Loading...
HomeMy WebLinkAboutSW8010405_HISTORICAL FILE_20190531 STORMWATER DIVISION CODING SHEET POST-CONSTRUCTION PERMITS PERMIT NO. SW8 010uO 5- DOC TYPE ❑ CURRENT PERMIT ❑ APPROVED PLANS HISTORICAL FILE ❑ COMPLIANCE EVALUATION INSPECTION DOC DATE )Wg 05 � I YYYYMMDD D 3 ROY COOPER oAF Governor MICHAEL S. REGAN Secretary S. DANIEL SMITH NORTH CAROLINA Interim Director Environmental Quality Mav 31, 2019 Coastal Community Baptist Church Alm- Greg Hales, Pastor P.O. Box 12270 Wilminoon,NC 28405 Subject: Notice ol'Permit Extension,Permit Transfer,Permit Renewal, Notice of Inspection Not Compliant and Application Return State Stormwater 1lanagement Permit No. SW8 010405 Coastal Community.Baptist Church New Hanover County Dear Mr. Hales: Effective August 1, 2013 the State Stormwater program has been transferred from the Division of Water Quality(DWQ)to the Division of Energy, Mineral and Land Resources(DEMLR). All previous references to DWQ will remain in older stormwater permits issued prior to August 1, 2013 until they are modified. Please note that the updated permit or any updated pages to the permit will now reference DEMLR as the Division responsible for issuance of the permit. Notice of Permit Extension: On August 5, 2009, the Governor signed Session Law 2009-406. This law impacts any development approval issued under Article 21 of Chapter 143 of the General Statutes, which is current and valid at any point between January 1, 2008, and December 31, 2010. The law extends the effective period of any stormwater permit that was set to expire during this time frame up to three (3)years from its current expiration date. On August 2, 2010,the Governor signed Session Law 2010-177, which granted an extra year for au extension of up to four(4) years. Accordingly, this permit, which was set to expire on June 1, 2011, was effective from the date of issuance until June 1, 2015, which included all available extensions. Permit Transfer under SL 2013-121: On May 2, 2019, the DEMLR Wilmington Regional Office received and accepted a Penn it Transfer Application Form from Coastal Baptist Church for the subject project under the provision of Session Law 2013-121. A file review and site inspection were performed on May 17, 2019 by DEMLR staff. While the aforementioned inspection found that the site is not in compliance with the permit, as noted below and in the enclosed inspection report, the transfer and renewal of this permit are necessary in order to move forward with any modifications that will be necessary to bring this site back into compliance. The Division has determined that the provisions of SL 2013-121 have been met as indicated by the supporting documents and findings listed below: 1. The successor-owner of the property has submitted a written request for the transfer of the permit. Reference is made to the attached signed Permit Transfer Application Form, 2. The original permit holder,North Grove Evangelical Presbyterian Church, has dissolved and was lawfully and finally divested of title to the property on which the permitted activity is occurring. Reference is made to the Articles of Dissolution for North Grove Evangelical Presbyterian Church and letter explaining the transfer of the entities assets submitted on May 2, 2019 3. The successor-owner holds title to the property on which the permitted activity is occurring. Reference is made to the deed recorded on November 3, 2011 in DB 5596 PG 1566-1575 with New Hanover County. 4. The successor owner has not proposed any substantial changes to the permitted activity. 5. The updated permit does not impose new or different terms—it merely restates some of the previous terms to provide you with a better understanding of your obligations under the permit. V_ f � North Carolina Department of Environmental Quality I Division of Energy.Mineral and Land Resources Wilmington Regional Office 1 127 Cardinal Drive Extension I Wilmington,North Carolina 28405 910.796.7215 r State Stormwater Permit No. SWS 010405 Page 2 of ?� B acknowledging receipt of the permit, and by checking the last box in Section F of and signing the Permit Transfer Application form and new Operation and Maintenance Agreement, you have accepted the responsibili y for complying with the terms and conditions outlined in this permit and for addressing any compliance issues outlined in the Compliance Inspection Report. The Division is hereby notifying you that permit SW8 010408 has been transferred on May 20, 2019 per the requirements of LS 20L3-121. permit Renewal: On -day 20; 2019,the DE-MLR Wilmington Regional Of ice received and accepted a Permit Renewal application from Coastal Baptist Church for the subject project. The Division is hereby notifying you that permit SW8 010408 has been renewed on May 31, 2019 and that this permit shall be effective mail June 1, 2023. Notice of Inspection —lot Compliant: As noted above, on -May 17, 2019, staff of the DENMLR Wilmington Regional Office conducted a file review and site inspection of the subject project and found that the site is not in compliance with the terms and conditions of this permit. Please find a copy of the completed form entitled "Compliance Inspection Report' attached to this letter, which summarizes the findings of the recent inspection. It should be noted, that part of DA I and all of DA2 have not yet been constructed. It should also be noted that the Engineers Certification for Pond I has not been submitted and is not on file with the Division.It is understood that the Engineer's Certification is pending completion of pond maintenance, however, please ensure the required certifications are submitted after the deficiencies listed below are addressed. As indicated in the attached inspection report, the following deficiencies must be resolved: I. Two unpermitied buildings and a playground were constructed behind the Family Life Center building.These structures extend beyond the permitted boundary for this project.. The permit must be modified to include these buildings within the permitted boundary. 2. An unpermitied drop inlet was added to the parking lot adjacent to the Family Life Center building due to incorrect grading in the southwestern side of the parking lot. The permit must be modified to include this drop inlet. 3. The forebay of Pond 1 contains excess sediment and debris and is overgrown with phragmites. The forebay needs to be cleaned out and maintained per the permit and signed Operation and Maintenance Agreement. 4. The outlet structure orifice is clogged and buried below dirt and debris. The outlet structure orifice needs to be unclogged and free of dirt and debris. 5. The side slopes of Pond 1 are bare and show signs of erosion. The side slopes need to be stabilized. 6. The normal pool in Pond I is not at the permitted elevation. Although this is not a compliance problem at this time;please continue to maintain the pond to ensure these side slopes remain vegetated and stable. 7. Drop inlet C.I. No. 18 contains excessive debris and needs to be cleaned out. Failure to provide the requested information, or to respond to this letter with a plan of action, including a timeline to resolve the identified deficiencies, by July 1,2019, are considered violations of the permit. If the requested information is not submitted to this office by the due date, then DE-MLR staff will re-inspect the site and may issue a Notice of Violation. Please also note that any individual or entity found to be in noncompliance with the provisions of a Stormwater management permit or the stormwater rules is subject to enforcement action as set forth in NCGS 143 Article 21, including the assessment of civil penalties of up to 525,000 per day. Application Return: On -May 2, 2019, the Division received a Minor'\Modification form for the subject project. The application is being returned because the deficiencies listed above and in the attached Compliance Inspection Rcpon will require a major modification application to be submitted to be resolved. Please ensure the submitted major modification application package contains all the applicable required information as listed in 15A NCAC 0211 1042. For your records,please find enclosed copies of the transferred, renewed and updated permit; the new Operation and Maintenance agreement; the Compliance Inspection Report; the Permit Transfer Applicatiot form and the Renewal Application Form. Please keep this letter, the updated permit. and the associated permit 61000MeMS on file. t State Stormwater Permit No. SVV8 010405 Page: Of This permit is subject to the conditions and limitations as specified in the updated permit. Please pay special attention to the conditions listed in this permit regarding the Operation and Maintenance of the SCAM(s), recordation of deed restrictions, procedures for chancing ownership, transferring the permit, and renewing the permit. Failure to establish an adequate system for operation and maintenance of the stormwater management system,to record deed restrictions,to transfer the permit, or to renew the permit, will result in future compliance problems. If any parts; requirements, or limitations contained in this permit are unacceptable;you have the right to request an adjudicatory hearing by filing a written petition with the Office of Administrative Hearings (OAH). The written petition must conform to Chapter 15013 of the North Carolina General Statutes, and must be filed with the OAH within thing(30) days of receipt of this permit. You should contact the OAH with all questions regarding the Filing fee (if a filing fee is required) and/or the details of the filing process at 6714 -Mail Service Center, Raleigh; NC 27699-6714, or via telephone at 919-431-3000, or visit their website at www.\COAI-I.com. Unless such demands are made this permit shall be final and binding. If you have any questions regarding anything covered in this letter, need additional copies of the permit or approved plans, please contact Garetl 7orda with DE\MLR in the Wilmington Regional Office at (9)0) 796-7215 or via email at garrett.zorda@ncdenr.gov. Sincerely, i,..S. Daniel Smith. Interim Director Division of Energy,Mineral and Land Resources GDS/gdz: \\\Stormwater\Permits& Projects\2001\010405 HD\2019 05 permit_CEI_deficicnt_returt_app 010405 Enclosures: Attachment A—Certification Forms Compliance Inspection Report cc: Phillip G. Tripp; PE,Tripp Engineering Wilmington Regional Office Stormwater File f State Stormwater Management Permit No. SW8 010405 STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES STATE STORMWATER MANAGEMENT PERMIT HIGH DENSITY DEVELOPMENT 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 Coastal Community Baptist Church Coastal Community Baptist Church 7721 Alexander Rd., Wilmington, New Hanover County FOR THE construction, operation and maintenance of two wet detention ponds 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 Energy; Mineral and Land Resources (the "Division" or "DEMLR") and considered an enforceable part of this permit. This permit shall be effective from the date of issuance until June 1, 2023 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 in Section 1.7 of this permit. The stormwater controls have been designed to handle the runoff from 123,807 ft2 and 23,551 ftz of impervious area, respectively. 3. Approved plans and specifications for this project are incorporated by reference and are enforceable parts of the permit. 4. The tract will be limited to the amount of built-upon area indicated on page 3 of this permit, and per approved plans. 5. The built-upon area for the future development is limited to the future area shown on the plans has not been accounted for. ) 6. The runoff from all built-upon area within the permitted drainage area of this project must be directed into the permitted stormwater control system. A permit modification must be submitted and approved prior to the construction of additional built-upon area from outside of the approved drainage area. 7. The following design criteria have been permitted for the wet detention ponds and it must be provided and maintained at the design condition: Project Name: Coastal Community Baptist Church Page 1 of 4 State Stormwater Management Permit No. SW8 010405 Name of Receiving Stream/Index #: Cape Fear/ 18-87-22 Classification of Water Body: "SA" If Class SA; chloride sampling results: >1/2 mile from SA waters Pond Number. 1 2 Pond Depth, feet: 6.5 5 Permanent Pool Elevation, FMSL: 33 38 Drainage Area. acres: 5.31 0.99 Total Impervious Surfaces; ft': 123,807 23;551 Offsite Area entering Pond, ft2: none, per Engineer Required Surface Area, ft2: 5;812 1,669 Provided Surface Area. ft2: 6.328 4.042 Required Storage Volume; ft': 10.249 1.946 Provided Storage Volume: ft': 12.467 4.563 Temporary Storage Elevation, FMSL: 34.65 39 Controlling Orifice: 1.5"0 0.75T pipe II. SCHEDULE OF COMPLIANCE 1. 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. 2. During construction, erosion shall be kept to a minimum and any eroded areas of the system will be repaired immediately. 