Solis Report Summary
Hydrologic soil group (HSG) of subgrade
A
Infiltration rate
5.00
in/hr
Pavement Design Summary
BUA Credit for Permeable Pavement Footprint:
Permeable Pavement (PP) design type
Infiltration - HSG A/B
750k BUA Credit
SA of PP being proposed (Ap)
2,016
ft2
Resulting BUA counted as impervious for main application form
504
ft2
Adjacent BUA directed to PP (AJ
0
ftz
K
Ratio of A, to Ap
0.00
(unitless)
Flow from pervious surfaces is directed away from PP?
Yes
Design rainfall depth
1.5"
in
Permeable pavement surface course type
PICP
Layer 1- Washed aggregate size (ex. No. 57)
No. 57
Layer 1- Aggregate porosity (n)
0.40
(unitless)
OK
Layer 2 - Washed aggregate size (ex. No. 57)
No. 4
Layer 2 - Aggregate porosity (n)
0.40
(unitless)
OK
Minimum total aggregate depth for design rainfall (D,y)
3.8
in
Drawdown/infiltration time for DWq
0.1
days
OK
How is 10-yr, 24-hr storm handled?
infiltrated
Aggregate depth to infiltrate 10-yr, 24-hr storm (Dlo)
-42.8
in
Drawdown/infiltration time of 10-yr, 24-hr storm
0.29
days
Actual provided total aggregate depth
12.0
in
OK
Top of aggregate base layer elevation
26.25
fmsl
Storage elevation of design rainfall depth
25.56
fmsl
Overflow elevation
NA
fmsl
Bottom elevation at subgrade
25.25
fmsl
#REF!
SHWT elevation
22.50
fmsl
Underdrain diameter
NA
in
EI
FAPR 2 2014
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 1 of 3

N
i
Detention Systems (skip for infiltration systems)
Diameter of orifice
in
Coefficient of discharge (CD)
(unitless)
Driving head (Ho)
ft
Storage volume discharge rate (through discharge orifice)
ft3/sec
Storage volume drawdown time
days
Pre -development 1-yr, 24-hr peak flow
ft,/Sec
Post -development 1-yr, 24-hr peak flow
ft3/sec
Additional Information
Slope of soil subgrade at bottom of permeable pavement
0.50
%
OK
Slope of the permeable pavement surface
0.50
%
OK
Construction sequence minimizes compaction to soils?
Yes
OK
Subsoil preparation specified (must select one)
scarified
Meets industry standards for structural requirements?
Yes
OK
Washed stone is specified for the aggregate?
Yes
OK
Required signage specified on plans?
Yes
OK
Number of observation wells provided
1
OK
Distance to structure
45.00
ft
Distance to surface waters
1,400.00
ft
OK
Distance to water supply well(s)
NA
ft
OK
Form SW401-Permeable Pavement-Rev.4-October 16, 2012
Permit
(to be provided by DWQ)
APR 2 8 2014
BY:
PP Supplement Farm, Page 2 of 3

Permit No.
(to be provided by DWQ)
Ill 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.
1. Plans (1" = 50' or larger) of the entire site showing:
- Design at ultimate build -out,
Off -site drainage (if applicable),
- Delineated drainage basins (include Rational C coefficient per
basin),
Location of permeable pavement,
Roof and other surface flow directed away from permeable
pavement,
- Location of the permeable pavement sign(s).
2. Section view of the permeable pavement (1" = 20' or larger)
showing:
All layers (including details about the surface course), and
SHWT
3. A detail of what the permeable pavement sign.
4. A site specific soils report that is based upon an actual field
investigation, soil borings, and infiltration tests within the
footprint of the proposed permeable pavement. The soils
investigation shall state the infiltation rate, SHWT elevation, and
information about any confining layers. County soil maps are not
an acceptable source of soils Information.
(Projects in the WIRO - The results of the soils report must be
verified in the field by DWI)by completing & submitting the soils
investigation request form.)
S. A construction sequence that shows how the permeable
pavement will be protected from sediment until the entire
drainage area is stabilized.
6. The supporting calculations.
7. A copy of the signed and notarized operation and maintenance
(O&M) agreement.
8. A copy of the deed restrictions (if required).
Sheets C-
2, C-8, C-
9, C-10, C-
11
' J
SheetC-12
* '2, Sheet C-12
Attached
SheetC-15
Attached
Attached
N/A
Pagel Plan Sheet No.
;.m,ECEI
VE
APR Z 8 20%
BY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 3 of 3

.51V oa-�
Permit No.
(to be provided by DWO)
of 11Areo
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
WDENR 401 CERTIFICATION APPLICATION FORM
PERMEABLE PAVEMENT SUPPLEMENT
This form must be completely filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
-
I: PROJECT INFORMATION
Project Name
Carteret General Hospital
Contact Person
Richard A. Brvenik, President
Phone Number
252-808-6094
Date
2-Apr
Drainage Area
5
IL DESIGN INFORMATION
Soils Report Summary
Hydrologic soil group (HSG) of subgrade
A
Infiltration rate
5.00 in/hr
Pavement Design Summary
BUA Credit for Permeable Pavement Footprint:
Permeable Pavement (PP) design type
Infiltration - HSG A/B
75/6 BUA Credit
SA of PP being proposed (AP)
3,008 ft2
Resulting BUA counted as impervious for main application form
752 ft2
Adjacent BUA directed to PP (A,)
3,008 ftz OK
Ratio of Ac to AP
1.00 (unitless)
Flow from pervious surfaces is directed away from PP?
Yes OK
Design rainfall depth
1.5" in
Permeable pavement surface course type
PICP
Layer 1- Washed aggregate size (ex. No. 57)
No. 57
Layer 1- Aggregate porosity (n)
0.40 (unitless) OK
Layer 2 - Washed aggregate size (ex. No. 57)
No. 4
Layer 2 - Aggregate porosity (n)
0.00 (unitless) OK
Minimum total aggregate depth for design rainfall (DWq)
7.5 in
Drawdown/infiltration time for DWq
0.1 days OK
How is 30-yr, 24-hr storm handled?
infiltrated
Aggregate depth to infiltrate 10-yr, 24-hr storm (Dlo)
-25.7 in
Drawdown/infiltration time of 1D-yr, 24-hr storm
0.57 days
Actual provided total aggregate depth
12.0 in OK
Top of aggregate base layer elevation
25.65 fmsl
Storage elevation of design rainfall depth
25.28 fmsl
Overflow elevation
NA fmsl
Bottom elevation at subgrade
24.65 fmsl
#REFI
SHWTelevation
22.50 fmsl
Underdrain diameter
NA in
ECIV'
PR 2 8 20%
BY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 1 of 3

