SW7060926_CURRENT PERMIT_20070212

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW��,Q
DOC TYPE
CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
P)
YYYYMMDD

5
MS-1
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
DIVISION OF WATER QUALITY
February 12, 2007
Mr. Bernice J. Ballance
PO Box 69
Buxton, NC 27920
Subject
Dear Mr. Balance:
Alan W. Klimek, P.E. Director
Division of Water Quality
Stormwater Permit No. SW7060926
CAP'N B's Campgroung
High Density Stormwater Project
Dare County
The Washington Regional Office received your completed
Stormwater Application for the subject project on February 8,
2007. 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. We are
forwarding Permit No. SW7060926 dated February 12, 2007 to Mr.
Bernice J. Ballance.
This permit shall be effective from the date of issuance
until February 12, 2017 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, P.O. Drawer 27447, Raleigh, NC 27611-
7447. Unless such demands are made this permit shall be final and
binding.
North Carolina Division of Water Quality Internet h2o.enr.state.nc.us
943 Washington Square Mall Phone: [phone]
Washington, NC 27889, FAX [phone]
An Equal Opportunity/Affrmatve Acton Employer — 50% Recycled110% Post Consumer Paper
Nne
orthCarolina
JVaturallry

Mr. Bernice J. Ballance
February 12, 2007
Page Two
If you have any questions, or need additional information
concerning this matter, please contact Mr. Bill Moore at (252)948-
3919.
,, ncerely,
A
Al Jd"geRegal.Su ervisor
onP
Surface Water Protection Section
Washington Regional Office
cc: Performance Engineering
Dare County Planning/Inspections
-,4ARO Stormwater Files
Central Files

State Stormwater Management Systems
Permit No. SW7060926
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
Mr. Bernice J. Ballance
Dare County
FOR THE
construction, operation and maintenance of stormwater management
systems in compliance with the provisions of 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 for
(2) infiltration basins to serve CAP'N B's Campground located off
SR1232 (Buxton Back Road) at Buxton, NC.
This permit shall be effective from the date of issuance until
February 12, 2017, 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 on page 4 of this permit,
the Project Data Sheet.
3. Approved plans and specifications for this project are
incorporated by reference and are enforceable parts of the
permit.
3

DIVISION OF WATER QUALITY
PROJECT DATA
Project Name:
Permit Number:
Location:
Applicant:
Mailing Address:
Application Date:
Water Body Receiving Stormwater
Runoff:
Classification of Water Body:
Total Site Area:
Total Impervious
Surfaces Allowed:
Basin Depths:
Required Storage Volume:
Provided Storage Volume:
Provided Surface Area:
Storage Elevations:
0
CAP'N B's Campground
SW7060926
Dare County
Mr. Bernice J. Ballance
PO Box 69
Buxton, NC 27920
09/27/2006; original
02/08/2007; complete
UT -Pamlico Sound
SA
6.29 acres
43,666 sf
1.50 - Basin A
1.50 - Basin B
5794 cf - Basin A
4699 cf - Basin B
12,460 cf - Basin A
10,102 cf - Basin B
7343 sf - Basin A
5527 sf - Basin B
4.0 ft for both Basins

4. No homeowner/lot owner/developer shall be allowed to fill in,
alter, or pipe any vegetative practices (such as swales)
shown on the approved plans as part of the stormwater
management system without submitting a revision to the permit
and receiving approval from the Division.
5. The following items will require a modification to the
permit:
a. Any revision to the approved plans, regardless of size
b. Project name change
C. Transfer of ownership
d. Redesign or addition to the approved amount of built -
upon area
e. Further subdivision of the project area.
In addition, the Director may determine that other revisions
to the project should require a modification to the permit.
6. 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.
II. SCHEDULE OF COMPLIANCE
1. The permittee will comply with the following schedule for
construction and maintenance of the stormwater management
system.
a. 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 surfaces except roads.
b. During construction, erosion shall be kept to a minimum
and any eroded areas of the system will be repaired
immediately.
2. The facilities must be properly maintained and operated at
all times. The approved Operation and Maintenance Plan must
be followed in its entirety and maintenance must occur at the
scheduled intervals.
3. The permittee shall at all times provide the operation and
maintenance necessary to assure the permitted stormwater
system functions at optimum efficiency including, but not
limited to:
5

a. Semi-annual scheduled inspections (every 6 months)
b. Sediment removal
C. Mowing and revegetation of side slopes
d. Immediate repair of eroded areas
e. Maintenance of side slopes in accordance with approved
plans and specifications
f. Debris removal and unclogging of outlet structure,
orifice device and catch basins and piping.
4. Records of maintenance activities must be kept and made
available upon request to authorized personnel of DWQ. The
records will indicate the date, activity, name of person
performing the work and what actions were taken.
5. 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.
6. Upon completion of construction 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. Mail the
Certification to the Washington Regional Office, 943
Washington Square Mall, Washington, North Carolina, 27889,
attention Division of Water Quality.
7. A copy of the approved plans and specifications shall be
maintained on file by the Permittee for a minimum of five
years from the date of the completion of construction.
III. GENERAL CONDITIONS
1. This permit is not transferable. In the event there is a
desire for the facilities to change ownership, or there is a
name change of the Permittee, a formal permit request must be
submitted to the Division of Water Quality accompanied by an
application fee, documentation from the parties involved, and.
other supporting materials as may be appropriate. The
approval of this request will be considered on its merits and
may or may not be approved.
2. 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 143-215.6(a) to 143-215.6(c).
3. 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) which have jurisdiction.
6

