SW8980729_Current Permit_20230718

ROY COOPER , ``,
Governor
ELIZABETH S.BISER. .
Secretary
DOUGLAS R.ANSEL NORTH CAROLINA
frrterimnirector Environmental Quality
July 18,2023
Dosher Memorial Hospital
Attn: Susan Daniels, CFO
924 Howe Street
Southport,NC 28461
Subject: Permit Correction
Stormwater Permit No. SW8 980729
Dosher Memorial Hospital
Brunswick County
Dear Ms.Daniels:
The Wilmington Regional Office was recently notified that the subject permit issued on June 22,2023,contained
an error. This permit correction is necessary to correct the expiration date from January 31,2024 to January 31,
2034.Please replace the previously issued permit with the enclosed correct permit.
This project is subject to the conditions and limitations as specified in the corrected permit. Please pay special
attention to the conditions listed in this permit regarding the Operation and Maintenance of the BMP(s),
recordation of deed restrictions, certification of the project,procedures for changes of 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 150B of the North Carolina General Statutes,and must be filed with the
OAH within thirty(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.NCOAH.com.Unless
such demands are made this permit shall be final and binding.
If you have any questions,need additional copies of the permit or approved plans,please contact Ashley Smith
with DEMLR in the Wilmington Regional Office at(910)796-7215 or [e-mail].
CA1PAr.-3.9111
Douglas R.Ansel,Interim Director
Division of Energy,Mineral and Land Resources
Enclosures: Attachment C—Permitting History
DES/ams: \\\Stormwater\Permits&Projects\1998\980729 HD\2023 07 permit correction 980729
cc: John S.Tunstall,PE;Norris&Tunstall,Consulting Engineers,PC
Wilmington Regional Office Stormwater File
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Northington lte Carolinagt.Donalepartment o1 f 12 Environmental
Dri QualityExtensi I Division1 ofilmington EnergyNorth.MmeraI and Land.1eesources28405
Office Cardve on 1N . CaroCma
.NORTH CAROLINA
n.p.en.aoe[a......q 910.796.7215

Post-Construction Stormwater Management
Permit No. SW8 980729
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
POST-CONSTRUCTION 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
J.A. Dosher Memorial Hospital
924 N. Howe Street, Southport, Brunswick County
FOR THE
construction, operation and maintenance of a wet detention pond in compliance with the provisions of 15A
NCAC 2H .1000 (hereafter referred to as the "stormwater rules') and as outlined in the application, approved
stormwater management plans, supplement, calculations, operation and maintenance agreement, recorded
documents, specifications, and other supporting data (the "approved plans and specifications") as attached
and/or on file with and approved by the Division of Energy, Mineral and Land Resources (the "Division" or
"DEMLR"). The project shall be constructed, operated and maintained in accordance with these approved
plans and specifications. The approved plans and specifications are incorporated by reference and are
enforceable part of this permit.
This permit shall be effective from the date of issuance until January 31, 2034 and shall be subject to the
following specified conditions and limitations. 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 condition. The issuance of this permit does not prohibit the Director from
reopening and modifying the permit, revoking and reissuing the permit, or terminating the permit for cause as
allowed by the laws, rules, and regulations contained in Title 15A NCAC 2H.1000 and NCGS 143-215.1 et.al.
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 on
page 2 of this permit. The stormwater control has been designed to handle the runoff from 303,345
square feet of impervious area.
3. The tract will be limited to the amount of built-upon area indicated on page 2 of this permit, and per
approved plans. The built-upon area for the future development is limited to 5,662 square feet.
4. All stormwater collection and treatment systems must be located in either dedicated common areas or
recorded easements. The final plats for the project will be recorded showing all such required
easements, in accordance with the approved plans.
5. 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.
Page 1 of 5

