Loading...
HomeMy WebLinkAboutWQ0037347_Modification_20211217Non -Discharge Branch Upload/Submittal Form NORTH CAROLINA EnWrvnmemfal Qualify Version 2 - Revised June 23, 2020 Initial Review Reviewer Thornburg, Nathaniel D Is this submittal an application? (Excluding additional information.)* Yes No Permit Number (IR) * WQ0037347 Applicant/Permittee Town of Holly Springs Applicant/Permittee Address 128 S. Main St. Holly Springs NC 27540 Is the owner in BIMS? Yes No Is the facility in BIMS? Yes No Owner Type Municipal Facility Name IRD Wake Power Plant RWDL County Wake Fee Category RW Distribution Line Fee Amount $0 Is this a complete application?* Yes No Signature Authority Signature Authority Title Signature Authority Email Document Type (if non -application) Email Notifications Does this need review by the hydrogeologist?* Yes No Regional Office CO Reviewer Admin Reviewer Complete App Date 12/17/2021 Below list any additional email address that need notification about a new project. Email Address Comments to be added to email notfication Comments for Admin Comments for RO Comments for Reviewer Comments for Applicant Submittal Form Project Contact Information Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence. Name* Theresa Randall Email Address* Phone Number* theresa.randall@hollyspringsnc.gov 9195573150 Project Information Application/Document Type * New (Fee Required) Modification - Major (Fee Required) Renewal with Major Modification (Fee Required) Annual Report Additional Information Other Modification - Minor Renewal GW-59, NDMR, NDMLR, NDAR-1, NDAR-2 Residual Annual Report Change of Ownership We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form. https://edocs.deq.nc.gov/Forms/NonDischarge_Monitoring_Report Permit Type: * Permit Number: * Applicant/Permittee * Wastewater Irrigation Other Wastewater Closed -Loop Recycle Single -Family Residence Wastewater Irrigation Town of Holly Springs WQ0037347 Has Current Existing permit number Applicant/Permittee Address* 128 S. Main St. Holly Springs NC 27540 Facility Name* IRD Wake Power Plant RWDL Please provide comments/notes on your current submittal below. High -Rate Infiltration Reclaimed Water Residuals Other At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg at nathaniel.thornburg@ncdenr.gov. Please attach all information required or requested for this submittal to be reviewed here. * (Application Form, Engineering Plans, Specifications, Calculations, Etc.) 41949 Carolina Springs Reclaimed Water Line Minor Mod. Permit to State.doc.pdf Upload only 1 PDF document (less than 250 MB). Multiple documents must be combined into one PDF file unless file is larger than upload limit. 16.17MB * By checking this box, I acknowledge that I understand the application will not be accepted for pre -review until the fee (if required) has been received by the Non - Discharge Branch. Application fees must be submitted by check or money order and made payable to the North Carolina Department of Environmental Quality (NCDEQ). I also confirm that the uploaded document is a single PDF with all parts of the application in correct order (as specified by the application). Mail payment to: NCDEQ — Division of Water Resources Attn: Non -Discharge Branch 1617 Mail Service Center Raleigh, NC 27699-1617 Signature Submission Date 12/17/2021 3017 01.25.21 Utilities and Infrastructure Services P.O. Box 8  128 S. Main Street  Holly Springs, NC 27540  www.hollyspringsnc.gov December 14, 2021 NCDEQ – Division of Water Resources Water Quality Permitting Section, Non-Discharge Permitting Unit 1617 Mail Service Center Raleigh, NC 27699-1617 Re: Holly Springs Reclaimed Water Distribution System Extension Request; Application for Approval Project: RECLAIMED Water – Carolina Springs Reclaim Water Line Replacement (Minor Permit Modification) Dear Sir or Madam: Please find enclosed the following items in application for a RECLAIMED water extension permit to the Town of Holly Springs’ existing reclaimed water distribution system:  One copy of the State application  One copy of Instruction  One copy of the locally-required Reclaimed Water Extension Design and Application Certification (Form 3016)  One copy of the Town Engineering Design and Construction Standards Reclaimed Water Distribution System Section - to be used for the project in conjunction with the State's extension standards  One copy of No Impact Letter  One copy of plats  One copy of previous permit WQ0037347 INGENCO Reclaimed Water Line Feel free to contact me at 919-577-3150 should you have any questions or need additional information in order to process this application. Sincerely, Kendra D. Parrish, P.E., C.F.M Executive Director of Utilities and Infrastructure Services KDP/tr cc: Project Consultant Engineer, David McClure, PE Rachel Ingham, Utility Engineer Drew Johnson, Development Construction Manager Seann Byrd, Director Public Utilities Project file/paper/electronic/Correspondence #41949 DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 Rachel Ingham Utility Engineer 3016 .Utilities and Infrastructure Services 01.25.21 P.O. Box 8 Ÿ 128 S. Main Street Ÿ Holly Springs, NC 27540 Ÿ www.hollyspringsnc.gov DO NOT SUBMIT RECLAIMED WATER EXTENSION APPLICATION UNTIL CONSTRUCTION DRAWINGS HAVE BEEN APPROVED BY STAFF! RECLAIMED Water Distribution Extension Design & Application Certification Note: This form must be submitted with Permits for Extensions to the Town of Holly Springs RECLAIMED Water System Project: Design Engineer: Address: Phone Number: Email: Date Complete Application Package Received by Town: Date Approved: ______________ (by RI) ________________ (by KDP) ____________ (by DJ) As design engineer for this project, I certify the following (please check (x) each applicable box): That the design of the project is in complete conformance with Town of Holly Springs Engineering Design and Construction Standards and the State of North Carolina NC DEQ. That each of the following items are completed and enclosed for submittal to the State for a RECLAIMED Water Distribution System Permit: One copy of Reclaimed Instructions One copy of a Reclaimed Water extension permit application for the project One set of sealed construction drawings, as approved by the Town of Holly Springs. All comments by the Town of Holly Springs are addressed and reflected on the plans. In addition, the plans must include all of the information required per Section 15A NCAC 2T.0100 and .0900. Owner Certification Letter A check for Town processing fee is enclosed A check to NC DEQ is enclosed Design Engineer’s Signature _______________________________ Date For your information, a copy of the Town’s Engineering Design and Construction Standards (RECLAIMED Water Distribution System Section 11.00) will be forwarded to the State along with these plans. Please contact Theresa Randall at theresa.randall@hollyspringsnc.gov if you have any questions. David McClure 5-5-21 x x x x x x x X dmcclure@withersravenel.com919-469-3340 115 MACKENAN DR, CARY, NC 27511 DAVID A. MCCLURE, P.E. CAROLINA SPRINGS RECLAIM WATER LINE REPLACEMENT DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 12/14/2021 12/14/2021 12/14/2021 WithersRavenel Our People. Your Success. 12/03/2021 NC DEQ 1628 Mail Service Center Raleigh, NC 27699-1628 RE: Carolina Springs Reclaim Water Line Replacement Dear Sir or Madam: This letter is to serve as a minor permit modification request for WQ0037347, issued October 30, 2014, for INGENCO Reclaimed Water Distribution Line. Approximately 2,820 LF of an existing 6” reclaim water line will be replaced with a 12” reclaim water line. Approximately 227 LF of the original 6” reclaim water line will remain in place. There will be no additional use associated with this project. Attached please find the RWPI, RWDL, and plats for your review and approval. If you have any questions or need any additional information, please feel free to contact me at 9 19-469- 3340. Sincerely WithersRavenel David McClure David A. McClure, P.E. Project Manager 115 MacKenan Drive | Cary, NC 27511 t: 919.469.3340 | f: 919.467.6008 | www.withersravenel.com | License No. C-0832 Cary | Greensboro | Pittsboro | Raleigh | Wilmington DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 State of North Carolina Department of Environmental Quality Division of Water Resources 15A NCAC 02U – RECLAIMED WATER SYSTEMS – DISTRIBUTION LINES INSTRUCTIONS FOR FORM: RWDL 06-16 & SUPPORTING DOCUMENTATION INSTRUCTIONS FOR FORM: RWDL 06-16 & SUPPORTING DOCUMENTATION Page 1 of 2 Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional information requested. Failure to submit all of the required items will lead to additional processing and review time for the permit application. For more information, visit the Water Quality Permitting Section’s Non-Discharge Permitting Unit website General – This application is for projects involving the construction of reclaimed water distribution lines that will supply reclaimed water for conjunctive use activities. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation. Do not submit this application without an associated Reclaimed Water Project Information (FORM: RWPI) form. A. Reclaimed Water Distribution Lines (FORM: RWDL 06-16) Application (All application packages): Submit the completed and appropriately executed Reclaimed Water Distribution Lines (FORM: RWDL 06-16) form. Please do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer. The system name in Item II.1. shall be consistent with the user name on the plans, specifications, agreements, etc. The Professional Engineer’s Certification on Page 5 of this form shall be signed, sealed and dated by a North Carolina licensed Professional Engineer. The Applicant’s Certification on Page 5 of this form shall be signed in accordance with 15A NCAC 02T .0106(b). The application must be signed by a principal executive officer of at least the level of vice-president or his authorized representative for a corporation; by a general partner for a partnership or limited partnership; by the proprietor for a sole proprietorship; and by either an executive officer, an elected official in the highest level of elected office, or other authorized employee for a municipal, state, or other public entity. An alternate person may be designated as the signing official if a delegation letter is provided from a person who meets the criteria in 15A NCAC 02T .0106(b). B. Property Ownership Documentation (All Application Packages): Per 15A NCAC 02U .0201(e) or 15A NCAC 02U .0202(f), the Applicant shall demonstrate that they are the owner of the property where the reclaimed water lines will be installed. Documentation shall consist of one of the following (or a combination of): Legal documentation of ownership (i.e., GIS, deed or article of incorporation), or Written notarized intent to purchase agreement signed by both parties with a plat or survey map, or An easement specifically indicating the intended use of the property and meeting the requirements of 15A NCAC 02L .0107(f), (i.e. municipality right of way) or A written notarized lease agreement signed by both parties, indicating the intended use of the property, as well as a plat or survey map. DocuSign Envelope ID: 0F0ABD35-AEC4-480F-A43D-8977761335ABDocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 INSTRUCTIONS FOR FORM: RWDL 06-16 & SUPPORTING DOCUMENTATION Page 2 of 2 C. Engineering Plans (All Application Packages): Per 15A NCAC 02U .0201(c)(1) or .0202(c), submit standard size and 11 x 17-inch plan sets that have been signed, sealed and dated by a North Carolina licensed Professional Engineer. At a minimum, the engineering plans shall include the following items: Table of contents. A general location map with at least two geographic references and a vicinity map. Plan and profile views of all pump stations and reclaimed water line extensions as well as the proximity of the reclaimed water line extensions to other utilities and natural features. Depict minimum separation distances required by 15A NCAC 02U .0403(h), (i), and 15A NCAC 02T .0305). Minimum cover in accordance with 15A NCAC 02T .0305(g)(4). Location and details of all pump stations. All labeling and color coding requirements per 15A NCAC 02U .0403. Plans shall represent a completed design