SW8990406_HISTORICAL FILE_20091013 (2)

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW8 q 9 D4 0 6
DOC TYPE
❑ CURRENT PERMIT
❑ APPROVED PLANS
HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
YYYYMMDD

NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
October 13, 2009
Division of Water Quality
Coleen H. Sullins
Director
Mr. John Clark, Director of Operations
Sampson-Bladen Oil Co., Inc.
P.O. Box 469
Clinton. NC 28329
Subject: Stormwater Permit No. SW8 990406 Renewal
Han — Dee Hugo's #21
High Density Commercial Project
Brunswick County
Dear Mr. Clark:
Dee Freeman
Secretary
The Wilmington Regional Office received a complete Stormwater Management Permit Transfer
of Ownership and Renewal Application for Han — Dee Hugo's #21 on October 1, 2009. The
Division is hereby notifying you that permit SW8 990406 has been renewed on October 13,
2009, and shall be effective until June 24, 2019. The plans previously approved on June 24,
1999, in accordance with the regulations set forth in Title 15A NCAC 2H.1000 effective
September 1, 1995, remain in full force and effect.
This site was inspected on September 17, 2009. All deficiencies noted in the inspection report
have been addressed and the site is currently in compliance with the terms and conditions of
this renewed state stormwater permit.
Please pay special attention to the Operation and Maintenance requirements in this permit.
Failure to establish an adequate system for operation and maintenance of the stormwater
management system will result in future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the
right to request an adjudicatory hearing upon written request within thirty (30) days following
receipt of this permit. This request must be in the form of a written petition, conforming to
Chapter 150B of the North Carolina General Statutes, and filed with the Office of Administrative
Hearings, P.O. Drawer 27447, Raleigh, NC 27611-7447. 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
Angela Hammers, or me at [phone].
SincIprely,
Veeo ette colt
Stormwater Supervisor
Division of Water Quality
GDS/akh: S:\WQS\STORMWATER\PERMIT\990406ren.oct09
cc: CWiI niiigton Regional Office]
Central Files
Wilmington Regional Office
127 Cardinal Drive Extension, Wilmington, North Carolina 28405 One
Phone: [phone] FAX: [phone] Customer service: 1-877-623-6748 NorihCarolina
Internet:w ,ncmmterqualily.org Naturally
ly
An Equal Opponunily l Affirmative Action Employer (i

State Stormwater Management Systems
Permit No. SW8 990406 Renewal
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY COMMERCIAL 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
John Clark & Sampson-Bladen Oil Co., Inc.
Han — Dee Hugo's #21
6170 Ocean Hwy, Winnabow, Brunswick County
FOR THE
operation and maintenance of a dry detention basin with a grassed swale in compliance
with the provisions of 15A NCAC 2H .1000 effective September 1, 1995 (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 June 24, 2019, 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 98,855 square feet of
impervious area. This basin must be operated with a grassed swale.
3. This 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.
Page 2 of 5

State Stormwater Management Systems
Permit No. SW8 990406 Renewal
5. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
6. The following design criteria have been permitted for the dry detention basin and
must be provided and maintained at design condition:
a. Drainage Area, Acres: 3.67
Onsite, ft : 160,000
Offsite, ft2: 0
b. Total Impervious Surfaces, ft2: 98,855
C. Design Storm, inches: 1
d. Basin Depth, feet: 1.35
e. Permanent Pool Elevation, FMSL: 18.15
f. Provided Surface Area, ft2: 81315 @ elevation 18.15
g. Permitted Storage Volume, ft3: 8,081 (required); 13,852 provided
h. Temporary Storage Elevation, FMSL: 19.5
i. Receiving Stream/River Basin: Bell Swamp / Cape Fear
j. Stream Index Number: 18-81-6-1-5
k. Classification of Water Body: "C Sw"
Notes:
The side slopes of the basin must be maintained at 3:1 or flatter.
A small permanent pool is provided at the orifice to reduce clogging.
The seasonal high water table is located approximately 4.5' below the proposed bottom
of the system.
A 270' grassed swale located at the overflow from the basin has been provided to meet
the required 85% TSS removal.
II. SCHEDULE OF COMPLIANCE
1. The stormwater management system shall be constructed in its entirety,
vegetated and operational for its intended use prior to the construction of any
built -upon surface.
2. During construction, erosion shall'be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The permittee shall at all 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 re -vegetation 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.
Page 3 of 5