r
4. 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.
5. 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.
6. At least 6 months prior to the expiration date, the permittee
shall request that this permit be renewed.
Permit issued this the 12 th day of February, 2007.
NORTH CAROLINA ENVIRONMENTAL
Alan W. K imek, .E., Director
Division of Water Quality
By Authority of the Environmental
Permit Number SW7060926
7
COMMISSION
Management Commission

Stormwater Permit SW7060926
(2) Infiltration Basins
CAP'N B's Campground
Buxton, NC
Designer's Certification
as a duly
registered Professional Engineer in the State of North Carolina,
having been authorized to observe (periodically/weekly/full time)
the construction of the project,
for
(Project)
(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.
Signature
Registration Number
Date
M

®WQ_WAI
State of North Carolina
epartment o
dV �'aQ Df Environment and Natural Resources
2�
Division of Water Quality
q'y7�Ob
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original
I. GENERAL INFORMATION
1. Applicants name (specify the name of the corporation, individual, etc. who owns the project):
8a_.rnlc:a T hall ��lr�
2. Print Owner/Signing Official's name and title (person legally responsible for facility and compliance):
err f c a T 8 aJ1,3 iu 4_
3. Mailing Address for person listed in item 2 abode:
City:
State: N Zip: 27920
Telephone Number: f Z 5 2 ) C% ZJ 3
4. Project Name (subdivision, facility, or establishment name -should be consistent with project name on
plans, specifications, letters, operation and maintenance agreements, etc.):
5. Location of Project (street address): l
City: Uk_ f 0':1 County: /)ry f. p
6. Directions to project (from nearest major intersection): L
Sk /232 /bp „?�dS Cjs7 of KOSSGJ"V
� v
7. Latitude:/t( 3S� %.� 5 .�, r� Longitude: jj(, 7Sa 32 I /S-, r of project
S. Contact person who can answer questions about the project:
Name:9,6ead 1: .�i!, PC Telephone Number: (J,S 2, ) 4'0 193,5¢
II. PERMIT INFORMATION:
1. Specify whether project is (check one): ✓ New Renewal Modification
Form SWU-101 Version 3.99 Page 1 of 4

2. If this application is being submitted as the result of a renewal or modification to an existing permit, list the
existing permit number SW IN 012-6 and its issue date (if known) PV-Whi N 4
3. Specify the type of project check one):
_Low Density High Density _Redevelop _General Permit _Other
4. Additional Project Requirements (check applicable blanks):
_LAMA Major LSedimentation/Erosion Control _404/401 Permit _NPDES Stormwater
Information on required state permits can be obtained by contacting the Customer Service Center at
1-577-623-6745.
III. PROJECT INFORMATION
1. In the space provided below, summarize how stormwater will be treated. Also attach a detailed narrative
(one to two pages) describing stormwater management for the pn,ject .
2. Stormwater runoff from this project drains to the p it ; r Utdz vs Y, River basin.
` /�
3. Total Project Area: 7. �3 acres 4. Project Built Upon Area: Z9� %
5. How many drainage areas does the project have? 2
6. Complete the following information for each drainage area. If there are more than two drainage areas in the
project, attach an additional sheet with the information for each area provided in the same format as below.
R/ICIAi R
Basic Infoii iation '
bxx
77Dramage Aiea 1 S£ ",F e
Dramage Area 2
Receiving Stream Name
0.<, w. E
E cE
Receiving Stream Class.S
A
Drainage Area
Existing Impervious* Area
Proposed Irn ervious Area
et ? 6 1, 6 j
%Impervious* Area (total)
30, ' `'
z 7. 9 c
Impervious` -Surface A ea Dra nage Aieala Drainage Area_ 2
On -site Buildings f�
On -site Streets 27 656F 19, 136
On -site Parking
On -site Sidewalks
Other on -site
Off -site rJj
Total: F Total: 34
Impervious area is defined as the built upon area including, but not tinrited to, buildings, roads, parking areas,
sidernalks, gravel areas, etc.
Form S11'U-101 Version 3.99 Page 2 of 4

