SW6120803_CURRENT PERMIT_20120925

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW
DOC TYPE
CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
DOC DATE
Ac/9, 1%q(%!�
YYYYMMDD

SEP 2 5 2012
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, PE
Governor Director
August 22, 2012
Mr. Steve Mitchael
Wal-Mart Real Estate Business Trust
2001 SE 10th Street, Mail Stop 5570
Bentonville, NC 72716-5570
Subject: Stormwater Permit No. SW6120803
Stedman Walmart #5017-00
High Density Commercial Wet Pond Project
Cumberland County
Dear Mr. Mitchael:
Dee Freeman
Secretary
The Stormwater Permitting Unit received a complete Stormwater Management Permit Application for
Stedman Walmart #5017-00 on August 13, 2012: Staff review of the plans and specifications has
determined that the project, as proposed, will comply with the Stormwater Regulations set forth in Title 15A
NCAC 2H.1000 and Session Law 2006-246. We are forwarding Permit No. SW6120803, dated August 22,
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 August 21, 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 150E 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
brian.lowther(a_ncdenr.gov.
Sincerely,
fr)r Charles Wakild, PE
cc: Fayetteville Regional Office
SW6120803 File
ee: Matthew Edwards, PE — Kimley-Horn and Associates, Inc.
Wetlands and Storrnwaler Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Localion 512 N. Salisbury Si. Raleigh, North Carolina 27604
Phone: [phone] FAX [phone]
Internet: www.ncwaterqualityorg
An Equ31 Opportunity 1 Aflirrnalive Action Employer
None
rthCarojina
naturally

State Stormwater Permit
Permit No.SW6120803
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of
North Carolina as amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Wal-Mart Real Estate Business Trust
Stedman Walmart #5017-00
600 ft from Southeast Comer of Carol Street and NC 24, Stedman, Cumberland County
FOR THE
construction, operation and maintenance of a wet detention pond in compliance with
the provisions of 15A NCAC 2H .1000 and S.L. 2006-246 (hereafter referred to as the
"stormwater rules') and the approved stormwater management plans and specifications
and other supporting data as attached and on file with and approved by the Division of
Water Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until August 21, 2020, and shall
be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
1. This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. This stormwater system has been approved for the management of stormwater
runoff as described in Section 1.6 of this permit. The stormwater control has been
designed to handle the runoff from 68,825 square feet of impervious area.
3. The tract will be limited to the amount of built -upon area indicated on page 3 of
this permit, and per approved plans.
4. All stormwater collection and treatment systems must be located in either
dedicated common areas or recorded easements. The final plats for the project
will be recorded showing all such required easements, in accordance with the
approved plans.
5. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
Page 1 of 6

State Stormwater Permit
Permit No.SW612080S
11,
6. The following design criteria have been provided in the wet detention pond and
must be maintained at design condition:
a. Drainage Area, aSres: 2.01
Onsite, ft : 87,556 .
Offsite, ft2: 0
b. Total Impervioys Surfaces, ft2:
Buildings ft
Roads/Parking, ft2:
Other, ft2
Offsite, ft�:
C. Pond Depth, feet:
d. TSS removal efficiency:
e. Design Storm:
f. Permanent Pool Elevation, FMSj�
g. Permitted Surface Area @PP ft
h. Permitted Storage Volume, ft�:
i. Storage Elevation, FMSL:
j. Controlling Orifice:
k. Permanent Pool Volume, ft
3
I. Forebay Volume, ft3.
m. Receiving Stream/River Basin:
n. Stream Index Number:
o. Classification of Water Body:
II. SCHEDULE OF COMPLIANCE
68,825
11,892
56,933
0 (sidewalks)
0
3.17
90%
1.0 inch
122.0
10,735
27,379 at temporary pool
122.5
1.5" 0 pipe
6,071
5,255
Sandy Creek 1 Cape Fear
16-41-1-11
"WS-V; NSW"
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 times 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 revegetation of slopes and the vegetated filter.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of outlet structure, orifice device, flow
spreader, catch basins and piping.
g. Access to the outlet structure must be available at all times.
4. Records of maintenance activities must be kept and made available upon
request to authorized personnel of DWQ. The records will indicate the date,
activity, name of person performing the work and what actions were taken.
5. The stormwater treatment system shall be constructed in accordance with the
approved plans and specifications, the conditions of this permit, and with other
supporting data.
Page 2 of 6