State Stormwater Management Systems
Permit No. SW8 990406 Renewal
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. Access to the stormwater facilities shall be maintained via appropriate recorded
easements at all times.
8. The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed
below:
a. Any revision to any item shown on the approved plans, including the
stormwater management measures, built -upon area, details, etc.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
e. Further development, subdivision, acquisition, lease or sale of any, 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. Prior to the construction of any permitted future areas shown on the approved
plans, the permittee shall submit final site layout and grading plans to the
Division for approval.
11. A copy of the approved plans and specifications shall be maintained on file by
the Permittee at all times. At the time the permit is transferred to a new owner,
the permittee shall forward the approved plans to the new owner.
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 to any person or entity except after notice to and
approval by the Director. In the event of a change of ownership, or a name
change, the permittee must submit a completed Name/Ownership Change form
to the Division of Water Quality, signed by both parties, and accompanied by the
supporting documentation as listed on page 2 of the form. The approval of this
request will be considered on its merits and may or may not be approved.
Page 4 of 5

State Stormwater Management Systems
Permit No. SW8 990406 Renewal .
The permittee is responsible for compliance with all permit conditions until such
time as the Division approves the transfer request. Neither the sale of the project
nor the transfer of common area to a third party constitutes an approved transfer
of the stormwater permit.
3. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the Division of Water Quality, in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
4. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
5. In the event that the facilities fail to perform satisfactorily, including the creation of
nuisance conditions, the Permittee shall take immediate corrective action,
including those as may be required by this Division, such as the construction of
additional or replacement stormwater management systems.
6. The permittee grants DENR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
7. The permit remains in force and effect until modified, revoked, terminated, or
renewed. The permit may be modified, revoked and reissued or terminated for
cause. The filing of a request for a permit modification, revocation and
reissuance, renewal or termination does not stay any permit condition.
8. Unless specified elsewhere, permanent seeding requirements for the stormwater
control must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
9. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
10. The permittee shall notify the Division in writing of any name, ownership or
mailing address changes at least 30 days prior to making such changes.
11. The permittee shall submit a permit renewal application at least 180 days prior to
the expiration date of this permit. The renewal request must include the
appropriate documentation and the processing fee.
Permit issued this the 13th day of October 2009.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
/orLoieen I�!Suwns, uirector
Division of Water Quality
By Authority of the Environmental Management Commission
Page 5 of 5

Foster€ Lake
b Pond management
183 Donmoor Court • Gamer North Carolina 27526 • Phone [phone] • Fax [phone] • www fostedake com
September 25, 2009
Sampson Bladen Oil Company
C/o Winnabow Exxon Station
6170 Ocean Highway
Winnabow, NC 28479
Re: Year -Round Monitoring Service Agreement
Agreement #: WinnabowExxon092509
Location: Winnabow. NC 28479
Dear Mr. Clark:
Introduction
OCT a 1 2009
Foster Lake & Pond Management, Inc. (FLPM) is pleased to provide Winnabow Exxon Station with
this agreement for year-round aquatic monitoring services. We understand that the ponds are
located at the Winnabow Exxon Station in Winnabow, NC.
Based on the absence of an existing Stormwater Management Plant for this property, it is our
recommendation that quarterly visits to inspect the stormwater management system and perform
maintenance tasks necessary to keep the structures operating property are done. Mowing of the
grass swales should be done regularly by the owner, when the rest of the grass is mowed.
Scope of Services
The following scope of services, for Year -Round Monitoring Service is based on FLPM's assessment
of your ponds.
Year -Round Monitoring Service
The following Year -Round Aquatic Monitoring Services are designed to help identify potential
problems and prevent them from reaching critical status.
Monitoring
FLPM personnel will make 4 monitoring visits to the ponds during the service year. The following
parameters will be monitored during each visit:
• general appearance including pond water level, presence of surface film, need to mow or trim
shoreline vegetation and weather conditions
• water color and clarity
• aquatic vegetation present
• nuisance animal activity
• water quality (hardness, alkalinity, light penetration, pH, temperature and dissolved oxygen (if
required))
• fish population conditions
• presence of trash and/or debris
• erosion of banks or stream channels and sedimentation

