SW7100804_CURRENT PERMIT_20101130

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW v
DOC TYPE
CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
YYYYMMDD

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue
Governor
Coleen H. Sullins
Director
Dee Freeman
Mr. Danny Cooper, Chief Construction Officer
HMC/CAH Acquisition Company, LLC
143 K. Shaffer
Drumright, OK 74030
Subject: Stormwater Permit No. SW7100804
Washington County Hospital
High Density Project
Washington County
Dear Mr. Cooper:
The Washington Regional Office received a complete Stormwater Management Permit
Application for Washington County Hospital on September 21, 2010 and additional information
on November 29, 2010. Staff review of the plans and specifications has determined that the
project, as proposed, will comply with the Stormwater Regulations set forth in Session Law
2008-211 and Title 15A NCAC 2H.1000. We are forwarding Permit No. SW7100804 dated
November 30, 2010 for the construction of the subject project.
This permit shall be effective from the date of issuance until November 30, 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 to establish an adequate
system for operation and maintenance of the stormwater management system will result in
future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have
the right to request an adjudicatory hearing upon written request within thirty (30) days
following receipt of this permit. This request must be in the form of a written petition,
conforming to Chapter 150B of the North Carolina General Statutes, and filed with the Office of
Administrative Hearings, P.O. Drawer 27447, Raleigh, NC 27611-7447. Unless such demands
are made this permit shall be final and binding.
If you have any questions, or need additional information concerning this matter, please
contact Samir Dumpor, or me at [phone].
'Si crly,
�A Hod
Regional Supervisor
Surface Water Protection Section
AH/ sd: K:\WQS\STORMWATER\PERMIT\SW7100804
cc: Tim Foley, PE, HensonFoley, Inc. (10224 Hickorywood Hill Av., Suite 101A,
Huntersville, NC 28078)
Washington County Building Inspections
k,Mashington Regional Office
North Carolina Division of Water Quality Internet: www.nc%vateraualitc.ore
943 Washington Square Mall Phone: [phone] One Washington, NC 27889 FAX [phone] North
Carol1
tna
An Equal Opportunity/Affirmative Action Employer —50%Recycled/10% Post Consumer Paper Natural&

State Stormwater Management Systems
Permit No. SW7100804
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of
North Carolina as amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
HMC/CAH Acquisition Company, LLC
Washington County Hospital
Washington County
FOR THE
construction, operation and maintenance of 2 Wetlands Basins, in compliance with the
provisions of Session Law 2008-211 and 15A NCAC 2H .1000 (hereafter referred to as
the "stormwater rules') and the approved stormwater management plans and
specifications and other supporting data as attached and on file with and approved by
the Division of Water Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until November 30, 2020, and
shall be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. This stormwater system has been approved for the management of stormwater
runoff as described in Section 1.7, 1.8 and 1.9 of this permit.
The tract will be limited to the amount of built -upon area indicated in Section I. of
this permit, and per approved plans.
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.
5. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
6. The built -upon areas associated with this project shall be located at least 50 feet
landward of all perennial and intermittent surface waters.
7. The following design criteria have been provided in the Wetland Basins and must
be maintained at design condition:
Page 2 of 7

State Stormwater Management Systems
Permit No. SW7100804
a.
b.
C.
d.
e.
f.
h.
i.
k.
1.
n.
Drainage Area, ftz:
Total Impervious Surfaces, ftz:
Design Storm, inches:
Wetland Forebay Depth, feet:
TSS removal efficiency:
Permanent Pool Elevation, FMS�:
Permanent Pool Surface Area, ft
Permitted Storage Volume, ft :
Temporary Storage Elevation, FM
Controlling Orifice:
Permitted Forebay Surface Area,
Receiving Stream/River Basin:
Stream Index Number:
Classification of Water Body:
II. SCHEDULE OF COMPLIANCE
Wetland #1
Wetland #2
102;780
44,851
91,698
37,148
1.5
1.50
3.90
2.40
85%
85%
7.80
6.80
12,189
4,733
12,189
4,733
SL: 8.80
7.80
2.0" 0 pipe
1.25 0 pipe
ftZ: 1,277
475
Conaby Creek/Roanoke
23-56
"C; Sw"
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.
During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
The permittee shall at all time 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 re -vegetation of slopes and the vegetated filter strip.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of outlet structure, orifice device, level
spreader, filter strip, catch basins and piping.
g. Access to the outlet structure must be available at all times.
4. Records of maintenance activities must be kept for each permitted BMP. The
records 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 inspection records for each BMP. The report shall
summarize the inspection dates, results of the inspections, and the maintenance
work performed at each inspection.
6. Access to the stormwater facilities shall be maintained via appropriate
easements at all times.
7. The facilities shall be constructed as shown on the approved plans. This permit
shall become void unless the facilities are constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other
supporting data.
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
Page 3 of 7

