HomeMy WebLinkAboutSW8010128_CURRENT PERMIT_20020819STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW RL2 /D 119S
DOC TYPE
� CURRENT PERMIT
APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
o�/�oUS(lg
YYYYMMDD
�1
wt
AUG 21 2002�
STROUD ENGINEERING, P.A.Aa
_-
CONSULTING ENGINEERS
HESTRON PLAZA TWO
151-A HWY. 24
MOREHEAD CITY, NORTH CAROLINA 28557
(252) 247-7479
August 19, 2002
Mr. Rick Shiver, Water Quality Regional Supervisor
NCDWQ- WiRo
127 Cardinal Diiyc ESICI1Si011
Wilmington. North Carolina 28405
Re'. Notice of Violation- Atlantic Harbor Condominiums
Stonilwatcr Permit No. SW8 0 10 128
Dear Mr. Slii\,cr.
We are in receipt of a copy of the Notice of Viohlion for the above referenced project (fated Jule
24. 2002. We have also discussed this project Nvilh N1s. Noelle Lutheran . of }-our Staff. The project was
constructed in Iwo phases and the first phase slonusraler nlamugcmenl facilities haiv been in place for sonic
time. We Nvithheld certification simply to gait for the completion of phase l4. In the flllllrc. MQ Will certify
a phase ifconlpleled in accordance vilh the plans approved by your office.
Phase Iwo of the slorlimaler managenlerlt l'acililies is now completed and final landscaping and
secding/sodding provisions will begin soon. As discussed with Ms. l..,uthcran. tale owlter colnnliticd In
completing the storinw iter management devices to Cnsilre llo fill -tiler problems with four agency,
f have attached cerfificatioll for the pmicct w1iich is the onh• remaining ilenl addressed in the Juh-
24, 2002 correspondence. if I can provide any addilonal ilirormaliou, please lci me know. I would retluesl
that \,oil notifi, Chief Building Inspector. Mr. Rick Shllitz,'rowa of Morehead City. th;tl like protccl is rlo\r
in compliance. it is lily understanding that Ms. E.utlierarl is on leave the remainder of this +Neck and request
that you slake arrangements for his notification.
- rrrrry��'
?incach.. ";k 14 C
,);on�aldES�D. (Cuili he .� .Y
` SEA r z
Cc: ma's 133 :
Ronnic Gillikin : O
Bob Griffith•'•�;G/NEEQ; ..•�Q``�
Rick Shultz •,,�OrQlCu1 i9e?�i�
107 COMMERCE ST.
HESTRON PLAZA TWO
SUITE B
102-D CINEMA DRIVE 151-A HWY. 24
GREENVILLE, NC 27858
WILMINGTON, NC 28403 MOREHEAD CITY, NC 28557
(252) 756-9352
(910) 815-0775 (252) 247-7479
;• State Stormwater Management Systems
Permit No. SWS 0 10 128
Atlantic Harbor Condominiums
Stormwater Permit No. SWS 010128
Carteret County
Designer's Certilic-atinn
as a dui)' registered Zncarnudin
the State of�1'01rth Carolina, having been authorized to obscrv<t periodica / Aekly/full time) the construction of
the project,
i_x1 A- mS_j_— (Project)
For (Project Owner) hereby state that, to the best of my abilities; due care
and dilit:7 vas used in the: observation of the project construction such that. the constuiction was observed to he
bUllt within substantial compliance and intent of the approval plans and specifications.
The chceklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
41 - - SAun FIc. L-i - 2,1 z�vv) .i A WAS st�oe- t-��D o Acr�o� E s i�G c� i t�t�t�5 B�( � r
001 of -ram PLM3 APKOvEND = GF [ZFt�. Ttl Of_16IN4A_ I B0 ftZj WAS
[ o(9r- of MfAT RES uUl )'
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ss e . '�'p q. S ESA L
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13343
1Zeoistration Nun bur. 133
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State Stormwater Management Systems
Permit No. SW8 0 10 128 .
Certification Requirements:
4—e— I. The drainage area to the system contains approximately the permitted acreage.
Ph—f-- 2. The drainage area to the system contains no more than the permitted amount of built -upon area.
13. All the built -upon area associated with the project is graded such that the runoffdrains to the system.
F- �_d. The structure elevations are per the approved plan.
lj��5. '['he structures al-e located per the approved plans.
-brash rack is provided on the outlet/bypass struCure.
7. All slopes are grassed with permanent ve(ictation.
fj tMS. Veygetatcd slopes are no steeper than 3:1.
(zW—C). The inlets and outlets ttre located per the approved plans and do not cause short-circuiting of' the
system.
10. "file permitted amounts of surface area aild/or volume have been provided.
1 1. Recuired drawdown devices are correctly'sized and located per'the approved plans.
Edkj2. Ali required design depths are provided.
13. All required parts of'the system are provided; such as a sediment chamber, stone, per[orated piping.
al l.* The overall dimensions of the system, as shown oil the approved plans, are provided.
