SW6120805_CURRENT PERMIT_20121019

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW &IOt (%7SlJ�J
DOC TYPE
� CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
DOC DATE
42�0�2Z21-'?
YYYYMMDD

OU 19 &Z
NC®ENR r)W0
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, PE Dee Freeman
Governor Director Secretary
October 16, 2012
Mr. tarry Smith
English Congregation Of .Jehovah's Witnesses, Raeford, North Carolina, Inc.
108 South Roberts Street
Raeford, NC 28376
Subject: Stormwater Permit No. SW6120805
Raeford Congregation Kingdom Hall
High Density Commercial Infiltration Basin Project
Hoke County
Dear Mr. Smith:
The Stormwater Permitting Unit received a complete Stormwater Management Permit Application for Raeford
Congregation Kingdom Hail on September 19, 2012. Staff review of the plans and specifications has
determined that the project, as proposed, will comply with the Stormwater Regulations set forth in Title 15A
NCAC 2H.1000 and Session Law 2006-246. We are forwarding Permit No. SW6120805, dated September 28,
2012, for the construction, operation and maintenance of the subject project and the stormwater BMPs.
8c4,, fr, par.
This permit shall be effective from the date of issuance until-&WemtsT27, 2020 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 conditions listed in this permit regarding the Operation
and Maintenance of the BMP(s), recordation of deed restrictions, procedures for changes of ownership,
transferring the permit, and renewing the permit. Failure to establish an adequate system for operation and
maintenance of the stormwater management system, to record deed restrictions, to follow the procedures
for transfer of the permit, or to renew the permit, 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 150E of the North Carolina
General Statutes, and filed with the Office of Administrative Hearings, P.O. Drawer 27447, Raleigh, NC
27611-7447, Unless such demands are made this permit shall be final and binding.
This project will be kept on file at the Fayetteville Regional Office. If you have any questions, or need
additional information concerning this matter, please contact Brian Lowther at [phone],- or
[e-mail].
Sincerely,
for Charles Wakild, PE
cc: Fayetteville Regional Office
SW6120805 File
ec: David L. Smith, PE — Rivers and Associates, Inc.
Wetlands and Slormwater Branch One
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 NorthCaroiina
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 AwwrallyInternet: www.ncwaterqualily.org
An Equal Opportunity 1 Affirmative Action Employer

State Stormwater Permit
Permit No. SW6120805
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
English Congregation Of Jehovah's Witnesses, Raeford, North Carolina, Inc.
Raeford Congregation Kingdom Nall
529 West Cole Avenue Extension, Raeford, Hoke County
FOR THE
construction, operation and maintenance of two (2) infiltration basin(s) in compliance
with the provisions of Session Law 2006-246 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 October 15, 2020, and
shall be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
1. 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 27,527 square feet of
impervious area.
3. The tract will be limited to the amount of built -upon area indicated in Section 1.8
on page 3 of this permit, and as shown on the approved plans. No built -upon
area for the future development is allocated in this permit.
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.
5. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
6. The built -upon areas associated with this project shall be located at least 30 feet
Page 1 of 6

f State Stormwater Permit
Permit No. SW6120805
landward of all perennial and intermittent surface waters.
7. The following design criteria have been permitted for the infiltration basin and -
must be provided and maintained at design condition:
a.
Drainage Area, cres:
0.90
0.43
Onsite, f .
39,237
18,930
Offsite, ft2:
0 -
0
b.
Total Imperviou? Surfaces, ft2:
17,937
9,590
Onsite, ft :
17,937
9,590
Offsite, ft2:
0
0
C.
Design Storm, inches:
V
V
d.
Basin Depth, feet:
3'
3'
e.
Bottom Elevatiop, FMSL:
260'
261'
f.
Surface Area, ft :
4,268
2,896
g.
Bypass Weir Elevation, FMSy
263
264
h.
Permitted Storage Volume, ft :
9,309
4,202
i.
Type of Soil:
FaB-Sandy
Clay
j.
Expected Infiltration Rate, inlhr:
0.55
0.68
k.
Seasonal High Water Table, FMSL:
256.0
257.0
I.
Time to Draw Down, hours:
79.2
52.8
m.
Receiving Stream/River Basin:
Toneys Creek
1 Lumber
n.
Stream Index Number:
14-10-1.2
o.
Classification of Water Body:
"C, Sw"
II. SCHEDULE OF COMPLIANCE
1. 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.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. 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.
4. 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.
Page 2 of 6

State Stormwater Permit
Permit No. SW6120805
6. The stormwater treatment system shall be constructed in accordance with the
approved plans and specifications, the conditions of this permit, and with other
supporting data.
7. 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.
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 for a minimum of ten years from the date of the completion of
construction.
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. . i
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.
Page 3 of 6

State Stormwater Permit
Permit No. SW6120805
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
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 flail 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 2006-
246, 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. The permittee shall submit a renewal request with all required forms and
documentation at least 180 days prior to the expiration date of this permit.
Permit issued this the 16th day of October 2012.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Division of Water Quality
By Authority of the Environmental Management Commission
Page 4 of 6 .

