SW3130302_CURRENT PERMIT_20130423

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW
DOG TYPE
� CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
DOC DATE
�e&-7'�p75
YYYYMMDD

WA
AJ��
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Mr. J. T. Ross
Love's Travel Stops & Country Stores, Inc.
P.O. Box 26210
Oklahoma City, OK 73120
Division of Water Quality
Charles Wakild, P.E.
Director
March 26, 2013
Subject: Stormwater Permit No. SW3130302
Love's Travel Stops & Country Stores, Inc.
High Density Commercial Sand Filter
Rowan County
Dear Mr. Ross:
John E. Skvarla, III
RECEIVED ry
DIVISION.O9; I.nrglr�-R QUALITY
APR G ,3 2,013
MOGRESV;LLia HEMONAL QFFIClr
The Stormwater Permitting Unit received a complete Stormwater Management Permit Application for the
subject project on March 13, 2013. Staff review of the plans and specifications has determined that the project,
as proposed, will comply with the Stormwater Regulations set forth in Title 15A NCAC 02H .1000. We are
forwarding Permit No. SW3130302, dated March 26, 2013, for the construction, operation and maintenance of
the subject project and the stormwater BMPs. This redevelopment project is treating the net increase in built
upon area.
This permit shall be effective from the date of issuance until March 26, 2021 and shall be subject to the
conditions and limitations as specified therein, and does not supersede any other agency permit that may be
required. Please pay special attention to the conditions listed in this permit regarding the Operation and
Maintenance of the BMP(s), recordation of deed restrictions, 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 follow the procedures for
transfer of 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. Per NCGS 143-
215(e) the petition 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.
This project will be kept on file at the Mooresville Regional Office. If you have any questions, or need additional
information concerning this matter, please contact Robert Patterson at [phone]; or
[e-mail].
Sincerely,
Z/W,J
for Charles Wakild, P.E., Director
Wetlands and Stormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699.1617
Location 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone [phone] FAX: [phone]
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affumative Action Employer
NorthCaroli na
Naturally

Mr.1. T. Ross
SW3130302 - Love's Travel Stop & Country Stores, inc.
March 26, 2013
cc: SW3130302 File
ec: Ross Grimball, PE - Resource Consulting, LLC
Michael Parker - Mooresville Regional Office
i RESOURCE CONSULTING
CIVIL ENGINEERING
Page 2 of 2

State Stormwater Permit
Permit No. SW3130302
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of
North Carolina as amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Love's Travel Stops & Country Stores, Inc.
1105 Peeler Rd., Salisbury, Rowan County
FOR THE
construction, operation and maintenance of one (1) sand filter in compliance with the
provisions of 15A NCAC 02H .1000 (hereafter referred to as the "stormwater rules') and
the approved stormwater management plans and specifications and other supporting
data as attached and on file with and approved by the Division of Water Quality and
considered a part of this permit.
This permit shall be effective from the date of issuance until March 26, 2021, and shall
be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
1. This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. This stormwater system has been approved for the management of stormwater
runoff as described in Section 1.7 of this permit. The stormwater control has been
designed to handle the runoff from 49,658 square feet of impervious area. This
is the net increase in BUA for this redevelopment.
3. The tract will be limited to the amount of new built -upon area as indicated in
Section 1.7 of this permit, and per the application documents and as shown on
the approved plans.
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.
6. The built -upon areas associated with this project shall be located at least 30 feet
landward of all perennial and intermittent surface waters.
Page 1 of 6

State Stormwater Permit
Permit No. SW3130302
7. The following design criteria have been provided in the sand filter and must be
maintained
at design condition:
a.
Drainage Area, aSres:
1.46
Onsite, ft :
63,598
Offsite, ft2:
0
b.
Total Impervious Surfaces, ft2:
49,658
Onsite, ft : 1
49,658
Offsite, ft2:
0
C.
Design Storm, inches:
1.0
d.
Sediment Chamber Bottom Elev., fmsl:
790.5
d.
Top of Sand Elevation, fmsl:
790.5
e.
Seasonal High Water Table, fmsl:
765.0
f.
Sand Depth, feet:
1.5
In.
Bottom of Sand Elevation fmsl-
789.0
i.
Sediment Chamber S/a, ft�:
689
i.
Sand Chamber SA, ft :
1,237
j.
Permitted Storage Volume, ft3:
5,988
k.
Bypass I Storage Elevation, fmsl:
792.5
n.
Drawdown Time, hours:
24
o.
Underdrain Diameter, inches:
4.0
q.
Receiving Stream/River Basin:
Town Creek 1 Yadkin - Pee Dee
r.
Stream Index Number:
12-115-3
s.
Classification of Water Body:
"C"
11. SCHEDULE OF COMPLIANCE
1. The stormwater management system shall be constructed in its entirety,
vegetated and operational for its intended use prior to the construction of any
built -upon surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The permittee shall at all time provide the operation and maintenance necessary
to assure the permitted stormwater system functions at optimum efficiency. 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 re -vegetation of slopes and the filter strip.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans.
f. Debris removal and unclogging of all drainage structures, level spreader,
filter media, planting media, underdrains, catch basins and piping.
g. Access to the cell and outlet structure must be available at all times.
4. Records of maintenance activities must be kept for each permitted BMP. The
reports will indicate the date, activity, name of person performing the work and
what actions were taken.
5. The permittee shall submit to the Division of Water Quality an annual summary
report of the maintenance and inspection records for each BMP. The report
shall summarize the inspection dates, results of the inspections, and the
maintenance work performed at each inspection.
6. The stormwater treatment system shall be constructed in accordance with the
Page 2 of 6

