SW6220802_Supplement-EZ Form_20230217

SUPPLEMENT-EZ COVER PAGE
L6ADSUPPLEMENTFORMS
PROJECT INFORMATION
1 Project Name Champs Convenience Store
2
Pro act Area ac)
3,46
3
Coastal Wetland Area ac)
0
4
Surface Water Area ac —
0
5
_
Is thisHI h or Low Density?
Both High and Low Density —_
:]
6
_project
Does this project use an off -site kM?
No
Yes
9 If BUA is proposed in the setback, does it meet NCAC 02H.1003 4)(c-d ? MIA
10 j Is streambank stabilization proposed on this project? No
NUMBER AND TYPE QF SCMs:
11 Infiltration System 1
12
Sioretention Cell
13
Wet Pond
14
Stormwater Wetland
15
Permeable Pavement
—
16
Sand Filter
17
Rainwater Harvesting (RWH)
_
— —
18
Green Roof
-
19
Level S reader -Filter Stri (LS-FS
20
Disconnected impervious Surface DI5
—
21
Treatment Swale
—
22 _Dry
Pond �-
23
StormFilter
24
Silva Cell —
25
Bayfilter
26
Filterra
LOAD SUPPLEMENT FORMS
Certification Statement:
I certify, under penalty of law that th.is Supplement-EZ form and all supporting information were prepared under my direction or supervision; that the
information provided in the form is, to the best of my knowledge and belief, true, accurate, and complete; and that the engineering plans,
specifications, operation and maintenance agreements and other supporting information are consistent with the information provided here:
0OS H Ca RESS
p��.,,
sea
i
Sig re of D igner
Date

DRAINAGE AREAS
1
Is this a hi h densit ro'ect?
Yes
2
If so, number of drains a areasISCMs
1
3
Does this project have low density areas?
Yes
4
If so, number of low densy drainage areas
1
5
Is all/part of this project subject to previous rule
versions?
No
FORMS LOAUD
DialNAGE AREA INFORMATION Entire Situ 1 LD 1
4
Type of SCIVI
Infiltration
5
Total drainage areas ft
150,717.60 sf
87,120.00 sf
68,389.20 sf
6
Onsite drainage area (sq ft
150,717.60 sf
82,328.40 sf
68,389.20 sf
7
Offsite drainage area (sq ft
0 sf
4,791.60 sf
0 sf
8
Total BUA in project s ft
78408 sf
72310 sf
10,890.00 sf
9
New BUA on subdivided lots (subject to permitting)
1 (sq ft
NA
NA
NA
10permitting)
New BUA not on subdivided lots (subject to
s
78408 sf
67518 sf
10.890,00 sf
11
Offsite BUA (sq ft
0 sf
4792sf
0 sf
12
Breakdown of new BUA not on subdivided lots:
Parking (sq ft
8086 sf
8086 sf
0 sf
Sidewalks ft
10271 sf
4608 sf
5,662.80 sf
Roof (sq ft
6600 sf
6600 sf
_0 sf
Roadwa sg ft
52819 sf
42,800 sf
5,227,20 sf
Future (sq ft
NA
NA
NA
Other, please specify in the comment box
below s 8
5424 sf
5424 sf
0 sf
13
New infiltrating permeable pavement on
subdivided lots s ft
NA
NA
NA
14
New infiltrating permeable pavement not on
Isubdivided lots (sq ft
NA
NA
NA
15permitting)
Existing BUA that will remain (not subject to
s ft
NA
NA
0 sf
16
Existing BUA that is already permitted s ft
NA
NA
0 sf
17
Existing BUA that will be removed (sq ft
NA
NA
0 sf
18
Percent BUA
52%
83%
16%
19
Desi n storm inches
1.0 in
20
Design volume of SCM cu ft
7260 of
21 1
Calculation method for design volume
MDC5
ADDITIONAL INFORMATION
Please use this space to provide any additional information about the
22 drainage area(s):
"Other' impervious came from big fuel island ( 3;360sf), small fuel island (
1,056.00 sf), big slab over fuel tanks ( 528 sf), small slab over fuel tanks ( 96
sf), dumpster pad and apron ( 384 sf).

INFILTRATION SYSTEM
1-1 Drainace area number 1
3
Is the SCM sized to treat the SW from all surfaces at build -out?
Yes
4
Is the SCM located awa from contaminated soils?
Yes
5
What are the side slopes of the SCM (H:V or enter "Vertical' for
trenches)?
vertical
6
Does the SCM have retaining walls, gabion walls or other engineered
side slopes?
No
7
Are the inlets, outlets, and receiving stream protected from erosion
10 ear storm ?
Yes
8
Is there an overflow or bypass far inflow volume in excess of the
design volume?
Yes
is the method for dewaterin the SCM for maintenance?
Pump (preferred)
If ap licable, will the SCM be cleaned out after construction?
Yes
Does the maintenance access com I with General MDC 8)?
Yes
rWhat
Does the drains a easement comp) with General MDC (9)?
Yes
If the SCM is on a single family lot, does (will?) the plat comply with
General MDC (10)?
N/A
Is there an O&M Agreement that complies with General MDC (11)?
Yes
15
Is there an 0&M Plan that complies with General MDC (12)?
Yes
16
Does the SCM follow the device specific MDC?
Yes
17
INFILTRATION
Was the SCM designed by an NC licensedprofessional? Yes
SYSTEM MDC FROM 02H .1051
18
Proposed slope of the subgrade surface (%)
0%
19
Are terraces or baffles provided?
No
20
Type of pretreatment:
Other
1_21l n..f..
21
Was the soil investigated in the footprint and at the elevation of the
infiltrations stem?
Yes
22
SHWT elevation fmsi)
326.00
23
Depth to SHWT per soils report (in)
24.00
24
Ground elevation at boring in soils report (fmsi)
328.00
25
Is a detailed hydrogeologic study attached if the separation is
between 1 and 2 feet?
NIA
26
Soil infiltration rate (inlhr)
0.60
27
Factor of safety (FS) (2 is recommended):
2.27
elevations
29 1 Bottom elevation (fmsl) 328 ft
30 IStoraqe elevation ffmsl) 330.37 ft
For Basins Only
32 Bottom surface area ft2 �47
33 storage elevation surface area ft2 ft
c.,� r.......H..t nil,.
34
Length (ft)
93 ft
35
Width (ft)
56 ft
36
Perforated pipe diameter, if applicable (inches)
NA
37
Number of laterals
NA
38
Total length of perforated piping
NA
39
Stone type, if applicable
#4
40
Stone porosity (%)
40%
41
Is stone free of fines?
Yes
42
Is the stone wrapped in eotextile fabric?
Yes
43
Has at least one ins ection port been provided?
Yes
44 Design volume of SCM (cu ft)
45 1 Time to draw down hours) .—
DDITIONAL INFORMATION —
46 Please use this space to provide any additional information about tt
infiltration system(s):
filtration system is a network of underground storm chambers with 2 foot sumps in
let structures to serve as forebays.
Infiltration 1 2:50 PM 2/10/2023