WQ0042734_Application_20210915

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: WO. 70"1 Zto' be cl ipleted by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
RECEIVED/NCDEQ/DWR
SEP 1 5 2021
MOORESVILWOROS
LE REGIONAL OFFIC
1. Applicant's name: MTS CLT, LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: per 15A NCAC 02T .0106(b)
Title:
4. Applicant's mailing address: 2857 Westport Road
City: Charlotte State: North Carolina Zip: 28208-
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail]
II. PROJECT INFORMATION:
1. Project name: Brookdale 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: WQ00
3. County where project is located: Cabarrus county
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.281669° Longitude: -80.668732°
5. Parcel ID (if applicable): 5506-11-8513, 5506-21-1602
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Riyad BaroudiLicense Number: 049484
Firm: Stewart, Inc
Mailing address: 101 N. Tryon Street
City: Charlotte State: NC Zip: 28202-
Phone number: [phone] Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Rocky River WWTF Permit Number: NC0036269
Owner Name: WSACC
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQN/A Downstream (Receiving) Sewer Size: N/A inch
System Wide Collection System Permit Number(s) (if applicable): WQCSN/A
Owner Name(s): N/A
FORM: FTA 04-16 Page 1 of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
El Yes ❑No ®N/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 ZN/A
3. If the Applicant is a Home/Property Owners' Association, has an Operational Agreement (FORM: HOA) been attached?
❑ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
® Residential Owned
❑ Residential Leased
❑ School / preschool / day care
E Food and drink facilities
❑ Businesses / offices / factories
❑ Retail (stores, centers, malls)
❑ Retail with food preparation/service
❑ Medical / dental / veterinary facilities
❑ Church
❑ Nursing Home
5. Nature of wastewater : 100 % Domestic/Commercial % Commercial
% Industrial (See 15A NCAC 02T .0103(20))
�Is there a Pretreatment Program in effect?
6. Has a flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes
> If ves, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool /Clubhouse
❑ Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
❑ Yes ❑ No
® No
Establishment Type (see 02T.0114(f))
Daily Design Flow a,b
No. of Units
Flow
Multifamily Residential - 2 Bedrooms
240 gal/Unit
50
12,000 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
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.0114] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 12.000 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
❑ 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
625
DIP
6
684
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: . Longitude: -
3. Design flow of the pump station:
4. Operational point(s) of the pump(s):
millions gallons per day (firm capacity)
gallons per minute at
5. Summarize the force main to be permitted (for this Pump Station):
feet total dynamic head (TDH)
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 - 15A 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(f)):
1. Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (g)
➢ 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
® Yes ❑ No
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(g) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
➢ If noncompliance with 02T.0305(f) 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
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buffer Permitting Branch
❑ Yes ® No
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:
1. 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/Alternative 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:
1, Riyad Baroudi
(Professional Engineer's name from Application Item III.1.)
attest 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 143-215.6A 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):
J o wv C I o10 - ctow ou-t-
(Signature Authority's name & title from Application Item I.3.)
attest that this application for
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. I 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 accordance with General Statutes 143-215.6A 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.
Signature: Date:
c1/4/eti
FORM: FTA 04-16
Page 5 of 5

LIMITED LIABILITY COMPANY ANNUAL REPORT •
10/2017
NAME OF LIMITED LIABILITY COMPANY: MTS CLT, LLC
SECRETARY OF STATE ID NUMBER: 1419128
REPORT FOR THE CALENDAR YEAR: 2021
SECTION A: REGISTERED AGENTS INFORMATION
STATE OF FORMATION:
1. NAME OF REGISTERED AGENT: Stewart, J. Clark
NC
Filing Office Use Only
E - Filed Annual Report
1419128
CA202117300520
6/22/2021 11:00
Changes
2. SIGNATURE OF THE NEW REGISTERED AGENT:
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
2857 Westport Rd 2857 Westport Rd
Charlotte, NC 28208-3647 Mecklenburg County Charlotte, NC 28208-3647
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: Real Estate
2. PRINCIPAL OFFICE PHONE NUMBER: [phone]
4. PRINCIPAL OFFICE STREET ADDRESS
2857 Westport Road
Charlottte, NC 28208-3647
3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
5. PRINCIPAL OFFICE MAILING ADDRESS
2857 Westport Road
Charlottte, NC 28208-3647
6. Select one of the following if applicable. (Optional see instructions)
The company is a veteran -owned small business
The company is a service -disabled veteran -owned small business
SECTION C: COMPANY OFFICIALS (Enter additional company officials in Section E.)
NAME: Eastwood Construction Co., Inc. NAME: NAME:
TITLE: Chief Financial Officer TITLE: TITLE:
ADDRESS:
2857 Westport Rd.
Charlotte, NC 28208
ADDRESS: ADDRESS:
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity.
Eastwood Construction Co., Inc., by Kevin Hutchins CFO 6/22/2021
SIGNATURE DATE
Form must be signed by a Company Official listed under Section C of This form.
Eastwood Construction Co., Inc., by Kevin Hutchins CFO Chief Financial Officer
Print or Type Name of Company Official Print or Type Title of Company Official
This Annual Report has been filed electronically.
MAIL TO: Secretary of State, Business Registration Division, Post Office Box 29525, Raleigh, NC 27626-0525