Winnabow Exxon
September 25, 2009
Page 2
• drainage structure and emergency spillway condition
• condition of sediment collection forebays, berms, swales and riprap rock channels
• condition of stormwater inlets, outlets, pipes, conduits and conveyances
• condition of dam slopes, embankments, conduits and cover vegetation
• trash (not including sticks, logs, leaves, pine straw, mulch, or natural debris) will be removed
• nuisance vegetation will be controlled within requirements
Observations will be included in your visit report and we will contact you if developing conditions need
additional and/or immediate attention.
Monitoring Reports
After each site visit, FLPM will prepare a monitoring report detailing site visit observations, activities
and recommendations. This report is made available for on-line review on our website. A user name
and password will be provided to you when the first report is uploaded. If conditions are observed
that require immediate attention, you will be notified immediately.
• FLPM will provide customized quotations for repairs or maintenance if and when
necessary.
Cost
FLPM proposes to provide the services listed above for $1,550.00 (Year -Round Aquatic Monitoring
Service). We will not exceed either amount without prior approval from Winnabow Exxon. These
services will be invoiced on a quarterly basis.
This Agreement shall have an initial term of twelve months, beginning upon execution of this
Agreement, and then continue on a Month -to -Month basis until terminated by one of the parties (see
attached General Terms and Conditions). Cost revisions may be renegotiated annually between the
parties on an annual basis and made a part of this Agreement via amendment.
If this agreement and the attached General Terms and Conditions are acceptable, please sign and
dale in the space provided on the next page as your authorization to proceed.
000
FLPM looks forward to assisting you with your aquatic services needs. Should you have any
questions or require any additional information, please do not hesitate to call.
Best regards,
John E Foster III

Winnabow Exxon
September 25, 2009
Page 3
Authorization to Proceed and Acceptance of General Terms and Conditions
The scope of work, estimated cost and General Terms and Conditions (see attached) presented in
this Agreement (Agreement No. WinnabowExxon092509 dated September 25, 2009), are acceptable.
Upon receiving this Authorization to Proceed, FLPM is authorized to proceed with the services
described herein.
By: � J�
,9ignature / 7
CIn.05,i
Organization
Printed Name
s/o9
Date
Service: Year -Round Aquatic Monitoring Service
Customer: Winnabow Exxon
Location: Winnabow, NC
Please initial each cost below to indicate your agreement.
Year -Round Cost: $1,550.00 ($387.50/quarterly)
u`� /• (initials)
This Agreement and any additional information provided by FLPM to CUSTOMER is considered
confidential and is not to be used or relied upon by third parties without the express written
consent of FLPM.
Q=' vjt�o
OCT 0 1 2009
Rn

STATE OF North Carolina
COUNTY OF Sampson
On September 28, 2009, John L. Clark, personally appeared before
me, acknowledged to me that he executed the enclosed
Authorization to Proceed and Acceptance of General Terms and
Conditions, and that by his signature on the instrument,
executed the instrument.
WITNESS m d officia seal.
Signature an an
My Commission Expires: February 15, 2013
(Seal)