Ho,v wJ•as the off -site impervious area listed above derived? Z U i (LG d'y_8 r'a' / ct l 7 t z n
Yr7,1T 111E C2hd( Ma7r, 0ti- <'17/ini1bd, Ln/ !'77hnd�< _l i.,,i na✓L,, n.. cnrr• .
IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
The following italicized deed restrictions and protective covenants are required to be recorded for all
subdivisions, outparcels and future development prior to the sale of any lot. If lot sizes vary significantly, a
table listing each lot number, size and the allowable built -upon area for each lot must be provided as an
attachment.
1. The follorving
number_
covenants are intended to ensure ongoing compliance with state stormwater management pem,it
as issued by the Division of Water Quality. These covenants may
not be changed or deleted without the consent of the State.
2. No more than ,S SZ square feet of any ion s))wll be covered by stnnctures or impervious materials.
Impervious materials include asphalt, gravel, concrete, brick, stone, slate or similar naterial but do not include wood
decking or the water surface of swinaning pools.
3. Swales shall not be filled in, piped, or altered except as necessary to provide driveway crossings.
4. Built -upon area in excess of the permitted amount requires a state storrnwater management permit modification prior to
construction.
5. All permitted runoff from outparcels or future development shall be directed into the permitted stor»uaater control
system. These connections to the stormwater control system shall be performed in a manner flat maintains the
integrity and performance of the system as pemnitted.
By your signature below, you certify that the recorded deed restrictions and protective covenants for this project
shall include all the applicable items required above, that the covenants will be binding on allparties 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 State, and that they will be recorded prior to the sale of any lot.
V. SUPPLEMENT FORMS
The applicable state stormwater management permit supplement form(s) listed below must be submitted for
each BMP specified for this project. Contact the Stormw•ater and General Permits Unit at [phone] for the
status and availability of these forms.
.Form SWU-102
Wet Detention Basin Supplement
Form SWU-103
Infiltration Basin Supplement
FormSWU-104
Low Density Supplement
Form SWU-105
Curb Outlet System Supplement
Form SWU-106
Off -Site System Supplement
Fora. SWU-107
Underground Infiltration Trench Supplement
Form SWU-108
Neuse River Basin Supplement
Form SIVU-109
Innovative Best Management Practice Supplement
Form SWU-101 Version 3.99 Pa.-e 3 of 4

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. The complete application package should be
submitt d to the appropriate DWQ Regional Office.
1. Mel indicate that you have provided the following required information by initialing in the space
provided next to each item.
In tials
• Original and one copy of the Stormwater Management Permit Application Form
• One copy of the applicable Supplement Form(s) for each BMf
• Permit application processing fee of S"-_20 (payable to NCDENR) ;
• Detailed narrative description of stormwater treatment/management
• Tt,vo copies of plans and specifications, including:
- Development/Project name
- Engineer and firm'
- Legend
- North arrow
- Scale ✓
- Revision number k date "
- Mean high water line rv/f
- Dimensioned property/project boundary ✓
- Location map with named streets or NCSR numbers '
- Original contours, proposed contours, spot elevations, finished floor elevations ✓
- Details of roads, drainage features, collection systems, and stormwater control measures✓
- Wetlands delineated, or a note on plans that none exist ✓
- Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations 001
- Drainage areas delineated r o A -, E NTi zE S t T
-Vegetated buffers (whererequired) tilfA
VII. AGENT AUTHORIZATION
If you wish to designate authority to another individual or firm so that they may proN',ide information on your
behalf, please complete this section.
Designated agent (individual or
Mailing Address:t?uW V
City: State: W C zip: ��(o
Phone: (IS Fax:
VIII. APPLICANT'S CERTIFICATION
I,(print ortype name ofper;onliaedinGeneral Informal ion, item.2) Rn�h\C� J • ����c�V\CO.
certify, that the information included on this perm t application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance ;,. ith the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of 15A
NCAC 2H .1000.
Signatu
Form SWU•101 Version 3.99 Page 4 of 4
Date: v

LETTER OF TRANSMITTAL
PERFORMANCE ENGINEERING
8604 CARATOKE HIGHWAY
POWELLS POINT, NC 27966
PHONE [phone] FAX [phone]
CERTIFIED — RETURN RECEIPT REQUESTED
TO: Mr. Bill Moore DATE: 12/29/06
OF: NCDENR-DWQ-WaRO
943 WASHINGTON SQUARE MALL
WASHINGTON, NC 27889
JAN 0 3 2007
DWQ-WAR®
PROJECT NUMBER: 978, CAP'N B'S CAMPGROUND, BUXTON, DARE
COUNTY, PERMIT NUMBER SW7060926
WE TRANSMIT THE FOLLOWING:
-Original + I copy- STORMWA TER MANAGEMENT PERMIT APPLICATION FORM
-Two copies, Plan Sheet 5 of 5
-One each, INFILTRATION BASIN SUPPLEMENT, for Basins "A" & `B"
- Original, Project Narrative
- Original, Soils Report
-Original, STORMWA TER BMP DESIGN CALCULATIONS
COMMENTS: Bill, I have only submitted thepla
BMP. The change to high density will require that
don't want to proceed wit that exercise ant e e)
sure the stormwater plan will be approved with no
which depicts the
tem and I
i until I am
Nothing
pertaining to the sewerage system changes will impact coverage or any other stormwater
related issues. Please let me know as soon as possible if you have any questions or
concerns regarding this revised plan. Thanks and best regards, Bob Stewart
CC: Mr. Bernice J. Ballance

