20040026 Ver 2_401 Application_20061207

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.~ , .
To: US Army Corps of Engineers
Raleigh Regulatory Office
Attn: Jamie Shern
6508 Falls of the Neuse Road
Suite 120
Raleigh, North Carolina 27615
Re: Cedar Ridge Subdivision PCN Submittal
Wake County, North Carolina
December 6, 2006
KELLER ENVIRONMENTAL
ENVIRONMENTAL CONSULTANTS
7921 Haymarket Lane, Raleigh, NC
[phone]
Fax [phone]
NC Division of Water Quality
401 Oversight and Express Permits Unit
Attn: Staff
2321 Crabtree Boulevard
Suite 250
Raleigh, North Carolina{pL~O~;~~Qr
i !~ i ~ ~ ,..-. , ,
RECEIVED
v~, o-~-ooa-tD
On behalf of the applicant, Robert Polanco, please find attached a complete application and supplemental
information requesting written concurrence from the United States Army Corps of Engineers (COE) and the North Carolina
Division of Water Quality (DWQ) that the activities proposed below may precede utilizing Nationwide Permit 39. We are
requesting to place culverts and headwalls in 2 streams and a bottomless arched culvert in a third stream for the purpose of
building Virginia Water and Irina Drives. 108 homesites are also proposed for this subdivision. These proposed impacts are
contained in the attached packet of information.
PROJECT SUMMARY
Pro'ect Name CEDAR RIDGE
Pro'ect T e SUBDIVISION
Owner / A licant Robert Polanco
Count Wake
Nearest Town Rolesville
Waterbod Name Harris Creek
Basin /Sub-basin Neuse 03-04-02
Index Number 27-26
Class C; NSW
IMPACT SUMMARY
Stream Im act acres 0.06 acres
Neuse River Buffer Im acts acres 0.87 acres ermanent
Wetland Im acts acres 0
Total Im act to Waters of the State acres 0.06
Total Stream Im act linear feet 220 linear feet ermanent; 160 linear feet tem ora
Please contact me at [phone] (office) or [phone] (cell) or jay~a kellerenvironmental.com if you have any
questions or require any additional information.
Sincerely,
KELLER ENVIRONMENTAL, LLC
~-~
Jay Keller
Principal
Attachments:
$475 Check for Application Fee
Pre-Construction Notification (PCN) Application Form
Agent Authorization
Cedar Ridge Subdivision Site Plans (4 sheets)
Wake County GIS Property Map, Streams, & Aerial
USGS Map
Level Spreader Worksheets (14)
Stream Crossings Profile Views
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Office Use Only: Form Version March OS
USACE Action ID No. DWQ No. ~ a- D ~'~' " fl'~ a'to
fir any par<~cu~ar item ~s not appncan~e to tn~s project, please enter "Not Applicable" or "N/A".)
I. Processing
II.
,. ,: _
' ~ .:.. i`
~~CEIVED
1. Check all of the approval(s) requested for this project:
® Section 404 Permit ® Riparian or Watershed Buffer Rules
^ Section 10 Permit ^ Isolated Wetland Permit from DWQ
® 401 Water Quality Certification ^ Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested
39
3. If this notification is solely a courtesy copy because ~~ritten approval for the 401 Certification
is not required, check here: ^
4. If payment into the North Carolina Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: ^
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coas ement Area of
Environmental Concern (see the top of page 2 for further details), c c n/j~
Applicant Information DEC 7 2 . D
pgfi
4FN~ , Wi~T
1. Owner/Applicant Information ~~Bt~H~~n.
Name: Robert Polanco ~R6 u~y
Mailing Address: 8804 Albright Road;
Raleigh, NC 27612
Telephone Number:[phone] Fax Number:
E-mail Address:
2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name: Jay Keller
Company Affiliation: Keller Environmental
Mailing Address: 7921 Haymarket Lane; Raleigh, NC 27615
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: jay(a~kellerenvironmental.com
Page 1 of 9

III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. 1'he specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: Cedar Ridge Subdivision
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 1768-07-3234
4. Location
County: Wake Nearest Town: Rolesville
Subdivision name (include phase/lot number): Cedar Ridge
Directions to site (include road numbers/names,`landmarks, etc.): Site is located on
Rolesville Road approximately'/4 mile south of downtown Rolesville and US401.
5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): 35.5474 °N 78.2746 °W
6. Property size (acres)
70.07 Acres
7. Name of nearest receiving body of water: Harris Creek
8. River Basin: Neuse
(Note -this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: Site is comprised of an existing subdivision (phase 1)
adjacent to Rolesville Road. Remaining Phase II is mostly .wooded with one pond,
Harris Creek, and its tributaries. Adjacent land uses include residential, forested and
agricultural areas.
Page 2 of 9

10. Describe the overall project in detail, including the type of equipment to be used: Three
road crossings are proposed to access upland areas at the rear of the property and
provide connectivity to the northern parcel. All lots to have county water and
sewer. Equipment to be used includes trackhoes, bulldozers, and other land grading
eauinment.
11. Explain the purpose of the proposed work: The proposed impacts to the stream area
will be necessary to complete the subdivision, thus sustaining the development of
the proposed residential area. Extending Virginia Water Drive across Harris Creek
and its tributary will also provide connectivity to the adjacent parcels.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules. None.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
None.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should be shown on a delineation map, whether or not impacts are proposed to these systems.
Wetland and stream evaluation and delineation forms should be included as appropriate.
Photographs may be included at the applicant's discretion. If this proposed impact is strictly for
wetland or stream mitigation, list and describe the impact in Section VIII below. If additional
space is needed for listing or description, please attach a separate sheet.
1. Provide a written description of the proposed impacts: Permanent impacts to streams
totaling 220 linear feet are anticipated for this project. The Irma Drive stream
crossing will involve 95-feet of twin 42-inch diameter RCP's. The eastern Vir_ iy nia
Water Drive stream crossing will involve 120-feet of a single 48-inch diameter RCP.
Page 3 of 9

Temporary Impacts to Harris Creek on the western property end are 160 linear feet
to allow for construction of the Con-Span bottomless culvert installation.
2. Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams,
cenarately list impacts due to both structure and flooding.
Wetland Impact
Site Number
(indicate on map)
Type of Impact Type of Wetland
(e.g., forested, marsh,
herbaceous, bog, etc.) Located within
100-year
Floodplain
(yes/no) Distance to
Nearest
Stream
(linear feet) Area of
Impact
(acres)

Total Wetland impact (acres) 0
3. List the total acreage (estimated) of all existing wetlands on the property: 2 Acres
4. Individually list all intermittent and perennial stream impacts. Be sure to identify temporary
impacts. Stream impacts include, but are not limited to placement of fill or culverts, dam
construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
walls, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed,
plans and profiles showing the linear footprint for both the original and relocated streams
mast he included. To calculate acrea~e_ multiply length X width. then divide by 43,560.
Stream Impact
Perennial or Average Impact Area of
Number Stream Name T e of Im act
yP p
Intermittent? Stream Width Length Impact
(indicate on ma) Before Impact (linear feet) (acres)