and not be labeled with preliminary phrases (e.g., FOR REVIEW ONLY, NOT FOR CONSTRUCTION, etc.) that indicate they are anything other than final specifications. However, the plans may be labeled with the phrase: FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION. D. Specifications (All Application Packages): Per 15A NCAC 02U .0201(c) or .0202(c), submit specifications that have been signed, sealed and dated by a North Carolina licensed Professional Engineer. At a minimum, the specifications shall include the following items: Specifications for standard equipment may be omitted for municipalities with approved standard specifications. Use of standard specifications must be noted on each page of the plans. Table of contents with each section/page numbered. Detailed specifications for each reclaimed water line and pump station (as applicable). Site Work (i.e., earthwork, clearing, grubbing, excavation, trenching, backfilling, compacting, fencing, seeding, etc.) Materials (i.e., concrete, masonry, steel, painting, method of construction, etc.) Electrical (i.e., control panels) All labeling and color coding requirements per 15A NCAC 02U .0403. Specifications shall represent a completed design and not be labeled with preliminary phrases (e.g., FOR REVIEW ONLY, NOT FOR CONSTRUCTION, etc.) that indicate they are anything other than final specifications. However, the specifications may be labeled with the phrase: FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION. E. Engineering Calculations (All Application Packages): Per 15A NCAC 02U .0201(c) or .0202(c), submit calculations that have been signed, sealed and dated by a North Carolina licensed Professional Engineer. At a minimum, the calculations shall include the following items: Provide justification for the required pipe capacity, and details for how pipe sizes were determined. Minimum velocities to be maintained in the reclaimed water line. Friction/total dynamic head calculations and system curve analysis for each pump used. Pump selection information including pump curves, manufacturer’s information, and recommended installation guidelines. Detailed specifications for each reclaimed water line and pump station (as applicable). Floatation calculations for any pump stations entirely or partially below grade. For connection to a pump station, submit an evaluation of the existing pump station’s ability to handle peak flows. Provide calculations to detail how peak flows were determined. For connection to a force main, submit an evaluation of the existing force main based on peak flows to the proposed project and peak flows already tributary to the existing force main. ONE ORIGINAL AND TWO COPIES OF THE COMPLETED APPLICATION AND SUPPORTING DOCUMENTATION SHALL BE SUBMITTED TO: NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF WATER RESOURCES WATER QUALITY PERMITTING SECTION NON-DISCHARGE PERMITTING UNIT By U.S. Postal Service: By Courier/Special Delivery: 1617 MAIL SERVICE CENTER 512 N. SALISBURY STREET RALEIGH, NORTH CAROLINA 27699-1617 RALEIGH, NORTH CAROLINA 27604 TELEPHONE NUMBER: (919) 807-6464 FAX NUMBER: (919) 807-6496 DocuSign Envelope ID: 0F0ABD35-AEC4-480F-A43D-8977761335ABDocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 FORM: RWDL 06-16 Page 1 of 5 State of North Carolina Department of Environmental Quality Division of Water Resources 15A NCAC 02U – RECLAIMED WATER SYSTEMS – DISTRIBUTION LINES FORM: RWDL 06-16 I. CONTACT INFORMATION: 1. Applicant's name: Town of Holly Springs Mailing address: 128 South Main Street City: Holly Springs State: NC Zip: 27540- Telephone number: (919) 577-3150 Email Address: Kendra. Parrish@HollySpringsnc.gov 2. Signature authority’s name: Kendra Parrish (per 15A NCAC 02T .0106) Title: Executive Director of Utilities and Infrastructure 3. Consulting Engineer’s name: David A. McClure, P.E. License Number: 030282 Firm: WithersRavenel Mailing address: 115 Mackenan Drive City: Cary State: NC Zip: 27511- Telephone number: (919) 469-3340 Email Address: dmcclure@withersravenel.com II. DISTRIBUTION SYSTEM INFORMATION 1. Distribution system project name (name of subdivision, shopping center, etc.): Carolina Springs Reclaim Water Line Replacement 2. Project county: Wake 3. USGS map name: Apex 4. Owner of reclaimed water generating facility: Town of Holly Springs 5. Permit number of reclaimed water generating facility: WQ0032289 6. List the owner(s) of any intermediate reclaimed water lines if different from the applicant, or the generating facility. N/A 7. Permit number for reclaimed water line immediately upstream: WQ0032893M 8. Pipe diameter for reclaimed water line immediately upstream: 6” 9. Specify the proposed destination of the reclaimed water: No usage with the application 10. Capacity of proposed distribution system: N/A gallons per day 11. Explanation of how capacity was determined: No usage with the application III. DISTRIBUTION LINE DESIGN INFORMATION 1. Complete the table below for by providing the required information on the proposed distribution lines: Diameter (inches) Length (linear feet) Pipe Material High Elevation (ft) Discharge Elevation (ft) 12 2,820 C900 PVC 334 254 2. Station location of air release valves: N/A Note: Air release valves must be provided at all high points along the line where the elevation difference exceeds 10 ft. DocuSign Envelope ID: 0F0ABD35-AEC4-480F-A43D-8977761335ABDocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 FORM: RWDL 06-16 Page 2 of 5 III. DISTRIBUTION LINE DESIGN INFORMATION (Continued) 3. Complete the table below by providing the location of each design criteria in the specification and/or plans in accordance with 15A NCAC 02U .0403. Items that are not applicable shall be marked N/A. Design Criteria Page Number in Plans Page Number in Specifications Labeling on reclaimed water piping, valves, storage facilities, and outlets 05 11-4 Color coding on reclaimed water piping, valves, etc. 05 11-4 Method of securing valves and outlet for operation by authorized personnel only 05 11-8 Locking mechanism for hose bibs N/A N/A Cross connection control devices N/A N/A IV. SETBACKS (15A NCAC 02U .0701) 1. Provide the actual minimum distance (in feet) from any reclaimed water storage units and/or pump station within the distribution system to each item listed (distances greater than 500 feet may be marked N/A): Setback Parameter Pump stations within distribution system Reclaimed Water Storage Units Required Actual Required Actual Any private or public water supply source N/A 100 N/A Any property line N/A 50 N/A Any well with exception of monitoring wells 100 N/A 100 N/A Surface waters (streams – intermittent and perennial, perennial waterbodies, and wetlands) classified as SA 100 N/A 50 N/A Surface waters (streams – intermittent and perennial, perennial waterbodies, and wetlands) classified as SA 25 N/A 50 N/A 2. Do the pump stations and storage units comply with all setbacks found in the river basin rules (15A NCAC 2B .0200)? Yes or No (N/A) ✓ If no, list non-compliant setbacks: 3. Are any setback waivers required in order to comply with 15A NCAC 02U .0701? Yes or No ✓ If yes, have these waivers been written, notarized, signed by all parties involved and recorded with the County Register of Deeds? Yes or No ✓ If yes, have the required Non-Discharge Wastewater System Waiver (FORM: NDWSW) forms been included with this application package? Yes or No DocuSign Envelope ID: 0F0ABD35-AEC4-480F-A43D-8977761335ABDocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 FORM: RWDL 06-16 Page 3 of 5 V. SEPARATION DISTANCES 1. Provide the actual minimum separation distance (in feet) from the reclaimed water distribution system to each item listed in accordance with 15A NCAC 02U .0403(h), (i), and (j): Separation Parameter Horizontal Vertical Required Actual Required Actual Any water line (feet) 10 10 1.5 N/A Any well 50 N/A N/A Sewer lines (reclaimed over sewer) 2 N/A 1.5 N/A Final earth grade N/A 3 4 2. Are the separation requirements listed above met? Yes or No ✓ If No, has documentation been provided to show that piping and integrity testing procedures meet water main standards in accordance with 15A NCAC 18C? Yes or No Note: In no case shall reclaimed water lines be closer than 25 feet to a private well. VI. PUMP STATION INFORMATION IF MORE THAN ONE PUMP STATION, PROVIDE ADDITIONAL COPIES OF THIS PAGE AS NECESSARY. 1. Are there any reclaimed water pump stations proposed as part of the distribution system? Yes or No (N/A) ✓ If no, then skip the remaining items in Section VI. 2. Complete the table below by providing the required information regarding the reclaimed water pump station(s) Pump Station Design Plan Sheet Number Specification Page Number Internal dimensions (L x W x H or φ x H) ft ft ft Volume gallons Inlet Elevation ft Outlet Elevation ft Number of pumps Pump capacity GPM Lead pump on elevation ft Lag pump on elevation ft Lead pump off elevation ft Lag pump off elevation ft High water elevation ft Audible/Visual high water alarm 3. What is the 100-year flood elevation? (ft) 4. Precautions to be taken to protect the pump station from flooding: (ft) DocuSign Envelope ID: 0F0ABD35-AEC4-480F-A43D-8977761335ABDocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 FORM: RWDL 06-16 Page 4 of 5 VII. STORAGE TANK INFORMATION IF MORE THAN ONE STORAGE TANK, PROVIDE ADDITIONAL COPIES OF THIS PAGE AS NECESSARY. 1. Are there any reclaimed water storage tanks proposed as part of the distribution system? Yes or No ✓ If no, then skip the remaining items in Section VII. 2. Complete the table below by providing the required information regarding the reclaimed water storage tank(s) Storage Tank Design Plan Sheet Number Specification Page Number Type of storage tank Select Internal dimensions (L x W x H or φ x H) ft ft ft Storage Volume gallons Inlet Elevation ft Outlet Elevation ft High water elevation ft Audible/Visual high water alarm 3. What measures will be taken to reduce the risk of overflow? DocuSign Envelope ID: 0F0ABD35-AEC4-480F-A43D-8977761335ABDocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 FORM: RWDL 06-16 Page 5 of 5 Professional Engineer's Certification: I, David A. McClure, P.E. , attest that this application for Carolina Springs Reclaim Water Line Replacement has been reviewed by me and is accurate, complete and consistent with the information supplied in the engineering plans, 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 this application package and its instructions as well as all applicable regulations and statutes. 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 NC 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: Applicant's Certification (signing authority must be in compliance with 15A NCAC 02T .0106): I, Kendra D. Parrish, P.E, Executive Director of Utilities & Infrastructure Services (signing authority name – PLEASE PRINT) (title) attest that this application for Carolina Springs Reclaim Water Line Replacement (facility name) has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that any discharge of wastewa ter 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. I fu rther certify that the applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without proper closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant with any active compliance schedule, and do not have any overdue annual fees under Rule 15A NCAC 02U .0105. Note: In accordance with NC 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: DocuSign Envelope ID: 0F0ABD35-AEC4-480F-A43D-8977761335AB 12/3/2021 DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 12/14/2021 State of North Carolina Department of Environmental Quality Division of Water Resources 15A NCAC 02U – RECLAIMED WATER SYSTEMS – PROJECT INFORMATION INSTRUCTIONS FOR FORM: RWPI 06-16 & SUPPORTING DOCUMENTATION INSTRUCTIONS FOR FORM: RWPI 06-16 & SUPPORTING DOCUMENTATION Page 1 of 2 Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional information requested. Failure to submit all of the required items will lead to additional processing and review time for the permit application. For more information, visit the Water Quality Permitting Section Non-Discharge Permitting Unit website. General–This form is required for all projects involving the generation, utilization, and or distribution of reclaimed water. At least one of the following forms must also be included in the application package. However, multiple forms may be applicable. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation. Please check the boxes below as appropriate to indicate which additional forms are included in the application package: Reclaimed Water Generation (FORM: RWG) –– for wastewater treatment facilities producing reclaimed water. Non-Conjunctive Utilization (FORM: RWNC) –– for reclaimed water utilization activities, when the reclaimed water utilization activity is required in order to meet the wastewater disposal needs of the facility. Conjunctive Utilization (FORM: RWCU) –– for reclaimed water utilization activities, when the reclaimed water option is not necessary to meet the wastewater disposal needs of the facility and other wastewater utilization/disposal methods are available. Bulk Distribution (FORM: RWBD) –– for distribution of reclaimed water in a bulk manner. Distribution Lines (FORM: RWDL) –– for construction of reclaimed wa ter distribution lines. Wetland Augmentation (FORM: RWWA) –– for projects seeking to utilize reclaimed water for the purpose of wetland augmentation. Local Program Approval (FORM: RWLPA) –– for projects seeking permitting delegation for reclaimed water users. A. Cover Letter (All Application Packages): List all items included in the application package, as well as a brief description of the requested per mitting action. B. Application Fee (All New and Major Modification Application Packages): Submit a check, money order or electronic funds transfer made payable to: North Carolina Department of Environment al Quality (NCDEQ) according to the following fee schedules: STANDARD REVIEW – Submit the appropriate fee for all new and major modification applications as listed in the table below. Facility Classification New Permit Major Modification 1 Major Generator/User (ADF ≥ 10,000 gallons per day) $1,310 $395 Minor Generator/User (ADF ≤ 10,000 gallons per day) $810 $245 Reclaimed Water Distribution Lines $480 N/A 1 A major modification shall be defined as any permit modification that: increases the generating facility’s average daily flow (ADF); increases the utilization area acreage; adds additional utilization areas not previously approved; or includes the addition of new treatment units/processes not previously permitted. There is no fee for minor permit modifications. DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 INSTRUCTIONS FOR FORM: RWPI 06-16 & SUPPORTING DOCUMENTATION Page 2 of 2 C. Reclaimed Water Project Information Form (FORM: RWPI 06-16) (All application packages): Submit the completed and appropriately executed Reclaimed Water Project Information (FORM: RWPI 06-16) form. Please do not make any unauthorized content changes to this form. The applicant name in Item I.1. shall be consistent with the applicant name on the plans, specifications, agreements, etc. The Applicant’s Certification on Page 3 of this form shall be signed in accordance with 15A NCAC 02T .0106(b). The application must be signed by a principal executive officer of at least the level of vice -president or his authorized representative for a corporation; by a general partner for a partnership or limited partnership; by the proprietor for a sole proprietorship; and by either an executive officer, an elected official in the highest level of elected office, or other authorized employee for a municipal, state, or other public entity. An alternate person may be designated as the signing official if a delegation letter is provided from a person who meets the criteria in 15A NCAC 02T .0106(b). If this project is for a renewal without modification, use the Non-Discharge System Renewal (FORM: NDSR) application. There is no fee for permit renewal without modification. D. Existing Permit: (All Modification Packages): Submit the most recently issued existing permit. Provide a list of any items within the permit the Applicant would like the Division to address during the permit modification (i.e., compliance schedules, permit description, monitoring, permit conditions, etc.). ONE ORIGIANL AND TWO COPIES OF THE COMPLETED APPLICATION AND SUPPORTING DOCUMENTATION SHALL BE SUBMITTED TO: NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF WATER RESOURCES WATER QUALITY PERMITTING SECTION NON-DISCHARGE PERMITTING UNIT By U.S. Postal Service: By Courier/Special Delivery: 1617 MAIL SERVICE CENTER 512 N. SALISBURY STREET RALEIGH, NORTH CAROLINA 27699-1617 RALEIGH, NORTH CAROLINA 27604 TELEPHONE NUMBER: (919) 807-6464 FAX NUMBER: (919) 807-6496 DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 FORM: RWPI 06-16 Page 1 of 3 State of North Carolina Department of Environmental Quality Division of Water Resources 15A NCAC 02U – RECLAIMED WATER SYSTEMS – PROJECT INFORMATION FORM: RWPI 06-16 I. GENERAL INFORMATION: 1. Applicant's name: Town of Holly Springs Mailing address: 128 South Main Street City: Holly Springs State: NC Zip: 27540- Telephone number: (919) 577-3150 Email Address: Kendra.Parrish@hollyspringsnc.gov 2. Signature authority’s name: Kendra Parrish (per 15A NCAC 2U .0106) Title: Executive Director of Utilities and Infrastructure 3. Applicant type (check all that apply): Government Federal State Municipal County Individual Corporation ✓ For new permits, submit documentation that the company is registered for business with the NC Secretary of State. General Partnership ✓ For new permits, submit a copy of the certificate filed with the Register of Deeds in the county of business. Privately Owned Public Utility ✓ For new permits, submit a Certificate of Public Convenience and Necessity from the NC Utilities Commission, or a letter from the NC Utilities Commission’s Water and Sewer Division Public Staff stating an application for a franchise has been received and that the service area is contiguous to an existing franchised area or that franchise approval is expected. Home Owners Association ✓ For new permits, submit a properly executed Operational Agreement (FORM: HOA); and proposed or approved Articles of Incorporation, Declarations and By-laws. Developer (where residential lots are to be sold) ✓ For new permits, submit a properly executed Operational Agreement (FORM: DEV) 4. Demonstration of historical consideration for permit approval: Has the Applicant or any parent, subsidiary or other affiliate exhibited the following? a. Has been convicted of environmental crimes under Federal law or G.S. 143-215.6B? Yes or No b. Has previously abandoned a wastewater treatment facility without properly closing that facility? Yes or No c. Has unpaid civil penalty where all appeals have been abandoned or exhausted? Yes or No d. Is non-compliant with an existing non-discharge permit, settlement agreement or order? Yes or No e. Has unpaid annual fees in accordance with 15A NCAC 02T .0105(e)(2)? Yes or No DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 FORM: RWPI 06-16 Page 2 of 3 II. PROJECT INFORMATION 1. Application type: Minor Modification (See Instruction B) Fee Submitted $0 (See Instruction B) 2. For modifications, provide the existing permit number: WQ0037347 and most recent issuance date: 10/30/2014 3. Provide a brief description of the activities proposed for permitting: replace 6” line with 12” line is same location 4. What is the status of the following associated permits and/or certifications ? (if not applicable, please ma rk as N/A) Permit/Certification Date Submitted Date Approved Permit/Certification No. Agency Reviewer Collection System (Q ≥ 200,000 GPD) N/A Dam Safety N/A Erosion & Sedimentation Control Plan 08/02/2021 Holly Springs Nationwide 12 / Section 404 N/A Pretreatment N/A Sewer System N/A Stormwater Management Plan N/A Other: ✓ For any of the permits and certifications listed above that will directly impact the construction of the proposed reclaimed water project, please provide documentation of permit approval or final certification. Note: This application may be considered incomplete, or the resulting permit may be issued conditionally if a pending issuance of any of the related permits/certifications directly impacts the proposed facility. 5. Documentation of the presence or absence of threatened or endangered aquatic species at the project site utilizing information provided by the Department’s Natural Heritage Program is required for construction of all new WWTP projects and/or non- conjunctive utilization sites, and for any project involving expansion of a WWTP and/or non-conjunctive utilization site in accordance with 15A NCAC 02T .0105(c)(10). Provide the location in application package where this documentation is located: N/A; or explain why this item is N/A. No new WWTP or utilization sites. 6. Does this project utilize public monies or lands? Yes or No ✓ If yes, was an Environmental Assessment required under 15A NCAC 01C? Yes No Include one of the following final environmental documents with this submittal: Finding of No Significant Impact, or Record of Decision Describe any mitigating factors from the Environmental Assessment that impact the design and/or construction of the reclaimed water project: 7. Is any portion of the proposed project (reclaimed water treatment units, storage units, distribution lines, or utilization areas) located within the 100 year flood plain? Yes or No ✓ If yes, specify which portion(s) of the project are affected? Approximate Sta 24+24 to Sta 25+25 ✓ If yes, has the Applicant submitted written documentation of compliance with §143 Article 21 Part 6? Yes or No Documentation should consist of a letter from the local authority (i.e., county/municipality) stating that the project complies with any local floodplain ordinance that may apply. DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 FORM: RWPI 06-16 Page 3 of 3 Applicant's Certification (signing authority must be in compliance with 15A NCAC 02U .0106): I, Kendra D. Parrish, P.E. Executive Director of Utilities and Infrastructure Services (signing authority name – PLEASE PRINT) (title) attest that this application for Carolina Springs Reclaim Water Line Replacement (facility name) has been reviewed by me and is accurate and complete to the best of my kn owledge. 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 ma ke 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 a re not included, this application package will be returned to me as incomplete. I further certify that the applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without proper closure, does no t have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant with any active compliance schedule, and do not have any overdue annual fees under Rule 15A NCAC 02U .0105. Note: In accordance with NC 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: DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 12/14/2021 Engineering Department P.O. Box 8  128 S. Main Street  Holly Springs, NC 27540  www.hollyspringsnc.us December 13, 2021 Subject: Re: Compliance of Flood Damage Prevention Ordinance. To Whom It May Concern: Carolina Springs Reclaimed Waterline is in compliance with the Town of Holly Springs Flood Damage Prevention Ordinance. The reclaimed line is in the shoulder of an existing road and has no-impact to the flood plain it crosses. Please feel free to contact me with any further questions at (919) 557-2921 or by email at darin.eyster@hollyspringsnc.us. Thank you, Darin Eyster, CFM Stormwater Administrator Town of Holly Springs Utilities and Infrastructure Div. DSE/se cc: Correspondence DocuSign Envelope ID: 7026A9DA-6845-4A50-8324-60570D710FA0DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 T: 336-886-4821 • F: 336-886-4458 • License: F-0245 6415 Old Plank Road, High Point, NC 27265 • www.dmp-inc.com Technical Memorandum Date: July 8, 2021 Prepared For: Town of Holly Springs Reclaimed Water Modeling Carolina Springs PUD Prepared By: Michael Goliber, PE Project: DMP 200139 Background As requested by the Town of Holly Springs (Town), DMP has evaluated the feasibility of adding the proposed Carolina Springs PUD to the Reclaimed Water System. The proposed project is in the north limits of the Reclaimed Service Area and is bordered by Woods Creek Road, and Highway 1, and Highway 540 Model Setup DMP performed the evaluations utilizing the Town’s reclaimed water system model in WaterCAD. The following setup was used for the modeling:  Reclaimed Model Setup  Tank Water Elev: 578’ (normal low, down 7 ft)  WRF Pumps off  SFR Lots at Typical Demand (1.83 gpm/SFR due to average lot size being approximately 15,000 SF) (assumes 70% of SFR’s are connected).  