State Stormwater Permit
Permit No. SW3130302
approved plans and specifications, the conditions of this permit, and with other
supporting data.
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. Access to the stormwater facilities shall be maintained via appropriate recorded
easements at all times.
10. The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed
below:
a. Any revision to any item shown on the approved plans, including the
stormwater management measures, built -upon area, details, etc.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
e. Further subdivision, acquisition, lease or sale of all or part of the project
area. The project area is defined as all property owned by the permittee,
for which Sedimentation and Erosion Control Plan approval was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
11. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
12. A copy of the approved plans and specifications shall be maintained on file by
the Permittee for a minimum of ten years from the date of the completion of
construction.
13. The Director may notify the permittee when the permitted site does not meet one
or more of the minimum requirements of the permit. Within the time frame
specified in the notice, the permittee shall submit a written time schedule to the
Director for modifying the site to meet minimum requirements. The permittee
shall provide copies of revised plans and certification in writing'to the Director
that the changes have been made.
III. GENERAL CONDITIONS
This permit is not transferable except after notice to and approval by the Director.
In the event of a change of ownership, or a name change, the permittee must
submit a completed Name/Ownership Change form signed by both parties, to the
Division of Water Quality, accompanied by the supporting documentation as
listed on page 2 of the form. The approval of this request will be considered on
its merits and may or may not be approved.
2. The permittee is responsible for compliance with all permit conditions until such
time as the Division approves a request to transfer the permit.
Page 3 of 6

State Stormwater Permit
Permit No. SW3130302
3. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the Division of Water Quality, in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
4. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
5. In the event that the facilities fail to perform satisfactorily, including the creation
of nuisance conditions, the Permittee shall take immediate corrective action,
including those as may be required by this Division, such as the construction of
additional or replacement stormwater management systems.
6. The permittee grants DENR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
7. The permit issued shall continue in force and effect until revoked or terminated.
The permit may be modified, revoked and reissued or terminated for cause. The
filing of a request for a permit modification, revocation and re -issuance or
termination does not stay any permit condition.
8. Unless specified elsewhere, permanent seeding requirements for the stormwater
control must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
9. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
10. 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
as allowed by the laws, rules and regulations contained in Session Law 2006-
246, Title 15A NCAC 2H.1000, and NCGS 143-215.1 et.al.
11. The permittee shall notify the Division in writing of any name, ownership or
mailing address changes at least 30 days prior to making such changes.
12. The permittee shall submit a renewal request with all required forms and
documentation at least 180 days prior to the expiration date of this permit.
Permit issued this the 26th day of March, 2013.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for Charles Wakild, P.E,, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 4 of 6

State Stormwater Permit
Permit No. SW3130302
Love's Travel Stops & Country Stores, Inc.
Stormwater Permit No. SW3130302
Rowan County
Designer's Certification
I, , as a duly registered in the
State of North Carolina, having been authorized to observe ❑ periodically 1❑ weekly 1
❑full time) the construction of the project,
(Project Name)
for (Project Owner) hereby.state that, to the
best of my abilities, due care and diligence was used in the observation of the project
construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
SEAL
Page 5 of 6

State Stormwater Permit
Permit No. SW3130302
Certification Requirements:
1. The drainage area to the system contains approximately the permitted
acreage.
2. The drainage area to the system contains no more than the permitted
amount of built -upon area.
3. All the built -upon area associated with the project is graded such that the
runoff drains to the system.
4. All roof drains are located such that the runoff is directed into the system.
5. The outlet/bypass structure elevations are per the approved plan.
6. The outlet structure is located per the approved plans.
7. Under drains are located per the approved plans.
8. All slopes are grassed with permanent vegetation, per the vegetation plan.
9. Vegetated slopes are no steeper than 3:1.
10. The inlets are located per the approved plans and do not cause short-
circuiting of the system.
11. The permitted amounts of surface area and volume have been provided.
12. Required drawdown devices are correctly sized per the approved plans.
13. All required design depths are provided.
14. All required parts of the system are provided, such as a sediment
chambers, sand chambers, under drains, and outlets.
15. The required system dimensions are provided per the approved plans.
Please submit this Designer's Certification to: Mooresville Regional Office
Surface Water Protection
610 East Center Ave., Ste. 301
Mooresville, NC 28115
Cc: Shane Stewart — Rowan County
Page 6 of 6

