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SW8120509_CURRENT PERMIT_20120530
STORMWATER DIVISION CODING SHEET POST -CONSTRUCTION PERMITS PERMIT NO. SWAY DOC TYPE CURRENT PERMIT rAPPROVED PLANS ❑ HISTORICAL FILE ❑ COMPLIANCE EVALUATION INSPECTION DOC DATE a&�/JS?o YYYYMMDD trz NCDEE R� North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Charles Wakild, P E Dee Freeman Governor Director Secretary May 30, 2012 Carl Baker, Deputy Public Works Officer USMC - Camp Lejeune 1005 Michael Road Camp Lejeune, NC 28547 Subject State Stormwater Management Permit No SW8120509 NICOE SAT Clinic High Density Commercial infiltration Basin Protect Onslow County Dear Mr Baker The Wilmington Regional Office received a complete State Stormwater Management Permit Application for 120509 on May 24, 2012 Staff review of the plans and specifications has determined that the project, as proposed, will comply with the Stormwater Regulations set forth in Session Law 2008-211 and Title 15A NCAC 2H 1000 We are forwarding Permit No SW8120509 dated May 30, 2012, for the construction, operation and maintenance of the BMP's and built -upon area associated with the subject project This permit shall be effective from the date of issuance until May 30, 2020, 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 by filing a written petition with the Office of Administrative Hearings (OAH) The written petition must conform to Chapter 150B of the North Carolina General Statutes, and must be filed with the OAH within thirty (30) days of receipt of this permit You should contact the OAH with all questions regarding the filing fee (if a filing fee is required) and/or the details of the filing process at 6714 Mad Service Center, Raleigh, NC 27699-6714, or via telephone at 919-431-3000, or visit their website at www NCOAH com Unless such demands are made this permit shall be final and binding If you have any questions, or need additional information concerning this matter, please contact Chris Baker, at (910) 796-7215 ;S�ierely, For Charles Wakild, P E , Director Division of Water Quality GDSlcsb S 1WQS1Stormwate6Permits & Projects120121120509 HD 12012 05 permit 120509 cc Sean P Gleason, P E , AECOM Wilmington Regional Office Stormwater File Wilmington Regional Office 127 Cardinal Dnve Extension Wilmington North Carolina 28405 Phone 910 796 72151 FAX 910 350 20041 Customer Service 1-877-623.6748 Internet www ncwaterquality org Ahmally nthCarolina State Stormwater Management Systems Permit No SW8 120509 STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER QUALITY STATE STORMWATER MANAGEMENT PERMIT HIGH DENSITY COMMERCIAL 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 USMCB Camp Lejeune N1COE SAT Clinic Hospital Corps Blvd, Camp Lefeune, Onslow County FOR THE construction, operation and maintenance of two infiltration basins in compliance with the provisions of Session Law 2008-211 and 15A NCAC 2H 1000 (hereafter collectively and separately 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 30, 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 18 on page 3 of this permit The stormwater control has been designed to handle the runoff from 100,555 square feet of impervious area 3 The tract will be limited to the amount of built -upon area indicated in Section 17 on page 3 of this permit, and as shown on the apppproved plans The built -upon area for the future development is limited to 12,067 square feet 4 All stormwater collection and treatment systems must be located in either dedicated common areas or recorded easements The final plats for the project will be recorded showing all such required easements, in accordance with the approved plans 5 The runoff from all built -upon area within the permitted drainage area of this project must be directed into the permitted stormwater control system Page 2 of 7 State Stormwater Management Systems Permit No SW8 120509 6 The protect shall provide a 50' wide vegetated buffer adjacent surface waters, measured horizontally from and perpendicular to the normal pool of impounded structures, the top of bank of both sides of streams and rivers, and the mean high water line of tidal waters 7 The following design criteria have been permitted for the infiltration basin and must be provided and maintained at design condition Infiltration Basin #1 Infiltration Basin #2 a Drainage Area, acres Onsite, ft2 Offsite, ft2 20 87,320 NIA 149 64,914 NIA b Total Impervious Surfaces, ft Onsite, ft2 Offsite, ft2 59,825 59,825 NIA 4o,730 40,730 NIA c Design Storm inches 1 5 1 5 d Basin Depth, feet 25 20 e Bottom Elevation FMSL 135 16 f Bottom Surface Area ft 7,700 7,365 _Bypass Weir Elevation FMLS 155 175 h Permitted Storage Volume ft 18,604 12 470 1 Pre-dev 1 r-24 hr discharge rate cfs 003 002 Post-dev 1 r-24 hr discharge rate, cfs 902 233 k Type of Sod Ba meade Ba meade I Expected Infiltration rate 377 983 m Seasonal High Water Table FMSL 11 5 138 n Time to Draw Down, hours 77 22 o Receiving Stream/River Basin Northeast Creek 1 White Oak Stream Index Number 19-16- 3 5 Classification of Water Body SC HQW NSW R. SCHEDULE OF COMPLIANCE 1 The stormwater management system shall be constructed in its entirety, vegetated and operational for its intended use prior to the construction of any built -upon surface 2 During construction, erosion shall be kept to a minimum and any eroded areas of the system will be repaired immediately 3 The permittee shall at all 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 Mowin.9 