SW8060118_CURRENT PERMIT_20060515

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW
DOC TYPE
� CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
YYYYMMDD

Ot0 W ATF
� Y
May 15, 2006
Mr. Ray Lovingood, P.E.
NCDOT Hydraulics Unit
1590 Mail Service Center
Raleigh, NC 27699-1590
Subject: Stormwater Permit No
R-2245 2" Oak island
High Density Project
Brunswick County
Dear Mr. Lovingood:
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
. SW8 060118
Bridge and Road
Alan W. Klimek, Y.E. Director
Division of Water Quality
The Wilmington Regional Office received a complete Stormwater Management Permit
Application for R-2245 2nd Oak Island Bridge and Road on April 28, 2006. Staff review of the
plans and specifications has determined that the project, as proposed, will comply with the
Stormwater Regulations set forth in Title 15A NCAC 2H.1000. We are forwarding Permit No.
SW8 060118 dated May 15, 2006, for the construction of the subject project.
This permit shall be effective from the date of issuance until May 15, 2016, and shall be
subject to the conditions and limitations as specified therein. Please pay special attention to
the Operation and Maintenance requirements in this permit. Failure to establish an adequate
system for operation and maintenance of the stormwater management system will result in
future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have
the right to request an adjudicatory hearing upon written request within sixty (60) 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.
If you have any questions, or need additional information concerning this matter, please
contact Linda Lewis, or me at [phone].
Sincerely, ,-
Edward Beck
Regional Supervisor
Surface Water Protection Section
ENBlari: S:1WQSISTORMWATIPERMIT1060118.may06
CC' Max Price, P.E., NCDOT Hydaulics Unit
Delaney Aycock, Brunswick County Building Inspections
Brian Wrenn, NCDOTIDENR Coordinator
Doug Huggett, DCM
Linda Lewis
Wilmington Regional Office
Central Files
.\orthCarol ina
Forth Carolina Division of Water Quality 127 Cardinal Drive Extension Wilmington, NC 28405 Phone [phone] Customer Service
Wilmington Regional Office internet: H�s�ti.nc+vatc_rctuality.or� Fax [phone]
An Equal OpportunitylAdirmaGve Action Employer — 50% Recycled/10% Post Consumer Paper

State Stormwater Management Systems
Permit No. SW8 060118
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
NCDOT
R-2245 2nd Oak Island Bridge and Road
New Route from SR 1004 Oak Island to NC 211, Brunswick County
FOR THE
construction, operation and maintenance of an infiltration basin and StormTech (or
equivalent) underground infiltration chambers, in compliance with the provisions of 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 May 15, 2016, and shall be
subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
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 Sections 1.6 and 1.7 on page 3 of this permit. The
stormwater controls have been designed to handle the runoff from 61,630 ft2 and
14,861 ft respectively, of impervious area. Each infiltration facility must be
operated with a 50' vegetated filter.
3. The remainder of the linear road project will utilize grassed swales for treatment
of the runoff.
3. The drainage area for each proposed stormwater facility 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 within the DOT
right-of-way or in recorded easements. The final plats for the project will be
recorded showing all such required easements, in accordance with the approved
plans.
Page 2 of 7