I
`
Permit No.
(to be provided by DWQ)
Detention Systems (skip for infiltration systems)
Diameter of orifice
in
Coefficient of discharge (Co)
(unitless)
Driving head (H.)
ft
Storage volume discharge rate (through discharge orifice)
ft3!sec
Storage volume drawdown time
days
Pre -development 1-yr, 24-hr peak flow
ft3/sec
Post -development 1-yr, 24-hr peak flow
ft3/sec
Additional Information
Slope of soil subgrade at bottom of permeable pavement
0.50
%
OK
Slope of the permeable pavement surface
0.50
%
OK
Construction sequence minimizes compaction to soils?
Yes
OK
Subsoil preparation specified (must select one)
scarified
Meets industry standards for structural requirements?
Yes
OK
Washed stone is specified for the aggregate?
Yes
OK
Required signage specified on plans?
Yes
OK
Number of observation wells provided
1
OK
Distance to structure
45.00
ft
Distance to surface waters
1,400.00
ft
OK
Distance to water supply well(s)
NA
ft
OK
E IV E
APR 2 8 20%
FAY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form. Page 2 of 3

Permit
Ili. REQUIRED ITEMS CHECKLIST
(to be provided by DWQ)
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will result in a reauesf
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.
1. Plans (1" = 50' or larger) of the entire site showing:
- Design at ultimate build -out,
Off -site drainage (if applicable),
Delineated drainage basins (include Rational C coefficient per
basin),
Location of permeable pavement,
Roof and other surface flow directed away from permeable
pavement,
- Location of the permeable pavement sign(s).
2. Section view of the permeable pavement (1" = 20' or larger)
showing:
All layers (including details about the surface course), and
SHWT
3. A detail of what the permeable pavement sign.
4. A site specific soils report that is based upon an actual field
investigation, soil borings, and infiltration tests within the
footprint of the proposed permeable pavement. The soils
investigation shall state the infiltation rate, SHWT elevation, and
information about any confining layers. County soil maps are not
an acceptable source of soils Information.
(Projects in the WiRO - The results of the soils report must be
verified in the field by DW4 by completing & submitting the soils
investigation request form.)
S. A construction sequence that shows how the permeable
pavement will be protected from sediment until the entire
drainage area is stabilized.
6. The supporting calculations.
7. A copy of the signed and notarized operation and maintenance
(O&M) agreement.
8. A copy of the deed restrictions (if required).
nitial� Page/ Plan Sheet No.
Sheets C-2, C-8, C-9, C-10, C-11
Sheet C-12
Sheet C-12
Attached
Sheet C-15
Attached
Attached
N/A
IECE6y e
APR 2 8 20%
BY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 3 of 3

Permit No. -:5
(to be provided by DWQ)
ot WAL4 G
STORMWATER MANAGEMENT PERMIT APPLICATION FORM o
NCDENIL 401 CERTIFICATION APPLICATION FORM
PERMEABLE PAVEMENT SUPPLEMENT
This form must be completely filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
L PROJECT INFORMATION
Project Name
Carteret General Hospital
Contact Person
Richard A. Brvenik, President
Phone Number
252-808-6094
Date
2-Apr
Drainage Area
6
II. DESIGN INFORMATION
Soils Report Summary
Hydrologic soil group (HSG) of subgrade
A
Infiltration rate
5.00 in/hr
Pavement Design Summary
BUA Credit for Permeable Pavement Footprint:
Permeable Pavement (PP) design type
Infiltration - HSG A/B 75% BUA Credit
SA of PP being proposed (Ap)
3,008 ft2
Resulting BUA counted as impervious for main application form
752 ft2
Adjacent BUA directed to PP (AJ
1,640 ftZ OK
Ratio of A, to AP
0.55 (unitless)
Plow from pervious surfaces is directed away from PP?
Yes
Design rainfall depth
1.5" in
Permeable pavement surface course type
PICP
Layer 1- Washed aggregate size (ex. No. 57)
No. 57
Layer 1- Aggregate porosity (n)
0.40 (unitless) OK
Layer 2 - Washed aggregate size (ex. No. 57)
No. 4
Layer 2 - Aggregate porosity (n)
0.40 (unitless) OK
Minimum total aggregate depth for design rainfall (Dwq)
5.8 in
Drawdown/infiltration time for Dwq
0.1 days OK
How is 10-yr, 24-hr storm handled?
infiltrated
Aggregate depth to infiltrate 10-yr, 24-hr storm (Dlo)
-33.5 in
Drawdown/infiltration time of 30-yr, 24-hr storm
0.44 days
Actual provided total aggregate depth
12.0 in
Top of aggregate base layer elevation
25.85 fmsl
Storage elevation of design rainfall depth
25.33 fmsl
Overflow elevation
NA fmsl
Bottom elevation at subgrade
24.85 fmsl #REF!
SHWT elevation
22.50 fmsl
Underdrain diameter
NA in
,vPR 2 a 2014
BY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 1 of 3

Permit No.
(to be provided by DWQ)
Detention Systems (skip for infiltration systems)
Diameter of orifice
in
Coefficient of discharge (Co)
(unitless)
Driving head (H.)
ft
Storage volume discharge rate (through discharge orifice)
ft3/sec
Storage volume drawdown time
days
Pre -development 1-yr, 24-hr peak flow
ft'/sec
Post-deve'opment 1-yr, 24-hr peak flow
ft3/sec
Additional Information
Slope of soil subgrade at bottom of permeable pavement
0.50
%
OK
Slope of the permeable pavement surface
0.50
%
OK
Construction sequence minimizes compaction to soils?
Yes
OK
Subsoil preparation specified (must select one)
scarified
Meets industry standards for structural requirements?
Yes
OK
Washed stone is specified for the aggregate?
Yes
OK
Required signage specified on plans?
Yes
OK
Number of observation wells provided
1
OK
Distance to structure
45.00
ft
Distance to surface waters
1,400.00
ft
OK
Distance to water supply well(s)
NA
ft
OK
. I V
APR 2 8 20%
BY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 2 of 3

Permit
Ill. REQUIRED ITEMS CHECKLIST
(to be provided by DWQ)
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.
1. Plans (1" = 50' or larger) of the entire site showing:
- Design at ultimate build -out,
Off -site drainage (if applicable),
Delineated drainage basins (include Rational C coefficient per
basin),
Location of permeable pavement,
Roof and other surface flow directed away from permeable
pavement,
- Location of the permeable pavement sign(s).
2. Section view of the permeable pavement (1" = 20' or larger)
showing:
All layers (including details about the surface course), and
SHWT
3. A detail of what the permeable pavement sign.
4. A site specific soils report that is based upon an actual field
Investigation, soil borings, and Infiltration tests within the
footprint of the proposed permeable pavement. The soils
investigation shall state the infiltation rate, SHWT elevation, and
information about any confining layers. County soil maps are not
an acceptable source of soils information.
(Projects in the WiRO - The results of the soils report must be
verified in the field by DWQ, by completing & submitting the soils
investigation request form.)
5. A construction sequence that shows how the permeable
pavement will be protected from sediment until the entire
drainage area Is stabilized.
6. The supporting calculations.
7. A copy of the signed and notarized operation and maintenance
(0&M) agreement.
S. A copy of the deed restrictions (if required).
Initials
J Pagel Plan Sheet No.
Sheets C-2, C-8, C-9, C-10, C-11
Ef 09
SheetC-12
Sheet C-12
Attached
0
SheetC-15
Attached
Attached
N/A
APR 2 8 20%
BY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 3 of 3