General Terms and Conditions
This Agreement is subject to the following terms and conditions and, by accepting this Agreement or any
part thereof, the OWNER agrees and accepts the terms and conditions outlined below:
1. Payment:
a) Owner will pay Foster Lake 8 Pond Management Inc (FLPM) for the
services and expenses in accordance with Invoices to OWNER on a
quarterly basis, and a final Invoice upon wrnplellon of the service
proNtled, Each Invoice Is due and payable In full upon presentation to
the OWNER. Involms are past due after 30 days, Past due amounts
are subject to a Service Charge of 1.5 permnl per month (18 percent
per annum) on the outstanding balance, from date of Invoice.
Attorneys fees and other costs Incurred In collecting past due amounts
shall be paid by OWNER.
b) If the OWNER falls to make payment to FLPM within 30 days after the
transmittal of an Invoice, FLPM may, after giving 7 days written notice
to the OWNER, suspend services under this Agreement until all
amounts due hereunder are paid In full. If an Invoice remains unpaid
after 90 days from Invoice date. FLPM may Initiate legal proceedings to
collect the fees owed, plus other reasonable expenses of collection
Including attorneys fees.
2. Term of Agreement: This Agreement shall have an Initial term of 12 months,
beginning on the date this Agreement Is executed and mellow on a Monthdo-
Month basis until terminated by either party (see Paragraph 16 below).
3. Cost Revision: Coal revisions may be renegotiated annually between the
Parties and made a part of this Agreement via amendment.
4. Representations of OWNER: OWNER warrants and covenants that
suffclent funds are available or will be available upon receipt of FLPM's
invoice to make payment In full for the services provided by FLPM.
5. Representations of FLPM: FLPM represents that It Is an Independent
contractor and Is not an agent, partner, joint venture or employee of OWNER.
FLPM shall have no authority to bind or othervnse obligate OWNER In any
manner.
6. Ownership of Instruments of Service: Al field data, reports, plans,
specifications, notes and other documents, Including all documents on
elearonlc media, prepared by FLPM as an Instrument of service, shall remain
the property of FLMP. FLPM shall retain all common law, statutory and other
rights, Including the copyright, thereto. In the event of termination of the Is
Agreement and upon full payment of fees owed to FLPM, FLPM shall make
available to OWNER males of all plans, specifications, reports, computations
and correspondence.
7. Reuse of Documents: The Service, and any data, recommendations,
Proposals, reports, design cnterla and similar Information provided by FLPM to
OWNER pusuanl to this Agreement are provided for the exclusive use of
OWNER on the Project and are not to be used or relied upon In connection
with other projects or by third parties without the express written consent of
FLPM.
8. Confidentiality: Subject to any obligation FLPM may have under applicable
law or regulation, FLPM agrees to release Information relating to the Services
only to Its employees and subcontractors In the performance to the Services or
to OWNER's authorized representative and to persons designated by
OWNER's authorized representative to receive such Information throughout!
the active period of Service of this Agreement.
9. Assignment and Subcontracting: Nothing under this Agreement shall be
construed to give any rights or benefits In this Agreement to anyone other than
the OWNER and FLPM, and all duties and respominlilles undertaken
pursuant to this Agreement will be for the sole and exclusive benefit of the
OWNER and FLPM and col for the benefit of any other party. Neither the
OWNER nor FLPM shall assign, sublet or frausfer any rights under or Interests
in this Agreement without the written consent of the other, which shall not be
unreasonably withheld. However, nothing contained herein shall prevent or
restrict FLPM from employing Independent professionals and/or
subWotrectom, as FLPM may deem appropriate to assist in the performance
of services hereunder.
10. Project Site: Should OWNER not be owner of the project site, then OWNER
agrees to reply the Ounegs) of the aforementioned possibility of unavoldable
alteration and damage to Indemnify, and defend FLPM against any claims by
the Owner or persons having possession of the site through the Owner which
are related to such alteratlon or damage.
11. Access to She: OWNER Is responsible for Providing access to site, to the
extent necessary for FLPM to carry out the services to be rendered under this
Agreement.
12. Period of Services: Unless otherwise provided In the Agreement, FLPM will
begin work promptly upon execution of this Agreement and, shall complete the
services within a reasonable length of time. The mmpensatlon to FLPM
included In this Agreement has been agreed to In anticipation of a continuous
and orderly progress through the completion of FLPM's services. If FLPM's
services are delayed or suspended In whole or In pan by the OWNER or
others col under FLPM's control, the times of performance shall be extended
to the extent of such delay or suspension. If such delay or suspension extends
for such a time that demobilization and remobilization have to occur, the
compensation provided for In this Agreement shall be subject to renegotiation
13. Unforeeen Occurrences or Conditions: If, during the performance of
services hereunder, any unforeseen hazardous substance, material, element
Of mnsli cent or other unforeseen conditions or occurenoes are encountered
which, in FLPM's sets judgment significantly affects or may affect the
services, the risk Involved In providing the service or the recommended scope
of services, FLPM will promptly notify OWNER thereof. Subsequent to that
notification, FLPM my. (a) If practicable, in FLPM's sole judgment and with
approval of OWNER. complete the original scope of mnAces In accordance
with the procedures originally intended in the Proposal; (b) Agree with
OWNER to modify the scope of services and the estimate of charges to
Include study of the previously unforeseen conditions or cocmreromi such
revision to be in writing and signed by the parties and Incorporated herein; or
(c) Terminate the services effective on the date of notlflcation pursuant to the
terms of TERMINATION OF CONTRACT.
This Agreement is else subject to revision or termination by FLPM due to
concealed contingencies such as leaks, debris, poor drainage situations,
dogged drains, design flaws, structural failure, etc. rat readily apparent in
estimating the labor and materials required for the Project.
14. Form Majeum: Should mmpletlon of any portion of the Services be delayed
for causes beyond the control of or Without the taut or negligence of FLPM
including force majeure, the time for performance shall be extended for a
period equal to the delay and the parties shall mutually agree on the terns
and conditions upon which Services may be continued. Force majeure
includes but Is Trot restricted to acts of God or the public enemy, acts of the
Government of the United States (or individual States, Counties or Local
governments), or any foreign country, acts of OWNER's contractors or
Agents, fire floods, epidemics, riots, quarantine restrictions, strikes, civil
insurrections, freight embargoes andfor severe weather.
15. Standard of Care: FLPM shell perform Services for OWNER In a profess-
sional manner, using that degree of care and skill ordinary exercised by and
mnsistent with the standards of competent firms practicing In the same or a
similar locality as the Project. No other warranty is expressed or Implied,
16. Subsurface Utilities: Any and all subsurface utilities (water, sewer, cable,
irrigation, power, telephone, etc.) are to be located by the OWNER prior to
FLPM site work. OWNER assumes all responsibility for any accidental
damage that occurs If the locations of utilities are not clearly and accurately
marked prior to commencement of work.
17. Accidental Damage: The pavement of heavy equipment may damage any
and all concrete andfa asphalt roads, driveways, walking paths, curbing, and
sidewalks that are locating In the area of the pmjecl. FLBPM, Inc. personnel
will utilize the utmost caution to prevent this from omuring. However, the
signer of this quotation assumes all responsibility for any accidental damage
that occurs to these structures.
18. Limitation of Liability: The remedies set forth herein are exclusive and the
total liability of FLPM whether in contract, tort (Including negligence whether
sole or concurrent), or otherwise arising out of, mnnectlon with or resulting
from the services provided pursuant to this Agreement shall not exceed the
total fees paid by OWNER.
19. Termination of Contract: This agreement may be terminated by either party
upon 30 days when notice in the event of substantial failure by the other
parry to perform In accordance with the terns herein. Such termination shall
net be effective if that substantial failure has been remedied before expiration
of the period specified in the written notice. In the event of termination, FLPM
shall be paid for Services performed to the terminmilm date. In the case of
year-round service, FLPM shall also be compensated for materials cost which
has been mlanlated for the tern of the contract period.
20. Sevembilhy: If any provision of this Agreement, or application thereof to any
person or circumstance, shall fo any extent be Invalid, then such provision
shall be modified if possible, to fulfill the intent of the parties as reflected in
the original provision, the remainder of this Agreement, or the application of
each provision to persons or circumstances other man those as to Which it is
held Invalid, shall cot be affected thereby, and each provision of this
Agreement shall be vend and enforced to the fullest extent permitted by law.
21. No Waiver: No waiver by either party of any default by the other parry In the
perfomanm of any provision of this Agreement shall operate as or be
construed as a waiver of any future default, whether like or difference in
character.
22. Merger, Amendment: This agreement constitutes the entire Agreement bet-
ween FLPM and the OWNER, and negotiations, written and oral
understandings between the parties are merged herein. This Agreement can
be supplemented and/or amended only by a written document executed by
both FLPM and the OWNER.
23. Lew to Apply: The validity, Interpretation and performance of this
Agreement shall be governed by and construed in accordance with the laws
of the State of North Carolina,

