The URL can be used to link to this page

Home My WebLink AboutNCS000518_Navassa MS4 AUDIT REPORT_20190106MUNICIPAL SEPARATE STORM SEWER SYSTEM (MS4) PROGRAM AUDIT REPORT NPDES PERMIT NO. NCS000518 NAVASSA, NORTH CAROLINA 334 Main Street Navassa, NC 28451 Audit Date: 12/09/2019 Report Date: 01/06/2020 North Carolina Department of Environmental Quality Division of Energy, Mineral & Land Resources Stormwater Program 512 N. Salisbury Street, 9th floor 1612 Mail Service Center Raleigh, NC 27699-1612 (This page intentionally left blank) NCS000518 Navassa MS4 Audit 20191209 TABLE OF CONTENTS Audit Details ................. Permittee Information........... List of Supporting Documents........... Program Implementation, Documentation & Assessment....................................................... Illicit Discharge Detection and Elimination(IDDE).................................................................... Post -Construction Site Runoff Controls.................................................................................... Pollution Prevention and Good Housekeeping for Municipal Operations ............................... Site Visit Evaluation: Municipal Facility No. 1........................................................................... Site Visit Evaluation: MS4 Outfall No. 1.................................................................................... Site Visit Evaluation: MS4 Outfall No. 2 Site Visit Evaluation: Post -Construction Stormwater Control Measure No. Appendix A: Supporting Documents ........1 .......... 2 .................3 .................8 ..........25 DISCLAIMER This audit consists of an evaluation of program compliance with the issued permit and implementation of the approved Stormwater Management Plan. This audit report does not include a review of all program components, and program deficiencies in addition to those noted may be present. The permittee is required to assess program progress and permit compliance, and to implement the approved Stormwater Management Plan in accordance with the issued permit. NCS000518 Navassa MS4 Audit 20191209 This page intentionally left blank NC5000518 Navassa MS4 Audit 20191209 Hi Audit Details Audit ID Number: Audit Date(s): NCS000519_Navassa MS4 Audit_20191209 12/09/2019 Minimum Control Measures Evaluated: ® Program Implementation, Documentation & Assessment ❑ Public Education & Outreach ❑ Public Involvement & Participation ® Illicit Discharge Detection & Elimination ❑ Construction Site Runoff Controls— No delegated Sediment and Erosion Control Program ❑ Construction Site Runoff Controls— Delegated Sediment and Erosion Control Program M Post -Construction Site Runoff Controls ® Pollution Prevention and Good Housekeeping for Municipal Operations ❑ Total Maximum Daily Loads (TMDLs) Field Site Visits: ❑ Municipal Facilities. Number visited: Choose an item. ❑ MS4 Outfalls. Number visited: Choose an item. ❑ Construction Sites. Number visited: Choose an item. ❑ Post -Construction Stormwater Runoff Controls. Number visited: Choose an item. ❑ other: Number visited: Choose an item. ❑ Other: Number visited: Choose an item. Inspector(s) Conducting Audit Name, Title Organization Jeanette Powell, MS4 Program Coordinator NCDEQ-DEMLR Paul Clark, WSWP Program Coordinator NCDEQ-DEMLR Thad Valentine, Raleigh Regional Office Inspector NCDEQ-DEMLR Brian Lambe, Wilmington Regional Office Inspector NCDEQ-DEMLR Audit Report Author: Jea ette Powell, CPSWQ Date; January 6, 2020 Signature NCS000518_Navassa MS4 Audit_20191209 Page 1 of 37 Permittee Information MS4 Permittee Name: Town of Navassa Permit Effective Date: February 1, 2018 Permit Expiration Date: January 31, 2023 Mailing Address: 334 Main Street, Navassa, NC 28451 Date of Last MS4 Inspection/Audit: May 16, 2019 Co-permittee(s), if applicable: N/A Permit Owner of Record: Eulis A. Willis, Mayor Primary MS4 Representatives Participating in Audit Name, Title Organization Barnes Sutton, Town Planner Town of Navassa MS4 Receiving Waters Waterbodv Classification Impairments Cape Fear River C;Sw Sturgeon Creek C;Sw Indian Creek C;Sw Rowell Branch C;Sw Brunswick River SC Mill Creek C;Sw Mill Branch C;Sw Cherry Tree Prong C;Sw Cartwheel Branch SC;Sw NCS000518_Navassa MS4 Audit_20191209 Page 2 of37 List of Supporting Documents Item Number Document Title When Provided (Prior to/During/After) 1 Proposed Organizational Chart Prior 2 2018 Annual Report (SWMPA) —on file Prior 3 2019Annual Report (SWMPA)—onfile Prior 4 Town of Navassa Phase II Stormwater Ordinance (Adopted 12/16/2010) — on file Prior 5 Stormwater Responsibilities (Ordinance Sec. 1-21) Prior 6 ePayment Statement Prior 7 Map 3-8 Stormwater and Water Quality Monitoring During 8 Phase II Stormwater Implementation Plan (June 2007) During 9 Public Reporting of Stormwater Illicit Discharges Form During 10 Stormwater Management Permit Application Form During 11 Public Comment Form for Stormwater Suggestions or Concerns During Program Implementation, Documentation & Assessment Staff Interviewed: Barnes Sutton, Town Planner (Name, Title, Role) Permit Citation Program Requirement Status I supporting Doc Na. NCS000518_Navassa MS4 Audit_20191209 Page 3 of 37 Program Implementation, Documentation & Assessment II.A.1 The permittee maintained adequate funding and staffing to implement and manage Staffing and the provisions of the Stormwater Plan and meet all requirements of the permit. Partial 8 Funding The Stormwater Plan identifies a specific position(s) responsible for the overall coordination, implementation, and revision to the Plan. Yes 1,5 Responsibilities for all components of the Stormwater Plan are documented and position(s) assignments provided. Yes 1,5 The permittee is current on payment of invoiced administering and compliance ' monitoring fees (see Stormwater e-payments on DEMLR MS4 web page). Yes 6 Comments (eriefiy describe funding mechanism, number of staff, etc.) The permittee has approximately 1.5 FTEs funded through the general fund for the stormwater program. There SWMP for the town is a 2007 draft and program implementation is primarily focused on post -construction. The ePayment statement indicates that the permittee is current on all invoice payments as of 12/06/2019. II.A.2 Stormwater The permittee evaluated the performance and effectiveness of the program Plan components at least annually. Partial 2,3 Implementation and Evaluation If yes, the permittee used the results of the evaluation to modify the program components as necessary to accomplish the intent of the Stormwater Program. Partial Did the permitted MS4 discharges cause or contribute to non -attainment of an applicable water quality standard? No If yes, did the permittee expand or better tailor its BMPs accordingly to address Not the non -attainment? Applicable Comments The permittee's annual report is the standard online Basinwide Information Management System (BIMS) Stormwater Management Program Assessment (SWMPA). Program components are primarily modified in response to field observations in order to address key areas that affect the community. II.A.3 Keeping the The permittee kept the Stormwater Plan up to