SW6100703_CURRENT PERMIT_20100810

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
DOC TYPE CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE 69ml/
YYYYM M D D

s�
NC®ENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Division of Water Quality
Coleen H. Sullins
Director
August 10, 2010
Mr. Larry Graham, President
Albemarle Oil Company
PO Box 1059
Albemarle, NC 28002
Subject: Stormwater Permit No. SW6100703
ALCO-Camden Road
High Density Commercial Infiltration Basin Project
Cumberland County
Dear Mr. Graham:
Dee Freeman
Secretary
The Stormwater Permitting Unit received a complete Stormwater Management Permit Application for
ALCO-Camden Road on August 4, 2010. Staff review of the plans and specifications has determined that
the project, as proposed, will comply with the Stcrrnwater Regulations set forth in Title 15A NCAC 21-1.1000
and Session Law 2006-246. We are forwarding Permit No. SW6100703, dated August 10, 2010, for the
construction, operation and maintenance of the-saoject project and the stormwater BMPs.
This permit shall be effective from the date of issuance until August 9, 2020, and shall be subject to the
conditions and limitations as specified therein. Please pay special attention to the Operation and
Maintenance requirements in this permit. Failure.'o establish an adequate system for inspection 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.
This project will be kept on file at the Fayetteville Regional Office. If you have any questions, or need
additional information concerning this matter, please contact Brian Lowther at [phone]; or
[e-mail].
Sincerely,
for Colleen H. Sullins
cc: Fayetteville Regional Office
Central Files
SPU Files
Wetlands and Stormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: w .ncvvaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
DENR-FRO
SEP 14 2010
-F
NorthCarolina
Naturally

State Stormwater Permit
Permit No. SW6100703
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERIAIENR-FRO,
SEP 14 2010
HIGH DENSITY DEVELOPMENT ®WQ
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
Albemarle Oil Company
ALCO-Camden Road
6047 Camden Road, Cumberland County
FOR THE
construction, operation and maintenance of two infiltration basin(s) in compliance with - the provisions of Session Law 2006-246 and 15A NCAC 2H A 000 (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 August 9, 2010, 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.
This stormwater system has been approved for the management of stormwater
runoff as described in Section 1.8 on page 2 of this permit. The stormwater
control has been designed to handle the runoff from 43,554 square feet of
i,npervious area.
3. This basin must be operated with a 30' vegetated filter.
4: The tract will be limited to the amount of built -upon area indicated in Section 1.8
on page 3 of this permit, and as shown on the approved plans. The built -upon
area for the future development is limited to 43,554 square feet.
5. All stormwater collection and treatment systems must be located in either
dedicated common areas or recorded easements. The final plats for the project
will be recorded showing all such required easements, in accordance with the
approved plans.
The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
Page 1 of 6

State Stormwater Permit .-
Permit No. SW6100703
7. The built -upon areas associated with this project shall be located at least 30 feet
landward of all perennial and intermittent surface waters.
8. The following design criteria have been permitted for the infiltration basin and
must be provided and maintained at design condition:
a. Drainage Area, acres:
1.79
Onsite, ft :
31,197 26,136
Offsite, ftz:
0 0
b. Total Imperviou� Surfaces, ft2:
26,698 16,856
Onsite, ft :
26,698 16,856
Offsite, ftz:
0 0
C. Design Storm, inches:
1"
d. Basin Depth, feet:
2' 1.5'
e. Bottom Elevation, FMSL-
169.0 169.5
f. Storage Surface Area, ft2:
2,953 2,399
g. Permitted Storage Volume, ft3:
4,429 2,809
h. Type of Soil:
Candor (CaB)
i. Expected Infiltration Rate, in/hr:
4.68 4.68
j. Seasonal High Water Table, FMSL:
166.83 167.33 .
k. Time to Draw Down, hours:
7.2
I. Receiving Stream/River Basin:
Little Rockfish Creek / Cape Fear
M. Stream Index Number:
18-31-24-(4)
n. Classification of Water Body:
"C"
II. SCHEDULE OF COMPLIANCE
-1. The stormwater management system shall be constructed in its entirety,
vegetated and operational for its intended use prior to the construction of any
built -upon surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The permittee shall at all times provide the operation and maintenance
necessary to assure the permitted stormwater system functions at optimum
efficiency. The approved Operation and Maintenance Plan must be followed in
its entirety and maintenance must occur at the scheduled intervals including, but
not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and revegetation of slopes and the vegetated filter. -
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of bypass structure, infiltration media, flow
spreader, catch basins, piping and vegetated filter.
g. A clear access path to the bypass structure must be available at all times.
4. Records of maintenance activities must be kept for each permitted BMP. The
reports will indicate the date, activity, name of person performing the work and
what actions were taken.
The permittee shall submit to the Division of Water Quality an annual summary
report of the maintenance and inspection records for each BMP. The report
shall summarize the inspection dates, results of the inspections, and the
maintenance work performed at each inspection.
Page 2 of 6

State Stormwater Permit
Permit No. SW6100703
6. 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.
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.
8. Upon completion of construction, prior to issuance of a Certificate of Occupancy,
and prior to operation of this permitted facility, a certification must be received
from an appropriate designer for the system installed certifying that the permitted
facility has been installed in accordance with this permit, the approved plans and
specifications, and other supporting documentation. Any deviations from the
approved plans and specifications must be noted on the Certification. A
modification may be required for those deviations.
9. Access to the stormwater facilities shall be maintained via appropriate
easements at all times.
10. The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed
below:
a. Any revision to any item shown on the approved plans, including the
stormwater management measures, built -upon area, details, etc.
b. Project name change.
c.= Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
e. Further subdivision, acquisition, lease or sale of all or part of the project
area: The project area is defined as all property owned by the permittee,
for which Sedimentation and Erosion Control Plan approval or a CAMA
Major permit was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
11. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
12. 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.
13. zhe Director may notify the permittee when the permitted site does not meet one
or more of the minimum requirements of the permit. Within the time frame
specified in the notice, the permittee shall submit a written time schedule to the
Director for modifying the site to meet minimum requirements. The permittee
sha!t;Yxovide copies of revised plans and certification in writing to the Director
that the changes have been made. -
III. GENERAL CONDITIONS
This permit is not transferable to any person or entity except after notice to and
approval by the Director. In the event of a change of ownership, or a name
change, the permittee must submit a completed Name/Ownership Change form
to the Division of Water Quality, signed by both parties, and accompanied by the
appropriate documentation as listed on page 2 of the form. The approval of this
request will be considered on its merits and may or may not be approved.
Page 3 of 6