State Stormwater Management Systems
Permit No. SW7100804
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.
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.
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 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
shall provide copies of revised plans and certification in writing to the Director
that the changes have been made.
12. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
13. A copy of the approved plans and specifications shall be maintained on file by
the Permittee at all times.
III. GENERAL CONDITIONS
This permit is not transferable 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 supporting documentation
as listed on page 2 of the form. The project must be in good standing with the
Division. The approval of this request will be considered on its merits and may or
may not be approved.
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
Page 4 of 7

State Stormwater Management Systems
Permit No. SW7100804
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government 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 those 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 re -issuance or
termination does not stay any permit condition.
8. Unless specified elsewhere, permanent seeding requirements for the stormwater
control must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
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 2008-
211. Title 15A NCAC 2H.1000. and NCGS 143-215.1 et.al.
11. The permittee shall notify the Division of any name, ownership or mailing
address changes at least 30 days prior to making such changes.
12. This permit shall be effective from the date of issuance until November 30, 2020.
Application for permit renewal shall be submitted 180 days prior to the expiration
date of this permit and must be accompanied by the processing fee.
Permit issued this the 30th day of November, 2010.
N�RTH C&ROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for
Ljoiee,n h. Sumrts, uirector
Division of Water Quality
By Authority of the Environmental Management Commission
Stormwater Permit No. SW7100804
Page 5 of 7

State Stormwater Management Systems
Permit No. SW7100804
Washington County Hospital
Stormwater Permit No. SW7100804
Washington County
Designer's Certification
I, , 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.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
SEAL
Page 6 of 7

State Stormwater Management Systems
Permit No. SW7100804
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 outlet/bypass structure elevations are per the approved plan.
6. The outlet structure is located per the approved plans.
7. Trash rack is provided on the outlet/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 and do not cause short-
circuiting of the system.
11. The permitted amounts of surface area and/or volume have been
provided.
12. Required drawdown devices are correctly sized per the approved plans.
13. . All required design depths are provided.
14. All required parts of the system are provided, such as a vegetated shelf,
and a forebay.
15. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Washington Regional Office
Washington County Building Inspections
Page 7 of 7

�n
DWQ USE ONLY
Date Remived
Fee Paid
Permit Number
Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M mt Plan: S�W&ck
State of North Carolina=•'t`°.' "' ;�
Department of Environment and Natural Resources
IV Division of Water Quality SEP 2 1 2010
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original
I. 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.):
Washington Countv Hospital
2. Location of Project (street address)
City:Ply mou th County: W ashington Zip:27962
3. Directions to project (from nearest major intersection):
2600 I f west of intersection of US 64 and E. Main Street in Plymouth, NC
4. Latitude:35' 51' 47.28" N Longitude:760 43' 45.83" W of the main entrance to the project.
it. 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 certification
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
❑NPDES Industrial Stormwater
®Sedimentation/Erosion Control: 9.5 ac of Disturbed Area
❑404/401 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:
Form SWU-101 Version 07Jun2010 Page I of

J.E.IDunn Construction Company
1001 Locust St
Kansas City. MO 64106
Vendor 012730 STATE OF NORTH CAROLINA
# : 770514
Date 07-22-2010
No. 'Invoice Inv Date Descrlplion
Invoice Amount
Deduilion
Pay
' 1 RE0072210A 07-22-2010
505.00
0.00
505.00
TOTAL:
505.00
SEP 21
2010
I
1
J _
,
% EDUM0 J. E. DUNN CONSTRUCTION COMPANY
as No�rmuanoN i 1001 LOCUST STREET, KANSAS CRY,M064106,
UMB BANK, N.A. Dates r .,_ Number
,•a. •£C4 a'�'"<> /`` ��,.:. _ �J §.,•'", a ,�,t.r.ST. JOS-�EPH, MISSOURI 0722 2010g
770514,
36-1901/1012V, • J. E. DUNN,CONSTRUCTION COMPANY,
. DUMI „ 1001 LOCUST; STREET, KANSAS CITY, MO 64106
PAY
FIVE HUNDRED FIVE'DOLLARS 0/100.
�. a > ice, < ,,,• 7
TO THE STATE OF, NORTH CAROLINA
ORDER DEPT OF•ENVIRONMENTAL 8 NATURAL RESOURCE 1601 r>y
OF MAIL SERVICE CENTER s ` r
RALEIOH NC'27699-1601
,
Psl xv
I -

