SW7091208_CURRENT PERMIT_20091223

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
DOC TYPE
CURRENT PERMIT
APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
E'�i%fit
YYYYMMDD

r0 A
NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Mr. Bill M. Taylor, President
Tandem, Inc.
PO Box 709
Elizabeth City, NC 27907
Dear Mr. Taylor:
Division of Water Quality
Coleen H. Sullins
Director
Dee Freeman
Subject: Stormwater Permit No. SW7091208
Tandem, Inc.
High Density Project
Pasquotank County
The Washington Regional Office received a complete Stormwater Management Permit
Application for Tandem, Inc. project on December 16, 2009. Staff review of the plans and
specifications has determined that the project, as proposed, will comply with the Stormwater
Regulations set forth in Session Law 2008-211 and Title 15A NCAC 2H.1000. We are
forwarding Permit No. SW7091208 dated December 23, 2009, for the construction of the
subject project. v2-t 30 0-- 1
This permit shall be effective from the date of issuance until December 23, 2019, and shall be
subject to the conditions and limitations as specified therein. Please pay special attention to
the Operation and Maintenance requirements in this permit. Failure to establish an adequate
system for operation and maintenance of the stormwater management system will result in
future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have
the right to request an adjudicatory hearing upon written request within thirty (30) days
following receipt of this permit. This request must be in the form of a written petition,
conforming to Chapter 150B of the North Carolina General Statutes, and filed with the Office of
Administrative Hearings, 6714 Mail Service Center, Raleigh, NC 27699-6714. 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 Samir Dumpor, or me at [phone].
Sincerely,
Al Hodge
Regional Supervisor
Surface Water Protection Section
AH/sd: K:\WQS\STORMWATER\PERMIT\SW7091208
cc:. Kim Hamby, Hyman & Robey
Pasquotank County Building Inspections
Washington Regional Office
Central Files
North Carolina Division of Water Quality Internet: www.ncwmcrquality.org
943 Washington Square Mall Phone: [phone] One
Washington, NC 27889 FAX [phone] NorthCaroftna
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper Nat r l&

State Stormwater Management Systems
Permit No. SW7091208
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY 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
Tandem, Inc.
Tandem, Inc.
Pasquotank County
FOR THE
construction, operation and maintenance of two connected infiltration basins in compliance
with the provisions of Session Law 2008-211 and 15A NCAC 2H .1000 (hereafter referred
to as the "stormwater rules') and the approved stormwater management plans and
specifications and other supporting data as attached and on file with and approved by the
Division of Water Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until December 23, 2019, 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 application and other supporting data.
2. This stormwater system has been approved for the management of stormwater
runoff as described in Section 1.8 on page 3 of this permit. The stormwater control
has been designed to handle the runoff from total of 24,048 square feet of
impervious area.
3. The tract will be limited to the amount of built -upon area indicated in Section 1.7 on
page 3 of this permit, and as shown on the approved plans.
4. All stormwater collection and treatment systems must be located in either dedicated
common areas or recorded easements. The final plats for the project will be
recorded showing all such required easements, in accordance with the approved
plans.
The runoff from all built -upon area within the permitted drainage area of this project
must be directed into the permitted stormwater control system.
The built -upon areas associated with this project shall be located at lest 50 feet
landward of all surface waters.
Page 2 of 7