SANSflt_ E� 5`(S� A . WAS S4c,� . �iEvJ TD A000rv�0�A C- 51G
t c..t tt �y 7 . oUro,/0Arc.. bE-S(�ti WAS f Drp OF I"T �t��o .
cc: NC;DI-;NR-D\V�Regional Office OP—Ir0tk)1a-t_ L� �(� jgp
Morehead Cite Fimiding Inspections
7
Nurth Carolinit
Department of Environment and Natural Resources
Division of \Vlkler Qtiality
\N'ilrninolon Reuiollal Office
Michael F. Easley, Governor
William G. Ross, .Ir., Seeretary
May 18. 2001
Mr, Robert W. Griffith, Jr., Managing Partner
Dockside Partriership
PO Box 650
Morehead City. NC 28557
Subject: Permit No. SW8 0 10 128
Atlantic Harbor Condominiums
High Density Stormwater Project
Carteret County
Dear Mr. Griffith:
The Wilmington Regional Office received a complete Stormwater Management Permit Application for Atlantic
}-Harbor Condominiums on April 5, 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 1 SA NCAC 21-1.1000. We are
forwarding Permit No. SW8 010128 dated May 18, 2001, for the construction of Atlantic 1-Harbor Condominiums.
This permit shall be effective from the date of issuance until May 18, 2011, and shall be subject to the conditions
and limitations as specif icd therein. Please pay special attention to the Operation and Maintenance requirements
in'this permit. Failure to establish an adequate system for operation and maintenance ofthe stormwater management
systenl 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
adjudicator), hearing upon written request within thirty ()0) days followinb 1•eceipt of tliis permit. This request must
be in the form of a written petition, conforming to Chapter 1 5OB.of the North Carolina General Statutes. and filed
with the Office of Administrative 1-lcarings, P.O. Drawer 27447, Raleigh, NC 2761 1-7447. Unless such demands
are made this permit shall. be final and binding.
If VOL) have 111y CILIC:S11011S; or need additional information concerning this matter, please contact Linda Lewis, or
nic at (910) 195-1900.
Sincerely,
Rick Shiver
Water Quality Regional Supervisol•
RSS/art: S:1WQSISTORMWAT\11ERMFRO 10128.MAY
Ron CL11I1phe1-, P.E.
Jeff Schaffer. DCM
Morehead City Building Inspections
Linda Lewis
Wilmington Regional Office
Central files
127 Cardinal Dr. I;xt., Wilmington, north Carolina 28405 'Telephone 910-395-3900 FAX 910-350-2004
An Equal Opportnuily Affirmative Action Employer 50`%, recycled/10%, posi-consumer paper
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Statc Stormwater Manauement Systems
Permit No. SWh 01U1?8
STATE OF NORTH CAROLINA
I)F:1'ARTMENT OU ENNARONMENT AN]) NATURAL lZrSOIJRCES
DIVISION OF WATER QUALITY
STATE STORM WATER MANAGEMENT PERMIT
HIGH I)ENSITY I)EVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Staf ites of North Carolina as amended, and
other applicable Laws. Rules, and Re�oulations
i
Pi-RM1SSION IS HEREBY GRANTE� D TO
Dockvide Parinership
Atlantic Harbor Condominiums
Carteret Counly
FOR THE
construction, operation and maintenance of 2 infiltration trenches and 2 sand filters 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 oil file with and approved by the
Division of Water Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until May 18, 2011 and shall be subject to the following
spccifiied conditions and limitations:
L DESIGN STANDARDS
1. This permit is effective only with respect to the nature and volume of stormwater described in the
application and other supporting data.
2. These storn7watcr systems have been approved for file management of stormwater runoff as described on
Pageof this permit, the Project Data Sheet. The stormwater controls have been designed to handle the
runoff• from 6,453. 2,865. 30.915. and 3,991 square feet of impervious area, respectively.
3. Approved plans and specifications for this project are incorporated by reference and are enforceable parts
of the permit.
4. "file tract will be limited to the amount of built -upon area indicated on page i of this permit, and per
approved plans.
5. Due to site contraints, a vegetated filter is not provided for the runoff from System 41-1. The vegetated filter
for System 91-2 is the expanse of grassed area prior to the runoff entering the system.
G. `EThe runoff from all built -upon area within the permitted drainage area ofthis project must be directed into
the permitted stormwater control system.
Stale Slormwaler Management Systems
Permit No.
SW8 010128
DIVISION OF WATER QUALITY
PRO.IECT I)IISIGN DATA Slirr,,T
Project Name:
Atlantic 1-larhor Condominiums
Pcrmh Number:
S"18 010128
Locatiow
Carteret County
Applicant:
Mr. Robert W. Griffith, .ir.,
Managing Partner
Mailln- Address:
Dockside Partnership
PO Box 650
Morehead Cily, NC 28557
Application Date:
April 5. 2001
Name of Receiving Stream/Index #?:
Harbor Channel 1 White Oak
120-36-14
Classification of Water Body:
"SC"
Trench /.Sand hiller Number:
1-1 I-2
S-i A&B
S-2
`french/Sand I"Ilter Depth; feet:
1' 7"
20"
20"
Bottom Elevation, FMSI.:
6.5 4.5
4.18/4.5
3.9
Drainage Area, acres:
.26 .35
.79
.11
"Total Impervious Surfaces; W:
6,453 2,865
30,915
3,991
Offsite Area entering fond, ft2:
none, per Engineer
Required Surface Area, W:
---- ----
360
360
Provided Surface Area. ft':
---- ----
270
36
Required Storage Volume, ft':
531 343
854
119
Provided Storage Volume, ft':
569 425
855
120
Temporary Storage Elevation_ F MSL:
7.5 5.08
5.85/6.17
5.57
Controllina Orifice: _
overflow overflow
20 a 6"
3 cr,6"� pipe
Type of Soil:
Natural sandy soils and historic
fill
Expected Infiltration Rate:
3" per hour
Seasonal High Water Table Elevation:
2.5 1,MSL
Time to DrawdoWll, how's:
4 1
----
-=--
3
State StorEnwalor Mami-emeni Sysicros
Permit No. SWS 010125
11. SC14E1)U1,F: 0 F COMPLIANCE
The stormwater manaOenicnt system shall be constructed in it's entirety. ve-elated and operational for its
intended use prior 10 the construction ofany built -upon sttrfacc.