date. No 8 Stormwater Plan Up to Date The permittee notified DEMLR of any updates to the Stormwater Plan. Not Applicable NC5000518_Navassa MS4 Audit_20191209 Page 4 of 37 Program Implementation, Documentation & Assessment Comments The Phase II Stormwater Implementation Plan is a 2007 document marked as "Draft for Town Review". II.A.4 Availability The permittee kept an up-to-date version of its Stormwater Plan available to the of the Stormwater Division and the public online. Partial --- Plan The online materials included ordinances, or other regulatory mechanisms, or a list identifying the ordinances, or other regulatory mechanisms, providing the legal Yes --- authority necessary to implement and enforce the requirements of the permit. Comments (Note what materials are available on line) The ordinance, public comments forms, guidance and informational brochures, and 2007 Draft Phase II Stormwater Implementation Plan are posted on the permittees stormwater web page. II.A.3 & II.A.5 Stormwater Plan Did DEMLR require a modification to the Stormwater Plan? No --- Modifications If yes, did the permittee complete the modifications in accordance with the Not established deadline? Applicable --- Comments N/A II.A.6 Sharing Responsibility Are any control measures implemented by an entity other than the permittee? Yes If yes, is there a written agreement in place? No --- Comments A consultant reviews post -construction plans and the town issues permits based on the consultant's recommendations. There is no written agreement for consulting services, but there is a line item in the budget for professional services. II.A.7 The permittee maintained written procedures for implementing the six minimum Written control measures. No --- Procedures Written procedures identified specific action steps, schedules, resources and responsibilities for implementing the six minimum measures. No --- Comments The permittee's 2007 SWMP and 2010 ordinance are the only written documents governing the stormwater program. IllA The permittee maintained documentation of all program components including, but Program not limited to, inspections, maintenance activities, educational programs, No --- Documentation implementation of BMPs, enforcement actions etc., on file for a period of five years. Comments The permittee does not maintain documentation of inspections, maintenance activities, educational programs, implementation of BMPs, enforcement actions, etc. NCS000518_Navassa MS4 Audit_20191209 Page 5 of37 Program Implementation, Documentation & Assessment IV.B Annual Report The permittee submitted annual reports to the Department by October 31 each year. ves 2,3 Submittal The Annual Reports included appropriate information to accurately describe the progress, status, and results of the permittee's Stormwater Plan, including, but not limited the following: 1. A detailed description of the status of implementation of the Stormwater Plan as a whole. This will include information on development and implementation Not of each major component of the Stormwater Plan for the past year and Applicable schedules and plans for the year following each report. 2. An adequate description and justification of any proposed changes to the Stormwater Plan. This will include descriptions and supporting information for Not the proposed changes and how these changes will impact the Stormwater Applicable Plan (results, effectiveness, implementation schedule, etc.). 3. Documentation of any necessary changes to programs or practices for assessment of management measures implemented through the Stormwater Not Plan. Applicable 4. A summary of data accumulated as part of the Stormwater Plan throughout the year along with an assessment of what the data indicates in light of the Not Stormwater Plan. Applicable S. An assessment of compliance with the permit, information on the establishment of appropriate legal authorities, inspections, and enforcement Not — actions. Applicable Comments The permittee submitted Stormwater Management Program Assessments (SWMPAs) in 2018 and 2019 that fulfill all annual reporting requirements per Part IV.B.3 of the current permit. IV.B Annual Reporting The Annual Reports document the following: 1. A summary of past year activities, including where applicable, specific Not quantities achieved and summaries of enforcement actions. Applicable ... 2. A description of the effectiveness of each program component. Not — Applicable 3. Planned activities and changes for the next reporting period, for each Not program component or activity. Applicable ... 4. Fiscal analysis. NotApplicable Comments) The permittee submitted Stormwater Management Program Assessments (SWMPAs) in 2018 and 2019 that fulfill all annual reporting requirements per Part IV.13.3 of the current permit. NCS000518—Navassa MS4 Audit_20191209 Page 6 of 37 Program Implementation, Documentation & Assessment Additional Navassa has a population of approximately 1,500 and a boundary of roughly 13.8 square miles (2010 census). Comments: The town has not experienced the growth that neighboring Leland has, but does have three brownfield sites and an ongoing superfund remediation project that includes a $23M fund for waters, buffers, and a stormwater management plan. The permittee was encouraged to consider the following for the next permit cycle: • Review requirements for financial securities for SCMs and consider other options • Consider cooperative agreements which may include contract services or co -permitting with Leland • Plan for future requirements/funding including mapping and establishing required minimum control measures • Funding/resources for additional staffing of the permitted stormwater program • Establish standard documentation (forms, inventories, tracking, SOPS, templates, etc.) • Reach out to other MS4s for assistance with standard documentation • Engage public works staff in stormwater management and pollution prevention • Provide staff training for all field staff, etc. NC5000518_Navassa MS4 Audit_20191209 Page 7 of 37 Illicit Discharge Detection and Elimination (IDDE) Staff Interviewed: Barnes Sutton, Town Planner (Name, Title, Role) Permit Citation Program Requirement Status supporting Doc No. II.D.2.a The permittee annually reviewed the IDDE ordinances or other regulatory Legal Authorities mechanisms. No --- If yes, the permittee adopted new ordinances/authorities to provide adequate authority to prohibit illicit connections and discharges and enforce the IDDE Not Program. Applicable Comments (Note any deficiencies) Article VII, Sec.'1-96 of the permittees ordinance addresses illicit discharges and connections and deems them to be nuisances. The IDDE program is reactive rather than proactive. II.D.2.b The permittee maintained a current map showing major outfalls* and receiving Storm Sewer streams. Yes 7 System Map Comments The permittee maintains a stormwater and water quality map that includes outfalls, SCMs and receiving waters. *Major outfalls are discharges from > 36" diameter pipes or drainage areas of> 50 acres. In areas zoned for industrial activity, major outfalls are > 12" or drainage area > 2 