SW4080701_CURRENT PERMIT_20080905

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW ��°LO7o i
DOC TYPE
CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
DOC DATE
2A o S C) O'15,
YYYYMMDD

Michael F. Faslcy, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H, Sullins, Director
Division of Water Quality
September 5, 2008
Mr. Ellis Tusing
Construction Specialist
1605 Miller Street
Winston Salem, North Carolina 27103
Subject: Stormwater Project No. SW4080701
Zone 8 School Property -Proposed Elementary and Middle Schools
Ebert Road Site, Southfork Township, Forsyth County
Dcar Mr. Tusing:
The Stormwater Permitting Unit received a complete Stormwater Management Permit Application for
Zone 8 School Properly -Proposed Elementary and Middle Schools on September 3, 2008. 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. SW4080701, dated September 5, 2008, for the construction, operation and maintenance of the subject
project and the stormwater BMPs.
This permit shall be.effectivc � rom the date of issuance until September 4, 2018, and shall be subject to the
conditions and limitations as specified therein. Please pay special attention to the Operation and
Maintenance requircments'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 North
Carolina General Statutes, and filed with the Office of Administrative Hearings, P.O. Drawer 27447,
Raleigh, NC 2761 1-7447. Unless such demands are made this permit shall be final and binding.
This project will be kept on file at the Winston-Salem Regional Office. If you have any questions, or need
additional information concerning this matter, please contact Mike Randall at [phone]; or
[e-mail].
Sincerely,
n for Coleen H. Sullins
cc: Kevin Davie, Allied Design
Winston-Salem Regional Office
Central Files
SPU Files
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone]
Internet: www.newatercrualitv.or¢ location: 512 N. Salisbury St. Raleigh, NC 27604 Fax [phone]
One
N hCarolina
Nntrim!!y
Customer Service
1-877-623-6748
An Equal Opportunity/Affirmative Action Employer — 50% Recycledl100% Post Consumer Paper

State Stormwater Permit
Permit No. SW4080701
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
Winston-Salem/Forsyth County Board of Education
Zone 8 School Property - Elementary and Middle Schools
Ebert Road Site, Southfork Township, Forsyth County
FOR THE
construction, operation and maintenance of 2 bioretention basin(s) in compliance with
the provisions of Session Law 2006-246 and 15A NCAC 2H .1000 (hereafter referred to
as the "stormwater rules') and the approved stormwater management plans and
specifications and other supporting data as attached and on file with and approved by
the Division of Water Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until September 4, 2018, 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 of this permit. The stormwater control has been
designed to handle the runoff from 83,019 square feet of impervious area for
Drainage Area 4-13 and 55,496 square feet of impervious area for Drainage Area
4-A.
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.
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.
Page 1 of 6

State Stormwater Perrhit
Permit No: SW408()701
6. The built -upon areas associated with this proJ'ect shall be located at least 30 feet
landward of all perennial and intermittent surface
waters.
7. The following design criteria have been provided in the bioretention
basin and
must be maintained at design condition:
Drainage Area
4-A
4-B
a. Drainage Area, ft2:
149,148
126,889
b. Total Impervious Surfaces, ft2:
83,019
55,496
C. Design Storm, inches:
1.0
1.0
d. Max. Ponded Depth, inches:
9 inches
9 inches
e. Seasonal High Water Table, fmsl:
716.50
716.50
f. Planting Media Depth, feet:
2.0
2.0
g. Basin Dimensions, feet:
168 x 56
138 x 46
h. Bottom Elevatiop, fmsl:
729.05
724.55
i. Surface Area, ft :
9,150
6300
j. Permitted Storage Volume, ft3:
6,850
4,690
k. Bypass 1 Storage Elevation, fmsl:
731.80
727.30
I. Drawdown Time, hours:
33
33
m. Underdrain Diameter, inches:
6.0
n. Receiving Stream/River Basin: South Fork Muddy Creek/Yadkin River Basin
o. Stream Index Number: 12-94-13
p. Classification of Water Body: C
II. SCHEDULE OF COMPLIANCE
1. The stormwater management system shall be constructed in its entirety,
vegetated and operational for its intended use prior to the construction of any
built -upon surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The permittee shall at all 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.
G. 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 basin 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. SW4080701
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.
Page 3 of 6

State Stormwater Permit
Permit No. SW4080701
III. GENERAL CONDITIONS
1. 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.
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.
Permit issued this the 5tn day of September, 2008.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for Cor'een H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 4 of 6

State Stormwater Permit
Permit No. SW4080701
Zone 8 School Property - Elementary and Middle Schools
Stormwater Permit No. SW4080701
Forsyth 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 5 of 6

State Stormwater Permit
Permit No. SW4080701
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

DENT 1 FUL-
;- DI'VQ USE ONLY
Date Received
Fee Paid
Permit Numher
09
jwOLffU SD al
State of North Carolina
f 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. Applicants name (specify the name of the corporation, individual, etc, who owns the project):
Winston-Salem/Forsyth County Board of Education
2. Print Owner/Signing Official's name and title (person legally responsible for facility and compliance):
Ellis Tusine, Construction
3. Mailing Address for person listed in item 2 above:
1605 Miller Street
City: W ins ton -Salem State:North Carolina Zip:27103
Phone: [phone] Fax: (336 ) 727.2008
Email:emtusingQwsfcs. kl2.nc.us
4. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Zone 8 School Property _
5. ]rotation of Project (street address):
Ebert Road
City:Southfork Township County:Forsyth County Zip:27127
6. Directions to project (from nearest major intersection):
approximately 2000' south of Fraternity Church Road. The property borders the northern side of South Fork
Muddy Creek, NW of its intersection with Ebert Road (SR 2902)
7. Latitude:36° 00' 32" N Longitude:80° 18' 06" W of project
8. Contact person who can answer questions about the project:
Name:Kevin Davie Telephone Number: (336 397.1217
Email:kevin©allied-engsu rv.coni
H. PERMIT INFORMATION:
1. Specify whether project is (check one)
®New
❑Renewal ❑Modification
Form SWU-101 Version 03.27.08 Page 1 of

2. If this application is being submitted as the result of a renewal or modification to all existing permit, list the
existing permit number and its issue date (if known)
3. Specify the type of project (check one):
❑Low Density ®High Density ❑Redevelop ❑General Permit ❑Universal SMP ®Other
4. 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 Z404/401 Permit ®NPDES Stormwater
III. PROJECT INFORMATION
1. In the space provided below, summarize how stormwater will be treated. Also attach a detailed narrative
(one to two pages) describing stormwater management for the project.
To the west, water is collected in a stormwater system to be conveyed down a hillside; then flows are split and
released in two directions on the property, with one incorporating a energy dissipation outlet to redistribute flow
in a level sheet pattern. Flows to the east will enter one of two Bioretention cells overflows will be directed west
2. Stormy+•titer runoff from this project drains to the Yadkin River basin.
3. Total Property Area: 53.975 acres 4. Total Wetlands Area: 3.158 acres
5. 100' Wide Strip of Wetland Area: 3.123 acres (riot applicable if no zoetlands exist on site) Zy,1-9
6. Total Project Area**:53.94 acres 7. Project Built Upon Area:50.3 max (24 avg) %
8. How many drainage areas does the project have?6
9. Complete the following information for each drainage area. If there are more than two drainage areas in the
project, attach an additional sheet with the information for each area provided in the same format as below.
For high density oroiects, comolete the table with one drainaee area for each engineered stormwater device.
Basin Information.
Drainage Area 1
Drainage Area 2 .
Receiving Stream Name
South Fork Muddy Creek
South Fork Muddy Creek
Stream Class & Index No.
C 12-94-13
C 12-94-13
Total Drainage Area (so
1,838,409
55,321
On -site Drainage Area (so
1,829,084
55,321
Off -site Drainage Area (so
9,325
0
Existing Impervious* Area (so
0
0
Proposed Impervious*Area (so
393,068
5,421
Impervious* Area (total)
1 21.6
9.8
Impervious* Surface Area
Drainage Area 1
Drainage Area 2
On -site Buildings (so
185,345
On -site Streets (so
23,733
5,421
On -site Parking (so
-115,230
On -site Sidewalks (so
15,852
Other on -site (so
52,908
Off -site (so
0
Total (so:
393,068
5,421
* Impervious area is defined as the built rrporr area including, brit not lirzrited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
**Total project area shall be calculated based on the czrrrent policy regarding inclusion of wetlands in the built rrporr area
percentage calculation. This is the area used to calculate percent project built upon area (BUA).
Form SWU-101 Version 03.27.08 Page 2 of 4