During, construction, erosion shall be kept to a minimum and any eroded areas ofthe system will be repaired
immediatel�r.
The permittee shall at all times provide the operation and maintenance necessary to assure the permitted
stormwater systern 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 vegetated filter
d. Immediate repair of eroded areas.
C. Debris removal and unclogging of structures. orifice devices, filter media, catch basins and piping.
g Access to the structures must be available at all times.
h. The grassed area serving as the vegetated filter will be kept grassed with no erosion, and must
distribute the runoff evenly over its width.
4. Records of maintenance activities must be kept and made available upon request to authorized personnel
of DV IQ. The records will indicate the date, activity_ name of person performing the work and what actions
were taken.
The facilities shall be constructed as shown on the approved plans. This permit shall become voidable unless
the facilities are constructed in accordance with the conditions of this permit, the approved plans and
specifications, and other supporting data.
6. Upon completion of construction, prior to issuance of a Certificate of Occupancy, and prior to operation of
this permitted facility, a certification must be received from an appropriate designer for the system installed
certifying that the permitted facility has been installed in accordance with this permit%the approved plans
and specifications, and other supporting documentation. Any deviations from the approved plans and
specifications must be noted on the Certification.
7. If the stormwater system was used as an Erosion Control device, it must be restored to design condition prior
to operation as a stormwater treatment device, and prior to occupancy of the facility.
A modification must be permitted prior to an), construction. The following items will require a modification
to the permit. The Director may determine that other revisioris to the project should require a modification
to the permit:
a. Anv revision to the approved plans, regardless of sire.
b. Project name change.
C. "Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the drainage areas.
C. FUrthUsubdivision, acquisition, or sale of the proJect at-ca. The pro , ect area 1 s de Fi 11 ed as al I property
owned by the permittee, for which Sedimentation and Erosion Control Plan approval was sought,
or for which a CAMA Major Permit was issued.
f. l:illino M. altering, or piping of any vegetative conveyance shown on the approved plan.
A copy of the approved plans and specifications shall be maintained on file by the Permittee fora minimum
of tcn years from the date of the completion of construction.
4
State Storillwater ManaPnnent Svsicros
Permit No. S%V8 010128
10. Prier to the sale orally portion ofthc property. all access/maintenance casement to the stormNvater facilities
shall he granted in favor of the pernnittcc if access to the storm water facilities will he restricted by the sale
of any portion of the property.
1 ] . The permittcc is responsible for verifying that the proposed built -upon area does not exceed the allowable
huilt-upon area.
12. The Director may notify the pernnittce when the permitted site does not nnect one or more of the minimum
requirements ofthe permit. Within the time frame specified in the notice, the permittee shall submit a written
time schedule to the Director for modifying the site to meet minimum requirements. The permittee shall
provide copies of revised plans and certification in writing to the Director thatthe changes have been made.
13. The permittec shall notify the Division of an), name, ownership or mail ing address changes within 30 days.
M. GENERAL CONDITIONS
1. "phis 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 formal permit request must he submitted to the Division of Water
Quality accompanied by an application fee, documentation from the parties involved; and other supporting
materials as may be appropriate. The approval of this request will be'considered on its merits and may or
may not he 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 he imposed by other government agencies (local, state, and federal)
which have jurisdiction.
4. In the event that tine 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 storrnwater management systems.
5. The permittee ygrants DENR Staff permission to enter the property for the purpose of inspecting all
components of the permitted storrnwater management ilicility.
6. "file permit may be modified, revolved and reissued or terminated for cause. The filing of a request for a
permit modification, revocation and reissuance or termination does not stay any permit condition.
7. Unless specified elsewhere, permanent seeding requirements for the storrnwater control must -,follow the
euideiiiies established in the North Carolina Erosion and Sediment Control Planning and Design Manual.
Permit issued this the 18111 clay of May. 2001.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
•��„, Kerr T. Stevens, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number- SW8 (1110128
5
State Stormwater Management Systems
Permit No. SNW8 Olol )8
,atlantic Harbor Condominiums
Storm,,vater Permit No. SW8 Ol Ol28
Carteret County
Designer's Certilicatimi
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 dili4ocilce was Used ill the observation of the project Go11�lI'UCtI[}ll SUCH that tEle Coll Stl'uetloil was observed t0 he
built within substantial compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
Signature
Rc�,istration Number
Date
• r
SEAL
6
State Stormwater Management Systems
Permit No. SW8 010128
Certification IZequircrllents:
1. The drainage area to the system contains approximately the permitted acreal;e.
2. The drainaoc a1'ca to the system Wiliallls no 11101"e than the permlued amount of built -upon area.
1 All the hrrill-upon area associated with the project is graded such that the runolTdrains to the system.
4. The structure elevatirnls are per the approved plan.
5. The structures arc located per the approved plans.
6. Trash rack is provided on the outlet/bypass structure.
7. All slopes are grassed with permanent vefletation.
8. Veoctated slopes are no steeper than ):I .
9, The inlets and outlets are located per the approved plans and do not cause short-circuiting; of the
System.
