SW8120705_CURRENT PERMIT_20130729

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW8 12 0-1 O 5
DOC TYPE
�] CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
201301201
YYYYMMDD

IMC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Pat McCrory Thomas A. Reeder John E. Skvarla, III
Governor Acting Director Secretary
July 29, 2013
George C. Venters, Owner
905 Williamson Dr.
Raleigh, NC 27608
Subject: Name Change / Ownership Change
Dollar General — Piney Green
Stormwater Permit No. SW8 120705
Onslow County
Dear Mr. Venters:
On July 3, 2013, the Wilmington Regional Office received a request for the transfer of ownership
of the Stormwater Management Permit for the subject project. Staff of the Division of Water
Quality have inspected the project, determined that the documentation is in order, and the
project is in compliance with the Stormwater permit requirements. As indicated on the
Name/Ownership Change form, you have acknowledged receipt of a copy of the permit, which
includes the application and supplement forms, a copy of the approved plans and a copy of the
required Operation and Maintenance agreement from the previous permittee. By acknowledging
receipt of the permit, and by signing the Name/Ownership Transfer form, you have accepted the
responsibility for complying with the terms and conditions outlined in this permit. If you need
additional copies of the permit, or copies of the approved plans, please contact the Division of
Water Quality in the Wilmington Regional Office at the phone number below. For your records,
please find enclosed a copy of the updated page 2 of the permit, a copy of the inspection report,
and a copy of the Name/Ownership Change form submitted on July 3, 2013.
Please be aware that the project's built -upon area and stormwater controls must be built and
maintained in compliance with the permit documents and the approved plans. Maintenance
of the approved system shall be performed in accordance with the signed Operation and
Maintenance agreement. Any modifications to this project must be submitted to the Division
of Water Quality and approved prior to construction. The issuance of this approval does not
preclude you from complying with all other applicable statutes, rules, regulations or
ordinances, which may have jurisdiction over the proposed activity, and obtaining a permit
or approval prior to construction.
If you have any questions concerning the requirements of. the permit, please do not hesitate to
call David Cox at [phone].
Sincerely,
4�AoZa3s . Reeder
Division of Water Quality
GDS/ dwc: S:\WQS\Stormwater\Permits & Projects\2012\120705HD\2013 07 permit 120705
cc: George Barnes
Wilmington Regional Office Stormwater File
Wilmington Regional Office
127 Cardinal Drive Extension, Wilmington, North Carolina 28405 '
Phone: [phone] FAX: [phone] DENR Assistance: 1-877$23-6748 OrthCarohna
IntemeC v .ncwalerquality.org
An Equal Opportunityl AF=aive Action Employer ,

State Stormwater Management Systems
Permit No. SW8 120705
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
George C. Venters
Dollar General - Piney Green Road
intersection of Piney Green Road and Charles Road, Jacksonville, Onslow County
FOR THE
construction, operation and maintenance of two (2) bioretention basins in compliance
with the provisions of Session Law 2008-211 and 15A NCAC 2H .1000 (hereafter jointly
and severally 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 18, 2020, 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 1.7 of this permit. The stormwater controls labeled
1 and 2, have been designed to handle the runoff from 16,771 and 15,250
square feet of impervious area, respectively.
A 50' wide vegetative buffer must be provided and maintained adjacent surface
waters, measured horizontally from and perpendicular to the normal pool of
impounded structures, the top of bank of both sides of streams and rivers and the
mean high water line of tidal waters.
4. The tract will be limited to the amount of built -upon area as indicated in Section
1.7 of this permit, and per the application documents and the approved plans.
This permit does not provide any allocation of built -upon area for future
development.
All stormwater collection and treatment systems must be located in public rights -
of -way, dedicated common areas or recorded easements. The final plats for the
project will be recorded showing all such required rights -of -way, common areas
and 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.
Page 2 of 7

Permit Number:
(m be provided by DA1Q)
Drainage Area Number:
Bioretention 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.
Important operation and maintenance procedures:
— Immediately after the bioretention cell is established, the plants will be watered
twice weekly if needed until the plants become established (commonly six
weeks).
— Snow, mulch or any other material will NEVER be piled on the surface of the
bioretention cell.
— Heavy equipment will NEVER be driven over the bioretention cell.
— Special care will betaken to prevent sediment from entering the bioretention cell.
— Once a year, a soil test of the soil media will be conducted.
After the bioretention cell is established, I will inspect it once a month and within 24
hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblems:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
bioretention cell
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
The inlet device: pipe,
The pipe is clogged (if
Unclog the pipe. Dispose of the
stone verge or 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.
Stone verge is clogged or
Remove sediment and clogged
covered in sediment (if
stone and replace with clean stone.
applicable).
ECEI W E"
JUL 0 6 2012 1
Form SW401-Bioretention O&M-Rev.3 Page 1 of 4