State Stormwater Management Systems
Permit No. SW7091208
7
The following design criteria have been permitted for the infiltration basin and must
be provided and maintained at design condition:
a.
Drainage Area, ftz:
BASIN
34,553
b.
Total Impervious Surfaces, ft2:
24,048
C.
Design Storm, inches:
1.5
d.
Basin Depth, feet:
2.25
e.
Bottom Elevation, FMSy
9.0
f.
Bottom Surface Area, ft :
753.66+171.11=925.00
g.
Bypass Weir Elevation, FMSY
11.25
h.
Permitted Storage Volume, ft :
4,539
i.
Type of Soil:
Urban
j.
Expected Infiltration Rate, in/hr:
0.93
k.
Seasonal High Water Table, FMSL: 7.0
I.
Time to Draw Down, days:
1.21
M.
Receiving Stream/River Basin:
Knobbs Creek/Pasquotank River basin
n.
Stream Index Number:
30-3-8
o.
Classification of Water Body:
"C; Sw"
II. SCHEDULE OF COMPLIANCE
The stormwater management system shall be constructed in its entirety, vegetated
and operational for its intended use prior to the construction of any built -upon
surface.
During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
The permittee shall at all times provide the operation and maintenance necessary to
assure the permitted stormwater system functions at optimum efficiency. The
approved Operation and Maintenance Plan must be followed in its entirety and
maintenance must occur at the scheduled intervals including, but not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and revegetation of slopes and the vegetated filter.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of bypass structure, infiltration media, flow
spreader, catch basins, piping and vegetated filter.
g. A clear access path to the bypass structure must be available at all times.
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.
5. The permittee shall submit to the Division of Water Quality an annual summary
report of the maintenance and inspection records for each BMP. The report shall
summarize the inspection dates, results of the inspections, and the maintenance
work performed at each inspection.
The facilities shall be constructed as shown on the approved plans. This permit shall
become voidable unless the facilities are constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other
supporting data.
If the stormwater system was used as an Erosion Control device, it must be
Page 3 of 7

i
State Stormwater Management Systems
Permit No. SW7091208
restored to design condition prior to operation as a stormwater treatment device,
and prior to occupancy of the facility.
8. Upon completion of construction, prior to issuance of a Certificate of Occupancy,
and prior to operation of this permitted facility, a certification must be received from
an appropriate designer for the system installed certifying that the permitted facility
has been installed in accordance with this permit, the approved plans and
specifications, and other supporting documentation. Any deviations from the
approved plans and specifications must be noted on the Certification. A modification
may be required for those deviations.
9. Access to the stormwater facilities shall be maintained via appropriate easements at
all times.
10. The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed below:
a. Any revision to any item shown on the approved plans, including the
stormwater management measures, built -upon area, details, etc.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
e. Further subdivision, acquisition, lease or sale of all or part of the project area.
The project area is defined as all property owned by the permittee, for which
Sedimentation and Erosion Control Plan approval or a CAMA Major permit
was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
11. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
12. A copy of the approved plans and specifications shall be maintained on file by the
Permittee at all times.
13. 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
This permit is not transferable to any person or entity except after notice to and
approval by the Director. In the event of a change of ownership, or a name change,
the permittee must submit a completed Name/Ownership Change form to the
Division of Water Quality, signed by both parties, and accompanied by the
appropriate documentation as listed on page 2 of the form. The approval of this
request will be considered on its merits and may or may not be approved.
2. The permittee is responsible for compliance with all permit conditions until such time
as the Division approves the transfer request.
3. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the Division of Water Quality, in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
4. The issuance of this permit does not preclude the Permittee from complying with
Page 4 of 7

State Stormwater Management Systems
Permit No. SW7091208
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
5. In the event that the facilities fail to perform satisfactorily, including the creation of
nuisance conditions, 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.
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 revoked or terminated. The
permit may be modified, revoked and reissued or terminated for cause. The filing of
a request for a permit modification, revocation and reissuance or termination does
not stay any permit condition.
8. 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.
9. Approved plans and specifications for this project are incorporated by reference and
are enforceable parts of the permit.
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. The permittee shall notify the Division in writing of any name, ownership or mailing
address changes at least 30 days prior to making such changes.
12. This permit shall be effective from the date of issuance until December 23, 2019.
Application for permit renewal shall be submitted 180 days prior to the expiration
date of this permit and must be accompanied by the processing fee.
Permit issued this the 23rd day of December, 2009.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
ol-
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit No. SW7091208
Page 5 of 7

