SW8951007_HISTORICAL FILE_20100429

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW8 a51Uo1
DOC TYPE
❑ CURRENT PERMIT
❑ APPROVED PLANS
Ell HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
2olo o`i2'1
YYYYMMDD

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Colleen H. Sullins
Governor Director
April 29, 2010
Harvest Grove Home Owners Association
Mr. Robert B. Myrick, Vice President
PO Box 3043
Wilmington, NC 28406
Subject: Stormwater Management Permit No. SW8 951007
Harvest Grove
High Density Subdivision System Stormwater Project
New Hanover County
Dear Mr. Myrick:
Dee Freeman
Secretary
The Wilmington Regional Office received a complete Stormwater Permit Transfer of Ownership
Application for Harvest Grove on April 29, 2010. As required by the Stormwater Regulations set
forth in Title 15A NCAC 2H.1000 effective September 1, 1995, this site was inspected on
February 17, 2010 and found in compliance with permit conditions. Therefore, permit SW8
951007 was transferred on April 29, 2010 and shall be effective until August 13, 2017.
Please note that when the President/Officer of the HOA changes, notification to this office of the
new point of contact for the Harvest Grove HOA is required.
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. The plans previously approved
on August 13, 1997 remain in full force and effect.
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 150E 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
either Angela Hammers or me at [phone].
Sincerely,
Georgett
Stormwater Supervisor
Division of Water Quality
GDS/akh: S:\WQS\STORMWATER\PERMIT\951007.apr10
cc: New Hanover County Planning Department; WiRO; Central Files
Wilmington Regional Office
127 Cardinal Drive Extension, Wilmington, North Carolina 28405 One
Phone. [phone] FAX: [phone] Customer Service: 1-877-623-6748 North Caro I i na
IntemeC www.nwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer ���������✓

State Stormwater Management Systems
Permit No. SW8 951007
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY SUBDIVISION DEVELOPMENT WITH A CURB OUTLET SYSTEM
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
Mr. Robert B. Myrick & Harvest Grove Home Owners Association
Harvest Grove Subdivision
Harvest Grove Ln, Wilmington, New Hanover County
FOR THE
operation and maintenance of a detention pond in compliance with the provisions of 15A
NCAC 2H .1000 (hereafter referred to as the "stormwater rules') and the approved
stormwater management plans and specifications and other supporting data as attached
and on file with and approved by the Division of Water Quality and considered a part of this
permit.
This permit shall be effective from the date of issuance until August 13, 2017 and shall be
subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
1. This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. This stormwater system has been approved for the management of stormwater
runoff as described on page 3 of this permit, the Project Data Sheet. The
subdivision is permitted for 28 lots, each allowed 5,989 square feet of built -upon
area. A portion of the runoff from the road and future development is treated in a
curb outlet system.

State Stormwater Management Systems
Permit No. SW8 951007
3. Approved plans and specifications for this project are incorporated by reference and
are enforceable parts of the permit.
DIVISION OF WATER QUALITY
PROJECT DATA SHEET
Project Name:
Permit Number:
Location:
Water Body Receiving Stormwater Runoff:
Classification of Water Body:
If Class SA, chloride sampling results:
Pond Depth:
Permanent Pool Elevation:
Total Impervious Surfaces Allowed:
(28 lots at 5,989 ftz each)
Roads/Parking
Offsite Area entering Pond:
Required Surface Area:
Provided Surface Area:
Required Storage Volume:
Provided Storage Volume:
Temporary Storage Elevation:
Controlling Orifice:
Harvest Grove Subdivision
951007 Modification
Harvest Grove Ln, Wilmington, New
Hanover County
Hewletts Creek
"SA"
10 mg/I
3.5 feet
12.8 MSL
142,695 square feet
167,692 square feet
52,860 square feet
None, per Engineer
14,270 square feet
15,000 square feet
16,601 cubic feet
51,504 cubic feet
15.77 MSL
2" pipe
4. No homeowner/lot owner/developer shall fill in, alter, or pipe any drainage feature
(such as swales) shown on the approved plans as part of the stormwater
management system without submitting a revision to the permit and receiving
approval from the Division.
5. The permittee is responsible for verifying that the proposed built -upon area does not
exceed the allowable built -upon area. Once the lot transfer is complete, the built -
upon area may not be revised without approval from the Division of Water Quality,
and responsibility for meeting the built -upon area limit is transferred to the individual
property owner.
3