Permit No.
(to be provided by DIV&
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
47
:"jj
INFILTRATION BASIN SUPPLEMENT
This form may be photocopied for use as an original JAN 0 3 2007
DWO Stormwater Management Plan Review: rt:'^_'� �
A complete stormwater management plan submittal includes a stormwater management permityaplilA,-? n, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name: CAP' W g` S C, A M P CjIjZ o 0 to 1�>
Contact Person: Rc?6yt -S . S&a oa - tIf. QT, • Phone Number: (ZSZ Xs —
This worksheet applies to: Basin No. A in Drainage Area _A
(as identified on plant) (from Form SIVU-101)
I1. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable
source of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type
Infiltration Rate
SHWT Elevation
Basin Design Parameters
Design Storm
Design Volume
Drawdown Time
Basin Dimensions
Basin Size
Basin Volume Provided
Basin Elevations
Bottom Elevation
Storage Elevation
Top Elevation
Fetes
6 •D - Z 0. Q 1 r r cf/hr/sf (circle appropriate units)
Q, 83 ' fmSI (Seasonal High Water Table elevation)
it
inch (1.5 inch event for SA waters, 1 inch event for others)
c.f.
days
IRRE6ULAR y'eomt72y(^'
ft. x
12.4� 6a c.I.
Z.S t fmsl
4, o ` fmsl
4. Z ` fills]
srk�34)
sq. ft.
(bottont dimensions)
2• S' G'aNrdvR
Form SWU-103 Rev 3.99 Page I of 3

Ill. la QUIRED FULMS CHECKLIST l
The following checklist outlines design requirements per the Stormcvater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 211 .1008. ,
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stomiwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials d' `'
a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
QQ� b. System is located at least 100 feet from water supply wells.
C. Bottom of system is at least 2 feet above the seasonal high water table.
$ d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
e. System is not sited on or in fill material or DWQ approval has been obtained.
tl
f. System is located in a recorded drainage casement for the purposes of operation and
maintenance and has recorded access easements to the nearest public right-of-way.
IQ S g. Drainage area for the device is less than 5 acres.
_ K4� It. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
i. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event
for areas draining to SA waters ). Design volume and infiltration calculations attached.
24-- s j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
k
1p - M.
a
All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
A pretreatment device such as a catch basin, grease trap, filter strip, grassed Swale or
sediment trap is provided.
Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches
or dense vegetative cover is provided.
Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
Flow distribution mechanism within the basin is provided.
p. A benchmark is provided to determine the sediment accumulation in the pretreatment
device. K, S'' ."'
E
g4s - r
Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
Systern is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
s. Plans ensure that the installed systean will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
I. After every runoff producing rainfall event and at least,monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved
design specifications.
Remove accumulated sediment from the pretreatment system and infiltration basin annually or when
depth in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored
to the original design depth without over -excavating. Over -excavating may cause the required water
table separation to be reduced and may compromise the ability of the system to perform as designed.
Removed sediment shall be disposed of in an appropriate manner and shall not be handled in a manner
that will adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream,
etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used
to determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads . r� feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2FI .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that 1 am responsible for the performance of the five
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.
Print Name and Title: 31z ic. ;cc Beg dance Owylrt jr
Address:
D"Itp
Signature:!
Note: The legally responsible party sbou d 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.
t, ee_T l V—k t Q&e I a Notary Public for the State of N C County of
tA2r , do hereby certify that _T;EVZN 10E T- _P5 A 1-LAYICC personally appeared before me this J�"74�
day of and acknow edge t e due execution of the forgoing infiltration basin maintenance
requirements. Witness my hand and official sea47
,
SEAS M commission expires -C' a06
Form SWU-I03 Rev'3.99 Page 3 of 3

Permit No.
(to be provided by DW&
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
j NE
INFILTRATION BASIN SUPPLEMENT
This forni nmy be photocopied for use as an original JAN 0 3 2007
DWO Stormwater Management Plan Review:N r��f y Qn�A��
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name : CAP' f`I R' S CAMPG i) ) MD
Contact Person: Qob f -T. t-St,,U. Phone Number: (7--52 14ht fs35�
This worksheet applies to: Basin No. _P�l in Drainage Area _�__
(as identified on plans) (from Form SIVU-101)
II. DESIGN INFORMATION -Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable
source of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type 'FYi bo
Infiltration Rate 4.0 -, Z.O. O in/hr r cf/hr/sf (circle appropriate units)
SHWT Elevation I.13 fmsl_.(SeasonalHig?JaterTable elevation)
Basin Design Parameters
Design Storm
Design Volume
Drawdown Time
Basin Dimensions
Basin Size
Basin Volume Provided
Basin Elevations
Bottom Elevation
Storage Elevation
Top Elevation
Form SWU-103 Rev 3.99
inch(1.5 inch eventfor SA waters, I inch eventfor others)
�-r c.f.
A . 1 days
iRRE4Ul.AR GEoM'`?Ri
ft. x
/O 02 c.f.
2 . s , fmsl
4. 0 - fmsl
9
flnSl
Page I of 3
ft. = 5 � 5 21 sq. ft. (bottom dimensions)
2-6t cog-TaUP,