v Ll
DWQ USE ONLY
Date Received
Fee Paid CK4 1 I(,
Permit Number
3� � 4eoo
r•► 1 08
a a
Applica astal SW —1995 Col SW — 2008 El Ph II - Post Construction
�n-Coastal
(select all i E SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M t Plan:
State of North Carolina
INC DENRDepartment of Environment and Natural Resources
Division of Water Quality
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.):
2. Location of Project (street address):
1314 Ehringhaus Street
City:Elizabeth City County:Pasquotank Zip:27909
3. Directions to project (from nearest major intersection):
From the intersection of US 17 Business (Ehringhaus St.) and NC 344 (Halstead Blvd.) travel east on
Ehringhaus St. The site is located 0.33 miles east, on the left, just past the signalized intersection with
4. Latitude:36° 17' 42" N Longitude:76° 14' 24" W of the main entrance to the project.
11. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number , its issue date (if known) 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 DWQ
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):
❑LAMA 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:
Fonn SWU-101 Version 07July2009
Page I 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 oroiect):
Applicant/Organization:Tandem. Inc.
Signing Official & Title:Bill M. Taylor, President
b.Contact information for person listed in item la above:
Street Address:202 West Main Street
City:Elizabeth City State:NC Zip:27909
Mailing Address (if applicable):P.O. Box 709
City:Elizabeth City State:NC Zip:27907
Phone: (252 ) 338-1793 Fax:
Email:
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
Signing Official &
b.Contact information for person listed in item 2a above:
Street Address:
City:
Mailing Address (if
City:
Phone: ( )
Zip:
State: Zip:
Fax: ( )
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/Organization:A. R. Chesson Construction Co. Inc.
Signing Official & Title:Zack Mixon
b.Contact information for person listed in item 3a above:
Mailing Address:P. O. Box 1147
City:Williamston State:NC Zip:27892
Phone: (252 ) 7924486 Fax: (252 ) 792-9090
Em a i I:[e-mail]
4. Local jurisdiction for building permits: Elizabeth City
Point of Contact:Stanley Ward, Chief Bldg Inspector Phone #: (252 ) 337-6868
Form SWU-101 Version 07July2009 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the storm water runoff will be treated.
All runoff from impervious surfaces will be collected using an underground collection system and routed to
one of two infiltration ntion basins to store the first 1.5 inches of runoff at 90% TSS removal.
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Appproval of a Site Specific Development Plan or PUD Approval Date:
ElVand Building Permit Issued Date:
❑ Other: Date:
b.Identify the regulation(s) the prorct has been designed in accordance with:
❑ Coastal SW —1995 ❑ Ph II — Post Construction
3. Stormwater runoff from this project drains to the Pasquotank River basin.
4. Total Property Area: 0.97 acres 5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
7. Total Property Area (4) — Total Coastal Wetlands Area (5) — Total Surface Water Area (6) = Total Project
Area*:0.97 acres
Total project area shall be calculated to exclude the followin the normal pool of imppounded structures, the area
between the banks of streams and rivers, the area below the Lrmal High Water (NM line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or MHW) line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal wetlands landward of the NHW (or MHW) line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 60.96 %
9. How many drainage areas does the project have?2 (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 below.
Basin Inforniation
Drainage Areal _
rama a re a _
Drainage Area
rams a rea
Receiving Stream ame
o s Creeko
s ree
Stream Class
w
w
Stream Index Number *
____M_T_T_
I otal Drainage rea s
,
site Drainage Area s
Off -site ramage rea s
Proposed Impervious Area (sf)
%Impervious Area (total)
Im ervious Surface Area
Drainage Area _
Drainage Area _
Drainage Area _
Drainage rea
site m ngs ots s
On -site Streets s
On -site Parking s
site Sidewalks s
Other on -site s
umpster
uture s
site s
Existing s
ota s
* Stream Class and Index Number can be determined at: http://`h2o.enr.state.nc.uslbims/reports&MortsWB.htmi
Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
*"* Report only that amount of existing BUA that will remain after development. Do not report any existing BUA that
is to be removed and which will be replaced by new BUA.
11. How was the off -site impervious area listed above determined? Provide documentation. N/A
Form SWU-101 Version 07July2009 Page 3 of 6