State Stormwater Permit
Permit No.SW6120803
6. 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'.
7. 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.
8. Access to the stormwater facilities shall be maintained via appropriate
easements at all times.
9. The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed
below:
a. Any revision to any item shown on the approved plans, including the
stormwater management measures, built -upon area, details, etc.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
e. Further subdivision, acquisition, lease or sale of all or part of the project
area. The project area is defined as all property owned by the permittee,
for which Sedimentation and Erosion Control Plan approval or a CAMA
Major permit was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
10. The permittee shall submit final site layout and grading plans for any permitted
future areas shown n the approved plans, prior to construction.
11. 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.
12. The Director may notify the permittee when the permitted site does not meet one
or more of the minimum requirements of the permit. Within the time frame
specified in the notice, the permittee shall submit a written time schedule to the
Director for modifying the site to meet minimum requirements. The permittee
shall provide copies of revised plans and certification in writing to the Director
that the changes have been made.
III. GENERAL CONDITIONS
This permit is not transferable except after notice to and approval by the Director.
In the event of a change of ownership, or a name change, the permittee must
submit a completed Name/Ownership Change form, to the Division of Water
Quality, signed by both parties, and accompanied by supporting documentation
as listed on page 2 of the form. The project must be in good standing with the
Division. 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 the transfer request.
Page 3 of 6

State Stormwater Permit
Permit No.SW6120803'
3. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the Division of Water Quality, in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
4. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
5. In the event that the facilities fail to perform satisfactorily, including the creation
of nuisance conditions, the Permittee shall take immediate corrective action,
including those as may be required by this Division, such as the construction of
additional or replacement stormwater management systems.
6. The permittee grants DENR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
7. The permit issued shall continue in force and effect until revoked or terminated.
The permit may be modified, revoked and reissued or terminated for cause. The
filing of a request for a permit modification, revocation and re -issuance or
termination does not stay any permit condition.
8. Unless specified elsewhere, permanent seeding requirements for the stormwater
control. must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
9. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
10.The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revoking and reissuing the permit, or terminating the permit
as allowed by the laws, rules and regulations contained in Session Law 2006-
246, Title 15A NCAC 2H.1000, and NCGS 143-215.1 et.al.
11.The permittee shall notify the Division 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 22"d day of August, 2012.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for Charles Wakild, PE, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 4 of 6

State Stormwater Permit
Permit No.SW6120803
Stedman Walmart #5017-00
Stormwater Permit No. SW6120803
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,
Stedman Walmart #5017-00
(Project)
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.SW6120803'' '
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.
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.
Please submit this Designer's Certification to: Fayetteville Regional Office
Surface Water Protection
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301
Page 6 of 6

®EN R-FRC
{ A=l*rAAIiC 1 4 zUi2
NCDENR Dwo
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, PE Dee Freeman
Governor Director Secretary
August 22, 2012
Mr. Steve Mitchael
Wal-Mart Real Estate Business Trust
2001 SE 10th Street, Mail Stop 5570
Bentonville, NC 72716-5570
Subject: Stormwater Permit No. SW6120803
Stedman Walmart #5017-00
High Density Commercial Wet Pond Project
Cumberland County
Dear Mr. Mitchael:
The Stormwater Permitting Unit received a complete Stormwater Management Permit Application for
Stedman Walmart #5017-00 on August 13, 2012: Staff review of the plans and specifications has
determined that the project, as proposed, will comply with the Stormwater Regulations set forth in Title 15A
NCAC 2H.1000 and Session Law 2006-246. We are forwarding Permit No. SW6120803, dated August 22,
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 August 21, 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, PE
cc: Fayetteville Regional Office
SW6120803 File
ed: Matthew Edwards, PE — Kimley-Horn and Associates, Inc.
Wetlands and Stormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury SI Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone]
Internet: wwwncwaterquality.org
An Equal Opportunity 4 Affirmative Action Employer
Nne
orthCarolina
Naturall#

State Stormwater Permit
Permit No.SW6120803
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of
North Carolina as amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Wal-Mart Real Estate Business Trust
Stedman Walmart #5017-00
600 ft from Southeast Corner of Carol Street and NC 24, Stedman, Cumberland County
FOR THE
construction, operation and maintenance of a wet detention pond in compliance with
the provisions of 15A NCAC 2H .1000 and S.L. 2006-246 (hereafter referred to as the
"stormwater rules') and the approved stormwater management plans and specifications
and other supporting data as attached and on file with and approved by the Division of
Water Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until August 21, 2020, and shall
be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
1. This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. This stormwater system has been approved for the management of stormwater
runoff as described in Section 1.6 of this permit. The stormwater control has been
designed to handle the runoff from 68,825 square feet of impervious area.
3. The tract will be limited to the amount of built -upon area indicated on page 3 of
this permit, and per approved plans.
4. All_stormwater collection_and_treatment_systems_must_be_located_in_either
dedicated common areas or recorded easements. The final plats for the project
will be recorded showing all such required easements, in accordance with the
approved plans.
5. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
Page 1 of 6