3. The permittee shall at all times provide the operation and maintenance necessary to assure the permitted stormwater system functions at the design condition. 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: 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. 4. Records of maintenance activities must be kept and made available upon request to authorized personnel of DEMLR. The records will indicate the date, activity, name of person performing the work and what actions were taken. 5. Decorative spray fountains will not be allowed in the stormwater treatment system. 6. The facilities shall be constructed; operated and maintained in accordance with the provisions of this permit, the approved plans and specifications, and the supporting documents attached to this permit and on file with the Division. 7. 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. 8. If the stormwater system was used as an Erosion Control device, it must be restored to design condition prior to operation as a stormwater treatment device, and prior to occupancy of the facility. 9. A modification must be permitted prior to any construction. The following items will require a modification to the permit. The Director may determine that other revisions to the project should require a modification to the permit: a. Any revision to the approved plans; regardless of size. b. Project name change. C. Transfer of ownership. Page 2 of 4 State Stormwater Management Permit No. SW8 010405 d. Redesign or addition to the approved amount of built-upon area or to the approved drainage areas. e. Further subdivision, acquisition; or sale of the project area. The project area is defined as all property owned by the permittee, for which Sedimentation and Erosion Control Plan approval was sought. f. Filling in, altering, or piping of any vegetative conveyance shown on the approved plan. 10. 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. 11. The permittee shall submit final site layout and grading plans for any permitted future areas shown on the approved plans; prior to construction. If the proposed BUA exceeds the permitted amount, a modification to the permit must be submitted and approved prior to construction. 12. Prior to the sale of any portion of the property, an access/maintenance easement to the stormwater facilities shall be granted in favor of the permittee if access to the stormwater facilities will be restricted by the sale of any portion of the property. 13. The permittee is responsible for verifying that the proposed built-upon area does not exceed the allowable built-upon area. 14. 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. III. GENERAL CONDITIONS 1. This permit is not transferable to any person or entity except after notice to and approval by the Director. The permittee shall submit a completed and signed "Permit Transfer Application Form" (available on the Division website) accompanied by the required fee and supporting documentation as listed on the form, to the Division at least 60 days prior to any one or more of the following events: a. The sale or conveyance of the project area in whole or in part, except in the case of an individual lot sale that is made subject to the recorded deed restrictions and protective covenants; b. Dissolution of the partnership, corporate. or LLC entity, subject to NCGS 55-14-05 or NCGS 57D-6-07 and 08; c. Bankruptcy; d. Foreclosure, subject to the requirements of Session Law 2013-121; 2. Any individual or entity found to be in noncompliance with the provisions of this stormwater management permit or the requirements of the Stormwater rules is subject to enforcement procedures as set forth in NCGS 143 Article 21. 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 permittee grants DEQ Staff permission to enter the property for the purpose of inspecting all components of the permitted stormwater management facility. 6. The permit issued shall continue in force and effect until the permittee files a request with the Division for a permit modification, transfer, renewal, or rescission; however, these actions do not stay any permit conditions. Page 3 of 4 State Stormwater Management Permit No. SW8 010405 7 ' Unless specified elsewhere, permanent seeding requirements for the stormwater control must follow the guidelines established in the North Carolina Erosion and Sediment Control Planning and Design Manual 8. The permittee shall submit a completed "Permit Information Update Application Form" (available on the Division website) to the Division within 30 days to making any one or more of the following changes: a. A name change of the current permittee; b. A name change of the project: c. A mailing address change of the permittee; 9. The permittee is responsible for compliance with all permit conditions until such time as the Division approves the transfer request. Neither the sale of the project; in whole or in part, nor the conveyance of common area to a third party constitutes an approved transfer of the stormwater permit. 10. A permit renewal request must be submitted at least 180 days prior to the expiration date of this permit. The renewal request must include the appropriate application; documentation and the processing fee as outlined in Title 15A NCAC 02H.1045(3). Permit updated, renewed; transferred and reissued this the 31s` day of May 2019. NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION i-7r, anny Smi , Interim Director Division of Energy, Mineral and Land Resources By Authority of the Environmental Management Commission Permit Number SW8 010405 Page 4 of 4 State Stormwater Management Permit No. SW8 010405 Attachment A Certification Forms The following blank Designer Certification forms are included and specific for this project: • As-Built Permittee Certification • As-Built Designer's Certification General MDC • As-Built Designer's Certification for Wet Detention Pond Project A separate certification is required for each SCM. These blank certification forms may be copied and used; as needed, for each SCM andlor as a partial certification to address a section or phase of the project. Pasc l of 1 State Stormwater Management Permit# SW8 010405 AS-BUILT PERMITTIA, Ch-R"FIIICA"IION I hereby state that I am the current perrinuce for the project named above, and 1 certify by my signature below, that the pro,cct meets the below listed Final Submittal Requirements found in\CAC 021-I.1042(4) and tic terms, conditions and provisions listed in the permit documents, plans and specifications on file with or provided to the Division. HCheck here if this is a partial certification. Section/phase/SCNI l ? Check here if this is pan of a Fast Track As-built Package Submittal. Printed Name Signature L , a Notary Public in the State of County of , do hereby cenify that personally appeared before me this day of ,20 and acknowledge the due execution of this as-built ceniftcation. (SEAL) Witness my hand and official seal ,My commission expires Permittee's Certification NCAC .1042(4) completed Provided A. DEED RESTRICTIONS / BUA RECORDS 1. The deed restrictions and protective covenants have been recorded Y or N and contain the necessary language to ensure that the project is maintained consistent with the stormwater regulations and with the permit conditions. 2. A copy of the recorded deed restrictions and protective covenants has Y or N been provided to the Division. 3. Records which track the 13UA on each lot are being kept. (See Note Y or N 1 B. MAINTENANCE ACCESS l. The SCMs are accessible for inspection, maintenance and repair. Y or N 2. The access is a minimum of 10 feet wide. 1' or N 3. The access extends to the nearest public right-of-way. Y or N C. EASEMENTS 1. The SCN4s and the components of the runoff collection convevancc Y or N system are located in recorded drainage casements. 2. A copy of the recorded plat(s) is provided. Y or -N- D. SINGLE FAMILY RESIDENTIAL LOTS - Plats for residential lots that have an SCM include the following: Y or N l . The specific location of the SCM on the lot. Y or N 2. A typical detail for the SCAM. Y or N 3. A note that the SCM is required to meet stormwater regulations and that the lot owner is subject to enforcement action as set forth in NCGS 143 Article 21 if the SC\4 is removed_ relocated or altered ti or N without prior approval. E. OPERATION AND MAINTENANCE AGREEMENT Y or N 1. The 0&Nl Agreement is referenced on the final recorded plat. Y or N 1 2. The O&vl Agreement is recorded with the Register of Deeds and Y or N appears in the chain of title. Page 1 of 6 State Stormwater Management Permit# SW8 010405 F. OPERATION AND MAINTENANCE PLAN —maintenance records I are being kept in a known set location for each SCM and are available for Y or N review. G. DESIGNER'S CERTIFICATION FORM— has been provided to the Y or N Division. Note 1- Acceptable records include ARC approvals, as-built surveys, and county tax records. Provide an explanation for every_ requirement that was not met, and for every "N/A" below. Attach additional sheets as needed. Page 2 of 6 State Stormwater Management Permit# SW8 010405 AS-BUILT DF,SIGNER'S Cl•'R'IIFICA170N GENERAL �N1DC 1 hereby state that I am a licensed professional and I certify by my signature and seal below, that I have observed the construction of the project named above to the best of my abilities with all clue care and diligence, and that the project meets the below listed General \4DC found in NCAC 02I-1.1050 in accordance with the permit documents, plans and specifications on file with or provided to the Division, except as noted on the "AS-BUILT" drawings; such that the intent of the stormwater rules and statutes has been preserved. Check here if this is a partial certification. Section/phasc/SC:Nl 10 Check here if this is a part of a Past-Track As-Built Package Submittal per .104403 _ Check here if the designer did not observe the construction, but is certifying the project. Check here if pictures of the SCM are provided. Printed-Name Signature NC Registration Number Date SEAL: Consultant's \-lailing Address- City/State/ZIP Phone Number Consultant's Email address: 10 Circle ifthe as-built value differs from the Plan. IfN is circled, provide an explanation on Page 2. ON'/13= not evaluated (provide explanation on page 2) OO i\/A=not applicable to this SCM or project. Consultant's Certification NCAC .1003((3) & General MDC OO As-built "/ OO N/A .1050 E A. TREATMENT REQUIREMENTS I. The SCM achieves runoff treatment. Y or N 2. The SCM achieves runoff volume match. Y or N �- 3. Runoff from offsitc areas and or x sting 13UA is Y or N bypassed. .4. Runoff f� rom oftsitc areas and or existing BUA is directed y or N into the permitted SCM and is accounted for at the full build-out potential. 5. The project controls runoff through an offsite permitted y or N SCM that meets the rc uiremen's of the MDC. 6. The net area of new BUA increase or an existing project Y or N has been accounted for at the appropriate design storm level. 7. The SCM(s) meets all the specific minimum design y or N criteria. B. VEGETATEDSETBACKS /BUA j 1. The width of the vegetated setback has been measured y or from the normal pool of impounded waters. the MI-I\V line of tidal waters, or the top of bank of each side of rivers or streams. 2. The vegetated setback is maintained in grass or other Y or N vcgcta 3.13UA thhatat meets the requirements ofNCGS 143-214.7 Y or N b(_2)(2) is located in the setback. Page 3 of 6 State Stormwater Management Permit# SW8 010405 4. 13UA that does not meet the requirements ofNCGS 143- Y or N 214.7 (b2)(2) is located within the setback and is limited to: a. Publicly funded linear projects (road,_ greenway sidewalk) b. Watcr-dependent structures c. Minimal footprint uses (utilip poles; signs; security lighting and appurtenances) 5. Stormwater that is not treated in an SCM is released at Y or the edge of the setback and allowed to (low through the ! setback as dispersed flow. ON/ OO As-built OO N/A ; I C. STORNINVATER OUTLET —the outlet handles the peak Y or N flow from the 10 year storm with no downslo e erosion. D. VARIATIONS 1. A variation (alternative) from the stornnwater rule Y or V _provisions has been implemented. 2. The variation provides equal or better stormwater control Y or :N and equal or better protection of surface waters. E. COMPLIANCE WITH 01HER RE ULATORY PROGRAMS has been met. Y or N F. SIZING -the volume of the SCM takes the runoff from all surfaces into account and is sufficient to handle the required i Y or N storm depth. G. CONTAMINATED SOILS —infiltrating SCM's are not Y or N located in or on areas with contaminated soils. A. SIDE SLOPES l. Vegetated side slopes are no steeper than 31-1:1 V. Y or N 2. Side slopes include retaining walls, gabion walls, or Y or :N� other surfaces that are steeper than 311:1 V. 3. Vegetated side slopes are steeper than 31I:l V (provide I Y or :N supporting documents for soils and vc etation . 