State Stormwater Management Systems
Permit No. SW8 060118
1,
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 infiltration basin provides treatment for the runoff from the southern half of
the larger bridge. The following design criteria have been provided in the
infiltration basin and must be maintained at design condition:
a
b.
C.
d.
e.
f.
9.
i.
j•
k.
I.
m
n.
o.
Drainage Area, Acres:
Onsite, ft .
Offsite, ft2:
Total Impervious Surfaces, ft2:
Design Storm, inches:
Basin Depth, feet:
Bottom Elevation, FMS,�-
Bottom Surface Area, ft :
Bypass Weir -Elevation, FMSY
Permitted Storage Volume, ft
Type of Soil:
Expected Infiltration Rate, in/hr:
Seasonal High Water Table, FMSL:
Time to Draw Down, hours:
Receiving Stream/River Basin:
Stream Index Number:
Classification of Water Body:
1.415
61,630
0
61,630
1.5
3.0
23.0
4,308
24.5
8,668
Wando Variant
64
20.5
1
Intracoastal Waterway 1 Lumber
LBR59 15-25
"SA"
T; The StormTech chambers provide treatment for the runoff from the smaller
bridge. The following design criteria have been provided in the Stormtech
Chamber System (or equivalent) and must be maintained at design condition:
a
b
c
d
e.
9.
i.
I
M.
n.
o.
P.
Drainage Area, acres:
Onsite, ft
Offsite, ft2:
Total Impervious Surfaces, ft2:
Design Storm, inches:
Chamber Volume, ft :
Bottom Elevation, FMSL:
Bypass Weir Elevation, FMSY
Permitted Storage Volume, ft :
Required number of StormTech units:
Type of Soil:
Expected Infiltration Rate, in/hr:
Seasonal High Water Table, FMSL
Time to Draw Down, hours:
Receiving Stream/River Basin:
Stream Index Number:
Classification of Water Body:
II. SCHEDULE OF COMPLIANCE
0.34
14,861
0
14,861
1.5
74.9 with 6" stone
81.6 with 12" stone
88.4 with 18"
11.75
14.25
1,765
24 with 6" stone
22 with 12" stone
20 with 18" stone
Dredge Spoil
23
<11
<1
ICWW (Davis Canal) 1 Lumber
LBR59 15-25
"SA"
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.
Page 3of7

N
State Stormwater Management Systems
Permit No. SW8 060118
3. The facilities shall be constructed as shown on the approved plans. This permit
shall become voidable unless the facilities are constructed in accordance with
the conditions of this permit, the approved plans and specifications, and other
supporting data.
4. 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 bypass structure, infiltration media, flow
spreader, catch basins, piping and vegetated filter.
g. A clear access path to the bypass structure must be available at all times.
5. 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.
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. 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, in 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.
9. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
10. 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.
Page 4 of 7

State Stormwater Management Systems
Permit No. SW8 060118 +.
11, 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 formal permit transfer request to the Division of Water Quality,
accompanied by a completed name/ownership change form, documentation
from the parties involved, and other supporting materials as may be appropriate.
The approval of this request will be considered on its merits and may or may not
be approved. The permittee is responsible for compliance with all permit
conditions until such time as the Division approves the transfer request.
2. 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.
3. 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.
4. In the event that the facilities fail to perforrr'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.
5. 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.
6. The permit may be modified, revoked and reissued or terminated for cause. The
filing of a request for a permit modification, revocation and reissuance or
termination does not stay any permit condition.
7. 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.
8. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
9. The permittee shall notify the Division any name, ownership or mailing address
changes within 30 days.
Permit issued this the 15th day of May 2006.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for Alari-W. mek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 5 of 7

State Stormwater Management Systems
Permit No. SW8 060118
R-2245 2"d Oak Island Bridge and Road
Stormwater Permit No. SW8 060118
Brunswick Countv
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)
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 6 of 7

State Stormwater Management Systems
Permit No. SW8 060118
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 bypass structure weir elevation is per the approved plan.
6. The bypass structure is located per the approved plans.
7. A Trash Rack is provided on the 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. All required design depths are provided.
13. All required parts of the -system are provided.
14. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Regional Office
Delaney Aycock, Brunswick County Building Inspections
Page 7 of 7