Sequiris: 550 gpm (includes 400 gpm cooling and 150 gpm irrigation)  WRF: 360 gpm (NPW uses + 200 gpm for RCW bulk filling)  Twelve Oaks Pond: 500 gpm  Ingenco: 53 gpm  Burt Tract: Full build out active and in service (412 gpm)  Hensley Tract: Full build out active and in service (214 gpm)  Twelve Oaks Phase 09: Full build out active and in service (Stephenson) (150 gpm)  Addison Subdivision: Full build out active and in service (Formerly Harris) (72 gpm)  New Hill Road Subdivision (52 GPM)  Carolina Springs PUD Phases 1-5 (296 GPM)  Model Calculations: All modeling calculations were performed as a Steady State Model. Modeling as a Steady State Model provides for worst case demand condition, meaning that all demands in the model are active as part of the Scenario calculation.  Carolina Springs PUD Based on CAD drawings and PDF’s provided to DMP by the Town of Holly Springs dated 07/31/2020 and additional information supplied to DMP on 09/29/2020, the proposed development includes five (5) Phases expected to be developed over the next seven (7) years. See attached Build-out Scenario Exhibit. The CAD information provided primarily consisted of Phase 1, which is also subdivided into five (5) Sub-phases along with an Eastern Leg to serve future phases. See attached Exhibit for phases. 07/08/2021 DocuSign Envelope ID: C7E4CA3C-9104-4429-AF98-051629034A45 Technical Memorandum Page 2 DMP 200139 The layout provided to DMP was brought into the model as a backdrop. The reclaimed water lines and system nodes, with corresponding elevations, were then added to the model. Nodes on the property range in elevation from approximately 290 ft to 330 ft and are based on the information provided. At this time the Eastern leg extension of the Reclaimed Water System to serve future Carolina Springs PUD development is only being considered as a line extension. This includes the portion along Woods Creek Road as well as the Roadway Section A and Roadway Section C. While some minimal demands were investigated as part of the modeling, no demands are included as part of the line extension permitting. Modeling Results: Carolina Springs PUD Eastern extension was modeled as a 12” RCWL along Woods Creek Road and a 6” RCWL along Roadway Section A and Roaday Section C. The model assumed a 6” RCWL from New Hill Road to Ingenco and a 12” RCWL was constructed from Ingenco north to feed the Twelve Oaks Phase 09 (Stephenson) Development. The model also assumed that the developments proposed and approved prior, as outlined under Reclaimed Model Setup, are active and in service. Based on the above described model setup, several scenarios were modeled and are described with their results summarized as follows: Scenario 4: Base System (CS PUD Eastern Extension) This Scenario assumes full build out all Sub-phases in Phase 1-5  Existing 6” RCWL from New Hill Road to Ivy Arbor Way  New 12” RCWL installed from Ivy Arbor Way to Ingenco  Existing 12” RCWL to Twelve Oaks Phase 9 (Stephenson)  New 12” RCWL to serve Carolina Springs PUD  Results: Pressures are above 45 psi, which is the target system requirement minimum pressure. Feasible - Does meet the Project Objectives Summary With no Demands being considered along the Carolina Springs Eastern Extension, the line can be built as part of the initial build within the Carolina Springs PUD. As indicated with the analysis for Scenario 4, improvements within the existing RCW system will need to be completed as part of the full buildout of Carolina Springs PUD, Subphases 1-5 In order for the Town to be able to implement the full buildout of the Carolina Springs PUD additional improvements within the existing system to replace the 6” RCWL feed along Old Holly Springs Apex Road will need to be implemented. Additionally, one system component that should be monitored as part of the build-out for Carolina Springs PUD is the impact on the previously approved Twelve Oaks Phase 09. This system was designed to be installed with master meters, which require a 70 psi minimum, based on design information supplied to DMP at the time of review for Twelve Oaks Phase 09. With significant demands being placed on the system adjacent to and north of these master meters could potentially have impact on the operation of this system. Attached are the following documents: Exhibit: Build-out Scenario Exhibit: Phase 1 Sub-phases Exhibit: Active System Exhibit: Scenario 4 P:\2020\200139\Technical Memo\200139 Technical Memo for Carolina Springs PUD Eastern Leg - 2021-06-19.docx DocuSign Envelope ID: C7E4CA3C-9104-4429-AF98-051629034A45 s s ! ! ! ! !! ! ! ! ! ! ! !!! !!! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !! ! ! ! ! ! ! !! ! ! ! ! !! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !! ! ! !! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !!! !!! ! !! ! !!! ! ! ! ! ! ! !! ! ! ! ! ! !! ! !! ! ! ! !! ! ! ! ! !! ! !!! ! !!!! !! !! ! ! ! !!! !! ! ! !!!! ! ! ! ! ! ! ! ! ! ! ! !! ! ! !!!!! ! ! ! ! ! ! !! ! ! ! !! !!! ! ! Sources: Esri, HERE, DeLorme, TomTom, Intermap, increment P Corp., GEBCO, USGS, FAO, NPS, NRCAN, GeoBase, IGN, Kadaster NL, Ordnance Survey, EsriJapan, METI, Esri China (Hong Kong), swisstopo, MapmyIndia, © OpenStreetMap contributors, and the GIS User Community t Hydraulic Analysis Map for Carolina Springs PUD - 2nd ReviewActive System Legend s reservoirs Tank IS_ACTIVE? ! Pipes Diamter 4 6 8 10 12 16 2,000 0 2,000 4,000 6,0001,000 Feet Document Path: P:\2020\200139\WaterCAD\2021-07-08 Shapefiles Updated for Eastern Section\Carolina Springs PUD 1st Review Analysis Map - Active System Exhibit 2021-07-08.mxd DocuSign Envelope ID: C7E4CA3C-9104-4429-AF98-051629034A45 ! ! !! ! ! ! ! ! ! ! ! ! ! ! ! !!! ! ! ! ! ! ! ! !!! !! ! ! ! ! ! ! ! ! ! ! ! !! !!! ! ! J-43J-13 J-52 J-14 J-29 J-42 J-79 J-8a J-924 J-911 J-900 J-227 J-108 J-103 J-109J-110 J-938 J-937J-936 J-1022 J-1021 J-1020 J-1019 J-1018 J-1017 J-1016 J-1015 J-1014 J-1013 J-1012J-1011 J-1010 J-1009 J-1008 J-1007 J-1006 J-1004 J-1003 J-1002 J-1001 J-1000J-1024 J-1023 J-283I IngencoPhase 09: Entrance 02 Phase 09: Entrance 01 Phase 09 Transmission Node 01 Phase 09 Transmission Node 016 812 4 6 6 126 1212666 66 844 6 6 46 1266 661 2 66 6126 61 26 6666126 12 6 6 64 4 6666 4 6 4 66 61 2 6 66 6 4Sources: Esri, HERE, DeLorme, TomTom, Intermap, increment P Corp., GEBCO, USGS, FAO, NPS, NRCAN, GeoBase, IGN, Kadaster NL, Ordnance Survey, EsriJapan, METI, Esri China (Hong Kong), swisstopo, MapmyIndia, © OpenStreetMap contributors, and the GIS User Community t Hydraulic Analysis Map for Carolina Springs PUD - 2nd ReviewScenario 4 Legend Tank SCENARIO 4 PRESSURES Range !-13.600000 - 0.000000 !0.000001 - 20.000000 !20.000001 - 40.000000 !40.000001 - 60.000000 !60.000001 - 80.000000 !80.000001 - 100.000000 500 0 500 1,000 1,500250Feet 1 inch = 750 feet Document Path: P:\2020\200139\WaterCAD\2021-07-08 Shapefiles Updated for Eastern Section\Carolina Springs PUD 2nd Review Analysis Map - Scenario 4 Updated Exhibit.mxd CAROLINA SPRINGS PUDPhase 1 (Subphases 1-5) CAROLINA SPRINGS PUDSection A Roadway CAROLINA SPRINGS PUDSection C Roadway DocuSign Envelope ID: C7E4CA3C-9104-4429-AF98-051629034A45 WITHERSRAVENEL I CAROLINA SPRINGS I TOWN of HOLLY SPRINGS 74TOWN PARK+/- 25 ACNEIGHBORHOODDISTRICTINNOVATIONDISTRICTVILLAGESQUAREVILLAGESQUAREFIRE STATION+/- 4.3 ACTOWNCENTER+/- 21 AC WOODSFEILD DAED END US-1100’ HWY BUFFERPROPOSED 115’ TRANSMISSION LINE EASEMENT135’ TRANSMISSION LINE EASEMENT+/- 78 AC+/- 135 AC+/- 36 ACOLD HOLLY SPRINGS APEX ROADWOODS CREEK ROADWOODS CREEK ROADOLD H O LLY S P R IN G S A P E X R O A DNC-540WOWODSFEILDDAEDENDUS-1100’ HWY BUFFEROLD HOLLY SPRINGS APEX ROADWOODS CREEK ROADWWWWWWWWOOOOOODSCRREEEEEEEEEEKKKKKKKKKKKKKKKKKKKKKKKKKKKRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRROOOOOOOOOOOOOOOOOOOOOOOOOOOOAAAAAAAAAAAAAAAAAAAAAAAAAAAAADDDDDDDDDDDDDOLDH O LLYLL S P RRRRRR IIIIIINNNNNNNNNNN GGG SS A P E X RRRRRRRRRR OOOOOOOOOOOOOOOOOOOOOOOOOO AAAAAAAAAAAAAAAAAAA DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDNC-540BUILD-OUT SCENARIO SUMMARYTOTAL RESIDENTIAL UNITS ± 1700 UNITSTOTAL NON-RESIDENTIAL ± 1,020,000 SFNOTES: 1. BUILD OUT PHASING IS CONCEPTUAL AND DOES NOT REFLECT CONSTRUCTION PHASING. CONSTRUCTION PHASING WILL BE DETERMINED AT THE TIME THE PROJECT PLANS ARE DEVELOPED AND REVIEWED BY THE TOWN'S CONSTRUCTION DRAWING PLAN REVIEW PROCESS. 2. GRADING OPERATIONS MAY EXTEND BEYOND PROPOSED PHASING BOUNDARIES AS THE AVAILABILITY OF DIRT FOR GRADING OPERATIONS MAY NOT CORRESPOND WITH THE PROPOSED PHASING PLAN. SUCH ACTIVITIES WILL BE PERMITTED THROUGH THE TOWN’S SEDIMENTATION AND EROSION CONTROL ORDINANCE BUT SHALL NOT BE SUBJECT TO PHASING LIMITS OF THIS DOCUMENT. 3. INFRASTRUCTURE NECESSARY TO SERVE MULTIPLE PHASE AREAS OF THE PUD MAY BE INSTALLED OUTSIDE THE BOUNDARIES OF THE PHASING PLAN CONTAINED WITHIN THE PUD DOCUMENT SUBJECT TO STANDARD PERMITTING BY THE TOWN AND OTHERS. EXAMPLES OF SUCH ARE PUMP STATIONS, FORCE MAINS, STREAM CROSSINGS OF ROADS AND GREENWAYS, ETC.) 4. TREE PRESERVATION WILL BE PROVIDED IN ACCORDING WITH THE “TREE PRESERVATION PRIORITY LIST” LISTED WITHIN THE TREE PRESERVATION SECTION OF THE CAROLINA SPRINGS PUD DOCUMENT. AS LONG AS THE MINIMUM PERCENTAGE OF TREE PRESERVATION IS MET ON AN OVERALL BASIS FOR LAND WITHIN THE PUD BOUNDARY, NO MINIMUM TREE PRESERVATION AREA IS REQUIRED ON A SITE BY SITE OR PHASE BY PHASE BASIS. THE DEVELOPER (OR MASTER DECLARANT) SHALL BE RESPONSIBLE FOR TRACKINGCUMULATIVE TREE PRESERVATION AND REPORTING SUCH TO THE TOWN UNTIL THE MINIMUM TREE PRESERVATION REQUIREMENTS HAVE BEEN MET THOUGH TREE SAVE AREAS DESIGNATED AS SUCH ON APPROVED DEVELOPMENT PLANS WITHIN THE PUD BOUNDARY. 5. RESIDENTIAL AND NON-RESIDENTIAL DENSITY IS TRANSFERRABLE BETWEEN PHASESBUILD-OUT PLANNEIGHBORHOODDISTRICTPPPROPOSED 115’ TRANSMISSION LINE EASEMENTMIOONEASEMENEAEASESEMEMENNAASSASAASSMMMMMMEMEMENNSEASE3131313131313131313131313131313313131331313131313131331315’5’5’5’5’5’5’5’5’5’5’5’5’5’5’5’5’5’5’5’5555’5555TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTRRRARARARARARARARARARARARARARAARARARARARARRARARARARARARARASSNSNSNSNSNSNSNSNSNSNSNSNSNSSNSNSSNSNSNSNSNSNSNSSNSNSNSNSNMMMMMIMIMIMIMIMIMIMIMIMIMIMIMIMIMIMIMMIMIMIMMIMIMIMMISSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSOOOOIOIOIOIOIOIOIOIOIOIOOIOOOIOIOIOIOIOIOIOIOIOIOIOIIONNNNNNNNNNNNNNNNNNNNNNNNNNNNNNIIIIILILILILILILILILILILILILILIILILILILILILILILILINEENENENENENENENENENENENENENENENENENENEEENENENENEENENENEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEASASASASASASASASASASASASASASASSASASSASASASASASASASASASASASEMEMEMEMEMEMEMEMEMEMEMEMEMEMMEMEMEMEMEMEMEMEMEMMEMEMEMEMMEMNNENENENEENENENENENENENENENENENENNENENENENENNNENENENENENTTTTTTTTTTTTTTTTTTTTTTTTTTTT1313131313131315’5’5’5’5’5’55TTTTTTTTRRRRRRRRAAAAAAAAANNNNNNNNNSSSSSSSSSMMMMMMMMMMIIIIIIIIISSSSSSSSSSSSSSSSSSSSSOIOOIOIOOIOIOIOIOOOOOOOOOONNNNNNNNNLLLLLLLLLINENENENNENENENENEENEEEEEEEEEEEEEEEEEEEASASASASASASASASASASASAEMEMEMEMMEMEMEMEMEMEMEMEMMMMMMMMMMMMMEEEEEEEEEEEENNNNNNNNNNNNNNTTTTTTTTTTTNTNTENMEEMSEASEAEEEETTTTTTTTTTTTTTTTT+/- 135 ACFIRE STATION+/- 4.3 ACINNOVATIONDISTRICT+/- 36 ACNEIGHBOVILLAGESQUARE+/- 78 ACTOWNCENTER+/- 21 ACPHASE 3 (PROJECTED COMPLETION: 2025)RESIDENTIAL ± 260 UNITSPHASE 1 (PROJECTED COMPLETION: 2021)RESIDENTIAL ± 490 UNITSNON-RESIDENTIAL ± 120,000VILLAGESQUAREPHASE 2 (PROJECTED COMPLETION: 2023)RESIDENTIAL ± 950 UNITSNON-RESIDENTIAL ± 500,000 SF PHASE 4 (PROJECTED COMPLETION: 2027)NON-RESIDENTIAL ± 400,000 SFTOWN PARKTOWN PARK+/- 25 ACPHASE 5 TOWN PARK± 25 ACRES,\'''"c' A.,,,,,, ,,, NOT APPROVED FOR CONSTRUCTION ,, 1111 RD ,,'"' ,,,,,..11,,,, PRELIMINARYNOT FOR CONSTRUCTIONCAROLINA SPRINGSTOWN OF HOLLY SPRINGS300 0 150 300 600 & ҃&$SCENARIO1200’600’0’REVISION DATE: MAY 08, 2020DocuSign Envelope ID: 7D6EE272-7479-44F2-A115-D40429B41017DocuSign Envelope ID: C7E4CA3C-9104-4429-AF98-051629034A45 OHE OHE OHE OHE UP M M M T T T T WETLAND AREA W31 WETLAND AREA W23 WETLAND AREA W21 WETLAND AREA W31 WETLAND AREA W31 WETLAND AREA W21 WETLAND AREA W31 XXXXXXXXXXXX X X X X X X PS SR 1154 WOO D S C R E E K R O A D 60' PUBLIC R/W ( D B . 