BMP element:
Potentialproblems:
How I will remediate theproblem;
The pretreatment area
Flow is bypassing
Regrade if necessary to route all
pretreatment area and/or
flow to the pretreatment area.
gullies have formed.
Restabilize the area after grading.
Sediment has accumulated to
Search for the source of the
a depth greater than three
sediment and remedy the problem if
inches.
possible. Remove the sediment and
restabilize the pretreatment area.
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.
The bioretention cell:
Best professional practices
Prune according to best professional
vegetation
show that pruning is needed
practices.
to maintain optimal plant
health.
Plants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Tree stakes/wires are present
Remove tree stake/wires (which
six months after planting.
can kill the tree if not removed).
The bioretention cell:
Mulch is breaking down or
Spot mulch if there are only random
soils and mulch
has floated away.
void areas. Replace whole mulch
layer if necessary. Remove the
remaining much and replace with
triple shredded hard wood mulch at
a maximum depth of three inches.
Soils and/or mulch are
Determine the extent of the clogging
clogged with sediment.
- remove and replace either just the
top layers or the entire media as
needed. Dispose of the spoil in an
appropriate off -site location. Use
triple shredded hard wood mulch at
a maximum depth of three inches.
Search for the source of the
sediment and remedy the problem if
possible.
An annual soil test shows that
Dolomitic lime shall be applied as
pH has dropped or heavy
recommended per the soil test and
metals have accumulated in
toxic soils shall be removed,
the soil media.
disposed of properly and replaced
with new lantin media.
Form SW401-Bioretention O&M-Rev.3
r
CEIVE
UL 0 6 2012
Page 2 of 4

BMP element:
Potentialproblems:
How I will remediate theproblem:
The underdrain system
Clggging has occurred.
Wash out the underdrain system.
(if applicable)
The drop inlet
Clogging has occurred.
Clean out the drop inlet. Dispose of
the sediment off -site.
The drop inlet is damaged
Repair or replace the drop inlet.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
outlet.
733-1786.
JUL 0 6 20'2
Form SW401-Bioretention O&M-Rev.3 Page 3 of 4

Permit Number:
(to be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project name:Dollar General - Piney Green Road Onslow County
BMP drainage area number:
Print name:George T. Barnes Jr.
Titic:mcmber-manager
Address:3900 Merton Drive Suite 210 Raleigh NC 27609
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
1, a'Cdfe1YWt1 /1/ a Notary Public for the State of
/!//d rii �A(ej iAyly County of / ✓A do hereby certify that
[�co/tcv % a�/dil�/�s ✓2 personally appeared before me this O% Irlv
day of J//E ,)Olj , and acknowledge the due execution of the
forgoing bioretention maintenance requirements. Witness my hand and official seal,
N,h''�.
CO�pTAgy w N
f'UBV� m 2U:
i�•9 �rCh 15,�'
COO
SEAL
My commission expires
ECEOVE
JUL 0 6 2012
BY:
Forni SW401-Bioretention I&M-Rev. 2 Page 4 of 4

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Permit Number:-5wS--1,—W%OS
(to be provided by DWQ)
Drainage Area Number:
Bioretention 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.
Important operation and maintenance procedures:
— Immediately after the bioretention cell is established, the plants will be watered
twice weekly if needed until the plants become established (commonly six
weeks).
— Snow, mulch or any other material will NEVER be piled on the surface of the
bioretention cell.
— Heavy equipment will NEVER be driven over the bioretention cell.
— Special care will betaken to prevent sediment from entering the bioretention cell
— Once a year, a soil test of the soil media will be conducted.
After the bioretention cell is established, I will inspect it once a month and within 24
hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblems:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
bioretention cell
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide time and a
one-time fertilizer application.
The inlet device: pipe,
The pipe is clogged (if
Unclog the pipe. Dispose of the
stone verge or 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.
Stone verge is clogged or
Remove sediment and clogged
covered in sediment (if
stone and replace with clean stone.
applicable).
Form SW401-Bioretention O M-Rev3
�CEIVE-
JUL 0 6 2012
BY: --------
Page I of 4