1. EROSION PROTECTION 1. The inlets do not cause erosion in the SC\,I. Y or N 2. The outlet does not cause erosion downslopl�thc Y or N discharge point during the peak flow from the 10 year storm. J. EXCESS FLOWS—An overflow bypass has been j provided. Y or N K. DEWATERING—A met nod to drawdown standing water Y or N has been provided to facilitate maintenance and inspection. I L. CLEANOUT AFTER CONSTRUCTION—the SCM has Y or N been cleaned out and converted to its approved design state. M. MAINTENANCE ACCESS t. The SCM is accessible for maintenance and repair. Y or _N 2. The access does not include lateral or incline slopes>3:1. Y or N I N. DESIGNER QUALIFICATIONS (FAST-TRACK PERMIT)—The designer is licensed under Chapters 89A, Y or N 89C, 89E, or 89F of the General Statutes. Provide an explanation for every MDC that was not met, and for every item marked "N/A" or below. Attach additional pages as needed: Page 4 of 6 State Stormwater Management Permit# SW8 010405 AS-BUILT DESIGNER'S CER7'IFfCATION FOR WET I)FTENTION POND PRO.IFICT 1 hereby state that 1 am a licensed professional and I certify by my signature and seal below, that I have observed the construction of the project named above to the best of my abilities with all due care and diligence, and that the project meets all of the _A4DC found in NCAC 021-1.1053. in accordance with the permit doctunents, plans and specifications on file with or provided to the Division, except as noted on the "AS-BUILT" drawings, such that the intent of the stornnvater rules and the general statutes has been preserved. Check here if this is a partial certification. Section/phase/SCN4 =i'1 Check here if this is part of a last-Track As-l3uilt Package Submittal per .1044(3). Check here if the Designer did not observe the construction,_ but is certifying the project. Check here if pictures of the SC\4 are provided. Printed Name Signature NC Registration Number Date SEAL: Consultant's \•tailing Address: City/State/ZIP Phone\umber Consultant's Email address: D Circle N if the as-built value differs from the Plan/permit. If N is circled, provide an explanation on page 2 OON/F= not evaluated (provide explanation on page 2) ( N/A = not applicable to this project or SC\4. This Cenification must be completed in conjunction with the General NIDC certification under'NCAC 021-1.1050 Consultant's Certification (t\4DC .1053) OO As-built OO N/E OO N/A A. Forebay/Depths /Fountain 1. The available Sediment storage is consistent with the Y or N approved plan and is a minimum of 6 in. 2. later Ilow over the forebav berm into the main pond Y or N occurs at a non-erosive velocity_. 3. The provided Forebay Volume is 15%-20% of Fic main Y or N pool volume. 4. fhc Forebay entrance elevation is deeper than the exit � y or elevation into the pond. 5. The Average Design Depth of the main pond below the permanent pool elevation is consistent with the permitted Y or N value? 6. Fountain documentation is provided. Y or N B. Side slopes /Banks / Vegetated Shelf l. The width of the Vegetated Shelf is consistent with the Y or :N approved plans and is a minimum of 6 feet. 2. The slope of the Vegetated Shelf is consistent with the Y or N ap rp oyed plans and is no steeper than 6:1. C. As-built Main Pool /Areas / Volumes / Elevations 1. The permanent pool surface area provided is consistent Y or with the permitted value. 2. The Temporary Pool Volume provided is consistent with Y or N the permitted value. I� Page 5 of 6 State Stormwater Management Permit# SW8 010405 i " �. The permanent pool elevation is consistent with the Y or permined value. i 4. The temporary pool elevation consistent with the Y or N' _permitted value. j OAs-built OO N/L ON/A ID. Inlets / Outlet/ Drawdown l . The design volume draws down in 2-5 days. l or 2. The size of the Orilice is consistent ���iili the permitted Y or V� value. 3. A trash rack is provided on the outlet structure. Y or N 4. I Ivdrologic impacts to the receiving channel arc minintized Y or N from the 1 yr 24 hr storm discharge? 5. The inlets and the outlet location are Situated per the Y or N, approved plan and avoid short-circuiting. C. Vegetation j l. The vegetated shelf has been planted with a minimum of 3 1 or N diverse species. _ I 2. 7'hc vegetated shelf plant density is consistent with the approved plans and is no less than 50 plants per 200 sr or Y or N no Tess than 24 inches on center. Provide an explanation for every V11)C that was not met, and for every item marked "N/A' or "N/L" below. Attach additional pages as needed: Page 6 of 6 Application Completeness Review Checklist Project Name: GDr__ ,, f Date Delivered to WIRO: 0 BIMS Received/Accepted Date: AJOA all, clk5i Project County/Location: *BIMS Acknowledged Date: Rule(s): ®2017 Coastal 02008 Coastal ®1995 Coastal ®Phase II ®Universal 111988 Coastal Permit Action: New/Major Mod/Minor Mod Renewal/Transfer **New Permit#: Permit Type: @LD/ LD Overall/ HD &LD Combo Existing Permit#: General Permit/Offsite/Exempt/Rescission ®PE Cert on File? SCM Type(s): a LAD-0 &--. Offsite to SWB: Development Type: Commercial/Residential/Other ®Master PE Cert on File? Subdivided?: Subdivision or Single Lot For New or Transferred Permits Permittee is: Stream Class: Property Owner(s) ❑Developer ®Lessee ®Purchaser®HOA ❑SA Map ®ORW Map Paperwork Emailed Engineer on: ®Supplement(s) (1 original per BMP) ®O&M with correct/original signatures (1 original per BMP except LS/VFS and swoles) (application with correct/original signatures ®Email Address: Design Engineer Corp or LLC: Sig. Auth. per SoS or Signature Authorization letter or report ®Email Address: Property Owner $505 (within 6mo) Check#(s): (>g�j 0�sy ❑No Fee ❑Deed ®Soils Report:w/SHWT or General Report ®Email Address: Lessee ®Calculations(signed/sealed) ❑Lease Agreement ®Deed Restrictions, if subdivided: Email Address: Purchaser r—i**Signed & Notarized Template Purchase Agreement Correct Template (Comm/Res& HD/LD) or Dec Covenants& Rest Email Address: Developer ❑Recorded Covenants Email Address: HOA Representative ❑Recorded Plats 1:150%or more Lots Sold List Project Narrative F-1USGS Map Plans 72 Sets Wetlands: Delineated or No Wetlands ®Vicinity Map FProject Boundaries Legend Layout(proposed BUA dimensions) EIDA Maps FIDetails (roads, cul-de-sacs, curbs, sidewalks, BMPs, Buildings, etc) ®Existing Conditions FiLandscape Plan ❑Grading OPE Seal REVIEWER NAME: NOTES TO REVIEWER: *Enter BIMS Acknowledged Date on this Sheet **FOR NEW Projects-Enter New Permit #on ( _ Supplements& Deed Restiction Templates. wckd do b rl-rA-r--oC-mot . G:WQ\\\Reference Libra ry\Procedures\Checklists\Completenass Review Checklist 20180313 Application Completeness Review Checklist Project Name: �r;'e,6.'/-G.-L �j {yc.� {,4, � �'�. Date Delivered to WIRO: BIMS Received/Accepted Date: Project County/Location: *BIMS Acknowledged Date: Rule(s): ®2017 Coastal 2008 Coastal ®1995 Coastal ®Phase II ®Universal ®1988 Coastal Permit Action: New/Major Mod Minor Mo / Renewal/Transfer **New Permit#: Permit Type: HD LD/ LD Overall/ HD &LD Combo Existing Permit#: General Permit/Offsite/ Exempt/ Rescission ❑PE Cert on File? SCM Type(s): (O.e.0' �pl`t Offsite to SWB: Development Type: Commercial/Residential/ the " ®Master PE Cert on File? Subdivided?: Subdivision or Single Lot For New or Transferred Permits Permittee is: Stream Class: Property Owner(s) ®Developer ®Lessee ®Purchaser❑HOA ®SA Map ®ORW Map Paperwork Emailed Engineer on: ®Supplement(s) (1 original per BMP) M with correct/original signatures (1 original per BMP except LS/VFS and swoles) Application with correct/original signatures Email Address: Design Engineer Corp or LLC: Sig. Auth. per SoS or Signature Authorization letter or report Email Address: Property Owner ®$505(within 6mo) Check#(s): ®No Fee ®Deed ❑Soils Report: w/SHWT or General Report Email Address: Lessee ®Calculations (signed/sealed) Lease Agreement ❑Deed Restrictions, if subdivided: Email Address: Purchaser F—I**Signed & Notarized Template ❑Purchase Agreement ❑Correct Template (Comm/Res& HD/LD) or Dec Covenants& Rest Email Address: Developer ❑Recorded Covenants Email Address: HOA Representative Recorded Plats �SO% or more Lots Sold List Project Narrative EIUSGS Map Plans Sets Wetlands: Delineated or No Wetlands ❑Vicinity Map Project Boundaries ❑Legend Layout(proposed BUA dimensions) QDA Maps Details (roads, cul-de-sacs, curbs, sidewalks, BMPs, Buildings, etc) ❑Existing Conditions Landscape Plan Grading OPE Seal REVIEWER NAME: NOTES TO REVIEWER: *Enter BIMS Acknowledged Date on this Sheet **FOR NEW Projects-Enter New Permit#on Supplements& Deed Restiction Templates. G:1NQ\\\Reference Library\Procedures\Checklists\Completeness Review Checklist_2018 03 13 Burd, Tina J From: Burd, Tina J Sent: Tuesday, May 21, 2019 8:24 AM To: bmorgan@paragonwilmington.com; ptripp@ec.rr.com Subject: SW8 010405 - Coastal Community Baptist Church The Wilmington Regional Office of the Division of Energy, Mineral and Land Resources (Stormwater Section) accepted the Stormwater Permit Renewal Application and $505.00 fee for the subject project on May 21, 2019. The project has been assigned to Garrett Zorda and you will be notified if additional information is needed. Please be advised that the construction of built-upon area may not commence until the Stormwater Permit is issued. Best Regards, Tina Burd Administrative Associate II Wilmington Regional Office Division of Environmental Assistance & Customer Service Phone 910-796-7215 NCDEQ Wilmington Regional Office 127 Cardinal Drive Ext. Wilmington, NC 28405 Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties. i DEMLR USE ONLY Dale R ceiy d Fee Paid Permit Number 1 1 *-OS' - t� D to NC DEd Division of Energy, Mineral and Land Resources STATE STORMWATER: PERMIT RENEWAL APPLICATION FORM In accordance with 15A NCAC 2H.1045(3), the current permit holdershall renew their high density permit 180 days priorto its expiration. Renewed permits are valid fora period of 8 years per Session Law 2011-398(SB 781) Section 60.(c). This application form is forperrnit renewals only. A. PROJECT INFORMATION 1. State Stormwater Permit Number: S W8 010405 2. Project name: Coastal Community Baptist Church 3. Project street address: 77y 21 Alexander Road City: Wilmington County: New Hanover ZIP : 28411 4. What, if any, changes have been made to the project as permitted? NA If the project has changed from the original approved plans, please complete SWU-101 fora Major Modification or Minor Modification Application form available at: https://deq.nc.goy/about/divisions/energy- mineral-land-resou rces/energv-mi neral-land-rules/stormwater-program/post-construction. B. PERMITTEE INFORMATION If changes to the permittee or project name have been made, please complete either the Permit Update form orthe Permit Transferform available at: httl)s://deq.nc.gov/about/divisions/energv-mineral-land- resources/energv-mineral-land-rules/stormwater-program/past-construction. State Stormwater Permits do not automatically transfer with the sale of the property. 1. Current Permit Holder's Company Name/Organization: Coastal Community Baptist Church 2. Signing Official's Name: Greg Hales 3. Signing Official's Title: Pastor 4. Mailing Address: PO Box 12270 City: Wilmington State: NC ZIP 28405 5. Street Address: 7721 Alexander Road City: Wilmington State: NC ZIP 28411 6. Phone: (910) 686-7775 Email: bmorganCo�,paragonwilmington.com EGIEIME MAY 21 2019 Stormwater Permit Renewal Form Page 1 of 3 BY: May 11, 2018 C. SUBMITTAL REQUIREMENTS Submit the application package to the appropriate DEMLR Regional Office (Coastal, SA Waters) orDEMLR Central Office (Urbanizing Areas Ph 2, USMP, Non-Coastal HQW/ORM). Only applications packages that include all required items listed below will be accepted and reviewed. Initial each item below to indicate that the required information is provided in the application package: 1. A permit application processing fee of$505.00 payable to NCDEQ. 2. One original signed hard copy and one electronic copy of this completed form. The signing official named on this application to represent the current permittee must meet one of the following: a. Corporation—a principle executive officer of at least the level of vice-president; b. Limited Liability Company (LLC)—a manager or company official as those terms are defined in G.S. 57D "North Carolina Limited Liability Company Act;" c. Public Entity—a principal executive officer, ranking official, or other duly authorized employee; d. Partnership or limited partnership—the general partner; e. Sole proprietor; or f. Letter of authorization signed by one of the signatories noted in a—e above authorizing the signature of another entity. 