1
1 ✓-
I
I
PROPOSED
LOT LINES
(4.174 Ac.)
i
i
/ If e,
1

III. CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicant/ Organ ization:HMC/ CAH
Signing Official & Title:Danny Cooper - Chief Construction Officer
b.Contact information for person listed in item I above:
Street Address:143 K. Shaffer
City:Drumright State:OK Zip:74030
Mailing Address (if applicable):
City: State
Phone: (918 ) 671-8655 Fax:
Email:copperd anny@shcglobal,net
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:
Signing Official & Title:
b.Contact information for person listed in item 2a above:
Street Address:
City:
Mailing Address (if
City:
Phone: ( 1
State:
Fax:
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/ Organization: I E Dunn Construction
Signing Official & Title:David Glueck - Project Manager
b.Contact information for person listed in item 3a above:
Mailing Add
City:Kansas City State:MO Zip:64106
Phone: (816 ) 474-8600 Fax: ( ) david.glueckOjedunn.com
Email: D�*/� I KeG�- (2Ii
e.AII.NVI. GON1
4. Local jurisdiction for building permits: Washington County
Point of Contact: Wayne Lillie Phone #: (252 ) 793-4114
Form SWU-101 Version 07Jun2010 Page 2 of

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
The net new impervious area (total new impervious area minus the old total impervious area) is being treated
through 2 storm water wetland BMP's at the rear of the project.
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:
b.If 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 Roanoke River basin.
4. Total Property Area: 20.57 acres 5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0.30 acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area`:20.27 acres
Total project area shall be calculated to exclude the following the nonrral pool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NHW) line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or MHW) line. The resultant project area is used to
calculate overall percent built upon area (BUA). Nan -coastal wetlands tmidtuard of the NHW (or MHW) litre may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 35.4
9. How many drainage areas does the project have?4 (For high density, count 1 for each proposed engineered
stornuoater BMP. For 1071) density and other projects, use 1 for the whole properhJ 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
Draina e Area%
Drainage Area 2
Drainage Area 3
Drainage Area 4
Receiving Stream Name
Conaby Creek
Conaby Creek
Conaby Creek
Conaby Creek
Stream Class * I
C; Sw /'
C; Sw
C; Sw
C; Sw
Stream Index Number *
21-56
23-56
23-56
23-56
Total Drainage Area (sf)
102780 V
44851 ✓
606372 t%
51057 V
On -site Drainage Area (sf)
102780
44851 ✓
606372
51057
Off -site Drainage Area (so
0
0
93937
0
Proposed Imervious Area** (so
91698 V
37148 f
93937 V
24692
% Impervious Area** total
89.2
82.8
15.5
20.6
Impervious- Surface Area
Drainage Area 1
Drainage Area 2
Drainage Area 3
Drainage Area 4
On -site Buildings/Lots (so
52768
1437
0
0
On -site Streets (so
0
0
0
0
On -site Parking (so
30447
1112 ✓
45915 /
13562 d
On -site Sidewalks (so
4488
727 J
5394
610
Other on -site (sf)
0
0
0
0
Future(so
0
0
0
0
Off -site (so
0
0
0
0
Existing BUA*** (so
3995 V,
33872 Y
93937 V.
10520 V1
Total (so:
91698 V
37148 v
145246 V
24692 d
Stream Class and Index Number can detenuined-at. Itt vor i.nedenrlorgfweblwq[ps/csu/classifications
"* Impervious area is defined as the built upon area including, L-�"
not lintited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SWU-101 Version 07Jun2010 Page 3 of ot�7

'Report only that amount of existing BUA thatWill remain after development. Do not report any existing BUA that
is to be removed and which will be replaced by new BUA.
11. How was the off -site impervious area listed above determined? Provide documentation. Map is attached to
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.
Vl. 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 fromhttp://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.ncdenr.org/web/wq/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 ham://portal.ncdenr.org/web/wq/ws/su/statesw/forms_docs.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part VII belozo)
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
httl2://www.envhelp.org/pages/onestopexpress.html 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
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 1/2
mile radius on the map.
7. Sealed, signed and dated calculations.
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify 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 waters.
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.
I. 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.
f— C(Itc.
C61C. 6rk
eJ,.eled
Form SWU-101 Version 07Jun2010 Page 4 of 6

