SW6120302_CURRENT PERMIT_20120723

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

ATLA.
WDENR
North Carolina Department of Environment and
Beverly Eaves Dorr414e
Governor
Division of Water Quality
rV Uli ha�les 1.6)a!;ild, PE
Director
June 20, 2012
Mr. David Heins, Environmental Division Works (DPW)
Directorate of Public Works
2175 Reilly Road Stop A
Fort Bragg, NC 28310
DENR—FRO
JUL 2 3 2012
Natural Resources DWQ
Subject: Stormwater Permit No. SW6120302
3`d Brigade Combat Team Complex, In/Out Processing facility
High Density Commercial Bio-Retention Project
Cumberland County
Dear Mr. Heins:
Dee Freeman
Secretary
The Stormwater Permitting Unit received a complete Stormwater Management Permit Application for 3rd
Brigade Combat Team Complex, In/Out Processing Facility on June 18, 2012 after additional information
requested on March 23, May 4, and May 24. Staff review of the plans and specifications has determined
that the project, as proposed, will comply with the Stormwater Regulations set forth in Title 15A NCAC
2H.1000 and Session Law 2006-246. We are forwarding Permit No. SW6120302, dated June 19, 2012,
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 June 19, 2020 and shall be subject to the
conditions and limitations as specified therein, and does not supersede any other agency permit that may
be required. Please pay special attention to the conditions listed in this permit regarding the Operation and
Maintenance of the BMP(s), recordation of deed restrictions, procedures for changes of ownership,
transferring the permit, and renewing the permit. Failure to establish an adequate system for operation and
maintenance of the stormwater management system, to record deed restrictions, to follow the procedures
for transfer of the permit, or to renew the permit, will result in future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to
request an adjudicatory hearing upon written request within thirty (30) days following receipt of this permit:.
This request must be in the form of a written petition, conforming to Chapter 150B of the North Carolina
General Statutes, and filed with the Office of Administrative Hearings, P.O. Drawer 27447, Raleigh, NC
27611-7447. Unless such demands are made this permit shall be final and binding.
This project will be kept on file at the Fayetteville Regional Office. If you have any questions, or need
additional information concerning this matter, please contact Brian Lowther at [phone]; or
[e-mail].
Sincerely,
,for Charles Wakild, P.E.
cc: Fayetteville Regional Office
SW6120302
ec: Yeznik S . Yeretzian, PE — [e-mail]
Wetlands and Stormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
LOCatIOn', 512 IN Salisbury St. Raleigh, North Carolina 27604
Phone [phone] FAX: [phone]
Internet: wwwncwaterquallty.org
An Equal Opportunity 1 Affirmative Action Employer
One
NorthCarolina
Naturally

.-.
State Stormwater Permit
Permit No. SW612U302
STATE OF NORTH CAROLINA ®ENR-FR0
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY JUL
STATE ST0`RMWATER MANAGEMENT 'PERMIT
HIGH DENSITY DEVELOPMENT
in accordance with the provisions of Articie 21 of Chapter 143, General Statutes of
North Carolina as amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Directorate of Public Works (DPW}
YdBrigade Combat Team Complex, In/Out Processing Facility
Fort Bragg and Cumberland County
FOR THE
construction, operation and maintenance of four (4) bioretention cell(s) in compliance
with the provisions of Session Law 2006-246 and 15A NCAC 2H .1000 (hereafter
referred to as the "stormwater rules') and the approved stormwater management plans
and specifications and other supporting data as attached and on file with and approved
by the Division of Water Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until June 19, 2020, and shall
be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
1. This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. This stormwater system has been approved for the management of stormwater
runoff as described in the attached supplement forms. The stormwater control
has been designed to handle the runoff from 42,804 square feet of impervious
area.
3. The tract will be limited to the amount of built -upon area per the application
documents and as shown on the approved plans. The built -upon area for the
future development is limited to 0 square feet.
4. All stormwater collection and treatment systems must be located in either
dedicated common areas or recorded easements. The final plats for the project
will be recorded showing all such required easements, in accordance with the
approved plans.
5. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
6. The built -upon areas associated with this project shall be located at least 30 feet
landward of all perennial and intermittent surface waters.
Page 1 of 6

State Stormwater Permit
Permit No. S Vv6120302
7. The design criteria for each bioretention cell has been attached to this permit
and must be maintained at design condition.
il. SCHEDULE OF COMPLIANCE
1. The stormwater management system shall be constructed in its entirety,
vegetated and operational for its intended use prior to the construction of any
built -upon surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The permittee shall at all time provide the operation and maintenance necessary
to assure the permitted stormwater system functions at optimum efficiency. The
approved Operation and Maintenance Plan must be followed in its entirety and
maintenance must occur at the scheduled intervals including, but not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
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.
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
Page 2 of 6

r
State Stormwater Permit
Permit No. SW6120'1302
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, !ease or sale of all or park of the project
area. The project area is defined as all property owned by the permittee,
for which Sedimentation. and Erosion Contro! Plan approval or a CAMA
Major permit was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
11. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
12. A copy of the approved plans and specifications shall be maintained on file by
the Permittee for a minimum of ten years from the date of the completion of
construction.
13. The Director may notify the permittee when the permitted site does not meet one
or more of the minimum requirements of the permit. Within the time frame
specified in the notice, the permittee shall submit a written time schedule to the
Director for modifying the site to meet minimum requirements. The permittee
shall provide copies of revised plans and certification in writing to the Director
that the changes have been made.
III. GENERAL CONDITIONS
1. This permit is not transferable except after notice to and approval by the Director.
In the event of a change of ownership, or a name change, the permittee must
submit a completed Name/Ownership Change form signed by both parties, to the
Division of Water Quality, accompanied by the supporting documentation as
listed on page 2 of the form. The approval of this request will be considered on
its merits and may or may not be approved.
2. The permittee is responsible for compliance with all permit conditions until such
time as the Division approves a request to transfer the permit.
3. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the Division of Water Quality, in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
4. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
5. In the event that the facilities fail to perform satisfactorily, including the creation
of nuisance conditions, the Permittee shall take immediate corrective action,
including those as maybe 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.
Page 3 of 6

State Stormwater Permit
Permit No. SW6120302
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 Darts of the oermit.
10. The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revoking and reissuing the permit, or terminating the permit
as allowed by the laws, rules and regulations contained in Session Law 2006-
246, Title 15A NCAC 2H.1000, and NCGS 143-215.1 et.al.
11. The permittee shall notify the Division in writing of any name, ownership or
mailing address changes at least 30 days prior to making such changes.
12. The permittee shall submit a renewal request with all required forms and
documentation at least 180 days prior to the expiration date of this permit.
Permit issued this the 20th day of June 2012.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
.ior Charles Wa ild, PE, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 4 of 6

State Stormwater Permit
Permit No. SW V61203G'2
3rd Brigrade Combat Team Complex, In/Out Processing Facility
Stormwater Permit No. SW6120302
Cumberland County
Designer's Certification
I, , as a duly registered in the
State of North Carolina, having been authorized to observe (periodically/ weekly/
full time) the construction of the project,
(Project Name)
for (Project Owner) hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the project
construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
SEAL
Page 5 of 6

State Stormwater Permit
Permit No. SA612�3302'�
Certification Requirements:
1. The drainage area to the system contains approximately the permitted
acreage.
2. The drainage area to the system contains no more than the permitted
amount of built -upon area.
3. All the built -upon area associated with the project is graded such that the
runoff drains to the system.
4. All roof drains are located such that the runoff is directed into the system.
5. The outlet/bypass structure elevations are per the approved plan.
6. The outlet structure is located per the approved plans.
7. Trash rack is provided on the outlet/bypass structure.
8. All slopes are grassed with permanent vegetation, per the vegetation plan.
9. Vegetated slopes are no steeper than 3:1.
10. The inlets are located per the approved plans and do not cause short-
circuiting of the system.
11. The permitted amounts of surface area and/or volume have been
provided.
12. Required drawdown devices are correctly sized per the approved plans.
13. All required design depths are provided.
14. All required parts of the system are provided, such as a vegetated shelf,
and a forebay.
15. The required system dimensions are provided per the approved plans.
CC' NCDENR-DWQ Regional Office
Cumberland County Building Inspections
Page 6 of 6