. ti-
PermitNumber:.SIV 31 303oZ
{ro he provided by DlrQ)
Drainage Area Number:
Sand Filter Operation and Maintenance Agreement
FI
I will keep a maintenance record on this BMP. '['his maintenance record will be kept in a log in a
known set location. Anv deficient 13NW elements noted in the inspection will be corrected, repaired or
replaced immediately. 'These deficiencies can affect the integrity of structures, safety of the public, and
the removal efficiency of the 13M11.
Important maintenance procedures.-
- The drainage area will be carefully managed to reduce the sediment load to the sand filter.
- The sedimentation chamber or forebay will be cleaned out whenever sediment depth exceeds
Six Inches.
- Once a year, sand media will be skimmed.
- "the sand filter media will be replaced whenever it fails to function properly after maintenance.
The sand filter will be inspected quarterly and within 24 hours after every storm event greater than
1.0 inches (or 1.5 inches if in a Coastal County). I:ecords of operation and maintenance will be kept in
a known set location and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall be repaired
immediately.
Bi1�is"eleirient ; '3`':>; `. �:
P.atential; Yiiblerti:i<' f ter. �r y -
How.l,:will reiriediaEe,the" roblem" z;
Entire BMP
"Trash/debris is resent.
Remove the trash/debris.
Adjacent pavement (if
Sediment is present on the
Sweep or vacuum the sediment as soon as
applicable)
pavement surface.
possible.
Perimeter of sand filter
Areas of bare soil and/or erosive
Regrade the soil if necessary to remove the,
gullies have formed.
gully, and then plant a ground cover and
water until it is established. Provide lime
and a one-time fertilizer ap2lication.
Vegetation is too short or too long.
Maintain vegetation at an appropriate
height.
Flow diversion structure
The structure is clogged.
Unclog the conveyance and dispose of any
sediment offsite.
The structure is damaged.
Make any necessary repairs or replace if
damage is too large for repair.
>Forebay or pretreatment area
Sediment has accumulated to a
Search for the source of the sediment and
depth of greater than six inches.
remedy the problem if possible. Remove
the sediment and stabilize or dispose of it
in a location where it will not cause
impacts to streams or the BMP.
Erosion has occurred.
Provide additional erosion protection such
as reinforced turf matting or riprap if
needed to prevent future erosion
roblems.
Weeds are present.
Remove the weeds, preferably by hand. If
a pesticide is used, wipe it on the plants
rather than spraying.
Dorm SW401-Sand Filter O&M-Rev.4 2009Sept17
Page I o1-3

=BMP°element r ` '
i'ateiitialr." rolilem :',;=sir, , k_`
:,How,.z�wtll`iemec iate #he,` iablem:q; `f
Filter bed and underdrain
Water is ponding on the surface for
Check to see if the collector system is
collection system
more than 24 hours after a storm.
Clogged and flush if necessary. If water
still ponds, remove the top few inches of
filter bed media and replace. If water still
ponds, then consult an exj2ert.
Outlet device
Clogging has occurred.
Clean out the outlet device. Dispose of the
sediment offsite.
The outlet device is damaged
Repair or re lace the outlet device.
Receiving water
Erosion or other signs of damage
Contact the NC Division of Water Quality
have occurred at the outlet.
401 Oversight Unit at 919-733-1786.
Form SW401-Sand Filter O&M-IZev.4 2009Septl7 !'age 2 of

Permit Number: 5 V 3 ) 303o Z
(10 be prnrided by INIQ)
acknowledge and agree by my signature below that I am responsible for the performance ofthe
maintenance procedures listed above. I agree to notify DWQ of any problems with the system or prior
to any changes to the system or responsible party.
Pi-(Iject name:l_ovcs Travel Stop & Country Store, Inc - Salisbury NC
BMP drainage area nu nher:FI
Print name:Terry Ross
Titlemce President
Address: 1060 1 North. Pennsylvania Avenue - Construction Dept_- Oklahoma City. OK 73120
Phon
Sign,
Date
Note: The legally responsible party should not be a homeowners association unless more than 50`%, ofthe lots have been
sold and a resident of the subdivision has been named the president.
1, 3arbetra " Young , a Notary Public for the State of
❑klari.o,na . County of Oklahoma , do hereby certify that
Terry toss, va '2 P- esident. personally appeared before me this 'S day of
Fa: ruart 2 0 `-' and acknowledge the due execution ofthe forgoing sand filter
maintenance requirements. Witness my hand and of-ficial sea],
S
My commission expires `�
Form SW401-Sand FlltcrO&M-Rcv.4 2009Sept17 Page 3 of3

�J
RESOURCECONSULTING
CIVIL EN6INEERIN6
MondayOctober 06, 2014
7411_
d1
Mr. Samar Bou-ghazale��f1J;�CsQ
NCDENR — Division of Water Quality,, �Cl°"'^�GTID��tS via email
Stormwater Branch c)-Oio l
512 N. Salisbury Street �
Raleigh, NC 27604�
Subject: Designer's Certification — Sand Filter (v8r7)
NCDENR Stormwater Permit No. SW3130302
Loves Travel Stop —1-85 @ Peeler Road
Rowan County, North Carolina
RC Project No. 120508
Dear Mr. Bou-ghazale,
In response to your correspondence and subsequent review of the below information, please
accept this letter as our written reply for the required Designer's Certification.
The following documentation was reviewed culminating in the issuance for this designer's
certification:
• NCDENR Water Quality calculations for this specific installation and circumstances.
• Construction Plans for the stormwater filtration systems issued previously by this firm.
• As Built Survey submitted to,this office for the ponds.
• Re -Calculations of the constructed water treatment volumes based on the constructed
ground contours (as -built survey).
• A brief comparison for the forebay and sand filter treatment volumes for their designed
versus the constructed treatment volumes.
• NCDENR Certification Checklist
2223 Quail Run Drive • Resource Suite D2 • Baton Rouge, Louisiana 70808. • [phone] • [phone] fax
■=E —

