WQ0041592_Application (FTSE)_20200324

State of North Carolina
DWR Department of Environmental Quality
� Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number:
(to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: OZ Investments. LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership
❑ Federal ❑ State/County ❑ Municipal
3. Signature authority's name: Ryan Snipes per 15A NCAC 02T .0106(b)
Title: Owner
4. Applicant's mailing address: 2572 Caraway Springs Trail
City: Sophia State: NC Zip: 27350-
5. Applicant's contact information:
Phone number: 3( 36) 337-1298 Email Address: [e-mail]
❑ Privately -Owned Public Utility
❑ Other
NC Department of
Environmental Quality
Received
MAR 2 4 2020
Winston-Salem
IL PROJECT INFORMATION: Regional Office
1. Project name: Riverwalk Townhomes
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date: _
If new construction but part of a master plan, provide the existing permit number: W000
3. County where project is located: Randolph
4. Approximate Coordinates (Decimal Degrees): Latitude: 39.820 Longitude: -79 800
5. Parcel ID (if applicable): 7766241895
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Hiram J. Marziano License Number: 7707
Firm: Hiram J. Marziano, P.E.
Mailing address: P. O. Box 278
City: Asheboro State: NC Zip: 27204-0278
Phone number: QM) 4934450 Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Randleman W W P1amPermit Number: NCO025445
Owner Name: City of Randleman
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): W00041550 in processing Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS_
Owner Name(s): City of Randleman
FORM: FTA 04-16 Page] of 5

V1. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
[-]Yes [—]No NN/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been attached?
❑ Yes ❑No NN/A
3. If the Applicant is a Home/Property Owners' Association, has an Operational Agreement (FORM: HOA) been attached?
❑ Yes ❑No NN/A
4. Origin of wastewater: (check all that apply):
N Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool /Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater : 100 % Domestic/Commercial % Commercial
% Industrial (See 15A NCAC 02T.0103(20))
"Is there a Pretreatment Program in effect? []Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(fl? ❑ Yes ❑ No
➢ If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow "b
No. of Units
Flow
Duples Townhome(6 ea)
720 gal/duplex
6
4320 GPD
2 residential units/Duplex
gall
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gall
GPD
Total
4320 GPD
a See 15A NCAC 02T .0114(b), (d). (e)(1) and (e)(2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use
areas; and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals
as defined in G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.01141 shall
be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 0 GPD (per 15A NCAC 02T .0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
N Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
6 719 PVC
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: 0Longitude: - °
3. Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
❑ Standby power source or pump with automatic activation and telemetry - I SA NCAC 02T .0305(h)(1)(B).'
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C):
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations'
storage capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be
provided in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(i)):
1. Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (e)
® Yes [-]No
➢ 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
24 inches
Water mains (vertical -water over sewer including in benched trenches)
18 inches
Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
**Any private or public water supply source, including any wells, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water (or tide elevation) and wetlands (see item IX.2)
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
➢ 15A NCAC 02T.0305(s) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpa¢e
➢ If noncompliance with 02T.0305(fl or (g). see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No ❑ N/A
➢ See the Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ®Yes ❑ No ❑ N/A
➢ This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project require coverage/authorization under a 404 Nationwide or [:]Yes ® No
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ❑ Yes ❑ No
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ®No ❑ N/A
➢ If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and
inspections documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
I. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria (latest version) as applicable?
❑ Yes ❑ No
If No, complete and submit the Variance/Altemative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
name from Application Item 111.1.)
that this application for
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-2I5.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per violation.
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
that this application for
name & title from Application Item 1.3.)
has been reviewed by me 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 documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
of this permit be violated. 1 also understand that if all required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
NOTE — In :
statement, rel
include a fine
Signature:
with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
ed $10,000 as well as civil penalties up to $25,000 per violation.
Date:
FORM: FTA 04-16 Page 5 of 5