OFFICE USE ONLY'
Date Received
Fee Paid
Permit Number
4-ti-200co
5420col
5WE3 d CooJ I
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
LINEAR ROADWAY PROJECT
This form may be photocopied for use as an original.
DWQ Stormwater Management Plan Review:
A complete stotmwater management plan submittal includes this application form, a supplement form for each B1vIP
proposed (see Section V), design calculations, and plans and specifications showing all road and BMP details.
1. PROJECT INFORMATION
NCDOT Project Number:
R-224!5
Project Name: NEw RouTe FiRoM 5 R - 1104
BRIJMSW)CK
BEACIA UWE ) TO iJ C-
ProjectLocation: FRom [OAK 15LAI.I1) Tb MIDWAY .SECoND 2;P-06E TO OAIC
Contact Person: RAY Lov i hi &G om Phone: L 9 i 9, 250. 4 J.OD Fax: [phone]s 410 8
Receiving Stream Name: INTIZACOASTAL River Basin: Lumoeft Class: 5A
Proposed linear feet of project: 23� SivS
_ County:
( OCCAO
Proposed Structural BMP and Road Station (attach a list ofstation and BMP type if more room is needed):
-L STA 25-r00 Qt STORM 60AMBEIt —L- STA 46}00 LT q RT f sir ljp_ATI
Type of proposed project. (check all that apply):
ti BA51 I1
VNew 14'Widening R lane* CRI"lane* U urb and Gutter Midge Replacement
❑Other (Desct-ibe)
*2 lane and 4 lane imply that roadside ditches are used unless Curb and Gutter is also checked.
II. REQUIRED ITENIS CHECKLIST
13LAO
Initial in the space provided below to indicate the following design requirements have been met and supporting
documentation is attached. Supporting documentation shall, at a minimum, consist of a brief narrative description
including (1) the scope of the project, (2) how the items below are met, (3) how the proposed best management practices
minimize water quality impacts, and (4) any significant constraints and/or justification for not meeting a, b, c and d to the
maximum extent practicable.
Designer's Initials
RDL a. The amount of impervious surface has been minimized as much as possible.
D L b. The runoff from the impervious areas has been diverted away from surface waters as much as possible.
R OL c, Best Management Practices are employed which minimize water quality impacts.
kDL- d. Vegetated roadside ditches are 3:1 slope or flatter.
Form SWU-1 12 Rev 04,00' Page 1 of 2

Ill. OPERATION AND MAINTENANCE AGREENIENT
I acknowledge and agree by my initials below that the North Carolina Department of Transportation is responsible for the
implementation of the four maintenance items listed. I agree to notify DWQ of any operational problems with the BMP's
that would impact water quality or prior to making any changes to the system or responsible party.
Maintenance Engineer's Initials
a. BMP's shall be inspected and maintained in good working order.
�b. Eroded areas shall be repaired and reseeded as needed.
C. Stormwater collection systems, including piping, inlets, and outlets, shall be maintained to insure proper
functioning.
Maintenance Engineer's Name:—
•Z& z ' ..►� a . s ilia �i� ��
IV. APPLICATION CERTIFICATION
1, (prim of• type name) of Branch,
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 and that the proposed project complies with the
requirements of 15A NCAC 2H .1000.
Title:
Address:
Signature: Date:
V. SUPPLEMENT FORMS
The applicable state stormwater management permit supplement form(s) listed below must be submitted for each BMP
specified for this project. Contact the Stomlwater and General Permits Unit at [phone] for the status and
availability of these forms.
Form SWU-102
Wet Detention Basin Supplement
Form SWU-103
Infiltration Basin Supplement
Form SWU-104
Low Density Supplement
Form SWU-105
Curb Outlet System Supplement
Form SWU-106
Off -Site System Supplement
Form SWU-107
Underground Infiltration Trench Supplement
Form SWU-108
Neuse River Basin Supplement
Form SWU-109 Innovative Best Management Practice Supplement
Form SWU-110 Extended Dry Detention Basin Supplement
Form SWU-112 Rev 04.00 Page 2 of 2

Permit No. S�Jj�g OCocm U
(to be provided by D U"Q)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
UNDERGROUND INFILTRATION TRENCH SUPPLEMENT
This form may be photocopied for use as an original
DWO Stormwater Management -Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
underground infiltration trench supplement for each system, design calculations, and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION .Secooa &2to&C to OAK ISLAWD
Project Name : ISEW ROUTC r120K S2-.1104 C OCt:A13 BEACH OCIve) TO IJC-2tL
Contact Person: RAY LoutmLGona Phone Number: (91q) 250. 410 o
For projects with multiple infiltration systems, a supplement form must be completed for each system. This
worksheet applies to: Trench .5TOR11 CWAHEEIL in Drainage Area DAV16 CAWL .B1Z10&E
(from plans) (from Form SWU--101)
II. DESIGN INFORMATION (attach supporting calculations/documentation):
Soils Report Summary (based upon an actual field investigation and soil borings)
Soil Type {'1 LL
Infiltration Rate 23-3 in/h or eUhr/sf (circle appropriate units)
SHWT Elevation L 11 fmsl (Seasonal High Water Table elevation)
Trench Design Parameters
Design Volume c.E
Design Storm 1 inch event (L5 inch event for SA waters, I inch event for others)
Drawdown Time days
Perforated Pipe Size 51 \A/ +t .30 h inchdiarneter• 6Ornl Ck(A nv�e•r
Perforated Pipe Length ft.
No. Observation Wells (may be required on a case -by -case basis)
Stone Type (if used) WASHCO ' 57
Stone Void Ratio 40010
Trench Elevations (in feet mean sea level)
Bottom Elevation 11. 45' BOTTOM fmsl OF SrOiZr1 C-OArl2EjC
Storage/Overflow Elevation
14. 2 5' fmsl
Fonn SWU-107 Rev 3.99 Page 1 of 4