State Stormwater Permit
Permit No.SW6120803
6. The following design criteria have been provided in the wet detention pond and
must be maintained at design condition:
a. Drainage Area, ages: 2.01
Onsite, ft : 87,556 .
Offsite, ft2: 0
b. Total Impervioys Surfaces, ft2:
Buildings ft
Roads/Parking, ftZ:
Other, ft2
Offsite, ft
c. Pond Depth, feet:
d. TSS removal efficiency:
e. Design Storm:
f. Permanent Pool Elevation, FMS�:
g. Permitted Surface Area @PP ft
h. Permitted Storage Volume, ftl:
i. Storage Elevation, FMSL:
j. Controlling Orifice:
k. Permanent Pool Volume, ft3
1. Forebay Volume, ft3:
m. Receiving Stream/River Basin:
n. Stream Index Number:
o. Classification of Water Body:
11. SCHEDULE OF COMPLIANCE
68,825
11,892
56,933
0 (side0walks)
3.17
90%
1.0 inch
122.0
10,735
27,379 at temporary pool
122.5
1.5"0 pipe
6,071
5,255
Sandy Creek 1 Cape Fear
16-41-1-11
"WS-V; NSW" .
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 times 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 revegetation of slopes and the vegetated filter.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of outlet structure, orifice device, flow
spreader, catch basins and piping.
g. Access -to -the -outlet -structure must -be -available -at -all -times.
4. Records of maintenance activities must be kept and made available upon
request to authorized personnel of DWQ. The records will indicate the date,
activity, name of person performing the work and what actions were taken.
5. The stormwater treatment system shall be constructed in accordance with the
approved plans and specifications, the conditions of this permit, and with other
supporting data.
Page 2 of 6

1w
State Stormwater Permit
Permit No.SW6120803
6. 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.
7. 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.
8. Access to the stormwater facilities shall be maintained via appropriate
easements at all times.
9. The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed
below:
a. Any revision.to any item shown on the approved plans, including the
stormwater management measures, built -upon area, details, etc.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
e. Further subdivision, acquisition, lease or sale of all or part of the project
area. The project area is defined as all property owned by the permittee,
for which Sedimentation and Erosion Control Plan approval or a CAMA
Major permit was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
10. The permittee shall submit final site layout and grading plans for any permitted
future areas shown n the approved plans, prior to construction.
11. 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.
12. 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, to the Division of Water
Quality, signed by both parties, and accompanied by supporting documentation
as listed on page 2 of the form. The project must be in good standing with the
Division. 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 the transfer request.
Page 3 of 6

State Stormwater Permit
Permit No.SW6120803
3. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement. action by the Division of Water Quality, in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
4. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
5. In the event that the facilities fail to perform satisfactorily, including the creation
of nuisance conditions, the Permittee shall take immediate corrective action,
including those as may be required by this Division, such as the construction of
additional or replacement stormwater management systems.
6. The permittee grants- DENR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
7. The permit issued shall continue in force and effect until revoked or terminated.
The permit may be modified, revoked and reissued or terminated for cause. The
filing of a request for a permit modification, revocation and re -issuance or
termination does not stay any permit condition.
8. Unless specified elsewhere, permanent seeding requirements for the stormwater
control. must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
9. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
10. The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revolting 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 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 22"d day of August, 2012.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for Charles Waki d, PE, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 4 of 6

State Stormwater Permit
Permit No.SW6120803
Stedman Walmart #5017-00
Stormwater Permit No. SW6120803
Cumberland Count
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,
Stedman Walmart #5017-00
(Project)
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.SW6120803 .4
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.
.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.
Please submit this Designer's Certification to: Fayetteville Regional Office
Surface Water Protection
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301
Page 6 of 6

Kimley»>Horn
Transmittal
Date: April 25, 2016 Job Number:
Project Name: Walmart Stedman #5017
To: Favetteviile Regional Office
Surface Water Protection
225 Green Street
Systel Building, Suite 714
Fayetteviiie, NC 28301
RECEIVED
DEQIZI,CAL.o�
APR 2 6 2016
FAYETfEVILLE REGIONAL OFFICE
We are sending these by
❑ U.S. Mail ® FedEx Standard ❑ Courier Select One
❑ Other: bland Deliver
We are sending you
® Attached ❑ Under separate cover via the following items
❑ Shop Drawings ❑ Prints/Plans ❑ Samples ❑ Specifications ❑ Change Orders
❑ Other:
Copies Date No. Description
1 4/22/16 01 Designer's Certification - State SW Permit No. SW6120803
These are transmitted as checked below:
❑ For your use ❑ Approved as submitted ❑ Resubmit ❑ Copies for approval
® As requested ❑ Approved as noted ❑ Submit ❑ Copies for distribution
❑ For review and comment ❑ Returned for corrections ❑ Return ❑ Corrected prints
Remarks:
Copy to: File Signed fA& l A! U r r I t
Matt Cox, P.E.

