20050578 Ver 1_Approval Letter_20051115

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Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Watcr Quality
November 15, 2005
Sister Lucy Hennessy
Pennybyrn At Maryfield
1315 Greensboro Road
High Point, NC 27260
Re: Pennybyrn At Maryfield, GuilfordCounty
DWQ #OS-0578; USACE Action ID. No. 200120668
APPROVAL of 401 Water Quality Certification
Dear Sister Hennessy:
Attached hereto is a copy of Certification No. 3546 issued to Sister Lucy Hennessy of Pennybyrn At
Maryfield ,dated November 15, 2005. In addition, you should get any other federal, state or local permits
before you go ahead with your project including (but not limited to) Solid Waste, Sediment and Erosion
Control, Stormwater, Dam Safety, Non-discharge and Water Supply Watershed regulations.
If we can be of further assistance, do not hesitate to contact us.
Sincerely,
1 t~
~~
Alan W. Klimek, P.E.
AWK/cbk
Attachments: Certificate of Completion
ec: U.S. Army Corps of Engineers, Raleigh Regulatory Field Office
Daryl Lamb, DWQ, Winston-Salem Regional Office
DLR Winston-Salem Regional Office
File Copy
Central Files
Ms. Denise Poulos, Engineering Consulting Services, Ltd., 6909 International Drive, Suite 103,
Greensboro, NC 27409
Filename: 050578Pennybyrn_MaryField(Guilford)401 IC
401 OversighUExpress Review Pennits Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone:. [phone] /FAX [phone] / Internet http://h2o.enr.state.nc.us/ncwetlands
Noe Carolina
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An Equal OpportunitylAffirmafive Action Employer- 50% Recycled110% Post Consumer Paper

Perurybryn At Maryfield
Page 2 of 6
November 15, 2005
NORTH CAROLINA 401 WATER QUALITY CERTIFICATION
THIS CERTIFICATION is issued in conformity with the requirements of Section 401 Public Laws 92-
500 and 95-217 of the United States and subject to the North Carolina Division of Water Quality (DWQ)
Regulations in 15 NCAC 2H, Section .0500 to Pennybyrn At Maryfield to fi11506 feet of jurisdictional
streams, impact 0.09 acre of forested wetland, and fill 1.44 acres of Randleman Watershed Riparian Buffers
in the Cape Fear River Basin, associated with the construction of an Independent Living and Community
Center with associated parking lots and roadways as an expansion of the Pennybyrn At Maryfield campus
in Guilford County, North Carolina, pursuant to an application filed on the fourth day of April of 2005, and
all additional correspondence received that included Pennybyrn at Maryfield: Variance request for
disturbing a Stream Buffer in the Randleman Lake Watershed and all Supplemental Materials provided for
the Pennybyrn at Maryfield variance request.
The application and supporting documentation provides adequate assurance that the proposed work will
not result in a violation of applicable Water Quality Standards and discharge guidelines. Therefore, the
State of North Carolina certifies that this activity will not violate the applicable portions of Sections 301,
302, 303, 306, 307 of PL 92-500 and PL 95-217 if conducted in accordance with the application, the
supporting documentation, and conditions hereinafter set forth.
This approval is only valid for the purpose and design submitted in the application materials, as described
in the Public Notice and materials provided for Randleman Lake variance request. If the project is
changed, prior to notification a new application for a new Certification is required. If the property is sold,
the new owner must be given a copy of the Certification and approval letter and is thereby responsible for
complying with all conditions of this Certification. Any new owner must notify the Division and request
the Certification be issued in their name. Should wetland or stream fill be requested in the future,
additional compensatory mitigation maybe required as described in 15A NCAC 2H .0506 (h) (6) and (7).
If any plan revisions from the approved site plan result in a change in stream or wetland impact or an
increase in impervious surfaces, the DWQ shall be notified in writing and a new application for 401
Certification may be required. For this approval to be valid, compliance with the conditions listed below
is required.
Conditions of Certification:
1. Impacts Approved
The following impacts are hereby approved as long as all of the other specific and general
conditions of this Certification (or Isolated Wetland Permit) are met. No other impacts are
approved including incidental impacts:
Amount A roved nits Plan Location or Reference
Stream 506 (feet) Basin and Proposed Layout -
September 16, 2005
Forested wetland 0.09 acres of forested Basin and Proposed Layout -
wetlands Se tember 16, 2005
Buffer 1.44 acres Basin and Proposed Layout -
Se tember 16, 2005