State Stormwater Permit ,-
Permit No. SW6100703
2. The permittee is responsible for compliance with all permit conditions until such
time as the Division approves the transfer request.
3. 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.
4. 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 gov.6rnment agencies (local, state, and federal) having jurisdiction.
5. In the event that the facilities fail to perform satisfactorily, including the creation
of nuisance conditions, the Permittee shall take immediate corrective action,
including thdS6 as may be required by this Division, such as the construction of
additional or replacement stormwater management systems.
6. The permittee grants DENR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
7. The permit issued shall continue in force and effect until revoked or terminated..
The permit may be modified, revoked and reissued or terminated for cause. The
filing of a request for a permit modification, revocation and reissuance or
termination does not stay any permit condition.
8. Unless specified elsewhere, permanent seeding requirements for the stormwater
controls must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
.9. Approved. plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
10. The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revoking and reissuing the permit, or terminating the permit
as allowed by the laws, rules and regulations contained in Session Law 2006-
246, Title 15A NCAC 2H.1000, and NCGS 143-215.1 et. al.
11. The permittee shall notify the Division in writing of any name, ownership or
mailing address changes at least 30 days prior to making such changes.
12. The permittee shall submit a renewal request with all required forms and
documentation at least 180 days prior to the expiration date of this permit.
Permit issued this the 10th day of August 2010.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
w
for Uoleen H. Sullins, Uirector
Division of Water Quality
By Authority of the Environmental Management Commission
Page 4 of 6

State Stormwater Permit
Permit No. SW6100703
ALCO-Camden Road
Stormwater Permit No. SW6100703
Cumberland Countv
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 is included in the Certification.
Nosed deviations from approved plans and specification:
SEAL
Signature
Registration Number
Date
Page 5 of 6

State Stormwater Permit
Permit No. SW6100703
Certification Requirements:
1. The drainage area to the system contains approximately the permitted
acreage.
2. The drainage area to the system contains no more than the permitted
amount of built -upon area.
3. All the built -upon area associated with the project is graded such that the
runoff drains to, the system.
4. All roof drains are -located such that the runoff is directed into the system.
5. The bypass s`ructure weir elevation is per the approved plan.
6. The bypass structure is located per the approved plans.
7. A Trash Rack is provided on the bypass structure.
8. All slopes are grassed with permanent vegetation.
9. Vegetated slopes are no steeper than 3:1.
.10. The inlets are located per the approved plans pnd do not cause short-
circuiting of the.system.
11. The permitted amounts of surface area and/or volume have been
provided.
12. All required design depths are provided.
13. All required parts of the system are provided.
14. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Regional Office
Page 6 of 6

Permit Number:
(to be provided by D111Q)
Drainage Area Number:
Filter Strip, Restored Riparian Buffer and Level Spreader
Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important maintenance procedures:
- Immediately after the filter strip is established, any newly planted vegetation
will be watered twice weekly if needed until the plants become established
(commonly six weeks).
- Once a year, the filter strip will be reseeded to maintain a dense growth of
vegetation
- Stable.groundcover will be maintained in the drainage area to reduce the
sediment load to the vegetation.
- Two to three times a year, grass filter strips will be mowed and the clippings
harvested to promote the growth of thick vegetation with optimum pollutant
removal efficiency. Turf grass should not be cut shorter than 3 to 5 inches and
may be allowed to grow as tall as 12 inches depending on aesthetic requirements
(NIPC,1.993). Forested filter strips do not require this type of maintenance.
- Once a year, the soil will be aerated if necessary.
- Once a year, soil pH will be tested and lime will be added if necessary.
After the filter strip is established, it will be inspected quarterly and within 24 hours
after every storm event greater than 1.0 inch (or 1.5 inches if in'a Coastal County).
Records of operation and maintenance will be kept in a known set location and will be
available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblem:
How 1-will remediate theproblem:
The entire filter strip
Trash/debris is present.
Re -move the trash/debris.
system
The flow splitter device
(if applicable)
The flow splitter device is
clogged.
Unclog the conveyance and dispose
of any sediment off -site.
The flow splitter device is
. Make arty necessary repairs or
damaged.
replace if damage is too large for
A.
re air.
SEP 14 2010
®WQ
Form SWU401-Level Spreader, Filter Strip, Restored Riparian Buffer O&M-Rev.3 Page 1 of 3

BMP element:
The swale and the level
lip
The bypass channel
The filter
The receiving water
Potential problem:
The swale is clogged with
sediment.
The level lip is cracked,
settled, undercut, eroded or
otherwise damaged.
There is erosion around the
end of the level spreader that
shows stormwater has
bypassed it.
Trees or shrubs have begun
to grow on the swale or just
downslope of the level lip.
Areas of bare soil and/or
erosive gullies have formed.
Turf reinforcement is
damaged or ripap is rolling
downhill.
Grass is too short or too
Areas of bare soil and/or
erosive gullies have formed
Sediment is building up on
the filter strip.
Plants are desiccated.
Plants are dead, diseased or
dying.
Nuisance vi!i;etation is
choking out desirable species.
Erosion or other signs of
damage have occurred at the
outlet.
How I will remediate th
Remove the sediment an
of it off -site.
Repair or replace lip.
Regrade the soil to create a berm
that is higher than the level lip, and
then plant a ground cover and
water until it is established. Provide
lime and a one-time fertilizer
application.
Remove them
Regrade the soil if necessary to
remove the gully, and then
reestablish proper erosion control.
Study the site to see if a larger
bypass channel is needed (enlarge if
necessary). After this, reestablish
the erosion control material.
Maintain grass at a height of
approximately three to six inches.
Regrade the soil if necessary to
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
Remove the sediment and
restabilize the soil with vegetation if
necessary. Provide lime and a one-
time fertilizer application.
Provide additional irrigation and
fertilizer as needed.
Determine the source of the
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application.
Remove vegetation by hand if
possible. If pesticide is used, do not
allow it to get into the receiving
water.
Contact the NC Division of Water
Quality local Regional Office, or the
401 Oversight Unit at 919-733-1786.
Form SWU401-Level Spreader, Filter Strip, Restored Riparian Buffer O&M-Rev.3 Page 2 0l'3