a
Permit No:
(to be provided by DWQ)
AF
72
�E WATF9O
� , G
STORMWATER MANAGEMENT
PERMIT APPLICATION FORM
%
NCDENR 401 CERTIFICATION APPLICATION FORM
PERMEABLE PAVEMENT SUPPLEMENT
This form must be completely filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
1. PROJECT INFORMATION
Project Name
Carteret Generai Hospital
Contact Person
Richard A. Brvenik, President
Phone Number
252-808-6094
Date
2-Apr
Drainage Area
7
!l. DESIGN INFORMATION
Soils Report Summary
Hydrologic soil group (HSG) of subgrade
A
Infiltration rate
5.00 in/hr
Pavement Design Summary
BUA Credit for Permeable Pavement Footprint:
Permeable Pavement (PP) design type
Infiltration - HSG A/B
75% BUA Credit
SA of PP being proposed (AP)
3,008 ftZ
Resulting BUA counted as impervious for main application form
752 ftZ
Adjacent BUA directed to PP (AJ
3,008 ftZ OK
Ratio of Ac to Ap
1.00 (unitless)
Flow from pervious sur maces is directed away from PP?
Yes OK
Design rainfall depth
1.51, in
Permeable pavement surface course type
PICP
Layer i - Washed aggregate size (ex. No. 57)
No. 57
Layer 1- Aggregate porosity (n)
0.40 (unitless) OK
layer 2 - Washed aggregate size (ex. No. 57)
No. 4
Layer 2 - Aggregate porosity (n)
0.40 (unitless) OK
Minimum total aggregate depth for design rainfall (Dwq)
7.5 in
Drawdown/infiltration time for D,q
0.1 days OK
How is 10-yr, 24-hr storm handled?
infiltrated
Aggregate depth to infiltrate 10-yr, 24-hr storm (Dlo)
-25.7 in
Drawdown/infiltration time of 10-yr, 24-hr storm
0.57 days
Actual provided total aggregate depth
12.0 in OK
Top of aggregate base layer elevation
25.25 fmsl
Storage elevation of design rainfall depth
24.88 fmsl
Overflow elevation
NA fmsl
Bottom elevation at subgrade
24.25 fmsl
#REF!
SHWT elevation
22.50 fmsl
Underdrain diameter
NA in
EIr
APR 2 g 2014
BY.
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 1 of 3

Permit No.
(fo be provided by DWQ)
Detention Systems (skip for infiltration systems)
Diameter of orifice
in
Coefficient of discharge (Co)
(unitless)
Driving head (H.)
ft
Storage volume discharge rate (through discharge orifice)
ft3/sec
Storage volume drawdown time
days
Pre -development 1-yr, 24-hr peak flow
ft3/sec
Post -development 1-yr, 24-hr peak flow
ft3/sec
Additional Information
Slope of soil subgrade at bottom of permeable pavement
0.50
%
OK
Slope of the permeable pavement surface
0.50
%
OK
Construction sequence minimizes compaction to soils?
Yes
OK
Subsoil preparation specified (must select one)
scarified
Meets industry standards for structural requirements?
Yes
OK
Washed stone is specified for the aggregate?
Yes
OK
Required signage specified on plans?
Yes
OK
Number of observation wells provided
1
OK
Distance to structure
45.00
ft
Distance to surface waters
1,400.00
ft
OK
Distance to water supply well(s)
NA
ft
OK
ECEI'V
APR 2 8 20%
BY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 2 of 3

Permit No.
(to be provided by DWQ)
Ill, REQUIRED ITEMS CHECKLIST . I
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.
1. Plans (1" = 50' or larger) of the entire site showing:
- Design at ultimate build -out,
Off -site drainage (if applicable),
Delineated drainage basins (Include Rational C coefficient per
basin),
Location of permeable pavement,
Roof and other surface flow directed away from permeable
pavement,
- Location of the permeable pavement sign(s).
2. Section view of the permeable pavement (1" = 20' or larger)
showing:
All layers (including details about the surface course), and
SHWT
3. A detail of what the permeable pavement sign.
4. A site specific soils report that is based upon an actual field
investigation, soil borings, and infiltration tests within the
footprint of the proposed permeable pavement. The soils
investigation shall state the inflltation rate, SHWT elevation, and
information about any confining layers. County soil maps are not
an acceptable source of soils information.
(Projects In the WIRO - The results of the soils report must be
verified in the field by DWQ, by completing & submitting the soils
investigation request form.)
5. A construction sequence that shows how the permeable
pavement will be protected from sediment until the entire
drainage area is stabilized.
6. The supporting calculations.
7. A copy of the signed and notarized operation and maintenance
(0&M) agreement.
8. A copy of the deed restrictions (if required).
Page! Plan Sheet No.
Sheets C-2, C-8, C-9, C-10, C-11
Sheet C-12
J Sheet C-12
Attached
Sheet C-15
Attached
Attached
N/A
APR 2 S 20%
BY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 3 of 3

0
Permit No.
(to be provided by DWQ)
� AMA
MI STORMWATER MANAGEMENT
PERMIT APPLICATION FORM d
WDENR 401 CERTIFICATION APPLICATION FORM
PERMEABLE PAVEMENT SUPPLEMENT
This form must be completely filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
1, PROJECT INF0.RMATION
_
Project Name
Carteret Genera! Hospital
Contact Person
Richard A. 9rvenik, President
Phone Number
252-808-6094
Date
2-Apr
Drainage Area
8
11. DESIGN INFORMATION
Soils Report Summary
Hydrologic soil group (HSG) of subgrade
A
Infiltration rate
5.00 in/hr
Pavement Design Summary
BUA Credit for Permeable Pavement Footprint:
Permeable Pavement (PP) design type
Infiltration - HSG A/B 75% BUA Credit
SA of PP being proposed (Ap)
3,008 ft2
Resulting BUA counted as impervious for main application form
752 ft2
Adjacent BUA directed to PP (AJ
2,991 ft2 OK
Ratio of A, to Ap
0.99 (unitless)
Flow from pervious surfaces is directed away from PP?
Yes OK
Design rainfall depth
1.5" in
Permeable pavement surface course type
PICP
Layer 1- Washed aggregate size (ex. No. 57)
No. 57
Layer 1- Aggregate porosity (n)
0.40 (unitless) OK
Layer 2 - Washed aggregate size (ex. No. 57)
No. 4
Layer 2 - Aggregate porosity (n)
0.40 (unitless) OK
Minimum total aggregate depth for design rainfall (DWq)
7.5 in
Drawdown/infiltration time for DWq
0.1 days OK
How is 10-yr, 24-hr storm handled?
infiltrated
Aggregate depth to infiltrate 10-yr, 24-hr storm (Dlo)
-25.8 in
Drawdown/infiltration time of 10-yr, 24-hr storm
0.57 days
Actual provided total aggregate depth
12.0 in OK
Top of aggregate base layer elevation
25.65 fmsl
Storage elevation of design rainfall depth
25.27 fmsl
Overflow elevation
NA fmsl
Bottom elevation at subgrade
24.65 fmsl #REFI
SHWT elevation
22.50 fmsl
Underdrain diameter
NA in
IEGEIV E
APR 2820%
BY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 1 of 3