State Stormwater Permit
Permit No. SW6120805
Raeford Congregation Kingdom Hall
Stormwater Permit No. SW6120805
Hoke 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 included in the Certification.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
SEAL
Page 5 of 6

State Stormwater Permit
Permit No. SW61 20805
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. The bypass structure weir elevation is per the approved plan.
6. The bypass structure is located per the approved plans.
7. A Trash Rack is provided on the 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.
11. The permitted amounts of surface area and/or volume have been
provided.
12. All required design depths are provided.
13. All required parts of the system are provided.
14. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Regional Office
Hoke County Building Inspections
Page 6 of 6

c�RrG,r
DWQ USE ONLY
Date Received
Fee Paid
Permit Miinber
Applicable Rules: ❑ Coastal SW — 1995 ❑ Coastal SW — 2008 ❑ Ph I - Post Construction
(select all thdtapj? [v) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M mt Plan:
State of North Carolina
Department 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.):
Raeford Conereeation Kinedom Hall
2. Location of Project (street address):
529 West Cole Avenue Extension
City: Raeford
County: Hoke
3. Directions to project (from nearest major intersection):
4.
Zip:28376
From Intersection of Laurenburg Rd (US401) and Palmer Street - North West on West Palmer Street To Cole t
Ave. Ext. Tum left on Cole Ave Ext. +-200 FT Project on Lef _
Latitude:34° 58' 26" N Longitude:-79° 14' 41" W
II. PERMIT INFORMATION:
1. a.Specify whether project is (check one): ®New ❑Modification
of the main entrance to the project.
b. If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number N/A , its issue date (if known) N/A , 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 01-ligh 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, N/A and the previous name of the project, if different than currently
proposed, N/A
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: 1.6 ac of Disturbed Area
❑NPDES Industrial Stormwater ❑404/401 Permit: Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Nan
issue date and the type of each permit:ln Process
NOV 2 a 2012
it Number,
AIJG % 4 2912
Form SWU- l01 Version 07Jun2010 Page 1 of 6 nwo
sa

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:En lisl7 Congregation Of Jchova's Witnesses, Raeford North Carolina hic.
Signing Official & Title:Larry Smith, Registered Agent
b.Contact information for person listed in item 1a above:
Street Address: 108 South Roberts Street
City: Raeford State: NC Zip: 28376
Mailing Address (ifapplicable): 108 South Roberts Street
City: Raeford
Phone: (910 ) 848-5301
Email:l,irry,[e-mail]
yahoo.com_,
State: NC Zip: 28376
Fax: ( ) N/A
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:
Mailing Address (if applicable):
City:
Phone: (_ )
Email:
State: Zi
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: NC Regional Building, Committee #2
Signing Official & Title: Verne L. Thoren, Project Manager
b.Contact information for person listed in item 3a above:
Mailing Address: 1201 Green Branch Lane
City: Raleigh State: NC Zip: 27603
Phone: [phone] Fax: (919 ) 803-1944
Erna i1:[e-mail]
4. Local jurisdiction for building permits: City Of Raeford
Point of Contact: Felicia Locklear Phone #: [phone]
Form SWU-101 Version 07Jun2010 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the storm water runoff will be treated.
Runoff collected by combination of inlet and swales directed to vegetative conveyance where practical to
two infiltration basins which are "over -sized" to mitigate inability to provide bypass of larger storms (verb_
little fall on site) snd the lack of veg filter at exit (space constraints)
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development flan or PUDApproval Date:
❑ Valid Building Permit Issued Date:
❑ Other: N/A Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 ❑ Ph 11 - Post Construction
3. Stormwater runoff from this project drains to the Lumber
4. Total Property Area: 2.38 Ac acres
River basin.
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':
2.38 acres
' TOtaI p1-0.ectarea shell be calculated to exclude the following.• the rrorn1a1 pool of irnppour7ded structrlrt,s,
the area between the banks of streams and rivers, the area below the Normal High Water (NHW) 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 (13UA). Non -coastal KW1,711 ds
landward of the NHW (or MHW) line Wray be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 27.3 %
9. How many drainage areas does the project have? 2 (For high density; c01117t 1 for each proposed engineered
storm water BMP. For low density and other projects, use I 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 Information
Drainage Area 1
Draina e Area 2
Drainage Area _
Drainage Area _
Receiving Stream Name
Toneys Creek
Toneys Creek
Stream Class *
C, Sw
C, Sw
Stream Index Number *
14-10-1.2
14-10-1.2
Total Drainage Area (sf)
39,237
18,930
On -site Drainage Area (sf)
39,237
18,930
Off -site Drainage Area (sf)
0
0
Proposed Impervious Area** (sf)
17,937
9,590
'% Impervious Area** (total)
45.7
50.7
Impervious" Surface Area
Drainage Area _
Draina e Area _
Drainage Area _
Drainage Area _
On -site Buildings/Lots (sf)
6,120
0
On -site Streets (sf)
0
0
On -site Parking (sf)
11,267
9,590
On -site Sidewalks (sf)
550
0
Other on -site (sf)
0
0
Future (sf)
0
0
Off -site (sf)
0
0
Existing BUA*** (sf)
0
0
Totai (sf):
17,937
9,590
* Stream Class and Index Number can be determined at.-
http://portal.ncderrr:o t1(�a c6l�vc�s/csu/classificatior7s
* Impervious area is defined as the built upon area including, but not limited to, buildings roads, parking
areas, sidewalks, gra vel areas, etc.
Form SWU-101 Version 07Jun2010 Page 3 of 6