'r IF, .
Permit Number:
(to be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project name:ALCO-Camden Road
BMP drainage area number: Infiltration Basin 91
Print name:Larry Graham
Title:President
Address:PO Box 1059. Albemarle. NC 28002
Date: . 7— 2- z --it)
Note: The legally responsible parry should not be a homeo';;ners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
reenR a Notary Public for the State of
Nor.u, Ca oU a , County of S}@.,,ta - , do hereby certify that
arr %. Gra.ka. personally appeared before me this zz.^d
day of Shy zo 1 o , and acknowledge the due execution of the
forgoing filter strip, riparian buffer, and/or level spreader maintenance requirements.
Witness my hand and official seal,
SEAL
My commission expires L -10-1
Form SWU401-Level Spreader, Filter Strip, Restored Riparian Buffer O&M-Rev.3 Page 3 of 3

Permit Number:
(to be provided by DWQ)
Drainage Area Number:
Filter Strip, Restored Riparian Buffer and Level Spreader
Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important maintenance procedures:
— Immediately after the filter strip is established, any newly planted vegetation
will be watered twice weekly if needed until the plants become established
(commonly six weeks).
— Once a year, the filter strip will be reseeded to maintain a dense growth of
vegetation
— Stable groundcover will be maintained in the drainage area to reduce the
sediment load to the vegetation.
Two to three times a year, grass filter strips will be mowed and the clippings
harvested to promote the growth of thick vegetation with optimum pollutant
removal efficiency. Turf grass should not be cut shorter than 3 to 5 inches and
may be allowed to grow as tall as 12 inches depending on aesthetic requirements
_ — (NIPC,1993). Forested filter strips do not require this type of maintenance. —
Once a year, the soil will be aerated if necessary.
Once a year, soil pH will be tested and lime will be added if necessary.
After the filter strip is established, it will be inspected quarterly and within 24 hours
after every storm event greater than 1.0 inch (or 1.5 inches if in a Coastal County).
Records of operation and maintenance will be kept in a known set location and will be
available.upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblem:
How I will remediate theproblem:
Tlv,entire filter strip
Trash/debris is present.
Remove the trash/debris.
s sem
The flow splitter device
(if applicable)
The Flow splitter device is
clogged.
Unclog the conveyance and dispose
of arry sediment off -site.
The flow splitter device is
damaged.
Make any necessary repairs or
replace if damage is too large for
re air.
Form SWU40l-Level Spreader, Filter Strip, Restored Riparian Buffer O&M-Rev3 Page 1 of 3

BMP element:
Potentialproblem:
How I will remedia to theproblem:
The swale and the level
The swale is clogged with
Remove the sediment and dispose
lip
sediment.
of it off -site.
The level lip is cracked,
Repair or replace lip.
settled, undercut, eroded or
otherwise damaged.
There is erosion around the
Regrade the soil to create a berm
end of the level spreader that
that is higher than the level lip, and
shows stormwater has
then plant a ground cover and
bypassed it.
water until it is established. Provide
lime and a one-time fertilizer
ap lication.
Trees or shrubs have begun
Remove them.
to grow on the swale or just
downslo e of the level lip.
The bypass channel
Areas of bare soil and/or
Regrade the soil if necessary to
erosive gullies have formed.
remove thegully, and then
reestablish proper erosion control.
Turf reinforcement is
Study the site to see if a larger
damaged or ripap is rolling
bypass channel is needed (enlarge if
downhill.
necessary). After this, reestablish
the erosion control material.
The filter strip
Grass is too short or too long
Maintain grass at a height of
f applicable).
ap2roximately three to six inches.
Areas of bare soil and/or
Regrade the soil if necessary to
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
Sediment is building up on
Remove the sediment and
the filter strip.
restabilize the soil with vegetation if
necessary. Provide lime and a one-
time fertilizer application.
Plants are desiccated.
Provide additional irrigation and
fertilizer as needed.
Plants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application.
Nuisance vegetation is
Remove vegetation by hand if
choking out desirable species.
possible. If pesticide is used, donot
allow it to get into the receiving
water.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality local Regional Office, or the
outlet.
401 Oversight Unit at 919-733-1786.
Form SWU401-Level Spreader, Filter Strip, Restored Riparian Buffer O&M-Rev.3 Page 2 of 3

Permit Number:
(to be provided by DIVQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project name:ALCO-Camden Road
BMP drainage area number: Infiltration Basin 42
Print name:Lar
Address:PO Box _1.059, Albemarle, NC 28002
Signature:
Date:_
Note: The legally responsible party should not be a homeowners association unless more than 50%of ,
the lots have been sold and a resident of the subdivision has been named the president.
I> Tanga w. (, reer.0 a Notary Public for the State of
t Ior w Ca'. ]; ,& County of Sd-a t.t do hereby certify that
—Larry Graham personally appeared before me this Zz^d
day of -X lq zo t o , and acknowledge the due execution of the
forgoing filier.strip, riparian buffer, and/or level spreader maintenance requirements.
Witness my hand and official seal,
:i
SEAL
My commission expires Z-to_ 0
Form SWU401-1-evel Spreader, Filter Strip, Restored Riparian Buffer O&M-Rev.3 Page 3 of 3

Permit Number:
(to be provided by DWQ)
Drainage Area Number:
Infiltration Basin Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important maintenance procedures:
— The drainage area will be carefully managed to reduce the sediment load to the
infiltration basin.
— Immediately after the infiltration basin is established, the vegetation will be
watered twice weekly if needed until the plants become established (commonly
six weeks).
— No portion of the infiltration basin will be fertilized after the initial fertilization
that is required to establish the vegetation.
— The vegetation in and around the basin will be maintained at a height of
approximately six inches.
After the infiltration basil is established, it will be inspected once a quarter and within
24 hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and, maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblem:
How I will remediate theproblem:
The entire BMP-
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
infiltration basin
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
The inlet device: pipe or
The pipe is clogged (if
Unclog the pipe. Dispose of the
swale
applicable).
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to
Swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future roblems with erosion.
Form SW401-Infiltration Basin O&M-Rev.3 Page 1 of 3