STEWART
FAST -TRACK APPLICATION (FTA 04-16) — COVER LETTER RECEIVED/NCDEQ/DWR
Re: Brookdale Townhomes
Town of Harrisburg, North Carolina
ALio 9 Li21
WQROS
Prepared by: Riyad Baroudi, PE MOORESVILLE REGIONAL OFFI(
April 14, 2021
Proposed Design flow from Town of Harrisburg:
Proposed Average Daily Flow = 50 homes X 240 GPD/Unit = 12,000 GPD
Proposed Development:
This is a modification to an existing permit with Permit Number WQ0024410. The
original permit is not available because the developer of the proposed sanitary
sewer extension was not associated with the first phase of the development.
Brookdale Townhomes proposes the construction of 50 multi -family homes resulting
in an average daily flow of 12,000 gallons.
The sewer flow will travel via a gravity sanitary sewer system consisting of 1,309
linear feet of 6" sewer main with associated manholes and 4" service laterals.
The wastewater will be 100% domestic type waste.
STRONGER BY DESIGN
101 NORTH TRYON ST.
SUITE 1400
CHARLOTTE, NC T 704.334.7925
28202 F 704.334.7926

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: /AA Obt-i S 734to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1.
Applicant's name: Town of Harrisburg, NC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State/County ® Municipal
3. Signature authority's name: Robert Donham, P.E. per 15A NCAC 02T .0106(b)
Title: Director of Public Works
4. Applicant's mailing address: 4100 Main Street, Suite 101
City: Harrisburg State: North Carolina Zip: 28075-
5. Applicant's contact information:
Phone number: [phone] Email Address: rdonham(aiharrisburgnc.org
RECEIVED/NCDEQ/DWR
AUG 9 2021
WQROS
MOORESVILLE REGIONAL OFFICE
❑ Privately -Owned Public Utility
El Other
II. PROJECT INFORMATION:
1. Project name: Brookdale Townhomes
2. Application/Project status: ❑ Proposed (New Permit) ® Existing Permit/Project
If a modification, provide the existing permit number: WQ0024410 and issued date: 10/5/2004
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Cabarrus county
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.281669° Longitude: -80.668732°
5. Parcel ID (if applicable): 5506-11-8513, 5506-21-1602
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Riyad BaroudiLicense Number: 049484
Firm: Stewart, Inc
Mailing address: 101 N. Tryon Street
City: Charlotte State: NC Zip: 28202-
Phone number: (704) S' 9-3543 Email Address: rbaroudi@,stewartinc.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Rocky River WWTF Permit Number: NC0036269
Owner Name: WSACC
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQN/A Downstream (Receiving) Sewer Size: N/A inch
System Wide Collection System Permit Number(s) (if applicable): WQCSN/A
Owner Name(s): N/A
FORM: FTA 04-16
Page 1 of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
['Yes ❑No ®N/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 ®N/A
3. If the Applicant is a Home/Property Owners' Association, has an Operational Agreement (FORM: HOA) been attached?
❑ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
® Residential Owned
❑ Residential Leased
❑ School / preschool / day care
❑ Food and drink facilities
❑ Businesses / offices / factories
❑ Retail (stores, centers, malls)
❑ Retail with food preparation/service
❑ Medical / dental / veterinary facilities
❑ Church
❑ Nursing Home
5. Nature of wastewater : 100 % Domestic/Commercial % Commercial
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool /Clubhouse
❑ Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
% Industrial (See 15A NCAC 02T .0103(20))
�Is there a Pretreatment Program in effect? ['Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .0114(0? ❑ 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 a,h
No. of Units
Flow
Multifamily Residential
240 gal/Unit
50
12,000 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
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.0114] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 12,000 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
❑ 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
625
DIP
6
684
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: . Longitude: -
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 - 15A 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(f)):
1. Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (g)
➢ 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
® Yes ❑ No
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(g) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
➢ If noncompliance with 02T.0305(f) 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
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buffer Permitting Branch
Yes ®No
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:
1. 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/Alternative 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:
I, Riyad Baroudi
(Professional Engineer's name from Application Item III.1.)
attest 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 143-215.6A 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:
Riyatad
02108.33EOT)
Apr22,2021
3. Applicant's Certification per 15A NCAC 02T .0106(b):
Robert Donham, P.E.
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049484
03/11/2021
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attest that this application for
(Signature Authority's name & title from Application Item I.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. I 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 accordance with General Statutes 143-215.6A 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.
Signature: Robert Donham (Apr 21, 202117:09 EDT)
Date: 4/21/21
FORM: FTA 04-16 Page 5 of 5

