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HomeMy WebLinkAboutSW7080810_CURRENT PERMIT_20080902STORMWATER DIVISION CODING SHEET POST -CONSTRUCTION PERMITS PERMIT NO. SW _ 2Oa4f% DOC TYPE VP CURRENT PERMIT ❑ APPROVED PLANS ❑ HISTORICAL FILE ❑ COMPLIANCE EVALUATION INSPECTION DOC DATE�(JgjJ� YYYYMMDD Fig OG Michael F. Easley, Governor William G. Ross Jr, Secretary rNorth Carolina Department of Environment and Natural Resources —i Y Coleen H. Sullins, Director Division of Water Quality Mr. Ed Mitchell September 2, 2008 River Dunes Corporation 416-A Pollock Street New Bern, NC 28560 Subject: Stormwater Permit No. SW7080810 River Dunes Marina and Residential Development — RV & Boat Storage Area High Density Subdivision Project Dear Mr. Mitchell: Pamlico County The Washington Regional Office received a complete Stormwater Management Permit Application for River Dunes Marina and Residential Development — RV & Boat Storage Area on August 13, 2008. Staff review of the plans and specifications has determined that the project, as proposed, will comply with the Stormwater Regulations set forth in Title 15A NCAC 2H.1000. We are forwarding Permit No. SW7080810, dated September 2, 2008, for the construction of the project, River Dunes Marina and Residential Development — RV & Boat Storage Area. This permit shall be effective from the date of issuance until September 2, 2018, 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 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 150E 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, or me at (252) 946-6481. Sin ely, od Regional Supervisor Surface Water Protection Section AH/sd: J:\WPDATA\WQS\Samir - State SW\Permits — Infiltration cc: Curtis Blazier, PE, McKim & Creed, PA (1730 Varsity Dr., Suite 500, Raleigh, NC 27606) Pamlico County Building Inspections ✓Washington Regional Office Central Files North Carolina Division of Water Quality Internet: %svw.ncwaterqualitv.ore One 943 Washington Square Mall Phone (252) 946-6481 NorthCarolina Washington, NC 27889 Fax (252) 946-9215 � l tuml y An Equal Opportunity/Affirmative Action Employer —50%Recycled/10% Post Consumer Paper �/Vlib sLt`( State Stormwater Management Systems Permit No. SW7080810 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 River Dunes Corporation River Dunes Marina and Residential Development — RV & Boat Storage Area Pamlico County FOR THE construction, operation and maintenance of four infiltration basins 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. This permit shall be effective from the date of issuance until September 2, 2018, and shall be subject to the following specified conditions and limitations: I. DESIGN STANDARDS 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 1.6 on page 3 of this permit. The stormwater control has been designed to handle the runoff from 264,706 square feet of impervious area. This basin must be operated with a 50' vegetated filter. 3. The tract will be limited to the amount of built -upon area indicated 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. Page 2 of 8 State Stormwater management systems Permit No. SW7080810 6. The following design criteria have been provided in the infiltration basin and must be maintained at design condition: Basin RV-1 Basin RV-2 a. Drainage Area, acres: 2.60 2.55 b. Total Impervious Surfaces, ft2: 85,153 86,067 C. Design Storm, inches: 1.5 1.5 d. Basin Depth, feet: 2.00 2.00 e. Bottom Elevation, FMSL: 2.50 2.50 f. Bottom Surface Area, ft2: 6,616 13,795 g. Permitted Storage Volume, ft3: 20,581 21,206 h. Type of Soil: Loamy Sand Loamy Sand i. Expected Infiltration Rate, in/hr: 1.30 1.30 j. Seasonal High Water Table, FMSL: 0.50 0.50 k. Time to Draw Down, hours: 44 40 I. Receiving Stream/River Basin: Parris Creek Neuse River Neuse River Basin M. Stream Index Number: 27-141-6 27-(118) n. Classification of Water Body: "SA, HQW, NSW" Basin RV-3 Basin RV-4 a. Drainage Area, acres: 1.32 1.29 b. Total Impervious Surfaces, ft2: 46,416 47,070 C. Design Storm, inches: 1.5 1.5 d. Basin Depth, feet: 2.00 2.00 e. Bottom Elevation, FMSL: 3.00 3.50 f. Bottom Surface Area, ft2: 2,640 2,886 g. Permitted Storage Volume, ft3: 7,068 7,084 h. Type of Soil: Loamy Sand Loamy Sand i. Expected Infiltration Rate, in/hr: 1.30 1.30 j. Seasonal High Water Table, FMSL: 0.50 0.50 k. Time to Draw Down, hours: 37 29 I. Receiving Stream/River Basin: Neuse River Page 3 of 8 State Stormwater Management Systems Permit No. SW7080810 Neuse River Basin M. Stream Index Number: 27-(118) n. Classification of Water Body: "SA, HQW, 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 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 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, infiltration 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. 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: Page 4 of 8 State Stormwater Management Systems Permit No. SW7080810 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. 