Permit No.
(to be provided by DWQ)
Detention Systems (skip for infiltration systems)
Diameter of orifice
in
Coefficient of discharge (CD)
(unitless)
Driving head (H.)
ft
Storage volume discharge rate (through discharge orifice)
ft3/set
Storage volume drawdown time
days
Pre -development 1-yr, 24-hr peak flow
ft3/sec
Post -development 1-yr, 24-hr peak flow
ft3/sec
Additional information
Slope of soil subgrade at bottom of permeable pavement
0.50
%
OK
Slope of the permeable pavement surface
0.50
%
OK
Construction sequence minimizes compaction to soils?
Yes
OK
Subsoil preparation specified (must select one)
scarified
Meets industry standards for structural requirements?
Yes
OK
Washed stone is specified for the aggregate?
Yes
OK
Required signage specified on plans?
Yes
OK
Number of observation wells provided
1
OK
Distance to structure
45.00
ft
Distance to surface waters
_ 1,400.00
ft
OK
Distance to water supply well(s)
NA
ft
OK
'El
APR 2 8 2014
BY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 2 of 3

Permit
Ill. REQUIRED ITEMS CHECKLIST
(to be provided by DWQ)
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.
1. Plans (1" = 50' or larger) of the entire site showing:
- Design at ultimate build -out,
Off -site drainage (if applicab;e),
Delineated drainage basins (include Rational C coefficient per
basin),
Location of permeable pavement,
Roof and other surface flow directed away from permeable
pavement,
- Location of the permeable pavement sign(s).
2. Section view of the permeable pavement (1" = 20' or larger)
showing:
All layers (including details about the surFace course), and
SHWT
3. A detail of what the permeable pavement sign.
4. A site specific soils report that is based upon an actual field
investigation, soil borings, and infiltration tests within the
footprint of the proposed permeable pavement. The soils
Investigation shall state the infiltation rate, SHWT elevation, and
information about any confining layers. County soil maps are not
an acceptable source of soils information.
(Projects in the WiRO - The results of the soils report must be
verified in the field by DWQ, by completing & submitting the soils
investigation request form.)
5. A construction sequence that shows how the permeable
pavement will be protected from sediment until the entire
drainage area is stabilized.
6. The supporting calculations.
7. A copy of the signed and notarized operation and maintenance
(O&M) agreement.
8. A copy of the deed restrictions (if required).
ini Pagel Plan Sheet No.
Sheets C-2, C-8, C-9, C-10, C-11
Sheet C-12
SheetC-12
Attached
SheetC-15
"�— Attached
Attached
[p�[� N/A
:IVE-,..
r
APR 2 g 2014
BY..
Form SW401-Permeable Pavement-Rev.4-October 16. 2012 PP Supplement Form, Page 3 of 3

Permit No.
(to be provided by DINO)
acOF WaTgAQG
' STORMWATER MANAGEMENT PERMIT APPLICATION FORM
p T
WDENR 401 CERTIFICATION APPLICATION FORM
PERMEABLE PAVEMENT SUPPLEMENT
This form must be completely filled out printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with ail of the required information.
L PROJECT INFORMATION
Project Name
Contact Person
Phone Number
Date
Drainage Area
Carteret General Hospital
Richard A. Brvenik, President
252-808-6094
1-Aug
9
Ili DESIGN INFORMATION
Soils Report Summary
Hydrologic soil group (HSG) of subgrade
A
Infiltration rate
3.00
in/hr
Pavement Design Summary
BUA Credit for Permeable Pavement Footprint:
Permeable Pavement (PP) design type
Infiltration - HSG A/B
75% BUA Credit
SA of PP being proposed (AP)
22,400
ft2
Resulting BUA counted as impervious for main application form
5,600
ft2
Adjacent BUA directed to PP (k)
22,400
ft2
OK
Ratio of Ac to A.
1.00
(unitless)
Flow from pervious surfaces is directed away from PP?
Yes
OK
Design rainfall depth
1.5"
in
Permeable pavement surface course type
PICP
Layer 1- Washed aggregate size (ex. No. 57)
No. 57
Layer 1- Aggregate porosity (n)
0.40
(unitless)
OK
Layer 2 - Washed aggregate size (ex. No. 57)
No. 4
Layer 2 - Aggregate porosity (n)
0.40
(unitless)
OK
Minimum total aggregate depth for design rainfall (D„q)
7.5
in
Drawdown/infiltration time for DWq
0.2
days
OK
How is 10-yr, 24-hr storm handled?
infiltrated
Aggregate depth to infiltrate 10-yr, 24-hr storm (Dlo)
-1.7
in
Drawdown/infiltration time of 10-yr, 24-hr storm
0.95
days
Actual provided total aggregate depth
12.0
in
OK
Top of aggregate base layer elevation
22.40
fmsl
Storage elevation of design rainfall depth
22.03
fmsl
Overflow elevation
NA
fmsl
Bottom elevation at subgrade
21.40
fmsl
#REF!
SHWTelevation
20.00
fmsl
Underdrain diameter
NA
in
APR 2 8 2014
BY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 1 of 3

Permit No.
(to be provided by DWQ)
Detention Systems (skip for infiltration systems)
Diameter of orifice
in
Coefficient of discharge (CD)
(unitless)
Driving head (Ho)
ft
Storage volume discharge rate (through discharge orifice)
ft3/sec
Storage volume drawdown time
days
Pre -development 1-yr, 24-hr peak flow
ft3/sec
Post -development 1-yr, 24-hr peak flow
ft3/sec
Additional Information
Slope of soil subgrade at bottom of permeable pavement
0.50
%
OK
Slope ofthe permeable pavement surface
0.50
%
OK
Construction sequence minimizes compaction to soils?
Yes
OK
Subsoil preparation specified (must select one)
scarified
Meets industry standards for structural requirements?
Yes
OK
Washed stone is specified for the aggregate?
Yes
OK
Required signage specified on plans?
Yes
OK
Number of observation wells provided
1
OK
Distance to structure
45.00
ft
Distance to surface waters
_ 1,000.00
ft
OK
Distance to water supply well(s)
NA
ft
OK
i•.
APR 2 g 2014
BY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 2 of 3

Permit
111. REQUIRED ITEMS CHECKLIST
(to be provided by DWQ)
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.
1. Plans (1" = 50' or larger) of the entire site showing:
- Design at ultimate build -out,
Off -site drainage (if applicable),
Delineated drainage basins (include Rational C coefficient per
basin),
Location of permeable pavement,
Roof and other surface flow directed away from permeable
pavement,
- Location of the permeable pavement sign(s).
2. Section view of the permeable pavement (1" 20' or larger)
showing:
All layers (including details about the surface course), and
SHWT
3. A detail of what the permeable pavement sign.
4. A site specific soils report that is based upon an actual field
Investigation, soil borings, and Infiltration tests within the
footprint of the proposed permeable pavement. The soils
investigation shall state the infiltation rate, SHWT elevation, and
information about any confining layers. County soil maps are not
an acceptable source of soils information.
(Projects in the WiRO - The results of the soils report must be
verified in the field by DWO, by completing & submitting the soils
Investigation request form.)
S. A construction sequence that shows how the permeable
pavement will be protected from sediment until the entire
drainage area is stabilized.
6. The supporting calculations.
7. A copy of the signed and notarized operation and maintenance
(O&M) agreement.
8. A copy of the deed restrictions (if required).
Initials Pagel Plan Sheet No.
Sheets C-2, C-8, C-9, C-10, C-11
SheetC-12
Sheet C-12
Attached
SheetC-15
Attached
Attached
N/A
iVEA
APR p 8 210% ,
BY:
Form SW401-Permeable Pavement-Rev.4-October 16, 2012 PP Supplement Form, Page 3 of 3