111. REQUIRED I'ITNIS CIILCKLIS"1' F.
The following checklist outlines design requirements per the Slorntvvafer Best Management Practices Manual
(N.C. Department of Environment, Health and Natural 'Resources, February 1999) and Administrative Code
Section: 15 A NCAC 21-1 .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stonnwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials' a"
Qa6 a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
b. System is located at least 100 feet from water supply wells.
o C. Bottom of system is at least 2 feet above the seasonal high water table.
d. Bottom of the system is 3 feel above any bedrock or impervious soil horizon.
e. System is not sited on or in fill material or DWQ approval has been obtained.
f. System is located in a recorded drainage casement for the purposes of operation and
maintenance and has recorded access easements to the nearest public right-of-way.
R%S _ g. Drainage area for the device is less than 5 acres.
It. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
i. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event
for areas draining to SA waters ). Design volume and infiltration calculations attached.
QO� j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
RDc� k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided. skojQ. - SL..'F ff�J
NS - m. Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches
or dense vegetative cover is provided.
n. Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
OFlow distribution mechanism within the basin is provided.
QO p. A benchmark is provided to determine the sediment accumulation in the pretreatment
D device.
q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
Q6 r. System is designed to draw down the design storage volutiie to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
s. Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved
design specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when
depth in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored
to the original design depth without over -excavating. Over -excavating may cause the required water
table separation to be reduced and may compromise the ability of the system to perform as designed.
Removed sediment shall be disposed of in an appropriate manner and shall not be handled in a manner
that will adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream,
etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used
to determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
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.
Print Name and Title: 9 ✓n ice 3 7 It 2 nCy� 01Jp �
' • A '��VA t._ _0 1 e1—,
Si —nature:/ O
Note: The legally responsible party shou d 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.
p3E M F-i • 0 t DCTEt I a Notary Public for the State of W C— —County of 1
C)A o_15 —,do hereby certify that � P i61 Ce �• �t4LL_A nel✓ personally appeared before me this Q 7
day of � ei1em )xY' , 2tdd2, and acknow diet e due execution of the forgoing infiltration basin maintenance
requirements. Wimess my hand and official seal, / A 'cI/LC
.o
SEAL. -' My commission expires
Form SWU-103 Rev 3.99 Page 3 of 3

I'aVt- L U
JAN 0 3 2007
CAP'N. B's CAMPGROUND ��JITAAR0
VILLAGE OF BUXTON — HATTERAS ISLAND — DARE COUNTY — NC
ENGINEER'S PROJECT NUMBER 978
December 27, 2006
HIGH DENSITY STORMWATER BMP — PROJECT NARRATIVE
Cap'n. B's Campground is a 56 site facility proposed for construction on a 6.293 acre
tract (404 wetlands excluded) located in the Village of Buxton, on Hatteras Island, Dare
County. The tract is essentially clear with widely scattered trees and bushes. The
prevailing soil types are fine sands in the Corolla and Fripp series. Pursuant to the
requirements of the NCDENR Division of Environmental Health a licensed Soil Scientist
was retained by the owner to conduct a site soils evaluation and groundwater mounding
analysis. A copy of the report prepared by Mr. E. Scott Stone, LSS of Environmental and
Soil Service, Inc. was previously submitted with the STORMWA TER MANAGEMENT
PERMIT APPLICATION FORM to fulfill the requirements for soils investigation. The
original application was based on low density development as the BMP. The Div. of
Water Quality ruling regarding the classification of the adjacent ditches and ponds
necessitated the implementation of infiltration basins as the BMP. Supplemental soils
investigation was conducted on December 20, 2006 in the specific areas proposed for
infiltration basins. A report summarizing this investigation is included in the high density
BMP application package.
The site is essentially flat towards the rear (south) of the property while sloping at
approximately 2% from north to south in the first approximately 160 feet. There are three
existing ponds located along the south property line. These ponds separate the
campground property from the tract owned and resided on by the project owner Mr.
Bernice Ballance. To the east there is a broad expanse of 404 wetlands which has
historically received runoff from the site. To the west, along the west property line is a
drainage swale which drains to the previously mentioned ponds. An outfall ditch extends
westerly from the string of ponds to an expansive swampy area known as Jeanette's
Sedge..
The proposed BMP will consist of two shallow infiltration basins, one on the east side
and one on the west side. The attached calculation sheet provides a breakdown of the size
of each drainage area, the percentage of impervious coverage and the volumetric capacity
of each basin. The basins are designed with a bottom elevation of 2.5'. This results in a
separation from the seasonal high water table of 1.67' for Basin A and 1.37' for Basin B.
To mitigate the reduced vertical separation distance, the basins have been designed for a
three inch rainfall event, twice the volume required by the prevailing regulations. Both
basins have capacity to store in excess of 100% of the design run-off volume. The site
grading is designed to provide gentle sloping to convey stormwater run-off to the basins
via sheet flow across the primarily vegetated site. All of the roadways are to be gravel
which, although considered impervious, are significantly more conducive to infiltration
than are hard surface pavements.
One road side swale is provided to collect and convey run-off generated within the
most southerly lots, adjacent to the existing ponds. The volume of storage available

