SW4130301_CURRENT PERMIT_20130404

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW 413 03 O
DOC TYPE
E�J; CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
DOC DATE
;;or3 09-?4
YYYYMMDD

NC®ENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Mr. Jeff Chamberlain
Charter Development Company, LLC
3850 Broadmoor Ave., SE, Ste. 201
Grand Rapids, M1 49512
Division of Water Quality
Charles Wakild, RE,
Director
April 4, 2013
Subject: Stormwater Permit No. SW4130301
Summerfield Charter Academy
High Density Commercial Sand Filter
Guilford County
Dear Mr. Chamberlain:
John E. Skvarla, !II
Secretary
The Stormwater Permitting Unit received a complete Stormwater Management Permit Application for the
subject project on April 3, 2013. Staff review of the plans and specifications has determined that the project, as
proposed, will comply with the Stormwater Regulations set forth in Title 15A NCAC 2H .1000. We are
forwarding Permit No. SW4130301, dated April 4, 2013, for the construction, operation and maintenance of
the subject project and the stormwater BMPs.
This permit shall be effective from the date of issuance until April 4, 2021 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 150B of the North Carolina General Statutes. Per NCGS 143-
215(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 Winston-Salem 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 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 Opportunity l Affrmative.d& Employer
One
NorthCarolina
Naturatlb

Mr. Jeff Chamberlain
SW4130301 -- Summerfield Charter Academy
April 4, 2013
cc:-SW4130301 File
David R. Shepherd - Property Owner
ec: Charles 1. Christy, PE - Wade Trim, Inc.
Sue Homewood - Winston-Salem Regional Office
Page 2 of 2

State Stormwater Permit
Permit No. SW4130301
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
Charter Development Company, LLC
Summerfield Charter Academy
5303 US 220 North, Summerfield, Guilford County
FOR THE
construction, operation and maintenance of one (1) sand filter in compliance with the
provisions of 15A NCAC 02H .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 April 4, 2021, 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 174,001 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.
4. All stormwater collection and treatment systems must be located in either
dedicated common areas or recorded easements. The final plats for the project
will be recorded showing all such required easements, in accordance with the
approved plans.
5. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
6. An undisturbed riparian buffer must be provided 50 feet landward of all surface
waters.
Page 1 of 6

State Stormwater Permit
Permit No. SW4130301
7. The following design criteria have been provided in the sand filters and must be
maintained at design condition:
a. Per the attached Sand Filter Supplement Form & Level Spreader —
Vegetated Filter Strip Supplement Form for DA #1 dated April 2, 2013, and
approved April 4, 2013.
b. Per the attached Sand Filter Supplement Form for DA #2 dated April 2,
2013, and approved April 4, 2013.
c. Per the attached Sand Filter Supplement Form for DA #3 dated April 2,
2013, and approved April 4, 2013.
d. Per the attached Sand Filter Supplement Form for DA #5 dated April 2,
2013, and approved April 4, 2013.
e. All discharging to:
Receiving Stream/River Basin: UT to Haw River 1 Cape Fear
Stream Index No.: 16-(1)
Classification of Water Body: "WS-V; NSW"
II. SCHEDULE OF COMPLIANCE
The stormwater management system shall be constructed in its entirety,
vegetated and operational for its intended use prior to the construction of any
built -upon surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The permittee shall at all time provide the operation and maintenance necessary
to assure the permitted stormwater system functions at optimum efficiency. The
approved Operation and Maintenance Plan must be followed in its entirety and
maintenance must occur at the scheduled intervals including, but not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and re -vegetation of slopes and the filter strip.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans.
f. Debris removal -and unclogging of all drainage structures, level spreader,
filter media, planting media, underdrains, catch basins and piping.
g. Access to the cell and outlet structure must be available at all times.
4. Records of maintenance activities must be kept for each permitted BMP. The
reports will indicate the date, activity, name of person performing the work and
what actions were taken.
5. The permittee shall submit to the Division of Water Quality an annual summary
report of the maintenance and inspection records for each BMP. The report
shall summarize the inspection dates, results of the inspections, and the
maintenance work performed at each inspection.
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. SW4130301
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 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.
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'.
2. The permittee is responsible for compliance with all permit conditions until such
time as the Division approves a request to transfer the permit.
Page 3 of 6

State Stormwater Permit
Permit No. SW4130301
3. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the Division of Water Quality, in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
4. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
5. In the event that the facilities fail to perform satisfactorily, including the creation
of nuisance conditions, the Permittee shall take immediate corrective action,
including those as may be required by this Division, such as the construction of
additional or replacement stormwater management systems.
6. The permittee grants DENR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
7. The permit issued shall continue in force and effect until revoked or terminated.
The permit may be modified, revoked and reissued or terminated for cause. The
filing of a request for a permit modification, revocation and re -issuance or
termination does not stay any permit condition.
8. Unless specified elsewhere, permanent seeding requirements for the stormwater
control must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
9: Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
10. The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revoking and reissuing the permit, or terminating the permit
as allowed by the laws, rules and regulations contained in Session Law 2006-
246, Title 15A NCAC 2H.1000, and NCGS 143-215.1 et.al.
11. The permittee shall notify the Division in writing of any name, ownership or
mailing address changes at least 30 days prior to making such changes.
12. The permittee shall submit a renewal request with all required forms and
documentation at least 180 days prior to the expiration date of this permit.
Permit issued this the 4th day of April, 2013.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for Charles Wa ild, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 4 of 6

State Stormwater Permit
Permit No. SW4130301
Summerfield Charter Academy
Stormwater Permit No. SW4130301
Guilford County
Designer's Certification
I, , as a duly registered in the
State of North Carolina, having been authorized to observe (❑ periodically 1 ❑weekly 1
❑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. SW4130301
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: Winston-Salem Regional Office
Surface Water Protection
565 Waughtown Road
Winston-Salem, NC 27107
Page 6 of 6

Permit NumberSW -! 3 °:W
1 (to be provided by DWQ)
�p.Y1r:T[•�
AN .
NCDENR 1
STORMWATER MANAGEMENT PERMIT APPLICATION FORM_
401 CERTIFICATION APPLICATION FORM
SAND FILTER SUPPLEMENT
This form must be filled out on line, printed and submitted with all of the required information.
Make sure to also.ftll out and submit the Required Items Checklist (Section Ill) arid the IN Agreement (Section M.
I!: PROJECTaINF,ORMATION ._ `.; _ :,.' _ Tit; .1 _...ilfi __ _s �.' w. _ _` 9�� _ r i µ a -•1
Project name _fSummerfield Charter.Academy
Contact name !Charles J. Christy
Phone number AB28.337.0251 1
Date !April 2, 2013 J
Drainage area number 'D.A. #1 -� 7. 1'
II!'DESIGN INFORMATIONI,•
Site Characterlslics
Drainage area (Ao) 93,021'.00;V,' OK
Impervious area ; 36304.00Itz,
% Impervious (la) 39.0% % •
�I;}Nr(Ftryi,!' ��ti?e':':'.•,'}?, .� i ii11i i.1Dl:UritiCniS
Design rainfall depth (Ro) 1.06-in t`anstructior irs accor8,:;, ti„I,'i :zse docurnents i�
Peak Flow Calculations
1,yr, 24-hr runoff depth
1-yr, 24-hr intensity
Pro -development 1-yr, 24-hr runoff
Post -development 1-yr, 24-hr runoff
Pro/Post 1-yr. 24-hr peak control
Storage Volume
Design volume (WOV)
Adjusted water quaiity.volume,(WQV4)
Volume contained in the sedimentation basin and on top of the sand filter
Top of sand fltertgrate elevation
Weir elevation (between chambers)
Maximum head on the sedimentation basin and sand filter (hM.Fibr)
Average head on the sedimentation basin and sand filter (hA)
Runoff Coefficient (Rv)
Type of Sand Filter
Open sand filter?
SHWT elevation
Bottom of the sand filter elevation
Clearance (dsHw!r)
Closed/pre-cast 'sand filter?
SHWT elevation
Bottom of the sand filter elevation_
Cie ara_ nce (dsw)
If this is a closed, underground closed sand filter; The clearance between,
the sufface of.lhe sand friter and the bottom of the roof of the undergroun'd
structure (ds,o,)
mqutreel by tYt' storrnwnter r ::;, ;. Nuri`i ,amlin-,
2-76_
In'
ides require that the s'.«nr:v;-,' . Fv:;' :r Jesigner
Inspect
during con: ru. iiun: c:erlliy'f.olrformity with thk!
inthr
Plans and spe;:s; certify ce mptiance with the
'0 89
3
l ff lsec
3orruwater rules. r 15A NCAC 21­1 .1008 (j) )
r'Li:t,it i,_ 51Vq 130 301 I N !:3 '
3.45
1ft3lsec
_1Zp�� - J+t(: �; :jjt:ll pf'lyat� Q tciliti
2.56
ft3lsec
--
` LL 3;110.00'R3
2,332.50 ft3.
( - ,85ti55 _I ft amsl
60:5t J ft amsl
I ;1'29�,I1
l' -;0;95'•fl
�0:40 (unitless)
I Y. YorN
J V1342"Wftamsl
i !�846:50]Ramsl
-
i,. aN J Y or
Jft amsl
rJft amsl
Jft
I
- r
ax
Insufficient depth.
Ensure.that the average is half of the max,
Form SW401-Sand Filter-Rov.5 2008Sept17 Parts) and II, Project Design Summary, Page 1 of 2

N.
Permit Number. �iY-3Q3b1
:;(to be '(4vided by DWQ)
Sedimentation Basln
Surface area of sedimentation basin (As)
Sedimentation basinlchamber depth
Sand Filter
Surface area of sand filter (AF)
Top of sand media filter bed elevation
Bottom of sand media filter be_d/drain elevation
Depth of the sand media filler bed'00
Coefficient of permeability for, the sand filter (k)
Outle't'diameter_
Outlet dischargelflowrate
Time to drain the sand filter (t)'•
Time to drain the sand filter (t)'
Additional Information
Does volume in excess of the design volume bypass the sand filter?
Is an off-line Row -splitting device used?
If draining to SA waters: Does volume in excess of the design volume flaw
evenly distributed through a vegetated filter?
What is the length of the vegetated filter?
Does the design use a level spreader to evenly distribute stow?
Is the BMP located at least 30ft from surface waters (50ft if SA waters)?
if not a closed bottom, is BMP located at least 100ft 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)?
What is the width of the sedimentation chamberlforebay.(WW)?
What -Is the depth of sand over the outlet pipe (dpipe)?
240.00' ft?
_ 3,0a, ft
I i1;566:00!fir
'; 'f34850ift amsl
8.46 50, ft amsl
"2.00 It
':3.50' (ftlday)>
z4:ri;1ift'lsec I,
27 60' flours
• 1.15-days
VR IVIMAZD IIIIId111UL11, UUL IIIdy 11=U LU UG 111Ud CdbeU LU
Vr\. muum Ir IIl111nu 11 I, UuL'rlldy Itvtu-LU Ur IIu�LGdz vu LU
OK. Submit drainage calculations.
�Yr _ J Y.o'r N'i OK't
3Yz' t
YarN,
OK {•
,I
YorN
`} Y ' �'
YorN'
OKi
Y
Y or
OK
Y... ?
Y or N.
M
1'
Y l4
OK=.
tY
Y or N
,OK
- 30.%ft
OK,.
2,001ft
OK-,
Form SW401-Sand Filter-Rev.5 2009Sept17 Parts I and II. Project Design Summary, Page 2 of 2