Permit Number
—
(to be provided by aw0)
OF W A7FR
AM
OG
TA
HC®EWR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
BIORETENTION CELL SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
I. PROJECT INFORMATION
Project name 3rd Brigade CombatTeam Complex, in/Out Processing Facility
Contact name Yeznik (Nick) S. Yeretzian
Phone number [phone]
Date June 5 2012
Drainage area number CA3
II, DESIGN INFORMATION
Site Characteristics
Drainage area
18,111 Ile
Impervious area
8,921 ft'
Percent impervious
49.3% %
Design rainfall depth
1,0 inch
Peak Flow Calculations
Is prelpost control of the 1-yr, 24-hr peak flow required?
1-yr, 24-hr runoff depth
1-yr. 24-hr intensity
Pre -development 1-yr, 24-hr peak flow
Post -development 1-yr, 24-hr peak flow
Pre/Post i-yr, 24-hr peak control
Storage Volume; Non -SA Waters
Minimum volume required
Volume provided
Storage Volume; SA Waters
1.5' runoff volume
Pre -development 1-yr, 24-hr runoff
Post -development 1-yr, 24-hr runoff
Minimum volume required
Volume provided
Cell Dimensions
Ponding depth of water
Ponding depth of water
Surface area of the top of the bioretention cell
Length:
Width:
-or- Radius
Media and Solis Summary
Drawdown time, ponded volume
Drawdown time, to 24 inches below surface
Drawdown time, total:
In -situ soil"
Soil permeability
Planting media soil:
Soil permeability
Soil composition
% Sand (by volume)
% Fines (by volume)
% Organic (by volume)
Phosphorus Index (P-Index) of media
Form SW 401-Bioretention-Rov.B
N (Y or N)
NIA in
NIA in/hr
NIA fl3lsec
ft'lsec
ft'/sec
745.0 ft3
911.0 ft3 OK
NIA ft'
ft'
It
NIA It
NIA It OK
12 inches
OK
1.00 ft
911.0 ft2
OK
33 ft
OK
22 It
OK
ft
6 hr OK
12 hr OK
18 hr
0.10 inlhr Insufficient, Increase infiltration rate or include underdrains.
l9 n � Qfdt•o�i ►. g ,�]roa i de d� .
2.00 in/hr OK
88% OK
8% OK
4% OK
Total: 100%
15 (unitless) OK

Permit Number;
(to be provided by OWO)
Basin Elevations
Temporary pool elevation
Type of bioretention cell (answer 'Y' to only one of the two
following questions):
Is this a grassed cell?
Is this a cell with trees/shrubs?
Planting elevation (top of the mulch or grass sod layer)
Depth of mulch
Bottom of the planting media soil
Planting media depth
Depth of washed sand below planting media soil
Are underdrains being installed?
How many clean out pipes are being installed?
What factor of safety is used for sizing the underdrains? (See
BMP Manual Section 12.3.6)
Additional distance between the bottom of the planting media and
the bottom of the cell to account for underdrains
Bottom of the cell required
SHWT elevation
Distance from bottom to SHWT
Internal Water Storage Zone (IWS)
Does the design include IWS
Elevation of the top of the upturned elbow
Separation of IWS and Surface
Planting Plan
Number of tree species
Number of shrub species
Number of herbaceous groundcover species
Additional Information
Does volume in excess of the design volume bypass the
bioretention cell?
Does volume in excess of the design volume flow evenly distributed
through a vegetated filter?
What is the length of the vegetated filter?
Does the design use a level spreader to evenly distribute flow?
Is the BMP located at least 30 feet from surface waters (50 feet if
SA waters)?
Is the EMP located at least 100 feet from water supply welts?
Are the vegetated side slopes equal to of less than 3:1?
Is the BMP located in a proposed drainage easement with access
to a public Right of Way (ROW)?
Inlet velocity (from treatment system)
Is the area surrounding the cell likely to undergo development in
the future?
Are the slopes draining to the bioretention cell greater than 20%?
is the drainage area permanently stabilized?
Pretreatment Used
(Indicate Type Used with an "X' in the shaded cell)
Gravel and grass
(flinches gravel followed by 3-5 it of grass)
Grassed swale
Forebay
Other
382.00 fmsl
Y (Y or N) OK
N (Y or N)
381 fmsl
4 inches OK
378 fmsl
3 ft
0.33 ft
Y (Y or N)
3 OK
10 OK
1 ft
376.67 fmsl
372 fmsl
4,67 ft OK
N (Y or N)
fmsl
381 ft
0
3
3 OK
Y (Y or N) OK
Y (Y or N) OK
3 ft
N (Y or N) Show how flow is evenly distributed.
Y (Y or N) OK
Y (Y or N) OK
Y (Y or N) OK
Y (Y or N) OK
1 ttlsec OK
N (Y or N) OK
N (Y or N) OK
Y (Y or N) OK
X
N2
Form SW401-Bloretentlon-Rev.e

Permh No:
(to be assigned by O WO)
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 wilt 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,
Paget Plan
Initials Sheet No.
C — I I G, 1. Plans (V - 50' a larger) of the entire site showing:
Design at ultimate build -out,
Off -site drainage ('rf applicable).
Delineated drainage basins (include Rational C coefficient per basin).
Cell dimensions,
Pretreatment system,
High flow bypass system,
Maintenance access,
Recorded drainage easement and public right of way (ROW),
Clean out pipe locations.
Overflow device, and
Boundaries of drainage easement.
YS C ~ 510 2. Plan details (1' = 30' or larger) for the borelention cell showing:
Cell dimensions
Pretreatment system,
High Bow bypass system,
Maintenance access,
Recorded drainage easement and pubiic right of way (ROW),
Design atultimale build -out,
OH -site drainage (if applicable),
Clean out pipe locations,
Overflow device, and
Boundaries of drainage easement.
Indicate the P-Index between 10 and 30
Ys%( C - 5ln A 3. section view of the bioretealion cell (i' = 20' or larger) showing
Side slopes, 3:1 or lower
Underdrain system (if applicable), and
Biorelenfion cell layers [ground level and slope, pre-treatment, ponding depth, mulch depth, fili media
depth, washed sand, Filter fabric (or choking stone if applicable), #57 stone, underdrains (if applicable),
SHWT level(s), and overflow structure)
S _ soil- S
4. A solls report that is based upon an actual lieid investigation, soil borings, and infiltration tests. The
91M K l
results of the soils report must be verified in the field by DWO, by completing & submitting the soils
investigation request form. County soil maps are not an acceptable source of soils information. All
elevations shall be in feet mean sea level (fmsl). Results of soils tests of both the planting soil and the in
situ soil must include:
Soil permeability,
Sol composition (% sand, % fines, % organic), and
P-index.
YS Y�
5. A detailed planting plan (1' = 20' or larger) prepared by a qualified individual showing:
L 50 3
- A variety of suitable species,
Sizes, spacing and locations of plantings,
Total quantity of each type of plant specified,
A planting detail,
The source nursery for the plants, and
FertBizer and watering requirements to establish vegetation.
YS Y r� 3b
6. A construction sequence that shows how the biorelenlion cell will be protected from sediment until the
entire drainage area is stabilized.
�sY ,c r
7. The supporting calculations (including undardrain calculations, if applicable),
INCLlla1-ill
-
YSY cA�cS
8. A copy of the signed and notarized inspection and maintenance (I0) agreement.
9. A copy of the deed restriction.
�L 5u8+�tTT�•a �rAtR•Lt k le
Form SW401-8ioretentlon•Rev.7 Pan In, Page 1 C1 1

Permit Number:
(10 be provided by DWO)
Apw
of wnr�9
A*_
+� Y
MODEA a
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
BIORETENTION CELL SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Para 111) must be printed, filled out and submitted along with all of the required information.
I. PROJECT INFORMATION
Project name 3rd Brigade Combat Team Complex, In/Out Processing Fad'hy
Contact name Yeznik (Nick) S. Yeretzian
Phone number [phone]
Date June 52012
Drainage area number CA4
11, DESIGN INFORMATION
Site Characteristics
Drainage area
10,966 ftz
Impervious area
7,582 ftz
Percent impervious
69.1% %
Design rainfall depth
1.0 inch
Peak Flow Calculations
Is pre/post control of the 1-yr, 24•hr peak flow required?
1-yr, 24-hr runoff depth
1-yr, 24-hr intensity
Pre -development 1-yr, 24-hr peak flow
Post -development 1-yr, 24-hr peak flow
PrelPosl 1-yr, 24-hr peak control
Storage Volume: Mon -SA Waters
Minimum volume required
Volume provided
Storage Volume: SA Waters
1.5" runoff volume
Pre -development 1-yr, 24-hr runoff
Post -development 1-yr, 24-hr runoff
Minimum volume required
Volume provided
Cell Dimensions
Ponding depth of water
Ponding depth of water
Surface area of the top of the bioretention cell
Length:
Width:
-or- Radius
Media and Soils Summary
Drawdown time, ponded volume
Drawdown time, to 24 inches below surface
Drawdown time, total:
In -situ soft.,
Soil permeability
Planting media soil:
Soil permeability
Soil composition
% Sand (by volume)
% Fines (by volume)
% Organic (by volume)
Phosphorus Index (P-Index) of media
Form SW401-Bioretention-Rev.8
.lone 75 7Mn
N (Y or N)
NIA in
NIA in/hr
N/A ft3/sec
ft'/sec
ft3lsec
614.0 ft3
655.0 ft3 OK
NIA ft3
ft3
fts
NIA ft3
NIA ft3 OK
12 inches
OK
1.00 it
655.0 ffl
OK
33 fi
OK
16 ft
1t
OK
6 hr OK
12 hr OK
18 hr
0.10 in/hr Insufficient,. Increase infiltration rate or include unnderdrrains.
Uf,dQrJreLtirs f rOlt1R�CJ
2.00 in/hr OK
88% OK
8% OK
4% OK
Total: 100%
15 (unitless) OK
Parts I nrW rl n..inn Cn _m Pen. i m v