9 2 6 4 P G . 2 9 5 ) OHE OHE OHE OHE UP M M M T T T T WETLAND AREA W31 WETLAND AREA W23 WETLAND AREA W21 WETLAND AREA W31 WETLAND AREA W31 WETLAND AREA W21 WETLAND AREA W31 XXXXXXXXXXXX X X X X X X PS 1 of 1 Revisions K:\19\19-0370\190372.10-Lennar- Carolina Springs Master Plan\CAD\Exhibits\Preliminary Layout.dwg- Monday, February 3, 2020 12:41:45 PM - FERM, DEBRASheet No. Designer Drawn By Date Job No.WithersRavenel115 MacKenan Drive | Cary, NC 27511 | t: 919.469.3340 | license #: C-0832 | www.withersravenel.comEngineers | Planners | SurveyorsCAROLINA SPRINGSEXHIBIT 302190372.10 11/26/2019 WR WR 1 inch = 300 ft. 300 GRAPHIC SCALE 0 150 300 600 ROADWAY SECTION A ROADWAY IMPROVEMENTS BY OTHERS (RKA) ROADWAY SECTION C PHASE 1 FUTURE AMENITY PHASE 2 PHASE 4 PHASE 3 PHASE 5 ROADWAY SECTION B TO BE SUBMITTED WITH PHASE 1 - 5 CDS ROAD WIDENING DESIGN BY OTHERS; TO BE COMPLETED WITH PHASE 1-5 CD BOARDWALK TO BE SUBMITTED WITH ROADWAY SECTION C FUTURE PHASE; LAYOUT TO BE DETERMINED FUTURE PHASE; LAYOUT TO BE DETERMINED FUTURE PHASE; LAYOUT TO BE DETERMINED FUTURE PHASE; LAYOUT TO BE DETERMINED FUTURE PHASE; LAYOUT TO BE DETERMINED 3,176 sf DocuSign Envelope ID: 7D6EE272-7479-44F2-A115-D40429B41017DocuSign Envelope ID: C7E4CA3C-9104-4429-AF98-051629034A45 11.05 TESTING AND INSPECTION A. General B. Testing C. Inspection D. Cross Connection Control 11.06 REPAIR OF RECLAIMED WATER SYSTEM SECTION 11.00 RECLAIMED WATER DISTRIBUTION SYSTEM TABLE OF CONTENTS 11.00 GENERAL 11.01 RECLAIMED WATER DISTRIBUTION PIPE A. Design B. Materials C. Installation 11.02VALVES AND APPURTENANCES A. Valves B. Appurtenances 11.03 RECLAIMED WATER SERVICE TAPS A. Design B. Materials 11.04 RECLAIMED WATER IRRIGATION SYSTEMS A. General B. Designs C. Street Crossing ....... VA C+,4 ,, D. Hose Bibs SOQ; 6 f ES sio O`►,.;� E. Rain Sensors r+�•' Q••••'L nSE • s 2015 ED&CS 11-1 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 11.00 GENERAL A. All aspects of the design and construction of any portion of the reclaimed water distribution system shall, at a minimum, meet the requirements of the North Carolina Department of Environmental Quality (NCDEQ) Division of Water Resources (DWR). Requirements presented in the Town of Holly Springs Standard Specifications hereunder that are more restrictive or go above and beyond the requirements of DWR are required by the Town of Holly Springs. B. All Reclaimed water systems must be designed per North Carolina Administrative Code 15A NCAC 02U — Reclaimed Water, latest revision, the governing regulations. C. Extensions of the existing reclaimed water distribution system must adhere to any and all Policy Statements and/or Master Plans pertaining to the reclaimed water distribution system, and receive prior approval from the Executive Director of Utilities and Infrastructure Services, prior to consideration. D. Reclaimed water main extensions may require a detailed hydraulic report, signed and sealed by a North Carolina Professional Engineer, be submitted to the Executive Director of Utilities and Infrastructure Services and receive approval prior to construction drawing submittal. E. Reclaimed Water main extensions shall be submitted to the Executive Director of Utilities and Infrastructure Services for notification only. Engineering will forward to NCDEQ for review and approval. F. Any reclaimed water that leaves the reclaimed water distribution system other than by means of a properly permitted use must be disposed of into the Town of Holly Springs sanitary sewer system. This includes any reclaimed water line flushing, and/or line breaks unless otherwise allowed by NCDEQ rules. De minimus runoff from distribution air relief valves and blow -off is deemed permitted per NCDEQ rules. Any reclaimed water that is not a properly permitted use or sent to a sanitary sewer must be reported and handled as if it were a wastewater spill. 11.01 RECLAIMED WATER DISTRIBUTION PIPE All new irrigation systems located within the Town's reclaimed service area desiring to obtain water service for such system from the Town must connect to the reclaimed water system, if reclaimed water is available to the property. Design must be in accordance with Chapter 16 Article IV of the Holly Springs Town Code of Ordinances. These areas are shown on the Reclaimed Water Distribution Service Area Map located on the Town's website. 2015 ED&CS 11-2 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 A. DESIGN 1. Location: Reclaimed water lines shall be extended along the roadway to the adjacent property line. All public reclaimed water mains shall be located within dedicated right of way or dedicated easements with a minimum width of 20 feet. See Section 2.10 for allowable landscape plantings within a Town of Holly Springs easement. 2. Sizing: Reclaimed water mains shall be sized in accordance with good design procedures to provide adequate pressures throughout the system or as directed by the Executive Director of Utilities and Infrastructure Services. The minimum pipe size for reclaimed water mains shall be 4 inches in accordance with the reclaim hydraulic model. 3. Installation: All utility extension permits must be obtained prior to construction utilizing appropriate application forms from NCDEQ. All reclaimed water mains shall have a minimum cover of 4 feet measured from the top of the pipe to the finished grade. When reclaimed water mains are installed along a roadway which does not have curb and gutter, the reclaimed water main shall be installed at sufficient depth to prevent conflict with future road improvements or vertical alignment changes. 4. Relation to Potable Water Mains and Other Utilities a) Reclaimed water mains shall be laid with at least 5 feet horizontal separation from existing potable water mains or sanitary sewer mains, measured laterally edge to edge. b) Where a reclaimed water main and potable water main cross, and the vertical separation is less than 18 inches or the reclaimed water main passes above the potable water main, both the potable water main and the reclaimed water main shall be ductile iron pipe at least one whole pipe length from the crossing point with joints equivalent to water main standards. c) Reclaimed water mains should only cross sanitary sewer mains or potable water mains at an approximate 90 degree angle. d) The minimum separation between reclaimed water mains and storm sewer mains must be either 5 feet horizontal or 2 feet horizontal with a vertical separation of 24 inches unless otherwise approved by the Executive Director of Utilities and Infrastructure Services. Where storm sewers cross reclaimed water with a vertical separation of less than 24 inches the segment of reclaimed water pipe shall be ductile iron pipe at least one whole pipe length from the crossing point with joints equivalent to water main standards. 2015 ED&CS 11-3 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 e) Where reclaim water main crosses under storm sewer main with a vertical separation less than 24 inches then reclaim water must be ductile iron minimum of 10 feet each side of crossing and properly marked as reclaim. f) Where sanitary sewer crosses reclaimed mains, a vertical separation of 18 inches must be maintained. g) Reclaimed water distribution lines shall not be less than 50 f from a well unless the piping and integrity testing procedures meet water main standards, but in no case shall they be less than 25 feet from a private well or 50 fi from a public well. 5. Identification of Reclaimed Piping a. General: All new distribution piping in the reclaimed water system, including service lines, valves and other appurtenances should either be colored purple (Pantone 522 or similar) and embossed or be integrally stamped/marked "CAUTION: RECLAIMED WATER — DO NOT DRINK," or be installed with a purple identification tape, and a purple polyethylene vinyl wrap. b) Polyethylene Wrap: Buried ductile iron pipe and fittings shall be wrapped with a purple colored polyethylene membrane conforming to ANSI A21.5, and installed in accordance with AWWA C105. The polyethylene sheets shall be 8 mils thick, minimum, and be colored purple (Pantone 522 or similar). c) Tracer Wire: Tracer wire shall be installed along those portions of reclaimed water main located outside existing or future street pavement. Tracer wire shall be installed as shown in the Details. d) Identification Tape: 2015 ED&CS Identification tape should be prepared with white or black printing on a purple field (Pantone 522 or similar) having the words "CAUTION: RECLAIMED WATER — DO NOT DRINK." The overall width of the tape should be at least 3 inches. ii. Identification tape should be installed on the top of the distribution piping longitudinally and should be centered over the pipe. The identification should be continuous in its coverage on the pipe and should be fastened to each pipe length no more than 10 feet apart. Tape 11-4 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 attached to sections of pipe before they are placed in the trench should have flaps sufficient for continuous coverage. Other satisfactory means of securing the tape during backfill of the trench may be used if suitable for the work, as determined by the Executive Director of Utilities and Infrastructure Services. iii. The identification tape differentiating the reclaimed water piping from other utility lines should be consistent throughout the service area. e) Signage: i. The public shall be notified of the use of reclaimed water. ii. Advisory signs shall be posted around reclaimed water irrigation activities in public areas, adjacent to ponds used to store reclaimed water in public areas, and at decorative water features that use reclaimed water. B. MATERIALS 1. Material: All reclaimed water main distribution pipe 4" thru 12" diameter shall be C900 PVC pipe. All reclaimed water main distribution pipe greater than 12" diameter shall be C905 PVC. Ductile Iron Pipe shall only be used in special cases and with the Executive Director of Utilities and Infrastructure Services approval. New manufacturers must submit requests for approval to the Executive Director of Utilities and Infrastructure Services. Additional information such as catalogs, list of installations in the area or material samples may be required. A written response will be mailed to the applicant accepting or rejecting the product within 90 days of the receipt of all necessary information. 2. Ductile Iron Pipe: a) This material shall only be used for reclaimed water lines with Executive Director of Utilities and Infrastructure Services' approval. b) Buried ductile iron pipe and fittings shall be wrapped with a purple colored polyethylene membrane conforming to ANSI A21.5, and installed in accordance with AWWA C105. The polyethylene sheets shall be 8 mils thick, minimum, and be colored purple (Pantone 522 or similar). c) Ductile iron pipe shall be designed and manufactured in accordance with AWWA C150 and C151. The minimum required pressure ratings for ductile iron pipe installed at a Type 2 laying condition are tabulated below. For all other installations other than specified, the laying condition or the minimum pressure class rating shall be increased in accordance with AWWA C151, 2015 ED&CS Pipe Diameter Depth of Cover T Pressure Class 6-8 -inch 3-20 feet 350 psi 11-5 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 10-12 -inch 3-14 feet 350 psi 14-20 -inch 3-10 feet 250 psi 24-64 -inch 3 - 8 feet 150 psi d) Pipe joints shall be of the push -on type as per AWWA C111. Pipe lining shall be cement mortar with a seal coat of bituminous material in accordance with AWWA C104. Galvanized steel pipe will not be allowed as a material for reclaimed water mains or reclaimed water service lines. 