S by q.13o Yb/
ASP
NCDENR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
LEVEL SPREADER - VEGETATED FILTER STR,I. (LS-VFSj SUPPLEMENT
ir
This form must be completely filled out, printed, Initialed, and suhmitted..
1k=PROJECT INFOR-MATION' _ -` „ 71; - ~i
Project name — jiSummerfieldCharterAcademy
Contact name ,Charles J. Christy ;
Phone number' `828,337.0251
Date 'April 2, 2013 — ---- j
Drainage area number jnA911.,
The purpose"of the LS-VFS (Buffer Rule, Diffuse Flow„
Slomwater enters LS-VFS from !A BMP t
Type of VFS i9ther: Explained below — l
-7
Explanation of any'Other' responses above ' Diffuse flow before buffer and 15% slope
If Stormwater Enters the LS-VFS from the Drainage Area
Drainage area
Impervious surface area
Percent impervious
Rational C coefficient
Peak now from the 1 Whr storm
Time of concentration
Rainfall intensity, 10-yrstorm
Peak flow from the .10-yr storm
Design storm,
Maximum amount of now directed to the LS-VFS
Is a Row bypass system going to be used?
Explanation of any"Other" responses above
If Stormwater Enters the LS-VFS from a BMP
Type of BMP
„Peak discharge from the BMP during the design storm
,;Peak discharge from the BMP during the 10-year storm
Maximum capacity of a 100-foot long LS-VFS
Peak flow directed to the LS-VFS
Is a Row bypass system going to be used?
Opfanatlor; of any 'Other' responses above
!".ahzlrr;tiwrilr7�i�rurl�� �fi�, . oc
}�4ilfoi�:l�y�lr.�ti dltJrrtiu;lttJi `: .,Irl,, „la rsi�
tnp s`I'i,�ufra.'tlrrl;:iJle u:.ltfi�.t
f7oC! Sfulffig:�Yitlri lull c (Y f �iin•'Ofr
J rn S Aride`'t . rirl�� �`ryyla�rfl,rh
�ftrllYiri3(fJF.1rILS fl;cjtli�,�af'i''.it7C13(i,
Form SW40i - LS-VFS - Mune2012 - Rev. IQ'
{a ' Do not complete this section of the form.
'. Do not complete this section of the form.
95 Do not complete this section of the form.
'
Do not complele this section of the form
cis
Do not complete this section of the form.
; ndn
Do not complete this sectGh of the form.
( j 6thr
Do not complete this section of the form.
cis`
Do not complete this section of the form.
_I cis
Do not complete this section of the form;
( _ ;(Y or N) _
_Do not complete this section of the form.
Olher; Explained below
710.28 -. '{cis
0.28 Jds
.,,cis
rlfp`41 s(�ts,:
Sand Filter _
i 11111 fF! ,`
fr04 =
G� page 1 of 3

Sw�tf 3� �01
LS•VFS Design
Foretlay surface area
Depth of lorebay at stormwater entry point
Depth of lorebay at stormwater exit point
Feel a1 level lip needed per cfs
Computed minimum length of the level lip needed
Length of level lip provided
Width of VF§
Flevallon at downslope base of level llp'
Elevation at the end of the VFS that is farthest from the LS
Slope (from level lip to the end of the VFS)
Ale any draws present in the VFS?
Is there a collector Swale at the end of the VFS?
Bypass System Design (if applicable)
Is a bypass system provided?
Is there an engineered flow splitting devEce?
Dimensions of the channel (see diagram below):
fu1
Y�V�Yj
4i•.
y (flow depth for 10-year storm)
freeboard (during the 10-year storm)
Peak velocity in the channel during the 10-yr storm
Channel lining material
Does the bypass discharge through a wetfand?
Does the channel enter the stream at an angle?
Explanation of any 'Olher' responses above
190
sq ft
No lorebay is required:
6
jln`
Daplli is approprlale—
fticls
a.
) ft
Level spreader is.loo short 0 handle the flow.
f�. 837
if
.� -.639.75`
Ifmsl
14.76
%
VFS is too steep.
j(YarNY
OK
N.
1(YorN)
N= j(Y or N)
N 1(YorN)
_
[ft
�.- —
f Ws©c
;.,
i(YcrN)
'
(YorN)
Form SW401 - LS-VFS - 2SJune2012 - Rev.10 page 2 of 3

Permit Number. 5_ik l�l3p 0r
c (ro be provided by DWQ)
NCDENR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM'-
S_ ANDIFfLTER S,UPPLEM.ENT
This form must be filled out on line, printed and submitted with all of the required information.
Make sure to also fill out and submit the Required Items Checklist (Section lll)-and the I&M Agreement (Section IV)
IrtPROJECT INFORMATION
Project name ISurpmerfield Charter Academy
Contact name. ICharles'J. Christy }
Phone number j828.337.0251 d
Date [April,2, 2013
Drainage area number JD.A. #2 f
Ih,OESIGMINFORMATION
l:
'Site Characterlstics
Drainage area (Ao) �149;79900ptl „ 01(;
ft2
Impervious area '98;461t1t]It�
% Impervious (Ix} 64 4% o7p
Design rainfall depth (Ro} 001i -. N -►! • ,auntrsryt+.
.t►n4lrri�t�t,i u:..+a + ",e •lt,'�strr • t� '.
Peak Flow Calculation's
1-yr, 24-hr runoff depth
1-yr, 24-hr intensity
Pre -development 1-yr, 24-hr runoff
Post -development 1-yr, 24-hr runoff
Pre/Post 1-yr, 24-hr peak control
Storage,Volume
Design volume (WQV)
Adjusted water quality volume (WQVA)
Volume contained In the sedimentation basin and on top of the sand filter
Top of sand filter/grate elevation
Weir elevation (between chambers)
Maximum head_ on the, sedimentation bas-in and sand filter (hM.Flw)
Average head on the sedimentation basin_ and_ sand filte_r.(hA)
Runoff Coefficient (Rv)
Type of Sand.Filter
Open sand filter?
SHWT elevation
Bottom of the sand filter elevation
Clearance (d§kn)
Closed/pre-cast sand filter?
SHWT elevation
Bottom of tita sand filter elevation
Clearance (dsHl}
If this is a closed, underground Closed sand filler: The clearance between
the surface of the sand frlterand the bottom of the roof of the underground
structure (dsmw)
• 1r.n .• t
'+-7tirrc hy.lt ,trltrr,nv,ll+, t r;t+ *011N _�arr,lirl.
2;78
in
.
,lIE7 i�l'US;UIrFl tltll�iill.", �a_rt'� 4igneI.
�Inspofi
swrirt�j •',:+!e�H,�"i1:,r,. drl.r+no:ifon�+l►y tivirll tit
i 4l}a2x�
linlhr
�hn .aim sfx% i , ;1r'I' _: rlJdRi,ice ►vlth the
1:43i.ltf?8{f1}
ftt3lsec
,n-, 1;1?rUIe!t tt Js rtr`�'.f
S�t13o 30!! K T
:,taTu
5.D7
f[ 15eC
m f': (it: oiof [1�1 Ftflsv
(lie
i 7i864 0000 ft3-
5,898.00 its
B;D9D,OD it';
( 826; 5 10 amsl' I
825,25 lft am_ sl,
ri _ 17.lift
1 ,0AII `
0.63 (unitless).,
!Y,77 Y or N
[ ` 818,93ift amsl
821:OOfl amF�
'2>071
f 75 i. YorN
( Iftamsl,f
' ].ftamsl
1.
f i
ill
OK,.
Ins u_tfic_ ient depth.
OK
:.•�uinrr�,.,
IF
is
42
„ ,9 .F•t�INE e¢�Co
.,, S.J. �, f
Form SV11401-Sand Filler-Rov.5 2009Sept17 Paris I and II, Project Design Summary, Paget of 2

Peirnti Number:'S 6/41 3o3z) '
'
(to be provided by MVQ)
Sedimentation Basin
Surface area of sedimentation basin (As)
z .
V1%.
IYICUO IIIIIIIIIIUIII, UUt I[I0Y IIUt;U N UC IItUAJdbCU LU
Sedimentation basinlchamber depth
2i50 fit.
'
Sand Filter
Surface area of sand fitter A)F
:2ie51-tt0i fit'-
Vr\:
14IGGW 01IIIIII IUII I, 11Ul IIIpy IIt= N Uu ulid tld�Cu tll
Top of sand media filter bed elevation
a823:00ft amsl
�t �/4_ 'J. 1,. ' •! _1�. !+- ..
Bottom of sand media filter bed/drain elevation
a
Depth of the sand media fitter bed OF)
2,OO.ft
Coefficient of permeability for.the sar_id filter (k),
3;5Q,(ftlday)
Outletdiameter [
_ .92,GOlfii
Outlet dischargelflowrate (
f!t)20ift3lsec
Time to drain the sand filter (t) (
29.801hours
OK.
Submit drainage calculations.
Time to drain the sand filter (t)
1.24days
"
Additional Information
Does volume in excess of the design. bypass the sand filter? (
_ 9 YP
°°Y, Y; —N I N,
OK
Is an off-line flow -splitting device used? f
_
y y; '
Y; pf
� N
OK
it draining to SA waters: Does volume in excess of the design.volume flow
evenly distributed through a vegetated filter?
Y or N
What is the length of the vegetated filter?
Does the design use a level spreader to'evenly distribute flow?
i Y or, N,
Is the BMP located at least 30ft from surface waters (50ft if SA.waters)?= ;
LY. _) Y or N
OK'
If not a closed bottom, is BMP located at least 100ft from water supply wells? .i
*Y ) Y or N
OK .
Are the vegetated side slopes.equal to or less than 3:1 i
'Y . _ Y or N
OK'
Is the BMP located in a recorded drainage easement with a recorded access
Y
easement to a public Right of Way (ROW)? i
Y or N
. OK
What is the width of the sedimentation chamberlforebay (Wsm)?
25.001ft
OK '
What is the depth of sand over the outlet pipe (dpipe)? €
-3,66j'ft
OK
Form SW401•Sand Filter-Rev.5 2000Sept17 Parts I and II. Project Design Summary, Page 2 of 2