acres. II.D.2.c The permittee maintained a program for conducting dry weather flow field Dry Weather Flow observations in accordance with written procedures for detecting and removing the No --- Program sources of illicit discharges. Comments There is no written program, IDDE is performed reactively. The permittee maintained written procedures for conducting investigations of II.D.2.d identified illicit discharges. No --- Investigation Procedures If yes, the permittee evaluated the written procedures annually. Not Applicable Comments There is no written program, IDDE is performed reactively. rLD,e For each case of an illicit discharge or potential illicit discharge, the permittee documented and tracked the following: NCS000518_Navassa MS4 Audit_20191209 Page 8 of 37 Illicit Discharge Detection and Elimination (IDDE) Track and Document 1. The dates) the illicit discharge was observed Not --- Applicable Investigations 2. The results of the investigation Not _ Applicable 3. Any follow-up of the investigation Not Applicable 4. The date the investigation was closed Not Applicable Comments There is no standard form or SOP for evaluating illicit discharges. II.D.2.f Employee The permittee implemented and documented a training p P g program for appropriate Training municipal staff who, as part of their normal job responsibilities, may come into Partial --- contact with or otherwise observe an illicit discharge or illicit connection. Comments The Town Planner has received on the job training through various external events, but there is no documented training program. II.D.2.e The permittee informed public employees of hazards associated with illegal Public Education discharges and improper disposal of waste. No --- The permittee informed businesses of hazards associated with illegal discharges and improper disposal of waste. Partial ___ The permittee informed the general public of hazards associated with illegal discharges and improper disposal of waste. Partial -- Comments) The permittee has a standard form for public reporting of illicit discharges and also relies upon the EPA fact sheet for IDDE (EPA- 833-F-00-007). The form is available on the web page. There have been no documented illicit discharges in the past two (2) years. New businesses are informed during the permitting / technical review committee process. There is no staff training component. The public is informed through open council meetings and information on the web page. NCS000518_Navassa MS4 Audit_20191209 Page 9 of 37 Illicit Discharge Detection and Elimination (IDDE) II.D.2.h The permittee promoted, publicized, and facilitated a reporting mechanism for the Public Reporting public to report illicit discharges. Yes 9 Mechanism The permittee promoted, publicized, and facilitated a reporting mechanism for staff to report illicit discharges. Yes 9 The permittee established and implemented response procedures for citizen requests/reports. Partial --- Comments The permittee publicizes the reporting form on the web page, which is available to the general public, staff, businesses and citizens. Reports/complaints are routed to the Town Planner for immediate investigation and resolution. There is no written response procedure, but the general understanding is that all reports will be investigated upon receipt. II.D.2.1 The permittee implemented a mechanism to track the issuance of notices of violation Not Enforcement and enforcement actions administered by the permittee. Applicable If yes, the mechanism includes the ability to identify chronic violators for Not initiation of actions to reduce noncompliance. Applicable Comments The permittee has not issued any enforcement actions in the past two (2) years. If necessary, the permittee would rely upon the general zoning code enforcement process and forms. Additional Comments: NC5000518_Navassa M54 Audit_20191209 Page 10 of 37 I Post -Construction Site Runoff Controls I Staff Interviewed: Barnes Sutton, Town Planner (Name, Title, Role) that ❑ The permittee implements the components of this minimum measure. ® The permittee relies upon another entity to implement the components of this minimum measure: Right Angle Engineering ❑ The permittee implements the following deemed -compliant program(s), which meet NPDES MS4 post -construction requirements for the areas where implemented and in compliance with the specific program requirements as provided in 15A NCAC and noted below (Complete Session Law 2006-246 section below): ❑ Water Supply Watershed I (WS-1) —15A NCAC 213.0212 ❑ Water Supply Watershed II (WS-11) —15A NCAC 28.0214 ❑ Water Supply Watershed III (WS-III) —15A NCAC 213.0215 ❑ Water Supply Watershed IV (WS-IV) —15A NCAC 26 .0216 ❑ Freshwater High Quality Waters (HQW) —15A NCAC 2H .1006 ❑ Freshwater Outstanding Resource Waters (ORW) —15A NCAC 2H .1007 ❑ Neuse River Basin Nutrient Sensitive (NSW) Management Strategy —15A NCAC 2B .0235 ❑ Tar -Pamlico River Basin Nutrient Sensitive (NSW) Management Strategy-15A NCAC 2B .0258 ❑ Randleman Lake Water Supply Watershed Nutrient Management Strategy —15A NCAC 213.0251 ❑ Universal Stormwater Management Program —15A NCAC 2H .1020 Ordinance(s) (check all that apply): The permittee utilizes the following ordinances and/or regulatory authority to fulfill post construction minimum measure program requirements throughout the MS4 permitted area (check all that apply): ® DEQ model ordinance ❑ MS4 designed post -construction practices that meet or exceed 15A NCAC 02H .1000. ❑ DEQ approved comprehensive watershed plan ❑ DEQ approved ordinance for a deemed -compliant Program (see list above) Instructions: For MS4s not implementing a S.L. 2006-246 deemed -compliant program, complete only the Permit Citation section below. For MS4s implementing a S.L. 2006-246 deemed -compliant program, complete the Session Law 2006-246 section below. If the MS4 does not implement a deemed -compliant program throughout the entire MS4 permitted area, then complete the Permit Citatiori section below for the permitted area(s) not covered under the S.L. 2006-246 deemed -compliant program. NCS000518_Navassa MS4 Audit_20191209 Page 11 of 37 Post -Construction Site Runoff Controls Permit Citation Program Requirement Status supporting Doc No. II.F.2.a The permittee maintained an ordinance or other regulatory mechanism designed Legal Authority to meet the objectives of the Post -Construction Site Runoff Controls Stormwater Yes 4 Management Program. If yes, the ordinance applies throughout the jurisdictional area of the permittee. Yes 4 The permittee has the authority to review designs and proposals for new development and redevelopment to determine whether adequate stormwater Yes 4 control measures will be installed, implemented, and maintained. The permittee has the authority to request information such as Stormwater plans, inspection reports, monitoring results, and other information deemed necessary to evaluate compliance with the Post -Construction Stormwater Management Yes 4 Program. The permittee has the authority to enter private property for the purpose of inspecting at reasonable times any facilities, equipment, practices, or operations Yes 