HomeMy WebLinkAboutSW8000905_CURRENT PERMIT_20010613STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT N0.
SW ��US
DOC TYPE
CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
o6I/,y7��1�
YYYYMMDD
State of North Carolina
Department of Environment
and Natural Resources
Wilmington Regional Office
Michael F. Easley, Governor
It
William G. Ross, Jr., Secretary
Division of Water Quality
June 13, 2001
Ms. Betty Bullock, President
Sunset Cove Development, Inc.
PO Box 1685
Jacksonville, NC 28540
Subject: Permit No. SW8 000905
Harbor Pointe
High Density Subdivision Stormwater Project
Pender County
Dear Ms. Bullock:
The Wilmington Regional Office received a complete Stormwater Management Permit Application for Harbor
Pointe on June 1, 2001. Staff review of the plans and specifications has determined that the project, as proposed,
will comply with the Stormwater Regulations set forth in Title 15A NCAC 21-1.1000. We are forwarding Permit
No. SW8 000905, dated ,tune 13, 2001, for the construction of the project, Harbor Pointe.
This permit shall be effective from the date of issuance until June'] 3, 2011, and shall be subject to the conditions
and limitations as specified therein. Please pay special attention to the Operation and Maintenance requirements
in this permit. failure to establish an adequate system for operation and maintenance of the stormwater management
system will result in future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to request an
adjudicatory hearing.upon written request within thirty (30) days following receipt of this permit. This request must
be in the form of a written petition, conforming to Chapter 150B of the North Carolina General Statutes, and filed
with the Office of Administrative Hearings, P.O. Drawer 27447, Raleigh, NC 27611-7447. Unless such demands
are made this permit shall be final and binding.
If you have any questions, or need additional information concerning this matter, please contact Scott Vinson, or
me at (910) 395-3900.
Sincerely,
kph L -k -.-
Rick Shiver
Water Quality Regional Supervisor
RSS/sav: S:IWQSISTORMWATIPERMI'1,1000905.JUN
cc: Sam Altman, Topsail Beach Building Inspections
Scott Vinson
CWilmington-Regional-Office
Central Files
127 Cardinal Dr. Ext., Wilmington, North Carolina 28405 Telephone 910-39-5-3900 FAX 910-350-2004
An Equal Opportunity Affirmative Action Employer 50% rccvc1ed/101%o post -consumer paper
State Stormwater Management Si,stems
Permit No. aVL8 000905
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as amended. and
other applicable Laws, Rules, and Regulations _
PERMISSION IS HEREBY GRANTED TO
Sunset Cove Development, Inc.
Harbor Pointe
Pender County
FOR THE
construction, operation and maintenance of 17 infiltration trench systems in compliance with the provisions of 15A
NCAC 2H .1000 (hereafter referred to as the "stormwater rules' and the approved stormwater management plans
and specifications and other supporting, data as attached and on file with and approved by the Division of Water
Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until June 13, 2011 and shall be subject to the following
specified conditions and limitations:
1. DESIGN STANDARDS
This permit is effective only with respect to the nature and volume of stormwater described in the
application and other supporting data.
2. This stormwater system has been approved for the management of stormwater runoff as described on pages
3 and 4 of this permit, the Project Data Sheets. The subdivision is permitted for 11 lots, each allowed the
following amount of built -upon area: Lot 1 = 1,462 ft2; Lot 2 = 1,515 ft-; Lot 3 = 1,451 ftz; Lot 4 = 1,528
ftz; Lot 5 1;810 ft2; Lot 6 = 1,809 ftz; Lot 7 = 1,914 ft2; Lot 8 = 2,508 ft2; Lot 9A = 2,173 ft2; Lot 9B
2,312 ft2; and Lot 9C = 2,387 ftz.
Approved -plans and specifications for this project are incorporated by reference and are enforceable parts
of the permit.
4. These underground trench systems must be operated with a 50' vevetated filters.
2
State Stormwater Management Systems
Permit No. SWN 000905
Project Name:
Permit Number:
Location:
Applicant:
Mailing Address:
DIVISION OF WATER QUALITY
PROJECT DATA SHEET
Harbor Pointe
Application Date:
Name of Receiving Strearn / Index 4:
Classification of Water Body:
If Class SA, chloride sampling results:
Design Storm, inches:
Project Area, acres:
Total Impervious Surfaces, fie: 33,967
.11 lots at: Lot 1 = 1,462 ft2
Lot 2 = 1,515 ft2
Lot 3 = 1,451 W
Roads, ft2: 13,098
Parking, ft2: 9,957
Of -site Area entering Pond, ftz:
Controlling Orifice:
Seasonal High Water Table:
Type of Soil:
Expected infiltration Rate:
S W 8 000905
Pender County
Ms. Betty Bullock, President
Sunset Cove Development, Inc.
PO Boa 1685
Jacksonville, NC 28540
June 1, 2001
Topsail Sound / ICWW / 18-87-10
"SA"
n/a
1.5
2.14
Lot 4 = 1,528 ft2
Lot 5 = 1,810 ft2
Lot 6 = 1,809 ft2
Lot. 7 = 1,914 fie
Lot 8 = 2,508 ft2
Lot 9A = 2,173 ft2
Lot 9B = 2,312 ft2
Lot 9C = 2,387 ft2
none, .per Engineer
4"d overflow pipe to vegetated filter (standard for all systems)
0.90
Sand/Clay/Debris Mix, trenches will be filled with select
materials, i.e. clean sand
0.52".per hour
3
State Storm%vater Mana4�enzent Systems
Permit No. SVI18 000905
DIVISION OF WATER QUALITY
PROJECT UATA SHEET
17 Underground Infiltration Trench Systems
1 A
1 B
2A
2B
3A
313
4A
4B
5
5/6
Required Storage Volume, ft3:
43
82
43
82
57
57
57
57
60
1,168
Provided Storage Volume, ft3:
46
88
46
88
60
60
60
60
64
1,236
Overflow Elevation, FMSL:
6.4
6.4
6.4
6.2
59
5.9
5.9
5.9
5.2
5.0
Bottom of Trench Elevation, FMSL:
2.90
2.90
2.90
2.90
2.90
2.90
2.90
2.90
2.90
2.90
Seasonal High Water Table, FMSL:
0.90
0.90
0.90
0.90
0.90
0.90
090
0.90
0.90
0.90
Time to Draw Down, hrs:
38.4
38.4
36.1
36.1
32.8
32.8
32.9
3 2. 9
25.2
23.0
Drainage Area, ft2:
366
694
366
694
476
476
476
476
.504
] I,376
Total Impervious Surfaces, ft2:
366
-694
366
694
476
476
476
'476
504
9,751
6
7A
7B
8
8/9A
9A19B
9B19C
Required Storage Volume, ft3:
60
60
60
60
930
472
755
Provided Storage Volume, W:
64
64
64
64
972
480
775
Overflow Elevation, FMSL:
5.7
5.3
5.3
5.0
4.6
4.4
3.8
Bottom of Trench Elevation, FMSL:
2.90
2.90
2.90
2.90
2.90
2.90
2.90
Seasonal High Water Table, FMSL:
0.90
0.90
0.90
0.90
0.90
0.90
0.90
Time to Draw Down, hrs:
30.7
26.3
26.3
22.9
18.7
16.5
9.9
Drainage Area, ftz:
504
504
504
504
10,375
6,898
9,669
Total Impervious Surfaces, f12:
504
504
504
504
7,691
3,811
6,170
4
State Stormwater Management Systems
Permit No. SW8 000905
11. SCHEDULE OF COMPLIANCE
No homeowner/lot owner/developer shall fill in; alter, or pipe any drainage feature (such as swales). shown
on the approved plans as part of the stormwater management system vvithout submitting a revision to the
permit and receiving approval from the Division.
2. The permittee is responsible for verifying; that the proposed built -upon area for the entire lot, including
driveways and sidewalks, does not exceed the allowable built -upon area. Once the lot transfer is complete,
the built -upon area may not be revised without approval from the Division of Water Quality, and
responsibility for meeting the built -upon area limit is transferred to the individual property owner.
3. If an Architectural Review Committee (ARC) is required to review plans for compliance with the BUA
limit, the plans reviewed must include sidewalks and driveways. Any approvals given by the ARC do not
relieve the homeowner of the responsibility to maintain compliance with the permitted BUA limit.
4. The following items will require a modification to the permit:
a. Any revision to the approved plans, regardless of size.
b. Project name change.
C. Transfer of ovaiership.
d. Redesign or addition to the approved amount of built -upon area.
e. Further subdivision, acquisition, or sale of the project area. The project area is defined as all property
owned by the permittee, for which Sedimentation and Erosion Control Plan approval was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the approved plan.
5. The Director may determine that other revisions to the project should require a 'modification to the permit.
b. The Director may notify the permittee when the permitted site does not meet one or more of the minimum
requirements ofthepermit. 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.
The stormwater management system shall be constructed in it's entirety, vegetated and operational for its
intended use prior to the construction of any built -upon surface.
During construction,.erosion shall be kept to a minimum and any eroded areas of the system will be repaired
immediately.
9. 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.
10. Decorative spray fountains will not be allowed in the stormwater treatment system.
11. 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.
5
State Stormwater Management Systems
Permit No. SW8 000905
12. Unless specified elsewhere, permanent seeding requirements for the stormwater control must follow the
guidelines established in the North Carolina Erosion and Sediment Control Planning and Design Manual.
13. Prior to transfer of the permit, the pond must be inspected by DWQ personnel, and determined to be in
compliance with all permit conditions. Any items not in compliance must be repaired or replaced to design
condition prior to the transfer. Records of maintenance activities performed to date will be required.
14. The permittee shall at all times provide the operation and maintenance necessary to assure the permitted
stormwater system functions at optimum efficiency. The approved Operation and Maintenance Plan must
be followed in its entirety and maintenance must occur at the scheduled intervals including, but not limited
to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and revegetation of side slopes.
d. Immediate repair of eroded areas.
C. Maintenance of side slopes in accordance with approved plans and specifications.
f. Debris removal and unclogging of outlet structure, orifice device and catch basins and piping.
g. Access to the outlet structure must be available at all times.
h. The vegetated filter shall be kept free of erosion. The spreader mechanism shall be kept free of
sediment and trash, and shall evenly distribute the runoff across the width of the filter.
15. Records of maintenance activities must be kept and made available upon request to authorized personnel
of DWQ. The records will indicate the date, activity, name of person performing the work and what actions
were taken.
16. Prior to the sale of any lot, deed restrictions must be recorded which limit the built -upon area per lot to the
amount as shown on the Project Data Sheet, per Section 1, Part 2. The recorded statements must follow the
form:
"The maximum built -upon area per lot is: Lot I = 1,462 fie; Lot 2 = 1,515 ft2; Lot 3 = 1,451 ft2; Lot
4 = 1,528 ft2; Lot 5 = 1,810 ft2; Lot 6 = 1,809 ft2; Lot 7 = 1,914 ft2; Lot 8 = 2,508 ft2; Lot 9A = 2,173
ft2; Lot 9B = 2,312 ft2; and Lot 9C = 2,387 W. This allotted amount includes any built -upon area
constructed within the lot property boundaries, and that.portion of the right-of-way between the front
lot line and the edge of the pavement. Built upon area includes, but is not limited to, structures,
asphalt, concrete, gravel, brick, stone, slate, coquina and parking areas, but does not include raised,
open wood decking, or the water surface of swimming pools."
b. "The covenants pertaining to stormwater regulations may not be changed or deleted without
concurrence of the State."
"Alteration of the drainage as shown on the approved plan may not take place without the
concurrence of the State."
d. "Lots within CAMA's Area of Environmental Concern may be subject to a reduction in their
allowable built -upon area due to CAMA regulations."
C. "All runoff on the lot must drain into the permitted systems. This may be accomplished through
providing roof drain gutters which drain to the street, grading the lot to drain toward the street, or
grading perimeter swales and directing them into the pond or street. Lots that naturally drain into the
system are not required to provide these measures."
State Stormwater Mana^cement Systems
Permit No. SW8 000905
17. A cop), of the recorded deed restrictions must be submitted to the Division within 30 days of the date of
recording the plat, and prior to selling lots. The recorded cope must bear the signature of the Permittee, the
deed book number and page, and stanip/signature of the Register of Deeds.
18. 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.
19. 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.
III. GENERAL CONDITIONS
This permit is not transferable. In the event there is a desire for the facilities to change ownership, or there
is a name change of the Permittee, a "Name/Ownership Change Form" must be submitted to the Division
of Water Quality accompanied by appropriate documentation from the parties involved, such as a copy of
the deed of trust. Other supporting materials, such as a signed Operation and Maintenance plan in the case
of engineered systems, will also be required. The project must be in good standing with DWQ. The approval
of this request will be considered on its merits and may or may not be approved.
2. Failure to abide by the conditions and limitations contained in this permit may subject the Permittee to
enforcement action by the Division of Water Quality, in accordance with North Carolina General Statute
143-215.6A to 143-215.6C.
3. The issuance of this permit does not preclude the Permittee from complying with any and -all statutes, rules,
regulations, or ordinances which may be imposed by other government agencies (local, state, and federal)
which have jurisdiction.
4. 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.
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.
6. Permittee grants permission to staff of the DWQ to access the property for the purposes of inspecting the
stormwater facilities during normal business hours.
7. The permittee shall notify the Division of any name, ownership or mailing address changes within 30 days.
Permit issued this the 13th.day of June, 2001.
NORTI-1 CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Kerr T. Stevens, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number SW8 000905
7
State Stormwater Management Svstems
Permit No. SNNIS 000905
Harbor Pointe Page I of 2
Storrnwater Permit No. S WS 000905
Pender County
Designer's Certification
1, , 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 are a part of this Certification.
Noted deviations from approved plans and specifications:
Signature
Registration Number
Date
SEAL
State Stormwater Management Systems
Permit No. SWS 00090-5
Certification Requirements:
Pa`-c 2 of 2
1. The drainage area to the system contains approximately the permitted acreage.
2. The drainage area to the systern 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 systern.
4. The outlet/bypass structure elevations are per the approved plan.
5. The outlet structure is located per the approved plans.
6. Trash rack is provided on the outlet/bypass structure.
7. All slopes are grassed with permanent vegetation.
S. Vegetated slopes are no steeper than 3:1.
9. The inlets are located per the approved plans and do not cause short-circuiting of the system.
10. The permitted amounts of surface area and/or volume have been provided.
11. Required drawdown devices are correctly sized per the approved plans.
12. All required design depths are provided.
13. All required parts of the system are provided, such as a vegetated shelf, a forcbay, and the vegetated filter.
14. The overall dimensions of the system, as shown on the approved plans, are provided.
M. NCDENR-DWQ Regional Office
Sam Altman, Topsail Beach Building Inspections
9
State Stormwater Management Systems
Permit No. SW8 000905
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Caro]ina as amended, and
other applicable Laws, Rules, and Regulations
PERMISSION 1S HEREBY GRANTED TO
Sunset Cove Development, Inc.
Horbor Pointe
Pender County
FOR THE
construction, operation and maintenance of 17 infiltration trench systems in compliance with the provisions of 15A
NCAC 2H .1000 (hereafter referred to as the "stol'Inwater 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 .Tune 13, 2011 and shall be subject to the following
specified conditions and limitations:
I. DESIGN STANDARDS
This permit is effective only with respect to the nature and volume of stormwater .described in the
application and other supporting data.
2. This stormwater system has been approved for- the management of stormwater runoff as described on pages
3 and 4 of this permit, the Project Data Sheets. The subdivision is permitted for 11 lots, each allowed the
following amount of built -upon area: Lot I = 1,462 ft'; Lot 2 = 1,515 W, Lot 3 = 1 451 ft� Lot 4 = 1.528
ft'; Lot 5 = I,810 ft2; Lot 6 = 1,809 ftz; Lot 7 = 1,914 ftz; Lot 8 = 2,508 ft2; Lot 9A�= 2,173 ft2; Lot 913 =
2,312 ft2.; and Lot 9C = 2,387 ft2.
Approved plans and specifications for this project are incorporated by reference and are enforceable parts
of the permit.
4. These underground trench systems must be operated with a 50' vegetated filters.
2
pate Received ; Fee Paid Permit dumber
4-r-v l �fxv, �z9d� J8.0a0 yd
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER NL4NAGENIEIVT PERMIT APPLICATION FORM
ibis farm: may be photocopied for use as an criginaI
I_ GENERAL IN`FORNLXTION
1. AopLicants name (speci. ;r the name of the corporation, individual, etc. who owns the project):
2- Print Owner/Signing Official's name and title (person legally responsible for facility and compliance):
Betty Bu l loci. President
3. Mailing Address for person listed in item 2 above:
P.O. Box 1685-
City: Jacksonville State: NC zip: 28540
Telephone Number. ( 910 1 346-9800
4- Project Name (subdivision, faclit�,r, or establishment name - should be consistent with project name on
plans, specL ications, letters, operation and mainte-rtance agreements, etc_):
5. Location of Project (street address):
Located on Highway 210/50 at Intracoastal l4aterwa
City Topsail ( Two .) Counts:
6. Directions to project (from nearest major intersection):
Pender
f qpction of t +av 210/50 East on NC H' way 1 50
.tQ brijqep - nrct i f _ Dro.i,-ct. on left
7. Latitude: 34°25' 56.7"
Longitude: 77°33' 19" of project
S. Contact ne_rson who Can answer questions about the project
,Name: David K. Newsom, John L. Pierce & Telephone Number- ( 910 ) 346_9800
.Associates P.A.
H. PER-'Y= LNFORMATION:.
11. Specify whether project is (c'�eck one): Nero
FormSWU-101 Version 3.99 Page 1 0f 4
Renewal
XX Modification
Lf This application is being submitted as the result of a renewal or modification to an existing permit, List the
e,:cisting peirut number and its issue date (if known)
3. Specify the type of project (check one):
Low Density X (�F-~:.igh Density Redevelop General Pe ---nit �offier
4. Additional Project Rec•_:i:eme_nts (check applicable bia Lks):
_C AiMA Major _Sedimentation/ ,resion Control 41,04/4-01 Per --rut �.\iFDES Stor_-lwater
information on required swte pertits can be obtained by contacting the Customer Service Center at
-a? -67'S.
III. PROJECT NFORNLkTION
i. in the suace provided below, s = mar ze haw stormwater will be treated. Also attach a detaiied narrative
(ene to two pages) describing stormwater management for u7e project .
Stormwater generated by proposed and/or existing impervious surface to be treated
using vegetated conveyances and infiltration trenches.
? Storanwater r=ofi from this project drains to the
3. Total 1 roje_t Area: 2. 14 aces
White Oak
1--'ow many drainage areas does the project have? 1
River basin.
4. Project nza.lt Upon Area: 43.9
aQ
b. Ccmvlete the fcliowinz information for each drainage area. If there are more than two drainage areas in the
Croje-, attach an additional sheer with the information for eac-m area provided in the same format as below.
Fx-=umgStreamName
To sail
Sound/Intracoastal WAerway
Recavins Scnm eaClass
SA
Draznare Area
2.14 acres {
E-dszinz Impervious' Area
122 654
s . f .(0.52 acres) N/A
r nncse^ lmoez~,r ous`=:e_
1 1 1 , 313
s .f . (0. 26 acres)
°o Imnen-ousArea (total)
36. 5% 1
C�CI-7it2 Bti=f!run=G
i 10,912 s . f .
Gn-�Itest;ee� pre-existiAn)
I_ O {
Cr - it° parc-m�
- cirj vQw_a,ys
Other m-site
Cfr-Site
- 0 - E
#Total:33,967 s.f.(0.78 acres) Total:
{mpervious area is defined as the Guilt upon area including, bur nor limited to, buildings, rcads, parking areas,
sidewalks, gravel areas, e!c.
Form SWU-101 Version 3.99 Page 2 of 4
- I -.L -S -4 - T
System System System System System
IA 1B 2A 28 3A
Receiving Stream Name
Topsail Sound
Topsail Sound
Topsail Sound
Topsail Sound
Topsail Sound
Receiving Stream Class
SA
SA
SA
SA
SA
Drainage Area
366
694
366
694
476
Existing Impervious Area
0
0
366
694
0
Proposed Impervious Area
366
694
0
0
476
,% Impervious Area (total)
100.0.
