SW1100801_CURRENT PERMIT_20101025

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW
DOC TYPE
� CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
DOC DATE
YYYYMMDD

��*��
NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Mr. Greg Hining, President
UCB North Carolina Properties Inc.
10 Park Place East
Brevard, NC 28712
Division of Water Quality
Coleen H. Sullins
Director
September 20, 2010
Subject: Stormwater Permit No. SW1100801
United Community Bank
High Density Commercial Bio-Retention Project
Henderson County
Dear Mr. Hining:
Dee Freeman
Secretary
The Stormwater Permitting Unit received a complete Stormwater Management Permit Application for
United Community Bank on September 15, 2010. Staff review of the plans and specifications has
determined that the project, as proposed, will comply with the Stormwater Regulations set forth in Title 15A
NCAC 2H.1000 and Session Law 2006-246. We are forwarding Permit No. SW 1100801, dated September
20, 2010, for the construction, operation and maintenance of the subject project and the stormwater BMPs.
This permit shall be effective from the date of issuance until September 19, 2020, 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 inspection 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 Northi Carolina
General Statutes, and filed with the Office of Administrative Hearings, P.O. Drawer 27447, Raleigh, NC
27611-7447. Unless such demands are made this permit shall be final and binding.
This project will be Kept on file at the Asheville Regional Office. If you have any questions, or need
additional information concerning this matter, please contact Brian Lowther at [phone]; or
[e-mail].
Sincerely,
r
fifor oleen . Sullins
cc: Asheville Regional Office
Central Files
SPU Files
Wetlands and Slormwaler Brancn
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone. [phone] FAX [phone] Customer Service: 1-877-623-6748
Internet. www.iicwaterquaiity.org
An Equal Opportunity l Atfamalive Action Employer
y/yp,C�{it'iS".7'
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1l 0C 2 5 2010 j ,
L
3' VJATFER CUAUTY 5t-CTION
1;.. ASH-f VILLF i IHGICWA� O F1GE

State Stormwater Permit
Permit No. SW1100801
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL. RESOURCES
STATE
DIVISION OF WATER QUALIT4." f ]'
f : OCT 2 5 2010
STORMWATER MANAGEMENT PERMIT----
i,. vrrlTR QUALITY SECTIONASHzVUE REGIONAL Y
c 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
UCB North Carolina Properties Inc.
United Community Bank
Etowah Town Square, Etowa, NC and Henderson County
FOR THE
construction, operation and maintenance of a bioretention cell in compliance with the
provisions of Session Law 2006-246 and 15A NCAC 2H .1000 (hereafter referred to as
the "stormwater rules') and the approved stormwater management plans and
specifications and other supporting data as attached and on file with and approved by
the Division of Water Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until September 19, 2020, and
shall be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
1. This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. This stormwater system has been approved for the management of stormwater
runoff as described in Section 1.7 on page 3 of this permit. The stormwater
control has been designed to handle the runoff from 36,799 square feet of
impervious area.
3. The tract will be limited to the amount of built -upon area as indicated in Section
1.7 of this permit, and per the application documents and as shown on the
approved plans. The built -upon area for the future development is limited to
36,799 square feet.
4. All stormwater collection and treatment systems must be located in either
dedicated common areas or recorded easements. The final plats for the project
will be recorded showing all such required easements, in accordance with the
approved plans.
5. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
6. The built -upon areas associated with this project shall be located at least 30 feet
landward of all perennial and intermittent surface waters.
Page 1 of 6

State Stormwater Permit
r
Permit No. SW1100801
7. The following design criteria have been provided in the bioretention cell and must
be maintained at design condition:
a. Drainage Area, acres:
Onsite, ft :
Offsite, ft2:
b. Total Imperviou? Surfaces, ft2:
Onsite, ft :
Offsite, ft2:
C. Design Storm, inches:
d. Max. Ponded Depth, feet:
e. Seasonal High Water Table, fmsl:
f. Planting Media Depth, feet:
g. Cell Dimensions, feet:
h. Bottom Elevatiop, fmsl:
i. Surface Area, ft
j. Permitted Storage Volume, ft3:
k. Bypass / Storage Elevation, fmsl:
I. Predevelopment 1 year 24 hour-
M. Post development 1 year 24 hour:
n. Drawdown Time, hours:
o. Underdrain Diameter, inches:
p. Total number of plants provided:
q. Receiving Stream/River Basin:
r. Stream Index Number-
S. Classification of Water Body:
II. SCHEDULE OF COMPLIANCE
2.55
62,718
6,928
36,799
35,100
1,699
1.0"
12"
2094
2'
42' by 81'
2101.37
3,393
3,393
2105.7
0.07 cfs
0.14 cfs
36
6"
grassed cell
Gash Creek / French Broad
6-47
.,C„
1. The stormwater management system shall be constructed in its.entirety,
vegetated and operational for its intended use prior to the construction of any
built -upon surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The permittee shall at all time provide the operation and maintenance necessary
to assure the permitted stormwater system functions at optimum efficiency. The
approved Operation and Maintenance Plan must be followed in its entirety and
maintenance must occur at the scheduled intervals including, but not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and re -vegetation of slopes and the filter strip.
d. Immediate repair of eroded areas.
e. Maintenance of -all slopes in accordance with approved plans.
f. Debris removal and unclogging of all drainage structures, level spreader,
filter media, planting media, underdrains, catch basins and piping.
g. Access to the cell and outlet structure must be available at all times.
4. Records of maintenance activities must be kept for each permitted BMP. The
reports will indicate the date, activity, name of person performing the work and
what actions were taken.
5. The permittee shall submit to the Division of Water Quality an annual summary
report of the maintenance and inspection records for each BMP. The report
shall summarize the inspection dates, results of the inspections,• and the
maintenance work performed at each inspection..
Page 2 of 6