4 related to stormwater discharges. Comments The permittee's ordinance was adopted to meet the objectives of the post -construction program and applies throughout the jurisdictional area. The ordinance provides the appropriate authorities for plan review, permitting right of entry. The permittee has a verbal agreement with Right Angle Engineering to provide plan review services. II.F.2.b The permittee utilizes strategies which include a combination of structural and Stormwater Control non-structural SCMs. Yes 4 Measures (SCMs) If yes, SCM requirements are at least as stringent as 15A NCAC 02H .1000 by February 1, 2019. Yes 4 The permittee provides a mechanism to require longterm operation and maintenance of structural SCMs. Yes 4 The permittee requires annual inspection reports of permitted structural SCMs which are performed by a qualified professional. yes 4 Comments The ordinance provides for a combination of structural and non-structural BMPs in accordance with state requirements, requires long term operation and maintenance and submittal of annual SCM inspection reports to the Stormwater Administrator on or before February 1 of each year. The online permit application package includes a submittal checklist. Required operation and maintenance agreements are filed with plat approvals and are recorded on the plat. II.F.2.c The permittee conducted site plan reviews of all new development and Plan Reviews redeveloped sites that disturb greater than or equal to one acre (including sites that disturb less than one acre that are part of a larger common plan of Yes development or sale). If yes, the site plan reviews addressed how the project applicant meets the performance standards. Yes """ NCS000518_Navassa MS4 Audit_20191209 Page 12 of37 Post -Construction Site Runoff Controls If yes, the site plan reviews addressed how the project will ensure long-term maintenance. Yes --- Comments The permittee has only approved one project within the town's jurisdictional area. The project is new, so no annual report has been required to date. II.F.2.d The permittee maintained an Inventory of projects with post -construction Inventory of Projects structural stormwater control measures installed and implemented at new Partial development and redeveloped sites. The inventory included both public and private sector sites located within the permittee's corporate limits that are covered by its post -construction ordinance Not requirements. Applicable Comments The permittee has one permitted project and was familiar with the location of the project/devices. There was no written inventory. There are no municipal SCMs. A new public building is being planned with low density. II.F2.e Deed Restrictions The permittee provided mechanisms such as recorded deed restrictions and and Protective protective covenants that ensure development activities will maintain the project Yes 4,10 Covenants consistent with approved plans. Comments The permittee's ordinance requires recorded access easements and deed restrictions for post -development. II.F2.f The permittee implemented or required an inspection and maintenance plan for Mechanism to the long-term operation of the SCMs required by the program. Yes 4,10 Require Long-term Operation and The inspection and maintenance plan required the owner of each SCM to perform Maintenance and maintain a record of annual inspections of each SCM. Yes 4 Annual inspection of permitted structural SCMs are required to be performed by a qualified professional. Yes 4 Comments Annual inspections and maintenance are required to be performed per the approved plan, and inspections are required to be performed by a qualified professional. Annual reports are due to be submitted by February 1 of each year. II.F.2.e The permittee conducted and documented inspections of each project site covered Not Inspections of under performance standards, at least one time during the permit term. Applicable --- Structural Stormwater Control Before issuing a certificate of occupancy or temporary certificate of occupancy, the Measures permittee conducted post -construction inspections to verify that the permittee's P P P fY p Not --- performance standards have been met. Applicable The permittee documented and maintained records of inspection findings. Not Applicable NCS000518_Navassa MS4 Audit_20191209 Page 13 of37 Post -Construction Site Runoff Controls The permittee documented and maintained records of enforcement actions. Not"' Applicable Comments There is only one approved project within the permittee's jurisdictional area, the site is currently under development and no enforcement actions have been issued. The permittee conducts a final inspection prior to issuance of the certificate of occupancy. The permittee has an interlocal agreement with the Town of Leland to perform building inspections and hold COs pending a standard written authorization on the permittee's letterhead. II.F.2.h Educational The permittee made available through paper or electronic means, ordinances, Materials and post -construction requirements, design standards checklists, and other materials Yes --- Training for appropriate for developers. Developers Comments The permittee maintains relevant information on the web page, including application information and the stormwater ordinance. II.F.2.i Enforcement The permittee tracked the issuance of notices of violation and enforcement Not actions. Applicable ___ If yes, the tracking mechanism included the ability to identify chronic violators Not for initiation of actions to reduce noncompliance. Applicable --- Comments the permittee has not issued any enforcement actions to date. II.F.3.b The permittee fully complies with post construction program requirements on its Not New Development own publicly funded construction projects. Applicable Comments There are no municipal projects that have triggered post -construction requirements. However, any future projects would be permitted by DEQ. II.F3.c Does the MS4 have areas draining to Nutrient Sensitive Waters (NSW) pursuant to Nutrient Sensitive 15A NCAC 02H .0150? No --- Waters If yes, does the permittee use SCMs that reduce nutrient loading in order to Not meet local program requirements. Applicable If yes, does the permittee also still incorporate the stormwater controls Not required for the project's density level. Applicable --- If yes, does the permittee also require documentation where it is not feasible to Not use SCMs that reduce nutrient loading. Applicable -" NCS000518_Navassa MS4 Audit_20191209 Page 14 of 37 Post -Construction Site Runoff Controls Comments II.F.3.d The permittee ensured that the design volumes of SCMs take into account the Design Volume runoff at build out from all surfaces draining to the system. ves 4,10 Comments Additional Comments: NCS000518_Navassa MS4 Audit_20191209 Page 15 of 37 Pollution Prevention and Good Housekeeping for Municipal Operations Staff Interviewed: Barnes Sutton, Town Planner (Name, Title, Role) Permit Citation Program Requirement Status Supporting Doc No. II.G.2.a The permittee maintained a current inventory of facilities and operations owned Facility