*" Report only that amount of existing BUA that will rernairr after development. Do not report anv e,visting
BUA that is to be removed and which wi11 be replaced btu new BUA.
11. Flow was the off -site impervious area listed above determined? Provide documentation. Cad Areas
From Autocad Drawing - Back-up Attached -
ProieMs in. Union County: Contact DJYQ Cerrrrrr! Office .claff to check if the project is located ivithbi a Threatened c(
Endangered Species watershed that nury he sur jeci to more stringent stormwater requirements as per NC9 C 0 H , 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 BM P specified for this project. The latest versions of the forms can be downloaded
from litt ): pot-til.ncdent•.org/web/wq/ws/su/bmp-manual.
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 littLT////Liortal.tic(ienr.org/web/wq/ws/su/stitesw/forms_docs. 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://portal,ncdenr.org/web/wq/ws/stt/maps.)
Please indicate that the following required information have been provided by initiahn 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 littL)://poi-til.ilcdeiir.oi-g/web/wq/ws/sLi/stitesw/fot,m,; does.
itin
1. Original and one copy of the Stormwater Management Permit Application Form. t
2. Original and one copy of the signed and notarized Deed 1Zestrictions & Protective Covenants 11 'A
Form. (if required as per Part Vll below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreement(s) for each BM 1'.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
littl?://www.enviielp,org_/pages/onestopexpress.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 USCS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA eaters within'i mile of the site boundary, include the'><Z
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 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 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 07Jun2010 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).
9. Copy of any applicable soils report with the associated SH WT elevations (Please identify GJh.
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"xl1" 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].)
10. A copy of the most current property deed. Deed book: 964 Page No: 124
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 1a, 2a, and/or 3a per 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.
htt www.secretar .state.nc.us Cor orations CSearcli.as x
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
littp://port,il.ncLienr.ot-g/vveb vvq/ws/sti/st,iteswZforrns_clocs. 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 retarded.
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: David L. Smith, P.E.
Consulting Firm: Rivers And Associates, Inc.
Mailing Address:6131 Falls Of Neuse Road, Suite 300
City: Raleigh
Phone: (919 ) 861-6257
Email:dsmith a riversandassociates.com
State:NC Zip:27609
Fax: (919 ) 484-0319
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has bean filled out, complete this
section)
I, (print or type name of person listed in Contact Information, item 2a) Owner/Applicant , certify that l
oven the property identified in this permit application, and thus give permission to (print or ivpe name of person
listed in Contact Information, item la) with (print or type name of organization listed
in Contact Information, item la) 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 Mu112010 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 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 ill appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCCS 143-215.6.
Signature: --�- G�/lNt/�-may. � �- Date: (� /,,23 aV I c�
a
1, J�� _�L, a Notar Public for the St e of /�Jt—/��� QfZO/ f+4-ounty of
(-) i�E do hereby certify that personally appeared
before me this day of �C fNL 2y!?-, and a �owledg he c�l�� e �ition of the application fora
stormwater permit. Witness my hand and official sea], !/vJ
SEAL,
My commission expires 7'�'--J 2 /., "z 0 /
X. APPLICANT'S CERTIFICATION
1, (print or type name of person listed in Contact Information, item 1,7) Larry A. Smith
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. If - Post Construction) or SL 2008-211.
Signature:
a Notary Public for the State
do hereby certify that
before me this of f�2iuJ E' a2, and
stormwater permit. Witness my hand and official seal,
SEA L
Date: Ala slaol "�,
personally appeared
j,exeof the application for a
My commission expires � /� . 3 f Z—C) / Z
Form SWU-101 Version 07Jun2010 Page 6 of 6

OIV

DP-161 -
Permit Number: WCIZo$as
(to be provided big DiVQ)
Drainage Area Number:_
Infiltration, Basin Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. 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:
Potential roblem:
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 lime and a
one-time fertilizer application.
The inlet device: pipe or
The pipe is clogged (if
Unclog the pipe. Dispose of the
Swale
a licable).
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the s,�vale 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 oF3