State Stormwater Permit
Permit No. SW1100801
6. The facilities shall be constructed as shown on the approved plans. This permit
shall become void unless the facilities are constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other
supporting data.
7. Upon completion of construction, prior to issuance of a Certificate of Occupancy,
and prior to operation of this permitted facility, a certification must be received
from an appropriate designer for the system installed certifying that the permitted
facility has been installed in accordance with this permit, the approved plans and
specifications, and other supporting documentation. Any deviations from the
approved plans and specifications must be noted on the Certification. A
modification may be required for those deviations.
8. If the stormwater system was used as an Erosion Control device, it must be
restored to design condition prior to operation as a stormwater treatment device,
and prior to occupancy of the facility.
9. Access to the stormwater facilities shall be maintained via appropriate recorded
easements at all times.
10. The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed
below:
a. Any revision to any item shown on the approved plans, including the
stormwater management measures, built -upon area, details, etc.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
e. Further subdivision, acquisition, lease or sale of all or part of the project
area. The project area is defined as all property owned by the permittee,
for which Sedimentation and Erosion Control Plan approval or a CAMA
Major permit was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
11. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
12. A copy of the approved plans and specifications shall be maintained on file by
the Permittee for a minimum of ten years from the date of the completion of
construction.
13. The Director may notify the permittee when the permitted site does not meet one
or more of the minimum requirements of the permit. Within the time frame
specified in the notice, the permittee shall submit a written time schedule to the
Director for modifying the site to meet minimum requirements. The permittee
shall provide copies of revised plans and certification in writing -to the Director
that the changes have been made.
I11. GENERAL CONDITIONS
This permit is not transferable except after notice to and approval by the Director.
In the event of a change of ownership, or a name change, the permittee must
submit a completed Name/Ownership Change form signed by both parties, to the
Division of Water Quality, accompanied by the supporting documentation as
listed on page 2 of the form. The approval of this request will be considered on
its merits and may or may not be approved.
Page 3 of 6

State Stormwater Permit
Permit No. SW1100801
2. The permittee is responsible for compliance with all permit conditions until such
time as the Division approves a request to transfer the permit.
3. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the Division of Water Quality, in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
4. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
5. In the event that the facilities fail to perform satisfactorily, including the creation
of nuisance conditions, the Permittee shall take immediate corrective action,
including those as may be required by this Division, such as the construction of
additional or replacement stormwater management systems.
6. The permittee grants DENR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
7. The permit issued shall continue in force and effect until revoked or terminated.
The permit may be modified, revoked and reissued or terminated for cause. The
filing of a request for a permit modification, revocation and re -issuance or
termination does not stay any permit condition.
8. Unless specified elsewhere, permanent seeding requirements for the stormwater
control must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
9. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
10. The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revoking and reissuing the permit, or terminating the permit
as allowed by the laws, rules and regulations contained in Session Law 2006-
246, Title 15A NCAC 2H.1000, and NCGS 143-215.1 et.al.
11. The permittee shall notify the Division in writing of any name, ownership or
mailing address changes at least 30 days prior to making such changes.
12. The permittee shall submit a renewal request with all required forms and
documentation at least 180 days prior to the expiration date of this permit.
Permit issued this the 20th day of September 2010.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
r �
fbr Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 4 of 6

State Stormwater Permit
Permit No. SW1100801
United Community Bank
Stormwater Permit No. SW1100801
Henderson County
Designer's Certification
I, , as a duly registered in the
State of North Carolina, having been authorized to observe (periodically/ weekly/
full time) the construction of the project,
(Project Name)
for (Project Owner) hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the project
construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
SEAL
Page 5of6

State Stormwater Permit ,
Permit No. SW 1100801
Certification Requirements:
1. The drainage area to the system contains approximately the permitted
acreage.
2. The drainage area to the system contains no more than the permitted
amount of built -upon area.
3. All the built -upon area associated with the project is graded such that the
runoff drains to the system.
4. All roof drains are located such that the runoff is directed into the system.
5. The outlet/bypass structure elevations are per the approved plan.
6. The outlet structure is located per the approved plans.
7. Trash rack is provided on the outlet/bypass structure.
8. All slopes are grassed with permanent vegetation, per the vegetation plan.
9. Vegetated slopes are no steeper than 3:1.
10. The inlets are located per the approved plans and do not cause short-
circuiting of the system.
11. The permitted amounts of surface area and/or volume have been
provided.
12. Required drawdown devices are correctly sized per the approved plans.
13. All required design depths are provided.
14. All required parts of the system are provided, such as a vegetated shelf,
and a forebay.
15. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Regional Office
Page 6 of 6

State Stormwater Permit
Permit No. SW 1100801
United Community Bank
Stormwater Permit No. SW1100801
Henderson Countv
Designer's Certification
6,,q, a- 'I
OAPG''1 4
C,Vt,f
as a duly registered pF�ssiA^r'��- ���a� in the
State of North Carolina, having been authorized to observe eriodicall 1 eekly/
full time) the construction of the project, '
(Project Name)
fory'G6
°ram" �'`�''�'""� �' (Project Owner) hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the project
construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from.approved plans and specification -
Signature
Registration Number 7-
Date (, / t 12,011
�tibetv�a�r,�,rUr
Yt
V�• ., t i xI -,ti
SEAirA)
�IdtklVl�''
u JUN 1 4 2011 ! ,/
r
JUN 2 2011
c
Page 5 of 6