Inventories and operated by the permittee with the potential for generating polluted Partial --- stormwaterrunoff. The permittee maintained a current inventory of the MS4 system. No a The permittee maintained a current inventory of municipally -owned structural Not SCMS. Applicable Comments The permittee owns and operates a single public works complex, but does not own or operate any SCMS. The permittee was knowledgeable about the MS4, but did not maintain a written inventory. A GIS map of outfalis was provided. II.G.2.b The permittee maintained and implemented an I&M program for municipally Inspection and owned and operated facilities with the potential for generating polluted No -- Maintenance (I&M) stormwater runoff. for Municipal Facilities If yes, the 1&M program specifies the frequency of inspections. Not Applicable If yes, the I&M program specifies the frequency and routine maintenance Not requirements. Applicable --- Comments The permittee does not maintain a written inspection and maintenance program for the public works facility. The facility was reviewed and minor exposure items were discussed. II.G.2.c The permittee has written spill response procedures for municipally owned or Spill Response operated facilities. No --- Procedures Comments The permittee does not maintain written spill response procedures. NCS000518 Navassa MS4 Audit_20191209 Page 16 of 37 Pollution Prevention and Good Housekeeping for Municipal Operations II.G.2.d Streets, The permittee evaluated existing and new BMPs that reduce polluted stormwater Roads, and Public runoff from municipally -owned streets, roads, and public parking lots within its Partial --- Parking Lots corporate limits annually. Maintenance If yes, the permittee evaluated the effectiveness of existing and new BMPs based on cost and the estimated quantity of pollutants removed. Partial Comments The permittee performs litter pickup and conveyance maintenance as needed. The Town Council includes liaisons that direct staff work and response to complaints. There is no documented evaluation. II.G.2.e The permittee maintained and implemented an I&M program for the stormwater 1&M for Catch Basins and Conveyance sewer system including catch basins and conveyance systems that it owns and Partial Systems maintains. Comments The permittee performs MS4 maintenance as needed. The Town Council includes liaisons that direct staff work and response to complaints. There is no documented I&M program. II.G.2.f The permittee maintained a current inventory of municipally -owned or operated Structural structural stormwater controls installed for compliance with the permittee's post- Not Stormwater Controls construction ordinance. Applicable Comments The permittee does not own or operate any SCMs. II.G.2.x The permittee maintained and implemented an I&M program for municipally- I&M for Municipal owned or maintained structural stormwater controls installed for compliance with Not Structural the permittee's post -construction ordinance. If yes, then: Applicable Stormwater Controls The I&M program specified the frequency of inspections and routine Not maintenance requirements. Applicable "-- The permittee inspected all municipally -owned or maintained structural Not stormwater controls in accordance with the schedule developed by permittee. Applicable The permittee maintained all municipally -owned or maintained structural Not stormwater controls in accordance with the schedule developed by permittee. Applicable The permittee documented inspections of all municipally -owned or maintained Not structural stormwater controls. Applicable The permittee documented maintenance of all municipally -owned or Not maintained structural stormwater controls. Applicable Comments The permittee does not own or operate and SCMs. NCS000518_Navassa MS4 Audit_20191209 Page 17 of 37 Pollution Prevention and Good Housekeeping for Municipal Operations II.G.2.h The permittee ensured municipal employees are properly trained in pesticide, Pesticide, Herbicide herbicide and fertilizer application management. no and Fertilizer Application The permittee ensured contractors are properly trained in pesticide, herbicide and Management g fertilizer application management. yes --- The permittee ensured all permits, certifications, and other measures for applicators are followed. yes Comments The permittee has not had any certified applicators on staff since the one certified staff member retired in July. However, applicator work has been performed by the countys certified staff. There was no written contract for that work. II.G.2.1 The permittee implemented an employee training program for municipal Staff Training employees involved in implementing pollution prevention and good housekeeping Partial --- practices. Comments The Town Clerk and Administrative Assistance receive annual training on fats, oil and grease. II.G.2.1 The permittee described and implemented measures that prevent or minimize Vehicle and contamination of stormwater runoff from all areas used for vehicle and equipment yes --- Equipment Cleaning cleaning. Comments The permittee does not own/operate a vehicle washing facility and does not perform vehicle or equipment washing on site. All vehicles are taken to a commercial car wash. Additional Comments: NCS000518_Navassa MS4 Audit_20191209 Page 18 of 37 Site Visit Evaluation: Municipal Facility No. 1 Facility Name: Date and Time of Site Visit: Public Works Yard 12/09/19 Facility Address: Facility Type (Vehicle Maintenance, Landscaping, etc.): Public Works Yard Name of MS4 inspector(s) evaluated: Most Recent MS4 Inspection (List date and name of inspector): Barnes Sutton N/A Name(s) and Title(s) of Facility Representative(s) Present During the Site Visit: Name Title Barnes Sutton Town Planner Observations Facility Documentation/Training Does the facility have a Stormwater Pollution Prevention Plan (SWPPP) or similar document? Is it facility -specific? The facility is not subject to industrial stormwater permitting and does not have a SWPP or similar document. What type of stormwater training do facility employees receive? How often? Facility employees do not currently receive any stormwater training. Inspector Training/Knowledge What type of stormwater training does the MS4 inspector receive? How often? N/A Did the MS4 inspector appear knowledgeable about Permit requirements for pollution prevention and good housekeeping? The MS4 inspector was generally knowledgeable about stormwater pollution prevention. However, the permittee was not familiar with MS4 permit requirements and DEQ staff utilized the site visit to instruct the permittee. Did the MS4 inspector appear knowledgeable about stormwater pollution prevention and good housekeeping? The MS4 inspector was generally knowledgeable about stormwater pollution prevention and DEQ staff utilized the site visit to instruct the permittee. Inspection Procedures Does the MS4 inspector's process include the use of a checklist or other standardized form? No inspections are performed and there are no standard documents/templates. Does the MS4 inspector's process include taking photos? N/A Does the MS4 