B1VIP element:
The forebay
The main treatment area
The embankment
The outlet device
The receiving water
Potential problem:
Sediment has accumulated
and reduced the depth to 75%
of the original design depth.
Erosion has occurred or
riprap is displaced.
Weeds are present
A visible layer of sediment
has accumulated.
Water is standing more than
5 days after a storm event.
Weeds and noxious plants are
growing in the main
treatment area.
Shrubs or trees have started
to grow on the embankment.
An annual inspection by an
appropriate professional
shows that the embankment
needs repair.
Clogging has occurred
The outlet device is damaged
Erosion or other signs of
damage have occurred at the
outlet.
How I will remediate the problem:
Search for the source of the
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 BM P.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Remove the weeds, preferably by
hand. if pesticides are used, wipe
them on the plants rather than
spraying.
Search for the source of the
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.
Replace the top few inches of filter
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.
Remove the plants by hand or by
wiping them with pesticide (do not
spray).
Remove shrubs or trees
immediately.
Make all needed repairs.
Clean out the outlet device. Dispose
of the sediment off -site.
Repair or replace the outlet device.
Contact the NC Division of Water
Quality 401 Oversight Unit at 919-
733-7 786.
Form SW401-Infiltration Basin O&M-Rev.3
Page 2 of 3

Pennit Number:
(to be provided br DIVQ)
I acknowledge and agree by my signature below that I am responsible for the
perfonnance 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.
Projecl name: Raeford Congregation Kingdom Hall
BMP drainage area number: 1
Print name. Larry Smith
Title: Registered Agent - English Congregation Of Jehova's Witnesses, Raeford, NC, Inc.
Address:108 South Roberts Street, Raeford, North Carolina 28376
Phone. 9k-8$.8=5301 1, 5 • b?7s - 6 i3`J
Signature:
Date:
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.
a Notary Public for the State of
�C2. , County of o , do hereby certify that
A2 'a� ZZL-1 personally appeared before me this Z ! :—
day of r jd !�and acknowledge the due execution of the
forgoing infiltration basin maintenance requirements. Witness my hand and official seal,
SEAL
My commission expires r:2 01
Form SW401-Infiltration Basin O&M-Rev.3
Page 3 of 3

ci, a
no

OR-tC7 ,
Permit Number: �061Z0666-
Ou be provided by DIVQ)
Drainage Area Number: 2.
Infiltration Basin Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. 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 lime 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 SW40 I -Infiltration Basin O&M-Rev.3 Page I of'3

BMP element:
The forebay
The main treatment area
The embankment
The outlet device
The receiving water
Potential problem:
Sediment has accumulated
and reduced the depth to 75%
of the original design depth.
Erosion has occurred or
riprap is displaced.
Weeds are present.
A visible layer of sediment
has accumulated.
Water is standing more than
5 days after a storm event.
Weeds and noxious plants are
growing in the main
treatment area.
Shrubs or trees have started
to grow on the embankment.
An annual inspection by an
appropriate professional
shows that the embankment
needs repair.
Clogging has occurred
The outlet device is damage(!
Erosion or other signs of
damage have occurred at the
outlet.
How I will remediate the problem:
Search for the source of the
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.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Remove the weeds, preferably by
hand. If pesticides are used, wipe
them on the plants rather than
spraying. _
Search for the source of the
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.
Replace the top few inches of filter
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.
Remove the plants by hand or by
wiping them with pesticide (do not
spray).
Remove shrubs or trees
immediately.
Make all needed repairs.
Clean out the outlet device. Dispose
of the sediment off -site.
Repair or replace the outlet device.
Contact the NC Division of Water
Quality 401 Oversight Unit at 919-
733-1786.
Dorm SW40I-Infi11ration Basin O&M-Rev.3 Page 2 of 3

Permit Number:
(to beP;-ovided by Dff'Q)
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 siame: Raeford Con Ire *ation Kingdom Hall
BMP drainage cnrea number-: 2
Print name: Larry Smith
Title: Re Registered Agent - English Congregation Of Jehova's Witnesses, Raeford, NC, Inc.
Address:108 South Roberts Street, Raeford, North Carolina 28376
Phone: 910-`844-55-30I 8 -
o�-- f 3
Signature: GuVt '
Date:. . la. 5 / �O U°t
L, S ,
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, _)dlc. �`— , a Notary Public for the State of
,gizT/I a7^,,L",County of do hereby certify that
r
personally appeared before me this Z s
day of Z O/ 7_, and acknowledge the clue execution ofthe
forgoing infiltration basin maintenance requirements. Witness my hand and official seal,
GrA
'
.
ORS
.
SEAL
My commission expires -Z�,4 N • � / Z D 17
form SW40 I 4nfiltration Basin O&M-Rev.3
Page 3 of 3