Permit Number _'; W'0 3 Y0-
(to be provided by DING!)
MAIL
WDENR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
SAND FILTER SUPPLEMENT
This form must be filled out on tine, printed and submitted with all of the required information.,;
r
Make sure to also fill out and submit the Required Items Checklist (Section 111) and the I&M Agreement (Section t Lr7 ,
I: ', PROJECT. INFORMATION ,-- -. , a. _ _ -. t - -T
Project name jSummerfeld Charter Academy �.
Contact name (Charles J..Christy
Phone number 1828.337,0261� t,
Dale. }April 2, 2013
Drainage area number
ll.'DESIGNIINF,ORMATIONt
Site Characteristics' - -
Drainage area (AD) •j 86,59 p,t? 'QK
Impervious area l F38 723.0D, ft?
% Impervious (IA) 55.2%.0/.
Design rainfall depth (RD)
Peak Flow Calculations ,unstructior• ;n ,;ia oru_'sat dnouli un(d it
mauired by wt . storrnwalr.rj.,, r:;. tYnrti •'arolin:
1-yr, 24;hr runoff depth I :2:7Eir.. (in': -ales rei;10.0 rhat 1no i1ns. :, r rJo*rlgrinr
1-yr;•24-hr, intensity I Oil` linthr Inii'ri! I lririnjf 1;�nit.fnr �,n; ifr; zgntaimiiy wlill Ill
3 nl�nriarldOr -. at --nr'tolliYy li?PliniireNWith:ihe
Pre -development 1-yr. 24-hr runoff I rO.B+i- lft Isec ;,,;,r, ,w IItr Toles. f 15A rtii_: i; ai .1U08{j) t
Post•develooment 1-yr, 24-hr runoff (ft3lsec :tiGr.rrit tt $_bY.KI ,301 iiste�4T?
Pre./Post 1-yr, 24-hr peak control 2.25 fl Isec by __.0?7 f .... 'WC r-. •, ;;_i1)n oi'vV:alaif
Storage Volume rl' :t _ ''ai 1R! '�nii• �t?,i7
Design volume (WQV) 3,1531.00:fts
Adjusted water quality volume (WQVA.'A _ _ 2,273.25.ft�.
.OK
Volume contained in the sedimentation basin and on top of the sand filter 3;333':00} ft1
Top of sand filterlgrate elevation 1 ._ 944 f ft amsl
Weir elevation (between chambers) I ..843 _ 1ft amsl
Maximum head on the sedimentation basin and sand filter (hk,,,,F,,.,) S ?2:39itt OKr,
Average head on the sedimentation basin and sand filter (hA) , i 1:1911ty. OK,�
Runoff Coefficient (Rv) -- 0.55 (unitless),
Type of Sand Filter
Open sand filter? -� Y,'; _ �. Y or N
SHWT elevation s, 830A 01 ft amsl
Bottom of the sand filter elevation 838;501 ft amsl
Clearance. (dam): 40}:
.Closedlpro-cast sand filter? ; :N fs. Y or N'
SHWT elevation' ! _ Ift amsl t '
-. �
Bottom of the sand filter elevation ft amsl rrrnrr�, *�*,�►.-
Clearance (d.5 wr) j7",t'al
It this is a closed, underground closed'sand filter: The clearance between l : •:'pr`' y.
the surface of the sand,filter and the bottom of the root of the underground ft. _
structure (dam) -
- w 424.
Im
��rrl it 40%
R•--
Form SW401-Sand Filter-Rev.5 200QSep117 Parts I and It. Project Design Summary, Page 1 of 2

Permit hu`mber ,44*-W 36'
(to be provided by DWQ)
Sedimentation Basin,
Surface area of sedimentation basin (As)
Sedimentation basinlchamber.depth
Sand Filter
Surface area of sand filter (AF)_
Top of sand media filter bed elevation
Bottom of sand media filter bed/drain elevation,
Depth of the sand media filter bed (dF)''
Coefficient of permeability for the sand filter (k),
Outlet diameter.
Outlet discharge)flowrate
Time to drain the sand filter.(t)
Time,io drain:the,sand filter (t)
Additional Information
Does volume in excess of the design volume bypass the sand filter?
Is an off-line flow -splitting device used?
If draining to SA waters: 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 30111 from surface waters (50ft if SA waters)?
If not a closed bottom, is BMP located at least 100ft from water -supply wells?
Are the vegetated side slopes equal to or less than 11
Is the BMP located in.a recorded drainage easement with a recorded access
easem_ ent to a public Right of Way (ROW)?
What is the width of the sedimentation chamberlforebay (Wrd)?
What Is the depth of sand over the outlet pipe (d pipe)?'
�. � •
VI\. IVICGW I r 11111111U111, wul 111cly 11=u lu.uQ 1110 twbtu IV,
3`D0ift.
- , . ,.,
-Y -
i• --- =721'.04Q
Vr\. IvICCSW Inn 111l lur r 1, Uul Ildy II=U lu uC into CdZWU w
5;_s"'ni:.
j8A0.50.ft•amsI
_,���'t;._ ..�.:S..:i�.. raw
....- ,t .-_-..__.,.. .......� -.
18!uo0 ft amsl
2.00 .ft "
-_ 36 (it/day)
_ c6:00'in.
t '10;50ftylsec
i' 312tt`holars
OK. Submit drainage. calculations.
�1:30 days
Y
Y orRN:
Oi(�
Y.nr_N.
01(
^
Y.or N
I
if
[ —
Y'or.N.
'.w!,
Y'br ld
M,
s
'Y;.
{
Y"brN
OK'-
`�Y=
1
Y'a�N:
0.K
�r1
i
Y or N
6K;
--
1.
12.00',ft
OK
—
-
3:25,`ft
OK
Form SW401 Sand Filter-Rev.5 2009Sept17 Parts I and 11, Protect Design Summary, Page 2 of 2

+ � r
AATA
HCDENR
PermitWmber5'y
(to be provided by DWQ)
�4�qF ••V r'`�'R�G
� C!
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
SAND FILTER SUPPLEMENTt
This-fonn.must be filled out on tine, printed and submitted with allot the required information, -
Make sure. to also fill out and submit the Required Items Checklist {Section Ifl} and the 1 &M Agreement {Section IWJ
- —
NA710N�- -"• _: � � �� ,I" :t° � ;._
Project name V _
Conlact name
Phone number
Date
Drainage area number
,Charles J. Chrlsty _-
_'828.337.0251
!April 2, 2013
..lD.A. #5
I1POESIGN'INFORMATION'
Site Characteristics
Drainage area (AD)
`�—�8,340.00� ftz•
OK
Impervious area
4513.00,It�
% Impervious (la)
54.1 % %
Design rainfall depth (Rp)
1.00. in
I.; .' ys:ur►asit•.
Peak Flow Calculations
',OrY5lrUCtiUi'irlNLfp,�IL
;t;zli�ll'k+�! lilj si; csio�rr r,.r, •
l,n `s:fl�•ALmCRIi::!
t. litrn� :i�rrkirr
1 yr, 24 hr runoff depth;Iles
require that the a,_ ru:r.,
I is.'• rh stq) f
1-yr, 24-hr intensity
y -
,U,12. j nthr
lndpao dtiloll C.L01',TIr0-I`lirt..
rs,ns and s o; _� r call' `s
+Y i,P+11ormlty with m.-
1:niiiiarlee WWI 11it:''
Pre -development 1-yr, 24-hr runoff
; ft'lsec
?r,, ,water rues; (15:. N('1i.J, zip .1008 (p)
�rrllll r' �ti/•!�,l g3o l
Post -development 1-yr, 24-hr runoff
;;0:351 lft'lsec
'
Pre/Post 1-yr, 24-hr peak control
0.29 Wlsec
Storage Volume
'Design volume (WOV)
1 375.00, ft
Adjusted water quality.volume (WQV,do
281.25 ft3
Volume contained in the sedimentation basin and on to of the sand filter
DK
Top of sand filter/grate elevation
I ; 854 1 ft amsl
Weir elevation (between chambers)
! $52 5 I ft arrisl'i
Maximum head on the sedimentation basin and sand filler (hlYlazrnWr)
( 0;5Ti'fi
Insufficient depth.
Average head on the sedimentation basin and sand filter (hp) y,
solqjt.
OK
Runoff Coefficient (Rv)
0.54 (unitless)'„
Type of Sand Filter
Open sand filter?
Y or N
SHWT elevation
843.00'ftamsl
Bottom of the sand filter elevation
I 449,50, ft amsl
Clearance (dsyr,, &
' 6;50;
Closedlpre-cast sand filter?
( V i Y or N
SHWT elevation
i - .I ft amsi
Botlom of the sand filter elevation
1 Ift amsl
Clearance (dsie)
If this is a sand filter: The between
closed; underground closed clearance
the surface of the sand filter and the bottom of the roof of the underground
structure
5
fi
•
14Z°
I
Form SW401-Sand Filter-Rev.5 2009Sepd7 Parts I and II, Project Design Summary, Page 1 of 2