***Report only that amount of existing BUA that will remain after development. Do not report any existing BUA that is
to be removed and which will be replaced by new BUA.
11. How was the off -site impervious area listed above determined? Provide documentation. N/A
Projects in Union Countv: Contact DWQ 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 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 BMP specified for this project. The latest versions of the forms can be downloaded
fromhtti)://h2o.enr.state.nc.us/su/bmu forms.htm.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklists are available from http://h2o.enr.state.nc.us/su/bmp forms.htm. The complete application package
should be submitted to the appropriate DWQ Office. (The appropriate office may be found by locating project
on the interactive online map at http:/ /h2o.enr.state.nc.us/su/msi maos.htm.)
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 ht!p://h2o.enr.state.nc.us/su/­bmp forms.htm.
Ini 'a s
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
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
htip://www.envhelp.org/pages/onestgRexl2ress.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/management for
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 1h mile of the site boundary, include the th
mile radius on the map.
7. Sealed, signed and dated calculations.
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 NIA 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 control measures.
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
Form SWU-101 Version 07July2009 Page 4 of 6

o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required). r _
9. 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 DWQ to verify the SHWT prior
to submittal, [phone].1
Un
A copy of the most current property deed. Deed book:1036 Page No: 202
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 NCAC 2H.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.
htto: / /www.secretary.state.nc.us/­Corporations/CSearch.aspx
VIL 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://h2o.enr.state.nc.us/suibml2 forms.htm#deed restrictions. Download the latest versions for each subm ttal.
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 DWQ, 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:Sean C. Robey. PE
Consulting Firm: Hyman & Robey, PC
Mailing Address:P. O. Box 339
City:Camden
Phone: (252 ) 335-1888
Email:[e-mail]
State:NC Zip:27921
Fax: (252 ) 338-5552
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 la) with (print or type name of organization listed in
Contact Infornwtion, item lb) 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.
Form SWU-101 Version 07July2009 Page 5 of 6

As the legal property owner 1 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 DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ 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.
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 expires
X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact Information, item 2) Bill Taylor, President, Tandem, Inc.
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, SL 2006-246 (Ph. II — Post Construction) or SL 2008-211.
Signature: I_ ,IDate:
1 a Notary Public for theStateof �!)Kl I11 %➢ Q� J /YQCounty of
_do hereby certify that h personally appeared
before me thisI5 day of VFYYIbeg and acl owled a the d e exec 'o the application for a
stormwater permit. Witness my hand and official seal,
Kelt . Karpf-poyd
otary Pub is
Pasquotank County NC
mvr.- Am271010
SEAL
My commission expires Z 7,0 l (sl
Form SWU-101 Version 07July2009 Page 6 of 6

Permit No. SW 70912—oB
(to be provided by DWO)
AGXWA
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
NCDENR 401 CERTIFICATION APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part III) must be printed, filled out and submitted along with all of the required information.
II. PROJECT INFORMATION
Project Name Tandem, Inc.
Contact Person Kim Hamby
Phone Number 252-338-2913
Date 23-Sep-09
Drainage Area Number 1 - Basin 1 & 2 combined
II. DESIGN INFORMATION
Site Characteristics
/
Drainage area
34,553.00
f 2 t/
Impervious area
24,048. 00
flz ✓-
Percent impervious
0.70
%
Design rainfall depth
1.50
in
Peak Flow Calculations
1-yr, 24-hr rainfall depth
3.50
in
1-yr, 24-hr intensity
3.40
in/hr
Pre -development 1-yr, 24-hr discharge
1.19
ft3/sec
Post -development 1-yr, 24-hr discharge
0.65
ft3/sec j
Pre/Post 1-yr, 24-hr peak flow control
-0.54
fl�/sec •/
Storage Volume: Non -SA Waters
/
Minimum design volume required
3,161.91
ft3 1/
Design volume provided
4,538.82
ft3 v OK for non -SA waters Total of 2
Storage Volume: SA Waters Basin Sections
1.5' runoff volume N/A ft3
Pre -development 1-yr, 24-hr runoff volume ft3
Post -development 1-yr, 24-hr runoff volume ft3
Minimum required volume fta
Volume provided n3
Soils Report Summary
Soil type
Urban
Infiltration rate
0.93
inmr
SHWTelevation
7.00
fmSI
Basin Design Parameters
Drawdown time
1.21
days
✓ OK
Basin side slopes
4.00
:1
OK
Basin bottom elevation
9.00
fmsl
OK
Storage elevation
11.25
fmSI
Storage Surface Area
3,374.00
f 2
Top elevation
12.00
fmSI
Basin Bottom Dimensions
Basin length
43.3 ave.
ft
Dimensions for
Basin width
9.5ave.
ft
Basin Section #1
Bottom Surface Area
753.00
ft2
Form SW401-Infiltration Basin-Rev.4 Pans I. & 11. Design Summary, Page 1 of 2