Post-Construction Stormwater Management
Permit No. SW8 980729
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
Project Name: J.A. Dosher Memorial Hospital
Permit Number: SW8 980729
Location: Brunswick County
Applicant: Ms. Susan Daniels
Mailing Address: J.A. Dosher Memorial Hospital
924 Howe Street
Southport, NC 28461
Application Date: June 2, 2023
Name of Receiving Stream/Index#: Cape Fear/ UT Price Creek/3-6-17
Classification of Water Body: "SC Sw"
Pond Depth, feet: 7.5
Permanent Pool Elevation, FMSL: 14.10
Drainage Area, acres: 9.95
Total Impervious Surfaces, ft2: 303,345
Buildings, ft2: 130,828
Parking, ft2: 138,821
Sidewalks, ft2: 30,753
Future, ft2: 2,943
Offsite Area entering Pond, ft2: None, per engineer
Required Surface Area, ft2: 9,967
Provided Surface Area, ft2: 14,503
Required Storage Volume, ft3: 27,446
Provided Storage Volume, ft3: 32,187
Temporary Storage Elevation, FMSL: 16.10
Controlling Orifice: 2" pipe
II. SCHEDULE OF COMPLIANCE
1. The stormwater management system shall be constructed in it's 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 and vegetated filter.
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, flow spreader, 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.
Page 2 of 5

Post-Construction Stormwater Management
Permit No. SW8 980729
5. Decorative spray fountains will be allowed in the stormwater treatment system if calculations are
provided documenting the permanent pool volume is greater than 30,000 cubic feet.
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. A modification may be required
for those deviations.
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. Prior to the sale or lease of any portion of the property, the permittee shall notify DWQ and provide the
name, mailing address and phone number of the purchaser or leasee. 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 or lease of any portion of the property.
10. The permittee is responsible for verifying that the proposed built-upon area does not exceed the
allowable built-upon area.
11 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.
12. No person or entity, including the permittee, shall alter any component shown in the approved plans
and specifications. Prior to the construction of any modification to the approved plans, the permittee
shall submit to the Director, and shall have received approval for modified plans, specifications, and
calculations including, but not limited to, those listed below. For changes to the project or SCM that
impact the certifications, a new or updated certification(s), as applicable, will be required and a copy
must be submitted to the appropriate DEQ regional office upon completion of the modification.
a. Any modification to the approved plans and specifications, regardless of size including the
SCM(s), BUA, details, etc.
b. Redesign or addition to the approved amount of BUA or to the drainage area.
c. Further development, subdivision, acquisition, lease or sale of any, all or part of the project
and/or property area as reported in the approved plans and specifications.
d. Altering, modifying, removing, relocating, redirecting, regrading, or resizing of any component of
the approved SCM(s), the stormwater collection system and/or vegetative conveyance shown
on the approved plan.
e. The construction of any allocated future BUA.
f. The construction of any permeable pavement, #57 stone area, public trails, or landscaping
material to be considered a permeable surface that were not included in the approved plans and
specifications.
g. Other modifications as determined by the Director.
III. GENERAL CONDITIONS
1. CORRECTIVE ACTIONS REQUIRED. If the facilities fail to perform satisfactorily, the permittee shall
take immediate corrective actions. This includes actions required by this Division and the stormwater
rules such as the construction of additional or replacement on-site stormwater systems. These
additional or replacement measures shall receive a permit from the Division prior to construction.
Page 3 of 5