Stormwater Permit Number SW8 010220 MOD
Carteret General Hospital
Carteret County
Designer's Certification
I, Ginger Y. Turner, PE, as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe periodically the construction of the project,
Carteret General Hospital
(Western Lot Only)
for Carteret General Hospital Corporation hereby state that, to the best of my abilities, due care
and diligence was used in the observation of the project construction such that the
construction was observed to be built within substantial compliance and intent of the approved
plans and specifications. __al„ottem.__
Signature
Registration Number
Date 16
°°° IIA CAgO*',,,.
SEAL
36970 s"
Q• o �`
GINEE.��!`�,`
Certification Requirements:
1. The permeable pavement installed per the plans.
2. Required signage provided on site.
3. Vegetated areas drain away from the permeable pavement.
4. Simple infiltration test performed and requirements met for new permeable
pavement (provided by Larry Baldwin of Land Management Group, report
attached).
*5. Observation well installed per the plans.
OCT 0 6 2014
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�LMG
LAND MANAGEMENT GROUP ir...
Environmental Consultants
DATE: Gc;xe rasher 13. 20141
SUBJECT-, Post-constructiun site evaluation and testing of three pervioU.v, pavement areas within the Carteret
County Hospital NW parking area for stormwater treatment usage. Tract laratod within Morehead
City, at ffic GE intersection of Bridgers Street and Bald Street and Pine Street, Morehead Township,
Carteret County, NC. F'!NP`s 637614a23648000 63761402461600G. 37.1 32 '22:1i'O
iO Mr. Ron Cultiphor. PE and Ms. Gingur, runier. PE
Stroud Engineering, PA
151-A NC Hwy 24 W, Hestron Plata II -A
Morehead City, NC 28557
[phone] [o]; [phone] x-233
A final post-ronstruction / as• -built evaluation and tests wereconducted within three proposed permeable pavement
areas of the Carteret County Hospital NW parking area (-1.3 acres) for stormwate,r infiltration treatment usage
wccordng to NCDENR-DWQ "Stormwater Management' rules and regulations (NCAC 15-2H-.1000 and NC Session
Law 2008-211) and Best Management Practice Manual (BMP). The NCDENR-BMP Chapter 10 for perme~ablu
pnvcment requires quantitative and qualitative site assessments to be also completed after final construction for
infiltrative capacity of permeable pavement and final site conditions. This soil evaluation should fulfill these additional
past -construction / as -built NCDWQ-BMP site evaluation requirements. Please reference prior Land Management
Group (LMG) relx its of March 30. 2014, August 21, 2014, September 13. 2014 for this specific project and previous
documentation.
ASTM guidelines (ASTM-C1781) were used to test and document the infiltrative cnpacity of lea permeable pavement
suf tare The test is "Standard Test Method for Surface Infiltration Rate of Psrnaeahte Pavement Systvms' and called
an infiltration ! inundation test. The literature states this testis not highly accurate, but dues provide: (i).--proef the
permeable pavement can accept ,;;pater; (2)--provides a general benchmark of the surface's initial infiltrative capacity
so that later testing may indicate when preventative maintenance should be recommended. Surface; maintenance
cleanin0 is vicornmendrd when the infiltrative rate has diminished down to `60'',I+ — 70% of the surface's initial test
rate. This test was performed twice within each of the three parnreable pavement areas (see map for location). An
3 inch diamot r single -ring infiltronecter sealed to the: surface: was utilized with a +2 — 3 inch failing tread. The results
of tho singk_- -ring infiltration / inundation tosting are attached and as f6ky'vs:
Test i�epth
j Hy+draulicInfiltration
LoadingRate--^_'-
Maintenance
Site
i Tested
Rate Avg 2 tests
Equivalent
Recommended When Rate '
f#
(inches)
(inlhr)
(gaudaylsrgft)
c60 — 70% of initial
t,
00 — 07
1300.0 1
19448
<730 — 010
-13464
•^540 — 630
�:-
- _...
D
Ott — 02"
954 6
14230
`573 — 658
I~_
00-02"
_._:...- .__...,791.2 ._._.. :..
::475-554
_ ..118u7 _
19 -
-:526 614
The intii ri firm I iiiun:, atior, tests tahmv thkg, as -built p*rmoabik-p avEeniana wrt ace: <=,ozrpts bliglf hydraulic. hisding rote,:,
-.r. thot
s=.irface m ntenance should be considered when
€hia rate decreases below
a rate of <475 -- 910 ite/ter
In addition, snon after testing, was Ming cornpletr;d a heavy prE;• ipitabon evont oc:_.urr•:&r1 of +1 inches, toetnef:ra —4:1T
— 5:30 pm on 09-12-2014. It was no rare -tiff IL'ft V10 parkin%
I test areZr:. all imps^•rviousi pavement drainage
fx,viu d towaids then permeable pavoment area ►, and suilaco run-off was totally infiltrated into the; permeaabie
p,ave.rnent areas ( attached phcato).
www.lmgroup.net - infoOlmgroup.net . Phone: [phone] Fax: [phone]
3805 Wrightsville Ave., Suite 15, Wilmington, NC 28403 s RO. Box 2522, Wilmington, NC 28402