, o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required). /fn
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify
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"x11" 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: 44 S Page No: 03-L 34
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC
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 21-1.1003(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.
http://www.secretary.state.nc.us/Corporations/-CSearch.aspx
VIL 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 number, 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
htto://oortal.ncdennore/web/wa/ws/su/statesw/forms does. Download the latest versions for each submittal.
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:Timothy D. Foley, P.E.
Consulting
Mailing Address:10224 Hickorywood Hill Avenue, Suite 101 A
City:Huntersville State:NC Zip:28078
Phone: (704 ) 875-1615
Email:[e-mail]
Fax: (704 ) 875-0959
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section) n
I, (print or hype name of person listed in Contact Information, item 2o) `V certify that I
own the property identified in this permit application, and thus give permission to (print or hjpe mmie of person
listed in Contact Information, item ]a) with (print or h/pe mmne of organization listed in
Contact Information, item 1n) 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

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.
1,
a Notary Public for the State of
Date:
County of
. do hereby certify that personally appeared
before me this _ day of and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission expires
0
1'5C APPLICANTS CERTIFICATION. 1 /�
],(print or type name of person listed in Contact Infori ation, item 1a) / f ,V&J l/ l o U r—
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 appic ved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable sto rules under 15A , CAC 211.1000, SL 2006-246 (Ph. ll - Post Construction) or SL 2008-211. .
Sip atu)re: /� Date:
I, /^///eG//�� 1 O� a Not. Public for the State of V `may . County of
.doh ebycertify that 110AqA personally appeared
before me ttus:L� day of C/GJI 5Z>710. and aaAowledg a the du execution of the application for
a stormwater permit. Witness my hand and official seal,
...........................
,i�9 ANITA J, COOPER
SEAL 1 srai NotoryPubllo
1 .yeC,f. State of Oklahoma
i
- Commission # 990009628 Expires 08115111---------------------------------
'' Mycommissiori expues � ' � , i' -i' x'
Form SWU-101 Version 071un2010 Page 6 of 6

F'
SEP 2 1 2010 Permit Number:
(to be provided by DWQ)
t•r Drainage Area Number: 5jN W j
Stormwater Wetland 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 stormwater wetland is established, the wetland plants will
be watered twice weekly if needed until the plants become established
(commonly six weeks).
— No portion of the stormwater wetland will be fertilized after the first initial
fertilization that is required to establish the wetland plants.
— Stable groundcover will be maintained in the drainage area to reduce the
sediment load to the wet detention basin.
— Once a year, a dam safety expert will inspect the embankment.
After the wet detention pond is established, I will inspect it once a month 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
wetland
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.
Vegetation is too short or too
Maintain vegetation at a height of
long.
approximately six inches.
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 problems with erosion.
Form SW401-Wetland O&M-Rev.3 Page 1 of

BMP element:
Potentialproblem:
How I will remediate theproblem:
The forebay
Sediment has accumulated in
Search for the source of the
the forebay to a depth that
sediment and remedy the problem if
inhibits the forebay from
possible. Remove the sediment and
functioning well.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred.
Provide additional erosion
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 a pesticide is used, wipe it
on the plants rather than spraying.
The deep pool, shallow
Algal growth covers over
Consult a professional to remove
water and shallow land
50% of the deep pool and
and control the algal growth.
areas
shallow water areas.
Cattails, phragmites or other
Remove the plants by wiping them
invasive plants cover 50% of
with pesticide (do not spray) -
the deep pool and shallow
consult a professional.
water areas.
Shallow land remains Flooded
Unclog the outlet device
more than 5 days after a
immediately.
storm event.
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 to establish the
ground cover if a soil test indicates
it is necessary.
Best professional practices
Prune according to best professional
show that pruning is needed
practices.
to maintain optimal plant
health.
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
of the deep pools.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Form SW401-Wetland O&M -Rev.' Page 2 of

BMP element:
Potentialproblem:
How I will remediate theproblem:
The embankment
A tree has started to grow on
Consult a dam safety specialist to
the embankment.
remove the tree.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair.
Evidence of muskrat or
Use traps to remove muskrats and
beaver activity is present.
consult a professional to remove
beavers.
The micropool
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.
Plants are growing in the
Remove the plants, preferably by
micropool.
hand. If a pesticide is used, wipe it
on the plants rather than spraying.
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
of the sediment off -site.
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-Wetland O&M-Rev.3 Page 3 of 4

Permit Number:
(to be provided by DWQ)
ijck"
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: Washington County Hospital
BMP drainage area number:Stormwater Wetland #1 (SWW 1)
Printname: /dual) &^' C
Title: PP A2-LGTart_
Address: gS-L US Nwy' 6 q LA C7- /�O/ywto-w1-
Date: XI 7
Note: The legally responsible parry 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
do hereby certify that
personally appeared before me this
Lowledge the due execution of the
forgoing stormwater wetland maintenance requirements. Witness my hand and official
seal,
%aaaacaaaa
,. �a,puOilr- A P�r��.y
._w
per �Ls''si
J, ���Or6G UE
aa�,•'e
y�. oN CO
aa�aalla aapp��i
SEAL
My commission expires I \I ��2Q ��
Form SW401-Wetland O&M-Rev.3 Page 4 of 4

