2019-03 Circle K US 117 North Carolina Commerce Drive

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0City of Goldsboro
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BE MORE DO MORE SEYMOUR North Cararo1
(919) 58o-4328
STORMWATER PERMIT NO.2019-03
FOR STORMWATER DISCHARGES UNDER THE
STORMWATER MANAGEMENT PROGRAM
In compliance with the provisions of Stormwater Discharge Permit NCS00396 issued by the State of North
Carolina and the City of Goldsboro Ordinance 2007—48,
Circle K,
is hereby authorized to discharge stormwater from a facility,commercial or residential complex,or other
development located at
US 117 North,Carolina Commerce Drive,
Goldsboro,North Carolina,27530
to receiving waters as shown on approved plans on file with the City and in accordance to limitations placed
on the discharge and other conditions set forth in this permit and in the approved plans on file with the City
and as noted on deeds and covenants duly recorded with the Register of Deeds of Wayne County.
This permit shall become effective September 20,2019,and shall remain in effect for a period of five years
until September 20,2024.
Signed this 20 day of September 2019.
Rama Chittilla,P.E.
City of Goldsboro
Civil Engineer
NOTE: PRIOR TO THE ISSUANCE OF THE CERTIFICATE OF OCCUPANCY,All BMP CERTIFICATIONS,
RECORDED EASEMENTS AND FORMAL MAINTENANCE COVENANT MUST BE SUBMITTED.

STORM WATER DISCHARGES AUTHORIZED BY THE PERMIT
This permit authorizes the discharge of storm water from the permittee's separate storm water drainage system,
storm water commingled with discharges authorized under other NPDES permits, and specific non-storm water
discharges provided these discharges do not contribute to a violation of North Carolina's Water Quality Standards
(WQS).
The following non-storm water discharges are authorized by this permit, provided these discharges do not contribute
to a violation of state Water Quality Standards: water line flushing, landscape irrigation runoff, diverted stream flows,
rising groundwater, uncontaminated groundwater infiltration (as defined by 40 CFR 35.2005(20)), pumped
groundwater (except for groundwater cleanups), discharges from potable water sources, foundation drains, air
conditioning condensate, irrigation water, springs, water from crawl space pumps, footing drains, lawn watering
runoff, water from non-commercial car washing, flows from riparian habitats and wetlands, residential swimming pool
discharges and other dechlorinated swimming pool discharges, residual street wash waters, and discharges or flows
from emergency fire fighting activities.
This permit does not relieve the permittee from responsibility for compliance with any other applicable federal, state,
or local law, rule, standard, ordinance, order,judgment or decree.
PENALTIES
The City of Goldsboro Ordinance §6.5.14 provides for penalties upon violation of the City's Stormwater Management
Program: "Any person who is found in violation of any provision of this chapter, rule, regulation or order duly adopted
or issued pursuant to this chapter shall be guilty of a misdemeanor, punishable by a fine not to exceed $500. Each
violation shall be a separate offense."
The Federal Clean Water Act of 1977 (P.L. 95-217), as amended, Section 309(c)(4), states: "Any person who
knowingly makes false material statement, representation, or certification in any application, record, report, plan, or
other document filed or required to be maintained under this act or who knowingly falsifies, tampers with, or renders
inaccurate any monitoring device or method required to be maintained under this act, shall upon conviction, be
punished by a fine not more than $10,000, or by imprisonment for not more than 2 years, or by both. If a conviction
of a person is for a violation committed after a first conviction of such person under this paragraph, punishment shall
be a fine of not more than$20,000 per day of violation, or by imprisonment of not more than 4 years, or by both."
GENERAL INFORMATION
The following items submitted and/or prepared by the permittee are a part of this permit and are enforceable as such:
• Stormwater Management Plan
o Site Plan showing BMP locations, construction details and specifications, drainage areas
and directions, outfalls, and related information
o For detention and retention structures, stage routing and storage
o Calculations for reduction of peak runoff for the 1-year, 24-hour storm event and
reduction in nitrogen loading
o Operations and maintenance procedures, and periodic maintenance schedules
o Responsible parties (owner and operator). If a multimember association such as a
Homeowner, Property Owner, Condominium or Master Association is proposed, the
owner or developer must submit Articles of Incorporation for the Association, and
Declaration of Covenants and Restrictions, or such other organizational and operational

documents that affirmatively assign authority and responsibility for the operation and
maintenance of the stormwater management system.
• Deed restrictions and protective covenants
o All stormwater management structures shall be located in recorded drainage easements
for the purposes of operation and maintenance and shall have recorded access
easements to the nearest public right-of-way. These easements shall be granted in favor
of the party responsible for operating and maintaining the stormwater management
structures and shall include access for City Inspectors and Department of Engineering
Personnel.
o Maintenance of all stormwater management facilities shall be ensured through the
creation of a formal maintenance covenant that must be approved by the City Engineer
and recorded into the land record.
• Maintenance agreement
o The agreement shall provide for access to the facility at reasonable times for periodic
inspection by the City Engineer or their contractor or agent. The City will inspect each
BMP at least annually as provided by other Ordinances and the City's Phase II
Stormwater Discharge Permit. The City Council has established an annual inspection fee
of$100.00 per BMP.
o The agreement shall provide for regular or special assessments of property owners to
ensure that the facility is maintained in proper working condition to meet design
standards and any other provisions established by The City of Goldsboro Stormwater
Management Program.
o The agreement shall require that owner/operators keep records of the installation,
maintenance, and repair of BMPs, and retain those records for at least five (5)years.
These records shall be made available to the City Engineer during inspection of the
facility and at other reasonable times upon request.
REPORTING AND RECORD KEEPING
The permittee will notify the City Engineer orally or in writing within 24 hours of the time the permittee became aware
of any circumstance that creates a situation of non-compliance with this permit. The permittee will provide a written
report of the circumstances of non-compliance within five days of becoming aware of the circumstance. The written
report will contain a description of the non-compliance and its cause including dates and times; if the non-compliance
has been corrected and if not, when it is anticipated to be corrected; and steps to be taken to prevent a reoccurrence
of the non-compliance.
All records, reports, and documentation that the permittee either creates or receives concerning this permit will be
retained by the permittee for a period of five years.
The permittee will report any change of address and/or change of phone number to the City Engineer within 30 days
of the change. If the permittee anticipates a change or transfer of ownership that affects this permit, the permittee will
contact the City Engineer 30 days prior to the anticipated change and provide the City Engineer with all the relevant
information on the anticipated change.
If the permittee is not the Responsible Party as shown on the permit application, the Responsible Party will also
report any change of address and/or change of phone number to the City Engineer within 30 days of the change.