State Stormwater Permit
Permit No. SW 1100801
Certification Requirements:
�1. The drainage area to the system contains approximately the permitted
acreage.
/
2.
The drainage area to the system contains no more than the permitted
amount of built -upon area.
✓
3.
All the built -upon area associated with the project is graded such that the
runoff drains to the system.
4.
All roof drains are located such that the runoff is directed into the system.
5.
The outlet/bypass structure elevations are per the approved plan.
✓
6.
The outlet structure is located per the approved plans.
✓
7.
Trash rack is provided on the outlet/bypass structure.
8.
All slopes are grassed with permanent vegetation, per the vegetation plan.
9.
Vegetated slopes are no steeper than 3:1.
✓
10.
The inlets are located per the approved plans and do not cause short-
circuiting of the system.
✓
The permitted amounts of surface area and/or volume have been
_11.
provided.
12.
Required drawdown devices are correctly sized per the approved plans.
✓
13.
All required design depths are provided.
14.
All required parts of the system are provided, such as a vegetated shelf,
and a forebay.
✓
15.
The required system dimensions are provided per the approved plans.
cc:
NCDENR-DWQ Regional Office
�,1 142011
�•j JUN j
-.._. ,
Page 6 of 6

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A7jA,
NCDENR
North Carolina Department of Environment and Natura
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
October 18, 2011
Greg Hining
UCB North Carolina Properties, Inc.
10 Park Place East
Brevard, NC 28712
SUBJECT: NPDES Stormwater Permit Compliance Inspection
United Community Bank - Etowah
Permit No: SWI100801
Henderson County
Resources
E'NLE CO-Y
Dee Freeman
Secretary
Dear Mr. Hining:
This letter is in follow-up to the NPDES Stormwater Permit Compliance Inspection conducted on
October 6, 2011. The facility was found to be in compliance with permit SW 1100801,
Enclosed is a copy of the Compliance Inspection Report, which contains additional observations
and comments for your reference.
Please contact me at [phone] or Susan.A.Wilson a,ncdenr. ov, if I can be of any further
assistance.
Sincerely,
Au �anl. Wilson, Environmental Engineer
Surface Water Protection
Enclosure
cc: Henderson County Planning, Tim Fox (e-copy) '/
G. Thomas Jones 111, P.E., William G. Lapsley & Associates, P.A. (wllnspection Report)
Asheville Files
S:ISWP1HcndersonlStorrnwaterl5-State StormwatCAUCB F.1owah\CEI,Lt1r.UCB 1:towah.10201 I.doc
Location: 2090 U.S. Highway 70, Swannanoa, North Carolina 28778
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
An Equal Opportunity � Affffinnalive Action Employer
One
NOI-thCarolina
Naturally

Compliance Inspection Report
Permit: SW1100801 Effective: 09/20/10 Expiration: 09/19/20 Owner: Ucb North Carolina Properties Inc
Project: United Community Bank
County: Henderson Etowah Town Sq
Region: Asheville
Contact Person: Greg Hiring Title:
Directions to Project:
Type of Project: State Stormwater - HD - Other
Drain Areas: 001 - (Gash Creek) (04-03-02) ( C)
On -Site Representative(s):
Related Permits:
Inspection Date: 1011312011 Entry Time: 03:44 PM
Primary Inspector: Susan A Wilson
Secondary Inspector(s):
Reason for Inspection: Routine
Permit Inspection Type: State Stormwater
Facility Status: ■ Compliant ❑ Not Compliant
Question Areas:
■ State Stormwater
(See attachment summary)
Etowah NC 28729
Phone:
Exit Time: 04:15 PM
Phone: [phone]
Inspection Type: Compliance Evaluation
Page: 1

Permit: 5W1100801 Owner - Project: Ucb North Carolina Properties Inc
Inspection Date: 10/13/2011 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Susan Wilson (AROIDWQ) and Tim Fox (Henderson County) performed a site inspection at UCB- Etowah. This site is
newly completed. The site is well graded, with all diversions going to the stormwater BMP.
The bioretention basin has good grass growth. The outlet and bypass lead to a rock lined scour pool, which has some
sediment in it (and should be periodically cleaned out).
There are no adverse impacts to surface waters from this system.
Page: 2

Permit: SW1100801 Owner • Project: Ucb North Carolina Properties Inc
Inspection Date: 10/1312011 inspection Type: Compliance Evaluation
Reason for Visit: Routine
File Review
Yes
No NA
NE
Is the permit active?
■
❑ ❑
❑
Signed copy of the Engineer's certification is in the file?
■
❑ ❑
❑
Signed copy of the Operation & Maintenance Agreement is in the file?
■
❑ ❑
❑
Copy of the recorded deed restrictions is in the file?
❑
❑ ❑
■
Comment:
Built Upon Area Yes No NA NE
Is the site BUA constructed as per the permit and approval plans? 011013
Is the drainage area as per the permit and approved plans? ■ ❑ ❑ ❑
Is the BUA (as permitted) graded such that the runoff drains to the system? ■ ❑ ❑ ❑
Comment: BUA area appears to match plans (from visual inspection)
CIA! RA........- Ync Nn NA NF
Are the SW measures constructed as per the approved plans? ■ ❑ ❑ ❑
Are the inlets located per the approved plans? ■ ❑ ❑ ❑
Are the outlet structures located per the approved plans? ■ ❑ ❑ ❑
Comment:
Operation and Maintenance Yes No NA NE
Are the SW measures being maintained and operated as per the permit requirements? ■ ❑ ❑ ❑
Are the SW i3MP inspection and maintenance records complete and available for review or provided to DWQ ❑ ❑ ❑ ■
upon request?
Comment: This site is very new - not in need of much maitenance at this time.
Other Permit Conditions Yes No NA NE
Is the site compliant with other conditions of the permit?
Comment:
Other WQ Issues
Is the site compliant with other water quality issues as noted during the inspection?
Comment:
■ ❑ ❑ ❑
Yes No NA NE
■ ❑ ❑ ❑
Page: 3