Permit No. 5v� (P l 7.O19aS
(to be provided by DWQ)
A.'to
?A STORMWATER MANAGEMENT PERMIT APPLICATION FORM o Y
HCDENR 401 CERTIFICATION APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form must be 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 X P, WECTiINFORMATION ;w .
Project Name Raeford Congregation Kingdom Hall
Contact Person Verne L. Thoren
Phone Number 919-661-8161
Date 61112012 Rev 1010812012
Drainage Area Number 2
Site Characteristics
Drainage area
Impervious area
Percent impervious
Design rainfall depth
Peak Flow Calculations
1-yr, 24-hr rainfall depth
1-yr, 24-hr intensity
Pre -development 1-yr, 24-hr discharge
Post -development 1-yr, 24-h r discharge
Pre/Post 1-yr, 24-hr peak Flow control
Storage Volume: Non -SA Waters
Minimum design volume required
Design volume provided
Storage Volume: SA Waters
1.5" runoff volume
Pre -development 1-yr, 24-hr runoff volume
Post -development 1-yr, 24-hr runoff voiume
Minimum required volume
Volume provided
Soils Report Summary
Soil type
Infiltration rate
SHWT elevation
Basin Design Parameters
Drawdown time
Basin side slopes
Basin bottom elevation
Storage elevation
Storage Surface Area
Top elevation
Basin Bottom Dimensions
Basin length
Basin width
Bottom Surface Area
18,930,00 ft2
9,590.00 ft2
50,66 %
1.00 in
3.04 in
0.13 inlhr
0.01 h3isec
0.04 ft3isec
0.02 0sec
2,185.00 ft3
4,202.00 ft3 OK for non -SA waters
nla ft3
ft3
tt3
ft3
ft3
�1) [j @ [RO[go
IJ
O C T 1 1 2012
IJENFt - WATER QUAL n
FaB-Sandy Clay
0.68
infhr
257.00
fmsl
2.20
days OK
3.00
:1 OK
261.00
fmsl OK
fmsl
264.00
2.896.00
ft2
265.00
fmsl
r+ S
SE AL '
30.00
It
20744
10.00
ft
*
277.00
ft2
�f%°elrs�v� �A
(j �1rfci
�
�_:` yhtitrtiuu�tl4
9
Form SW401-Infiltration Basin-Rev.5 11Apr2011
Paris I. & II. Design Summary, Page 1 of 2

J
9
t9 Q
Permit No.
(to be provided by DWO)
Additional Information
Maximum runoff to each inlet to the basin?
0,55
ac-in
OK
Length of vegetative filter for overflow
NA
ft
OK
Distance to structure
100+
ft
OK
Distance from surface waters
100+
ft
OK
Distance from water supply well(s)
100+
ft
OK
Separation from impervious soil layer
NA
ft
OK
Naturally occuring sail above shwt
3.50
ft
OK
Bottom covered with 4-in of clean sand?
Y
(Y or N)
OK
Proposed drainage easement provided?
Y
(Y or N)
OK
Capures all runoff at ultimate build -out?
Y
(Y or N)
OK
Bypass provided for larger storms?
NA
(Y or N)
OK
Pretreatment device provided
NA
ADUL Vol added for No Bypass/No Filler
Form SW401-Infiltration Basin-Rev.5 11Apr2011 Parts I. & IL Design Summary, Page 2 of 2

Permit No. 15%.Z &IZA $ c)5
(to be provided by DINO)
IINREQUIRERITEMSICHECKLIST ��c i; rr�gti- � a 'Si S�'. Z'
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.
Page/ Plan
Initials Sheet No.
_DL.5 C- 2 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.
DLS C.-2 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.
DLS C-2 3. Section view of the infiltration basin (1" = 20' or larger) showing:
Pretreatment and treatment areas, and
Inlet and outlet structures.
DL.5 C--2 4. A table of elevations, areas, incremental volumes & accumulated volumes to verify the volume provided.
DLS
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.
6, A construction sequence that shows how the infitlration basin will be protected from sediment until the
entire drainage area is stabilized.
p�5
ri A
7. The supporting calculations.
D1-S�
8. A copy of the signed and notarized operation and maintenance (0&M) agreement.
& f4 I A— 9. A copy of the deed restrictions (if required)
Form SW401-Infiltration Basin-RevA
Page t of 1 Part III. Required Items Checklist, Page 1 of 1

