Bridge No. 688 on SR 2032

BEVERLY PURDUE
GOVERNOR
Stormwater Section
N C Division of Water Quality
Winston -Salem Regional Office
585 Waughtown St
Winston Salem, NC 27107
Attention Ms Amy Euhss
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
P O Box 25201 Raleigh NC 27611 5202
PHONE [phone]
April 2012
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SECRETAR%8?
Subject State Stormwater Permit Request for the replacement of Bridge #688 over Grassy Fork
on SR 2032 in Wilkes County Debit WBS 45357 1 14 $505
Dear Ms Euliss
The North Carolina Department of Transportation is scheduled to replace Bridge #688 with a new longer
bridge at the same location Since this bridge crosses a High Quality Water I have included a Stormwater
Application Form the Project Scope Narrative two sets of the project plans and the authority to debit $505
for the permit application fee Please review this project for authorization by your Division
We would like to begin construction as soon as possible If further information is required, please let me or
Jami Guynn know Your early review and consideration will be appreciated
Sincerely
Heath Slaughter
Division Environmental Officer
Enclosures
cc Monte Matthews, US Army Corps of Engineers
Brian Wrenn, Division of Water Quality
Mike Petty3ohn, PE, Division Engineer
Jami Guynn, Division Bridge Program Manager
Heath Slaughter, Division Environmental Officer
Neil Tnvette, Roadside Environmental Field Operations Engineer
P O Box250 N WaimSaoxo NC 28659
PHONE [phone] FAX [phone]

OFFICE USE ONLY
Date Received Fee Paid Pernut Number
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
LINEAR ROADWAY PROJECT
This form may be photocopied for use as an ongsna!
DWO Stormwater Management Plan Review
A complete stormwater management plan submittal includes tins application form, a supplement form for each BMP
proposed (see Section V) design calculations and plans and specifications showing all road and BMP details
PROJECT INFORMATION
NCDOT Project Number 45357 1 14 County Wilkes
Protect Name TIP# BD 51118 Replace Bgddge #688 on SR 2032 over Grassy Fork
Project Location 4 miles NW of Elkin on SR 2032
Contact Person Jame Guynn Phone [phone] Fax [phone]
Receiving Stream Name Grassy Fork River Basin Yadkin Class WS II, HOW
Proposed linear feet of project 280
Proposed Structural BMP and Road Station (attach a list of station and BMP type if more room is needed)
PSH V, station 12 +70 Rt Grass fill embankment
Type of proposed project (check all that apply)
❑ New ❑Widening ❑2 lane* ❑4 lane* ❑Curb and Gutter ®Badge Replacement
❑Other (Describe)
*2 lane and 4 lane imply that roadside ditches are used unless Curb and Gutter is also checked
II REQUIRED ITEMS CHECKLIST
Initial in the space provided below to indicate the following design requirements have been met and supporting
documentation is attached Supporting documentation shall at a minimum, consist of a brief narrative description
including (1) the scope of the project (2) how the items below are met (3) how the proposed best management practices
minimize water quality impacts, and (4) any significant constraints and/or justification for not meeting a, b c and d to the
maximum extent practicable
Eigner In itials
a The amount of impervious surface has been minimized as much as possible
b The runoff from the impervious areas has been diverted away from surface waters as much as possible
C Best Management Practices are employed which minimize water quality impacts
d Vegetated roadside ditches are 3 1 slope or flatter

III OPERATION AND MAINTENANCE AGREEMENT
I acknowledge and agree by my initials below that the North Carolina Department of Transportation is responsible for the
implementation of the four maintenance items listed I agree to notify DWQ of any operational problems with the BMP s
that would impact water quality or prior to making any changes to the system or responsible party
Maintenance Engineer s Initials
a BMP s shall be inspected and maintained in good working order
MAd b Eroded areas shall be repaired and reseeded as needed
/YW c Stormwater collection systems including piping, inlets and outlets shall be maintained to insure proper
functioning
Maintenance Engineer s Name
- Title 0 � V -'�
IV APPLICATION CERTIFICATION
I (print or type name) 11ea4A S au kt- of biU P 60wfooweKk,-( Branch
certify that the information included on this permit 4plication. form is, to the best of my knowledge correct and that the
protect will be constructed in conformance with the approved plans and that the proposed project complies with the
requirements of 15A NCAC 2H 1000
Title D f U 15 r at C`ivr /eat men Qgce r—
Address
Signature
V SUPPLEMENT FORMS
The applicable state stormwater management permit supplement form(s) listed below must be submitted for each BMP
specified for tins project Contact the Stormwater and General Permits Unit at [phone] for the status and
availability of these forms
Form SW401 Low Density
Form SW401 Curb Outlet System
Form SW401 Off Site System
Form SW401 Wet Detention Basin
Form SW401 Infiltration Basin
Form SW401 Infiltration Trench
Form SW401 Bioretention Cell
Form SW401 -Level Spreader
Form SW401 Wetland
Form SW401- Grassed Swale
Form SW401 Sand Filter
Low Density Supplement
Curb Outlet System Supplement
Off Site System Supplement
Wet Detention Basin Supplement
Infiltration Basin Supplement
Underground Infiltration Trench Supplement
Bioretention Cell Supplement
Level Spreader /Filter Strip /Restored Fapanan Buffer Supplement
Constructed Wetland Supplement
Grassed Swale Supplement
Sand Filter Supplement

STORMWATER MANAGEMENT PLAN
Project 45357 1 14, TIP# BD -5111R April 4 2012
Wilkes County
Project Engineer Jami Guynn
Roadway DescnlItion
This project consists of replacing Bridge #688 over Grassy Fork on SR 2032 and improving the
roadway bridge approaches The existing 18'x 31 bridge is structurally deficient and will be
replaced with a new 30 x 70' bridge at the same location An off -site detour will be utilized
during construction Total project length is 280 linear feet The existing 8 travel lanes will be
widened to 10', including the paved shoulders Due to tapering, impervious surface area will
increase by approximately 0 03 acres The project drainage consists of two drop inlets and stub
out pipe near station 12 +70
Environmental Descnption
This project is located in the Yadkin River Basin and is not subject to riparian buffer rules
Grassy Fork is classified as Class WS -II, HQW at this location No other jurisdictional streams
will be impacted by this proposed project
Best Management Practices and Major Structures
The primary goal for Best Management Practices (BMPs) is to prevent degradation of the state s
surface waters by the location, construction and operation of the highway system BMPs are
activities, practices and procedures taken to prevent or reduce stormwater pollution As per the
attached plans, we have added a PSH at the pipe stub outlet to address stormwater at this
discharge point The stream is approximately 50' south of the PSH so that should provide an
ample buffer for stormwater treatment
II. Reauired Items Checklist
The proposed structure is a 70' long single span 21 cored slab bridge with spill through
abutments Approximately 280 linear feet of roadway is being widened, including the bridge
a Minimized to the extent hydraulically possible
b Stormwater on the southern end of the project will sheet flow off of the roadway
Stormwater landing on the bridge will flow to the drop inlets and will discharge into
the PSH No deck drains are called for in the plans There will be no slots in the
railing so all drainage will be routed to the ends of the bridge
c This is not an arterial route so a hazardous spill basin is not required The PSH and
50 buffer should adequately treat stormwater running off of the bridge Roadway
fill slopes will be vegetated All appropriate construction BMPs will be employed
during bridge demolition and reconstruction

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