Irina Drive UT To Harris Culverts & Perennial 4 100 0.01
Creek headwalls
Virginia Water Culverts &
Drive East Harris Creek headwalls Intermittent 6 120 0.02
Virginia Water
Drive West Harris Creek Temporary Perennial 8 160 0.03
Total Stream Impact (by length and acreage) 220 Perm.
160 Temp. 0.06
5. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fll avravatinn ~IrPrlaina flnnrlina rlrainaae httlkhearls etc_
Open Water Impact Name of Waterbody v Type of Waterbody Area of
Site Number (if applicable) Type of Impact (lake, pond, estuary, sound, bay, Impact
(indicate on ma) ocean, etc.) (acres)

Total Open Water Impact (acres) 0
Page 4 of 9

6. List the cumulative impact to all Waters of the U.S. resulting from the project:
Stream Impact (acres): 0.06
Wetland Impact (acres): 0
Open Water Impact (acres): 0
Total Impact to Waters of the U.S. (acres) 0.06
Total Stream Impact (linear feet): 220 Permanent;
160 Tem ora
7. Isolated Waters
Do any isolated waters exist on the property? ^ Yes ®No
Describe all impacts to isolated waters, and include the type of water (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that have specifically been determined to be isolated by the USACE.
8. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ^ uplands ^ stream ^ wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Current land use in the vicinity of the pond:
Size of watershed draining to pond:
Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were plot feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts._The_proposed Virginia Water
Drive Extension crossings were strategically placed to connect with the subdivision to
the west and the large upland area between it and Phase I. The Irina Drive Extension
will provide access to the upland areas to the area north of Harris Creek. The crossings
were also placed perpendicular in a fairly linear stream corridor and headwalls were
utilized to minimize stream and buffer impacts. The culverts will be placed 1-foot below
the stream bed in accordance to best management practices (BMP's) to allow aquatic
passage. A bottomless arched culvert will be utilized on the Virginia Water Drive
western crossing.
Page 5 of 9

VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on January 15, 2002, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCEEP concurrence shall be placed on hold as incomplete.
An applicant may also choose to review the current guidelines for stream restoration in DWQ's
Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.nc.us/ncwetlands/stnn~ide.html.
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
The proposed,~roject should not be required to provide mitigation for the proposed
impacts. This is due the efforts of the developer's team to avoid jurisdictional areas
to the maximum extent possible. As shown in the attached Engineering Plans the
properties adjacent to the stream will not encroach into the vegetated buffers to
protect open waters along Harris Creek and its tributaries. Moreover areas adjacent
to the stream crossings will be in the dedicated open space area. This will prevent
homes from encroaching into the riparian buffer areas. Examples include areas
west of Lots 103 & 118. 15.78 Acres will be permanently preserved along Harris
Creek and its tributaries. This includes the large pond at the rear of lots 72-88.
2. Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this form. For
Page 6 of 9

additional information regarding the application process for the NCEEP, check the NCEEP
website at http://h2o.enr.state.nc.us/wrp/index.htm. If use of the NCEEP is proposed, please
check the appropriate box on page five and provide the following information:
Amount of stream mitigation requested (linear feet): n/a
Amount of buffer mitigation requested (square feet): n/a
Amount of Riparian wetland mitigation requested (acres): n/a
Amount ofNon-riparian wetland mitigation requested (acres): n/a
Amount of Coastal wetland mitigation requested (acres): n/a
IX.
X.
Environmental Documentation (required by DWQ)
1. Does the project involve an expenditure of public (federal/state/local) funds or the use of
public (federal/state) land? Yes ^ No
2. If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether aNEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ^ No ^
3. If yes, has the document review been finalized by the State Clearinghouse? If so, please
attach a copy of the NEPA or SEPA final approval letter. Yes ^ No ^
Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts iri Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
1. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify )? Yes ® No ^
2. If "yes", identify the square feet and acreage of impact to each zone of the riparian buffers.
If buffer mitigation is required calculate the required amount of mitigation by applying the
buffer multipliers.
Zone* Impact
(s uare feet) Multiplier Required
Mitigation
1 22,800 3 (2 for Catawba) 68,400
2 15,200 1.5 22,800
Total 3 8,000 91,200
Page 7 of 9

3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration /Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within 15A NCAC 2B .0242 or .0244, or .0260. Riparian buffer mitigation is not required.
XI. Stormwater (required by DWQ)
Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss stormwater
controls proposed in order to protect surface waters and wetlands downstream from the property. If
percent impervious surface exceeds 20%, please provide calculations demonstrating total proposed
impervious level. Total acreage: 70.07 Acres. Impervious areas: existing-0; proposed-
15.03 Acres; 15.03 Ac/70.07 Ac = 21%. Proposed impervious surfaces include: roads,
parking lots, driveways, roofs, paved storage areas, etc. Please refer to Table on
Overall Site Grading and Drainage Plan. While under construction, temporary custom
sedimentation basins will be installed outside of the wetlands and streams to protect
them against sedimentation along with other appropriate sedimentation and erosion
control measures in compliance with the DWQ and Wake County Sedimentation and
Erosion Control requirements. Fourteen Level Spreaders will be utilized to provide
diffuse flow. Utilizing fourteen level spreaders that average 55-feet and are no longer
than 95-feet will maximize stormwater distribution. As seen on the Site Grading and
Drainage Plan, site rq aging will be minimal. This will maximize the penetration of
surface water into the ground.
XII. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
To City of Raleigh Walnut Creek Waste Water Treatment Plant.
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ^ No
Is this anafter-the-fact permit application? Yes ^ No
XIV. Cumulative Impacts (required by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes ^ No
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with
the most recent North Carolina Division of Water Quality policy posted on our website at
http://h2o.enr.state.nc.us/ncwetlands. If no, please provide a short narrative description:
Page 8 of 9

XV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
Ja-~- o~
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 9 of 9