+ - I r
i
Sedimentation Basin
Surface area of sedimentation basin (As)
Sedimentation basin/chamber depth
Sand Filter
Surface area of sand filter (AF)
Top of sand media filter bed elevation
Bottom of sand media,filter bed/drain elevation
Depth of the sand media filter bed (dr)
Coefficient of permeability for the sand filter (k)
Outlet diamoier
Outlet dischargelflow(ate
Time to drain the sand filter (t)
Time to drain the sand filter (t)
Additional Information
Does volume in excess of the design volume bypass the sand filter?
Is an,off;line flow -splitting device used?
If draining to SA waters: 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 3011 from surface waters (50ft if. SA waters)?
If not a closed bottom, is BMP located at least 100ft from water supply wells?
Are the vegetated side slopes equal to or less than 3:1
Is the BMP located in a recorded drainage easementwith a recorded access
easement to a public Right of Way (ROW)?
What is the.width.of the sedimentation chamberlforebay (Ws,a)?
What is the depth of sand over the outlet pipe (dpipe)?
Permit Number.—w-1-1130'30/
(fo be piovided by'DWQ)
t :'Z Un. fll AMP IIIIIIIIIIUIII, UUt Wdy 11tau IU UV 111t ludJCU tU
st�:oa;h�
"f'i' "'� `• VA. IYitiCIJ IIIII II III UIII, UUt lllay IICCU tU VC lnu abvu tV
425.00IItr
I-851'50i 1t amsl - '�^ . _ ., . ,. - - . _ .. . _ -..... '=�: •:
.849'50)ft amsl
-2.00 It
- - 0,5flftlday)
I 'i24X,hours OK. Submit drainage calculations.
.1.00 days
-1 Y+or N,) OK„
Y o1 N:.
OK ,
Y.or N
I
t. .
YoiN
i ;X
# Y of N '
OK
Y ar N .
OK
Y or M.
OK
jy,.
YorN
10.06'#t
OK;,
325`:ft:
OK:.
r
Form SW401-Sand Filter-Rev.5 2009Sep117 Parts I and II. Project Design Summary, Page 2 of 2

Permit NumberSW'�13 030�
'I,
(to be provided by DWQ)
A &7* A&
a� W a7�9
0 Oy
NCDENR
r
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
SAND FILTER
SUPPLEMENT
This form must be filled out on line, printed and submitted with at/ of the required information.
Make sure to also fill out and submit the Required Items Checklist (Section 111) and the I&M Agreement (Section IV)
I. PROJECT INFORMATION
Project name
Summerfield Charter Academy
Contact name
Charles J. Christy
Phone number
828.337.0251
Date
April 2, 2013
Drainage area number
D.A. #1
II. DESIGN INFORMATION
Site Characteristics
Drainage area (AD)
93,021.00 ft2
OK
Impervious area
36,304.00 ft2
% Impervious (la)
39.0% %
Design rainfall depth (Ro)
1.00 in
r uprotfetf or^ _�.v, -tn!.:' ocurnents
C6nstructior� in ar,';oroar, : ���;,n ' iese documents iv.
Peak Flow Calculations
inquired by the stormwater N-:fm3 North carolin;
?vies require that the sus,e r designer
1-yr, 24-hr runoff depth
2.78 in
Inspect during constru. ik)n. certily conformity with thr-,
1-yr, 24-hr intensity
0.12 inihr
plans and spec -i; ame' certify compliance with the
Pre -development 1-yr, 24-hr runoff
0.89 ft lsec
stormwater rules. r 15A NCAC 2H .1008 (j) )
Permit#_ Sti/�i3o301 Late �tfy j3
Post -development 1-yr, 24-hr runoff
3.45 ft3lsec
b„ -- J"-
NC C-cision of'Nate• O•!alih7
Pre/Post 1-yr, 24-hr peak control
2.56 ft3lsec
_2�P
; ,ac; _ - - ` _ r• ,,,; ; rate. y)?!7 .
Storage Volume
Design volume (WQV)
3,110.00 ft'
Adjusted water quality volume (WQVAdi)
2,332.50 ft3
Volume contained in the sedimentation basin and on top of the sand filter
3,442.00 ft3
OK
Top of sand fiilterigrate elevation
851.5 ft amsl
Weir elevation (between chambers)
850.5 It amsl
Maximum head on the sedimentation basin and sand filter (hMaxRller)
1.29 It
Insufficient depth.
Average head on the sedimentation basin and sand filter (hA)
0.65 ft
Ensure that the average is half of the max.
Runoff Coefficient (Rv)
0.40 (unitless)
Type of Sand Filter
Open sand filter? Y
Y or N
SHWT elevation
842.00 ft amsl
Bottom of the sand filter elevation
846.50 ft amsl
Clearance (dsNwr)
4.50
Closed/pre-cast sand filter? N
Y or N
SHWT elevation
ft amsl
Bottom of the sand filter elevation
ft amsl
Clearance (dsaWT)
If this is a closed, underground closed sand filter: The clearance between
the surface of the sand filter and the bottom of the roof of the underground
ft
structure (ds,,,)
�rtir�rrirrrrrr
."IkA CAP?
SOP-�FIESSi
Form SW401-Sand Filter -Rev,$ 2009Sept17 Parts I and II. Project Design Summary, Page 1 of 2

r 111
Sedimentation Basin
Surface area of sedimentation basin (As)
Sedimentation basin/chamber depth
Sand Filter
Surface area of sand filter (AF)
Top of sand media filter bed elevation
Bottom of sand media filter bed/drain elevation
Depth of the sand media filter bed (dF)
Coefficient of permeability for the sand filter (k)
Outlet diameter
Outlet dischargelflowrate
Time to drain the sand filter (t)
Time to drain the sand filter (t)
Additional Information
Does volume in excess of the design volume bypass the sand filter?
Is an off-line flow -splitting device used?
If draining to SA waters: 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 30ft from surface waters (50ft if SA waters)?
If not a closed bottom, is BMP located at least 100ft 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)?
What is the width of the sedimentation chamberlforebay (Wsk)?
What is the depth of sand over the outlet pipe (dpipe)?
Permit Number: '9 Y / 303b,
(to be provided by DINQ)
240.00 ft2
VA.
IVRXIL. IIIIIIIUIUIII, uUL IIIdy IICtlU LU uU ILIL IGUJGU 111
3.00 ft
1,566.00
ft'
VIN.
IVIVULJ IIIII IIIIIUI I I, ULIL IIIdy IIUCU IU uC Il ILI vcnwu LU
848.50 ft amsl
846.50 ft amsl
2.00 ft
3.50 (fUday)
12.00 in
0.11 ft'lsec
27.60 hours
OK.
Submit drainage calculations.
1.15 days
Y
Y or N
OK
Y
Y or N
OK
YorN
ft
Y
YorN
OK
Y
Y or N
OK
Y
YorN
OK
Y
YorN
OK
Y
YorN
OK
30.00 ft
OK
2.00 ft
OK
Form SW401-Sand Filter-Rev.52009Sept17
Parts I and II. Project Design Summary, Page 2 of 2

M
SW if 13o3b/
AA
o�c4 warFRoG
NCDENR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION
APPLICATION FORM
LEVEL SPREADER - VEGETATED FILTER STRIP (LS-VFS) SUPPLEMENT
This form must be completely
filled out, printed, initialed, and submitted.
I. PROJECT INFORMATION
Project name
Summerfield Charter Academy
Contact name
Charles J. Christy
Phone number
828.337.0251
Date
April 2, 2013
Drainage area number
DA#1
II. DESIGN INFORMATION
The purpose of the LS-VFS
Buffer Rule: Diffuse Flow
Stormwater enters LS-VFS from
A BMP
Type of VFS
Other: Explained below
Explanation of any 'Other' responses above
Diffuse flow before buffer and 15% slope
If Stormwater Enters the LS-VFS from the Drainage Area
Drainage area
fe Do not complete this section of the farm.
Impervious surface area
ftz Do not complete this section of the farm.
Percent impervious
% Do not complete this section of the form.
Rational C coefficient
Do not complete this section of the form.
Peak flow from the 1 Whr storm
cts Do not complete this section of the form.
Time of concentration
min Do not complete this section of the form.
Rainfall intensity, 10-yr storm
inlhr Do not complete this section of the form.
Peak Flow from the 10-yr stone
cis Do not complete this section of the form.
Design storm
10-year storm
Maximum amount of flow directed to the LS-VFS
cfs Do not complete this section of the form.
Is a flaw bypass system going to be used?
(Y or N) Do not complete this section of the form.
Explanation of any 'Other" responses above
If Stormwater Enters the LS-VFS from a BMP
Type of BMP
Peak discharge from the BMP during the design storm
Peak discharge from the BMP during the 10-year storm
Maximum capacity of a 100-toot long LS-VFS
Peak Flow directed to the LS-VFS
Is a Flow bypass system going to be used?
Explanation of any 'Other' responses above
c,`onuctior in acc
st��,��:'tc:r`+as { -rn:t "]m
cutnls
ord4r
rliquired by I" storrnwa,er -, ­, t ?se documents
rules require that the $,-rnzvr:. �dortL, arojin
Inspect duringconstru ,-- , st` r" designer
Plans and specs,
r cPrt,ry co,lformity with th . cerirfy c"npliance with the
:;wrr,„water.tijes. f 15A NCAC 2H .1008(j})
Permit # jW f-►' t 30 3 o r
Date 4�t�
sion of'vYare 0 rality
ate It 2
Form SW401 - LS-VFS - 29June2012 - Rev.10
Other: Explained below
0.28 cfs
0.28 cfs
cfs
0.41 cfs
N (YorN)
Sand Filter
`%,,IIN r1Irrl,,
`% �� CAF?O ,
=OP •FESSi'
PO
42 -
page 1 of 3

5 LvLi 1 3 0 3"1
I_S-VFS Design
Forebay surface area
Depth of forebay at stormwater entry point
Depth of forebay at stormwater exit point
Feet of level lip needed per cfs
Computed minimum length of the level lip needed
Length of level lip provided
Width of VFS
Elevation at downslope base of level lip
Elevation at the end of the VFS that is farthest from the LS
Slope (from level lip to the end of the VFS)
Are any draws present in the VFS?
Is there a collector swale at the end of the VFS?
Bypass System Design (if applicable)
Is a bypass system provided?
Is there an engineered flow splitting device?
Dimensions of the channel (see diagram below):
M
B
W
y (flow depth for 10-year storm)
freeboard (during the 10•yearstorm)
Peak velocity in the channel during the 10-yr storm
Channel lining material
Does the bypass discharge through a we@and?
Does the channel enter the stream at an angle?
Explanation of any "Other" responses above
190
sq fl
No forebay is required.
6
in
6
in
Depth is appropriate.
fUcfs
ft
40
ft
Level spreader is too short to handle the flow.
83
ft
839.75
fmsl
827.50
fmsl
14.76
%
VFS is too steep.
N
(Y or N)
OK
N
(Y or N)
N (Y or N)
N (Y or N)
ft
tt
ft
ft
fUsec
Pick one:
(Y or N)
(Y or N)
Form SW401 - LS-VFS - 29June2012 - Rev.10 page 2 of 3