100.0.
100.0.
100,01
100.0..
DhAft.ai"
On -site Buildings
366
694
366
694
476
On -site Streets
0
0
0
0
0
On -site Parking
0
0
0
0
0
On -site Sidewalks
0
0
0
0
0
Other on -site
0
0
0
0
0
,off -site
0.
0.
0.
0
0
1 Total:
3661
6941
3661
6947r
4761
tv
zf�
cl
v fl,
- (0 - ri F - 1 -/0 11 -i;z,
System System System System System System System
3s 4A 4B 5 516 6 7A
i3raina` Area 6 w.
Drains `e Area 7 ,,.:K.
Drairta e.Area S .`w;iraiia
a AreaB..,..-
Drain ` Area 9Q ;>
Wlhi§ifkv'a Y
Drama
Topsail Sound
Topsail Sound
Topsail Sound
Topsail Sound
Topsail Sound
Topsail Sound
Topsail Sound
SA
SA
SA
SA
SA
SA
SA
476
476
476
504
11,376
504
504
0
0
0
504
8,274
504
504
476
476
476
0
1,477
0
0
100.01
100.0,
100,0-
100-0.
85.7,
100.0
100.0
gi*lfia'" :
Or"AWniG7APPO :
Diifiq§6iIra
goof
476
476
476
I
504
1,008
504
504
0
0
0
0
6,009
0
0
0
O
0
0
2,734
0
0
0
G:
0
0
0
0
0
0
0
0
0
0
0
0
0.
0
0.
01
0,
0
0
4761
476
4764761
-
5041
9,751
5041
504
.. Il .
r i
• 1 ,:.
• _ � r
.. - . 'i � i
e ; �'. .
— ' —
. � � • � � .
. — - ,
' �_ �l
' t
i _ S
• � _
.. .. ._..--- .. �... __.. ._. _... _j �. La._ _ _ .... .� _ .._ �.'.s __� _. - .�. _. � ._ � - '- '
-13 — H —15- —(6 — I r?
System System System System System
7B 8 8/9A 9A19B 9B19C
Di
.M.-m
- I 16
m-
Topsail Sound
Topsail Sound
Topsail Sound
Topsail Sound
Topsail Sound
SA
SA
SA
SA
SA
504
504
10,375
6,888
9,669
504
504
7,215
1,110
2,475
0
0
476
Z 701
3,695
100.0j
100.0
74.1,
55.31
63.8,
Draina&W#03
PMM49 42
P jil"cl . ....... . Ajeaj 6 2.
504
504
980
952
1,428
0
0
3,504
1,110
2,475
0
0
0
0
0
0
0
3,207
1,749
2,267
0
0
0
0
0
0
0
0
0
0
5041
5041
7,6911
3,8111
--671-701
,'t.
ef....
ai ''ice.. .;F-a .,: 'i4.i. r: :�••� .i::_ � ;,i:.?t'-. :rZi.!'.-.
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, _ �
i� �.
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.� `iye ,s•.1
- _� -� .�. _.
� :t, '-i,:1� '�ti•"
- mil' �. ____ _ _ _ _ �_. -z� .�- -.
,��"� _.. it•'i7 �--:y'�.• e.>r ;if:-..
- Y.w-.- -1-. -� ... _.. _"1
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- -- - ----
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_ -- _.._-_......_ __.-_•..5-- __.._ ._�_.._
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--- -- -- - ---- --• � �—
q i-Iow was the off -site impervious area listed above aerivea?
IV. DEED RESTRICTIONS AND PROTECTIVE COVE -IN N 5
The following italicized deed restrictions and protective covenants are required to be recorded for all
subdivisions, outparcels and future development prior to the sale of any lot. Lf lot sizes vary sig u#icantiv, a
table listing each lot number, size and the allowabie built -upon area for each lot must be provided as an
attachment.
1. Tne following covenants are intended to ersure ongoing compliance with state stormwater rnanagement permit
number as issued bu the Division of Water Qualitl. Tnese covenants ma_;r
nai 6e changed or deleted xitlxut the consent Of the State.
?. Vo more than sa=re feet of any lot shall be covered by 4tructures or imperious materials.
lmpeT-,Jious rnater=.als include asphalt, gravel, cone ff e, brick, stone, slate or s:rnilar mater.al b-ur do not include wood
dec ng or the water swfxe of swimming pools.
3. S=les shall not be fzIIed in, piped, or altered except as necessary to provide driveway crossings.
-L. Buiit-upon area in excess of thi permitted amount requires a state stcrnmater management permit modirzcxr2Drc prat to
construction.
5 All permitted runqfffrom outparcels or future de:,elaprnent shall be directed into the permitted stormwater control
sustem. T"nese connections to the stormwater control system shall be perfor-ned in a manner that maintains the
integrity and performance of the system as permitted.
By yoursi'nature below, you certify that dhe recorded deed restrictions and protective covenants for this project
shall include all the applicable items required above, that the covenants will be binding on all parries 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 State, and that thev will be recorde± prior to the sale of any lot.
V. SUPPLE__ F_NT FOMMS
ine aapdcabie state stornzwater a=agn_ient pe--wit supplement form(5) listed below roust be submitted for
each BM1P specified for this project. Contact the Stormwater and General Permits Unit at (919) 733-5083 for the
s=s and availability of these fo=.
Form SAIU-102
Wet Detention Basin Supplement
Form SKU-103
infiltration Basin Supplement
FormSWU-104
Low DensitvSupplement
Form TvVU-105
Curb Outlet System. Supplement
Form SWT_T_106
Off -Site System. Supplement
Form SWU-107
Underground Lnfiltration Trencli Supplement
Form 5vVU-108
Neuse River Basin Supplement
Form SvVU-109
Innovative Best Management Practice Supplement
Form SWU-101 Version 3.99 Page 3 of 4
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. The complete application package should be
submitted to the appropriate DWQ Regional Office.
Please indicate that you have provided the following required information by initialing in the space
provided next to each item.
'tials
• Original and one copy of the Stormwater Management Permit Application Form
• One copy of the applicable Supplement Form(s) for each BMP
• Permit application processing fee of $420 (payable to NCDENR)
• Detailed narrative description of stormwater treatment/management
• Two copies of plans and specifications, including.
- Development/Project name
- Engineer and firm
- Legend
- North arrow
- Scale
- Revision number & date
- Mean high water line
- Dimensioned property/project boundary
- Location reap with named streets or NCSR numbers
- Original contours, proposed contours, spot elevations, finished floor elevations
- Details of roads, drainage features, collection systems, and stormwater control measures
- Wetlands delineated, or a note on plans that none exist
- Existing drainage (including off -site), drainage easements, pipe sizes, runoff calcu3ations
- Drainage areas delineated "
- Vegetated buffers (where required)
VIL AGENT AUTHORIZATION
if you wish to designate authority to another individual or firm so that they may provide information on your
behalf, please complete this section.
Designated agent (individual or firm): John L . Pierce & Associates P.A.
Mailing Address: P.O. Ap x _ 1_68' i _
City:_ Jacksonville _ State: NC Zip: 2,540
Phone: ( 910 ) 346-9800 _ Fax: ( 910 ) 346-1210
VUL APPLICANT'S CERTIFICATION
If
I, (print or type name of person listed in General Information, item 2) RPt.ty Ri 1 l nc_k, Prps i dpnt __
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 15A
Nw-4C' 7�4 Tr4NI _
Signature
Form 5WU-101 Version 3.99 Page 4 of 4
Date:
Permit No.
(ro be provided by DWQ)
State of North Carolina
J Department of Environment and Natural Resources
Division of Water Quality
STORNfWATER MANAGEMENT PERMIT APPLICATION FOR'
UNDERGROUND INFILTRATION TRENCH SUPPLEMENT
i his form may be photocopied. for use as an original
DWQ Stornwater Management Plan Review-
A complete stot:nwater management plan submittal includes a stormwater management permit application. an
undermund infiltration trench supplement for each system, design calculations. and plans and specincadons .
showing ail storrnwater conveyances and system derails.
L PROJECT INFORMATION
Project Name
Contact Person: ZD42- A� Q,- l Phone Number. (9/0 ) -5!5 26 %ln
For projects with multiple intzltration systerns, a'supplernent form must be completed for each system- This
worksheet applies to: Trench & 04 in Drainage Area
(from plans) (from Form SWU-101)
IL DESIGN LNF'ORMATION (attach supporting calculations/documentation):
Soils Report Summary (based upon an acrualTceld investigation and soil borings)
Soil Type �rcp/0C. ��x.7a,6le, - a.�`/
Innitradon Rate r cJhr/sf (circle appropriare unirs)
SHUNT Elevation _C,.2r�
(Seasonal High Warer Table elevation)
Trench Design Parameters
Design Volume
Design Storm
Drnwdown 7 =e
Perforated Pipe Size
Perforated Pipe Length
No. Observation Wells
Stone T}Me (if used`
Scone 'void Rarc
;Z55, a c.f.
inch event (1.5 inch event for SA ware,-,, I inch event for orhers)
days
inch diameter
(n=y be-reauired on a case -by -case basis)
Trench Elevations (in feer mean sea level)
Bottom Elevation 2.fmsl
StomgelOverfiow Elevation &asi
Fcrm SWU-lo7 Rev 3.99 Page 1 of 4
r
Trench Dimensions
Height . ^.sue ti�i ft. Length
Width -C3 ft. Volume Provided 9�'t1/0 cu.ft.
IH. REQU RED ITEVMS C=CKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices manual (N.C.
Departnent of Environment, Health and Natural Resources, November 1995) and Administrative Code Section: 15
A NCAC 2H .1008.
Initial in the space provided -to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
ZY(6___ a.' System is located 50 feet from class SA waters and 30 feet from other surface waters.
t_)164Z b. System is located at least 100 feet from water supply wells.
1L.Y&V ._ c. Bottom of system is at least 2 feet above the seasonal high water table.
d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
e. Off -Line system, runoff in excess of the design volume bypasses the system (bypass detail
provided).
f. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days based upon infiltration
through the bottom only (a hydrogeologic evaluation may be required).
Soils have a minimum hydraulic conductivity of 0.52 inches per hour.
h. System is not sited on or in fill material or DWQ approval has been obtained.
i. Plans ensure that the installed system will meet design specifications (cons,—, acted or
restored) upon initial operatibn once the project is complete and the entire drainage area is
stabilized.
Z2ZdZ J. System is sized to take into account the runoff at the uiti.mate built -out potential from all
surfaces draining to the systern, including anv off' -site drainage.
�L�dCQL k. Svstetn is located in a recorded drainaQe easement for the purposes of operation and
maintenance and has recorded access easements to the nearest public nant-of- Jay.
1. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event
for areas draining to SA waters }.
/ L2wrn_ Drainage area for the device is less :han 5 acres.
f?, a UCCWreai: e.^.t 4e'J_C� 1, !t�r 5tn_ti, g' _se." S"w? s Se,'_?ent CSi.. t.r is m ice _
o. Trench bottom is covered with a layer of clean sand to an average depth of 4 inches.
p. Sides of the infiltration trench are lined with geotextile fabric.
Z q. Rock used is free of fines (washed stone) and has a large void ratio.
r. Side to bottom area ratio is less than 4:1.
Form SWU-Zo7 Rev 3.99 Page 2 of 4
Observation well(s) are provided (case -by -case basis).
t. Vegetated filter is provided for overflow (50 feet for SA waters, 30 feet for other waters) and
detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
rV. UNDERGROU"M LNTM ATION TRENCH OPERATION AIND MAEN,TENA..NCE AGREEMENT
After eve:; runoff producing rainfall event and at least monthly inspect the bypass/overflow structure -for
blockade and deterioration and the infiltration system for erosion:. gash accumulation. grass cove;, and general
condition.
_. Repair eroded areas immediateiy, re -seed as necessary to raintain adequate vegetative cover, mow ve2etarive
cover to maintain a rn=mum height of six inches, and :emove trash and blockages as needed to maintain
System pe:'forfnance.
Remove accumulated sediment annually or when depth is reduced to -`'o of the oraQinal design depth. Restore
'depth to or ginal design depth without over -excavating. Over-excavaring may cause the required water table
separation to be reduced and may comprormse the ability of the system to perform as designed_
^. Tne ware: level in any monitoring wells will be recorded after a 1 inch ra, =rail event and at least once a month.
Chronic high water table elevations (wid in I foot or the bottorn of the system for a period of three months)
shall be reported to DWQ i=ediately.
5. I DWQ determines that the system is railing, the system will irnmediately be repaired or replaced to original
design specincadons_ If the system cannot be repaired to pe:fo= its design function, other stormwamr control
devices as allowed by NCAC 2I-I .1000 must be designed. approved and constructed.
o. Remove accumulated sediment from the infiltration system annually or when depth in the unit is reduced
to 15117a of the ongnal design depth. The systern shall be resiored to the orlgznal design depth without
aver -excavating. Ove.-excavating may cause the required water table seo=rion to be reduced and may
cornpromise the ability of the sysfern to perltb= as designed_ Removed sediment shall be disposed of in
an appropriate manner and shall not be handled in a manner :hat will adversely impact water oualirV (i.e.
stockpiling near a stormwater treatanent device or seam etc.).
benchmark s:�ail be esr4bLshed in the infiltration sysre n ine benchmmark will document the orizn3l
desisn de,,iLt1 so that accurate 5_-d i.menc accur2i uiadon readings can be talon. The lneasur n-z device use.'".
to detet:-Line die depth at the benci=.ar_k snail be such Mat it wiH give an accurate depan reacuag and not
p-_adi1Y penetrate into accar7i taiated sediments.
When the depot at the benchmark: reads Tom, the accumulated sediment shall be removed
u orni the s?ste.m.
Form sWU-107 Rev 3.99 Page 3 of 4
I acknowledge and agree by my signature below that I am responsible for maintaining the stormwater
collection system in accordance with the six maintenance procedures listed above. I aa=ree to notify DWQ
of any problems with the system or prior to any changes to the system or responsible party.
Print tiame and Title:
:dote: The leg ally responsible parry should not be a homeowner,; associarion unless more than .5Oca of the Tors have been sciZ and
a resident of the subdivision has been named the presidenr.
I. J p a :votary Public for the S=e of _North Carn 1 ire County of
Ons low , do hereby that Betty Bullock personally appeared before me thus
25 day of MaY 2QO 1 , and acicnowiedge the due execurion of the forgoing indiaadon
basin maintenance requiremears. Wimess my hand and of.ciai seal,
Q �O�AA1- "v9
* b
O 'O2JBl U
SE -AL
My commission expires 6 -;' 6
Form SWU-I07 Rev 3.99 Page 4 of 4
Perrnk No.
= (to be'pravided by DWE
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORM'VVATER yLkNAGEMEN 1 PEIRti, HT APPLICATION FORM
UNDERGROL)`NVD INFILTRATION TRENCH SUPPLEMENT
7 ris form ir= be phatoco? ed.Jor ;use as an ordinal
DWO $tot ]water ?vlanagement Plan_
A comnie:e sto .1 water mmnaacrnent plan subrninal includes a szo=water manaaerneni perzut aoclicatlon. an
undersroond infiltration trench supplement for each s yszern. desic*1 calculations. and plans and speclacariorls .
showing all.storrlwater conveyances and system derails.
L PROJECT LNFORIYIATION
Project Name &
Contar Peon: .q Phone Number: (%O ) ;5 fYp '7&^�
For orcje= with multiple irtrltranon systems, a supplement fora must be cornnieted for each system. This
worksnee; anpiies to: Trench _ - in Drainaze Area _
(!rota pi=-S) U-rom Form s u-!01)
IL DESIGN IN -FOR -AA XON (attach sunpordne calc,-,lazions/docuine:ttati.on):
Soils Report Summary (based upon an ac ual field investibarion and sail borings)
oil SType cz woC bl-l5 irl:,y ��e�/�c� v� Tab/�, &7aO �✓� T///�
lnt~ltration Rate 010 2_ In/hr or c Thr/s: (c.rcie appropriare unus)
S r W'I' Elevation
Trench Design Parameters
Desi= Volume
Desim Stcrm
Drawdown i1me
Perforated Pipe Size
�e:IOl3Ie:I Pie L4rlatrl
Nio. Otseri;:don We1...s
Scone 7 � - (;i ,sew'
acne Veid 3-1 C
-nsi (Seasonal High Water Table elevation)
/, i.nCH event. U-4 inch eve= for SA waver.;, I inch eve .t for orhers)
�. aays
inch =me:�er
_._ Z-
&Zzi (rru7I be -re uired on a c-ue-vv-case oasis)
Trench Elevations (in Jeer mean sea level)
Bottom Elevation 2.9F fmsi
Storage:{Overflow Elevation b. fmsl
Form SWN-107 Rev 3.99 Pace 1 of 4
Trench Dimensions _ _
Height3 5 ft. i.enadh % 7 Z «-
Width Et• Volume Provided /W.'7___ cu.ft.
Ej. pEQ[,TnED ITEMS CEECKLIST
7tie following checklist outlines design requirements per the-Stornwater Best Management Practices manual
De,partrne:it of Environment. Health and Natural Resources. November 1995) and Administrative Code Section_ 15
A NCAC 2H .1008.
iwi ai in the space provided to indicate that the following desi-m requirements have been met and suppoiSal*e
documentation is attached. If the applicant has designated an age it in the Stormwaier Management Pe.•mit
Aot}iication Form, the anent may initial below. Anach justiLca.tion if'a requirement- has not been met
Applicants Laitials
/- , — a. System is located 50 fe4t from class SA waters and 30 feet from other surface waters.
b. System is located at lest 100 feet from wane: sup"
iy wells.
Irl—YL� ___ c. Bottom of system is at Least 2 feet above the seasonal high water table.
d. Bottom of the syste a is 3' feet above any bedrock or impervious soil horizon.
e. Off-line system, runoff is excess of the des:Qn volume bypasses the system (bypass detail
provided).
f_ System is designed to draw down the desim storage volume to the proposed bottom
elevation under seasonal hiElh water conditions within five days based upon LMIri ation
throuan the bottom only (a hydrogeolog;c evaluation may be required).
g. Soils have a minimum hydraulic conductivity of 0.52 inches per hour.
h. System is not sited on or in ell material or DWQ approval has been obtained.
i. Plans ersure that the installed system will meet design specifications (consacred or
restored) upon initial operation once the proiec: is comp_ fete and the entire drainage area is
stabdiz
j. System is sizcd to Lake into account the runoff at the ultimate built -out potentiai from ail
surfaczs crzlin aZQ to the syste;a, including anv off-si'Le dralnaQP.
�1Z2,e& k. Svstem is located in a reworded dmi aan e:semern for the purposes or cperation and
maintenance and has recorded ac: ess easements to tLZe nearest public :.,ant -or -way.
1. Svstem captures and Lafltrates the runoff uom the first 1.0 inch or rainfall (1.5 inca•evenr
for areas draining to SA wales }.
Z m. Drainage area for the device:is less :hen 5 acres.
+. a :re�P r-e:.t ce'/:� (r -. $� _r cr;`vim . S se ;r e;at �1i. �.' l rr•b`/?ceC:.
42,- o. Trench botLorn is covered with a layer of clean sand to an average death of 4 inches.
p. Sides of the iri-Filtration zezich. are lined with geese rE fabric.
q. Rock used is free of fines (washed stone) and has a large void ratio.
r. Side to bottom area ratio is less rhan4:1.
Form SWU-107 1Zev 3.99 page 2 of 4
s. Observation well(s) are provided (case -by -case basis).
t. Vegetated filter is provided for overflow (50 feet for 5A waters, 30 feet for other waters) and
detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
IV. UNDERGROUND LN ILTRATION TRENCH OPERATION AN'D IVLALNTENANCE AGREEM_ETNT
1. After every runoff, producing rainfall event and at least monthly inspect the bypass/overflow structure -for
blockage and deterioration and the infiltration system for erosion, trash accumulation, grass cover, and aenerai
condition. ~
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, snow vegetative
cover to maintain a maximum height of six inches, and remove trash and blockages as needed to maintain
system performance.