:Basin Information .:. .s.
'Dr.'. ea. i�r.;Area 4 --: ";
_Dr.'Area 5 _
Dr._Area.6;•, ;
Receiving Stream Name
South Fork Muddy Creek
Stream Class & Index No.
C 12-94-13
Total Drainage Area (sf)
142,877
277,297
19,166
55,757
On -site Drainage Area (sf)
142,877
276,170
19,166
55,757
Off -site Drainage Area (sf)
1,127
Existing Impervious Area (sf)
0
0
0
0
Proposed Impervious Area (sf)
17,288
138,347
1 1,840
1 12,099
`% Impervious Area (total)
12.1
50.3
1 9.6
1 2"1.7
Im ervi6us Surface Area, . ' . '.'
Dr.,Area,3 ,:
Dr. Area,4 . ,..'Dr..Are'a
5 " .. :
'Dr. Area 6..
On -site Buildings (sf)
On -site Streets (sf)
4,328
59,423
1,840
12,099
On -site Parkin (sf)
70,804
On -site Sidewalks(sf)
8,120
Other on -site (sf)
12,960
Off -site (sf)
Total (sf):
17,288
138,347
-1,840
12,099

10. How was the off -site impervious area listed above derived?N/ A
IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
One of the following deed restrictions and protective covenants are required to be recorded for all subdivisions,
outparcels and future development prior to the sale of any lot. If lot sizes vary significantly, a table listing each lot
number, size and the allowable built -upon area for each lot must be provided as an attachment. Forms can be
downloaded from httfh2o.enr.state.nc,us/su/Limp forms.htm - deed restrictions.
Form DRPC-1
High Density Commercial Subdivisions O
Form DRPC-2
High Density Developments with Outparcels
Form DRPC-3
High Density Residential Subdivisions o
Form DRPC-4
Low Density Commercial Subdivisions
Form DRPC-5
Low Density Residential Subdivisions
Form DRPC-b
Low Density Residential Subdivisions with Curb OutletsO
J1JSf 1Tb0T1G"L YIJ w ScM,
1O ,?06ptVISIDJ AL SA%AS WI&L
OCCUAW
Acce$% T AA,41i1AAAt FASAT,
C Ot„ AA xalT -a W 1090a-ems
By your signature below, you certify that the recorded deed restrictions and protective covenants for this
project shall include all the applicable items required in the above form, that the covenants will be binding
on all parties and persons claiming under them, that they will run with the land, that the required covenants
cannot be changed or deleted without concurrence from the State, and that they will be recorded prior to the
sale of any Iot.
V. SUPPLEMENT FORMS
The applicable state stormwater management permit supplement form(s) listed below must be submitted for each
BMP specified for this project. Contact the Stormwater and General Permits Unit at [phone] for the status
and availability of these forms. Forms can be downloaded from http:l/h2o.c nr.state.nc,us/su/bmp forms,htm.
Form SW401-Low Density
Form SW401-Curb Outlet System
Form SW401-Off-Site System
Form SW401-Wet Detention Basin
Form SW401-Infiltration Basin
Form SW401-Infiltration Trench
Form SW401-Bioretention Cell
Form SW401-Level Spreader
Form SW401-Wetland
Form SW401-Grassed Swale
Form SW401-Sand Filter
Form SW401-Permeable Pavement
Low Density Supplement
Curb Outlet System Supplement
Off -Site System Supplement
Wet Detention Basin Supplement
Infiltration Basin Supplement
Underground Infiltration Trench Supplement
Bioretention Cell Supplement
Level Spreader/Filter Strip/Restored Riparian Buffer Supplement
Constructed Wetland Supplement
Grassed Swale Supplement
Sand Filter Supplement
Permeable Pavement Supplement
I-orm SWU-101 Version 03.27.08 Page 3 of

VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. The complete application package should be
submitted to the appropriate DWQ Office. (Appropriate office may be found by locating project on the
interactive online map at litt ):I/h2o.enr.state.nc.us(su(nisi ma s.httn)
1. Please indicate that you have provided the following required information by initialing in the space provided
next to each item.
Initials
• Original and one copy of the Stormwater Management Permit Application Form w1w
• Original and one copy of the Deed Restrictions & Protective Covenants Form (if ?Vb.
required as per Part IV above) SCMM4
• Original of the applicable Supplement Form(s) and O&M agreement(s) for each BMP
• Permit application processing fee of $505 (Express: $4,000 for HD, $2,000 for LD)
payable to NCDENR i�IGD
• Calculations & detailed narrative description of stormwater treatment/management
• Copy of any applicable soils report NJK4
• Two copies of plans and specifications (sealed, signed & dated), including:
- Development/Project name
- Engineer and firm
-Legend
- North arrow
- Scale
- Revision number & date
- Mean high water line
- Dimensioned property/ project boundary
- Location map with named streets or NCSR numbers
- Original contours, proposed contours, spot elevations, finished floor elevations
- Details of roads, drainage features, collection systems, and stormwater control measures
- Wetlands delineated, or a note on plans that none exist
- Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations
- Drainage areas delineated
- Vegetated buffers (where required)
V1I. AGENT AUTHORIZATION
If you wish to designate authority to another individual or firm so that they may provide information on your
behalf, please complete this section. (ex. designing engineer or firm)
Designated agent (individual or firm):Allied Design, Attn. Kevin Davie
Mailing Address:4720 Kester Mill Road
City: Winston-Salem State:North Carolina Zip:27103
Phone: (336 ) 397.1217
Email:[e-mail]
VIII. APPLICANT'S CERTIFICATION
Fax: [phone] )
I, (prifit or _ e mine of person listed t►r General InforttlRtiori; itei�t�2) _
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will d d, and that the proposed project complies with the requirements of 15A
NCAC 2H .1000. _
Date:
Form SWU-101 V
Page 4 of 4

Permit Number:
(to he provided Gy 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�0
weeks).
— Snow, mulch or any other material will NEVER be piled on the surface of the J
bioretention cell. V
— Heavy equipment will NEVER be driven over the bioretention cell. V�
— Special care will be taken to prevent sediment from entering the bioretention cell. V
— 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:
Potentialproblems:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
bioretention cell
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application,
The inlet device: pipe,
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
swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
Stone verge is clogged or
Remove sediment and clogged
covered in sediment (if
stone and replace with clean stone.
applicable).
Form SW401-Bioretention O&M-Rev.3 Page I Of 4

BMP element:
The pretreatment area
The bioretention cell:
vegetation
The bioretention cell:
soils and mulch
Potential problems:
Flow is bypassing
pretreatment area and/or
gullies have formed.
Sediment has accu mulcted to
a depth greater than three
inches.
Erosion has occurred
Weeds are present.
Best professional practices
show that pruning is needed
to maintain optimal plant
health.
Plants are dead, diseased or
dying.
Tree stakes/wires are present
six months after planting.
Mulch is breaking down or
has floated away.
Soils and/or mulch are
clogged with sediment.
An annual soil test shows that
pH has dropped or heavy
metals have accumulated in
the soil media.
How I will remediate the problem:
Regrade if necessary to route all
flow to the pretreatment area.
Restabilize the area after grading.
Search for the source of the
sediment and remedy the problem if
possible. Remove the sediment and
restabilize the pretreatment area.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Remove the weeds, preferably by
hand.
Prune according to best professional
practices.
Determine the source of the
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.
Remove tree stake/wires (which
can kill the tree if not removed).
Spot mulch if there are only random
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.
Determine the extent of the clogging
- 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.
Dolomitic lime shall be applied as
recommended per the soil test and
toxic soils shall be removed,
disposed of properly and replaced
with new planting media.
Corm SW401-Bioretention O&M-Rev.3 Page 2 of 4

BMP element:
Potentialproblems:
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 re lace the d ro2 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-
ou tlet.
733-1786.
Form SW40 1 -Bioretention O&M-Rev.3 Page 3 of 4

Permit Number:
(to be Provided by DIVQ)
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:
BMP drainage area number:
Print name:
Title:
Address:
Phone:
Signature:_
Date:O
`
Note: The legally respon i
part slfould not be a homeowners association unless more than 50% of
the lots have been sold a,p resident of the subdivision has been named the president.
1, , a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this
day of , and acknowledge the due execut of the
forgoing bioretention maintenance requirements. Witness my hand official seal,
SEAL
My commission expires
/G" y t Rio'
'40
toy-
Form SW401-Bioretention I&M-Rev, 2 Page 4 of 4

c ,u {to be provided by DWQ}
.. . OF vJA rF9
NCDENR, Y
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
BIORETENTION CELL SUPPLEMENT
This form must be tilled out, printed and submitted.
The Required Items Checklist (Part Ill) must be printed, filled out and submitted along with all of the required information.
I. PROJECT INFORMATION
Project name Zone 8 Schools (Elementary & Middle)
Contact name Allied Design, Inc. - Attn. Kevin Davie
Phone number 336.397.1217
Date April 29, 2008 (Rev. 8123/08)
Drainage area number 4-A
II. DESIGN INFORMATION
Site Characteristics
Drainage area 126,889.00 ftz
Impervious area 55,496.00 ftz
Percent impervious 43.7% %
Design rainfall depth 1.00 inch
Peak Flow Calculations
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 -SR Waters
Design volume
Storage Volume: SR Waters
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
Soils Report 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 weight)
% Fines (by weight)
% Organic (by weight)
0.44 in
_ in/hr
ft3lsec
T ft3lsec
ft3lsec
4,690.00 ft3
ft3
ft3
0.00 ft,
ft3
9.00 inches
OK
0.75 ft
6300.00 ft 2
OK
138,00 ft
OK
46.00 ft
OK
ft
9.00 hr
OK
24.00 hr
OK
33.00 hr
0.52 in/hr OK
1.00 inihr OK
85% OK
10% OK
5% OK
Total: 100%
SEAL_
0234
0
EM
Form SW401-Bioretention-Rev.3 Paris I and !I. Design Summary, Page 1 of 2

