SW3120701_CURRENT PERMIT_20121205

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

A
RECEIVED
; DIVISION OF WATER
QUALITY
NCDENR DEC 0 5 2012
North Carolina Department of Environment and Natural Resources
Division of Water Quality MOORESViLLI RE[= ONAL OFFICE
Beverly Eaves Perdue Charles Wakild, P. E. Dee Freeman
Governor
Director
November 2, 2012
Mr. William L. Allen
Midland -Durban Retail Investors, LLC
3735 Beam Rd., Ste. B
Charlotte, NC 28217
Subject: Stormwater Permit No. SW3120701 Modification
Tractor Supply - Midland, NC
High Density Commercial Sand Filter
Cabarrus County
Dear Mr. Allen:
Secretary
The Stormwater Permitting Unit received a complete Stormwater Management Permit Application to modify
Permit No. SW3120701 on October 31, 2012. Staff review of the plans and specifications has determined that
the project, as proposed, will comply with the Stormwater Regulations set forth in Title 15A NCAC 2H .1000
and Session Law 2006-246. We are forwarding modified Permit No. SW3120701, dated November 2, 2012, for
the construction, operation and maintenance of the subject project and the Stormwater BM Ps.
This permit shall be effective from the date of issuance until August 17, 2020 and shall be subject to the
conditions and limitations as specified therein, and does not supersede any other agency permit that may be
required. Please pay special attention to the conditions listed in this permit regarding the Operation and
Maintenance of the BMP(s), recordation of deed restrictions, procedures for changes of ownership,
transferring the permit, and renewing the permit. Failure to establish an adequate system for operation and
maintenance of the stormwater management system, to record deed restrictions, to follow the procedures for
transfer of the permit, or to renew the permit, will result in future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to
request an adjudicatory hearing by filing a written petition with the Office of Administrative Hearings (OAH).
The written petition must conform to Chapter 150E of the North Carolina General Statutes. Per NCGS 143-
21S(e) the petition must be filed with the OAH within thirty (30) days of receipt of this permit. You should
contact the OAH with all questions regarding the filing fee (if a filing fee is required) and/or the details of the
filing process at 6714 Mail Service Center, Raleigh, NC 27699-6714, or via telephone at 919-431-3000, or visit
their website at www.NCOAH.com. Unless such demands are made this permit shall be final and binding.
This project will be kept on file at the Mooresville Regional Office. If you have any questions, or need additional
information concerning this matter, please contact Robert Patterson at [phone]; or
[e-mail].
Sincerely,
for Charles Wakild, P.E., Director
Wetlands and Stormwater Branch
1617 Mail Service Cerrter, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone]
Internet: www.ncwallerquality.org
An Equal Opportunily 1 Airrrvative Action Employer
cc: 9W3120701 File'
cc: Mike Parker - Mooresville Regional Office
Carlton T. Burton, PE - Burton Engineering
Glenn Morris - Burton Engineering
Brian M. Wilson, PE - Town of Midland
NorthCarolina
;Vatundy
1 l

State Stormwater Permit
Permit No. SW3120701 MOD
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Midland -Durban Retail Investors, LLC
Tractor Supply
11855 US Hwy 601, Midland, Cabarrus County
FOR THE
construction, operation and maintenance of a sand filter in compliance with the provisions of
Session Law 2006-246 and 1SA 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 August 17, 2020, and shall be subject to
the following specified conditions and limitations:
L DESIGN STANDARDS
This permit is effective only with respect to the nature and volume of stormwater described
in the application and other supporting data.
This stormwater system has been approved for the management of stormwater runoff as
described in Section L7 of this permit. The stormwater control has been designed to handle
the runoff from 99,316 square feet of impervious area.
3. The tract will be limited to the amount of new built -upon area as indicated in Section 1.7 of
this permit, and per the application documents and as shown on the approved plans. Prior
to the construction of the future street extensions shown on the approved plans, this permit
must be modified.
4. All stormwater collection and treatment systems must be located in either dedicated
common areas or recorded easements. The final plats for the project will be recorded
showing all such required easements, in accordance with the approved plans.
The runoff from all built -upon area within the permitted drainage area of this project must
be directed into the permitted stormwater control system.
The built -upon areas associated with this project shall be located at least 30 feet landward of
all perennial and intermittent surface waters.
Page 1 of 6

