SW4231001_Supplement-EZ Form_20231023

SUPPLEMENT-EZ COVER PAGE
FORMS LOADED I
PROJECT INFORMATION
1 Project Name Word of Life
2 Project Area(ac) 3.24
3 Coastal Wetland Area(ac) 0
4 Surface Water Area(ac) 0
5 Is this project High or Low Density? High
6 Does this project use an off-site SCM? No
1.COMPLIANCE WITH 02H.1003(4)
7 Width of vegetated setbacks provided(feet) 0
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)? N/A
10 Is streambank stabilization proposed on this project? No
NUMBER AND TYPE OF SCMs:
11 Infiltration System 0
12 Bioretention Cell 1
13 Wet Pond _ 0
14 Stormwater Wetland 0
15 Permeable Pavement 0
16 Sand Filter 0
17 Rainwater Harvesting(RWH) 0
18 Green Roof 0
19 Level Spreader-Filter Strip(LS-FS) 0
20 Disconnected Impervious Surface(DIS) 0
21 Treatment Swale 0
22 Dry Pond 0
23 StormFilter 0
24 Silva Cell 0
25 Bayfilter 0
26 Filterra 0
FORMS LOADED I
DESIGNNER CERTIFICATION
27 I.Name and Title: Steve Causey,PE
28 Organization. 1 Allied Design, Inc.
29 'Street address: 4720 Kester Mill Road
30 City,State,Zip: Winston-Salem,NC 27103
31 Phone number(s): [phone]
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
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DRAINAGE AREAS
1 Is this a high density project? Yes
2 If so,number of drainage areas/SCMs 1 _
3 Does this project 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 7
4 Type of SCM bio cell bio cell
5 Total drainage area(sq ft) 63597.6 63597.6
6 Onsite drainage area(sq ft) 63597.6 63597.6
7 Offsite drainage area(sq ft) 0 0
8 Total BUA in project(sq ft) 38300 sf 38300 sf
New BUA on subdivided lots(subject to
9 permitting)(sq ft) n/a n/a
New BUA not on subdivided lots(subject to
10 permitting)(sf) 38300 sf 38300 sf
11 Offsite BUA(sq ft) sf sf
12 Breakdown of new BUA not on subdivided lots:
-Parking(sq ft) 28262 sf 28262 sf
-Sidewalk(sq ft) 2472 sf 2472 sf
-Roof(sq ft) 7566 sf 7566 sf
-Roadway(sq ft) sf sf
-Future(sq ft) sf sf
-Other,please specify in the comment box
below(sq ft) n/a n/a
New infiltrating permeable pavement on
13 subdivided lots(sq ft) n/a n/a
New infiltrating permeable pavement not on
14 subdivided lots(sq ft) n/a n/a
Existing BUA that will remain(not subject to
15 permitting)(sq ft) n/a n/a
16 Existing BUA that is already permitted(sq ft) n/a n/a
17 Existing BUA that will be removed(sq ft) 2309 sf 2309 sf
18 Percent BUA 27% 27%
19 Design storm(inches) 1.0 in 1.0 in
20 Design volume of SCM(cu ft) 4354 cf 4354 cf
21 Calculation method for design volume simple simple
ADDITIONAL INFORMATION U
Please use this space to provide any additional information about the
22 drainage area(s):

BIORETENTION CELL
1 Drainage area number 1
2 Minimum required treatment volume(cu ft) 31-40 cf
GENERAL MDC FROM 02H.1050
3 Is the SCM sized to treat the SW from all surfaces at build-out? Yes
4 Is the SCM located away from contaminated soils? Yes
5 What are the side slopes of the SCM(H:V)? 3:1
Does the SCM have retaining walls,gabion walls or other engineered
6
side slopes? No
Are the inlets,outlets,and receiving stream protected from erosion 7
(10-year storm)? Yes
Is there an overflow or bypass for inflow volume in excess of the
8
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? Yes
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 Is there an O&M Plan that complies with General MDC(12)? Yes
16 Does the SCM follow the device specific MDC? Yes
17 Was the SCM designed by an NC licensed professional? Yes
BIORETENTION CELL MDC FROM 02H.1052
18 SHWT elevation(fmsl) <909.85
19 Bottom of the bioretention cell(fmsl) 911.85
20 Ponding depth of the design storm(inches) 12 in
21 Surface area of the bioretention cell(square feet) 3520 sf
22 Design volume of SCM(cu ft) 4354 cf
23 Is the bioretention cell used for peak attenuation? Yes
24 Depth of peak attenuation over planting surface(in) 12 in
25 Height of peak attenuation outlet above the planting surface(in) 12 in _
26 Infiltration rate of the in situ soil(inch/hour) 1 in/hr _
27 Diameter of the underdrain pipes(if applicable) 6 in
28 Does the design include Internal Water Storage(IWS)? Yes
29 if so,elevation of the top of the IWS(fmsl) 914
30 Elevation of the planting surface(fmsl) 916
31 What type of vegetation will be planted? (grass,trees/shrubs,
other)? Grass
32 Media depth(inches) 3 in
33 Percentage of medium to coarse washed sand by volume 75%
34 Percentage of fines(silt and clay)by volume 15%
35 Percentage of organic matter by volume 10% _
36 Type of organic material Pine Bar Fines
37 Phosphorus Index(P-Index)of media(unitless) 50
38 Will compaction be avoided during construction? Yes
39 Will cell be maintained to a one inch/hour standard? Yes
40 Depth of mulch,if applicable(inches) n/a
41 Type of mulch,if applicable n/a
42 How many clean out pipes are being installed? 6
4 forebay/grass and
3
Type of pretreatment that will be used: gravel
ADDITIONAL INFORMATION
Please use this space to provide any additional information about the
44
bioretention cell(s):
Bioretention 3 9:13 AM 10/13/2023