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LEVEL SPREADER. t)PERATION AtdD MAIN~'Eh1A1~1CE AGREEMENT
Ti^t~l~+~el spreader 1s defined as an e`on~~4edr t~~r~t tftr~:S~soid, d~~i~n~ti to r~i~fu~~ stc~rr~~~t~r runoff.
(~~1~ainter~~anr:e activities st~ial! be performed as fo'i~a~r~s:
1_ Afier construction and unt~i veq~t~at;orl i~a~ ~~r/en ~~iat!rst~~c~, lovo# spre~~Sorts) shat! bo insp~+~ttt after
t>ve; Y rair~fail. Thereafter , level sp~e,~cfer{sl sral! rrt ,n~tre~t~d of ir;~sf dvc~ry month. and m'+~r
frequently dunn~~ the fail season and ~ftor ~~eavy r~, ;.f;3ll e~.~;nts~
c3 ACL'L:r(1'~:I`dt~d SeCl~rfi?~r".t, ift9'~i~S, .=~nCt i'ciSfl ot'~ll'~ tip: rE'rnoVf,d, a~nci''r~:pa(rs rTrr`kt~£: 4f CE'CtUIrBCt.
~~ Insper~t level :at~readeri,sj frr evrd~:nc"r; of tiCUr.r. ~,;n~a,~rcrattirr~, settier~r~ntof the 5tructurr:, and
concentrated flows do4vnhil! from thc~ !c'to', spr~.ada^s~.
c. ~+ le~del ilF~v~rtion Shall k;~;;' n~a,n'a:nr'd acrc~~s thc~ i nt: r+ f;~w-~pre~cinr; ~lruc:ture ~~t ~~ll iirr~es.
Reparr or replace the levE~! Spreader if it is dama~^e~~
d_ t~,1ow vegetative: waver to ~a t'~erc~t~i cif six 4~~ u~c7e~s arycf prune plants if tt;~;y cover oti^~~r txalf ~f the
level spreader surfiace.
F~. Repair erode:? :rrer3s anti rcala~F~~r4pl~r~t dead or d~:ma~ett v~~getatian.
'~. Tne t:antractc3r ~,tt~~Glci <~vo ci t~ . ~~la.,~, n~:nt :~f any '~~<~t~riat tin ~nci f'ir~v€:nt cc~nstrcartion trri~f;c acr~s~s
tt~e structure- It the rn~~asure is dai'a ~';r~d b'a ::onstruction tr;~ffi~, it st~ali b~ repaired ir~ni~.:."<:~tE>Iy.
3. Inspect any' rNpair the ~~~I :ctsc~n >y~.tf~rn je g.. c;~tGh basins, pipes, svrales, ripr~p} four t.t1 r n cis a y>rar
#r~ maintain prt~per functioning.
t ar/kr~ol^;ietlge dnrf agree by mY sr,nat.:r~~ I~I~~^~ that I am rcup<~nsibl~ for tt`i~ ;,e~orman~~ of the rnaint~~n~:ric,r
prr~redures Irsted above. Iagr~;r~ to n:.~tify DWt~ of any t}rot>ler~~s ~r,th tt~~: system ,~r prior to any changFs tb
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WAKE
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Cedar Ridge Property Map Rolesville
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Number: 1768073234
0044829
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DWQ Project No
DIVISION OF WATER QUALITY • LEVEL SPREADER WORKSHEET
I, PROJECT INFORMATION (please complete the following information):
Project Name : `re~'~. r ~'~ ~,~~
Contact Person: ~. C~llcr Phone Number: (~/`7) 5'Y`1-~ ~'`l `1
Level Spreader ID:. .~-~°
Level Spreader Length
Drainage Area
Impervious Area
Maximum Filter Strip/Buffer Slope
grass
Max. Discharge from a 10 Year Storm
Max. Discharge to Level Spreader
Filter StriplBuffer Vegetation
Pre-treatment or Bypass Method
II. REQUIRED ITEMS CHECKLIST
~~> ft.
t7. u~~ ac.
~%
~.%~ ~ ~' cfs
,ter cfs
~' ~~ S
n/~
(perpendicular to flow)
(on-site and off-site drainage to the level spreader)
(on-site and off-site drainage to the level spreader)
(6% for forested, leaf littler cover, 8% for thick ground cover)`
(thick ground cover or grass, canopied forest v~ith leaf litter
groundcover)
Initial in the space provided to indicate the following design requirements have been met and supporting documentation is attached..f a
requirement has not been met, attach an explanation of why. At a minimum, a complete stormwater management plan submittal includes
a worksheet for each BMP, design calculations, plans and specifications showing all BMPs and outlet structure details, a detailed
drainage plan and a fully executed operation and maintenance agreement. An incomplete submittal package will result in a request for
additional information and will substantially delay final review and approval of the project.
A licants Initials
Level spreader is at least 13 ft. per cfs for thick ground cover
litter.
n/G Pre-Form Scour Holes are on flat slopes only
No structures are located in protected buffers'
If bypass method specified in the Draft level Spreader Design Option Document:
or grass or 100 ft per cfs in canopied forest with leaf
Bypass method is specified (if applicable) and plan details and calculations are provided
Discharge to level spreader and subsequent filter strip is hydraulically and spatially separate from the bypass
discharge.
No structures are located in protected buffers.
Plan details for the bypass and outlets are provided.
The operation and maintenance agreement includes annual erosion and vegetation repair.
The operation and maintenance agreement signed and notarized by the responsible party is provided.
Level spreaders in series can be used on slopes of up to 15% in forested areas with leaf littler cover or on slopes of up to 25% in areas
v~ith thick ground cover or grass if designed according to the Draft Level Spreader Design Option Document. This potentially requires a
minor variance in protected buffer areas. In any event the second level spreader cannot be located in Zone 1 of a protected buffer area.

DWQ Project No
DIVISION OF WATER QUALITY • LEVEL SPREADER WORKSHEET
I. PROJECT INFORMATION (p
Project Name : r~Ci
Contact Person:
Level Spreader ID:. ~F ~~
Level Spreader Length
Drainage Area
Impervious Area
Maximum Filter Strip/Buffer Slope
grass
Max. Discharge from a 10 Year Storm
Max. Discharge to Level Spreader
Filter StriplBuffer Vegetation
Pre-treatment or Bypass Method
.e complete the following information):
~e
der Phone Number: j, ~J' %) 8 `l `1 ~ ~ 8 y ~
~ ft. (perpendicular to flow)
/- ~' ac. (on-site and off-site drainage to the level spreader)
®_:3~ ac. (on-site and off-site drainage to the level spreader)
~ % (6% for forested, leaf littler cover, 8% for thick ground cover)*
3. ~'~ cfs
3. ~+~' cfs
~~ -~; ~ (thick ground cover or grass, canopied forest with leaf litter
~ groundcover)
I1 ~G
II. REQUIRED ITEMS CHECKLIST
Initial in the space provided to indicate the following design requirements have been met and supporting documentation is attached. If a
requirement has not been met, attach an explanation of why. At a minimum, a complete stormwater management plan submittal includes
a worksheet for each BMP, design calculations, plans and specifications shovnng all BMPs and outlet structure details, a detailed
drainage plan and a fully executed operation and maintenance agreement. An incomplete submittal package will result in a request for
additional information and will substantially delay final review and approval of the project.
A licants Initials
Level spreader is at least 13 ft. per cfs for thick ground cover or grass or 100 ft per cfs in canopied forest with leaf
litter.
n/a Pre-Form Scour Holes are on flat slopes only
,- No structures are located in protected buffers*
If bypass method specified in the Draft Level Spreader Design Option Document:
Bypass method is specified (if applicable) and plan details and calculations are provided
Discharge to level spreader and subsequent filter strip is hydraulically and spatially separate from the bypass
discharge.
No structures are located in protected buffers.
Plan details for the bypass and outlets are provided.
The operation and maintenance agreement includes annual erosion and vegetation repair.
The operation and maintenance agreement signed and notarized by the responsible party is provided.
* Level spreaders in series can be used on slopes of up to 15% in forested areas v~ith leaf littler cover or on slopes of up to 25% in areas
v~ith thick ground cover or grass if designed according to the Draft Level Spreader Design Option Document. This potentially requires a
minor variance in protected buffer areas. In any event the second level spreader cannot be located in Zone 1 of a protected buffer area.