STATE OF NORTH CAROLINA
COUNTY OF Cabarrus Permit No. lid0()c.2'LA-75Li
DEVELOPER'S OPERATIONAL AGREEMENT
This AGREEMENT made pursuant to G.S. 143-215.1 (di) and entered into this day of
, by and between the North Carolina Environmental Management
Commission, an agency of the State of North Carolina, hereinafter known as the COMMISSION; and
Eastwood Homes , a corporation/general partnership registered/licensed to do
business in the State of North Carolina, hereinafter known as the DEVELOPER.
WITNESSETH:
1. The DEVELOPER is the owner of the certain lands lying in Cabarrus County, upon
which it is erecting and will erect dwelling units and other improvements, said development to be known
as Brookdale Townhomes (hereinafter the Development).
2. The DEVELOPER desires, to construct a wastewater collection system with pumps, wastewater treatment
works, and/or disposal facilities (hereinafter Disposal System) to provide sanitary sewage disposal to serve
the Development on said lands.
3. The DEVELOPER has applied to the COMMISSION for the issuance of a permit pursuant to G.S. 143-
215.1 to construct, maintain, and operate the Disposal System.
4. The DEVELOPER has created or shall create unit ownership in said dwellings units, other improvements
and lands through filing of a Declaration of Unit Ownership (hereinafter Declaration), pursuant to Chapter
47C or 47F of the North Carolina General Statutes.
5. The DEVELOPER has caused to be formed or will cause to be formed at the time of filing of the
Declaration, Unit Owners' Association (hereinafter
Association), a non-profit corporation organized and existing under and by the virtue of the laws of the State
of North Carolina, for the purpose, among others, of handling the property, affairs and business of the
Development; of operating, maintaining, re -constructing and repairing the common elements of the lands
and improvements subject to unit ownership, including the Disposal System; and of collecting dues and
assessments to provide funds for such operation, maintenance, re -construction and repair.
b. The COMMISSION desires to assure that the Disposal System of the Development is properly constructed,
maintained and operated in accordance with law and permit provisions in order to protect the quality of the
waters of the State and the public interest therein.
NOW, THEREFORE, in consideration of the promises and the benefits to be derived by each of the parties
hereto, the COMMISSION and DEVELOPER do hereby mutually agree as follows:
1. The DEVELOPER shall construct the Disposal System in accordance with the permit and plans and
specifications hereafter issued and approved by the COMMISSION, and shall thereafter properly operate
and maintain such systems and facilities in accordance with applicable permit provisions and law.
The DEVELOPER shall not transfer ownership and/or control of the Disposal System to the Association
until construction has been completed in accordance with the permit and approved plans, and the staff of
the Division of Water Resources has inspected and approved of the facilities. In order to change the name
of the permit holder, the DEVELOPER must request that the permit be reissued to the Association. The
request must include a copy of the Association Bylaws andDeclaration.
3. The DEVELOPER shall not transfer, convey, assign or otherwise relinquish or release its responsibility for
the operation and maintenance of its Disposal System until a permit has been reissued to the DEVELOPER's
successor.
2.
FORM: DEV 03-19 Page 1 of 2