Post-Construction Stormwater Management
Permit No. SW8 980729
2. PERMIT RENEWAL. 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).
3. CHANGES TO THE PROJECT NAME, PERMITTEE NAME OR CONTACT INFORMATION. The
permittee shall submit a completed Permit Information Update Application Form to the Division within
30 days to making any one of these changes.
4. TRANSFER. This permit is not transferable to any person or entity except after notice to and approval
by the Director. Neither the sale of the project and/or property, in whole or in part, nor the conveyance
of common area to a third party constitutes an approved transfer of the permit.
a. TRANSFER REQUEST. The transfer request must include the appropriate application,
documentation and the processing fee as outlined in 15A NCAC 02H.1045(2). This request must
be submitted within 90 days of the permit holder meeting one or more of the following:
i. A natural person who is deceased;
ii. A partnership, limited liability corporation, corporation, or any other business association that
has been dissolved;
iii. A person or entity who has been lawfully and finally divested of title to the property on which
the permitted activity is occurring or will occur through foreclosure, bankruptcy, or other legal
proceeding.
iv. A person or entity who has sold the property, in whole or in part, on which the permitted
activity is occurring or will occur,
v. The assignment of declarant rights to another individual or entity;
vi. The sale or conveyance of the common areas to a Homeowner's or Property Owner's
Association, subject to the requirements of NCGS 143-214.7(c2);
b. TRANSFER INSPECTION. Prior to transfer of the permit, a file review and site inspection will be
conducted by Division personnel to ensure the permit conditions have been met and that the project
and the on-site stormwater system complies with the permit conditions. Records of maintenance
activities performed to date may be requested. Projects not in compliance with the permit will not be
transferred until all permit and/or general statute conditions are met.
5. COMPLIANCE. The permittee is responsible for compliance with the terms and conditions of this
permit until the Division approves the transfer request.
a. APPROVED PLANS AND SPECIFICATIONS. A copy of this permit, approved plans, application,
supplement, operation and maintenance agreement, all applicable recorded documents, and
specifications shall be maintained on file by the permittee at all times.
b. DIVISION ACCESS. The permittee grants Division Staff permission to enter the property during
normal business hours to inspect all components of the permitted project.
c. ENFORCEMENT. Any individual or entity found to be in noncompliance with the provisions of a
stormwater management permit or the requirements of the stormwater rules is subject to
enforcement procedures as set forth in NCGS 143 Article 21.
d. ANNUAL CERTIFICATION. The permittee shall electronically submit to the Division an annual
certification completed by either the permittee or their designee confirming the projects
conformance with permit conditions
Page 4 of 5

Post-Construction Stormwater Management
Permit No. SW8 980729
e. OBTAINING COMPLIANCE. 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 modified plans and certification
in writing to the Director that the changes have been made.
f. OTHER PERMITS. The issuance of this permit does not preclude the permittee from complying
with and obtaining any other permits or approvals that are required for this development to take
place, as required by any statutes, rules, regulations, or ordinances, which may be imposed by any
other Local, State or Federal government agency having jurisdiction. Any activities undertaken at
this site that cause a water quality violation or undertaken prior to receipt of the necessary permits
or approvals to do so are considered violations of NCGS 143-215.1, and subject to enforcement
procedures pursuant to NCGS 143-215.6.
Permit corrected, updated and reissued this the 18th day of July 2023.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
cka,
Douglas R. Ansel, Interim Director
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Permit Number SW8 980729
Page 5 of 5

Attachment C-Permitting History
Dosher Memorial Hospital
Permit No.SW8 980729
Noject i Drssm=ge
PWINLPV'l '.tAt oin J�sr'or a,3cr�s �.c,m�of (halves Modified Kart neets Ann(at)
DateHigh Density Stormwater Project-Long Term Care and Dietary Addition-
Original construction,operation and maintenance of a detention pond in compliance with the
12/22/1998 0
Approval 1' provisions of 15A NCAC 2H.1000.The stormwater control has been designed to
handle the runoff from 45,738 square feet of impervious area.
High Density Stormwater Project-construction,operation and maintenance of a wet
detention pond in compliance with the provisions of 15A NCAC 2H.1000.The
stormwater control has been designed to handle the runoff from 303,345 square feet
1/31/2002 Major 1 1 of impervious area.Approved plans and specifications for this project are
Modification incorporated by reference and are enforceable parts of the permit.The tract will be
limited to the amount of built-upon area indicated on page 3 of this permit,and per
approved plans.The built-upon area for the future development is limited to 5,662
square feet.
High Density Subdivision Project-construction,operation and maintenance of a wet
11/10/2011 Renewal 2.0 detention pond in compliance with the provisions of 15A NCAC 2H.1000.The
original permit conditions contained in the permit issued on January 31,2002
remain in full force and effect,except as amended herein.
Approved Plan Revision-The revisions include the demolition and removal of a
portion of an existing drive and the construction of two building additions and
Minor COV, ,C100 C200,
11/7/2012 Modification 2.1 roundabout resulting in a net increase of 2,719 square feet of impervious surface.A C300,C500,C920
future allocation of of 5,662 square feet of impervious is reduced to 2,943 square
feet future allocation due to these improvements.
6/22/2023 Renewal 3.0 Expires January 31,2024
7/18/2023 Correction Corrected the expiration date to January 31,2034
Page 1of1

