SW7121108_CURRENT PERMIT_20121204

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW
DOC TYPE
Fzl' CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
DOC DATE„�jZ�l.U�
YYYYMMDD

NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, F.E. Dee Freeman
Governor Director Secretary
December 14, 2012
Mr. Clark Moore, Vice president 1Gn ���+s�Gr> P V-c o
Coastal Beverage Co., Inc.
PO Box 849 0'� 2 4 y
Farmville, NC 27828-849
Subject: NPDES Phase II Stormwater Permit No. SW7121108
Coastal Beverage of Farmville, NC
High Density Commercial Wet Pond Project
Pitt County
Dear Mr. Moore:
The Washington Regional Office received a complete NPDES Phase 11 Stormwater
Management Permit Application for Coastal Beverage of Farmville, NC on November 14, 2012
and additional information on November 26, 2012. Staff review of the plans and specifications
has determined that the project, as proposed, will comply with the Stormwater Regulations set
forth in Session Law 2006-246, and Title 15A NCAC 2H.1000. We are forwarding Permit No.
SW7121108 dated December 14, 2012, for the construction of the subject project.
This permit shall be effective from the date of issuance until December 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. 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
thleright 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, 6714 Mail Service Center, Raleigh, NC 27699-6714. Unless such
demands are made this permit shall be final and binding.
If you have any questions, or need additional information concerning this matter, please
contact Samir Dumpor at [phone].
Sin erely, ada'y_YV_2-"
h
harles akild, P.E., Director
ivision of Water Quality
AA/ sd K:ISDIPermits —Wet Pond\SW7121108
cc: ✓Steve Janowski, PE, J.S. Janowski Engineering, PA (PO Box 30906, Greenville,
NC 27833-0906)„ (ew,,,led)
✓Pitt County Building Inspections
,-'Washington Regional Office
North Carolina Division of Water Quality Internet +c+++;.uc++atergarrlit�.or
943 Washington Square Mall Phone: [phone] One
Washington, NC 27889 FAX [phone] NorthCarolina
An Equal Opportun4lAffirmative Action Employer — 50% Recycled110% Post Consumer Paper AdU144711Y

17'
Z7

State Stormwater Management Systems
Permit No. SW7121108
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
NPDES PHASE II 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 .
Coastal Beverage Co., Inc.
Coastal Beverage of Farmville, NC
Pitt County
FOR THE
construction, operation and maintenance of a wet detention pond in compliance with
the provisions of Session Law 2006-246, and 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.
This permit shall be effective from the date of issuance until December 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 1.7 on page 3 of this permit. The stormwater
control has been designed to handle the runoff from 171,653 square feet of
impervious area.
3. The tract will be limited to the amount of built -upon area indicated in Section 1.7
on page 3 of this permit, and per 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 protect shall be located at least 50 feet
landward of all perennial and intermittent surface waters.
Page 2 of 7

State Stormwater Management Systems
Permit No. SW7121108
7. The following design criteria have been provided in the wet detention pond and
must be maintained at design condition:
a.
b.
d.
e.
f.
h.
i.
1•
k.
I.
m
n.
Drainage Area, ft2:
Total Impervious Surfaces, ft2:
Design Storm, inches:
Avg. Pond Depth, feet:
TSS removal efficiency:
Permanent Pool Elevation, FMS�
Permanent Pool Surface Areq, ft
Permitted Storage Volume, ft:
Temporary Storage Elevation,
Controlling Orifice:
Permitted Forebay Volume, ft3
Receiving Stream/River Basin:
Stream Index Number:
Classification of Water Body:
II. SCHEDULE OF COMPLIANCE
222,156
171,653
1.0
3.4
90%
76.50
10,000
14,050 at temporary pool el.
FMSL: 77.60
2.0" 0 pipe
4,843
Middle Swamp 1 Tar -Pam River Basin
27-86-26-5
"C, Sw; NSW"
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 vegetated filter strip.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of outlet structure, orifice device, level
spreader, filter strip,, catch basins and piping.
g. Access to the outlet structure must be available at all times.
4.. Records of maintenance activities must be kept for each permitted BMP. The
records 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 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. Access to the stormwater facilities shall be maintained via appropriate
easements at all times.
7. The facilities shall be constructed as shown on the approved plans. This permit
shall become void unless the facilities are constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other
supporting data.
8. Upon completion of construction, prior to issuance of a Certificate of Occupancy,
Page 3 of 7