3. One hard copy and one electronic copy of recorded documents required by the original permit that have not yet been received by DEMLR, including: deed restrictions, protective covenants, condominium/planned community declaration and easements. If the project has been built, include documentation that the maximum BUA per lot or maximum total BUA has not been exceeded. If the project has not been built, include a signed agreement that the final recorded deed restrictions and protective covenants will be submitted at a later date. 4. O&M Agreements, Please select one: 13e nF wrt+. ® I have a copy of the current recorded O&M Agreement for all SCMs, and I will continue to keep this on file with the permit; or ❑ I do not have a copy of the current recorded O&M Agreement for all SCMs and am requesting a copy be sent to me. I agree to keep this on file with the permit. 5. Designer Certifications, Please select one: ❑ A copy of the certification(s) confirming that the project was built in accordance with the approved plans have been previously provided to the Division; or ® A copy of the certification(s) confirming that the project was built in accordance with the approved plans are enclosed; or ❑ The project has not yet been built. 6. [IF APPLICABLE] If the project has been built, one original hard copy and one electronic copy of a signed, sealed, and dated letter from a licensed professional stating that the SCMs have been inspected, and that they have been built and maintained in accordance with the permit. 7. [IF APPLICABLE]When the permittee is a corporation or a limited liability corporation (LLC): Provide one hard copy and one electronic copy of documentation from the NC Secretary of State, or other official documentation, which supports the titles and positions held by the persons listed in Section C.2 per 15A NCAC 2H. 1043(3)(b). https://www.sosnc.gov/online services/search/bv title/ Business Registration r. MAi 21 21M BY: _ ---_ Stormwater Permit Renewal Application Form Page 2 of 3 May 11, 2018 D. PERMITTEE'S CER;(".15 ATION I, , the person legally responsible for the permit, certify that I have a copy of the Per4plt and O&M Agreement on site (or I will obtain a copy and it will be kept on site), that I am responsible for the performance of the maintenance procedures, and the site has been and will be maintained according to the O&M Agreement and approved plans. I agree to notify DEMLR of any problems with the SCMs or built-upon area and to submit the proper forms to modify or transfer the permit prior to any changes to the project, SCMs, or ownership. All information provided on this permit renewal application is, to the best of my knowledge, correct�ple Q Signature: /�( Date: �7 NOTARIZATION: I, It te&C4•. a Notary Public for the State of _ //County of ✓e v` do hereby certify that personally appeared before me this.the,tA r., /3 �' d / P h✓lia a! 20��, and acknowledge the due executibh?of.the forgoing instrument. Witness my hand and official seal, '' w5' i ,r'.'�j� ny,t'�7r• �. � , iNotary�Seal)W�� " Notary Signature:;," •a ` My commission expires��Z-z EC E!VE kiA'i' 21 2019 . Br Stormwater Permit Renewal Application Form Page 3 of 3 May 11, 2018 Compliance Inspection Report Permit: S1V8010405 Effective: 06/01/01 Expiration: 06/01/15 Project: Coastal Community Baptist Church Owner: Coastal Community Baptist Church County: Nev.,Hanover Across: 7721 Alexander Rd Region: VVilminalon City/SlalelZip: Wilmington NO 28411 Contact Person: Greg Hales Title: Pastor Phone: 910-686-7775 Directions to Project: Type of Project: State Stormwater-HD-Detention Pond Drain Areas: 1 -(Paces Creek) (03-06-24)(SA,HOI^) On-Site Representative(s): Related Permits: Inspection Date: 05117/2019 Entry Time: 01 CCPM Exit Time: 01:45PM Primary Inspector: Garrett D Zorda Phone: 919-796-7345 Secondary Inspector(s): Reason for Inspection: Other Inspection Type: Transfer Renewal Permit Inspection Type: State Stormwater Facility Status: ❑ Compliant M Not Compliant Question Areas: ® State Stormwater (See attachment summary) page: 1 - Permit: S:SV5010405 Owner-Project: Coastal Commun,t,Barrel Churcn Inspection Dale: 0511712➢Ie Inspection Type Transfer Renewal Reason for Visit: Other Inspection Summary: To brina this system into compliance:the following must be completed: 1. A Major Modification application must be submitted to modify the permitted boundary and include the unpermitted buildings behind the Family Lice Center building and the additional drop inlet located in the parking lot adjacent to the Family Life Center. 2. The sediment and debris in the forebay of Pond 1 must be cleaned out and the phragmite overgrowth must be remediated. 4. The side slopes of Pond 1 must be stabilized and any erosion must be repaired. 5. The outlet structure orifice must be unclogged and free of any dirt and debris. 6. Drop inlet C.I. No. 18 must be cleaned out. File Review Yes No NA NE Is the permit active? ❑ 0 ❑ ❑ Stoned copy of the Engineer's certification is In the file? ❑ 0 ❑ ❑ Sioned copy of the Operation& Maintenance Agreement is in the file? 0 ❑ ❑ ❑ Copy of the recorded deed restrictions is in the file? ❑ ❑ 0 ❑ Comment: Permit expired-renewal application pending transfer. Engineers Certification not on file. Built Upon Area Yes No NA NE Is the site BUA constructed as per the permit and approval plans? ❑ ❑ ❑ Is the drainage area as per the permit and approved plans? ❑ E ❑ ❑ Is the BUA(as permitted)graded such that the runoff drains to the system? 0 ❑ ❑ ❑ Comment: Unpermitted buildings were added behind Family Life Center building. Unpermitted buildings extend beyond the permitted boundary. SW Measures Yes No NA NE Are the SW measures constructed as per the approved plans? ❑ 0 ❑ ❑ Are the inlets located per the approved plans? ❑ 0 ❑ ❑ Are the outlet structures located per the approved plans? 0 ❑ ❑ ❑ Comment: An unpermitted drop inlet was added to the parking lot adjacent to the Family Life Center building. Operation and Maintenance Yes No NA NE Are the SW measures beino maintained and operated as per the permit requirements? ❑ 0 ❑ ❑ Are the SW Bf✓IP inspection and maintenance records complete and available for review or provided to ❑ ❑ ❑ E DVJQ upon request? Comment: Forebay contains excessive sediment and is overgrown with phracrutes. Side slopes of Pond 1 are bare and show signs of erosion. Drop inlet C.I. No. 18 contains excessive amounts of debris. pace: 2 NEW EW HANOVER COUNTY Y M1'1 Engineering Department 230 Government Center Drive • Suite 160 Beth E.Wetherill,C.P.E.S.C. Soil Erosion Specialist Wilmington, North Carolina 28403 TELEPHONE(910)-798-7139 Fax(910) 798-7051 g \�tU-�4t.0\• Memorandum Date: ! j 141 Lg To: NCDENR - WQ From: Beth Easley Wetherill Soil Erosion Engineer Re: Sedimentation and Erosion Control Plans Grading Permit # fro --o t i2P1 ' S'T' -4-) The attached plans have been submitted for approval to New ]Hanover County Engineering. If you have any questions regarding these plans, please contact this office. so 9 0 1 O#oS Burd, Tina J From: Burd, Tina J Sent: Wednesday, May 8, 2019 3:52 PM To: bmorgan@paragonwilmington.com'; 'ptripp@ec.rr.com' Subject: SW8 010405 - Coastal Community Baptist Church/ North Grove Evangelical Presbyterian Church The Wilmington Regional Office of the Division of Energy, Mineral and Land Resources (Stormwater Section) accepted the Stormwater Permit Transfer Application and $505.00 fee for the subject project on May 2, 2019. The project has been assigned to Garrett Zorda and you will be notified if additional information is needed. Please be advised that the construction of built-upon area may not commence until the Stormwater Permit is issued. Best Regards, Tina Burd Administrative Associate II 910-796-7215 NCDEQ Wilmington Regional Office 127 Cardinal Drive Ext. Wilmington, NC 28405 Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties. � 1 L- IM �t t 1 R¢A) A- I oo earr. `o APPLICATION FOR PERMIT FOR A pile N GF°.26-O( �s LAND DISTURBING ACTIVITY Q g Under the conditions set forth by LD Fe //,, !o(Jc)Revicw Fee YZOD The New Hanover County i Soil Erosion and Sedimentation Control Ordinance (} Date 1'd_pate I'd 'T�ean��• Engineering Department Applicant or Applicants Agent: Coastal Community Baptist Church Mailing Address: PO Box 12270 Telephone Number: 910- 686-7775 Fax Number: Wilmington NC 28405 Email Address: bmorgan a paragonwilmington.com Total Acres of Land Disturbance: ---2.0 Purpose of Development: church Description of Land Disturbance: site work for church building parking and utilities Address of Land Disturbance 7721 Alexander Road Latitude: N34°17'06" Longitude: W77°48'34" STATEMENT OF FINANCIAL RESPONSIBILITY Land owner(s) of record: Person or firm(s) financially responsible for the land disturbing activity. If not a North Carolina resident, you MUST have a N.C. agent. (List Below) Name: Coastal Community Baptist Church Name: Coastal Community Baptist Church Address: PO Box 12270 Address: PO Box 12270 City/State: Wilmington.NC City/State: Wilmington,NC Zip Code: 28405 -Lip Code: 28405 Telephone Number: 910-620-4015 Telephone Number: 910-620-4015 Email: bmorgan@ paragonwilmington.com FaxNumber Email: bmorgan cr naragonwilmington.com FaxNumber: _ Location of dced(s) or instrument(s): County: New Hanover Book: 5596 Page: 1566 The above information is a Lie and correct to the best of my knowledge and belief and was provided by me while under oath. (This form must be signed by the financially responsible person if an individual and by an officer, director, partner, attorney-in- fact, or other person of authority to execute instruments for the financially responsible person if not an individual.) 1 agree to providecorrected information should there be any change in the information provided herein. ^^ Date: 0 Name Grey, Hales Title Pastor Signature I, a Notao Public of the County of ✓W State of North Carolina, hereby certify that /fs appeared personally before me this day and being duly sworn acknowledged that the above I orm was executed by him. Witness'my hand�r tary seal, this_/ day of �T�fk47 20 9 :Notary My commission expires ,SEAL Pdrhiission to Enter on Land l certify thaLI am authorized to gr rat and do in fact grant permission to the Erosion C'o ' - I rater on the.land in question in connecti r lated to this permit application. MAY — 3 ?019 2 /2 Application signature and Dat I ENGNEERiPJG DEP,IRTMENT PLEASE COMPLETE ALL PORTIONS OF APPL ENGINE n Application Completeness Review Checklist Project Name: (�O� C pY-n� , w j5 y U«�2— Date Delivered to WIRO: Z015 �W✓tte�(c rs{o - G /y �v �cehSe.(; c Date: r. 'Z BIMS Received/Accepted 7-L)f ProjectCounty/Location: *BIMS Acknowledged Date: Rule(s): ®2017 Coastal ®zoos Coastal ED1995 Coas I ®Phase II ®Universal 01988 Coastal Permit Action: New/Major Mod/Minor Mod/Renewa Transfer **New Permit#: Permit Type: HD/LD/ LD Overall/ HD &LD Combo Existing Permit#: Su. ) 61 d Y05 General Permit/Offsite/ Exempt/ Rescission ®PE Cert on File? 1b SCM Type(s): Off site to SWB: Development Type: Commercial/Residential/Other ®Master PE Cert on File? Subdivided?: Subdivision or Single Lot For New or Transferred Permits Permittee is: Stream Class: Property Owner(s) Developer ®Lessee ®Purchaser®HO ®SA Map ®ORW Map Paperwork Emailed Engineer on: �lement(s) (1 original per BMP) O&M with correct/original signatures (1 original per BMP except LS/VFS and sw es) �- �Applica 'on with correct/original signatures�Di55Jj�y CC, uk r�ti mail Address: Design Engineer Corp or LLC: Sig. Auth, per SoS or Signature Authorization letter or report �^v Ermail Address: Property Owner �505 (within 6mo) Check#(s): v 0 30 ®No Fee Deed � ®Soils Report: w/SHWT or General Report 1 �(_ ❑Email Address: Lessee ❑Calculations (signed/sealed) V I ❑Lease Agreement ®Deed Restrictions, if subdivided: y ®Email Address: Purchaser r—i**Signed & Notarized Template I' � / Purchase Agreement ®Correct Template (Comm/Res & HD/LD) or Dec Covenants& Rest ° ❑Email Address: Developer ®Recorded Covenants ®Email Address: HOA Representative ❑Recorded Plats F-150%or more Lots Sold List Project Narrative ❑USGS Map Plans �j ❑2 Sets ❑Wetlands: Delineated or No Wetlands �rQ Q J en?CI_ ®Vicinity Map ®Project Boundaries ®Legend Layout(proposed BUA dimensions) VVV IMF F�DA Maps Details (roads, cul-de-sacs, curbs, sidewalks, BMPs, Buildings, etc) ®Existing Conditions Landscape Plan I ®Grading EIPE Seal REVIEWER NAME: NOTES TO REVIEWER: *Enter BIMS Acknowledged Date on this Sheet **FOR NEW Projects-Enter New Permit#on Supplements & Deed Restiction Templates. IIJ� �s F�,•,,o� C Lun � c�Z l��-, .�.4 h-�-a. Sz,�-�-�'%�-�S G:wQ\\\Reference Library\Procedures\Checkliss\Completeness Review Checklist 2018 03 13 NA 3 A-c f�S Plt-Z 5� �� X��� IIIBIIIIIII Ilill illllllll II 2011030223 FOR REGISTRNIFRTION REGISTER OF DEEDS NEWNHRNOVER COUNTY IS BK 55961PG�1566-10575 FEE $26 00 NC REV STP111,964 00 INF U RI 12011030223 Prepared by Alley Register& McEachern No title exam performed 701 North 4,h Street by preparer of this instrument Wilmington,NC 284111 Rene nee sfcrs. 196y Mwl after ecordmg to oasta Community Baptist Church R ED TO P.O Box 12270 , Ael Wilmington, NC 28405 Tax Parcel ID# R03600-003-007-000 1 STATE OF NORTH CAROLINA COUNTY OF NEW HANOVER NORTH CAROLINA GENERAL WARRANTY DEED THIS INDENTURE made this--it day of November,2011,by and between Presbytery of the Mid-Atlantic, a North Carolina Non-profit Corporation having an address of c/o DMC. 41 Sam Newell Road,Matthews NC 28105 Grantor,and Coastal Community Baptist Church, a North Carolina Non-prof it Corporation having an address of P O Box 12270 Wilmington.