BMP element:
Potentialproblem:
Flow I will remediate theproblem:
The forebay
Sediment has accumulated
Search for the source of the
and reduced the depth to 75%
sediment and remedy the problem if
of the original design depth.
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred or
Provide additional erosion
riprap is displaced.
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticides are used, wipe
them on the plants rather than
spraying.
The main treatment area
A visible layer of sediment
Search for the source of the
has accumulated.
sediment and remedy the problem if
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streaIms or
the BMP. Replace any media that
was removed in the process.
Revegetate disturbed areas
immediately.
Water is standing more than
Replace the top few inches of filter
5 days after a storm event.
media and see if this corrects the
standing water problem. If so,
revegetate immediately. If not,
consult an appropriate professional
for a more extensive repair.
Weeds and noxious plants are
Remove the plants by hand of by
growing in the main
wiping them with pesticide (do not
treatment area.
spray).
The embankment
Shrubs or trees have started
Remove shrubs or trees
to grow on the embankment.
immediately.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair.
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
of the sediment off -site. 1.
The outlet device is damaged
Repair or replace the outlet device.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
outlet.
733-1786.
Form SW401-Infiltration Basin O&M-Rev.3
Page 2 of 3

Permit Number:
(to be provided by DIVQ)
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.
Projee! name: ALCO-Camden Road
BMP drainage area number: Infiltration Basin 92
Print name:Larry Graham
Title:President
Address:PO Box 1059. Albemarle, NC 28002
Date: 7— '- — in
Nete: 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.
1, 1 ar`ya w- cm re rlR , a Notary Public for the State of
V�'orwh Ga of a , County of 5-Fa..l., , do hereby certify that
Z&F ,r%1 CGr&ham personally appeared before me this Z^d
day of Su.l,f z o t o ., and acknowledge the due execution of the
forgo ing.infiltration basin maintenance requirements. Witness my hand and official seal,
SEAL
My commission expires
Form SW40I-Infiltration Basin O&M-Rev.3 Page 3) of 3

Permit Number:
(to be provided by DIVA)
Drainage Area Number:
Infiltration Basin Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important maintenance procedures:
— The drainage area will be carefully managed to reduce the sediment load to the
infiltration basin.
— Immediately after the infiltration basin is established, the vegetation will be
watered twice weekly if needed until the plants become established (commonly
six weeks).
— No portion of the infiltration basin will be fertilized after the initial fertilization
that is required to establish the vegetation.
— The vegetation in and around the basin will be maintained at a height of
approximately six inches.
After the infiltration basin is established, it will be inspected once a quarter and within
24 hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblem:
How I will remediate theproblem:
The entire BMP
Trash/debris is resent.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
infiltration basin
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application,
The inlet device: pipe or
The pipe is clogged (if
Unclog the pipe. Dispose of the
swale
applicable). 1-
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to
swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
Form SW401-Infiltration Basin O&M-Rev.3 Page 1 of 3

BMP element:
Potentialproblem:
How I will remediate theproblem:
The forebay
Sediment has accumulated
Search for the source of the
and reduced the depth to 75%
sediment and remedy the problem if
of the original design depth.
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred or
Provide additional erosion
riprap is displaced,
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticides are used, wipe
them on the plants rather than
spraying.
The main treatment area
A visible layer of sediment
Search for the source of the
has accumulated.
sediment and remedy the problem if
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP. Replace and media that
was removed in the process.
Revegetate disturbed areas
immediately.
Water is standing more than
Replace the top few inches of filter
5 days after a storm event.
media and see if this corrects the
standing water problem. If so,
revegetate immediately. 'If not,
consult an appropriate professional
for a more extensive repair.
Weeds and noxious plants are
Remove the plants by hand or by
growing in the main
wiping them with pesticide (do not
treatment area.
spray).
The embankment
Shrubs or trees have started
Remove shrubs or trees
to grow on the embankment.
immediately.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
-
needs repair.
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
of the sediment off -site. ,
The outlet device is damaged
Re air or replace the outlet device.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
outlet.
733-1756.
Form SW401-Infiltration Basin O&M-Rev.3 Page 2 of 3

Permit Number:
(to be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ_of any
problems with the system or prior to any changes to the system or responsible party:
Project name: ALCO-Camden Road
BMP drainage area number: Infiltration Basin #1
Print name:
Title:President
Address:PO Box 1059. Albemarle. NC 28002
Phone
Date:
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
a Notary Public for the State of
Uor44' Cct,ot)nct , County of S+411\1 do hereby certify that
L a� m rmrchQpersonally appeared before me this Z"`I
day of Z, 1, zo io , and acknowledge the due execution of the
forgoing infiltration basin maintenance requirements. Witness my hand and official seal,
SEAL
My commission expires Z,1 o- 13
Form SW401-Infiltration Basin O&M-Rev.3 _ Page 3 of 3

DWQ USE ONLY
Date Received
Fee Paid
Permit Number
% tP
6'0 '
jW(.IOa76S
Applicable Rules ❑ Coastal SW - 1995 ❑ Coastal SW
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters
❑ Other WQ M mt Plan:
- 2008 ❑ Ph II - Post Construction
❑ Universal Stormwater Management Plan
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This forni may be photocopied for use as an original
1. GENERAL INFORMATION
1. Project Name (subdivision, facility, or establishment name -should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
ALCO-Camden Road
2. Location of Project (street address):
City:Fayetteville County:Cumberland Zip:28306
3. Directions to project (from nearest major intersection):
From I-95 take the Chicken Foot Road exit 41. Head North on Chicken Foot Road SR 59 and then turn left
onto Camden Road. Travel 0.9 miles and the site is located on the left (south side of Camden Road)
4. Latitude:34058' 46" N
Longitude:-78° 58' 45" W
of the main entrance to the project.
Il. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New []Modification
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number , its issue date (if known) and the status of
construction: ❑Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certificntion
2. Specify the type of project (check one):
❑Low Density ®High Density ❑Drains to an Offsite Stormwater System ❑Other
3. If this application is being submitted as the result of a previously returned application or a letter from DWQ
requesting a state stormwater management permit application, list the stormwater project number, if
assigned, and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major ®Sedimentation/Erosion Control: 1.65 ac of Disturbed Area
❑NPDES Industrial Stormwater 0404/401 Permit: Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:
SEP 14 2010
DWO
FormSWU-101 Version07Jun2010 PageIof6