Permit Number:
��� ���� (to be provided by DWQ)
Drainage Area Number: `, >w\k) 2
Stormwater Wetland Operation and Maintenance Agreement
.1t.
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 stormwater wetland is established, the wetland plants will
be watered twice weekly if needed until the plants become established
(commonly six weeks).
— No portion of the stormwater wetland will be fertilized after the first initial
fertilization that is required to establish the wetland plants.
— Stable groundcover will be maintained in the drainage area to reduce the
sediment load to the wet detention basin.
— Once a year, a dam safety expert will inspect the embankment.
After the wet detention pond is established, I will inspect it once a month and within 24
hours after every stone 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
wetland
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.
Vegetation is too short or too
Maintain vegetation at a height of
long.
approximately six inches.
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 problems with erosion.
Form SW401-Wetland O&M-Rev.3 Page 1 of 4

BMP element:
Potentialproblem:
How I will remediate theproblem:
The forebay
Sediment has accumulated in
Search for the source of the
the forebay to a depth that
sediment and remedy the problem if
inhibits the forebay from
possible. Remove the sediment and
functioning well.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred.
Provide additional erosion
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 a pesticide is used, wipe it
on the plants rather than spraying.
The deep pool, shallow
Algal growth covers over
Consult a professional to remove
water and shallow land
50% of the deep pool and
and control the algal growth.
areas
shallow water areas.
Cattails, phragmites or other
Remove the plants by wiping them
invasive plants cover 50% of
with pesticide (do not spray) -
the deep pool and shallow
consult a professional.
water areas.
Shallow land remains flooded
Unclog the outlet device
more than 5 days after a
immediately.
storm event.
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 to establish the
ground cover if a soil test indicates
it is necessary.
Best professional practices
Prune according to best professional
show that pruning is needed
practices.
to maintain optimal plant
health.
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
of the deep pools.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Form SW401-Wetland O&M-Rev3 Page 2 of 4

BMP element:
Potentialproblem:
How I will remediate theproblem:
The embankment
A tree has started to grow on
Consult a dam safety specialist to
the embankment.
remove the tree.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair '
e air.
Evidence of muskrat or
Use traps to remove muskrats and
beaver activity is present.
consult a professional to remove
beavers.
The micropool
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.
Plants are growing in the
Remove the plants, preferably by
micropool.
hand. If a pesticide is used, wipe it
on the plants rather than spraying.
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
of the sediment off -site.
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.
733-1756.
Form SW401-Wetland O&M-Rev.3 Page 3 of 4

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: Washington County Hospital
BMP drainage area number:Stormwater Wetland #2 (SWW 2)
Print name: k2,c//A/zd L /otti-6
Title: �,d r-7 QA,71LA
Address: 452 tIT 1` VY y fr4S i .p�Y/�I bc�;r// /1/C a 7 S 6 2
Note: The legally responsible parry 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.
Public for the State of
do hereby certify that
v /1.
personally appeared before me this
and acknowledge the due execution of the
forgoing stormwater wetland maintenance requirements. Witness my hand and official
seal,
P "W
%40Ta pI.
,yvC ?e `P
,,,,,,,ON CO04%"%'
���11"te nal",
SEAL
My commission expires [\1;2y/i1bta/ / 5, 20 / T
Form SW401-Wetland O&M-Rev.3 Page 4 of 4

ivill
�JG
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
September 13, 2010
Ms. Betty T. Bowen, Administrator
Washington County Hospital
PO Box 707
Plymouth, NC 27962
Dee Freeman
Secretary
Subject: Stormwater Project No. SW7100804
Washington County Hospital — Expansion Project
Washington County
Dear Ms. Bowen:
This office received a copy of your Sedimentation and Erosion Control Plan for the subject project on
August 15, 2010. North Carolina Administrative Code 15 NCAC 2H.1000 requires that any project that must
receive either a Sedimentation and Erosion Control Plan approval and/or a CAMA Major permit apply for and
receive a Stormwater Management Permit by the Division of Water Quality.
To obtain a Stormwater Permit you must submit a completed application, application fee of $505.00,
two sets of plans and specifications showing the proposed project and all stormwater treatment units along
with engineering calculations and a narrative description. This application package should be received by this
office prior to October 13, 2010. If an application package is not received by this date we will consider the project
incomplete. We also have an Express Permitting program. If you are interested in this program you may contact
Ms. Lyn Hardison, One Stop Permit Coordinator, at 252-948-3842.
Any development of the site prior to receipt of the required permit will constitute a violation of 15A
NCAC 2H.1000 and North Carolina General Statute 143-215.1 and may result in appropriate enforcement
action including civil penalty assessment of up to $10,000 per day.
Please reference the Stormwater Project Number.above on all correspondence. If you have questions,
please feel free to contact me at [phone].
Sincerely,
1�
Scott Vinson
Environmental Engineer
Surface Water Protection Section
cc: Washington County Planning/Inspections
Denny Cooper, SBC Global —143
asnington Regional Office
Norlh Carolina Division of Water Quality Internet: www.ncwaterquality.org One
943 Washington Square Mall Phone. [phone] FAX: [phone] North Caro 11 n it
Washington, NC 27889 FAX: [phone] JN6 !!d".l7 Va mil //s i