i\
NCDENR.,� ,
North Carolina Department of Environment and Natural Resources
Division of Water oualiky
Beverly Eaves Perdue Coleen H. -Sullins I I - (�_ i : Dee Freeman
Governor Director r I ; �-'� `— ' I Secretary
II �
August, 2010 k I' AUG 5 2010
Mr. G. Thomas Jones III, PE
William G. Lapsley & Associates, P.A.
Onc down Square Blvd,
Suite 320
Asheville, North Carolina 28803
Dear Mr. Jones:
w17-Y SECTION
Subject: Request for Additional Information
Stormwater Project No, SW1100801
United Community Bank
Henderson County
The Division of Water Quality Central Office received a Stormwater Management Permit Application for the
subject, project on August 9, 2010. A preliminary review of that information has determined that the application
is not complete. The following information is needed to continue the stormwater review:
1. The post -development 1-yr, 24-hr peak flew on the bioretention cell supplement appears incorrect.
Please revise without routing through the proposed BMP and include the calculations in the project's
stormwater calculations section.
2. Please provide the following items that were not included from the Required Item Checklist on the
Bioretention Cell Supplement Form: recorded drainage easement and public right of way,
boundaries of drainage easement, cell dimensions and indicate the P-Index between 10 and 30.
3. Considering adding notes to C-200 to emphasize that (1) in -situ soils must not be compacted by
equipment, and (2) the bottom of the cell should be scarified prior to cell material installation to
promote infiltration.
The requested information should be received by this Office prior to September 2, 2010, or the application will
be returned as incomplete. The return of a project will necessitate resubmittal of all required items, including
the application fee. If you need additional time to submit the information, please send your request, including
date by which you expect to submit the required information, to my attention. The Division is allowed 90 days
from the receipt of a completed application to issue the „permit.
Please reference the State assigned project numbv 'on all correspondence. New original documents must be
provided and copies are not acceptable. If you have any questions concerning this matter feel free to contact
me at [phone] or brian.lowther(ancdenr.gov.
Sincerely,
;Kl- zw"4_�
Brian Lowther
Environmental Engineer
cc: Asheville Regional Office
DWQ Central Files
Stormwater Permitting Unit Files
Wetlands and Slorrnwater Branch One
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 NortliCaroti na
Location: 512 N. Salisbury St, Raleigh, North Carolina 27604 / �7
Phone: [phone]FAX: 91"07-64941Customer Service: 1-677-323.6748 ii�7 t�iri lly
Internet: www.nmaterauality.orq

State Stormwater Inspection Report
General
Project Name: L _ ^ I
Permit No: SW
Expiration Date:
Contact Person:
Phone Number:
Inspection Type:
Inspection Date: I o ,t
Time in: '3 .
Time Out:
Current Weather: Sum
Recent Rain (Date)? lJo
Rain -- in
Location
Facility Address 1 Location:
City: Zip: County: Lac 0 4"N Long: - 0 "W
Permit Information
Rule Subject to (circle one): 1988 Coastal Rule 1995 Coastal Rule 2008 Coastal Rule Session Law 2006-246
Goose Creek High Quality Waters Outstanding Resource Waters
Density (circle one): I lig}3 D) Low (LD)
Stormwater Best Manage ractices (BMPs) (insert number of each). -
Wet Ponds Infiltration Basins Infiltration Trenches LD Swales Stormwater Wetlands
Dry Ponds toretention 6 ,4v Permeable Pavement Sand filters (circle one) Open Closed
Cistern erlh'ilter Strip Other (specify):
File Review Yes No NIA NIE
1. Is the eermit active?
2. Signed Engineer's Certification on file?
3. Signed Operation and Maintenance agreement on file? C, fj t
✓
4. Recorded Deed Restrictions on file?
Sits Visit-. guilt Unnn Area MUM Yes .No NIA NIF
5. BUA is constructed and consistent with the permit requirements?
6. BUA aspermitted) is graded such that the runoff drains to the system? (high densit .onl
7: Drainage area is consistent withpermit? i.e. no un ermitted drainage to the SW BMPs)
8. Drainage area is stabilized? to reduce risk of sedimentation to the SW BMPs a p_
u�r
Site Visit: Stormwater BMPs Yes No NIA NIF
9. Stormwater 13MPs are located per the approved fans?
10, Stormwater BMPs have dimensions e , len th, width, area) matching the approvedplans? Sp
11, Stormwater BMPs are constructedper the approvedplans?
Site Visit: Operation and Maintenance Yes No NIA NIE
12. Access points to the site are clear and well maintained?
>,
13. Trash has been removed as needed?
J
14. Excessive landscape debris (grass clippings, leaves, etc) is controlled?
15. Stormwater BMPs bein a operated and maintained as per the permit requirements?
16. Inspection and Maintenance records are available for inspection? (hi �h density only, 1995 — present only)
Site Visit: Other Permit Conditions Ye No NIA NIE
17, Is the site compliant with other conditions of thepermit?
Site Visit: Other Water Qualitv Issues Yes No NIA NIE
1 18. Is the site compliant with other',water quality issues as noted during, the inspection? I `11
State Stormwater Inspection Report, Version 3.0 Page 1 01,2