III. CONTACT INFORMATION
L a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the oroject):
Applicant/Organization:Albemarle Oil Company
Signing Official & Title:Larry Graham - President
b. Contact information for person listed in item la above:
Street Address:300 Circle Drive
Citv:Albeinarle State:NC Zip:28001
Mailing Address (ifapplicable):PO Box 1059
City:Albemarle State:NC Zip:28002
Phone: [phone] Fax: f704 982-2199
EmaiLaoclarry@carolina. rr.conn
c. Please check the appropriate box. The applicant listed above is:
❑ The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
® Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Owner/Organization:AOC Investments L.L.C.
Signing Official & Title:Lanv Graham - Manager
b.Contact information for person listed in item 2a above:
Street Address300 Circle Drive
City:Albemarle State:NC Zip:28001
Mailing Address (ifapplicable):PO Box 1059
City:Albemarle State:NC Zip:28002
Phone: f704 982-2191 Fax: (704 ) 982-2199
Email:[e-mail]
3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other
person who can answer questions about the project:
Other Contact Person/Or¢anization:
Signing Official &
b. Contact information for person listed in item 3a above:
Mailing Ad
Phone:
State:
Fax: ( )
4. Local jurisdiction for building permits: Cumberland County
Point of Contact:Carrol Post Phone #: (910 ) 321-6640
ForinSWU-101 Version 07Jun2010 Page 2of6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
The front of the site drains to the proposed infiltration basin which is sited on the western boundary of the
site. The building and back of the site drains to an infiltration basin at the back southwest corner of the site
due to the flat nature of the site a level spreader is used to discharge to the filter strip
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
bAf claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW - 1995 ❑ Ph II - Post Construction
3. Stormwater runoff from this project drains to the Cape Fear River basin.
4. Total Property Area: 1.79 acres
5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area':1.79 acres
Total project area shall be calculated to exclude thefollowing: the normal pool of impointded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NHIIV) line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or MHM line. The resultant project area is used to
calculate overall percent built upon area (BUA). Nett -coastal zoetlmzds laizdzuard of the NHW (or MHW) line nay
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 55.7
9. How many drainage areas does the project have?2 (For high density, count 1 for each proposed engineered
stornuuater BMP. For low density and other projects, use 1 for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
Basin Information
Drainage Area 1
Drainage Area 2
Drama e Area
Drainage Area_
Receiving Stream Name
Little Rockfish
Little Rockfish
_
Stream Class *
C
C
Stream Index Number *
18-31-24-(4)
18-31-24-(4)
Total Drainage Area (so
31,197
26136
On -site Drainage Area (sf)
31,197
26,136
Off -site Drainage Area (so
0
0
Proposed Impervious Area*' (SO
26,698
16,856
% Impervious Area** (total)
86
64
Impervious— Surface Area
Drainage Area 1
Drainage Area 2
Drainage Area
Drainage Area..
On -site Buildings/Lots (so
4600
5089
_
On -site Streets (so
0
0
On -site Parking (so
21,365
11,325
On -site Sidewalks (sf)
733
439
Other on -site (so
0
0
Future (so
0
0
Off -site (sf)
0
0
Existing BUA*** (so
0
0
Total (sf):
26,698
16,856
arreant �-uass atza nzaex ivumber call be determined at: Irttn://vortal ncdcnr ory/tueb/tugps/cat/cla<-i6ratic u�
Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Report only that amount of existing BUA that will remain after development. Do not report any existing BUA that
is to be removed and which will be replaced by new BUA.
Form SWU-101 Version 07Jun2010 Page 3 of

11. How was the off -site impervious area listed above determined? Provide documentation. Site is situated on the
ridge in the drainage basin so no off -site water drains through the site
Projects in Union County: Contact DWQ Central Office staff to check ifthe project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per NCAC 02B.0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from http:/ / Portal, ncdenr org/web/wq/ws/su/bmp-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklists are available fromhttn://portal.ncdenr.org/web/wq/ws/su/statesw/forms does. Thecomplete
application package should be submitted to the appropriate DWQ Office. (The appropriate office may be
found by locating project on the interactive online map at http://portal.nccicin orn/web/wa/ws/su/maps.)
Please indicate that the following required information have been provided by initialing in the space provided
for each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions
for each submitted application package from http://portal ncdenr orw/web/wq/ws/suZstatesa-/forms does.
Initial
1. Original and one copy of the Stormwater Management Permit Application Form. j
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants timid
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to QDq
http:/ /www.envhelp.org/ pages/ onestopexpresshtml for information on the Express.program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/managementfor �C.1_'-tt Qv-5
the project. This is required in addition to the brief summary provided in the -Project
Information, item 1.
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the ih
mile radius on the map.
7. Sealed, signed and dated calculations. ob/ 1
8., Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:( --
a. Development/Project name. —t—
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
& Revision number and dates.
h. Identifv all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal eaters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned_
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required).
Form SWU-101 Version 07Jun2010 Page 4 of

p. Vegetated buffers (where required).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify C��7
elevations in
addition to depths) as well as a map of the boring locations with the existing elevations and boring
logs. Include an 8.5"xli" copy of the NRCS County Soils map with the project area clearly
delineated. For projects with infiltration BMPs, the report should also include the soil type,
expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DWQ to verifij the SHWT prior
to submittal, [phone].).
10. A copy of the most current property deed. Deed book: 7943 Page No: 189 ti( A
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC \ N(
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per NCAC 2H.1003(e). The
corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
htto: / /wx"A,.secretary.state.nc.us/Cor2orations/CSearch.aspx
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot nrmnber, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from
lnttp://12ortaLncdenrorg/web/wq/ws/su/statesw/forms does. Download the latest versions for each
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DWQ, and that they will be recorded prior to the sale of any lot.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting Engineer: eff McCluske
Consulting Firm: Mc2 Engineering, Inc.
Mailing Address:2110 Ben Craig Dr., Suite 400
Citv:Charlotte
Phone: (704 ) 510-9797
Email: IeffOmc2eng.com
State:NC Zip:28262
Fax: [phone]
IX. PROPERTY OWNER AUTHORIZATION (if Contact hitormation, item 2 has been filled out, complete this
section)
I, (print or type name of person listed in Contact Infonnation, item 2a) Larry Graham certify that I
own the property identified in this permit application, and thus give permission to (print or hype name of person
listed in Contact Information, item 1a) Lanni Graham (self) with (print or hype name of organization listed in
Contact Infonnation, item la) Albemarle Oil Compmm to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the stormwater system.
Form SWU-101 Version 07Jun2010 Page 5 of 6