rermu v4umoer,
(to be provided by D WQ)
P„ r-nho-1; Index (P-Index)
Basin Elevations
Temporary pool elevation
Planting elevation (top of the mulch)
Bottom of the cell
Planting depth
Depth of mulch
SHWT elevation
Are underdrains being installed?
How many clean out pipes are being installed?
What factor of safety is used for sizing the underdrains? (See
BMP Manual Section 12.3.6)
Additional distance between the bottom of the planting media and
the bottom of the cell to account for underdrains
Bottom of the cell required
Distance from bottom to SHWT
Type of bioretention cell (answer "Y" to only one of the two
following questions):
Is this a grassed cell?
Is this a cell with trees/shrubs?
Planting Plan
Number of tree species
Number of shrub species
Number of herbaceous groundcover species
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?
Is the BMP located at least 30 feet from surface waters (50 feet if
SA waters)?
Is the BMP located 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 recorded drainage easement with a
recorded access easement to a public Right of Way (ROW)?
Inlet velocity (from treatment system)
Is the area surrounding the cell likely to undergo development in
the future?
20 (unitless)
OK
727.30 fmsl
726.55 fmsl
OK
724.55 fmsl
2.00 ft
3.00 inches
OK
716,50 fmsl
OK
y (Y or N)
B OK
2.00 OK
1ft
723.55 fmsl
7.05 ft OK
y (Y or N) OK
n (Y or N)
0 More species are recommended.
1 More species are recommended.
y (Y or N) OK
y (Y or N)
110 ft
n (Y or N)
y (Y or N)
y (Y or N)
y (Y or N)
y (Y or N)
4.20 ftlsec
n (Y or N)
Are the slopes draining to the bioretention cell greater than 20%? n (Y or N)
Is the drainage area permanently stabilized? y (Y or N)
Pretreatment Used
(Indicate Type Used with an "X" in the shaded cell)
Gravel and grass
(8'inches gravel followed by 3.5 ft of grass)
Grassed swale
Forebay x
OK
Show how flow is evenly distributed.
d�.Cio- 1 I AND
OK a4fw— -r. ewtm— 12TTOO
OK 1-IC+M AD. S .
OK
OK
insufficient inlet velocity unless energy dissipating devices are
being used. W*A4S uq E-N&"N plS4+PA14A$
OK CAL&ft FV& 001 SR7. Cfo-I
OK
OK
OK
Form SW401-Bioretention-Rev.3 Parts I and 11. Design Summary, Page 2 of 2

NCDENR
rerma rvumoer.
(to be provided by DWQ)
Oc�DC VJA TF-QG
y �
O r
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
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
Project name Zone 8 Schools (Elementary & Middle)
Contact name Allied Design, Inc. - Attn. Kevin Davie
Phone number 336.397.1217
Date April 29, 2008 (Rev. 8123108)
Drainage area number 4-13
II, DESIGN INFORMATION
Site Characteristics
Drainage area
149,148.00 ftz
Impervious area
83,019.00 ft'
Percent imperious
55.7% %
Design rainfall depth
1.00 inch
Peak Flow Calculations
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 -SR Waters
Design volume
Storage Volume: SR Waters
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
Soils Report Summary
Drawdown time, ponded volume
Drawdown time, to 24 inches below surface
Drawdown time, total:
In -situ soil:
Soil permeability
Planting media sail:
Soil permeability
Soil composition
% Sand (by weight)
% Fines (by weight)
% Organic (by weight)
0.55 in
_ in/hr
ft3lsec
ft3lsec
ft3lsec
6,850.00 ft3
ft3
0.00 ft,
—ft3
9.00 inches
OK
0.75 ft
9150.00 ft'
OK
168.00 ft
OK
56.00 ft
OK
ft
9.00 hr
OK
24,00 hr
OK
33.00 hr
SEAL -
0.52inlhr
OK34
1.00 in/hr
OK�
wee ti
��
85%
OK
to4
��•
10%
OK
5%
OK
Total: 100%
Form SW401-Bioretention-Rev.3 Parts I and It. Design Summary, Page 1 of 2

rermis rvumoer:
(to be provided by DWO)
PhCpbphon,6.I,ndex (P-Index)
Basin Elevations
Temporary pool elevation
Planting elevation (top of the mulch)
Bottom of the cell
Planting depth
Depth of mulch
SHWT elevation
Are underdrains being installed?
How many clean out pipes are being installed?
What factor of safety is used for sizing the underdrains? (See
BMP Manual Section 12.3.6)
Additional distance between the bottom of the planting media and
the bottom of the cell to account for underdrains
Bottom of the cell required
Distance from bottom to SHWT
Type of bioretention cell (answer "Y" to only one of the two
following questions):
Is this a grassed cell?
Is this a cell with trees/shrubs?
Planting Plan
Number of tree species
Number of shrub species
Number of herbaceous groundcover species
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?
Is the BMP located at least 30 feet from surface waters (50 feet if
SA waters)?
Is the BMP located 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 recorded drainage easement with a
recorded access easement to a public Right of Way (ROW)?
Inlet velocity (from treatment system)
Is the area surrounding the cell likely 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 ft of grass)
Grassed swale
Forebay
20 (unitless)
OK
731.80 fmsl
731.05 fmsl
OK
729.05 fmsl
2.00 ft
3.00 inches
OK
716.50 fmsl
OK
y (Y or N)
10 OK
2.00 OK
1ft
728.05 fmsl
11,55 ft OK
(Y or N) OK
n (Y or N)
0 More species are recommended.
1 More species are recommended.
y (Y or N) OK
y (Y or N)
OK
110 ft
n (Y or N)
Show how flow is evenly distributed. CovelL Lrll�
0 A+�p
y (Y or N)
OK
3111T. CIO.1
(Y or N)
OK
y (Y or N)
OK
y (Y or N)
OK
4.60 fUsec
Insufficient inlet velocity unless energy dissipating devices are
being used. C, j E&3* ,ir �rSSe�ih�rrsh
n (Y or N)
OK SfE'tA F+E,• set l&VYAXC. "C' 4 J
SST. Cto.l
n (Y or N)
OK
y (Y or N)
OK
OK
Form SW401-Bioretention-Rev.3 Parts 1 and II, Design Summary, Page 2 of 2

Allied Design, Inc.
RECFIVEO
CIVIL ENGINEERING •: LAND SURVEYING
tJ.C, Deot. o� ENR
JUN 2 3 2010
Winston-Salem
Regional Office
June 16, 20 10 �lrt5�ti/1 �r,�tvvl
Mr. Mike Randall yv
DWQ Stormwater PerX27604
* iGV
512 N. Salisbury St. �vrcc ZZ 2ele9
Raleigh, North Caroli
SUBJECT: DESIGNER'S CERTIFICATION
ZONE 8 ELEMENTARY & SOUTH AREA MIDDLE SCHOOLS
ADI PROJECT: 08-013
Stormwater Proj. No.: S`1'4080701
M ike:
On behalf of the Winslon-SalemlF'or.syth County Schools, we are pleased to submit the enclosed
certification form for the Zone 8 Elementary (Kimmel Farm) and Middle (Flat Rock) Schools
located on Ebert Road (SR #2902) in Forsyth County. The required volume, area, and supporting
infrastructure have been installzd and in-service for .i:,proximately a year now, but we have been
waiting for some evidic ce of growing .vegetation within the biocells before certifying them.
While we still have minor issues to track and correct, with the ongoing growth and establishment
of the plantings, and some spots of bank erosion, we continue to observe the cells functioning
properly during recent intense storm events, and feel it is proper to certify the overall site controls
at this time.
We anticipate that future reports from the owner will be submitted annually to the regional office.
Thank you for your help and guidance wit_t the rrojcc-"
Slnccr cly,
K�
Kevin Davie, P.E.
cc: Mr. Ellis Turing, Winston-Salem/Forsyth County Schools
Mr. Carlos Sanders, El, Winston-Salem/Forsyth County Schools
J
I
JUN 2 1 2010
DENR - WAIER WAM
4720 KESTER MILL ROAD WINSTON-SALEM, NORTH CAROLINA 27103
Phone: [phone] e Fax: [phone]
www.allieddesign.com .

