SW3221007_Supplement-EZ Form_20230629

SUPPLEMENT-EZ COVER PAGE
FORMS LOADED
PROJECT INFORMATION
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1 Project Name Dollar General Store#24556
2 Project Area ac 6.7
3 Coastal Wetland Area ac 0
4 Surface Water Area ac 0
5 Is this ro'ect High or Low Density? High
Does this project use an off-site SCM? No
COMPLIANCE WITH 02H.1003(4)
7 Width of vegetated setbacks provided feet 30
8 Will the vegetated setback remain vegetated? N/A
9 If BUA is proposed in the setback,does it meet NCAC 02H.1003 4 c-d? I N/A
10 1 Is streambank stabilization proposed on this project? No
NUMBER AND TYPE OF SCMs:
11 Infiltration S stem 1
12 Bioretention Cell
13 Wet Pond
14 Stormwater Wetland
15 Permeable Pavement
16 Sand Filter
17 Rainwater Harvesting RWH
18 Green Roof
19 Level Spreader-Filter Strip LS-FS
20 Disconnected Impervious Surface DIS
21 Treatment Swale
22 Dry Pond
23 StormFilter
24 Silva Cell
25 Ba filter
26 lFilterra
FORMS LOADED
DESIGNER CERTIFICATION
27 Name and Title: Justin Church,PE-Principal Engineer
28 Or anization: BREC,PA
29 Street address: 1520 Meadowview Drive
30 City,State,Zip: Wilkesboro,NC 28697
31 Phone numbers : 336 844-4088
32 Email: [e-mail]
Certification Statement:
I certify,under penalty of law that this 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.
Designer
W �
Sign a of Designer
05/08/2023
Seal Date

DRAINAGE AREAS
1 Is this a high density project? Yes
2 If so,number of drainage areas/SCMs 1
3 Does this roject have low density areas? No
4 If so number of low density drainage areas 0
Is all/part of this project subject to previous rule
5 versions? No
FORMS LOADED
DRAINAGE AREA INFORMATION Entire Site 1
4 Type of SCM - Infiltration
5 Total drainage area(sq ft 291837 46905
6 Onsite drainage area(sq ft 291837 46905
7 Offsite drainage area(sq ft 0 0
8 Total BUA in project(sq ft 34566 sf 34095 sf
New BUA on subdivided lots(subject to
9permitting) s ft sf sf
New BUA not on subdivided lots(subject to
10 permitting)(sf) 34566 sf 34095 sf
11 Offsite BUA(sq ft sf sf
12 Breakdown of new BUA not on subdivided lots:
-Parking(sq ft 21721 sf 21250 sf
-Sidewalk(sq ft 1940 sf 1940 sf
-Roof(sq ft 10905 sf 10905 sf
-Roadway s ft sf sf
-Future(sq ft sf sf
-Other,please specify in the comment box
below(sq ft sf sf
New infiltrating permeable pavement on
13 subdivided lots(sq ft sf sf
New infiltrating permeable pavement not on
14 subdivided lots(sq ft sf sf
Existing BUA that will remain(not subject to
15 ermitting)(sq ft sf sf
16 Existing BUA that is already permitted (sq ft sf sf
17 Existing BUA that will be removed(sq ft sf sf
18 Percent BUA 12% 73 0
19 IDesign storm inches 1.0 in
20 IDesign volume of SCM cu ft 2753 cf
21 lCalculation method for design volume Shueler
ADDITIONAL INFORMATION
Please use this space to provide any additional information about the
22 drainage area(s):

INFILTRATION SYSTEM
1]Drainage area number 1
2 1 Minimum required treatment volume cu ft 2753 cf
GENERAL MDC FROM 02H.1050
76
3 Is the SCM sized to treat the SW from all surfaces at build-out? Yes
4 Is the SCM located awayfrom contaminated soils? Yes
5 What are the side slopes of the SCM(H:V or enter"Vertical'for
trencher)? 3:1
Does the SCM have retaining walls,gabion walls or other
en ineered 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 for inflow volume in excess of the
design volume? Yes
9 What is the method for dewatering the SCM for maintenance? Pump(preferred)
10 If applicable,will the SCM be cleaned out after construction? N/A
11 Does the maintenance access comply with General MDC 8? Yes
12 Does the drainage easement comply with General MDC(9)? Yes
13 If the SCM is on a single family lot,does(will?)the plat comply with
General MDC 10? N/A
14 Is there an O&M Agreement that complies with General MDC(11)? Yes
15 Ils there an O&M Plan that complies with General MDC 12? Yes
16 IDoes the SCM follow the device specific MDC? Yes
17 lWas the SCM designed by an NC licensedprofessional? Yes
INFILTRATION SYSTEM MDC FROM 02H.1051
18 Proposed slope of the subgrade surface{%) 00
19 jAre terraces or bafflesprovided? No
20 IType ofpretreatment: Forebay
Soils Data
21 Was the soil investigated in the footprint and at the elevation of the
infiltrations stem? Yes
22 SHWT elevation(fmsl) 811.00
23 Depth to SHWT per soils report in 72.00
24 Ground elevation at boring in soils report(fmsl) 817.00
25 Is a detailed hydrogeologic study attached if the separation is
between 1 and 2 feet? N/A
26 ISoil infiltration rate(in/hr) 1.00
27 lFactor of safety FS 2 is recommended): 2.00
Elevations
29 Bottom elevation fmsl 813.0 ft
30 IStorage elevation(fmsl) 816.5 ft
31 (Bypass elevation fmsl 816.83 ft
For Basins Only
32 1 Bottom surface area(ft)
33 IStorage elevation surface area(ft)
For Trenches Only
34 Length(ft) 50 ft
35 Width ft 21 ft
36 Perforated pipe diameter,if applicable(inches) 4 in 1
37 Number of laterals 2
38 Total length of perforated piping 106 ft
39 Stone type,if applicable #57
40 Stone porosity(%) 32%
41 Is stone free of fines? Yes
42 Is the stone wrapped in geotextile fabric? Yes
43 Has at least one inspection port beenprovided? Yes
Volumes/Drawdown
44 IDesign volume of SCM cu ft 2753 cf
45 ITime to draw down hours) 62.5 hrs
ADDITIONAL INFORMATION
46 Please use this space to provide any additional information about
the infiltration system(s):
Infiltration 3 5:30 PM 2/2/2023