0. The permitted amounts of surface area and/or volume have been provided.
1 1. Required drawdown devices are correctly sized and located per the approved plans.
12. All required design depths arc provided.
1 a. All required parts of the system are provided, such as a sediment chamber, stone, perforated piping.
14. The overall dimensions of the system, as shown on the approved plans, are provided.
cc: NCDLNR-DWQ Re,ional Office
Morehead Cite 1iL111d111i! inspections
7
a.,<sa;'r a� Ya Ys..a.ifa%eo,i+... 'OFFICE' USE ONLYfi.,#$Ko-'3#:'>
Date Received
Fee Paid
Permit Number
ao, �, I
Q
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original
I. GENERAL INFORMATION
I. Applicants name (specify the name of the corporation, individual, etc. who owns the project):
Dockside Partnership
2. Print Owner/Signing Official's name and title (person legally responsible for facility and compliance):
Robert W. Griffith, Jr-. , Managing Partner
3. Mailing Address for person listed in item 2 above:
P.O. Sox 650
City: Morehead Clty State: NC zip: 28557
Telephone Number: ( 252 } 728-4191�
4. Project Name (subdivision, facility, or establishment name - should be consistent with project name on
plans, specifications, letters, operation and maintenance agreements, etc.):
Atlantic Harbor Condominiums
5. Location of Project (street address):
104 S. 3rd Street
City: Morehead City County: Carteret
6. Directions to project (from nearest major intersection):
from intersection of U.S. Hwy. 70 and SSR 1182— Atlantic Beach Brie, take U.S. 70
Arendell St. approx. 1.5 miles to 3rd St., take right on 3rd St. to enter pro'ect
site
7. Latitude: N 340 43' 12" Longitude: W 76° 42',17"
8. Contact person who can answer questions about the project:
Name: Robert W. Griffith, Jr. Telephone Number:
II. PERMIT INFORMATION:
1. Specify whether project is (check one): x New . Renewal
of project
252 7 728--4191
Modification
Form SWU-101 Version 3.99 Paae 1 of 4
2. If this application is being submitted as the result of a renewal or modification to an existing permit, list the
existing permit number n/a and its issue date (if known)
3. Specify the type of project (check one):
Low Density High Density x Redevelop General Permit Other
4. Additional Project Requirements (check applicable blanks):
x CAMA Major x Sedimentation/Erosion Control _404/401 Permit _NPDES Stormwater
Information on required state permits can be obtained by contacting the Customer Service Center at
1-877-623-6748.
III. PROJECT INFORMATION
1. In the spare provided below, summarize how stormwater will be treated. Also attach a detailed narrative
(one to two pages) describing stormwater management for the project.
sand filter systems and infiltration systems
2. Stormwater runoff from this project drains to the WHite Oak River basin.
3. Total Project Area: 1.60 acres 4. Project Built Upon Area: -(o %
5, How many drainage areas does the project have? 5
6. Complete the following information for each drainage area. If there are more than two drainage areas in the
project, attach an additional sheet with the information for each area provided in the same format as below.
Basuz irtfoiiriai�on" ..:
I 1 Drainage Area `S y : 5 i airtagj F rea N T
D
I.eceiv tn9 Stream Name
Harbor Channe
Receiving Stream Class
SC
if
Drainage Area
0.258 AC
0.110 AC
0.791 Ac
0.354 AC
Existing Impervious* Area
n/a
n/a
n/a
n/a
Proposed Im ervious"Area
0: 148 AC
0.092 Ac
0.710 AC
0.066 AC
% Impervious* Area (total)
57 %
84 %
90 %
19 %
I
0.0y7 AC
0.0` -7AC
n/a
100 %
On -site Buildings
6173 SF
1134 SF
8735 Sf
1699 SF
n/a
On -site Streets
n/a
2668 SF
17854 SF
n/a
n/a
On -site Parking
__
—
_
On -site Sidewalks / Patios
280 SF
189 SF
1049 SF
830 SF
n/a
Other on -site pool area
walkways
n/a
n/a
2692 + 585 S7
336 SF
202$ SF
Off -site
n/a
I n/a
n/a
n/a
n/a
Total: 6453 SF
1 3991 SF
Total; 30915 SF
2865 SF
7_02$ SF
Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SWU-101 Version 3.99 Page 2 of 4
7. How was the off -site impervious area listed above derived? n/a
IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
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. If lot sizes vary significantly, a
table listing each lot number, size and the allowable built -upon area for each lot must be provided as an
attachment.
2. The following covenants are intended to ensure ongoing compliance with state stormwater management permit
number as issued by the Division of Water Quality. These coverwnis may
not be changed or deleted without the consent of the State.
2. No more than square feet of any tot shall be covered by structures or impervious materials.
Impervious materials include asphalt, gravel, concrete, brick, stone, slate or similar material but do not include wood
decking or the water surface of swimming pools.