ci;;;;.1„ s
ROY COOPER
Governor 1101h1., ,.,, "
ELIZABETS.BISER : ` .
Secretary `�l
DOUGLAS R.ANSEL NORTH CAROLINA
June 22,2023
Dosher Memorial Hospital
Attn: Susan Daniels,CFO
924 Howe Street
Southport,NC 28461
Subject: Permit Renewal
Post-Construction Stormwater Management Permit No.SWS 980729
Dosher Memorial Hospital
Brunswick County
Dear Ms.Daniels:
Effective August 1,2013 the Post-Construction Stormwater Management 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 permits issued prior to August 1,2013 until they are modified.
Please note that this permit will now reference DEMLR as the Division responsible for enforcement of the permit.
On.August 5,2009,the Governor signed Session Law 2009-406.This law impacted any development approval
issued by the former Division of Water Quality under Article 21 of Ch. -r 143 of the General Statutes,which
was current and valid at any point between January 1,2008,and Decem a,-1 31,2010.The law extended the
effective period of any permit that was set to expire during this time frame 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
a total of four(4)years extension.
The Division of Energy,Mineral and Land Resources received a complete 8-year Permit Renewal Application for
the subject permit on June 2,2023. The Division is hereby notifying you that permit SW8980729 has been
renewed,updated,and re-issued on June 22,2023,as attached.Please be aware that the renewal and re-issuance
of this stormwater permit does not imply that the site is currently in compliance.
This permit shall be effective until January 31,2024,which includes all available extensions,and does not
supersede any other agency permit that may be required. The project shall be subject to the conditions and
limitations as specified therein. This permit does not impose new or increased sormwater control requirements;it
clarifies the rules and requirements of diis program to provide you with a better understanding of your obligations
under this permit. Failure to comply with these requirements will result in future compliance problems. Please
note that this permit is not transferable except after notice to and approval by the Division.
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 150B of the North Carolina General Statutes and must be filed with the
OAH within thirty(39)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.NCOAH.com.Unless
such demands are made this permit shall be final and binding.
If you have any questions concerning this permit,please contact Ashley Smith in the Wilmington Regional
Office,at(910)796-7215 or [e-mail].
Sincerely,aitiO .A9`11
. Douglas R.Ansel,Interim Director
Division of Energy,Mineral and Land Resources
'1'''L''d-----'''‘DE .
Q
North Carolina Department of Environmental Quality I Division.of Energy,M15nerai and Land Resources
Wilmington Regional Office 1127 Cardinal Drive Extension I Wilmington,North Carolina 28405
aom
ono an. iw g.i limit '� 910.796.72155

State Stormwater Permit No.SWS 980729
Page 2 of 2
Enclosures: Attachment C—Permitting History
copy of the Renewal Application Documents
DES/ams: \\1Stormwater\Permits&Projects\I9981980729 HD\2023 06 permit 980729
cc: John S.Tunstall,PE;Norris&Tringtn11,Consulting Engineers,PC
Wilmington Regional Office Stormwater File
North Carolina Department of Environmental Quality I Division of Energy,.Mineral and Land Resources
Wi[muvgtan Regional Office ! 127 Cardinal Drive Extension i Wilmington.North Carolina 28405
0.1.4 'bd 910.7967215