Permit Number'. 5"J 30 3D!
(to be provided by DWQ)
�� oaoF wnrE9oG
r
A ,
HCDEHR Q Y
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
SAND FILTER SUPPLEMENT
This form must be filled out on line, printed and submitted with att of the required information.
Make sure to also fill out and submit the Required Items Checklist (Section 111) and the I&M Agreement (Section I V�
I. PROJECT INFORMATION
Project name Summerfield Charter Academy
Contact name Charles J. Christy
Phone number 828.337.0251
Date April 2, 2013
Drainage area number D.A. #2
II. DESIGN -INFORMATION
Site Characteristics
Drainage area (Ac)
Impervious area
% Impervious (IA)
Design rainfall depth (Rc)
Peak Flow Calculations
1-yr, 24-hr runoff depth
1-yr, 24-hr intensity
Pre -development 1-yr, 24-hr runoff
Post -development 1-yr, 24-hr runoff
Pre/Post 1-yr, 24-hr peak control
Storage Volume
Design volume (WQV)
Adjusted water quality volume (WQVAaJ
Volume contained in the sedimentation basin and on top of the sand filter
Top of sand filter/grate elevation
Weir elevation (between chambers)
Maximum head on the sedimentation basin and sand filter (hMaxFiker)
Average head on the sedimentation basin and sand filter (hA)
Runoff Coefficient (Rv)
Type of Sand Filter
Open sand filter?
SHWT elevation
Bottom of the sand filter elevation
Clearance (dsHWT)
Closed/pre-cast sand filter?
SHWT elevation
Bottom of the sand filter elevation
Clearance (dsHwr)
If this is a closed, underground closed sand filter: The clearance between
the surface of the sand filter and the bottom of the roof of the underground
structure (ds,.)
149,799.00 ftz
96,461.00 ftZ
64.4% %
1.00 in
2.78 in
0.12 inihr
1.43 ftylsec
6.50 ft3/sec
5.07 ft3/sec
7,864.00 ft'
5,898.00 ft,
8,090.00 ft,
826.25 ft amsl
825.25 fit amsl
OK
' JnstruCi,ar �i, :3;:cora_ e,. 'se documt?nts }e
rrrywred by tie stormwatu, ; wrid Niari'R Arolin::
,files require that the s,. rmw :V"Ic designer
Inspect during constru•'lmi c �,niy co,1formity with th
plans and spe_3; .'Ir` ce*4compliance with the
r . err water rules. f 1 SA NCAC 2H .1008 (j) )
Per•nif # ySw'fl 30 301 _ pate
NG I . sion of .Valor Ouality
-- evis .. 7ase_t{l2lf 3.
OK
1,71 ft Insufficient depth.
0.86 ft OK
0.63 (unitless)
YorN
818.93 ft amsl
821.00 ft amsl
2.07
YorN
ft amsl
ft amsl 00,1111 111 f r l,
•P'(H CAR
2p ,OFESS!
ft
I'�1111111�111 , y�
Form SW401-Sand Filter-Rev.5 2009Sep117 Parts I and il. Project Design Summary, Page 1 of 2

. . 1
Permit Number: 56/4ff 30301
(to be provided by DWQ)
Sedimentation Basin
Surface area of sedimentation basin (As)
Sedimentation basin/chamber depth
Sand Filter
Surface area of sand filter (AF)
Top of sand media filter bed elevation
Bottom of sand media filter bedld rain elevation
Depth of the sand media filter bed (dF)
Coefficient of permeability for the sand filter (k)
Outlet diameter
Outlet dischargelflowrate
Time to drain the sand filter (t)
Time to drain the sand filter (t)
Additional Information
Does volume in excess of the design volume bypass the sand filter?
Is an off-line flow -splitting device used?
If draining to SA waters: 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 30ft from surface waters (50ft if SA waters)?
If not a closed bottom, is BMP located at least I00ft 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)?
What is the width of the sedimentation chamberlforebay (Wsed)?
What is the depth of sand over the outlet pipe (dpipe)?
593,00 ft2
Ur\. MutAb IILIIrIIIIUIII, Uul Illtljl IICCU LU Ut IIIWCCJI;U LU
2.50 ft
2,851.00
ft2
Uri. IYICCW Irlllllrllulll, Uul IlldY IICCU LU UC Ir IL,r CCI.JGU LU
823.00 It amsl
821.00 It amsl
2.00 ft
3.50 (ftlday)
12.00 in
0.20 113lsec
29.80 hours
OK. Submit drainage calculations.
1.24 days
Y
YorN
OK
Y
YorN
OK
YorN
ft
YorN
Y
YorN
OK
Y
YorN
OK
Y
Y or N
OK
Y
Y of N
OK
25.00 ft
OK
3.66 ft
OK
Form SW401-Sand Filter-Rev.52008Sept17
Parts I and 11, Project Design Summary, Page 2 of 2

Permit Number; 5 4111303
r v (to be provided by DWO)
m o� warF9
% Y
NCDENR p
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
SAND FILTER SUPPLEMENT
This form must be filled out on tine, printed and submitted with all of the required information.
Make sure to also fill out and submit the Required Items Checklist (Section lll) and the I&M Agreement (Section IV)
I. PROJECT INFORMATION
Project name Summerfield Charter Academy
Contact name Charles J. Christy
Phone number 828.337.0251
Date
Drainage area number
April 2, 2013
D.A. #3
II. DESIGN INFORMATION i
Site Characteristics
Drainage area (AD)
Impervious area
% Impervious (IA)
Design rainfall depth (Ro)
Peak Flow Calculations
1-yr, 24-hr runoff depth
1-yr, 24-hr intensity
Pre -development 1-yr, 24-hr runoff
Post -development 1-yr, 24-hr runoff
Prelf'ost 1-yr, 24-hr peals control
Storage Volume
Design volume (WOV)
Adjusted water quality volume (WOVAdi)
Volume contained in the sedimentation basin and on top of the sand filter
Top of sand filter/grate elevation
Weir elevation (between chambers)
Maximum head on the sedimentation basin and sand filter (hMaxriner)
Average head on the sedimentation basin and sand filter (hA)
Runoff Coefficient (Rv)
Type of Sand Filter
Open sand filter?
SHWT elevation
Bottom of the sand filter elevation
Clearance (dSHWT)
Closed/pre-cast sand filter?
SHWT elevation
Bottom of the sand filter elevation
Clearance (dsHwT)
If this is a closed, underground closed sand filter: The clearance between
the surface of the sand filter and the bottom of the roof of the underground
structure (dsp.}
66,583.00 ft'
OK
36,723.00 ft'
55.2% %
1.00 in
'pprciveu w.a•.:�.v,. • r 1 -rrsrt ;1acunnents
t::onstructior, in accordar. M,.. :ese documents iv
2.78
required by tree stormwaier pu,mit Norlh -Arolina
in
ules require that the s, rmw:. -ysta o designer
0.12 inlhr
Inspect during con5tru, Lion, ct;rWy conformity with th .
3
0.64 ft lsec
plans and specs; art ' certify compliance with the
2.89 ft3lsec
rc;orr^water rules. (15A NCAC 2H .1008(j))
Permit # 5kvq)` 30301 Date ���s
2.25 ft3lsec
_
by_0zwV _- NC i.. -sion of Water 11, ilify
/zl�
3,031.00 ft3
2,273.25 ft3
3,333,00 ft3
OK
844 It amsl
843 It amsl
2.38 It
OK
1.19 It
OK
0.55 (unitless)
Y YorN
830.10 It amsl
838.50 ft amsl
8.40
N YorN
ft amsl
7
Itamsl
NICAFJ ''..
OQ0SS
C 9
ft
; a
= 42 "
4NGIN,GE.•`�5�
/r11111141t
Form SW401-Sand Filter-Rev.5 2009Sept17 Parts I and II. Project Design Summary, Page 1 of 2

Permit Number: qj 307
(ro be provided by DWQ}
Sedimentation Basin
Surface area of sedimentation basin (As)
234.00 ft2
vr.. I MLZl I I I1111111U I 1 I, UUL IIIdy IICCU LU UC 111UUdZ'UU LU
Sedimentation basin/chamber depth
3.00 ft
Sand Filter
Surface area of sand filter (AF)
721.00 ft2
Vr..' IVIVULJ IIIIIIIIIIUIII, UUL IIIdy IICCU LU UC 111UCtlJCU LU
Top of sand media filter bed elevation
840.50 ft amsl
Bottom of sand media filter bed/drain elevation
838.50 ft amsl
Depth of the sand media filter bed (dF)
2.00 ft
Coefficient of permeability for the sand filter (k)
3.50 (fYday)
Outlet diameter
8.00 in
Outlet dischargelflowfate
0.50 W/sec
Time to drain the sand filter (t)
31.20 hours
OK. Submit drainage calculations.
Time to drain the sand filter (t)
1.30 days
Additional Information
Does volume in excess of the design volume bypass the sand filter?
Y
Y or N
OK
Is an off-line flow -splitting device used?
Y
Y of N
OK
If draining to SA waters: Does volume in excess of the design volume flow
Y or N
evenly distributed through a vegetated filter?
What is the length of the vegetated filter?
ft
Does the design use a level spreader to evenly distribute flow?
Y or N
Is the BMP located at least 30ft from surface waters (50ft if SA waters)?
Y
Y or N
OK
If not a closed bottom, is BMP located at least 100ft from water supply wells?
Y
Y or N
OK
Are the vegetated side slopes equal to or less than 3:1
Y
Y or N
OK
Is the BMP located in a recorded drainage easementwith a recorded access
Y
Y or N
OK
easement to a public Right of Way (ROW)?
What is the width of the sedimentation chambeflforebay (Wsd)?
12.00 It
OK
What is the depth of sand over the outlet pipe (dpipe)?
3.25 It
OK
Form SW401-Sand Filter-Rev.5 2009Sept17 Parts I and 11. Project Design Summary, Page 2 of 2