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 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 Page 5 of 8 State Stormwater Management Systems Permit No. SW7080810 Sediment Control Planning and Design Manual. Approved plans and specifications for this project are incorporated by reference and are enforceable parts of the permit. The permittee shall notify the Division any name, ownership or mailing address changes within 30 days. 10. This permit shall be effective from the date of issuance until September 2, 2018. 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 2nd day of September, 2008. NA ENVIRONMENTAL MANAGEMENT COMMISSION for Division of Water Quality By Authority of the Environmental Management Commission Permit No. SW7080810 Page 6 of 8 oiaie ocormwaier management oystems Permit No. SW7080810 River Dunes Marina and Residential Development— RV & Boat Storage Area Stormwater Permit No. SW7080810 Pamlico 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 7 of 8 State Stormwater Management Systems Permit No. SW7080810 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 bypass structure weir elevation is per the approved plan. 6. The bypass structure is located per the approved plans. 7. A Trash Rack is provided on the 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. cc: NCDENR-DWQ Regional Office Pamlico County Building Inspections Page 8 of 8 • l J • DWQ USE ONLY Dale Received Fee Paid Permit Number I ZoD O W "108�8 O State of Nor{h Carolina IlVECE W" E® Department of Environment and Natural Resources Division of Water Quality At;G 13 2008 STORMWATER MANAGEMENT PERMIT APPLICATION FORM DW6X-GtlARO This form may be photocopied for use as an original I. GENERAL INFORMATION 1. Applicants name (specify the name of the corporation, individual, etc. who owns the project): Rver Dunes Corporation 2. Print Owner/Signing Official's name and title (person legally responsible for facility and compliance): Mr. Ed Mitchell President ✓ 3. Mailing Address for person listed in item 2 above: 416-A Pollock Street Citv:New Bern State:NC Zip:28560 Phone: (252 1 634-3373 Fax: (252 1 633-5775 EmaiLed. mitchell©riverdu nes.com 4. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans, specifications, letters, operation and maintenance agreements, etc.): River Dunes Marina and Residential Development RV and Boat Storage Area 5. Location of Project (street address): SR 1317 Orchard Creek Road City:Oriental County:Pamlico Zip:28571. 6. Directions to project (from nearest major intersection): From the intersection of NC 55 and Straight Road right on Straight Road right on Orchard Creek Road (SR 1317), right on Old Lighthouse Road (Proposed) 7. Latitude:350 04' 45" N Longftude:76° 36' 25" W of project 8. Contact person who can answer questions about the project: Name:Ed Mitchell Telephone Number: (252 1 634-3373 Eniail:ed.niitchell@riverdunes,.com II. PERMIT INFORMATION: 1. Specify whether project is (check one): ®New [—]Renewal ❑Modification Form SWU-101 Version 03.27.08 Page] of 4 2. If this application is being submitted as the result of a renewal or modification to an existing permit, list the • existing permit number and its issue date (if known) 3. Specify the type of project (check one): ❑Low Density ®High Density ❑Redevelop ❑General Permit ❑Universal SNIP []Other 4. 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 ❑404/401 Permit ❑NPDES Stormwater u III. PROJECT INFORMATION 1. In the space provided below, summarize how stormwater will be treated. Also attach a detailed narrative (one to two pages) describing stormwater management for the project . Stormwater will be treated using multiple infiltration basins Level spreader overflow devices, located on berms surrounding the basins andvegetated filter strips will be used to treat stormwater and discharge it to the 2. Stormwater runoff from this project drains to the Neuse River basin. 3. Total Property Area: 7.71 acres 4. Total Wetlands Area: 0 acres 5. 100' Wide Strip of Wetland Area: N/A acres (not applicable if no eoetlands exist on site) 6. Total Project Area**:7.71 acres 7. Project Built Upon Area:78 % 8. 1-low many drainage areas does the project have?4 9. Complete the following information for each drainage area. If there are more than two drainage areas in the project, attach an additional sheet with the information for each area provided in the same format as below. C,.« hi,.1 dFit., „r„ects n,nlar,� fhv tahla with nne drainage area for each engineered stormwater device. ♦o w-u uu�o..v..,.......r�.,......-_..._--------______._. Basin Information Drainage Area 1 Drainage Area 2 Receiving Stream Name See Attached Stream Class & Index No. Total Drainage Area (sf) On -site Drainage Area (so Off -site Drainage Area (sf) Existing Impervious* Area (sf) Proposed Impervious*Area (sf) % Impervious* Area (total) Impervious* Surface Area Drainage Area 1 Drainage Area 2 On -site Buildings (sf) On -site Streets (sf) On -site Parking (sf) On -site Sidewalks (so Other on -site (so Off -site (so Total (sf): Form SWU-101 Version 03.27.09 Page 2 of 4 Impervious area is deferred as the built upon area including, but not limited to, buildings, roads, parking areas, sidewalks, gravel areas, etc. • urrent policy regarding inclusion of wetlands in the built upon Total project area shall be calculated based on the c area percentage calculation. This is the area used to calculate percent project built upon area (BUA). 