State Stormwater Permit
Permit No. SW3120701 MOD
VA
The following design criteria have been provided in the sand filter and must be maintained
at design condition:
a. Drainage Area, acres:
Onsite, ft2:
Offsite, 112:
b. Total Impervious Surfaces, ftz:
Onsite, ft2:
Offsite, ftz:
C. Design Storm, inches:
d. Sediment Chamber Bottom Elev., fmsl
d. Top of Sand Elevation, fmsl:
e. Seasonal High Water Table, fmsl:
f. Sand Depth, feet:
h. Bottom of Sand Elevation, fmsl:
i. Sediment Chamber SA, ftz:
i. Sand Chamber SA, ft2:
j. Permitted Storage Volume, ft3:
k. Bypass / Storage Elevation, fmsl:
n. Drawdown Time, hours:
o. Underdrain Diameter, inches:
q. Receiving Stream/River Basin:
r. Stream Index Number:
S. Classification of Water Body:
1I. SCHEDULE OF COMPLIANCE
DA 2
2.1.4
93,218
0
60,548
60,548
0
1.0
504.0
504.0
below 502.0
1.5
502.5
1,330
1,110
3,930
505.5
29
4.0
Anderson Cree'
13
DA 3
1.25
54,450
0
38,768
38,768
0
1.0
504.6
504.5
below 502.0
1.5
503.0
30
620
3,492
506.0
40
4.0
c / Yadkin - Pee Dee
-17-13
"C"
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.
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 BM P. The report shall summarize the
inspection dates, results of the inspections, and the maintenance work performed at each
inspection.
6. The stormwater treatment system shall be constructed in accordance with the approved
plans and specifications, the conditions of this permit, and with other supporting data.
Page 2 of 6

State Stormwater Permit
Permit No. SW3120701 MOD
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 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.
1.2. 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.
III. 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.
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 1.43-215.6C.
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.
Page 3 of 6

State Stormwater Permit
Permit No. SW3120701 MOD
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.
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 2nd day of November, 2012.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for Charles Wakild, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 4 of 6

State Stormwater Permit
Permit No. SW3120701 MOD
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. Under drains are located per the approved plans.
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 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 sediment chambers, sand chambers,
under drains, and outlets.
15. The required system dimensions are provided per the approved plans.
Please submit this Designer's Certification to:
Cc:
Mooresville Regional Office
Surface Water Protection
610 East Center Ave., Ste. 301
Mooresville, NC 28115
Scott Devaux — Cabarrus County
Page 6 of 6

State Stormwater Permit
Permit No. SW3120701 MOD
Tractor Supply - Midland, NC
Stormwater Permit No. SW3120701.
Cabarrus_County
Designer's Certification
I, as a duly registered in the State of North Carolina, having
been authorized to observe (0 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 5 of 6

State Stormwater Permit
Permit No. SW3120701 MOD
Tractor Supply - Midland, NC
Stormwater Permit No. SW3120701
Cabarrus County
Designer's Certification
RECEIVED
DIVISION OF IPJ.' 7 FR QUALITY
APR 0 2 2013
S'Vor ".a., r iON
MOORESViLLE REGIONAL OFFICE
I, 64"413N Wit'1*4 , as a duly registered "40JOE42- in the State of North Carolina, having
been authorized to observe (® periodically / weekly / full time) the construction of the
project,
MtrAAM -
(Project Name)
oJ40I'tiaZs, u.Z
for MtrX4Nt>-DbtnPW4I MAk (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:
SEAL
Signature C541�;C—
Registration Number /Z 55 7
Date 4.t. ta,
Page S of 6