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 4 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 Page 3 of 7 State Stormwater Management Systems Permit No SW8 120509 5 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 6 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 7 Records of maintenance activities must be kept for each permitted BMP The reports will indicate the date, activity, name of person performing the work and what actions were taken 8 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 9 Access to the stormwater facilities shall be maintained via appropriate easements at all times 10 The permittee shall submit to the Director and shall have received approval for revised plans, specifications, and calculations prior to construction, for any modification to the approved plans, including, but not limited to, those listed below a Any revision to any item shown on the approved plans, including the stormwater management measures, built -upon area, details, etc b Protect 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 development, subdivision, acquisition, lease or sale of any, all or part of the protect area The protect area is defined as all property owned y the permittee, for which Sedimentation and Erosion Control Plan approval or a CAMA Ma)or permit was sought f Filling in, altering, or piping of any vegetative conveyance shown on the approved plan 11 The permittee shall submit final site layout and grading plans for any permitted future areas shown on the approved plans, prior to construction 12 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 Approved plans and specifications for this protect are incorporated by reference and are enforceable parts of the permit 2 The permittee is responsible for compliance with all permit conditions until such time as the Division approves the transfer request Neither the sale of the protect in whole or in part, nor the conveyance of common area to a third party shall constitute an approved transfer request Page 4 of 7 State Stormwater Management Systems Permit No SW8 120509 3 This permit is not transferable to any person or entity except after notice to and approval by the Director At least 30 days prior to a change of ownership, or a name change of the project or of the permittee or a mailing address change, the permittee shall submit a completed and signed Name/Ownership Change form to the Division of Water Quality, accompanied by the appropriate documentation as listed on the form The approval of this request will be considered on its merits and may or may not be approved 4 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 5 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 6 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 7 The permittee grants DENR Staff permission to enter the property during normal business hours for the pur ose of inspecting all components of the permitted stormwater management facility 8 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 reissuance or termination does not stay any permit condition 9 Unless specified elsewhere, permanent seeding requirements for the stormwater controls must follow the guidelines established in the North Carolina Erosion and Sediment Control Planning and Design Manual 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 2008- 211, Title 15A NCAC 2H 1000, and NCGS 143-215 1 et al 11 The permittee shall submit a permit renewal application at least 180 days prior to the expiration date of this permit The renewal request must include the appropriate documentation and the processing fee Permit issued this the 30th day of May, 2012 NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION Division of Water Quality By Authority of the Environmental Management Commission Page 5 of 7 State Stormwater Management Systems Permit No SW8 120509 NICOE SAT Clinic Stormwater Permit No SW8 120509 Onslow 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 120509 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 Page 7 of 7 9 Date Received Fee Paid Permit Number Applicable Rules ❑ Coastal SW -105 ❑ Coastal SW - 2008 ' ❑ Ph II - Post Construction (select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan ❑ Other WQ Mgmt Plan State of North Carolina Department of Environment and Natural Resources Division of Water Quality STORMWATER MANAGEMENT PERMIT APPLICATION FORM This form may be photocopied for use as an original I GENERAL INFORMATION 1 Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans, specifications, letters, operation and maintenance agreements, etc) USMCB Camp Lejeune, NICOE SAT Clinic 2 Location of Project (street address) Hospital Corps Blvd _ City USMCB Camp,Lpjeune _ County Onslow Zip 28547 3 Directions to project (from nearest major intersection) From main, head South on Holcomb Blvd Take first right toward Brewster Blvd, Turn right onto Brewster Blvd Turn right onto Hospital Corps Blvd and project site is at)Vroximately 0 3 rriles on Left 4 Latitude 34' 43' 10 72" N Longitude 77' 21' 43 88" W of the main entrance to the project II PERMIT INFORMATION 1 a Specify whether project is (check one) ®New ❑Modification b If this application is being submitted as the result of a modification to an existing permit, list the existing permit number , its issue date (if known) , and the status of construction ❑Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certification 2 Specify the type of project (check one) []Low Density ®High Density ❑Drams to an Offsite Stormwater