NCDENR Stormwater Permit No. SW3130302
Loves Travel Stop —1-85 @ Peeler Road
Rowan County, North Carolina
RC Project No. 120508
Monday, October 06, 2014
Meanwhile, please telephone and should you have additional questions or wish to discuss any
of this in greater depth and detail. Again we appreciate your assistance with this project.
Respectfully submitted;
RES C GONSULTING
Ross G. G 'mbWP,
Enclosures, as noted
Cc via email: Shane Stewart — Rowan County
JT Ross — Love's
Michael Key —Love's
Chris Weldeon — Love's
Resource Consulting, LLC page 2

NCDENR Stormwater Permit No. SW3130302
Loves Travel Stop —1-85 @ Peeler Road
Rowan County, North Carolina
RC Project No. 120508
Monday, October 06, 2014
DESIGNER'S CERTIFICATION:
I, Ross G, Grimball, PE, as duly registered professional engineer in the state of North Carolina,
having been authorized to observe periodically the construction of the project,
Dye`s Travel_StoTs_&_Country Stores , Inc- in Sa% Nr.
(Project Nome)
For Love's Travel Stops & Country Stores, Inc. (Project Owner) hereby state that, to the best of
my abilities, due to care and diligence was used in the observation for the project construction
such that the construction was observed to be built within substantial compliance and intent of
the approved plans and specifications.
The checklist of items on page 2 of this form is included in the certification.
_ SEAL _
t 02BQ01
Signature /
l
Registration Number NCPE# 28001
Dater
Resource Consulting, LLC page 3

'N ;Ve r� State Stormwater Permit
Permit No. SW3130302
Certification Requirements:
vi.The drainage area to the system.contains approximately the permitted
acreage.+';
)V12. The drainage area to the system contains no more than the permitted
amount of built -upon area.
y 3. All the built -upon area associated with the project is graded such that the
runoff drains to the system.
4. All roof drains are located such that the runoff is directed into the system.
5. The outletlbypass structure elevations are per the approved plan.
t/ 6. The outlet structure is located per the approved plans.
✓7. Under drains are located per the approved plans.
1_ 8. All slopes are grassed with permanent vegetation, per the vegetation plan.
t✓ 9. Vegetated slopes are no steeper than 3:1.
10. The inlets are located per the approved plans and. do not cause short-
circuiting of the system.
✓11. The permitted amounts of surface area and volume have been provided.
1' 12. Required drawdown devices are correctly sized per the approved plans.
✓13. All required design depths are provided.
14. All required parts of the system are provided, such as a sediment
chambers, sand chambers, under drains, and outlets.
15. The required system dimensions are provided per the approved plans.
Please submit this Designer's Certification to: Mooresville Regional Office
Surface Water Protection
610 East Center Ave., Ste. 301
Mooresville, NC 28115
Cc: Shane Stewart -- Rowan County
Page 6of6

Permit Number; Sti/3 ! 303 0 —
(fo be provided by DWQ)
APWA
-*A
NCDENR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
SAND FILTER SUPPLEMENT
This form must be filled out on line, printed and submitted with all of the required information.
Make sure to also fill out and submit the Required Items Checklist (Section 111) and the 1&M Agreement (Section IV)
It. PROJECT INFORMATION
Project name Loves Travel Stop -Salisbury NC
Contact name Resource Consulting, Ross Grimball PE civil engineer
Phone number 225 761 9909
Date February 26, 2013
Drainage area number F1 -lower truck parking area
II. DESIGN INFORMATION
Site Characteristics
Drainage area (AD)
63,597.60 ff2 1, `164QOK
Impervious area
49,658.40 ft2 1 , + _t
% Impervious (IA)
78.1% %
Design rainfall depth (Ro)
1.00 in
Peak Flow Calculations
1-yr, 24-hr runoff depth
1.00 in
1-yr, 24-hr intensity
2.73 inlhr
Pre -development 1-yr, 24-hr runoff
0.51 fl3lsec
Post -development 1-yr, 24-hr runoff
0.48 ft3lsec
Pre/Post 1-yr, 24-hr peak control
-0-03 ft'lsec
Storage Volume
Design volume (WQV)
3,989.00 it
Adjusted water quality volume (WQVAdi)
2,991,75 fi3
Volume contained in the sedimentation basin and on top of the sand filter
OK
5,988,00 fl'
Top of sand filterigrate elevation
790.5 fl amsl
Weir elevation (between chambers)
792.5 ft amsl
Maximum head on the sedimentation basin and sand filter (hMa r;aer)
2.00 ft OK
Average head on the sedimentation basin and sand filter (hA)
1.00 ft OK
Runoff Coefficient (Rv)
0.75 (unitless)
Type of Sand Filter
Open sand filter? Y
Y or N
SHWT elevation
765.00 ft amsl
Bottom of the sand filter elevation
788.41 ft amsl
Clearance %d WT)
25.00
Closed/pre-cast sand filter? N
Y or N
SHWT elevation
ft amsl
Bottom of the sand fitter elevation
ft amsl
Clearance (d$,MT)
If this is a closed, underground closed sand filter: The clearance between
the surface of the sand filter and the bottom of the roof of the underground
fl
structure (dsp,,,e)
i
Form SW401-Sand Filter-Rev.5 2009Sept17 Parts I and 11. Project Design Summary, Page 1 of 2