BMP element:
The pretreatment area
The bioretention cell:
vegetation
The bioretention cell:
soils and mulch
Votenttal problems:
Flow is bypassing
pretreatment area and/or
gullies have formed.
Sediment has accu mulated to
a depth greater than three
inches.
Erosion has
Weeds are present.
Best professional practices
show that pruning is needed
to maintain optimal plant
health.
Plants are dead, diseased or
dying.
Tree stakes/wires are present
six months after planting.
Mulch is breaking down or
has floated away.
Soils and/or mulch are
clogged with sediment.
An annual soil test shows that
pH has dropped or heavy
metals have accumulated in
the soil media.
How I will remediate the problem:
Regrade if necessary to route all
flow to the pretreatment area.
Restabilize the area after grading.
Search for the source of the
sediment and remedy the problem if
possible. Remove the sediment and
restabilize the pretreatment area.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Remove the weeds, preferably by
hand.
Prune according to best professional
practices.
Determine the source of the
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.
Remove tree stake/wires (which
can kill the tree if not removed).
Spot mulch if there are only random
void areas. Replace whole mulch
layer if necessary. Remove the
remaining much and replace with
triple shredded hard wood mulch at
a maximum depth of three inches.
Determine the extent of the clogging
- remove and replace either just the
top layers or the entire media as
needed. Dispose of the spoil in an
appropriate off -site location. Use
triple shredded hard wood mulch at
a maximum depth of three inches.
Search for the source of the
sediment and remedy the problem if
Dolomitic lime shall be applied as
recommended per the soil test and
toxic soils shall be removed,
disposed of properly and replaced
JUL 0 6 2012
Form SW401-Bioretention O&M-Rev.3 19 I fide 2 of 4

BMP element:
Potentialproblems:
How I will remediate theproblem:
The underdrain system
Clogging has occurred.
Wash out the underdrain system.
if applicable)
'The drop inlet
Clogging has occurred.
Clean out the drop inlet. Dispose of
the sediment off -site.
The drop inlet is damaged
Repair or replace the drop inlet.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
outlet.
733-1786.
JUL 0 6 2012
Form SW401-Bioretention O&M-Rev3 Page 3 of 4

Permit Number:
(to be provided by DWQ)
1 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:Dollar General - Piney Green Road Onslow County
BMP drainage area number:
Print name:George T. Barnes, Jr.
Titic:member-manager
Address:3900 Merton Drive, Suite 210 Raleigh, NC 27609
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, Llll' 7lwlaA/& , a Notary Public for the State of
//�l County of icE do hereby certify that
(9FDPP,f T d)'p/! 1t/ES e'iL personally appeared before me this
day of o /,^/r , ay2/�? , and acknowledge the due execution of the
forgoing bioretention maintenance requirements. Witness my hand and official seal,
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tssloq
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�CO 40TAq` N N
'*UBI.\r'
9 a'oh t K.
••'•.F COUNt���•
SEAL
My commission expires
Form SW401-i3iorelcntion I&M-Rev. 2
1 'F C''EIV
JUL 0 6 282
Page 4 of 4