Permit No.
(to be provided by DWO)
Additional Information
Maximum runoff to each inlet to the basin?
1.08
ac-in
OK Total to two sections
Length of vegetative filter for overflow
N/A
ft
OK
Distance to structure
ft
Distance from surface waters
1,600.00
It
OK
Distance from water supply well(s)
N/A
ft
OK
Separation from impervious soil layer
N/A
It
OK
Naturally occuring soil above shwt
2.00
ft
OK
Bottom covered with 4-in of clean sand?
Y
(Y or N)
OK
Proposed drainage easement provided?
N
(Y or N)
OK
Capures all runoff at ultimate build -out?
Y
(Y or N)
OK
Bypass provided for larger storms?
Y
(Y or N)
OK
Pretreatment device provided
yes
12" sump
in drainage structures
Form SW401-Infiltration Basin-Rev.4 Parts I. & II. Design Summary, Page 2 of 2

Permit
(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.
Pagel Plan
Initials Sheet No.
3 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),
- Basin dimensions,
Pretreatment system,
High flow bypass system,
Maintenance access,
Proposed drainage easement and public right of way (ROW),
Overflow device, and
Boundaries of drainage easement.
/ 1
3.4, & 6
2. Partial plan (1" = 30' or larger) and details for the infiltration basin showing:
- Bypass structure,
- Maintenance access,
- Basin bottom dimensions,
- Basin cross-section with benchmark for sediment cleanout,
- Flow distribution detail for inflow,
- Vegetated filter, and
- Pretreatment device.
IQ�A_
KII
4
3. Section view of the infiltration basin (1" = 20' or larger) showing:
- Pretreatment and treatment areas, and
'.� 1
VAr l
- Inlet and outlet structures.
4. A table
attached
of elevations, areas, incremental volumes & accumulated volumes to verify the volume provided.
attached
5. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. The
results of the soils report must be verified in the field by DWO, by completing & submitting the soils
investigation request form. County soil maps are not an acceptable source of soils information.
1,
f L
4
6. A construction sequence that shows how the infiltration basin will be protected from sediment until the
entire drainage area is stabilized.
i�cth
attached
7. The supporting calculations.
fQr�L
attached
6. A copy of the signed and notarized operation and maintenance (0&M) agreement.
NIA
9. A copy of the deed restrictions (if required).
Form SW401-Infiltration Basin-Rev.4 Page 1 of 1 Part III. Required Items Checklist, Page 1 of 1

Permit Number: Sw7og12-Op
(to be provided by DWQ)
Drainage Area Number:
Infiltration Basin Operation and Maintenance Agreement
I will keep a maintenance record on this 13MP. This maintenance record will 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 removal efficiency of the BMP.
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 will 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 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 I will remediate theproblem:
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
infiltration basin
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide time and a
one-time fertilizer application.
The inlet device: pipe or
The pipe is clogged (if
Unclog the pipe. Dispose of the
Swale
applicable).
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to
swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
Form SW401-Infiltration Basin O&M-Rev.3 Page 1 of 3