Permit Number.
(to be provided by DWQJ
Sedimentation Basin
Surface area of sedimentation basin (As)
Sedimentation basinichamber depth
Sand Filter
Surface area of sand filter (AF)
Top of sand media filter bed elevation
Bottom of sand media filter bed/drain elevation
Depth of the sand media filter bed (dF)
Coefficient of permeability for the sand filter (k)
Outlet diameter
Outlet dischargelflowrate
Time to drain the sand filter (t)
Time to drain the sand filler (t)
Additional information
Does volume in excess of the design volume bypass the sand filter?
Is an off-line flow -splitting device used?
If draining to SA waters: Does volume in excess of the design volume flow
evenly distributed through a vegetated filter?
What is the length of the vegetated filter?
Does the design use a level spreader to evenly distribute flow?
Is the BMP located at least 30ft from surface waters (50ft if SA waters)?
If not a closed bottom, is BMP located at least 100ft from water supply wells?
Are the vegetated side slopes equal to or less than 3:1
Is the BMP located in a recorded drainage easement with a recorded access
easement to a public Right of Way (ROW)?
What is the width of the sedimentation chamberlforebay (Ws d)?
What is the depth bf sand over the outlet pipe (dpipe)?
1 ., 689.001ft2
OK. Meets minimum, but may need to be increased to
2.001 ft
y_,.1,237,001 ftZ
OK. Meets minimum, but may need to be increased to
1 °`' : 790,501ft amsl
E 789.001ft amsl
1.50 ft
E : 3.501(ftlday)
,4.001in
E : 10.051ftlisec
24,001hours
OK. Submit drainage calculations.
1.00 days
Y or N
OK
Y YorN
OK
fE
f YorN
E YorN
1 Y or N
E Y or N
1 Y or N
YorN
BMP must be sufficient distance from surface waters.
OK
OK
OK
OK
OK
r.:..
a N
4Y
Y
3 .
_ Y
22.001ft
1.501ft
Form SW401-Sand Filter-Rev.5 2009Sep117 Parts I and It. Project Design Summary, Page 2 of 2

WIN
JAI, ;. AV
NODE R
North Carolina Department of Environment and Natural Resources
Pat McCrory John E. Skvarla, III
Governor Secretary
August 21, 2014
Love's Travel Stops & Country Stores, Inc.
Attention: Mr. J. T. Ross
P.O. Box 25210
Oklahoma City, OK 73120
Subject: Stormwater Permit No. SW3130302
Advance Auto Parts -Rockwell
High Density Commercial Sand Filter
Rowan County, North Carolina
Dear Mr, Ross:
Attached is a copy of the subject permit inspection conducted on August 20, 2014
By Samar Bou-Ghazale of this Office.
The report should be self-explanatory; however, should you have any questions
concerning the report, please do not hesitate to contact Mr. Bou-Ghazale at (704)
235-2199.
Sincerely,
Zahid S. Khan, CPM, CPESC, CPSWQ
Regional Engineer
Land Quality Section
Attachment
Division of Energy, Mineral, and Land Resources
Land Quality Section - Mooresville Regional Office
610 East Center Avenue, Suite 301, Mooresville, North Carolina 28115
Telephone: [phone] FAX [phone] a Internet: http:llportal.ncdenr.org/web/Ir/land-quality
An Equal Opportunity I Affirmative Action Employer— 50% Recycled 110%4 Post Consumer Paper

k
Compliance Inspection Report
Permit: SW3130302 Effective:03126/13 Expiration: 03/26/21
Project: Love's Travel Stops & Country Stores Inc
Owner: Love's Travel Stops & Country Stores Inc
County: Rowan Adress: 1105 Peeler Rd
Region: Mooresville
City/StaWZip: Salisbury NC 28146
Contact Person: J T Ross Title: Phone: [phone]
Directions to Project:
southwest quadrant of the intersection of 1-85 exit #71 at peeler rd head south 200 ft site on rt (existing prior truck stop)
Type of Project: State Stormwater - HD - Sand filters
Drain Areas: F1 - (Town Creek) (03-07-04) ( C)
On -Site Representative(s):
Related Permits:
Inspection Date: 08/20/2014
Primary Inspector: Samar E Bou Ghazale
Secondary Inspector($):
State Stormwater - Redevelopment
Entry Time: 01:35PM
Reason for Inspection: Routine
Permit Inspection Type: State Stormwater
Facility Status: ❑ Compliant ® Not Compliant
Question Areas:
0 State Stormwater
(See attachment summary)
Exit Time: 02:50PM
Phone: [phone] Ext.2199
Inspection Type: Compliance Evaluation
page: 1