State Stormwater Permit
Permit No. SW3120701 MOD
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.
✓ S. The outlet/bypass structure elevations are per the approved plan.
✓6. The outlet structure is located per the approved plans,
✓7. Under drains are located per the approved plans.
`//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 volume have been provided.
✓1.2. Required drawdown devices are correctly sized per the approved plans.
1/13. All required design depths are provided.
✓14.All required parts of the system are provided, such as a sediment chambers, sand chambers,
under drains, and outlets.
✓ 15.The required system dimensions are provided per the approved plans.
Please submit this Designer's Certification to: Mooresville Regional Office
Surface Water Protection
610 Last Center- Ave., Ste. 301
Mooresville, NC 28115
Cc: Scott Devaux - Cabarrus County
Page 6 of 6

v AGCDENR
aw
N
North Carolina Department of Environment and Natural Resources
Division of Energy, Mineral and Land Resources
Land Quality Section
Tracy E. Davis, PE, CPM
Director
February 20, 2014
Midland -Durban Retails Investors, LLC
Attn: Mr. William L. Allen
3735 Beam Road, Suite B
Charlotte, North Carolina 28217
Pat McCrory, Governor
John E. Skvarla, III, Secretary
Subject: Compliance Evaluation Inspection
Stormwater Permit No. SW3120701
Midland Durban Retail Investors LLC
Cabarrus County, NC
Dear Mr. Allen:
Enclosed is a copy of the Compliance Evaluation Inspection (CEI) report for the
inspection conducted at the subject sites on February 19, 2014 by Mr. Samar Bou-
Ghazale and me with the Division of Energy, Mineral and Land Resources.
The enclosed report should be self-explanatory. However, if you have any
questions, comments or need assistance with understanding any aspect of your permit,
please do not hesitate to contact Mr. Bou-Ghazale at [phone].
Sincerely,
{ 'P .S I<Z'__
Zahid S. Khan, CPM, CPESC, CPSWQ
Regional Engineer
Land Quality Section
Enciosure
cc: MRO-Files
Stormwater — DEM&LR Central Files
Mooresville Regional Office
610 East Center Avenue, Suite 301, Mooresville, North Carolina 28115
Telephone [phone] I FAX: [phone] - Internet: http://portal.nrdenr.o[g/web/ir/land-quality
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

Compliance Inspection Report
Permit: SW3120701 Effective: 11/02/12 Expiration: 08/17/20 Owner: Midland - Durban Retail Investors LLC
Project: Tractor Supply Midland NC
County: Cabarrus 11855 US Hwy 601
Region: Mooresville
Midland NC 281.07
Contact Person: Darren Tuitt Title: Phone: [phone]
Directions to Project:
760 If north of intersection of INC 24127 & NC 601 along NC 601
Type of Project: State Stormwater - HD - Sand filters
Drain Areas: 002 - (Anderson Creek) (03-07-12 ) ( C)
003 - (Anderson Creek) (03-07-12 ) ( C)
On -Site Representative(s):
Related Permits:
Inspection Date: 02/19/2014 Entry Time: 09:30 AM Exit Time: 10:05 AM
Primary Inspector: Zahid S Khan Phone:
Secondary lnspector(s):
Samar E Bou Ghazale Phone: [phone] Ext.2199
Reason for Inspection: Routine
Permit Inspection Type: State Stormwater
Facility Status: Q Compliant ® Not Compliant
Question Areas:
® State Stormwater
(See attachment summary)
Inspection Type: Compliance Evaluation
Page: 1

Permit: Sw3120701 Owner - Project: Midland - Durban Retail Investors LLC
Inspection Date: 02/19/2014 Inspection Type: Compliance Evaluation Reason for Visit:
Routine
Inspection Summary:
Please provide sod per approved plan at the outlet structure. Stablize all slopes. Maintain sand filter and remove weeds
from the dry pond located near the back of building. Remove trash from the top of the outlet structure.
File Review Yes
No
NA
NE
Is the permit active?
❑
n
n
Signed copy of the Engineer's certification is in the file? ❑
®❑
❑
Signed copy of the Operation & Maintenance Agreement is in the file? ®
n
n
n
Copy of the recorded deed restrictions is in the file? ❑
❑
n
Comment: Site has been completed and no Engineer Certification in file. No Deed
restriction in file.
Built Upon Area
Yes
No
NA NE
Is the site BUA constructed as per the permit and approval plans?
Im
n
n n
Is the drainage area as per the permit and approved plans?
to
n
n n
Is the BUA (as permitted) graded such that the runoff drains to the system?
®n
n n
Comment:
SW Measures
Yes
No
NA NE
Are the SW measures constructed as per the approved plans?
❑
®❑
❑
Are the inlets located per the approved plans?
m
❑
❑ ❑
Are the outlet structures located per the approved plans?
®.n
n n
Comment: Sod was not provided at the Outlet structure.
Operation and Maintenance Yes
No
NA NE
Are the SW measures being maintained and operated as per the permit requirements?
Es
❑ n
Are the SW BMP inspection and maintenance records complete and available for review or provided to DWQ
n
❑
❑
upon request?
Comment:
Page: 2