inspector's process include reviewing the facility's SWPPP (or similar document)? N/A NCS000518_Navassa MS4 Audit_20191209 Page 19 of 37 Site Visit Evaluation: Municipal Facility No. 1 Does the MS4 inspector's process include walking the entire facility and inspecting all points of discharge? N/A. The inspector was instructed of such. Did the MS4 inspector miss any obvious areas of concern? If so, explain: N/A. The instructor was instructed on performing and documenting a general inspection. Does the MS4 inspector's process include presenting the inspection findings to the facility contact? N/A Inspection Results Did the facility inspection result in any corrective actions to be implemented? If so, for what issue(s)? See below. If compliance corrective actions were identified, what timeline for correction/follow-up was provided? See below. Notes/Comments/Recommendations The inspection was performed by DEQ staff as an instructional opportunity. Minor exposure routes were noted, including open containers stored so that they collect stormwater, batteries stored outdoors, paint applicators outdoors, and checking for leaking vehicles/equipment. The permittee was instructed to remedy and document. NCS000518 Navassa MS4 Audit_20191209 Page 20 of 37 Site Visit Evaluation: MS4 Outfall No. 1 Outfall ID Number: Date and Time of Site Visit: 12/09/2019 Old Railroad Bed Outfall Location: Outfall Description (Pipe Material/Diameter, Culvert, etc.): RCP Old Railroad Bed Receiving Water: Is Flow Present? If So, Describe (Color, Approximate Flow Rate, Sheen, Odor, Floatables/Debris, etc.): None Most Recent Outfall Inspection/Screening (Date): N/A Days Since Last Rainfall: Inches: Name of M54 Inspector(s) evaluated: Barnes Sutton, Town Planner Observations Inspector Training/Knowledge What type of stormwater training does the MS4 inspector receive? How often? The inspector does not receive training specific to outfall inspections and illicit discharges. Did the MS4 inspector appear knowledgeable about illicit discharge indicators and investigations? The inspector was somewhat knowledgeable, but needs to be supported by standard documentation and tracking. Inspection Procedures Does the inspector's process include the use of a checklist or other standardized form? No Does the inspector's process include taking photos? No Did the MS4 inspector miss any obvious potential illicit discharge indicators or maintenance issues? If so, what were they? No NCS000518_Navassa MS4 Audit_20191209 Page 21 of 37 Site Visit Evaluation: MS4 Outfall No. 1 Inspection Results - Did the out fall inspe :ion result in any work orders or maintenance requests? If so, for what issue(s)? No Will a follow-up outfall inspection be conducted? If so, for what reason? No Notes/Comments/Recommendations The site was not very accessible and multiple sections of pipe had failed (likely from hurricane activity). No stormwater pollution evidence was observed other than the failed pipe sections in the stream. I NCS000518_Navassa MS4 Audit_20191209 Page 22 of 37 Site Visit Evaluation: MS4 Outfall No. 2 Outfall ID Number: Date and Time of Site Visit: 12/09/19 CSX Railroad Trestle Outfall Location: Outfall Description (Pipe Material/Diameter, Culvert, etc.): CSX Railroad Trestle Receiving Water: Is Flow Present? If So, Describe (Color, Approximate Flow Rate, Cape Fear River Sheen, Odor, Floatables/Debris, etc.): No flow and no visible indicators of stormwater pollution Most Recent Outfall Inspection/Screening (Date): N/A Days Since Last Rainfall: Inches: Name of MS4 Inspector(s): Barnes Sutton, Town Planner Observations Inspector Training/Knowledge What type of stormwater training does the MS4 inspector receive? How often? The inspector does not receive training specific to outfall inspections and illicit discharges. Did the MS4 inspector appear knowledgeable about illicit discharge indicators and investigations? The inspector was somewhat knowledgeable, but needs to be supported by standard documentation and tracking. Inspection Procedures Does the inspector's process include the use of a checklist or other standardized form? Obtain copy. No Does the inspector's process include taking photos? No Did the MS4 inspector miss any obvious potential illicit discharge indicators or maintenance issues? If so, what were they? No NCS000518_Navassa MS4 Audit_20191209 Page 23 of37 Site Visit Evaluation: MS4 Outfall No. 2 Inspection Results Did the outfall inspection result in any work orders or maintenance requests? If so, for what issue(s)? No Will a follow-up outfall inspection be conducted? If so, for what reason? No Notes/Comments/Recommendations The site was very accessible. No indicators of stormwater pollution were observed. NCS000518_Navassa MS4 Audit_20191209 Page 24 of 37 Site Visit Evaluation: Post -Construction Stormwater Control Measure No. 1 Site Name: Crete Solutions Date and Time of Site Visit: 12/09/19 at 1:00 pm Site Address: 9540 Seaboard Industrial Park Drive Lot 2 Seaboard Industrial Park Navassa, NC SCM Type: Wet Detention Most Recent MS4 Inspection (Include Date and Entity): N/A Name of M54 Inspector(s) evaluated: Barnes Sutton Most Recent MS4 Enforcement Activity (include Date): N/A Name(s) and Title(s) of Site Representative(s) Present During the Site Visit: Name Title Barnes Sutton Town Planner Observations Site Documentation Does the site have an operation and maintenance plan? None was available. Does the site have records of annual inspections? Are they performed by a qualified individual? The site has not yet been inspected. Inspector Training/Knowledge What type of stormwater training does the MS4 inspector receive? How often? None. Did the MS4 inspector appear knowledgeable about MS4 requirements for post -construction site runoff controls? The inspector was knowledgeable about the requirements. Did the MS4 inspector appear knowledgeable about post -construction BMPs (general purpose/function, components, 0&M requirements, etc.)? The inspector was familiar with some SCM function (not short circuiting), and was knowledgeable about device components. Inspection Procedures Does the MS4 inspector's process include the use of a checklist or other standardized form? What format? No Does the MS4 inspector's process include taking photos? No Does the MS4 inspector's process include reviewing the site's operation and maintenance plan and records of annual inspections? N/A. The devices were recently installed. NCS000518_Navassa MS4 Audit_20191209 Page 25 of 37 Site Visit Evaluation: Post -Construction Stormwater Control Measure No. 1 Does the MS4 inspector's process include walking the entire site and inspecting all points of discharge? No Did the MS4 inspector miss any obvious operation and maintenance deficiencies? If so, explain: N/A Does the MS4 inspector's process include presenting the inspection findings to the site contact in writing? N/A Compliance/Enforcement What, if any, enforcement actions (verbal warnings, NOV, etc.) did the inspection result in? None If compliance issues were identified, what timeline for correction/follow-up was provided? None Notes/Comments/Recommendations The