SW7120114_CURRENT PERMIT_20120314

STORMWATER DIVISION COOING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW 7Ia1��
DOC TYPE
� CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
DOC DATE
„2)/a/2 5
YYYYMMDD

'A A
wotRo
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Walkid Dee Freeman
Governor Director Secretary
March 14, 2012
Eastern Pride Inc.
Attn: Mr. Barnes Boykin
2405-F Nash Street
Wilson, NC 27896
Subject: Stormwater Permit No.SW7120114
Family Dollar Store - Washington, NC
High Density Stormwater Project
Beaufort County
Dear Mr. Boykin:
The Washington Regional Office received your completed application for a
Stormwater Management Permit on February 16, 2012. Staff review of the plans
and specifications has determined that the subject project will comply with the
Stormwater Regulations set forth in Title 15A NCAC 2H.1000. We are
forwarding Permit No. SW7120114 dated March 14, 2012 for the subject project.
This permit shall be effective from the date of issuance until March 14, 2020, and
shall be subject to the conditions and limitations as specified therein. Please pay
special attention to the Operation and Maintenance requirements in this permit
and in the submitted application. Failure to establish an adequate system for
operation and maintenance of the stormwater management system 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 upon written
request within thirty (30) days following receipt of this permit. This request must
be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings,
P.O. Drawer 27447, Raleigh, NC 27611-7447. Unless such demands are made
this permit shall be final and binding.
North Carolina Division of Water Quality Internet: www,ncwaterquaGty.or�
943 Washington Square Mail Phone: [phone] One
Washington, NC27889 FAX [phone] NorthCarolina
An Equal opportunitylAffirmative Action Employer— 50% Recycledl10% Post Consumer Paper Natunally

K
Page 2 of 9
Eastern Pride, Inc
March 14, 2012
Page Two
If you have any questions, or need additional information concerning this matter,
please contact either Bill Moore, or me at [phone].
Si cerely,
9
Regional Supervisor
Surface Water Protection Section
cc: Pamlico Engineering Services, PLLC
Beaufort County Planningllnspections
/`N ,ashington Regional Office

Page 3 of 9
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
Eastern Pride, Inc
Mr. Barnes Boykin
Beaufort County
FOR THE
construction, operation and maintenance of a bioretention system in compliance
with the provisions of 15A NCAC 2H .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 for
the Family Dollar Store located off River Road in Washington, NC.
This permit shall be effective from the date of issuance until March 14, 2020 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 1.5 on page 4 of this permit.
3. 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 and permit.
4. The tract will be limited to the amount of built -upon area indicated on page
4 of this permit,.and per approved plans. The runoff from all built -upon
area within the permitted drainage areas of this project must be directed
into the permitted stormwater control system.

Page 4 of 9
5. The following design criteria have been provided for the construction of
the wet pond system and must be maintained at design condition:
a. Total Site Area: 1.76 acres
b.
Impervious Area:
0.65 acres
C.
Required Storage Volume:
3556 cf
d.
Provided Storage Volume:
4984 cf
e.
Provided Surface Area:
5047 sf
If.
Design Storm:
1.5-inch
g.
Receiving Stream:
UT -Spode Creek
h.
Classification of Water Body:
C-NSW
II. SCHEDULE OF COMPLIANCE
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 times provide the operation and maintenance
necessary to assure the permitted stormwater system functions at
optimum efficiency. The approved Operation and Maintenance Plans
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. Mowin.9 and revegetation of slopes and the vegetated filter.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of bypass structure, filter media,
flow spreader, catch basins, piping and vegetated filter.
g. A clear access path to the bypass structure must be available at all
times.
4. Records of maintenance activities must be kept and made available upon
request to authorized personnel of DWQ. The records will indicate the
date, activity, name of person performing the work and what actions were
taken.

{
Page 5 of 9
5. The facilities shall be constructed as shown on the approved plans. This
permit shall become voidable unless the facilities are constructed in
accordance with the conditions of this permit, the approved plans and
specifications, and other supporting data.
6. 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.
7. 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.
8. Access to the stormwater facilities shall be maintained via appropriate
easements at all times.
9. 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 or a CAMA Major permit was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on
the approved plan.
10. The permittee shall submit final site layout and grading plans for any
permitted future areas shown on the approved plans, prior to construction.
11. A copy of the approved plans and specifications shall be maintained on
file by the Permittee at all times.
12. 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.

Page 6 of 9
13. This permit shall be effective from the date of issuance until March 14,
2020. Application for permit renewal shall be submitted 180 days prior to
the expiration date of this permit and must be accompanied by the
processing fee.
Ill. 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 formal permit transfer request to the Division of
Water Quality, accompanied by a completed name/ownership change
form, documentation from the parties involved, and other supporting
materials as may be appropriate. The approval of this request will be
considered on its merits and may or may not be approved. The permittee
is responsible for compliance with all permit conditions until such time as
the Division approves the transfer request.
2. 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.
3. 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.
4. 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.
5. 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.
6. The permit may be modified, revoked and reissued or terminated for
cause. The filing of a request for a permit modification, revocation and
reissuance or termination does not stay any permit condition.
7. 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.
8. Approved plans and specifications for this project are incorporated by
reference and are enforceable parts of the permit. A copy of the approved
plans and specifications shall be maintained on file by the Permittee for
the life of the project.

Page 7 of 9
9. The permittee shall notify the Division of any name, ownership or mailing
address changes within 30 days.
Permit issued this the 'loth day of March, 2012.
OLINA ENVIRONMENTAL MANAGEMENT COMMISSION
=C'r NVA"MIr
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number SW7120114

Page 8 of 9
Stormwater Permit No. SW7120114
Bioretention System
Family Dollar - Washington, NC
Beaufort County
Designer's Certification
as a duly registered
in the State of North Carolina, having been
authorized to observe (periodically/ weekly/ full time) the construction of the
project,
(Project)
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.
Note: The checklist on the following page must be included with this
Certification. Any changes or deviations from the approved plans and
specifications must be explained in detail, and may require a permit modification.
The certification forms should be submitted to the Division of Water Quality at the
appropriate Regional office.
SEAL
Signature
Registration Number
Date

i
Page 9 of 9
Com fete this checklist for each system and include with
Certification:
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 bypass structure elevations are per the approved plan.
6. The bypass structure is located per the approved plans.
7. A Trash Rack is provided on the outlet/bypass structure.
8. All slopes are grassed with permanent vegetation.
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/or volume have been
provided.
12. All required design depths are provided.
13. All required parts of the system are provided.
14. The required system dimensions are provided per the approved
plans.

1-110y COOP1 R
=,.r,' ''f I rN
MICA-IAR. S. RE.GAN
S. SMITH
!rrle);'i?r� 1.>rrr,rnif�
Eastern Pride, Inc.
Attention: Mr. Barnes Boykin
2405-F Nash Street
Wilson, NC 27896
Dear Mr. Boykin:
�Vo_R
NC.,P i 111 C..Ai� .) E.I iA
E110I nrrn<r?nlaI Qualify
August 16, 2019
Subject: Stormwater Permit No. SW7120114 Renewal
Family Dollar Store — Washington, NC
High Density Stormwater Project
Beaufort County
A Division of Energy, Mineral, and Land Resources file review has determined that
Stormwater Permit SW7120114 for a stormwater treatment system consisting of a
bioretention system serving the Family Dollar Store located on Hwy 32, Washington, NC
expires on March 14, 2020. This is a reminder that permit renewal applications are due
180 days prior to expiration. We do not have a record of receiving a renewal application.
Please submit a completed permit renewal application along with a $505.00 fee for
permit renewal. Also, it was noted in the file review that a designer's certification that the
project was constructed in accordance with the approved plans as required by the
permit has not been submitted. Please include this with your application. Permit
application forms for renewal can be found on our website at:
:' ... _ �:-.. �: -'s 1�.� ; ':: i... l!'i f�t .o'i-r, !'r4.'-i i�li; s •. 4S- r';li iil_.i
North Carolina General Statutes and the
Coastal Stormwater rules require that this property be covered under a stormwater
permit. Failure to maintain a permit subjects the owner to assessment of civil penalties.
If you have questions, please feel free to contact me at [phone]. 1 will be glad to
discuss this by phone or meet with you. If you would like, I can e-mail you a copy of the
application forms. You can request a copy by e-mailing me at
Sincerely,
k
Roger K. Thorpe
Environmental Engineer
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swCW r/z�/iZ__-
DWQ USE ONLY
Date Received
ZFee Paid
Permit
/Number
Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph H - Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M t Plan:
State of North Carolina � � � � �'� �// � D
Department of Environment and Natural Resources
Division of Water Quality
F E B 16 2012
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original 1 f
I. GENERAL INFORMATION D V Vj Q" Y V n' /'SRO
1. Project Name (subdivision, facility, or establishment name -should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
/ Washington - Family Dollar)
2. Location of Project (street address):
NC Hwy 32 River Road
City: W ashington County:Beaufort Zip:27889
3. Directions to project (from nearest major intersection):
500' East of NC 32 and Brick Kiln Road
4. Latitude:.35 ° 3T 3.67" N Longitude:77 " 1' 22.64" W of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification
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* El Completed* *provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ; ®High 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/Erosion Control:1.76 ac of Disturbed Area
❑NPDES Industrial Stormwater 0404/401 Permit: Proposed Impacts
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:
Form S WU- I0 I Version 07July2009 Page I of 6

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1. a. Print Applicant / Signing Official's name and title (specificalIy the developer, property owner, lessee,
designated government official, individual, etc. who owns the projeect):
Applicant/Organization:Eastern Pride Inc. a
Signing Official & Title:Barnes Boykin _
b.Contact information for person listed in item la above:
Street Address:2405-F Nash Street
City: W ilson State -.NC Zip:278%
Mailing Address (if applicable):
City:
State:
Zip:
Phone: ( 1 Fax:
Email:
c. Please check the appropriate box. The applicant listed 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:Clared LLC - Howard W. Cadmus
Signing Official & Title:President
b. Contact information for person Iisted in item 2a above:
Street Address:P o Box 724
City: Washington_ State:NC Zip:27889
Mailing Address (if applicable):
City: State: Zip:
Phone: (252 Fax: ( 2 ... }
Email:
3. a. (Optional) Print the name and title of another contact such as the projects construction supervisor or other
person who can answer questions about the project:
Other Contact Person/ Organization:Selden.Taylor - Stock and Taylor Construction Co. _
Signing Official & Title:Selden Taylor, P.E. President
b.Contact information for person listed in item 3a above:
Mailing Address:1825 Carolina Ave
City:Washington State:NC Zip:27889
Phone. (252 ) 975-5855 T Fax: -
Email:
4. Local jurisdiction for building permits: City of Washineton
Point of Contact:AlIen Pittman Phone #; f252} 975-9300
Form SWU-10I Version 07July2009 Page 2 of 6

w
IV. PROJECT INFORMATION
1. In the space provided below, hLLefly summarize how the stormwater runoff will be treated.
Stormwater runoff from the development shall be treated through vegetated swales and ultimately
into a grassed Lined bio retention facifil1y. The flow will then infiltrate into the soil
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.Identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 ❑ Ph II - Post Construction
3. Stormwater runoff from this project drains to the Tar Pam River basin.
4. Total Property Area: 1.76 1 acres 5. Total. Coastal Wetlands Area: 0.43 - 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+: 1.33 acres
Total project area shall be calculated to exclude the following: the normal pool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NHM lure or Mean High Water
(MHM line, and coastal wetlands landward from the NHW (or MHM line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal wetlands landward of the NHW (or MHM line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 48.5 %
9. How many drainage areas does the project have72 (For high density, count 1 for each proposed engineered
Stormwater SMP. For Iow density and other projects, use 1 for the whole 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
Drainage Area 1
Drainage Area 2
Drainage Area
Drainage Area _
Receiving Stream Name
Snode Crk
Snode Crk
Stream Class *
C-NSW
CNSW
Stream Index Number *
29-3-4
29-3-4
Total Drainage Area (so
58,345
18730.8
2 r
On -site Drainage Area (so
58,345
18730.8
Off -site Drainage Area (so
-
-
Pro osed Ime2rvious Area** (sq
28306
a 0
r S /• 3
% Impervious Area** total
48.8
0
Impervious** Surface Area
Draina a Area 1
Drainage Area _
Drainage Area _
Drainage Area _
On -site Buildings/Lots (so
8010
0
0
On -site Streets (so
0
0
On -site Parkin (so
20,296
0
On -site Sidewalks (so
0
0
Other on -site (so
0
0
Future (so
-
0
Off -site (sf)
-
0
Existing BUA*** (so
-
Total (so:
XM6
1 0
Stream Class and Index Number can be determined at: lrttp//h2o.enr.state.rrc.us/biros/reports�repartsWB�hhnl
*" Imppervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
* Report only that amount of existing BUA that will remain after development. Do not report any existing BUA that
is to be removed and which will be replaced by new BUA.
Form SWU-101 Version 07Ju1y2009 Page 3 of 6

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Permit Number:
. (to be p wvded by DWO
Draiaagc Area Namber.
Bioretention Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
tog in a known set location. Any deficient BW 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 BW.
Important operation and maintenance procedures:
— Immediately after the bioretention cell is established, the plants will be w VE
twice weekly if needed until the plants become established (commonly s"RE C E I
weeks).
— Snow, mulch or any other material will NEVER be piled on the surface of the F E 8 16 2012
bioretention cell.
— Heavy equipment will NEVER be driven over the bioretention cell.
— Special care will be taken to prevent sediment from entering the bioreter� —Q —� t /� R C
— Once a year, a soil test of the soil media will be conducted. V V /'�
After the bioretention cell is established, I will inspect it once a month and within 24
hours after every storm event greater than 1.0.inches (or 1.5 inches if in a Coastal
County). Records 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.
BW element:
Potentialproblems:
How I will remediate theproblem:
The entire BMP
Trash debris is present
Remove the trash debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
bioretention cell
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide Time and a
one-time fertilizer !eLhcation.
The inlet device: pipe,
The pipe is clogged (if
Unclog the pipe. Dispose of the
stone verge or Swale
a linable -
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to
swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
futureREablerrts with erosion.
Slane verge is clogged or
Remove sediment and clogged
covered in sediment (if
stone and replace with dean stone.
livable .
Fonn SW401-Bioretention O&M-Rev-3 Page i of 4

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BMP element:
Potentialproblems:
How I will remediate the problenc
The pretreatment area
Flow is bypassing
Regrade if necessary to route all
pretreatment area and/or
flow to the pretreatment area.
gullies have formed.
Restabilize the area after din .
Sediment has accumulated to
Search for the source of the
a depth greater than three
sediment and remedy the problem if
inches.
possible. Remove the sediment and
re,,ta_hilize the pretreatment area.
Erosion has occurred.
Provide additional erosion
protection such as reinforced turf
matting" or riprap if needed to
prevent future erosion problems.
Remove the weeds, preferably by
hand.
Weeds are present.
The bioretention cell:
Best professional practices
Prune according to best professional
vegetation
show that pruning is needed
practices.
to maintain optimal plant
health.
Plants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is n
Tree stakes/wires are present
Remove tree stake/wires (which
six months after planting
can kill the tree if not removed).
The bioretention cell:
Mulch is breaking down or
Spot mulch if there are only random
soils and mulch
has floated away.
void areas. Replace whole mulch
layer if necessary. Remove the
remaining much and replace with
triple shredded hard wood mulch at
a maximum qq± of three inches.
Soils and/or mulch are
Detern ine the extent of the clogging
clogged with sediment - remove and replace either just the
bop layers or the entire media as
needed. Dispose of the spoil in an
appropriate off -site location. Use
triple shredded hard wood mulch at
a maximum depth of three inches.
Search for the source of the
sediment
and remedy the problem if
An annual soil best shows that Dolomitic lime shall be applied as
pH has dropped or heavy recommended per the soil test and
metals have accumulated in toxic soils shall be removed,
the soil media. disposed
of properly and replace{
with new lam ' media.
Form SW401-Bioretention O&M-Rev.3 Page 2 of 4

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BMP element
i Potential blems:
How I wiA remediate the Mklexpu
The underdrain system
Clogging has occurred.
Wash out the underdrain system
if applicable)
The drop inlet
Clogging has occurred.
Clean out the drop inlet. Dispose of
the sediment off -site.
The drop inlet is dams
Repair or replace the drop inlet.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
outiet.
733-1786.
Form S W401-Bioretention 0&M-Rev.3 Page 3 of 4

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Permit Number.
(to be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the 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.
Project nameTamily Dollar Washin n River Road
BAP drainage area number. I
Address:2405-F Nash Street Wilson. N C
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Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
1, 1 a Notary Public for the State of
ty of do hereby certify that
A.-.d Xonally appeared before me this I(�
day of " LO J L' and acknowledge the due execution of the
requirements. Witness my hand and official seal,
My commission expires
t����
Form SW40I-Rioretention I&M-Rev. 2 Page 4 of 4

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Permit Number.
(to be provided by DWG?)
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
BIORETENTION CELL SUPPLEMENT
This (omr must be filled out, printed and submitted.
The Required Items Cheddist (Part 111) must be printed, filled out and submitted afong *0 all of the requkW irrfomwhw.
meet name
Contact name
Phone number
Date
Drainage area number
Site Charwterlstfcs
Drainage area
Impervious area
Pemnt impervious
Design rahrfall depth
Peak Flow Caicutations
Is prelpost control of the 1-rr, 24-hr peak flow required?
1-yr, 24-hr runoff depth
1-yr, 24-hr intensity
Pr&devetopment 1-yr, 24-hr peak flow
Post -development 1-yr, 24-hr peak flow
Pre/Post 1-yr, 24-hr peak control
Storage Volume: Non -SA Waters
Minimum volume required
Volume provided
Storage Volume: SA Waters
1.5' runoff volume
Pre -development 1-yr, 24-hr runoff
Post -development 1-yr, 24-hr runoff
Minimum volume required
Volume provided
Cell Dimensions
Pending depth of water
Ponding depth of water
Surface area of the top of the bloietentton cell
Length:
Width:
-or- Radius
Media and Sails Summary
Drawdown time, ponded volume
Drawdown time, to 24 indtes below surface
Drawdown dme, total:
In-artu sal.
Soil permeability
PfanBng media soli.'
Soil permeability
Soil composition
% Sand (by volume)
% Fines (by volume)
% Organic (by volume)
Phosphorus Index (P-Index) of media
Form SW401-Bforetentlon-Rev.a
June 25, 2010
Family Dollar 2
Bemes Boykin
252-230-06M
February 15, 2012
1
57,935 iiz
28,306 fi3 ✓
48.9% %
1.5 inch
Y (Y or N)
3.5 in
0.15 in/hr
2.100 felsec
4.020 felsec
1.920 felsec
3,555.8 f13
+�
4,984.0 ft3
OK
3,555 It,
0, f13
0ft3
3,555 ft
ft3
l
12 inches OK
1.00 ft
5,0470 ft'
'� OK
103 It
OK
49 ft
OK
ft
6 hr OK
9 hr OK
15 hr
4.50 irdhr OK
2.00 Mr OK
85% OK
10% OK
5% OK
Total: 100%
10 (unitless) OK
RECEIVED
F E B 16 2012
DWQ-WARO
Parts I and If. Design Summary, Page 1 of 2

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Permit Number:
(to be provided by DWO)
Swint Elevafte
Temporary pool elevdM
Type of bbmterrtivn cell (answer'Y' to My one of the two
following questions):
Is this a grassed cell?
Is this a cell with tresslshnubs?
Planting elevation (top of the mulch or grass sod layer)
Depth of mulch
Bottom of the plardfng media soil
Planting media depth
Depth of washed sand below planting media soil
Are underdrains being installed?
Blow many clean out pipes are being Installed?
What favor of safety is tised for slang the itmderdirains? (See
BMP Manual Section 12.3.6)
Additional distance between the bottom of the planting media and
the bottom of the cell to accaurd for underdrains
Bottom of the cell required
SWWT elevation
Distance from bottom to SHWT
Intemal Water Storage Zone DNS)
Does the design include IWS
Elevation of the top of the upturned elbow
Separation of IWS and Surface
Planting Plan
Number of tree species
Number of shrub species
Number of herbaceous groundcover species
Addldo,nal Infomra ion
Does volume in excess of the design volume bypass the
bioretentlon cell?
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 now?
Is the BMP located at least 30 feet from surface water; (50 feet ff
SA waters)?
Is the BMP located at least 100 feet from water supply wells?
Are the vegetated We slopes equal to or less than 3:1?
Is the BMP located in a proposed drainage easement with acaema
to a public Right of Way (ROW)?
Inlet velocity (from treatment system)
Is the area surrounding the cell likety to undergo devebptment to
the future?
10.57 f nsl
Y (Y or N) OK
N (Y or N)
9.57 fmsl
0 Inches Insuf icienf mulch depth, unless installing grassed cell.
7.57 fmsl
2ft
0 ft
n (Y or N)
0 InsuffiEient number of dean out pipes provided.
0 Insiffoent factor of safety.
Oft
7.57 fmsl Z
5.57 fmsl
2ft OK
N (Y or N)
fmsl
9.57 it
0
0
0 Recommend more species.
Y (Y or N) OK
N (Y or N) Excess vd mte must pass through filter.
Oft
N (Y or N) Show how flow is overtly diluted.
Y (Y or N) OK
Y (Y or N) OK
Y (Y or N) OK
Y (Y or N) OK
3 ft/sec 1=0=d robot vim' unless energy dissipating devices are
being used.
n (Y or N) OK
Are the slopes drab" to the bluretwkin cell greater than 20%? N (Y or N) OK
Is the drainage area perrmartently stabilized? Y (Y or N) OK
Pretreatment Used
(Indicate Type used with an'r in the shaded cell)
Gravel and grass
(S°inches gravel followed by 3-6 ft of grass)
Grassed $wale
Forebay
Other
x OK
Form SW401-Bioretentlon-Rev.8
June 25, 2010 Parts I and II. Design Summary, Page 2 of 2

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Permit No:
(to be assigned by DWQ)
HI,�REQUIRED'ITEMS;CHECKL'IST ,T-,;''A:J'V-RRWz
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package
will result In a request for addWonat Information. This will delay final review and approval of the project. Initial in the space provided
to indicate the following design requirements have been met if the applicant has designated an agent, the agent may initial below. If a
requirement has not been met, attach Justification.
Page! Plan
Inwa Sheet No.
d� �. 1. Plans (1' - 50' m target of the enEffe alto shawnrg:
- Design at ultimate build-oul,
- Off -site drainage (if applicable),
- Delineated drainage basins (include National C coefficient per basin),
- Cell orlensior1%
- Pre reahtMent system,
High fbw bypass system,
- Maintenance access,
- Recorded drainage easement and public right of way (ROW),
- Clean out pipe locations,
- Overflow device, and
Boundaries of drainage easerr►ent.
2. Plan details (1' = W or larger) for the biorebentiar cell showing:
- Cell di nemions
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
Recorded drainage easement and public right of way (ROW),
- Design at ultimate build -out,
Off -site drainage (if applicable),
- Clean out pipe locations,
- Overflow device, and
- Boundaries of drainage easement
- Indicate the P-Index betww 10 and 30
coo 3 3. Section view of the Woretsntior cell (1' = 27 or larger) shmft:
Side slopes, 3.1 or lower
- llnderdrain system (if applicable), and
- Bioretention cell layers [ground level and siope, pre4realmeK ponding depth, mulch depth, fill media
depth, washed sand, filter fabric (or choking stone if applicable), #57 stone, urderdrains (If appfio "),
SHWT level(s), and overflow structure]
4. A soils report that is based upon an actual field investigation, soil borbW, and infiltration tests. The
results of the soils report must be verified in the field by DWa by cmoe&Q & submitting the sons
investigation request form. County soil maps are not an acceptable source of soils information. AN
elevaticxns shall be in feet mean sea level (fr*. Results of sob tests of bath the planting soil and the in
situ sort must include:
- Soil penneabrTrty,
- Sal composition (% sand, % fines, % organic), and
��/� Pam.
5. A detailed piambng plan (1' = 2V or larger) prepared by a qualified individual showing:
- A variety of suitable species,
- Sipes, spacing and locations of plantings,
- Toted quantity of each type of plant specified,
- A plarrting detail,
- The source nursery for the plants, and
- FartiTmar and watering requirements to estabristn vegetation.
Ca 3 6. Aaonstructiarn sequence that shows how the biorefiention Dell will be protected from seftrnenf until the
entire drainage area is stabn7ized.
The supporting calculalions (mdudmg underdrain calculations, if applicable).
8. A copy of the signed and notarized Inspection and maintemmm (IW agreement
a. A Dopy at the deed restnctiar.
Form SW401-131oretenlion-Rev.7 Pan III, Pape 1 or 7