System ❑Other If this application is being submitted as the result of a previously returned application or a letter from DWQ requesting a state stormwater management permit application, list the stormwater project number, if assigned, and the previous name of the project, if different than currently proposed, 4 a Additional Project Requirements (check applicable blanks, information on required state permits can be obtained by contacting the Customer Service Center at 1-877-623-6748) ❑CAMA Major ®Sedimentation/Erosion Control 6 ac of Disturbed Area ❑NPDES Industrial Stormwater ❑404/401 Permit Proposed Impacts b If any of these permits have already been acquired please provide the Project Name, Project/Permit Number, issue date and the type of each permit Form SWU-101 Version 071un2010 Page 1 of 6 MAY 2 4 L012 , IYI CONTACT INFORMATION 1 a Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee, designated government official, individual, etc who owns the project Applicant/Organization Commanding Officer, Marine Corns Base, Capin Leleune, Signing Official & Title Carl Baker, Deputy Public Works Officer b Contact information for person listed in item 1a above Street Address Bldg 1005 Michael Rd City MCB Camp Le)eune State NC Zip 28547 Mailing Address (if applicable) City State Zip Phone (910 ) 451-2-213 Fax (910 _ _ ) 451-2927 Email earl h baker®usmc mil c Please check the appropriate box The applicant listed above is ® The property owner (Skip to Contact Information, item 3a) ❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below) ❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and 2b below) ❑ Developer* (Complete Contact Information, item 2a and 2b below) 2 a Print Property Owner's name and title below, if you are the Iessee, purchaser or developer (This is the person who owns the property that the project is located on) Property Owner/Organization Signing Official & Title b Contact information for person listed in item 2a above Street Address City Mailing Address (if applicable) City Phone Email State State Zip Zip Fax ( 3 a (Optional) Print the name and title of another contact such as the project's construction supervisor or other person who can answer questions about the project Other Contact Person/Organization Andrew B Wilson, EIT. AECOM Signing Official & Title b Contact information for person listed in item 3a above Mailing Address 701 Corporate Center Drive City Raleigh _ State NC Zip 27607 Phone 919 854-6225 Fax (919 1 854-6259 Email andrewb wilson@aecom com 4 Local jurisdiction for building permits Point of Contact Phone # Form SWU-101 Version 07Jun2010 Page 2 of 7 MAY 2 4 2012 r C, IV PROJECT INFORMATION 1 In the space provided below, briefly summarize how the stormwater runoff will be treated Additional Stormwater from construction of the NICOE SAT Clinic wiII be routed via a stonnater convey e�ystem utilizing curb and gutter from impervious areas to 2 infiltration basins The infiltration basins meet DWO requirements for drawdown time and are sized for 2 5 times the required treatment volume This 12roject is not located within 1 2 mile of SA waters or within 575 ft of ORW waters 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 White Oak River basin 4 Total Property Area 5 2 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' 5 2 acres + Total project area shall be calculated to exclude the following the normal pool of impounded structures, the area between the banks of streams and rivers, the area below the Normal High Water (NUM line or Mean High Water (MHW) line, and coastal wetlands landward from the NHW (or MHI9 line The resultant project area is used to calculate overall percent built upon area (BUA) Non -coastal wetlands landward of the NHW (or MHW) line may be included in the total project area S Project percent of impervious area (Total Impervious Area / Total Project Area) X 100 = 44 4 % 9 How many drainage areas does the project have?2 (For high density, count I for each proposed engineered stormwater BMP For low density and other pro)ects, use 1 for the whole property area) 10 Complete the following information for each drainage area identified in Project Information item 9 If there are more than four drainage areas in the project, attach an additional sheet with the information for each area provided in the same format as below Form SWU-101 Version 07Jun2010 Page 3 of 7 MAY 2 4 181Z Basin Information Drainage Area Al Drainage Area A2 Drainage Area _ Drainage Area _ Receiving Stream Name Northeast Creek Northeast Creek Stream Class SC, HQW, NSW SC, HQW, NSW Stream Index Number * 19-16-(3 5) 19-16-(3 5) Total Drainage Area (so 87320 64914 On -site Drainage Area (so 87320 64914 Off -site Drainage Area (so 0 0 Proposed Impervious Area** (so 59825 40730 Impervious Area" total 685 627 Impervious" Surface Area Drainage Area Drainage Area Drainage Area Drainage Area _ On -site Buildings/Lots (so 0 25875 On -site Streets (sf) 0 0 On -site Parkin (so 53616 0 On -site Sidewalks (so 4254 4743 Other on -site (sf) 0 0 Future (so 1955 10112 Off -site (sf) 0 0 Existing BUAI (so 0 0 Total (so 59825 40730 * Stream Class and Index Number can be determined at http /fportal ncdenr org/`web/w ps/csu/classificat:ons ** Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas, sidewalks, gravel areas, etc ***Report only that amount of existing BUA that will remain after development Do not report any existing BUA that is to be removed and which will be replaced by new BUA 11 How was the off -site