AJ 5

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
STATE STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION
1. Stormwater Management Permit Number: S k) 9 i2c 7 o !�-
2. Project Name: I), Ila.r &e;lze -k }7, nQy Gr-ev,- t'o, 4
3. Current Permit Holder's Company Name/Organization: G/an,(o,n Fores-I &au:f1, LNG
4. Signing Official's Name:
5. Mailing Address: 900
Title:
(3
City: R- It;5 h State: AIL. Zip: Z-74!�-j 9
6. Phone: 00 ) rfsg- 7-6o0 Fax: (911 ) �Is-q-2 6o#
II. PROPOSED PERMITTEE / OWNER / PROJECT / ADDRESS INFORMATION
This request is for: (please check all that apply)
❑ Name change of the owner (Please complete Items 1, 2 and 3 below)
❑ Name change of project (Please complete Item 5 below)
Change in ownership of the property/company (Please complete Items 1, 2, 3, and 4 below)
❑ Mailing address / phone number change. (Please complete Item 4 below)
❑ Other (please explain):
1. Proposed permittee's company name/organization: Ge-oqe- C: Ve,itQrs areal w.-& Wcl,�.Y_V j e i*rj
2. Proposed permittee's signing official's name: George. C- tfesilers
V
3. Proposed permittee's title: 0 u,le�r
4. Mailing Address: 90 S W, //%4 W NZn D-k-
City:
Rk
lersk
State:
IVC--
Zip: Z7 G c 9
Phone:
(911 )
9 3 2 - 963 1?
Fax: (919
) 932-5
4 3 9
5. New Project Name to be placed on permit:
Please check the appropriate box. The proposed permittee listed above is:
❑ HOA or POA (Attach documentation showing that the HOA or POA owns, controls, or has a
recorded easement for all areas that contain stormwater system features. Print name of HOA or
POA in #1 above and provide name of HOA/POA's authorized representative in #2 above)
❑ The property owner
❑ Lessee (Attach a copy of the lease agreement and complete Property Owner Information on
page 4)
Purchaser (Attach a copy of the pending sales agreement. Final appro 8f�fs�ir�7tsfer ill be
granted upon receipt of a copy of the recorded deed) Il
❑ Developer (Complete Property Owner Information on page 4) JUL 03 1013 U
SSW N/O Change Rev15Feb2011 Page 1 of 4
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III. REQUIRED ITEMS
A request to transfer a permit will not be approved by the Division of Water Quality (DWQ) unless all
of the applicable required items listed below are included with the submittal. Failure to provide the
listed items may result in processing delays or denial of the transfer.
1. This completed and signed form. This certification must be completed and signed by both the
current permit holder and the new applicant if this is a change of ownership..
2. Legal documentation of the property transfer to a new owner.
3. A copy of any recorded deed restrictions, covenants, or easements, if required by the permit.
4. The designer's certification (DWQ Engineer and Designer Certification Forms are available from
each DWQ Regional office), if required by the permit and if not already submitted to DWQ.
5. If the proposed permittee is a firm, partnership, association, institution, corporation, limited liability
company, or other corporate entity, provide documentation showing the authority of the named
representative to act on behalf of the proposed permittee.
6. The $40.00 processing fee. If this is an initial transfer from the original permittee the processing
fee is not required. Subsequent ownership transfers will require the $40.00 processing fee.
IV. CURRENT PERMITTEE'S CERTIFICATION
Please check one of the following statements and fill out the certification below that statement:
❑ Check here if the current permittee is only changing his/her/its name, the project name, or mailing
address, but will retain the permit. I, , the current
permittee, hereby notify the DWQ that I am changing my name and/or I am changing my mailing
address and/or I am changing the name of the permitted project. I further attest that this application
for a name/ownership change is accurate and complete to the best of my knowledge. I understand
that if all required parts of this application are not completed or if all required supporting information
and attachments listed above are not included, this application package will be returned as
incomplete.
® Check here if current permittee is transferring the property to a new owner and will not retain
ownership of the permit.
I, 41"doN 'Forts* aw .LLB r3corfc. &rntf!he current permittee, am submitting this application
for a transfer of owner hip or permit # 5w 2 f2,o'7 o i . I hereby notify DWQ of the sale or
other legal transfer of the stormwater system associated with this permit. I have provided a copy of
the most recent permit, the designer's certification for each BMP, any recorded deed restrictions,
covenants, or easements, the DWQ approved plans and/or approved as -built plans, the approved
operation and maintenance agreement, past maintenance records, and the most recent DWQ
stormwater inspection report to the proposed permittee named in Sections II and V of this form. I
further attest that this application for a name/ownership change is accurate and complete to the best
of my knowledge. I understand that if all required parts of this application are not completed or if all
required supporting information and attachments listed above are not included, this application
package will be returned as incomplete. I assign all rights and obligations as permittee to the
proposed permittee named in Sections II and V of this form. I understand that this transfer of
ownership cannot be approved by the DWQ unless and until the facility is in compliance with the
permit. , I
Signature: c ` d ^-C Date: -,> t F,
a Notary Public for the State of
County of yziza , do hereby certify that
A R� r,,-- T &/uAAe-S 4- personally appeared before me this the
4/,rN day of c, .E'LNi= 20-4�­ and acknowledge the due execution of the
forgo/i�J� instrument. Witness my and and official seal
N-ofaryySignature
SSW N/O Change Rev15Feb2011 Page 2 of 4
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V. PROPOSED PERMITTEE CERTIFICATION: (This section must be completed by the
Proposed Permittee for all transfers of ownership)
1, �f 0 C5 L C-y! miler- , hereby notify the DWQ that I have acquired
through sale, lease or legal transfer, the responsibility for operating and maintaining the permitted
stormwater management system, and, if applicable, constructing the permitted system. I
acknowledge and attest that I have received a copy of: (check all that apply to this permit)
U the most recent permit
"the designer's certification for each BMP
❑ any recorded deed restrictions, covenants, or easements
P-the DWQ approved plans and/or approved as -built plans
R-the approved operation and maintenance agreement
Bpast maintenance records from the previous permittee (where required)
DWQ stormwater inspection report showing compliance within 90 days prior to this transfer
I have reviewed the permit, approved plans and other documents listed above, and I will comply with
the terms and conditions of the permit and approved plans. I acknowledge and agree that I will
operate and maintain the system pursuant to the requirements listed in the permit and in the
operation and maintenance agreement. I further attest that this application for a name/ownership
change is accurate and complete to the best of my knowledge. I understand that if all required parts
of this application are not completed or if all required supporting information and attachments listed
above are not included, s applicatiop- ge will be returned as incomplete.
l�Z+� Date:
Signature,
I, a Notary Public for the State of
County of _ , do hereby certify that
�Pi✓//>Exs personally appeared before me this the
�V day of i 1V,4- , 20_4L, and acknowledge the due execution of the
my hand and official
Seal)
Additional copies of the original permit and the approvUYMViation and Maintenance agreement can
be obtained from the appropriate Regional Office of the Division of Water Quality.
This completed form, including all supporting documents and processing fee (if required), should be
sent to the appropriate Regional Office of the North Carolina Department of Environment and Natural
Resources, Division of Water Quality, as shown on the attached map.
Please note that if the Proposed Permittee listed above is not the property owner, the property owner
must complete and sign page 4 of this document. Both the lessee / developer and the property
owner will appear on the permit as permittees.
ECEUVE ,
JUL 0 3 2013
8
SSW N/O Change Revl5Feb2011 Page 3 of 4 By:

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VI. PROPERTY OWNER CONTACT INFORMATION AND CERTIFICATION
If the Proposed Permittee listed in Sections 11 and V of this form is not the Property Owner, the
Property Owner must provide his/her Contact Information below and sign this form:
Printed Name:
Organization:
Title within the Organization:
Street Address:
City:
Mailing Address:
(if differer
City:
Phone:
Email:
State:
street address)
State:
Fax:
NO
Zip:
I certify that I own the property identified in this permit transfer document and have given permission
to the Proposed Permittee listed in Sections II and V to develop and/or, lease the property. A copy
of the lease agreement or other contract, which indicates the party responsible for the construction
and/or operation and maintenance of the stormwater system, has been provided with the submittal.
As the legal property owner I acknowledge, understand, and agree by my signature below, that I will
appear as a permittee along with the lessee/developer and I will therefore share responsibility for
compliance with the DWO Stormwater permit. As the property owner, it is my responsibility to notify
DWO by submitting a completed Name/Ownership Change Form within 30 days of procuring a
developer, lessee or purchaser for the property. I understand that failure to operate and maintain the
Stormwater treatment facility in accordance with the permit is a violation of NC General Statute
(NCGS) 143-215.1, and may result in appropriate enforcement action including the assessment of
civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature of the property owner
County of
Date:
a Notary Public for the State of
do hereby certify that
personally appeared before me this the
day of , 20, and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
(Notary Seal)
Notary Signature
JUL 112111
d
BY:-----
SSW N/O Change Rev15Feb2011 Page 4 of 4

Permit Number: 5xrcI IaO705
(to be provided by DWQ)
Op VJA7F-
�.
w 9
NCDENR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
BIORETENTION CELL SUPPLEMENT
This form must he filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
L PROJECT INFORMATION
Project name Dollar General - Onslow County
Contact name
Phone number
Date
Drainage area number
Bio-Retention Pencil
II. DESIGN INFORMATION
Site Characteristics
Drainage area 21,820 112
Impervious area 16,771 ft2
Percent impervious 76.9% %
Design rainfall depth 1.5 inch
Peak Flow Calculations
Is pre/post control of the 1-yr, 24-hr peak flow required? Y (Y or N)
1-yr, 24-hr runoff depth 3.63 in
1-yr, 24-hr intensity 0.492 inlhr tp+.tuurlN��
Pre -development 1-yr, 24-hr peak flow 0.710 ft2/sec O% *A+4Q��N�i��
Post -development 1-yr, 24-hr peak flow 2.360 ff3/sec ��` �0,�•� Sip
Pre/Post 1-yr, 24-hr peak control 1.650 ft /sec Q�
Storage Volume: Non -SA Waters - SEAL
Minimum volume required 2,020.0ff' = 24434
Volume provided 2,240.0 ft OK
o:
Storage volume: SA waters ','9J�, ,,°GINE,°°
1.5"runoff volume (t� (,;' rEi
Pre -development 1-yr, 24-hr runoff fl ✓
Post -development 1-yr, 24-hr runoff ft3
Minimum volume required 0 ft Volume provided It
Cell Dimensions
Pending depth of water
12 inches
OK
Pending depth of water
1.00 It
Surface area of the top of the bioretention cell
2,240.0 ft2
OK
Length:
60 ft
OK
Width:
30 ft
OK
-or- Radius
If
p�
h [EC E Q �!Y E
Media and Soils Summary
Drawdown time, ponded volume
6 hr
OK
SEP 0 7 2012
Drawdown time, to 24 inches below surface
14 hr
OK
Drawdown time, total:
20 hr
!
In -situ soil:
BY:
Soil permeability
0.40 in/hr
Insufficient.
Increase infiltration rate or include underdrains.
Planting media soil
Soil permeability
2.00 in/hr
OK
Soil composition
Sand (by volume)
87%
OK
Fines (by volume)
8%
OK
Organic (by volume)
5%
OK
Total: 100%
Phosphorus Index (P-Index) of media
10 (unitless)
OK
Form SW401-Bioretention-Rev e
June 25, 2010
Pans I and 11. Design Summary, Page 1 of 2