Narrative, 12/27/06, Cap'n. B's Campground, p.n.978, page 2 of 2
within this roadside swale is not included in the basin volume calculations. The swale and
connecting culverts will provide an additional 2,198 cubic feet of storage volume.
Each campsite will be limited to one 10' x 20' gravel parking space and one 7' x 14'
pervious, wood framed, open deck. These limitations are imposed by the Dare County
Zoning Ordinance. The impervious coverage calculations are also based on each site
including an 8' x 44' camper, the maximum size for a "street legal" camper.
bI-
✓• STE`NP%%k I1,/Z-7
PERFORMANCE ENGINEERING
8604 CARATOKE HIGHWAY
POWELLS POINT, NC 27966
PH. 252-491-8354 FAX [phone]

CAP'N. B'S CAMPGROUND
STORMWATER BMP DESIGN CALCULATIONS
DECEMBER 27, 2006
ENGINEER'S PROJECT NUMBER 978
JAN 0 3 2007
IA R0
INFILTRATION BASIN "A"
Total drainage area = 144,849 s.f. (see basin boundary delineation, plan sheet 5 of 5)
Impervious coverage: gravel roadway- 27,658 s.f.
parking spaces- 10' x 20' x 29 sites = 5,800 s.f.
campers- 8' x 44' x 29 sites = 10,208 s.f.
TOTAL IMPERVIOUS COVERAGE = 43,666 S.F. (30.1%)
Design for 3" rainfall event, calculate unit volume, using Schuler equation-
Rv = 0.05 + 0.009(30.1) = 0.32 inches per inch I „- s 7q9' ! 6X 170
Design volume = 144,849 s.f. x 3"/12 x 0.32 = 11,588 c.f.
basin capacity: 4' contour area = 9,270 s.f.; 2.5' contour area = 7,343 s.f.
basin capacity = 7,343 s.f(1.5') + (9,270 s.f. -7,343 s.f)(0.75') = 2,460 c.f. (108%) f/Co
Drawdown time- using permeability rates published in the U.S.D.
SURVEYFOR DARE COUNTY, NORTH CAROLINA, for Fripp Fine Sands permeability
ranges from 6-20 inches per hour. Use low end number for conservative design: 9,270 s.f.
basin area x 0.5 ft./hr = 4,635 c.f per hour
drawdown time = 11,588 c.f. / 4,635 c.f/hr = 2.5 hours
INFILTRATION BASIN "B"
Total drainage area = 125,309 s.f. (see basin boundary delineation, plan sheet 5 of 5)
Impervious coverage: gravel roadway- 19,136 s.f.
parking spaces- 10' x 20' x 27 sites = 5,400 s.f.
campers- 8' x 44' x 27 sites = 9,504 s.f.
bath house = 864 s.f.
TOTAL IMPERVIOUS COVERAGE = 34,904 S.F. (27.9%)
Design for 3" rainfall event, calculate unit volume, using Schuler equation- EQ
Rv = 0.05 + 0.009(27.9) = 0.30 inches per inch
Design volume = 125,309 s.f. x 3"/12 x 0.30 = 9,398 c.f
basin capacity: 4' contour area = 7,942 s.f.; 2.5' contour area = 5,5
basin capacity = 5,527 s.f.f.)( (1.5') + (7,942 s.f. - 5,527 s0.75') =j4 0,102 c.f. (108%
Drawdown time- using permeability rates published in the U.S.D. ., S. .S., SOIL
SURVEY FOR DARE COUNTY, NORTH CAROLINA, for Fripp Fine Sands permeability
ranges from 6-20 inches per hour. Use low end number for conservative design: 7,942 s.f.
basin area x 0.5 ft./hr = 3,971 c.f. per hour
drawdown time = 9,398 c.f. / 3,971 c.f/hr = 2.4 hours
PERFORMANCE ENGINEERING
8604 CARATOKE HIGHWAY
POWELLS POINT, NC 27966
PHONE [phone] FAX [phone]
`t0111u1tot"
OFE ...... �y
3; 100 i71J1-7l0.6