DWQ Project
DIVISION OF WATER QUALITY • LEVEL SPREADER WORKSHEET
I. PROJECT INFORMATION (please complete the following information):
Project Name : 'IE'(~r. ~ ,R~~-,e
Contact Person: ~ . ~ ller Phone Number: ~~l `l 1 ~'Y y - c;~ ~ `I ~
Level Spreader ID:. ~'~' ~ ~~
Level Spreader Length
Drainage Area
Impervious Area
Maximum Filter StriplBuffer Slope
grass
Max. Discharge from a 10 Year Storm
Max. Discharge to Level Spreader
Filter Strip/Buffer Vegetation
Pre-treatment or Bypass Method
~r ft. (perpendicular to flow)
~! ~ ac. (on-site and off-site drainage to the level spreader)
[~.:~ ~ ac. (on-site and off-site drainage to the level spreader)
~ % (6% for forested, leaf littler cover, 8% for thick ground cover)'
`~ • `~~ cfs
~, ~ `~ cfs
~° -<, ~ (thick ground cover or grass, canopied forest v+nth leaf litter
~ groundcover)
n/~
II. REQUIRED ITEMS CHECKLIST
Initial in the space provided to indicate the following design requirements have been met and supporting documentation is attached. If a
requirement has not been mef, attach an explanation of why. At a minimum, a complete stormwater management plan submittal includes
a worksheet for each BMP, design calculations, plans and specifications showing all BMPs and outlet structure details, a detailed
drainage plan and a fully executed operation and maintenance agreement. An incomplete submittal package will result in a request for
additional information and will substantially delay final review and approval of the project.
A licants Initials
Level spreader is at least 13 ft. per cfs for thick ground cover or grass or 100 ft per cfs in canopied forest with leaf
litter.
n G Pre-Form Scour Holes are on flat slopes only
No structures are located in protected buffers'
If bypass method specified in the Draft Level Spreader Design Option Document;
Bypass method is specified (if applicable) and plan details and calculations are provided
Discharge to level spreader and subsequent filter strip is hydraulically and spatially separate from the bypass
discharge.
No structures are located in protected buffers,
Plan details for the bypass and outlets are provided.
The operation and maintenance agreement includes annual erosion and vegetation repair.
The operation and maintenance agreement signed and notarized by the responsible party is provided.
' Level spreaders in series can be used on slopes of up to 15% in forested areas with leaf littler cover or on slopes of up to 25% in areas
with thick ground cover or grass if designed according to the Draft Level Spreader Design Option Document. This potentially requires a
minor variance in protected buffer areas. In any event the second level spreader cannot be located in Zone 1 of a protected buffer area.

DWQ Project
DIVISION OF WATER QUALITY -LEVEL SPREADER WORKSHEET
I. PROJECT INFORMATION (please complete the following information):
Project Name : ~~, r ~: ~C•,~
Contact Person: ~ . Ce ller Phone Number: (~1'7) ~'Y `1 ' cv 8 `I `>!
Level Spreader ID:. FE ~ i3
Level Spreader Length `7.~ ft. (perpendicular to flow)
Drainage Area /. 4~ ~ ac. (on-site and off-site drainage to the level spreader)
Impervious Area ~ ~~ ac. (on-site and off-site drainage to the level spreader)
Maximum Filter Strip/Buffer Slope ~ % (6% for forested, leaf littler cover, 8% for thick ground cover)'
grass
Max. Discharge from a 10 Year Storm -~ • ~ ~ cfs
Max. Discharge to Level Spreader -. ~' `~ cfs
Filter StriplBuffer Vegetation ~r; .~ (thick ground cover or grass, canopied forest with leaf litter
~ groundcover)
Pre-treatment or Bypass Method /1/~i
II. REQUIRED ITEMS CHECKLIST
Initial in the space provided to indicate the following design requirements have been met and supporting documentation is attached. If a
requirement has not been met, attach an explanation of why. At a minimum, a complete sformwater management plan submittal includes
a worksheet for each BMP, design calculations, plans and specifications showing all BMPs and outlet structure details, a detailed
drainage plan and a fully executed operation and maintenance agreement. An incomplete submittal package will result in a request for
additional information and will substantially delay final review and approval of the project.
A~licants Initials
Level spreader is at least 13 ft. per cfs for thick ground cover or grass or 100 ft per cfs in canopied forest v~ith leaf
litter.
n/~, Pre-Form Scour Holes are on flat slopes only
No structures are located in protected buffers'
If bypass method specified in the Draft Level Spreader Design Option Document:
Bypass method is specified (if applicable) and plan details and calculations are provided
Discharge to level spreader and subsequent filter strip is hydraulically and spatially separate from the bypass
discharge.
No structures are located in protected buffers.
Plan details for the bypass and outlets are provided.
The operation and maintenance agreement includes annual erosion and vegetation repair.
The operation and maintenance agreement signed and notarized by the responsible party is provided.
' Level spreaders in series can be used on slopes of up to 15% in forested areas with leaf littler cover or on slopes of up to 25% in areas
v~ith thick ground cover or grass if designed according to the Draft Level Spreader Design Option Document. This potentially requires a
minor variance in protected buffer areas. In any event the second level spreader cannot be located in Zone 1 of a protected buffer area.