3. Remove accumulated sediment annually or when depth is reduced to 7517,o of the original design depth. Restore
depth to original design depth without over -excavating. Over -excavating may cause the required water tabie
separation to be reduced and may compromise the ability of the system to perform as designed.
4. The water level in any monitoring wells will be recorded after a 1 inch rainfall event and at least once a month.
Chronic high water table elevations (within I foot of the bottom of the system for a period of three months)
shall be reported to DWQ immediately.
5. If DWQ determines that the system is failing, the system will immediately be repaired or replaced to original
design specifications. if the system cannot be repaired to perform its design function, other stormwater control
devices as allowed by NCAC 2H .Z000 must be designed, approved and constructed.
Remove accumulated sediment from the infiltration system annually or when depth in the unit is reduced
to 7517c of the original design depth. The system shall be restored to the original design depth without
over -excavating. Over -excavating may cause the required water table separation to be reduced and may
comprorruse the ability of the system to perform as designed. Removed sediment shall be disposed of in
an appropriate manner and shall not be handled in a manner that will adversely impact water quality (i.e.
stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the infiltration system. The beric.'tma k will doctimerft the ori!:nal
design depth so &,at accurate sediment accumulation'readinzs can be taken. i ne measunrig device used
to determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the depth at the benchmark reads the accumulated sediment shall be removed
from the system.
Form SWU-1o7 Rev 3.99 Page 3 of 4
I acknowledge and agree by my signature below that I am responsible for main[aining the stormwater
collection system in accordance with the six maintenance procedures listed above. .I agree to notify DWQ
of any probiems with the system or prior to any changes to the system or responsible parry.
Print .Name and Ti tie: X�3 Tf EV/ / C2cd
.address:
Phone:
Signan
:dote: 7fw le -ally responsible par'v should nor be a homeowners ay.7o Iciarior. unless more than 50% of the !ors have been sold and
a resident or the stxdivision has been named . -he president.
I. �+ O ewes 'Y'k • a Norary Puoiic for the State of North Carolina Counry of
Ons 1 ow do hereby ce:ufy that Betty Bullock personally appeared before me this
25 day of _ May 2001, and acknowiedQe the due e xecsuon of the forgoing inriitrtion
basin zaintenanc,
pk° OI AR1, ;p
O '0iJB1.NG Ci
StAi..
my hand and official seal,
My commission expires 6 Z-Lz ° 1
Form SWU-107 Rev 3.99
Page A of 4
Permit No.
= (,o be'pravided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STOIZ'v[WATER MA—N;AGEMEN i PER NET APPLICATION FORM
UNDERGROUND LNFTLTRATION TRENCH SUPPLEMENT
! rs jonr: ma-w be z7hotcca ie--�.frar use as an Orginal
DWQ an Review- _
A complete sto=Lwater mmagernent plan submittal L-acludes a stormwater mana2etnent �e.snlC anoLicauon. a.q
underg—round lnliltratlon trend supplement for each syszern. design calculations. and plans and speci;ic3Lors
Slowing ail storrnwater convey=ceS and system details.
L PROJECT IINTOPUNLA TxON
Project Name . f,,z aO7T
Contact Person: IC /� ��� Phone Numbe'r: (/D ) tit !Z
For projec-2 with multiple infiltration systems, a suopiement form must be complete: for each syszern. This
woric_sher: applies to: Trench _ 2 in Drainage Area
(from piers) ffrnm Form SWU-101)
II. DESIGN LNFORMATION (arraca supporting calcularions/documentation):
Soils Report S-IMMary (based upon an ac-ual-lield invesrigarion and soil borings)
Sail Type �n �� !S �• }
Tabi�,rr�� /
lnnitration Rate Q.52 inlhr or cftes-I (circle appropriare unirs)
Si-:WT Sevation 0-'70 _ fznsl (Seasonal High Water Table e!eva;-ion)
Trench Design Parameters
Desi= Volume
Design Storm.
Dr2wdown Tirue
Perforatd Pipe Si--e
'Je_=ior'ated Pike Lenz ri
No. Observation We'.ls
Stone 7v- (lf used?
Scone "void Rrric
Pq c.r-
_� 5 _r inc:, event U. 47 inch evens jor cis waters, I inch eve:r- or others)
/• 57 days
5'- incri diameter
be -required orz a case -ay -case basis)
/V
Trench Elevations (injeer mean sea level)
Bottom Elevation _ ,2..9 _ frnsI
Storage/Ove:r'low Elevation C'o. _ fnsl
Fors 5-WU-107 Rcv 3.99 Pape 1 of 4 r
Trench Dimensions T _
Heist , Z_ fr. Length
Width 2-;5 fr. Volume Provided qJ,` .. cu.ft.
M. REQUE ED ITEMS C=CKLIST
Tne following checklist outlines design requirernents per the-Storm.water Best Manage-nent practices manual (N.C.
Deoartzment of Environment, Health and Naturai Resources, Novembe- 1995) and Administrative Code Section: 15
A NCAC 21..1008.
Initial in the space provided to indicate that the following design requirernents have been met and supporting
documentation is artached. L the applicant has desi�ated an agent in the Stormwater ManagementPe.�nit
Application Form, the agent may initial below. Attach justification if a requirement has not beer met_
Appiicants Initials
a. System is located ;p feet from class SA watenn and 30 feet from cmer, suz ace waters.
ZVAI b. Svstem is located at least 100 feat from water sur)ply wells.
c. Bottorn or system is at least 2 feet above the seasonal high water cable.
d. Bottom of the system is 3' feet above any bedrock or impervious soil horizon.
e. Off-line system, runoff in excess of the design volume bypasses the systern (bypass detail
provided).
f_ System is designed to draw down the desigp storage volume to the proposed bottom
elevation under seasonal hiari water conditions within save days based upon irtElarion
through the bottom only (a hydrogeologic evaluation may be required).
/Q2f& . g. Soils have a minimum hvdrauiic conducdviry of 0.52 inches per hour.
MAh. System is not sited on or in fill material or DWQ approval has beta obtained.
i. Plans ensure that the installed system will meet design specincations (consmscmd or
restored) upon initial operation once Ll e proiec: is complete and the entire dr�rnage area is
stabil td-
]. System is si=d to take into ac--ount the runoff at the ultimate lbuilt-out pocen iai "from all
s-uriac= draining to the system, inciudi,ng any on -site d—=aQe.
�21,1& k. Svstem is located in a recorded dr-ease easement for the puraoses of ccerarion and
tn='t':ance and has ecorded access easements to the nearest public right—x way.
1. Svstem captures and is bakes the rm-rof= :tom the first l.0 inch of rainfall (1.5 inch event
for areas drainino to SA waters )_
M. Dn nap area for tue device.is less :han 5 acres.
rrc�iePd-
o. Trench conorn is covered wide a layer of clean sand to an average depth of—'. inches.
p. Sides of the inrltradon trench are limed with gectextile fabric.
q. Rock used is free of fines (washed stone)'and has a large void ratio.
r. Side to bottom area ratio is less than 4: 1.
Fora SWLT-1t77 R.-v 3.99 Page 2 of 4
Observation well(s) are provided (case -by -case basis).
Vegetated filter is provided for overflow (50 feet for SA waters, 30 feet for other waters) and
detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
rV. UNTERGROLTN-D L`TMTR-ALTiON TRENCH OPERATION A,NTD NLA24=1NANCE AGREENIENI'
1. t,f;e, ever✓ runoff producing rainfall event and at least monthly inspect die bypass/ove.tiow suucture-for
blockage and deterioration and the infiltration system for erosion. gash accumulation. grass cover, and general
condition.
roded areas immediately, re -seed as necessary to maintain adequate vegetative cover. mow vegetaeve
Repair e
cover to maintain a maximum height of six inches, and remove trash and blockages as needed to maintain
system performance.
Remove accumulated sediment annually or when deotf: is reduced to 75% of the oacg nal design depth. Restore
depth to ori?inai design depth without over -excavating. Over -excavating may cause the require: water table
separadon to be reduced and may compromise the ability of the system to pe:ionn as designed-
4. Tne water level in any monitoring webs will be recorded ante: a l inch rainfall event and at least once a month.
Chronic hiss water table elevations (witain I foot of the bcaorn of the sv_ stem for a taeriod of three months)
sloop be reported to DWQ immediateiv.
5. If DWQ determines that the system is fa ling, the system will immediately be repaired or replaced to original
design speciEcations. If the system cannot be repaired to perform its design function, other stormwater conmol
devices as allowed by NCAC 2f-:.1000 must be designed, annroved and constructed_
Remove accumulated sediment from the infiltration system annually or when depth in the unit is reduced
to 7517a of the oriz nal design depth. The system shall be restored to the original design depth without
over -excavating,. Over -excavating may cause the required water table se-jaration to be reduced and may
comprormse the ability of the syszetn to perxorm as designed_ Removed sediment shall be disposed or in
an appropriate marine: and shall not be handled in a manner chat will adversely impact water quality (i.:.
stockpiling near a szormwarer treatment device or stream, etc.).
A berchmar_K snail be es=bdshed in the innitration syste,-m ine benc:un r< will document rhe orLnal
design deptin so i at accurate sedimenr accurnulacon readings c: n ee raicen_. ine measurmg device used
to dete-:-ii_ne the depth at the'benc, ar, shall be such that: it will give an accurate depul reading and nor
--cadily periezwre into accumulated sediments.
�r
When the depth at the benchmark reads the accumulated sediment shall be removed
C or:, the s 7stem.
Farm SWU-L07 Rcv 399 Page 3 of 4
1 acknowledge and agree by my signature below that I am responsible for maintaining the stormwater
collection system in accordance with the six maintenance procedures listed above. I agree to no
D�,tjQ
of any problems with the system or prior to any changes to the system or responsible parry.
print Name and Title: ,E�c!52.C�dr� /�:���T_,�•v�-v�Gor�iYyrii
Note: 7-m !egaliv responsibie par'v should nor be a homeowners associarion uniess more rhan 5017c ol:ne lors have been said and
a residenr of me subdivision has been named me president.
1 T I 06k�lQ_c_:, � a i l.Anl 11 _ _, a tionrr P'sbiic for Lhe S=e of Counry of
Ons low M do heresy cerTify that Betty Bullock personally acurared before me this
25 day of � a� 2001 , and ac.+cnowiedge the due e..ecsdon of the forgoing irifutmdon
basin mainreaance reauiremears. Witness my hand and official se :i.
EDWA,gOs
off• ��I A CV
V ti
pU0 _/,Z-/f
SEA O,yS<O coU�' My commission expires
F
SWU-I07 Rev 3.0 Rage 4 of 4
Permit No.
(ro beprovided by DWQ)
State of North Carolina
Department of Environment and Natural. Resources
Division of Water Quality
STORtiIWATER MA-N.- .GE��-NI i PEIZtiIIT APPLICATION FORM
UNDERGROL`N-D LNFTLTRATTON TRENCH SUPPLEMENT
i nis fore may be pirotccci7ie-1:.1;br ze as an or"Einal
DCVO Storuwater ManaQenent Plan Review: .
?. cornolete stornwater mzragement plan submittal
undera-ocnd irultranon tre:ica supoietnent for each
show3na all storrnwater, conveya=c s and systern de..ails.
L PROJECT LNTFOR:'1 -MON
includes a stormwater management per, -rut application. an
s,/stern. design calculations, and plans and specifications.
Project Name :
Contact Pt on: ,��7� �6 /��aflii Phone Number: ( %O `f
For projects With multiple infiltration systems, a supplement form must be complete: for each system- This
wodcshert applies to: Trench 2 in Drainage A.iea
(from pi=) (from corm SrVU'-101)
IL DESIGN I.+�-F"ORNL-.TION (attach supporting calculations/documentation):
Soils Report Sunman' (based upon an ac-ua1 j' eid invesrigarion and soil borings)
Soil Type
4b s rri''.r Cfc,�/ate vn ; 7a6i� m� l wl tje-71ezZ, 701/d
inn-ltration Rate Q 52 _ infhr or cfhm's.-- (c-rcle aporopriare urirs)
Si?WT Elevation f-rzsl (Seasorcl High Warer Table elevation)
Trench Design Parameters
Desgm Volume
Design Stctm
Drawdown Time
perforated Pipe Size
Periorated Pipe Le:igth
No. Observation W ells
Stone-e jj' sec;
Stone Vclo 2a Ec
86A c._.
�. incrl event (1. ; inch evenr for Si ware: ,, I inch evenr for others)
-� days
inch diameter
N%9 (ma,; oe-required on a case -ay -case basis)
Trench Elevations (in feer mean sea level)
Bottom Elevation _ 2 •9 _ fznsi
StoragerOverffow Elevation &asI
Farm SWU-107 Rcv 3.99 Page I of 4
r
~ Trench Dimensions
Height
Width
.t�"Ii . REQi-uzED ITEMS CBICKLIST
Length Ll. `.
ft. Volume Provided cu.ft.
Tne following checclist outlines design requirements Pe:- the. Stormwater Best Pylanagement Practices manual (N.C.
DeaarAnent of Environment Health and Natural Resources, November 1995) and Administrative Code Section: 15
A NCAC 2H .1008.
Inidai in the space provided to indicate that the following design requirtme:ats have been met and supporam,
documentation is attached. If the applicant has designated an agent in the Stormwater Management Per-=
Anniicaticn Form. the agent may initial below. Attach justcation if a requirement has not been met,
Applicants Lnitials
V a. System is located 50 feet from class SA waters and 30 feet from other suz-ace waters.
b. Svstern is located at least 100 feet 5 om water supply wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
d. Bottom of the system is 3 ' feet above any be :rock, or impervious soil horizon.
e. Ofi-lire system, runoff in excess of the design volume bypasses the system (bvpass detail
provided).
ZY�/- F. System is desired to draw down the design storage voiume to the proposed bottom
elevation under seasonal high water conditions within five days based upon infiltration
through the bottom only (a hydrogeologic evaluation may be recuired).
Soils have a minim= hydraulic conductivity of 0.52 inches per hoer.
IWO h. Svstem is not sited on or im 5L mate,ia. or DWQ approval has been obtained.
i. Plans ensure that the installer syste:n will meet design specifications (constructed or
restored) upon initial operation once the project is complete and Lhe entire drainage area is
stabilI2e,
j. System is sized to take into account the runoff at the uirmate built -out poten iai from all
surfaces Crutning to me system, including any off -sire drainage.
K. Svstem is located in a recorded dr.. iagP-asernenz for the purposes of operation and
mailnteaance and has recorde- access easeme:nrs to the nearest pubuc :fit-of-way.
i. System cat?trsres and iriEl tes the rsnoi:i f om the first 1.0 inch cErainfall (1.5 inch.ever,t
for areas rr-a=z to SA waten ).
r,,. Drainage area for the device is less han5 awes.
cr=7�a
o. Trench bottom 1S covert- w di a layer of clean sand to an aver'aQe depth of '` Lnci3es.
g. Sides of the infiltration trench are lined with gectextile fabric_
q. Rock, used is free of fines (washed stone) and has a large void ratio.
n Side to bottom area ratio is less than 4:1.
Fora SWU-107 Rev 3.99 Page 2 of 4 c'
Observation well(s) are provided (case -by -case basis).
E. Ve4etated filter is provided for over -flow (50 feet for SA waters, 30 feet for other Ovate s) and
detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
FV. UNDERGROUND ENTMTR TION TRENCH OPER UON AN-D NLA24=, .4_ CE AGREEMENT
1. after eve~J runoff, producing rainfall event and at least monthly inspect the bypass/overaow structure for
blockage and dete.:oration and the inflic-arion system for erosion, trash accumulation, grass cover, and General
condition.
Reoair eroded areas immediately, re -seed as necessary to maintain adeouate vegetative cove., mow ve_emdve
cover to maintain a maximum height of six inches, and retnove trash and biockaaes as needed to maintain
system performance.
_. Remove accumulated sediment annually or whe z depth is -educed to 75a'o of tine original design depth. Restore
depth to original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise tine abiliry of the system to perform as designed.
The water level in any monitoring wells will be recorded after a 1 inch rainfall event and at least once a month.
Chronic high water table elevations (within I foot of the betrom of the system for a period of three months)
shad be reported to DWQ immediately.
�. If DWQ determines that the system is failing, the system will immediately be repaired or replaced to orsdnal
design specifications. If the system cannot be repaired to perform its desim function, other stormw.ater control
devices as allowed by NCAC 2:-1 .1000 trust be designed, approved and constructed.
Remove accumulated sediment from the infiltration system annually or when depth in the unit is reduced
to 75°io of the original design, depth. The system shall be restored to the or;ainal design depth without
over -excavating. Over -excavating may cause the required ware. table separation to be reduced and may
compromise the ability of the system to per —form as desizned. Removed sediment shall be disposed of in
an appropriate manner and shall not be handled in a manner that will adversely impact water auaiity (i.e.
stockpiling near a storm -ware.- treatment device or stream,. etc.).
A benchmark, shall be established in the infiltration system_ iae beachzzin k will dcc=ent the original
resign depth_ so that accurate sed Lrnent accumuianon readings car, be taken. The measunm-sr device used
to detemi -ne :he depth at the oencntna.r_t snail be such that it will give an accurate depm rearing and not
readily penetrate into accumulated sedi.mears.
1r
17r'hen the depth at the bench. marl: reads -- / the accu.muIated sediment shall be removed
Lora the system.
Farm 5wU-107 R-v 3.44 Page 3 of 4
1 acknowledge and agree by my signature below that I am responsible for maintaining the stormwater
collection system in accordance with the six maintenance procedures listed above. I agree to notify DWQ
of any problems with the system or prior to any changes to the system or responsible party.
Print dame and Title: )- —
Address
R.
Si
:Vote: ine legally responsible part' should nor be a homeowner,; associarion unless more then 50`.'0 of the !ors have been said and
a resident of the subdivision has been named the president
l if ,I.c) A)CU'd-S �re— a Notary Public for the State of North Carol i na County or
_ Ons low do he:-ehv cartiiy. that Betty Bullock personally appeared before me d-iis
25 day of May _ 2001 and a6mowiedge the due execution of the fcraoin; ituH=Eioa
basin maintenance repuiremeats. Witness my hand and of-Ecial seal.
y�-DWA�O
ak.� I A Rr
*4tr
c, ti
SEAL S�QW
7-e�� cea� (�'
My commission expires � 7' 0 r
Form sWU-107 Rev 3.99
Page 4 of 4
Permit No.
(to be:provided by Dwo
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER M.�NAGE.�IE�i7' PEIZMIIT .FFLICATIOI; FORM
UNDERGROUND INFILTRATION TRENCH SUPPLEMENT
1 ni5 jbM ;nm.I be phot00017ie .fDr USE a5 an original
DWn Stormwa.ter Management Plan Review:
A complete stormwater m.,naQement plan submirLal includes a stormwater mana_ae;nent pe, rdc apvlicatson. an
uncle -mound infill radon tr-Inch suppiement for each system. design calculations. and plans and specinc tiom .
snowing all 5tor nwater convevanc-ts and sVStem demL5.
L PROJECT ENF'OR TATION
Project Name :
Con:ac.Pe-son_ Y -)A1L77) A�/Zr— iY Phone Number: (WO) L!2:6 'Z&en,
For prcje-= with Multicle inzl-ltration systems, a supplement form must be completed for each system. TTZis
worksaee: applies to: Trench _ 3 A _ in Drai.na2t .lea _
(from plans) (from Form 5-w -lo!)
IL DESIGN Lti"F ORI12.4TION (at-Lach supporting calculations/documentation):
Soils Report Surnmary (bcsed upon an actual fie>d inves,"garion and soil borings)
Sail Type �ebri� �r1,.Y (rCp/�� Ci/� ; Tabk, &7aZ / w/ �e%r.� f ill}
Innitradon Rate in/hr or cfhr/sr (circle apprcpr:are urirs)
5c-,'W 1 Eevation sl (Seasonal High Warer Table elevaran)
Trench Design Parameters
Desi-M VoiUM0
Desiza Storm
Drwdown —:L me
perforated Pipe S ire
?e:rorate;i Pipe Le::gTh
No. Obse.-vadon
Stone T V;e is Lse
Scone VCIL IaL c
�a'a c.f.
incbl event U. -5 inch rjen for Sr? wavers, 1 inch eve':.- j or Others)
T days
inch diameter
NZ/9 (rrrq; be -required on a case-pv-case basis)
Trench Elevations (in jeer mean: sec level)
Bottom Elevation _ Q..9 fmsl
StoragelOverflow Elevation L-nsl
Form SWU-I07 Rev 3.99 Pa6e 1 of 4 r
Trench Dimensions -
Hei;l�t 3,0 _ fr_ Length 17' Z
Width fr. Volume Provided cu.ft.