•1 �
Permit: SW3130302 Owner - Project: Love's Travel Stops R Country Stores Inc
Inspection Date: 08/2012014 Inspection Type Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Please submit to this Office the items requested in the inspection report. Also, include a copy of the annual summary
report of the maintenance and inspection records for each BMP per the pemit requirements as noted under ( Section II,
Schedule of Compliance 5). If you have any qustions please call Samar Bou-Ghazale at 704-663-1699 Ext 2199 or by
email at: [e-mail]
File Review
Yes No NA NE
Is the permit active? is ❑ ❑ ❑
Signed copy of the Engineer's certification is in the file? ❑ ®❑ ❑
Signed copy of the Operation & Maintenance Agreement is in the file? 02 ❑ ❑ ❑
Copy of the recorded deed restrictions is in the file? ❑ ®❑ ❑
Comment: Please Provide this Office with a Designer's Certification that the proiect has been constructed_
according to approved plan. Also, submit a copy of the deed restrictions for the stormawter structures.
Built Upon Area Yes No NA NE
Is the site BUA constructed as per the permit and approval plans? BE ❑ ❑ ❑
Is the drainage area as per the permit and approved plans? ® ❑ ❑ ❑
Is the BUA (as permitted) graded such that the runoff drains to the system? EM ❑ ❑ ❑
Comment:
Operation and Maintenance
Yes No NA NE
Are the SW measures being maintained and operated as per the permit requirements? ❑ 01❑ ❑
Are the SW BMP inspection and maintenance records complete and available for review or provided to ❑ ❑ ❑ 0
DWQ upon request?
Comment Trash was noted in the forebay. Most of the slopes have dead grass and some areas are uncovered.
The sand filter needs to be maintained. Please remove vegetation from the sand filter and check same
for clogginq. Water standing was noted on the sand filter. Slopes need to be provided with permanent
oroundcover vegetation. Please give the above comments your immediate_ attention.
page: 2

s DWQ USE ONLY
1 ate Receivecl
Fee Paid Permit Number
3 13 113;
` 00 SW3
Applic able Zules:
(select all that apply)
❑ Coastal SW -1995 ❑ Coastal SW - 200$ Ph II - Post Construction
❑ i`'on-Coastal SW- I-IQW/ORLV Waters ❑ Universal Stormwater Management flan
❑ Other WQ M rot Plan:
State of North Carolina DIVISION 67 "d41"`=R QUALITY
Department of Environment and Natural Resources APR G 3 2013
Division of Water Quality
icy
STORMWATER MANAGEMENT PERMIT APPLICATION F RMESVILLE REGIONAL OFFICE
This form may be photocopied for use as an original
1. GENERAL INFORMATION
1. Project Nance (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Love's Travel Stops & Country Stores, Inc.
2. Location of Project (street address):
1105 PEELER ROAD
City:SAL1SSURY County:ROWAN Zip:28146
3. Directions to project (from nearest major intersection):
Southwest quadrant of the intersection of I-85 exit #71 AT Peeler Road; head South 200 Feet, site on right
( existing prior truck stop).
Latitude:35" 36' 27.792" N
Longitude:-80° 31' 6.1968" W of the main entrance to the project.
IL PERMIT INFORMATION:
1.a.Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ rModificationi
tRerrtwals with modifications also requires SWLI-102 - Rerrc-a,al Appticalim Ffmn
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number , its issue date (if known) and the status of
construction: ❑Not Started [:]Partially Completed* ❑ Completed* *provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ®I-ligh Density []Drains to an Offsite Stormwater System ❑Other
3. If this application is being submitted as the result of a previously returned application or a letter from DWQ
requesting a state stormwater management permit application, list the stormwater project number, if
assigned, and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major ❑Sedimentation/Eros ion Control:10± ac of Disturbed Area
❑NPDES Industrial Stormwater 0404/401 Permit: Proposed Impacts n a
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:
5. Is the project located within 5 miles of a public airport? [:]No ®Yes
If yes, see S.L. 2012-200, Part Vl: http://12ortal.iicdenr.org/wel)/�,v(i/ivslsufst itesw/rules laws
Form SWU-101 Version 06Aug2012 Page 1 ol'6