State Stormwater Management Systems
Permit No. SW8 951007
The following items will require a modification to the permit
a. Any revision to the approved plans, regardless of size.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area.
e. Further subdivision of the project area.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
In addition, the Director may determine that other revisions to the project should
require a modification to the permit.
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.
II. SCHEDULE OF COMPLIANCE
The permittee will comply with the following schedule for construction and
maintenance of the stormwater management system:
.a. 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 except roads.
b. During construction, erosion shall be kept to a minimum and any eroded
areas of the system will be repaired immediately.
2. The permittee grants permission to DEHNR Staff to enter the property for the
purposes of inspecting the project for compliance with the conditions of this permit.
3. 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.
4. 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:
n

State Stormwater Management Systems
Permit No. SW8 951007
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and revegetation of side slopes.
d. Immediate repair of eroded areas.
e. Maintenance of side slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of outlet structure, orifice device and catch
basins and piping.
g. Access to the outlet structure must be available at all times.
5. Records of maintenance activities must be kept and made available upon request to
authorized personnel of DWQ. The records will indicate the date, activity, name of
person performing the work and what actions were taken.
6. Prior to the sale of any lot, deed restrictions must be recorded which limit the built -
upon area per lot to the amount as shown on the Project Data Sheet, per Section I,
Part 2. The recorded statements must follow the form:
a. "The maximum built -upon area per lot is 5,989 square feet, inclusive of that
portion of the right-of-way between the lot line and the edge of pavement,
structures, pavement, walkways of brick, stone, or slate, but not including
open wood decking."
b. "The covenants pertaining to stormwater regulations may not be changed or
deleted without concurrence of the State."
C. "Alteration of the drainage as shown on the approved plan may not take
place without the concurrence of the State."
d. "Lots within CAMA's Area of Environmental Concern may be subject to a
reduction in their allowable built -upon area due to CAMA regulations."
7. 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.
8. A copy of the recorded deed restrictions must be submitted to the Division within 30
days of the date of recording the plat. The recorded copy must be signed by the
Permittee, dated, stamped with the deed book number and page, and bear the
stamp/signature of the Register of Deeds.
9. 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.
Page 5 of 6

State Stormwater Management Systems
Permit No. SW8 951007
III. GENERAL CONDITIONS
This permit is not transferable. In the event there is a desire for the facilities to
change ownership, or there is a name change of the Permittee, a "Name/Ownership
Change Form" must be submitted to the Division of Water Quality accompanied by
appropriate documentation from the parties involved, such as a copy of the deed of
trust. Other supporting materials, such as a signed Operation and Maintenance plan
in the case of engineered systems, will also be required. The project must be in
good standing with DWQ. The approval of this request will be considered on its
merits and may or may not be approved.
2. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the Division of Water Quality, in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
3. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances which may be imposed by
other government agencies (local, state, and federal) which have jurisdiction.
4. In the event that the facilities fail to perform satisfactorily, including the creation of
nuisance conditions, the Permittee shall take immediate corrective action, including
those as may be required by this Division, such as the construction of additional or
replacement stormwater management systems.
5. The permit may be modified, revoked and reissued or terminated for cause. The
filing of a request for a permit modification, revocation and reissuance ortermination
does not stay any permit condition.
6. The permittee grants permission to staff of the Division to enter the property for the
purposes of inspecting the stormwater facilities during normal business hours.
Permit issued this the 29th day of April 2010.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
By Authority of the Environmental Management Commission
Page 6 of 6

NGDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Colleen H. Sullins Dee Freeman
Governor Director REC IVE retary
STATE STORMWATER PERMIT F€S ] % aO1O
NAME/OWNERSHIP CHANGE FORM BY:
I. CURRENT PERMIT INFORMATION:
1. Stormwater Management Permit Number:
2. Permit Holder's name: � E,( 0 c/ B ER
3. Signing official's name: I-e-leey, ,(Y,-_,4s- /.Fv, T. Title:
(pprsorf legally responsible fof permit)
Mailing address: xEdi:Nbo;r0 L 41 City: �Jl?j n! �oOX1
State:/v6 ZipCode: Phone:7g9-Y06.ZFax: q/O-313- /5-39
(Area Code and Number) (Area Code and Number)
H. NEW OWNER / PROJECT / ADDRESS INFORMATION
1. This request is for: (please check all that apply)
Era. Change in ownership of the property/company (Please complete Items #2, #3, and
#4 below).
❑ b. Name change of project (Please complete Item #5 below)
❑ c. Mailing address change. (Please complete Item #4 below)
❑ d. Other (please explain):
2. New owner's name to be put on permit: fACP� ,ES f d/Ca!/E l/ 'm,� 1&%N Ies /tss l;V- � b941
3. New Signing official's name: e t/ /3. / IV�XCXC Title: y/CE �ti°Es; d�N7t
(person legally responsible for permiQ
4. New Mailing address: R N, 13 0X 3 0 �Z3 City: / 1 M 7N r0&
State: �_ ZipCodeJf1/a6 Phone: /&,9- 791 FUVq, Z Fax:
(Area Code and Number) (Area Code and Number)
5. New Project Name to be placed on permit:
Wilmington Regional Office
127 Cardinal Dnve Extension, Wilmington, North Carolina 28405 1. One
?hone 910-796-72151 FAX [phone] Customer Service 1-877-623-6748 1 orth Carolina
Internet v .nc atereuality org Nahmally
An Equal Oppodunity 1 Affrmalive Action Employer
Page t of 2

PERMIT NAME/OWNERSHIP CHANGE FORM
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BY THE DIVISION OF
WATER QUALITY UNLESS ALL OF THE APPLICABLE ITEMS LISTED BELOW
ARE INCLUDED WITH THE SUBMITTAL.
REQUIRED ITEMS:
1. This completed form.
2. Legal documentation of the transfer of ownership. .I)Ez=P f,)ENdih
3. A copy of the recorded deed restrictions, if required by the permit. pn/ F/GE
4. The designer's certification, if required by the permit. ON Fl/t
5. An Operation and Maintenance plan, signed by the new applicant, if a system that requires
maintenance will change ownership. MjqL/'Ni��✓4weE y/e,✓ irne/udel ;n dPe�resfeic�,'a✓s.
6. Maintenance records. N/EP-E Nof RE29uie D when f h P'"' teas 15a, /f
CERTIFICATION MUST BE COMPLETED AND SIGNED BY BOTH THE CURRENT
PERMIT HOLDER AND THE NEW APPLICANT IN THE CASE OF A CHANGE OF
OWNERSHIP.
FOR NAME CHANGES, COMPLETE AND SIGN ONLY THE CURRENT
PERMITTEE'S CERTIFICATION.
Current Permittee's Certification:
1, 1 ge,4 �E/1S�Py , //e• , attest that this application for a name/ownership
change has been reviewed and is accurate and complete to the best of my knowledge. I
understand that if all required parts of this application are not completed and that if all required
supporting information and attachments are not included, this application package will be
returned as incomot9te.
Signature:
Date: Al / 0 19 ) 4
New Ap icant's Certification: (Must be completed for all transfers of ownership)
I, Rv�C-47 e. %%f/t../c/— , attest that this application for a name/ownership
change has been reviewed' and is accurate and complete to the best of my knowledge. I
understand that if all required parts of this application are not completed and that if all required
supporting information and attachments are not included, this application package will be
returned as incomplete. ? �
Signature: //!.� Date: a�i 7�au�o
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
INFORMATION AND MATERIALS, SHOULD BE SENT TO THE FOLLOWING
ADDRESS:
NCDENR Division of Water Quality
Surface Water Protection Section — Stormwater
127 Cardinal Drive Extension
Wilmington, NC 28405
Name Ownership Change Form — 021209
Page 2 of 2