State Stormwater Inspection Report
fh PAcl� a�Y
welvyl) `i
of the pictures taken during the site
Compliance Status ❑ Compliant ❑ Non -Compliant
Letter Sent {circle one}: Yes No Letter type: CEI NOV NOVRE Other
Date Sent: Reference Number:
Inspector Name and Signature:
sum �tp ULGO�-
cam,-pr���
Date:
Qop �{.Y,rr • (kla-
� trr Cr
qoo> (J(o Iu
State Stormwater Inspeclion Report, Version 3.0 Pape 2 of 2

State Stormwater Inspection Report
General
Project Name;
Permit No: SW
Expiration Date:
Contact Person:
Phone Number:
Inspection 'Type:
Inspection Date:
Time In:
Time Out:
Current Weather:
Recent Rain (Date)?
Rain - in
Location
Facility Address / Location:
City:
Zip:
County:
Lat: "N
Long: - "W
Permit Information
Rule Subject to (circle one): 1988 Coastal Rule 1995 Coastal Rule 2008 Coastal Rule Session Law 2006-246
Goose Creek High Quality Waters Outstanding Resource Waters
Density (circle one): High (HD) Low (LD)
Stormwater Best Management Practices (BMPs) (inserl number of each):
Wet Ponds Infiltration Basins Infiltration Trenches LD Swales Stormwater Wetlands
Dry Ponds Bioretention Permeable Pavement Sand filters (circle one) Open Closed
Cistern Level Spreader/Filter Strip Other (specify):
File Review
Yes No NIA NIE
1. Is the permit active?
2. Signed Engineer's Certification on file?
3. Signed Operation and Maintenance agreement on file'?
4. Recorded Deed Restrictions on file?
Site Visit- Ftuilt tfnnn Area IR W
Yes Kin NIA NIF
5. BUA is constructed and consistent with the permit requirements?
6. BUA aspermitted) is graded such that the runoff drains to the system? (high density only)
7. Drainage area is consistent withpermit? i.e. no un ermitted drainage to the SW BMPs
8. Drainage area is stabilized? to reduce risk of sedimentation to the SW BMPs
Site Visit: Stormwater BMPs
9. Stormwater BMPs are located per the approvedplans?
10. Stormwater BMPs have dimensions e . length, width, area) matchin the approvedplans?
11. Stormwater BMPs are constructed per the approvedplans?
Site Visit: Operation and Maintenance
Yes No NIA NIE
12. Access points to the site are clear and well maintained?
13. Trash has been removed as needed?
14. Excessive landscape debris (grass clippings, leaves, etc) is controlled?
15. Stormwater BMPs being operated and maintained as per thepen-nit requirements?
16, Inspection and Maintenance records are available for inspection? (high density only, 1995 — present only)
Site Visit: Other Permit Conditions Yes No NIA NIE
17. Is the site compliant with other conditions of thepermit?
Site Visit: Other Water Quality Issues Yes No NIA NIE
18. Is the site compliant with other water quality issues as noted during the inspection?
Stale Stornmaler Inspection Report, Version 3.0 Page 1 01'2

State Stormwater Inspection Report
InS ection Pictures (some of the pictures taken during the site visit)
Compliance Status Cl Compliant D Non -Compliant
Letter Sent (circle one): Yes No Letter type: CEI NOV NOVRE Other
Date Sent: Reference Number:
Inspector Name and Signature:
d
Date:
State Sformwater Inspection Report, Version 3.0 Page 2 or2

r
D WQ USE•'ONLY: .
Date Received Fee Paid Permit Number
Applicable Rules: ❑ Coastal SW —1995 ❑ Coastal SW — 2008 ❑ Ph 11- Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M t Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original
I. GENERAL INFORMATION
1. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
_United Community Bank _
2. Location of Project (street address):
Etowah Town Square
City: Etowah _ County: Henderson Zip: 28729
3. Directions to project (from nearest major intersection):
From Hendersonville, follow 64 west to Etowah (8 miles), projet will be -the first drive past Brickyard Road
(SR 1424)_on the right
4. Latitude:35° 19' 5" N Longitude:82° 35' 51" W of the main entrance to the project.
1I. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number , its issue date (if known)_ , and the status of
construction: []Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ®High Density []Drains to an Offsite Stormwater System ❑Other
3. If this application is being submitted as the result of a previously returned application or a letter from DWQ
requesting a state stormwater management permit application, list the stormwater project number, if
assigned, and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major ®Sedimentation/Erosion Control: ac of Disturbed Area
❑NPDES Industrial Stormwater ❑404/401 Permit: Proposed Impacts
b.If any of these perrnits have already been acquired please provide"the"Project Name Project/Permit Number,
issue date and the type of each permit: County Erosion Conrol Permit
Form SWU-101 Version 07Jun2010
i 'ILI OCT 2 5 2010 ,
A
Page 1 of 6 WATER (.!!_At.1T`(
r
a

III. CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicant/Organization: UCE North Carolina Prol2erties Inc.
Signing Official &Title: Greg Hining, President
b.Contact information for person listed in item 1a above:
Street Address: 10 Park Place East
City: Brevard State: NC Zip: 28712
Mailing Address (if applicable). -
City: State: Zip:
Phone. ( } Fax: ( L
Email: greg hinine:@ucbi.com
c. Please check the appropriate box. The applicant listed above is:
® The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Owner/Organization:
Signing Official & Title:
b. Contact information for person listed in item 2a above:
Street Address:
City:
Mailing Address (if appl
City:
Phone: f }
Email:
State: Zip:
State: Zip:
Fax:
3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other
person who can answer questions about the project:
Other Contact Person/Organization:
Signing Official &
b. Contact information for person listed in item 3a above:
Mailing Address:0
City: State: NC Zip: 28803
Phone: ( )
Email:
Fax: (
4. Local jurisdiction for building permits: Henderson County _
Point of Contact: Tom Staufer Phone #: (828 �} 697-48P
Form 5WU-101 Version 073un2010 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Stormwater from the the rgposed building and parking areas will be directed to a proposed bioretention
area.
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUDApproval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW —1995 ❑ Ph II — Post Construction
3. Stormwater runoff from this project drains to the French Broad River basin.
4. Total Property Area: 2.55 acres
5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
7. Total Property Area (4) — Total Coastal Wetlands Area (5) — Total Surface Water Area (6) = Total Project Area*:
2.55 acres
Total project area shall be calculated to exclude the followin . the normal pool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NHW) Iine or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW for MHW) line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal wetlands landward of the NNW (or MHW) line may be
included in the total project area.
8. Project percent of impervious area: (Total impervious Area / Total Project Area) X 100 =
9. How many drainage areas does the project have? 1 (For high density, count 1 for each proposed engineered
stormwater BMP. For low density and other projects, use 1 for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
Basm Iriforrnafion
Drama eArea 1
?Diaina "e`.Area'_
.Daina' e Area _.
;Drairia" a P:rea
Receiving Stream Name
Gash Creek
Stream Class *
C
Stream Index Number *
6-47
Total Drainage Area (so
69,646
On -site Drainage Area (sf)
62,718
Off -site Drainage Area (sf)
6,928
Proposed Impervious Area** (so
36,799
% Impervious Area"* (total)
52.8
Irri ervious" Surface Area
Drains- e Area:
Drains e Area s
Drains e Area,;_,
. Drains e Area':_
On -site Buildings/Lots (so
5,016
On -site Streets (sf)
0
On -site Parking (so
28,986
On -site Sidewalks (so
1,098
Other on -site (so
0
Future (sf)
0
Off -site (sf)
1,699
Existing BUA*** (sf)
0
Total (so:
36,799
* Stream Class and Index Number can be determined at: htt�//Aortal.ncdenr.org/rveb/inq[ps/csu/classifications
** lm ervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SWU-101 Version 07.1un2010 Page 3 of 6

'Report only that amount of existing BUA that will remain after development. Do not report any existing BUA that is
to be removed and which will be replaced by new BUA.
11. How was the off -site impervious area listed above determined? Provide documentation. Off -site impervious
area listed above is prolosed - shown as part of shared drive to be constructed_ as part of project.
Projects in Union County: Contact DWQ Central Office staff to check if the project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from httrr//vortalmcdennore/web/wa/ws/su/b=-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items Iisted below. A detailed application instruction sheet and BMP
checklists are available from h ortal.ncdenr.or web w ws su statesw forms does. The complete
application package should be submitted to the appropriate DWQ Office. (The appropriate office may be
found by locating project on the interactive online map atht!p: /yortaLncdennorg(web/wq/ws/su/maps.)
Please indicate that the following required information have been provided by initiating in the space provided
for each item- All original documents MUST be signed and initialed in blue ink. Download the latest versions
for each submitted application package from http://12ortal.ncdenr.org/web/wq/ws/su/statesw/forms does.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (seated signed and dated) and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
http:/_/www.envhel12.org/12ages/onestol2exl2ress.html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/management for
the project. This is required in addition to the brief summary provided in the Project
Information, item 1.
b. A USGS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within 1h mile of the site boundary, include the'k
mile radius on the neap.
7. Sealed, signed and dated calculations.
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
in. WetIands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
Form SWU401 Version 077un2010 Page 4 of 6
%S�

o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify^
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"x11" copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DWQ to verb the SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 1'4 2 5 Page No: 1141 193
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item 1a, 2a, and/or 3a per NCAC 2H.1003(e). The
corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
http://www.secretary.state.nc,us/CoLRorations/CSearch.aspx
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from
httpl112ortal.ncdenr.org/web/wq/ws/su/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 the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DWQ, and that they will be recorded prior to the sale of any lot.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting Engineer: G. Thomas ]ones III, PE
Consulting Firm: William G. Lapsley & Associates, P.A.
Mailing Address: One Town Square Blvd, Suite 320
City: Asheville State: NC Zip: 28803
Phone: (828 ) 687-7177 ext. 303 Fax: (828 _) 687-7178 _T
Email:_ [e-mail]
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or type name of person listed in Contact Information, item 2a) certify that I
own the property identified in this permit application, and thus give permission to (print or type name of person
Iisted in Contact Information, item 1a) with (print or type name of organization fisted in
Contact Information, item Ia) to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the stormwater system.
Form SWU-101 Version 077un20]0 Page 5 of 6