OPERATION AND MAINTENANCE
The permittee will operate and maintain all BMPs detailed in the Stormwater Management Plan in accordance with
the operations and maintenance procedures found in the Stormwater Management Plan. Records of maintenance
activities will be kept for a period of five years and are subject to inspection by the City as described in the
Maintenance agreement and by other City ordinances.
The following City of Goldsboro Ordinance is quoted for your information:
§96.03 PUBLIC NUISANCES.
(C) Stormwater treatment, retention or impoundment devices(Structural Best Management Practice(BMP)).
4) Inspections and annual inspection fee.
(a) The Building Inspector (or other authorized agent of the city) has full power and authority to enter
upon a premise housing a BMP for the purpose of inspecting the BMP on an annual basis. The City Council has
established an annual inspection fee of$100 per structural BMP to fund this additional inspection program.
(b) In addition, the Building Inspector may enter the site as necessary to document improperly operating
BMPs,follow up on scheduled maintenance activities, or to conduct maintenance themselves.
OTHER CONSIDERATIONS
The permittee must comply with all conditions of this permit. Any permit non-compliance constitutes a violation and is
grounds for enforcement, for permit termination, revocation, reissuance, or modification, or denial of permit upon
reapplication.
This permit does not convey any property rights in either real or personal property, or any exclusive privileges, nor
does it authorize any injury to private property or any invasion of personal rights, nor any infringement of federal,
state or local laws or regulations.
The provisions of this permit are severable, and if any provision of this permit, or the application of any provision of
this permit to any circumstances is held invalid, the application of such provision to other circumstances, and the
remainder of this permit, shall not be affected thereby.
The permittee shall take all reasonable steps to minimize or prevent any discharge in violation of this permit that has
a reasonable likelihood of adversely affecting human health or the environment.
Page 4

ct soenr Engineering Department,City of Goldsboro PITY USE ONLY
°o STORM WATER MANAGEMENT PERMIT Nu beg
_ APPLICATION
r�
O,prH C+td�e
PLEASE TYPE OR PRINT
fl. PPLICANT NAME AND MAILING ADDRESS: Project Name:
cle K Circle K
et Address or P, ', ax Project Street Address
00 Situs Court, Suite 100 To be determined during site plan review
State I Zip Code City Y ZIP Code
Raleigh 'NC W606 Goldsboro 27530
Telephone (with area code) Fax Number (with area code)
919-771-5714
2, OWNER NAME AND MAILING ADDRESS: 3. RESPONSIBLE PARTY NAME FOR PERMIT(if different from 2)
North Carolina Warehousing LLC Circle K
E-mail Address Email address:
[e-mail]
Street Address Street Address or P.O.Box
2815 Carolina Commerce Circle 1100 Situs Court, Suite 100
Additional Street Address Additional Street Address or P.O.Box Information
Suite 2A
City State Zip Code City State ZIP Code
Goldsboro [NC 27530-5536 Raleigh NC 27606
Telephone(witn area codes Telephone Iwith area code)
919-771-5714
Fax Number(wish area code) Fax Number(with area code)
4. Non-refundable permit review fee
5. Stormwater Management Plan
• Site Plan showing BMP locations,construction details and specifications,drainage areas and directions,outfalls,and related information
• For detention and retention structures,stage routing and storage
• Calculations for reduction of peak runoff for the 1-year,24-hour storm event and reduction in nitrogen loading
• Operations and maintenance procedures,and periodic maintenance schedules
• Responsible parties(owner and operator). If a multimember association such as a Homeowner,Property Owner,Condominium or Master
Association is proposed,the owner or developer must submit Articles of Incorporation for the Association,and Declaration of Covenants
and Restrictions,or such other organizational and operational documents that affirmatively assign authority and responsibility for the
operation and maintenance of the stormwater management system.
6. Deed restrictions and protective covenants
• Show recorded drainage easements for stormwater management structures.
• Provide a covy of the formal maintenance covenant that provides for the maintenance of all stormwater management facilities.
7. Maintenance agreement
• Provide for access to the facility for periodic inspection by the City Engineer or their contractor or agent. The City will inspect each BMP at
least annually..
• Provide for regular or special assessments of property owners.
• Describe how the owner/operator will keep records of the installation,maintenance,and repair of BMPs,retain those records for at least five
(5)years,and will be made available to the City Engineer.
8. CERTIFICATION
"I certify under penalty of law that this document and all attachments were prepared under my direction or supervision In accordance with a
system designed to assure that qualified personnel property gather and evaluate the Information submitted_ Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true,accurate,and complete. 1 am aware that there are significant penalties for submitting false information,
including the possibility of fine `and imprisonment for having knowledge of violations."
Applicant Name: Stan " •i g0 Title: Project Manager/McAdams
Applicant Signature: Date:
Owner/RP Signature: G� I Date: 9/10/2019
(if different from applicant signature)