4. The DEVELOPER shall provide in the Declaration and Association Bylaws that the Disposal System and
appurtenances thereto are part of the common elements and shall thereafter be properly maintained and
operated in conformity with law and the provisions of the permit for construction, operation, repair, and
maintenance of the system and facilities. The Declaration and Bylaws shall identify the entire wastewater
treatment, collection and disposal system as a common element which will receive the highest priority for
expenditures by the Association except for Federal, State, and local taxes and insurance.
5. The DEVELOPER shall provide in the Declaration and Association Bylaws that the Disposal System will
be maintained out of the common expenses. In order to assure that there shall be funds readily available to
repair, maintain or construct the Disposal System, beyond the routine operation and maintenance expenses,
the Declaration and Association Bylaws shall provide that a fund be created out of the common expenses.
Such fund shall be separate from the routine maintenance funds allocated for the facility and shall be part
of the yearly budget.
6. In the event the common expense allocation and separate fund are not adequate for the construction, repair,
and maintenance of the Disposal System, the Declaration and Association Bylaws shall provide for special
assessments to cover such necessary costs. There shall be no limit on the amount of such assessments, and
the Declaration and Bylaws shall provide that such special assessments can be made as necessary at any
time.
7. If a wastewater collection system and wastewater treatment and/or disposal facility provided by any city,
town, village, county, water and sewer authorities, or other unit of government shall hereinafter become
available to serve the Development, the DEVELOPER shall take such action as is necessary to cause the
existing and future wastewater of the Development to be accepted and discharged into said governmental
system, and shall convey or transfer as much of the Disposal System and such necessary easements as the
governmental unit mayrequire as condition of accepting the Development's wastewater.
8. Recognizing that it would be contrary to the public interest and to the public health, safety and welfare for
the Association to enter into voluntary dissolution without having made adequate provision for the continued
proper maintenance, repair and operation of its Disposal System, the DEVELOPER shall provide in the
Association Bylaws that the Association shall not enter into voluntary dissolution without first having
transferred its said system and facilities to some person, corporation or other entity acceptable to and
approved by the COMMISSION by the issuance of apermit.
9. The agreements set forth in numbered paragraphs 1, 2, 3, 4, 5, 6, 7, and 8 above shall be conditions of any
permit issued by the COMMISSION to the DEVELOPER for the construction, maintenance, repair and
operation of the Disposal System.
10. A copy of this agreement shall be filed at the Register of Deeds in the County(ies) where the Declaration is
filed and in the offices of the Secretary of State of North Carolina with the Articles of Incorporation of the
Association.
IN WITNESS WHEREOF, this agreement was executed in duplicate originals by the duly authorized
representative of the parties hereto on the day and year written as indicated by each of the parties named below:
FOR THE ENVIRONMENTAL
MANAGEMENT COMMISSION
S. Daniel Smith
Director, Division of Water Resources
(Date)
EASTwoon (-IU.►%ES
Name fDEVELOPER
By:
(Signature)
-Rorrtd �2 r L,. J
Print Name and Title
Macc N ls 20 21
(Date)
FORM: DEV 03-19 Page 2 of 2

FTA 04-16 Harrisburg as Applicant
Final Audit Report
2021-04-22
Created: 2021-04-16
By: Mallory Hodgson ([e-mail])
Status: Signed
Transaction ID: CBJCHBCAABAAVs5F3a67FILGPwXFfAmm2X2zWGHPn3ab
"FTA 04-16 Harrisburg as Applicant" History
Document created by Mallory Hodgson ([e-mail])
2021-04-16 - 6:10:55 PM GMT- IP address: 174.99.207.162
ma Document emailed to Robert Donham ([e-mail]) for signature
2021-04-16 - 6:11:35 PM GMT
c:>o. Document e-signed by Robert Donham ([e-mail])
Signature Date: 2021-04-21 - 9:09:09 PM GMT - Time Source: server- IP address: 174.99.207.162
Document emailed to Riyad Baroudi ([e-mail]) for signature
2021-04-21 - 9:09:11 PM GMT
i Email viewed by Riyad Baroudi ([e-mail])
2021-04-22 - 12:32:59 PM GMT- IP address: 12.51.138.242
Document e-signed by Riyad Baroudi ([e-mail])
Signature Date: 2021-04-22 - 12:33:36 PM GMT - Time Source: server- IP address: 12.51.138.242
Agreement completed.
2021-04-22 - 12:33:36 PM GMT
Adobe Sign