3. Swales slurll not be filled in, piped, or altered except as necessary to provide driveway crossings.
4. Built -upon area in excess of the permitted amount requires a state stormwater management permit modification prior to
construction.
S. All permitted runoff from outparcels or future development shall be directed into the permitted stormwater control
system. These connections to the stormwater control system shall be performed in a manner flirt maintains the
integrity and performance of the system as permitted.
By your signature below, you certify that the 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 parties and
persons claiming under them, that they will run with the land, that the required covenants cannot be changed or
deleted without concurrence from the State, and that they will be recorded prior to the sale of any lot.
V. SUPPLEMENT FORMS
The applicable state stormwater management permit supplement form(s) listed below must be submitted for
each BMP specified for this project. Contact the Stormwater and General Permits Unit at (919) 733-5083 for the
status and availability of these forms.
Form SWU-102
Wet Detention Basin Supplement
Form SWU-103
Infiltration Basin Supplement
Form SWU-104
Low Density Supplement
Form SWU-105
Curb Outlet System Supplement
Form SWU-106
Off -Site System Supplement
Form SWU-107
Underground Infiltration Trench Supplement:,
Form SWU-108
Neuse River Basin Supplement
Form SWU-109
Innovative Best Management Practice Supplement
Form SWU-101 Version 3,99 Page 3 of 4
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. The complete application package should be
submitted to the appropriate DWQ Regional Office.
1. Please indicate that you have provided the following required information by initialing in the space
provided next to each item.
• 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 neap 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 sixes, runoff calculations
- Drainage areas delineated
- Vegetated buffers (where required)
ViI. 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): Stroud ENgineering, P.A.
Mailing Address: 151—A N.C. Hwy. 24
City: Morehead Cit
Phone:{ 252 } 247-7479
VIII. APPLICANT'S CERTIFICATION
State: NC Zip: 28557
Fax: ( 252 ? 247-4098
I, (print or type name of person listed in General Information, item 2) Robert W. Griffith, Jr.
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 record er# d t the proposed project complies with the requirements of 15A
NCAC 2H .1000 , %% /% i ////
Signa
U11
Date: VZZ /'9 4
Form SWU-101 Version 3.99 Page 4 of 4
Permit No. __ OJLV B
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
UNDERGROUND INFILTRATION TRENCH SUPPLEMENT
This form nwy be photocopied for use as an original
DWQ Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
underground infiltration trench supplement for each system, design calculations, and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name:
Atlantic Harbor Condominiums
Contact Person: Robert W. Griffith, Jr. Phone Number: ( 252 ) 728-4191
For projects with multiple infiltration systems, a supplement form must be completed for each system. This
worksheet applies to: Trench T- 1 in Drainage Area - 1
(from PC
(from Form SWU-101)ti d�
H. DESIGN INFORMATION (attach supporting calculations/documentation):
Soils Report Summary (based upon an actual field investigation and soil borings)
Soil Type Wan do -urban phase soils/Sandy historic fill,Wando-urban fill phase,
and Seabrook fill soils
Infiltration Rate 3 in/hr or cf/hrlsf (circle appropriate units)
SHWT Elevation avg. 4.5 fmsl (Seasonal High Water Table elevation)
Trench Design. Parameters :
Design Volume 5 c.f.V'
Design Storm 1 inch event'(,. inch event for SA waters, 1 inch event for others)
Drawdown Time 0.17 days
Perforated Pipe Size n/a inch diameter
Perforated Pipe Length n / a ft.
No. Observation Wells n/a (may be required on a case -by -case basis)
Stone Type (if used) n/a
Stone Void Ratio n/a
Trench Elevations (in feet mean sea level)
Bottom Elevation
Storage/Overflow Elevation
5.5 fmsl
7.5 fmsl
Form SWU-107 Rev 3.99 Page 1 of 4
Trench Dimensions
Height
Width
2.5
III. REQUIRED ITEMS CHECKLIST
ft. Length
ft. - ' Volume Provided
2Z-7.5
ft.
56.9 tuft.
The following checklist outlines design requirements per the Stormwater Best Management Practices manual (N.C.
Department of Environment, Health and Natural Resources, November 1995) and Administrative Code Section: 15
A NCAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
rZ_— f.
g
a h
System is Iocated 50 feet from class SA waters and 30 feet from other surface waters.
System is located at least 100 feet from water supply wells.
Bottom of system is at least 2 feet above the seasonal high water table.
Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
Off-line system, runoff in excess of the design volume bypasses the system (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 infiltration
through the bottom only (a hydrogeologic evaluation may be required).
Soils have a minimum hydraulic conductivity of 0.52 inches per hour.
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 (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
tabi iz d.
Y10— 9 tF �A c)j. System is sized to take into account the.runoff at the ultimate built -out potential front all
surfaces draining to the system, including any off -site drainage.
+a be re. W ed k. System is located in a recorded drainage easement for the purposes of operation and
9-D1%__ maintenance and has recorded access easements to the nearest public right-of-way.
n c>18 GI o f� Irf ` System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event
kpc A�N for areas draining to SA waters ).
uy m. Drainage area for the device is less than 5 acres.
ash 5 OLreQ n. A pretreatment device ( filter strip, grassed swale, sediment trap, etc.) is provided.
ho — (0" si one o. Trench bottom is covered with a layer of clean sand to an average depth of 4 inches.
Vl A 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.
Side to bottom area ratio is less than 4:1.