FINANCIAL RESPONSIBILITY/OWNER HIP FORM '
t?�4 SEDIMENTATION POLLUTION CONTROL ACT k)WQ-tdVAR(.'
No person may initiate any land -disturbing activity on one or more acres as covered by the Act before this
form and an acceptable erosion and sedimentation control plan have been completed and approved by the
Land Quality Section, N.C. Department of Environment and Natural Resources. (Please type or print and, if
the question is not applicable or the e-mail and/or fax information unavailable, place N/A in the blank.)
Part A.
1. Project Name WAS8Ir46Tbt4 Coun+Ty Kospnvm
2. Location of land -disturbing activity: County WASHiNG70N City or Township PL'f Mo Vh{
Highway/Street V6L4-W-WL Latitude5S°51'4-1ZV"K Longitude7(e'43'45.8�"I�
3. Approximate date land -disturbing activity will commence: AuUV ST �SEPTEMISLi+ . 2b1 b
4. Purpose of development (residential, commercial, industrial, institutional, etc.): MEOt CAL.
5. Total acreage disturbed or. uncovered (including off -site borrow and waste areas): t 9 -SO
6. Amount of fee enclosed: $ (.SO.00 . The application fee of $65.00 per acre (rounded
up to the next acre) is assessed without a ceiling amount (Example: a 9-acre application fee is $585).
7. Has an erosion and sediment control plan been filed? Yes No Enclosed X
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name TrM t=uLEY E-mail Address tiM cam
Telephone T04.8-1S•tb15 Cell#'704.66'1-46(o1 Fax# ?o4-6'7S-69S9
9. Landowner(s) of Record (attach accompanied page to list additional owners):
CAN 10C&utSin cK Go, J�,1 �LLf_ Z52.793-7(-54 252-743.7740
Name Telephone Fax Number
P.O. '3o,4 '70-1
Current Mailing Address Current Street Address
PLY' 4OUT14 me Z'7967
City State Zip City State Zip
10. Deed Book No. 44S Page No. 905 * 10` Provide a copy of the most current deed.
Part B.
1. Person(s) or firm(s) who are financially responsible for the land -disturbing activity (Provide a
co/m�prehensivelliist of all responsible parties on an attached sheet):
VANA4y (..-eloor CodPef ArN✓�SOL.9i�41�I?C7.;; `:
Names— E-mail Jkddress
Current Mailing Address Current Street Address
2010
City State Zip City State.=,•
Telephone ?L'1� 71Fax

4
2. (a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina Agent:
Name
�,.c.-7Roy "1Q)'1
Current Mailing Address
City State Zip
E-mail A dress
4R N�., lcV
Current Street Add ss
C, `19
City State Zip
Telephone - 193 ,� 1 Fax Number ') 5.p - '`ACi � - �1 �4 q ll
(b) If the Financially Responsible Party is a Partnership or other person engaging in business under an
assumed name, attach a copy of the Certificate of Assumed Name. If the Financially Responsible
Party is a Corporation, give name and street address of the Registered Agent:
Name of Registered Agent
Current Mailing Address
E-mail Address
Current Street Address
City State Zip City State Zip
Fax Number
The above information is true and correct to the best of my knowledge and belief and was provided
by me under oath (This form must be signed by the Financially Responsible Person if an individual
or his attorney -in -fact, or if not an individual, by an officer, director, partner, or registered agent with
the authority to execute instruments for the Financially Responsible Person). I agree to provide
corrected information should there be any change in the information provided herein.
pAuA4y ezrvr4r
Ty or print ame
Signature
0� ,.�- (-.?" o� ��—
Title or Authority
-7- a-aP)o
Date
I, /1i . F-dmondsewl , a Notary Public of the County of 71 6V n'7n
State of North Carolina, hereby certify that YI-Mt,/ C00O i appeared
personally before me this day and being duly sw rn acknowledged that the above form was
executed by him.
Witness my hand and notarial seal, this day of , 201_
6� iSO.� No ary
h _ My commission expires /e?-
Ali Goc,