. !t>

State Stormwater Permit
Permit No.SW6120803
Stedman Waimart #5017-00
Stormwater Permit No. SW6120803
Cumberland County
Designer's Certification
B. Matthew Cox , as a duly registered professional Engineer
in the State of North Carolina, having been authorized to observe eriodicall weekly/
full time) the construction of the project,
Stedman Walmart #5017-00
(Project)
forWal-Mart Real Estate Business Trust (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:
Certification is limited to my observations of the construction in
accordance with our Agreement with Wal-Mart. Certification is limited
and based on an as -built survey provided by the Contractor's
surveyor. This certification does not relieve any parity of their
contractual obligation or other obligations. Certification is based
on the condition of the stormwater facility at the time of
construct' n com�L_
tion on or around March 2013. SEA
�0%ki I II Iii//
Signature I ����1� CARD/f�i
Registration Number 031446
`�,•QoFE ��,g',• 9'/'r
_ ; Q SEAL :
Date April 22, 2016 ""' _ 031446 _
r��fy1
Page 5 of 6

.�.l�.,IV i'iil�,
• � • ',!� n
_ � • -

State Stormwater Permit
Permit No.SW6120803
Certification Requirements:
X 1. The drainage area to the system contains approximately the permitted
acreage.
X 2. The drainage area to the system contains no more than the permitted
amount of built -upon area.
x 3. All the built -upon area associated with the project is graded such that the
runoff drains to the system.
x 4. All roof drains are located such that the runoff is directed into the system.
X 5. The outlet/bypass structure elevations are per the approved plan.
x 6. The outlet structure is located per the approved plans.
�X 7. Trash rack is provided on the outlet/bypass structure.
X 8. All slopes are grassed with permanent vegetation.
X 9. Vegetated slopes are no steeper than 3:1.
X 10. The inlets are located per the approved plans and do not cause short-
circuiting of the system.
X 11. The permitted amounts of surface area and/or volume have been
provided.
X 12. Required drawdown devices are correctly sized per the approved plans.
x 13, All required design depths are provided.
x 14_ All required parts of the system are provided, such as a vegetated shelf,
and a forebay.
X 15. The required system dimensions are provided per the approved plans.
Please submit this Designer's Certification to: Fayetteville Regional Office
Surface Water Protection
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301
Page 6 of 6

Shaw Environmental, Inc. (CB&I)
11206 Thompson Avenue
Lenexa, KS 66219
Tel: [phone]
Fax: [phone]
[e-mail]
March 8, 2016
Michael Lawyer, Environmental Program Specialist
North Carolina Department of Environmental Quality
225 Green Street, Suite 714
Fayetteville, NC 28301
Subject: NPDES Permit #SW6120803
Walmart Express - Facility Number 5017
7670 Clinton Road, Stedman, NC 28391
Mr. Lawyer:
This letter serves as notification that the Walmart facility listed above was closed to the public on
January 28, 2016. Walmart will maintain the property and any stormwater features until the property is
sold.
Please mail licenses and renewal applications to:
Shaw Environmental, Inc. (CB&I)
ATTN: Licensing Support
11206 Thompson Avenue
Lenexa, KS 66219
We may also be contacted by:
Phone: [phone]
Fax: [phone]
Email: [e-mail]
If you need additional information, please contact us at 877-829-5505.
Sincerely,
MAR 1 0 2016
Diane Grabmiller
CB&I Licensing Support
Shaw Environmental, Inc., a CB&I Company, as agent for Wal-Mart Stores, Inc.

Walmart
Save money. Live better.
Shaw Environmental, Inc.
"NOTE: C881 has acquired The Shaw Group
December 2, 2015
RE: Walmart I CB&I Partnership for Managing Permitting Requirements
To Whom It May Concern,
This letter is to inform you that Wal-Mart Stores, Inc. has contracted with Shaw Environmental
Inc. (CB&I) to manage environmental related permit renewals for an indefinite period of time.
Environmental permitting, registration, and notification responsibilities will now be handled by
CB&I.
Please note: Submittals that do not come from CB&I should not be returned to CB&I,
these should be sent back to the original party who submitted them.
Walmart has provided the attached limited Power of Attorney which provides CB&I the authority
to sign applications as an agent for Wal-Mart Stores, Inc.
Any future correspondence, permits and associated renewal invoices for environmental
related items should be provided to:
Shaw Environmental, Inc. (CB&I)
ATTN: Licensing Support
11206 Thompson Avenue
Lenexa, KS 66219
If you have any additional questions, please contact CB&I Licensing at the following:
Phone: [phone]
Fax: [phone]
Email: [e-mail]
Thank you,
CB&I Licensing Support
MAR 1 0 2016
Rev 8 — 12/2/2015