3. PVC Pipe: a) PVC pipe (4" to 12") shall be designed and manufactured in accordance with AWWA C900. PVC pipe larger than 12" shall be designed and manufactured in accordance with AWWA C905. The PVC pipe shall be made of virgin PVC resin that provides chemical and physical properties that meet or exceed cell class 12454-B as defined in ASTM D1784. All PVC pipe shall be supplied in standard laying lengths of 20 feet. Pipe shall be furnished in factory packaged units, with each joint plainly marked with the manufacturer's name, pressure class, size, etc. PVC pipe shall have integral wall, bell and spigot joints fabricated with elastomeric gaskets that meet or exceed the performance requirements of ASTM D3139 and F477. Fittings used on PVC pipe shall be AWWA C 153 compact ductile iron fittings. b) All PVC pipe supplied for reclaimed water applications shall be color coded purple (Pantone 522 or similar) as required by15A NCAC 02U — Reclaimed Water). c) Furnish pipe for the following minimum pressure classes as indicated. Diameter 4"-12", C900 Pressure Class 150, SDR 18 Diameter 14" and larger, C905 Pressure Class 165, DR18. 4. Steel Encasement for reclaimed water pipes are required for the following Street Classifications to avoid traffic disruption in the future: • Controlled Access Highway For carrier pipes that employ cathodic protection anticorrosion systems, the carrier and casing pipes shall be effectively insulated from one another. Carrier and casing shall be cathodically protected as a unit. See Section 5.03 Boring and Jacking for more casing pipe size requirements. C. INSTALLATION 2015 ED&CS 11-6 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 1. Ductile iron pipe shall be installed in accordance with the requirements of AWWA C600 and the Ductile Iron Pipe Handbook published by the Ductile Iron Pipe Research Association. At a minimum, all ductile iron pipe shall be installed at a Type 2 laying condition as specified by AWWA C600. 2. PVC pipe shall be installed in accordance with AWWA C605. At a minimum, all PVC pipe shall be installed at a Type 3 laying condition as specified by AWWA C605. 3. Materials at all times shall be handled with mechanical equipment or in such a manner to protect them from damage. At no time shall pipe and fittings be dropped or pushed into ditches. 4. Pipe and fitting interiors shall be protected from foreign matter and shall be inspected for damage and defects prior to installation. In the event foreign matter is present in pipe and fittings, it shall be removed before installation. Open ends of pipe shall be plugged or capped when pipe laying is not in progress. 5. All pipes shall be in nominal lengths of eighteen or twenty feet and shall be installed with at least 48 inches of cover below the finished subgrade. Pipe shall be laid on true lines as directed by the Executive Director of Utilities and Infrastructure Services. Trenches shall be sufficiently wide to adjust the alignment. Bell holes shall be dug at each joint to permit proper joint assembly. The pipe shall be laid and adjusted so that the alignment with the next succeeding joint will be centered in the joint and the entire pipeline will be in continuous alignment both horizontally and vertically. Pipe joints shall be fitted so that a thoroughly watertight joint will result. All joints will be made in conformance with the manufacturer's recommendations for the type of joint selected. All transition joints between different types of pipe shall be made with transition couplings approved on shop drawings showing the complete assembly to scale. 6. Prior to beginning construction, the Contractor shall contact local utility companies and verify the location of existing utilities. The Contractor shall be completely and solely responsible for locating all existing buried utilities inside the construction zone before beginning excavation. The Contractor shall be solely responsible for scheduling and coordinating the utility location work. When an existing utility is in conflict with construction, it shall be exposed prior to beginning construction to prevent damage to the existing utility. 7. Valves in the existing Town of Holly Springs water system shall not be operated without a minimum notice of 24 hours to the Executive Director of Utilities and Infrastructure Services and the Director of Public Utilities. The Contractor shall operate valves only in accordance with Town of Holly Springs Engineering Design and Construction Standards. 2015 ED&CS 11-7 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 11.02 VALVES AND APPURTENANCES A. VALVES 1. General a) Valves shall be installed on all branches from feeder reclaimed water mains according to the following schedule: 4 valves at crosses; 3 valves at tees. When a loop section of reclaimed water line is connected back into the feeder reclaimed water main within a distance of 200 feet or less, only one valve will be required in the feeder reclaimed main. Reclaimed water main extensions or mains extending at a project phase line shall include a valve and one additional standard length of pipe with a cap and a temporary blow -off assembly. b) Where no reclaimed water line intersections are existing, a main line valve shall be installed at every 100 feet per 1-inch diameter main up to a distance of 1000 feet between valves. In addition, the Town of Holly Springs reserves the right to require additional isolation valves where necessary for efficient operation and maintenance. c) Valves shall be properly located, operable and at the correct elevation. All valves and reducers shall be rodded to the tee or cross if one is located within 10 feet as shown in the Details. If reducers cannot be rodded, concrete blocking or other restraining methods will be required. The maximum depth of the valve nut shall be 5 feet. When valve extension kits are used, they must be manufactured by the same company which manufactured the valve. 2. Combination Air Valves a) Combination air valves shall be installed at all high points of reclaimed water lines 12" inches in diameter or larger and at other locations as directed by the Town of Holly Springs. The reclaimed water main shall be installed at a grade which will allow the air to migrate to a high point where the air can be released through an air valve. A minimum pipe slope of 1 foot in 500 feet should be maintained. The valve shall have a minimum two (2) inch NPT inlet and 200- PSIG working pressure. Combination air valves shall be sized by the Engineer and approved by the Town of Holly Springs. b) Combination air valves shall be of the single housing style that combines the operation of both an air/vacuum and air release valve. The valve must meet the requirements of AWWA C512 and be installed in accordance with the Details. c) Manholes installed for the combination air valves shall meet all requirements of Section 7.00. 3. Gate Valves 2015 ED&CS 11-8 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 a) Gate valves 2 inches and greater shall meet all requirements of AWWA C500 for a working pressure of 200 psi. All gate valves shall be mechanical joint with iron body, bronze mounting double disc parallel seat type with a non -rising stem and open left with a double 0-ring seal. b) Gate valves, up to and including 12 inches, shall be installed in a vertical position. c) Gate Valves 16 inches and larger must be approved by the Executive Director of Utilities and Infrastructure Services. They may be installed horizontally and equipped with bevel gears, grease case, rollers, tracks scrapers, and a bypass located on the side of the body (fully revolving disc valves shall not require rollers), or vertically and be equipped with spur gears enclosed in a grease case and with a bypass located on the side of the body. In either case, the roller and scraper operators shall be installed in a manhole that meets all requirements of Section 7.00. 4. Resilient Seat Wedge Gate Valves: Resilient seat wedge gate valves shall be manufactured in accordance with AWWA C509 for a working pressure of 200 psi. All shall be mechanical joint with iron body, open left with a non -rising stem and two 0-ring stem seals. All ferrous surfaces, both inside and outside, shall be protected by a fusion -bonded epoxy coating. 5. Butterfly Valves: Butterfly Valves may be installed in reclaimed water mains 24 inches or greater with the permission of the Executive Director of Utilities and Infrastructure Services. All butterfly valves shall meet the requirements of AWWA C504 with mechanical joints, 2 inch open left operating nut. Valves installed on reclaimed waterlines at depths greater than 6' (measured to top of pipe) shall be installed in a manhole (see Section 7.00) as shown in the Details. Valves designated by the Town of Holly Springs to potentially have a remote actuator shall be installed in a manhole (see Section 7.00) as shown in the Details. 6. Valve Boxes a) Valve boxes shall be cast iron, screw or telescopic type, with a 5-inch opening. Valve box ring adjustments will not be allowed. All valve boxes shall be fumished with an approved operating key which shall allow operation by authorized personnel only. b) Valve box covers shall be square in shape (NOT round) and shall be designed for AASHTO H-20 truck loadings. All valve box covers shall be of non - interchangeable shape with potable water covers, and cast on the top surface with a recognizable inscription indicating "Reclaimed Water". All valve box covers shall be painted purple (Pantone 522 or similar). 2015 ED&CS 11-9 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 c) The valve box shall be centered over the wrench nut and seated on compacted backfill without touching the valve assembly. All valve boxes shall be encased in a trowel finished 2' x 2' x 6" pad of 3000-psi concrete beneath the asphalt with the cover flush with the top of the pavement or flush with the finished grade. Precast concrete valve box encasements may not be used for valve box encasement outside of paved areas. The maximum depth of the valve nut shall be 5 feet. When valve extension kits are used, they must be manufactured by the same company that manufactured the valve. B. APPURTENANCES 1. Pipe Fittings: Pipe fittings shall be cast or ductile iron designed and manufactured as per AWWA C110. Sizes of fittings up to and including 12 inches shall be designed for an internal pressure of 250 psi, and larger size fittings shall be designed for an internal pressure of 150 psi. Compact ductile iron mechanical joint fittings designed and manufactured as per AWWA C111 are also acceptable. Joints for fittings shall be mechanical and lined with cement mortar with a seal coat of bituminous material, all in accordance with AWWA C 104. 2. Blowoffs a) Blowoffs installed at the end of cul-de-sacs shall be a minimum of 2 inches. Blowoffs installed on transmission and distribution mains shall be a minimum of 2 inches. Where there is not sufficient pressure to thoroughly flush the system, a larger blowoff will be required. b) Blowoff assemblies shall be constructed as shown in the Details. The valves shall be gate type with a non -rising stem and a 2-inch operating nut, 0-ring seals and screwed ends. A full-size valve is required on mains that are planned to be extended. c) Blowoffs shall be directed in a non -erosive manner to a stabilized grassed area at least 50 ft. from a jurisdictional feature or directed into the closest sanitary sewer manhole. Blowoffs installed at the end of cul-de-sacs should be tied into a sanitary sewer manhole where available. 3. Thrust Restraint: Reaction blocking for all fittings or components subject to hydrostatic thrust shall be securely anchored by the use of concrete thrust blocks poured in place or restrained joint piping as described below a. Concrete thrust blocks shall be poured in place with reaction areas as shown in the Details. No concrete shall interfere with the removal of fittings. Material for reaction blocking shall be 3000 psi concrete. A minimum 4 mil plastic shall cover the fitting to ensure that no concrete will interfere with removal of the fitting. 