State Stormwater Permit
Permit No. SW4080701
)perty - Elementary and Middle Schools
t No. SW4080701
ication
I, �U1#4 _-DAV%f. , as a duly registered in the
State of North Carolina, having been authorized to obse (periodically eeklyl
full time) the construction of the project,
Zj�j_ 6 � ewoorr oPetgec!gq - K,,-%okeL. -FmcM Fctm Ftm Rock. A+goo ScItoaa.I
(Project Name)
for Z* Ws fe-414oCl S (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 1
Registration Number z 3 `154
Date 8; / t f p� 1417, eft- C&dA-I L4-riod e* ::
3 / 411 /io 1�40" 0..7 • Ue r-':AA -14s
G //4� /W� FY�.1�r oaaf►�wT..�,l�
Page 5 of 6

State Stormwater Permit
Permit No. SW408d'ib1'-"
Certification Requirements:
�1. The drainage area to the system contains approximately the permitted
acreage.
V2. 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.
f 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.
571ts. CO2404T"*44 M IAMd, fif.�S �o✓
9. Vegetated slopes are no steeper than 3:1. Mb-M . C000eord,"tA►4 `�' awIroc
# CoA"&AC-r0.t
✓ 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. 4r hivifita tvAL blaeEct At Z , Aitew I Yoc . oPrAI'reo
w�'12. Required drawdown devices are correctly sized per the approved plans.
✓11 All required design depths are provided.
4. All required parts of the system are provided, such as a vegetated shelf,
and a forebay.
_k!!!!�'f5. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Regional Office
Page 6 of 6

R,
r'�
r
:�
s%

A'I-K� 1®
NC®ENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Division of Water Quality
Charles vvakild, P.E.
Director
January 13, 2012
Dee Freeman
Secretary
RECEIVED
N.C. n�.,. •,f ENR
Mr. Darrell W. Walker JAN 19 2012
Winston-Salem/Forsyth County Schools Winston-Salem
RLgionai Office
1605 Miller Street
Winston-Salem, NC 27103
Subject: Approved Plan Revision
Stormwater Permit No. SW4080701
Zone 8 School Property - Kimmel Farm Elem. & Flat Rock Middle School
Forsyth County
Dear Mr. Walker:
The Stormwater Permitting Unit received a request for a plan revision for Stormwater Management
Permit Number SW4080701 on December 2, 2011; with additional information received January 12,
2012,' The plan revision includes revisions to the distribution of approved BUA to the walking track
and access path; and does not change the total allowable amount of BUA on the site. It has been
determined that a formal permit modification is not required for the proposed changes. We are
forwarding you an approved copy of the revised plan for your files.
Please be aware that all terms and conditions of the permit issued on September 5, 2008 remain in full
force and effect. Please also understand that the approval of this revision to the approved plans for
the subject State Stormwater Permit is done on a case -by -case basis. Any other changes to this
project must be submitted to and approved through the Division of Water Quality prior to construction.
The issuance of this plan revision does not preclude the permittee from complying with all other
applicable statutes, rules, regulations or ordinances which may have jurisdiction over the proposed
activity, and obtaining a permit or approval prior to construction.
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.
enclosures - approved revised plan
cc: SW4080701 File w/ enclosure
ec: Carlos Sanders - Winston-Salem/Forsyth County Schools - Maintenance Div.
Kevin Davie, PE -Allied Design, Inc.
Sue Homewood - Winston-Salem Regional Office
Wetlands and Stornawater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone]
Internet: www.ncwaterquality.org
An Equal Opportuky'rAffrmativeAction Ernpioyer
One
NorthCarolina
;Vaturallq

DWQ USE ONLY
Date Received
Fee Paid a ress only)
Permit Number
2 !1 r77[-iGl�►/Iki..l.0
mil-
.SV✓�'� ��©�
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT PLAN REVISION APPLICATION FORM
This form may be photocopied for else as an original
I. GENERAL INFORMATION
1. Stormwater Management Permit Number: SW 4foCO-7a t
2. Project Name: Z-- 8 Se-tviot Eb&-t t4-a/ �d /J. 'dd�k- Sc���
3. Permit Holder's name (specify the name of the corporation, individual, etc.):
4. Print Owner/Signing Official's name and title (person legally responsible for permit):
9q{o,tli Uork�q,- r o
5. Mailing Address for person listed in item 2 above:
? o raj, 2-5-(3 - -- — City:—V. Y't s�,,., S--UIV\ State: ,\)C_ Gip: 2-*-7 t�
Phone: ( ?3 to ) Uzi ^ 7-0 Fax:
Email:
H. PLAN REVISION INFORMATION
Summarize the plan revision proposed (attach additional pages if needed):
CFc.cYc�cc
I✓�h(lrce�l
'('�c� ..
2? .i' dv
ZS Adr(
(a 1 601t,C(
wArk
-YAJ-- '59
bn-S;n .tr<A
d
Ce.te&, re�;j0%S
Sd, c1
Lw-E�.
III. 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. The complete application package should be
submitted to the DWQ Office that issued the permit.
1. Please indicate that you have provided the following required information by initialing in the space provided
next to each item.
• Original & I copy of the Plan Revision Application Form
• Two (2) copies of revised plans (mast be revisions of original approved plan shcet(s))
If applying for Express review (only available in 20 coastal counties):
• Application fee of $500.00 (made payable to NCDENR)
Initials
CFs
CES
V1. APPLICANT'S CERTIFICATION ,i.vI
I, (print or type name of person listed br General Information, iterrr 3) - AO-4S41- wAt-KkfA
certify that. I.have -au thorized these plan revisions and that the information included on this plan revision
application is, to the best of•my knowledge, correct and complete.
N
Signature:
Date: I - L(- 1 Z
Plan Revision Form Rev 13July2010 Page I of I
4.na S�rG,K if`�sy(L G-n S4c,�•t;'
ry r l �nS�nt�� ride%P/{ifiG4

y,
.r
�.
�
1
•1 i

I am writing to inform you that Winston Salem/Forsyth County Schools have addressed the last
issue with bringing Stormwater Permit No. SW4080701 back into compliance. There was an
unapproved gravel road constructed that made the site stormwater calculations inaccurate. With
the help of the Design Engineer, Kevin Davie, Allied Design, Inc., we were able to reduced the
approved walking track from 27.5' down to 25'. This allowed us to keep the gravel road at 6' for a
walking path and an access road for vehicle track for maintenance work needed in that area. The
changes to the walking track and the gravel road happen within that same basin area, therefore
bringing the previous approved stormwater calculations to remain the present accurate
calculations. Pictures of the work completed are available upon request. All disturbed areas were
seeded and strawed. If there are any questions, please contact us at the information listed
above.
Sincerely,
Carlos Sanders
Winston Salem/Forsyth County Schools
Civil Engineer Apprentice
336.661.4999
fax [phone]

Carlos Sanders
Winston Salem/Forsyth County Schools
Maintenance Division
4897 Lansing Drive
Winston Salem, NC 27105
.January 9, 2012
Robert D. Patterson, PE
NC DENR
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27604-1617
Subject: Lone 8-Kimmel farm Elementary and Flat Rock Middle School
Plan Revision -Additional Information Request Provided
Mr. Patterson,
/y
� � 1
59f ri n, N�'t`
Winston Salem/Forsyth Co.
Schools
Maintenance Division
4897 Lansing Drive
Winston Salem, NC 27105
336.661.4999
fax [phone]
RIE&NOW[RO
JAN 1 2 2012
DENR • WATER QtWJTY
4 AN AW 5 MMY M wax"
This is in response to your letter dated December 12, 2011 requesting additional information. I
have provided an updated plan revision application and a copy of sealed, signed and dated plans.
If there are any questions, please contact us at the information listed above.
Sincerely,
Carlos Sanders
Winston Salem/Forsyth County Schools
Civil Engineer Apprentice
WSI O; Maintenance Division

A�A,..,�.,e
NC®ENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Mr. Carlos Sanders
W i nston-Sa lem/Forsyth
4897 Lansing Drive
County Schools
Winston-Salem, NC 27105
Division of Water Quality
Coleen H. Sullins
Director
December 12, 2011
Subject: Plan Revision - Additional Information Request
Stormwater Permit No. SW4080701
Zone 8 School Property - Kimmel Farm Elem. & Flat Rock Middle School
Forsyth County
Dear Mr. Sanders:
Dee Freeman
Secretary
The Division of Water Quality Central Office received a Stormwater Management Permit Plan Revision
request for the subject project on December 2, 2011. A preliminary review of that information has
determined that the application is not complete. The following information is needed to continue the
stormwater review:
As stated in the email from DWQ on November 4, 2011, please use the plan revision
application form available at: htti)://I)ortal.ncdenr.orp,/web/wq/ws/su/statesw/forrns does This
form must be signed by someone that has the appropriate signature authority for Winston-
Salem/Forsyth County Schools; similar to the original permit application.
2. The revised plan(s) must be sealed, signed, and dated by an appropriate NC licensed
professional.
If you have any questions concerning this matter please feel free to contact me at [phone], or
at [e-mail].
Sincerely,
Robert D. Patterson, PE
Environmental Engineer
Stormwater Permitting Unit
cc: SW4080701 File
ec: Kevin Davie, PE -Allied Design, Inc.
Sue Homewood - Winston-Salem Regional Office
Wetlands and Stormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Rhone: 919-807-63001 FAX: [phone] Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
NofthCarohna
Adwra!!rf
An Equal Opportunity 1 Affirmative Action Employer