SPECIAL POWER OF ATTORNEY
We, Cindy Moehring, Sr. Vice President and Chief Ethics & Compliance Officer, and Andrea Lazenby,
Assistant Secretary, acting on behalf of WAL-MART STORES, INC., in its own capacity, and in its capacity
as parent corporation of wholly -owned subsidiaries SAM'S WEST, INC., SAM'S REAL ESTATE BUSINESS
TRUST, WAL-MART REALTY CO., WALMART PROPERTY CO. and WAL-MART REAL ESTATE BUSINESS
TRUST (collectively, the "SUBSIDIARIES"), do hereby appoint Shaw Environmental, a CB&I Company, of
4171 Essen Lane, Baton Rouge, Baton Rouge Parrish, Louisiana, as our attorney in fact to act in our place
for the purpose of signing and processing the following on behalf of WAL-MART STORES, INC. and
SUBSIDIARIES:
(i) All documents required by any governmental agency regarding new environmental permits and
renewal of existing environmental permits required for WAL-MART STORES, INC. OR SUBSIDIARIES;
(ii) All documentation required to update the corporate records on file with governmental agencies
identifying the Officers authorized to sign documents on behalf of WALMART STORES, INC. or
SUBSIDIARIES; and
We further grant to our attorney in fact full authority to act in any manner both proper and necessary to
the exercise of the foregoing powers, including the full power of substitution and revocation, and ratify
every act that they may lawfully perform in exercising those powers. This power of attorney is granted
for the period beginning on the execution date below until December 31, 2016
Executed on 1OV6^41tr 2� ` , 2015, at Bentonville, Arkansas.
frn
Cindy Moehring QQ��
SVP and Chief Ethics & Compliance Officer
Andrea Lazenby
Assistant Secretary

ACKNOWLEDGEMENT
STATE OF ARKANSAS
COUNTY OF BENTON
�n A
On " ✓ , 2015, before me, p—A-40� wk�
Notary Public, personally appeared CINDY MOEHRING and ANDREA LAZENBY, acting on behalf of WAL-
MART STORES, INC., who proved to me on the basis of satisfactory evidence to be the persons whose
names are subscribed to the within instrument and acknowledged to me that they executed the same in
their authorized capacities, and that by their signatures on the instrument the persons, or entity upon
behalf of which the persons acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of Arkansas that the foregoing
paragraph is true and correct.
WITNE;35 my)hand and official seal.
Sig�atu elof Notary Public
My Commission Expires: `vL�- �/�
LAUFtiNRtCHS
Benton county
Commission Number i239pg94
Notary Public Arkansas 2p22
�y Gommission Expires November 28,
MAR 10 2016

--r DWQ USE ONLY
Date ]received
Fee Paid
Permit Numlxr
#-tg4
3,D8fD3
Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph Il - 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 foon tray be photocopied for trse as an original
I. GENERAL INFORMATION
1. Project Name (subdivision, facility, or establislunent name -should be consistent with project name on
plans, specifications, letters, operation and maintenance agreements, etc.):
Stedman Walmart #5017-00
2. Location of Project (street address):
600 feet from the southeast corner of Carol Street and NC 24
City:Stedmtul County: CuinbeHand Zip:28391
3. Directions to project (from nearest major intersection):
From I-95: 'fake exit 52A onto NC Hwy 24 east. The site is approximately 600 feet southeast past the
intersection of Carol Street.
4. Latitude:35° 0' 37" N Longitude:78' 41' 17" W of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification
b.11 this application is being submitted as the result of a modification to an existing permit, list the existing;
permit number , its issue date (if known) , and the status of
construction: Not Started ❑Partially Completed* ❑ Completed* *provide a designer's
certi fical ion
2. Specify the type of project (check one):
❑Low Density ®High Densitv []Drains to an Offsite Stormwater System ❑Other
3. If this application is being submitted as the result of a previously returned application or a letter from
DWQ requesting a state stormwater management permit application, list file stormwater project number,
if assigned, and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major ®Sedimentation/ Erosion Control: 5 ac of Disturbed Area
❑NI'DES Industrial Stormwater ❑404/401 Permit: Proposed Impacts
b.If an), of these permits have already been acquired please provide the Project Name, 'rQiect/Permit
Number, issue date and the type of each permit: n tz? -�
9ct��
Form SWU-101 Version 07Jun2010 Page l of6