DWQ Project No
DIVISION OF WATER QUALITY • LEVEL SPREADER WORKSHEET
I. PROJECT INFORMATION (please complete the following information):
Project Name :=~et~~. ~ Ri ~~e
Contact Person: ~. e(l~~ Phone Number (~/';~) ~'YY' ~ ~ y ~ _
Level Spreader ID: - :~~ ~~
Level Spreader Length
Drainage Area
Impervious Area
Maximum Filter StriplBuffer Slope
grass
Max, Discharge from a 10 Year Storm
Max. Discharge to Level Spreader
Filter Strip/Buffer Vegetation
Pre-treatment or Bypass Method
II. REQUIRED ITEMS CHECKLIST
ft. (perpendicular to flow)
~. ~ . - ac. (on-site and off-site drainage to the level spreader)
C~ ~/~ ac. (on-site and off-site drainage to the level spreader)
~ % (6% for forested, leaf littler cover, 8% for thick ground cover)*
~.~, z= cfs
~~ ~.
~,,.~ cfs
r' .:; s (thick ground cover or grass, canopied forest with leaf litter
~ groundcover)
n/~
Initial in the space provided to indicate the following design requirements have been met and supporting documentation is attached. 'f a
requirement has not been met, attach an explanation of why. At a minimum, a complete stormwater management plan submittal includes
a worksheet for each BMP, design calculations, plans and specifications showing all BMPs and outlet structure details, a detailed
drainage plan and a fully executed operation and maintenance agreement. An incomplete submittal package will result in a request for
additional information and will substantially delay final review and approval of the project.
A licants Initials
Level spreader is at least 13 ft. per cfs for thick ground cover or grass or 100 ft per cfs in canopied forest with leaf
litter.
n/G Pre-Form Scour Holes are on flat slopes only
No structures are located in protected buffers*
If bypass method specified in the Draft Level Spreader Design Option Document:
Bypass method is specified (if applicable) and plan details and calculations are provided
Discharge to level spreader and subsequent filter strip is hydraulically and spatially separate from the bypass
discharge.
No structures are located in protected buffers.
Plan details for the bypass and outlets are provided.
The operation and maintenance agreement includes annual erosion and vegetation repair.
The operation and maintenance agreement signed and notarized by the responsible party is provided.
* Level spreaders in series can be used on slopes of up to 15% in forested areas with leaf littler cover or on slopes of up to 25% in areas
with thick ground cover or grass if designed according to the Draft Level Spreader Design Option Document. This potentially requires a
minor variance in protected buffer areas. In any event the second level spreader cannot be located in Zone 1 of a protected buffer area.

DWQ Project No
DIVISION OF WATER QUALITY LEVEL SPREADER WORKSHEET
I. PROJECT INFORMATION (please complete the following information):
Project Name : '+-ec~~~ ~ ift': ~[-,e
Contact Person: ~'~,.~ ~e/ler Phone Number: (1,
Level Spreader ID:. ~~ ~' 3 G~'
Level Spreader Length
Drainage Area
Impervious Area
Maximum Filter Strip/Buffer Slope
grass
Max. Discharge from a 10 Year Storm
Max. Discharge to Level Spreader
Filter Strip/Buffer Vegetation
Pre-treatment or Bypass Method
II. REQUIRED ITEMS CHECKLIST
55 ft.
_ ac.
• ~id ac.
Q
~~. ~ ~'' cfs
~', ~~" cfs
.. ,.~ .~
n/~
y
(perpendicular to flow)
(on-site and off-site drainage to the level spreader)
(on-site and off-site drainage to the level spreader)
(6% for forested, leaf littler cover, 8% for thick ground cover)'
(thick ground cover or grass, canopied forest with leaf litter
groundcover)
Initial in the space provided to indicate the following design requirements have been met and supporting documentation is attached. if a
requirement has not been met, attach an explanation of why. At a minimum, a complete stormwater management plan submittal includes
a worksheet for each BMP, design calculations, plans and specifications showing all BMPs and outlet structure details, a detailed
drainage plan and a fully executed operation and maintenance agreement. An incomplete submittal package will result in a request for
additional information and will substantially delay final review and approval of the project.
A licants Initials
Level spreader is at least 13 ft. per cfs for thick ground cover or grass or 100 ft per cfs in canopied forest with leaf
litter.
n/a Pre-Form Scour Holes are on flat slopes only
_ No structures are located in protected buffers'
If bypass method specified in the Draft Level Spreader Design Option Document:
Bypass method is specified (if applicable) and plan details and calculations are provided
Discharge to level spreader and subsequent filter strip is hydraulically and spatially separate from the bypass
discharge.
No structures are located in protected buffers.
Plan details for the bypass and outlets are provided.
The operation and maintenance agreement includes annual erosion and vegetation repair.
The operation and maintenance agreement signed and notarized by the responsible party is provided.
* Level spreaders in series can be used on slopes of up to 15% in forested areas with leaf littler cover or on slopes of up to 25% in areas
with thick ground cover or grass if designed according to the Draft Level Spreader Design Option Document. This potentially requires a
minor variance in protected buffer areas, In any event the second level spreader cannot be located in Zone 1 of a protected buffer area.

DWQ Project No.
DIVISION OF WATER QUALITY -LEVEL SPREADER WORKSHEET
I. PROJECT INFORMATION (please complete the following information):
Project Name : u ~ ~: ~(-;e
Contact Person: ~ . elle~ Phone Number (~/`%) ~' y `~ - ~ ~ y 9
Level Spreader ID:. F~ ,~(~~
Level Spreader Length ~v~ ft. (perpendicular to flow)
Drainage Area ~ , `~8 ac. (on-site and off-site drainage to the level spreader)
Impervious Area b,;3 / ac. (on-site and off-site drainage to the level spreader)
Maximum Filter Strip/Buffer Slope ~'~ % (6% for forested, leaf littler cover, 8% for thick ground cover)'
grass
Max. Discharge from a 10 Year Storm
Max. Discharge to Level Spreader
Filter Strip/Buffer Vegetation
,~ ~ ~ cfs
3 , ~`' 7 cfs
~~
(thick ground cover or grass, canopied forest with leaf litter
groundcover)
Pre-treatment or Bypass Method
II, REQUIRED ITEMS CHECKLIST
n/G
Initial in the space provided to indicate the following design requirements have been met and supporting documentation is attached..f a
requirement has not been met, attach an explanation of why. At a minimum, a complete stormwater management plan submittal includes
a worksheet for each BMP, design calculations, plans and specifications showing all BMPs and outlet structure details, a detailed
drainage plan and a fully executed operation and maintenance agreement. An incomplete submittal package will result in a request for
additional information and will substantially delay final review and approval of the project.
A licants Initials
Level spreader is at least 13 ft. per cfs for thick ground cover or grass or 100 ft per cfs in canopied forest with leaf
litter.
n/~ Pre-Form Scour Holes are on flat slopes only
No structures are located in protected buffers'
If bypass method specified in the Draft Level Spreader Design Option Document:
Bypass method is specified (if applicable) and plan details and calculations are provided
Discharge to level spreader and subsequent filter strip is hydraulically and spatially separate from the bypass
discharge.
No structures are located in protected buffers.
Plan details for the bypass and outlets are provided.
The operation and maintenance agreement includes annual erosion and vegetation repair.
The operation and maintenance agreement signed and notarized by the responsible party is provided.
Level spreaders in series can be used on slopes of up to 15% in forested areas with leaf littler cover or on slopes of up to 25% in areas
with thick ground cover or grass if designed according to the Draft Level Spreader Design Option Document. This potentially requires a
minor variance in protected buffer areas. In any event the second level spreader cannot be located in Zone 1 of a protected buffer area.