:5�vtoy 0) 0) ?L"V �C-_V)'_S) OA)
Winston &0em/Forsy1h Co.
Schools
Maintenance Division
4897 Lansing Drive
Winston Salem, NC 27105
336,661,4999
fax [phone]
Carlos Sanders
Winston Salem/Forsyth County Schools -Maintenance Division
4897 Lansing Drive
Winston Salem, NC 27105
November 30, 2011
912@20YRDO
Robert D. Patterson, PE "C — 2 2Dij `
NC D EN R OENR - WATER QUALIiy
Division of Water Quality WETUWDSANOSTORMWATER
1617 Mail Service Center BRANGH
Raleigh, NC 27604-1617
Subject: Zone 8-Kimmel Farm Elementary and Flat Rock Middle School
Mr. Patterson,
am writing to inform you that Winston Salem/Forsyth County Schools have addressed the last issue with
bringing Stormwater Permit No. SW4080701 back into compliance. There was an unapproved gravel road
constructed that made the site storrnwater calculations inaccurate. With the help of the Design 13ngincer,
Kevin Davie, Allied Design, Inc., we were able to reduced the approved walking track from 27.5' down to
25'. This allowed us to keep the gravel road at 6' for a walking path and an access road for vehicle track for
maintenance work needed in that area. The changes to the walking track and the gravel road happen
within that same basin area, therefore bringing the previous approved stormwater calculations to remain the
present accurate calculations. Pictures of the work completed are available upon request. All disturbed
areas were seeded and strawed.
If there are any questions, please contact us at the information listed above.
Sincerely,
Carlos Sanders
Winston Salem/Forsyth County Schools
Civil Engineer Apprentice
,31dFCS Maintenance Division

Taylor -Smith, Aana
From: Sanders, Carlos <[e-mail]>
Sent: Thursday, May 15, 2014 10:00 AM
To: Homewood, Sue; Taylor -Smith, Aana; White, Sue
Cc: Kneiler, Todd E.
Subject: 2014 Zone 8 Yearly Inspection - Permit #4080701
Attachments: Zone 8 Monthly Inspection sheets--2014.pdf; Zone 8 Yearly Inspection--2014.pdf; 20140515_
072158[1).jpg; 20140515_072149[1].jpg; 20140515_072225[l),jpg; 20140515_072424[11.jpg;
20140515_072506[1).jpg
To A11,
Attached are the 2014 yearly inspection for Zone 8 Elementary/Middle School Perniitt#410807017. Pictures are attached too
Thanks in advance,
Carlos Sanders
Civil Engineer Apprentice
Maintenance Division
Winston-Salem/Forsyth County Schools
336-748-4000 ext. 44518
336-399-6214 (mobile)
336-661-4971 (fax)
All e-mail correspondence to and from this address is subject to the North Carolina Public Records Law, which
may result in monitoring and disclosure to third parties; including law enforcement. AN EQUAL
OPPOR'I"UNITY/AFI,IRMA'I'IVE ACTION EMPLOYER

Stormwater Inspection Report
�ICM M a -
Project nrame:ip� 8 ��� Ail.d.f
i
Contact Person; ea.-los 34.1 -Le,-S
Inspection Date: S- I !T- 2. al
Cun•ent Weather: (p B o
Sc�[us I Permit No: zyo g D 7a
r,-
Phone Number: 11 ss
lime In: -7; Zp A�►t
Recent Rain (Date)?
Inspection Type:
`lime Out:
Rain -- in
Location
Facility Address / Location: 471(O-72- 1�b,,4 Z^J
City: W K,. r, n - S, l e.�� Zip: z712"? County: F, -at: o iI Long: - W
Permit Information
Rule Subject to (circle one): `'Vater Quality ]rater Quantity oth
Density (circle once): High (HD) i.ow
Stormwater Best Management Practices (BMPs) (insert number of each):
Wet Ponds Infiltration Basins Infiltration "trenches
Dry Ponds ✓ Bioretention Permeable Pavement
Cistern Level Spreader/Filter Strip Other (spec):
File Review
LD Swales Storrowaler Wetlands
Sand filters (circle one) Open Closed
Yes No NIA
1. [s the permit active?
I/
2. Signed L'n incer's Certification on tile?
3. Signed Operation and Maintenance agreement on file?
Y
4. Recorded Deed Restrictions on file?
Site Visit: Built Uoon Area fBUAI Yes No NIA
5. BUA is constructed and consistent with the permit requirements?
✓
G. BUA (aspermitted) is graded such that the runoff drains to the system?
✓
7. Drainage area is consistent withpermit? (i.e. no un ermitted drains a to the SW BMPs)
8, Drainage area is stabilized? (to reduce risk of sedimentation to the SW BMPs) _ _
✓
Site Visit: Stormwater BMPs
Yes No NIA
9. Stormwater 13MPs arc located per the approvedplans?
10, Stormwater BIM[Ps have dimensions (eg. length, width, area) matching the approvedplans?
I I. Stormwater BMI's are constructed per the approvedplans?
12. Riparian buffers recorded during permitting are free of disturbance and built upon area
✓�
Site Visit: Oneration and Maintenance Yes No NIA
11 Access points to the site are clear and well maintained?
14. `]'rash has been removed as needed?
1 S. Excessive landscape debris (grass clippin s, leaves, etc) is controlled?
✓
16. Stormwater BMPs bein- operated and maintained as per the permit requirements?
r/
17, Inspection and Maintenance records arc available for inspection?
Site Visit: Other Permit Conditions Yes No NIA
18. is the site compliant with other conditions of the permit? t/ 1
Site Visit: Other Water Quality Issues Yes No NIA
19. Is the site compliant with other water quality issues as noted during the inspection?
Stormwater Inspection Report Pagt 1 01'2

Stormwater Inspection Report
c;ommems _
Inspection Pictures (some of the pictures taken during the site visit) Attach as rtecesso
Compliance Status Compliant 0 Non -Compliant
If non -compliant please provide additional documentatio , plan of action etc. of how and when the non -compliant issues were
addressed.
Inspector Name and Signature: Date: S— rS -- Z+.j t _
Stormwater Inspection Report Page 2 of 2

BIORETENTION CELL: O & M Inspection Checklist
YES
NO
N A
INLIT and!PERIMETER.
1. Inlet and Perimeter are free of erosive gullies and bare soil areas:
❑
❑
2. Inlet device (swale, pipe, stone verge) is free of erosion, damage or clogs:
Z
❑
❑
3. Weir heights appear to match approved plans:
-
[g"
❑
❑
PRETREATMENT/FORE BAY
4. Flow is entering pretreatment area (not being bypassed):
L�`
❑
❑ .
S. Pretreatment area is free of erosion:
13""
❑
❑
6. Level Spreader (if applicable) is structurally sound and remains level:
❑
❑
[r
7. Pretreatment area is free of excessive sediment or clogs:
[�
❑
❑
8. Energy Dissipaters (rip rap aprons/plunge pools) are correct size and functioning:
Q�
❑
❑
9. Pretreatment area is free of trash and other debris:
ff�
❑
❑
MAIN 7REATMN7AltEA
10. vegetated side slopes are no steeper -than 3:1:
►�
❑
❑
11. The under drain system is free flowing and free of clogs (if applicable):
[>�
❑
❑
12. Main treatment area is free of sediment:
2
❑
❑
13. Cleanout(s) and cap is provided for the under drain as per the approved plans:
R
❑
❑
14, Cleanouts(s) and caps free of damage potentially caused by mowing/maintenance:
M`-
❑
❑
15. Heavy equipment has not been driven into the cell:
2r
❑
❑
16. The "Do Not Fertilize" signs are still in place and visible for sodded cells: _
❑
❑
17. Surface is free of piles of heavy materials (piles of mulch, etc):
[�
❑
❑
18. Ponding depth is 9-12 inches after rain:
[-
❑
❑
19. All dimensions are >=10ft.:
E'
❑
❑
20. Main treatment area is free of trash and other debris:
ff
❑
❑
21. Access easement is being maintained:
2`-
❑
❑
OIL'/:MULCH/.SOD and VEGETATION
22. Plants are healthy and being maintained:
[�'
❑
❑
23. The proper amount and type of vegetation/plantings is present in the celC
❑
❑
24. Mulch (if applicable) is in good condition (has not broken down or floated/migrated towards the outlet):
ER" ❑ ❑
25. Surface if free of excessive sediment and clogs: Er' ❑ ❑
26. Sod (if applicable) is in good condition and free of weeds and bare spots ❑ ❑ 2'-
27. Trees are free of stakes/wires > 6 months after planting: El' ❑ ❑