r
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 Lion: Wal-Mart Real Estate Business Trust c/o Steve Mitchael
Signing Official & Title:Design Director
b.Contact information for person listed in item la above:
Street Address:2001 SE 10t" Street, Mail Stop 5570
Citv:Bentonville State:AR Zip:72716-5570
Mailing Address (if ayphcable):See above
City:--- State: ---
Phone: (479 ) 204-1195 Fax: 479
Email:mark.zoldsmith©wal-mart.com
— Zip:_
204-0934
c. Please check the appropriate box. `File applicant listed above is:
❑ The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease agreement and complete Contact information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 21
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:Horne Hail] ff). 1&[Fayff.
Signing Official & Title:Billy D. Horne
b.Contact information for person listed in item 2a above:
Street Add
City: State:
Mailing Address (if applicable):PO Box 205
City:Favetteville
Phone: (910 ) 237-7890
Email:
Zip:
Sta te: NC Zip:28302
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/Orgttnization:MattFLdwards
Signing Official & Title:
b.Contact information for person listed in item 3a above:
Mailing Address:2000 South Boulevard, Suite 440
City:Charlotte
Phone: (704 ) 333-5131
Email:nnatt.edwards©kinnley-lnorn.com
4. Local jurisdiction for building permits: Cumberland Co
Point of Con
State:NC
Fax:
Zip:28203
Phone #: [phone]
Form SWU-101 Version 07ALn2010 Page 2 of 7

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
There will be one wet detention p—and that will treat the runoff from the proposed site.
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b. If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 ❑ Ph II - Post Construction
3. Stormwater runoff from this project drains to the Cape Fear River basin.
4. Total Property Area: 2.98 acres
5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
7. Total Property Area (4) -Total Coastal Wetlands Area (5) -Total Surface Water Area (6) = Total Project
Area+:2.9$ acres
+ Total project area shall be calculated to exclude the followin the normal pool of im omided structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NHM-line or Mean High Water
(MHW) line, atr.d coastal zoetlaruds landward from the NHW (or MHW) line. The resultant project area is used to
calculate overall percent built upon area (BUA). Nott-coastal uietlands lartdzirard of the NHW (or MHW) late tttay
be included in the total project area.
8_ Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 78.61 %
9. How many drainage areas does the project have?1 (For high density, count I for each proposed engineered
startnwater BMP. For low density 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,
Basin Information
Drainage Area 1
Drainage Area _
Drainage Area _
Drainage Area
Receiving Stream Name
Sandy Creek
Stream Class *
WS-V; NSW
Stream Index Number *
16-41-1-11
Total Drainage Area (so
87,556
On -site Drainage Area (so
87,556
Off -site Drainage Area (sf)
0
Proposed Impervious Area** (so
68,825
Impervious Area** totaI
72
Impervious- Surface Area
Drainage Area'I
Draina e,Area '
Draina e Area
Drainage Areas.
On -site Buildings/Lots (so
11,892
On -site Streets (so
0
On -site Parking (so
56,933
On -site Sidewalks (so
Other on -site (so
0
Future (so
Off -site (sf)
0
Existing BUA*** (so
0
Total (so:
68,825
* Stream Class and lrzdex Number cast be determined at: lrttp://Portal.tucdenr.otw(web�4?gZ7sJesri/classifrcatiotrs
* Imppervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Report only that atuouttt of existing BUA that will remain after developntetit. Do not report arz y existing BUA that
is to be removed and which will be replaced btu new BUA.
Form SWU-101 Version 07Jun2010 Page 3 of 6

*** Report only that amount of existing BUA that will remain of ter developrnerrt. Do not report any existing I3LIA that
is to be rerrroved and which will be replaced by new BLIA.
11. How was the off -site impervious area listed above determined? Provide documentation. Since these onds
are designed to only treat the proposed roadway, there is no off -site impervious area included in these
calculations.
Proiects in Union County: Contact Dit/Q Central OJJice staff to check if the pn jeer is located is4thin a Threatened &
Endangered Species sratershed that nrar be sidled to mare stringent stormmuter requirements as per NC.4C 02B .0000.
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://Liortal.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 littp://portaI.ncdenr.org/web/wq/ws/su/statesw/forms_docs. 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.ncdenr.org/web/wq/ws/su/rnaps.)
Please indicate that the following required information have been provided by initialing in the space
provided for each item. All original documents MUST be signed and initialed in blue ink. Download the latest
versions for each submitted application package from
httlL.ZZ portal.ncdenr.or web wq Z wsZ su statesw forms dots.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form, _ddk:iF-
2. Original and one coley of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part VI1 belozv)
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 _MAE—.-
http://www.eiivheII2.org/pages/onestoL)express.htmI for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/management for
6. A USCS reap identifying the site location. If the receiving strearn is reported as class SA or the MAE _
receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the 1/2 i�
mile radius on the reap.
7. Sealed, signed and dated calculations. MAE
S. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including: .I�nr�
a. Development/Project name. —t`��
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Seale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
s 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 13UA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
I. Details of roads, drainage features, collection systcrns, and stormwater control measures.
I�orrn SWU-101 Version 07Jun2010 Page 4 of 7