impervious area listed above deterrruned? Provide documentation n/a Proieets in Union County Contact DWQ Central Office staff to check if the project is located within a Threatened & Endangered Species watershed that may be rubject to more stringent stormwater requirements as per NCAC 02B 0600 V SUPPLEMENT AND O&M FORMS The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms must be submitted for each BMP specified for this project The latest versions of the forms can be downloaded from http //portaI ncdenr or /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 htt ortal nedenr or web w wsl su/stateswZ forms does The complete application package should be submitted to the appropriate DWQ Office (The appropriate office may be found by locating project on the interactive online map athttp/[portal ncdenr org/weblwg/ws/su/ maps } Please indicate that the following required information have been provided by initialing in the space provided for each item All original documents MUST be signed and initialed in blue ink Download the latest versions for each submitted application package from http j/portal ncdenr org/web/wq/ws/su/statesw/frms does In Is 1 Original and one copy of the Stormwater Management Permit Application Form 2 Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants Form (f required as per Part VII below) /1! 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 ht www envhel org/12ageslonestopexpress html for information on the Express program r Form SWU-101 Version 07Jun2010 Page 4 of 7 1 MAY 2 4 ZU1Z 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 USGS map identifying the site location If the receiving stream is reported as class SA or the receiving stream drains to class SA waters within'/2 mile of the site boundary, include the mile radius on the map 7 Sealed, signed and dated calculations 8 Two sets of plans folded to 8 5" x 14" (sealed, signed, & dated), including a Development/Project name b Engineer and firm c Location map with named streets and NCSR numbers d Legend e North arrow f Scale g Revision number and dates h Identify all surface waters on the plans by delineating the normal pool elevation of impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal waters, and any coastal wetlands landward of the MHW or NHW lines • Delineate the vegetated buffer landward from the normal pool elevation of impounded structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters i Dimensioned property/project boundary with bearings & distances j Site Layout with all BUA identified and dimensioned k Existing contours, proposed contours, spot elevations, finished floor elevations I Details of roads, drainage features, collection systems, and stormwater control measures 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 SHWT elevations (Please identify elevations in addition to depths) as well as a map of the boring locations with the existing elevations and boring logs Include an 8 5"x11" copy of the NRCS County Soils map with the project area clearly delineated For projects with infiltration BMPs, the report should also include the soil type, expected infiltration rate, and the method of determining the infiltration rate (Infiltration Devices submitted to WiRO Schedule a site visit for DWQ to verify the SNWT prior to submittal, (910) 796-7378 ) 10 A copy of the most current property deed Deed book Page No 11 For corporations and limited liability corporations (LLC) Provide documentation from the NC t Secretary of State or other official documentation, which supports the titles and positions held by the persons listed in Contact Information, item 1a, 2a, and/or 3a per 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 //www secretary state nc us/Corporations/CSearch aspx VII DEED RESTRICTIONS AND PROTECTIVE COVENANTS For aII 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 httportal ncdenr or web wq Z wsZ su statesw forms does Download the latest versions for each submittal In the instances where the applicant is different than the property owner, it is the responsibility of the property owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring that the deed restrictions are recorded By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and protective covenants for this project, if required, shall include all the items required in the permit and listed on the forms available on the website, that the covenants will be binding on all parties and persons claiming under them, that they will run with the land, that the required covenants cannot be changed or deleted without concurrence from the NC DWQ and that they will be recorded prior to the sale of any lot Form SWU-101 Version 07Jun2010 Page 5 of 7 1 MAY 2 4 Z01Z III CONSULTANT INFORMATION AND AUTHORIZATION Applicant Complete this section if you wish to designate authority to another individual and/or firm (such as a consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as addressing requests for additional information) Consulting Engineer Andrew B Wilson, EIT Consulting Firm AECOM Technical Services Inc Mailing Address 701 Corporate Center Drive - Suite 475 City Raleigh _ State NC Zip 27607 Phone ( } 854-6225 Fax (919 ) 854-6259 Email AndrewB Wilson®AECOM com IX PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this section) I, (print or type name of person listed in Contact Information, item 2a) , certify that I own the property identified in this permit application, and thus give permission to (print or type name of person listed