28. Ponded volume drains completely into the soil layer within 12 hours:
['�
❑
❑
29. Ponded volume drains completely from the device within 48 hours:
[]"'
❑
❑
30. The annual sail test shows the proper pH and absence of heavy metal accumulation:
[l'
❑
❑
4q
31. Outlet is free of evidence of improper drainage (no standing water, cattails, etc.):
[�
❑
❑
32. Outlet device (drop inlet, weir, etc.) is free of damage or clogs:
[]'
❑
❑
33. Orifice size matches approved plans:
[!T�
❑
❑
34. Outlet is free of damage, clogs, or erosion:
❑
❑
35. Outlet Energy dissipater is correct size and functioning (if applicable):
❑
❑
Er
36. Relative elevations match approved plans:
[+-'—
❑
❑

BIORETENTION CELL: O & M Inspection Checklist
S nh Svc J' IFka.
LINL1cT and.PERIMETER;.. >:.. :..
1. Inlet and Perimeter are free of erosive gullies and bare soil areas:
Er
❑
❑
2. Inlet device (swale, pipe, stone verge) is free of erosion, damage or clogs:
[Er
❑
❑
3. Weir heights appear to match approved plans:
2'--'
❑
❑
7777.
0-R1l TREATMENT/:FOREBAY
4. Flow is entering pretreatment area (not being bypassed):
[�'
❑
❑
5. Pretreatment area is free of erosion:
[
❑
❑
6. Level Spreader (if applicable) is structurally sound and remains level:
❑
❑
7. Pretreatment area is free of excessive sediment or clogs:
[r
❑
❑
S. Energy Dissipaters (rip rap aprons/plunge pools) are correct size and functioning:
❑
❑
9. Pretreatment area is free of trash and other debris:
L''J
❑
❑
MAIN-tREATMEN7 AREA;.
10. Vegetated side slopes are no steeper than 3:1:
Z"_
❑
❑
11. The under drain system is free flowing and free of clogs (if applicable):
M
❑
❑
12. Main treatment area is free of sediment:
Zr_
❑
❑
13. Cleanout(s) and cap is provided for the under drain as per the approved plans:
R�_
❑
❑
14. Cleanouts(s) and caps free of damage potentially caused by mowing/maintenance:
2�'
❑
❑
15. Heavy equipment has not been driven into the cell:
❑
❑
16. The "Do Not Fertilize" signs are still in place and visible for sodded cells:
❑
❑
[�
17. Surface is free of piles of heavy materials (piles of mulch, etc):
21"
❑
❑
18. Ponding depth is 9-12 inches after rain:
❑
❑
19. All dimensions are >=10ft.:
U
❑
20. Main treatment area is free of trash and other debris:/
❑
❑
21. Access easement is being maintained:
L`�
❑
❑
SOIL%MUCH/SOD andiVEGETATION
22. Plants are healthy and being maintained:
[�
❑
❑
23. The proper amount and type of vegetation/plantings is present in the cell:
❑
❑
24. Mulch (if applicable) is in good condition (has not broken down or floated/migrated towards the outlet):
25. Surface if free of excessive sediment and clogs:
[r
❑
❑
26. Sod (if applicable) is in good condition and free of weeds and bare spots
❑
❑
Er
27. Trees are free of stakes/wires > 6 months after planting:
S'
❑
❑

i
28. Ponded volume drains completely into the soil layer within 12 hours:
ff'�
El
Elf
29. Ponded volume drains completely from the device within 48 hours:
Irl
❑
❑
30. The annual soil test shows the proper pH and absence of heavy metal accumulation:
["
❑
❑
:... :;.
OUTLET ' ... :..
31. Outlet is free of evidence of improper drainage (no standing water, cattails, etc.):
❑
❑
32.Outlet device (drop inlet, weir, etc.) is free of damage or clogs:
[R"
❑
❑
33. Orifice size matches approved plans:
Er
❑
0
34. Outlet is free of damage, clogs, or erosion:
❑
❑
35. Outlet Energy dissipater is correct size and functioning (if applicable):
❑ .
❑
36. Relative elevations match approved plans:
ffr'
❑
❑

ate Created: ! 1/2 1t3 C12 07AMchools 11111111111111111111 Printed onP41�15/2013
Work Order ID 158518
TFralt Environmental Services
Completion Date4115/2013
Description
Monthly - Stormwater System Inspection 426 - Refer to PM schedule
details.
Location
Kimmel Farm Elementary
Request Date
4 1 2013
BuildingStatus
Closed Work Orders
Area
Priority
Medium
Area Number
Purpose Code
Preventive Maintenance
E ui Item No,
StrmVVtr426
Bud et Code
Equip. Desc
Bio-Retention Pond
Requester
Wayne Loflin
Assigned To
Kneller, Todd
Requester Phone
336-661-4999
Notes
Labor To Date: h
Purchases To Date: $0.00
Date
Name
Hrs
Date
PO
Description
Supplier
Qty
Cost
Each
Inventory To Date: $0.00
Date
Item No
Description
Qty
Pool
Action Taken Monthly inspection revealed no issues. +i-inch rain event on 4/12/13;
no problems resulting. TK
Tech n i ci a n/Supervisor
www.schooldude.com Maintanancenirect
Date Confirmation/Accepted By
Date
Printed by Todd Kneller

Winston-Salem/Forsyth County Schools III1111111111111111 Page 1 of 2
Date Created: 5/112013 12:07AM Printed on: 5113/2013
Work Order ID 1619S5
Craft Environmental Services Completlon Date5/13/2013
Description
Monthly - Stormwater System Inspection 426 - Refer to PM schedule
details,
Location
Kimmel Farm Elementary
Request Date
5 1 2013
Building
Status
Closed Work Orders
Area
Priority
Medium
Area Number
Purpose Code
Preventive Maintenance
Equip Item No.
StrmWtr426
Bud et Code
Equip. Desc
Bio-Retention Pond
Requester
Wayne Loflin
Assigned To
Kneller, Todd
Requester Phone
336-661-4999
Notes
Labor To Date: h
Purchases To Date:. $0.00
Date
Name
Hrs
Date
PO
Description
Supplier
Qty
Cost
Each
Inventory To Date: $0.00
Date
Item No
Description
Qty
Pool
Action Taken
2+ inch rain event over the course of the days of Apr. 28-29; no issues
resulting. No issues of note at time of monthly inspection. Maintenance
work set for biccell- to begin in late May or June. TK
Tech n is i s n/S u perviso r
www.schooldude.com Maintenance0irect
Date Confirmation/Accepted By Date
Printed by Todd Kneller

Winston-Salem/Forsyth County Schools 1111111111111111111 Printed on:
1 of 2
Date Created: 6/3/2013 12:05AM fl : 6117/2013
Work Order ID 165819
craft Environmental Services
Completion Date6/17/2013
Description
Monthly - Stormwater System Inspection 426 - Refer to PM schedule
details.
Location
Kimmel Farm Elementary
Request Date
6 3 2013
Building
Status
closed Work Orders
Area
Priority
Medium
Area Number
Pur ose Code
' Preventive Maintenance
Equip Item No.
StrmWtr426
Bud et Code
Equip. Desc
Bio-Retention Pond
Requester
Wayne Loflin
Assigned To
Kneller, Todd
Requester Phone
336-661-4999
Notes
Labor To Date: h
Purchases To Date: $D.00
Date
Name
Hrs
Date
PO
Description
Supplier
Qty
Cost
Each
Inventory To Date: $0.00
Date
Item No
Description
Qty
Pool
Action Taken
No issues to report for monthly Inspection. 3-plus inches of rain over the
course of 6/7 through 6/10; no issues as a result. Maintenance
scheduled for week of 6/17. TK
Technician/Supervisor Date
www.schooldude.com MalnturanceDirect
Confirmation/Accepted By Date
Printed by Todd Knchw

Winston-Salem/Forsyth County Schools 1111111111111111111
Printed onPape 1 of 2
Date Created: 7/112D13 12:C8AM : 7/19/2013
Work Order ID 169183
Craft Environmental Services
Completion Date7/19/2013
Description
Monthly - Stormwater System Inspection 426 - Refer to PM schedule
detalls,
Location
Kimmel Farm Elementary
Reguest Hate
7 1 2013
Building
Status
Closed Work Orders
Area
Priority
Medium
Area Number
Purpose Code
Preventive Maintenance
Equip Item No.
StrmWtr426
Bud et Cade
Equip, Desc
Bio-Retention Pond
Requester
Wayne Loflin
Assigned To
Kneller, Todd
Requester Phone
336-661-4999
Notes
Labor To Date: h
Purchases To Date: $0.00
Date
Name
lirs
ate
PO
Description
Supplier
Qty
cost
Each
Inventory To Date: $0.00
Date
Item No
Description
Qty
Pool
Action Taken
Heavy rains earlier this month; several dates in a row with inch -plus rain
events. No Issues resulting. Maintenance completed: double -shredded
mulch added, geotextile added to rlprap pad and new riprap. Juncus
plants installed. Looks great. TK
Tech nlclan/Supervisor Date Conflrmation/Accepted By Date
www.schooldude,com MaintenanceDirect Printed by Todd Kneiler