__N_C 28405, Grantee The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors and assigns,and shall include singular,plural,masculine,feminine or neuter as required by context WITNESSETH WHEREAS, Roby Wallin,Phil Stump,Rob Buchanan,Gary McGhee,Frank Carter, and John Brown,the undersigned are all Trustees in accordance with the bylaws of the Presbytery of the Mid-Atlantic,a North Carolina Non-profit Corporation WHEREAS,that the Grantor,for a valuable consideration paid by Grantee, has and by these presents does grant and convey unto the Grantee in fee simple, all that certain lot or parcel of land situated in the County of New Hanover and State of NORTH CAROLINA, and more artiicularlly ClaWE MAY 0 2 2019 BY: described as follows- See Exhibit"A" and Exhibit"S"attached The real property is not the primary residence of Grantor TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee simple And the Gruntor covenants with the Grantee, that Grantor is seized of the premises in fee simple,has die right to convey the same in fee simple,that title is marketable amid free and clear of all encumbrances,and that Grantor will warrant and defend the title against the lawful claims of all persons whomsoever except for the exceptions hereinafter stated. Title to the property hereinabove described is subject to the following exceptions: 2011 New Hanover County Taxes and subsequent years. Restrictions recorded in New Hanover County Registry Federal,State,and Local governmental regulations IN WITNESS WHEREOF, the undersigned Trustees of the Presbytery of the Mid- Atlantic, a North Carolina Non-profit Corporation and in acourdmcc with the Articles of Organization and Bylaws of the Presbytery of the Mid-Atlantic,Article VH,Section Z,hereby sets their bands as the duly authorized act of the corporation, the day and year first above written. Presbytery of the Mid-Atlantic, a North Carolina Non-profit Corporation By Roby WaTim Trustee STATE OF IU t lJOl1 Uxy� d` COL1T1'Y�O1F U/v.ilXI-1 1,t�Y t1'i ' t-(O , a Notary Public of the County and State aforesaid,do hereby certify that Roby lin, personally appeared before me this day and acknowledged that be is a Trustee of the Presbytery of the Mid-Atlanue,a North Carolina Nun-profit Corporation,and that by authority duly given,the foregoing instrument was signed by him as his capacity as Trustee. Witness my band and official seal this 1 day of November,2011. 1" t . My Commission Expirestutttprrq NotaryPubhc �SNiY v MAY 0 2 2019 w PO 2 ON tGO Jt```� 1 - hil Shunji Trustee STATE OF NORTH CAROLINA COUNTY OF A cl-, W uti,,,,cv I, . a Notary Public of the County and State aforesaid,do hereby certify that Pliff Stump, personally appeared before me this day and acknowledged that he is a Trustee of the Presbytery of the Mid-Atlantic,a North Carolina Non-profit Corporation,and that by authority duly given,the foregoing instrument was signed by him as his capacity as Trustee Witness my hand and official seal this N! day of November,2011. Not, y Public My Commission Expires: ) ,2 J i ,,,h Z- NOTARY PUBLIC - IaG �*NC ECEIVE MAY 0 2 20 BY:— Buchanan Trustee STATE OF //�� COUNTY OF (2,?C,P 1, O a Notary Public of the County and State aforesaid,do hereby certify thaYRob Buchanan, personally appeared before me this day and acknowledged that he is a Trustee of the Presbytery of the Mid-Atlantic,a North Carolina Non-profit Corporation,and that by authority duly given,the foregoing instrument was signed by him as his capacity as Trustee Witness my hand and official seal this o� Owlday of November. 2011 Notary Public My Commission Expires H / PATSY A MILLER Notary Public Comrrionwealtb of Virginia 1060822 My Commnalon Exprtes Nay 30.2014 ECE@ME -) MAY 0 2 2+019 i 0 BY: -- cG e TOstee STATE OF Nor "A COUNTY OF VJ"'7 1, 6< r,f\ lot Lp4&A). a Notary Public of the County and State aforesaid,do hereby ce that Gary McGhee, personally appeared before me tlus day and acknowledged that he is a Trustee of the Presbytery of the Mid-Atlantic,a North Carolina Non-profit Corporation, and that by authority duly given,the foregoing instrument was signed by him as his capacity as Trustee Witness my hand and official seal this Z day of November, 2011 No ary Public My Commission Expires. b"AAp C)I Fri y 's => C g 5 'e U G = q�� Geld ECEIV L MAY 022019 By.-_ rank Carter Trustee STATE OF P(tAm (dn)6n2 COUNTY OF , I, Pain rd D 'Ftnwut a Notary Public of the County and State aforesaid,do ertify that Frank hereby c Carter, personally appeared before me this day and acknowledged that he is a Trustee of the Presbytery of the Mid-Atlantic,a North Carolina Non-profit Corporation, and that by authority duly given,the foregoing instrument was signed by him as his capacity as Trustee. Witness my hand and official seal this 2 day of November,2011 Notary Public OFFICAL SEAL My Commission Expires' 9 $01 U15 "t ":'r: PATRICIA D.FLOWERS r5 Y !votary Pubde Forsytn County,NC W CMAWSVON EXPIRE iri 2 E cEIVE') MAY 0 2 2019 G_. rusteee STATE OF NORTH CAROLINA COUNTY OF U y\i oYcl_(_ 1, 5F oo-'tn'It Jch-ate -a Notary Public of the County and State aforesaid,do hereby certify that John Brown, personally appeared before me this day and acknowledged that he is a Trustee of the Presbytery of the Mid-Atlantic, a North Carolina Non-profit Corporation, and that by authority duly given,the foregoing instrument was signed by him as his capacity as Trustee. Witness my hand and official seal this Sf day of November, 2011 10-ow 6U�� Notary Public My Commission Expires: Sea t 05 ag ��S'it 115rQv,\; EcEIVE EXHIBIT"A" TRACT ONE BEING all that certain tract or parcel of land lying and being located in Harnett Township, New Hanover County, North Carolina and being bound on the North by (now or formerly) William G &Jo Ellen Rabon as recorded in the New Hanover County Registry in deed book 2286, page 477. Bound on the East by (now or formerly) Emily Darden Motley in deed book 1724, page 631. Bound on the South by(now or formerly) Tract IA a 193 acre tract referenced in deed book 2313, page 239 Bound on the West by (now or formerly) G Allie Moore in deed book 1754, page 979,Teresa J Bigford in deed book 1652, page 111 and a 60 foot public right of way of Bertha Road and being more particularly described as follows- Commencing from a point located in the eastern 60 foot right of way of Greenview Drive and the northern 100 foot right of way of U.S. Highway 17 Thence running with the western right of way of U,S. Highway 17 North 45 degrees 29 minutes 03 seconds East 315 feet more or less to an existing iron pipe and said pipe being the southwestern comer of Tax Parcel R03600-003- 001-000. Thence leaving said right of way and running with the common property line of Mildred Williams North 54 degrees 23 minutes 19 seconds West 105.49 feet to an existing iron pipe. Thence running North 54 degrees 23 minutes 38 seconds West 70 95 feet to a new iron pipe and said pipe being the northwestern corner of New Tract 2 Thence running North 41 degrees 42 minutes 33 seconds East 80.22 feet to a new iron pipe. Thence running with the southwestern property line of Warrant Keith Rabon North 54 degrees 30 minutes 1 l seconds West 117.72 feet to an existing iron pipe. Thence running North 54 degrees 30 minutes 11 seconds West 208 11 feet to a point located in the center of a Special Highway Overlay district and said point being the Point of Beginning. Thence running North 54 degrees 30 minutes I 1 seconds West 35 63 feet to an existing iron pipe and said pipe being located in the northeastern comer of property of G Allie Moore and the southeastern comer of property of Teresa J Bigford. Thence running North 54 degrees 30 minutes 11 seconds West 180.12 fee to an existing iron pipe Thence running with the common property line of William G and Jo Ellen Rabon North 35 degrees 28 minutes 39 seconds East 265 81 fee to an existing iron pipe. Thence running with the common property ]me of Emily Darden Motley South 54 degrees 15 minutes 16 seconds East 262 44 feet to a point located in the center of the Special Highway Overlay District Thence running with a new property line for Tracts 1 A and l B South 45 degrees 29 minutes 03 seconds West 268.69 feet to the point of beginning containing 1.46 acres and being shown as Tract 1 B on a Boundary Survey Map prepared by Hobbs Surveying Company, Inc. dated June 5, 2000 to which reference is hereby made for a more full and accurate description. MAY 0 2 20119 I 4: EXHIBIT`B" TRACT TWO. BEING ALL of that certain tract or parcel of land lying and being located in Harnett Township, New Hanover County,North Carolina. Being bound on the north by (now or formerly)Mollie R. Johnson as recorded in the New Hanover County Registry in Deed Book 1397, Page 209, (now or formerly) Janice Boyd Ward in Deed Book 2165, Page 959 and the public 60 foot right-of-way of Alexander Road,bound on the east by (now or formerly) Bernard L. Morgan in Deed Book 2405, Page 264 and (now or formerly) Henry J and Monica N Pierpan in Deed Book 1998, Page 225. Bound on the south by (now or formerly) Warren Keith Rabon in Deed Book 2313, Page 239 and William G and Jo Ellen Rabon in Deed Book 2286, Page 477 Found on the south by (now or formerly) Ogden Pines in Map Book 37 at Page 387, a private 45 foot access right-of-way and (now or formerly) D. H Johnson in Deed Book 1397, Page 209 and being more particularly described as follows COMMENCING FROM a point located in the centerline of road right-of-ways Said point being located in the intersection of the public 100 foot right-of-way of U S Highway 17 (Market Street)and the public 60 foot right-of-way of Alexander Road and running with a survey. The line from said point north 56 degrees 58 minutes 41 seconds west 284 22 feet to an existing iron pipe located in the southern right-of-way of Alexander Road and said pipe being the point of beginning Thence leaving said right- of-way and running with the common property line of Bernard L Morgan south 37 degrees 04 minutes 22 seconds west 173 49 feet to an existing iron pipe Thence running south 37 degrees 18 minutes 01 seconds west 61.83 feet to an existing iron pipe Thence running with the common property line of Warren Keith Rabon north 54 degrees 15 minutes 16 seconds west 575.61 feet to an existing iron pipe Thence running with the common property line of William G. and Jo Ellen Rabon north 54 degrees 12 minutes 34 seconds west 1070.15 feet to an existing iron pipe. Thence running with a portion of the eastern property line of Ogden Pines subdivision north 40 degrees 31 minutes 54 seconds east 336 04 feet to an existing iron pipe Thence running with the common property line of Mollie R. Johnson south 51 degrees 59 minutes 26 seconds east 1323.86 feet to an existing iron pipe located in the southern right-of-way of Alexander Road. Thence running with said right-of-way with a curve to the left,having a chord bearing and distance of south 30 degrees 32 minutes 24 seconds east 86 13 feet and having a radius of 124.59 feet to a new iron pipe Thence running south 50 degrees 45 minutes 47 seconds east 222 14 feet to an existing iron pipe and said pipe being the point of beginning containing 11.19 acres and being shown on a boundary survey map prepared by Hobbs Surveying Company, inc. dated June 16, 2000, to which reference is hereby made for a more full and accurate description EGEIVEh . y MAY 0 2 2319 BY:---- .. I .. OONTY.� ► 0 2 D Q r 2 � FrTABIISNE���,, JENNIFER H. MACNEISH REGISTER OF DEEDS, NEW HANOVER 216 NORTH SECOND STREET WILMINGTON, NC 28401 gtUflfiRl Rf Rf ff fi4i Mf MftifftllftMMNtR1f H;1R1fl4f Off R1 fllMtifttlf tlfia Miffuulf RRf 1Rf R1f f4Rtl R1f fbtiRftlftfftR Filed For Registration. 11/03/2011 01:29:16 PM Book: RE 5596 Page: 1566-1575 Document No.: 2011030223 10 PGS $26.00 NC REAL ESTATE EXCISE TAX: $1,964.00 Recorder: CARTER,CAROLYN State of North Carolina, County of New Hanover PLEASE RETAIN YELLOW TRAILER PAGE WITH ORIGINAL DOCUMENT. * 2011030223 * ECEIVE ; 2011030223 ��: SOSID: 1156779 Date Filed: 5/4/2018 1:52:00 PM Elaine F. Marshall North Carolina Secretary of State STATE OF NORTH CAROLINA C2018 115 03518 DEPARTMENT OF THE SECRETARY OF STATE STATEMENT OF CHANGE OF REGISTERED E C E IV OFFICE AND/OR REGISTERED AGENT MAY 0 2 20 Pursuant to §55D-31 of the General Statutes of North Carolina, the undersigned entity submits the follow E.4 irJg,for the purpose of changing its registered office and/or registered agent in the State of North Carolina. INFORMATION CURRENTLY ON FILE The name of the entity is: Coastal Community Baptist Church The street address and county of the entity's registered office currently on file is: Number and Street: 1612 Setter Lane City: Wilmington State: NC zip Code: 28411 County: New Hanover The mailing address if different from the street address of the registered office currently on file is: Number and Street: PO BOX 12270 City: Wilmington State: NC zip code: 28405 County: New Hanover The name of the current registered agent is: Greg Hales I NEW INFORMATION 1. The street address and county of the new registered office of the entity is: (complete this item only if the address of the registered office is being changed) Number and street•. 