2015 ED&CS 11-10 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 b. PVC Bell Joint Restraint - All PVC bell joints shall be restrained for both C900 and C905 PVC pipe. The bell joint restraint shall consist of either an approved restrained PVC joint provided by the same manufacturer of the PVC pipe or an approved bell joint restraint harness. All bell joint restraint harness assemblies shall be made of ductile iron pipe (DIP), coated with a manufacturer applied epoxy coating or polyester powder coating, including stainless steel bolts, nuts and rods. The bell joint restraint harness shall be manufacturer approved for use with PVC pipe and rated for at least 200-psi with a 3:1 safety factor. c. All valves and fittings shall be restrained to C900 or C905 pipe with an approved wedge action retainer gland or other approved restraining method. All DIP fittings for reclaimed water use shall be identified by purple painting or wrapping with polyethylene wrap (Pantone 522 or similar). Alternative restraining methods and mechanical joint restraints may be used upon approval by the Executive Director of Utilities and Infrastructure Services. 11.03 RECLAIMED WATER SERVICE TAPS A. DESIGN 1. Individual reclaimed water services, and multiple branch services, shall be provided from the reclaimed water main to each reclaimed water meter for single customer locations in accordance with the Details. All connections shall be made by wet taps. Service connections shall be made perpendicular to the reclaimed water main and shall run straight to the reclaimed water meter. 2. All reclaimed water meter boxes and vaults shall be located at the edge of the serviced lot's right of way or easement. Reclaimed water meter boxes shall not be placed in streets, sidewalks, parking areas or obstructed by fencing or buildings. Exceptions to these conditions will be at the direction of the Executive Director of Utilities and Infrastructure Services. 3. Service taps to existing reclaimed water mains shall be made by the Town of Holly Springs. Service taps to new reclaimed water mains shall be made by the Contractor in accordance with the Specifications. 4. Water meters shall be sized based on applicant water budget calculations using the approved method. Water meter size shall be determined from the following table; or as otherwise specified by the Executive Director of Utilities and Infrastructure Services. Multiple branch services size shall be determined by the designer. 2015 ED&CS 11-11 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 METER SIZING GUIDE Meter Size (inches) 3/4" PD 1" PD 1 %2" PD 2" C 3" C 4" C Flow Range SGPM} 0-20 20-50 50 - 100 100 - 200 200 - 400 400 - 600 PD = Positive Displacement T = Turbine (may be required on a case -by -case basis) C = Compound (must be sized on a case -by -case basis) 5. Service taps greater than 2 inches shall be made by a Contractor of the Developer. B. MATERIALS 1. Taps: Direct taps shall not be allowed on C900 or C905 PVC mains. The maximum allowable size for saddle taps is 2". All taps larger than 2-inches shall be installed by inline fittings or tapping sleeves. All tapping of C900 or C905 PVC mains shall be implemented with shell type cutting tools classified for use with PVC pipe that retains the coupon cut while penetrating the pipe wall, use of twist drill bits and auger bits shall be prohibited. The maximum size of direct taps without a fitting, tapping sleeve or saddle for ductile iron mains shall be as follows: Main Size (inches) Tap Size (inches) 4" main 3/4" tap 6" main 1" tap 8" main 1 1/4" tap 10" main 1 1 /2" tap 12" main 2" tap 2. Tapping Sleeves: Tapping Sleeves shall be made of either cast iron or stainless steel. The sleeve shall be two-piece with mechanical joint to the main line and 2015 ED&CS 11-12 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 flanged to the tapping valve. Cast iron shall meet AWWA C110 specifications. Stainless steel shall meet AWWA C223 specifications. All sleeves shall require full circumferential gasket. All tapping sleeves shall be manufactured and approved for installation on the specific main line pipe material (DIP, C900, C905). 3. Tapping Saddles: Tapping Saddles shall be used on reclaimed water mains 16 inches and larger. Saddles shall be made of ductile iron providing a factor of safety of 2.5 with a working pressure of 250 psi. Saddles shall be equipped with an AWWA C110 flange connection on the branch. Sealing gaskets shall be 0-ring type, high quality molded rubber having an approximate 70 durometer hardness, placed into a groove on the curved surface of the saddles. Straps shall be alloy steel. The maximum size saddle outlet for each size of pipe to be tapped shall be as follows: Size pipe to be tapped Maximum size Saddle Outlet 16" 8" 18" 8" 20" 10" 24" and larger 12" 4. Corporation Stops: Corporation Stops shall be ball type, made of brass and complete with a compression or flared coupling and AWWA Standard threads as per AWWA C800. Taps shall be located at 10:00 or 2:00 o'clock on the circumference of the pipe. Service taps shall be staggered alternating from one side of the reclaimed water main to the other and at least 12 inches apart. The taps must be a minimum of 24 inches apart if they are on the same side of the pipe. No burned taps will be allowed and each corporation stop will be wrapped with Teflon tape for ductile iron pipe reclaimed water mains. No tapping shall be made where rodding is placed. 5. Service Saddles: Service saddles shall be bronze body (85-5-5 waterworks brass) and double strap for taps with silicon bronze nuts conforming to ASTM A98 and factory installed grade 60 rubber gaskets. Service saddles shall be approved by the manufacturer for use on C900/C905 PVC mains. 6. Service Tubing: Copper service tubing shall be type K soft copper tubing per ASTM B88. No union shall be used in the installation of the service connection of 100-feet or less. The longest available length of service line shall be used with no unions (e.g. for 3/4 inch, only 1 union will be allowed for each 100 foot section). Unions shall be made with flare type couplings. Copper service tubing shall be installed with a purple colored polyethylene wrap. 2015 ED&CS 11-13 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 7. Coppersetters for 3 and 1-inch Reclaimed Water Services: All 3 and 1-inch reclaimed water services shall be installed with coppersetters as shown in the Details. All coppersetters shall be as manufactured by Mueller or Ford at the dimensions shown in the Details. All coppersetters shall be installed with a lockable angle ball valve assembly and outlet angle check valve on all size setters. Coppersetters shall be installed with flare fittings and all coppersetter assemblies shall be provided as shown in the Details with galvanized brace pipes for additional stability. All installations shall provide the coppersetter properly aligned with the meter box reader lid such that the meter is clearly visible below the reader lid. 8. Meter Boxes for 3 -inch services: 3/-inch meter boxes shall be light weight polymer concrete as shown in the Details. Meter boxes for 3 -inch reclaimed water services shall provide a cover opening of 11 X 18 inches and boxes shall measure at least 18-inches in depth. Meter boxes and covers shall be rated for "heavy duty" uses, such as alleys, driveways, parking lots, etc. Standard meter box covers shall not bolt down to the box. The box interior walls and covers shall be consistently color - coded purple (Pantone 522 or similar). All covers shall include a 4 X 6 inch cast iron reader lid with the words "RECLAIMED WATER — DO NOT DRINK" cast into the lid in 1-1/2" tall lettering. The Town of Holly Springs reserves the right to require all meter box covers to include brackets and housing for "ITRON" compatible transponders for automated meter reading systems. All meter boxes and covers shall be installed as shown in the Details. 9. Meter boxes for 1-inch services: 1-inch meter boxes shall be light weight polymer concrete as shown in the Details. Meter boxes for 1-inch reclaimed water services shall provide a cover opening of 11 X 18 inches and boxes shall measure at least 18-inch in depth. Meter boxes and covers shall be rated for "heavy duty" uses, such as alleys, driveways, parking lots, etc. Standard meter box covers shall not bolt down to the box. The box interior walls and covers shall be consistently color - coded purple (Pantone 522 or similar). All covers shall include a 4 X 6 inch cast iron reader lid with the words "RECLAIMED WATER — DO NOT DRINK" cast into the lid in 11/2' tall lettering. The Town of Holly Springs reserves the right to require all meter box covers to include brackets and housing for "ITRON" compatible transponders for automated meter reading systems. All meter boxes and covers shall be installed as shown in the Details. 10. Meter boxes for 1'/2 and 2-inch services: 1 1/2" and 2" meter boxes shall be light weight polymer concrete as indicated in the Standard Details. All meter box interiors and covers shall be consistently color -coded purple (Pantone 522 or similar). Covers shall be marked on the top surface with a recognizable inscription indicating "RECLAIMED WATER — DO NOT DRINK" in 1-1/2" tall lettering. Piping for 1 1/2 and 2 inch reclaimed water meters shall be constructed from brass and copper tubing and shall be equipped with angled check valve outlets and by-pass flanged valve or by-pass flanged ball valve inlets. The box shall have an open bottom to allow drainage through stone. 2015 ED&CS 11-14 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 11. Meter Vaults: Meter vaults and access doors within street right of way shall meet HS-20 loading requirements and shall be located outside of travel areas. The access double doors shall be aluminum with a flush drop lift handle, stainless steel hinges and bolts, a stainless steel slam lock, an automatic hold open arm, and compression springs to allow for easy opening. Covers shall be marked on the top surface with recognizable inscription indicating "Reclaimed Water -Do Not Drink" 12. Reclaimed Water Meters: Reclaimed water meters for 3/4" to 2" services will be provided by the Town of Holly Springs. Larger meters shall be provided by the developer as directed by the Executive Director of Utilities and Infrastructure Services. Reclaimed water meters, registers and covers shall be purple (Pantone 522 or similar). 11.04 RECLAIMED WATER IRRIGATION SYSTEMS A. GENERAL All reclaimed water irrigation systems within public street right of way require an encroachment agreement from the Town of Holly Springs or NCDOT prior to installation. Plans designating the location, size, material, and depth shall be submitted with the agreement application to the Engineering Department. Pipe material for the irrigation mainline proposed to be used within the public right of way shall be Schedule 40 PVC or greater. All pipe, fittings, and appurtenances shall be purple (Pantone 522 or similar). A minimum depth of 2 feet of cover shall be provided. A soil evaluation is necessary in order to determine the loading rate for irrigation permits. All development within the reclaim service area will need to complete an independent soil evaluation prior to submitting a reclaim irrigation permit. All reclaimed water irrigation systems are required to secure permits from the Code Enforcement Department and the Utilities and Infrastructure Services prior to installation and shall be inspected after installation. A separate meter is required for irrigation systems. For single family irrigation design, a CID, PE, or LA is required to develop the plan. For non -single family irrigation system designs, a PE must develop the plan. Impoundments for reclaimed water storage for large scale irrigation systems or aesthetic/decorative water features shall be designed in accordance with 15A NCAC 02U — Reclaimed Water. 2015 ED&CS 11-15 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 Service lines from mainline tap to the meter are installed and identified per the Town of Holly Spring's Standard Details. There shall be no direct cross -connection between potable and reclaimed water supplies. B. DESIGNS Sprinklers chosen and located to maintain the following setbacks from the irrigation area to the following features: 1.25 feet from surface waters [perennial and intermittent streams, wetlands] not classified as tidal salt waters or high -quality water (SA). 2.100 feet from surface waters [perennial and intermittent streams, wetlands] classified as tidal salt waters or high -quality water (SA). 3.100 feet from any water supply well (not including monitoring wells). 4.Sprinklers located on a steep slope have check valves installed on all the heads on that irrigation zone. 5.No mainlines or valves shall be allowed within the utility/devil strip. Laterals will be allowed and shall be placed within 1 ft of sidewalk. 