III. REQUIFZED ITENLS C=CKLIST
The following checklist outlines design requirerments per the-Stonnwater Best Management Practices manual
Deoarmnent of Environmenr, Health and Natural Resources, November 1995) and Administrative Code Section: la
A C.-;C 21- .1008.
Init ai in the space provided .to indicate that the following design requirements nave 'oee:i met and supporing
doc".imentation is attacked. If the applicant has designated an agent in the Stormwaier Management Pe.�it
Atapiicadcn Form. the agent may initial below. Ar�ach jusdfcaiion ii a requirement. has not been met_
Applicants initials
V a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
Z)v6v b. System is located at Lest I00 feet from water supply wells_
zX611_ c. Bottom of system is at least 2 feet above the seasonal high water table.
�dL d. Bottoms of the system is .' feet above any bedrock or impervious soil horizon_
e. Off-line system, runoff in excess of the design volume bypasses the sysmm (bypass detail
provided).
f_ System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within. five days based upon inm ation
through the bottom only (a hydrogeolocric evaluation may be reouired).
g. Soils have a minimum hydraulic conductivity of 0.52 inches per hour.
h. System is not sited on or in till material or DWQ approval has been obtained.
i_ Plans ensure that the installer system will meet design speciEcations (consu acted or
restored) upon initial operation once the proiect is complete and the entire drainase area is
stabilizew
Svsterm is s1Ze: to take into account the ranoff at the ultimate built -out polendal from all
s-,=aces dr—aninz to the 5y5IezI including any off -site drainage.
/7V/I/ k. Svstem is located in a recorded drz?nage e^serment for the purposes of ece:ation and
rn--i nenancz and has recorded access easements to die nearest public right-OI-;Way.
1. System cazcurrs and in.E=es r-he =of corn the list 1.0 inch of rainfall (1 .5 incn event
for areas draining to SA wales }_
mi. Drainage area fcr the device'is less than 5 ac.es.
e^t ��� . :" } . -ro"liQec.
o. Trench bororn is covered witi'i a layer of clear, sand to an average depth of—" inches.
p. Sides of the in_E radon trench are lined with geotextiie fabric.
q. Rock used is free of fines (washed stone) and has a large void ratio.
r. Side to bottom area ratio is less than 4:1.
Fern sWU-io7 Rev 3.99 Page 2 of 4
Observation well(s) are provided (case -by -case basis).
t. Vegetated filter is provided for overflow (50 feet for SA waters, 30 feet for other waters) and
detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
IV. LNDERGROUND LNTILTRATION TRENCH OPERATION AN`D 1YLkPNTENANCE AGREEMENT
ate; ever, runoff produciL er,i ng rainfavent and at least mondily insuect the bvpass/oveow sL cture for
bIoc...ge and deterioration and the infiltration system for erosion. trash accumulation, crass cover, and senerai
condition.
:. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow vegetative
cover to maintain a maximum height of six inches, and remove trash and blockages as needed to maintain
system performance.
3. Remove accumuiared sediment annually or when depth is reduced to 75% of the original design depth. Restore
depth to or? ginal design depth without over -excavating. Over -excavating may cause Lne required water tame
separation to be reduced and may compromise the abiiiry of the system to perform as designed.
.1. The water level in any tnoniWring wells will be recorded of 2r- a 1 inch rainfall event and at least once a month.
Chronic higri water table elevations (within I foot of the flcnorn of the system for a period of diree months)
shall be reported to DWQ untied iateiy.
5. l~ DWQ determines that the system is f 'ailing, the system will ir=ff-diately be repaired or replaced to original
desi_i specincations. If the system cannot be repaired to perform its design function, other stormwater control
devices as allowed by NCAC 2H .1000 must be des4med, anoroved and cons'ucted.
Remove accumulated sediment from the infiltration sv_ stern annually or when depth in the unit is reduced
to 75G5 of the original design depth_ The system shall be restored to the original design depth without
overexcavatins. Over-excavadng may cause the re aired ware; table separation to be reduced and may
compromise the ability of the system to perform as designed. Rernoved sediment shall be disposed of ir,
an appropriate manner and shall not be handled in a manner that will adverse?y impact water euaiity (i.e.
stockpiling near a stormwater treatment device or stream. etc.).
. be:,ciarnar'� snail be es- Lshed in the infiltration syste n e berlchmn..rk will dccu:-Lent tahe original
Cesian Gieptin so that acz-amte se Lt end acc muiadon reaa*-n s car, oe t:aK--n. 1 fie measur"i-na cevlcC Ilse
to dote ,arie the depth a[ Lhe be:ic:z .ark S,-iall be S:iCI: c Lhat ,t will Ve are accurate dept<-i i43C1ng and not
readily penetzate into accumulated sediments.
When the depth at the benchmark reads %;Z,. - ; the accumulated sediment shall be removed
morn the system-
Form SWU-107 Rev 3.99 Page 3 of 4
I acknowledge and agree by my signature below that I am responsible for maintaining tine stormwa[er
collection system in accordance with the six 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 parry.
Print lame and Title: eE:fr- Z11 / c2Le4 BaJ = t
Addre:
Phone
Sinar,
;1O12: iar fe;ally responsible par-v should not be a homeowner assoc?atian unless more than 5D10 of the lors have been sold and
a resident of the subdivision has been named the president
Of ue4 LI t �L, TP_. a No=, Public for the State of -North Carol il],� _. Couary or
Ons toW do he;-eby Cerny char Betty Bullock personally appeared before me this
25 day of , and acknowiedge the due e xecudon of the forgoing indl=con
basin m atea=c-z
ScAL.
Wimess my hand and official se al.
EpINARD,,
�� otARy ''9
0
AUBV
coop
uy commission expires
Form 5WU•107 Rev 3.99
Page 4 of 4
Permit No.
(ro biprovided by DWQ)
State of North Carolina
J Department of Environment and Natural Resources
Division of Water Qualify
STOiZ�[4ti TER �iAGE IE� i PElZNIT aFPLIC-kT ION FLORM
UNDERGROUND LNFILTRATION TRENCH SUPPLEMENT
i r.:s form mmr be photocopied. jar use as an 0Hgi=I
DWQ 5 crnwater 14ianaffe -lent Plan Review: .
:? compie:e sto a. water rnaragernent plan submir'.:l includes a szorm,water management pe='t application, an
unde.—oUnd infiltration trznch suppie:nenr for each system, design calculations. and plans and speci1.1cadors
silawing all storrnwater conveyances and syszern de:.aiis.
L PROJECT LN'FOR ATION
Project Name : /! JIZABOZT
Contact Peon: / D4,0�n L� / Phone tiurnb' r: (q%O ) L46
For projer-s with multiple infiltration systems, a supplement form roust be completed for each system;. i iris
wodcshee: applies to: Tre:rch in Drainage Area
(from p1ars) (from town SWU401)
II. DESIGN LNFOR WLTION (a=- ca supporting caiculadons/doc•=entadon):
Sails Report Suxzzmary (based upon an ac iral jie r investigation and soil bongs)
Sail Type o�G�7i-i5 irl�.� (lC���aC-� Ci/I ;7,7b/�,r /. +✓� 't'G� T///�
Jnnitraticn Rate D z in/hr or c:ThrJs: (circle appropriare unirs)
SHWT Eevation
Trench Desi;n Par-ameters
Design Volume
Desi= Storm
Drawdown 7=e
ner=orated Pipe S ire
'crated
Tive L-n2i:
'lo. Observadon W eLs
Stone Ty^e (;T ,ace'
S tone V c(* ' a tic
�.90 frnsl (Seasonal F?ign Water Table elevation)
59.5 C.I"
_ /. i __ inc:, eveaL (I inch ever -., for SA ware:- , I inch eve; �r or others)
44 days
Y' incii diameter
(may be -required on a case -ay -case basis)
w
Trench Elevations (inleer mean sea level)
Bottom Elevation 2.q frnsl
StaragelOve-Eow Elevation fmsl
Fora S-WU-107 Rev 3.99 Page t of 4
.y
_ Trench Dimensions
Height fr"
Width
��`Ii . REQLRED ITEMIS C.CKI.AST
Length 7 n•
Volurne Provided U16 0 cu.ft.
The following checklist outlines design requirements per the-Stormwater Best Management Practices manual (N.C.
Deaarnneac of Environment, Health and Natural Resources, November 1995) and Administrative Code Section: 15
A -iCAC 211 .1008.
Inical in the space provide: to indicate rhat the following design requirements have been met and suppordna
documentation: is artacheY_ If the applicant has designated an agent in the Stormwater Tyfanasement Perlait
ALniication Form, the agent may initial below. Ar�ach justification it a requirement.has not been rhea
Applicants Initials
V a-' System is located 50 feet from class SA waters and 30 fez,, from, odner surface waters. )16
b. Svstem is located at Least 100 feet from ware. supply wells.
c. Bottom of system is at least Z feet above the seasonal high ware. table.
nl l _ d. Bottom of the system is S feet above any bedrock or irnpervious soil horizon.
_ e. Or -Line system, runoff in excess of the design volume bypasses the system (bypass detail
provided).
Z)/� f. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high ware: condiriens within five days based upon iniiltiatian
dirough the bottom only (a hvdroaeclo,:,;c evaluation may be required).
g. Soils have a minimum hydraulic conduc;viry of 0.52 inches per hour.
1/ h. Svstem is not sited on or in tall mate -.-,;al or DWQ anproval has been obtained.
i. Plans ensure that the installed system will meet design stae-ificarions (consu acted or
restored) ucon initial operation once the proje= is complete and the endre drainage area is
stabilize:.
Dire j. System Is sir 10 take into ac0ount the runoff at the uitLimaIe built -out potential Fi0m all
surtaczs eradnzrlg to the system, inciud=- g any Ot;-site drainage.
k. S vstem is located in a recorded draLi rage erse:menl for the purposes of operation and
maintenance azd has recorded access e:se:menrs to tZe nearest public rl t-of-way.
1. S vste y caocunr s and t_he : arnor z" em the Lrst 1.0 inch of rain all ( l.= inch event
for areas dr3ini�g to SA warets }.
rn. Draina-ae ar--a for the device'is less :uan 5 acres.
:_. �u_ �`v� S"�- ', 5ZC_e.^,r �1^. �r� _ teri A
.. wC..0
o. Trench bonorn is covered with a Jaye- of cleats sand to an average depth of-' inches.
p. Sides of the in -filtration trench are lined wirh geotextile fabric.
q. Rock used is free of fines (washed stone) and has a large void ratio.
r. Side to bottom area ratio is less than 4:1.
Fare swU-107 Rcv 3.99 Page 2 of 4 c'
Observation weil(s) are provided (case -by -case basis).
t. Vegetated filter is provided for overriow (50 feet for SA waters, 30 feet for other waters) and
detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
IV.. UNDERGROUND L TTLTR-A.TI0N TREI CH 0PERUTI0_ Av'D IT_kEN`rENAINCE A.GREEME_NT
I. After every rsnoE producing rainfall event and at least monthly inspect the bypass/overflow szruczure for
bloc.+caae and deterioration and the irifltiation system for erosion, trash accumulation. grass cover, and aeZeral
condition.
=. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover. mow vegetative
cove: to maintain a mammutn height or six inches, and remove trash and blockages as needed to maintain
system periornaance.
3. Remove accumuaated sediment annually or when deouh is reduced to 75% of the originai design depth. Restore
depth to original design depth without over -excavating. Over -excavating may cause the required water [abie
seoaration to be reduced and rnav compromise the ability of the system to perorm as designed. .
4. Tee water level in any monitoring wells will be recorded after a I inch rainfall event and at least once a month.
Chronic high water table elevations (within 1 foot of the bottom of the system For a period of three Months)
shall be reported to DWQ immediately.
5. If DWQ deter Haines that the system is failing, the system will iramediately be repaired or replaced to original
design specifications. if the system cannot be repaired to per -form its design function, other szornwarer ccntioi
devices as allowed by NCAC 2H .I000 must be designee. approved and constructed_
Remove accumuiated sediment from the infiltration sv5zem annuaily or when depth in the unit is reduced
to 754'o of die origsnai design depth_ The system shall be restored to the original design depth without
aver -excavating. Over -excavating may cause the required water table separation to be reduced and may
compromise the ability of the system to perorm as designed_ Removed sediment shall be disposed of in
an appropriate manner and shall not be handled in a manner that will adversely impact water quality (i.e.
stockpiling near a stormwater treatme:at device or stream, etc.).
A be^chmarlt suaLl be esmbiished in the infiltration sysze:m zne benc:a=k- will dec=eat the oriEnai
design dept:`+ so that accurate sediment accumulation readings can be micen_ Tile measur�-t_ device used
to dete=-_ine the depth at the benchnaa k shall be such that it will give an accurate depda Leading and not
readily penetrate into. accumulated sediments.
When the depth at the benchsnark reads - ; the accumulated sediment shall be removed
Lnru the system.
Farm SWU-107 Rcv 3.99 Pap 3 of 4
1 acknowledge and agree by my signature below that I am responsible for maintaining the stormwater
collection system in accordance with the six maintenance procedures listed above. -I agree to notify DWQ
of any problems with the system or prior to any changes to the system or responsible party.
Print N=e and Title:
A
19
:dote: ine Ie,aLly resaonsibie par'v shar�Id nor be a iomeawrze-s av�sociarion unless more then 507c of the lots have been soil and
a resident of the subdivision has been named the president.
I, �� pE`'id� YQd.>>r�A rlx 6e a ,;o.mry Public for the Smie of _ Nort.h Tarn 1 i na coumry or
Ons 1 ow do be:-eav ce:ufy that _ Betty Bullock , pe anaily appeared before me tnis
25 day of May _ 2001 and acknowiedge the due execu6ca of the forpoin'-inrutrction
basin mainrmance requiremems_ Wimess my hand and of5cial seal,
AI?Ds
Q�, �pLARy 9
v �
p pUBV z
SEAL. „•.„ My commission eznires Z ��
Farm SWU-107 Rev 3.99 page 4 of 4
Permit No.
(ro beprovided by DWQ)
State of North Carolina
J Department of Environment and Natural Resources
Division of Water Quality
STORNEWATEIR iVf.. NAGEME11 T PER:tiII T APPLICATION FORML
UNDERGROUND LVFTLTRA.TION TRENCH SUFFLEI ENT
7 h,'s Earn mart be use as an o7-iginal
DWQ an Review:
A water mxnazemeaplan subart.d includes a somwater al7cdcation- an
ifi
unQerm--oand infiltration trend supplement for each system, design calculations. and plans and specincadors
sflowlrl° all stormwater conveyanCf�s and system details.
L PROJECT L`rFORM-MON
Projec dame : /
Contact Person: Z—)40"T�L ? Phone Number: ( /O )
For proje= with multiple infiltration systems, a supplement fot-m must be complete^ for each system- i rds
work5ht�t aoplies to: Trench 15�r/Q in Drainage Area
(Tram plans) (from Form SWU-101)
IL DESIGN INFORMATION (attach supporting calculations/documentation)-
Soils Report Summary (based upon on ac.ual.;7eld invesrigarion and soil borings)
Soil Type 1 o�edr-�-5 irJ:.ice (rCP/�C,-, 7,3b/19�- 1175-
l ltrarion Rate _, 0 52 in/hr or c: h5 /s: (circle appropriare unirs)
S — i F-:evadon _ 0. !Fo f.MS1 (Seasonal high Warer Table elevation)
Trench Design Parameters
Desiza Volume
Desim Stcrm
Drawdown 7=e
ae; �o� Pipe S ice_
PerForated Pipe Lenzzhl
No. Obserrradon W-- s
Stone T y-e OF- qe;
Stone -void R �:c
5 - c.f.
/ inc:, event inch r-,en: for SA wasers, I inch event for others)
/ r - days
inch di==er
Ih.3
&1147 — (may ae-recuired on a case-bv-case oasis)
Meg, E L�/' ,-Z):
Trench EIevations (in feet mean sea level)
Bottom Elevation _ 2 -Y _ f-nsl
Storage/Overflow Elevation �'�.`� _ fmsl
Fcrn SWU-107 Rev 3.99 Pale 1 of 4
r
Trench Dimensions
Height 3, K) ft_ Length 13 . Z ft.
Width ft. Volume Provided cu.ft.
IE, REQGT�MED ITEMS CMCKLIST
The following checklist outlines design requirements per the-Stormwater Best Management Practices manual (N.C.
Deoaruneat of Environment. Health and Natural RespurLes, November 1995) and Administrative Code Section. 15
A NCAC 2H .100s.
Initial in the space provided to indicate that the following design requirements have been met and supo_ ordna
documentation is attached. If the applicant has designated an agent in the Stornwater Management Per,=:
AppUcation Form, the agent may initial below. Attach justification if 'a requirement. has riot been me;_
pOicants Iait3als
v a. System is located 50 feet from class SA waters and SO feet from ot= surface waters.
b. Svstem is located at least 100 feet from water suovly wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
d. Boacm of the system is 3' feet above any bedrock or impervious soil horizon.
e. Off -Line system, runoff in excess of the desiz-2 volume bvpasses the system (bypass detail
provided).
��jlit% f_ System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days based upon infilrraniorr
through the bottom only (a hydrogeologic evaluation may be recuired).
g. Soils have a minimum hydraulic conductivity of 0.52 inches per hour.
h. System is not sited on or in fill material or DWQ approval has been obtained.
i_ Plans ersttre that the installed syste:n wiil meet design saes Ecallons (consu acted or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
J. System is sized to take into account the runoff at the uiti=ate built -out poteatiai from all
surfac!s draining to the system.. including any or -site drainage.
k System is located in a recorded drainage easement for the our:,cses or ocerafion and
mai nte:lad-ic.'_ anc has recorded access easements to une nearest pumic npr-or-way.
1. S vste:n captures and inf-,bates the runoff :mom the first 1.0 inch of rainfall (1._4 inch event
for areas draining to SA waters ).
in. Draina_Pe area for the device"is less than 55 awes.
r,_ cr?_ee ..... dev. ( :_. s� :p. �- . �ed s•W5edi fie^t �? ,rovidet_
4. -
_ 1 � o. Trench bonorn is covered wide a layer or clean sand to an average depth or 4 inches.
DAZI p. Sides of the inrltration trench are lined with geotextile fabric.
q. Rock used is free of fines (washed stone) and has a large void ratio.
r. Side to bottorn area ratio is less than 4:1.
F=SWU-107 Rcv 3.99 Page 2 of 4
s. Observation well(s) are provided (case -by -case basis).
t. Vegetated fIter is provided for overflow (50 feet for SA waters, 30 feet for other waters) and
detail is shown on ?tarts.
u. A benchmark for checking sediment accumulation is provided.
Iv. UNDERGROLIND LN, =TRATION TRENCH OPERaTION A1V-D MkLNTENA:NCE AGREEMENT
ever.v ranoff producing rainfall evert and at least montLy inspect the bvuass/overfow suucrure for
biccicaae and dete.ioration and the infiltration system for erosion, trash accumuiaaon. Grass cover, and Gene.-!
condition.
Repair e-roded areas immediately, re -seed as necessary to maintain adepuate ve?emcive cover, mow vemadve
cover to maintain a maximum hei¢hr of six inches, and remove trash and blockages as needed to maintain
System perzor anc_-.
_. Remove accumulated sediment annually or when dead, is r,. 'uced to 75% of the original design. dept�n. Restore
death to original desim depth without aver-excavatins. Over -excavating may cause tie required water tabie
separation to be reduced and may compromise the ability of the system to perform as designed -
Lae water level in any monitoring wells will be recorded after a 1 inct rainfall evert and at least once a month.
Chronic hizh water tabie elevations (widLi.n I foot of the bottom of the system for a period of three months)
shall be rer?orted to DWQ immediately.