�.,, ra it W, F IM
CAP'N. B's CAMPGROUND — SOILS REPORT
ENGINEER'S PROJECT NO.978 JAN 0 3 2007
December 27, 2006 (VA
Preface- On site soils investigation and analysis was conducted by the Engineer on
December 20, 2006. Borings were augured to a depth of approximately four feet in two
locations. The boring locations coincide with the locations of the proposed infiltration
basins; Boring A was taken in the location of Basin A and Boring B was taken in the
location of Basin B.
A review of the U.S.D.A., S.C.S. Soil Survey of Dare County, North Carolina, Sheet
number 20 of 22, indicates that the prevailing soil types in the project vicinity are Fripp
Fine Sands and Currituck Mucky Peat. The Currituck series soils are located in the
adjacent marshy areas lying predominantly to the east and south of the project site.
RTi771WR7:Qf1-1101 ►0Ioj"aw.I116W[cIM1
0-6"- light gray sand with thin turf
6"-32"- chocolate brown loamy sand with trace of organics
32"-38"- darker brown loamy sand with slightly more organics
FREE WATER IN BORING 36" BELOW SURFACE AFTER TWENTY MINUTES,
ELEVATION 0.83'
BORING B- GROUND ELEVATION 3.63'
0-6"- light gray sand
6"-18"- medium brown sand with trace organics
18"-36"- dark brown sand with some peat nodules
FREE WATER IN BORING 30" BELOW SURFACE AFTER TWENTY MINUTES,
ELEVATION 1.13'
CAR
p
'gyp :oFEssio,�29.
SEAL
N
STP%%lz/zVo
---
PERFORMANCE ENGINEERING
8604 CARATOKE HIGHWAY
POWELLS POINT, NORTH CAROLINA
PHONE [phone] FAX [phone]

I

Permit No.
(to provided by DR'Q)
State of Nortli Carolina
Department, of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM RECER ED1
INFILTRATION BASIN SUPPLEMENT ;if 'i
This form may be photocopied for use as an original FEB B 2007
DWO Stormwater Management Plan Review: DWQ-WARO
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name: CAr'' W \3` :� C.AN f> QL)\)1AIN>
Contact Person: IZnba.(t -S ` A-a,,�al I i W • P ti. Phone Number: (LSZ
This worksheet applies to: Basin No. % in Drainage Area _A
(as identified on plait) (from Form SWU-101)
II. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable
source of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type f Yf op
Infiltration
--
Infiltration Rate 6 o - 20 d in/hr r cf/hr/sf (circle appropriate units)
SHWT Elevation D RJ ' fmsl (Seasonal High Water Table elevation)
Basin Design Parameters
Design Storm .S inch (1.5 inch event for SA waters, 1 inch event for others)
Design Volume i( �7 c.f.
Drawdown Time 0. L 1 days
Basin Dimensions IRRE(ii,'!)R C£ornEtP Y
Basin Size ft. x ft. _ � 34 3 Sq. ft. (bottom dimensions)
Basin Volume Provided 1Z�4(nn c.f. Z, J ' (e"J d-'R
Basin Elevations
Bottom Elevation 7.J ` fmsl
Storage Elevation 4, o l fmsl
Top Elevation Z finsl
Form SWU-103 Rev 3.99 Page I of 3

r,
111. REQUIRED T E-NIS CHECKLIST
The following checklist outlines design requirements per the Stornnvater Best Management Practices Manual >
- (MC. Department of Environment, Health and Natural Resources, -February 1999) and Administrative Code
Section: 15 A NCAC 211 .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting -
documentation is attached. If the applicant has designated an agent in the Stornwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
r b. System is located at least 100 feet from water supply wells.
SFyE 1 i.ARQli71UEc. Bottom of system is at least 2 feel above the seasonal high water table.
Al d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
S e. System is not sited on or in fill material or DWQ approval has been obtained.
SEE fJIfekArlU6 f. System is located in a recorded drainage easement for the purposes of operation and
maintenance and has recorded access easements to the nearest public right-of-way.
g. Drainage area for the device is less than 5 acres.
h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
'Y i. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event
for areas draining to SA waters ). Design volume and infiltration calculations attached.
.f4— s j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
k� k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (FIN).
/JARQIi71U81. A pretreatment device such as a catch basin, grease trap, filter strip, grassed Swale or
sediment trap is provided.
in. Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches
or dense vegetative cover is provided.
eF r_ n. Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
SEr DARPA -ME o. Flow distribution mechanism within the basin is provided.
p. A benchmark is provided to determine the sediment accumulation in the pretreatment
device.
',EC W-Urluff q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
5 r. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
U s. Plans ensure that the installed system will meet design specifications (constructed or
U restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SwU-103 Rev 3.99 Page 2 of 3