10. Flow was the off -site impervious area listed above IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS One of the following deed restrictions and protective covenants are required to be recorded for all subdivisions, outparcels and future development prior to the sale of any lot. If lot sizes vary significantly, a table listing each lot number, size and the allowable built -upon area for each lot must be provided as an attachment. Forms can be downloaded from httn //h2o ear state nc us/su bmo forms.htm - deed restrictions. Form DRPC-1 High Density Commercial Subdivisions Form DRPC-2 High Density Developments with Outparcels Form DRPC-3 High Density Residential Subdivisions Form DRPC-4 Low Density Commercial Subdivisions Form DR PC-5 Low Density Residential Subdivisions Form DRPC-6 Low Density Residential Subdivisions with Curb Outlets By your signature below, you certify that the recorded deed restrictions and protective covenants for this project shall include all the applicable items required in the above form, 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 State, and that they will be recorded prior to the sale of any lot. V SUPPLEMENT FORMS The applicable state stormwater management permit supplement forn(s) listed below must be submitted for each BMP specified for this project. Contact the Stormwater and General Permits Unit at (919) 733-5083 for the status and availability of these forms. Forms can be downloaded from htto'//h2o ear shte nc us/su/bmn forms.htm. Form SW401-Low Density Form SW401-Curb Outlet Svstem Form SW401-Off-Site System Form SW401-Wet Detention Basin Form SW401-Infiltration Basin Form SW401-Infiltration Trench Form SW401-Bioretention Cell Form SW401-Level Spreader Form SW401-Wetland Form SW401-Grassed Swale Form SW401-Sand Filter Form SW401-Permeable Pavement Form SWU-101 Version 03.27.08 Low Density Supplement Curb Outlet System Supplement Off -Site System Supplement Wet Detention Basin Supplement Infiltration Basin Supplement Underground Infiltration Trench Supplement Bioretention Cell Supplement Level Spreader/Filter Strip/Restored Riparian Buffer Supplement Constructed Wetland Supplement Grassed Swale Supplement Sand Filter Supplement Permeable Pavement Supplement Fage 3 of 4 VI. SUBMITTAL REQUIREMENTS • Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ). A complete package includes all of the items listed below. The complete application package should be submitted to the appropriate DWQ Office. (Appropriate office may be found by locating project on the interactive online map at hum://h2o enr state nc us/su/lnsi mans.hun) • v 1. Please indicate that you have provided the following required information by initialing in the space provided next to each item. Ins • Original and one copy/ of the Stormwater Management Permit Application Form • Original and one copy of the Deed Restrictions & Protective Covenants Form (if required as per Part 1 V above) • Original of the applicable Supplement Form(s) and O&M agreement(s) for each BMF • Permit application processing fee of $505 (Express: $4,000 for HD, $2,000 for LD) payable to NCDENR • Calculations & detailed narrative description of Stormwater treatment/managemeni • Copy of any applicable soils report • Two copies of plans and specifications (sealed, signed & dated), including: - Development/Project name - Engineer and firm -Legend - North arrow - Scale - Revision number & date - Mean high water line - Dimensioned property/project boundary - Location map with named streets or NCSR numbers - Original contours, proposed contours, spot elevations, finished floor elevations - Details of roads, drainage features, collection systems, and stormwater control measures - Wetlands delineated, or a note on plans that none exist - Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations - Drainage areas delineated - Vegetated buffers (where required) VIL AGENT AUTHORIZATION If you wish to designate authority to another individual or firm so that they may provide information on your behalf, please complete this section. (ex. designing engineer or firm) Designated agent (individual or firm):McKim & Creed P.A. Mailing Address:]730 Varsity Drive Suite 500 City:Ralei h Phone: (919 ) 233-8091 Ema i Lc bl a z i erOmc ki mcreed. co m Vill. APPLICANT'S CERTIFICATION State:NC Zip:27606 Fax: (919 ) 233-8031 1, (print or type mmne of person listed irr General Information, item 2) Ed Mitchell certify that the information included on this permit application form is, to the best of my knowledge, correct and oject w*11 be construct formance with the approved plans, that the required deed restrictions and protects cove7ants will be recorde and that the proposed project complies