5. If DWQ dere:m=es that the system is failing, the system will irtumediately be repaired or replace3 to original
desiz n spec cations. If the system cannot be repaired to perform its desi= function, other storrnwater control
devices as allowed by NCAC ?N .1000 must be designed, approved and constructed.
6. Remove accumulated sediment from the infiltration sysrem annually or when depth in the unit is reduced
to 7590 of the original design depth. The system shall be restored to the oriznai design depth without
over�xcavating_ Over -excavating may cause the required water table separation to be reduced and may
compromise the ability of the system to periorn as designed_ Removed sediment shall be disposed of in
an appropriate manner and sh' not be handled in a manner that will adversely impact water Quality
stockpiling near a stormwarer treatment device or seam, etc_).
A benchmar'{ shall be es•.abLsbed in the infiltration sv_ stein. the benc:unark will document Lie original
design depth so t^,at accurte sediment accurmuiadon readings can be taken. ine measurinz device used
to determine the death at the'benc,==_'t shall be such ha z it will rive an accurate depth reading and nor
readily penesa.re into accumulated sediments.
)Nhen the depth at the benchmark reads _%�, the accumulated sediment shall be removed
frorn the system.
Form 5WU-107 Rev 3.99 Page 3 of 4
I acknowledge and agree by my signature below that I am responsible for maintaining the stormwater
collection system in accordance with the six maintenance procedures listed above. I a--ree to notify L}WQ
of any problems with the system or prior to any changes to the system or responsible parry.
Print Name and Title: n�,/ 24l
Address:
Note: ine legally responsible per~v should nor be a homeowners associarfon unless more than 5017a of the lots have bee! sold and
a resident of the subdivision has been earned the presid'en..
1 J. 'E AW,4 �le,c Yxjs a Notar,? Pubiic for the Stale of NQrth Carol i na . Counry of
Ons low _ do hereby c=rdfy chat Bett $U 11 OCk gemanaIly appeared before me this
25 day of _ may 2001 and acknowiedge the due execarioa of the forgoing inLI=::'on
basin =s ntenaace requirements. Wimess my hand and oflic;al seal,
4'� ��ARy '✓9
2
G ti
SF —AL D AUSV ?7 My commission expires lo
'940W C60N
Faun SVJU-107 Rev 3.99 Page 4 of 4
Permit No.
(ro beprovided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STOR:vI'vV�TER f.�tiAGE�rIE�1 i PER:tiIIT AIPLICA T TON FORM
UNDERGROUND LNFILTRATION TRENCH SUPPLEMENT
i ais�rOrn mmq be pnotoiedjbr ze as an or.'ginai c^p
Dw 5tornwate- N1ana�e._ent Plan Review,
A cornole:e storrnwater maraQernent pian subtnir,al inciudes a stormwater manaaemeni ce-mit application. an
underg—round inf ltraaon trench supplement for each system, design calculations. and plans and saecincatiors .
snowing all storrmwater conveyances and system deraE5.
L PROJECT E FOR --LOTION
project :Name :
Contact Person: ,IDi4IT7 /�� Phone Number: (/O )
For proje_s with Muldple irEltradon systerns, a supplement form roust be completed for each system. 7-r is
wodcshert applies to: Trench ��� in Drainage Area
(from pimrs) (from -Q,= s u-101)
IL DESIGN LNG ORNL4TSON (at'tach supporting calculations/documentation):
Soils Repart Sutmraary (based upon an acmalFeld invesrigariorz and soil borings)
Soil Type
lnnitmdon Rate in/hr or cfhr/sf (circle appropriare unirs)
S .W'I' Eevation 0. 90 fl sl (Seaso=l High rarer Tabie elevaron)
Trench Design Parameters
Desim Volume
Design Storm
Drawdown tune
Perforated Pine Sire
Pe-forated Pipe Lena*R
No. 0bser adon We'd5
Stone T
S tone Void Rac:-c
C---
l/. inc:. event (1- 4 e inch eve= or S�! wale I inch evr for orhers)
/ � days
inch diameter
r
(may be�e�u:res on a case -by -case bezis)
_ Q. 92
Trench Elevations (in jeer mean sea level)
Bottom Elevation 2. q _ fmsl
Storage/Overflow Elevation _ �`J% _ fmsl
Fora S-NU-107 Rev 3.99 Page 1 of 4 r
Trench Dimensions
Height ��. (� — ft. Length 13-2, ft.
Width ft• Volume Provided cu.ft.
III, REQU-MED ITEMS C=ECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices manual (N.C.
Departtne nt of Environment. Healthand Natural Resources, November 1995) and Administrative Code Section. 15
A NCAC 2H .1008.
Inidai in the space provided to indicate that the following design requirements have been met and supporting
documentaacin is attached. If the applicant has designated an agent in the Stormwater y[anaaemem Pe,,=
Ataeiicadon Fortin, the agent may initial below. Anach jus-df cation if"a requirement has not been met_
Applicants Initials
a.' System is located 50 feet from class SA waters and 30 feet from otrier surface waters.
b. Systern is locate- at least 100 feet from water supply wells.
c. Bottom of system is at least 2 fee: above the seasonal high water table.
d. Bottom of the system is S feet above any be -rock or impervious soil horizon.
e. Off-line system. runoff in excess of the design volume bypasses the system (bypass derail
provided).
LW 2Z
f. System is designed to draw down the design storage volume to the proposed bottom
eievation under seasonal high water conditions within five days based upon infiltration
through the bottom only (a hydrogeciog c evaluation may be required).
Q2Z g. Soils have a minimum hydraulic conduct viry of 0_ 2 inches per hour.
h. System is not sited on or in Ell matenai or DWQ approval has been obtained_
i. Plans ensure that the installed system will meet design specifications (constiscied or
restored) upon initial ocerati.on once uhe project is complete and the endre dr�a. 4.naQe area is
stabili?ed_
System is sized to take into account the runoff at the ultimate built -gut potential from all
surfaces draining m tce system, including any off-s.te drainage.
k. Svstem is locates in. a recorded drr.1rage easement for the purposes of ot;emtion and
anaitntenance� ane 'teas -Le:oroed acctss easements to tine nearest public ;�?�l[ �7I- ✓ay.
1. S vsiem captures and ,.--,Elti aces Lhie runoff 4forn rile dnz 1.0 inch of rainfaL (1.5 inch event
for areas draining to SA waters }_
r:._ Drainage area for the device is less ratan 5 acres.
n. a_ pre=eat :: �ev �; - s�_p S-av�sed s w _ seq. -:e �t _a^ =.� i_ �rofided_
c. Trench bottom is covered with a layer of clean sand to an avemae depth of '' inches.
dZ p. Sides of the infiltration trench are lined with geotextile fabric.
q. Rock used is free of fines (washed stone) and has a large void ratio.
r. Side to bottorn area ratio is less than 4:1.
Fora swU-207 kav 3.99 Page 2 of 4 c
s. Observation well(s) are provided (case -by -case basis)_
t. Vegetated filter is provided for overflow (50 feet for SA waters, 30 feet for other waters) and
detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
FV. UNDERGROUND LNFMTR.T7ON TRENCH OPE:k-MON AID yT.kLN-TE`+A1NCE AGREEN EIN7
I. A:ier eve: v ranori producing rainfall event and at least monthly ins-pect the bypass/overlow structure for
blockage and deterorarien and the MEtration system for erosion, trash accumulation. grass cover, and general
condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow vesttacve
cover to maintain a maximum height of six inches, and :emove trash and blockages as needed tb maintain
system ve�ot:nance.
3. Remove accumulated sediment annually or when dect-h is reduced to 7517o of me odQinai design depth. Restore
depth to oriamai design depth without over -excavating. Over-excavadria ma—v cause the required water table
sevaration to be reduced -and may compromise the ability of the system to per orm as designed -
"Flue water level in any monitoring wells will be reworded af-.er a 1 inch rainfall event and at least once a month.
Chronic hisn water table elevations (within 1 foot of the bottom of die system for a pe.iod of three rncnths)
shall be reported to DWQ immediateiv.
5. If DWQ determmes that the system is failing, the system will immediately be recaired or replaced to original
design speciitcations. If the system cannot be repaired to perform its design function, atizer storriawater conu-ol
devices as allowed by NCAC 21-1 .1000 must be designed, approved and constructed.
Remove acc=ulated sediment from the infiltration system annually or when depth in the unit is reduced
to 75% of the oral design depth- ine system shall be restored to the or-,aitiai design depth without
over -excavating. Over -excavating may cause the required water table separadon to be reduced and tnav
comorotnise the ability of the system to perform as desi�ted- Removed sedime zt shall be disposed of it
an appropriate manner and shall riot be handled in a manner that will adversely impact water quality (i.e.
stockpiling near a stormwater treatanent device or stream, etc.).
A benchmarc suall be estabdsned in the innitration system The beachr�x will decumenr the on nal
design depdn so that accurate sediment accumulaeen readings can be taken. The measurliliQ device used
ro dete =ne.the depth at rhe"benchmark shall be such that it will give an accurate depth reading and nor
reacily pene=te into accumt:.iared sediments.
When the depth at the benchmark reads _%1 the accumulated sediment shall be removed
froth the .system.
Form SWU- 107 Rcv 3.99 Page 3 of 4
I acknowledge and agree by my signature below that I am responsible for maintaining the stortnwater
coIIection system in accordance with the six maintenance procedures listed above. I ac&ee to notify pWQ
of any problems with the system or prior to any changes to the system or responsible parry.
Prim Name and Title: ,3- c'v Lor�it-Icrii
addre
Phone
Si4nat
.dote: i ne lei ally resDonsiple pony should nor be a homeowners a sOC:aROn unless more rh: rs �� c Oj the lOr� have rarer. Said and
a resident of rite subdivision has been named the president.
1 ��, �� U renr�5 9� a Nogry Public for he State of North Cdr^o1 i na---- .County of
Ons low do hereby certify thar 3 EttY 8u1 lock personally appeared before me this
25 day of May __ 2001 and acicnowiedge the due execurion of the forgoing incur anon
basin maintenance recuiremencs. Wimess my hand and ofh-c:al seai,
POg�\Ci Z L
Sr4L ,YSZOW 0 LVy czammission C=ims v r
Form SwU-IQ7 Rev 3.99 Page 4 of 4
Permit No.
(to be provided! by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORNNIWATER PEI I—WT APPLiC T10!V FORM
UNDERGROU-N-D LNFILTR4TION TRENCH SLTPLEMENT•
iris jorn moy be photocaried. jnr use as an oriyi=l
DWQ Stormwater Man agemen, Plan Review,
A cGmDle:e ston-nwater management plan submittal includes a szormwater manaaernent pe-rut aonlication. an
unde:a_*-ound isitiltration trenei sugpiemenr for each system, design calculations. and plans and specifications.
stlowin; all stc=water conveyances and system details.
L PROJECT LN-FORNLA-TION
project
Contact Person: .4r�fr� %� / Phone Number: (9'%O 2BUI,
For proje--m with multiple innlrration systems, a supplement form must be completed for each system. This
workshe_, applies to: Trench es in Drainage Area
(from plain) (from Form S'VIi-10I)
IL DESIGN LNFORM.4TION (arrach supportna calcuiatioris/documentation):
Soils Report Summary (based upon an aczmllield inves:fgarion and sail borings)
sail Type rfebi75 ir1;.i� �rc�/ac.� r��rTabi�z/ w/
Innitradon Rate O1a`Z in/hr or c5 r/sf (circle aporopriare urirs)
SP17N7 Elevation (Sec-sorrci Rion rarer Table elevation)
Trench Design Parameters
Design Voiume
Desim Storm
Dmwdown iirie
Pt= -orate' Pipe SiZ2
?eriorateu Pipe L---nx l
No. Qdse:vadon Wells
Stone T�'e (iT =.ise^�'
Scone Void -RaCr
c-f.
/_. 5 inch Vie= (1-5 inch even. -for SA warers, 1 inch ever-r for others)
1� days
inch diameter
(may on a case -by -case basis)
r7.9�
Trend Elevations (in feet mean sec level)
Bottom Elevationfrnsl
StcragelOverflow Elevation _ 52 fins!
Fora 5-WU-107 Rev 3.99 Page 1 of 4
Trench Dimensions
Height
Width
III. REQC-,,rRED ITEMS C-CKLIST
fr_
Length /0,0 fL_
Volume Provided 13 11cu.ft.
T1ze following the--k_Jist outlines design requirements per die Stormwater Best Management Practices manual (N.C.
Departtnent of Environment. Health and Natural Resources, November 1995) and Administrative Cade Section: 15
A -,CAC 2H .1008.
initial in the space provided to indicate that the following Qesip repuiremerits have been Chet and suppor".u'lg
docsmeatation is attached. L the applicant has designated an agent in the Stormwawr Managtment Pe,=n i
Application Form, the agent may initial below. Attach jus=cation ii a requirement has not been met
Applicants Initials
11 a. System is located 50 feet from class SA waters and SO feet from ollier surface waters.
b. System is located at least 100 feet mom water supply wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
d. Bottom of the system is 3 feet above any bedrock- or impervious soil horizon.
e. Off-line system. runoff in excess of the design volume bypasses the system (bypass detail
provided).
f. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days based upon LT12i1=cn
through the bottom only (a hydrogeoloa-ic evaivation may be required).
X'1 ¢. Soils have a minim= hydraulic conduct viry of 0.52 inches per hour.
h. System is not sited on or in fill rnate:ial or DWQ anproval has been obtained.
i. Plans ensure that the installed system will meet desiazt or
restored) upon initial operation once the proiec: is cornpiete and the endre drainage area is
stabiiiz�.
j. System is sired to tale into account the runoff at the ultimate built -out potential aom all
surfaces draining to the system, includiz z any off --sire drainage.
k. System is located in a recorded crainage easement for the purposes of ocerarion and
may tenance aIId has ecorde access easements to the nearest public righL-ar-way.
1. S vste:n canvures and infEtrates the anoff s ota the Eirsz 1.0 inch of rainfall (1. 5 inert event
for areas draining to SA water, ).
m. Drainase area for the device'is less hu 5 acres.
o. Trench bot`O is covered witch a layer of clean s.,nd to an average depth of 4 inches.
p. Sides of the inritration trench.are lined witr`t creotextile fabric.
q. Rock used is free of fines (washed stone) and has a iarQe void ratio.
r. Side to bottom area ratio is less than 4:1.
Form SWLT-107 Rev 3.99 Page 2 of 4
Observation well(s) are provided (case -by -case basis).
t. Vegetated filter is provided for overflow (50 feet for 5A waters, 30 feet for other waters) and
detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
rv. UN-D ~RGROU.Ni D LN=TRkTION TRENCH OPERkTION �.- D NLA.LNI=14ANCE AGREEMENT
1. .After every r uncff producing rainraLl event and at least monthly inspect die bypass/overflow szmcrurn, -for
biockage and deterioration and the infiltration system for erosion, trash accumulation. grass cover, and seneral
condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow vegetative
cover to maintain a maximum height of six inches. and remove trash and blockages as needed to maintain
system performance.
_. Remove accumulated sediment annually or when depth is re :aced to 75F0 of pie orginal design depth. Restore
-depth to originai design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed.
?. Tze water level in any monitoring wells will be recorded after a I inch rainfall event and at least once a month.
Chronic high water table eievarions (within 1 foot of the bottom of the system for a period of three months)
shall be reported to DWQ immediately.
5. If DWQ determines that the system is failing, the sivstem. will immediately be repaired or replaced to orL2inal
design mec-if cations. If the system cannot be repaired to perform its desi= function, other stortrlwater conuol
devices as allowed by NCAC 2N .1000 must be designed, anproved and constructed.
6. Remove accurnuiated sediment from the infiltration sysre:n annually or when depth in the unit is reduced
to 75% of tlhe orgznai design. depth. The system shall be restored to the crizinai design depth without
over -excavating. Over-excavatin4 may cause the required water table separation to be reduced and may
comororzuse the ability of the syszern to perform as designed. Removed sediment shall be disposed of in
an appropriate manner and shall not be handled in a manner that will adve ,ely impact water quality (i.e.
sto6coillna near a stormwarer treatment device or S7=14 etc.).
A bench -mark- shall be estabdshed in the inn.itratien syszem. 71 he bench=k- will dccument the original
design dead: so that accurate sediment accumulation rea=-- as can be takzrl_ The aleasur"'la device used
to deter:ri*ie tare de;,th at the benchmark shall be such t"at it will give an accurrate deptIl'a reading and not
readily penea—ate into accumulated sentiments.
When the depth at the bencbmark reads %�. ,. -: the accumulated sediment shall be removed
L otn the syste
Form sWU-107 Rcv 3.99 Page 3 of 4
1 acknowledge and agree by my signature below that I am responsible for maintaining the stormwater
collection system in accordance .with the six maintenance procedures listed above. "I ghee to notify DWQ
of any problems with the system or prior to any changes to the system or responsible parry.
print Name and Title: /ar —
Address: P. �
Phone:
Signan
,Vote: iae legally responsible par-v should nor be a homeowners association unless more Than 507c or -he fors have been scld and
a resident or the s:cbdivision has been named the president.
I. tT D e " P.0 1Yl&A laeJ6_�,Tf_ __, a tiotarr Pubiic for the Sra[e of North Carolina Couaryof
On s l ow do hereby comfy that _ Betty Bullock personally appeared before m� this
25 day of May _ 2001 and acknowiedge the due execudon of the forgoing infii don
basin tnainreaance recuiremears, Wimess my hand and off cial seal.
My commission expires Z a
Form SWU-1D7 Rev 3.99
Page 4 of 4
Permit No.
(to beprovided by Dtv2)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STO'RtiIATI=,R 2NAGEIMTIN 1 PER ffT APPLICATION FORM
UNDERGROUND LNFTLTR.ATION TRENCH SUPPLEMENT
i nis forri may be piWtac,-•vie:i.jror use as an ortnal
Dwp Stonnwaier Ivianaoe^ent Plan Review-
P, complete stor.•nwater manaaement plan submittai includes a sion-nwate: rnana serneni pe.,rut application. an
under—mand irifHLraz?on tre:ic i supplement for each system. desisn calculations. and plans and so_ ecincations .
snowing all stor;nwater conveyances and syste:n derails.
L PROJECT T—N-FOR'YL-kTION
Project Name
Contact Person: C Phone Number: r9i0 ) 3'fCo Tefor: _
For projeets widi multiple inr:ltiarior: systems, a supplement form must be completed for eact system. This
workshert applies io: Trenc: in Drainage Area
(from p m�s) (from Form SWU-101)
E. DESIGN LN, -FORNIATION (arzach supporting calculariom/aocumemation)_
Soils Report Summary (based upon an ac:ualneld invesrigation and soil borings)
Sbil Type �e6�!5 �J.X (lCa,�/� U/J ; 7a6%rrnt /
Innin don Rate 0A 2- _ inliir or c liarlsz (circle appropna:e urirs)
Sr:WT Eevation nsl (Se asoricl High Warer Table elevation)
Trench Design Parameters
Design Volume
Design Storm
Dmwdown TiLme
> erforaieo+ Pipe Size :)=- oramd Pipe Levi Vth
No. Observation Wells
Stone T��;e is ase�`
atone Void'.Z.t..c
c-f.
1-5 ine:l event U.J* inch even: for SA wcse: s, 1 inch event for others)
OR pays
/�il inch diame:e_
357
(rna'l be-requirea' on a case-cy-case basis)
.9
Trench Elevations (in jeer mean sea level)
Bottom Elevation 2.9 fmsi
Storage/Overflow Elevation _ -� _ fmsl
Form SW!-107 Rev 3.99 Pape 1 of 4
r
Trench Dime¢sions
Height .2.. ! fr. Length Height
` 7 fr. Volume Provided 2 !1-13 cu.fr.
HI. REQU-U,'ED ITEMS CEECKLIST
The following chec'.ust outlines design requirements pet the-Siormwater Best 1tiTanagernent Practices manual (N.C.
