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 [phone] FAX [phone] 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 [phone] Fax [phone]
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, [phone] )
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