with the req/yirements of 15A NCAC 2H .100 . // / Signature: Form SWU-101 Version 03.27.08 Page 4 of • s Permit Number: (to be provided bT UIVQ) �p Drainage Area Number: AUG 1 3 "" Pnfiltration Basin Operation and Maintenance Agreement IDWONVAR0 I will keep a maintenance record on this BMP. This maintenance record will be kept in 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. Important maintenance procedures: — The drainage area will be carefully managed to reduce the sediment load to the infiltration basin. — Immediately after the infiltration basin is established, the vegetation will be watered twice weekly if needed until the plants become established (commonly six weeks). — No portion of the infiltration basin will be fertilized after the initial fertilization that is required to establish the vegetation. — The vegetation in and around the basin will be maintained at a height of approximately six inches. After the infiltration basin is established, it will be inspected once a quarter 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. BMP element: Potentialproblem: 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 infiltration basin erosive gullies have formed. remove the gully, and then plant a ground cover and water until it is established. Provide lime and a one-time fertilizer application. The inlet device: pipe or The pipe is clogged (if Unclog the pipe. Dispose of the swale applicable). 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 future problems with erosion. Form SW401-Infiltration Basin O&M-Rev.3 Page I of 3 BMP element: Potentialproblem: How I will remediate theproblem: The forebay Sediment has accumulated Search for the source of the and reduced the depth to 75% sediment and remedy the problem if of the original design depth. possible. Remove the sediment and dispose of it in a location where it will not cause impacts to streams or the BMP. Erosion has occurred or Provide additional erosion riprap is displaced. 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 pesticides are used, wipe them on the plants rather than spraying. The main treatment area A visible layer of sediment Search for the source of the has accumulated. sediment and remedy the problem if possible. Remove the sediment and dispose of it in a location where it will not cause impacts to streams or the BMP. Replace any media that was removed in the process. Revegetate disturbed areas immediately. Water is standing more than Replace the top few inches of filter 5 days after a storm event. media and see if this corrects the standing water problem. If so, revegetate immediately. If not, consult an appropriate professional for a more extensive repair. Weeds and noxious plants are Remove the plants by hand or by growing in the main wiping them with pesticide (do not treatment area. spray). The embankment Shrubs or trees have started Remove shrubs or trees to grow on the embankment. immediately. An annual inspection by an Make all needed repairs. appropriate professional shows that the embankment needs repair. 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 NC Division of Water damage have occurred at the Qualitv 401 Oversight Unit at 919- outlet. 733-1786. Form SW401-Infiltration Basin O&M-Rev.3 Page 2 of 3 Permit Number. (to be provided b,i, DIVQ) I acknowledge and agree by my signature below that 1 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. Pr(?ject narne:River Dunes Marina and Residential Development - RV and Boat Storag BMP dretinage area number: Print Title: Note: The legally responsible party should not be a homeowners association unless more than 50% of Is the lots have been sold and a resident of the subdivision has been named the president. 1, 91 p', if U), �l/Q(�) lC.//% S , a Notary Public for the State of NO County ofyr, /�) , do hereby certify that �I I., -J'r personally appeared before me this 4h day ofAuqus+ and acknowledge the due execution of the forgoing infiltration basin maintenance requirements. Witness my hand and official seal, Form SW401-Infiltration Basin O&M-Rev.3 Page 3 of 3 Permit (to be provided by DWQ) o�OF WA re. � ®lMa STORMWATER MANAGEMENT PERMIT APPLICATION FORM o NCDENR 401 CERTIFICATION APPLICATION FORM INFILTRATION BASIN SUPPLEMENT This form must be filled out, printed and submitted. The Required Items Checklist (Part III) must be printed, filled out and submitted along with all of the required information. Project Name Contact Person Phone Number Date Drainage Area Number River Dunes Marina 8 (252)634-3373 811312008 IL'DESIGNJNF.ORMATIONr r ., 'ar- ire ,,r 1 Site Characteristics Drainage area Impervious area Percent impervious Design rainfall depth Peak Flow Calculations 1-yr, 24-hr runoff depth 1-yr, 24-hr intensity Pre -development 1-yr, 24-hr runoff volume Post -development 1-yr, 24-hr runoff volume Pre/Post 1-yr, 24-hr peak flow control Storage Volume: Non -SR Waters ® Minimum design volume required Design volume provided Storage Volume: SR Waters ;1-yr, 24-hr rainfall depth Pre -development 1-yr, 24-hr runoff