As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
lease agreement, or pending sale, responsibility for compliance with the DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ immediately and submit a
completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater treatment
facility without a valid permit. I understand that the operation of a stormwater treatment facility without a valid
permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
I, . a Notary Public for the State of _ , County of
do hereby certify that
personally appeared
before me this — day of and acknowledge the due execution of the application for a
stormwater permit. Witness my hand and official seal,
SEAL
My commission expires
X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact Information, item Ia) G,941tV'DF-(rQ
certifythat the information included on this permit application form i the bes f m knowledge, correct and
s p t aPp Y g� L
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable ormwa e under 15A NCAC 2H .1000, SL 2006-246 (Ph. II —Post Construction) or SL 2008-211.
Si naftire: I I Date: -1/1C, of o
1, _ / a N
a _I I A'1� zi
K 114-F -1- L11 vzuyn o here by� certify that
before me this "I day of
Public for the State of rv=ounty of
stormwater permit. Witness my hand and official seal,
SEAL
My commission expires
personally appeared
ledge P9 due execution of the application for a
Form SWU-101 Version 07Jun2010 Page 6 of 6

Permit Number:
(to be provided by DWO)
()F %NA7fq
Ot:r
HCDENR a Y
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FOAM
BIORETENTION CELL SUPPLEMENT
This form must be filled out, printed and submitted,
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
I: PROJECT INFORMATION • . ' k- {� � � � ' � f � m`��'� t � � r f � r *� Ma : � r „ � �.� ��r t � �.� t�
Project name United Community Bank Etowah
Contact name
Phone number
Date 7/1412010 Revised 911312010
Drainage area number 1 (One)
II DESIGN INFORMATION, ; i : ' `'' ",r�
S Y 'Y . r l Sr_ .r i l tit',
Site Characteristics
Drainage area 69,646 it
Impervious area 36,799 it
Percent impervious 52-8% %
.i
Design rainfall depth 1.0 inch
Peak Flow Calculations
Is prelpost control of the 1-yr, 24-hr peak flow required?
1-yr, 24-hr runoff depth
1-yr, 24-hr intensity
Pre -development 1-yr, 24-hr peak flow
Post -development 1-yr, 24-hr peak flow
Pre/Post 1-yr, 24-hr peak control
Storage Volume: Non -SA Waters
Minimum volume required
Volume provided
Storage Volume: SA Waters
1.5" runoff volume
Pre -development 1-yr, 24-hr runoff
Post -development 1-yr, 24-hr runoff
Minimum volume required
Volume provided
Cell Dimensions
Ponding depth of water
Ponding depth of water
Surface area of the top of the bioretention cell
Length:
Width:
-or- Radius
Y (Y or N)
In
0.14 inlhr
0,070 it3lsec
0,140 it3lsec
0,070 fl3lsec
3,061.0 Ila
3,393.0 it
113
It
_ it
0 it
_it3
12 inches
1.00 it
3.393.0 it2
42 it
81 it
It
.s
I
�..r...w-r..�.-..,�wJ'..rw14}.:�i....fw.cl...�...-r.1...�..� -.. . .4-�.a . ..-..
OK
OK
OK
OK
OK
Form SW401-Biwetenlion-Rev.8
June 25, 2010 Parts I and If. Design Summary. Page 1 of 3

Permit Number:
(to be provided by DWO)
Media and Soils Summary
Drawdown time, ponded volume
Drawdown time, to 24 inches below surface
Drawdown time, total:
In -situ soil:
Soil permeability
Planting media soil:
Soil permeability
Soil composition
% Sand (by volume)
Fines (by volume)
% Organic (by volume)
Phosphorus Index (P-Index) of media
Basin Elevations
Temporary pool elevation
Type of bioreiention cell (answer "Y" to only one of the Iwo
following questions):
Is this a grassed cell?
Is this a cell with treestshrubs?
Planting elevation (top of the mulch or grass sod layer)
Depth of mulch
Bottom of the planting media soil
Planting media depth
Depth of washed sand below planting media soil
Are underdrains being installed?
12 hr OK
24 hr OK
36 hr
0.01 in/hr Insufficient. Increase infiltration rate or include underdrains.
1.00 in/hr OK
85% OK
10% OK
5% OK
Total: 100%
20 (unitless) OK
2105.70 fmsl
Y (Y or N) OK
N (Y or N)
2104.7 fmsl
0 inches Insufficient mulch depth, unless installing grassed cell.
2102.7 fmsl
2 It
0.33 It
Y (Y or N) .
How many clean out pipes are being installed?
14' 2. OK
`
What factor of safety is used for sizing the underdrains? (See
2 OK
BMP Manual Section 12.3.6)
Additional distance between the bottom of the planting media and
1 ft
the bottom of the cell to account for underdrains
Bottom of the cell required
2101.37 imsl
SHWT elevation
2094 fmsl
Distance from bottom to SHWT
7.37 It OK
Internal Water Storage Zone (IWS)
Does the design include IWS
N (Y or N)
Elevation of the top of the upturned elbow
fmsl
Separation of IWS and Surface
2104.7 It
Planting Plan
Number of tree species
0
Number of shrub species
Number of herbaceous groundcover species
Form SW401-13ioretention-Rev.8
June 25, 2010
Parts I and tl. Design Summary. Page 2 of 3