Trench Dimensions
Height '�, 5 ft
Width 4. z $ ft
III. REQUIRED ITEMS CHECKLIST
Length 17o ft.
Volume Provided 1 500 cu.ft.
The following checklist outlines design requirements per the Stormwater Best Management Practices manual (N.C.
Department of Environment, Health and Natural Resources, November 1995) and Administrative Code Section: 15
A NCAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
WDL a.
System is located 50 feet from class SA waters and 30 feet from other surface waters.
�Jx_ b.
System is located at least 100 feet from water supply wells.
Q L c.
Bottom of system is at least 2 feet above the seasonal high water table.
RIX d.
Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
WL e.
Off-line system, runoff in excess of the design volume bypasses the system (bypass detail
provided).
�L f.
System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days based upon infiltration
through the bottom only (a hydrogeologic evaluation may be required).
g.
Soils have a minimum hydraulic conductivity of 0.52 inches per hour.
h.
System is not sited on or in fill material or DWQ approval has been obtained_
L i.
Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
! DL- j.
System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage.
nL k.
System is located in a recorded drainage easement for the purposes of operation and
maintenance and has recorded access easements to the nearest public right-of-way.
4L I.
System captures and infiltrates the runoff from the first 1.0 inch of rainfall 0.5 inch event
for areas draining to SA waters ).
m.
Drainage area for the device is less than 5 acres.
n.
A pretreatment device ( filter strip, grassed swale, sediment trap, etc.) is provided.
o.
Trench bottom is covered with a layer of clean sand to an average depth of 4 inches.
1�1�L P.
Sides of the infiltration trench are lined with geotextile fabric.
q.
Rock used is free of fines (washed stone) and has a large void ratio_
r.
Side to bottom area ratio is less than 4:1.
Fonn SWU-107 Rev 3.99 Page 2 of 4

s. Observation well(s) are provided (case -by -case basis).
K�l?� t. Vegetated filter is provided for overflow (50 feet for SA waters, 30 feet for other waters)
and detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
IV. UNDERGROUND INFILTRATION TRENCH OPERATION AND MAINTENANCE AGREEMENT
After every runoff producing rainfall event and at least monthly inspect the bypass/overflow structure for
blockage and deterioration and the infiltration system for erosion, trash accumulation, grass cover, and general
condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow vegetative
cover to maintain a maximum height of six inches, and remove trash and blockages as needed to maintain
system performance.
3. Remove accumulated sediment annually or when depth is reduced to 75% of the original design depth. Restore
depth to original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed.
4. The water level in any monitoring wells will be recorded after a I inch rainfall event and at least once a month.
Chronic high water table elevations (within 1 foot of the bottom of the system for a period of three months)
shall be reported to DWQ immediately.
5. If DWQ determines that the system is failing, the system will immediately be repaired or replaced to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater control
devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
6. Remove accumulated sediment from the infiltration system annually or when depth in the unit is reduced to
75% of the original design depth. The system shall be restored to the original design depth without over -
excavating. Over -excavating may cause the required water table separation to be reduced and may
compromise the ability of the system to perfonn as designed. Removed sediment shall be disposed of in an
appropriate manner and shall not be handled in a manner that will adversely impact water quality (i.e.
stockpiling near a stonnwater treatment device or stream, etc.).
A benchmark shall be established in the infiltration system. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
i
When the depth at the benchmark reads C`%. J� , the accumulated sediment shall be removed
from the system.
Form SWU-l07 Rev 3.99 Page 3 of 4