As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
lease agreement, or pending sale, responsibility for compliance with the DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ immediately and submit a
completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater treatment
facility without a valid permit. I understand that the operation of a stormwater treatment facility without a valid
permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signatu
Date: 7— 2- 16
I, l anq z uJ- Gr a Notary Public for the State of Nor-N. ('c.o]•„c , County of
do hereby certify that La l C cM 'n personally appeared
before me this 2"'� day of 'T,,Aq Zo r o , and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
u
SEAL.
My commission expires Z-
X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact Information, item la) Lame Graham
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormwater rules under 15A NCAC 2H .1000, SL 2006-246 (Ph. II - Post Construction) or SL 2008-211.
n
Date:
r n a Notary Public for the State of tJ n,.,a County of
do hereby certify that personally appeared
before me this Z"OIday of J wi_ q_ ZO to , and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal, L QA la eJ,
SEAL
My commission expires 2-1o•13
Fnrin SWI I-101 vercinn n7rnn?nln D—K-r4

Permit
(to be provided by DWO)
O20F WA1FgOG
®fir STORMWATER MANAGEMENT PERMIT APPLICATION FORM o 3
NCDENR 401 CERTIFICATION APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
Project Name
Contact Person
Phone Number
Date
Drainage Area Number
II „rDESIGNINFORMATION
Site Characteristics
Drainage area
Impervious area
- e 26,698.00it'
Percent impervious
0.86 %
Design rainfall depth
".,� _.."1.00.,_�,'.ii in
Peak Flow Calculations
1-yr, 24-hr rainfall depth
.,,_=3.02 a�..�.^"in
1-yr, 24-hr intensity
,t 0.13:?`w. iNhr
Pre -development 1-yr. 24-hr discharge -
'"' .:�k',fta/sec
Post -development l-yr, 24-hr discharge
=' i===,,.<"'!ft'/sec
Pre/Post 1-yr, 24-hr peak flow control
Storage Volume: Non -SA Waters
_ft1/sec
"-
Minimum design volume required
4j308.00 waft'
Design volume provided
,'4,429.00 a,".`#}f3 OK for non -SA waters
Storage Volume: SA Waters
1.5" runoff volume
h3
Pre -development 1-yr, 24-hr runoff volume':°,
Post -development 1-yr, 24-hr runoff volume
Minimum required volume
W
Volume provided
a a„n3
Soils Report Summary
Soil type.
Infiltration rate
w _4.68' ="irVhr
SHWT elevation
A66.83" rifmsl
Basin Design Parameters
Drawdown time
° 030'f ;¢days OK
'
Basin
�, : 300 - ;K:1 OK
Basin bottom elevation
bottom elevation
i Io9.00=_ „�fmsl OK
DENR-FRO
Storage elevation
V71100` '.fmsl
Storage Surface Area .
1?2,953.00_-&4.f?
SEP 14 2010
Top elevation
N 171'.00'-^ fmsI
Basin Bottom Dimensions
DW�1
-e
Basin. length
8810t it
e�
Basin width
I-23.00, it
Bottom Surface Area
sa 511':00 tfta
Fonn SW401-Infiltration Basin-Rev.4 - Parts I. & IL Design Summary, Page 1 of 2

Permit No.
(to be provided by DWO)
Additional Information
Maximum runoff to each inlet to the basin?
Length of vegetative filter for overflow
Distance to structure
Distance from surface waters
Distance from water supply well(s)
Separation from impervious soil layer
Naturally occuring soil above shwt
Bottom covered with 4-in of clean sand?
Proposed drainage easement provided?
Capures all runoff at ultimate build -out?
Bypass provided for larger storms?
Pretreatment device provided
' 0.72
ac-in.
OK
�= 50.00....
it
OK
". 9,800.00 i`
"it
OK
100.00.:.
:.ft
OK
�. Y..-):'
`(Y or N)
OK
s Y ;e[ --?'
(Y or N)
OK
-, Y'
(Y or N)
OK -
' Y-
;.(YorN)
OK
. . - ForebaY
Form SW401-Infiltration Basin-Ray.4 Pals 1. & 11. Design Summary, Page 2 of 2

Permit
(to be provided by DWC)
111 REQUIREWTEMS CHECKLISTS 5- i.rMA' . s
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to
indicate the following design requirements have been met. If the applicant has designated an agent, the agent may initial below. If a
requirement has not been met, attach justification.
Page/ Plan
Initials
Sheet No.
�17
C2.0
1. Plans (I" - 50' or larger) of the entire site showing:
C4.0
- Design at ultimate build -out,
C4.2
- Off -site drainage (if applicable),
C6.0
-Delineated drainage basins (include Rational C coefficient per basin),
C6.1
- Basin dimensions,
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Proposed drainage easement and public right of way (ROW),
n- Overflow device, and
Boundaries of drainage easement.
_Z=
C4.0
2. Partial plan It' = 30' or larger) and details for the infiltration basin showing:
C6.0
I,- Bypass structure,
C6.1
Maintenance access,
Basin bottom dimensions,
Basin cross-section with benchmark for sediment cleanout,
Flow distribution detail for inflow,
Vegetated filter, and
Pretreatment device.
_C6.0 3. Section view of the infiltration basin (V = 20' or larger) showing:
- Pretreatment and treatment areas, and
I - Inlet and outlet structures.
2 _CALCS_ 4. -A table of elevations, areas, incremental volumes & accumulated volumes to verify the volume provided.
_Q�24f _CALCS_ 5. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. The
results of the soils report must be verified in the field by DWO, by completing & submitting the soils
investigation request form. County soil maps are not an acceptable source of soils information.
`4sd _C3.0_
_CALCS_
6. A construction sequence that shows how the infitlration basin will be protected from sediment until the
entire drainage area is stabilized.
7. The supporting calculations.
_YES_ 8. A copy of the signed and notarized operation and maintenance (0&M) agreement.
_N/A_ 9. A copy of the deed restrictions (if required).
Form SW401-Infiltration Basin-Rev.4 Page 1 of 1 Part III. Required Items Checklist, Page 1 of 1