Harvest Grove Subdivision
Wet Detention Basin # I
Stormwater Permit No. SW8 951007
I acknowledge and agree by my signature below that I am responsible for the performance of the
maintenance procedures listed above. 1 agree to notify DWQ of any problems with the system or prior to
any changes to the system or responsible party.
Print name:_ / 0/3E. 7- C�, /yf� ,Q�eK �/fiVe✓r"s r Leo% i�0.4�
Title:_ Vice 7�fs of 7 - 1,V/;gle vEs — Gi?vV', y
Address:_ 56
Phone: 7 91. 9)j 4/ Z
Signature:_ V/3
Date:_ O
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.
1, hfofr Z, C-46 , a Notary Public for the State of A�i N
County of ��4,1 �f4,00✓C-2 , do hereby certify that U. /Yry.2se tc
personally appeared before me thisVday of Zvi o , and acknowledge the due
execution of the forgoing wet detention basin maintenance requirements. Witness my hand and official
seal,
My commission expires _�9q/4;'S1aU/O
APR 2 9 2010
m—
r— =
SEAL
REcv 4131%
010

Hammers, Angela
From: Hammers, Angela
Sent: Monday, April 19, 2010 4:16 PM
To: '[e-mail]'
Subject: Harvest Grove Subdivision Transfer Request Paperwork (SW8 951007)
Dear Mr. Myrick,
I had in my notes from last week that you would be getting the O&M paperwork signed in a couple of days. Our
administrative staff has been out since Thursday so I haven't seen anything submitted yet. What is the status of the
transfer?
I may have to return the request if the completed forms aren't submitted prior to May 10, 2010. Please let me know if I
can be of any more assistance in this process.
Sincerely,
Angel Hammers (Please note my new email address is [e-mail])
Environmental Specialist
NC Department of Environment and Natural Resources
Wilmington Regional Office
127 Cardinal Drive Ext.
Wilmington, NC 28405
Office: 910.796.7215
Fax: [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.

'.{iITTTT'TTTTT�TT�TTTTTTTTmT�TTTTTT�TTTTTT�TTTTTTTT�TTmTTTTTTT�T�TTTTTTT�TTTTTTTTTTTTTT�T�TTTTTTTTTTTT�TT
TRANSACTION REPORT
MAR-16-2010 TUE 02:18 PM
irlll I '
'll .I 'i�l FORi�.l�l i .,DENR I�ii I� ��'
i 910 350 2004
j I i
li V. �4I II n III�� 1 6Ili
1 .� 1 1 i ll .II'. 1'
I
ij
t Ni III'I'
DATE' START •;(RECEIVER TIME PAGES TYPE NOTE p `. M# DP
TX
1 I ,aaln0: lul. . I Iu 1'
M16 02;F1`171PM 991079118542�' 44" 3 FAX TX I OK t' 'I
„I dj ��i' � i I ti11J !I 568
AR-1
1 �
TOTAL'': I 44S PAGES; (' 31
State of North Carolina
Department of Environment and Natural Resources
Wilmington Region. )ffice
.; IPa:�,i. I l l ,
Beverly;:Eaves Perdue;IGovemor Dee Freeman, Secretary '
COVER SHEET'
1 G�
� t
Daterd13 ' 6 `;Xa d' No. OF. Pages: ,(excluding cover)A-A
1
To:';1s� Sa6 liil' �— From: iP� tl.lc,wgrr
CO: CO: NC
' ! , � I' I I 11 Ili II,
FAX:# RtA% 2 Ssyz FAUm 910-350-2ooa
I. i' , I�:,
it REMARKS: �QI (tea llvw - MAi Ak ta--ce_ 9� f�FPA 61 rl ' f��ry e.T
'I
I i ,
I
i1. 'l
f •' I IIII•tl . ' 127 Cardinal Drive Extension, Wilmington, N.C. 28405-3845'rclephune [phone] Fa: [phone]
An
Fual opportunity Affirmative AeiOn Employer
;h'„I � � � IVI���a � Id" �1 '� II ;1 Ili ,'111I , I i• it
' 6
L II i I
i
i .