Permit Number: `JW3) 2r0 r%O/
(to be Provided Utz 1)iYQ)
Drainage Area Number:
Sand Filter Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a log in a
known set location. Any deficient BMP elements noted in the inspection will be corrected, repaired or
replaced immediately. These deficiencies can affect the integrity of structures, safety of the public, and
the removal efficiency of the BMP.
Important maintenance procedures:
— The drainage area will be carefully managed to reduce the sediment load to the sand filter.
— The sedimentation chamber or forebay will be cleaned out whenever sediment depth exceeds
six inches.
— Once a year, sand media will be skimmed.
— The sand filter media will be replaced whenever it fails to function properly after maintenance.
The sand filter will be inspected quarterly 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.
;Pat`ent'ialr oblem ° cgs i; a a
How t will remedtate t
Entire BMP
Trash/debris is present.
Remove the trash/debris.
Adjacent pavement (if
Sediment is present on the
Sweep or vacuum the sediment as soon as
applicable)
pavement surface.possible.
Perimeter of sand filter
Areas of bare soil and/or erosive
Regrade the soil if necessary to remove the
gullies have formed.
gully, and then plant a ground cover and
water until it is established. Provide lime
and a one-time fertilizer application,
Vegetation is too short or too long.
Maintain vegetation at an appropriate
height.
Flow diversion structure
The structure is clogged.
Unclog the conveyance and dispose of any
sediment offsite.
The structure is damaged.
Make any necessary repairs or replace if
damage is too large for repair.
Forebay or pretreatment area
Sediment has accumulated to a
Search for the source of the sediment and
depth of greater than six inches,
remedy the problem if possible. Remove
the sediment and stabilize or dispose of it
in a location where it will not cause
impacts to streams or the BMP.
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. If
a pesticide is used, wipe it on the plants
rather than spraying.
Form SW401-Sand Filter O&M-Rev.4 2009Septl7
Page 1 of 3

BMPelemerit:',.
:Potential .robjem ;;
ll6w,.V,will remediatethe. roblein •..:.•,
Filter bed and underdrain
Water is ponding on the surface for
Check to see if the collector system is
collection system
more than 24 hours after a storm.
clogged and flush if necessary. If water
still ponds, remove the top few inches of
filter bed media and replace. If water still
ponds, then consult an ex ert.
Outlet device
Clogging has occurred.
Clean out the outlet device. Dispose of the
sediment offsite.
The outlet device is damaged
Repair or replace the outlet device.
Receiving water
Erosion or other signs of damage
Contact the NC Division of Water Quality
have occurred at the outlet.
401 Oversight Unit at 919-733-1786.
Form SW401-Sand Filter O&M-Rev.4 2009Sept17 Page 2 of 3

' %,
Permit Number: W3 1 Z0"?d'
(to be provider! Iry 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: Tractor Supply - Midland, NC
BMP drainage area number: #2
Print name: UJO►Am `. MA&tJ
Title:_
Addre�
Phone:
Signati
Date: 'l 31 � 1 2—
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.
1, 0 t&ljAA /I 1 , a Notary Public for the State of
County of /� _ , do hereby certify that
L ,A��y�_ _� personally appeared before me this _ day of
_-21)17 and acknowledge the due execution of the forgoing sand filter
m inten ice requirements. Witness my hand and official seal,
SEAL
My commission expires
Form SW401-Sand Filter O&M-Rev.4 2009Sept 17 Page 3 of 3