State Stormwa ter Management Systems
Permit No. SW7121108
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.
9. 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.
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 or a CAMA
Major permit was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
11. 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.
12. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
13. 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.
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, to the Division of Water
Quality, signed by both parties, and accompanied by supporting documentation
as listed on page 2 of the form. The project must be in good standing with the
Division. 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 the transfer request.
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.
Page 4 of 7

State Stormwater Management Systems
Permit No. SW7121108
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 of any name, ownership or mailing
address changes at least 30 days prior to making such changes.
Permit issued this the 14th day of December, 2012
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for Lonaries vva , rt, uirector
Division of Wat&rlQuality
By Authority of the Environmental Management Commission
Stormwater Permit No. SW7121108
Page 5 of 7

State Stormwater Management Systems
Permit No. SW7121108
Coastal Beverage of Farmville, NC
Stormwater Permit No. SW7121108
Pitt County
Designer's Certification
I, - , 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.
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 6of7

State Stormwater Management Systems
Permit No. SW7121108
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.
G. The outlet structure is located per the approved plans.
7. 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. 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 vegetated shelf,
and a forebay.
15. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Regional Office
Pitt County Building Inspections
Page 7 of 7

�JOJF'_o
DWQ USE ONLY
Date Received
Fee Paid
Permit Number
Lf r
s a
Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2W8 ❑ Ph II - Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters 0 Universal Stormwater Management Plan
❑ Other WQ M mt Plan:
State of North Carolina RECEIVED
Department of Environment and Natural Resources
Division of Water Quality NOV 14 2012
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be plmtocopied for use as mi original DWQ—WARO
1. GENERAL INFORMATION
1. Project Name (subdivision, facility, or establishment name -should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Coastal lieverafze of Farmville, NC
2. Location of Project (street address):
3973 South Fields Street
City:Farmville County:Pltt Zip:27828-8569
3. Directions to project (from nearest major intersection):
Head west on Marlboro Road and turn left (south) on South Fileds Street The property is on the left
4. Latitude:350 35' 7.07" N Longitude:-77* 36' 20.1" W of the main entrance to the project.
U. PERMIT INFORMATION:
1. a. Specify whether project is (check one): NNew ❑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: ❑Nat Started ❑Partially Completed* ❑ 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).
❑LAMA Major ®Sedimentation/Erosion Control: 7.0 ac of Disturbed Area
❑NPDES Industrial Stormwater ❑404/401 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:
FormSWU-101 Version07Iun2010
Page 1 of 6

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Hwy warn
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OPAW-DVICA

DWQ USE ONLY
Date Received
Fee Paid Permit Number
Applicable Rules: ❑ Coastal SW -1995 ❑ CoastaI SW - 2008 ❑ Ph I1- Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M mt Plan:
State of North Carolina REE E ! V E
Department of Environment and Natural Resources
Division of Water Quality
NOV 2 6 2012
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form Ynay be photocopied for use as an original D V V Q- V V ARO
1. GENERAL INFORMATION
I. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Coastal Beverage of Farmville, NC
2. Location of Project (street address):
3973 South Fields Street
City:Farmville County:PItt Zip:27828-8569
3. Directions to project (from nearest major intersection):
Head west on Marlboro Road and turn left (south) on South Fileds Street. The property is on the left
4. Latitude:350 35' 7.07" N Longitude:-770 36' 20.1" W of the main entrance to the project.
IL 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* ❑ 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
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: 7.0 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 SWU-101 Version 07Jun2010 Page 1 of 6

Ili. 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/ Organ ization:Coastal Beverage Co. Inc
Signing Official & Title:Clark Moore, Vice President
b.Contact information for person listed in item 1a above:
Street Address:3973 South Fields Street
City:Farmville State:NC Zip:27828-8569
Mailing Address (if applicable):PO Box 85fft-941
CitTFarmville State:NC Zip:27828-85t1J'-
Phone: (252 ) 753-3332 Fax:
Email:cmoore®coastal-bev.coni
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:Coastal Beverage Co. Inc
Signing Official & Title:CIark Moore, Vice President
b.Contact information for person listed in item 2a above:
Street Address:3973 South Fields Street
City:Farmville State:NC Zip:27828-8569
Mailing Address (if applicable):PO Box 8569 a4 I T
City-i*M460-p = f_ V State:NC Zip:27828-8r369
Phone: [phone]
Email:[e-mail]
Fax: (SS z ) -7 5 `�, „— (, q 7, C
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:]. Stephen lanowski, PE
Signing Official & Title:LS. lanowski Engineering, PA
b.Contact information for person listed in item 3a above:
Mailing Address:PO Box 30906
City:Greenville State:NC Zip:27833-0906
Phone: (252 ) 714-3002 Fax:
Email:jstephenjanowski®jsjengineering.com
4. Local jurisdiction for building permits: Town of Farmville
Point of Contact:Paul Ellis Phone #: (252 ) 753-671.1 -
Form SWU-101 Version 07Jun2010 Page 2 of