Permit Number:
(to be provided by DWO)
Additional Information
Does volume in excess of the design volume bypass the
bioretention cell?
Does volume in excess of the design volume flow evenly
distributed through a vegetated filter?
What is the length of the vegetated filter?
Does the design use a level spreader to evenly distribute flow?
4s the BMP located at least 30 feet from surface waters (50 feet if
SA waters)?
Is the BMP localed at least 100 feet from water supply wells?
Are the vegetated side slopes equal to or less than 3:1?
Is the BMP located in a proposed drainage easement with access
to a public Right of Way (ROW)?
Inlet velocity (from treatment system)
Is the area surrounding the cell Nety to undergo development in
the future?
Are the slopes draining to the bioretention cell greater than 20%?
Is the drainage area permanently stabilized?
Pretreatment Used
(Indicate Type Used with an "X" in the shaded cell)
Gravel and grass
(8`inches gravel followed by 3.5 it of grass)
Grassed swale
Forebay
Other
Y (Y or N) - OK
(Y or N)
it
(Y or N)
Y (Y or N) OK
Y (Y or N) OK
Y (Y or N) OK
(Y or N)
3.5 fUsec Insufficient inlet velocity unless energy dissipating devices are
being used.
N (Y or N) OK
N (Y or N) OK
Y (Y or N) OK
X
Me"
`j III f to
Form SW401-&oretention-Rev. 8
June 25, 2010 Parts I and II. Design Summary, Page 3 of 3

Permit Number:
(to be provided by DWQ)
Drainage Area Number:
Bioretention Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important operation and maintenance procedures:
— Immediately after the bioretention cell is established, the plants will be watered
twice weekly if needed until the plants become established (commonly six
weeks).
— Snow, mulch or any other material will NEVER be piled on the surface of the
bioretention cell.
Heavy equipment will NEVER be driven over the bioretention cell.
Special care will be taken to prevent sediment from entering the bioretention cell.
Once a year, a soil test of the soil media will be conducted.
After the bioretention cell is established, I will inspect it once a month and within 24
hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
PotentialEmblems:
How I will remediate the roblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
bioretention cell
erosive gullies have formed.
iemove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer apElication.
The inlet device: pipe,
The pipe is clogged (if
Unclog the pipe. Dispose of the
stone verge or swale
applicable).
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
''Erosion is occurring in the
Regrade the swale if necessary to
�t•
swale (if applicable).
smooth it over and provide erosion
wI [ 1
control devices such as reinforced
turf to
CI
f
matting or riprap avoid
future problems with erosion.
Stone verge is clogged or
Remove sediment and clogged
OCT 2 5 2010 ; +
covered in sediment (if
stone and replace with clean stone.
al licable).
QE
Y SECTION
' q ;l l Vi1.LENAL OFf--CE
i
xL`
Form SW401-Bioretention O&M-Rev.3
Page I of 4

BMP element:
Potentialproblems-.
How I will remediate the iRroblerm
The pretreatment area
Flow is bypassing
Regrade if necessary to route all
pretreatment area and/or
flow to the pretreatment area.
gullies have formed.
Restabilize the area after grading.
Sediment has accumulated to
Search for the source of the
a depth greater than three
sediment and remedy the problem if
inches.
possible. Remove the sediment and
restabilize the pretreatment area.
Erosion has occurred.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand.
The bioretention cell:
Best professional practices
Prune according to best professional
vegetation
show that pruning is needed
practices.
to maintain optimal plant .
health.
Plants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Tree stakes/wires are present
Remove tree stake/wires (which
six months after planting.can
kill the tree if not removed).
The bioretention cell:
Mulch is breaking down or
Spot mulch if there are only random
soils and mulch
has floated away.
void areas. Replace whole mulch
layer if necessary. Remove the
remaining much and replace with
triple shredded hard wood mulch at
a maximum depth of three inches.
Soils and/or mulch are
Determine the extent of the clogging
clogged with sediment.
- remove and replace either just the
top layers or the entire media as
needed. Dispose of the spoil in an
appropriate off -site location. Use
triple shredded hard wood mulch at
a maximum depth of three inches.
Search for the source of the
sediment and remedy the problem if
possible.
An annual soil test shows that
Dolomitic lime shall be applied as
pH has dropped or heavy
recommended per the soil test and
metals have accumulated in
toxic soils shall be removed,
the soil media.
disposed of properly and replaced
with new plan!tg media.
Form SW401-Bioretention O&M-Rev.3 Page 2 Of 4

BMP element:
Potential roblems:
How I will remediate theproblem:
The underdrain system
Clogging has occurred.
Wash out the underdrain system,
(if applicable)
The drop inlet
Clogging has occurred.
Clean out the drop inlet. Dispose of
the sediment off -site.
The drop inlet is damaged
Repair or replace the drop inlet.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
outlet.
733-1786.
Form SW401-Bioretention O&M-Rev.3 Page 3 Of 4

Permit Number:
(to be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project name: United Community Bank Etowah
BMP drainage area number: 1 One
Print name: Greg Hining, UCB North Carolina Properties Inc.
Title: President
Address:_10 Park Place East,_ Brevard, NC 29712 _
Signature: I
Date: ! t4 t) a
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
a Notary Public for the State of
County of Y(CGZ_ GC, do hereby certify that
personally appeared before me this
day of and acknowledge the due execution of the
forgoing bioretention maintenance requirements. Witness my hand and official seal,
SEAL
j* SI, 2W
My commission expires
Form SW401-Bioretention I&M-Rev. 2 Page 4 of 4