Permit NumbeF:
(10 be provided by 0WO)
Basin Elevations
Temporary pool elevation
Type of bioretention cell (answer "Y" to only one of the two
following questions):
Is this a grassed cell?
Is this a cell with trees/shrubs?
Planting elevation (top of the mulch or grass sod layer)
Depth of mulch
Bottom of the planting media soil
Planting media depth
Depth of washed sand below planting media soil
Are underdrains being installed?
How many clean out pipes are being installed?
What factor of safety is used for sizing the underdrains? (See
BMP Manual Section 12.3.6)
Additional distance between the bottom of the planting media and
the bottom of the cell to account for underdrains
Bottom of the cell required
SHWT elevation
Distance from bottom to SHWT
Internal Water Storage Zone (IWS)
Does the design include IWS
Elevation of the top of the upturned elbow
Separation of XS and Surface
Planting Plan
Number of tree species
Number of shrub species
Number of herbaceous groundcover species
Additional Information
Does volume in excess of the design volume bypass the
bioretention cell?
Does volume in excess of the design volume flow evenly distributed
through a vegetated filter?
What is the length of the vegetated filter?
Does the design use a level spreader to evenly distribute flow?
Is the BMP located at least 30 feel from surface waters (50 feet if
SA waters)?
Is the BM? localed at least 100 feet from water supply wells?
Are the vegetated side slopes equal to or less than 3:1?
Is the BMP located in a proposed drainage easement with access
to a public Right of Way (ROW)?
Inlet velocity (from treatment system)
Is the area surrounding the cell likely to undergo development in
the future?
Are the slopes draining to the bioretention cell greater than 20%?
Is the drainage area permanently stabilized?
Pretreatment Used
(indicate Type Used with an "X' in the shaded cell)
Gravel and grass
(flinches gravel followed by 3-5 ft of grass)
Grassed swale
Forebay
Other
384.00 fmsl
Y (Y or N) OK
N (YorN)
383 fmsl
4 inches OK
380 fmsl
3 it
0.33 ft
Y (Y or N)
2 OK
10 OK
1 ft
378.67 fmsl
374 fmsl
4.67 ft OK
N (Y or N)
fmsl
383 ft
0
3
3 OK
Y (Y or N) OK
Y (Y or N) OK
sn
N (Y or N) Show how flow is evenly distributed.
Y (Y or N) OK
Y (Y or N) OK
Y (Y or N) OK
Y (Y or N) OK
1 ft/sec OK
N (Y or N) OK
N (Y or N) OK
Y (Y or N) OK
X
OK
Forth SW401-Bioretention-Rev.8
Jiinn 7F 7nin

Permh No: ___ __
(lobe assigned by r)WQj
III. REQUIREp 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 pro)ect. 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.
Pagel Plan
initials Sheet No.
Cf aL f, Plans (1' - 50' or larger) of the entire site showing:
Design at ultimate build -out,
Off -site drainage (if applicable),
Delineated drainage basins (include Rational C coefficient per basin),
Cell dimensions,
Pretreatmen t system.
High flow bypass system,
Maintenance access,
Recorded drainage easement and public right of way (ROW),
Clean out pipe locations,
Overflow device, and
Boundaries of drainage easement,
2. Plan details (1' = 30' or larger) for the bioretenlion coil showing:
Cell dimensions
Pretreatment system,
High flow bypass system,
Maintenance access,
Recorded drainage easement and public right of way (ROW).
Design at ultimate build -out,
Off -site drainage (if applicable),
Clean out pipe locations,
Overflow device, and
Boundaries of drainage easement.
Indicate the P-Index between 10 and 30
YSA 3. Section view or the bioretentien cell (1' = 20' or larger) showing.
Side slopes, 3:1 or lower
Underdrain system (if applicable), and
Biorelention cell layers (ground level and slope, pre-treatment, ponding depth, mulch depth, fill media
depth, washed sand, filter fabric (or choking stone if applicable), #57 stone, underdrains (if applicable),
SHWT level(s), and overflow structure)
'� \ asoILS
fl`cl°d RT
YSY l -50 l
L - 56 3
ME
i k y 'az
NCLLAU C�
YSS- C At.0
—4--
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 DWO, by completing & submitting the soils
investigation request form. County soil maps are not an acceptable source of soils information. All
elevations shall be in feel mean sea level (fmsl), Results of soils tests of both the planting soil and the in
situ soil must include,
Soil permeability,
Soil composition (% sand, % fines, % organic), and
P-index.
5. A detailed planting plan (1' = 29 or larger) prepared by a qualified individual showing:
A variety of suitable species,
Sizes, spacing and locations of plantings,
Total quantity of each type of plant specified,
A planting detail,
The source nursery for the plants, and
Fertilizer and watering requirements to establish vegetation.
6. A construction sequence that shows how the bioretealion cell will be protected from sediment until the
entire drainage area is stabilized.
The supporting calculations (including underdrain calculations, if applicable),
B. A copy of the signed and notarized inspection and maintenance (f&M) agreement.
_ 9. A copy of the deed restriction.
Su BM l i�Prr2[ t E l�
Form 9W4011-81orelention-Rev.7 Part Ili, Page 1 or 1

Permit Number,
f to be provided by DWQ)
o�oF warEgoG
PIMA
WJDEN R
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
BIORETENTION CELL SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
I. PROJECT INFORMATION
Project name 3rd Brigade Combat Team Complex, WOutProcessing FacilAy
Contact name Yeznik (Nick) S. Yeretzian
Phone number [phone]
Da1e June 5 2012
Drainage area number CA5
II. DESIGMINFORMATION
Site Characteristics
Drainage area
14,375 ft2
Impervious area
7,274 ft2
Percent impervious
50.6% %
Design rainfall depth
1.0 inch
Peak Flow Calculations
Is prelpost control of the 1-yr, 24-hr peak flow required?
N (Y or N)
1-yr, 24-hr runoff depth
NIA in
1-yr, 24-hr intensity
NIA in/hr
Pre -development 1-yr, 24-hr peak flow
NIA ft'lsec
Post -development 1-yr, 24-hr peak flow
ft'lsec
Pre/Post 1-yr, 24-hr peak control
fi'lsec
Storage Volume: Non -SA Waters
Minimum volume required
611.0 ft3
Volume provided
737,0 ft'
OK
Storage Volume: SA Waters
1.5" runoff volume
N/A fi'
Pre -development 1-yr, 24-hr runoff
fi'
Post -development 1-yr, 24-hr runoff
ft3
Minimum volume required
NIA ft3
Volume provided
NIA ft3
OK
Cell Dimensions
Ponding depth of water
12 inches
OK
Ponding depth of water
1.00 ft
Surface area of the top of the bioretention cell
737.0 ft2
OK
Length:
32 ft
OK
Width:
25 ft
OK
-or- Radius
fi
Media and Soils Summary
Drawdown time, panded volume
6 hr
OK
Drawdown time, to 24 inches below surface
12 hr
OK
Drawdown time, total:
18 hr
In -situ soil:
Soil permeability
0,10 in/hr
Insufficient. Increase infiltration rate or include underdrains.
Planting media soil:
U (�! first+ F. 9 p r o V tie j
Soil permeability
2.00 inlhr
OK
Soil composition
% Sand (by volume)
88%
OK
% Fines (by volume)
8%
OK
% Organic (by volume)
4%
OK
Total:
100%
Phosphorus Index (P-Index) of media
15 (unitless)
OK
Form SW401-Bloretentron-Rev.8