in Contact Information, item 1a) with (print or type name of organization listed in Contact Information, item 1a) to develop the project as currently proposed A copy of the lease agreement or pending property sales contract has been provided with the submittal, which indicates the party responsible for the operation and maintenance of the stormwater system As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their lease agreement, or pending sale, responsibility for compliance with the DWQ Stormwater permit reverts back to me, the property owner As the property owner, it is my responsibility to notify DWQ immediately and submit a completed Name/Ownership Change Form within 30 days, otherwise 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 143-2151 and may result in appropriate enforcement action including the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215 6 Signature R Date a Notary Public for the State of __, ,� County of do hereby certify that personally appeared before me this _ day of _ , and acknowledge the due execution of the application for a stormwater permit Witness my hand and official seal, SEAL My commission MAY 2 4 1U12 Form SWU-101 Version 07Jun2010 Page 6 of 7 X APPLICANT'S CERTIFICATION I, (print or type name of person fisted in Contact Information, item 1a) (Ar ( t7. Bu Ler certify that the information included on this permit application form is, to the best of my knowledge, correct and that the project will be constructed in conformance with the approved plans, that the required deed restrictions and protective covenants will be recorded, and that the proposed project complies with the requirements of the applicable stormw^ rules undef 15A PqAC 2f J 1000, SL 2006-246 (Ph lI - Post Construction) or SL 2008-211 Signature Date 5-17`12 I, D a No�4ry Public for the State of County of ".) _ do hereby certify that �/ 44 personally appeared before me thts,!�7day of % ;�iL ' and acknowl dge theme due execution of the application for t � a stormwater permit Witness my hand and official seal,�`--- ALICE A BONNETTE Notary Public Onslow County State of North C,, c ,u M Commission Ex Ircgtr11 SEAL My commission expires�?�-�/! A%-- , _ _ I - MAY 2 4 Z012 Form SWU-101 Version 07Jun2010 Page 7 of 7 Permit (to be provided by DWO) �eti wArgR ARA. STORMWATER MANAGEMENT PERMIT APPLICATION FORM a WDEHR 401 CERTIFICATION APPLICATION FORM INFILTRATION BASIN SUPPLEMENT This form must be filled out, printed and submitted The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information LMPROJEUINFORMATION , ,, t �� , t*&- � lke44 4��, 4 "AAa Project Name USMCB Camp Leleune NICOE SAT Clinic _ Contact Person Andrew B Wilson EIT Phone Number 91M54.6225 Date 5/23/2012 Drainage Area Number Drainage Area 1 f1.11DEM6111 WORMATION dr � '�a ':�` T�4 k IV tlwi 1-*' r , Site Characteristics Drainage area 67,32000 ft Impervious area 59,825 00 ftz Percent Impervious 6851 % Design rainfall depth 150 in Peak Flow Calculations 1 yr 24 hr rainfall depth 370 in 1 yr 24 hr intensity 090 inlhr Pre -development 1 yr, 24 hr discharge 003 ft3/sec Post -development 1-yr, 24 hr discharge 902 folsec Pre/Post 1 yr, 24 hr peak flow control 899 f0lsec Storage Volume Non -SA Waters Minimum design volume required 7,27600 ft3 Design volume provided 18,604 00 ft3 OK for non -SA waters Storage Volume SA Waters 1 5' runoff volume Pre -development 1 yr, 24 hr runoff volume Post -development 1 yr 24-hr runoff volume Minimum required volume Volume provided Solis Report Summary Sod type Infiltration rate SHWT elevation Basin Design Parameters Drawdown time Basin side slopes Basin bottom elevation Storage elevation Storage Surface Area Top elevation Basin Bottom Dimensions Basin length Basin width Bottom Surface Area ft3 ft3 ft3 ft3 ft3 _ Baymeade 377 inlhr 1150 fmsl 032 days OK 300 1 OK 1350 fmsl OK 1550 fmst 10,904 00 ftz 16 00 fmsl 22000 ft 3500 ft 7,70000 Y A*' — MAY 2 4 z01Z Form SW401 Infiltration Basin Rev 5 11Apr2011 Parts I & 11 Design Summary Page 1 of 2 Additional Information Maximum runoff to each Inlet to the basin? Length of vegetative filter for overflow Distance to structure Distance from surface waters Distance from water supply well(s) Separation from Impervious sod layer Naturally occunng sod above shwt Bottom covered with 4-in of dean sand? Proposed drainage easement provided? Capures all runoff at ultimate build -out? Bypass provided for larger storms? Pretreatment device provided 200 ac-in OK NA ft OK 7000 ft OK NA It OK NA ft OK NA ft OK 350 ft OK Y (Y or N) OK Y (Y or N) OK Y (Y or N) OK Y (Y or N) OK mad Scour Holes and Grassed Swales Permit No ((a be provided by DWQ) MAY 2 4 ZU12 Form SW401 rn811rabon Basin Rev 5 11Apr2011 Paris I & 11 Design Summary Page 2 of 2 Permit No (to be provided by DWQ) Please Indicate the page or plan sheet numbers where the supporbng documentation can be found An incomplete submittal package will result in a request for additional information This will delay final review and approval of the project Initial in the space provided to Indicate the following design requirements have been met If the applicant has designated an agent, the agent may Initial below If a requirement has not been met, attach justification Page/ Plan InIMIs Sheet No [ Vlol 1 Plans (1 " - 50' or larger) of the entire site showing Design at ultimate build -out, Off -site drainage (if applicable), Delineated drainage basins (Include Rational C coefficient per basin), - Basin dimensions, - Pretreatment system, High flow