Hammers, Angela
From:
Hammers, Angela
Sent:
Tuesday, July 28, 2009 9:00 AM
To:
'[e-mail]'
Cc:
'Abby Spencer'
Subject:
SW8 990406 - Han Dee Hugo's #21 (formerly proposed Bolivea Exxon Station)
Dear Mr. Clark,
I just wanted to send you a note to let you know DWQ received the renewal application, processing fee and transfer of
ownership paperwork for the Han Dee Hugo's #21 (formerly proposed Bolivea Exxon Station) project last Monday
(7/20/09). Thank you for the note also stating that Abby is working on the corrections.
Upon receipt of a signed O&M agreement, I can proceed with the renewal of the permit to keep it up to date while the
work to correct the deficiencies continues according to a written plan of action. Please put the O&M agreement and
plan of action to my attention when sending to DWQ.
Please let me know if you have any questions. I look forward to working with you in bringing this project into
compliance with the state stormwater permit conditions.
Sincerely,
Angel Hammers (Please note my new email address is [e-mail])
Environmental Specialist
NC Department of Environment and Natural Resources
Wilmington Regional Office
127 Cardinal Drive Ext.
Wilmington, NC 28405
Office: 910.796.7215
Fax: [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
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July 20, 2009
To: Angela Hammer
NCDGNR
From: John Clark
Director of Operations
Sampson-Bladen Oil Co.
Re: Storm water Permit # SW 8990406
Angela,
1 have included everything in this packet except the Operations and Maintenance Agreement.
have been in contact with Retention Pond Services and Abby over there is working me up a
quote based on the results of your inspection. Once Abby gets me her quote I will submit the
0&M agreement.
ohnf
JUL Z p 2009
BY:

DWQ USE ONLY
Date Received
Fee Paid
Permit Number
-ze9 -CO 7
1
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT RENEWAL APPLICATION FORM
This form may be photocopied for use as an original
1. GENERAL INFORMATION
I_ Stormwater Management Permit Number: SW 811NO G
2. Permit Holder's name (specify the name of the corporation, individual, etc.):
Si.'M n3dn^ �4] `QUi//1 �� C°O• .�nl .
3. Print Owner/Signing Official's name and title (person legally responsible for permit):
Oi rec�, - of Dpenlka� s
4. MajJjng Address for person listed in item 2 above:
City: &" State: /jl C Zip: �3ez 9
Phone: (Qro , 5-F6 V Fax: (9'i� 5-1? .t - 0'5-0 Y
Email:_ 0AA
5. Project Name:
6. Location of project (street address)): '
6t "�20 6CPRn �'7cUY np
City: W i it ALL60 ".� County:
to project (from nearest major intersection):
it. PERMIT INFORMATION:
1. Specify the type of stormwa ter treatment: ❑Constructed Wetland ❑Bioretention ❑Wet Detention Basin
❑Dry Detention Basin ❑Infiltration Basin []Infiltration Trench ❑Sand Filter ❑Other:
2. List any changes from project that was originally approved (attach additional,p!ges i�eeedvedh���
..
M
20
Form SWU-102 (Renewal Form) Version 02.16.09 Page 1 of 3

3. Do you have a copy of the original Operation and Maintenance Agreement? (check one)
❑Ycs (If yes, submit the attached (page 3) Operations and Maintenance verification sheet.)
k- (If no, then submit a new Operations and Maintenance Agreement that can be located on the
Division of Water Quality Home Page under the BMP Manual link:
http://l12o.enr.state.nc.us/su/bmp—forms.htm)
Ill. 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 htto://h2o.enr.state.nc.tis/su/tusi maos.hun)
Please indicate that you have provided the following required information by initialing in the space provided
next to each item.
Initials
• Original & 1 copy of the Stormwater Management Permit Renewal Application Form
• Application fee of $500.00 (made payable to NCDENR)
• Operation & Maintenance Verification or a new O&M Agreement
• SWU-101 Application Form (if requesting mod cation to the permit)
• Transfer of Ownership/Name Change Form (if requesting transfer of ownership) "r or
VI. APPLICANT'S CERTIFICATION
1, (print or type name of person listed in General Information, item 3)
certify that the information included on this permit renewal application is, to the best of my knowledge, correct
/ p and complete. 'n/
Signatu
Form SWU-102 (Renewal Form) Version 02.16.09 Page 2 of 3

Operations and Maintenance Verification
1 acknowledge and agree by my signature below that I am responsible for the performance of the
maintenance procedures listed in the original Operations and Maintenance Agreement. 1 agree to notify
DWQ of any problems with the system or prior to any changes to the system or responsible party.
Print name:
Title:
Address:
Phone:
Date:
Q t �dM
Note: The legally responsible party should not be a lion�t 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
County of , do hereby certify that
personally appeared before me this day of , and acknowledge the due
execution of the forgoing stormwater BMP maintenance requirements. Witness my hand and official
seal,
Notary Signature:
SEAL
My commission expires:
Form SWU-102 (Renewal Form) Version 02.16.09 Page 3 of 3