in. 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 SHw,r elevations (Please identify _ 4E,_
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 MRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedide a site visit far DWQ to verifil [lie SHWT prior
to subinittal, [phone].)
10. A copy of the most current property deed. Deed book: 5258 Page No: 602 O
1-1. For corporations and limited liability corporations (LLC): Provide documentation from the NC
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per NCAC 2H.1003(e). The
corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
http://iv%vw.secretarv.state.nc.us/Corporations/CSearcli.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
http://portal.ncdenr.org/%veb/wq/ws/su/statesw/fornis 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 %'our behalf for this project (such as
addressing requests for additional information).
Coctisulting Engineer:Matthew Edwards, P.E.
Consulting Firm: Kimley-Horn and Associates, Inc.
Mailing Address:2000 South Blvd Suite 440
City:Charlotte
Phone: (704 ) 954-7493
Email:matt.edwardsOkimlev-horn.coni
State:NC
Zip:28203
Fax: [phone]
Form SWU-101 Version 07Jun2O10 Page 5 of 7

IX. PROPERTY OWNER AUTHORIZATION (if Contact MfOrruatiorr, itcrrr 2 has beery filler! ont, complete this
section)
1, (print or type name of person listen in Contact Information, item 2n) Bi11y D. Home , certify that 1
own the property identified in this permit application, and thus give permission to (print or type name of person
listed in Contact Information, item In) Steve Mitchnel with (print or type name of or fmiaation listed in
Contact Information, itcrrr 1a) Wal-Mart Real Estate Business Trust 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 1 acknowledge, understand, and agree by my signature below, that if my
designated agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or
defaults on their lease agreement, or pending sale, responsibility for compliance with the DWQ Stormwater
permit reverts back to me, the property owner. As the property owner, it is my responsibility to notify DWQ
immediately and submit a completed Name/Ownership Change Form within 30 days; otherwise I will be
operating a stormwater treatment facility without a valid permit. I understand that the operation of a
stormwater treatment facility without a valid permit is a violation of NC General Statue 143-215.1 and may
result in appropriate enforcement action including the assessment of civil penalties of tip to $25,000 per day,
pursuant to NC(;,S 143-215.6. n
Signature:
Date:
1, _` e-1)nikr ice, UUAW - i1��' a Notary Public for the State of 1 (4+1 Ca.r0lino— County of
E do hereby certify that rr 11 L4 b � -t i nr� —personally a peared
before me this 25—cT�Ity of ab l , and acknowledge the du - execution of the app cation or
a stormwater permit. Witness my hand and official seal, _
7—
AL090 L KLVM
NOTARY PUBLIC
Cuftm nd CounV
North cold"
SEAL
My commission expires 5 1, e201 '1
Form SWU-101 Version 07Am2010 Page 6 of 7

T'�1�+4Y ii'A'� 171�y�. r'i ��
L......�,.._.............. ...,...�...,..... �..,...,.

X. APPLICANT'S CERTIFICAT[ON
I, (print or type narlie of person listed ill Conlacf Information, ifem 1a) SIMC Mitchael
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 ' nformance with the approved plans, that the required deed restrictions
and protective covenants ti ' be r cor e �, and tl the proposed project complies with the requirements of the
applicable stornrwaicr r un i,1C .1000, SL 2006-246 (P11. 11 - Post Construction) or SL 2008-2�1-1.
Signature: Date: 7-? - 12
7 �
a Notary Public for the State of ��� , County of
ado he�r�eby certify (ha( s��1/ti/i'L�i7"%�/�-�' C� personally appeared
before me thi day o`E�LCc�;-r _ en/ and,acknowlJedge lie du mccution of the ap eiftion for
a stormwater permit. Witness my hand and official seal, = c i�---
NOTARY PUBLIC
Benton County, Arkansas
My Commission Ex ices S 1312016
Commission Num er 12 9235
SEAL
M} y commission expires p
Form SWU-101 Version 07Jun2010
Page 7 01.7