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
POST-CONSTRUCTION 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
J.A. Dosher Memorial Hospital
924 N. Howe Street, Southport, Brunswick County
FOR THE
construction, operation and maintenance of a wet detention pond in compliance with the provisions of 15A
NCAC 2H .1000 (hereafter referred to as the "stormwater rules') and as outlined in the application, approved
stormwater management plans, supplement, calculations, operation and maintenance agreement, recorded
documents, specifications, and other supporting data (the "approved plans and specifications") as attached
and/or on file with and approved by the Division of Energy, Mineral and Land Resources (the "Division" or
"DEMLR"). The project shall be constructed, operated and maintained in accordance with these approved
plans and specifications. The approved plans and specifications are incorporated by reference and are
enforceable part of this permit.
This permit shall be effective from the date of issuance until January 31, 2024 and shall be subject to the
following specified conditions and limitations. 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 condition. The issuance of this permit does not prohibit the Director from
reopening and modifying the permit, revoking and reissuing the permit, or terminating the permit for cause as
allowed by the laws, rules, and regulations contained in Title 15A NCAC 2H.1000 and NCGS 143-215.1 et.al.
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 on
page 2 of this permit. The stormwater control has been designed to handle the runoff from 303,345
square feet of impervious area.
3. The tract will be limited to the amount of built-upon area indicated on page 2 of this permit, and per
approved plans. The built-upon area for the future development is limited to 5,662 square feet.
4. All stormwater collection and treatment systems must be located in either dedicated common areas or
recorded easements. The final plats for the project will be recorded showing all such required
easements, in accordance with the approved plans.
5. 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.
Page 1 of 5

DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
Project Name: J.A. Dosher Memorial Hospital
Permit Number: SW8 980729
Location: Brunswick County
Applicant: Ms. Susan Daniels
Mailing Address: J.A. Dosher Memorial Hospital
924 Howe Street
Southport, NC 28461
Application Date: June 2, 2023
Name of Receiving Stream/Index#: Cape Fear/ UT Price Creek/3-6-17
Classification of Water Body: "SC Sw"
Pond Depth, feet: 7.5
Permanent Pool Elevation, FMSL: 14.10
Drainage Area, acres: 9.95
Total Impervious Surfaces, ft2: 303,345
Buildings, ft2: 130,828
Parking, ft2: 138,821
Sidewalks, ft2: 30,753
Future, ft2: 2,943
Offsite Area entering Pond, ft2: None, per engineer
Required Surface Area, ft2: 9,967
Provided Surface Area, ft2: 14,503
Required Storage Volume, ft3: 27,446
Provided Storage Volume, ft3: 32,187
Temporary Storage Elevation, FMSL: 16.10
Controlling Orifice: 2" pipe
II. SCHEDULE OF COMPLIANCE
1. The stormwater management system shall be constructed in it's 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 and vegetated filter.
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, flow spreader, 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 be allowed in the stormwater treatment system if calculations are
provided documenting the permanent pool volume is greater than 30,000 cubic feet.
Page 2 of 5