Post -development 1-yr, 24-hr runoff Minimum volume required Volume provided Soils Report Summary Soil type Infiltration rate SHWT elevation Basin Design Parameters Drawdown time basin side slopes Basin bottom elevation Storage elevation Storage SA Top elevation Basin Bottom Dimensions Basin length Basin width Bottom SA 113,175.00 ft' 85,153.00 ft2 0.75 % 3.00 in 3.48 in 0.15 in/hr 1,641.00 ft'/sec 23,866.00 1 22,225.00 ft'/sec 20,574.00 ft3 20,581.00 ft3 T ft3 Its Its ft3 Loamy Sand 1.30 n1hr 0.50 fmsl 1.83 days 3.00 :1 2.50 fmsl 4.50 fmsl 13,992.96 ft' 5.50 fmsl 596.77 ft 11.10 It 6,616.37 ft' OK for non -SR waters OK OK OK Form SW401-Infiltration Basin-Rev.2 Parts I. E 11. Design Summary, Page 1 of 2 Permit (to be provided by DWQ) Additional Information Total runoff volume captured by basin Length of vegetative filter for overflow Distance to structure Distance from surface waters Distance from water supply well(s) Separation from impervious soil layer Naturally occuring soil above shwt Bottom covered with 4-in of clean sand? Proposed drainage easement provided? Capures all runoff at ultimate build -out? Bypass provided for larger storms? Pretreatment device provided 5.67 ac-in 180.00 ft NIA It 245.00 ft NIA it NIA ft 3.65 ft Y (Y or N) Y (Y or N) Y (Y or N) N (Y or N) N Maximum of 2 acre -inches allowed OK OK OK OK OK OK OK OK OK Must provide bypass for larger (lows Form SW401-Infiltration Basin-Rev.2 Pans I. & II. Design Summary, Page 2 of 2 Permit No. (to be provided by DWQ) r 1 III. REQUIREDJTEMS 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 Initials Sheet No. G%T3-1 1. Plans (1" - 50' or larger) of the entire site showing: - Design at ultimate build -out, - Off -site drainage (if applicable), - Delineated drainage basins (include Rational C coefficient per basin), - Basin dimensions, - Pretreatment system, - High flow bypass system, - Maintenance access, - Proposed drainage easement and public right of way (ROW), - Overflow device, and - Boundaries of drainage easement. ,e�—V13 2. Partial plan IV = 30' or larger) and details for the infiltration basin showing: Bypass structure, Maintenance access, Basin bottom dimensions, Basin cross-section with benchmark for sediment cleanout, Flow distribution detail for inflow, Vegetated filter, and Pretreatment device. V'q 3. Section view of the infiltration basin (1" = 20' or larger) showing: - Pretreatment and treatment areas, and - Inlet and outlet structures. CM �'f%.1/f S4. A table of elevations, areas, incremental volumes & accumulated volumes to verify the volume provided. SFcfioll 9" 5. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. The �T�oN results of the soils report must be verified in the field by DWQ, by completing & submitting the soils investigation request form. County soil maps are not an acceptable source of soils information. 6. A construction sequence that shows how the inftlration basin will be protected from sediment until the entire drainage area is stabilized. GM9 1W7. The supporting calculations. C/h%3&MrAwi 8. A copy of the signed and notarized operation and maintenance (0&M) agreement. GMS 9. A copy of the deed restrictions (if required). Form SW401-Infiltration Basin-Rev.2 Page 1 of 1 Part III, Required Items Checklist, Page 1 of 1 f • • Permit Number: (to he provided by DWO Drainage Area Number: AUG 1 3'rifiltration Basin Operation and Maintenance Agreement DWO-WARO 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. important maintenance procedures: — The drainage area will be carefully managed to reduce the sediment load to the infiltration basin. — Immediately after the infiltration basin is established, the vegetation will be watered twice weekly if needed until the plants become established (commonly six weeks). — No portion of the infiltration basin will be fertilized after the initial fertilization that is required to establish the vegetation. — The vegetation in and around the basin will be maintained at a height of approximately six inches. After the infiltration basin is established, it will be inspected once a quarter 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 imtediately. BMP element: The entire BMP The perimeter of the infiltration basin Potential roblem: Trash/debris is resent. Areas of bare soil and/or erosive gullies have formed. How I will remediate the roblem: Remove the trash debris. Regrade the soil if necessary to remove the gully, and then plant a ground cover and water until it is established. Provide lime and a one-time fertilizer ap lication. The inlet device: pipe or swale The pipe is clogged (if applicable) . Unclog the pipe. Dispose of the sediment off -site. The pipe is cracked or Replace the pipe. otherwise damaged (if applicable). Erosion is occurring in the swale (if applicable). Regrade the swale if necessary to smooth it over and provide erosion control devices such as reinforced turf matting or riprap to avoid future problems with erosion. Form SW401-Infiltration Basin O&M-Rev.3 Page 1 of 3 E I— L-1 • BMP element: The forebay