F�
NCDENR
North Carolina Department of Environment and Natural
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
STATE STORMWATER PERMIT
NAME/OWNERSHIP CHANGE FORM
1. CURRENT PERMIT INFORMATION:
Stormwater Management Permit Number: d / TN O 6
2. Permit Holder's name:
[BY:
ECEIVED
JUN 9 2009
Resoues
Signing official's name:( /X<,'//jpv Title:
per�i legally r spon able fo crmit) / 11
Mailing address:` //2/1_City:
Dee Freeman
Secretary
State: N ZipCode: i Phone: ,g �� G6f..2 Fax: 9/� ;2 f3 ���/
(Area Code and Number) (Area Code and NuAer)
11. NEW OWNER / PROJECT / ADDRESS INFORMATION
This request is for: (please check all that apply)
a;- Change in ownership of the property/company (Please complete Items 92, #3, and
#4 below).
❑ b. Name change of project (Please complete Item #5 below)
❑ c. Mailing address change. (Please complete Item #4 below)
❑ d. Other (please explain):
2. New owner's name to be put on permit:
3. New Signing official's name: Title: l�PP�w� o C/i7p/rXl��u�>
(person legally responsible for permit)
4. New Mailingaddress: /. (,, 1?0V Volq City: C,/ik 7�^
State: Xt( ZipCode: 3 Q Phone: %/0 T96_(f3Y7 Fax: f/0-SF y
(Area Code and Number) / (Area Code and Number)
1
5. New Project Name to be placed on permit:
Wilmington Regional Office
127 Cardinal Drive Extension, Wilmington, North Carolina 28405 One
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 Nortf 1Caroll n a.
Internet, wwivmcwaterquality.org J�/a atimn //ff
An Equal Opportunity l Affirmative Action Employer !L"
Page 1 of 2

PERMIT NAME/OWNERSHIP CHANGE FORM
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BY THE DIVISION OF
WATER QUALITY UNLESS ALL OF THE APPLICABLE ITEMS LISTED BELOW
ARE INCLUDED WITH THE SUBMITTAL.
REQUIRED ITEMS:
1. This completed form.
2. Legal documentation of the transfer of ownership.
3. A copy of the recorded deed restrictions, if required by the permit.
4. The designer's certification, if required by the permit. f
5. An Operation and Maintenance plan, signed by the new applicant, if a system that requires
maintenance will change ownership.
6. Maintenance records.
CERTIFICATION NIUST BE COMPLETED AND SIGNED BY BOTH THE CURRENT
PERMIT HOLDER AND THE NEW APPLICANT IN THE CASE OF A CHANGE OF
OWNERSHIP.
FOR NAME CHANGES, COMPLETE AND SIGN ONLY THE CURRENT
PERMITTEE'S CERTIFICATION.
Current Permittee's Certification:
I, DlaV/ ba �l h./,4 s , attest that this application for a name/ownership
change has been reviewed and is accurate and complete to the best of my knowledge. I
understand that if all required parts of this application are not completed and that if all required
supporting information and attachments are not included, this application package will be
returned as incomplete.
F10FAM, -
New Applicant's Certification: (Must be completed for all transfers of ownership)
attest that this application for a name/ownership
change has been reviewed and is accurate and complete to the best of my knowledge. I
understand that if all required parts of this application are not completed and that if all required
supporting information and attachments are not included, this application package will be
returned as incomplete. .,
Signature: / /�/(�� A . ///I/ice/L _ _ Date:
THE COXYLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
INFORMATION AND MATERIALS, SHOULD BE SENT TO THE FOLLOWING
ADDRESS:
NCDENR Division of Water Quality
Surface Water Protection Section - Stormwater
127 Cardinal Drive Extension
Wilmington, NC 28405
Name Ownership Change Form — 021209
Page 2 of 2