Ill. CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project}:
Applicant/Organization:LQVS'S'TRAVEL STOPS & COUNTRY STORES, Inc.
Signing Official & Title:L T. 1:oss, VP of Construction
b.Contact information for person listed in item la above:
StreetAddress:"10601 NORTH PENNSYLVANIA AVE.
City:OKLAHOMA CITY Statc:OK Zip:73120
Mailing Address (if applicable): P.O. Box 26210
City:Oklahoma Citv State. -OK Zip:73120
Phone: (405 ) 302-6725 Pax: (4.05 } 463.3725
Email:'I'EIZRY.I\OSSQLOVES.CON 4
c. Please check the appropriate box. The applicant Iisted above is:
®The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Owner/Organization:
Signing Official & Title:
b.Contact information for person listed in item 2a above:
Street Address:
City:
Mailing Address (if applicable):
City:
Phone:
Email:
State:
State:
Fax! ( }
Zip:
Zip:
3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other
person who can answer questions about the project:
Other Contact Person/Organization:
Signing Official & Title:
b.Contact information for person listed in item 3a above:
Mailing Address:
City:
Phone:
i;mail:
State! Zip:
Fax: ( )
4, local jurisdiction for building permits: ROWAN COUNTY
Point of Contact:SHANt? STEWAI:T Phone #: (704 } 216-8591
Form SWU-101 Vcrsion 06Aug2012 Page 2 of 6

IV, PROJECT INFORMATION
1. In the space provided below, brieflv summarize how the stormwater runoff will be treated.
The net incrase of impervious area is to be treatedvia sand filter BMP (lower truck parking area F l)
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.lf claiming vested rights, identify the regu I a ti on (s) the project has been designed in accordance with:
❑ Coastal SW _ 1995 ❑ Ph 11 — Post Construction
3. Stormwater runoff from this project drains to the YADKIN, PEE DEE River basin.
4. Total Property Area: 10 acres 5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
7. Total Property Area (4) — Total Coastal Wetlands Area (5) -- Total Surface Water Area (6) = Total Project
Area+:10t acres
+ 'Total project area shall be calculated to exclude thefollowing: the normal ool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NHW) line or Mean High Water
(NIHM line, and coastal wetlands landward frorn the NHW (or MHW) Line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal wetlands lurrdroard of the NHW (nr Ml-IW) line rnm_!
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X '100 = 68+/-
9. How many drainage areas does the project have?] (For high density, count 1 for each proposed engineered
siormwater BMP. For lore density and other projects, use I for the zofrole property area)
10_ Complete the following information for each drainage area identified in Project Information item 9. if there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
Basin Information
Drama e Area F1
.Draina e'Area '"
Drainage Area _
Draina e Area _
Receiving Stream Name
TOWN CREEK
Stream Class *
t'tZL CR'P"
1 ?- -
Stream Index Number *
496-1$3-
G
Total Drainage Area (so
-F948�
6 3 S9 -'er
On -site Draina e Area (sf)
—F94132-
3 t <R'
Off -site Drainage Area (so
0
Pro usedlm ervious Area'* s
'52810'
% Impervious Area** total
_66~
Itn ervious"'Surface Area,
Drainage Area F1
Draina g e`Area
.Draina Te Area _
Draina e Area._
On -site Buildings/Lots (so
0
On -site Streets (so
0
On -site Parking (so
F52849
zt(S
On -site Sidewalks (so
0
Other on -site (so
0
Future(SO
0
Off -site (so
0
Existing BUA*** (so
0
Total (sf):
-2
q 6�
Strerrnr Clrrss mud Indet Nurrnc�r cm� he detennined at: Irtt ortal.rrc:,tern.ar retch u! s csrr classi rcutunas
** Irnperoiairs area is defined as the built upon area including, but not Iinriled to, buildings, roads, parking areas,
sidezoalks, gravel areas, etc.
I-orm SWU-101 Version 06Aug2012 1'abc 3 of'6

** Report only that amount of existing BUA that will retnain after development. Do not report any existing BUA that
is to be removed and which apill be replaced by near BUA.
11. How was the off -site impervious area listed above determined? Provide documentation.
quad map & site topographic survey
Projects -in -Union County: Contact DIYQ Central Ofjice sluff to check if the project is located within a Threatened c,
L:ndongeredSpecies watershed theft rngv be subject to more stringent stur»nvater requiremews as per 15A A'CAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from Etta://portal.ncdenr,org/wcb/w=q/ws/su/bmp-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklists are available from http://portal.ncdeiir.org/"web/N_vd/ws su/statesw/forms_docs. The complete
application package should be submitted to the appropriate DWQ Office. (The appropriate office may be
found by locating project on the interactive online map at htt ortal.ncdennor well wyl w s su rra ps.)
Please indicate that the following required information have been provided by initiating in the space provided
for each item. All original documents M UST be signed and initialed in blue ink. Download the latest versions
for each submitted application package from 1-ittp:/Iportal.ncLiL-iii-.org/web/wq/ws/su/st,,itesw/foriiis dots.
— Initials
1. Original and one copy of the Stormwater Management Permit Application Form,
2. Original and anr: copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part V1I belom) '
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (for an Express review, refer to
http://www,envhelp.org/pages/onestopexpress,htm] for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/management for
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the'/z
mile radius on the map.
7. Sealed, signed and dated calculations (one copy).
S. Two sets of plans folded to 8.5" x "14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the X1H W (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
Form SWU-101 Version 06Aug2012 Page 4 of6