Permit Number:
(to be provided by DWQ)
Basin Elevations
Temporary pool elevation
Type of bioretention cell (answer 'Y" to only one of the two
following questions):
Is this a grassed cell?
Is this a cell with trees/shrubs?
Planting elevation (top of the mulch or grass sod layer)
Depth of mulch
Bottom of the planting media soil
Planting media depth
Depth of washed sand below planting media soil
Are underdrains being installed?
How many clean out pipes are being installed?
What factor of safety is used for sizing the underdrains? (See
BMP Manual Section 12.3.6)
Additional distance between the bottom of the planting media and
the bottom of the cell to account for underdrains
Bottom of the cell required
SHWT elevation
Distance from bottom to SHWT
Internal Water Storage Zone (IWS)
Does the design include IWS
Elevation of the top of the upturned elbow
Separation of IWS and Surface
Planting Plan
Number of tree species
Number of shrub species
Number of herbaceous groundcover species
Additional Information
Does volume in excess of the design volume bypass the
bioretention cell?
Does volume in excess of the design volume flow evenly distributed
through a vegetated filter?
What is the length of the vegetated filter?
Does the design use a level spreader to evenly distribute flow?
Is the BMP located at least 30 feet from surface waters (50 fact if
SA waters)?
Is the BMP located at least 100 feet from water supply wells?
Are the vegetated side slopes equal to or less than 3:1?
Is the BMP located in a proposed drainage easement with access
to a public Right of Way (ROW)?
Inlet velocity (from treatment system)
Is the area surrounding the cell likely to undergo devetopmenl in
the future?
Are the slopes draining to the bioretention cell greater than 20%?
Is the drainage area permanently stabilized?
Pretreatment Used
(Indicate Type Used with an'X' in the shaded cell)
Gravel and grass
(Binches gravel followed by 3-5 ft of grass)
Grassed swale
Forebay
Other
382.00 fmsl
Y (Y or N) OK
N (Y or N)
381 fmsl
4 inches OK
378 fmsl
3 It
0.33 ft
Y (Y or N)
3 OK
10 OK
1 f1
376.67 fmsl
372 fmsl
4,67 ft OK
N (Y or N)
fmsl
381 ft
0
3
3 OK
Y (Y or N) OK
Y (Y or N) OK
3 111
N (Y or N) Show how flow is evenly distributed.
Y (Y or N) OK
Y (Y or N) OK
Y (Y or N) OK
Y (Y or N) OK
1 ftlsec OK
N (Y or N) OK
N (Y or N) OK
Y (Y or N) OK
X
OK
Form SW401-Sioretention-Rev.8
.r„na vR 9n+n

Permit No:
(to be assigned by t7 WO)
lit. 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 justiflcatlon.
Page/ Plan
Initials Sheet No.
YS Y
1, Plans (1" - 50' or larger) of the entire site showing:
Design at ultimate build -out,
OH -site drainage (if applicable),
Delineated drainage basins (include Rational C coefficient per basin),
Cell dimensions,
Pretreatment system,
High flow bypass system,
Maintenance access,
Recorded drainage easement and public right of way (ROW),
Clean out pipe locations,
-Overflow device, and
- Boundaries of drainage easement.
2. Plan details (1' = 30' or larger) for the bioretention cell showing:
Cell dimensions
Pretreatment system,
High now bypass system,
Maintenance access.
Recorded drainage easement and public right of way (ROW),
Design at ultimate build -out,
Off -site drainage (N applicable),
Clean out pipe locations.
Overflow device, and
Boundaries of drainage easement.
Indicate the P-Index between 10 and 30
3, Section view of the biorelenton cell (1' = 20' or larger) showing:
Side slopes, 3:1 or lower
Underdrain system (d applicable), and
Bloretention cell layers (ground level and slope, pre-treatment, ponding depth, mulch depth, fill media
depth, washed sand, filter faMe (or choking stone if applicable). #57 stone, underdrains (if applicable),
SHWT level(s), and overflow structure)
Y5 Y soil 4. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests, The
R 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 information. All
elevations shall be in feet mean sea level (fmsl). Results of soils tests of both the planting soil and the in
situ soil must include,
Soil permeability,
Soil composition (% sand, % fines, % organic), and
y`Y P-index.
1Y L-fol 5. A detailed planting plan (1" = 20' or larger) prepared by a qualified individual showing:
L — 50 3 A variety of suitable species,
Sizes, spacing and locations of plantings,
Total quantity of each type of plant specified,
A planting detail,
The source nursery for the plants, and
Fertilizer and watering requirements to establish vegetation.
YL_ 3 6. A construction sequence that shows how the bioretention cell will be protected from sediment until the
_ _ entire drainage area is stabilized.
y `qq r 7. The supporting calculations (including underdrain calculations, if applicable).
to ► lPpo 9 (� 9
if NL65
8, A copy of the signed and notarized inspection and maintenance (10) agreement.
Y� Y 9. A copy of the deed restriction,
Form SW401-ftrelentian•Rev.7 4 Sggm-, � "Re f- K
r
Part Ht. Pagel a i

r � i
Permit Number: _
Ito be provided by OWO)
oao� w a rFR pGL
ATA O T
NCDEN
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
BIORETENTION CELL SUPPLEMENT
This form must be filled out, printed and submitted,
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
I. PROJECT INFORMATION
Project name 3rd Brigade Combat Team Complex, tnlOut Processing Fadlitp
Contact name Yeznik (Nick) S. Yeret6an
Phone number [phone]
Date June 5 2012
Drainage area number CA6
II. DESIGN INFORMATION
Site Characteristics
Drainage area
28,863 ft2
Impervious area
19,767 fie
Percent impervious
68.4% %
Design rainfall depth
1.0 inch
Peak Flow Calculations
Is pre/post control of the 1-yr, 24-hr peak flow required?
1-yr. 24-hr runoff depth
1-yr. 24-hr intensity
Pre -development 1-yr, 24-hr peak flow
Post -development 1-yr, 24-hr peak flow
PreIPost 1-yr, 24-hr peak control
Storage Volume: Non -SA Waters
Minimum volume required
Volume provided
Storage Volume: SA Waters
1.5" runoff volume
Pre -development 1-yr, 24-hr runoff
Post -development 1-yr, 24-hr runoff
Minimum volume required
Volume provided
Cell Dimensions
Ponding depth of water
Ponding depth of water
Surface area of the top of the bioretent+on cell
Length:
Width:
-or- Radius
Media and Soils Summary
Drawdown time, ponded volume
Drawdown time, to 24 inches below surface
Drawdown time, total:
In -situ soil:
Soil permeability
Planting media soil:
Soil permeability
Soil composition
% Sand (by volume)
% Fines (by volume)
% Organic (by volume)
Phosphorus Index (P-index) of media
Form SW401-13ioretontion-Rev-e
1„ 6 J5 7nin
N (Y or N)
NIA in
NIA in/hr
NIA 0/sec
ft'lsec
ft'/sec
1,603.0 ft3
1,630.0 f13 OK
NIA ft'
—ft 3
ft3
NIA ft3
NIA ft' OK
12 inches
OK
1.00 ft
1,630.0 ft'
OK
32 ft
OK
25 fl
OK
ft
6 hr OK
12 hr OK
18 hr
0.10 in/hr Insufficient. Increase infiltration rate or include underdrains.
2.00 inthr OK
88% OK
8% OK
4% OK
Total: 100%
15 (unitless) OK

Permit Number;
fro be provider! by DWQ}
Basin Elevations
Temporary pool elevation
Type of bioretention cell (answer 'Y' to only one of the two
following questions):
Is this a grassed cell?
Is this a cell with trees/shrubs?
Planting elevation (top of the mulch or grass sod layer)
Depth of mulch
Bottom of the planting media soil
Planting media depth
Depth of washed sand below planting media soil
Are underdrains being installed?
How many clean out pipes are being installed?
What factor of safety is used for sizing the underdrains? (See
BMP Manual Section 12.3.6)
Additional distance between the bottom of the planting media and
the bottom of the cell to account for underdrains
Bottom of the cell required
SHWT elevation
Distance from bottom to SHWT
Internal Water Storage Zone (IWS)
Does the design include IWS
Elevation of the top of the uptumed elbow
Separation of IWS and Surface
Planting Plan
Number of tree species
Number of shrub species
Number of herbaceous groundcover species
Additional Information
Does volume in excess of the design volume bypass the
bioretention cell?
Does volume in excess of the design volume flow evenly distributed
through a vegetated filter?
What is the length of the vegetated filter?
Does the design use a level spreader to evenly distribute flow?
Is the BMP located at least 30 feet from surface waters (50 feet if
SA waters)?
Is the BMP located at least 1DO feet from water supply wells?
Are the vegetated side slopes equal to or less than 3:1?
Is the BMP located in a proposed drainage easement with access
to a public Righl of Way (ROW)?
Inlet velocity (from treatment system)
Is the area surrounding the cell likely to undergo development in
the future?
Are the slopes draining to the bioretention celi greater than 20%?
Is the drainage area permanently stabilized?
Pretreatment Used
(Indicate Type Used with an'X' in the shaded cell)
Gravel and grass
(81inches gravel followed by 3-5 ft of grass)
Grassed Swale
Forebay
Other
375.00 fmsl
Y (Y or N) OK
N (Y or N)
374 fmsl
4 inches OK
371 fmsl
3 f1
0.33 ft
Y (Y or N)
4 OK
10 OK
1 ft
369.67 fmsl
365 fmsl
4.67 It OK
N (Y or N)
fmsl
374 ft
0
3
3 OK
Y (Y or N) OK
Y (Y of N) OK
3 ft
N (Y or N) Show how flow is evenly distributed.
Y (Y or N)
OK
Y (Y or N)
OK
Y (Y or N)
OK
Y (Y or N)
OK
1 filsec
OK
N (Y or N) OK
N (Y or N) OK
Y (Y or N) OK
r�l
110
Form SW4e1-Bioretention-Rev.8
Juno 9F min oo.�� , .....e a n.,��..� c............. n....., ..�

,
Permit No:
(to be assrened by AWO)
ill. 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 desgnated an agent, the agent may initial below. If a
requirement has not been met, attach justification.
Page/ Plan
Initials Sheet No.
T
Ys_Y___. c - S (n A
YSY _ C-iwA
Plans (V - 50' or larger) of the entire site showing:
Design at ultimate build-oul,
Off -site drainage (A applicable),
Delineated drainage basins (include Rational C coefficient per basin),
Cep dimensions,
Pretreatment system,
High flow bypass system,
Maintenance access,
Recorded drainage easement and public right of way (ROW),
Clean out pipe locations.
Overflow device, and
Boundaries of drainage easement.
2. Plan details (1' = 30' or larger) for the bioretention cell showing:
Gell dimensions
Pretreatment system,
High flow bypass system,
Maintenance access,
Recorded drainage easement and public right of way (ROW),
Design at ultimate build -out,
Off -site drainage (if applicable),
Clean out pipe locations,
Ove4ow device. and
Boundaries of drainage easement.
indicate the P-Index between 10 and 30
3. Section view of the biorelention cell (1' = 20' or larger) showing:
Side slopes, 3:1 or lower
Underdrain system (if applicable), and
Biorelention cell layers )ground level and slope, pre-treatment, ponding depth, mulch depth, fill media
depth, washed sand, filter fabric (or choking stone if applicable), #57 stone, underdrains (if applicable),
SHWT level(s), and overflow structural
L 1� A 0 t L S 4. A soils report that is based upon an actual field investigalion, soil borings, and infiltration tests. The
R R i results of the soils report must be vedhed in the field by DWO, by completing & submil#ing the soils
investigation request form. County soil maps are not an acceptable source of soils information. All
elevations shall be in feel mean sea level (fmsl). Results of solls tests of both the planting soil and the in
situ soil must include:
Soil permeability,
Sail composition (% sand, % fines, % organic), and
P-index.
5. A detailed planting plan (1` = 2V or larger) prepared by a quafified individual showing:
,& A variety of suitable species,
L — S O - Sizes, spacing and locations of planlings,
- Total quantity of each type of plant specified,
- A planting detail.
The source nursery for the plants, and
Fertilizer and watering requirements to establish vegetation.
6. A construction sequence that shows how the bioretention cell w1k be protected from sediment until the
entire drainage area is stabilized.
yjT _ 7. The supporting calculations (including underdrain calculations, if applicable).
I W LUZIE,")
C faf_t S
Y� ,T � 8. A copy of the signed and notarized inspection and maintenance (t&M) agreement,
9. A copy of the dead restriction.
�! C(�I ) w %7 ( tS S "Am , TT> L
Form SW4e1•Biorelenllon•Rev.7
Pert III. Page 1 of 1

Permit Number:
(to be provided by DWQ)
Drainage Area Number:
Bioretention Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important operation and maintenance procedures:
— Immediately after the bioretention cell is established, the plants will be watered
twice weekly if needed until the plants become established (commonly six
weeks).
— Snow, mulch or any other material will NEVER be piled on the surface of the
bioretention cell.
— Heavy equipment will NEVER be driven over the bioretention cell.
— Special care will betaken to -prevent sediment from entering the bioretention cell.
— Once a year, a soil test of the soil media will be conducted.
After the bioretention cell is established, I will inspect it once a month and within 24
hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblems:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
bioretention cell
erosive gullies have formed,
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
The inlet device: pipe,
The pipe is clogged (if
Unclog the pipe. Dispose of the _
stone verge or swale
a licable .
sediment off -site.
The pipe is cracked or
Replace the pipe,
otherwise darnaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to
swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
Stone verge is clogged or
Remove sediment and clogged
covered in sediment (if
stone and replace with clean stone.
applicable).
I:ornn SW401-Bioretention O&M-Rev.3 Page 1 of 4

BMP element:
Potentialproblems:
How 1 will remediate theproblem:
The pretreatment area
Plow is bypassing
Regrade if necessary to route all
pretreatment area and/or
flow to the pretreatment area.
_gullies have formed.
Restabilize the area after grading.
Sediment has accumulated to
Search for the source of the
a depth greater than three
sediment and remedy the problem if
inches.
possible. Remove the sediment and
restabilize the pretreatment area.
Lrosion has occurred.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand.
The bioretention cell:
Best professional practices
Prune according to best professional
vegetation
show that pruning is needed
practices.
to maintain optimal plant
health.
Plants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Tree stakes/wires are present
Remove tree stake/wires (which
six months after planting.
can kill the tree if not removed).
The bioretention cell:
Mulch is breaking clown or
Spot mulch if there are only random
soils and mulch
has floated away.
void areas. Replace whole mulch
layer if necessary, Remove the
remaining much and replace with
triple shredded hard wood mulch at
a maximum depth of three inches.
Soils and/or mulch are
Determine the extent of the clogging
clogged with sediment.
- remove and replace either just the
top layers or tine entire media as
needed. Dispose of the spoil in an
appropriate off -site location. Use
triple shredded hard wood mulch at
a maximum depth of three inches.
Search for the source of the
sediment and remedy the problem if
possible,
An annual soil test shows that
Dolomitic lime shall be applied as
pH has dropped or heavy
recommended per the soil test and
metals have accumulated in
toxic soils shall be removed,
the soil nnedia.
disposed of properly and replaced
with new planting media.
Form SW401-Rioretention O&M-Rev.3 Page 2 o1�4

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

Permit Number:
(to he provided by DIVQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the sysfeni or responsible party.
Project name:Yrd Brigade Combat Team Complex, In/Out Processing l� 'acility
BMP clrainage area nutnber:CA5
Print name:Mr. David Heins
Title:Ft_ Bragg Di_r_ectorate ol' Public Works (DPW)/ Chief Environmental Division
Address:2175 Reilly Road Stop A, Fort Bragg, NC 28310-5000
Phone:[phone]
C
Signature:
Date:
Note: The legally responsible party shotild 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, , a Notary Public for the State of'
County of , do hereby certify that
personally appeared before me this
day of , and acknowledge the due execution of the
forgoing bioretention maintenance requirements. Witness my hand and official seal,
SEAL
My commission expires
Form 5W401-Bioretention I&M-Rev. 2 Page 4 of`4

Permit Number:
(to he provided br, DWQ)
Drainage Area Number:
Bioretention Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important operation and maintenance procedures:
— Immediately after the bioretention cell is established, the plants will be watered
twice weekly if needed until the plants become established (commonly six
weeks).
— Snow, mulch or any other material will NEVER be piled on the surface of the
bioretention cell.
— Heavy equipment will NEVER be driven over the bioretention cell.
— Special care will be taken to prevent sediment from entering the bioretention cell.
— Once a year, a soil test of the soil media will be conducted.
After the bioretention cell is established, I will inspect it once a month and within 24
hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblems:
How I will remediate theproblem:
The entire BMP
Trash debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
bioretention cell
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
The inlet device: pipe,
The pipe is clogged (if
Unclog the pipe. Dispose of the
stone verge or swale
applicable).
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
a llicable).
Erosion is occurring in the
Regrade the swale if necessary to
swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
Stone verge is clogged or
Remove sediment and clogged
covered in sediment (if
stone and replace with clean stone.
applicable).
Forin SW401-Bioretention O&M-Rev.3 Page 1 of'4

8MP element:
The pretreatment area
The bioretention cell:
vegetation
The bioretention cell:
soils and mulch
Potential problems:
Flow is bypassing
pretreatment area and/or
gullies have formed. _
Sediment has accumulated to
a depth greater than three
inches.
];rosion has occurred
Weeds are present.
I3est professional practices
show that pruning is needed
to maintain optimal plant
health.
Plants are dead, diseased or
eying.
"free stakes/wires are present
six months after planting.
Mulch is breaking down or
has floated away.
Soils and/or mulch are
clogged with sediment.
An annual soil test shows that
pl-I has dropped or heavy
metals have accumulated in
the soil media.
How I will remediate the problem:
Regrade if necessary to route all
flow to the pretreatment area.
Restabilize the area after grading.
Search for the source of the
sediment and remedy the problem if
possible. Remove the sediment and
restabilize the pretreatment area.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Remove the weeds, preferably by
hand.
Prune according to best professional
practices.
Determine the source of the
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Remove tree stake/wires (which
can kill the tree if not removed).
Spot mulch if there are only random
void areas. Replace whole mulch
layer if necessary. Remove the
remaining much and replace with
triple shredded hard wood mulch at
a maximum depth of three inches.
Determine the extent of the clogging
- remove and replace either just the
top layers or the entire media as
needed. Dispose of the spoil in an
appropriate off -site location, Use
triple shredded hard wood mulch at
a maximum depth of three inches.
Search for the source of the
sediment and remedy the problem if
Dolomitic lime shall be applied as
recommended per the soil test and
toxic soils shall be removed,
disposed of properly and replaced
with new planting media,
Form SW401-Bioretention O&M-Rev.3 Page 2 of. 4