Ike
se
4�srr'
ell

Perin it Number: 5 W 31 ZO 1� () I
(10 be provided by DWo
Drainage Area Number:
Sand Filter Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a log in a
known set location. Any deficient BMP elements noted in the inspection will be corrected, repaired or
replaced immediately. These deficiencies can affect the integrity of structures, safety of the public, and
the removal efficiency of the BMP.
Important maintenance procedures:
— The drainage area will be carefully managed to reduce the sediment load to the sand filter.
— The sedimentation chamber or forebay will be cleaned out whenever sediment depth exceeds
six inches.
— Once a year, sand media will be skimmed.
— The sand filter media will be replaced whenever it fails to function properly after maintenance.
The sand filter will be inspected quarterly 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-eleinent:,..
Potential rablem *i `„
How.I will remediat°e,the,brob.l M
Entire BMP
Trash/debris is present.
Remove the trash/debris.
Adjacent pavement (if
Sediment is present on the
Sweep or vacuum the sediment as soon as
applicable)
pavement surface.
possible.
Perimeter of sand filter
Areas of bare soil and/or erosive
Regrade the soil if necessary to remove the
gullies have formed.
gully, and then plant a ground cover and
water until it is established. Provide lime
and a one-time fertilizer application.
Vegetation is too short or too long.
Maintain vegetation at an appropriate
height.
Flow diversion structure
The structure is clogged.
Unclog the conveyance and dispose of any
sediment offsite.
The structure is damaged.
Make any necessary repairs or replace if
damage is too large for repair.
Forebay or pretreatment area
Sediment has accumulated to a
Search for the source of the sediment and
depth of greater than six inches.
remedy the problem if possible. Remove
the sediment and stabilize or dispose of it
in a location where it will not cause
impacts to streams or the BMP.
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. If
a pesticide is used, wipe it on the plants
rather than spraying.
Form SW401-Sand Filter O&M-Rev.4 2009Sept17 Page I of 3

BMP'elentent:
Pot'ential` roblen�. `.°„'. -'' �::
�,.,
,l_low I`wil9.rernediate,flie, roblen� '_..,..
Filter bed and underdrain
Water is ponding on the surface for
Check to see if the collector system is
collection system
more than 24 hours after a storm.
clogged and flush if necessary. If water
still ponds, remove the top few inches of
filter bed media and replace. If water still
ponds, then consult an expert.
Outlet device
Clogging has occurred.
Clean out the outlet device. Dispose of the
sediment offsite.
The outlet device is damaged
Repair or replace the outlet device.
Receiving water
Erosion or other signs of damage
Contact the NC Division of Water Quality
have occurred at the outlet.
401 Oversight Unit at 919-733-1786.
Form SW401-Sand Filter O&M-Rev.4 2009Sept17 Page 2 of 3

Permit Number:
(to be provided by I)fVQ)
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: Tractor Supply - Midland, NC
BA4P drainage area number. #3
Print name:
Title:
Address: YNI�-N- • ' ,. o6
::f:qrsr-
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Signature:
Date:
Note: The legally responsible party should not be a homeoxvners 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 1 I�C�L , do hereby certify that
A personally appeared before me this 31 day of
,,and acknowledge the due execution of the forgoing sand filter
e requirements. Witness my hand and official seal,
&41�
SEAL
My commission expires �';�n nit,
()i 4awit—
Form SW401-Sand Filter O&M-Rev.4 2009Sept17 Page 3 of 3