The overall finished site and sr r,,+ :ri : w;wan, well landscaped, and wkh no rig-Ln*,� o no-, VI rnaterlaiS
remaining within or outside the p rk;:ing .:p�;�. The permeable paw.in-,:;_pit nvi, i ^� :> c ar' '%d 4Mi v) �� it:,^*. t`�r }l �'r
materiar ; to potentially inhibit sugar.., itiOrn.t f,)r., or evidence of non-speuix f i
median =yeas were stabilized. lent, arc , =Aiaw-mulched, and with si ns of rttrzs vopetal"iu++ e;iwrcting.
Based upon representative site alad observation of post-const utt�on as-buitt conditkmr ,, thi: projoLt Shouid
meet or .ixceed the site condition: icy atat d vAthin NCDENR's BMP ymunual Chapter-10 ijejr p.ri
Future maintenance of the permo,.b - i, +o.c ant's surface, and engina:c�ed drainwe to vxsd f:'vYn tN,,�e sfins
critical components for the propr•.r i+arsctioning t.f "his system to meet ur Ms:wAri itr,, designed sp*rifica tirns.
Larry F. SaHwin. N .,LSS #1040; CPSS/Sc #2101
(910) .171- 0504 [rig,
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INUNDAIiON - SURFACE INFILTATION TEST ASTIVI C -1781
Single -.Ring (id 8.00"; sealed bottom)
TEST LOCATION: Carteret Co Hospital NW Permeable Pavement Parking Lot, M
DATE: August 12, 2014
Flie-Wetted surface km -fore testing.
115T SITE #
": I IE (set)
MCH READING
INCH DIF
W / SEC
A-1
39.0
.3.00
0.00
47.0
5.00
2.00
0.25
A-t
14.0
3.00
0.00
23.0
5.00
2.00
0.22
(A VG 2 Readings)
TEST RESULTS:
21.667
inch./minute
1300.00
inch/hour
Equivalent
19448.00
gal/day/sqf#
Scar$ ++.s, Maintenance recommended
(530%
initial) when:
429.00
Inch/hr
F FST SWE #
TIME (sec)
INCH READING
INCH DIF
IN / SEC
B-1
23.0
3.00
0.00
35.0
5.00
2.00
0.17
5-2
28.0
3.00
0.00
40.0
5.00
2.00
0.17
IAVG 2 Rea dings;
TEST RESULTS:
15.000
inch/minute
900.00
inch/hour
Equivalent
13464.00
gat/day/sqft
Surface Maintenance recommended (530%
initial) when:
297.00
inch/hr
TEST SITE #
YIME (sec)
INCH READING
INCH DIF
IN / SEC
C 1
35.G
3.00
0.00
48.0
5.00
2.00
0.15
C 2
21.0
3.00
0.00
33.0
5.00
2.110
0.17
(AVG 2 Readings)
TEST RESULTS:
14.231
inch/minute
853.85
inch/hour
Equivalent
12773.54
gal/day/sgft
Surfac : MaEn'll-e lance rec:ciameWed (130"A initial) when:
281.77
inch/hr

TEST SITE #f TIME (sec) INCH READING INCH DIF 1:=! / SEC
0-1 15.0 3.00 0.00
26.0 '.i.00 2.00 0.18
D-2 31.0 3'.0o 0.00
43.0 5.00 2.00 0.17
(AVG 2 Readings)
TEST RESULTS: 15.909 inch/minute
954.55 inch/hour
Equivalent 14280.00 gal!day/sgft
Surface Maintenance recommended 1,5307% initial) when: 315.00 inch/hr
TEST SITE * TIME (sec) INCH READING INCH DIF III! / SEC
E-1 2.0 "�.;)0 0.00
16.0 5.0o 2.00 0.14
E-2 11.0 :�.00 0.00
24.0 5.00 2.00 0.15
(A%JG 2 Reading-)
TEST RESULTS: 13.187 inch/minute
791.21 inch/hour
Equh.,talent 7.1836.48 gal/day/sgft
Surface Mainten ince recommended (5300N, initial) vil'rpn: 262.10 inch/hr
TEST SITE ## TIME (sec) INCH READ114G INCH DIF IN / SEC
F-i 10.0 3.U0 0.00
22.0 5.00 2.00 0.17
F-2 21..0 3.00 0.90
34.0 5.00 2.00 0.15
(AVG?Rmdhiys)
TEST RESULTS: 14.61r, inch/minute
8116.92 inch/hour
Equivalent 1.3118.77 gal/day/sgft
Surface Maintenance ra-Lommeridcd (----30% initial) when: 289.38 inch/hr

STROUD ENGINEERING, P.A.
107-B Commerce Street
GREENVILLE, NC 27858AA
[phone] 4
TO Na
121 CW&v A DV.
WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via
❑ Shop drawings ❑ Prints ❑ Plans
❑ Copy of letter ❑ Change order ❑
WHO
.:
M W
the following items:
❑ Samples ❑ Specifications
•
THESE ARE TRANSMITTED as checked below:
❑ For approval
❑ For your use
❑ As requested
or review and comment
❑ FORBIDS DUE
REMARKS
❑ Approved as submitted
❑ Approved as noted
❑ Returned for corrections
❑ Resubmit copies for approval
❑ Submit copies for distribution
❑ Return corrected prints
❑ PRINTS RETURNED AFTER LOAN TO US
COPY TO
SIGNED:
If enclosures are not as noted, kindly notify us at

Stormwater Permit Number SW8 010220 MOD
Carteret General Hospital
Carteret County
Designer's Certification
I, Ginger Y. Turner, PE, as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe periodically the construction of the project,
Carteret General Hospital
(Employee Lot Only)
for Carteret General Hospital Corporation hereby state that, to the best of my abilities, due care
and diligence was used in the observation of the project construction such that the
construction was observed to be built within substantial compliance and intent of the approved
plans and specifications.
Signature ���`p4'�.��SS/p�•'�4 �%
Company JKqi owAaKA• :aQ
SEAL �
Registration Number *2''-"�`r 70 36970
� �Q `ate:
Date 11 �Z� `��% ''.,� •.Na;N;�� ••.
���i..ER Y- -..•••
Certification Requirements:
1, The permeable pavement installed per the plans.
2. Required signage provided on site.
3. Vegetated areas drain away from the permeable pavement.
4. Simple infiltration test performed and requirements met for new permeable
pavement (provided by Larry Baldwin of Land Management Group, report
attached).
bldl-- 5. Observation well installed per the plans.
ECEIVEP,
NOV 2 4 2014 4
BY:

_ - Observation Well
(NW corner of Lot)
.rw

1i' ni• y
1+
r
existingSouthern •�� f r.
V 1 ~. ■ looking .
- r

oil
��.
' -job�
A
.F-
rJ

DATE: October 31, 2014
SUBJECT: Pre- & Post -construction site evaluation and testing of the permeable pavement site improvements within
the Carteret County Hospital SW parking area for stormwater treatment usage. Tract located within
Morehead City, NE of the intersection at Arendeil Street and SW entrance to hospital, Morehead
Township, Carteret County, NC. PIN# 637614423756000 (SW portion)
TO: Mr. Ron Cullipher, PE and Ms. Ginger Turner, PE
Stroud Engineering, PA
151-A NC Hwy 24 W, Hestron Plaza II -A
Morehead City, NC 28557 [phone] [o]; [phone] x-233
The land and soils within the Carteret County Hospital SW parking area were evaluated for post -construction subgrade,
soil and site conditions for permeable pavement construction being used as a stormwater treatment. These evaluations
were completed at three separate times to coincide with progress of construction phases on Sept 9, Sept 30, and Oct 6,
2014. NCDENR "Stormwater Management" rules and regulations (NCAC 15-2H-.1000 and NC Session Law 2008-211)
and Best Management Practice Manual (BMP) were used as guidelines for these evalutations. The NCDENR-BMP
Chapter 10 for permeable pavement requires quantitative site assessments to be completed before components of the
pervious stormwater infiltration structure are installed and in addition to qualitative soil evaluations. This evaluation should
fulfill these additional NCDWO-BMP site and soil evaluation requirements.
The attached Land & Soils map shows the location of soil boring evaluations (see map "red" dots). The soil boring
descriptions are attached to this report. The surface soil materials were excavated and removed from the site as
designed by the engineering plans, thus the soils evaluated were the exposed subsoil horizons.
Representative hydraulic conductivity testing was performed to determine infiltration rates of the subgrade soil materials
using the Turf-Tec double -ring infiltrometer (id 2.38" x od 4.25" x depth 2.0" x falling head 3.5") method (see soils map
"blue" dots). All infiltrometer test sites were pre -saturated for +15 minutes before final testing was conducted. As
recommended by the literature, -•10% of the actual readings were used as being representative for each site tested. The
rPcultc of the riot ihip-rinn infiltration testinn are as follows:
Test
Site
#
Depth
Tested
inches
Hydraulic Infiltration
Rate
in/hr
Soil Horizon / Texture
Loading Rate
(gal/day/sgfit)
1-1-A
00 — 02"
6.71
E / sand
100.4
1-1-B
00 — 02"
0.12
Bh spodic / loamy sand
1.8
1-5-A
00 — 02"
4.50
E / sand
67.3
1-5-B
00 — 02"
3.00
Bh spodic / loamy sand
44.9
2-8-A
00 — 02"
5.06
C / sand
75.8
2-9-A
00 — 02"
9.00
E / sand
134.6
2-10-A
00-02-
3.00
E / sand
44.9
2-11-A
00 — 02"
3.00
E / sand
44.9
3-13-A
00 — 02"
5.40
C / sand
80.8
3-14-A
00 — 02"
1.80
Bh spodic / loamy sand
26.9
3-15-A
00 — 02"
3.60
C / sand
53.9
GM=3.0
GM=44.9
These infiltration test rates are representative of the fine to medium sand textures, and soil structure found within the
subgrade of this tract. The main variability of hydraulic infiltration rates occur between areas with presence of a spodic or
hardpan horizon, vs. those where it is absent. A minority of the site has a spodic horizon within the subgrade soil
material, and it occurs within the southeastern section portion of the site. It is variable as to massiveness structure (1-1-
B), but the majority is soft and non-restrictive (1-5-B & 3-14-A). The geomean (GM) is a more representative hydraulic
infiltration rate of the overall site and how the site will function which is 3.0 in/hr or 44 gal/day/sqft. Infiltration rates are

representative of vertical water movement, whereas lateral water movement is 7 to 9 times this rate, or —20 — 27 in/hr.
Both the vertical and horizontal tested hydraulic rates exceed the minimum NCDENR design rate of 0.52 in/hr for
stomrwater infiltration structures.
A final post -construction evaluation and tests were conducted on Oct 28, 2014 of the permeable pavement areas of the
Carteret County Hospital SW parking area for stormwater infiltration treatment usage according to NCDENR-DWQ
"Stormwater Management" rules and regulations (NCAC 15-21-1-1000 and NC Session Law 2008-211) and Best
Management Practice Manual (BMP). The NCDENR-BMP Chapter 10 for permeable pavement requires quantitative and
qualitative site assessments to also be completed after final construction for infiltrative capacity of permeable pavement
and final site conditions. This portion of the soil evaluation should fulfill these additional post -construction / as -built
NCDWQ-BMP site evaluation requirements.
ASTM guidelines (ASTM-C1781) were used to test and document the infiltrative capacity of the permeable pavement
surface. The test is "Standard Test Method for Surface Infiltration Rate of Permeable Pavement Systems" and called an
infiltration / inundation test. The literature states this test is not highly accurate, but does provide: (1)--proof the
permeable pavement can accept water; (2)--provides a general benchmark of the surface's initial infiltrative capacity so
that later testing may indicate when preventative maintenance should be recommended. Surface maintenance cleaning is
recommended when the infiltrative rate has diminished down to <60% — 70% of the surface's initial test rate. This test
was performed twice within each of the three permeable pavement areas (see map for location). An 8 inch diameter
single -ring infiltrometer sealed to the surface was utilized with a —4 — 5 inch falling head. The results of the single -ring
infiltratinn / inundation testina are attached and as follows:
--------------
Test
Site
#
-------------------
Head
(inches)
--- - - --- -
Hydraulic Infiltration
Rate Avg 2 tests
(in/hr)
Loading Rate
Equivalent
(gal/day/sgft)
Maintenance
Recommended When Rate
<60 — 70% of Initial
in/hr
1-1 -a
01 — 05"
938.8
14044
<313
1-2-a
01 —05"
617.1
9232
<206
1-3-a
00 — 05"
857.1
12823
<286
Perform surface maint. when
<268 in/hr
The infiltration / inundation tests show the as -built permeable pavement surface accepts high hydraulic loading rates, and
that surface maintenance should be considered when this rate decreases below a rate of <268 in/hr.
In addition, on Oct 15, 2014 the site was observed during a +1.5 inch rainfall event. During this heavy precipitation event
it was observed that no run-off left the parking lot area, surface run-off was totally infiltrated into the permeable paved
areas, and with no surface ponded areas.
The overall finished site and area were clean, well landscaped, and with no debris or non -specified materials remaining
within or outside the parking area. The permeable pavement area was clean with no fines or other materials to potentially
inhibit surface infiltration, or evidence of non -specified off -site drainage onto these areas. The median perimeter area was
stabilized, landscaped, straw -mulched, and with signs of grass vegetation emerging.
Based upon representative site testing and observation of post -construction as -built conditions, the project should meet or
exceed the site conditions as stated within NCDENR's BMP manual Chapter-10 for permeable pavement. Future
maintenance of the permeable pavement's surface, and maintaining the engineered drainage to and from these sites are
critical components for the proper functioning of this system to meet or exceed its' designed specifications.
Larry F. Baldwin, NCLSS #1040; CPSS/Sc #2183

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SUBGRADE SOIL BORING DESCRIPTIONS CARTERET COUNTY HOSPITAL SW PARKING
AREA FOR POST -SITE IMPROVEMENT STORMWATER INFILTRATION AREAS
CARTERET COUNTY, NC Sept 9, Sept 30, Oct 6, 2014
PIN #'s 637614423756000 (SW portion)
Borina #
Horizon
Depth
in
Texture
Structure
Color
1
E
00-18
S
Loose
White / LightGray
Leon -cut
Bhir
18-30
LS
Hard Massive
V.DarkGrayBrown
SHWT
Cl
30-50
S
Loose
DarkGrayBrown
+12 -15"
C2
50-60
S
Loose
DarkYellowBrown
2
E
00-14
S
Loose
White / LightGray
Leon -cut
Bh
14-20
LS
Soft Massive
V.DarkGrayBrown
SHWT
Cl
20-31
LS
Loose
PaleGrayBrown
14 -16"
C2
31-60
S
Loose
Brown
3
E1
00-18
S
Loose
White
Leon -cut
E2
18-41
S
Loose
LightGray
SHWT
Bh / C
41-51
LS-S
Soft / Loose
V.DarkGrayBrown
+12 -15"
4
E1
00-18
S
Loose
White / LightGray
Leon -cut
E2
18-45
S
Loose
LightGray / PaleGrayBrown
SHWT
Bh
45-55
LS
Soft / Loose
V.DarkGrayBrown
14 -15"
5
E1
00-15
S
Loose
White
Leon -cut
E2
15-36
S
Loose
LightGray
SHWT
E3
36-45
S
Soft / Loose
Gray
+12 -15"
Bh
45-55
S
Soft / Loose
V.DarkGrayBrown
6
E1
00-05
S
Loose
White / LightGray
Leon/Mandarin-cut
Bhl
05-18
LS
Soft / Loose
DarkBrown
SHWT
Bh2
18-23
LS
Soft / Loose
V.DarkGrayBrown
14 -15"
Cl
23-41
S
Loose
LightGray / Gray
C2
41-55
S
Loose
Light Gray
7
E1
00-16
S
Loose
White
Leon/Mandarin-cut
E2
16-19
S
Loose
LightGray
SHWT
Bh
19-21
LS/S
Soft / Loose
DarkGrayBrown
18 - 20"
Cl
21-30
S
Loose
Brown
C2
30-46
S
Loose
V.PaleBrown
C3
46-55
S
Loose
DarkBrown
8
Cl
00-18
S
Loose
Brown
Cnetoe-cut
C2
18-30
S
Loose
YellowBrow
SHWT 30-32"
C3
30-55
S
Loose
PaleYellow red mttls