7721 Alexander Rd. City: Wilmington state: NC Zip Code: 28411 County: New Hanover 2. The mailing address if different from the street address of the new registered office is: (complete this item only if the address of the registered office is being changed) Number and Street: PO BOX 12270 City: Wilmington State: NC zip Code: 28405 County: New Hanover 3. The name of the new registered agent and the new agent's consent to appointment appears below: (complete this item only if the name of the registered agent is being changed) Type or Print Name of New Agent •Signature&Title 4. The address of the entity's registered office and the address of the business office of its registered agent,as changed, will be identical. 5. This statement will be effective upon filing,unless a date and/or time is specified: This is the 18 day of April 2018 Coastal Community Baptist Church ryN Signature ' Greg Hales,Past (Registered Agent) Notes: Filing fee is$5.00. This document must be filed with the Secretary of State. Type or Print Name and Title R Instead of stgning here,the new registered agent may sign a separate written consent to the appointment,which must be attached to this statement. BUSINESS REGISTRATION DMSION P.0.BOX 29622 RALEIGH,NC 27626-0622 Revised July 2017 Form BE-06 SOSID:0547626 Date Filed: 1/12/2012 4:47:00 PNI Elaine F. Marshall State of North Carolina North Carolina Secretary of State Department of the Secretary of State C201136200717 ARTICLES OF ISSOD LUTION�BY DIRECTORS,MEMBERS,AND THIRD PERSONS FOR NONPROFIT CORPORATION Pursuant to§55A-14-04 of the General Statutes of North Carolina,the undersigned corporation hereby submits the.following Articles of Dissolution for the purpose of dissolving the corporation. 1. The name of the corporation is North Grove Evangelical Presbyterian Church 2. The names,titles,and addresses of the officers of the corporation are- Dr.Bryan A.Slater;Pastor;7721 Alexander Road.Wilmington,NC. 3. The names and addresses of the directors of the corporation are: Mr.William Noland,1842 Cadbe Ct,Wilmington,NC 28409 Mr Willis Adair,81 Marble Dr.,Rocky Point,NC 28457 4. Attached is the plan of dissolution as required by N.C.G.S.§55A-14-03. $-eel 5. The dissolution of the corporation was authorized on the 34th day of October ,2011 _ 7 6. (Check a, b,and/or, c, as applicable.) a. ✓ Approval of members was not required for the dissolution,and the plan of dissolution was approved by a sufficient vote of the board of directors. b. Approval of the members was required for the dissolution,and the plan of dissolution was approved as required by Chapter 55A of the North Carolina General Statutes. C. _Approval of the dissolution by some.person or persons other than the-members or the-board of directors was required. pursuant to N.C.G.S.§55A-I 4-02(a)(3),and such approval was obtained. 7. These articles will be effective upon filing,unless a delayed date and/or time is specified This the 23rd day of December 2011 North Grove Evangelical Presbyterin Church Name of Co at'on Signature Bryan A.Slater Lez Type or Print Name—d Title ECEOVEP MAY 0 2 '"1 Notes: 1. Filing fee is$15. This document and one exact or conformed ropy of these articles most be filed with the Secretary of State. (Revised January 2000) (Form N-06) CORPORATIONS DIVISION P.O.BOX 29622 RALEIGH,NC 27626-0622 -- Jan•11.2012 12:38 PM YAHWEH CENTER CHILDREN S VILL 9106753405 1/1 NORTH GROVE Evangelical presoyterlan Church Wd/K/ng/n Wt love together,9nd9N/nBk Bway.. To Whom It May Concern: All liabilities and bills were paid for by North Grove Evangelical Presbyterian Church before we closed the doors on this church, To further clarify dissolution of this church, every asset which was a part of North Grove Evangelical Presbyterian Church was given to Grace Evangelical Presbyterian Church, for the work of ministry of that church. Sincerely, Dr. ryan A Slater, pastor and evangelist N. P ,;Y J 2 2+319 bv: i i Dr.Bryan A. glater•910-S47-8e91(Ce1D•emall, bslatermbizee.mcom 7721 Alexander izpad • Wllm109W11, NC 289u • Church Phone: 910-601.OW 'Fax: 910-681-020.9 . Church emalit ngepc@blzec.rr.com • www.nor h9rove.orm i Operation & Maintenance Agreement Project Name: Coastal Community Baptist Church Project Location: 7721 Alexander Road Cover Page Maintenance records shall be kept on the following BMP(s). This maintenance record shall be kept in a log in a known set location. Any deficient BMP elements noted in the inspection will be corrected, repaired, or replaced immediately. These deficiencies can affect the integrity of structures, safety of the public, and the pollutant removal efficiency of the BMP(s). The BMP(s)on this project include(check all that apply&corres onding O&M tables will be added automatically): Bioretention Cell Quantity: Location(s): Dry Detention Basin Quantity: Location(s): Grassed Swale Quantity: Location(s): Green Roof Quantity: Location(s): Infiltration Basin Quantity: Location(s): Infiltration Trench Quantity: Location(s): Level SpreaderNFS Quantity: Location(s): Permeable Pavement Quantity: Location(s): Proprietary System Quantity: Location(s): Rainwater Harvesting Quantity: Location(s): Sand Filter Quantity. Location(s): Stormwater Wetland Quantity: Location(s): Wet Detention Basin Quantity: 2 Location(s): front and rear of properly Disconnected Impervious Area Present: No Location(s): User Defined BMP Present: No Location(s): I acknowledge and agree by my signature below that I am responsible for the performance of the maintenance procedures listed for each BMP above, and attached O&M tables. I agree to notify NCDENR of any problems with the system or prior to any changes to the system or responsible party. ' Responsible Party: Greg Hales Title& Organization: Pastor, Coastal Community Baptist Church Street address: 7721 alexander Road City, state, zip: Wilmington, NC 28411 Phone number(s): 910-686-7775 Email: bmorgan@@n/paragonwilmington.com Signature:x. x4v /t� y Date: Q� lc I, k .( c r a Notary Public for the State of �pj//'�- County of C do hearby certify that (J L-le personally appeared before me this 9-�X- day of L.U( and acknowledge the due execution of the Operayoac,and Main tena/nncee Agreement. Witness my hand and official seal, / 2019 lr; ! 0Y Seal . "!'rr?,'•" My commission expires STORM-E7_ 4/2/2019 Version 1.4 O&M Manual Page 1 of 4 • Wet Detention Pond Maintenance Requirements The wet detention basin system is defined as the wet detention basin, pretreatment including forebays and the vegetated f lterif one is provided. Important maintenance procedures: Immediately after the wet detention basin is established, the plants on the vegetated shelf and perimeter of the basin should be watered twice weekly if needed, until the plants become established(commonly six weeks). No portion of the wet detention pond should be fertilized after the first initial fertilization that is required to establish the plants on the vegetated shelf. Stable groundcover should be maintained in the drainage area to reduce the sediment load to the wet detention basin. If the basin must be drained for an emergency or to perform maintenance,the flushing of sediment through the emergency drain should be minimized to the maximum extent practical. - Once a year, a dam safety expert should inspect the embankment. After the wet detention pond is established, it should be inspected once a month and within 24 hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal County). Records of operation and maintenance should be kept in a known set location and must be available upon request. Inspection activities shall be performed as follows. Any problems that are found shall be repaired immediately. BMP element: Potential problem: How I will remediate the problem: The entire BMP Trash/debris is present. Remove the trash/debris. The perimeter of the BMP Areas of bare soil and/or Regrade the soil if necessary to remove the gully, and then plant a erosive gullies have formed. ground cover and water until it is established. Provide lime and a one- time fertilizer application. Vegetation is too short or too Maintain vegetation at a height of approximately six inches. long. The inlet device The pipe is clogged. Unclog the pipe. Dispose of the sediment off-site. The pipe is cracked or Replace the pipe. otherwise damaged. Erosion is occurring in the Regrade the swale if necessary to smooth it over and provide erosion Swale. control devices such as reinforced turf matting or riprap to avoid future problems with erosion. Stone verge is clogged or Remove sediment and replace with clean stone. covered in sediment(if applicable). The forebay Sediment has accumulated to Search for the source of the sediment and remedy the problem if a depth greater than the possible. Remove the sediment and dispose of it in a location where it original design depth for will not cause impacts to streams or the BMP. sediment storage. Erosion has occurred. Provide additional erosion protection such as reinforced turf matting or riprap if needed to prevent future erosion problems. Weeds are present. Remove the weeds, preferably by hand. If pesticide is used,wipe it on the plants rather than spraying. The vegetated shelf Best professional practices Prune according to best professional practices show that pruning is needed to maintain optimal plant health. Plants are dead, diseased or Determine the source of the problem: soils, hydrology,disease, etc. dying. Remedy the problem and replace plants. Provide a one-time fertilizer application to establish the ground cover if a soil test indicates it is necessary. Weeds are present. Remove the weeds, preferably by hand. If pesticide is used,wipe it on the plants rather than spraying. rMA; EY 0 2 2019 STORM-EZ 41212019 version 1.4 O&M Manual BY:--- Page 2 of 4 I Wet Detention Pond Maintenance Requirements (Continued) I The main treatment area Sediment has accumulated to Search for the source of the sediment and remedy the problem if a depth greater than the possible. Remove the sediment and dispose of it in a location where it original design sediment will not cause impacts to streams or the BMP. storage depth. Algal growth covers over 50% Consult a professional to remove and control the algal growth, of the area. Cattails, phragmites or other Remove the plants by wiping them with pesticide(do not spray), invasive plants cover 50%of the basin surface. The embankment Shrubs have started to grow Remove shrubs immediately. on the embankment. Evidence of muskrat or beaver Use traps to remove muskrats and consult a professional to remove activity is present. beavers. A tree has started to grow on Consult a dam safety specialist to remove the tree. the embankment. An annual inspection by an Make all needed repairs. appropriate professional shows that the embankment needs repair. (if applicable) The outlet device Clogging has occurred. Clean out the outlet device. Dispose of the sediment off-site. The outlet device is damaged Repair or replace the outlet device. The receiving water Erosion or other signs of Contact the local NC Department of Environment and Natural damage have occurred at the Resources Regional Office. outlet. The measuring device used to determine the sediment elevation shall be such that it will give an accurate depth reading and not readily penetrate into accumulated sediments. MAY 0 2 2`3 I; WY; STORM-EZ 4/2/2019 Version 1.4 O&M Manual Page 3 of 4 I Wet Detention Pond Design Summary I Wet Pond Diagram WET POND ID FOREBAY MAIN POND Permanent Pool El. 33 Permanent Pool El. 33 Temporary Pool El: 34.65 Temporary Pool El: 34.65 Pretreatment other No Clean Out Depth: 2.25 Clean Out Depth: 4.875 than forebay? Sediment Removal EI: 30.75 Sediment Removal El: 28.125 Has Veg.Filter? [:Ye.:] Bottom Elevation: 30 Bottom Elevation: 28 WET POND ID FOREBAY MAIN POND Permanent Pool El. 38 Permanent Pool El. 38 Temporary Pool El: 39 Temporary Pool El: 39 Pretreatment other No Clean Out Depth: 2.25 Clean Out Depth: 3.75 than Forela Sediment Removal El: 35.75 Sediment Removal El: 34.25 Has Veg.Filter? Yes Bottom Elevation: 35 Bottom Elevation: 33 ECEIVE MAY 0 2 2019 av: STORM-EZ 4/2/2019 Version 1.4 O&M Manual Page 4 of 4 DEMLR USE ONLY Da t Re eived Fee Paid Permit Number J - 08 85a db 05 — 1 sw D NC DEQ Division of Energy, Mineral and Land Resources STATE STORMWATER: PERMIT TRANSFER APPLICATION FORM LA Pursuant to 15A NCAC 02H.1045 and other applicable statues as reference within Only complete applications packages will be accepted and reviewed. This form and the required items(with original signatures)must be sent to the appropriate DEMLR Regional Office, which can be determined by locating the project on the interactive online map at: http//deo nc pov/contact/regional-offices. After