Pennybryn At Maryfield
Page 3 of 6
November 15, 2005
Variance for Stream Buffer in the Randleman Lake Watershed
On November 9, 2005, the Water Quality Committee of the Environmental Management
Commission approved a Major Variance Request for project known as the Pennybyrn at
Maryfield. Specifically the Variance Approval was based on information provided by Pennybyrn
at Maryfield to do the following: 1) build and expand an existing nursing home and indigent care
facility as depicted in the information provided for the Variance request for disturbing a Stream
Buffer in the Randleman Lake Watershed and the Supplemental Variance request information; 2)
Mitigate the 506 linear feet of stream impacts at a 1.5:1 ratio by paying into the Ecosystem
Enhancement Program; 3) Construct two (2) wet-detention ponds, [one that treats approximately
21.2 acres and the second that treats approximately 6.2 aces such that 85% TSS reduction is
achieved and greater than 30% Total Nitrogen reduction is achieved]; and 4) to preserve
approximately 4 acres of Buffers as depicted in the September 16, 2005 Pennybym at Maryfield
map, by SFCS Inc. and Koontz-Bryant, P.C and labeled Basin and Proposed Layout.
The failure to comply with proposed conditions of Variance approval will constitute a violation of
this Certification condition.
3. Riparian Buffer Preservation
For all of the remaining riparian buffers and the approximately 4 acres of riparian buffer proposed
for preservation, Pennybyrn at Maryfield must place these areas in a conservation easement or
deed restrictions. The conservation easement or deed restrictions must be maintained in
perpetuity such that protection is provided to all streams and riparian areas proposed for
preservation as depicted in the September 16, 2005 Pennybyrn at Maryfield map, by SFCS Inc.
and Koontz-Bryant, P.C and labeled Basin and Proposed Layout.
Pennybyrn at Maryfield must establish the decd restrictions or a conservation easements,
and a copy must be provided to the North Carolina Division of Water Quality, Central
Office within 90 days of issuance of this Certification. These riparian (stream-side) areas must
remain in a Conservation Easement or under a protective deed restriction. Pennybyrn at
Maryfield must maintain the Conservation Easement or deed restrictions as long as it owns the
facilities and transfer the conservation easement or deed restrictions and its requirements to any
future owners, trustees executors or other agents including any Home Owners Association within
the subject tract.
Sediment and Erosion Control:
4. Erosion and sediment control practices must be in full compliance with all specifications
governing the proper design, installation and operation and maintenance of such Best
Management Practices in order to protect surface waters standards:
a. The erosion and sediment control measures for the project must be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Sediment and Erosion Control Planning and Design Manual.
b. The design, installation, operation, and maintenance of the sediment and erosion control
measures must be such that they equal, or exceed, the requirements specified in the most
recent version of the North Carolina Sediment and Erosion Co~ttrol Manual. The devices
shall be maintained on all construction sites, borrow sites, and waste pile (spoil) projects,
including contractor-owned or leased borrow pits associated with the project.

Pennybryn At Maryfield
Page 4 of 6
November 15, 2005
c. For borrow pit sites, the erosion and sediment control measures must be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Surface'Mini~tg Manual.
d. The reclamation measures and implementation must comply with the reclamation in
accordance with the requirements of the Sedimentation Pollution Control Act.
5. No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond
the footprint of the impacts depicted in the 404/401Permit Application. All construction activities,
including the design, installation, operation, and maintenance of sediment and erosion control Best
Management Practices, shall be performed so that no violations of state water quality standards,
statutes, or rules occur;
6. Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum
extent practicable. If placement of sediment and erosion control devices in wetlands and waters is
unavoidable, they shall be removed and the natural grade restored within six months of the date that
the Division of Land Resources has released the project;
Continuing_Compliance:
7. Pennybyrn At Maryfield shall conduct construction activities in a manner consistent with State
water quality standards (including any requirements resulting from compliance with section
303(d) of the Clean Water Act) and any other appropriate requirements of State law and federal
law. If the Division determines that such standards or laws are not being met (including the
failure to sustain a designated or achieved use) or that State or federal law is being violated, or
that further conditions are necessary to assure compliance, the Division may reevaluate and
modify this Certification to include conditions appropriate to assure compliance with such
standards and requirements in accordance with 15A NCAC 2H.0507(d). Before modifying the
Certification, the Division shall notify Pennybyrn At Maryfield and the US Army Corps of
Engineers, provide public notice in accordance with 15A NCAC 2H.0503 and provide
opportunity for public hearing in accordance with 15A NCAC 2H.0504. Any new or revised.
conditions shall be provided to Pennybyrn At Maryfield in writing, shall be provided to the
United States Army Corps of Engineers for reference in any Permit issued pursuant to Section
404 of the Clean Water Act, and shall also become conditions of the 404 Permit for the project;
Miti ag tion:
6. Compensatory Mitigation Using the Ecosystem Enhancement Program (EEP)
Mitigation must be provided for the proposed impacts as specified in the table below. We
understand that you wish to make a payment to the Wetlands Restoration Fund administered by
the NC Ecosystem Enhancement Program (EEP) to meet this mitigation requirement. This has
been determined by the DWQ to be a suitable method to meet the mitigation requirement. Until
the EEP receives and clears your check (made payable to: DENR -Ecosystem Enhancement
Program Office), no impacts specified in this Authorization Certificate shall occur. The EEP
should be contacted at [phone] if you have any questions concerning payment into a
restoration fund. You have one month from the date of this approval to make this payment. For
accounting purposes, this Authorization Certificate authorizes payment into the Wetlands
Restoration Fund to meet the following compensatory mitigation requirement:

Pennybryn At Maryfield
Page 5 of 6
November 15, 2005
Compensatory Mitigation
Re uired River and Sub-basin Number
Stream 506 feet Ca e Fear/03030003
8. Construction Stormwater Permit NCGO 10000
Upon the approval of an Erosion and Sedimentation Control Plan issued by the Division of Land
Resources (DLR) or a DLR delegated local erosion and sedimentation control program, an
NPDES General stormwater permit (NCGO10000) administered by DWQ is automatically issued
to the project. This General Permit allows stormwater to be discharged during land disturbing
construction activities as stipulated by conditions in the permit. If your project is covered by this
permit [applicable to construction projects that disturb one (1) or more acres), full compliance
with permit conditions including the sedimentation control plan, self-monitoring, record keeping
and reporting requirements are required. A copy of this permit and monitoring report forms may
be found at http://h2o.em•.state.nc.rss/sr~/For»as Documertts.htnt.
9. Written Stormwater Management Plan (Final Plan Needed)
A final, written stormwater management plan (including a signed and notarized Operation and
Maintenance Agreement) shall be submitted to the 401 Oversight and Express Permitting Unit
(2321 Crabtree Blvd., Suite 250, Raleigh, NC, 27604) within GO days of the issuance of the 401
Water Quality Certification. The stormwater management plans shall be approved in writing by
this Office before the impacts specified in this Certification occur. You have the option of using
the Express Review Program for expedited approval of these plans. If you propose to use the
Express Review Program, remember to include the appropriate fee with the plan. The stormwater
management plan must include plans, specifications, and worksheets for stormwater management
facilities that are appropriate for the surface water classification and designed to remove at least
85% TSS according to the most recent version of the NC DENR Stormwater Best Management
Practices Manual. These facilities must be designed to treat the runoff from the e~itire project,
unless otherwise explicitly approved by the Division of Water Quality. Also, before any
permanent building is occupied at the subject site, the facilities (as approved by this Office) shall
be constructed and operational, and the stormwater management plan (as approved by this Office)
shall be implemented. The structural stormwater practices as approved by this Office as well as
drainage patterns must be maintained in perpetuity. No changes to the structural stormwater
practices shall be made without written authorization from the Division of Water Quality.
8. Written Stormwater Management Plan (Final Plan Needed)
The final, written stormwater management plans, as depicted in the Pennybyrn at Maryfield:
Variance request for disturbing a Stream Buffer in the Randleman Lake Watershed and all
Supplemental Materials variance request materials, must be implemented and the stormwater
management facilities shall be constructed and operational before any permanent building is
occupied at the subject site. The structural stormwater practices as approved by this Office as well
as drainage patterns must be maintained in perpetuity. No changes to the structural stormwater
practices shall be made without written authorization from the Division of Water Quality.
Also within 90 days of this Certification, a signed, dated and notarized Operation and
Maintenance Agreement shall be submitted to the 401 Oversight and Express Permitting
Unit (2321 Crabtree Blvd., Suite 250, Raleigh, NC, 27604).

Pennybryn At Maryfield
Page 6 of 6
November 15, 2005
9. Upon completion of all work approved within the 401 Water Quality Certification and any
subsequent modifications, the applicant is required to return the attached certificate of completion
to the North Carolina Division of Water Quality, North Carolina Division of Water Central Office
at 1650 Mail Service Center, Raleigh, NC, 27699-1650.
This approval to proceed with your proposed impacts or to conduct impacts to waters as depicted
in your application shall expire upon expiration of the 404 or CAMA Permit.
If this Certification is unacceptable to you, you have the right to an adjudicatory hearing upon written
request within sixty (60) days following receipt of this Certification. This request must be in the form of a
written petition conforming to Chapter 150B of the North Carolina General Statutes and filed with the
Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, N.C. 27699-6714. If
modifications are made to an original Certification, you have the right to an adjudicatory hearing on the
modifications upon written request within sixty (60) days following receipt of the Certification. Unless
such demands are made, this Certification shall be final and binding.
This the Fifteenth day of November 2005
DIVISION OF WATER QUALITY
`~~
Alan W. Klimek, P.E.
050578Pennybyrn_Maryfield(Guilford)401 IC