Form SWU-I07 Rev 3.99 Page 2 of 4 �'
°i s. Observation well(s) are provided (case -by -case basis).
yta ec�eyel�mertt" Vegetated filter is' provided for overffow (50 feet for SA waters, 30 feet for other'waters) and
detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
IV. UNDERGROUND INFILTRATION TRENCH OPERATION AND MAINTENANCE AGREEMENT
After every runoff producing rainfall event and at least monthly inspect the bypass/overflow structure for
blockage and deterioration and the infiltration system for erosion, trash. accumulation, grass cover, and general
condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow vegetative
cover to maintain a maximum height of six inches, and remove trash and blockages as needed to maintain
system performance.
3. Remove accumulated sediment annually or when depth is reduced to 75% of the original design depth. Restore
depth to original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as de§igned. '•�r,
�f +
4. The water level in any monitoring wells will be recorded after a 1 inch rainfall eventland at�leasPt,'on once -month.
Chronic high water table elevations (within 1 foot of the bottom of the system for_a.pcnodof'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; Qther ^Z;?rnw"aet control
devices as allowed b NCAC 2H .1000 must be designed, approved and constructed. `•��„���`' �'`�
Y g PP eie�rrrrf
6. Remove accumulated sediment from the infiltration system annually or when depth in the unit is reduced
to 75% of the original design depth. The system shall be restored to the original design depth without
over -excavating. Over -excavating may cause the required water table separation to be reduced and may
compromise the ability of the system to 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 benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used
to determine the depth at the benchmark shall be such that it will dive an accurate depth reading and not
readily penetrate into accumulated sediments.
1!
When the depth at the benchmark reads , the accumulated sediment shall be removed
from the system.
1=orm 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 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: Robert W. Griffith, Managing Partner
Address: P.O. Box 650, Morehead City, N.C. 28557
Phone: 252-7282�191� f 4�z41 .,- Date: 1zZ�a/
Signature:
Note: The legally responsible party should not be a homeowners association unless more than 50% of the lots have been sold and
a resident of the subdivision has been named the president.
I, . 1(-I 7%/11E2ci C A-4r, can S/Q , a Notary Public for the State of klowrN county of
✓E71J do hereby certify that _ 70 /3672 r W . 0,C- i Ff 11� personally appeared before me this
2�2A-10 day of , --ZOO and acknowledge the due execution of the forgoing infiltration
basin maintenance requirements. Witness my hand and official seal,PIP
SS
A,; '•.� 9
•
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Abe `�G
�'•�%'A/J���••,.••' �• �.` My commission expires T.
Form SWU=107 Rev 3.99. Page 4 of 4
Permit No. 7 G/ b 12 8
(to be provided by_DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
UNDERGROUND INFILTRATION TRENCH SUPPLEMENT
This form may be photocopied for use as an original
DWQ Stormwater Management Plan Review: .
A complete stormwater management plan submittal includes a stormwater management permit application, an
underground infiltration trench supplement for each system, design calculations, and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name : _ A4 `ar -k- C V a rlD_a r C o,n a o,mi V),i um S-
Contact Person: Robert W . Gt'�,%fii+�1 , Tr. Phone Number: (252- ) i 28 — LA 19 1
For projects with multiple infiltration systems, a supplement form must be completed for each system. This
worksheet applies to: Trench in Drainage Area �' Z
_ (from plans) (from Form SWU-101)
IL' DESIGN INFORMATION (attach supporting calculations/documentation):
Soils Report Summary (based upon an actual f eld invIstigation and soil borings) „
Soil Type Mixed �"star{c f� l sah s y✓j clay. faun%-ala� I t A s e s +a 3fo (�„ be re,naved)
Sand �v 1 oaw.,1 sc vxd be tcl
Infiltration Rate 2 infhr r cf/hr/sf (circle appropriate units)
SHWT Elevation Z . -5 fmsl (Seasonal High Water Table elevation)
Trench Design Parameters
Design Volume
Design Storm
Drawdown Time
Perforated Pipe Size
Perforated Pipe Length
No. Observation Wells
Stone Type (if used)
Stone Void Ratio
Aa+e-rm;l%e& toy P W 0
3 41 c.f.
�. inch event (1.5 inch event for SA waters, I inch event for others)
days
inch diameter
7-o2 ft. ((o) e S , 1212. PF i i,.I le,n5-11�
)nl a (may be required on a case -by -case basis)
No, S
0.
Trench Elevations (in feet mean sea level)
Bottom Elevation '1 . 5 0 fmsl
Storage/Overflow Elevation 5. g fmsl
Form SWU-107 Rev 3.99 Page 1 of 4
Trench Dimensions
Height
Width
III. REQUIRED ITEMS CHECKLIST.
Length
Volume Provided
Z D Z ft.
3 y -7 cu.ft.
The following checklist outlines design requirements per the Stormwater Best Management Practices manual (N.C.
Department of Environment, Health and Natural Resources, November 1995) and Administrative Code Section: 15
A NCAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have'been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
ApplKants Initials
a. System is located 50 feet from class'SA •waters and 30 feet from other surface waters.
b. System is located at least 100 feet from,watensupply 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 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 (constructed 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 ultimate built -out potential from all
surfaces draining to the system, including any off-site.drainage.
k. System is located in a recorded drainage easement for the purposes of operation and
_rD S- aintenance and has recorded access easements to the nearest public right-of-way.