this application is accepted, DEMLR will conduct a compliance inspection and report any deficiencies to the current permittee and/or the proposed pennittee. Per the state stormwater rules and the state stormwater permit conditions, the permit shall not be transferred until: 1. the current permittee resolves all non-compliance issues identified in the inspection report; 2. the current permittee negotiates a resolution with the proposed permittee(in writing and signed by both entities. The negotiated resolution must identify the necessary actions, the responsible party(ies), and the timelines to correct the deficiencies. The site must either be found in compliance or a copy of the negotiated resolution must be submitted prior to the transfer of the permit.);or 3. in the case where a transfer falls under G.S. 143-214.7(c2l (see also SL 2011-256), the proposed permittee resolves all non-compliance issues upon acquiring the permit. Signature requirements for the named signing official(for current and proposed permittee) must meet the following: • Corporation-a principal executive officer of at least the level of vice-president; • Limited Liability Company(LLC)-the designated manager, (Documentation from the NC Secretary of State or other official documentation must be provided that states the titles and positions held by the person who signed the application(pursuant to 02H.1040) that shows they have legal authority to sign for the LLC) • Municipality-a ranking official or duly authorized employee; • Partnership or limited partnership- the general partner, • Sole proprietor, • The signature of the consultant or other agent shall be accepted on this permit transfer application only if accompanied by a letter of authorization signed by one of the signatories noted in a-e above, as applicable. A. GENERAL INFORMATION 1. State Stormwater Permit Number: SW8 010405 2. Project name: Coastal Community Baptist Church Is this an updated project name from the current permit? ®Yes ❑ No 3. Reason for the permit transfer request: Change of ownership E �� � MAY 0 2 Stormwater Permit Transfer Application Form Page 1 of 7 April 27, 2018 B. PERSON(S) WHO HAVE SIGNED THIS FORM (select only one response below) ❑ 1. Both the current and proposed permittees ❑ 2. Only the current permittee of a condominium or planned community (skip Part F&G). In accordance with G.S. 143-214.7(c2) (see also SL 2011-256), this type of transfer is allowed only when all of the following items can be trrthfully checked: ❑ Any common areas related to the operation and maintenance of the stormwater management system have been conveyed to the unit owners' association or owners' association in accordance with the declaration; ❑ The declarant has conveyed at least fifty percent(50%) of the units or lots to owners other than a declarant(provide documentation per submittal requirements below); ❑ The stormwater management system is in compliance with the stormwater permit. NOTE: If subdivision was built prior to 1999, the Declarant's Attorney can make a determination that the elements of the Planned Community Act(see§47F) have been met by the Declarant for the subdivision. If the Declarant chooses to use this type of transfer, the determination must be in writing, signed by the attorney, and submitted to DEMLR with this form. ® 3. Only the proposed permittee(skip Part D below). In accordance with G.S. 143-214.7(c5) (see also SL 2013-121), this type of transfer is allowed only when all of the following items can be truthfully checked: ® a. The proposed permittee is either(select one of the following): ® The successor-owner who holds title to the property on which the permitted activity is occurring or will occur; ❑ The successor-owner who is the sole claimant of the right to engage in the permitted activity. ® b. The current permittee is(select at least one of the following, but all that apply): ❑ A natural person who is deceased. ® A partnership, Limited Liability Corporation, corporation, or any other business association that has been dissolved ❑ A person who has been lawfully and finally divested of title to the property on which the permitted activity is occurring or will occur. ❑ A person who has sold the property on which the permitted activity is occurring or will occu r. ❑ Other(please explain): ® c. The proposed permittee agrees to the following requirements (all must be selected): ® There will be no substantial change in the permitted activity. ® The permit holder shall comply with all terms and conditions of the permit until such time as the permit is transferred. ® The successor-owner shall comply with all terms and conditions of the permit once the permit has been transferred. ECEOV , MAY 0 2 2019 'Y: _. Stormwater Permit Transfer Application Form Page 2 of 7 April 27, 2018 C. SUBMITTAL REQUIREMENTS Please mark"Y"to confirm the items are included with this form. Please mark"X"if previously provided. If not applicable or not available, please mark N/A.: Y 1. A processing fee of five hundred and five dollars($505.00) per G.S. 143-215.3D(e)(2). Y 2. Two hard copies (with original signatures) and one electronic copy of this completed form and the required items. Y 3. For proposed permittees that are corporations or LLC's, documentation from the NC Secretary of State demonstrating that the proposed permittee is a legal and viable entity able to conduct business in North Carolina. Y 4. If Part B, Items 1 or 3 of this form is selected, the signed and notarized applicable O&M agreement(s)from the proposed permittee, as required by the permit. Y 5. Legal documentation that the property has transferred to the proposed permittee (such as a recorded deed for the property, uncompleted development and/or common areas) or legal documentation demonstrating that the proposed permit ee is the sole claimant of the right to engage in the permitted activity. Y 6. If required by the permit and if the project has been built, a signed, sealed and dated certification document from a licensed professional stating that the stormwater management system has been inspected and that it has been built and maintained in accordance with the approved plans. NA 7. A copy of the recorded covenants and deed restrictions, if required by the permit. If the project has been built, documentation that the maximum allowed per lot built-upon area or the maximum allowed total built-upon area has not been exceeded. If the project has not been built, the new owner shall provide a signed agreement to submit final recorded deed restrictions and protective covenants. NA 8. If transferring under G S 143-214.7(c2) (i.e., Part B, Item 2 of this form is selected), documentation verifying that 50% or more of the lots have been conveyed to individuals(not builders). Copies of the deeds of conveyance or a chart listing the lot number, lot address, owner's name, conveyance date and deed book and page number are acceptable. Y 9. If transferring under G S 143-214.7(c5) (i.e., Part B, Item 3 of this form is selected), provide legal documentation supporting the dissolution of the corporation or documentation supporting the current permittee was lawfully and finally divested of title of the property. NA 10. A copy of the lease agreement if the proposed permittee is the lessee. NA 11. A copy of the pending sales agreement if the proposed permittee is the purchaser. NA 12. A copy of the development agreement if the proposed permittee is the developer. ECEWL MAY 0 2 2019 Stormwater Permit Transfer Application Form Page 3 of 7 April 27, 2018 D. CURRENT PERMITTEE INFORMATION AND CERTIFICATION Please be sure to provide Email. 1. Current Permit Holder's Company Name/Organization: North Grove Evangelical Presbyterian Church 2. Signing Official's Name: 3. Signing Official's Title: 4. Mailing Address: City: State: -ZIP : 5. Street Address: City: State: -ZIP : _ 6. Phone: Email: I, the current permittee, am submitting this application for a transfer of ownership for the above listed stormwater permit under the General Statute and Session Law identified on Page 1 of this application. I hereby notify DEMLR of the sale or other legal transfer of the property/project and/or the stormwater system associated with this permit. I have provided a copy of the following documents to the proposed permittee named in this application form: (select all that apply) ❑ the most recent permit; ❑ the designers certification for each SCM; ❑ any recorded deed restrictions, covenants, common areas, drainage easements or plats; ❑ the approved plans and/or approved as-built plans; ❑ the approved operation and maintenance agreement; ❑ past maintenance records from the previous permittee (where required); ❑ a copy of the most recent inspection report; I further attest that this application and request for a permit transfer is accurate and complete to the best of my knowledge. I attest that I have provided all of the required items per the law to transfer this permit. I understand that if all required parts of this request are not completed or if all required supporting information and attachments listed above are not included, this request package will be returned as incomplete I assign all rights and obligations as permittee to the proposed permittee named below. I understand that this request to transfer the permit may not be approved by the DEMLR unless and until the facility is in compliance with the permit. Signature: Date: a Notary Public for the State of County of , do hereby certify that personally appeared before me this the day of 20 , and acknowledge the due execution of the forgoing instrument. Witness my hand and official seal, (Notary Seal) g ECEI �4' Notary Signature: MAY 0 2 2019 My commission expires Y. Stormwater Permit Transfer Application Form Page 4 of 7 April 27, 2018 E. PROPOSED PERMITTEE INFORMATION 1. The proposed permittee is the: ® Property owner(Also complete Part F.) ❑ Home Owners Association (HOA), Property Owners Association (PDA),or Unit Owner Association (UOA) (Also complete Part F.) ❑ Lessee-Attach a copy of the lease agreement. Both the lessee and the property owner will appear on the permit as co-permittees. If the lease is terminated, responsibility for the permit reverts to the property owner. (Also complete Parts F&G.) ❑ Purchaser-Attach a copy of the pending sales agreement. The permit will require submission of a copy of the recorded deed after the purchase has taken place. If the purchase agreement is cancelled the permit reverts to the property owner. (Also complete Parts F& G.) ❑ Developer-Attach a copy of the development agreement. Both the developer and the property owner will appear on the permit as co-permittees. If the development agreement is terminated, responsibility for the permit reverts to the property owner. (Also complete Parts F&G.) 2. Proposed permittee name (check one of the following and provide the name): ® Corporation, LLC, Partnership, Municipality name: Coastal Community Baptist Church ❑ HOA/POA/UOA name: ❑ Sole Proprietor 3. Proposed permittee contact information: Please be sure to provide Email. a. Signing Official's Name: Greg Hales b. Signing Official's Title: Pastor c. Mailing Address: P.O. Box 12270 City: Wilmington State: NC ZIP : 28405 d. Street Address: 7721 Alexander Road City: Wilmington State: NC ZIP : 28411 e. Phone: (91 )686-7775 Email: bmorganaparagonwilmington com 4. If there is a Management Entity that manages the property for an HOA, PDA or UOA, please provide: Please be sure to provide Email. a. Management Company or Business name: b. Contact Name: Title: c. Mailing Address: d. City: State: ZIP: e. Phone: (_) Email: E C E 19S' IC i. MAY 0 2 2019 .y: Stormwater Permit Transfer Application Form Page 5 of 7 April 27, 2018 F. PROPOSED PERMITTEE CERTIFICATION I,Greg Hale , hereby notify the DEMLR that I have acquired through sale,lease; development agreement, or other legal transfer,the project/property covered by the stormwater management permit and/or the responsibility for constructing and/or operating and maintaining the permitted stormwater management system. I acknowledge and attest that I have received a copy of: (select all that apply): ® the most recent permit; ❑ the designer's certification for each SCM; ❑ any recorded deed restrictions, covenants, common areas, drainage easements or plats; ❑ the approved plans and/or approved as-built plans; ❑ the approved operation and maintenance agreement; ❑ past maintenance records from the previous permittee (where required); ❑ a copy of the most recent inspection report; ® Check here if the proposed permittee agrees to be the entity responsible for addressing any compliance issues outlined in the Compliance Inspection Report. If checked, the proposed permittee must provide a written document statement, with a 'plan of action and schedule"addressed to this office stating that they will bring the project into compliance upon receipt of the transferred permit. This written "plan of action and schedule"must be received by the Division before