Permit
(to be provided by DWQ)
OF W NFH
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
NCDENR 401 CERTIFICATION APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part //I) must be printed, filled out and submitted along with all of the required information.
Project Name
Contact Person
Phone Number
Date
Drainage Area Number
TOAD -"•i
IQZESIGN)NFORMATION
Site Characteristics
-
Drainage area
25,395.00'1
Impervious area
1`,.16.856.00,;,,, fe .
Percent impervious
0.66 %
Design rainfall depth
, 1 OOara_din
Peak Flow Calculations
1-yr, 24-hr rainfall depth
•.3021',,,, in
1-yr, 24-hr Intensity
_
::, 0.13:"•- _`Jr/hr
Pre -development 1-yr, 24-hf discharge
* `. -,tt3/sec
Post -development 1-yr, 24-hr discharge
rya/sec
Pre/Post 1-yr, 24-hr peak flow control -
ry°/sec
Storage Volume: Non -SA Waters
-
Minimumdesignvolumerequired
Design volume provided
�: 2,809.00''-"9ry3 OK for non -SA waters
Storage Volume: SA Waters
1.5" runoff volume
' '-" i "'rya -
Pre -development 1-yr, 24-hr runoff volume
{' '?'-.f. ft3
Post -development 1-yr, 24-hr runoff volume
, •''+' r; tt3
Minimum required volume
to
-Volume provided-._'ry3
..
Soils Report Summary
Soil type
-.Candoo(Ca8)
Infiltration rate
„4.68:=. ''inlllr
SHWT elevation
167.331° fmsl
Basin Design Parameters
Drawdown time
•`,days OK . .
Basin side slopes
.,-; 3.00`7,;:1:1 OK
Basin bottom elevation -
„ 169.50`r �'-'fmsl OK
_
Storage elevation
1'',-l71.00,-. ,'fmsl
Storage Surface Area -
,•.12,399.00 ; ,'Sry2
'. Top elevation
!%^ '17P:00T." ;;fmsl
'-- Basin Bottom Dimensions
Basin length
70-:40 'ry
Basin width
27.10,"<,i''ry
Bottom Surface Area
-;.>• 1,339.00 ' ;rye
Form SW401-Infiltration Basin-Rev.4 Pans I. a It. Design Summary, Page 1 of 2

Permit
(to be provided by DWQ)
Additional Information
Maximum runoff to each inlet to the basin?
Length of vegetative filter for overflow
Distance to structure
Distance from surface waters
Distance from water supply well(s)
Separation from impervious soil layer
Naturally occuring soil above shwt
Bottom covered with 4-in of clean sand?
Proposed drainage easement provided?
Capures all runoff at ultimate build -out?
Bypass provided for larger storms?
Pretreatment device provided
i
Form SW401-Infiltration Basin-Rev.4 Pans 1. & If. Design Summary, Page 2 of 2

Permit
(to be provided by DWQ)
111 ,REQUIRED.ITEMS;CIiECKL='IST
Please indicate the page or plan sh66t numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to
indicate the following design requirements have been met. If the applicant has designated an agent, the agent may initial below. If a
requirement has not been met, attach justification.
Page/ Plan
Initials Sheet No.
JDM C2.0
1. Plans (1' - 50' or larger) of the entire site showing:
C4.0
- Design at ultimate build -out,
C4.2
- Off -site drainage (if applicable),
C6.0
- Delineated drainage basins (include Rational C coefficient per basin),
C6.1
- Basin dimensions,
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Proposed drainage easement and public right of way (ROW),
- Overflow device, and
- Boundaries of drainage easement.
JDM C4.0
2. Partial plan (1' = 30' or larger) and details for the infiltration basin showing:
C6.0
- Bypass structure,
C6.1
- Maintenance access,
- Basin bottom dimensions,
- Basin cross-section with benchmark for sediment cleanout,
- Flow distribution detail for inflow,
- Vegetated filter, and
- Pretreatment device.
JDM _C6.0 3. Section view of the infiltration basin (1' = 20' or larger) showing:
- Pretreatment and treatment areas, and
- Inlet and outlet structures.
JDM _CALCS_ 4. A table of elevations, areas, incremental volumes & accumulated volumes to verify the volume provided.
JDM
_CALCS_
5. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. The
results of the soils report must be verified in the field by DWQ, by completing & submitting the soils
investigation request form. County soil maps are not an acceptable source of SOi;3 information.
JDM
_C3.0
6. A construction sequence that shows how the infitiration basin will be protecta'd from sediment until the
entire drainage area is stabilized.
JDM
_CALCS_
7. The supporting calculations.
JDM
8. A copy of the signed and notarized operation and maintenance (0&M) agreement.
JDM
_N/A_
9. A copy of the deed restrictions (if required).
Form SW401-Infiltration Basin-Rev:4 Page 1 of 1 Part III. Required Items Checklist, Page 1 of 1

/'whro.' ?af WAipgO
h L
NC ENR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
LEVEL SPREADER, FILTER STRIP AND RESTORED RIPARIAN BUFFER SUPPLEMENT
This form must be completely filled out, printed and submitted.
DO NOT FORGET TO ATTACH THE REQUIRED ITEMS CHECKLIST AND ALL REQUIRED ITEMS (NEXT WORKSHEET)!
Project name
Contact name
Phone number
Date
Drainage area number
I15DESIGN INFORMATIONi
For Level Spreaders Receiving Flow From a BMP
Type of BMP Inffhrahon Basln`Ovedlow'(Besln Designed based on 2x Require Storage) i•�1' •_''
� z
Drawdown flow from the BMP-"_0`49.�t-�-�cfs
For Level Spreaders Receiving Flow from the Drainage Area
Drainage area
Impervious surface area
Percent impervious
Rational C coefficient
Pc,* flow from the 1 Whir storm
Time of concentration
Rainfall intensity, 10-yr storm
Peak flow from the 10-yr storm
Where Does the Level Spreader Discharge?
To a grassed bioretention cell?
To a mulched bioretention cell?
To a wetland?
To a filter strip or riparian buffer?
Other (specify)
Filter Strip or Riparian Buffer Characterization (if applicable)
Width of grass
Width of dense ground cover
Width of wooded vegetation
Total width
Elevation at downslope base of level lip
Elevation at top of bank of the receiving water
slope (from level lip to to top of bank)
Are any draws present?
Level Spreader Design
Forelbay surface area
Feet oilevel lip needed per cfs
Answer "Y" to one of the following:
Length based on the 1 inAfr storm?
Length based on the 10-yr storm?
Length based on the BMP discharge rate?
Design flow
Is a bypass device provided?
Length of the level lip
Do not complete this section of the worksheet.
n
ry .w; ff2
Do not complete this section of the worksheel.
- - Al2
Do nor complete this section of the worksheel.
%
Do not complete this section of the worksheet.
Do not complete this section of the worksheel.
cis
Do not complete this section of the worksheel. /.
W,; min
in/hr
Do not complete this section of the worksheel. -
cfs
Do not complete this section of the worksheet.
or N)
or N)
or N)
or N) Please complete filler strip characterization below.
'3000 'r.ff -
o0o4ff
�. 0.00 ..• It
:171.005 <fmsl
-170'SO�s 'fmsl - -
1.67 % OK _. <
N =. (Y or N) OK -
sq ff
13 fUcfs
_d Y_s (YorN)
N(YorN)
t 45 s! cfs
i000�m:-n
No forebay is needed.
A bypass device is not needed.
Level spreader must be at least 13 feet but.
Form SW401-1-evel Spreader, Filter Strip, Restored Riparian Buffer-Rev.5 Pads I. and II. Design Summary, page 1 of 2