Boring #
Horizon
Depth
in
Texture
Structure
Color
9
E1
00-17
S
Loose
White/LightGray
Mandarin -cut
Bhir
17-30
LS
Hard -Soft loose
V.DarkGrayBrown
SHWT 16 —17"
C
30-55
LS/S
Loose
DarkGrayBrown
10
E1
00-13
S
Loose
White
Leon -cut
E2
13-15
S
Loose
LightGray
SHWT
Bh
15-20
LS/S
Soft / Loose
DarkGrayBrown
13 -16"
C
20-31
S
Loose
DarkBrown
Bh'
31-34
LS/S
Loose
DarkGrayBrown
C'
34-55
S
Loose
Brown/LightGray
11
E1
00-16
S
Loose
White
Mandarin -cut
E2
16-19
S
Loose
LightGray
SHWT
Bhir
19-28
LS/S
Hard -Soft loose
V.DarkGrayBrown
16 -19"
Bh
28-52
S
Loose
DarkGrayBrown
C
52-60
S
Loose
DarkBrown
12
E1
00-11
S
Loose
GrayBrown/White
Mandarin -cut
E2
11-17
S
Loose
White
SHWT
Bhir
17-40
LS/S
Hard -Soft loose
V.DarkGrayBrown
17 - 20"
C
40-60
S
Loose
V.DarKBrown
13
C1
00-21
S
Loose
YellowBrown
Wando-cut
C2
21-30
S
Loose
PaleYellow f.red mttls
SHWT 21 — 22"
C3
30-55
S
Loose
PaleYellow gray/red mttls
14
Bh
00-12
LS
Soft / Loose
DarkBrown
Mandarin -cut
C1
12-18
S
Loose
GrayBrown
SHWT
C2
18-41
S
Loose
PaleYellow gray/red mttls
16 -19"
C3
41-55
S
Loose
V.PaleYellow red/gray mttls.
C4
40-60
j S
Loose
Yellow red/brown mttls.
15
C1
00-06
S
Loose
YellowBrown
Wando-cut
C2
06-21
S
Loose
BrownYellow
SHWT
C3
21-26
S
Loose
PaleYellowBrown red mttls
22 - 24"
C4
26-31
S
Loose
LightGray.
C5
31-40
S
Loose
Gray
Bh
40-55
S
Loose
DarkGrayBrown
L.F. Baldwin, CPSS/Sc #2183; NCLSS #1040 Sept / Oct -2014

DOUBLE -RING INFILTRATION TEST
Turf-Tec infiltrometer (id 2.38" x od 4.25" x depth 2.0" x 3.5" falling head)
All test sites pre -saturated +15 minutes prior to test run.
TEST LOCATION:
Carteret County Hospital SW Parking Area Subgrade
DATE:
Area 1-9/19/2014; Area 2-9/30/2014, Area 3-10/06/2014
TEST SITE #
TIME
INCH READING
INCH DIF
IN / MINUTE
1-1-A
25.0
0.00
Area 1 East E horizon
24.0
1.25
1.25
1.25
23.0
2.50
1.25
1.25
22.0
3.50
1.001
1.00
(GM Last 2 Readings)
TEST RESULTS:
1.118
inch/minute
10%
6.71
inch/hour
Equivalentl
100.35
gal/day/sqft
TEST SITE #
TIME
INCH READING
INCH DIF
IN / MINUTE
1-1-B
25.0
0.00
Area 1 East Bh horizon
20.0
0.20
0.20
0.04
15.0
0.30
0.10
0.02
10.0
0.40
0.10
0.02
5.0
0.50
0.10
0.02
0.0
0.60
0.10
0.02
(GM Last 2
Readings)
TEST RESULTS:
0.020
inch/minute
10%
0.12
inch/hour
Equivalent
1.80
gal/day/sgft
TEST SITE #
TIME
INCH READING
INCH DIF
IN / MINUTE
1-5-A
24.0
0.00
Area 1 East E horizon
23.0
0.75
0.75
0.75
22.0
1.50
0.75
0.75
21.0
2.25
0.75
0.75
20.0
3.00
0.75
0.75
(GM Last 2
Readings)
TEST RESULTS:
0.750
inch/minute
10%
4.50
inch/hour
Equivalent
67.32
gal/day/sqft

TEST SITE # TIME INCH READING INCH DIF IN / MINUTE
1-5-B
20.0
0.00
Area 1 East Bh horizon
15.0
2.50
2.50
0.50
14.0
3.00
0.50
0.50
13.0
3.50
0.50
0.50
(GM Last 2 Readings)
TEST RESULTS:
0.500
inch/minute
10%
3.00
inch/hour
Equivalent
44.88
gal/day/sqft
TEST SITE #
TIME
INCH READING
INCH DIF
IN / MINUTE
2-8-A
25.0
0.00
Area 2 Center C horizon
22.0
2.75
2.75
0.92
21.0
3.50
0.75
0.75
refill
20.0
0.00
18.0
1.75
1.75
0.88
17.0
2.70
0.95
0.95
(GM Last 2 Readings)
TEST RESULTS:
0.844
inch/minute
10%
5.0G
inch/hour
Equivalent
75.77
gal/day/sqft
TEST SITE #
TIME
INCH READING
INCH DIF
IN / MINUTE
2-9-A
12.0
0.00
Area 2 Center E horizon
11.0
1.50
1.50
1.50
10.0
3.00
1.50
1.50
(GM Last 2 Readings)
TEST RESULTS:
1.500
inch/minute
10%
9.00
inch/hour
Equivalent
134.64
gal/day/sqft
TEST SITE #
TIME
INCH READING
INCH DIF
IN / MINUTE
2-10-A
21.0
0.00
Area 2 Center E horizon
20.0
0.50
0.50
0.50
19.0
1.10
0.60
0.60
18.0
1.60
0.50
0.50
17.0
2.10
_ 0.50
0.50
15.0
3.10
1.00
0.50
(GM Last 2 Readings)
TEST RESULTS:
0.500
inch/minute
10%
3.00
inch/hour
Equivalent
44.88
gal/day/sgft

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