IV. INPILTR.ATION I3ASIN OPERATION AND NIAINTENAN'CE AGREEMENT
'1.- After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash -accumulation, vegetative cover, and general condition._-
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved
design specifications.
Remove accumulated sediment from the pretreatment system and infiltration basin annually or when
depth in the pretreatment unit is reduced to 751/o of the original design depth. The system shall be restored
to the original design depth without over -excavating. Over -excavating may cause the required water
table separation to be reduced and may -compromise the ability of the system to perform as designed.
Removed sediment shall be disposed of in an appropriate manner and shall not be handled in a manner
that will adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream,
etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so'that accurate sediment accumulation readings can be taken. The measuring device used
o
to determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
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.
Print Name and Title: n I Bcglbn(e 01,046,
Address�?��1
Pho
C
Signature:
Note: The legal1), responsible party shou d not be a homeowners association unless more than 50% of the lots have been sold and
a resident of the subdivision has been maned the president.
I, Cl2TK1 h ( l� t DG�t l as Notary Public for the State of (J C County of n
A 2F , do hereby certify that t`)E1QN ICE - �.1� LLAt2CE personally appeared before me this ,,9Nrj -
day of �DPp )if , 006 acknSNIC0111nissionexpires
ue execution of the forgoing infiltration basin maintenance
requirements. Witness my hand and official sea
�t,h? `ii2�c,C �.�pSEAL o0
Form SWU-103 Rev 3.99 Page 3 of 3

Permit No.
(to be provided bY DII'p)
State of North Carolina
Department ofEnvironnient and Natural Resources --
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM F"ECEIVE®
INFILTRATION BASIN SUPPLEMENT FEB 8 2001
This form may be photocopied for use as an original DWQ.WARO
DCVO Stormwater Management Plan Review
A complete storntwater management plan submittal includes a stormwatcr management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stonnwater conveyances and systern details.
L PROJECT INFORMATION
Project Name: C_AP'N R'S �eMPL��t�t)isD
Contact Person: ()b j tar 'S• �� L v> �r t Si Phone Number: (ZS'L. 1 4�1 £i 1 4
This work -sheet applies to: Basin No.
(as Uenr;fied on plans)
in Drainage Area,_
(from Farm SWU-101)
II. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable
source of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type r Y i pp
Infiltration Rate (,•o-20,o m/hr ref/hr/sf (circle appropriate an its)
SH`rVT Elevation 1 J -�' fmSl 'Seasonal High Water Table elevation)
Basin Design Parameters
Design Storm
Design Volume
Drawdown Time
Basin Dimensions
Basin Size
Basin Volume Provided
Basin Elevations
Bottom Elevation
Storage Elevation
Top Elevation
inch(1.5itneheventforSAwaters, Iincheventforothers)
C) c.f.
o l days
tRREC,v'�.Ak c;Eot.rstTR'(
ft. x
/o t7L c.f.
2 .S r fmsl
4- fmsl
4.21 fmsl
ft. _ _5r��—sq. ft. (bottom dimensions)
2.V Cot1Tc�:2
Form SWU-103 Rev 3.99 Page t of 3

111. lU QUIMA) ITEMS CIlLCKLISI'
The follo«ing checklist outlines design requirements per the Stornnvater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February4-999)-and-Administrative Code
Section: 15 A NCAC 211 .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Storrnwater Management Permit
Application Form,- the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
Ns a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
b. System is located at least 100 feet from water supply wells.
$cC u A kizAh r c. Bottom of system is at least 2 feet above the seasonal high water table.
S d. Bottom of the system is 3 feel above any bedrock or impervious soil horizon.
e. System is not sited on or in fill material or D%VQ approval has been obtained.
5rELjayaRrruC f. System is located in a recorded drainage casement fertile purposes of opemlion and
maintenance and has recorded access easements to the nearest public right-of-way.
Q y g. Drainage area for the device is less than 5 acres.
f�6c h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
i. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event
U for areas draining to SA waters ). Design volume and infiltration calculations attached.
j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
Rcxt _ k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
,>C AIaL'f'YFTI& I. A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided.
Rt� m. Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches
or dense vegetative cover is provided.
n. Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
U length is 50 feet for SA waters, 30 feet for other waters).
;ir r lihRIZIM J{ o. Flow distribution mechanism within the basin is provided.
A benchmark is provided to determine the sediment accumulation in the pretreatment
device.
q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
r. System is designecl to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions v%ithin five days. A soils report and all
pertinent draw-do.vn calculations are attached.
s. Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

IfWIV. IWILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition. -----.--__-_._
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximurn height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved
design specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when
depth in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored
to the original design depth without over -excavating. Over -excavating may cause the required water
table separation to be reduced and may compromise the ability of the system to perform as designed.
Removed sediment shall be disposed of in an appropriate manner and shall not be handled in a manner
that will adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream,
etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used
to determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 21-1 .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
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.
Print Nan
Address:
c
Phone:
Signature
Note
Title: RG�_1—qdanev.
The legally, responsible parrm shard not be a honteox hers association unless more than 50% of the lots have been sold and
a resident of the subdivision has been named the president.
I, R03CRrra �1 �t n �JEt l , a Notary Public for the State of tIN L ' County of
I�AfZE ,do hereby certify that 1�)FRiJiOE personally pp rl{t`
—,� 1 � �,,,/ Ji . ��4LI—a� Ylei� ersonall appeared before me this a
day of I Ih(�QI'1'1 FAQ \' , �4d._l2, and acknow die t e due execution of the forgoin- infiltration basin maintenance
requirements. witness my hand and official seal,
SEAL MY commission expires C D
Form SwU-103 Rev 3.99 Page 3 of 3