BROOKDALE VILLAGE
USGS QUADRANGLE
STEWART MAP OVERLAY
101 N. TRYON ST., STE 1400
CHARLOTTE, NC 28202
T 704.334.7925
FIRM LICENSE #: C-1051
www.stewartinc.com
PROJECT #: C19040.00
PROJECT NUMBER: C19040.00
DATE: 05/08/2020
DRAWN BY: RGB
•
0 200
SCALE:
400
1 "=400'
•
800
NORTH

WASTEWATER FLOW ACCEPTANCE FORM
FOR THE
WATER AND SEWER AUTHORITY OF CABARRUS COUNTY
Jurisdiction Requesting Flow Acceptance: Date: 03/11/2021
❑City of Concord ❑City of Kannapolis OTown of Harrisburg Town of Mt. Pleasant
❑ Charlotte Mecklenburg Utilities
Project Title, Description, and Number of Lots/Unit:
Project Title: Brookdale Townhomes
Description: Proposed multifamily development located on Stafford Road approximately 0.5 miles East of Highway
485. This project involves the construction of twnhomes and associated streets, parking areas and sidewalks on a 4.926-
acre parcel in the Town of Harrisburg.
*Number of Lots: 50 OR *Number of Units: 50
*Must be included in request.
Where will the new line be connected:
❑ Directly into a WSACC Interceptor
• Into the Jurisdiction's existing collection system
❑ Into a private line
Describe the location of the tie-in line to which the new sewer line will connect: Brookdale is an existing
subdivision. Construction was paused on Phase 2 and not completed. The developer intends to finish the subdivision
utilizing the existing sanitary sewer system and bring the system into compliance with current design standards. There
will be minimal changes to the existing system. The existing connection for the neighborhood ties into the Cabarrus
Woods subdivision and eventually outfalls into the Upper Reedy Creek Interceptor..
Which WSACC Interceptor will the flow ultimately be discharged into: Upper Reedy Creek
What is the WSACC manhole number that the flow will be discharged into? 019110
What is the quantity of flow that will be discharged? 12,000 GPD
Flow type:
® Domestic 100 % ❑ Commercial % ❑ Industrial
Name of wastewater treatment facility (WWTF) receiving wastewater:
® Rocky River Wastewater Treatment Facility — Permit #NC0036269
Muddy Creek Wastewater Treatment Facility — Permit #NC0081621
Design drawings of new lines will be submitted to WSACC with the request for acceptance. Drawings can be submitted
as a digital file (DWG) or distance and bearing starting with the tap on existing infrastructure.
If the new line is to connect directly into a WSACC interceptor, detailed drawings including specification of the tap, will
be required before flow acceptance will be provided.
Mark Lomax at 704-786-1783, ext. 231, must be notified 48 hours in advance of a connection into a WSACC interceptor.
WSACC will inspect connection before, during, and after completion.
If construction is not started within two (2) year from the date of approval of the flow acceptance for this project, the
approval is rescinded and a second request and approval will be required for the project.
WSACC USE ONLY: DATE:
❑ Current sewer model shows an Interceptor as being surcharged south of the manhole in question.
❑ Approved ❑ Not Approved
❑ Current Sewer Model shows:

R
State of North Carolina
Department of Environmental Quality
Division of Water Resources Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE—01/14)
(JURISDICTION USE ONLY)
Jurisdiction Requesting Flow Acceptance for Collection System:
❑City of Concord ['City of Kannapolis RI Town of Harrisburg ['Town of Mt. Pleasant
['Charlotte Mecklenburg Utilities
Project Title, Description, and Number of Lots/Unit:
Project Title:
Description: Proposed multifamily development located on Stafford Road approximately 0.5 miles East of Highway 485.
This project involves the construction of townhomes and associated streets, parking areas and sidewalks on a 4.926-acre parcel
in the Town of Harrisburg.
What is the quantity of flow that will be discharged? 12,000 GPD
Flow type:
® Domestic 100 % ❑ Commercial % ❑ Industrial
OA
Section I - List the Jurisdiction's pump stations located between the project connection point and the WSACC
Interce1Dtor connection point.
Pump Station
(Name or Number)
Firm Capacity *
MGD
(A)
Design Average Daily Flow **
(Firm/pf)
MGD
(B)
Approx. Current
Average Daily Flow
MGD
(C)
Obligated, Not Yet
Tributary Daily Flow
MGD
(D) = (B+C)
Total Current Flow
Plus Obligated Flow
MGD
(E)=(A-D)
Available
Capacity***
MGD
n/a
n/a
n/a
n/a
n/a
n/a
n/a
* The Firm Capacity of any pump station is defined as the maximum pumped flow that can be achieved with the largest pump taken out of service.
**Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor not less than 2.5.
***A Planning Assessment Addendum shall be attached for each pump station located between the project connection point and the WWTP where Available Capacity is < 0.
Section II. Jurisdiction's Certification Statement:
I, Robert Donham, P.E. , certify that, to the best of my knowledge, the addition of the volume of wastewater
to be permitted in this project has been evaluated along the route to the receiving WSACC interceptor; and the flow from this
project is not anticipated to cause any capacity related sanitary sewer overflows or overburden on any downstream pump station
in route to the receiving WSACC interceptor normal circumstances, given the implementation of the planned improvements
identified in the planning assessment where applicable. This analysis has been performed in accordance with local established
policies and procedures using the best available data. This certification applies to those items listed above in Section I plus all
attached planning assessment addendums for which, to the best of my knowledge, will not adversely affect the downstream
sewer capacity. Signature of this form indicates acceptance of this wastewater flow.
Apr 21,2021
Jurisdiction's Signing Official Signature Date
Revision Date: 08/09/13

WSACC
IS011001:2004 • NC Star Public Sector • ONSAS 18001:2007
June 21, 2021
Mr. Haynes Brigman
Town Manager
Town of Harrisburg
P.O. Box 100
Harrisburg, NC 28075
Subject: Flow Acceptance Request - Town of Harrisburg
Brookdale Village Townhomes
Dear Mr. Brigman:
WATER & SEWER AUTHORITY
OF CABARRUS COUNTY
232 Davidson Hwy.
Concord, NC 28027
704.786.1783 ♦ 704.795.1564 Fax
www.wsacc.org
This is a notice of capacity for the flow acceptance request received by the Water and Sewer Authority of
Cabarrus County (WSACC) from the Town of Harrisburg on April 26-27, 2021. WSACC has or will have
capacity at the Rocky River Regional Wastewater Treatment Plant and appropriate sewer interceptors to
transport and treat the domestic wastewater from the proposed project entitled Brookdale Village
Townhomes. The referenced project will serve a residential development with 50 two -bedroom
townhomes, with a projected wastewater flow of 12,000 gallons per day (gpd). The wastewater generated
by this project will be conveyed through a proposed and existing gravity system and then enter WSACC's
system at the existing 36-inch Reedy Creek Interceptor. WSACC acknowledges it has or will have capacity
for wastewater from the proposed development based on information provided by Stewart, Inc. (civil
engineer for the project) using North Carolina Department of Environmental Quality (NCDEQ) wastewater
flow guidelines.
If construction of this project does not commence within two (2) years of the date of this notice, the notice
is rescinded and a second request and notice will be required before flow capacity is accepted. Please notify
WSACC, in writing, when construction of this project is initiated. This sewer capacity allocation may also
be cancelled pursuant to the conditions set forth in the WSACC Sewer Allocation and Commitment Policy.
Please note that the final commitment to service to provide wastewater treatment services shall occur
upon application for a building permit for the project and when system development fees are paid
pursuant to N.C.G.S. §162A, Article 8.
If you have any questions, please call me at [phone], extension 224.
Sincere
Chad VonCannon, PE
Engineering Director
cc: Rob Donham, PE/Harrisburg
Riyad Baroudi, PE/Stewart, Inc.
Michael Wilson/WSACC
Thomas Hahn, PE/WSACC
Mark Lomax/WSACC
Trent Gobble/WSACC