DWQ Project No
DIVISION OF WATER QUALITY • LEVEL SPREADER WORKSHEET
I, PROJECT INFORMATION (please complete the following information):
Project Name : '."-~c~~, ~ ~: t{~;e
Contact Person: ~ ~ . Ce ller Phone Number: (~/`) ~'Y Y - U 8 `l 9
Level Spreader ID:. ~~ #
Level Spreader Length do ft. (perpendicular to flow)
Drainage Area dad ac. (on-site and off-site drainage to the level spreader)
Impervious Area ©. ~a ac. (on-site and off-site drainage to the level spreader)
Maximum Filter Strip/Buffer Slope ~ % (6% for forested, leaf littler cover, 8% for thick ground cover)'
grass
Max. Discharge from a 10 Year Storm f • S° cfs
Max. Discharge to Level Spreader ~. 5~ cfs
Filter Strip/Buffer Vegetation ~' -~; ss (thick ground cover or grass, canopied forest with leaf litter
V groundcover)
Pre-treatment or Bypass Method n/~
II. REQUIRED ITEMS CHECKLIST
Initial in the space provided to indicate the following design requirements have been met and supporting documentation is attached..f a
requirement has not been met, attach an explanation of why. At a minimum, a complete stormwater management plan submittal includes
a worksheet for each BMP, design calculations, plans and specifications showing all BMPs and outlet structure details, a detailed
drainage plan and a fully executed operation and maintenance agreement. An incomplete submittal package will result in a request for
additional information and will substantially delay final review and approval of the project.
A licants Initials
Level spreader is at least 13 ft. per cfs for thick ground cover or grass or 100 ft per cfs in canopied forest with leaf
litter.
n/~i Pre-Form Scour Holes are on flat slopes only
No structures are located in protected buffers'
If bypass method specified in the Draft Level Spreader Design Option Document:
Bypass method is specified (if applicable) and plan details and calculations are provided
Discharge to level spreader and subsequent filter strip is hydraulically and spatially separate from the bypass
discharge.
No structures are located in protected buffers.
Plan details for the bypass and outlets are provided.
The operation and maintenance agreement includes annual erosion and vegetation repair.
The operation and maintenance agreement signed and notarized by the responsible party is provided.
* Level spreaders in series can be used on slopes of up to 15% in forested areas with leaf littler cover or on slopes of up to 25% in areas
with thick ground cover or grass if designed according to the Draft Level Spreader Design Option Document. This potentially requires a
minor variance in protected buffer areas. In any event the second level spreader cannot be located in Zone 1 of a protected buffer area.

DWQ Project
DIVISION OF WATER QUALITY -LEVEL SPREADER WORKSHEET
I. PROJECT INFORMATION (please complete the following information):
Project Name : '.~~c~c. r ;R~~(•;~
Contact Person: ~'~, ~ j~~ //e~ Phone Number: (~/`%) ~ y y - ~ ~ y ~
Level Spreader ID:. ~~S ~ ~-~
Level Spreader Length GCS ft. (perpendicular to flow)
Drainage Area a . ~ y ac. (on-site and off-site drainage to the level spreader)
Impervious Area O•'i9 ac. (on-site and off-site drainage to the level spreader)
Maximum Filter Strip/Buffer Slope 8,_ % (6% for forested, leaf littler cover, 8% for thick ground cover)"
grass
Max. Discharge from a 10 Year Storm y~ `I~~ cfs
Max. Discharge to Level Spreader y, Y ~~ cfs
Filter Strip/Buffer Vegetation ~ (thick ground cover or grass, canopied forest with leaf litter
~ groundcover)
Pre-treatment or Bypass Method n/~
II. REQUIRED ITEMS CHECKLIST
Initial in the space provided to indicate the following design requirements have been met and supporting documentation is attached. If a
requirement has not been met, attach an explanation of why. At a minimum, a complete stormwater management plan submittal includes
a worksheet for each BMP, design calculations, plans and specifications showing all BMPs and outlet structure details, a detailed
drainage plan and a fully executed operation and maintenance agreement. An incomplete submittal package will result in a request for
additional information and will substantially delay final review and approval of the project.
A licants Initials
Level spreader is at least 13 ft. per cfs for thick ground cover or grass or 100 ft per cfs in canopied forest with leaf
litter.
n/G Pre-Form Scour Holes are on flat slopes only
No structures are located in protected buffers'
If bypass method specified in the Draft Level Spreader Design Option Document:
Bypass method is specified (if applicable) and plan details and calculations are provided
Discharge to level spreader and subsequent filter strip is hydraulically and spatially separate from the bypass
discharge.
No structures are located in protected buffers.
Plan details for the bypass and outlets are provided.
The operation and maintenance agreement includes annual erosion and vegetation repair.
The operation and maintenance agreement signed and notarized by the responsible party is provided.
`Level spreaders in series can be used on slopes of up to 15% in forested areas with leaf littler cover or on slopes of up to 25% in areas
with thick ground cover or grass if designed according to the Draft Level Spreader Design Option Document. This potentially requires a
minor variance in protected buffer areas. In any event the second level spreader cannot be located in Zone 1 of a protected buffer area.

DWQ Project
DIVISION OF WATER QUALITY • LEVEL SPREADER WORKSHEET
I. PROJECT INFORMATION (please complete the following information):
Project Name : ~. ~ ~: ~i~e _
Contact Person: j~~ jCeller Phone Number: (~1 %) ~'Y `l - ~ 8 `I `1
Level Spreader ID:. ~"~ ~ 5'$
Level Spreader Length 7~ ft. (perpendicular to flow)
Drainage Area 3.63 ac. (on-site and off-site drainage to the level spreader)
Impervious Area D, 5q ac. (on-site and off-site drainage to the level spreader)
Maximum Filter Strip/Buffer Slope ~ % (6% for forested, leaf littler cover, 8% for thick ground cover)'
grass
Max. Discharge from a 10 Year Storm 5. '{a cfs
Max. Discharge to Level Spreader 5,'(a cfs
Filter Strip/Buffer Vegetation ~' - ; s _ (thick ground cover or grass, canopied forest with leaf litter
groundcover)
Pre-treatment or Bypass Method /1/~i
II. REQUIRED ITEMS CHECKLIST
Initial in the space provided to indicate the following design requirements have been met and supporting documentation is attached..f a
requirement has not been met, attach an explanation of why. At a minimum, a complete stormwater management plan submittal includes
a worksheet for each BMP, design calculations, plans and specifications showing all BMPs and outlet structure details, a detailed
drainage plan and a fully executed operation and maintenance agreement. An incomplete submittal package will result in a request for
additional information and will substantially delay final review and approval of the project.
A licants Initials
Level spreader is at least 13 ft. per cfs for thick ground cover or grass or 100 ft per cfs in canopied forest with leaf
litter.
n ~ Pre-Form Scour Holes are on flat slopes only
No structures are located in protected buffers'
If bypass method specified in the Draft Level Spreader Design Option Document:
Bypass method is specified (if applicable) and plan details and calculations are provided
Discharge to level spreader and subsequent filter strip is hydraulically and spatially separate from the bypass
discharge.
No structures are located in protected buffers.
Plan details for the bypass and outlets are provided.
The operation and maintenance agreement includes annual erosion and vegetation repair.
The operation and maintenance agreement signed and notarized by the responsible party is provided,
* Level spreaders in series can be used on slopes of up to 15% in forested areas with leaf littler cover or on slopes of up to 25% in areas
with thick ground cover or grass if designed according to the Draft Level Spreader Design Option Document. This potentially requires a
minor variance in protected buffer areas. In any event the second level spreader cannot be located in Zone 1 of a protected buffer area.