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 ).
m. Drainage area for the device is less than 5 acres.
n. A pretreatment device ( filter strip, grassed swale, sediment trap, etc.) is provided.
o. Trench bottom is covered with a layer of clean sand to an average depth of 4 inches.
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 Rev 3.99 Page 2 of 4• c
6 1 a s. Observation well(s) are provided (case -by -case basis).
no— feeyt�a� fit. 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 INFILTRATION TRENCH OPERATION AND MAINTENANCE AGREEMENT
I . After every runoff producing rainfall event and at least monthly inspect the bypass/overflow structure for
blockage and deterioration and the infiltration system for erosion, trash accumulation, grass cover, and general
condition.
Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow vegetative
cover to maintain a maximum height of six inches, and remove trash and blockages as needed to maintain
system performance.
3. Remove accumulated sediment annually or when depth is reduced to 75% of the original design depth. Restore
depth io original design depth without over -excavating. Over -excavating may cgpe,tb4jfquired water table
separation to be reduced and may compromise the ability of the system to perform,as_l hed.
4. The water level in any monitoring wells will be recorded after a 1 inch rainfall"event, d at•,once a month.
Chronic high water table elevations (within 1 foot of the bottom of the system fora per " oNht
reemonths)
shall be reported to DWQ immediately. '
5. If DWQ determines that the system is failing, the system will immediately be repaired gr•re�e'ed to original
design specifications. If the system cannot be repaired to perform its design;funeyt i St}j'k rmwater control
devices as allowed by NCAC 2H .1000 must be designed, approved and consimk$1606`
6. Remove accumulated sediment from the infiltration system annually or when depth in the unit is reduced
to 75% of the original design depth. The system shall be restored to the original design depth without
over -excavating. Over -excavating may cause the required water table separation to be reduced and may
compromise the ability of the system to 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 benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used
to determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the depth at the benchmark reads I .5 , the accumulated sediment shall be removed
from 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 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: Robert W. Griffith, Jr. Managing Partner
Address: P.O. Box 650, Morehead City, N.C. 28557
Phone: 25�-7 e-44J� 1 ! .& —& ,. Date:
Signature:
Note: The legally responsible party should not be a homeowners association unless more than 50% of the lots have been sold and
a resident of the subdivision has been named the president.
n'0A s„ 1e_ , a Notary Public for the State of bl.l N EN , County of
�Z �y t: do hereby certify that _ �� �T „ ,,. �Q �F f iT, ,�, ? personally appeared before me this
day ofn/GA�1�/ and acknowledge the due execution the of g infiltration
basin maintenance requirements. Witness my hand and official seal, /J
005*661I11/*0I0
0
:n ..p�IIB L I-
SEAL ��y'9G�••••••N••'Cl
covN,,,•�`''
My commission expires L�'i• L�2' ?�a3
Form SWU-107 Rev 3.99 Page 4 of 4
I.
II
STORMWATER MANAGEMENT PERMIT
1
6Z�-
lose$"
APPLICATION .`��Q•�.•••••••O</ '•,
4 �•. O�E5S1p�•Mq ��
Q' y•
SAND FILTER SYSTEM SUPPLEMENT Z is SEALft
* 13343
00600490
PROJECT INFORMATION
Project Name: Atlantic Harbor Condominiums
Contact Person: Robert W. Griffith, Jr.
Phone Number: (252) 728-4191
This workshect applies to System S- 1 in Drainage Area S-1
DESIGN INFORMATION
Design Requirements:
Sediment Chamber:
Volume = 540 cf per acre of drainage area
Minimum 18 inch depth
Surface area of 360 sf/acre (18" depth)
Positive drainage to this chamber either in conduit or surface drainage
No outlet except to sand chamber
Outlet to the sand chamber to result in sheet flow
Sand Filter Chamber:
Volume = 540 cf per acre of drainage area
Minimum 18 inch depth
Surface area of 360 sf/acre minimum
An outlet positioned and sized such that the sand chamber will drain completely
in 24 hours
No single outlet pipe sized greater than 6 inches, in order to provide a minimum
of 12 inches of sand above pipe
RECEIVED
File: kglat1andcharhorft1ter1.wpd t APR 0 5 2001
DWQ
PROJ #
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Design Data:: a ��
:� raEp►L � � .
Drainage Area = 0.791 AC ¢.r,
Sediment Chamber Design: (D p•
` Volume required — 427 cf
Volume design:
Chamber length — 180,00 ft
Chamber width = 1.50 ft
Storage depth = 1.67 ft
Storage volume — 451 cf
Volume provided = (451 cf 1427 cf) x •100 = 106 % of volume required
Sand Filter Chamber Design:
Volume required = 427 cf
Volume design:
Chamber length = 180.00 ft
Chamber width = 1.50 ft
Sand depth = 1.50 ft
Sand Volume = 405 cf
Volume provided — (405 cf / 427 cf) x 100 = 95 % of volume required
Surface area required = 285 sf
Surface area design — 180 ft x 1.5 ft = 270 sf
Surface area provided = (270 sf / 285 so x 100 = 95 % of area required
Size of outlet pipes = 6 in.