/
Permit Number.15
(to be provided by OWQ)
OF W ATg9
O� O�
�
NCDENR
r 9 y
p `
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
SAND FILTER
SUPPLEMENT
This form must be filled out on line, printed and submitted with all of the required information.
Make sure to also fill out and submit the Required items Checklist (Section 111) and the 1&M Agreement (Section IV)
I. PROJECT INFORMATION
Project name
Summerfleld Charter Academy
Contact name
Charles J. Christy
Phone number
828.337.0251
Date
April 2, 2013
Drainage area number
Q.A. #5
II. DESIGN INFORMATION
Site Characteristics
Drainage area (AD)
8,340.00 ft2
OK
Impervious area
4,513.00 ft2
% Impervious (IA)
54.1% %
Design rainfall depth (RD)
1.00 in
',pprov,J : ,r r .%vi r rt i'74ur1tents
[: onstructior lit atcord�::'. ase documents i-
Peak Flow Calculations
required by tree stoimwalr;r pi,Rnt North %;arolinra
1-yr, 24-hr runoff depth
2.78 In
ales require that the s: -rmw. ;stc 11 designer
Inspect during constru, ;ion, ccrtriy ronformity with th _
1-yr, 24-hr intensity
0,12 inihr
plans and specs; _rw certify r-ornptiance with the
Pre -development 1-yr, 24-hr runoff
0.06 ft3lsec
s,orr-mater rules f 15A. NCAC 2H 1008 (j))
Post development 1 yr, 24 hrrunoff
3
0.35 ft/sec
Permit 1 3 030 I Date --Jr
#.- Swy k14�
hp-- NC C. --ion Watt -
Pre/Post 1-yr, 24-hr peak control
0.29 ft3/sec
--- of C'jality
Storage Volume
Design volume (WQV)
375.00 ft'
Adjusted water quality volume (WQVAdi)
281.25 ft3
Volume contained in the sedimentation basin and on top of the sand filter
791.00 ft'
OK
Top of sand filterigrate elevation
854 ft amsl
Weir elevation (between chambers)
852,5 ft amsl
Maximum head on the sedimentation basin and sand filter (hMall',W)
0.57 ft
Insufficient depth.
Average head on the sedimentation basin and sand filter (hA)
0.29 ft
OK
Runoff Coefficient (Rv)
0.54 (unitless)
Type of Sand Filter
Open sand filter? Y
Y or N
SHWT elevation
843.00 ft amsl
Bottom of the sand filter elevation
849.50 ft amsl
Clearance (dsr+vrr)
6.50
Closed/pre-cast sand filter? N
Y or N
SHWT elevation
ft amsl
Bottom of the sand filter elevation
ft amsl
Clearance (dsr,wT)
,�'`CAR���'
If this is a closed, underground closed sand filter: The clearance between
filter
�.� Q. •,.....,
0.
the surface of the sand and the bottom of the roof of the underground
ft
9
structure (dam)
;'Q� '•
142 "
`es
Form SW401-Sand Filter-Rev.5 2009Sept17 Parts I and 11. Project Design Summary, Page 1 or 2

Permit Number: 5W 4l 3o 301
(to be provided by DWQ)
Sedimentation Basin
Surface area of sedimentation basin (As)
Sedimentation basin/chamber depth
Sand Filter
Surface area of sand filter (AF)
Top of sand media filter bed elevation
Bottom of sand media filter bed/drain elevation
Depth of the sand media filter bed OF)
Coefficient of permeability for the sand filter (k)
Outlet diameter
Outlet dischargelflowrate
Time to drain the sand filter (t)
Time to drain the sand filter (t)
Additional Information
Does volume in excess of the design volume bypass the sand filter?
Is an off-line flow -splitting device used?
If draining to SA waters: 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 30ft from surface waters (50ft if SA waters)?
If not a closed bottom, is BMP located at least 100ft 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)?
What is the width of the sedimentation chamberlforebay (Wsd)?
What is the depth of sand over the outlet pipe (dpipe)?
68.00 ft'
3.00 ft
425.00 ft2
851.50 It amsl
849.50 ft amsl
2.00 ft
3.50 (fVday)
6.00 in
0.03 ft3lsec
24.00 hours
1.00 days
Ur\. 1MM-b 1111111111um, uu4 IIIdy IICCu LU UC 111L;ICdbtu LU
Ur\. IMMb IIIIIIIIIIUIII, UUl IIIdy 11=U LU UC IIIUCdJCU LU
OK. Submit drainage calculations.
Y Y or N OK
Y Y or N OK
YorN
R
YorN
Y Y or N
OK
Y Y or N
OK
Y Y or N
OK
Y Y or N
OK
10.00 ft
OK
3.25 ft
OK
Form SW401-Sand Filter-Rev.5 2009Sept17
Paris I and II. Project Design Summary, Page 2 of 2

Permit No.S w °F13o30/
�d /'! / �d � �y�rv►�v � �4' �!?�'y �Y ���iy� (to 6e provrded by DWQ)
III. REQUIRED ITEMS CHECKLIST
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal
package will result in a request For additional information. This will delay final review and approval of the project. Initial
in the space provided to indicate the following design requirements have been met. If the applicant has designated an agent,
the agent may initial below. If a requirement has not been met, attach justification.
Initials Page/ Plan
Sheet No.
l% 1. Plans (1" - 50' or larger) of the entire site with labeled drainage area boundaries
✓ - System dimensions (length, width, and depth) for both the sedimentation chamber and the filter
chamber, G - 24
Maintenance access,
Flow splitting device, C - 22, C- 2, 3
Proposed drainage easement and public right of way (ROW), e.
-Design at ultimate build -out, C- I o.6 -0
- Off -site drainage (if applicable), and L-Z, o, G
- Boundaries of drainage easement. 0-4,0
2. Plan details (1" = 30' or larger) for the sand filter showing:
- System dimensions (length, width, and depth) for both the sedimentation chamber and the filter
chamber, G- 0
-Maintenance access, 6-4, b
-Flow splitting device, G • 0,4-2,3
- Vegetative filter strip dimensions and slope (if SA waters), PIK
- Proposed drainage easement and public right of way (ROW),& -Q,6
- Design at ultimate build -out, Gam! a, 6-1, /
- Off -site drainage (if applicable), andG - 2, a, G- Q, D
- Boundaries of drainage easement.
AV 3. Section view of the sand filter (1" = 20' or larger) showing:
- Depth(s) of the sedimentation chamber and sand filter chamber, C-21
- Depth of sand filter media, C- 21
- Connection between the sedimentation chamber and the sand filter chamber and weir elevation, C-72
- SHWT elevation,' 60 P3d>e ►s� fAkfir'{ � -e.MF Slims 6- 2. 3
- Outlet pipe, and e- 2. f, C- ,o,G p, 3
- Clearance from the surface of the sand filter to the bottom of the roof of the underground structure (if
applicable). N/14
4. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. The
results of the soils report must be verified in the field by DWQ, by completing & submitting the soils
investigation request form. County soil maps are not an acceptable source of soils Infprm lion.
R r'lr►Gr►�'D — Srir E SMu� ll o f' A c��cl u�bti
5. Supporting calculations (including drainage calculations) qff. 'lAs/nu,
So;�S
6. Signed and notarized operation and maintenance (0&M) agreement 47T
�Ir 7. A copy of the deed restrictions (if required). #( 4-
Form SW401-Sand Filter-Rev.5 2009Sept17 Part III, Page 1 of 1

5;Wf-(13D30 /
III. REQUIRED ITEMS CHECKLIST
EDIT Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to indicate the
following design requirements have been met. If the applicant has designated an agent, the agent may initial below. If a requirement has not been
met, attach justification.
Requried Item:
1. Plans (1' - 5Cr or larger) of the entire site showing:
- Design at ultimate build -out. (— / V, G -/, f
Off -site drainage (if applicable), G - 2.0, G' `� D
Delineated drainage basins (include Rational C coefficient per basin), G ¢, U, _srp, Pcf,,
Forebay (if applicable),)JO
High flow bypass system, IU 0
- Maintenance access, G- y
Proposed drainage easement and public right of way (ROW), and
Boundaries of drainage easement- G- 4• 0
2. Plan details (1' = V or larger) for the level spreader showing:
- Forebay (if applicable), u
High flow bypass system,
One fool lopo lines between the level lip and top of stream bank,
Proposed drainage easement, and &r4 0
Design at ultimate buildouL G - 2 � 0. G' 4. 0
3, Section view of the level spreader (1' = 24' or larger) showing:
- Underdrain system (if applicable), / "k-
- Level lip, 6, 1, Z
Upslope channel, and G' LZ
Downslope filter labricL- Z•Z
4. Plan details of the flow splitting device and supporting calculations (if applicable) PIA
5. A construction sequence that shows how the level spreader will be protected from
sediment until the entire drainage area is stabilized.
b. If a non -engineered VFS is being used, then provide a photograph of the VFS showing
that no draws are present.
1. The supporting calcutaWns. Irin ,Q e '4
8. A copy of the signed and notarized operation and maintenance (0&M) agreement
Page or plan sheet number and any notes:
Forth SW401 - LS-VFS - Mune2012 - Rev.10 papa 3 of 3

Filter Strip, Restored Riparian Buffer
Operation and Maintenance
Permit Number: 5W 4f0D 30/
(to be provided by DIYQ)
Drainage Area Number: I
and Level Spreader
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:
- Immediately after the filter strip is established, any newly planted vegetation
will be watered twice weekly if needed until the plants become established
(commonly six weeks).
- Once a year, the filter strip will be reseeded to maintain a dense growth of
vegetation
- Stable groundcover will be maintained in the drainage area to reduce the
sediment load to the vegetation.
- Two to three times a year, grass filter strips will be mowed and the clippings
harvested to promote the growth of thick vegetation with optimum pollutant
removal efficiency. Turf grass should not be cut shorter than 3 to 5 inches and
may be allowed to grow as tall as 12 inches depending on aesthetic requirements
(NIPC,1993). Forested filter strips do not require this type of maintenance.
- Once a year, the soil will be aerated if necessary.
- Once a year, soil pH will be tested and lime will be added if necessary.
After the filter strip is established, it will be inspected quarterly and within 24 hours
after every storm event greater than 1.0 inch (or 1.5 inches if in a Coastal County).
Records of operation and maintenance will be kept in a known set Iocation and will be
available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblem:
How I will remediate theproblem:
The entire filter strip
Trash/debris is present.
Remove the trash/debris.
system
The flow splitter device
The flow splitter device is
Unclog the conveyance and dispose
(if applicable)
clogged.
of anysediment off -site.
The flow splitter device is
Make any necessary repairs or
damaged.
replace if damage is too large for
repair.
Form SWU40I-Level Spreader, Filter Strip, Restored Riparian Buffer O&M-Rev.3 Page 1 of 3