bypass system, - Maintenance access, Proposed drainage easement and public right of way (ROM, Overflow device, and Boundaries of drainage easement C& t o> 2 Parbal plan (1" = 30' or larger) and details for the infiltration basin showing - Bypass structure, - Maintenance access, - Basin bottom dimensions, - Basin cross-section with benchmark for sediment cleanout, - Flow distribution detail for inflow, - Vegetated filter, and - Pretreatment device 3 Section view of the infiltration basin (1" = 20' or larger) showing LG rJoy Pretreatment and treatment areas, and Inlet and outlet structures AL L & Soy 4 A table of elevations, areas, incremental volumes & accumulated volumes to verify the volume provided 1tyro 5 A sods report that is based upon an actual field Investigation, sod borings, and infiltration tests The results of the soils report must be venfied in the field by DWQ, by completing & submitting the sods investigation request fort County sod maps are not an acceptable source of soils information C[r toy - 6 A construction sequence that shows how the infitlrabon basin will be protected from sediment until the entire drainage area is stabilized 1) 7 The supporting calculations 8 A copy of the signed and notarized operation and maintenance (O&M) agreement t� 9 A copy of the deed restrictions (if required) MAY 2 4 2012 I Form SW401-Infiltration Basin Rev 4 Page 1 of 1 Part III Required Items Checklist Page 1 of 1 I Permit Number (to be provided by DWQ) Drainage Area Number Infiltration Basin Operation and Maintenance Agreement I will keep a maintenance record on this BMP This maintenance record will be kept in a log in a known set location Any deficient BMP elements noted in the inspection will be corrected, repaired or replaced immediately These deficiencies can affect the integrity of structures, safety of the public, and the removal efficiency of the BMP Important maintenance procedures — The drainage area will be carefully managed to reduce the sediment load to the infiltration basin — Immediately after the infiltration basin is established, the vegetation will be watered twice weekly if needed until the plants become established (commonly six weeks) — No portion of the infiltration basin will be fertilized after the trutial fertilization that is required to establish the vegetation — The vegetation in and around the basin will be matntained at a height of approximately six inches After the infiltration basin is established, it will be inspected once a quarter and within 24 hours after every storm event greater than 10 inches (or 15 inches if in a Coastal County) Records of operation and maintenance will be kept in a known set location and will be available upon request Inspection activities shall be performed as follows Any problems that are found shall be repaired immediately BMP element Potential problem How I will remediate the problem The entire BMP Trash debris is present Remove the trash debris The perimeter of the Areas of bare soil and/or Regrade the soil if necessary to infiltrahon 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 application The inlet device pipe or The pipe is clogged (if Unclog the pipe Dispose of the swale applicable) sediment off -site The pipe is cracked or Replace the pipe otherwise damaged (if a hcable Erosion is occurring in the Regrade the Swale if necessary to swale (if applicable) smooth it over and provide erosion control devices such as reinforced turf matting or nprap to avoid future problems with erosion Form 5W401-Infiltration Basin O&M -Rev 3 1 MAY 2 4 201Z Page 1 of 3 BMP element Potential problem How I will remediate the problem The forebay Sediment has accumulated Search for the source of the and reduced the depth to 75% sediment and remedy the problem if of the original design depth possible Remove the sediment and dispose of it in a location where it will not cause impacts to streams or the BMP Erosion has occurred or Provide additional erosion nprap is displaced protection such as reinforced turf matting or riprap if needed to prevent future erosion roblems Weeds are present Remove the weeds, preferably by hand If pesticides are used, wipe them on the plants rather than s ra in The main treatment area A visible layer of sediment Search for the source of the has accumulated sediment and remedy the problem if possible Remove the sediment and dispose of it in a Iocation where it will not cause impacts to streams or the BMP Replace any media that was removed in the process Revegetate disturbed areas immediate) Water is standing more than Replace the top few inches of filter 5 days after a storm event media and see if this corrects the standing water problem if so, revegetate immediately If not, consult an appropriate professional for a more extensive repair Weeds and noxious plants are Remove the plants by hand or by growing in the main wiping them with pesticide (do not treatment area spray) The embankment Shrubs or trees have started Remove shrubs or trees to grow on the embankment immediateI An annual inspection by an Make all needed repairs appropriate professional shows that the embankment needs repair The outlet device Clogging has occurred Clean out the outlet device Dispose of the sediment off -site The outlet device is damaged Repair or replace the outlet device The receiving water Erosion or other signs of Contact the NC Division of Water damage have occurred at the Quality 401 Oversight Unit at 919- outlet 733-1786 Form SW401-Infiltration Basin O&M -Rev 3 