Permit Number.
'
(to be Provided by DWQ)
' Basin Elevations
Temporary pool elevation
28.00 fmsl
Type of bioretention cell (answer "Y" to only one of the two
following questions):
Is this a grassed cell?
Y
(Y or N)
OK
Is this a cell with trees/shrubs?
N
(Y or N)
Planting elevation (top of the mulch or grass sod layer)
27 fmsl
Depth of mulch
0 inches
Insufficient mulch depth, unless installing grassed cell.
Bottom of the planting media soil
25 fmsl
Planting media depth
2 It
Depth of washed sand below planting media soil
0 ft
Are underdrains being installed?
Y
(Y or N)
How many clean out pipes are being installed?
3
OK
What factor of safety is used for sizing the underdrains? (See
2
OK
BMP Manual Section 12.3.6)
Additional distance between the bottom of the planting media and
1 If
the bottom of the cell to account for underdrains
Bottom of the cell required
24 1
SHWT elevation
22 fmsl
Distance from bottom to SHWT
2 ft
OK
Internal Water Storage Zone (IWS)
Does the design include IWS
N
(Y or N)
Elevation of the top of the upturned elbow
fmsl
Separation of IWS and Surface
27 It
Planting Plan '
Number of tree species
0
Number of shrub species
0
Number of herbaceous groundcover species
0
Recommend more species.
Additional Information
Does volume in excess of the design volume bypass the
Y
(Y or N)
OK
bioretention cell?
Does volume in excess of the design volume flow evenly distributed
Y
(Y or N)
OK
through a vegetated filter?
What is the length of the vegetated filter?
It
,Does the design use a level spreader to evenly distribute flow?
N
(Y or N)
Show how flow is evenly distributed,
Is the BMP located at least 30 feet from surface waters (50 feet if
Y
(Y or N)
OK
SA waters)?
Is the BMP located at least 100 feet from water supply wells?
Y
(Y or N)
OK
Are the vegetated side slopes equal to or less than 3:1?
Y
(Y or N)
OK
Is the BMP located in a proposed drainage easement with access
Y
(Y or N)
OK
to a public Right of Way (ROW)?
Inlet velocity (from treatment system)
2 ft/sec
Insufficient inlet velocity unless energy dissipating devices are
being used.
Is the area surrounding the cell likely to undergo development in
N
(Y or N)
OK
the future?
" Are the slopes draining to the bioretention cell greater than 20%?
N
(Y or N)
OK
Is the drainage area permanently stabilized?
Y
(Y or N)
OK
Pretreatment Used
(Indicate Type Used with an 'X' in the shaded cell)
Gravel and grass
(8 mches gravel followed by 3-5 ft of grass)
X
Grassed swale
OK
Forebay
X
SEP 0 7 2012
L�
Other
BY:
Form SW401-Bioretention-Rev.8
June 25, 2010 Pans I and II. Design Summary, Page 2 of 2

Permit No
(to be assigned 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.
f)Vz,L 4(- ro 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),
- Cell dimensions,
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Recorded drainage easement and public right of way (ROW),
- Clean out pipe locations,
- Overflow device, and
- Boundaries of drainage easement.
�?(5L C-4rCdo
2. Plan details (1" = 30' or larger) for the bioretention cell showing:
- Cell dimensions
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Recorded drainage easement and public right of way (ROW),
- Design at ultimate build -out,
- Off -site drainage (if applicable),
- Clean out pipe locations,
- Overflow device, and
- Boundaries of drainage easement.
- Indicate the P-Index between 10 and 30
3. Section view of the bioretention cell (1" = 20' or larger) showing:
- Side slopes, 3:1 or lower
- Underdrain system (if applicable), and
- Bioretention cell layers [ground level and slope, pre-treatment, ponding depth, mulch depth, fill media
depth, washed sand, filter fabric (or choking stone if applicable), #57 stone, underdrains (if applicable),
SHWT level(s), and overflow structure)
4. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. The
results of the soils report must be verified in the field by DWO, by completing & submitting the soils
investigation request form. County soil maps are not an acceptable source of soils information. All
elevations shall be in feet mean sea level Ifni Results of soils tests of both the planting soil and the in
situ soil must include:
- Soil permeability,
-Soil composition (%sand, %fines, %organic), and
Ink �/4 C /r
x
Adindex.
5. A detailed planting plan (1' = 20' or larger) prepared by a qualified individual showing:
- A variety of suitable species,
- Sizes, spacing and locations of plantings,
- Total quantity of each type of plant specified,
- A planting detail,
- The source nursery for the plants, and
- Fertilizer and watering requirements to establish vegetation.
pyJfL C' S
6. A construction sequence that shows how the bioretention cell will be protected from sediment until the
entire drainage area is stabilized.
�r
`N1G C wl 5
7. The supporting calculations (including underdrain calculations, if applicable).
ECEIVE
l'1� Ghv ✓'/ 8. A copy of the signed and notarized inspection and maintenance (AM) agreement
/M'k- O 9. A copy of the deed restriction. i JUL 0 6 2012
Alf..
Form SW401-13ioretention-Rev.7 Part III, Page 1 of 1