BMP element:
Potentialproblems:
blow l will remediate theproblem:
The underdrain system
Clogging has occurred.
Wash out the underdrain system.
if applicable)
The drop inlet
Clogging has occurred.
Clean out the drop inlet. Dispose of
the sediment off -site.
The drop inlet is damaged
Repair or replace the drop inlet.
The receiving water
13rosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
ou tlet.
733-1786.
Form SW401-13ioretention O&M-Rev.3 Page 3 of 4

Permit Number:
(to he provideel b), UIVQ)
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 ofany
problems with the system or prior to any changes to the system or responsible party.
Project nanie:Yrd Brigade Combat `heam Complex, In/Out Processing h� acility _
BAIP drerinctge area number:
Print name:Mr. David Heins
Title:Ft. Bragg Directorate of Public Works (DPW)/ Chief -Environmental Division_ _
Address:2175 Reilly Road Stop A, Fort Bragg,NC 28310-5000
Phone:[phone].E . . /
Signature:
Date:-t✓h / 2—
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
1, , a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this
day of , and acknowledge the due execution of the
forgoing bioretention maintenance requirements. Witness my hand and official seal,
SEAL
My commission expires
Form SW401-13ioretention I&M-Rev, 2 Page 4 of 4

Permit Number;
(to be provided by UWQ)
Drainage Area Nurnber:
Bioretention Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept ina.
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important operation and maintenance procedures:
- immediately after the bioretention cell is established, the plants will be watered
twice weekly if needed until the plants become established (commonly six
weeks).
- Snow, mulch or any other material will NEVER be piled on the surface of the
bioretention cell.
- Heavy equipment will NEVER be driven over the bioretention cell.
- Special care will be taken to prevent sediment from entering the bioretention cell.
- Once a year, a soil test of the soil media will be conducted.
After the bioretention cell is established, I will inspect it once a month and within 24
hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblems:
How I will remediate theproblem:
The entire BMP
'Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
bioretention cell
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer -application.
The inlet device: pipe,
The pipe is clogged (if
Unclog the pipe. Dispose of the
stone verge or swale
applicable).
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
a q licable .
Erosion is occurring in the
Regrade the swale if necessary to
Swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
Stone verge is clogged or
Remove sediment and clogged
covered in sediment (if
stone and replace with clean stone.
applicable).
Form SW401-Bioretention O&M-Rev.3 Page 1 of.

BMP element:
The pretreatment area
The bioretention cell:
vegetation
The bioretention cell:
soils and mulch
Potentialproblems:
Flow is bypassing
pretreatment area and/or
gullies have formed.
Sediment has accumulated to
a depth greater than three
inches.
Erosion has occurred
Weeds are present.
Best professional practices
show that pruning is needed
to maintain optimal plant
health.
Plants are dead, diseased or
dying.
'free stakes/wires are present
six months after planting.
Mulch is breaking down or
has floated away.
Soils and/or mulch are
clogged with sediment.
An annual soil test shows that
pl-1 has dropped or heavy
metals have accumulated in
the soil media.
How I will remediate the problem:
Regrade if necessary to route A
flow to the pretreatment area.
Restabilize the area after grading.W
Search for the source of the
sediment and remedy the problem if
possible. Remove the sediment and
restabilize the pretreatment area.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems,
Remove the weeds, preferably by
hand.
Prune according to best professional
practices.
Determine the source of the
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Remove tree stake/wires (which
can kill the tree if not removed).
Spot mulch if there are only random
void areas. Replace whole mulch
layer if necessary. Remove the
remaining much and replace with
triple shredded hard wood mulch at
a maximum depth of three inches.
Determine the extent of the clogging
- remove and replace either just the
top layers or the entire media as
needed. Dispose of the spoil in an
appropriate off -site location. Use
triple shredded hard wood mulch at
a maximum depth of three inches.
Search for the source of the
sediment and remedy the problem if
possible.
Dolomitic lime shall be applied as
recommended per the soil test and
toxic soils shall be removed,
disposed of properly and replaced
with new planting media.
Form SW40 I -Biorelention O&M-Rev.3 Page 2 ol'4

BMP element:
Potential roblems:
How I will remediate theproblem:
The underdrain system
Clogging has occurred.
Wash out the underdrain system.
if appIicable
The drop inlet
Clogging has occurred.
Clean out the drop inlet. Dispose of
the sediment off -site.
The drop inlet is damaged
Rz air or replace the drop inlet.
The receiving water
}erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
ou tlet.
733-1786.
Form 5W40I-Bioretention O&M-Rev.3 Page 3 of 4

Permit Number:
(to he provided by U1YQ)
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: 3'rd I3rifade Combat Team complex, In/Out Processing facility
BMP drainage area number:CA4
Print name:Mr. David Heins
Title:Ft. Brww Directorate of Public Works (DPW)/ Chief -Environmental Division
Address:2175 Reilly Road Stop A, fort Bragg, NC 28310-5000
Phone:
Signatl
Date: 1-2-6 / 2-
Note: The legally responsible party should not he 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, • , a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this
day of , and acknowledge the due execution of the
forgoing bioretention maintenance requirements. Witness my hand and official seal,
SEAL
My commission expires
Farm SW401-13ioretention 1&M-Rev. 2 Page 4 of 4

Penuit Number:
(to he provided by DIVQ)
Drainage Area Number:
Bioretention Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important operation and maintenance procedures:
- Immediately after the bioretention cell is established, the plants will be watered
twice weekly if needed until the plants become established (commonly six
weeks).
- Snow, mulch or any other material will NEVER be piled on the surface of the
bioretention cell.
- Heavy equipment will NEVER be driven over the bioretention cell.
- Special care will be taken to prevent sediment from enteritig the bioretention cell.
- Once a year, a soil test of the soil media will be conducted.
After the bioretention cell is established, I will inspect it once a month and within 24
hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblems:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
bioretention cell
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
The inlet device: pipe,
The pipe is clogged (if
Unclog the pipe. Dispose of the
stone verge or swale
applicable),
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to
swale (if applicable),
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problerns with erosion.
Stone verge is clogged or
1Zemove sediment and clogged
covered in sediment (if
stone and replace with clean stone.
applicable).
�� �----
L�A�9UWg
L
rii1 6 201R - S�kTE♦: at}ALITY
Form SW401-Bioretention O&M-Rev3

BMP element:
Potentialproblems:
How I will remediate theproblem:
The pretreatment area
Flow is bypassing
Regrade if necessary to route all
pretreatment area and/or
flow to the pretreatment area.
allies have formed.
Restabilize the area after 7radin T.
Sediment has accumulated to
Search for the source of the
a depth greater than three
sediment and remedy the problem if
inches.
possible. Remove the sediment and
restabilize the pretreatmetit area.
Erosion has occurred.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand.
The bioretention cell:
Best professional practices
Prune according to best professional
vegetation
show that pruning is needed
practices.
to maintain optimal plant
health.
Plants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
`free stakes/wires are present
Remove tree stake/wires (which
six months after planthig.
can kill the tree if not removed).
The bioretention cell:
Mulch is breaking; down or
Spot mulch if there are only random
soils and mulch
has floated away.
void areas. Replace whole mulch
layer if necessary. Remove the
remaining much and replace with
triple shredded hard wood mulch at
a maximum depth of three inches.
Soils and/or mulch are
Determine the extent of the clogging
clogged with sediment.
- remove and replace either just the
top layers or the entire media as
needed. Dispose of the spoil in an
appropriate off -site location. Use
triple shredded hard wood mulch at
a maximum depth of three inches.
Search for the source of the
sediment and remedy the problem if
possible.
An annual soil test shows that
Dolomitic lime shall be applied as
pFl has dropped or heavy
recommended per the soil test and
metals have accumulated in
toxic soils shall be removed,
the soil media.
disposed of properly and replaced
with new planthig media.
Form SW401-Bioretemion O&M-Rev.3 Page 2 of 4

BMP element:
Potentialproblems-
How I will remediate the roblem:
The underdrain system
Clogging has occurred.
Wash out the underdrain system.
if applicable)
The drop inlet
Clogging has occurred.
Clean out the drop inlet. Dispose of
the sediment off -site.
The drop inlet is damaged
Repair or replace the drop inlet.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
ou tlet.
733-1786.
]form 5W401-13ioretention O&M-Rev.3 Page 3 of 4

Permit Number:
(lobe provided bj, DIVQ)
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:Yrd Brigade Combat Team Complex, In/Out Processing Facility
BMP drainage area number:CA6
Print name:Mr. David Heins
Title:Ft. Bra" Directorate of Public Works (DPW)/ Chief -Environmental Division
Address:2175 Reilly Road Stop A, Fort Bram, NC 28310-5000
Phone
Signat
Date:-1�-
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 (lie subdivision has been named the president.
I, , a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this
day of , and acknowledge the due execution of the
forgoing bioretention maintenance requirements. Witness my hand and official seal,
SEAL
My commission expires
Form SW401-Bioretention IRM-Rev. 2 Page 4 of 4