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. A modification may be required
for those deviations.
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. Prior to the sale or lease of any portion of the property, the permittee shall notify DWQ and provide the
name, mailing address and phone number of the purchaser or leasee. 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 or lease of any portion of the property.
10. The permittee is responsible for verifying that the proposed built-upon area does not exceed the
allowable built-upon area.
11. 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.
12. No person or entity, including the permittee, shall alter any component shown in the approved plans
and specifications. Prior to the construction of any modification to the approved plans, the permittee
shall submit to the Director, and shall have received approval for modified plans, specifications, and
calculations including, but not limited to, those listed below. For changes to the project or SCM that
impact the certifications, a new or updated certification(s), as applicable, will be required and a copy
must be submitted to the appropriate DEQ regional office upon completion of the modification.
a. Any modification to the approved plans and specifications, regardless of size including the
SCM(s), BUA, details, etc.
b. Redesign or addition to the approved amount of BUA or to the drainage area.
c. Further development, subdivision, acquisition, lease or sale of any, all or part of the project
and/or property area as reported in the approved plans and specifications.
d. Altering, modifying, removing, relocating, redirecting, regrading, or resizing of any component of
the approved SCM(s), the stormwater collection system and/or vegetative conveyance shown
on the approved plan.
e. The construction of any allocated future BUA.
f. The construction of any permeable pavement, #57 stone area, public trails, or landscaping
material to be considered a permeable surface that were not included in the approved plans and
specifications.
g. Other modifications as determined by the Director.
III. GENERAL CONDITIONS
1. CORRECTIVE ACTIONS REQUIRED. If the facilities fail to perform satisfactorily, the permittee shall
take immediate corrective actions. This includes actions required by this Division and the stormwater
rules such as the construction of additional or replacement on-site stormwater systems. These
additional or replacement measures shall receive a permit from the Division prior to construction.
2. PERMIT RENEWAL. 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).
Page 3of5

3. CHANGES TO THE PROJECT NAME, PERMITTEE NAME OR CONTACT INFORMATION. The
permittee shall submit a completed Permit Information Update Application Form to the Division within
30 days to making any one of these changes.
4. TRANSFER. This permit is not transferable to any person or entity except after notice to and approval
by the Director. Neither the sale of the project and/or property, in whole or in part, nor the conveyance
of common area to a third party constitutes an approved transfer of the permit.
a. TRANSFER REQUEST. The transfer request must include the appropriate application,
documentation and the processing fee as outlined in 15A NCAC 02H.1045(2). This request must
be submitted within 90 days of the permit holder meeting one or more of the following:
i. A natural person who is deceased;
ii. A partnership, limited liability corporation, corporation, or any other business association that
has been dissolved;
iii. A person or entity who has been lawfully and finally divested of title to the property on which
the permitted activity is occurring or will occur through foreclosure, bankruptcy, or other legal
proceeding.
iv. A person or entity who has sold the property, in whole or in part, on which the permitted
activity is occurring or will occur,
v. The assignment of declarant rights to another individual or entity;
vi. The sale or conveyance of the common areas to a Homeowner's or Property Owner's
Association, subject to the requirements of NCGS 143-214.7(c2);
b. TRANSFER INSPECTION. Prior to transfer of the permit, a file review and site inspection will be
conducted by Division personnel to ensure the permit conditions have been met and that the project
and the on-site stormwater system complies with the permit conditions. Records of maintenance
activities performed to date may be requested. Projects not in compliance with the permit will not be
transferred until all permit and/or general statute conditions are met.
5. COMPLIANCE. The permittee is responsible for compliance with the terms and conditions of this
permit until the Division approves the transfer request.
a. APPROVED PLANS AND SPECIFICATIONS. A copy of this permit, approved plans, application,
supplement, operation and maintenance agreement, all applicable recorded documents, and
specifications shall be maintained on file by the permittee at all times.
b. DIVISION ACCESS. The permittee grants Division Staff permission to enter the property during
normal business hours to inspect all components of the permitted project.
c. ENFORCEMENT. Any individual or entity found to be in noncompliance with the provisions of a
stormwater management permit or the requirements of the stormwater rules is subject to
enforcement procedures as set forth in NCGS 143 Article 21.
d. ANNUAL CERTIFICATION. The permittee shall electronically submit to the Division an annual
certification completed by either the permittee or their designee confirming the projects
conformance with permit conditions
e. OBTAINING COMPLIANCE. 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 modified plans and certification
in writing to the Director that the changes have been made.
Page 4 of 5

f. OTHER PERMITS. The issuance of this permit does not preclude the permittee from complying
with and obtaining any other permits or approvals that are required for this development to take
place, as required by any statutes, rules, regulations, or ordinances, which may be imposed by any
other Local, State or Federal government agency having jurisdiction. Any activities undertaken at
this site that cause a water quality violation or undertaken prior to receipt of the necessary permits
or approvals to do so are considered violations of NCGS 143-215.1, and subject to enforcement
procedures pursuant to NCGS 143-215.6.
Permit renewed, updated and reissued this the 22nd day of June 2023.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
fjird
Douglas R. Ansel, Interim Director
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Permit Number SW8 980729
Page 5 of 5