No, of outlet pipes required = 1
Ill OPERATION AND MAINTENANCE
1. At least once a year and after major storm events:
a. Inspect the sand filter systems to ensure that the filter bed is passing the
runoff as expected. Maintenance operations must be performed when
File: kglatlanticharborfilterl.wpd 2
storms of approximately one inch are not passing through the filters within
24 hours.
b. Check and clear the overflow weirs of any obstructions.
2. Maintenance, when required shall consist of the following activities:
a. Removal of the first two to three inched of discolored sand from the filter
bed and replacing the removed material with new, clean sand.
Sand that has been removed shall be dewatered, if necessary, then
landfilled.
b. Pumping and cleaning of the sediment chamber.
Material removed from the sediment chamber shall be dewatered, if
necessary, then landfilled.
C. Removal of any vegetative or other obstructions to the grated inlet cover.
1 acknowledge and agree by my signature below that 1 am responsible for the performance of the
maintenance procedures listed above. 1 agree to notify DWQ of any problems with the system or
prior to any changes to the system or responsible party.
Print Name and Title: _ Robert W. Griffith, Jr. , managing_ partner
Address:
Phone:
Signature:
1, HO'T ilt-LID L. , a Notary Public for the State of n. CAito zl N A ,
County of ("m UP,cI , do hereby certify that CV7 %tieo
personally appeared before me this day of ,4rt/tl,gR (,Q , and
acknowledge the due execution of the forgoing sand filter system aintenance requirements.
'�,��N�gprip�� f�,I
Witness my hand and o cial seal, ,..... •�
s.
CO
My commission expires SB .•
�raua��
Pile: kglatlanticharhorfilterI.wpd 3
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1.
II
STORMWATER MANAGEMENT PERMIT APPLICATI(
SAND FILTER SYSTEM SUPPLEMENT
PROJECT INFORMATION
Project Name: Atlantic Harbor Condominiums
Contact Person: Robert W. Griffith, Jr.
Phone Number: (252) 728-4191
This worksheet applies to System S-2 in Drainage Area S-2
DESIGN INFORMATION
Design Requirements:
Sediment Chamber:
Volume = 540 cf per acre of drainage area
Minimum 18 inch depth
Surface area of 360 sf/acre (18" depth)
Positive drainage to this chamber either in conduit or surface drainage
No outlet except to sand chamber
Outlet to the sand chamber to result in sheet flow
Sand Filter Chamber:
Volume = 540 cf per acre of drainage area
Minimum 18 inch depth
Surface area of 360 sf/acre minimum
An outlet positioned and sized such that the sand chamber will drain completely
in 24 hours
No single outlet pipe sized greater than 6 inches, in order to provide a minimum
of 12 inches of sand above pipe
Pile: kglallanti charhorfilterlwpd
RECEIVED
APR 0 5 2001
nwe
PROJ #
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�$� �1 �'(.d�*S��i'
�� r�� pc.wc •n�a M:o ��,. �V.
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Y. � .`� q 4
Design Data:
Drainage Area = 0.11 AC
Sediment Chamber Design:
Volume required —
Volume design:
Chamber length
Chamber width
Storage depth
Storage volume
Volume provided =
Sand Filter Chamber Design:
59 cf
24.00
1.50 ft
1.67 ft
60.12 cf
(60 cf / 59 cf) x 100 = 102% of volume required
Volume required =
59 of
Volume design:
Chamber length
— 24.00 ft
Chamber width
= 1.50 ft
Sand depth
= 1.50 ft
Sand Volume
= 54.00 cf
Volume provided =
(54 cf / 59 co x 100 = 92 % of volume required
Surface area required =
39 sf
Surface area design =
24 ft x 1.5 ft = 36 sf
Surface area provided =
(36 sf 139 sf) x 100 = 92 % of area required
Size of outlet pipes =
6 in.
No. of outlet pipes required
= 1
III OPERATION AND MAINTENANCE
1. At least once a year and after major storm events:
a. Inspect the sand filter systems to ensure that the filter bed is passing the
runoff as expected. Maintenance operations must be performed when
Pile: kglat1an6charhorli1ter2.wpd
2
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. _ .a�Ai,
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storms of approximately one inch are not passing through the filters within
24 hours.
b. Check and clear the overflow weirs of any obstructions.
Maintenance, when required shall consist of the following activities:
a. Removal of the first two to three inched of discolored sand from the filter
bed and replacing the removed material with new, clean sand.
Sand that has been removed shall be dewatered, if necessary, then
landfilled.
b. Pumping and cleaning of the sediment chamber.
Material removed from the sediment chamber shall be dewatered, if
necessary, then landfilled.
Removal of any vegetative or other obstructions to the grated inlet cover.
I acknowledge and agree by my signature below that I am responsible for the performance of the
maintenance procedures listed above. I agree to notify DWQ of any problems with the system or
prior to any changes to the system or responsible party.
Print Name and Title: _ Robert W. Griffith, Jr. , managing partner
Address:
Phone:
Signature:
1, p,T-b-L3 (� „rt p , a Notary Public for the Skate of KLzaj CATZOLI Q 6 ,
County ofCRj@V!e do hereby certify that L6�erk C i ► F F rr SZ
personally appeared before me this Z ZN-0 day of _ TNL44 tzV �[)0 / _, and
acknowledge the due execution of the forgoing sand filter system maintenance requirements.
Witness my hand and of ial seal,
My commission expires T Z9Z003
File: k&tlautichurborfilter2wpd 3
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