Winston-SalemlForsyth County Schools � ' 1 �I I I� 1I Page 1 of 2
Dale Created: 8/112013 12:06AM Printed on: 812812013
Work Order ID 172171
Craft Environmental Services
Completion Date8/28/2013
Description
Monthly - Stormwater System Inspection 426 - Refer to PM schedule
details.
Location
Kimmel Farm Elementary
Request Date
8 1 2013
Building
Status
Closed Work Orders
Area
Priority
medium
Area Number
Pur ose Code
Preventive Maintenance
EquiR Item No.
5trmWtr426
Budget Code
Equip. Desc
Blo-Retention Pond
Requester
Wayne Loflin
Assigned To
Kneller, Todd
Requester Phone
336-661-4999
Notes
Labor To Date: h
Purchases To Date: $0.00
Date
Name
-irs
Date
PO
Description
Supplier
Qty
Cost
Each
Inventory To Date: $0.00
Date
Item No
Description
Qty
Pool
Action Taken
No issues to report. Several rain events totalling 1" or more this month;
�1" on 8/10; —1" on 8/13; -1.75" 8/17-19. See attached inspection
report, TK
Tech nlcian/S u pery isor Date
www.schooldude.com MaintenanceDirect
Confirmation/Accepted By Date
Printed by Todd Kneller

Mnston-SalemlForsyth County Schools 1111111111111111111 Page 1 of 2
Date Created: 9/2/2013 12:03AM 19 mesa" a o Printed on: 10/412013
Work Order ID 176910
Craft Environmental Services
Completion Pate 10/4/2013
Description
Monthly - Stormwater System Inspection 426 - Refer to PM schedule
details.
Location
Kimmel Farm Elementary
Request Date
9 2 2013
Building
Status
Closed Work Orders
Area
Priority
Medium
Area Number
Purpose Cade
Preventive Maintenance
Equip Item No,
StrmWtr426
Bud et Cade
Equip, Desc
Blo-Retention Pond
Requester
Wayne Loflin
Assigned To
Kneller, Todd
Requester Phone
336-661-4999
Notes
Labor To Date: h
Purchases To Date: $0.00
Date
Name
Hrs
Date
PO
Description
Supplier
Qty
Cost
Each
Inventory To Date: $0.00
Date
Item No
Description
Qty
Pool
Action Taken
No issues to report. TK
Technician/Supervisor
www.schooldude.corn MalntenanceDirect
Date Confirmation/Accepted By Date
Printed by Todd Kneller

{ Win ston-SalemlForsyth County Schools 111111111111111111 1111 Pape 1 of z
Date Created: 10/112013 12:07AM -1 1112& -2 -r a N Printed on: 101712013
Work Order ID 181151
Tcraft Environmenta4 Services
Completion Date10/7/2013
Description
Monthly - Stormwater System Inspection 426 - Refer to PM schedule
deta ils.
Location
Kimmel Farm Elementary
Request Date
14 1 2013
Building
Status
Closed Work Orders
Area
Priorit
Medium
Area Number
Purpose Code
Preventive Maintenance
Equip item No.
StrrnWtr426
Budget Code
Equip. Desc
Bio-Retention Pond
Requester
Wayne Loflin
Assigned To
Knellerr Todd
Requester Phone
336-661-4999
Notes
Labor To Date: h
Purchases To Date: $o.DO
Date
Name
Hrs
Date
PO
Description
Supplier
Qty
Cost
Each
Inventory To Date: $0.00
Date
Item No
Description
Qty
Pool
Action Taken Maintenance work completed during first week of October (bank erosion
correction, media plant installation (Juncus Effusus and Switchgrass). No
other Issues to report. TK
Technician/Supervisor
www.schooldude.cum main tenancel)irect
Date Confirmation/Accepted By Date
Printed by Todd Kneller

1
PERODIC BMP SITE INSPECTION OPERATION & MAINTENANCE RECORD
Recorded by Date General Observations or comments
V,, 0,,_ !:�,• 30 -f3
Location:_
A.
Any adverse observations
YES
1q0__�
NIA
13.
Plant life compromised or needing attention
YES
�6_ _
N/A
C.
Inlet/outlet clogged
YES
4G�__
NIA
D.
Vegetation growing in rip -rap or emergency spillway
YES
ld$—
NIA
E.
Trash accumulation
YES
?M_
NIA
1�.
Noxious weeds, invasive vegetation / cattails present
YES
NIA
G.
Bare soil erosion observed, slopes or embankments
YES
W9_
N/A
H.
Grasses no less than 8-12" in height (as applies to site)
YES
NI$.
N/A
I.
Animal interference or damage
YES
ke-
NIA
J.
Sediment accumulation
YES
'MO_
NIA
K.
Significant algae growth
YES
?qo-
N/A
L.
In need of mowing or string trimming
YES
KO`
N/A
M.
`I`rees present on dam as applies to site
YES
Nfr
N/A
N.
Observation Well Levels (Specs ES Only)
A
B
Describe maintenance activities performed or planned for `YES' answers above:
If more than one BMP on site, denote the Iocation of issue:

PERODIC BMP SITE INSPECTION, OPERATION & MAINTENANCE RECORD
Recorded by Date General Observations or comments
,-A— ��
Location: Gone 3 — Kimmel FarmES/Flat Rock MS
A.
Any adverse observations
YES
NO
B.
Plant life compromised or needing attention
YES
10
C.
Inlet/outlet clogged
YES
r0
D.
Vegetation growing in rip -rap or emergency spillway
YES
E.
Trash accumulation
YES
NO
F.
Noxious weeds, invasive vegetation / cattails present
YES
NO
G.
Bare soil erosion observed, slopes or embankments
YES
NO
H.
Grasses less than $-12" in height (as applies to site)
YES
60
I.
Animal interference or damage
YES
NO
J.
Sediment accumulation
YES
670)
K.
Significant algae growth
YES
NO
L.
In need of mowing or string trimming
YES
NO
M.
Trees present on dam as applies to site
YES
NO
N.
Observation Well Levels (Speas ES Only)
A
Describe maintenance activities performed or planned for `YES' answers above:
If more than one BMP on site, denote the location of issue:
fl3
NIA
N/A
N/A
N/A
N/A
N/A
N/A
N/A
NIA
N/A
N/A
N/A
N/A

V
PERODIC BMP SITE INSPECTION, OPERATION & MAINTENANCE RECORD
Recorded by Date General Observations or comments
� • �3
Location: Zone 8 — Kimmel I'armES/ lat Rock MS
A.
Any adverse observations
YES
NO
N/A
B.
Plant life compromised or needing attention
YLS
<DO
NIA
C.
Inlet/outlet clogged
YES
NO
NIA
D.
Vegetation growing in rip -rap or emergency spillway
YES
P O
NIA
E.
Trash accumulation
YLS
NO
NIA
R
Noxious weeds, invasive vegetation / cattails present
YES
NO
NIA
G.
Bare soil erosion observed, slopes or embankments
YES
NO
NIA
H.
Grasses less than 5-12" in height (as applies to site)
YES
NO
NIA
I.
Animal interference or damage
YES
NO
NIA
J.
Sediment accumulation
YES
NIA
K.
Significant algae growth
YES
NO
N/A
L.
In need of mowing or string trimming
YES
NO
NIA
M.
Trees present on dam as applies to site
YES
NO
NIA
N.
Observation Well I_,evels (Speas ES Only)
A
B
Describe maintenance activities performed or planned for `YES'. answers above:
If more than one ]SNIP on site, denote the location of issue:

PERODIC imu, SITE INSPECTION, OPERATION & MAINTENANCE RECORD
Recorded by Date General Observations or comments
Vocation: Zone 8 — Kimmel FarrnES/Flat Rock MS
A.
Any adverse observations
YES
NO
N/A
13,
Plant life compromised or needing attention
YES
(D
N/A
C
Inlet/outlet clogged
YES
TO
N/A
D.
Vegetation growing in rip -rap or emergency spillway
YES
0
N/A
17'
I
Trash accumulation
YES
(DO
N/A
1�.
Noxious weeds, invasive vegetation / cattails present
YES
NO
N/A
G,
Bare soil erosion observed, slopes or embankments
YES
NO
N/A
1-1.
Grasses less than 8-12" in height (as applies to site)
YES
(ITO—)
N/A
1.
Animal interference or damage
YES
NO
N/A
J.
Sediment accumulation
YES
N/A
K.
Significant algae growth
YES
NO
N/A
L.
In need of mewing or string trimming
Y ES
NO
N/A
M.
Trees present on dam as applies to site
YES
NO
NIA
N.
Observation Well Levels (Spear ES Only)
A
B
Describe maintenance activities performed or planned for 'YES' answers above:
el
. ....... . . — -
If more than one BMP on site, denote the location of issue:

PEROIIIC BMP SITE INSPECTION, OPERATION & MAINTENANCE RECORD
Recorded by Date General Observations or comments
_71�; f/ p_[ I � 'D 1<, ^-e4
Location: Zone 8 — Kimmel FarmES/Flat Rock MS
A.
Any adverse observations
YES
ND
N/A
B.
Plant life compromised or needing attention
YES
TO
NIA
C.
Inlet/outlet clogged
YES
NO
NIA
D.
Vegetation growing in rip rap or emergency spillway
YES
NO
NIA
E.
'Trash accumulation
YES
NO
NIA
F.
Noxious weeds, invasive vegetation / cattails present
YES
NO
NIA
G.
Bare soil erosion observed, slopes or embankments
YES
NO
NIA
14.
Grasses Iess than 8-12" in height (as applies to site)
YES
N/A
1.
Animal interference or damage
YES
NO
N/A
1,
Sediment accumulation
YES
NIA
K.
Significant algae growth
YES
CNO
NIA
L,
In need of mowing or string trimming
YES
NO
N/A
M.
Trees present on dam as applies to site
YES
NO
NIA
N.
Observation Well Levels (Specs ES Only)
A
B
Describe maintenance activities performed or planned i-or `YES' answers above:
If more than one BMP on site, denote the location of issue:

I
If

o�cens on co repujr�--r
State Stormwater Inspection Report
annwral
Project Name:Z
Permit No: SW yp &C .70 I
Expiration Date:
Contact Person: /i
C(3rr'os. antlers
Phone Number: 33y ._
UQI-�199
Inspection Type: nn
Yrr<
Inspection Date: y _IQ , Z� I Z
Time 1n: 2 ', 3 v
Time Out: 3 ;. �Z)
Current Weather: �} a 1
I C I O N C
Recent Rain (Date)? y 17 Ix is
Rain- in
Location
Facility Address lLocation: yU.J2 Eb2rlt k�ps}cj
City: W. ,n Sr.. - 54 l e"A I Zip: z712 % 1
County: FYay{i, Lat: o _N Long: - o 1W
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 �LP
Stormwater Best Management Practices (BMPs) (insert 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 (sped):
Kilo RAViaw Yes No NIA NIF
1. Is the permit active?
2. Signed Engineer's ineer's Certification on Ilk?
3. Signed Operation and Maintenance agreement on file?
4. Recorded Deed Restrictions on file?
Sitn Visit- Built ttnnn Area MUM Yes No NIA NIF
5. 13UA 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 with ermil? 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 Yes, No NIA NIE
9. Stormwater BMPs are located per the approvedplans?
10. Stormwater BMPs have dimensions c , len th, width, area matchin the a2pmved pjanO
11. Stormwater BMPs are constructed per the approvedplans?
Sita Visit- Onaratinn nnrt Maintananen Yes Nn NIA NIF
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?
Z
15. Stormwater BMPs being operated and maintained as 2er the ernit re uirements?
16. Inspection and Maintenance records are available for inspection? (high densit • only. 1995 - present on[ )_
Site Visit: Other Permit Conditions Yes No NIA NIE
17. Is the site compliant with other conditions ol'thepermit?
Site Visit: Other Water gualitX Issues Yes No NIA NIE
18. Is the site com liant with other water quality issues as noted during the inspection?
Stale Stormwater Inspection Report, Version 3,0_3-09 Page I of?

State Stormwater Inspection Report
comments
��a t� c7rd+t- SAS.,,., ��+�d Ti✓ �r� \ ' .,..._...rr 11 ....
M+ iC 1 (I.
r
ow' /-7ct11 ctl��Pfee� ��lJ
InS action PlctUfeS (some of the pictures taken during the site visit)
r4
Compliance status ilk Compliant D Non -Compliant
Letter Sent (circle one): Yes No Letter type: CEI NOV NOVRE Other
Date Sent: Reference Number:
Inspector Name and Signature: (i"1,,,, &"Uy,1 01- Date;
MC s 610M,. Bi
g A
0 tutntxsgw
I N 6 1/ i E II I N Gf
The North Carolina Cooperative Extension certifies that
Carlos Sanders
has successfully completed the written and
practical examination for and is duly recognized as a
Certified StormwaterSMPinspection B Maintenance Professional
Date Expires: December 31, 2012
Certification Number: 1214 William F, Hunt, PhD, PE
State Slormwater Inspection Report, Version 3.0_3-09 Page 2 of 2

BIORETENTION CELL: 0 & M Inspection Checklist
1. Inlet and Perimeter are free of erosive gullies and bare soil areas:
a
El
E]
0
2. Inlet device (swale, pipe, stone verge) is free of erosion, damage or clogs:
Er
El
El
0
3. Weir heights appear to match approved plans:
1:1
1, P,
;PRETREATMENT f if
71
4. Flow is entering pretreatment area (not being bypassed):
El
El
EJ
5. Pretreatment area is free of erosion: (- k- of &J-)
El
El
El
El
6. Pretreatment area is free of excessive sediment or clogs:
2-'
El
EJ
El
MAIN
7. Side slopes are 3:1 or less:
03"
E
El
El
8. The under drain system is free flowing and free of clogs (if applicable):
EY'
El
0
0
9. Cleanout(s) and cap is provided for the under drain as per the approved plans:
0'
1:1
0
0
10. Heavy equipment has not been driven into the cell:
El
'
EJ
El
11. Surface is free of piles of heavy materials (piles of mulch, etc):
0'-
El
El
EJ
12. Ponding depth is 9-12 inches after rain:
0"
El
11
EJ
13. All dimensions are >=10ft.:
Er'
0
C-3
El
S()IL/MliLCk'i6d.,VEGETATION:;�;.,,--
-j-
14. Plants are healthy and being maintained:
E�
El
El
El
15. The proper amount and type of vegetation is present in the cell:
�
0
EJ
El
16. Mulch is in good condition (has not broken down or floated/ migrated towards the qytlpt):
❑
0
0
El
17. Surface if free of excessive sediment and clogs:
11
0
0
18. Trees are free of stakes/wires > 6 months after planting:
2'
1:1
El
El
19. The annual soil test shows the proper pH and absence of heavy metal accumulation:
EJ
EJ
2-
ED
20, Outlet is free of evidence of improper drainage (no standing water, cattails, etc.):
21. Outlet device (drop inlet, weirr, etc.) is free of damage or clogs:
�
El
El
El
22. Orifice size matches approved plans:
El
El
El
23. Outlet is free of damage, clogs, or erosion:
'
11
El
11
24. Relative elevations match approved plans:
El'
El
El
1:1
V3.309

q
STORMWATER BMP: BIORETENTION BASIN
Inspector(s): Carlos SgAdAes
BMP ID#: 5w yceo-yo r
DIVISION:
COUNTY: Foesy►'h
DATE INSTALLED: Afr. i 7-D J0
Inspection Date: Apr: I lyr 2j, z
LOCATION: 1fb72- F_�k Qd•
w""+" - Sn1 � �.. N4 Z 71 17
Structural Components
Y..,N N/A
dil ❑ Inletloutlet drainage systems are structurally sound and functional.
E ❑ ❑ Forebay and transition berm are structurally sound and functional.
E<❑ ❑ Basin, embankment, and emergency spillway are structurally sound and functional.
(Sediment must be removed from the basin when it exceeds 50% or more of the
BID
storage capacity.)
U ❑ ❑ Filter media and underdrain, including cleanouts, appear to be structurally sound and
functional.
E'❑ ❑ Outlet control structure and components are structurally sound and functional.
Areas of Maintenance
Y N N/A
�❑ ❑ Inlet and outlet ditches/pipes are free of sediment, leaves, trash, and other debris.
L�J ❑ ❑ Forebay is clean and free of sediment, leaves, trash, and other debris. (Sediment must
,/ be removed when it exceeds 50% or more of the forebay's storage capacity.)
t(a ❑ ❑ Crass has been mowed and undesirable vegetation removed.
R"❑ ElPlants are healthy and mulch layer is adequate (at least 3 inches).
,
Y� ❑ ❑ Basin is free of standing water.
El 0 ❑ Areas of erosion have been repaired.
LJ ❑ ❑ Trash rack is unobstructed and free of sediment, leaves, trash, and other debris.
Y N
❑ Z Are structural repairs needed at this site? (If yes, describe in Comments.)
Z'EJ Is any maintenance necessary at this site? (If yes, describe in Comments.)
❑ tip Were maintenance activities conducted at the time of inspection?
(If yes, describe in Comments.)
4
Comments/Recommendations/Actions Taken:
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