Decaraneat of Environment, Health and Natural Resou.=ces, November 1995) and Administrative Code Section: 15
A NCAC _H .1008.
laical in the space provided to indicate that the following design requirements have been met and suno_ or-�ng
documentation is attached. If the applicant has designated an agent in the Stor;nwater AVlanaaenient Permit
Application Forte, the agent may initial below. Attach jusUjacation if a requirexnenr has not been met_
Applicants Initials
v a. System is located 50 feet from class SA waters and 30 feet from ether surace waters.
1yfiV b. System is located at lest 100 feet from water supply wells.
c. Bottom of system is ac least 2 feet above the seasonal high water table.
LY AZd. Bottom of the system is 3'feet above any bedrock or impervious soil horizon.
_ e. Off-line system. runoff in excess of the design volume by
asses the syste:n (bypass detail
provided).
System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days based upon innitration
through the bottortl only (a hydrogeoioo4c evaluation may be required).
g. Soils have a minimum hydraulic conducdviry of 0.52 inches per, hour.
h. System is not site on or in fill material or DWQ approval has been obtained.
l i. Plans ensure that the installed system will meet design spec ucanons Ccons�scted or
restored) upon initial operation once uhe project is compiete and the entire drainage area is
stabilized.
j. Svstem is sized to take into account the runoff at the ultimate built-o)ut potential from all
surfaces dr-m=g to the sysren:4 including any or -site drainage.
1C. System is located in a recorded dr-air■ase easement for the purposes of cperation and
x aiSltenanc2 and has recorder acctss ease:neni s to tale nearest public gat -of -way.
1. S vstem captures and iafatmtes the snoff :� om the f z 1.0 inch of mi_niall (1.5 in event
for areas draining to SA watery }.
�1`1JL i ra. Drainage area for the device -is less .roan 5 acres.
L7��1 •A ��sed sw, sediment cat. _tc tro�icec.
e
o. Trench bottom is covered widI a Jaye; of clean sand to an average death of-' inches.
p. Sides of the infltraTdon trench are lined with geotextile fabric.
q. Rock used is free of fines (washed stone) and has a large void ratio.
r. Side to bottom area ratio is less than 4:1.
Farm sWU-1Q7 Rev 3.99 Page 2 of 4 c
s_ Observation well(s) are provided (case -by -case basis).
t. Vegetated filter is provided for overflow (50 feet for SA waters, 30 feet for other waters) and
detail is shown on plans.
u_ A benchmark for checking sediment accumulation is provided.
IV. UNDERGROUND L'NTMTR.-,.TION TRENCH OPER.-TION ti� LkL�i TEN tiCE AGREEMENT
1. er every runoff producing rainfall event and at least monthly inspect the bypass/overflow structure Fo
Aftr
blockage and deter-Loratzen and the infiltration system for erosion. trash accumulation. grass cover, and Peneral
condition.
Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow vegetative
cover, to maintain a maximum heizht of six inches, and remove trash and blockages as needed to maintain
system performance.
3. Remove accumulated sediment annualiv or when depth is reduced to 75`*0 of the original desim-h depth_ Restore
-depth to original design depth w1rhout over -excavating. Over -excavating may cause the required water iabie
separation to be reduced and may compromise the ability of the system to perform as designed.
=. Tne Water level in any monitoring wells will be re4orded after a 1 inch rainfall event and at least once a month.
Chronic high water table elevations (within 1 foot of the bcaom of the system for a period of three months)
wall be reported to D WQ immediately.
5. If DWQ determines that the system is failing, the system will immediately be repaired or replaced to origznal
desi_m spe-iiications. If the system cannot be repaired to perform its design function, other stormwater control
devices as allowed by NCAC 2H' .1000 must be designed, approved and constructed.
o. Remove accumuiated sediment from the infiltration System annually or when dept in the unit is reduced
to 751To of the originai design depth_ The system shall be restored to the original design depth without
over -excavating. Over-excavadnQ may cause the required water table separation to be reduced and may
comprorzise the ability of the system to pe. o= as designed. Removed sediment shall be disposed of in
an appropriate manner and shall not be handled in a manner that will adversely impact water quality (i.e.
stoc= unz near a stormwater treatmear device or szr-nm etc.).
A benchmar-k shall be eszabdshed in the infiltration syszem. T.ae benchm=k will document the od&ai
design depth so that accurate sediment accumulation readings car, be uke:a_ The measuring device useu
to dete.h 'ne zhe deptia at the beaciuiart shall be such that it will Five an accurate dezui h,a=z and not
readily pene=re into accamLiated sediments.
When the depth at the benchmark reads _[ -: the accutnuiated sediment shall be removed
Eorn the system-
Form 5WU-1o7 Rev 3.99 Page 3 of 4
1 acknowledge and agree by my signature below that I am responsible for maintaining the stormwater
collection system in accordance with the six maintenance procedures listed above. -I ag-ree to notify DWQ
of any problems with the system or prior to any changes to the system or responsible party.
Print Name and Title: Zx2z/ rvr�i�'1c�iT
R
Si
:Vole: 1 m legally responsible parry should nor be a homeowners a.:soc.arion unless more than 5017a of me lors have been said and
a resident or rice subdivision has been named the preside^:.
I. !. nLo , eW �ril' )Garth—ze-• a Nocary Rsbiic for the Sr -ate of North L rn 1 i na County of
On low do hereby cerdiy tat Betty Bullock personally appeared before me ties
25 day or" May �2 ,01 and acknowie-d— the due execudoo of the forgoing inMuacion
basin mainEcaance requiremears. Witness my hand and offlciai seal,
INARp� ✓9
ws* o�PR-V Y, e, L,,
o z
011,
S�Ow�Ga��`� o
My commission exvires Z r
Form sWU-107 Rev 3.49 Page 4 of 4
Permit No.
(ro be' provided by DwQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORIW ATER PEZCIT A FLIC A TION FORM
UNDERGROL`?VD LVFILTRATION TRENCH SUPPLEMENT
i ais )brn mzy be photocopied. jor use as an or,'ginal
DWQ Stormwacer Manase,: ent Plan Review:
A commiete stor:nwater rnarnaQement plan subrnir-LJq includes a stormwate: management permit an_ plicat on. an
underr*ound inn.ltration trench supplemenr for each system, design calculations, and plans and specincatiars .
snowing all s:ornawater conveyances and system details.
L PROJECT UNTFORN- L-iTION
P�ject Name . &4/Z Qzr_ � 1 �- - _....
Contact Person: ZD4U17--> /C� /V—.t 7��_ Phone Number �`�%D } ` C� Tan
For projects with multiple inEltradon systems, a sunpietnent form mus: be completed for each syscern. This
wodcsneelaDalies to: Trench _ in Drainaze .lea
Guam pia s) (from Fours S'vVti' 101)
IL DESIGN LNFORNL41I0N (attach sunnordng calculadonsldoc.rmentadon):
Soils Report Surnmary (based upon an actual field invesrigarion and soil borings)
Sbil Type ��dehr15 (reR' laC-, Taeie, &7a
Innl='on Rate D.5 2 in/hr or cf/hr/sf (circle appropriare unirs)
SEWT Elevation __0 Qom% ilnsi (Seasorsa? high Warer Table eievar'ion)
Trench Design Par=eters
Desin Volume
Design Storm
Dmwdown 7=e
Peror,.Ied Pipe S IZ_
Fe -orated Pipe Lena*R
No. Observllion Weds
Stone T}Me
Stone - void'- azic
c1
1.5 inca even: (1.5 inch evens for SA water.;, I inch zvera or arhers)
days
`t inch diame:er
�5, b iz.
(may be -required on a c :.se-cy-case basis)
/V
.9
Trend EIevations (in feer mean sea level)
Bottom Elevation _ 2.•c7 _ frnsi
Storage/Overflow Elevadon irnsl
For SWU-107 Rcv 3.99 Page I of 4
Trench Dimensions
Height — ft. Length
Width �� I fit. Volume Provided cu.ft.
Ea. REQIU�ED ITEMS CEECKLIST
The following checklist outlines design reyuiremenrs per the-Stonnwater Best Management Practices manual (N.C_
Deparunent of Environment, Health and Natural Resources, November 1995) and Administrative Code Section: 15
A NC.="C 2H .1008.
Initial in the space provided' to indicate that the following design requirements have been met and supporting
doccsmentaion is attached. li the applicant has desipated an age:zt in the Stcrrnwater Management Permit
A:niicaEon Form, the agent may initial below. Attach jusancation if 'a repuirement.has not been men
Applicants Initials
V a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
Z'Y b. System is located at least 100 feet from water supply wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
d_ Bottom of the system is 3'feet above any bedrock or impervious soil horizon_
Tom' _ e. Off-line sysmm, runoff in excess of the design volume bypasses the system (bypass detail
provided).
System is deli- med to draw down the desim storage volume to the proposed bottom
elevation under seasonal high water conditions within five days based upon innla- on
through the bottom only (a hydrogeolocric evaluation may be recuired).
Sous have a minimum hydraulic conductivity of 0.5_7 inches per hour.
h. System is not sited on or in Sill material or DWQ approval has been obtained.
Plans ensure that the installed system will meet design spe;.-irications (conspztcted or
restored) upon initial operation once the project, is complete and the entire drainage area is
stabilize
j. System is sized to take into account the runoff, at the ultimate built -out potential from till
surfaces cr-ai- Z to the system, Luciuding any or -site drainage.
k. System is located in a recortied drainage e :seraent for the purposes of coeration and
rma_ntenancV and has recarde: ac :tss easements to die nearest public -'-* JI-waV.
I. System captures and iztfiitrates the nmor"f uom rite :Erst 1.0 inch of rainfall (l.5 inca-event
for areas d"Tairning to SA waters }.
�1�1r'L r . Drainage a:Ca for the device is less than acres.
o. Trench bottom is cove;-., with a layer or clean sand to an average depth of 4 inches.
p. Sides of the infiltration trench. are lined with geomextile fabric.
a. Rock used is free of fines (washed stone) and has a lame void ratio.
r. Side to bottom area ratio is less than 4:1.
Fang 5WU-Io7 Rev 3.99 Page 2 of 4
c
Observation well(s) are provided (case -by -case basis).
Vegetated filter is provided for overflow (50 feet for SA waters, 30 feet for other waters) and
detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
IV. UN-DERGROU D L'+TMTRATION TRENCH OPER.ALTION AND NLAEN=NANCE AGREEMENT
.kfter ever; ranoff, producing rainfall event and at least monthly inspect the bypass/overflow structure for
biockage and deterioration and Lie infla-adon system for e_osion. crash accumulation, grass cover, and General
condincn.
?. Repair eroded areasimmediately, re -seed as necessary to maintain adequate vegPnative cover. mow ve?etaeve
cover to maintain a maximum height of six inches, and remove trash and blockages as needed to maintain
system performance.
3. Remove accumulated sediment annually or when death is reduced cc 75% of the original design depth. Restore
-depth to oriz nai design depth wirheut over -excavating. Over -excavating may cause the required water tabie
separation to be reduced and may compromise the ability of the system to perform as designed.
4. The water level in any monitoring wells will be recorded after a 1 inch rainfall evert and at least once a month.
Chronic hi2jn water table elevations (within 1 foot of the bertom of the system for a period of three mond7s)
shall be reported to DWQ immediately.
5. Ir DWQ detertnines That the system is failing, the system will immediately be repaired or replaced to original
design specifications. If the system cannot be repaired to per:orm its desi-_ function, other stotmwater contiol
devices as allowed by NCAC 2H .I000 must be designed_ aoproved and consuucted.
6. Remove accumulated sedianeur from the infltradon system annually or when depth in the unit is reduced
to 75°'o of the original design depth_ The system shall be reszored to the original design depth without
over -excavating. Over -excavating may cause the required water table separation to be reduced and may
cornorornise the ability of the sysrcm to perxotln as designed. Removed sediment shall be disposed of in
an appropriate manner and shaJI not be handled in a manner chat will adversely impact water quality
srockailiztg near a stcrmwawr treatment device or sLLea.rn- etc.).
A benchmark -ail be es•.abiismed in the infutratien system T:�e beachm. r will dot li-nenr the ernnai
desizn dt-,vch so d:ar accurate sediment accumulation readings car. be 'mken_ The measurL--i¢ device use:
to deter ri_rie the death ar rhe'henc ==`< sha:l be such ahat it will Give an accurate deara'a treating and not
readily penetrate into accumulated sediments. -
f/
TN -hen the depth at the benchmars reads _/�._-- -.'the accumulated sediment shaII be removed
from the system.
Farm SWU-107 Rev 3.99 Page 3 of 4
l acknowledge and agree by my signature below that I am responsible for maintaining the stormwater
collection system in accordance with the six maintenance procedures listed above. -I a--ree to notify DWQ
of any problems with the system or prior to any changes to the system or responsible parry.
Print tN=e and Title: terry 111cX 1 r ,l�,��r;' � � �•-� /�t-v Lor�i�'I ii
Note: ine lebaily responsible oar'v should nor be a homeowners cssoc:a:ion unlessan more rh50% of the fors have been sold and
a residenr of the subdivision has been narned the president.
I. T• CAW C a tiomry PubUc for the S=e of NortL Carnlina Couury of
On low do berebv certify that Betty Bullock personally appeared before me this
25 day of May 2001 _, and acknowied;a dhe due execsuon of the [orzoing inrl=non
basin mainuaaace recuiremeats. Wimess my band =d ofncial seal.
I�P%A'D
�ZARy
_ «
0ow co�(�Z7-10
SEAL_.. �• My commission expires
Fo= SWU-107 Rev 3.99 Page 4 of 4
Permit No.
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
5T0RtiIWATER YL-kINAGEtiT�•IV T FE RN, U T aPPLICA TION F 0 E �NI
UNDERGROUTND INFYLTRA.TION TRENCH SUPPLEMENT
i cis form may be photocipied.jror :ue a5 an orginal
Dw4 an. Review-
A comnle:e stomnwate, marasemeat plan submir'l
underazmund inrzltraaon ire is I suppiement for each
silowin9 all Storrnwater conveyances and systern details.
L PROJECT LN-FORIILMON
includes a sic =, water rna-nagtmenc ce=iC application. an
system. desio-m calculations. and plans and specincwdors
Ptoje= Name . �': {i 1 27 le
Contact Person: Z2.4rLZ2 ZIl--' / P11one Nurnbe' - (` o ) --5t66 1-720cl-
For proje--:s with multiple infiltration systems, a sunplement form must be cornpieted for each systeln. i nis
worksheet mules to: Trend _ Z-A in DraimaQe Area
(from plmLs) (from : orm S'v u-1ol)
EL DESIGN LNFORMATION (attach supporting calculations/documentation):
Soils Report Summary (based upon an acruai) eld invesrigarion and soil borings)
Sail Type o�e6��5 rrl:.Y �icp/c,� c��,Ta6ie-Wit/ w/ II;id
Innitration Rate �2,32 in/hr or cfq r/s-J (circle appropriare unirs)
SHWT Elevation
Trench Design Parameters
Desip Volume
Desiga Storm
Drawdowa Time
,Der:orate- Pipe S i2._
O-r-orateII ?Ice L--riztn
No. Observation Weds
Stone T ,--
Stone void R. acc
_ 0. 9�f0 _ _. sl (Seasonal High Warer Table elevarion)
inc;l eveal: U.-finch eve..^..,jar SA warers, 1 inch event for ocher.-)
�. days
`t•inca diame=:
C) 8 Ct_
(may be-repuired on a case-?y-case basis)
Trench Elevations (injeer me art sea lever)
Bottom Elevation frnsl
Storage/Overrlow Elevation fzzlsI
Forzz S n V-107 Rev 3.99 PaDc I of 4
Trench Dimensions
Height 4, tt ft. Length
Width 3 ft- Volume Provided
IE. REQUZI,ED ITEMS CEECKLIST
7,7 ft.
l31.3 cu.ft.
The following checklist outlines design requirements per the Stormwater Best Management Practices manual (N.C.
Decartmeat of Environment. Healdi and Natural Resources, November 1995) and Administrative Code Section. 1�
A NCAC zH .1008.
Iridai in the space provider to indicate that the following design requirements have been met and suppor-drig
docimentarion is attached. If the applicant has designated an agent in the Stormwater Management Pe=In t
Aaniica, don Forth, the agent may initiaf below. Attach justification if a reauirement.has not beer [net.
Appiicauts IaitiaLs
_ L}/V a_ System is located -50 feet from class SA waters and 30 feet from other sur ace wares.
b. System is located at Least 100 feet from water supply. wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
d. Bottom of the system is 3'feet above any bedrock or impervious soil horizon.
ff e. Of -line syste runoff in excess of the design volume bypasses he system {bypass detail
provided).
f. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasona.i high water conditions within five days based upon innitration
through the bosom only (a hydrogeologic evaluation may be reouired).
g. Soils have a minimum hydraulic conducdviry of 0.52 inches per hour.
h. System is noc sited on or in fill material or DWQ approval has been obtained.
i_ Plans ensure that the installed system will meet design spermcations (consuac_ed or
restored) uvon iridal operation once the project is complete and :,he entire drainage area is
stabiii.ze:i.
.. System is sized to take into account the runoff at the ultimate built -out potential from all
sutra- ces draining to the system, inciuding any off -site drainage.
17VIII. k. System is located in a recorded drairaae easement for the purroses of opera -don and
maintenance and has re=erded access casements to u'le nearest public r,=- i-x-way.
1. S vszcm captures and iafl-iti aces the runoff w om the 5nt 1.0 innch of rainfall (1.5 inch evens
for areas rsai=- to SA waters }.
m. Drainage area for the device -is less :fan 5 acres.
n, cr?uP_as�e,�
c. Trench bottom is covered w L-i a layer of clean sand to an average depch of —'. inches.
P. Sides of the infiltration rrench are lined with oeotextile fabric.
q. Rock used is free of tines (washed stone) and has a large void ratio.
r. Side to bottom area ratio is less than 4:1.
F=SWU-I07 Rev 3.99 Page 2 of 4
s. Observation well(s) are provided (case -by -case basis).
Vegetated filter is provided for overflow (50 feet for SA waters, 30 feet for other waters) and
detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
IV. UNDERGROUND LNFILTRATION TRENCH OPERA.TION A_r-D INLA-24 ENA.NCE AGREEMENT
.maser eve7`1 Lanoff producing rainfall evert and at least monrhiv inspect the bypass/overflow structure -for
blo&x2e and deterioration and the innitration systen: for erosion, trash accumulation. grass cover, and genera?
condition.
roded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow vegetative
Repair e
cover to maintain a ma_cmum heiant of six inches, and remove trash and blockages as needed to maintain
system performanc-__
_. Remove accumulate: sedlirie:it annuallv or when de;�t~ is reduced to 75�0 of the original design depth. Restore
depth to oriain.ai desimh depth witlhom over-eXCavatin?. Over-e;,Cavadng may cause the required water table
separation to be reduced and may compromise the ability of the system to periorn as designed.
ine water level in any monitoring wells will be recorded =Ler a I inch rainfall event and at least once a month,.
Chronic high water table elevations (within I foot of the bottom of the system for a period or d ree months)
shall be reported to DWQ immed iarely.
5. If DWQ dere:m=es that the system is failing, the system will immediately be repaired or replaced to original
desip spe_incations. If the sysrem cannot be repaired to perform its design function, artier sro=water control
devices as a.11.owed by NCAC ?F-I .1000 must be designed, approved and constructed.
b. Remove accu.rnuiated sediment from the innitradon system annually or when depth in the unit is reduced
to 75ro of the original design depth. The sysrem shall be restored to the oriLrnai design depth without
over -excavating. Over-excavarin¢ may cause the required water table separation to be reduced and may
cotnprormse the ability of the system to per orn as designed. Removed sediment shall be disposed of in
an appropriate manner and shall not be handled in a manner chat will adverse?y imnacr water quality (i.e.
stock, iIing shear a srornwarer treatment device or steam. etc.).
A benchmar_k s"all be estabhsned in the infiltration system_ The benchrnarx will document the orisinal
design depth so that aczurare sed i=mcnt ac_—uMuiacon ;eadin!ZS can be taken. T ne nieasur-hz device used
to deter=ne the depth at the bench ank shall be such teat it will give an accurate depth reading and not
ieadjly penetrate mEo acct miHated sed meets.
rI .