6.The zoning of the irrigation system must allow that plants with different water requirements (such as grass and shrubs) are on separate zones. In addition, the irrigation design should consider the different microclimates found in most landscapes (such as north facing grass areas vs. south facing grass areas) and separate those microclimates into zones. These zoning practices may add slightly to the installation cost of an irrigation system, but can have a dramatic effect on system efficiency. 7.Guidelines on pressure at the head/emitter: Spray Heads 20 to 35 psi; gear rotors 60 psi or less; impact rotors 60 psi or less; drip emitters 40 psi or less. 8.Large commercial systems which have the potential to place undue burdens (demand or pressure requirements) on the Town of Holly Springs' public reclaimed distribution system must include on -site storage and/or pumping facilities. This determination will be made by the Executive Director of Utilities and Infrastructure Services. Design, operation, and maintenance of such on -site facilities shall be the sole responsibility of the applicant. These additional facilities must be designed in accordance with 15A NCAC 02U — Reclaimed Water. 9.Rain sensors must be installed to reduce the likelihood of overwatering. Rain sensors are required to remain in service at all times to prevent overwatering and/or ponding of reclaimed water. 2015 ED&CS 11-16 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 C. STREET CROSSING All irrigation line street crossings shall be contained within a ductile iron or steel casing pipe. The Town of Holly Springs may, in some instances, permit irrigation systems installed in the medians of Town -maintained roadways. These systems must also have french drains installed behind the curb and gutter and piped to a storm drainage collection system. These systems shall be allowed only when some permanent mechanism is established for the private perpetual maintenance of the system(s). D. HOSE BIDS Hose bibs are not permitted for the reclaimed water system. E. RAIN SENSORS Rain sensors must be installed to reduce the likelihood of overwatering. Rain sensor must remain in operation to prevent ponding or runoff. 11.05 TESTING AND INSPECTION A. GENERAL 1. All reclaimed water used in testing and inspection must be disposed of properly as described in Section 11.00. 2. All materials must be approved by the Inspector prior to installation. Materials rejected by the Town of Holly Springs' Inspector shall be immediately removed from the job site. 3. Under no circumstance shall any waterline system valve be operated without prior approval by the Construction Inspector. Damage to Town of Holly Springs infrastructure resulting from illegal operation of valves shall be the responsibility of the Contractor. In addition, the Contractor shall be subject to a fine for operating a valve without prior approval. 4. The Contractor shall furnish all materials, labor, equipment, and shall pay for the water used to perform all testing and inspections to the satisfaction of the Construction Inspector. The Contractor shall obtain a Blowoff Permit from the Town of Holly Springs Engineering Department for use when blowing off reclaimed water mains. 5. Reclaimed water service taps shall not be made until after all main testing is completed, and bacteriological testing is satisfactory. B. TESTING 2015 ED&CS 11-17 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 1. Hydrostatic Testing a) All valves in the Town of Holly Springs reclaimed water system shall be operated by the Town of Holly Springs. A section of reclaimed water main which is to be hydrostatically tested shall be slowly filled with water at a rate which will allow complete evacuation of air from the line. Hand pumps shall not be used for the pressure testing of reclaimed water mains. Taps used for testing purposes shall be removed after testing. The corporation stops shall be removed and a threaded tapered plug shall be installed on the line. When approved by the Town of Holly Springs, the Contractor may utilize potable water or reclaimed water via an approved hydrant meter and RPZ assembly for testing and disinfection of new reclaimed mains which are not physically connected to a live reclaimed water supply. Once reclaimed water has been introduced into the system no direct connection to potable water will be allowed and an approved air gap assembly must be used. b) Any measured leakage not within the allowable limits as specified in the following table shall require repair of the reclaimed water main and additional testing until the standards are met. For pipe sizes other than those shown, the Contractor shall test within the allowable leakage amounts as specified by AWWA C600-99. All visible leaks shall be repaired regardless of the amount of leakage. Pipe Size Allowable Leakage at 200-psi (Inches) (Gal./Hr. per 1000 feet of pipe) 4 0.43 6 0.64 8 0.85 12 1.28 16 1.70 20 2.12 24 2.55 2. Chlorination a) All additions or replacements to the reclaimed water system shall be chlorinated before being placed in service under the supervision of the Town of Holly Springs' Inspector in the following manner: i. Taps shall be made at the control valve at the upstream end of the reclaimed water main and at all extremities of the line including valves. ii. A solution of water containing 70% HTH available chlorine shall be introduced into the reclaimed water main by regulated pumping at the 2015 ED&CS 11-18 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 control -valve tap. The solution shall be of such a concentration that the reclaimed water main shall have a uniform concentration of 50 ppm total chlorine immediately after chlorination. The chart below shows the required quantity of 70% HTH compound to be contained in solution in each 1,000 feet section of line to produce the desired concentration of 50 ppm. Pipe Size Pounds High Test Hypochlorite (70%) (inches) per 1000 feet of line 6 1.76 8 3.12 10 4.84 12 7.00 14 9.52 16 12.44 20 19.52 24 28.00 iii. The HTH Solution shall be circulated in the reclaimed water main by opening the control valve and systematically manipulating blowoffs and taps at the reclaimed water main extremities. All reclaimed water leaving the system during this test must be disposed of through either an approved use or sent to the sanitary sewer. The HTH solution must be pumped in at a constant rate for each discharge rate so a uniform concentration will be produced in reclaimed water mains. iv. HTH solution shall remain in reclaimed water mains for no less than 24 hours or as directed by the Town of Holly Springs' Inspector. v. Extreme care shall be exercised at all times to prevent the HTH solution from entering existing reclaimed water mains. 3. Bacteriological Sampling a) Free residual chlorine after 24 hours shall be at least 10 ppm or the Town of Holly Springs' Inspector will require that the lines be rechlorinated. b) Flushing of reclaimed water mains may proceed after 24 hours, provided the free residual chlorine analysis is satisfactory. Reclaimed water leaving the system because of line flushing must be returned to a sanitary sewer. Flushing shall be continued until an orthotolidine check (or other method approved by the Town of Holly Springs) shows that the reclaimed water mains contain only the normal chlorine residual. Samples for bacteriological analysis shall be collected by the Town of Holly Springs' Inspector 24 hours after flushing is completed. The Contractor shall furnish the sample bottles, the testing agency and such help as may be required to secure these samples. The Contractor shall 2015 ED&CS 11-19 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 also submit the test results to the Town of Holly Springs' Development Inspector. c) If test results are unsatisfactory, the Contractor shall immediately rechlorinate reclaimed water mains and proceed with such measures as are necessary to properly sterilize those reclaimed water mains. d) The new reclaimed water system shall be valved off from the existing reclaimed water system until a satisfactory bacteriological sample has been obtained and the Town of Holly Springs' Inspector has authorized the use of the new reclaimed water system. C. INSPECTIONS 1. Approved plans and permit must be issued and available on -site before any inspections are performed. 2. Underground Inspections — before work is covered up/back filled: a) Inspection of main line tap and piping to meter box; b) Inspection of underground piping from meter box through irrigation system from meter to end of system to insure compliance with approved plan and standards; 3. Final Inspection a) Includes inspection of the location of all heads, type of heads, spacing of heads and throw pattern of each head and correct pressure; b) Testing the system to ensure compliance with approved plans and Town of Holly Springs Ordinance; 4. A map of the approved valve and head layout shall be provided by the Contractor to the property owner and a copy placed near or with the timer. 5. All zones shall be clearly labeled in the timer cabinet. 6. Responsible entity shall be listed on inner door of timer (for emergency contact purposes). 7. Verification of required setbacks (reclaimed water). D. CROSS CONNECTION CONTROL 1. Backflow prevention on potable water services serving any property that is also served with reclaimed water is required in accordance with the Federal Safe Drinking Water Act. At all locations where reclaimed water service is provided, the public potable water supply shall be protected by installation of an approved backflow prevention device. 2015 ED&CS 11-20 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 a. For Residential Properties: prior to receiving reclaimed water service, a dual check valve shall be installed on each residential customer's potable water meter in order to protect the potable water system. A Reduced Pressure Principal (RPZ) type backflow prevention device downstream of the potable water meter is not required when the only reclaimed water use is landscape irrigation. b. For Multi -family complexes and commercial properties: master -metered potable water service and master -metered reclaimed water service shall be required to install a Reduced Pressure Principal (RPZ) type backflow prevention device downstream of the master potable water meter. 11.06 REPAIR OF RECLAIMED WATER SYSTEM Reclaimed water that leaves the system due to a leak or break in the system must be reported and handled as if it were a wastewater spill. A. Reclaimed Water Main Line Repairs 1. Joint leaks of Cast Iron Pipe, Ductile Iron Pipe, and PVC pipe shall be repaired by use of a bell joint leak repair clamp as manufactured by Rockwell, or other approved equal. 2. Line Breaks or Punctures shall be repaired by a full circle repair clamp as manufactured by Rockwell, Mueller, or other approved material. 3. Line Splits or Blow Outs shall be repaired by replacing the damaged section with ductile iron pipe with a cast iron coupling at each end. The following cast pipe couplings shall be used for each pipe material indicated: a) Ductile Iron Pipe - Rockwell 431 cast coupling or other approved equal. b) PVC Pipe — Rockwell 411 cast coupling or other approved equal. B. Reclaimed Water Service Line Repairs 1. A reclaimed water service line severed between the reclaimed water main and the reclaimed water meter shall be repaired using new type K copper tubing and bronze or brass 3-piece flared unions. 2. A corporation stop pulled out of a reclaimed PVC pipe water main shall have a new service saddle and a new corporation stop installed on the reclaimed water main. 3. A corporation stop pulled out of a ductile iron pipe shall have a full circle repair clamp placed over the old tap hole. A new tap shall be made and a new corporation stop installed on the reclaimed water main. 2015 ED&CS 11-21 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 END OF SECTION 11.00 2015 ED&CS 11-22 Supp 1 2016 Supp # 2 Aug. 2017 Supp # 3 Aug. 2018 Supp # 5 Apr. 2021 DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76 DocuSign Envelope ID: 28DE4F95-C305-471C-9353-84FFA823CA76