Permit Number:
(to be provided bye DIVQ)
Drainage Area Nurnber:
Bioretention Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important operation and maintenance procedures:
— Immediately after the bioretention cell is established, the plants will be watered
twice weekly if needed until the plants become established (commonly six
weeks).
— Snow, mulch or any other material will NEVER be piled on the surface of the
bioretention cell.
— Heavy equipment will NEVER be driven over the bioretention cell.
— Special care will be taken to prevent sediment from entering the bioretention cell.
— Once a year, a soil test of the soil media will be conducted.
After the bioretention cell is established, I will inspect it once a month and within 24
hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblems:
How I will remediate theproblem:
The entire BMP
'Trash/debris is present,
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
bioretention cell
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
The inlet device: pipe,
The pipe is clogged (if
Unclog the pipe. Dispose of the
stone verge or Swale
applicable).
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to
swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
Stone verge is clogged or
Remove sediment and clogged
covered in sediment (if
stone and replace with clean stone.
applicable).
Donn 5W401-Bioretention O&M-Rev.3 Page 1 ol'4

BMP element:
Potentialproblems:
I -low I will remediate theproblem:
The pretreatment area
Flow is bypassing
Regrade if necessary to route all
pretreatment area and/or
flow to the pretreatment area.
allies have formed.
Restabilize the area after grading.
Sediment has accumulated to
Search for the source of the
a depth greater than three
sediment and remedy the problem if
inches.
possible. Remove the sediment and
restabilize the pretreatment area.
Erosion has occurred.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand.
The bioretention cell:
Best professional practices
Prune according to best professional
vegetation
show that pruning is needed
practices.
to maintain optimal plant
health.
Plants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Tree stakes/wires are present
Remove tree stake/wires (which
six months after planting.
can kill the tree if not removed).
The bioretention cell:
Mulch is breaking down or
Spot mulch if there are only random
soils and mulch
has floated away.
void areas. Replace whole mulch
layer if necessary. Remove the
remaining much and replace with
triple shredded hard wood mulch at
a maximum depth of three inches.
Soils and/or mulch are
Determine the extent of the clogging
clogged with sediment.
- remove and replace either just the
top layers or the entire media as
needed. Dispose of the spoil in an
appropriate off -site location. Use
triple shredded hard wood mulch at
a maximum depth of three inches.
Search for the source of the
sediment and remedy the problem if
possible.
An annual soil test shows that
Dolomitic lime shall be applied as
pH has dropped or heavy
recommended per the soil test and
metals have accumulated in
toxic soils shall be removed,
the soil media.
disposed of properly and replaced
with new planting media.
Form SW401-13ioretention OB:M-Rev.3 Page 2 of 4

BMP element:
Potentialproblems:
How 1 will remediate theproblem:
The underdrain system
Clogging has occurred.
Wash out the underdrain system.
if applicable)
The drop inlet
Clogging has occurred.
Clean out the drop inlet. Dispose of
the sediment off -site.
The drop inlet is damaged
Repair or replace the drop inlet.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
outlet.
733-1786.
Form SW401-Bioretention O&M-Rev.3 Page 3 of 4

Permit Number:
(to he provided by DWQ)
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 ofany
problems with the system or prior to any changes to the system or responsible party.
Project name: Yrd Brigade Combat Team complex, Brigade Headquarters
BUP -Irainage area nwnber:CA5
Print name:Mr. David Heins
Title: Ft. Bra,", Directorate of Public Works (DP W)/Chief-Environmental Division
Address.2175 Reilly Read Stop A, Fort Bragg, NC 28310-5000
Phone:
Signart
Date: Z 2 -,i -b / 2—
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been nained the president.
I, , a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this
day of , and acknowledge the due execution of the
forgoing bioretention maintenance requirements. Witness my hand and official seal,
SEAL
My commission expires
Form SW401-13ioretention I&M-Rev. 2 Page 4 of.

Permit Number:
(to be provider! by DWQ)
Drainage Area Number:
Bioretention Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important operation and maintenance procedures:
— Immediately after the bioretention cell is established, the plants will be watered
twice weekly if needed until the plants become established (commonly six
weeks).
Snow, mulch or any other material will NEVER be piled on the surface of the
bioretention cell.
— Heavy equipment will NEVER be driven over the bioretention cell.
— Special care will be taken to prevent sediment from entering the bioretention cell.
— Once a year, a soil test of the soil media will be conducted.
After the bioretention cell is established, I will inspect it once a month and within 24
hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired. immediately.
BMP element:
Potentialproblems:
flow 1 will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
bioretention cell
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
The inlet device: pipe,
The pipe is clogged (if
Unclog the pipe. Dispose of the
stone verge or swale
applicable).
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the Swale if necessary to
swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
Stone verge is clogged or
Remove sediment and clogged
covered in sediment (if
stone and replace with clean stone.
applicable).
Dorm SW401-Bioretention 0&M-Rev.3 Page I of'4

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

BMP element:
Potentialproblems:
How I will remediate theproblem:
The underdrain system
Clogging has occurred.
Wash out the underdrain system.
if applicable)
The drop inlet
Clogging has occurred.
Clean out the drop inlet. Dispose of
the sediment off -site.
The drop inlet is damaged
Repair or replace the drop inlet.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
outlet.
733-1786.
Form SW401-13ioretention O&M-Rev.3 Page 3 ol'4

Permit Number:
(to he provided by DJVQ)
l 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:Yrd Brigade Combat Team Complex, Bri�,Yade Headquarters
BMII drainage area number
Print name:Mr. David Heins
Title: Ft. Brag_, Directorate of Public Works (DPW)/Chief t?nvironmental Division
Address:2175 Reilly Road Stop A, Fort Bragg, NC 28310-5000
Phone: [phone]
/ c
Signature:
Date: 2--2—� JZ.
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, , a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this
day of , and acknowledge the due execution of the
forgoing bioretention maintenance requirements. Witness my hand and official seal,
SEA],
My commission expires
Form SW40I-13ioretention I&M-Rev. 2 Page 4 of 4

DWQUSE,ONLY
Date Received
Fee Paid
Permit Number
$05 -J� I0z
CIz0,1a2
Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M mt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form Wray be photocopied far use as an original
1. GENERAL INFORMATION
1. Project Name (subdivision, facility, or establishment name -should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
3rd Brigade Combat Team Complex, In/Out Processing Facilitv
2. Location of Project (street address):
Fort Bragg, North Carolina
City:Fayettville _ County:Cumberland Zip:28307
3. Directions to project (from nearest major intersection):
From the intersection of All American Expy and Reilly Street, south on Reilly then west on Ardennes Street.
The site is located to the north of Ardennes Street between Gela Street and Eindhaven Street-
4. Latitude:350 07' 85" N Longitude:-79° 01' 41" W of the main entrance to the project.
35. 1' ," u -,9 1, zs `
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit numberN A , its issue date (if known)N/A —, and the status of
construction: ®Not Started ❑PartialIy Completed" [] Completed" "provide a designer's certification
Specify the type of project (check one):
❑Low Density ®High Density ❑Drains to an Offsite Stormwater System ❑Other
3. If this application is being submitted as the result of a previously returned application or a Ietter from DWQ
requesting a state stormwater management permit application, list the Stormwater project number, if
assumed, NIA and the previous name of the project, if different than currently
proposed, N/A
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major
❑NPDES Industrial Stormwater
®Sedimentation/Erosion Control: 3.10 ac of Disturbed Area
0404/401 Permit: Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:
Fonn SWU-101 Version 07Iun2010 Page I 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/Organiza tion:Directorate of Public Works (DPW) ---
Signing Official & Title:Mr. David Heins Environmental Division Chief DPW
b.Contact information for person listed in item I above:
Street Address:2175 Reiliv road Stop A
City:Fort Bragg _ _ State:NC Zip:28310-5000
Mailing Address (if applicable):2175 Reilly Road Stop A T _
City:Fort Bragg _ State:NC Zip:28310-5000
Phone: (910 ) 396-8207 Fax: (910 , 907-2420
Email:david.a.heins.civ®mail.mil
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 Iease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Owner/Organization:
Signing Official & Title:
b.Contact information for person listed in item 2a above:
Street Add ress:
City:
Mailing Address (if applicable):
City:
Phone: ( ) --
Email:
State: Zip:
Sta
Zip:
Fax: (
3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other
person who can answer questions about the project.
Other Contact Person/Organization: Mr. Lee Ward
Signing Official & Title:DPW/ Water Management Branch_
b.Contact information for person listed in item 3a above:
Mailing Address:Bld 0-9125 McKellars Road
City:Fort Bragg State:NC Zip:28310-5000
Phone: (910 } 396-2301 Fax: (910 __- } 907-2420
Eniail:[e-mail]
4. Local jurisdiction for building permits: N/A _
Point of Contact:
Phone 4:
Form SWU-101 Version 07Jun2010 Page 2 of 7