Wheu the depth at the benchmark reads the accumulated sediment shall be removed
Lash the system_
Form SWU-107 Rev 3.99 Pagc 3 of 4
I acknowledge and agree by my signarure below that I am responsible for maintaining the stormwater
collection system in accordance with the six maintenance procedures listed above..1 agree to notify DWQ
of any probiems with the system or prior to any changes to the system or responsible parry.
Prirst.Name and Title: ,:n3m-r--v�L�iYIc`�ii
:Vole: 7-lie legally resDOrssi6le part' should not be a homeowners ¢s oc:ction unless more :iian -50ca or he lots nave aeen soil and
a resident of the subdivision has been named the presid'enr_
a Notary P-Sbiic for the State of _North Cara] i na_ County of
Ons 1 ow do Ile:-ebv c---=-v that Betty Bullock personally appeared before m! MIS
25 day of Mai._ _ 2001 , and acknowiedge the due e.:ecurion of the forgoin, infH lion
basin maintenance requirements. Witness my hand and official seal,
���pWARps J�
41
.y * ¢ U
O
SEAL 4W C 1Lly commission expires � �' 0
Form SWU-107 Rcv 3.99 Page 4 Of 4
Permit No.
(ro bei provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORE WATER MAIM AGEMEI i PERNUi APPLICATION FORM
-UNDERGROUND LNFILTRATION TRENCH Sit-PPLEMENT
i nis farm 1?= be piwtocapied jIar use as an original
DaiO Stormwate- Management Plan Re -view; _
,A, comple,.e stor;mwater management plan submittal includes a smrmwater mana2eme n perrmt application. an
underm-ound i.ritltration trench supplement for each systern. design calculations. and plans and s_oecincatiors .
snowulz all stornwater conveyances and sysze:m details.
L PROJECT LNI TOR -MON
Project
Contac: Person: ,�► Phone Nutabe- (`fi%D `f[� °1 &^� -
For proje--z with multiple infiltration systems, a suppiement form must be comnleted for each system. This
worksbe.t applies to: Trelich in Drainage :Azea _
{from plorLs) (from Form SWU-101)
IL DESIGN LNFORNIATION (arLaca supporting calculations/documentation):
Soils Report Summary (based upon art actual field investigariorz and soil borings)
Sail Type wz deb, s rri;.Y ���p/� c-e. �� ; 7,36ie- ,et'/
Infltration Rate inlhr or cLhr/s: (circie appropriare unirs)
S r:WT Elevadon
Trend Design Parameters
Desire Volume
Desigu Stone
Drxweown 1l�li e
P-:'orzm� Pipe Si--,!.
Perforate-? Pipe Lenz:h
No. Obse:Nauon Weds
Scone Ty e (if :set
S tone 'void
O. 90 imzsl (Seasonal High Water Table elevation)
6z,3, d
� 5 _ ine:. event incn evert for c waters, 1 inch .,err for others)
days
!nca diameter
bereauired on a case-oy-case oasis)
Trend Elevations (in feer mean sea level)
Bottom Elevation _ _�� fmsl
StoragejOverrlow Elevation fmsl
Form S U- I47 Rev 3.99 Page 1 of 4
Trench Dimensions - -- --
Height fr. Length ft.
Width 3,fr• Volume Provided cu.ft.
UI. REQLTIRED ITEM.�S CHECKLIST
Tne following checkiist outlines design requirements per the Stormwater Best Management practices manual (N.C.
Deoar=i ent of Environment. Health and Natural Resources, November 1995) and Adm-inis:rative Code Section: i5
A NCAC 21i .1008.
Iridal in the space provided .to indicate that the following design requirements have been met and supoor-.ing
documeatadon is attached. I- the applicant has designated an anent in the Storrnwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not beer met.
Applicants Initials
a_ System is located 50 feet from class SA waters and 30 feet frorn ot`ier surface waters.
ZW
b. System is located at least 100 feet frorn water supply wells.
(��_ c. Bottom of system is at least 2 fee: above the seasonal high water table.
/ _ d. Bottom of the system is S feet above any bedrock or impervious soil horizon.
e. Of` -line syste a. runoff in excess of the design volume bypasses the system (bypass detail
provided).
f. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days based upon infiltrarion
through the bottom only (a hvdrogeologic evaluation may be recuired).
g. Soils have a minimum hydraulic conductivity of 0.52 inches per hour.
h. System is not sited on or in fill mate-rial or DWQ approval has been obtained.
i_ Plans ensure that the installed system will meet design stae_ rications (consUsc:ed or
restored) upon initial op_ eradon once Lhe proiec: is complete and t'ae entire drainage area is
5tabrIized_
J. System is sized to mL- into account the runoff at the uldmaie built -out potential from all
sla:.aces Qrainins to the systern, including any oFf-site dra nape.
k System is located in a recorded drainage easement for the purposes of operation and
ma.inteaanc_ and has recorded access easements to the nearest public rgit of -way.
1. 5 vste n caocures and fat i-" ores the r anoff corn the fast 1.0 inch of rainrf, (I.5 inch event
for areas M u=01 to SA waters ).
i , Drainage area for tue devicY' is less Than ; acres.
Se�_mer. _az
o. Trench bonorn is covered wide a layer of clean sand to an average depth or 4 inches_
p. Sides of the inr:ltradon trench are lined with geotextile fabric.
q. Rock used is free of lines (washed stone) and has a large void ratio.
r. Side to bottom area ratio is less than 4:1.
Foray SwU-[o7 1 'cv 3.99 Page 2 of 4
Observation well(s) are provided (case -by -case basis).
Vegetated filter is provided for overflow (50 feet for 5A waters. 30 feet for other waters) and
detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
IV. UNDERGROUND EN=TR-A-TIOti TRENCH OPER.-kTION RIND N-LALNTEtiAI CE AGREEMENT
y[er every runoff producing rainfall evert and at least monthly insne4t the bypass/overflow strucnsre for
blockase and deterioration and tte infiltration syste,n for erosion, trash accumulation. grass cover, and general
conmEloa.
Repair eroded areas immediately. re -seed as necessary to rnaintain adequate vegerative cover, mow ve_etat?ve
cover tO maintain a rn=raurn height of six inches. and remove crash and blockages as needed to maintain
syste:n performance.
�. Remove accnraulated sediment a.*�nually or when depth is reduced to i5�"o of the originai design depth. Restore
depth to orimmal design dept`rz without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of tlie system to perform as designed.
The water level in any monitoring wells will be recorded after a 1 inch rainfall event and at least once a month.
Chronic hiall water table elevations (wid n I foal Of the bortom of the systern for a period of three months)
shall be reported to DWQ immediately.
5. If DWQ determines that the system is faiiing, the system will immediately be repaired or replaced to original
desio_q spec fications. If the system cannot be repaired to perform its design function, other storawater control
devices as allowed by NCAC 2::.I000 must be designed, approved and constructed.
Remove accumulated sediment from the infiltration syste;n annually or when depth in the unit is reduced
to 75% of the ons nal design depth. The system shall be restored to the oriEinal design depth without
over-excavatinW_lOver�xcavaeng may cause the required water table separation to be reduced and may
comorot ise the abiliry of the systern to per-orn as designed. Removed sediment shall be disposed or in
an appropriate manner and shall not be handled in a manner that will adversely impact water quality (1.e.
stockpiling near a storm.water treatment device or stream, etc.).
A benchmark s :ail be estabiisned in the infiltration sysa-m_ The bencluma-rti will dcc=enr the original
desiop depth so that accurate sediment accurrauladon r-adi-rzs can be zaken. The measur-iQ device szsed
to deterrai_ne the depth at rhe'benciimarc shall be sscn teat it will eve an accurate dept`f reading and not
readily perle=te nto accamn fared sediments.
Wien the depth at the bencbmarx reads _ _ the accumulated sediment shall be removed
Lora the system.
Forth SWU-107 Rev 3.99 Pag- 3 of 4
I acknowledge and agree by my signature below that I am responsible far maintaining the stormwater
collection system in accordance ;�irh the six 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 parry.
Parr Name and Title: ,Lc2Le4 1�ita6�,=.:r;�T�,v_
Adores
Phone:
S i mart
:Noce: i ne legally responsible pc;-v should nor ae a nomeawner,- =sac.'arior unie.:s more rnan - 05'a of the lors have been sold and
a resident of the subdivision has been named the president.
a.4otara Public for the S=e of North Caroli-na _ , Counry of
On low do hereby certify that Betty Bullock personally appeared before me this
25
day of Maw_ ! 2001 and acknowiedp the due exec adoa of the forgoing int =—lion
basin maintenance requiremems. Wimess my hand and of-icial sea.i,
o �ZARy
PU
O,y04 0
Sr 4L.......... ........ 'my commission expires [�
Form SWU-1Q7 Rev 3.44 Page 4 of 4
}
Perrrtit No.
(to be -"provided by DW2)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER M.AI AGEMENTI PER ET APPLIC-A_TION FORM
UNDERGROUND LNFILTR_gTION TRENCH SUPPLEIVEINT
7:i.5form, may be photocauie'.for USE aS an Drginal
_DaiO S[ornwater Manaae^�ent Pia,: Revie%
A comniere siorrnwater management plan submittal includes a sto=water, rnanaaemenc per='c application. an
underg—round inf1hration trench supplement for each system, desi;n calculations. and plans and so_ ecincatiors .
showin; ail stornwater convevances and sysiern derails.
L PROJECT LT+FORYL-kTION
-
Contac: Ptnon: C Phone NLrnbei — (7/0) L!5�6 2&20
For proje--:s wiL`1 multiple intltl-acon systems, a sunplernent form most be completed for each sysrem- This
worxsheet applies to: Trench 8 in Drainage Area
(from pia s) (front For. SWU-101)
II. DESIGN LNFORN ATION (attach supporting calculatioizs/docdnentarion):
Sails Report Sun=ary (based upon an acuaiiield invesr, -anion and soil borings)
soil Type 4,W &, 4 hris7a6i- &nL/
Innitration Rate 0252 __ in/lir or cfhU's1 (circle appropriare unirs)
Sr?47 Eevadon 0. 90 :`nsl (Seasonal High Warer Table elevariorz)
Trench Design Parameters
Desism Voittm.e
Denim Storm
Drawdowa lime
Per -orates Pipe Si e
Ferforated Pipe Lenz*'I
No. Obseriarion W--ds
Stone
S tone void :Lt=L
c.f.
�. Inc:. eVerlr (.1-4 inch everr for S1=S wares;, I inch event for orhers)
days
Inca dia.me:
&��9 (may be-reau=re on a case -ay -case aesis)
Trench Elevations (in f eer mean sew level)
Bottom Elevation 2•q frrrsl
StorsgelOve.*#Iow Elevation 0 iiasi
Form SWU-107 Rcv 3.99 Page I of 4
Trench Dimensions ._ ._
Heialit .
fr_ Length C7. 0 ft.
Width 3.� ft. Volume Provided 43/3 cu.ft.
M.g�QT�ZRED TTEI�,S CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Manaaernerit Practices manual (N.C.
Deoarune,it of Environment, Health and Natural Resources, November 1995) and Adr inistracve Code Section: 1-4
A NCAC 2H .1008.
iriidai in the space provided to indicate that the following design requirements have been met and supoot—a
documentation is attached. If the applicant has designated an agent in the Stormwaier Manaaement Pe.;nit
AupEcation Form, the agent may initial beiow. Attach justiacation if a requirement has not been me, -
Applicants iaitials
L)j&V _ a. System is located SO feet from ciass SA waters and 30 feet horn oL7e: surface waters.
Z�IA/ b. Svstem is located at Least 100 feet from water supply wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
L; l / d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
i� -- e. Off-line system. runoff in excess of the design volume bypasses the system (bypass detail
provided).
!ZY�_ f_ System is designed to draw down the design storage volume to the proposed bottom
eievation under seasonal high water conditions within five days based upon infltiaraon
through the bottom only (a hydroQeologic evaluation may be reouired).
Soils have a minimum hydraulic conductivity of 0.52 inches per, hour.
h. Svstern is noc sited on or in fill material or DWQ approval has been obtained-
i. Plans ensure that the installed system will meet desim or
restored) upon initial overanOn ca= the project is complete and :he e:?t'...re drainage area is
stabid ed.
i. Svstem is sized to take into account u"ie runoff at the uitimate built -out potential from all
sur,aces draining to the system, including any off -size damage.
_Z 21LI& k. Svstem is located in a recorded r_r-;;.age el se-nent for the pumoses of operation and.
mainieaanc_ and has recorded access ease-nents to ite nearest public right-or-Yvay.
1. Svste µ capt'lres and inritrates Lhe msnor from the Ent 1.0 Lzich or" rainf it ( l.f inch eve nt
for areas dr=- ing to SA waters }_
rn. Drainase arva for the devicz s less ratan 1 acres.
a. T re.^.ca 4ottom is covered w.6-1 a layer of ciean sand to an average depth of 4 inches.
p. Sides of the in -Filtration trench are Lined with geotextile fabric.
q. Rock used is free of fines (washed stone) and has a large void ratio.
r. Side to boaorn area ratio is less than 4:1.
Fora swU-107 Rev 3.99 Page 2 of 4
c-
Observation well(s) are provided (case -by -case basis).
t. Vegetated filter is provided for overflow (50 feet for SA waters, 30 feet for other waters) and
detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided_
i4. UNDERGROUND L TILTPUMON TRENCH OPERATION A_ND 1YLkEN7ENA.NCE AGREEIN ENT
1. per evens i unoff producing rainfall eve it and at least monthly inspect the bypass/overtiow structure for
blockage and deterioration and the infiltration system for erosion. trash accumulation. grass cover, and senerw+
condition_
_. Revair eroded areas imme fiately, re -seed as necessarl to maimain adequate vegetative cover, mow vegetative
cover to maintain a maximum height of six inches, and remove trash and blockages as needed to maintain
system performancz.
;. Remove accumulated sediment a_*Inualiv or when dead, —Ts reduced to 75�'o or the original design death. Restore
depth to origina.i design depth without over -excavating. Over -excavating may cause the reouired water tabie
separation to be reduced and may compromise the ability of the system to perform as desiQned-
4. The water level in any monitoring wells will be recorded after a 1 inch rainfall event and at least once a month.
Chronic high water table elevations (within I foot of the bottom of the system for a period of three months)
small be reported to DWQ immediately.
If DWQ determines that the system is failing, the system will immediately be repaired or replaced to original
design spemfications. If the system cannot be repaired to perform its design function, oche: stornwater control
devices as allowed by NCAC 2I_ .1000 must be designed. approved and constructed.
Remove accumulated sediment from the infiltration system annuallv or when depth in the unit is reduced
to 755'o of the original design depth. T"ne system small be restored to the or'lginal design depth without
aver -excavating. Over -excavating may cause the required water table separation to be reduced and-mav
compromise the ability of the sysrcm to pe:7,orn as desigaied. Removed sediment shall be disposed of ire
an appropriate manner and shad not be handled in a manner rhac will adve-rsely impact water auadry (z.e.
stockpiling' near a stormwarer treatment device or wean, etc.)_
A benc;,=X snail be established in the infitraden system, The bencllim :k will document the orizins
design depth. so LhaI accurate se; imenc accumular-ontr_adi=s car, be mkEC ,-?_ i at u-neasurina Qevlcz- uses
to dete�m-u-Tie tnP depth at tie benc:l='< sha11 be such that it will Cave an acc:Ij'�re depril ocaCl z rod- not
,cadlly penetmm into accuT"li ulate se;amears.
i/
IfN-hen the depth at the beac3umarr reads % the accumulated sediment shall be removed
LLorµ the 54stem.
Form SWU-L07 Pcv 3.99 Page 3 of 4
I acknowled-e and agree by my signature below that I am responsible for maintaining the stormwaier
collection system in accordance with the six 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 part;.
Print Blame and Title: ,��. — — /l/rLC7��jYlG•��
Address
Prone:
Signan
:SOLE: T7w legaily responsible parry should nor be a homeowner,; associarion unless more rnan -5017c of the ?ors have beer sold and
a resident of the subdivision has been named the president.
I i We EaW Vd-s 41 - a Votary Public for the Scare of North Carl i na_ County of
Ons 1 ow do Ise-eby ce:z y rfiar _ _ BettL Bullock pesanally appeared before me dais
25 day of . May 2001 and ack-nowiedge [he due emccurioa of the for-oing iaE don
basin mainreaance requiremears. Wimess my hand and oric:al seat,
WAgO�,v
off' OIAgy 9
v
V ti
'On _.
oysCow caU�'�
...„„.„....-• My commission exaires
Farm sWU-iO7 Rev 3.99 page 4 of 4
Permit No.
(ro beprovided by DWg)
State of North Carolina
Department of Environatent and Natural Resources
Division of Water Quality
STORNOYVATER PERNET APPLICATION FOI-Ltii
UNDERGROUND LNFILTR-TION TRENCH SUPPLEi1ZENT
T ris jbn may be photocopied jbr use as an original
DW0 an Review:
A comlile:e stornwater rB-naaerneat plan subrturr.,d iancludes a st4rmwater ma-r,--gt�:nent per nit application_ an
undergound inMrzation trench supplement For each s✓stern, design calculations. and plans and specincatiors .
snowing all stornwater convevances and system details.
L PROJECT INFORM-�TION
project'Name : ,A Za0-27 _ zP—Z /
Contact Person: .4,[f zza�� _ Phone
For prcje--z wit$ multiple inrlt-adon systems, a supplement form, must be completed for each system. i his
wodcshet: arolies to: Trench in Drainage Area I _
(from plans) (f-rom Form SWU-101)
IL DESIGN LNFORMATION (attach supportiz;cr calculations/doc-:umenta-tion):
Soils Report Summary (based upon an ac-uallield invesrigarion and soil borings)
Soil Type e7e7ri5
LIE on
Rate O�� 2 in/hr or cfIm's: (circle appropriate urirs)
Sc;W-T E'ievation 0.170 ilnsl (Seasonai Hign Water Table e?eva.-ion)
Trend Design Pnr-arnete:s
Desip Volume
DeSIM Sloan
Drawdown 7iine
Perforated Pipe Sice
Perrorat A Pipe Lenz*2
No. Obse radon Wells
Stone a�-" z�c4 .1
Stave Voic'Z:C
inc:. eloren= (I.; inch rye.^.r jor 5,? were; s, 1 inch r)enr for orhers)
(� 7� days
inch diameter
(may be-reauire4' on a c : 7e-by-case oasis)
d
Trend Elevations (in jeer mean sea level)
Bottom Elevation l 2, .,7 finsl
Staragt/Ove.�ow Elevation £rn.sl
Fora Swti-lr Rcv 3.99 Padc I of 4
F Trench Dimensions
Height ---,.. _ ft. Lengths ft.
Width ft. Voiume Provided cu.ft.
tit. REQCTRED ITEMS C.T�CK LIST
T-ne following checklist outlines design requirements per the-Sto=%vater Best Management Practices manual (N.C.
Deparunent of Environme it. Health and Natural Resources, Nove-nber 1995) and Administrative Code Section_ If
A IN CA =L .1008.
ln"itiai in the space provided to indicate that the following design recuire rents have been met and suppordnz
documentation is anached. L ttie applicant has designated an agent in the Stornwater Maragernent Pe.~mit
Application Form. the agent may initiaf below. Attach justcation if a requirement has not been met -
Applicants Lnitials
System is located -50 feet from class SA waters and 30 feet from other surface waters.
b. System is located at Ienst 100 feet from water supply wells.
c. Bottom of system is at Ieast 2 feet above the seasonal high water table.
- l!d-1 d_ Bottom of the system is 3'feet above any bedrock or impervious soil horzon-
I�'�/i% e. Off -lime system. runoff in excess of the design volume bypasses the system (bypass detail
provided). J
f. Svstem is designed to draw down the design storage volume to the proposed bottom
eievaden under seasonal high water conditions within rive days based upon innitration
through she bottom only (a hydrogeolog;c evaluation may be reouired).
g. Soils have a minimum hydraulic conducrvity of 0.52 inches per hour.