p. Vegetated buffers (where required).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"x i'l" copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit far DWQ to verify the SHWT' prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: Page No:
'11. For corporations and limited liability corporations (LLC): Provide documentation from the NC
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item 1a, 2a, and/or 3a per 15A NCAC 2H.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
htt www.secretar ,state.nc.us Corporations CSearch.as x
V11. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
13UA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must: be
provided as an attachment to the completed and notarized deed restriction form. The appropriate deed
restrictions and protective covenants forms can be downloaded from
l,ttp://portal.nedenr.or*/�aeb/wq/ws/5u/statesw/forms flocs. Download the latest versions for each
submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DWQ, and that they will be recorded prior to the sale of any lot.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting Engineer:Ross Grimball, P.E.
Consulting Firm: RESOURCE CONSULTING, LLC
Mailing Address:2223 QUAIL RUN DRIVE, Suite D2
City:BAT0N ROUGE ._ State:LA Zip:70808
Phone: [phone] Fax: [phone]
Email:[e-mail]
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or hype name of person listed in Contact Information, item 2a) certify that I
own the property identified in this permit application, and thus give permission to (print or type name of person
listed in Contact Information, item 1a) with (print or type name of organization listed in
Contact Information, item 1a) to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the stormwater system.
t'orm SWU-10t Version 06Aug2012 Page 5 of6

As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
lease agreement, or pending sale, responsibility for compliance with the DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ immediately and submit a
completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater treatment
facility without a valid permit. I understand that the operation of a stormwater treatment facility without a valid
permit is a violation of NC General Statue "143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature:
a Notary Public for the State of
do hereby certify that
before me this — day of
Date:
County of
personally appeared
, and acknowledge the due execution of the application for
a stormwater permit Witness my hand and official seal,
SI:A L
My commission expires
X. APPLICANT'S CERTIFICATION
1, (print or type narne of person listed in Contact Inforration, iteni 7a) 1. T. Ross _
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable storniVA-T& rul >s undc2 NCAC 21-1 .1000 and any other applicable state stormw ter requirements.
1�
Signature: Date:'
1 Barbara M YoRI�-g-'4<:'7 , a Notary Public for the State of Oklahoma County of
Oklahoma , do hereby certify that
1'. Fos F;, VJ P:rrsi.de:.riL nf Cc. rist.::ru.:t.:1j1'rsonally appeared
before me this `' day of "e'ruary 201 , and know edge the due exec Lion of the application for
a stormwater permit. Witness my hand and official seal,
„I❑p I'll ,,,
11glf,,,,
SEAq� � PAY,
'i'� lz�
m 5, A l 114;
9 PU
My commission expires r'-'=riist 'c, 7014
Fornt SWU-101 Version 06Aug2012 Fagc 6 of6

Compliance Inspection Report
Permit:
SW3130302 Effective:03126/13
Project:
Love's Travel Stops & Country Stores Inc
Owner:
Love's Travel Stops & Country Stores Inc
County:
Rowan
Region:
Mooresville
Expiration: 03/26/21
Adress: 1105 Peeler Rd
City/State/Zip- Salisbury NC 28146
Contact Person: J T Ross Title: Phone: [phone]
Directions to Project:
southwest quadrant of the intersection of 1-85 exit #71 at peeler rd head south 200 ft site on rt (existing prior truck stop)
Type of Project: State Stormwater - HD - Sand filters
Drain Areas: F1 - (Town Creek) (03-07-04 ) ( C)
On -Site Representative(s):
Related Permits:
Inspection Date: 02/06/2019
Primary Inspector: Angela Y Lee
Secondary Inspector(s):
James D Moore
State Stormwater - Redevelopment
Entry Time: 02:40PM
Reason for Inspection: Routine
Permit Inspection Type: State Stormwater
Facility Status: ❑ Compliant 0 Not Compliant
Question Areas:
■ State Stormwater
(See attachment summary)
Exit Time: 0100PM
Phone: [phone]
Inspection Type: Compliance Evaluation
page: 1

Permit: SW3130302 Owner - Project: Love's Travel Stops & Country Stores Inc
Inspection Date: 02/0612019 Inspection Type Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
A Notive of Violation is recommended based on this inspection.
File Review Yes No NA NE
Is the permit active? ® ❑ ❑ ❑ .
Signed copy of the Engineer's certification is in the file? ❑ ❑ ❑
Signed copy of the Operation & Maintenance Agreement is in the file? ® ❑ ❑ ❑
Copy of the recorded deed restrictions is in the file? ❑ ®❑ ❑
Comment: Please provide the Designer's certification and a copy of the recorded deed restrictions.
SW Measures Yes No NA NE
Are the SW measures constructed as per the approved plans? ® ❑ ❑ ❑
Are the inlets located per the approved plans? 0 ❑ ❑ ❑
Are the outlet structures located per the approved plans? E ❑ ❑ ❑
Comment:
Operation and Maintenance Yea No NA NE
Are the SW measures being maintained and operated as per the permit requirements? ❑ ®❑ ❑
Are the SW BMP inspection and maintenance records complete and available for review or provided to ❑ ®❑ ❑
DWO upon request?
Comment: It appears there has been an oilldiesel fuel release that has impacted the basins. All cells must be
cleaned out and replaced with anyropriate media to restore to as built conditions. A NOV is
recommended based on site conditions and no maintenance.
Please provide inspection and maintenance records.
page: 2