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Ftf vve_4s&011�
` DW
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Date Keceived
I tv Paid
Permit Number �f�Q
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sW3120 o/ /4-t
Applicab e Rut s: ❑ Coastal SW -- 1995 ❑ al SW
(select rill that apply) ❑ Non -Coastal SW- HQW/ORW Waters
❑ Other WQ M mt Plan:
- 2008 B'Ph 11 - Post Construction
❑ Universal Stormwater Management Plan
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
77iis form marl be photocopier) for use as an original
1. 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.):
Tractor Supply - Midland. NC
2. Location of Project (street address):
11855 US Hwy 601
City: Midland County: Cabarrus "Gip: 28107
3. Directions to project (from nearest major intersection):
760 If North of intersection of NC 24/27 & NC 601 along NC 601
4. Latitude: 35 ° 15 ' 12-8 , N Longitude:80 ° 30 ' 0-82 " W of the main entrance to the project.
Il. PERMIT INFORMATION:
1. a. Specify whether project is (check one): []New []i Modific6tion
b. If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number n/a , its issue date (if known) n/a , and the status of
construction: EJNot Started ❑Partially Compieteclk ❑ Completed* "prm ide u designer's certification
2. Specify the type of project (check one):
❑Low Density OHigh Density ❑Drains to an Offsite Stormwater System ❑Other
3. If this application is being submitted a, the result of a previously returned application Ora letter from DWQ
requesting a state stormwater management permit application, list the stormwater project numlx;r, if
assigned, SW3120701 and the previous name of the project, if different than currently
proposed, n/a
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major ❑I■ Sedimentation/Erosion Control: 5.52 ac of Disturbed Area
❑NPDES Industrial Stormwater []404/401 Permit: Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit: NCDENR LQS CABAR-2012-064
I-orm SWU-101 Version 071un2010 Page I of
OCT 2 3 2012
DENR - WA R Qu ITY
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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 ro'c!ct):
Applicant/Organization:##### Midland - Durban Retail Investors, LLC
Signing Official & Title: William L. Allen / Manager
b.Contact information for person listed in item la above:
Street Address: 3735 Beam Road, Suite B
City: Charlotte State: NC Zip: 28217
Mailing Address (ifuppricabie): 3735 Beam Road, Suite B
City: Charlotte
Phone: ( ) 704-496-7160
Email: [e-mail]
State: NC Zip: 28217
Fax: (_- ) 704-496-7160
c. Please check the appropriate box. The applicant listed above is:
N 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/Organisation:
Signing Official & Title:
b.Contact information for person listed in item 2a above:
Street Add
City:
Mailing Address (if applicable):
City:
State:
State:
Phone: l ) Fax:
Email:
Zip:
Zip:
3. a. (Optional) Print the name and title of another contact such as the projects construction supervisor or other
person who can answer yuc-stions about the project:
Other Contact Person/Organization:##### Darren TUitt
Signing Official & Title: Director of Developmental Services
b.Contact information for person listed in item 3a above:
Mailing Address: 3735 Beam road, Suite B
City: Charlotte
Phone: f 1 704-496-7190
Email:
State: NC Zip: 28217
Fax: ( ) 704-357-0037
Local jurisdiction for building permits: Cabarrus County
Point of Contact: Scott Devaux Phone #: () 704-920-2129
Fornt S W 0-101 Version 071un2010 Page 2 of 6 /
C`

IV. PROJECT INFORMATION
1. In the space provided below, bra summarize how the stormwater runoff will be treated.
Water quality treated within sand filters. Volume & peak detention diverted from sand filters
to dry detention basin
n/a 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 PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
n/a 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 projectdrains to the Rocky _ River basin.
4. 'Total Property Area:2.60 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*:2.60 acres
Total project area shall be calculated to exclude lire folhnoing the normal ool of impounded structures, flit, area
hefrrreen the banks of streams and rimers, tire area b, my fire Nonnal High Water (NHW) line or Mean High Winter
(MH1M line, and coastal wetlands landrrrard from tire NH W (or M14W) line. Tire resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal Wetlands landward of the NHW (or MHM line may
be included in fire total project area.
8. Project percent of impervious area: (Fotal Impervious Area / 'Total Project Area) X 100 = < 87.7 %
9. How many drainage areas does the project have? 2 (For high density, count I for each proposed engineered
slortnwater BMP. For Ime density and other projects, ruse 1 for lire whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
Basin Information
Draina }e Area 2
Drainage Area 3
Drainage Area
Drainage Area
Receivin > Stream Name
Anderson
Anderson
Stream Class *
C
C
Strea m Index Nu tuber *
13-17-13
13-17-13
Total Drainage Area (so
93,218
54,450
On -site Drainage Area (sO
93,218
54.450
Off -site Drainage Area (so
0
0
Proposed Impervious Area** (so
60,548
38,768
Impervious Area** total
65.0
71.2
im ervious" Surface Area
DrainaE Area
Draina e Area
Drainage Area
Drain a e Area
On -site Build I s/Lots (sf)
19,166
0
On -site Streets (so
41,382
0
On -site Parking (so
0
38,768
On -site Sidewalks (so
0
0
Other on -site (so
0
0
Future(so
0
0
Off -site (SO
0
0
F.xistin� BUA*** (so
0
0
Total (so:
60 548
38,768
� tf-
" Stream Class and Index Number can be determined at: http. portal.ncdenr.oWviebhvullpsicsu/classifications
* lrrr ?envious area is defined as lire built upon area including, but not limiled to, buildings, roads, parking areas,
sir�euralks, gravel areas, etc.
Form SWU-101 Version 073un2010 Page 3 of