blem: accumulated the depth to 75% ndepth l design depth. How I will remediate the problem: Search for the source of the sediment and remedy the problem if possible. Remove the sedimentand dispose of it in a location where it will not cause impacts to streams orthe BMP. ccurred or riprap is displaced 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 pesticides are used, wipe them on the plants rather than s pravin . The main treatment area A visible laver of sediment has accumulated. Search for the source of the sediment and remedy the problem if possible. Remove the sediment and dispose of it in a location where it will not cause impacts to streams or the BMP. Replace any media that was removed in the process. Revegetate disturbed areas immediatel . Water is standing more than 5 days after a storm event. Replace the top few inches of filter media and see if this corrects the standing water problem. If so, revegetate immediately. If not, consult an appropriate professional In a more extensive re air. Weeds and noxious plants are growing in the main treatment area. Remove the plants by hand or by wiping them with pesticide (do not s rav). The embankment Shrubs or trees have started to ow on the embankment. Remove shrubs or trees inmiediatel . An annual inspection by an Make all needed repairs. appropriate professional shows that the embankment needs re air. The outlet device Clogging has occurred. Clean out the outlet device. Dispose of the sediment off -site. The outlet device is dama ed Repair or replace the outlet device. The receiving water Erosion or other signs of damage have occurred at the outlet. Contact the NC Division of Water Quality 401 Oversight Unit at 919- 733-1786. Form SW401-Infiltration Basin O&M-Rev.3 Page 2 of 3 r1 \J C, J Permit Number: (to be provided by D IVQ) 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 nalne:River Dunes Marina and Residential Development - RV and Boat Storage BMP drainage area Print :416-a Pollock Street, New BernNC 28560 Phone: l Signature: 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. , a Notary Public for the State of jJC County of ORAVfW , do hereby certify that �Y . personally appeared before me this day of and acknowledge the due execution of the forgoing infiltration basin maintenance requirements. Witness my hand and official seal, My commission expires l a - -� ' 9-0 16 Form SW401-Infiltration Basin O&M-Rev.3 Page 3 of 3 Permit No. (to be provided by DWQ) O?Op WAiFgpG "A STORMWATER MANAGEMENT PERMIT APPLICATION FORM o NCDENR 401 CERTIFICATION APPLICATION FORM Gs INFILTRATION BASIN SUPPLEMENT This form must be filled out, printed and submited. The Required Items Checklist (Part III) must be printed, filled out and submitted along with all of the required information. L8?PRDJECT%INF0RMATI0N:_, e'a:+,a Project Name River Dunes Marina & Residential Development - RV and Boat Storage Area Contact Person Mr. Ed Mitchell Phone Number (252) 634-3373 Date 811312008 Drainage Area Number RV-2 IL4:DESIGN INFORMATION ".A Site Characteristics Drainage area 111,263.00 ftz Impervious area 86,067.00 ft' Percent impervious 0.77 % Design rainfall depth 3.00 in Peak Flow Calculations 1-yr, 24-hr runoff depth 3.48 in 1-yr, 24-hr intensity 0.15 in/hr Pre-development'1-yr, 24-hr runoff volume 1,613.00 ft'/sec Post -development 1-yr, 24-hr runoff volume 24,077.00 fl'/sec Pre/Post 1-yr, 24-hr peak flow control 22,464.00 ft'/sec Storage Volume: Non -SR Waters W, inimum design volume required 20,756.00 ft' Design volume provided 21,206.00 ft' OK for non -SR waters :.Storage Volume: SR Waters 1-yr, 24-hr rainfall depth in Pre -development 1-yr, 24-hr runoff rya Post -development 1-yr, 24-hr runoff ft' Minimum volume required ry' Volume provided ry' Soils Report Summary Soil type Loamy Sand Infiltration Tate 1.30 in/hr SHWT elevation 0.50 mist Basin Design Parameters ,Drawdown time 1.67 days OK Basin side slopes 3.00 :1 OK Basin bottom elevation 2.50 fmsl OK Storage elevation 4.50 fmsl Storage SA 13,795.71 ft' Top elevation 5.50 first Basin Bottom Dimensions Basin length 497.71 ft Basin width 1,479.00 ft Bottom SA 13,795.71 it' Form SW401-Infiltration Basin-Rev.2 Pans I. & II. Design Summary, Page 1 of Permit No. - (to be provided by DWq) Additional Information Total runoff volume captured by basin 5.84 ac-in Maximum of 2 acre -inches allowed •Length of vegetative filter for overflow 80.00 It OK Distance to structure NIA ft OK Distance from surface waters 50.00 ft OK Distance from water supply well(s) NIA ft OK Separation from impervious soil layer NIA ft OK Naturally occuring soil above shwt 2.00 ft OK Bottom covered with 4-in of clean sand? Y (Y or N) OK Proposed drainage easement provided? Y (Y or N) OK Capures all runoff at ultimate build -out? Y (Y or N) OK Bypass provided for larger storms? N (Y or N) Must provide bypass for larger flows Pretreatment device provided N Form SW401-Infiltration Basin-Rev.2 Parts I. 611. Design Summary, Page 2 of 2 Permit (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 Initials Sheet No. GMB <= l4 •/ 1. Plans (1" - 50' or larger) of the entire site showing:. - Design at ultimate build -out, - Off -site drainage (if applicable), - Delineated drainage basins (include Rational C coefficient per basin), - Basin dimensions, - Pretreatment system, - High flow bypass system, - Maintenance access, - Proposed drainage easement and public right of way (ROW), - Overflow device, and - Boundaries of drainage easement. C474 9-AZ-/a 2. Partial plan (1" = 30' or larger) and details for the infiltration basin showing: - Bypass structure, - Maintenance access, - Basin bottom dimensions, • - Basin cross-section with benchmark for sediment cleanout, - Flow distribution detail for inflow, - Vegetated filter, and - Pretreatment device. 