Attachment C-Permitting History
Dosher Memorial Hospital
Permit No.SW8 980729
APPmv Pc mit Action V e°ra • Description of thy Changes I Models!Pisa Shorts
Dee , High Density Stormwater Project-Long Term Care and Dietary Addition-
12/22/1998 Original 1.0 construction,operation and maintenance of a detention pond in compliance with the
Approval provisions of 15A NCAC 2H.1000.The stormwater control has been designed to
handle the runoff from 45,738 square feet of impervious area.
High Density Stormwater Project-construction,operation and maintenance of a wet
detention pond in compliance with the provisions of 15A NCAC 2H.1000.The
stormwater control has been designed to handle the runoff from 303,345 square feet
1/31/2002 Major 1.1 of impervious area.Approved plans and specifications for this project are
Modification incorporated by reference and are enforceable parts of the permit.The tract will be
limited to the amount of built-upon area indicated on page 3 of this permit,and per
approved plans.The built-upon area for the future development is limited to 5,662
square feet
High Density Subdivision Project-construction,operation and maintenance of a wet
11/10/2011 Renewal 2.0 detention pond in compliance with the provisions of 15A NCAC 2H.1000.The
original permit conditions contained in the permit issued on January 31,2002 remain
in full force and effect,except as amended herein.
Approved Plan Revision-The revisions include the demolition and removal of a
portion of an existing drive and the construction of two building additions and
Minor COV,C100,C200,
11/7/2012 2.1 roundabout resulting in a net increase of 2,719 square feet of impervious surface.A C300,C500,C920
Modification
future allocation of of 5,662 square feet of impervious is reduced to 2,943 square
feet future allocation due to these improvements.
6/22/2023 Renewal 3.0 Expires January 31,2024
Page 1of1

DEMLR USE ONLY
Date Replied Fee Paid Permit Number
la aa3 Af 9 665 5d5 S � 4g07a
NC DEQ Division of Energy, Mineral and Land Resources
STATE Si URMWATER:
PERMIT RENEWAL APPLICATION FORM
In accordance with 15A NCAC 2H.1045(3), the current permit holder shall renew their high density permit 180 days
prior to its expiration. Renewed permits are valid for a period of 8 years per Session Law 2011-398(SB 781)
Section 60.(c). This application form is for permit renewals only.
NT 4 1.3 D110
A. PROJECT INFORMATION
1. State Stormwater Permit Number: SW8 980729
2. Project name: J. A. Dosher Memorial Hospital Patient Rooms Expansion&Renovation
3. Project street address: 924 N. Howe Street
City: Southport County: Brunswick ZIP : 28461
4. What, if any, changes have been made to the project as permitted? None
If the project has changed from the original approved plans, please complete SWU-101 for a Major
Modification or Minor Modification Application form available at: https://deq.nc.gov/about/divisions/energy-
mineral-land-resources/energv-mineral-la nd-ru les/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
or the Permit Transfer form available at: https://deq.nc.gov/about/divisions/energy-mineral-land-
resources/energv-mineral-land-rules/stormwater-program/post-construction. State Stormwater Permits do not
automatically transfer with the sale of the property.
1. Current Permit Holder's Company Name/Organization: Dosher Memorial Hospital
2. Signing Official's Name: Susan Daniels
3. Signing Official's Title: CFO
4. Mailing Address: 924 Howe Street
City: Southport State: NC ZIP : 28461
5. Street Address: Same as Mailing
City: State: ZIP :
6. Phone: [phone] Email: susandanielsndosher.org
ECEIVE
JUN 0 L 2023 1)
BY:
Stormwater Permit Renewal Form Page 1 of 3 May 11,2018