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE —10/18)
(WSACC USE ONLY) Brookdale Village Townhomes
Section I. Name of wastewater treatment facility (WWTF) receiving wastewater:
Rocky River Wastewater Treatment Facility — Permit #NC0036269
n Muddy Creek Wastewater Treatment Facility — Permit #NC0081621
WWTP facility's permitted flow, MGD
26.500
Estimated obligated flow not yet tributary to the WWTP, MGD 3.299
WWTP facility's actual avg. daily flow, MGD 21.947 (82.82% of permit)
Total flow for this specific request, MGD
Total actual and obligated flows to the facility, MGD
Percent of permitted flow used
0.012
25.258
95.31%
Section II. Pump stations along the route from the Jurisdiction's connection point to the WWTP.
PumpStation
(Name or
Number)
Pump Station
Permit No.
Firm
Capacity *
MGD
(A)
Design Average
Daily Flow **
(Firm/pf)
MGD
(B)
Approx. Current
Average Daily
Flow
MGD
(C)
Obligated, Not Yet
Tributary Daily Flow
MGD
(D)= (B+C)(
Total Current Flow
Plus Obligated Flow
MGD
E = A-D
) ( )
Available
Capacity***
MGD
Reedy Creek
WQCS00009
16.500
6.600
2.047
0.584
2.631
3.969
PS
Lower Rocky
NC0036269
37.000
14.800
11.259
2.559
13.818
0.982
River PS
* The Firm Capacity (design flow) of any pump station is defined as the maximum pumped flow that can be achieved with the largest pump taken out of service.
**Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pt) not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum
Design Criteria.
***A Planning Assessment Addendum shall be attached for each pump station located between the project connection point and the WWTP where Available
Capacity is < 0.
Section III. WSACC Certification Statement:
I, Chad VonCannon, PE, certify to the best of my knowledge that the addition of the volume of wastewater to be permitted in this
project has been evaluated along the route from the connection to the WSACC interceptor to the receiving wastewater treatment facility
and that the flow from this project is not anticipated to cause any capacity related sanitary sewer overflows or overburden any
downstream pump station en route to the receiving treatment plant under normal circumstances, given the implementation of the
planned improvements identified in the planning assessment where applicable. This analysis has been performed in accordance with
local established policies and procedures using the best available data. This certification applies to those items listed above in Section I
and Section II plus all attached planning assessment addendums for which I am the responsible party. Signature of this form indicates
WSACC's guarantee of capacity for this wastewater flow. Notwithstanding the guarantee of capacity, WSACC does not make a
commitment to service this wastewater flow until a building permit is requested through the Cabarrus County Building Inspections
Department and WSAACeivf payment of the System Development Fee.
aa/a,
WSACC's Signing Official Signature Date

DWR
Division of '#+ at r Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE —01/14)
FTSE PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a Planning Assessment Addendum for each pump station located between the project
connection point and the WWTP listed in section 1 or 2 where Available Capacity is < 0.:
Pump Station Name (Number):
Pump Station Address:
Given that:
a.
The proportion and amount of Obligated, Not Yet Tributary Daily Flow
% and MGD of the Available Capacity (E) in
(C) accounts for
Pump Station (name) and that;
b.
The rate of activation of this obligated, not yet tributary capacity is currently approximately
MGD per year; and that
c.
A funded Capital Project that will provide the required planned capacity, through CIP
project (name)
is in design or under construction with a planned completion date of ; and/or
d.
The following applies:
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification
to allow this flow to be permitted, without a significant likelihood of over -allocating capacity in
the system infrastructure.
I understand that this does not relieve the collection system owner from complying with G.S.
143-215.67(a), which prohibits the introduction of any waste in excess of the capacity of the
waste disposal system.
Signing Official Signature
Date
Revision Date: 08/09/13

Brookdale - FTSE
Final Audit Report
2021-04-21
Created: 2021-04-16
By: Mallory Hodgson ([e-mail])
Status: Signed
Transaction ID: CBJCHBCAABAA7NvSj5SQQicICd0nz73Rr13RrfBIxjJ6
"Brookdale - FTSE" History
Document created by Mallory Hodgson ([e-mail])
2021-04-16 - 6:07:54 PM GMT- IP address: 174.99.207.162
Document emailed to Robert Donham ([e-mail]) for signature
2021-04-16 - 6:08:21 PM GMT
cr Document e-signed by Robert Donham ([e-mail])
Signature Date: 2021-04-21 - 9:09:52 PM GMT - Time Source: server- IP address: 174.99.207.162
Agreement completed.
2021-04-21 - 9:09:52 PM GMT
Adobe Sign