site is currently under construction. Two wet detention basins are installed and appear to be functioning appropriately. Note was made that the design of one pond encourages short circuiting (inlet in close proximity to outlet) and future plan review/approvals should address short circuiting as a key design element. The site inspector should have training in SCM inspection, operation and maintenance and standard documentation/templates/forms are needed. NC5000518_Navassa MS4 Audit_20191209 Page 26 of 37 APPENDIX A: SUPPORTING DOCUMENTS NCS000518_Navassa MS4 Audit_20191209 Page 27 of37 Navassa Proposed Organizational Chart ':5a��.5 F.tlalal a Note: This is the proposed, long-range organizational structure. Currently, the Town Planner holds all stormwater program responsibilities. NCS000518_Navassa MS4 Audit_20191209 Page 28 of37 Navassa Stormwater Responsibilities Barnss S1ito raenPlaveerCss Stmmeate Adnnnis®tm and FmodpleiaM gI3 Sec.1-21 Fai wseatdemioa-mh®g eetitis (A) Smrmaater Admieis&a . (1) Des p.ti A Smssmcaar Ad� shall he desig.a by the Town Admi s . of Nivasa avd snallbesespenabbfmaodeoEasaiglMsosd'mevice. (a) Pmren and IAties. fn O C Toof ff NNrm m the powm anddos may h ravb¢saN by mler pmsisims of th ovmN..ade ai aliv=.mce; e� otl�e Ions, fie Stmmwawx aa� shdi haathefo➢oaingpadeas avdd order BasmAome a.Toreeiewmi appcme, appsosewhnaxmditiv m disapprme stomswaHImmallmsm plms pmsoam to this asdmaace. b.Tamaha dete®e aodrm xwpreb .ef arbor . ,-To esmbnsn pmmit appU.4.. gavemeffi and scled.ks for sut®W and man of smsmwwamam mm[pbm P-mt gvhw�aad%vft's d.Ta resiew and make secaa>mmda w. m U Ta of Ii.. Tom Corm➢ aad ph—i. Hoard a¢ medif>[a4m of dos msnvmce ar dp psocass for smmanx mmag�em eTe a me the pssrtdsioas of dsis omiomce m accmdaace vim ffi eoCmcmem pmwwass. C To maimain records, snips, fe¢ma and aeta O ind mmerials m rWm m tb sdaymq av�i.»m mfmcemeoi,a�admmis4adaa oftlds wdmaam. g.To PMIde eq mm am txhmcal asistance m de Toga Cm..L PLmdag Board, Lf W Opeaatims Board, oof h4cicaameomisad Sta®vat¢Ads¢wry Comoattce npaa rognest 1To de 4i appropriate ether Pmsaa(s) m .y m the pawns ad domes of Poe Stmmoatr Ad®laaemF. LTa�acRoasecessasymed�mrshepmmi oftnsmdioau'e S W u Iippard, Hjglt Awe Bn�eaieg (ss cavort and eng�g fvm m shier appliutlo¢s) Sec.1-ZZ Bevinr Procedves. (F) Beeler. VVt forq`B%v (45) t Ail — days affi a camptm appncdia¢ sum the Sms mm Atlosmis¢amr shop renew the appticad®aalde®ewbelher tlx semmra +mag�]ileape ggpcatlrmcovpnes ahn Wezmdmds aftlds asdimse (1) Apyrasa! Iftne Stmmxawr Adnomsttam fiadsdirt Ne spplindon complies seitn the ssaadmis of tors asdmamce, de 5[ormwatm Admrms¢ator stall appmse tlr app5�on avd isste a stomswarc maaa9emm perm[ (ApprmW tadn GseTniray. The Smsttmaov Admioimatao mry impose cwdinass of approsal ss aeaMd m e¢me complimce with dd; mdmaace. Tne c®ditlaus $eB be mcl¢drd as port vF the appsosa[ and inc5sded m the isxred smrmwaM pmmic (3) Diav"p Ifthe Smt— AdmiIDsatlorfordstM[thcmamwmrre.�....,.pj bdl w comply wire a amad.* of this oNia tle Smsmwmz Admivis®tor stall mGfy th applicant andshaB iod;r.a nvwthe appticed®mPlanhds m mmp3y The appticm mall lose m appmaauY m s� a reris ed apppvGo¢ aM p1a¢ NCS000518_Navassa MS4 Audit_20191209 Page 29 of 37 ePayment Statement E Cor 21 e I lr arvr-ur..'ov. :.. �cmrrtrhu.wWwv.. eenurvre sw:e,,:.. .. vcueu.xw.e. roam-tuxmi 8'-w+aaa w<v.ww u:r.<ne a-e., scwswo .rcu•. fl"er:-�..,.Mw. • The Construction General Pemit. To pay the permH fee for a Construction General Permit please use the link provided In Me email you received when your protect was accepted as complete. • permits Issued by other 0E0 programs. To pay permH fees for another program, please visit the DEC) eFa b gill and select the applicable p"Itting program. NCS000519 Water S .. ,.. , PWjgd,, Navassa - Small MU • Tmvn of Novel. E There were no unpaM permit annwt tee invoices found for the above permit number. (ali p you have any questions regarding an Nvplce. bNing. or the ePayment System. please contact either Susanne McCoy at 919.707-3640 or Annette Lucas at (919) 70h3630. C fJ ! i NCS000518_Navassa MS4 Audit_20191209 Page 30 of 37 Map 3-8 Stormwater and Water Quality Monitoring aG NCS000518_Navassa MS4 Audit_20191209 Page 31 of 37 q`/6 c �•Sv To " `ofN' ssa Storm ' atigr M Bement lvp' ' .c:.,d G �OFH. Public Reporting of Stormwater Illicit Discharges This form is used to report potential illicit discharge contamination of sto mwater in the Town of Navassa only. An illicit discharge is defined as "discharges not entirely composed ofstormwataet. If you suspect that an entity is illegally discharging to anything other than a stonnwater system, please speak with your local law enforcement. If you wish to report illegal discharge to stonnwater systems not in the Town of Navassa, please contact the local Stontwater Management Officer of the locality where the potential illicit discharge is occurring. If they do not have a local Stormwater Management Officer and are unable to provide a suitable contact, you may contact the North Carolina Department of Environment and Natal Resources. Please print and provide as much detail as possible. Use the back of this sheet if necessary. Please Return This Form To: Navassa Town Planner 334 Main St Navassa, NC 28451 Date: Name of Person/Compatry Completing this Report: Contact Information: Location of Potential Illicit Discharge: Type of Structure Receiving the Discharge: Description of discharge: ❑ Continued on Back Comments: ❑ Continued on Back For Office Use Only Have the adjacent outfills been recently inspected? oYeso No Date Is it industrial? o Yes oNo Is Project in an MS4 Designated Area? oyes oNo NC5000518_Navassa M54 Audit_20191209 Page 32 of37 Town of Navassa Planning and Zoning STORMWATER MANAGEMENT PERMIT APPLICATION FORM Thisform may hephofo pfedfor use as w original I. GENERAL INFORMATION 1. Applicants Name (specify the name of the corporation, individual, etc. who owns the project): 2. Not Owner/Signing Official's name and title (person legally responsible for the facility and compliance): 3. Mailing Address for person listed in item 2 above: City: State: Zip: Phone: Fax:(__.) 4. Project Name (subdivision, facility, or establishment name- should be consistent with project name on plans, specifications, letters, operation and maintenance agreements, etc.): S. Location ofProject (street address): City: Zip: 6. Directions to project (from nearest major intersection): 7. Latitude: _'_'_^ N Longitude: MW 8. Contact person who can answer questions about the project Name: Telephone Number: Email: II. PERMIT INFORMATION: L Specify whether the project is (check one): ❑New ❑Renewal ❑Modification 2. If this application is being submitted as the result of a r,umal or modification to an existing permit, list the existing permit number and its issue date (if known) 3. S ecify the type of project (check all that apply): ULow Density ❑High Density ❑Redevelopment ❑Residential ❑Commercial 4. Additional Project Requirements (check the applicable blanks; information oe required state permits can be obtained by contacting the customer service center at 1-877-623-6748): ❑CAMA Major ❑LAMA Minor ❑Sedimcm/Emsion Control ❑404/401 Permit ❑404 Certification ❑ NPDES Industrial Stomrwater Permit NC5000518_Navassa M54 Audit_20191209 Page 33 of 37 2 of 4 Updated t 1/1/2011 APPlicaaon print Ill. PROJECT INFORMATION 1. In the space below, summarize how smarnwater will be treated. Also attach a detailed narrative (one to two pages) describing the stonnwater management for this project. 