3. Section view of the infiltration basin (1" = 20' or larger) showing: - Pretreatment and treatment areas, and - Inlet and outlet structures. r 1 U GLIB V—Y 6945 4. A table of elevations, areas, incremental volumes &accumulated volumes to verify, the volume provided. e.W19 6�E , 1�f2¢5. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. The sic ri4 J results of the soils report must be verified in the field by DWQ, by completing & submitting the soils investigation request form. County soil maps are not an acceptable source of soils information. 6. A construction sequence that shows how the inf llration basin will be protected from sediment until the entire drainage area is stabilized. G/✓J9 Gldl.S 1�. 7. The supporting calculations. C/7B PeAlL Al', 8. A copy of the signed and notarized operation and maintenance (0&M) agreement. NA 9. A copy of the deed restrictions (if required). Form SW401-Infiltration Basin-Rev.2 Page 1 of 1 Part III. Required Items Checklist, Page 1 of 1 Permit No. (to be Provided by DWQ) �� o?oe wn regoc VE STORMWATERMANAGEMENT PERMITAPPLICATIONFORM o `"" ^$ • NCDENR 401 CERTIFICATION APPLICATION FORM �r INFILTRATION BASIN SUPPLEMENT This form must be filled out, printed and submitted. The Required Items Checklist (Part III) must be printed, filled out and submitted along with all of the required information. Contact Person Phone Number Dale Drainage Area Number River Dunes Manna 8 Residential Development- RV and Boat Storage Area Mr. Ed Mitchell (252)634-3373 712212008 RV-3 II, DESIGN INFORMATION, Site Characteristics Drainage area 57,491.00 ft' Impervious area 46,416.00 ft' Percent impervious 0.81 % Design rainfall depth 1.50 in Peak Flow Calculations 1-yr, 24-hr runoff depth 3.48 in 1-yr, 24-hr intensity 0.15 in/hr Pre -development 1-yr, 24-hr runoff volume 834.00 ft'/sec Post -development 1-yr, 24-hr runoff volume 12,948.00 ft'/sec Pre/Post 1-yr, 24-hr peak Flow control - 12,114.00 ft'/sec Storage Volume: Non -SR Waters ® Minimum design volume required 5,581.00 ft' Design volume provided 7,068.00 ft' OK for non -SR waters • 'Storage Volume: SR Waters 1-yr, 24-hr rainfall depth Pre -development 1-yr, 24-hr runoff Post -development 1-yr, 24-hr runoff Minimum volume required Volume provided Soils Report Summary Soil type Infiltration rate SHWT elevation Basin Design Parameters Drawdown time Basin side slopes Basin bottom elevation Storage elevation Storage SA Top elevation Basin Bottom Dimensions Basin length Basin width Bottom SA my Sand 1.30 in/hr 0.50 fmSI 1.54 days 3.00 :1 3.00 first 5.00 fmsl 4,456.00 It' 6.00 fmsl 92.00 ft 21.20 ft 2,640.00 n' OK OK OK Form SW401-Infiltration Basin-Rev.2 Pans I. a It. Design Summary, Page 1 of 2 Permit (to be provided by DWQ) Additional Information Total runoff volume captured by basin 0.00 ac-in ®Length of vegetative filter for overflow 125.00 ft Distance to structure Nla ft Distance from surface waters 60.00 ft Distance from water supply well(s) NIA ft Separation from impervious soil layer NIA It Naturally occuring soil above shwl 2.50 It Bottom covered with 4-in of clean sand? Y (Y or N) Proposed drainage easement provided? Y (Y or N) Capures all runoff at ultimate build -out? Y (Y or N) Bypass provided for larger storms? Y (Y or N) Pretreatment device provided N ®. 10 OK OK OK OK OK OK OK OK OK OK OK Form SW401-Infiltration Basin-Rev.2 Pans I. & II. Design Summary, Page 2 of 2 Permit No. (to be provided by DWQ) 11 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 Initials Sheet No. C h1B I , f3, 1. Plans (1" - 50' or larger) of the entire site showing: - Design at ultimate build -out, - Off -site drainage (if applicable), - Delineated drainage basins (include Rational C coefficient per basin), - Basin dimensions, - Pretreatment system, - High flow bypass system, - Maintenance access, - Proposed drainage easement and public right of way (ROW), - Overflow device, and - Boundaries of drainage easement. 05�j V4 2. Partial plan (1" = 30' or larger) and details for the infiltration basin showing: - Bypass structure, - Maintenance access, - Basin bottom dimensions, - Basin cross-section with benchmark for sediment cleanout, - Flow distribution detail for inflow, - Vegetated filter, and - Pretreatment device. / 3. Section view of the infiltration basin (1" = 20' or larger) showing: - Pretreatment and treatment areas, and - Inlet and outlet structures. qJ6 s 4. A table of elevations, areas, incremental volumes & accumulated volumes to verify the volume provided. 