YIA h. Svstem is not sated on or in fill material or DWQ approval has beta obtained -
Plans ers*Ure t1tat the installed system will meet design specifications (consa-scted or
restored) upon initial operation once the project is complete and t<he entire d:-daage area is
stabilized.
i. System is sized to take into acccunt the runoff at the ultimate built -out potential from all
surraces draining to the system, including any or -site draina2t.
k. Svstem is located im a recorded dr-:—nage easement for the purposes of eceration and
tr=tenance and has recorded access e^serne-ms to tide nearest puraizc :,gnt-ar-way.
1. System cacrures and inLl=es i anolf uom the _fmz 1.d inch of rain- all (1 .5 inch -event
for areas ar3*ring to SA watts ).
r,-. Drainage area for the devicz'is less ::pan 5 acres.
S�_C se4ir e:'t AFL. t." lza:zz
Q. l rencii bonorn is covered with a layer of clean sand to an average depth of ' u'lciies.
p. Sides of the iris{ltrstion [reach are lined with Qeotexdle fabric.
q. Rock used is free of fines (washed stone) and has a large void ratio.
r. Side to bottom area ratio is less than 4:1.
Form SWU-107 Rcv 3.99 Page 2 of 4 c
Observation well(s) are provided (case -by -case basis).
Vegetated filter is provided for overflow (50 feet for SA waters, 30 feet for other waters) and
detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
IV. UNDERGROUND L=TRATION TRENCH OPERkTION Ati-D INLALN ENAI'tiCE A.GREEiti1ENT
i, -,e: eve-r rsnor producing rainfall evert and at least monLrdy inspect tie bypass/overflow s=. cture for
blockage and deterioration and L-le irirlcation system for erosion, trash accumulation, grass cover, and seneral
condition.
Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow veaetaz`ve
cover to maintain a maximum height of sir inches, and remove trash and blocicaaes as needed to maintain
system per o=ance.
3. Remove accurnuiated sediment annually or when denth is reduced to 75�'o of the or~ginai design denth. Restore
-deoth to ong-tnai design depth without over-excavauns. Over -excavating may cause the required water tanie
separation to be reduced and may compromise the ability or the system to perform as designed_
The water level in any monitoring wells will be recorded after a I inch rainfall event and at least once a month.
Chronic hizh water table elevations (within I foot of the bottom of the systern for a period of three months)
shall be reported to DWQ itnmediate:y.
5. If DWQ determines that the system is failing, the system wil.1 immediately be repaired or replaced to originnai
design specifications. If the system cannot be repaired to per`otm its design functon, other sto=, water control
devices as allowed by NCAC 2H .1000 must be designed, aonraved and constructed.
6. Remove acc=ulated sediment from the infiltration system annually or when depth in the unit is reduced
to 75% of the otiQinal design depth. The system shallbe restored to the oriz nai design depth without
Over -excavating. TOver-excavat?ng rray cause the required water table separation to be reduced and may
compromise the ability of the system to pertor-n as designed. Removed sediment shall be disposed of in
an appropriate manner and shall not be handled in a manner that will adverseiv impact water quality
stock7LL E near a stornwater treamenr device or stream., etc.).
A benc:2=ark saaL be es'm.bi.ished in the infiltration systmem- i ne benchrnar_'�c will dcc,=e:lt the orzinad
design deotF so chat accurate sediment accurnuiadon reacmngs can be raken. The meas=q device used
to deter ine the deodi at the benchc,ar{ shall be such drat it will give an accarate deozh readies: and not
readily pene�ate nto acur c.:ulated se^.itrzents. v
When the depth at the bencb-mark reads % ti , the accumulated sediment shall be removed
r ors the system.
Form SWU-107 Rev 3.99 Page 3 of 4
1 acknowledge and agree by my signature below that I am responsible for maintaining the stormwater
collection system in accordance with the six maintenance procedures listed above. I agree to notify DWQ
of any problems with the system or prior to any changes to the system or responsibie party.
Print Name and Title:. zV-z / C& /� �%� �> , 6za6a� .
Address: 0
Phone
Sian
1Vote: i ne ie; al?y responsii7le pc.-*v should nor oe a homeowner; a,:socian.'on unless more ri an 50% or me for.; have been soid and
a residenr of me subdivision hci; been named the presiderzr.
1 �. e L-'o�Ct icy✓c�� a tio= Public for the Stale of Counry of
Ons low do hereby c=rtify dhat _ Betty Bullock verso Iaily avveared before me this
25
day of May 2001 , and acicnowied;e the due execution of the forgoing iruiitradon
basin mm rmance re qu�remenn-- imess my hand and officiai seai.
a�
ti C
OW
SF —AL ~......... 'my commission expires � � 0
If
Ferm SWU-107 Rev 3.99 Pap: 4 of 4
Permit No.
- (co beprovided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STOR_M�VAT•ER MANAGEMEITT PER:MIIT APPLICATION FORZM
UNDERGROL`N-D L7V'FILTRA--TION TRENCH SUPPLEIN ENT
iris Porn may oe piwtocaaied, for +Ze as an ari"inal
_DW0 Stornwater Management Plan Review-
A complete storm water mwnagRment plan submit`:al includes a storawater manaQe:neni pe -nit application. an
underff*ound intltration trench supplement for each sVsnem. design calculations. and plans and so_ ecifications .
snowing all storinwater conveyances and system deraiis.
L PROJECT LNFOORMA TION
Project Name
Contac: Pe -son: ��_1 A. Phone Number: (WO
For projez with multiple L--ti ltYation syste:ns, a supplement form must be completed for each system- This
woricsne«�: ap_ giies to: Trench 17Yq 575 in Drai.nasP Area --�
Jrom pi ) (from Form SWU-101)
IL DESIGN LNFORMATION (attach supporting calculidons/documentation):
Sans Report Summary (based upon an ac-ual J7eld invesria anion and soil borings)
Soil Tyce oredris ;.i� (rC�/�� C��Jsv; Tah/� n?3Z� w/ 14,21t T///)
I EMMIrion Rate -0,6 Z in/hr or cJhr/sf (circle appropriare units)
SPWi Elevation 4. 90 fznsl (Seasonal High Water Fable elevation)
Trmch Design Parameters
Desi-m Volume
Design Storm
Drawdown i true
Pe.:orater' Pine Size
Penorated Pipe Lenzr-�
No. Observation Wens
Stone : r.�p (1T .�Cer`
tone void :t.tc
4 c-f.
1 inc:, eveat (L inch evenrfor cA waxers, I inch r.,eni for arhers)
Dt ( 9' days
inca di=e:er
f-
Wzi (May be -required on a case -by -case basis)
A
Trench Elevations (in jeer mean sea level)
BonomElevation 2.•9� frnsl
Storsge,'Ovafiow EIevation _ " _ fr=l
Fora SWU-107 Rev 3.99 Pa -MC I of 4 r
Trench Dimensions � �� - -
Height 1, ft_ Length rL
Width fr. Volume Provided 9�� cu.h.
M. REQUi'RED ITEMS CECIKLIST
The following checkiist outiines design requirements per the-Stounwater Best Management Practices manual (N.C.
Department of Environment, Health and Natural Resources, November 1995) and Administrative Code Section: 15
A NC.-kC 2H .1008.
Initial in the space provided to indicate mat the following design requirements have beer met and supporting
doccsmentadon is anached. If the applicant has desio—nated an agent in the Storrnwater Management
Apnlicarion Form. the agent may initial below. Attach jusdf1-:cation if'a requirernent.has not been me, -
Applicants Initials
V a. System is located 50 feet from class SA waters and 30 feet from other surace waters.
b. System is located at least 100 feat from water supply wells.
c. Bottom of system is at least _ feet above the seasonal high water table.
d. Bottom of the system is S'feet above any bedrock or impervious soil horizon.
e. Of -line sy5tern, runo in excess of tse design volume bwasses the system (bypass der ii
provided).
f_ System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days based upon innlr-ation
through the bottom only (a hydrogeoloc- c evaivadon may be required).
g. Soils have a minimum hydraulic conductivity of 0.52 inches per hour.
i3. System is not sited on or in till mase.ial or DWQ approval has'been obtained.
i. Plans ensure that the installed system will meet design sperm ftcations (constructed or
restored) upon initial op_ erasion once the protect is camp_ iete and the endre drry=a-2e area is
stabilized.
� Y Z j. System is sized to take into account the runoff at the ultimate built -out potential from all
s::rfaces ,,raining to the system, including anv orf-site ci ase.
1� Svstem is located in a recorded dr..isnaQ,, easement for the purposes or operation and
maiztezance and has ,,corded access easemears to the nearest public :fight -or' -way.
1. System capcires and LaLtrates the runoff Norm the drst 1.0 irch of rainfall (1.5 inc.� evert
for areas draining to SA waters ).
�ZC2r4/ r^. Drainagt ar--a forte devzce.is less :hap 5 acres.
s._--`..eC s'w j.:v, sz�=sera =sC. �tC �' _ �r•.`.`/?CeC.
o. Trench boc-orn is covered w.tla a layer of clean sand to an average depth of r inches-
p_ Sides of the infls`radon trench are lined with geotextile fabric.
q. Rock used is free of fines (washed stone) and has a large void ratio.
r. Side to bottom area ratio is less than 4:1.
Form SWU-[o7 Rev 3.99 page 2 of 4 �'
Observation wells) are provided (case -by -case basis).
Vegetated filter is provided For overflow (50 feet for SA waters, 30 feet for other waters) and
detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
IV. LZVDERGROUNTI) LN+TMTR-AMOK TRENCH OPERAMN AIND CE AGREEMENT
ae: eve�J runoff producing rainfaL event and at least tnontlly inspect L'ie bypass/overlow sa-Licture-for
biockaQe and deterioration and the llfU[ ation system for erosion, a -ash acc umulanon. grass cover, and Qe:herai
condition.
?. Repair eroded areas immediately, re -seed as necessary to maintain adeouate vegetative cover, mow vegetative
cover, to maintain a maumuri heiz ht of six incites, and remove trash and blockages as needed to maintain
system perfornancz.
Remove accumulated sediment annually or when depth is reduced to 75% of the anginal design depth_ Restore
depth to original design depth without over -excavating. Over -excavating rzav cause the rewired water tabie
separation to be reduced and may compromise the abiiiry or the system to per orm as designed.
ine ware: level in any monitoring wells will be recorded after a 1 inch rainfall event and at least once a month.
Chronic high water table elevations (within 1 foot of the bottom of the systetn for a period of three mantas)
Shall be reported to DWQ immediately.
5. if DWQ determines that the system is failing, the system will immediately be repaired or replaced to original
desigxh sperm ncations. If the system cannot be repaired to perform its deli= funcdon, other stormwater control
devices as allowed by NCAC 21I .1000 must be designed, approved and constructed.
6. Remove accumulated sediment from the infiltration system annually or when depth in the unit is reduced
to 75% of the original design depth. The system shall be restored to the original design depth without
overexcavating. !Over-excavadn4 may cause the rewired water table separation to be reduced and may
compromise the ability of the system to periorn as designed. Removed sediment shall be disposed of it
an appropriate matcher and small not be handled in a manner that will adversely impact water quadry (i.e.
srocicpwng near a stormwater treament device or stream etc.).
? benchmark shod be es=- fished in the infiltration system. T _-2um e bencHrarrk will docent the ozi�al h
design depr_ri so t_rlat acc=ate sediment accnrauiatzon readinas car, be zakez. The measur-3z devics use:
io dete.Tnine the depth at the benciiz=x shall be such teat it Will c-ive an accurate dt:) 1 rea= and riot
1_rdily peaetrte into accumalated sedi.rnears.
When the depth at the benchmark reads ' , the accumulated sediment shall be removed
L om the system. -
Form SWU-107 Rev 3.99 Page 3 of 4
I acknowledge and agree by my signature below that I am responsible for maintaining the stormwater
collection system in accordance with the six maintenance procedures listed above. I aairee to notify DWQ
of any problems with the system or prior to any changes to the system or responsible parry.
print Name and Title: as
:Vote: ine lea ally responsible pare should nor be a homeowners arsociarion unless mare than 509'''a ofthe Lars have been said and
a resident of the subdivision has been named the preside.^.r-
I. ,EJuja&L 7�� _ a Nodary Pubiic for the State of -North Carol ins Counry of
On I ow do he:-ebv certify dear , BettY Bullock pe sonally appeared before mt this
25 day of ma[ _ 2001 , and acknowied-s dhe due execauo❑ or me forgoing mr-litr don
basin maanreaance requirements—. Wimess my baud and of5cial seal.
Eawggos
�)IAR y
�° oys Us�-`°�z
cAL. `Ow -CO SIN My commission expires
Farm SWU-107 Rev IO Page 4 of 4
Permit No.
(to be provided by DW21
State of North Carolina
1 Department of Environment and Natural Resources
Division of Water Quality
STOiLtiENATER �. NTAGE: rN i PER;, T ATPLICATION F ORNI
UNDERGROUND LNFILTRATION TRENCH SUPPLEMENT
i rjsjibr mra Fe pnatcco-r iet.Jbr rue as an or rral
DW Storriwater ManaQer:ent Pfan Review:
A complete sto=L water m-nnaQernenc plan submittal Laciudes a stormwater management pe,nit apolication. ar,.
unde-apround irLfUrration trench supplement for each s ✓stem, desist calculations. and plans and specincatiors .
snowing all stor awater conveyances and system details.
L PROJECT INTORvLkITO-N
Proje=-
Contac: Person: .a Phone Numbe' :
For projecz with multiple infiltration systems, a supplernent form must be completed for each system. i nis
wodcsbe_t applies to: Trench in Drainage .Aea _ I _
(from pl ) (from Form .—, W -101)
IL DESIGN LN-'ORMA'TION (arazch supporting calcularions/docurnentation):
Soils ReportSummary (based upon an actual jteid invesrigarion And soil borings)
Soil Type W (4eloldTable, r»az/ w/ 701//)
Innitrarion Rate o•52 in/hr or cLrhr/s-A (circle apprcprare unirs)
Sc-:W7 Eevad.on 0. 92 fms1 (Se_asonal High 'surer 1 aide elevation)
Trench Design Parameters
Desi= Volume
Design Storm
Drawdown =e
a�or�ted Pipe Sipe
Pe:forame Pipe LenvTn
No. Obseriacon W-ds
Stone I (— I -Cep"`
S tape � aic'.Z::oc
77/.3 c.f.
J incrl elect (I.: inch even for SA wares. 1 inch even: for others)
Clays
� J
inch diante:e:
ce-rea_uired on a C=e-oy-case basis}
Trench Elevations (in jeer mean sea level)
Bottom Elevation _ 2.q _ f•nsi
StoragafOve,-flow Elevation 3. _ fmsl
Form SWU-i47 Rev 3.99 Pa-,e I of 4
Trench Dimensions
Height ft. Length 6 ft.
WidLh 17. Volume Provided cu.ft.
]M, REQL-IRED ITEMS C=CKLIST
Tine foilowing chec.'List outlines design requirements per the-Stornnwater Best Management Practices manual (N.C.
Depar=nent of Environment. Health and Natural Resources, November 1995) and Administrative Code Section: 15
A -+CAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentadon is attached. If the applicant has desi--riated an agent in the Storrrnwater Management Pe. -,nit
Agpiicadcn Form, the agent may initial below. Attach justification if a requiremerit has not been me'-
Applipnts Initials
t/ a. ' System is located 50 feet from class SA waters and SO feet from other surface waters.
b. Svste:rl is located at Least 100 feet frorn water supply wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
7- -�v'Wl _ d. Bottom of the system is 3 feel above any bedrock or impervious sou horizon_
e. Off-line system. runoff in excess of the design volume bypasses the Svstem (bypass derai:�
provided).
f. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within Live days based upon inultration
through the bottom oniv (a hvdrospolog4c evaluation may be required).
z. Sails have a minimum hydraulic conducdviry of 0-52 inches per hour.
h. System is not sited an or in fill material or DW"Q approval has been obtained_
i_ Plans ens that the installed s-�szcm will meet design spec tications (consuaczed or
restored) upon initial operation once the proiec: is complete and the e;ndre drzzinage area is
s tabil]2ed
j. System is sized to tak- into account the nanofT at the ultimate buns[ -out potenidal Lrom all
suita= dr:antnQ to tine SYsze:n., inclu=g any of= -site d=i,nage.
lc. System is located in a recorded dr-ainage-asemenj for the purposes of creraion and
mann:eaanc!! and leas -corded ac:ess easements to the nearest public :?EhI-QC-,Way.
1. Svsie:r caururns and i.nllitrales the runoff ;:om the fn5 1.0 Lnch of rat^_Iwll (1— inch evert
for areas dra n1ncrm SA waLe;s ).
Drainaze acre: for the device' is less roan f ac. es.
o. Trench boc-Lorn is covered wide a layer of clean sand to an average death of 4 inches.
p_ Sides of the infiltration trench are lined with geotextile fabric.
q. Rock used is free of fines (washed stone) and has a large void ratio.
r- Side to bottom area ratio is less than 4:1.
Form SWU-107 12ev 3.99 Page 2 of 4 L
Observation well(s) are provided (case -by -case basis).
Vegetated filter is provided for overflow (50 feet for 5A waters, 30 feet for other waters) and
detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
IV. UNDERGROUND LN- TMTRATION TRENCH ORERTION IND ILAEN ENA..NCE AGREEMENT
1. =t:�er every rumor producing rainfall event and at least monthly inspect tine bypasslove-low structure Tor
blockage and de,_—noration and die infiltration system for erosion. trash accurnulation. grass cover, and general
conaition.
-. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow vegetative
cover to tnaintaut a maximum height of six incites, and rEmove trash and blockages as needed to maintain
system pertor-mancz.
3. Remove accumulated sediment annually or when depth is reduced to 75% of the original desizr, depth. Restore
-depth to oM'2inai design depot without over —excavating— Over-exca.vattna may cause the required water tabie
separation to be reduced and may compromise the ability of the system to perform as designed.
The water level in any monitoring weils will be recorded after a 1 inch rainfall event and at least once a month.
Chronic high water tabie elevations (within 1 foot of the bcrtom of the system rcr a period of Three months)
shall be reaorted to DWQ immediately.
]. If DWQ dezermuies that the system is railing, the system will inumediaze?y be repaired or repiaced to originai
desist sperm Ecatiom. If the system cannot be repaired to perform its des-= funcd.on, other stormwarer contiol
devices as allowed by NCAC 2H .1000 must be designed. auvroved and constructed -
Remove accumulated sediment from the infiltration system annually or when depth in the unit is reduced
to 75 % of die original design deptl`t. ine system shall be restored to the original design depth without
overexcavating_ Over-2xcavating may cause the required water table separation to be reduced and tmav
compromise the ability cf the system to perform as designed Removed sediment shall be disposed or in
an appropriate manner and shall not be handled in a manner that will adversely impact water quality (i.e.
stockpiling near a stormwater aeatment: device or swam. etc.).
A benchmark siail be estabiisae in the infiltration system 77e benc:-unark will document the otinal
desig*t deoLn so t ,ar ac;um[e seed menr accurnuiacon readi zs car, be take;:. The meas=4 eevice used
to determine die depth at the benchmark, shall be such thzr it will give an accurate dept<`i reading and not
re:atly pene4ate into accuImulared sea menrs.
N
When the depth at the bencbnark reads -,. the accumulated sediment shall be removed
Lorn the system.
Form SWTT-Lo7 Rev 3.99 Page 3 of 4
I acknowledge and agree by my signature below that I am responsible for maintaining the stormwaier
collection system in accordance with the six maintenance procedures listed above. -I agree to notify DWQ
of any problems with the system or prior to any changes to the system or responsible party.
Print Name and Title:_, � �� i e2L ez C'CL/eE
:Vote: The legally responsible party should nor be a homeowners association unless more than 50% of the lots have been said and
a resident of the subdivision has been named the president.
DY Uj e-C1 UA JrkaL _• a Notary Public for the Mare of ,North Carolina County of
Oils 1 ow • , do hereby certify that Betty Bullock personally appeared before me this
25 day of Mav 2001 , and acknowled;e the due execudoo of the forgoing infiltration
basin maintenance requirements. Witness my hand and official seal,
���•l ED Wg9�S
«�t
0y 'OU130
SEAL` My commission expires Z 0�
SWU-107 Rev 3.99 Page 4 of 4