Permit Number / D 1;705
(to be provided by DWQJ
eF wA1Fq
®GA D2 OL
NCDENR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
BIORETENTION CELL SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
Project name
Contact name
Phone number
Date
Drainage area number
Bio-Retention Pond#2
II. DESIGN INFORMATION
Site Characteristics
Drainage area
21,780 ft' .
Impervious area
15,250 ft'
Percent impervious
70.0% %
Design rainfall depth
1.5 inch
Peak Flow Calculations
Is pre/post control of the 1-yr, 24-hr peak flow required?
1-yr, 24-hr runoff depth
1-yr, 24-hr intensity
Pre -development 1-yr, 24-hr peak flow
Post -development 1-yr, 24-hr peak Flow
Pre/Post 1-yr, 24-hr peak control
Storage Volume: Non -SA Waters
Minimum volume required
Volume provided
Storage Volume: SA Waters
1.5' runoff volume
Pre -development 1-yr, 24-hr runoff
Post -development 1-yr, 24-hr runoff
Minimum volume required
Volume provided
Cell Dimensions
Pending depth of water
Pending depth of water
Surface area of the top of the bioretention cell
Length:
Width:
-or- Radius
Media and Soils Summary
Drawdown time, ponded volume
Drawdown time, to 24 inches below surface
Drawdown time, total:
In -situ soil:
Soil permeability
Planting media soil.
Soil permeability
Soil composition
% Sand (by volume)
% Fines (by volume)
% Organic (by volume)
Phosphorus Index (P-Index) of media
Form SW401-Bioretention-Rev.8
June 25, 2010
Y (Y or N)
3.63 in
0.492 in/hr
u.r iv Tt-/seC
2.240 ft3/sec
1.530 ft3/sec
1,851.0 ft3
2,140.0 ft3 OK
12 inches
OK
1,00 It
2,140.0 ftz
OK
95 It
OK
20 If
OK
ft
III fill/l'
? ��FESS/p;�q
Q SEAL '
24434
"sue 9.5•�2�
6 hr OK
14 hr OK
20 hr
0.40 mlhr Insufficient. Increase infiltration rate or include underdrains.
2,00 in/hr OK
87% OK
8% OK � SEP 0 7 2012
5% OK
Total: 100% BY:-
10 (unitless) OK
Parts I and I. Design Summary, Page 1 of 2

Permit
(to be provided by DWQ)
Basin Elevations
Temporary pool elevation
Type of biorelention cell (answer "Y' to only one of the two
following questions)
Is this a grassed cell?
Is this a cell with trees/shrubs?
Planting elevation (top of the mulch or grass sod layer)
Depth of mulch
Bottom of the planting media soil
Planting media depth
Depth of washed sand below planting media soil
Are underdrains being installed?
How many clean out pipes are being installed?
What factor of safety is used for sizing the underdrains? (See
BMP Manual Section 12.3.6)
Additional distance between the bottom of the planting media and
the bottom of the cell to account for underdrains
Bottom of the cell required
SHWT elevation
Distance from bottom to SHWT
Internal Water Storage Zone (IWS)
Does the design include IWS
Elevation of the top of the upturned elbow
Separation of IWS and Surface
Planting Plan
Number of tree species
Number of shrub species
Number of herbaceous groundcover species
Additional Information
Does volume in excess of the design volume bypass the
biorelention cell?
Does volume in excess of the design volume flow evenly distributed
through a vegetated filter?
What is the length of the vegetated filter?
Does the design use a level spreader to evenly distribute flow?
Is the BMP located at least 30 feet from surface waters (50 feet if
SA waters)?
Is the BMP located at least 100 feet from water supply wells?
Are the vegetated side slopes equal to or less than 3:1?
Is the BMP located in a proposed drainage easement with access
to a public Right of Way (ROW)?
Inlet velocity (from treatment system)
Is the area surrounding the cell likely to undergo development in
the future?
Are the slopes draining to the bioretention cell greater than 20%?
Is the drainage area permanently stabilized?
Pretreatment Used
(Indicate Type Used with an'X' in the shaded cell)
Gravel and grass
(flinches gravel followed by 3-5 ft of grass)
Grassed swale
Forebay
Other
29.80 fmsl
Y (Y or N)
N (Y or N)
28.8 fmsl
0 inches
26.8 fmsl
2ft
0 ff
OK
Insufficient mulch depth, unless installing grassed cell.
Y (Y or N)
3 OK
2 OK
1 ft
25.8 fmsl
23.8 fmsl
2ft OK
N (YorN)
fmsl
28.8 ft
0'
0
0 Recommend more species.
Y (Y or N) OK
Y (YorN) OK
ft
N (Y or N) Show how flow is evenly distributed.
Y (Y or N) OK
Y (YorN) OK
Y (YorN) OK
Y (Y or N) OK
2 ft/sec Insufficient inlet velocity unless energy dissipating devices are
being used.
N (Y or N) OK
N (Y or N) OK
Y (Y or N) OK
F
OK IC C E 19v E
X �
SEP 0 7 2012
BY: --
Form SW401-8ioretention-Rev.8
June 25, 2010
Parts I and If. Design Summary, Page 2 of 2