*** Report only Hurt amount of existing BUA that will remain after development, Do not report airy existing BUA that
is to he removed and Which Will he replaced by rrenr BUA.
11. How was the off -site impervious area listed above determined? Provide documentation. Pull measured
Projects in Union County. Contact DWQ Central Office slaff to check if 1he project is iocaled tvilhin a 'threalened &
Endangered Species watershed Thai may he suhjecl to more strinbenl slormtvaler requiremenly ttv per NCAC 0213.06W
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 13MP specified for this project. The latest versions of the forms can be downloaded
from http://portal.ncdenr.org/web/wq/ws/su/bmp-manual.
Vl. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklists are available from hqp://portal.ncdenr.org/web/wq/ws/su/statesw/forms does. The complete
application package should be submitted to the appropriate DWQ Office. (i'he appropriate office may be
found by locating project on the interactive online map athttl2://12ortal.ncdenr.org/web/wq/ws/su/maps.)
Please indicate that the following required information have been provide_ d by initia_ing in the space provided
for each item. All original documents MUSi' be signed and initialed in blue ink. Download the latest versions
for each submitted application package from http://portal,ncdenr.orz/web/wq/ws/su/statesw/forms_docs.
initials
1. Original and one coley of the Stormwa ter Management Permit Application Form. (3UM
2. Original and one colnj of the signed and notarized Deed Restrictions & Protective Covenants
Form, (if required as per Bart V11 below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreement(s) for each BMP.
4. Permit application processing fee of,505 payable to NCDENR. (For an Express review, refer to
hU://www.envhelp.orA/pages/onestopexpre-,s.iitmI 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
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within r/z mile of the site boundary, include the t/z
mile radius on the map_
7. Sealed, signed and dated calculations.
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named struts 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 vegetateid buffer landward front the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n_ Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required).
Form SWU-101 Version 07Jun2010 Page 4 of
n/a
n/a
GDM
for GDM
GDM
GDM
GDM

9. Copy of any applicable soils report with the associated SHW I' elevations (Please identify GDM
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"xl l" 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 it site visit for DWQ to verify the SHM' prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 019020 Page Na: 320 GDM
11. For corporations and limited liability corporations (]-LC): Provide documentation from the NC
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per NCAC 21-1.1003(e). The
corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
ht!p://www,secretary.state.ne.us/Cori2orations/CSearch.asi2x
V11. 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 sires vary significantly or the proposed
13UA 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://i2ortal.ncdenr.org/web/wq/ws/su/statesw/forms_docs. 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.
Vlll. 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: Carlton T. Burton
Consulting Firm: Burton Engineering Associates
Mailing Address: 5950 Fairview Road, Suite 100
City: Charlotte State: NC Zip: 28210
Phone: ( 1 704-553-8881 Fax: ( ) 704-553-8860
[--,mail: [e-mail]
1X. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
seclion)
1, (print or type name of person listed in Contact Information, item 2a) , certify that
own the property identified in this permit application, and thus give permission to (print or type name of person
listed in Contact Information, item 1a) with (print or type narne of organization listed in
Contact Information, item 1a) 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 07Jun2010 Page 5 of

.i+

As the legal property owner 1 acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
lease agreement, or pending sale, responsibility for compliance with the DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ immediately and submit a
completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater treatment
facility without a valid permit. I understand that the operation of a stormwater treatment facility without a valid
permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature:
a Notary Public for the State of
do hereby certify that
before me this _ day of
Date:
County of
personally appeared
and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEA L
My commission expires
X. APPLICANT'S CERTIFICATION
1, (prinl or type narne of person listed in Contact lnforination, item 1a) Midland - Durban Retail Investors, LLC
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormwater es under PA NCAC 2H .1000, SL 2006-246 (Ph. 11 - Post Construction) or SL 2008-211.
41
Date: i 0 — / D
1, (e4X,'ffi4-Y FVA-,,5 , a Notary Public for the State of � lLro)_ir} ..__, County of
�telck.-,bw+J do hereby certify that L31llia, L. personally appeared
before me this 15 day of <DG-A be U 12 , and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEA L
My commission expires --bt C em6t, -f r 01 J'7-
Form SWU-101 Version 071un2010 Page 6 of