MAY 2 4 [012 i Page 2 of 3 w Permit Number (Io be provided by DWQ) I acknowledge and agree by my signature below that I am responsible for the performance of the maintenance procedures listed above I agree to notify DWQ of any problems with the system or prior to any changes to the system or responsible party Project name USMCB Camp Leieune, NICOE SAT Clinic BMP drainage area number Print name Carl Baker Title Deputy Public Works Officer Address Bldg 1005 Michael Rd, Camp Lemene NC 28547-2521 Phon S ignz Date Note The legally responsible party should not be a homeowners association unless more than 50% of the lots have been sold and a resident of the subdivision has been named the president I, Y ty t 0-.i � `� rl es, a Notary Public for the State of No f -+ :.a44, +n , County of CD y, stz) t,a , do hereby certify that Cpersonally appeared before me this day of O4 , LO(2 , and acknowledge the due execution of the forgoing infiltration basin maintenance requ ements Witness my hand and official seal, EONS SYLVIA fdORRIS M ° 1 u$LIC 1_3 ITY, SEAL �—�irc,..— r �d U My commission expires 3 (� Form 5W40I-infiltration Basin O&M -Rev 3 Page 3 of 3 MAY 2 4 1012 _ J .i Permit No (to be provided by D WQ) ATASTORMWATER MANAGEMENT PERMIT APPLICATION FORM o WDENR 401 CERTIFICATION APPLICATION FORM INFILTRATION BASIN SUPPLEMENT This form must be filled out, printed and submdted The Required Items Checklist (Part /U) must be printed, filled out and submitted along with all of the required rriformatron I PROJECT INFORMATION Project Name USMCS Camp Leleune NICOE SAT Clinic Contact Person Andrew S Wilson, EIT Phone Number 919-854-6225 Date 5/2312012 Drainage Area Number Drainage Area 2 IL'DESIGN IWORIISATION Site Characteristics Drainage area 64,914 00 ft Impervious area 40 730 00 fe Percent impervious 6274 % Design rainfall depth 150 in Peak Flow Calculations 1 yr, 24-hr rainfall depth 1 yr, 24-hr intensity Pre -development 1 yr 24 hr discharge Post -development 1 yr 24 hr discharge Pre(Post 1-yr 24 hr peak flow control Storage Volume Non -SA Waters Minimum design volume required Design volume provided Storage Volume SA Waters 1 5" runoff volume Pre -development 1 yr 24-hr runoff volume Post -development 1-yr, 24-hr runoff volume Minimum required volume Volume provided Soils Report Summary Soil type Infiltration rate SHWT elevation Basin Design Parameters Drowdown time Basin side slopes Basin bottom elevation Storage elevation Storage Surface Area Top elevation Basin Bottom Dimensions Basin length Basin width Bottom Surface Area Form S W401 Infiltration Basin Rev 5 11 Apr2011 370 in 090 irllhr 002 ft'/sec 233 ft3lsec 231 ft Isec 4,98800 ft3 12 470 00 113 OK for non -SA waters ft3 ft3 ft3 ft3 ft3 Bavmeade 983 irdhr 1380 fmsi 009 days OK 300 1 OK 1600 fmsl OK 1750 fmsl 9 261 00 fe 1800 fmsl IRREGULAR ft IRREGULAR ft 7 365 00 ft MAY 2 4 2012 Parts I & 11 Design Summary Page 1 of 2 Permit No Additional Information (to be provrded by DWO) Maximum runoff to each Inlet to the basin? 137 ac in OK Length of vegetative filter for overflow NA ft OK Distance to structure 6800 It OK Distance from surface waters NA ft OK Distance from water supply well(s) NA ft OK Separation from impervious sod layer NA ft OK Naturally occunng sod above shwt 366 ft OK Bottom covered wth 4 In of clean sand? Y (Y or N) OK Proposed drainage easement provided? Y (Y or N) OK Capures all runoff at ultimate build -out? Y (Y or N) OK Bypass provided for larger storms? Y (Y or N) OK Pretreatment device provided med Scour Holes and Grassed Swales Form SW401 Infiltration Bassn Rev 5 11 Apr201 t MAY 2 4 1032 Ports I & II Design Summary Page 2 of 2 J ,f Permit No fto be pmvrded by DWQJ Please indicate the page or plan sheet numbers where the supporting documentation can be found An incomplete submittal package will result in a request for additional Information This will delay final review and approval of the project Initial in the space provided to Indicate the following design requirements have been met If the applicant has designated an agent, the agent may Initial below If a requirement has not been met, attach Justification Pagel Plan Initials Sheet No (V 103 1 Plans (1" - 50' or larger) of the entire site showing .f161 Design at ultimate build -out, Off -site drainage (if applicable), Delineated drainage basins (include Rational C coefficient per basin), Basin dimensions, Pretreatment system, High flow bypass system, Maintenance access, Proposed drainage easement and public right of way (ROW), Overflow device, and - Boundaries of drainage easement _� C 6 to3 2 Partial plan (1" = 30' or larger) and details for the infiltration basin showing i Bypass structure, Maintenance access, Basin bottom dimensions, - Basin cross-section with benchmark for sediment cleanout, - Flow distribution detail for inflow, Vegetated filter, and Pretreatment device Lb 9 ny 3 Section view of the infiltration basin (1" = 20' or larger) showing Cv b4h - Pretreatment and treatment areas, and Inlet and outlet structures b So q 4 A table of elevations, areas, Incremental volumes & accumulated volumes to verify the volume provided ArrAcurs 5 A soils report that is based upon an actual field investigation, soil bonngs, and infiltration tests The results of the sods report must be verified in the field by DWO, by completing & submitting the sods investigation request form County soil maps are not an acceptable source of sods information G o I 6 A construction sequence that shows how the inftlration basin