Permit Number:
(to be Provided hip DJVQ)
Drainage Area Number:
Wet Detention Basin Operation and Maintenance Agreement
1 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.
The wet detention basin system is defined as the wet detention basin,
pretreatment including forebays and the vegetated filter if one is provided.
This system (check one):
❑ does ® does not incorporate a vegetated filter at the outlet.
This system (check one):
❑ does ® does not incorporate pretreatment other than a forebay.
Important maintenance procedures:
— Irunediately after the wet detention basin is established, the plants on the
vegetated shelf and perimeter of the basin should be watered twice weekly if
needed, until the plants become established (commonly six weeks).
— No portion of the wet detention pond should be fertilized after the first initial
fertilization that is required to establish the plants on the vegetated shelf.
— Stable groundcover should be maintained in the drainage area to reduce the
sediment load to the wet detention basin.
— if the basin must be drained for an emergency or to perform maintenance, the
flushing of sediment through the emergency drain should be minimized to the
maximum extent practical.
— Once a year, a dam safety expert should inspect the embankment.
After the wet detention pond is established, it should be inspected 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 should be kept in a known set
location and must be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblem:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the wet
Areas of bare soil and/or
Regrade the soil if necessary to
detention basin
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 a phcation.
Vegetation is too short or too
Maintain vegetation at a height of
long.
approximately six inches.
>;orin SW401-Wel Detention Basin 0&M-Rev.4
Page 1 of 4

Permit Number:
(to he provided by UiYQ)
Drainage Area Number:
BMP element:
Potentialproblem:
How I will remediate theproblem:
The inlet device: pipe or
The pipe is clogged.
Unclog the pipe. Dispose of the
Swale
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged.
Erosion is occurring in the
Regrade the Swale if necessary to
Swale.
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
The forebay
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design depth for
possible. Remove the sediment and
sediment storage.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying.
The vegetated shelf
Best professional practices
Prune according to best professional
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,
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying.
The main treatment area
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design sediment
possible. Remove the sediment and
storage depth.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Algal growth covers over
Consult a professional to remove
50%, of the area.
and control the al al growth.
Cattails, phragmites or other
Remove the plants by wiping them
invasive plants cover 50% of
with pesticide (do not spray).
the basin surface.
Form SW40I-Wet Detention Basin 0&,M-Rev.4 Page 2 of 4

Permit Number:
(if) he pro0ded by D6VQ)
Drainage Area Number:
BMP element:
Potentialproblem:
How I will remediate the roblem:
The embankment
Shrubs have started to grow
Remove shrubs immediately.
on the embankment.
Evidence of muskrat or
Use traps to remove muskrats and
beaver activity is present.
consult a professional to remove
beavers.
A tree has started to grow on
Consult a dam safety specialist to
the embankment.
remove the tree.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair. if a licable
The outlet device
Clogging has occurred,
Clean out the outlet device. Dispose
of the sediment off -site.
The outlet device is damaged
Repair or re dace the outlet device.
The receiving water
Erosion or other signs of
Contact the local NC Division of
damage have occurred at the
Water Quality Regional Office, or
outlet.
the 401 Oversight Unit at 919-733-
1786.
The measuring device used to determine the sediment elevation shall be such
that it will give an accurate depth reading and not readily penetrate into
accumulated sediments.
When the permanent pool depth reads 1.17 feet in the train pond, the sediment
shall be removed.
When the permanent pool depth reads 119_ feet in the forebay, the sediment
shall be removed.
BASIN DIAGRAM
(Jill in the blank-s)
Sediment Removal I.. 119.0 Pe manenN
------------- - Volume
Bottom Glevatioi 119.0 -li Min.
Sediment
Storage
FOREBAY
Permanent Pool Edevatioii 122.0
Pool
1------Sediment Removal I�lev_ttion-1 17.0--- Volum1
-------- ------
Bottom Elevation 116.0
MAIN POND
Form SW401-Wet Detention Basin O&M-Rev.4 Page 3 of
l-ft n.
Sediment
Storage

Permit Number:
(it) he provided by DIVA)
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:Stedman Walmart #5017-00
BMP drainage area number:
Print name:Steve Mitchael
Title:Design Director
Addre;
Phone
Signat
Date:
Note: The legally responsible party should not be a homeowners association wiless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
I, i ,. , ` , a Notary Public for the State of
County ofs,rs do hereby certify that
\E, L Ie> l � � personally appeared before me this _,2a�
day of and acknowledge the due execution of the
forgoing wet detention basin maintenance requirements. Witness my hand and official
seal,
BARBARA WiLUAMS V
NOTARY PUBLIC
Benton County, Arkansas
Commission Exp811 ires =016
Mmission Number 1 gm
SEAL
My commission expires
Form SW401-Wet Detention Basin O&M-Rev.4 Page 4 of 4