NCDE�R
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
March 2, 2009
Mr. David Phillips, President
Phillips Nursery, Inc.
1075 Town Creek Road
Leland, NC 28451
Subject: Stornwater Permit No. SW8990406
Bolivia Exxon Station
Brunswick County
Dear Mr. Phillips:
Dee Freeman
Secretary
The Division of Water Quality issued a Coastal Stornwater Management Permit, Number SW8990406 to Bolivia Exxon
Station for a High Density project on June 24, 1999. This permit expires on June 24, 2009. Section .1003(h) of 15 A
NCAC 2H .1000 (the stormwater rules) requires that applications for permit renewals shall be submitted 180 days prior to
the expiration of a permit and must be accompanied by a processing fee, which is currently set at $505.00, If this is still an
active project please complete and submit the enclosed renewal application in a timely manner. If this project has not
been constructed and a permit is no longer needed, please submit a request to have the permit rescinded. If you have
sold the project, or are no longer the permittee, please provide the name, mailing address and phone number of the
person or entity that is now responsible for this permit. Enclosed is a forth for change of ownership, which should be
completed and submitted if the property has changed hands.
Your permit requires that upon completion of construction and prior to operation of the permitted treatment units a
certification of completion be submitted to the Division from an appropriate designer for the system installed. This is to
certify that the permitted facility has been installed in accordance with the permit, the approved plans, specifications and
supporting documentation. Please include a copy of the certification with your permit renewal request and processing fee.
Enclosed is a copy of a sample certification. Also enclosed is a new Operation and Maintenance agreement that should
be completed and submitted along with your renewal application.
You should be aware that failure to provide the Designer's Certification and the operation of a stornwater treatment
facility without a valid permit, are violations of NC General Statute 143-215.1 and may result in appropriate enforcement
action including the assessment of civil penalties of up to $10,000 per day.
If you have any questions, please feel free to contact David Cox at 910-796-7318.
Sin
Georgette Scott Stormwater Supervisor
Surface Water Protection Section
Wilmington Regional Office
Enclosures
cc: Wilmington Regional Office
127 Cardinal Drive Extension, Wilmington, NC 28405
PHONE: [phone]TAX: [phone]
An Egm9 OpporMi y I AfiYmelm Action Empbpr
No�Caro a
datum ff

pfenany�r
>,v
s T 11 LIMITED LIABILITY COMPANY
ANNUAL REPORT
NAME OF LIMITED LIABILITY COMPANY: Southport Property, LLC
SECRETARY OF STATE L.L.C. ID NUMBER: 0819638
NATURE OF 13USINESS: Renlal Real Estate
REGISTERED AGENT: CT Corporation System
REGIS7-ERED OFPICI; MAILING ADDIZL'SS: 225 Hi1/sboroagh Streel
Raleigh, :NC 27603
E-Filed Annual Report
-1-0-7885274
For year 2008
Do not data enter manually.
STATE OF INCORPORA r10N: DE
REGISTERED OFFICE: STREETADDRESS: 225llill.shorough Street
Raleigh, NC 27603 Wake County
PRINC IPAI.OFFICE TELEPIIONI" NUMBER: 410-643-1797
PRINCIPAL OFFICE MAILING ADDRESS: 211 Cheers Alanor Drive
Stevensville, MI) 21666
PRINCIPAL OFFICE STREET ADDRESS: 211 ChewsiNanor Drive
Stevensville, jb1D 21666
MANAGERS/MEMI313RS/OIZGANIZI IZS:
Name: John F. Clarke 11l
Tide: A -/anger
Address:
211 Chews Manor Drive
Stevensville. A4D 21666
CERTIFICATION OF ANNUAL REPORT MUST. BE COMPLETED 13Y ALL LIMITED LIABILITY COMPANIES
John F. Clarke III
FORM MUST' ❑E SIGNED 13Y A MANAGER/MEN113FR
John F. Clarke III
01 /21 /2008
DATE
Manager
'1-YPIi OR PRINT NAblld TYPE OR PRINT TITLE
ANNUAL REPORT FEI7: $200 MAIL TO: Secrela y or Slate • Corporations Division • Post Office Box 29525 • Raleigh, NC 27626-0525

I
& SURVEYING, INC.
August 31, 2000
NCDENR
Division of Water Quality
127 Cardinal Drive Ext.
Wilmington, NC 28405
Attn: Ms. Noelle Lutheran
RF_: Compliance Inspection Exxon Station
Stormwater Project,No. SW8990406
Brunswick County
Dear Ms. Lutheran:
Please find enclosed the completed Designer's Certification for the subject project in
accordance with the permit requirements.
Please advise if additional information is required.
Sincerely,
N�
WillWia\m/EE.. Fenner, Jr., PE
Coastal Engineering & Surveying, Inc.
WEF/jwm
CC: Mr. David Phillips
Ratley Construction 6Aa �-A)
F:\Documents\Projects\P990322-United Energy\cert- Itr.doc
934 W. Kitty Hawk Rd. • Kitty Hawk, NC 27949 0 [phone] a Fax: [phone]