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HomeMy WebLinkAboutWQ0042371_Application (FTSE)_20220517Kimley»>Horn NCDEQ Winston-Salem Regional Office Water Quality Regional Operations Section 450 West Hanes Mill Road, Suite 300 Winston-Salem, NC 27105 RE: Forest Lake RV Park — Sewer Modification The requested permitting action for this application is to extend the sewer main at Forest Lake RV Park in Advance, Davie County, NC. An approximate 89 RV sites are proposed to be constructed with each site having its own sewer service. The modification of the previously approved sewer permit WQ0042371 dated March 11, 2021. The changes included in this modification are for 5,142 (originally 4,994) linear feet of 8" PVC gravity sewer, 1,655 (originally 2,800) linear feet of 3" force main, 1,250 (originally 200) linear feet of 2.5" (originally 2") force main. Due to the changes in size of forcemain the NCDEQ office has requested a permit modification be submitted for record. Transmitted to you is the following: • $480 Application Fee • FTA 06-21 • FTSE-10-18 Flow Tracking Acceptance Form • Original Permit WQ0024371 • NC Secretary of State Business Registration Documentation • Site Maps o USGS Map o Aerial Map • Power Reliability Letter • Thumb Drive Please do not hesitate to contact me at (919) 678-4178 or austin.jackson©kimley-horn.com should you or your staff have any questions. Sincerely, • J. Austin Jackson, P.E. Kimley-Horn and Associates kimley-horn.com 421 Fayetteville Street, Suite 600, Raleigh, NC 27601 919 677 2000 DWR Division of Water Resources State of North Carolina Department of Environmental Quality Division of Water Resources FAST TRACK SEWER SYSTEM EXTENSION APPLICATION INSTRUCTIONS FOR FORM: FTA 06-21 & SUPPORTING DOCUMENTATION This application is for sewer extensions involving gravity sewers, pump stations and force mains, or any combination that has been certified by a professional engineer and the applicant that the project meets the requirements of 15A NCAC 02T and the Division's Minimum Design Criteria (Gravity Sewer & Pump Stations/Force Mains) and that plans, specifications and supporting documents have been prepared in accordance with 15A NCAC 02T, 15A NCAC 02T .0300, Division policies, and good engineering practices. While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans, design calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimum design criteria. These documents shall be immediately available upon request by the Division. Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T.0303. Projects not eligible for review via the fast track process (must be submitted for full technical review): ➢ Projects that do not meet any part of the minimum design criteria (MDC) documents; ➢ Projects that involve more than one variance from the requirements of 15A NCAC 02T; ➢ Pressure sewer systems utilizing simplex septic tank -effluent pumps (STEPs) or simplex grinder pumps; ➢ Simplex STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains); ➢ Vacuum sewer systems. General — When submitting an application, 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 requested additional information. Failure to submit all required items will necessitate additional processing and review time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit one original and one copy of the application and supporting documentation. A. One Original and One Copy (second copy may be digital) of Application and Supporting Documents ® Required unless otherwise noted. Signatures on original must be "wet ink" or secure digital signatures. Please do not submit engineering design plans with the application unless specifically requested. B. Cover Letter/Narrative Description (Required for All Application Packages): ® List all items included in the application package, as well as a brief description of the requested permitting action. ➢ Be specific as to the system type, number of homes served, flow allocation required, etc. ➢ Include the permit number/status of any other required sewer permits (downstream/upstream) ➢ If necessary for clarity, include attachments to the application form. C. Application Fee (All New and Modification Application Packages): ® Submit a check or money order in the amount of $480.00, dated no more than 90 days prior to application submittal. ➢ Payable to North Carolina Department of Environmental Quality (NCDEQ) D. Fast Track Application (Required for All Application Packages, Form FTA 05-21): ® Submit the completed and appropriately executed application. ➢ If necessary for clarity or due to space restrictions, attachments to the application may be made. ® If the Applicant Type in Item I.2 is a corporation or company, provide documentation it is registered for business with the North Carolina Secretary of State. ❑ If the Applicant Type in Item I.2 is a partnership or d/b/a, enclose a copy of the certificate filed with the Register of Deeds in the county of business. ® The Project Name in Item