STORMWATER SUBMITTAL REQUIREMENTS
WET DETENTION POND
Objective
A. Collect all runoff from all BUA (proposed and/or existing and/or offsite) as the case may be,
by any means including piping or swales, and direct it to the pond.
B. Check the proposed pond design to make sure it meets or exceeds the minimum design
criteria for surface area, volume and drawdown.
II. What makes up a complete wet detention pond application package?
A. Two sets of sealed, signed & dated layout & grading plans with appropriate details.
(Additional sets of plans may be requested for projects in certain counties)
B. Completed application with supplement(s), SWU-101, SW401-Wet Pond, and inspection and
maintenance agreements.
C. Deed restriction document, if applicable (for subdivisions & projects with out parcels)
D. Sealed, signed & dated calculations.
E. Estimated seasonal high water table elevation at all pond locations.
F. Chlorides test results must be provided if the project is within''/2 mile of SR waters (Phase II).
(This is only required to test out of SR water treatment requirements)
III. BIMS entry (for DWQ use only)
Enter & track application acknowledged date, review date, add info requested/received dates, permit
issue dates, and drainage area info. Best done after the add info letter is written and before sending
permit up for signature.
IV. Shell documents (for DWQ use only)
Permit shells: s:\wqs\stormwater\shells\highcompond
s:\wqs\stormwater\shells\highsubpond
s:\wqs\stormwater\shells\HDhybrid
Spreadsheet: s:\wqs\stormwater\excel spreadsheets\pond
VI. Review Procedure
A. APPLICATION
1. ✓An original signature is required. Photocopied signatures cannot be accepted.
2. V/ A completed wet detention pond supplement and a signed, dated and notarized wet
detention pond Inspection and Maintenance Agreement with an original signature.
3. The numbers on the supplement match up to the numbers used in the calculations and
shown on the plan details.
4. -Shown
areas are reported in square feet in Section 111.6.
c l oft 5. Receiving stream name and classification. This is important because in the non -Phase
11 counties, a wet pond cannot be used on a project that is within ''/z mile of and draining
/to SA waters. For Phase 11, a wet pond is allowed within '/2 mile of SA waters.
6. V Section 111.6 is filled in -cannot be left blank. One column must be filled in for each
/proposed wet pond.
7. V If the applicant is a corporation, partnership or LLC, look it up on the Secretary of State
Corporations Database. Make sure corporation is spelled correctly (capitalization and
punctuation matter) and that the person signing the application is at least a vice-
president in the corporation, a General Partner in the partnership, a member in a
member -managed LLC, or the manager of a manager -managed LLC. Need
documentation to support if the Articles of Incorporation do not list the members or
managers of the LLC. If an agent signs, then a letter of authorization is needed from the
president, vice president, general partner, member or manager.
8 0Aor subdivided projects, a signed and notarized deed restriction statement must be
provided.

Wet Detention Pond, cont.
B. CALCULATIONS
1. The orifice is sized based on drawing down the calculated minimum volume in 2-5
days. The average head to use in the orifice equation is approximately one-third of
the distance between the permanent pool elevation (PPE) and the elevation of the
next available outlet above the permanent pool. The elevation of the next available
outlet must be either the elevation where the minimum volume is provided, or it can
be higher. The temporary pool elevation (TPE) to report on the supplement will be
the elevation of the next available outlet above the PPE. The temporary pool volume
(TPV) to report on the supplement is the volume between the specified PPE and the
TPE.
2. For Phase II projects that are within Yz mile of and draining to SR waters, the
difference in runoff from the predevelopment and post -development conditions for
the 1 year 24 hour storm must be controlled and treated.
3. For Phase II projects, the discharge rate leaving the pond can be no more than the
pre -development discharge rate for the 1 year 24 hour storm.
4. For Phase II projects draining to SA water, no discharge to surface waters may occur
from wet ponds. The discharge leaving the orifice must be effectively infiltrated prior to
reaching surface waters.
5. The average pond depth is the permanent pool volume divided by the permanent pool
surface area. The result must be between 3 ft. and 7.5 ft. Parts of the pond can be
deeper than 7.5 ft., but in no case can any part of the pond be less than 3 ft deep.
6. If the 85% TSS chart is used a 30' vegetated filter must be provided at the outlet of the
pond. If the 90% TSS chart is used, no filter is required.
7. Use the correct SA/DA TSS chart from the BMP Manual noting that there are different
charts for different areas of the State.
8. Required surface area at permanent pool.
9. Provided surface area at permanent pool (Based on pond dimensions)
10. Required volume calculation based on 1.5" storm for Phase II projects* and 1" storm for
all others projects. *unless the project is Phase II and within Yz mile of and draining to
SR waters then the volume calculation must be based on difference between the pre
and post development conditions for the 1-yr 24-hr storm.
11. Table of elevations, areas, incremental volumes and accumulated volumes for overall
pond and for forebay, to verify volumes provided.
12. Forebay designed to hold 20% of the permanent pool volume. (Range of 18%-22%
OK.)
13. Non -erosive flow for 10 yr. storm in the vegetated filter, if using 85% TSS.
14. The seasonal high water table must be at or below the proposed permanent pool
elevation to assure that the necessary volume will be available above the permanent
pool.
15. Rounding numbers off during the calculation process can result in deficiencies. Do not
round the numbers until you get to the final result.
16. An additional one foot must be excavated below the bottom elevation of the pond. The 1
foot sediment accumulation depth is not included in the average depth calculation.