DWQ Project
DIVISION OF WATER QUALITY • LEVEL SPREADER WORKSHEET
I. PROJECT INFORMATION (please complete the following information):
Project Name : ''rec~~. ~ R: ~,e
Contact Person: ~~r i ~Ce/ler Phone Number: (~;/`I) 8Y `1- ~ 3 `l 9
Level Spreader ID:. ~E-S ~ C
Level Spreader Length 9 o ft. (perpendicular to flow)
Drainage Area 3, 6a ac. (on-site and off-site drainage to the level spreader)
Impervious Area d.'7~ ac. (on-site and off-site drainage to the level spreader)
Maximum Filter StriplBuffer Slope ~ % (6% for forested, leaf littler cover, 8% for thick ground cover)*
grass
Max. Discharge from a 10 Year Storm (• ~~ I cfs
Max. Discharge to Level Spreader (~. ~ ( cfs
Filter Strip/Buffer Vegetation ~' -.:; s (thick ground cover or grass, canopied forest with leaf litter
~ grountlcover)
Pre-treatment or Bypass Method n~~i
II. REQUIRED ITEMS CHECKLIST
Initial in the space provided to indicate the following design requirements have been met and supporting documentation is attached. if a
requirement has not been met, attach an explanation of why. At a minimum, a complete stormwater management plan submittal includes
a worksheet for each BMP, design calculations, plans and specifications showing all BMPs and outlet structure details, a detailed
drainage plan and a fully executed operation and maintenance agreement. An incomplete submittal package will result in a request for
additional information and will substantially delay final review and approval of the project.
A lica~ nts Initials
~d`~ Level spreader is at least 13 ft. per cfs for thick ground cover or grass or 100 ft per cfs in canopied forest with leaf
litter.
r/~, Pre-Form Scour Holes are on flat slopes only
No structures are located in protected buffers*
If bypass method specified in the Draft Level Spreader Design Option Document:
Bypass method is specified (if applicable) and plan details and calculations are provided
Discharge to level spreader and subsequent filter strip is hydraulically and spatially separate from the bypass
discharge.
No structures are located in protected buffers.
Plan details for the bypass and outlets are provided,
The operation and maintenance agreement includes annual erosion and vegetation repair.
The operation and maintenance agreement signed and notarized by the responsible party is provided.
* Level spreaders in series can be used on slopes of up to 15% in forested areas with leaf littler cover or on slopes of up to 25% in areas
with thick ground cover or grass if designed according to the Draft Level Spreader Design Option Document. This potentially requires a
minor variance in protected buffer areas. In any event the second level spreader cannot be located in Zone 1 of a protected buffer area.

DWQ Project No
DIVISION OF WATER QUALITY • LEVEL SPREADER WORKSHEET
I. PROJECT INFORMATION (please complete the following information):
Project Name : ~~~~4'c~a r ~R:~- e
Contact Person: ~~ jCe lle~ Phone Number:
Level Spreader ID:. ~-ES ~ ~-
Level Spreader Length
Drainage Area
Impervious Area
Maximum Filter Strip/Buffer Slope
grass
Max. Discharge from a 10 Year Storm
Max. Discharge to Level Spreader
Filter Strip/Buffer Vegetation
Pre-treatment or Bypass Method
II. REQUIRED ITEMS CHECKLIST
3c> ft. (perpendicular to flow)
O. ~s ac. (on-site and off-site drainage to the level spreader)
O, ao ac. (on-site and off-site drainage to the level spreader)
_~ % (6% for forested, leaf littler cover, 8% for thick ground cover)'
a, 6 ~' cfs
~ , o ~ cfs
~- -~:; ~ ~ (thick ground cover or grass. canopied forest v~ith leaf litter
~ groundcover)
!1,/q
Initial in the space provided to indicate the following design requirements have been met and supporting documentation is attached..f a
requirement has not been met, attach an explanation of why. At a minimum, a complete stormwater management plan submittal includes
a worksheet for each BMP, design calculations, plans and specifications showing all BMPs and outlet structure details, a detailed
drainage plan and a fully executed operation and maintenance agreement. An incomplete submittal package will result in a request for
additional information and will substantially delay final review and approval of the project.
A licants Initials
Level spreader is at least 13 ft. per cfs for thick ground cover or grass or 100 ft per cfs in canopied forest with leaf
litter.
r/r, Pre-Form Scour Holes are on flat slopes only
No structures are located in protected buffers'
If bypass method specified in the Draft Level Spreader Design Option Document:
Bypass method is specified (if applicable) and plan details and calculations are provided
Discharge to level spreader and subsequent filter strip is hydraulically and spatially separate from the bypass
discharge.
No structures are located in protected buffers.
Plan details for the bypass and outlets are provided.
The operation and maintenance agreement includes annual erosion and vegetation repair.
The operation and maintenance agreement signed and notarized by the responsible party is provided.
' Level spreaders in series can be used on slopes of up to 15% in forested areas with leaf littler cover or on slopes of up to 25% in areas
with thick ground cover or grass if designed according to the Draft Level Spreader Design Option Document. This potentially requires a
minor variance in protected buffer areas. In any event the second level spreader cannot be located in Zone 1 of a protected buffer area.

DWQ Project No
DIVISION OF WATER QUALITY -LEVEL SPREADER WORKSHEET
I. PROJECT INFORMATION (please complete the following information):
Project Name : '~_E'{~r ~ ;R~ d-,e
Contact Person: ~ . '~ Viler Phone Number (~)`I) 5'Y Y - ~ 8 y 9
Level Spreader ID: _ ~' S ~ 6 ~
Level Spreader Length
Drainage Area
Impervious Area
Maximum Filter Strip/Buffer Slope
grass
Max. Discharge from a 10 Year Storm
Max. Discharge to Level Spreader
Filter StriplBuffer Vegetation
Pre-treatment or Bypass Method
II. REQUIRED ITEMS CHECKLIST
~ o ft. (perpendicular to flow)
O. ~~1 ac. (on-site and off-site drainage to the level spreader)
o, 13 ac. (on-site and off-site drainage to the level spreader)
~ % (6% for forested, leaf littler cover, 8% for thick ground cover)*
/- d Y cfs
/. c> y cfs
~~ -,~, s (thick ground cover or grass, canopied forest with leaf litter
~ groundcover)
n/~
Initial in the space provided to indicate the following design requirements have been met and supporting documentation is attached. If a
requirement has not been met, attach an explanation of why. At a minimum, a complete stormwater management plan submittal includes
a worksheet for each BMP, design calculations, plans and specifications showing all BMPs and outlet structure details, a detailed
drainage plan and a fully executed operation and maintenance agreement. An incomplete submittal package will result in a request for
additional information and will substantially delay final review and approval of the project.
Applicant~lnitials
Level spreader is at least 13 ft. per cfs for thick ground cover or grass or 100 ft per cfs in canopied forest with leaf
litter.
n/a Pre-Form Scour Holes are on flat slopes only
No structures are located in protected buffers*
If bypass method specified in the Draft Level Spreader Design Option Document:
Bypass method is specified (if applicable) and plan details and calculations are provided
Discharge to level spreader and subsequent filter strip is hydraulically and spatially separate from the bypass
discharge.
No structures are located in protected buffers.
Plan details for the bypass and outlets are provided.
The operation and maintenance agreement includes annual erosion and vegetation repair.
The operation and maintenance agreement signed and notarized by the responsible party is provided.
* Level spreaders in series can be used on slopes of up to 15% in forested areas with leaf littler cover or on slopes of up to 25% in areas
with thick ground cover or grass if designed according to the Draft Level Spreader Design Option Document. This potentially requires a .
minor variance in protected buffer areas. In any event the second level spreader cannot be located in Zone 1 of a protected buffer area.