BMP element:
Potentialproblem:
How I will remediate theproblem:
The swale and the level
The swale is clogged with
Remove the sediment and dispose
lip
sediment.
of it off -site.
The level lip is cracked,
Repair or replace lip.
settled, undercut, eroded or
otherwise damaged.
There is erosion around the
Regrade the soil to create a berm
end of the level spreader that
that is higher than the level lip, and
shows stormwater has
then plant a ground cover and
bypassed it.
water until it is established. Provide
lime and a one-time fertilizer
application.
Trees or shrubs have begun
Remove them.
to grow on the swale or just
downslo e of the level lip.
The bypass channel
Areas of bare soil and/or
Regrade the soil if necessary to
erosive gullies have formed.
remove the gully, and then
reestablish proper erosion control.
Turf reinforcement is
Study the site to see if a larger
damaged or ripap is rolling
bypass channel is needed (enlarge if
downhill.
necessary). After this, reestablish
the erosion control material.
The filter strip
Grass is too short or too long
Maintain grass at a height of
if applicable).
approximately three to six inches.
Areas of bare soil and/or
Regrade the soil if necessary to
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.
Sediment is building up on
Remove the sediment and
the filter strip.
restabilize the soil with vegetation if
necessary. Provide lime and a one-
time fertilizer application.
Plants are desiccated.
Provide additional irrigation and
fertilizer as needed.
Plants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application.
Nuisance vegetation is
Remove vegetation by hand if
choking out desirable species.
possible. If pesticide is used, do not
allow it to get into the receiving
water.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality local Regional Office, or the
outlet.
401 Oversight Unit at 919-733-1786.
Form SWU401-Level Spreader, Filter Strip, Restored Riparian Buffer O&M-Rev-3 Page 2 of 3

Permit Number: 5w4t1 30 3Ol
(Io he provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project name:Summerfield Charter Academy
BMP drainage area number:
Print name:Jeff Chamberlain
Title:-' -A'
VI , L"_C-
Address:3850 Broadmoor Ave SE Suite 201 Grand Rapids, MI 49512
Phone:[phone]
Signature:
Date: 7- l -L)'
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.
y C, a Notary Public for the State of
t,Jn612D L4Iy n , County of TH , do hereby certify that
��E:E G!-_AmLE ZLAJ,J _ personally appeared before me this 13
day of moo 13, and acknowledge the due execution of the
forgoing filter strip, riparian buffer, and/or level spreader maintenance requirements.
Witness my hand and official seal,
OTA
a
e • p.e© b
ze
d-Aua`\��
a
!444 8405000�
calk-
Q F- A 7
0 Gt11L
My commission expires L a61 J6 T i� r a2�15
Form SWU401-Level Spreader, Filter Strip, Restored Riparian Buffer O&M-Rev.3 Page 3 of 3

Permit Number: SW�13D
(to he provided by D6VQ)
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 element:
Potential problem:
How I will remediate the problem:
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
lama a 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

BMP element:
Potentialproblem:
How I will remediate theproblem:
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
Grids, 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

T
Permit Number: 5W,4t1 3 o 36
(to be provided by DI
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: Summerf eId Charter Academe
BMP drainage area number:
�b,a.�'rer os>Lus
Print name:Jeff Chamberlain
'Title:
�C.,onn�h•� u��
Address:3850 Broadmoor Ave. SE. Suite 201. Grad
Phone:
Signatt
Date:
MI 49512
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.
I, ] 4eq _ Cik� :5m 170 , a Notary Public for the State of
My27p4 CAR»j_l N , County of T'�n¢.sy -t a , do hereby certify that
=EE'F F 4f.44 & gel _a tr zL_g r_o,l _-_ personally appeared before me this J3-1�4day of
aeLj d,-2-q ,Qo 13 , and acknowledge the due execution of the forgoing sand filter
maintenance requirements. Witness my hand and official seal,
;.
00
:�syp U� ova
JCH11
My commission expires AG1G c./ST I o20IS-_
Norm SW401-Sand Filter O&M-Rev.4 2009Sept17 Page 3 of 3

Permit Number: -5wl't 30301
(to be provided by DIVQ)
Drainage Area Number: 21
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 Ioad 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 element: T
Potential problem:
How I will remediate the problem:
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.
ossible.
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,
FIow 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 S W401-Sand Filter O&M-Rev.4 2009Sept 17 Page 1 of 3

BMP element:
Potential roblem:
How I will remediate theproblem:
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
hrosion 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 2009Septl7 Page 2 of 3

Permit Number: S h/' H 3 0 3a 1
(Io be provided by DJNQ)
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:Summerfield Charter Academy
BMP drainage area number: DA#2
C L-koAtr dtustlwQ, , CQ,r,�V,A
g't :> ��r C],,,p,P Ckt r/)
Print name:Jeff Chamberlain
Ti
wL
Address:3850 Broadmoor Ave SE, Suite 201 Grad Rapids, MI 49512
Phone: [phone]
Signature:?
Date: Z- 3
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.
4" (` Aoe4Z Sn'11-r' 4 , a Notary Public for the State of
�1+� ✓L.�� b C4 (Lb LI NA , County of F�d,LSy n-1 , do hereby certify that
t^1= �NLLr�d3i=2Lla ie�i_ _ personally appeared before me this K2 t�iay of
1`Er312u a2`q , :9 b Q, and acknowledge the due execution of the forgoing sand filter
maintenance, jI�Iments. Witness my hand and official seal,
4.4
';��a rp
00
°10 Pax .-0
�1l C 0a alp
p4446e4611094
SEAL
My commission expires_ a 6i✓15-T 1-7 I c-D 1s
Form SW401-Sand Filter O&M-Rev.4 2009Sept17 Page 3 of 3

Permit Number: , W 40 303a/
(Io he provided by WVQ)
Drainage Area Number: 3
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 Iocation. 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 element:
Potential problem:
How 1 will remediate the problem:
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 time
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 element:
Potentialproblem:
How I will rernediate the roblem:
Filter bed and underdrain
Water is pond ing 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
Elrosion 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 SW40I-Sand Filter O&M-Rev.4 2009Septl7 Page 2 Of 3

Permit Number: 5 wq 130 3o/
(to be provided by 1)WQ)
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.
Projecl name: SummerfieId Charter Academy
BMP drainage area numher:DA#3
Print
'Citle
Address:3850 Broadmoor Ave, SE, Suite 201, Grad Rapids, MI 49512
Phone:
Signati
Date: G- «` t
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, ", C Q, A�k 51"t I _T4-1 , a Notary Public for the State of
brL`9A CA9Zot-I+J-A , County ofdo hereby certify that
�F G� Am�CbZ LtS t+� personally appeared before me this 13`1'�`day of
t'c---i5zu 4Lz , ;,)dJ -� , and acknowledge the due execution of the forgoing sand filter
maintenance requirements. Witness my hand and official seal,
SEAL
My commission expires _1�I-tC. US -� l-7 1 a bI'S
Form SW401-Sand Filter O&M-Rev.4 2009Sept17 Page 3 of 3

Permit Number: .SW 1130 3c] 1
(to he provided by I) 1i Q�
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 element:
Potential problem:
_How_ I will remediate the problem:
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 s ra in .
Form SW401-Sand Filter O&M-Rev.4 2009Septl7 Page 1 of 3

BMP element:
Potentialproblem:
How I will remediate theproblem:
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 SW40I-Sand Filter O&M-Rev.4 2009Sept17 Page 2 of 3

Permit Number: $WV YC)Y0/
(to he provided by IXVQ)
I acknowledge and agree by my signature below that I am responsible for the performance of the
maintenance procedures listed above. 1 agree to notify DWQ of any problems with the system or prior
to any changes to the system or responsible party.
Project name:Surnmerfield Charter Academ
BMP drainage area number:
C 6A(S' t"
Print
Title:
`. A=
Address:3850 Broadmooi Ave, SE, Suite 201, Grad Rapids, M149512
Phone:[phone]
Signature:
Date:
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, P4,a 2J G'A ZOZ Sn i 7-4 , a Notary Public for the State of
t\lnrLrtl L�}r2bLi..P,a , County of Fa25� Yt-1 , do hereby certify that
Prr— CJ-1 asi1 CIF r"L_'O I ".i _ _ personally appeared before me this J a -T1 lay of
r—Er3RU.&rI-J , ,�,b 1 and acknowledge the due execution of the forgoing sand filter
maintenance requirements. Witness my hand and official seal,
'A* oaQQWVUOVq q�
rZt rip,
n p.pp
90
461 A.
a 'R
• �V )�OCJ�
O" o
b
V f' A F
lJ L.It � LI
My commission expires ,& u6 L4sT 171 '�-01S
Form SW40I-Sand Filter O&M-Rev.4 2009Sept17 Page 3 of 3

IN WADETium
March 8, 2013
N.C. Division of Water Quality
512 N. Salisbury St.
Archdale Building —gth Floor
Raleigh, NC 27604
Attn: Mr. Robert Patterson
Re: Stormwater Management Application
Summerfield Charter Academy, Summerfield, NC
Dear Mr. Patterson,
Enclosed herewith, please find our submittal for a proposed school to be located in Summerfield, NC. We are applying for
a State stormwater permit for post -construction storm water.
Enclosed please find the following:
• One check in the amount of $505.
• Stormwater permit application form (original + copy)
• Storm Water Management and Soil Erosion & Sedimentation Control Plan (calculations & narrative)
• Completed Supplements and Checklists for the proposed BMP's.
• Executed Ct & M Agreements for the proposed BMP's.
• Copy of the Purchase and Sale Agreement for the property.
• Copy of the Development Clearance Certificate from the Town of Summerfield.
• Copy of the recorded deed for the property.
• USDA NRCS web soil survey of the property.
• Seasonal High Water Table Determination, by S&ME.
• Copies of boring logs performed on the property.
• USGS Quad Map, Summerfield, NC indicating property location and % mile radius from site.
• Soil Boring / W.T. Exhibit.
• ALTA/ACSM Land Title Survey.
• Two (2) full size copies of the plans, folded.
• Mini CD containing the above information.
Please let us know if you need any additional information to begin processing this application.
Sincerely,
Wade Trim, Inc.
-
Arles J. Chris , PE
Senior Associate
cc
ED0207702A
\Edd2077\02a\Docs\Correspondence\NCDENR DWQ Application Submittat 2013.03-08.docx
Enclosures
Wade Trim, Inc. 828.255.1197
46 Haywood Street 828.255.1199 fax
Suite 334 www.wadetrim.com
Asheville, NC 28801