Wet Detention Pond, cont.
C. PLANS- Due to storage space constraints, plan sheets should be kept to a minimum. For
small commercial single wet pond projects, the plan set could consist of only 2 or 3 sheets,
layout, grading and details. For larger projects, show as much information as possible on as
few Aeets as possible, without cluttering them up.
1. V,Development/Project Name
2. V Engineer name and firm.
3. ✓ Legend
4.✓ North Arrow
5.VLocation Map with nearest intersection of two major roads shown. Major road is any 1,
✓2,,or 3 digit NC, US or interstate highway.
6. Scale- standard engineering scale, no off-the-wall stuff.
7. ✓bate
8. Revision number and date, if applicable.
9. ✓Original contours, proposed contours, spot elevations, finished floor elevations, pipe
/inverts, swale inverts, etc.
10.V Existing drainage (piping, swales, ditches, ponds, etc.), including off -site. Include a map
1 J./delineating the offsite drainage areas.
11. Property/Project boundary lines, bearing & distances.
12. Mean High Water Line or Normal High Water Line, if applicable.
13. The permanent pool elevation must be above the SHWT and above the lowest
elevation of adjacent wetlands. Evaluate the need for a liner and/or berm/slurry wall to
prevent dewatering the wetland.
14. Drainage easement widths, pipe sizes and swale inverts are provided.
15. Wetlands delineated, or a note on the plans that none exist. Get a copy of the wetlands
delineation map signed by the Corps of Engineers, or have the applicant include a copy
of the unsigned delineation map submitted to the Corps. Wet ponds may not be located
in wetlands unless a permit to fill those wetlands has been obtained.
16. Details for the roads, parking, cul-de-sacs, including sidewalk width, radii, dimensions &
slopes.
17. Apartment / Condo development- Provide a typical building footprint with dimensions
and note all concrete and wood deck areas.
18. The drainage area for each wet pond is clearly delineated and numbered to match up to
the calculations and supplement. Drainage area delineation is best done as a separate
plan sheet.
19. A pond section detail to include the forebay, a 10 foot wide vegetated shelf, pertinent
elevations for the bottom, permanent pool, temporary pool, and SHWT, 3:1 slopes
above the permanent pool, and the weir elevation between the main pond and the
forebay.
20. The 10 vegetated shelf extends 6" below and 6" above the permanent pool elevation.
21. An outlet structure detail showing a trash rack with 56" square openings, the necessary
orifice invert elevation (i.e., the permanent pool), orifice size and temporary pool
elevation.
22. Dimensions for each line and arc formed by the permanent pool contour.
23. Where the 85% TSS chart was used, a 30 ft. vegetated filter strip is required to be
shown on the plans & detailed (elevations, inverts, slopes, and flow spreader
mechanism). Please note that the filter strip is not a ditch.
24. A forebay is provided for each inlet and located so as to prevent short-circuiting.
25. The pond must have a minimum 1.5:1 length to width ratio and a minimum 3:1 flow path
length. Artificial "baffles" of timber, vinyl, or earth can be used to create a longer flow
path. The top elevation of the baffle should be set at the temporary pool elevation or
higher.
26. A Vegetation plan is specified for the pond, including slopes. Wetlands species are
listed for planting on the 10:1 shelf. Weeping Love Grass is not suitable as a permanent
vegetated cover for pond slopes.
27. All roof drainage must be directed to the pond. Show the roof drain collection lines on
the plan. This is necessary for projects where the buildings back up the property lines
where roof drainage may leave the site prior to going through the pond.