IV. PROJECT INFORMATION
1. In the space provided below, Briefly summarize how the stormwater runoff will be treated.
The storm water will be collected and transported via closed storm drainage 1iping system
The storm water will be treated in a Wet Detention pond design for 90 % TSS removal
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.If claiming vested rights, 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 River River basin.
4. Total Property Area: 14.97 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
Area4:14.97 acres
+ Total project area shall be calculated to exclude the following the norrrrrrl pool of impounded strtwtrires, fire area
between the banks of streams and rivers, the area below the Normal High Water {NHM lure or Mean High Water
(MHW) lure, and coastal wetlands landward from the NHW (orMHM litre. The resultant Project area is used to
calculate overall percent built rrpon area (BUA). Non -coastal wetlands landward of the NHW (or MHW) line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 77.27 %
9. How many drainage areas does the project have?2 (For high density, count I for each proposed engineered
stormwater BMP. For low 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
Middle Swamp
Middle Swamp
Stream Class *
C;Sw,NSW
C;Sw,NSW
Stream Index Number *
27-86-26-5
27-86-26-5
Total Drainage Area (so
222156 S.tw
429937
On -site Drainage Area (so
222156
429937
Off -site Drainage Area (so
0
0
Proposed Impervious Area" (so
171653
-6986
% Impervious Area** total
77.27
0
Impervious— Surface Area
Drainage Area _
Drainage Area
Drainage Area
Drainage Area _
On -site Buildings/Lots (so
47026
0
On -site Streets (so
0
0
On -site Parking (so
8748
42788
On -site Sidewalks (so
0
0
Other on -site (so
0
0
Future (so
66105
0
Off -site (sf)
0
Existing BUA*** (so
49774
-49774
Total (so:
171653
-6986
Stream Class and Index Number call be determined at: http_/[portal.ncdenr.or UebAiLq )s/csrr/classifications
* lrrr Pervious 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 ally existing BUA that
is to be removed and which will be replaced by new BUA.
Form SWU-101 Version 07Jun2010 Page 3 of

11. How was the off -site impervious area listed above determined? Provide documentation. Survey and
Com2uter calcualtions
Proiects In Union County: Contact DWQ Central Office staff to check if the project is located within a Threatened &
Endangered Species watershed that may he subject to more stringent stormwater requirements as per MCA 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 http:llportaLncdenr.org/web/wg/ws/su/bmR-manual.
Vl. 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 1AM//porW.ncdenr.org/web/wglws/su/statesw/forms docs. The complete
application package should be submitted to the appropriate DWQ Office. (The appropriate office may be
found by Iocating project on the interactive online map athttp://portal.ncdenr.or web/wtl/ws/su/maps.)
Please indicate that the following required information have been provided by initialinyx in the space provided
for each item. All original documents MUST" be signed and initialed in blue ink. Download the latest versions
for each submitted application package from htW.//Rgrtal.ncdenr.ore/weblwg%ws/sulstatesw/forimn S.
1. Original and one copy of the Stormwater Management Permit Application Form,
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part VIl below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreement(s) for each BMP. %
d. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer kd`
lttip://www.envhelp.org[pa&gs/onestope_Uress.html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator f
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/manageme or
the project This is required in addition to the brief summary provided in the Project
Information, item 1.
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or th
receiving stream drains to class SA waters within 'A mile of the site boundary, include the Ih
mile radius on the map.
7. Sealed, signed and dated calculations.
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
✓ a. Development/Project name.
i/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.
• DeIineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (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).
p. Vegetated buffers (where required).
Form SWU-101 Version 07Jun2010 Page 4 of 6

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"41" copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BNn, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WaRO: Scleedule a site visit far DWQ to verify the SHV1lf prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book:1012 Page No: 380
11. For corporations and limited liability corporations (LLC): Provide documentation from the N
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 NCAC 21-1.1003(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.
hft:/ /www.secretM.state.ne.usICorporations/CSearch.asi)x
VII, 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
BUA 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
http://portal.ncdenr.org/web/n/ws/su/statesw/forms does. 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:]. Stephen Janowski, PE
Consulting Firm: 1. S. Janowski Engineering- PA
Mailing Address:PO Box 30906
City:Greenville State:NC Zip:278334)906
Phone: (252 ) 714-3002 Fax:
Email:isteyhenjanowski ft jeneineering com
IX. PROPERTY OWNER AUTHORIZATION (if Contact hiformation, item 2 has been filled out, cortcplete this
section)
I, (print or type name of person listed in Contact Inforrnatiou, item 2") 1as C �.at M �d's' certify that I
own the property identified in this permit application, and thus give permission to (print or type came of person
fisted in Contact Information, item 1a) with (print or type name of organization listed in
Contact Information, item Ia) 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 storrnwater system.
Form SWU-101 Version 071un2010 Page 5 of 6

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 u to a,/:), 00 per day, pursuant to NCGS 143-275.6.
Signature: r �C Ca G/ Date: 11 F ' C 1--
I,0VA)J'Th10-' - �rr/S' a Notary Public for the State of 60 - C oL��,� . County of
1Ct OS do hereby certify that IN r►'^ • C(a rk ffio2p-�° personally appeared
before me this -2) day of A) Q • a�>' and acknowledge the d e execution of the application for
a stormwater permit. Witness my hand and official seal,
Cynthia L. Harris
Notary Public
Perquirnans County, NC
My Commission Expires Apr, 1, 2017
X. APPLICANT'S CERTIFICATION
SEAL
My commission expires 4 - / aOI
I, (print or type name of person listed in Contact Information, item 1a) Clark Moore
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 stormwater rules under 15A NCAC 2H .1000, SL 2006-246 (Ph. II - Post Construction) or SL 2008-211.
Signature: Date:
1,, a Notary Public for the State of County of
do hereby certify that
personally appeared
before me this — day of , and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission expires
Form SWU-101 Version 071un2010 Page 6 of 6

1
Permit Number:
(to be provided by DWQ)
Drainage Area Number:
Wet Detention Basin Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP 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 BMP.
The wet detention basin system is defined as the wet detention basin,
pretreatment including forebays and the vegetated filter if one is prow e
tKLCEIVED
This system (check one):
❑ does ® does not incorporate a vegetated filter at the outlet. NOV 2 6 2012
This system (check one):
❑ does ❑ does not incorporate pretreatment other than a fc WQ-WARD
Important maintenance procedures:
— Immediately after the wet detention basin is established, the plants on the
vegetated shelf and perimeter of the basin should be watered twice weekly if
needed, until the plants become established (commonly six weeks).
— No portion of the wet detention pond should be fertilized after the first initial
fertilization that is required to establish the plants on the vegetated shelf.
— Stable groundcover should be maintained in the drainage area to reduce the
sediment load to the wet detention basin.
— If the basin must be drained for an emergency or to perform maintenance, the
flushing of sediment through the emergency drain should be minimized to the
maximum extent practical.
— Once a year, a dam safety expert should inspect the embankment.
After the wet detention pond is established, it should be inspected 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 should be kept in a known set
location and must be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblem:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the wet
Areas of bare soil and/or
Regrade the soil if necessary to
detention basin
erosive gullies have farmed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
Vegetation is too short or too
Maintain vegetation at a height of
long,
approximately six inches.
Form SW401-Wet Detention Basin O&M-Rev.4
Page 1 of 4

1 w Permit Number:
z/ (to be provided by DWQ)
Drainage Area Number:
BMP element:
Potentialproblem:
How I will remediate theproblem:
The inlet device: pipe or
The pipe is clogged.
Unclog the pipe. Dispose of the
Swale
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged.
Erosion is occurring in the
Regrade the Swale if necessary to
Swale.
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion,
The forebay
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design depth for
possible. Remove the sediment and
sediment storage.
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 problems.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying.
The vegetated shelf
Best professional practices
Prune according to best professional
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 necessary.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying.
The main treatment area
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design sediment
possible. Remove the sediment and
storage depth.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Algal growth covers over
Consult a professional to remove
50% of the area.
and control the algal growth.
Cattails, phragmites or other
Remove the plants by wiping them
invasive plants cover 50% of
with pesticide (do not spray).
the basin surface.
Forni SW441-Wet Detention Basin O&M-Rev.4
Page 2 of 4

Permit Number:
(to be provided by DWQ)
Drainage Area Number:
BMP element:
Potentialproblem:
How I will remediate theproblem:
The embankment
Shrubs have started to grow
Remove shrubs immediately.
on the embankment.
Evidence of muskrat or
Use traps to remove muskrats and
beaver activity is present.
consult a professional to remove
beavers.
A tree has started to grow on
Consult a dam safety specialist to
the embankment,
remove the tree.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair. if a licable
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
of the sediment off -site.
The outlet device is damaged
Repair or replace the outlet device.
The receiving water
Erosion or other signs of
Contact the local NC Division of
damage have occurred at the
Water Quality Regional Office, or
outlet.
the 401 Oversight Unit at 919-733-
1786.
The measuring device used to determine the sediment elevation shall be such
that it will give an accurate depth reading and not readily penetrate into
accumulated sediments.
When the permanent pool depth reads 3 feet in the main pond, the sediment
shall be removed.
When the permanent pool depth reads 4 feet in the forebay, the sediment shall
be removed.
BASIN DIAGRAM
(fill in the blanks)
0 Permanent Pool Elevation 76.5
Sediment Removal . 72.0 Pe anen Pool
- - - - - - - - - - - - - Volume Sediment Removal Elevation 72.0 Volume
Bottom Elevatio 71.0 -ft Min.
------------------------------------------ ------
Sediment Bottom Elevation 71.0 1-ft r
Storage Sedimet
Storage
FOREBAY MAIN POND
Form SW401-Wet Detention Basin O&M-Rev.4
Page 3 of 4

Permit Number:
(Io 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.
Projeet name:Coastal BeveraP,e of Farniville NC
BMP drainage area number: I
Print name:Clark Moore
Title:Vice President
Address:3973 South Fields St, Fannville, NC 27828-8569
Plione:252-753-3332
Signature:
Date: f
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.
I, �� "" """" p , a Notary Public for the State of
NO . ORAPwrrQ., County of ! q U i Ylrl cr_PS , do hereby certify that
4-A)(m , anQ1 personally appeared before me this
day of AA) U. , oZO/pZ, and acknowledge the due execution of the
forgoing wet detention basin mai Y
tenance requirements. Witness my hand and official
seal,
E
ia L. Harristary Publicans County, NCon Expires Apr.1, 2017
SEAL
My commission expires
ji-r aj7
Form SW401-Wet Detention Basin O&M-Rev.4 Page 4 of 4

:.RECEIVED
FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT NOV 2 6 2012
No person may initiate any land -disturbing activity on one or more acres as covered by the Act before this
form and an acceptable erosion and sedimentation control plan have been completed and�gpp y��Nt RO
Land Quality Section, N.C. Department of Environment and Natural Resources. (Plbee t`y"Ar prinN anAi
the question is not applicable or the e-mail and/or fax information unavailable, place NIA in the blank.)
Part A.
Project Name Coastal Beverage Compay Inc
2. Location of land -disturbing activity: County Pitt City or Township Farmville
Highway/Street S. Fields St Latitude 35 30 7 Longitude -77 36 20
3. Approximate date land -disturbing activity will commence: December 1
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Industrial
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 7.0 ac
6. Amount of fee enclosed: $ 455 . The application fee of $65.00 per acre (rounded up
to the next acre) is assessed without a ceiling amount (Example: a 9-acre application fee is $585).
7. Has an erosion and sediment control plan been filed? Yes_ No Enclosed x
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name J. Stephen Janowski, PE E-mail Address 'ste hen'anowski isaen ineerin .corn
Telephone Cell # 252-714-3002 Fax #
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Clark Moore, Vice President 252-753-3332
Name Telephone
3973 South Fields St same
Current Mailing Address Current Street Address
Fax Number
Farmville NC 27828-8569
City State Zip City State Zip
10. Deed Book No. 1012 Page No. 380 Provide a copy of the most current deed.
Part B.
Person(s) or firm(s) who are financially responsible for the land -disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet):
Clark Moore, Vice President cmoore c�coastal-bev.com
Name E-mail Address
3973 South Fields Street
Current Mailing Address Current Street Address
Farmville NC 27828-8569
City State Zip City State Zip
Telephone [phone] Fax Number

2. (a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina Agent:
Name
Current Mailing Address
City
Telephone
E-mail Address
Current Street Address
State Zip City
Fax Number
State Zip
(b) If the Financially Responsible Party is a Partnership or other person engaging in business under an
assumed name, attach a copy of the Certificate of Assumed Name. If the Financially Responsible
Party is a Corporation, give name and street address of the Registered Agent:
Name of Registered Agent
Current Mailing Address
City
E-mail Address
Current Street Address
State Zip City
Telephone Fax Number
State Zip
The above information is true and correct to the best of my knowledge and belief and was provided
by me under oath (This form must be signed by the Financially Responsible Person if an individual
or his attorney -in -fact, or if not an individual, by an officer, director, partner, or registered agent with
the authority to execute instruments for the Financially Responsible Person). I agree to provide
corrected information should there be any change in the information provided herein.
Clark Moore Vice President
Type or print name Title or Authority
Vt c I1 C c
SEgnature Date
I, �f a _ S , a Notary Public of the County of " (41 rv?Ct S
State of North Carolina, hereby certify that W/1v1 . a rk / 1/bC appeared
personally before me this day and being duly sworn acknowledged that the above form was
executed by him.
Witness my hand and notarial seal, this 6 day of A10 U , , 20 / o9—
:im
ris Notary
PNC _
My C�, 2077 My commission expires- _ _�

Compliance Inspection Report
Permit: SW7121108 Effective:02/08113 Expiration: 12/14/20
Project: Coastal Beverage of Farmville
Owner: Coastal Beverage Co Inc
County: Pitt Adress: 3973 S Fields St
Region: Washington
CitylState/Ztp: Farmville INC 278288569
Contact Person: Clark Moore / Title: Phone: [phone]
Directions to Project: C fhoolre 4 c...L,�� + b eV . CC M
Head west on Marlboro Rd and turn left (south) on South Fields Street. The property in on the left.
Type of Project: State Stormwater - HD - Detention Pond
Drain Areas: 1 - (Middle Swamp) (03-04-07) (C;Sw,NSW)
On -Site Representative(s):
Related Permits:
Inspection Date: 04/18/2018 Entry Time: 03:OOPM
Primary Inspector: William J Moore
Secondary Inspector(s):
Reason for Inspection: Routine
Permit Inspection Type: State Stormwater
Facility Status: E Compliant ❑ Not Compliant
Question Areas:
State Stormwater
(See attachment summary)
.vl 0 6'y c� F
Exit Time: 03:40PM
Phone: [phone] Ext.264
Inspection Type: Compliance Evaluation
page: 1

Permit: SW7121108 Owner - Project: Coastal Beverage Co Inc
Inspection Date: 0411812018 Inspection Type compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Site inspection 04/18/2018 at the Coastal Beverage facility, Farmville. Observed bare soil & erosion along slopes (may
be partially due to routinely cutting grass too close); outlet structure partially clogged with sediment & vegetation. Action
needed: inspect slopes, repair/seed eroded areas as needed; clean around outlet structure. Review O&M requirements
with landscape crews; maintain grass vegetation around pond slopes at least 4-6 inches height. Avoid/limit the use of
herbicides around the interior slopes of the pond. Follow-up inspection to be scheduled -in next 6 months.
Built Upon Area Yes No NA NE
Is the site BUA constructed as per the permit and approval plans? M ❑ ❑ ❑
Is the drainage area as per the permit and approved plans? 0 ❑ ❑ ❑
Is the BUA (as permitted) graded such that the runoff drains to the system? ❑ ❑ ❑
Comment:
5W Measures Yes No NA NE
Are the SW measures constructed as per the approved plans? M ❑ ❑ ❑
Are the inlets located per the approved plans? M ❑ ❑ ❑
Are the outlet structures located per the approved plans? M ❑ ❑ ❑
Comment:
Operation and Maintenance Yes No NA NE
Are the SW measures being maintained and operated as per the permit requirements? ❑ 0 ❑ ❑
Are the SW BMP inspection and maintenance records complete and available for review or provided to ❑ ❑ ❑ ❑
DWQ upon request?
Comment: see summary comments
page: 2