a Permit No._Sl►S
(to be provided by DWQ)
O�O� W n r�ROG
�'PA STORMWATER MANAGEMENT PERMIT APPLICATION FORM y
O �
HCDENR 401 CERTIFICATION APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part Ill) must be printed, filled out and submitted along with all of the required information.
KPR09ECTiINFORMATION .
Project Name Raeford Congregation Kingdom Hail
Contact Person Verne L. Thoren
Phone Number 919-661-8161
Date 611/2012 Rev-10/0712012
Drainage Area Number 1
Site Characteristics
Drainage area
39,237.00
ft2
Impervious area
17,937.00
ft'
Percent imperious
45.71
%
Design rainfall depth
1.00
in
Peak Flow Calculations
1-yr, 24-hr rainfall depth
304
in
1-yr, 24-hr intensity
0.13
inlhr
Pre -development 1-yr, 24-hrdischarge
0.03
ft3lsec
Post -development I-yr, 24•hr discharge
0.08
ft'/sec
Pre/Post 1-yr, 24-hr peak flow control
0.05
ft'/sec
Storage Volume: Non -SA Waters
Minimum design volume required
3,671.00
ft'
Design volume provided
9,309.00
ft,
Storage Volume: SA Waters
15' runoff volume
it
Pre -development 1-yr, 24-hr runoff volume
ft3
Post -development 1-yr, 24-hr runoff volume
fT
Minimum required volume
it
Volume provided
h3
Soils Report Summary
Soil type
InNtration rate
SHWT elevation
Basin Design Parameters
Drawdown time
Basin side slopes
Basin bottom elevation
Storage elevation
Storage Surface Area
Top elevation
Basin Bottom Dimensions
Basin length
Basin width
Bottom Surface Area
Form SW401-Infi1tration Basin-Rev.5 11Apr2011
L9 19 ME @0
OCT 1 1 Z61Z
DENIR - WA7gH OU TY IdlnwJ_ a w
OK for non -SA waters
FaB-Sandy Clay
0.55 inlhr
256.00 fmsl
3.30 days OK
3,00 1 OK
260.00 fmsl OK
263,00 fmsl r
4,268.00 fl
264.50 fmsl,�f�ay
SEAL �f
65,00 ft 20744
40.00 it g ► r
2,015.00 ftz 'ij ���`�PS�� ��•�r`�a►
Parts I. & }I. Design Summary, Page 1 of 2

e
~
Permit No. W (01 xO 19 a
(Io be provided by DWO)
Additional Information
Maximum runoff to each inlet to the basin?
1.04
ac-in
OK
Length of vegetative filter for overflow
NA
ft
OK
Distance to structure
24.00
ft
OK
Distance from surface waters
1CC+
ft
OK
Distance from water supply well(s)
100+
ft
OK
Separation tram impervious soil layer
NA
ft
OK
Naturally occuring soil above shwt
3.50
ft
OK
Bottom covered with 4-in of clean sand?
Y
(Y or N)
OK
Proposed drainage easement provided?
Y
(Y or N)
OK
Capures all runoff at ultimate build -out?
Y
(Y or N)
OK
Bypass provided for larger storms?
NA
(Y or N)
OK
Pretreatment device provided
NA
ADUL Vol added for No Bypass/No Filter
Form SW401-Infiltration Basin-Rev,5 t1Apf2011 Parts I. & II. Design Summary, Page 2 of 2

Permit No. 5WcoiZAD 1905
(to be provided by D WQ)
III. REQUIRED ITEMS CHECKLIST
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to
indicate the following design requirements have been met. If the applicant has designated an agent, the agent may initial below. if a
requirement has not been met, attach justification.
Page/ Plan
Initials Sheet No.
1rS C Z.
1. Plans (1" 50' or fiarger) 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.
ID L5 C— Z
2. Partial pian (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.
G 2 3. Section view of the infiltration basin (1" = 20' or larger) showing:
Pretreatment and treatment areas, and
Inlet and outlet structures.
pus L' — 2 4. A table of elevations, areas, incremental volumes & accumulated volumes to verify the volume provided.
DL'S 141A 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,
6. A construction sequence that shows how the infitlration basin will be protected from sediment until the
entire drainage area is stabilized.
DL t�! JA 7. The supporting calculations.
b LS NLA 8. A copy of the signed and notarized operation and maintenance (0&M) agreement.
ty h A 9. A copy of the deed restrictions (if required)
Form 5W401-Infiltration Basin-Rev.4
Page 1 of 1 Part III, Required Items Checklist, Page 1 of 1
tBAe.,A l

OCT 112012
DENR - WATER QUALrry
TO: NCDNR-Division of Water Quality
Stormwater Permitting
1650 Mail Service Center
Raleigh, North Carolina 27699-1650
WE ARE SENDING YOU
❑ Shop Drawings
❑ Copy of Letter
COPIES
DATE
2
10/8/2012
2
10/8/2012
4
1018I2012
LETTER OF TRANSMITTAL
'Date
Job No. 2011135
October 9, 2012
ATTENTION:
1Brian Lowther, Environmental Engineer
SUBJECT:
Raeford Congregation Kingdom Hall
Phase 2 Stormwater Plan
SW6120805
El Attached ❑ Under Separate Cover via
❑ Prints ❑ Plans ❑ Samples
❑ Change Order ❑ Other
Mail
❑ Specifications
DESCRIPTION
Construction Plans
Revised Calculations
Revised - Infiltration Supp. (2 each BMP)
the following items:
THESE ARE TRANSMITTED as checked below:
❑� For Approval ❑ Approved ❑ Resubmit copies for approval
❑ For Your Use ❑ Approved as Noted ❑ Submit copies for distribution
❑ As requested ❑ Disapproved Q Return copy with approval
❑ For Review and Comment ❑ Other
REMARKS
We have revised the basins based on your comments. 2.5 times treatment volume (1" p - simple method)
will infiltrate in less than 5 days at 0.5 times Ksat and routing to show no increase for post 1 year-24 hr.
rainfall event per Phase II requirements. Thanks, David L. Smith, P.E
919-861-6257
RIVERS & ASSOCIATES, INC.
COPY TO Mr. Verne Thoren SIGNED:If enclosures are not as noted, kindly notify us at once David L. Smith, PE
dsmith . rivenandassociatess m
6131 Falls of Neuse Road, Suite 300 * Raleigh, North Carolina 27609 * [phone] * FAX [phone]
107 East Second Street * Post Office Box 929 * Greenville, North Carolina 27835 * [phone] * FAX [phone]