54e.�I o,v &/JW e£orX 7*5. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. The S�wV results of the soils report must be verified in the field by DWQ, by completing & submitting the soils investigation request form. County soil maps are not an acceptable source of soils information. De 6. A construction sequence that shows how the infiltration basin will be protected from sediment until the entire drainage area is stabilized. CMB t,&&-ir-6�7j.7. The supporting calculations. �M8 ELj4lP 8. A copy of the signed and notarized operation and maintenance (00) agreement. GMg 9. A copy of the deed restrictions (if required). Form SW401-Infiltration Basin-Rev.2 Page 1 of 1 Part III. Required Items Checklist, Page 1 of 1 Permit Ito be provided by DWQ) AA 0=Of W p ieq�G o� STORMWATER MANAGEMENT PERMIT APPLICATION FORM y y NC ENR 401 CERTIFICATION APPLICATION FORM INFILTRATION BASIN SUPPLEMENT This form must be filled out, printed and submitted. The Required Items Checklist (Part III) must be printed, filled out and submitted along with all of the required information. Contact Person Phone Number Date Drainage Area Number (252)634-3373 7/2212008 RVA I'" -DESIGN= INFORMATION ':'="` Site Characteristics Drainage area 56,084.00 11' Impervious area 47,070.00 ft' Percent impervious 0,84 % Design rainfall depth 1.50 in Peak Flow Calculations 1-yr, 24-hr runoff depth 1-yr, 24-hr intensity Pre -development 1-yr, 24-hr runoff volume Post -development 1-yr, 24-hr runoff volume Pre/Post 1-yr, 24-hr peak flow control Storage Volume: Non -SR Waters ®Minimum design volume required Design volume provided .Storage Volume: SR Waters 1-yr, 24-hr rainfall depth Pre -development 1-yr, 24-hr runoff Post -development 1-yr, 24-hr runoff Minimum volume required Volume provided Soils Report Summary Soil type Infiltration rate SHWT elevation Basin Design Parameters Drawdown time Basin side slopes Basin bottom elevation Storage elevation Storage SA Top elevation Basin Bottom Dimensions Basin length Basin width Bottom SA 3.48 in 0.15 in/hr 813.00 ft'/sec 13,098.00 ft'/sec 12,285.00 ft'/sec 5,646.00 ft' 7,084.50 ft' in n' W ft' fl' ny Sand 1.30 inlhr 0.50 fmsl 1.21 days 3.00 :1 3.50 fmsl 5.50 fmsl 4,227.00 ft' 6.50 fmsl 78.24 it 41.99 ff 2,886.00 ft' OK for non -SR waters OK OK OK Form SW401-Infiltration Basin-Rev.2 Parts I. a H. Design Summary, Page 1 of 2 Permit (fa be provided by DWD) Additional Information Total runoff volume captured by basin 1.95 ac-in •Length of vegetative filter for overflow 50.00 ft Distance to structure Nla ft Distance from surface waters 500.00 ft Distance from water supply well(s) NIA ft Separation from impervious soil layer NIA It Naturally occuring soil above shwl 3.00 It Bottom covered with 4-in of clean sand? Y (Y or N) Proposed drainage easement provided? Y (Y or N) Capures all runoff at ultimate build -out? Y (Y or N) Bypass provided for larger storms? Y (Y or N) Pretreatment device provided N • 0 OK OK OK OK OK OK OK OK OK OK OK Form SW401-Infiltration Basin-Rev.2 Pans I. a II. Design Summary, Page 2 of 2 Permit (to be provided by DWQ) 0 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 Initials Sheet No. /181 C/-I1C3. 1. Plans (1" - 50' or larger) of the entire site showing: Design at ultimate build -out, Off -site drainage (if applicable), Delineated drainage basins (include Rational C coefficient per basin), Basin dimensions, Pretreatment system, High Flow bypass system, Maintenance access, Proposed drainage easement and public right of way (ROW), Overflow device, and Boundaries of drainage easement. V5, 2� 2. Partial plan (1" = 30' or larger) and details for the infiltration basin showing: - Bypass structure, - Maintenance access, - Basin bottom dimensions, - Basin cross-section with benchmark for sediment cleanout, Flow distribution detail for inflow, Vegetated filter, and Pretreatment device. L C B p 3. Section view of the infiltration basin (1" = 20' or larger) showing: Pretreatment and treatment areas, and Inlet and outlet structures. Pt C S 4. A table of elevations, areas, incremental volumes & accumulated volumes to verify the volume provided. SEA onN C/17,� 6c�PXA. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. The s2boo results of the soils report must be verified in the field by DWQ, by completing & submitting the soils ,,2 investigation request form. County soil maps are not an acceptable source of soils information. C/"/� S T% 6. A construction sequence that shows how the inftlration basin will be protected from sediment until the entire drainage area is stabilized. 7. The supporting calculations. C b �+4 i� y�[UY. 8. A copy of the signed and notarized operation and maintenance (0&M) agreement. �1 C1vV A) Id 9. A copy of the deed restrictions (if required). Form SW401-infiltration Basin-Rev.2 Page 1 of 1 Part ni. Required Items Checklist, Page 1 of 1