will be protected from sediment until the GG to2 entire drainage area is stabilized P'a1�+cti►E9 7 The supporting calculations REED 8 A copy of the signed and notarized operation and maintenance (0&M) agreement A 9 A copy of the deed restrictions (if required) MAY 2 4 241Z i Form SW401-Infiltration Basin -Rev 4 Page 1 of 1 Part III Required It,., Checklist Page 1 of 1 Permit Number (to be provided by DWQ) Drainage Area Number Infiltration Basin Operation and Maintenance Agreement I will keep a maintenance record on this BMP This maintenance record will be kept in a log in a known set location Any deficient BMP elements noted in the inspection will be corrected, repaired or replaced immediately These deficiencies can affect the integrity of structures, safety of the public, and the removal efficiency of the BMP Important maintenance procedures - The drainage area will be carefully managed to reduce the sediment load to the infiltration basin - Immediately after the infiltration basin is established, the vegetation will be watered twice weekly if needed until the plants become established (commonly six weeks) - No portion of the infiltration basin will be fertilized after the initial fertilization that is required to establish the vegetation - The vegetation in and around the basin will be maintained at a height of approximately six inches After the infiltration basin is established, it will be inspected once a quarter and within 24 hours after every storm event greater than 10 inches (or 15 inches if in a Coastal County) Records of operation and maintenance will be kept in a known set location and will be available upon request Inspection activities shall be performed as follows Any problems that are found shall be repaired immediately BMP element Potential problem How I will remediate the problem The entire BMP Trash/debris is present Remove the trash debris The penmeter of the Areas of bare soil and/or Regrade the soil if necessary to infiltration 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 application The inlet device pipe or The pipe is clogged (if Unclog the pipe Dispose of the Swale applicable) sediment off -site The pipe is cracked or Replace the pipe otherwise damaged (if applicable) Erosion is occurring to the Regrade the Swale if necessary to Swale (if applicable) smooth it over and provide erosion control devices such as reinforced turf matting or nprap to avoid future problems with erosion Form SW401-infiltration Basin O&M -Rev 3 MAY 2 4 �D1Z + Page 1 of 3 BMP element Potential problem How I will remediate the problem The forebay Sediment has accumulated Search for the source of the and reduced the depth to 75% sediment and remedy the problem if of the original design depth possible Remove the sediment and dispose of it in a location where it will not cause impacts to streams or the BMP Erosion has occurred or Provide additional erosion riprap is displaced 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 pesticides are used, wipe them on the plants rather than spraying The main treatment area A visible layer of sediment Search for the source of the has accumulated sediment and remedy the problem if possible Remove the sediment and dispose of it in a location where it will not cause impacts to streams or the BMP Replace any media that was removed in the process Revegetate disturbed areas immediateI Water is standing more than Replace the top few inches of filter 5 days after a storm event media and see if this corrects the standing water problem If so, revegetate immediately If not, consult an appropriate professional for a more extensive repair Weeds and noxious plants are Remove the plants by hand or by growing in the main wiping them with pesticide (do not treatment area spray) The embankment Shrubs or trees have started Remove shrubs or trees to grow on the embankment immediate) An annual inspection by an Make all needed repairs appropriate professional shows that the embankment needs repair The outlet device Clogging has occurred CIean out the outlet device Dispose of the sediment off -site The outlet device is damaged Repair or replace the outlet device The receiving water Erosion or other signs of Contact the NC Division of Water damage have occurred at the Quality 401 Oversight Unit at 919- ou tlet 733-1786 Form SW40 I -Infiltration Basin O&M -Rev 3 MAY 2 4 Page 2 of 3 J Permit Number (to he provided by DWQ) I acknowledge and agree by my signature below that I am responsible for the performance of the maintenance procedures listed above I agree to notify DWQ of any problems with the system or prior to any changes to the system or responsible party Project name USMCB Camp Leleune, NICOE SAT Clinic BMP drainage area number Print name Title Deputy Public Works Officer Address Bldg 1005 Michael Rd , Camp Leluene NC 28547-2521 Phone Signati Date S—iIk— Note The legally responsible party should not be a homeowners association unless more than 50% of the lots have been sold and a resident of the subdivision has been named the president [, J ,j C a-, � © irl 5 , a Notary Public for the State of County of _d In S�p� , do hereby certify that 0.y'ev- personally appeared before me this day of 0_01 and acknowledge the due execution of the forgoing infiltration basin maintenance requir ments Witness my hand and official seal, SYLVIA NORRIS NOTARY PUBLIC ONSLOW COUNTY, [It COMMISSION EXPIRES04 SEAL My commission expires 3 Qr,,L� ::2-01 5 Fonts SW401-Infiltration Basin O&M -Rev 3 MAY 2 4 xOiZ Page 3 of 3