7 (, 060
Permit No. --SA (�. S
(to be provided by DWQ)
}� of wa�eAo�
®01 STORMWATER MANAGEMENT PERMIT APPLICATION FORM o
NCDENR 401 CERTIFICATION APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form must be t<11ed out, printed and submitted.
The Required Items Checklist (Part IfI) must be printed, filled out and submitted along with all of the required information.
I 0JECTiINF.ORMATION.. a
Project Name Raeford Congregation Kingdom Hall
Contact Person Verne L. Thoren
Phone Number 919-661-8161
Date 6/1/2012 Rev-1010712012
Drainage Area Number 1
Site Characteristics
Drainage area
39,237.00
ft'
Impervious area
17,937.00
ft2
Percent impervious
45.71
%
Design rainfall depth
1.00
Jn
Peak Flow Calculations
1-yr, 24-hr rainfall depth
3.04
in
1-yr, 24-hr intensity
0.13
inlhr
Pre -development 1-yr, 24-hr discharge
0.03
ft3lsec
Post -development 1-yr, 24-hrdischarge
0.08
ft'/sec
PrelPost 1-yr, 24-hr peak Flow control
0.05
ft3lsec
Storage Volume: Non -SA Waters
Minimum design volume required
3,671.00
ft'
Design volume provided
9,309.00
ft,
Storage Volume: SA Waters
1.5' runoff volume
ft3
Pre -development 1-yr, 24-hr runoff volume
ft3
Post -development 1-yr, 24-hr runoff volume
ft3
Minimum required volume
ft3
Volume provided
ft3
Soils Report Summary
Soil type
Infiltration rate
SHWT elevation
Basin Design Parameters
Drawdown time
Basin side slopes
Basin bottom elevation
Storage elevation
Storage Surface Area
Top elevation
Basin Bottom Dimensions
Basin length
Basin width
Bottom Surface Area
FaB-Sandy Clay
0.55 inlhr
256,00 fmsl
3,30 days
3.00
:1
260.00
fmsl
263.00
fmsl
4,268.00
fie
264.50
fmsl
65.00 ft
40.00 ft
2,015.00 ft2
OK for non -SA waters
OK
OK
OK
Do
Ej
1 2012
DENR - WATER W TY
iL
Form SW401-Infiltration Basin-Rev.5 11Ap2011 Parts I. & If. Design Summary, Page 1 of 2

r
Permit No. SW (D 1 Zo 6015
(to be provided by DWO)
Additional Information
Maximum runoff to each inlet to the basin?
1.04
ac-in
OK
Length of vegetative Filer for overflow
NA
ft
OK
Distance to structure
24.00
ft
OK
Distance from surface waters
100+
ft
OK
Distance from water supply well(s)
100+
ft
OK
Separation from impervious soil layer
NA
ft
OK
Naturally occuring soil above shwl
3.50
ft
OK
Bottom covered with 4-ir of clean sand?
Y
(Y or N)
OK
Proposed drainage easement provided?
Y
(Y or N)
OK
Capures all runoff at ultimate build -out?
Y
(Y or N)
OK
Bypass provided for larger storms?
NA
(Y or N)
OK
Pretreatment device provided
NA
ADUL Vol added for No Bypassft Filter
Form SW 401-Infiltration Basin-Rev,5 11Apr2011 Parts I. & II. Design Summary, Page 2 of 2

Permit No. 511.4i011Aa(*
(to be provided by D WQ)
Ili. REQUIRED ITEM&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.
Page/ Plan
Initials Sheet No.
C — Z.
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.
ID 1r5 C. 2
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.
3. Section view of the infiltration basin (1" = 29 or larger) showing:
Pretreatment and treatment areas, and
Inlet and outlet structures.
4. A table of elevations, areas, incremental volumes & accumulated volumes to verify the volume provided.
J)L'S rAJA 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.
'DLS C--2 6. A construction sequence that shows how the infitlration basin will be protected from sediment until the
entire drainage area is stabilized.
DLA 7. The supporting calculations.
b L5 8. A copy of the signed and notarized operation and maintenance (O&M) agreement.
9. A copy of the deed restrictions (if required).
Form SW401-Infiltration Basin-Rev.4
Page 1 of 1 Part 111. Required Items Checklist, Page 1 of 1