II.1 shall be consistent with the project name on the flow acceptance letters, agreements, etc. ® The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North Carolina licensed Professional Engineer. ® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106(b). Per 15A NCAC 02T .0106(c), 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). INSTRUCTIONS FOR FORM: FTA 06-21 & SUPPORTING DOCUMENTATION Page 1 of 3 E. Flow Tracking/Acceptance Form (Form: FTSE 04-16) (If Applicable): ® Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility. ➢ Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different. ➢ The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one year prior to the application date. ➢ Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-215.67(a). ➢ Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific FTSE. F. Site Maps (All Application Packages): ® Submit an 8.5-inch x 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project area, including the closest surface waters. ➢ General location of the project components (gravity sewer, pump stations, & force main) ➢ Downstream connection points and permit number (if known) for the receiving sewer ® Include an aerial location map showing general project area (such as street names or latitude/longitude) so that Division staff can easily locate it in the field. G. Existing Permit (Application Packages for Modifications to an Existing Permit): ® Submit a copy of the most recently issued existing permit. ® Include a descriptive and clear narrative identifying the previously permitted items to remain in the permit, items to be added, and/or items to be modified (the application form itself should include only include items to be added/modified). The narrative should also include whether any previously permitted items have been certified. ® The narrative should clearly identify the requested permitting action and accurately describe the sewers to be listed in the final permit. H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station): ® Per 15A NCAC 02T .0305(h)(1), submit documentation of power reliability for pumping stations. ➢ This alternative is only available for average daily flows less than 15,000 gallons per day ➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible with the station. The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or proposed contractor, stating that "the portable power generation unit or portable, independently -powered pumping units, associated appurtenances and personnel are available for distribution and operation of this pump station." ➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided in the case of a multiple station power outage. (Required at time of certification) I. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities): ❑ Per 15A NCAC 02T .0115(a)(1) provide the Certificate of Public Convenience and Necessity from the North Carolina Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by the sewer extension, or ❑ Provide a letter from the North Carolina 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. J. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold): ❑ Home/Property Owners' Associations ❑ Per 15A NCAC 02T .0115(c), submit the properly executed Operational Agreement (FORM: HOA). ❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws. ❑ Developers of lots to be sold ❑ Per 15A NCAC 02T .0115(b), submit the properly executed Operational Agreement (FORM: DEV). For more information, visit the Division's collection systems website INSTRUCTIONS FOR FORM: FTA 06-21 & SUPPORTING DOCUMENTATION Page 2 of 3 THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE: REGIONAL OFFICE ADDRESS COUNTIES SERVED Asheville Regional Office 2090 US Highway 70 Swannanoa, North Carolina 28778-8211 (828) 296-4500 (828) 299-7043 Fax Avery, Buncombe, Burke, Caldwell, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Yancey Water Quality Section Fayetteville Regional Office 225 Green Street Suite 714 Fayetteville, North Carolina 28301-5095 (910) 433-3300 (910) 486-0707 Fax Anson, Bladen, Cumberland, Harnett, Hoke, Montgomery, Moore, Robeson, Richmond, Sampson, Scotland Water Quality Section Mooresville Regional Office 610 E. Center Avenue Mooresville, North Carolina 28115 (704) 663-1699 (704) 663-6040 Fax Alexander, Cabarrus, Catawba, Cleveland, Gaston, Iredell, Lincoln, Mecklenburg, Rowan, Stanly, Union Water Quality Section Raleigh Regional Office 3800 Barrett Drive Raleigh, North Carolina 27609 (919) 791-4200 (919) 571-4718 Fax Chatham, Durham, Edgecombe, Franklin, Granville, Halifax, Johnston, Lee, Nash, Northampton, Orange, Person, Vance, Wake, Warren, Wilson Water Quality Section Washinqton Regional Office 943 Washington Square Mall Washington, North Carolina 27889 (252) 946-6481 (252) 975-3716 Fax Beaufort, Bertie, Camden, Chowan, Craven, Currituck, Dare, Gates, Greene, Hertford, Hyde, Jones, Lenoir, Martin, Pamlico, Pasquotank, Perquimans, Pitt, Tyrrell, Washington, Wayne Water Quality