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Bioretention basins will be used to address stormwater quality and EISA_2007 Section 438 requirements. An
underground detention basin will address the develped site peak discharge rates to bring them down to
predeveloped _rates.
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 11 - Post Construction
3. Stormwater runoff from this project drains to the
4. Total Property Area: 3.10 acres
River basin.
5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
7. Total Property Area (4) -Total Coastal Wetlands Area (5) -Total Surface Water Area (6) = Total Project
Area':3,10 acres
' Total project area shall be calculated to exclude the following the normal pool of impounded structures, the area
between the batiks of streams and rivers, the area below the Normal High Water (NHW) lure or Mean High Water
(MHW) lure, and coastal wetlands landward from the NHW (or MHW) line. The resultant project area is used to
calculate overall percent built upon area (BUA). Nori-coastal wetlands landurard of the NHW (orMHW) lure rimy
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 =x 3F, s %
9. How many drainage areas does the project have?4 (For high density, count 1 for each proposed engineered
stonrnoater $MP. For low densihj and other projects, use 1 for the whole properhj 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.
Form S VIU-101 Version 07Jun2010 Page 3 of 7

J
Basin Information
Drainage Area 03
Drainage Area 04
Drainage Area 05
Drainage Area 06
r
Receiving Stream Name
Cape Fear
Cape Fear
Cape Fear
Cape Fear
Stream Class *
C
C
C
C
Stream Index Number *
C
C
C
C
Total Drainage Area (so
18,111
10,966
1.41375
28,883
On -site Drainage Area (so
18,111
10,966
14,375
28,883
Off -site Drainage Area (so
0
0
0
0
Proposed Impervious Area(so
8,921
7,582
7,274
19,767
% Impervious Area** total
49.3
69
50.60
68.4
Impervious" Surface Area
Drainage Area 03
Drainage Area 04
Drainage Area 05
Drainage Area 06
On -site Buildings/Lots (so
7,577
7,175
0
0
On -site Streets (so
0
0
5,130
0
On -site Parking (so
0
0
0
15,887
On -site Sidewalks (so
1,344
407
1,404
0
Other on -site (so
0
0
0
0
Future (so
0
0
0
0
Off -site (so
0
0
0
0
Existing BUA*** (so
0
0
740
3,880
Total (so:
8,921
7,582
7,274
19,767
* Stream Class and Index Number can be determined at: htt p.&ortal.lrcdenr.org_ L u�g/ns/csu/classi{rcations
Inn ervious area is defined as the built upon area including, but not limited 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 removed and which will be replaced by new B UA.
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 NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from 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 http.1/portal.ncdenr.org/web/wq/ws/su/statesw/forms does. The complete
application package should be submitted to the appropriate DWQ Office. (The appropriate office may be
found by locating project on the interactive online map at hqp://portal.ncdenr.org/web/wgLws/su maps.)
Please indicate that the following re uired information have been provided by initialing in the space provided
for each item. All original documents MUST be signed arid initialed in blue ink, Download the latest versions
for each submitted application package from http://portal.ncdenr.grg/web wgJws/su/statesw/forms_docs.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part V11 below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreement(s) for each BMP,
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
h!W://www.envhelp.org/pae,es/onestoi)express.httnl 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.)
Form SWU-101 Version 07Jun2010 Page 4 of 7

5. A detailed narrative (one to two pages) describing the stormwater treatment/ managementfor
the project. This 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' i
mile radius on the map.
7. Sealed, signed and dated calculations. _
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify aII surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
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).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"x11" copy of the NRCS County Soils snap with tine
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 SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: N/A__ Page No: N/A
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC
Secretary of State or other official documentation, which supports the titles and positions held
by the persons Iisted in Contact Information, item 1 a, 2a, and/or 3a per NCAC 21-1.1003(e). The
corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
h2p://www.secretary.state.nc.uslCgMorations/CSearch.asI2x
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each Iot 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
hU:IZportal.ncdenr.orp,/web/wq/ws/su/statesw/forms_docs. Download the latest versions for each submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DWQ, and that they will be recorded prior to the sale of any lot.
Form SWU-101 Version 07Jun2010 Page 5 of 7

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:Mr. Yeznik S. Yeretzian, PE _r
Consulting Firm: P rge_Waggoner_S_u_mner & Cannon, Inc.
Mailing Address:8280 Yankee Strett
City:Dayton _ _ State:Ohio Zip:45458
Phone: (937 ) 428_5249
Email:nick. eretzian@bwsc,net
Fax: [phone]
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been fitted out, connplete this
section)
1, (print or type naive of person listed in Contact Inforration, item 2a) 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 Inforrnration, itern In) with (print or type name of organization listed in
Contact Information, item 1a) to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the stormwater system.
As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact information, item 1) dissolves their company and/or cancels or defaults on their
lease agreement, or pending sale, responsibility for compliance with the DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ immediately and submit a
completed Name/Ownership Change Form within 30 days; otherwise 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.
Signature:
Date.
1, _ . a Notary Public for the State of - County of
do hereby certify that personally appeared
before me this _____ day of . and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEA] -
My commission expires
Fonn SWU-101 Version 07Juit2010 Page 6 of 7

X. APPLICANT'S CERTIFICATION
1, (print or type nante of person listed in Contact Information, item 7a) David Heins
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormwater rules under 15A NCAC 21-1.1000, SL 2006-246 (Ph. 11 - Post Construction) or SL 2008-211.
Signature:_
I,
before me this
a Notary Public for the State of
do hereby certify that
day of
Date:
County of
personally appeared
and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission expires
Form SWU-101 Version 07Jun2010 Page 7 of 7

11n ►eroious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
siYwalks, gravel areas, etc.
*** Report only that amount of existing BL1A that Will remain after development. Do not report any existing BL1A that
is to be removed and zohich Will be replaced by nezo BL1A.
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 u,atershed that may he subject to more stringent slorinx,ater requirements as per NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BM1'specified for this project. The latest versions of the forms can be downloaded
from http://portal.ncdenr.org/web/wq/ws/st►/bmp-►llamal.
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 littk)://Voi-tal.iick.leiir.orgLwet)/wq/ws/stjZstitesw/foriiis dots. 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://portal.nccienr.org/web/wq/ws/su/maps.)
Please indicate that the following required information have been provided by initialing in the space provided
for each item. All original documents MUSTbe signed and initialed in blue ink. Download the latest versions
for each submitted application package from http;//portal.ncdenr.org/web/wq/ws/su/statesw%farms
dots.
Initials
I. Original and one copy of the Storrnwater Management Permit Application Form.
Y� Y
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part V11 belozo)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
Y5 i
agreement(s) for each 13MP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
http://www.envhclp.org/pages/onestopexpress.html for information on the Express program
and the associated fees. Contact the appropriate regiona[.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/managenierttfor
i�SY
the project. This 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
YS
receiving stream drains to class SA waters within'/z mile of the site boundary, include the
mile radius on the map.
7. Sealed, signed and dated calculations.
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named 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 MI-IW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NI-IW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MI-IW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all l3UA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
I. Details of roads, drainage features, collection systems, and stormwater control measures.
Form SWU-101 Version 07Jun2010 rage 4 of

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 sires, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
-p. Vegetated buffers (where required).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify YS X
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"x11" copy of the NRCS County Soils map with the
project area clearly delineated, For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, all(] the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DWQ to verifij the SHWI-prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: N/A Page No: N/A
11. For corporations and limited liability corporations ([-LC): Provide documentation from the NC_
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item 1 a, 2a, and/or 3a per NCAC 214.1003(c). 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.secret,iry.state.nc.us/Corporations/CSea rcli.aspx
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective Covenants forms can be downloaded from
htt �ortal.ncdenr.or r web w /ws/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:Mr. Yeznik S. Yeretzian, PE
Consulting Firm-. Barge Waggoner Sumner & Cannon Inc.
Mailing Address:8280 Yankee Strett
City:Dayton _ State:Ohio Zip:45458
Phone: (937 ) 428.5249. Fax: (937 ) 438.0379
lamai I:n ick.yeretzianObwsc.net
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or type name of person listed in Contact Information, item 2a) , certify that I
own the property identified in this permit application, and thus give permission to (print or type nacre of person
listed in Contact Information, item 1a) with (print or type Name of organizatimi listed in
Contact Information, item 1a) to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the stormwater system.
Form SWU-101 Version 07Jun2010 Page 5 of

. 4
As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
lease agreement, or pending sale, responsibility for compliance with the DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ immediately and submit a
completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater treatment
facility without a valid permit, I understand that the operation of a stormwater treatment facility without a valid
permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature: Da
I, _ a Notary Public for the State of , County of
do hereby certify that
before me this _ day of
personally appeared
and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAT.
My commission expi
X. APPLICANT'S CERTIFICATION
1, (print or type name of person listed in Contact Information, item 1a) Davin Heins
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormwater ru! a er A C CAC 2I-1 .1000, SL 2006-246 (Ph. I1 - Post Construction) or SC. 2008-211.
Signature: Date: Z-7-
I, , a Notary Public for the State of , County of
do hereby certify that
personally appeared
before me this _ day of , and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission expires
Form SWU-101 Version 073tin2010 Page 6 of 6