2. Smrmwater runoff from this project drains to the River Basin, 3. Total Property Area: acres 4. Total Coastal Wetlands Area: acres 5. Total Property Area (3) — Total Coastal Wetlands Area (4) = Total Project Area**: acres 6. (Total Impervious Surface Arm/ Total Project) x 100 = Project Built Upon Area (BUA): */o 7. How many drainage areas does the project havev 8. 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 below. For High Density Projects, complete the table with one drainage area for each engineered smnnwater device. Basin Information Draina Area I Drainaite Area 2 Receiving Stream Name Stream Class and Index Number Total Drainage Area (at) On -site Drainage Area (s Off -site Drainage Area (s Existing Impervious* Area s Proposed Impervious* Area (st) % Impervious* Area(total Impervious* Surface Area Dmina a Area I Drainage Area 2 On -site Buildings s On -site Streets(sfl On -site Perkin s On -site Sidewalks Other On -site Off -site s Total sf): *Impervious area is dined as the built upon area including but not limited to buildings, roads, parkurg areas, sidewalk, gravel areas, etc. **Total Protect Area shall be calculated to exclude Coastal Wetlands from rise when calculating the built upon area percentage calculation. This is the area to calculate overall percent project built upon area (BUA). 9. How was the off -site impervious are listed above derived? NCS000518_Navassa MS4 Audit_20191209 Page 34 of37 3 of 4 Updated 11HI2011 ApPllcetlon PRM IV. DEED RESTRICTIONS AND PROTECTIVE COVENTANTS 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 very significantly or the proposed BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and protective covenants forms can be downloaded from http,,/oortal ncdem org/webiwa'wsfsu/statesw/forms dots. Download the latest versions for each submittal. In the instances where the applicant is different than the property owner, it is the responsibility of the property owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring that the deed restrictions are recorded. By signing this application, you certify that the recorded property restrictions and protective covenants far this project shall include all applicable items required in the above form, 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 Town of Navassa Stminwater Management Division, and that they will be recorded prior to the sale of any lot. V. SUPPLEMENT FORMS The applicable stormwater management permit supplemental form(s) listed below moat be Submitted for each BMP specified for this project. Contact the Town of Navassa Stormwater Management Division at (910)371-2432 for the status and availability of these forms. Forms can be downloaded from http•/fh2o.=.state.nc.us/su/bmt) forms btm Form SW401-Low Density Low Density Supplement Form SW401-Curb Outlet System Curb outlet System Supplement Form SW401-OffSite System Off -Site System Supplement Form SW401-Wet Detention Basin Wet Detention Basin Supplement Form SW401-Infiltration Basin Infiltration Basin Supplement Form SW401-Infiltration Trench Underground Infiltration Trench Supplement Form SW401-Bioretention Cell Bioretention Cell Supplement Form SW401-Level Spreader Level Spreader/Filter Strip/Restored Riparian Buffer Supplement Form SW401-Wetland Constructed Wetland Supplement Force SW401-Grassed Swale Grassed Swale Supplement Form SW401Sand Filter Sand Filter Supplement Form SW401-Permeable Pavement Permeable Pavement Supplement Form SW401-Cistern Cistern Supplement NCS000518_Navassa MS4 Audit_20191209 Page 35 of 37 4 of 4 Updated 11/l/2nt1 Applicator pant VI. SUBMITTAL REQUIREMENTS Only complete application packages will be accepted and reviewed by the Stormwater Management Division. A complete package includes all of the items listed below. The complete application package should be submitted to the Stormwater Management Division. 1. Please indicate that you have provided the following required information by initialing in the space provided next to each item. • Original and one copy of the Stormwater ManagementPermit Application Form Initials • Original and one copy of the Deed Restrictions & Protective Covenants Form (if required as per Part lV above) • Original of the applicable Supplement Form(s) and O&M agmement(s) for each BMP • Permit application processing fee (see Fee Schedule) Payable to the Town of Navassa • Calculations & detailed narrative description of stormwater treatment/management • Copy of any applicable soils report • Two copies of plans and specifications (sealed, signed & dated), including: - Development/Pmject name - Engineer and firm - Legend - North arrow - Scale - Revision number & date - Mean high water line - 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 sins, runoff calculations - Drainage areas delineated - Vegetated buffers (where required) • An electronic copy of all above mentioned forms, documents and plans VII. AGENT AUTHORIZATION If you wish to designate authority to another individual or firm so that they may provide information on your behalf (such as additional information requests), please complete this section. (ex. designing engineer or firm) Designated agent (individual or firth): Mailing Address: City. Phone:( 1 Email: VIII. APPLICANT'S CERTIFICATION Zip: Fax:(_ 1, (print or type name of person listed in General Information, item 2), 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 15A NCAC 211.1000. Signature: NCS000518 Navassa MS4 Audit_20191209 Page 36 of 37 11_Iry pal 'V' io To " `of Niiv sa Stonnw, tpr agement �sj\e " � i Public Comment Form For Stormwater Suggestions or Concerns This form is used to provide comments on stomrwater aspects of the design and/or construction pertaining to projects in the Town of Navassa only. If you wish to comment on anything other than stonewatef, please speak with the appropriate To" of Navassa staff person responsible for the project. If you wish to comment on the stamlwater aspects of project not being procured or performed in the Town of Navassa, please contact the local Stonnwater Management Officer of the entity that is responsible they do not have a local Stormwater Management Officer and are for the project, If unable to provide a suitable ible for you may contact the North Carolina Department OfEnvimament and Normal Resources for further assistance. Please print and provide as much detail as possible. Use the back of this sheet U necessary. Please Return This Form To: Navassa Town Planner 334 Main St Date: Navassa, NC 28451 / / Name of Person/Company Completing this Report. Contact Information: Title of Proiect: Description of Work Being ❑ Continued on Back Comments: ❑ Continued on Back Staff Notes Below, For Office Use Only: NCS000518_Navassa M54 Audit_20191209 Page 37 of 37