BMP element:
Potentialproblem:
How I will remediate theproblem:
The forebay
Sediment has accumulated
Search for the source of the
and reduced the depth to 75%
sediment and remedy the problem if
of the original design depth.
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred or
Provide additional erosion
riprap is displaced.
protection such as reinforced turf
matting or 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
has accumulated.
sediment and remedy the problem if
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
5 days after a storm event.
media and see if this corrects the
standing water problem. If so,
revegetate immediately. If not,
consult an appropriate professional
for a more extensive repair.
Weeds and noxious plants are
Remove the plants by hand or by
growing in the main
wiping them with pesticide (do not
treatment area.
spray).
The embankment
Shrubs or trees have started
Remove shrubs or trees
to grow on the embankment.
immediately.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair.
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
of the sediment off -site.
The outlet device is damaged
I Repair or replace the outlet device.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
outlet.
1 733-1786.
Form SW401-Infiltration Basin O&M-Rev.3 Page 2 of 3

Permit Number:
(to be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project name: Tandem, Inc
BMP drainage area number:
Print name:
Address: 202 W. Main Street
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
I, i�f� 1 ���0��(� �1 I a Notary Public for the State of
h,be4h CA f (l A .t . County of Ff�Ysll -Q(1 do hereby certify that
�Rl l i H .�QU l 4 ��i nn personally appeared before me this
day of NDV.:knowledge the due execution of the
forgoing infiltration basin maintenance requirements. Witness my hand and official seal,
I , - 9 1 /'N A
Kerr J. Karpf-poyd
otary Pub is
Pasquotank County NC
Mycommiis mExp es/wn127.2010
SEAL
My commission expires 69 I Z T )ZQ10
Form SW401-Infiltration Basin O&M-Rev.3
Page 3 of 3

April 29, 2011
Mr. Samir Dumpor
Dept. of Environment and Natural Resources
Water Quality Section
943 Washington Square Mall
Washington, NC 27889
Subject: Stormwater Management Permit
Tandem, Inc.
Proj. #090120
Stormwater Permit No. SW7091208
Dear Mr. Dumpor:
Enclosed please find the Designer's Certification for the above referenced project.
MAY - 5 2011
OVji'`?� VVARO
Please note that the two infiltration basins were surveyed and inspected for dimensional and
elevation accuracy on April 28, 2011, and found to comply with the design.
If you have any questions or require additional information, please do not hesitate to call this
office at [phone].
Sin
Sean_C'7�obey, PE
Principle Engineer
cc: file
Mr. Bill Taylor - Tandem, Inc.
P. O. Box 339 Camden, North Carolina 27921
[phone]
w .hymanrobey.com

Tandem, Inc.
Stormwater Permit No. SW7091 208
Pasquotank County
Designer's Certification
State Stormwater Management Systems
Permit No. SW7091208
�kE R� R V
MAY -62011
I, Sean C. Robey as duly registered Professional Engineer in
the State of North Carolina, having been authorized to observe (periodically/weekly/ full time)
the construction of the project,
Tandem, Inc.
(Project)
for Tandem, Inc . (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 included in the Certification.
Noted deviations from approved plans and specifications:
Signature
Registration Number
Date cl z9 w
18550
Page 6 of 7
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State Stormwater Management Systems
Permit No. SW7091208
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 buiolt-
upon area.
�j
c7 3.
All the built -upon area associated with the project is graded such that the runoff drains
to the system.
11
/ik
f3U1t..D/AjgS APE NOT
4.
All roof drains are located such that the runoff is directed into the system. �t7 CONST"CTED
5.
The outlet/bypass structure elevations are per the approved plan.
Ft 6.
The outlet structure is located per the approved plans.
7.
Trash rack is provided on the outlet/bypass structure.
8.
All slopes are grassed with permanent vegetation.
9.
Vegetated slopes are no steeper than 3:1.
10.
The inlets are located per the approved plans and do not cause short-circuiting of the
system.
6�11.
The permitted amounts of surface area and/or volume have been provided.
12.
Required drawdown devices are correctly sized per the approved plans.
, / 3.
All required design depths are provided.
N�i� 14.
All required parts of the system are provided, such as a vegetated shelf, and a forebay.
15. The required system dimensions are provided per the approved plans.
cc: NCDENR-DW4 Washington Regional Office
City of Elizabeth City Building Inspections
Page 7 of 7