Permit No
(to be assigned 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.
61t1L_ �' - f-/0
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),
- Cell dimensions,
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Recorded drainage easement and public right of way (ROW),
- Clean out pipe locations,
- Overflow device, and
- Boundaries of drainage easement.
2. Plan details (1' = 30' or larger) for the bioretention cell showing:
- Cell dimensions
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Recorded drainage easement and public right of way (ROW),
- Design at ultimate build -out,
- Off -site drainage (if applicable),
- Clean out pipe locations,
- Overflow device, and
- Boundaries of drainage easement.
- Indicate the P-Index between 10 and 30
A4, f L. C'- /1)
3. Section view of the bioretention cell (1' = 20' or larger) showing:
- Side slopes, 3:1 or lower
- Underdrain system (if applicable), and
- Bioretention cell layers [ground level and slope, pre-treatment, pending depth, mulch depth, fill media
depth, washed sand, filter fabric (or choking stone if applicable), #57 stone, underdrains (if applicable),
SHUT level(s), and overflow structure]
7l CJL e4'
4. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. The
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. All
elevations shall be in feet mean sea level (fmsl). Results of soils tests of both the planting soil and the in
situ soil must include:
- Soil permeability,
- Soil composition (% sand, % fines, % organic), and
C-//
P-index.
5. A detailed planting plan (1" = 20' or larger) prepared by a qualified individual showing:
- A variety of suitable species,
- Sizes, spacing and locations of plantings,
- Total quantity of each type of plant specified,
-A planting detail,
- The source nursery for the plants, and
- Fertilizer and watering requirements to establish vegetation.
6. A construction sequence that shows how the bioretention cell will be protected from sediment until the
entire drainage area is stabilized.
7. The supporting calculations (including underdrain calculations, if applicable).
C .SUbM+7i� 6. A copy of the signed and notarized inspection and maintenance (AM) agreeme 1. EVEIVE
/ii?£ Z AJA 9. A copy of the deed restriction. JUL 0 6 2012
Form SW401-Bioretention-Rev.7 Part III, Page 1 of 1

State Stormwater Management Systems
Permit No. SW8 120705
Dollar General - Piney Green Road /
Stormwater Permit No. SW8 120705
Onslow County ^n
Designer's Certification
I, y-rneto 4oku/e✓ as a duly registered in the
State of North Carolina, having been authorized to observe (periodical fit/ weekly/
full time) the construction of the project,
(Project Name)
for 410noon! F Pa E2/ti.4 Zz e (Project Owner) hereby state that, to the
best of my abilities, due c re 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:
SEAL
`C Signature �. o,(H,a,,p�i
� OFESS/p,_'PA
Registration Number a a*Q1W
FA
Date -/8 /3 24434 ,

State Stormwater Management Systems
Permit No. SW8 1 20705
Certification Requirements:
✓
1.
The drainage area to the system contains approximately the permitted
acreage.
2.
The drainage area to the system contains no more than the permitted
amount of built -upon area.
✓
3.
All the built -upon area associated with the project is graded such that the
runoff drains to the system.
✓
4.
All roof drains are located such that the runoff is directed into the system.
✓
5.
The outlet/bypass structure elevations are per the approved plan.
B.
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, per the vegetation" plan.
9.
Vegetated slopes are no steeper than 3:1.
✓
10.
The inlets are located per the approved plans and do not cause short-
circuiting of the system.
✓
11.
The permitted amounts of surface area and/or volume have been
provided.
vl
12.
Required drawdown devices are correctly sized and located per the
approved plans.
vl
13.
All required design depths are provided.
✓
14.
All required parts of the system are provided, such as plantings, a forebay,
filter media and a vegetated filter.
15.
The required system dimensions are provided per the approved plans.
cc:
NCDENR-DWQ
Regional Office
Onslow
County Building Inspections

State Stormwater Management Systems
Permit No. SW8 120705
Certification Requirements:
✓ 1. The drainage area to the system contains approximately the permitted
acreage.
2.
The drainage area to the system contains no more than the permitted
amount of built -upon area.
3.
All the built -upon area associated with the project is graded such that the
runoff drains to the system.
4.
All. roof drains are located such that the runoff is directed into the system.
5.
The outlet/bypass structure elevations are per the approved plan.
6.
The outlet structure is located per the approved plans.
7.
Trash rack is provided on the outlet/bypass structure.
8.
All slopes are grassed with permanent vegetation, per the vegetationplan.
✓ 9.
Vegetated slopes are no steeper than 3:1.
✓
10.
The inlets are located per the approved plans and do not cause short-
circuiting of the system.
✓
11.
The permitted amounts of surface area and/or volume have been
provided.
12.
Required drawdown devices are correctly sized and located per the
approved plans.
13.
All required design depths are provided.
✓
14.
All required parts of the system are provided, such as plantings, a forebay,
filter media and a vegetated filter.
✓
15.
The required system dimensions are provided per the approved plans.
cc:
NCDENR-DWQ Regional Office
Onslow,
County Building Inspections