DWQ USE ONLY
Date Received
Fee Paid Permit Number
[Applicable
—a . v c)
Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 Ph II - Post Construction
lect all that apply) ❑,Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
19 Other WQ M mt Plan: v o,G7� nl i3 w H-- o%25-
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original
L 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.):
Summerfield Charter Academ
2. Location of Project (street address):
5303 US 220 North
City:Town of Summerfield County:Guilford Zip:27358
3. Directions to project (from nearest major intersection):
North on US HWY 220from Greensboro, to the Town of Summerfield, approximately 4,000 feet (3/4 mile)
north of State Route 150, located on the left (west) side of US 220.
4. Latitude:36° 13' 5" N Longitude:-79° 54' 37" W of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ Modificationt
rRenemals with modifications also requires SWU-102 - Reneroal Application Forur
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number , its issue date (if known) , and the status of
construction: ❑Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ❑I-Iigh Density ❑Drains to an Offsite Stormwater System ®Other
If this application is being submitted as the result of a previously returned application or a letter from DWQ
requesting a state stormwater management permit application, list the stormwater project number, if
assigned, and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major ❑Sedimentation/Erosion Control: ac of Disturbed Area
❑NPDES Industrial Stormwater M404/401 Permit: Proposed Impacts Stream
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: �--------,
D g
5. Is the project located within 5 miles of a public airport? ❑No MYes RV
If yes, see S.L. 2012-200, Part VI: htt ortal.i cdenr.org/weblwws su st tes a*$ 2013
Farm SWU-l0l Version 06Aug2012 Page 1 of 6

III. CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicant/Organization:Charter Development Company, LLC
Signing Official & Title:leff Chamberlain, Director
b. Contact information for person Iisted in item 1a above:
Street Address:3850 Broadmoor Ave, SE, Suite 201
City:Grand Rapids State:MI Zip:49512
Mailing Address (if applicable):
City:
State: Zip:
Phone: (616 ) 954-2252 Fax: ( }
Emai I:jchamber lain®heritageacademies.co m
Please check the appropriate box. The applicant listed above is:
❑ The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
® Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Owner/Organization: David R. Shepherd
Signing Official & Title:David R. Shepherd
b.Contact information for person listed in item 2a above:
Street Address:126 Beech Street
City:Flkin State:NC Zip:28621
Mailing Address (if applicable):
City:
Phone: (336 ) 971-0551
Email:
State: Zip:
Fax: ( }
3. a. (Optional) Print the name and title of another contact such as the projects construction supervisor or other
person who can answer questions about the project:
Other Contact Person/Organization:
Signing Official & T
b.Contact information for person listed in item 3a above:
Mailing Address:
City: State:
Phone: ( ) Fax:
Email:
4. Local jurisdiction for building permits: Guilford Couz
Zip:
Point of Contact:Betty Carrett Phone #: (336 } 641-3394
Form SWU-101 Version 06Aug2012 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Storm water will be treated with bio-retention basins and sand filters.
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:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 ❑ Ph II - Post Construction
3. Stormwater runoff from this project drains to the Cape Fear River basin.
4. 'Total Property Area: 18.91 acres
5. Total Coastal Wetlands Area: 0.00 acres
6. Total Surface Water Area: 0.07 acres
7. Total Property Area (4) -Total Coastal Wetlands Area (5) -Total Surface Water Area (6) = Total Project
Area':18.84 acres
Total project area shall be calculated to exclude thefollowing. the norinal pool of irrrpounded structures, the area
between tine batiks of streams and rivers, the area below the Normal Ht It Water (NHW) titre or Mean High Water
(MHW) line, and coastal wetlands landward from Tire NHW (or = litre. Tire resultant project area is used to
calculate overall percent built upon area (BETA). Non -coastal wetlands landward of tine NHW (or MHW) line reap
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 22.45 %
9. How many drainage areas does the project have?1 (For high density, count 1 for each proposed engineered
stormwater BMP. For low densihj and other projects, use 1 for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
Basin Information
Prainage Area 1
Drainage Area _
Drainage Area _
Drainage Area
Receiving Stream Name
T to Haw River/
Stream Class '
N/A
Stream Index Number *
N/A
'( ►
-� LIB
Total Drainage Area (sf}
404237
On -site Drainage Area (so
270072
Off -site Drainage Area (so
0�
Proposed Impervious Area** (so
1 Ai247
ix
% Impervious Area** total
2 5
Impervious" Surface Area
Dra'ha a rea 1
Draina e Area _
Drainage Area _
Drainage Area
On -site Buildings/Lots (so
25028
On -site Streets (so
159219
On -site Parking (so
nc in abov
On -site Sidewalks (so
inc in above
Other on -site (so
0
Future (so
0
Off -site (so
0
Existing BUA*** (so
0
Total (sf)•
184247
* Stream Class and Index Nuniberfcall be determined at: http:llPortal.ncdenr.orgLebAog&lcsre%lassifications
Impervious area is defined as the built upon area including, but not Bruited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
* Report only that amount of existing BUA that will remain after development. Do not report any existing BUA that
is to be rennoved mid which will be replaced by new BUA.
Form SWU-101 Version 06Aug2012 Page 3 of

11. How was the off -site impervious area listed above determined? Provide documentation. N/A
Projects in Union County: Contact DWQ Central Office staff to check if the project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per 15,1 NCAC 02B3 0600,
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from http://portal.ncdenr.org/web/wq/ws/su/bmp-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklists are available from httR//portal.ncdenr.org/web/wq/wsIsu/statesw/forms does. The complete
application package should be submitted to the appropriate DWQ Office. (The appropriate office may be
found by locating project on the interactive online map at http // ortal.ncdenr.org/­webZwq/­ws/­su/­mii2s.)
Please indicate that the following required information have been provided by initialing in the space provided
for each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions
for each submitted application package from http://portal.ncdenr.org/web/`­wq/­ws/­su/­st-,itesw/­foriiis docs.
Initi
als
W `als
1. Original and one copy of the stormwater Management Permit Application Form. Ci -
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants 6V A
Dorm. (y required as per Part VIf 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
http://www.envhelp.org/pages/onestopexpress_html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/ managementfor
the project. 'Chis is required in addition to the brief summary provided in the Project
Information, item 1.
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 1/2 mile of the site boundary, include the 1/2
mile radius on the map.
7. Sealed, signed and dated calculations (one copy).
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
L 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).
CJ� (1,sc
C dG L'SL
c'L
C36 010-
cic CY-1
Form SWU-101 Version 06Aug2012 Page 4 of 6

9. Copy of any applicable soils report with the associated SHWT elevations (Please identify C CG i
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5x11" copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DWQ to verifij the SHWFprior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 3421 Page No: 1939J
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC N IBC
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item 1a, 2a, and/or 3a per 15A 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.
http://www.secretary.state.nc.us/Corporations/CSearch.aspx
VIL DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from
http://portal.ncdenr.org/web/wgLws/su/statesw/forms „does. Download the latest versions for each submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DWQ and that they will be recorded prior to the sale of any lot.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting Engineer:Chalres 1, Christy, PE
Consulting Firm:
Mailing Address:46 Haywood Street Suite 334
City:Asheville State:NC Zip:28801
Phone: (828 ) 255-1197
Emait:cchristy®wadetrim.com
Fax: (828 ) 255-1-199
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, iteiu 2 has been filled out, complete this
section)
I, (print or hjpe uarue of person listed in Contact Inforrmation, item 2a) David R. Shepherd certify that I
own the property identified in this permit application, and thus give permission to (print or type name of person
listed in Contact Information, item la) Jeff Chamberlain with (print or hjpe naine of organization listed in
Contact Information, item 1a) NationalTHeritage Academies 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 06Aug2012 Page 5 of 6

• As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity fisted 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 Narne/Ownership Change Norm within 30 days; otherwise 1 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.
Signa
Date: .2 - I i - 1 -3
I, W4 1 L- CIA L k a Notary Public for the State of A3�I I� J�/W, County of
vt - do hereby certify that personally appeared
before me this -tV day of - % I_ , and a Zowledge ti flue execution of the application for
a stormwater permit. Witness my hand and official seal,
OFFICIAL SEAL
"Wy PuWle - MOM C MWA
$DRAY COUNTY
DONALD E..¢,LARK
X. APPLICANT'S CERTIFICATION
SEAL
My commission expires J
I, (print or type ttattte of person listed ix Contact ltifortttation, itettt la)� Se) r cLkk ,,,._(OvA�;,n
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 heed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormwater rules under �5A NCAC 2H .1000 and any other applicable state stormwater requirements.
Signature:
Date: Z.- I %
1, �1�1 C'au S rn l -T 1-I , a Notary Public for the State of -1-� wz-iH CP46 Llr�A , County of
FORS-1l I1A , do hereby certify that I1=F t= ('..0AM13� bZL—Q I,)personally appeared
t
before me this 13 �ay of -Pc &z.tl.0tL)( 0, and acknowledge the due exec tion of the application for
a stormwater permit. Witness my hand an���"fwal'
GARB '44,•
%i rq $
UB1.�
on txpires A&)6U.S7 1 7, 264
form SWU-101 Version 06Aug2012 Page 6 of'6

BASIN INFORMATION TABLE
Supplement Information for Part IV.10 of the SWU-101 Stormwater Management Permit Application Form
Stormwater Project No. SW4130301
Basin Information
Drainage Area #1
Drainage Area #2
Drainage Area #3
Drainage Area #4
Drainage Area #5
Receiving Stream Name
UT to Haw River
UT to Haw River
UT to Haw River
ELIMINATED
UT to Haw River
Stream Class
Stream Index Number
Total Drainage Area (so
93,021
149,799
66,583
D.A. #2
8,340
On -Site Drainage Area (sf)
71,028
149,799
62,244
6,791
Off -Site Drainage Area (sf)
21,993
0
4,339
1,549
Proposed Impervious Area (SF)
36,304
96,461
36,723
4,513
% impervious Area (total)
39.0%
64.4%
55.2%
1
54.1%
_Impervious Surface Area
Drainage Area #1
Drainage Area #2
Drainage Area #3
Drainage Area #4
Drainage Area #5
On -Site Buildings/Lots (sf)
12,268
12,760
0
0
On -Site Streets (sf)
24,036
83,701
36,723
3,212
On -Site Parking (sf)
Inc. In Above
Inc. In Above
Inc. In Above
Inc. In Above
On -Site Sidewalks (sf)
Inc. In Above
Inc. In Above
Inc. In Above
Inc. In Above
Other On -Site (sf)
0
0
0
0
Future (sf)
0
0
0
0
Off -Site (sf)
0
0
0
1,301
Existing BUA (sf)
0
0
0
0
Total (sf)
36,304
96,461
36,723
4,513
`1yy 11Ito 1e/��
CAR
'aQ
t
42
Page 1 of 1
� IV 5 _V; NS G✓
'' Ic -W