Section Wilmington Regional Office 127 Cardinal Drive Extension Wilmington, North Carolina 28405 (910) 796-7215 (910) 350-2004 Fax Brunswick, Carteret, Columbus, Duplin, New Hanover, Onslow, Pender Water Quality Section Winston-Salem Regional Office 450 W. Hanes Mill Road Suite 300 Winston-Salem, North Carolina 27105 (336) 776-9800 (336) 776-9797 Fax Alamance, Alleghany, Ashe, Caswell, Davidson, Davie, Forsyth, Guilford, Rockingham, Randolph, Stokes, Surry, Watauga, Wilkes, Yadkin Water Quality Section INSTRUCTIONS FOR FORM: FTA 06-21 & SUPPORTING DOCUMENTATION Page 3 of 3 DWR Division of Water Resources State of North Carolina Department of Environmental Quality Division of Water Resources FAST TRACK SEWER SYSTEM EXTENSION APPLICATION FTA 06-21 & SUPPORTING DOCUMENTATION Application Number: (to be completed by DWR) All items must be completed or the application will be returned I. APPLICANT INFORMATION: 1. Applicant's name: MHC TT, L.P. (company, municipality, HOA, utility, etc.) 2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility ❑ Federal ❑ State/County ❑ Municipal 3. Signature authority's name: George Gudgeon per 15A NCAC 02T .0106(b) Title: Senior Vice President 4. Applicant's mailing address: Two N. Riverside Plaza City: Chicago State: IL Zip: 60606- 5. Applicant's contact information: Phone number: (312) 279-1880 Email Address: George.gudgeon@u,equitylifestyle.com II. PROJECT INFORMATION: 1. Project name: Forest Lake RV Park Expansion 2. Application/Project status: ❑ Other ❑ Proposed (New Permit) ® Existing Permit/Project If a modification, provide the existing permit number: WQ0042371 and issued date: 03/11/2021, For modifications, also attach a detailed narrative description as described in Item G of the checklist. If new construction, but part of a master plan, provide the existing permit number: WQ0004972 3. County where project is located: Davie County 4. Approximate Coordinates (Decimal Degrees): Latitude: 35.513896° Longitude: -80.234340 ° 5. Parcel ID (if applicable): 5787721571 (or Parcel ID to closest downstream sewer) III. CONSULTANT INFORMATION: 1. Professional Engineer: W. Jordan Brewer License Number: 039196 Firm: Kimley-Horn and Associates Mailing address: 421 Fayetteville Street, Suite 600 City: Raleigh State: NC Zip: 27601- Phone number: (919) 653-6654 Email Address: Jordan.brewera,kimley-horn.com IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION: 1. Facility Name: Forest Lake Preserve Wastewater Irrigation System Permit Number: WQ0004972 Owner Name: MHC, LLC V. RECEIVING DOWNSTREAM SEWER INFORMATION: 1. Permit Number(s): WQ0004972 2. Downstream (Receiving) Sewer Information: 3 inch ❑ Gravity ® Force Main 3. System Wide Collection System Permit Number(s) (if applicable): WQCS Owner Name(s): MHC TT, LLC FORM: FTA 06-21 Page 1 of 5 VI. GENERAL REQUIREMENTS 1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached? ❑ Yes ❑ No ® N/A 2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been attached? ❑ Yes ❑ No ® N/A 3. If the Applicant is a Home/Property Owners' Association, has an HOA/POA Operational Agreement (FORM: HOA) and supplementary documentation as required by 15A NCAC 02T.0115(c) been attached? ❑ Yes ❑ No ® N/A 4. Origin of wastewater: (check all that apply): ❑ Residential (Individually Owned) ❑ Retail (stores, centers, malls) ® Residential (Leased) ❑ Retail with food preparation/service ❑ School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Food and drink facilities ❑ Church ❑ Businesses / offices / factories ❑ Nursing Home El Car Wash ® Hotel and/or Motels El Swimming Pool/Clubhouse El Swimming Pool/Filter Backwash El Other (Explain in Attachment) 5. Nature of wastewater : 100 % Domestic % Commercial % Industrial (See 15A NCAC 02T .0103(20)) If Industrial, is there a Pretreatment Program in effect? ❑ Yes ® No 6. Has a flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes ® No ➢ If ves, provide a copy of flow reduction approval letter with this application 7. Summarize wastewater generated by project: Establishment Type (see 02T.0114(f)) Daily Design Flow a,b No. of Units Flow Recreational Vehicle Sites 100 gal/campsite 89 8,900 GPD gal/ GPD gal/ GPD gal/ GPD gal/ GPD gal/ GPD Total 8,900 GPD a See 15A NCAC 02T .0114(b), (d), (e)(1) and (e)(2) for caveats to wastewater design flow rates (i e , minimum flow per dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas; and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined in G.S. 42A-4). b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0114] shall be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data. 8. Wastewater generated by project: 8,900 GPD (per 15A NCAC 02T .0114) ➢ Do not include future flows or previously permitted allocations If permitted flow is zero, please indicate why: El Pump Station/Force Main or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line. Please provide supplementary information indicating the approximate timeframe for permitting upstream sewers with flow. El