the Division will transfer the permit. I have reviewed the permit, approved plans and other documents listed above, and I acknowledge that I will comply with the terms and conditions of the permit. I will construct the project's built-upon area as shown on the approved plans; and I will{construct}, operate and maintain the approved stormwater management system pursuant to the requir ments li ted' the permit and in the operation and maintenance greement. Signature: ��4 Date: -- 0Z , a here Notary Public for the State i gq� C County of do by certify that ��cs7 personally appeared before me this the /3 hL day of �t' 2gJ and acknowledge the due execution of the forgoing instrument.Witness my hand and official seal, • r �'Notary`Signature J r „ My commission expires MAY 0 2 2,' q BY: stormwater Permit Transfer Application Form Page 6 of 7 April 27,2018 G. PROPERTY OWNER INFORMATION AND CERTIFICATION Fill out this section only if the property owner is different from the proposed permittee. The permit will revert to the property owner if the purchase agreement, development agreement or lease expires or is terminated. Company Name/Organization: Signing Official's Printed Name: Signing Official's Title: Mailing Address: City: State: ZIP : Phone: (_) Email: 1, , hereby certify that I currently own the property identified in this permit transfer document and acknowledge that the Proposed Permittee listed in Part F will be purchasing the property, developing the property on my behalf, and/or leasing the property from me. A copy of the purchase agreement, development agreement or the lease agreement,which names the party responsible for the construction and/or operation and maintenance of the stormwater system, has been provided with the permit transfer request. I agree to notify DEMLR within 30 days if there are any changes to the purchase, developer or lease agreements and will submit the applicable completed and signed Permit Information Update Form, or Permit Transfer Application Form to address these changes. As the legal property owner, I acknowledge, understand, and agree by my signature below, that the permit will revert to me and I will be responsible for complying with the DEMLR Stormwater permit if the property purchase, lease or developer agreement/contract is cancelled or defaults. I understand that any individual or entity found to be in noncompliance with the provisions of the stormwater management permit or the stormwater rules, is subject to enforcement action as set forth in NC General Statute (NCGS) 143,Article 21. Signature of the property owner Date: a Notary Public for the State of County of , do hereby certify that personally appeared before me this the day of 20 , and acknowledge the due execution of the forgoing instrument. Witness my hand and official seal, (Notary Seal) Notary Signature My commission expires EC MAY 0 ? ' 7i Stormwater Permit Transfer Application Form Page 7 of 7 April 27, 2018 TRIPP ENGINEERING, P.C. 0 419 Chestnut Street Wilmington, North Carolina 28401 Phone: (910) 763-5100 • FAX: (910) 763-5631 May 2, 2019 NCDEQ Division of Energy, Mineral and Land Resources 127 Cardinal Drive Wilmington, NC 28405-3845 Attn: Ms. Kelly Johnson Re: Coastal Community Baptist Church (formerly North Grove Evangelical Presbyterian Church) Permit No. SW8 010405 TE 17048 Dear Kelly: We are requesting a transfer of ownership, permit renewal and minor modification of existing stormwater permit SW8 010405. Enclosed please find the following items for review: • Transfer Application • Renewal Application • Minor Modification Application • 2 $505 checks • 2 Plans • Operation & Maintenance Agreement • Copy of the Deed • Secretary of State info • Articles of Dissolution • Disk • Engineer's Certification is pending completion of pond maintenance and will be provided as soon as the work is finished. Please review for approval and contact us with any questions, comments or if you need additional information. Thank you. Since ely, Tri p ngin BrAg, C.Phillip . Tripp MAY 0 2 2019 PGT:dcb pyi Enc. ill �4 0 NCDENR North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Coleen H. Sullins Dee Freeman Governor Director Secretary April 9, 2010 North Grove Evangelical Presbyterian Church 804 Valley Forge Court Wilmington, NC 28411 Subject: PERMIT RENEWAL REQUEST Stormwater Permit No. SW8 010405 North Grove Evangelical Presbyterian Church Site New Hanover County Dear Pastor: The Division of Water Quality issued a Coastal Stormwater Management Permit, Number SW8 010405 to North Grove Evangelical Presbyterian Church Site for a High Density Project on June 1, 2001. This permit expires on June 1, 2011. Per 15A NCAC 2H.1003(h) (the stormwater rules), applications for permit renewals shall be submitted 180 days prior to the expiration of a permit and must be accompanied by a processing fee, which is currently set at $505.00. 1 f this is still an active project please complete and submit the enclosed renewal application prior to December 1, 2010. If this project has not been constructed and a permit is no longer needed, please submit a request to have the permit rescinded. If you have sold the project, or are no longer the permittee, please provide the name, mailing address and phone number of the person or entity that is now responsible for this permit. Enclosed is a form for change of ownership, which should be completed and submitted if the property has changed hands. Your permit requires that upon completion of construction and prior to operation of the permitted stormwater treatment system, a certification of completion be submitted to the Division from an appropriate designer for the type of system installed. This is to certify that the permitted facility has been installed in accordance with the permit, the approved plans, specifications and supporting documentation. Please include a copy of the certification with your permit renewal request and processing fee. Enclosed is a copy of a sample certification. Also enclosed is a new Operation and Maintenance agreement that should be completed and submitted along with your renewal application. You should be aware that failure to provide the Designer's Certification and the operation of a stormwater treatment facility without a valid permit, are violations of NC General Statute 143-215.1 and may result in appropriate enforcement action including the assessment of civil penalties of up to $10,000 per day. If you have any questions, please feel free to contact David Cox at 910-796-7318. Sincerely, Georgette S6ott, Stormwater Supervisor Surface Water Protection Section Wilmington Regional Office Enclosures GDS/dwc S:\WQS\Stormwater\Renewal\Requests\2001\010405.aprl0 cc: Wilmington Regional Office File Wilmington Regional Office 127 Cardinal Drive Extension,Wilmington,North Carolina 28405 One Phone:910-796-72151 FAX:910-350-2004\Customer service:1-877-623-6748 North Carolina. Internet:www.ncwaterqualiiiy.org Naturally ��1'/Nn//� An Equal Opportunity l Alterative Action Employer (.i/�/ `ural �QF W Michael F. Easley, Governor O G Division of Water Quality William G. Ross, Jr., Secretary co y North Carolina Department of Environment and Natural Resources r —I Alan W. Klimek, P.E., Director O C Wilmington Regional Office November 19, 2002 Rev. William Solomon North Grove Evangelical Presbyterian Church 804 Valley Forge Court Wilmington, NC 28411 Subject: REQUEST FOR ENGINEER'S CERTIFICATION Stormwater Project No. 010405 North Grove Evangelical Presbyterian Church Site New Hanover County Dear Rev. Solomon: On June 1, 2001, the Division of Water Quality issued a Stormwater Management Permit for North Grove Evangelical Presbyterian Church Site. Per the terms and conditions of the permit, and Stormwater Regulation 15A NCAC 2H.10086), which stipulates the following: "Upon completion of construction, the designer for the type of Stormwater system installed must certify that the system was inspected during construction,was constructed in substantial conformity with plans and specifications approved by the Division and complies with the requirements of this Section prior to issuance of the certificate of occupancy." As of this date, our records indicate the required designer's certification has not been received. Operation of the stormwater system prior to submission of the required certification is a violation of NCAC 2H.10080)in accordance with NCGS 143-215.6. Construction is considered complete at the time the project is occupied by an owner or tenant for its intended use.Please submit the required certification by December 19, 2002. Failure to submit the certification is considered a violation of the permit, and is subject to enforcement action, per NCGS 143-215.6A. If you have any questions concerning this matter, please call me at (910) 395-3900. Sincerely, Linda Lewis Environmental Engineer RSS/arl: S:\WQS\STORMWAT\PEREQ\010405.Nov 02 cc: Phil Tripp Tony Roberts, New Hanover County Inspections Linda Lewis Central Files NCDENR N.C. Division of Water Quality 127 Cardinal Drive Extension Wilmington, N.C.28405 (910)395-3900 Fax(910)350-2004 Customer service 800-623-7748 North Grove Evangelical Presbyterian Church Site Stormwater Permit No. SW8 010405 New Hanover County Designer's Certification I, as a duly registered in the State of North Carolina, having been authorized to observe (periodically/weekly/full time) the construction of the project, Iect) (Pro for (Project Owner) hereby state that, to the best of my abilities, due care and diligence was used in the observation of the project construction such that the construction was observed to be built within substantial compliance and intent of the approved plans and specifications. Required Items to be checked for this certification to be considered complete are on page 2 of this form. Noted deviations from approved plans and specifications: SEAL Signature Registration Number Date cc: Tony Roberts, New Hanover County Building Inspections 2 PE Certification Requirements: 1. The drainage area to the system contains approximately the permitted acreage. Z The drainage area to the system contains no more than the permitted amount ofbuilt-upon area. 3. All the built-upon area associated with the project is graded such that the runoff drains to the system. 4. The outlet/bypass structure elevations are per the approved plan. 5. The outlet structure is located per the approved plans. 6. Trash rack is provided on the outlet/bypass structure. 7. All slopes are grassed with permanent vegetation. S. Vegetated slopes are no steeper than 3:1. 9. The inlets are located per the approved plans and do not cause short-circuiting of the system. 10. The permitted amounts of surface area and/or volume have been provided. 11. Required drawdown devices are correctly sized per the approved plans. 12. All required design depths are provided. 13. All required parts of the system are provided, such as a vegetated shelf, forebay. and vegetated filter. 14. The overall dimensions of the system, as shown on the approved plans, are provided. S:\WQS\STORMWAT\PEREQ\010405.Nov 02 cc: Tony Roberts, New Hanover County Building Inspections 3 �X New Hanover County P1r1 • Engineering Department pwZ4O 414 Chestnut Street OCT I)Wilmington, North Carolina 2$ 1Jy (910) 341-7139 U Beth Easley Wetherill, CPESC Soil Erosion Specialist SEDIMENTATION INSPECTION REPORT Project Grading Permit #: cal, —p / Project: 110,2 J..6 (], n>Q 7L /o ,1 QE / r Q Y / � Project Location: r Person(s)Financially Responsible kJiz4,f, C' o- �{10h ,��Q D °�T�( sca_a r , t.4 rL Address: �3 D g-- Ve,,A Ln✓�e� catz'Al t' I A Q 4-6, r Fr - �Y-j J 1. Pictures: Yes No #_ Weather&Soil Conditions:�y� 7 ` 2. Is site currently under Notice of Violation: Yes S 3. Is the site in compliance with NHC Soil Erosion &Sedimentation Control Ordinance? Yes No Circle violations below: 4. Violations: (Circle letter) (A) No approved plan. (B Failure to follow approved plan. (C) Failure to submit revised plan. (D) Failure to provide adequate ground cover. (E) Insufficient measures to retain sediment on site. F Failure to take all reasonable measures. (G) Inadequate buffer zone. (H) Graded slopes &fills too steep. I Unprotected exposed slopes. (J) Failure to maintain erosion control measures. (K) NPDES Problems (L)Other(describe) 5. Has off-site sedimentation occurred since last inspection?Yese Degree: Slight Moderate Severe 6. Contactmadewith Title: Inspection report briven/sent N-.o I L-c/ .5 I tIo 7. Inspection Report sent to person(s) responsible: � I ).D h i'f pd C"n' Date sent /T—Z' 8. Corrective Actions Needed: _ / L�t` I f 2 •`..a /�I/1 P LJ42 �'N C�� �.l•(//�1�r i lam✓/ �//i 1 .'L /I.3 11( d/1-/ -19 YC. a �, .� .�r CT �-, C C./� .f i a .'�- o N ��. C �j<•. /i+•�. b r; /-:.. r r h 4-'`: C if-riv c �'l.�r . Ot p n f t Adir C/—nG rM er yen rY JPy y'r K,) Q/ri ✓r / =Le �/ cw 4 ((v/S :n Jl e �� r c r AM f!✓ ,S �—i J�U eY- J 4 41 -4 C Y` (j eJ7 �e J/-VG�Vre r Report By: 0, ve ; :.{{, P,,r Date: -'` e 7_ Others present: �d:�h. ✓rile,?�4 s"-Tf 11 Time to Comply: