SW7110114_CURRENT PERMIT_20200816

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
DOC TYPE
CURRENT PERMIT
APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
YYYYM M D D
9

.1!�
ROY COOPER
Governor
MICHAEL S. REGAN
Secretcry
BRIAN WRENN
Acany Director
Dr. Michael Sue
Northside Park Gastroenterology
102 Northside Park Drive
Elizabeth City, NC 27909
NORTH CAROLINA
Environmental Quality
October 16. 2020
l'V'�, AU
Subject: Stormwater Permit No. SW7110114 Renewal
Northside Park Gastroenterology and Endoscopy Center
High Density Project
Pasquotank County
Dear Dr. Sue:
The Washington Regional Office received a Stormwater Management Permit
Application for renewal of the subject permit on September 16, 2020. Staff review of the
applications have determined that the permit can be reissued. We are forwarding Permit
No. SV 7110114 dated October 16, 2020, for the continued operation of the subject
project.
This permit, upon its effective date, will replace all previous State Stormwater permits for
this project. This permit shall be effective from the February 9, 2021 until February 8,
2029 and shall be subject to the conditions and limitations as specified therein, and does
not supercede any other agency permit that may be required. 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 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, 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 me at [phone].
Sincerely,
Roger K. Thorpe
Environmental Engineer
Di i n or rnerg7 Mtneral and Land Resources
_ Woshington negion.l Office I-r Washirgtun Square Mall Washington Noi ih Carolina 27889
a•^• .^^^>wm� 5291o.ha81

v
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
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
Dr. Michael Sue
Northside Park Gastroenterology and Endoscopy Center
Located at 102 Northside Park Dr., Elizabeth City, NC
Pasquotank County
FOR THE
construction, operation and maintenance of a wet detention pond 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 Energy, Mineral, and
Land Resources (Division) and considered a part of this permit.
This permit shall be effective from February 9, 2021 until February 8, 2029, and shall be
subject to the following specified conditions and limitations:
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 34,784 square feet of impervious area.
3. The tract will be limited to the amount of built -upon area indicated in Section 1.7
of this permit, and per approved plans.

i
5.
6.
7.
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.
The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
The built -upon areas associated with this project shall be located at least 50 feet
landward of all perennial and intermittent surface waters.
The following design criteria have been provided in the wet detention pond and
must be maintained at design condition:
C.
d.
m
Drainage Area, acres:
Total Impervious Surfaces, ftz:
Design Storm, inches:
Pond Depth, feet:
TSS removal efficiency:
Permanent Pool Elevation, FMSL:
Permanent Pool Surface Area, ft2:
Permitted Storage Volume, ft3:
Temporary Storage Elevation, FMSL:
Predevelopment 1 year 24 hour:
Post development 1 year 24 hour:
Controlling Orifice:
Permitted Forebay Volume, ft3:
Fountain Horsepower, HP
Receiving Stream/River Basin:
Stream Index Number:
Classification of Water Body:
II. SCHEDULE OF COMPLIANCE
1.65
34,784
1.50
5.10 (3.10 average)
90%
8.10
6,706
13,189 at temporary pool el
9.60
0.07cfs
0.02cfs
1.00" 0 pipe
3,376
0 (fountain not allowed, pond too small)
Knobbs Creek / Pasquotank
30-3-8
"C: Sw"
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.
During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
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.
a. 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.
Access to the stormwater facilities shall be maintained via appropriate
easements at all times.
6. Decorative spray fountains shall not be allowed in the wet detention basin
stormwater treatment system due to the ponds small size.
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,
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 at all times.
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, 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, 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 DEQ 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 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.
12. This permit shall be effective from February 8, 2021 until February 8, 2029.
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.
Permit issued this the 6th day of October 2020.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Permit Number SW7110114

..�A Permit Coverage S w -q I I C5 f 14
-t0 j," , Renewal Application Form NPDES Permit Number
NCDENR National Pollutant Discharge Elimination System
Stormwater Individual Permit. NCS—yam 4
Please provide your permit number in box in the upper right hand corner, complete the information in the space provided
below and return the completed renewal form along with the required supplemental information to the address indicated.
Owner Information * Address to which permit correspondence will be IJ�led n
Owner /Organization Name: J1Jicl ge j,5'Ue, n, j,1�% No rl f-i2iv Iri3y�c � +rve n6fror f"
Owner Contact: M c 'iSz- s3 0
Mailing Address: 102 nmrtics,,-I Q PA✓41- sa 6e Fft r< 1,74'06
Phone Number:
Fax Number:
E-mail address:
Facilitv Information
Facility Name:
Facility Physical Address:
Facility Contact:
Mailing Address:
Phone Number:
Fax Number:
E-mail address:
Permit Information
Permit Contact:
Mailing Address
Phone Number:
Fax Number:
E-mail address:
Discharge Information
Receiving Streams.,
Stream Class:
Basin:
Sub -Basin:
Number of Outfalls:
naS (�hr� w cave
64e, PGLC
RFCFm IFD
—SEP / , C20
DENR-LAND Q ALITY
STORMWATER PERMITTING
SEP 1 & ?M
Facility/Activity Changes Please describe below any changes to your facility or activities since issuance of your permit. Attached a
separate sheet if necessary.
I certify that I am familiar with the inft
such information is true, complete and
Signature
Print or type name of person signing above
in the application and that to the best of my knowledge and belief
Date
Title
Please return this completed application form SW Individual Permit Coverage RenewalStormwater Permitting Program
and requested supplemental information to: 1612 Mail Service Center
Raleigh, North Carolina 27699-1612

� kSP95d�k :H'�.3�'�1�'='s'%dei as n`i� i xea s .4, ^' •U r �
STTTTTTTT®.RMaVVAT�ER POLL�UFTION PREVENTION PLANT ;
�r � _ }t DEVELOPMEN°T�AND IM�PLEMENTATION�
North Carolina Division of Energy, Mineral, and Land Resources - Stormwater Permitting
Facility Name: PAtf, 6CV,4 aer(o�tr
Permit Number: bra ptf
Location Address: l n..,,,,,,,a,..�l. / Inti
County:
"I certify, under penalty of law, that the Stormwater Pollution Prevention Plan (SPPP) document and all
attachments were developed and implemented under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gather and evaluate the information required by the SPPP.
Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information gathered is, to the best of my knowledge and belief, true,
accurate and complete."
"I certify that the SPPP has been developed, signed and retained at the named facility location, and the SPPP
has been fully implemented at this facility location in accordance with the terms and conditions of the
stormwater discharge permit."
And
" I am aware that there are significant penalties for falsifying information, including the possibility of fines and
imprisonment for knowing violations."
Signature
Print or type name of person signing above
Date I[ r/ ),Oyo
i^'t.� cc,rec✓ fa
Title
SPPP Certification 10/13

SUPPLEMENTAL INFORMATION REQUIRED FOR RENEWAL OF INDIVIDUAL
NPDES STORMWATER PERMIT
Two copies of each of the following shall accompany this submittal in order for the application
to be considered complete:
n
(Do not submit the site Stormwater Pollution Prevention Plan)
A current Site Map from the Stormwater Pollution Prevention Plan. The location of
industrial activities (including storage of materials, disposal areas, process areas and
loading and unloading areas), drainage structures, drainage areas for each outfall,
building locations and impervious surfaces should be clearly noted.
2. A summary of Analytical Monitoring results during the term of the existing permit
(if your permit required analytical sampling). Do not submit individual lab reports.
The summary can consist of a table including such items as outfall number,
parameters sampled, lab results, date sampled, and storm event data.
A summary of the Visual Monitoring results. Do not submit individual monitoring
reports. The summary can consist of a table including such items as outfall number,
parameters surveyed, observations, and date monitoring conducted.
4. A summary of the Best Management Practices utilized at the permitted facility.
Summary should consist of a short narrative description of each BMP's in place at
the facility. If the implementation of any BMP's is planned, please include
information on these BMP's.
A short narrative describing any significant changes in industrial activities at the
permitted facility. Significant changes could include the addition or deletion of
work processes, changes in material handling practices, changes in material storage
practices, and/or changes in the raw materials used by the facility.
6. Certification of the development and implementation of a Stormwater Pollution
Prevention Plan for the permitted facility (Sign and return attached form).
If the final year analytical monitoring of the existing permit term has not been completed
prior to filing the renewal submittal, then the last years monitoring results should be submitted
within 30 days of receipt of the laboratory reports. (i.e. do not withhold renewal submittal
waiting on lab results)

From: Mike Morway[mailto:MikeMCaiAlbemarleAssociates.comj
Sent: Monday, December 09, 2013 1:34 PM
To: Vinson, Scott
Cc: Michael Sue
Subject: FW: SW permit No - SW7110114 - Designer Certification
Scott,
I have received verification that the orifice has been installed.
Sincerely,
Michael J. Morway, PE
Albemarle and Associates, LTD
PO Box 3989, Kill Devil Hills, NC
Ph: 252-441-2113
Fx:252-441-0965
email: mikem(a)albemarleassociates.com
web: www.albemarleassociates.com
The information contained in this email message and any attachments is confidential information intended only far
the use of individuals or entities named above. if the reader of this message is not the intended recipient you are
hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. /fyou
have received this email in error, please notify us immediately by email at the originating address.
From: Mike Morway
Sent: Friday, December 06, 2013 5:13 PM
To: 'Vinson, Scott'
Cc: 'Michael Sue'
Subject: SW permit No - SW7110114 - Designer Certification
Scott,
I hope you are doing well. Please find the attached letter and certification for the Dr. Michael Sue. Please
contact me if you have any questions.
Sincerely,
Michael J. Morway, PE
Albemarle and Associates, LTD
PO Box 3989, Kill Devil Hills, NC
Ph: 252-441-2113
Fx:252-441-0965
email: mikem(c)albemarleassociates.com
web: www.albemarleassociates.com

ASSOCIATES,1 omarle
December 6, 2013
DEC - 6 2013
NCDENR — Division of Water Quality
943 Washington Square Mall
Washington, NC, 27889-3532
ATTN: Mr. Scott Vinson
RE: Dr. Michael Sue (Permit No SW7110114)
Designer's Certification
Dear Mr. Vinson:
The stormwater management pond for Dr. Michael Sue was constructed in 2011. Upon
completion, a designer certification could not be completed because an as -built survey
was not provided to Albemarle & Associates. Recently, Dr. Sue received a letter from
the Division of Water Quality requesting such certification and contacted us for
assistance. Earlier today we performed a visual inspection and obtained horizontal and
vertical measurements of the system. We found that the system was largely in
compliance with the design plans. However, no orifice or evidence of such could be
found within the control structure. Subsequently, we advised Dr. Sue of this deficiency
and he contacted a subcontractor to install the 1" orifice over the weekend. We will be
advised once the orifice is installed and we will notify the division as well. If you have
any questions pertaining to this project, please do not hesitate to contact me.
Sincerely,
Michael J. Morway, PE
Engineer
cc: Dr. Michael Sue, MD
File EC01116B
Land Planning - Engineering - Environmental - Construction Management
P.O. Box 3989. 115 NJ. Saint Clair St.. Pill Devil Hills, North Carolina 27948
North Carolina License No. C-1027
Phone: [phone] mm.AlhemadeAssociates.com Fax: [phone]

State Stormwater Management Systems
Permit No. SW7110114 `
Dr. Michael Sue, MD
Stormwater Permit No. SW7110114
Pasouotank Countv
Designer's Certification
1, Ih\chaCL 5 �Z\ Iy, as a duly registered the
State of North Carolina, having been authorized to observe (periodically/ weekly/ full (P0,-g
time) the construction of the project,
Z)Q. M\wo,E� JvE MO
0�1
for 02 • Sxl F (Project Owner) hereby state that, to the
best of my abilities,'due-eare 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
DEC - 6 2013
Page 6 of 7
SEAL

I
y State Stormwater Management Systems
Permit No. SW7110114
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.
s� sic 5.
The outlet/bypass structure elevations are per the approved plan.
✓ 6.
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.
s� Nac 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.
11_�15. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Washington Regional Office
Pasquotank County Planning / Building Inspections
'ff
"jV�t.cc �5 NG Mom'
Svl; wnS 2t'CAr�O P ��L'tCYL -ro i�SrGl� ` oF�c. tic
B'- o'�LF %S
DEC - 6 2013
Page 7of7 _,��

Vinson, Scott
From:
Mike Momay [[e-mail]
Sent:
Friday, December 06, 2013 5:13 PM
To:
Vinson, Scott
Cc:
Michael Sue
Subject:
SW permit No - SW7110114 - Designer Certification
Attachments:
EC01116B - 2013-12-06 - Dr. Michael Sue SW certification.pdf
Scott,
I hope you are doing well. Please find the attached letter and certification for the Dr. Michael Sue. Please contact me if
you have any questions.
Sincerely,
Michael J. Morway, PE
Albemarle and Associates, LTD
PO Box 3989, Kill Devil Hills, NC
Ph: 252-441-2113
Fx:252-441-0965
email: mikeme.albemarleassociates.com
web: www.albemarleassociates.com
The information contained in this email message and any attachments is confidential information intended onlyfor the use of
individuals or entities named above. if the reader of this message is not the intended recipient you are hereby notified that any
dissemination, distribution or copying of this, communication is strictly prohibited. Ifyou have received this email in error, please
notify us immediately by email at the originating address.

Permt N0
(b w D'o 3 by DWO)
LVM
NCDE�N—R—R
JAN 3.1 Zu,'I
NG DENR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICA 110N APPLICATION FORM
WET DETENTION BASIN SUPPLEMENT
Thus ;one must be 5w put. p1wed and sulvrced
The Required hags Chwisi (Par. Ill) mus: be pared, 64 d out and sjdns^d a" xxh e9 of ate reowad in:onnatiWn
OrQE W A ^EgOG
o
I: PROJECT INFORMATION".
pmoci name Dr. MCrad Sue M.D. NO tbrlrsCe Poi,
Contact person - Meael J. Mm.W. PE
Phone nunber 252441.2113
Dace 1246'2010
Drainage ants mrnDer i
IL DESIGN INFORMATION - - She Characteristics
Drainage area 72.045 r
Impevious area. postdeveiopmen; 34.7FA a
%inperriws 46,26 %
Oc*n rarda5 depth 1.5 in
Storage Volume: Non -SA Waters
Rti — Vdury reduced
Volume provided
Stonge Volume: SA Waters
14, nunff votune
Predevelopment 1-yT, 24-hr runoff
Pov-6welopmem i-) 244v rumf,,
W*wn vdune required
Vdune provided
Peak Flow CakvWtions
Is the prelpost coma of the tyr 24hr stone peak box requ'red7
1-yr, 244v rainfall depth
Rational C. predevelopmere
Rational C. ppatEevflpprtltY4
Rain3A htem .. i-yr, 244u stone
Predewlor, 1-yr. 244v peak 5tw
PostdermfoprnerY 1-yr. 244 peak Boa
PrePost 1-yr, 24-br peak fox oward
Elevations
Temporary pool elevation
Pemtanent pod elevaton
ShV7r ela lion (applox. at the perm pool efe'raton)
Top of 103 vegete.ed shelf Nevation
Solon of 10q vegem:ed Shah elevation
Sediment deanout top aeration (bogorn of pmd)
Secimm Beano" boacm elevation
Sedinery storage pcanded
Is Lwe add6iolal vohme cored abrne the sta:e-required temp. pod?
Eteration of C1e top of the addiional xtlurme
4.364 q1 OK
13,199 P,r OK, wiune p vAded is equal to ow in excess of wllane mqured.
n (Y oc N)
3.1 in
0,30 (uride i)
0.62 (uoess)
0.13 Wfw OK
0.07 t?tsec
0.14 gltaec
0.07 (tltset
9.50 Im5
8.10 Imsl
6.10 Bra
6.60 Ensi
7.60 Ind
100 fnsl
2.00 fed
1.00 B
y (YorM
9.6 fed OK
Forth V401: rM Deuxroon gmisRw,5 W 17M Pens 1. d B. Design Su cWy. Paps 1 of 2

Pentit No.
rm m aa+eed r" crv])
II. DESIGN INFORUAT10N - -
Surface Areas
Area. temporary pod 10.171 t`
Area R20UIR"D, permanent Door 3,S% ft'
SArJA ratio 5:40 (undless)
Area PROVIDED, permareM pool. A,
6,706 P,`
OK
Area. bndon of 10ft vegetated shelf, Ay, a,,r
5,001 ft`
Area. sedanera tlPanou, top elevation (oMon or pond), A.
060 ft
Volumes
Vohane, temporari pod
13.169 fl3
OK
Volume. pemtanent pod. V;._
15.669 ft3
Volume, forebay (sun of forebays if more than one forebay)
3,376 -°
Forebay % of pemanent pool volune
21.5% %
OK
SAIDA Table Data
Design TSS removal
90 %
Coastal SAMA Table Used?
Y (Y or N)
6lourdavVPiedmor4 SAIDA Table Used?
n (Y or N)
SAIDA ratio
5.40 (wG!ess)
���J
Average depth (used in SAIDA table):
Cakutation option 1 used? (See Figure 10-2b)
n (Y or N)
Vdune, Pehha em pod. V,,, ,e,
15.669 g'
Area pmided. pemanere pool. A,,,a, .
6.706 S`
Average oepuh caltt/ated
41
Need 3 ft min
Average dean used in SAIDA. d,,, (Round to nearest 0.5ft)
41
CakJation option 2 used? (See Figure 10-21g)
y (Y or N)
Area provided. pemanent pool. A,
6,706 f
Area. bo-om of 10ft vegetated she . Aou_r.v
5.001
Area, sedLmera clear" top elevation (bottom of pond). Ae.
660 fir
'Depth' (ds;ance bhv bodom of 10ft shed and top of sedhient)
4.60 ft
Average deom aJculated
3.1041
OK
Average depth used in SA vow, d,,, (Round to nearest 0.5.y
3.0 R
OK
Drawdown Calculation
D2ndo«n uvough orrice?
y (Y or N)
Diameter of Wait molar)
1.00in
.
Area of mice (fta7n{irW..r)
ii
Coe-aent of dscharge (Cp)
0.60 (unidess)
Dn irg head (Hj
0.49 a
Drawdown through weiR
n (Y or N)
Weir type
(unCess)
Coefficient of discharge (C,)
(urzess)
Length of weir (<)
fl
Driving head (H)
P,
Predeveoprnera 1-yr. 24-hr peak Sow
0.07 S31sec
Pm,devdoprera 1-yr. 244v peak flow
0.14 ft3t,,c
Storage suture discharge rate (rough dscnarge office or weu)
0,02 ti3ysec
Storage whane daadomh tine
2.75 days
OK draws do m in 2-5 days.
Additional Information
Vegetated side slopes
3 :1
OK
Vegetated shelf dope
10 :1
OK
Vegetated shelf widdh
10.0 u
OK
Length Of Sowyath to widen ratio
3 :1
OK
Length to width ratio
3.0 :1
OK
Trash rack for overflow & oriice?
y (Y or N)
OK
Freeboard provided
1.0 ft
OK
Vegetated filter provided?
n (Y or N)
OK
Recorded drasage easerertl provided?
Na (Y or N)
OK -
Caaues all runoff at d5nnate btddaP
y (Y or N)
OK
Drain medhanism for maintenance or energenaes is:
pond's below waver tale, who w79 be required to d.—= if needed
=ohm Swat -Wet DY.M aatif.Flev.be+t7Ad Pm 1, a 0. Design Su,vrvry. Pape 2 a 2

Permit No.
(to be provided by DWQ)
III. REQUIRED ITEMS CHECKLIST
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 additional 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.
Pagel Plan RN C-RI V ,
Initials Sheet No. �[1
1. ,Plans (1" - 50' or larger) of the entire site showing:
- Design at ultimate build -out, JAN3 ' 2o11
- Off -site drainage (if applicable), Di1 Q
- Delineated drainage basins (include Rational C coefficient per basin),Pgoj #
- Basin dimensions,
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Proposed drainage easement and public right of way (ROV),
- Overflow device, and
- Boundaries of drainage easement.
y� 2. Partial plan (1" = 30' or larger) and details for the wet detention basin showing:
- Outlet structure with trash rack or similar,.
- Maintenance access,
- Permanent pool dimensions,
- Forebay and main pond with hardened emergency spillway,
- Basin cross-section,
- Vegetation specification for planting shelf, and
-Filter strip.
hS�� 3. Section view of the wet detention basin (1" = 20' or larger) showing:
- Side slopes, 3:1 or lower,
- Pretreatment and treatment areas, and
- Inlet and outlet structures.
4. If the basin is used for sediment and erosion control during construction, clean out of the basin is specified
on the plans prior to use as a wet detention basin.
KAI 5. A table of elevations, areas, incremental volumes & accumulated volumes for overall pond and for forebay,
to verify volume provided.
A
6. A construction sequence that shows how the wet detention basin will be protected from sediment until the.
entire drainage area is stabilized.
rtii>ti�c{i 7. The supporting calculations.
C fp, C�X-OZD 8. A copy of the signed and notarized operation and maintenance (O&M) agreement.
9. A copy of the deed restrictions (if required).
KSNS k PF' OiZ: 10. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. County
soil maps are not an acceptable source of soils information.
Form SW401-Wet. Detention Basin-Rev.8-9117l09 Part 111. Required Items.Checklist,.Page 1 of 1

EXPRESS rmS4/7il
Peit Number: 0
JAN 3 ] 2011 (to be provided byDWQ)
Drainage Area Number: I
Wet MPAR' t 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 provided.
This system (check one):
❑ does ® does not incorporate a vegetated filter at the outlet.
This system (check one):
❑ does ® does not incorporate pretreatment other than a forebay.
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 1 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 formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide time and a
one-time fertilizer application.
Vegetation is too short or too
Maintain vegetation at a height of
I
long.
approximately six inches.
c.._... cwnni %If-. n........:.... n-..:.. no.ne o..., n n.,..,, r ..fA

Permit Number:
(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.
c.,— Qnl A ua.« n....._.:,,., o....:., no.nAD­ a n..,.,.7 ,.FA

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 applicable)
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 5__1 feet in the main pond, the sediment
shall be removed.
When the permanent pool depth reads 5.11 feet in the forebay, the sediment
shall be removed.
BASIN DIAGRAM
(fi!l in the blanks)
Permanent Pool Elevation 8.1
Sediment Removal Ej. 3_0 I Pe anen Pool
Elevatio +
Bottom
-------------- -- Volume Sediment Removal Elevation 3_0 Volume
-------------------------------------------- ------
2_0 -ft Min.
Sediment Bottom Elevation 2.0 I-ft n
Storage Sedimet
Storage
FOREBAY MAIN POND
D....,.1 nFA

Permit Number:
(to be provided by D
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 name:Dr. Michael Sue, MD
BMP drainage area number:
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, —�/ 5a s /A PA I Zeze-ef , a Notary Public for the State of
c ti- Pt- A County of _ �/1� [ �rA� t L do hereby certify that
AA i c-t-I of ---z 5 U c- personally appeared before me this /'�1
day of _�A o A p4 Zo I I , and acknowledge the due execution of the
forgoing wet detention basin maintenance requirements. Witness my hand and official
seal, zg_,_ /1 �
JASON A. MIZELLE
NOTARY PUBLIC
P",SOUOTANK COUNTY, N.C.
SEAL
My commission expires
c_— cwnn, n/... n....,...:,,_ n....:., nv.su n.... n n..,.,. A -FA