Are level spreaders in series? N (Y or N)
Bypass Channel Design (if applicable)
Does the bypass discharge through a wetland?
Does the channel enter the stream at an angle?
Dimensions of the channel (see diagram below):
M
B
W
y
Peak velocity in the channel during the 1 O-yr storm
Channel lining material
i'
(Y or N) Do not complete this section of the worksheet
(Y or N)
Do not complete this section of Ilia worksheet.
Do not complete this section of the worksheet.
it
Do not complete this section of the worksheel.
it
Do not complete this section of the worksheel.
- it
Do not complete this section of the worksheet.
it
Do not complete this section of the worksheet
'.' cis
Do not complete this section of the worksheet.
;Do oat complete this Section of the worksheet.
Form SW401-Level Spreader, Filter Strip, Restored Riparian Buffer-Rov.5 - Parts 1. and II. Design Summary, page 2 of 2

MP_
PA
o?� WniFq��
N
NC ENR
STORMWATER
MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION
APPLICATION FORM
LEVEL SPREADER, FILTER STRIP AND RESTORED RIPARIAN BUFFER SUPPLEMENT
This form must
be completely filled out, printed and submitted.
DO NOT FORGET TO ATTACH THE REQUIRED ITEMS CHECKLIST AND ALL REQUIRED ITEMS (NEXT WORKSHEET)!
I.PROJECT_;INFORMATION rrw i sfr ° saw' i
Project name
ALCO CAMDEN ROAD, r
Contact name
Jeff McCluskey _12
Phone number
Date -
21 Jul 10 ru, "
Drainage area number
'InfiltrationBasm
II'DESIGN INFORMATION _> txi g u �� s
_- �-'�s"xi"`���v �-�-.��.:sra-. e`-��`.�rr...f '_>�� '��za-�z�`-"`���"��"..
For Level Spreaders Receiving Flow From a BMP
Type of BMP
Inflltrairon Basin OJedlow (Basin Deslgrietl based on 2x Re;quire Storage): >
Drawdown flow from the BMP
z7' 0.001 z .acts
For Level Spreaders Receiving Flow from the Drainage Area
Drainage area
ff2
Impervious surface area
, _ff
Percent impervious
%
Rational C coefficient
-
Peak flow from the 1 iNhr storm
cfs
Time of concentration
min
Rainfall intensity, 10-yr storm
inthr
Peak flow from the 10-yr storm
cfs
Where Does the Level Spreader Discharge?
To a grassed bioretention cell?
` N_. �'�,(Y or N) -
To a mulched bioretention cell?
,� N'=`f`", ""-(Y or N)
To a wetland?
' N"y' (Y or N) '
- To a filter strip of riparian buffer?
Y ->;(Y or N) Please complele filter strip charactervalbn below.
Other (specify)
,. '" ' ",
Filter Strip or Riparian Buffer Characterization (if applicable)
Width of grass
Width of dense ground cover
O.00:r R
Width of wooded vegetation
It
Total width
30.00'Y-Z:'It
Elevation at downslope base of level lip
21 bf:00 +`#fmsl
Elevation at top of bank of the receiving water
,
`-.170.50 fast "
Slope (from level lip to to top of bank)
1.67 % OK .. -
Are any draws present?
(Y or N) OK
Level Spreader Design' -
Forebay surface area
sq ff ,.
Feet of level lip needed per cfs
13 ft/cfs
Answer "Y" to one of the following:
Length based on the 1 in/hr storm?
_ ,N.,:;'„`a(Y or N)
Length based on the 10-yr storm?
�. ,_.N _r�s-= (Y or N) -
Length based on the BMP discharge rate?
`r Y "" ' (Y or N)
Design flow
F 1.34, cfs
Is a bypass device provided?
A bypass device must be provided.
Length of the level lip
,.'10.00:-5 .`;i. it Level spreader must be at least 13 feel long.
Form SW401-Level Spreader, Filter Strip, Restored Riparian Buller-Rev.5 Parts I. and II. Design Summary, page 1 of 2

IIt"EQUIREDITEM"HECKLIST:
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to
indicate the following design requirements have been met. If the applicant has designated an agent, the agent may initial below. If a
requirement has not been met, attach justification.
Initials
JDM
JDM
-JDM
JDM
JDM
J=gin
JDM
Pagel Plan
Sheet No.
C4.0, 1. Plans (1° - 50' or larger) of the entire site showing:
C4.1, - Design at ultimate build -out,
C4.2 - Off -site drainage (if applicable), -
- Delineated drainage basins (include Rational C coefficient per basin),
- Forebay (if applicable),
- High flow bypass system,
- Maintenance access,
- Proposed drainage easement and public right of way (ROW), and
- Boundaries of drainage easement.
C3.0 2. Plan details (1" = 30' or larger) for the level spreader showing:
C4.0 - Forebay (if applicable),
- High flow bypass system,
- One foot topo lines between the level lip and top of stream bank,
- Proposed drainage easement, and
- Design at ultimate build -out.
C6.0 3. Section view of the level spreader (V = 20' or larger) showing:
- Underdrain system (if applicable),
- Level lip,
- Upslope channel, and
- Downslope filter fabric.
N/A
C3.0
CALCS
TO BE
SUBMITTED
N/A
4. A date -stamped photograph of the filter strip that clearly shows the type of vegetation that is present.
5. A construction sequence that shows how the level spreader will be protected from sediment until the
entire drainage area is stabilized.
6. The supporting calculations.
7. A copy of the signed and notarized operation and maintenance (0&M) agreement.
8. A copy of the deed restrictions (if required).
Form SW401-Level Spreader, Filter Strip, Restored Riparian Buffer-Rev.5 Part III, page 1 of 1