20090250 Ver 1_Approval Letter_20090414

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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
Ms. Denise Poulos
ECS Carolinas LLP
4811 Koger Blvd
Greensboro NC 27407
APPROVAL of 401 Water Quality Certification with Additional Conditions
Dear Ms. Poulos:
April 14, 2009
DWQ# 09-0250
Forsyth County
You have our approval, in accordance with the attached conditions, to place fill or otherwise permanently impact 130
linear feet of stream and 0.063 acres of wetlands in order to improve and upgrade and existing pond dam off Harper Rd
in Clemmons, NC in Forsyth County, as described in your application received by the Division of Water Quality
(Division) on March 11, 2009. After reviewing your application, we have determined that this fill is covered by General
Water Quality - Certification Number 3687, which can be viewed on our web site at
http://www.ncwatgrqualit?org/wetlands.html. This Certification allows you to use Nationwide Permit Number 3 when
it is issued by the U.S. Army Corps of Engineers. In addition, you should secure any other applicable federal, state or
local permits before you proceed with your project, including (but not limited to) those required by Sediment and
Erosion Control, Non-Discharge, and Water Supply Watershed regulations. Also, this approval will expire when the
accompanying 404 permits expire unless otherwise specified in the General Certification.
This approval is valid only for the purpose and design that you have described in your application. If you change your
project, you must notify us in writing, and you may be required to send us a new application for a new certification. 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. If total wetland fill for this project (now or in the future) exceeds one
acre, or total fill to perennial streams equals or exceeds 150 linear feet, additional compensatory mitigation may be
required as described in 15A NCAC 2H .0506 (h). For this approval to be valid, you must follow the conditions
listed in the attached certification, as well as the additional conditions listed below:
The following impacts are hereby approved as long as all other specific and general conditions of this
Certification are met. No other impacts, including incidental impacts, are approved:
Stream Impacts
Identifier Stream Impact length (feet)
Site 1 UT Johnson Creek 130 linear feet
Total 130 linear feet permanent
Wetland Impacts
Identifier T e of Impact Impact length (acres)
Site 1 Fill 0.063
Total 0.063 acres permanent
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] \ Customer Service: 1-877-623-6748
Internet: www.ncwaterquality.org
An Equal Opportunity \ Affirmative Action Employer
NorthCarolina
Naturally
Denise Poulos
DWQ# 09-0250
April 14, 2009
Page 2 of 3
2. All appropriate measures shall be taken to dewater the existing pond using best management practices and
dewatering rates that do not negatively impact the hydrological, geomorphological, or biological functions of
downstream waters. All appropriate sediment and erosion control measures shall be utilized to contain sediment
during dewatering and construction. This authorization does not approve temporary impacts from sediment and
erosion control measures in streams or wetland areas beyond the areas noted for permanent impacts.
3. All future development on this site shall adhere to appropriate stormwater controls as required by the NPDES
Phase II Stormwater program and/or Watershed Supply protection program.
4. Upon finishing the project, the Applicant shall fill out and return the enclosed "Certificate of Completion"
to notify NCDWQ when all work included in the §401 Certification has been completed. This certificate
should be returned to the Winston-Salem Regional Office of the NCDWQ at the address listed on the form.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You
must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition
which conforms to Chapter 150B of the North Carolina General Statutes to the Office of Administrative Hearings, 6714
Mail Service Center, Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless you
ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act. If you
have any questions, please contact Sue Homewood in the DWQ Winston-Salem Regional Office at 336-771-4964 or at
[e-mail].
Sincerely,
Coleen H. Sullins, Director
Division of Water Quality
cc: John Thomas, U. S. Army Corps of Engineers, Raleigh Regulatory Field Office
Mr. Van Hauser, Novant Health Inc, 10030 Gilead Rd, Suite B 120, Huntersville NC 28078
DWQ Winston-Salem Regional Office
DWQ Wetlands/401
Denise Poulos
DWQ# 09-0250
April 14, 2009
Page 3 of 3
DWQ Project No.: County:
Applicant:
Project Name:
Date of Issuance of 401 Water Quality Certification:
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules, and any
subsequent modifications, the applicant is required to return this certificate to the 401/Wetlands Unit, North Carolina
Division of Water Quality, 1621 Mail Service Center, Raleigh, NC, 27699-1621. This form may be returned to DWQ by
the applicant, the applicant's authorized agent, or the project engineer. It is not necessary to send certificates from all of
these.
Applicant's Certification
I, hereby state that, to the best of my abilities, due care and diligence was
used in the observation of the construction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications, and
other supporting materials.
Signature:
Date:
Agent's Certification
1, , hereby state that, to the best of my abilities, due care and diligence was
used in the observation of the construction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications, and
other supporting materials.
Signature: Date:
Engineer's Certification
Partial Final
1, , as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project,for the
Permittee hereby state that, to the best of my abilities, due care and diligence was used in the observation of the
construction such that the construction was observed to be built within substantial compliance and intent of the 401 Water
Quality Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature
Registration No.
Date