Permit No.Sko� (P�2n8�s
(to be provided by DWQ)
ATASTORMWATER MANAGEMENT PERMIT APPLICATION FORM
P -c
NCDENR 401 CERTIFICATION APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required items Checklist (Part 111) must be printed, rifted out and submitted along with all of the required information.
Project Name
Contact Person
Phone Number
Date
Drainage Area Number
Raeford Congregation Kingdom Hall
Verne L. Thoren
919-661-8161
611/2012 Rev 10108/2012
2
III DESIGKINFORMATION
Site Characteristics
Drainage area 18,930.00 ft2
Impervious area 9,590.00 f?
Percent impervious 1.00 in LD7ENR-
Design rainfall depth 1.00 in Peak Flow Calculations
1-yr, 24-hr rainfall depth 3.04 in Q12
1-yr, 24-hr intensity 0.13 inlhr
Pre -development 1-yr, 24-hr discharge 0,01ft31SecU tPost-development 1-yr, 24-hr discharge 0,04 ftIsecTy
m Brand
PrelPost 1-yr, 24-hr peak Flow control 0,02 ft3lsec
Storage Volume: Hon -SA Waters
Minimum design volume required 2185,00 ft'
Design volume provided 4,202.00 ft3 OK for non -SA waters
Storage Volume; SA Waters
1.5" runoff volume nla ft3
Pre -development 1-yr, 24-hr runoff volume h3
Post -development 1-yr, 24-hr runoff volume ft3
Minimum required volume 03
Volume provided ft,
Soils Report Summary
Soil type FaB-Sandy Clay
Infiltration rate 0,68 inlhr
SHWT elevation 257.00 fmsl
Basin Design Parameters
Drawdown time 2,20 days OK
Basin side slopes 3.00 :1 OK
Basin bottom elevation 261.00 fmsl OK ,ram
Storage elevation 264.00 fmsl ��
Storage Surface Area 2,896.00 ft2 '�: �T��'•.,'''
Top elevation 265.00 fmsl ;V.
Basin Bottom Dimensions SE AL
Basin length 30,00 ft 20744
Basin width 10.00 ft 4
Bottom Surface Area 277,00 ft2 s.00.eoe,kok
s.
s �.� fltr�4f•
Form SW401-Infiltration Basin-Rev.5 11Apr2011 Paris I. & 4I, Design Summary, Page 1 of 2

t
Q
Permit No. sW SQ Z O�ir_i�
(to be provided by DWQ)
Additional Information
Maximum runoff to each inlet to the basin?
0,55
ac-in
OK
Length of vegetative filter for overflow
NA
ft
OK
Distance to structure
100+
ft
OK
Distance from surface waters
100+
ft
OK
Distance from water supply well(s)
100+
ft
OK
Separation from impervious soil layer
NA
ft
OK
Naturally occuring soil above shwi
350
ft
OK
Bottom covered with 4-in of clean sand?
Y
(Y or N)
OK
Proposed drainage easement provided?
Y
(Y or N)
OK
Capures all runoff at ultimate build -out?
Y
(Y or N)
OK
Bypass provided for larger storms?
NA
(Y or N)
OK
Pretreatment device provided
NA
ADUL Vol added for No Bypass/No Filter
Form SW401-Infiltration Basin-Rev.5 11Apr2011 Parts I. & ll. Design Summary, Page 2 of 2

Permit No. -S+ (PtZO $ OS
(to be provided by DWQ)
y s j- ;
IIL�REQUIREDzITEMS'r,CMECKLiSTt~,��.s-0�f.V.��€}��wF�.����'Grk�:;�rw��:
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. 1f the applicant has designated an agent, the agent may initial below. If a
requirement has not been met, attach justification.
Page/ Plan
Initials Sheet No.
bi.5 C� 2
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.
'D(_S C.-2
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.
OLS C-2
3. Section view of the infiltration basin 0" = 20' or larger) showing:
Pretreatment and treatment areas, and
Inlet and outlet structures.
4. A table of elevations, areas, incremental volumes & accumulated volumes to verify the volume provided.
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 DWQ, by completing & submitting the soils
investigation request form. County soil maps are not an acceptable source of soils information.
�2
6. A construction sequence that shows how the infitlration basin will be protected from sediment until the
entire drainage area is stabilized.
J)L5 A
7. The supporting calculations.
DL'5 t4( I
8. A copy of the signed and notarized operation and maintenance (O&M) agreement.
tsf J4 (A 9. A copy of the deed restrictions (if required).
Form SW401-Infiltration Basin-Rev.4 Page 1 of 1 Part Ill. Required Items Checklist, Page 1 of 1