DWQ Project No
DIVISION OF WATER QUALITY -LEVEL SPREADER WORKSHEET
I. PROJECT INFORMATION (please complete the following information):
Project Name : _~~~: ~ ;R ~~{•' e
Contact Person: ~'~-r.~ ~Cel~c~ Phone Number: (
Level Spreader ID:. ~ # 73
Level Spreader Length
Drainage Area
Impervious Area
Maximum Filter StriplBuffer Slope
grass
Max. Discharge from a 10 Year Storm
Max. Discharge to Level Spreader
Filter StriplBuffer Vegetation
Pre-treatment or Bypass Method
II. REQUIRED ITEMS CHECKLIST
6G ft. (perpendicular to flow)
l: IcT ac. (on-site and off-site drainage to the level spreader)
p. ~tT ac. (on-site and off-site drainage to the level spreader)
A % (6% for forested, leaf littler cover, 8% for thick ground cover)*
y. `i'a cfs
y, ~' o cfs
~~ -~; ~
- (thick ground cover or grass, canopied forest with leaf litter
~ groundcover)
n/~
Initial in the space provided to indicate the following design requirements have been met and supporting documentation is attached. If a
requirement has not been met, attach an explanation of why. At a minimum, a complete stormwater management plan submittal includes
a worksheet for each BMP, design calculations, plans and specifications showing all BMPs and outlet structure details, a detailed
drainage plan and a fully executed operation and maintenance agreement. An incomplete submittal package will result in a request for
additional information and will substantially delay final review and approval of the project.
A licants Initials
Level spreader is at least 13 ft, per cfs for thick ground cover or grass or 100 ft per cfs in canopied forest with leaf
litter.
n/~ Pre-Form Scour Holes are on flat slopes only
No structures are located in protected buffers'
If bypass method specified in the Draft Level Spreader Design Option Document:
Bypass method is specified (if applicable) and plan details and calculations are provided
Discharge to level spreader and subsequent filter strip is hydraulically and spatially separate from the bypass
discharge.
No structures are located in protected buffers.
Plan details for the bypass and outlets are provided.
The operation and maintenance agreement includes annual erosion and vegetation repair.
The operation and maintenance agreement signed and notarized by the responsible party is provided.
'Level spreaders in series can be used on slopes of up to 15% in forested areas with leaf littler cover or on slopes of up to 25% in areas
with thick ground cover or grass if designed according to the Draft Level Spreader Design Option Document. This potentially requires a
minor variance in protected buffer areas. In any event the second level spreader cannot be located in Zone 1 of a protected buffer area.

IRINA RIVE
390
SALE _ (H)_ 1'~ = 40' _ (V~ = 4'
LOW POINT V = 371.82
LOW POINT S = 17+33.35
PVI STA 17+49.67
A.D. 7.21
K = 0.79
150. ~ VC
380 __
w _M _ .__ _ c~ ~ ~
c
C+p M •MM ~~ M ~: tp

Li.l
i' tV F- i' N
F- n cV
.F I~
U> M O r1 O ~ M
~? ~ z
m
m ~ ~
.8

27.OIf. `~~
/
0.41 X ~ 1-
370 15in. R P _ ~ _ /
rn

a
~
~
~z
TWIN 4 "RCP ~ N
US INV 366.17 cn w
DS INV 363.17
0
z
i

VIRGINI WATER DRIVE
4,D SCA LE {H) 1 " 50' {V) 1" = 5'

PVI STA ~ 11+44.09
PVI = 395.35
A.D. _ -1.14
K 43.89

LOW POINT ELEV = 386J3 .oo' vc
PVI STA = 13+07.18
PVI ELEV = '363.70 NN
A.D. = 9.98 •~n~ _~ ~
K = 24.00 '~
+ai~r- + rrni
' v
ac
z~a.~.s

400 ~»
~?? v+
o
~ >
m m
o
~ ~
~ ~
n
cp
M MO + N
M U
~n0~
~ ~ W W
~ao
~
z~
~ '~
~n~
yy;;

m
+Tk¢ +oi F- m
UUIK-- MO

O t0
O~
.p
t ~ >
~ Z

1

k~'
N
~ f~
~ Y1 pb
~M
M n
O ~ X1

\ ppM~..
~p
Mf~O n
+~
~

/
390 \ N
w ~
m ~~_ Z
`~i M
u°°in~ ~
/
\ N~ M ~ Q ~
~,t' mm~F~~
Ut/1 K ? Q\
~

/
f.
15i CP

8 fin. ~C /
35.OIf. /
\1.208
380 1 in
RCP /
.. ~

/
Ax
~ \
: /
\
~ /
/
7

1
48" RCP

US INV 370.95
1
DS INV 368.15

370 /
J
15+00 14+00 13+00 12+00 11 +(

380
370
360
350
340
330
320
wl n - ~s«un
GINIA IYATE DRIVE ~ - -0.~
SCALE ( ) 1" = 75' (V) 1" ; = 7.5' x ~s
yaw va~r aav
' xzn a

uoM PCIN
t STA .
~! g
PM STA - t7 ~ ~
VM DEV . .72
AA-12
x-7A1 ~ '
. . .
~ ~ ~ ~
~ ~
/
. f. .. ~
xa ~ ~
^
.~ /

~':~
._
~~
~~ ~ ~
/
~~ ,~
~
~ ~~ ~d~

~
~ ~

,ei.
~ /
~ /
~ ~

/
~
/
~

~ ~
'
uz-ir. (SPAN) x gar (RISC cONSP
o
eRlocE TEM w/ s NEADwAU and ~
WINCVY (FO[RJDATIONSi 8.~ wDE x 5
DEER; TOP OF FOUNDATION O EL 3 60) \

40+00 39+00 38+00 37+00 36+00