'
�;
..
Ill'
,•j
„i
-
•
.,
C
D
0
CD
W I
w
1 N
0
:.a
CD
CD
W
Ul
0
"-. A
Ln
'O
0
0
0
0
0
0
0
N
(D
N
(D
N
fV
J
N
N
�
lD
�,
>
�
n
�
a
m
I=
LA
r
hr .
a
•
O
.i
m
INFEED fIRES(eOK
LCF
00
j
a
7
Lower Cassette
�
"
'Pedestal 'Upper
Pedestal Lower ,
s81'PASS k'
Or
Dev. Kit (every 160K)
=
I�'
' '
F RXIT)`i
320Kyyg
F�
:irM1+
s.•pj
�,
yyT
`M�'�.'
.`(ev,y
��.I.4}i:•`Aa'}x�.M^!m�'..i 4
j~j.
y
Dev Seals (320K)
'
-
- y
ed
z
fit: i
:li
-'ZS
"'':'
::DRUM (as needed)
.� T°'•....?�'..^s :-z c�'z:

State of North Carolina
Department of Environment and Natural Resources
Wilmington Region; )ffice
t'
k
Beverly Eaves Perdue, Governor Dye Freeman, Secretary
FAX COVER SHEET
Date: 3-16-2ato
CO:
FAX #: &te) '/.9—
REMARKS
No. Of Pages: (excluding
cover) d 2—
From: / lA el
CO: NC DIENR
FAX#: [phone]
127 Cardinal Drive Extension, Wilmington, N.C. 28405-3845 Telephone [phone] Fax [phone]
An Equal Opportunity AfGrnrative Action Employer

Hammers, Angela
From: Bob Myrick [[e-mail]]
Sent: Tuesday, March 16, 2010 3:21 PM
To: Hammers, Angela
Subject: Re: Harvest Grove O&M Signature Page (SW8 951007)
Mike,
Re the below message, DWQ is sending me the does to transfer pond ownership to us. The attached document
implies that we can use the HOA as the signer. I will check with DWQ.
On Tue, Mar 16, 2010 at 9:26 AM, Hammers, Angela <[e-mail]> wrote:
Mr. Myrick,
Thanks for your return call today. I have attached the signature page for the Operation & Maintenance Form.
will ask our administrative person to fax the actual agreement to you this afternoon. Please send the signature
page with original signature back to me to complete the stormwater permit transfer request. You may keep the
agreement for your records.
Let me know if you have any questions!
Sincerely,
Angel Hammers (Please note my new email address is [e-mail])
Environmental Specialist
NC Department of Environment and Natural Resources
Wilmington Regional Office
127 Cardinal Drive Ext.
Wilmington, NC 28405

Permit: SW8951007
County: New Hanover
Region: Wilmington
Compliance Inspection Report
Effective: 11/05/09 Expiration: 08/13/17
Contact Person: Leroy Beasley
Title: Partner
Directions to Project:
Turn off Greenville Loop Rd onto Harvest Grove Lane, take to end.
Type of Project: State Stormwater - HD - Detention Pond
Drain Areas: 1 - (Hewletls Creek) (03-06-24 ) ( SA;HQW)
On -Site Representative(s):
Related Permits:
Inspection Date: 0211712010 Entry Time: 10:25 AM
Primary Inspector: Aisha H Lau
Secondary Inspector(s):
Reason for Inspection: Follow-up
Permit Inspection Type: Slate Stormwater
Facility Status: ■ Compliant 0 Not Compliant
Question Areas:
0 State Stormwater
(See attachment summary)
Owner: Beasley Assoc
Project: Harvest Grove
Harvest Grove Ln
Wilmington NC 28409
Phone:[phone]
Exit Time: 10:40 AM
Phone:[phone]
Inspection Type: Stormwater
Page: 1

V
Permit: SW8951007 Owner -Project: Beasley Assoc
Inspection Date: 02/17/2010 Inspection Type: Stormwater
Inspection Summary:
Reason for Visit: Follow-up
The requested corrections have been made. The offsite drainage pipe to the pond has been blocked, and was no longer
Flowing. The French drains from adjacent properties have been stabilized. Since they are from the pond's drainage area
and are entering up gradient of the official inlet, they were permitted to stay.
Some minor bank erosion was observed, but Mr. Bob Myrick, the HOA vice-president, is aware of it, and willing to accept
it along with the name/ownership change.
Page: 2