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CONSULTING, CIVIL ENGINEER
HIRAM J.
AVAARZIANOlPE
PO Box 278, Asheboro, NC 27204 - (336) 93-4460
[e-mail]
March 4, 2020
NC Department of Environmental Quality
Winston-Salem Regional Office
450 W. Hanes Mill Rd, Suite 300
Winston-Salem, NC 27105
NC Department of
Environmental Quality
Received
MAR 2 4 2020
Winston-Salem
Regional Office
Re: OZ Investments, LLC - Randolph Co -Riverwalk Townhomes On -Site Sewer Facilities
Please find one (1) original & one (1) copy each of the following documents for your review, comments
and/or approval:
1. A description of the project requested for permitting (see below).
2. A $480.00 check.
3. FTA 04-16 Fast Track Sewer System Extension Application.
4. Site Maps:
a. Color Copy of Quad Sheet location from Delorme GIS System.
b. Aerial photomap from County GIS snap for site location.
c. Color Street view picture of the intersection accessing the proposed sewer line.
Pr�ect Description.: OZ Investments, LLC located in Randleman, N.C. plan to construct six (6) duplex
townhomes located on a 2.73+/- acre site adjacent to the east side of US 220 Bus. (Main St.) in the
downtown business district of the City of Randleman (see the attached aerial site map). The townhomes
will be rental units owned by the developer.
The proposed Riverwalk Townhomes on -site sewer collection facilities will consist of 4" diameter service
laterals (sch40 PVC) to each townhome, residential unit (12 total). The service laterals will tie into 6"
diameter collection mains (2 branches of PVC, sdr35 pipe). The arrangement of the 6" collectors is
generally shown on the attached aerial site map. Eight (8) residential units will tie into one branch of the
on -site collection main and four (4) units will tie into and intersecting branch. The 6" collection main will
tie into the new, end manhole that will be located on the City's B" sewer line that is proposed to be located
on the north side of Presnell St. described above at the uppermost manhole located near the street right-
of-way. At the writing of this project description, the City's proposed Presnell St. sewer line in under
review by the NCDEQ, Winston-Salem District Office.
The minimum slope of the 6" collection system is designed to be 1.27% which allows the system to have a
minimum flow capacity of about 205 gallons per minute. The maximum slope of the 6" sewer lines is
6.7%. The 6" collection system will include 4" cleanouts spaced about 75' on -centers and constructed in
accordance with the NC Building Code. The on -site sewer facilities are planned to remain as private
sewers, maintained by the developer and are not included with the FTA 04-16 Application Form.

The sewer flow from the townhome site will be 100% residential. The total number of residential units
will be 12 and include 3-bedrooms each which would generate an estimated, daily sewer flow of 4,320
gallons/day based upon current NCDEQ flow estimating practice.
The Flow from the townhome site has been included in the FTA application for the City's proposed
Presnell St. sewer. Therefore, the attached Fast Track Application for this townhome project indicates a
zero -flow addition. The City's application for the Presnell St sewer includes an FTSE form that verifies
the existing downstream sewers have the capacity to accept the additional sewer flow. Consequently, this
application for the Riverwalk Townhomes does not include an FTSE from.
Please review the enclosures and let us have your comments and/or approval. If you require additional
information, please let me know.
Thank you for your review.
Sincerely,
Hiram J. Marziano
Encl.
cc: Mr. Zach Hewett, City Manager
Mr. Don Peeler, City DPU
Page 12

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Limited Liability Company
Legal Name
OZ Investments, LLC
Information
Sosld: 1932232
Status: Current -Active
Date Formed: 1/3/2020
Citizenship: Domestic
Annual Report Due Date: April 15th
CurrentAnnual Report Status:
Registered Agent: Snipes, Ryan Edward
Addresses
Reg Office
2572 Caraway Springs Trail
Sophia, NC 27350
Company Officials
Reg Mailing
2572 Caraway Springs Trail
Sophia, NC 27350
All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20.
Member/Manager
Ryan Edward Snipes
2572 Caraway Springs Trail
Sophia NC 27350
https://www.sosnc.gov/online_services/search/Business_Registration—Results 3/20/2020