7�"b�
1 acknowledge and agree by my signature below tha am responsible for maintaining the stortnwater
collection system in accordance with the six 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 parry.
Print Name and Title: „/� /D 4 7hi7-1,IA5 , R F- Et/O-0
Address:_ /Az¢ P11%�� T.�1�'
Phone: �910) Z✓5I-,°S'724- Date:
z
Signature:
Note: The Iegallr• responsible part), should not be a homeowners association unless more than 50% of the lots have been sold and a
resident of the subdivision has been named the president.
I, a Notary Public for the State of County of
do hereby certify that personally appeared before me this
day of and acknowledge the due excculion of the forgoing infiltration basin maintenance
requirements. Witness my hand and official seal,
SEAL My commission expires
Form SWU-l07 Rev 3.99 Page 4 of 4

Permit No.
(to be provided big DJVQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWQ Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION SEC-DIJb B121)1-r; o OAIL tSLA00
Project Name : NEVI ROUTt FRoM 6R 1104 ( OGaAO SEACk D1ZiVF-) To M C 2,11
Contact Person: RAY Lcay ui &c.000 Phone Number: (g La) 250 A -too
- 11.1T(LACAD wbTAL- UJATF-Q.WA`i
This worksheet applies to: Basin No. 1 N FIt_T EAT IZiA B A61 � in Drainage Area B P-1 D G-E�
(as identified on plans) (from Form SWU-101)
IL DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (frost).
Soils Report Summary
Soil Type \AW too VAiLWAT
Infiltration Rate 64.h in/hr or ef/hr/sf (circle appropriate units)
SHWT Elevation 20. 5" fmsl (Seasonal high Water Table elevation)
Basin Design Parameters
Design Storm
Design Volume
Drawdown Time
Basin Dimensions
Basin Size
Basin Volume Provided
Basin Elevations
Bottom Elevation
Storage Elevation
Top Elevation
L5
-4t 3 5 CD
c.f.
i
days
100
ft. x
22. Z©o
c.f.
Z3,0
fmsl
Z 4-.
fmsl
Z (0- d
fmsl
inch (1.5 inch event for SA waters, 1 inch event for others)
4130?
0 sq. ft.
V+ l72�c
(weir- elev2hon�
(bottom dimensions)
Dorm SWU-103 Rev 3.99 Page 1 of 3

Ill. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
I P L a.
System is located 50 feet from class SA waters and 30 feet from other surface waters.
D L b.
System is located at least 100 feet from water supply wells.
iZD` c.
Bottom of system is at least 2 feet above the seasonal high water table.
DL d.
Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
COL e..
System is not sited on or in fill material or DWQ approval has been obtained.
1RDL f.
System is located in a recorded drainage easement for the purposes of operation and
maintenance and has recorded access easements to the nearest public right-of-way.
9D L g. Drainage area for the device is less than 5 acres.
Rig L h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
QOL i. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event for
areas draining to SA waters )_ Design volume and infiltration calculations attached.
QadL j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
91) L k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H: V).
1. A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided.
DL in. Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches or
dense vegetative cover is provided.
�. n. Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
R1%L. o. Flow distribution mechanism within the basin is provided.
WL p. A benchmark is provided to determine the sediment accumulation in the pretreatment device.
9.0L q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
01- r. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
ROL s. Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads 0. 3 feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. if the Division detennines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perforn its design function, other stortnwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below thajAlarn responsible for the performance of the five
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.
Print Name and Title: Z✓/D L, 7,;bN1VS6 f7.4 Z'l!Z_S_1,W MllJy7A5A(A�� 6ya,
Address:2F
Phone: fla X 7 Dater
Signature:
Note: The legally responsible party should not be a homeoiti,ners association unless more than 50% of the lots have been sold and a
resident of the subdivision has been named the president.
a Notary Public for the State of County of
do hereby certify that personally appeared before me this
day of , and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my hand and official seal,
SEAL
My commission expi
Form SWU-103 Rev 3.99 Page 3 of 3