20230165 Ver 1_PCN revision_20230327

F. Stormwater Management and Diffuse Flow Plan (DWR requirement)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers
❑ Yes ❑x No
identified within one of the NC Riparian Buffer Protection Rules?
1 b. All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. If the
project is subject to a state implemented riparian buffer protection program, include a plan that fully documents
how diffuse/dispersed flow will be maintained.
All Stormwater Control Measures (SCM) must be designed in accordance with the NC Stormwater Design
Manual (https://deg.nc.gov/about/divisions/energy-mineral-land-resources/energy-mineral-land-permit-
guidance/stormwater-bmp-manual).
Associated supplement forms and other documentation must be provided.
❑ Level Spreader
What Type of SCM are you
❑ Vegetated Conveyance (lower seasonal high water table- SHWT)
providing?
❑ Wetland Swale (higher SHWT)
(Check all that apply)
❑ Other SCM that removes minimum 30% nitrogen
❑ Proposed project will not create concentrated stormwater flow through the
buffer
For a list of options to meet the diffuse flow requirements, click here.
Attach diffuse flow documentation.
2.
Stormwater Management Plan
2a.
Is this an NCDOT project subject to compliance with NCDOT's
Individual NPDES permit NCS000250? *
El Yes No
2b.
Does this project meet the requirements for low density projects as
defined in 15A NCAC 02H .1003(2)? *
❑x Yes ❑ No
To look up low density requirements, click here:
http1/reports.oah. state. nc.us/ncac/title%2015a%20-%20environmentaI%20cluality/chapter%2002%20-
%20environmental%20management/subchapter%20h/15a%20ncac%2002h%20.1003.pdf
2c.
Does this project have a stormwater management plan (SMP)
❑x Yes ❑ No
reviewed and approved under a state stormwater program or state -
approved local government stormwater program? *
❑ n/a — project disturbs < 1 acre
Note: Projects that have vested rights, exemptions, or grandfathering from state or locally implemented
stormwater programs or projects that satisfy state or locally -implemented stormwater programs through use of
community in -lieu programs should answer "no" to this question.
2d.
Which of the following stormwater management program(s) apply?
❑ Local Government
(Check all that apply.)*
❑x State
If you have local government approval, please include the SMP on their overall impact map.
❑ Phase II ❑ USMP
Local Government Stormwater Programs *
❑ NSW ❑ Water Supply
Page 16 of 21 PCN Form Version 4.3- April 20, 2022

Please identify which local government stormwater program you are using.
Click to enter.
State Stormwater Programs * 0 Phase II ❑ HQW or ORW
❑ Coastal Counties ❑ Other
Comments:
The SMP plan will be provided separately from this request for review and approval.
Page 17 of 21 PCN Form Version 4.3- April 20, 2022