General
State Stormwater Inspection Report
Project Name: - AY e 64ro ✓ e
Permit No: SW ?
Expiration Date: �Vis / 7
Contact Person �j 0 /� G -
/-7 `
Phone Number: sD d —-/yy
Inspection Type: /0 /( OW VP
Inspection Date: a
0 ,.
Time In. �
tt�:a �.
Time Out: �� ' 0 �.
y
Current Weather: < '0 °
Recent Rain (Date)? -
Ram— m ,
Location L // // //1� j / / Facility Address /Location. ��4r ✓e S % 6,,,o ✓ e Z O fI /� /, 6,k-c ✓, / � e G- e o
City: �(�� 10 1, Zip:o 51L(dCI Count /I�.✓ /�h Lat: o 1 „N
y' int.
Permit Information
Rule Subject to (circle one) 1988 Coastal Rule 995 2008 Coastal Rule Session Law 2006-246
Goose Creek High Quality Waters Outstanding Resource Waters
Density (circle one). igh ( Low (LD)
Sto ater Best Management Practices (BMPs) (insert number of each):
ill Wet Ponds _Infiltration Basins _Infiltration Trenches LD Swales Stormwater Wetlands
_Dry Ponds _Bioretention _Permeable Pavement _Sand filters (circle one) Open Closed
_Cistern _Level Spreader/Filter Strip Other (specify): .
File Review
1. Is the permit active?
Tub
I10
NIA
Nit
2. Signed Engineer's Certification on file?
3. Signed Operation and Maintenance agreement on file?
NT
4. Recorded Deed Restrictions on file?
Sifa Visit' Ruilf iinnn Arm /CItA%
-- --_'
5. BUA is constructed and consistent with the errriit requirements?
re5
NO
N/H
Nit
6. BUA (aspermitted) is graded such that the runoff drains to the system? (high dens[ only)
7. Drainage area is consistent withpermit'? (i.e. no un ermitted drainage to the SW BMPs
91
E
S. Drainage area is stabilized? to reduce risk of sedimentation to the SW BMPs)
Site Visit- Stnrmwatar RMDc
9. Stormwater BMPs are located er the a roved lans?
r CJ
NO
N/A
1
N/C
10. Stor,1
mwater BMPs have dimensions e . length, width, area matching the approvedplans?
#
11. Stormwater BMPs are constructed per the approvedplans?
Site ViSlt, Onarnfinn anel Mainfnn�n. e
12. Access points to the site are clear and well maintained?
Te5
NO
N/H
Nit:
13. Trash has been removed as needed?
14. Excessive landscape debris (grass chppins, leaves, etc) is controlled?
15. Stormwater BMPs bein operated and maintained as per the permit requirements?
16. ulsj2ccilonanaiviamienancerecorcis are available for inspection? (high density only, 1995 —present only)
Site Visit: Other Permit Conditions Yes No N/A N/E
17. Is the site co Kant with other conditions of the emnt?
Site Visit: Other Water Quality Issues Yes No N/A N/E
18 Is the site corn liant with other water quality issues as noted during the inspection?
State Stormwater inspection Report, version 3.0 Page i of 2

State Stormwater Inspection Report
5 /WasA 11JA Cor�,p 1IA6f(-c G�eC_ �/I��ovP
4 l7 0 /� Q reerat To ciC000 7 Dwh2vs� .� 0 7
y 5fe.k. '5 �yI c,� r 5 �WAv� 0� soy, h, , ti 0 r
L;lk er051oa. j, n1an5 0 k kn SO GC vt,r�. GtSAp'
nnaa
Compliance Status ////C����ompliant ❑ Non -Compliant
Letter Sent (circle one): Yes Letter type: CEI NOV NOVRE Other
Date Sent: Reference Number:
Inspector Name and Signature Date:_
State Storrnwater Inspection Report, Version 3.0 page 2 of 2