C. SUBMITTAL REQUIREMENTS
Submit the application package to the appropriate )EMLR Regional Office (Coastal, SA Waters)or DEMLR
Central Office (Urbanizing Areas Ph 2, USMP, Non-Coastal HQW/ORW). 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:
I 1 4 1. A permit application processing fee of$505.00 payable to NCDEQ.
1 if a 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.
N/A 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.
S . O&M Agreemenis, Please select one:
® 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.
L & kJ. 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
El 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.
4 1 [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.
N/A 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/by title/ Business Registration
liECEIVE
JUN 0 2 2023
BY:
Stormwater Permit Renewal Application Form Page 2 of 3 May 11,2018

D. ER MIT"i' ..•'
I, Susan Daniels, CFO ,the person legally responsible for the
permit, certify that I have a copy of the Permit 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 ' . :ement and approved plans. I agree to notify DEMLR of any
problems with t SCMs or built-upon area a,• ., submit the proper forms to modify or transfer the permit prior to
any changes t e project, SCMs, or owner- .. All infQrmatio provided on this permit renewal applic on is, to
the best of my nowt r t and •. - -
Signature: i ii Date: 6/C/0/ '.
NOTARIZATION:
I, 2)EA A)N 6-1?.. , a Notary Public for the State of
.OT2-41 C-Al2- ea ;n?iq ,County of_ - e-Ufi-St r'C, , do hereby certify
that St 4A.-) ' lrii-iS personally appeared before me
this the e9 I day of .Ppn I ,20 9 , and acknowledge the due
execution of the forgoing instrument. Witness my hand and official seal,
(Notary Seal)
0 Notary Signature: c4 C a.��,NNu1NrA/p`'4y�i
My commission expires i0 671 O
I NO Tq9 cv
i co G 0e�' V ��Es 2
A a
qip c Cotj$oe
mini mo
C LE VE
JUN 0 2 2023
BY:
Stormwater Permit Renewal Application Form Page 3 of 3 May 11,2018

NORRIS &TUNSTALL
CONSULTING ENGINEERS P.C.
2602 Iron Gate Drive,Suite 102 1429 Ash-Little River Road
Wilmington,NC 28412 Ash,NC 28420
[phone] [phone]
[phone] Fax [phone] Fax
John S.Tunstall,P.E. J.Phillip Norris,P.E.
T.Jason Clark,P.E. Joseph K.Bland,P.E.
Robbie P.Hennelly,E.I. Thomas J. Scheetz,P.E.
June 1, 2023
NC DEQ
Division of Energy, Mineral and Land Resources — State Stormwater Program
127 Cardinal Drive Extension
Wilmington, NC 28405-3845
Re: Licensed Professional Certification Letter for SCM's for Renewals (SW8 980729)
J. A. Dosher Memorial Hospital Patient Rooms Expansion & Renovation
Southport, NC
N&T Project No. 23016
Dear Sir or Madam:
Per Item #6 of the NC DEQ State Stormwater Permit Renewai Application Form, I, John S.
Tunstall, P.E. state that the SCMs have been observed, and it appears that they were built and
have been maintained in accordance with the permit.
Sincerely,
NORRIS & TUNSTALL
CONSULTING ENGINEERS, P.C.
4/L /1• Unuwnnhq /
Jon S. Tunstall, P. E. bd ..j
V SEAL
JST/asn j: 1985 (�. 2
23016 06-01-23-s-sw-renewal-PE Cert SCM-Itr %,,yid•S c�N, .• .`Q e'
rr�T�UN"
Enclosures
ECEIVE
JUN 0 2 2023 I)
BY:
NCBELS License C-3641