Flow has already been allocated in Permit Number: Issuance Date: El Rehabilitation or replacement of existing sewers with no new flow expected El Other (Explain): FORM: FTA 06-21 Page 2 of 5 VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers): 1. Summarize gravity sewer to be permitted: Size (inches) Length (feet) Material 8 5,142 PVC ➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria ➢ Section III contains information related to minimum slopes for gravity sewer(s) ➢ Oversizing lines to meet minimum slope requirements is not allowed and a violation of the MDC VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains): PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT 1. Pump station number or name: SEE ATTACHED 2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: - 3. Total number of pumps at the pump station: 3. Design flow of the pump station: millions gallons per day (firm capacity) ➢ This should reflect the total GPM for the pump station with the largest pump out of service. 4. Operational point(s) per pump(s): gallons per minute (GPM) at feet total dynamic head (TDH) 5. Summarize the force main to be permitted (for this Pump Station): Size (inches) Length (feet) Material If any portion of the force main is less than 4-inches in diameter, please identify the method of solids reduction per MDCPSFM Section 2.01C.1.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify) 6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1): ❑ Standby power source or El Standby pump ➢ Must have automatic activation and telemetry - 15A NCAC 02T.0305(h)(1)(B): ➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day ➢ Must be permanent to facility and may not be portable Or if the pump station has an average daily flow less than 15,000 gallons per day 15A NCACO2T.0305(h)(1)(C): ® Portable power source with manual activation, quick -connection receptacle and telemetry - or ❑ Portable pumping unit with plugged emergency pump connection and telemetry: ➢ Include documentation that the portable source is owned or contracted by the applicant and is compatible with the station. ➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided as part of this permit application in the case of a multiple station power outage. FORM: FTA 06-21 Page 3 of 5 IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(0): 1. Does the project comply with all separations/alternatives found in 15A NCAC 02T .0305(f) & (g)? ® Yes ❑ No 15A NCAC 02T.0305(fl contains minimum separations that shall be provided for sewer systems: Setback Parameter* Separation Required Storm sewers and other utilities not listed below (vertical) 18 inches 2Water mains (vertical - water over sewer preferred, including in benched trenches) 18 inches 2Water mains (horizontal) 10 feet Reclaimed water lines (vertical - reclaimed over sewer) 18 inches Reclaimed water lines (horizontal - reclaimed over sewer) 2 feet **Any private or public water supply source, including any wells, WS-I waters of Class I or Class II impounded reservoirs used as a source of drinking water, and associated wetlands. 100 feet **Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal high water (or tide elevation) and wetlands associated with these waters (see item IX.2) 50 feet **Any other stream, lake, impoundment, or ground water lowering and surface drainage ditches, as well as wetlands associated with these waters or classified as WL. 10 feet Any building foundation (horizontal) 5 feet Any basement (horizontal) 10 feet Top slope of embankment or cuts of 2 feet or more vertical height 10 feet Drainage systems and interceptor drains 5 feet Any swimming pools 10 feet Final earth grade (vertical) 36 inches ➢ If noncompliance with 02T.0305(f) or (g), see Section X.1 of this application *15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved. Please check "yes" above if these alternatives are used and provide narrative information to explain. **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage 2. Does this project comply with the minimum separation requirements for water mains? ® Yes ❑ No ❑ N/A ➢ If no, please refer to 15A NCAC 18C.0906(f) for documentation requirements and submit a separate document, signed/sealed by an NC licensed PE, verifying the criteria outlined in that Rule. 3. Does the project comply with separation requirements for wetlands? ® Yes ❑ No ❑ N/A ➢ Please provide supplementary information identifying the areas of non-conformance. ➢ See the Division's draft separation requirements for situations where separation cannot be met. ➢ No variance is required if the alternative design criteria specified is utilized in design and construction. 4. Is the project located in a river basin subject to any State buffer rules? ❑ Yes Basin name: ® No If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No ➢ This includes Trout Buffered Streams per 15A NCAC 2B.0202 5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ® Yes ❑ No or 401 Water Quality Certifications? ➢ Please provide the permit number/permitting status in the cover letter if coverage/authorization is required. 6. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications must be being prepared, have been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and sedimentation control plans, stormwater management plans, etc.). 7. Does this project include any sewer collection lines that are deemed "high -priority?" ❑ Yes ® No Per 15A NCAC 02T.0402, "high -priority sewer" means any aerial sewer, sewer contacting surface waters, siphon, or sewers positioned parallel to streambanks that are subject to erosion that undermines or deteriorates the sewer. Siphons and sewers suspended through interference/conflict boxes require a variance approval. ➢ If yes, include an attachment with details for each line, including type (aerial line, size, material, and location). High priority lines shall be inspected by the permittee or its representative at least once every six -months and inspections documented per 15A NCAC 02T.0403(a)(5) or the permittee's individual System -Wide Collection permit. FORM: FTA 06-21 Page 4 of 5 X. CERTIFICATIONS: 1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria (latest version) as applicable? ® Yes ❑ No If no, for projects requiring a single variance, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for review to the Central Office. Approval of the request will be issued concurrently with the approval of the permit, and projects requiring a variance approval may be subject to longer review times. For projects requiring two or more variances or where the variance is determined by the Division to be a significant portion of the project, the full technical review is required. 2. Professional Engineer's Certification: I, W. Jordan Brewer , attest that this application for Forest Lake RV Park Expansion (Professional Engineer's name from Application Item III.1.) (Project Name from Application Item II.1) has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications, engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and have judged it to be consistent with the proposed design. NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per violation. Misrepresentation of the application information, including failure to disclose any design non-compliance with the applicable Rules and design criteria, may subject the North Carolina -licensed Professional Engineer to referral to the licensing board. (21 NCAC 56.0701) North Carolina Professional Engineer's seal, signature, and date: IIIIIII I/// .FEScjO'� Jt L 039196 %c.vi '%/, /LOAN '''' /0/III I I I I1\\ 57 /2022 3. Applicant's Certification per 15A NCAC 02T .0106(b): I George Gudgeon attest that this application for Forest Lake RV Park Expansion (Signature Authority Name from Application Item 1.3.) (Project Name from Application Item II.1) attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not completed and that if all required supporting documentation and attachments are not included, this application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition of this permit be violated. I also understand that if all required parts of this application package are not completed and that if all required supporting information and attachments are not included, this application package will be returned to me as incomplete. NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation. Signature:(''''''*..---C:::77 Date: 05/03/2022 FORM: FTA 06-21 Page 5 of 5 1. Pump station number or name: Pump Station 2 2. Approximate Coordinates (Decimal Degrees): Latitude: 35.85914 Longitude: -80.39679 3. Design flow of the pump station: 0.099 millions gallons per day (firm capacity) 4. Operational point(s) of the pump(s): 69 gallons per minute at 80 feet total dynamic head (TDH) 5. Summarize the force main to be permitted (for this Pump Station): Size (inches) Length (ft) Material 2.5 1,250 PVC 6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1): Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T .0305(h)(1)(C) 1. Pump station number or name: Pump Station 3 2. Approximate Coordinates (Decimal Degrees): Latitude: 35.86156 Longitude: -80.3997 3. Design flow of the pump station: 0.121 millions gallons per day (firm capacity) 4. Operational point(s) of the pump(s): 84 gallons per minute at 87 feet total dynamic head (TDH) 5. Summarize the force main to be permitted (for this Pump Station): Size (inches) Length (ft) Material 3.0 1,655 PVC 6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1): Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T .0305(h)(1)(C) 1. Pump station number or name: Pump Station 4 2. Approximate Coordinates (Decimal Degrees): Latitude: 35.863989 Longitude: -80.369520 3. Design flow of the pump station: 0.294 millions gallons per day (firm capacity) 4. Operational point(s) of the pump(s): 204 gallons per minute at 67 feet total dynamic head (TDH) 5. Summarize the force main to be permitted (for this Pump Station): Size (inches) Length (ft) Material 6.0 967 PVC 6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1): Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B) Division of Water Resources State of North Carolina Department of Environmental Quality Division of Water Resources Flow Tracking for Sewer Extension Applications (FTSE 10-18) Entity Requesting Allocation: MHC TT, LLC Project Name for which flow is being requested: Forest Lake RV Park Expansion More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all pump stations along the route of the proposed wastewater flow. I. Complete this section only if you are the owner of the wastewater treatment plant. a. WWTP Facility Name: Forest Lake Preserve Wastewater Irrigation System b. WWTP Facility Permit #: WQ0004972 All flows are in MGD c. WWTP facility's permitted flow 24,400 GPD d. Estimated obligated flow not yet tributary to the WWTP 8,900 GPD e. WWTP facility's actual avg. flow 10,000 GPD f. Total flow for this specific request 8,900 GPD g. Total actual and obligated flows to the facility 18,900 GPD h. Percent of permitted flow used 77.5% II. Complete this section for each pump station you are responsible for along the route of this proposed wastewater flow. List pump stations located between the project connection point and the WWTP: Pump Station (Name or Number) 1 Pump Station Permit No. N/A 2 3 4 Firm Capacity, * MGD (A) Design Average Daily Flow** (Firm / p f), MGD (B) (C) (D)=(B+C) (E)=(A-D) Obligated, Approx. Not Yet Total Current Current Tributary Flow Plus Avg. Daily Daily Flow, Obligated Flow, MGD MGD Flow Available Capacity* * * * The Firm Capacity (design flow) of any pump station is defined as the maximum pumped flow that can be achieved with the largest pump taken out of service. ** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pf) not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria. *** A Planning Assessment Addendum shall be attached for each pump station located between the project connection point and the WWTP where the Available Capacity is < 0. Downstream Facility Name (Sewer): Downstream Permit Number: Page 1 of 6 FTSE 10-18 III. Certification Statement: W. Jordan Brewer certify to the best of my knowledge that the addition of the volume of wastewater to be permitted in this project has been evaluated along the route to the receiving wastewater treatment facility and that the flow from this project is not anticipated to cause any capacity related sanitary sewer overflows or overburden any downstream pump station en route to the receiving treatment plant under normal circumstances, given the implementation of the planned improvements identified in the planning assessment where applicable. This analysis has been performed in accordance with local established policies and procedures using the best available data. This certification applies to those items listed above in Sections I and II plus all attached planning assessment addendums for which I am the responsible party. Signature of this form certifies that the receiving collection system or treatment works has adequate capacity to transport and treat the proposed new wastewater. Signing Official Signature Design Engineer Title of Signing Official 3/5/2021 Page 2 of 6 FTSE 10-18 ROY COOPER Governor DIONNE DELLI-GATTI Secretary S. DANIEL SMITH Director Mr. George Gudgeon, Senior VP MHC TT, L.P. Two N. Riverside Plaza Chicago, IL 60606 NORTH CAROLINA Environmental Quality March 11, 2021 Subject: Permit No. WQ0042371 MHC TT, L.P. Forest Lake RV Park Expansion Wastewater Collection System Extension Permit Davie County Dear Mr. Gudgeon: In accordance with your application received March 8, 2021, we are forwarding herewith Permit No. WQ0042371 dated March 11, 2021, to the MHC TT, L.P. (Permittee) for the construction and operation upon certification of the subject wastewater collection system extension. This permit shall be effective from the date of issuance until rescinded and shall be subject to the conditions and limitations as specified therein. This cover letter shall be considered a part of this permit and is therefore incorporated therein by reference. Please pay particular attention to the following conditions contained within this permit: Condition 11.1: This permit shall not be automatically transferable; a request must be made and approved. Condition 11.4: Requires that the wastewater collection facilities be properly operated and maintained in accordance with 15A NCAC 02T .0403 or any individual system -wide collection system permit issued to the Permittee. Condition 11.7: Upon completion of construction and prior to operation of these permitted facilities, the completed Engineering Certification form with checklist attached to this permit shall be submitted with the required supporting documents to the address provided on the form. Permit modifications are required for any changes resulting in non-compliance with this permit, regulations, or the Minimum Design Criteria. [15A NCAC 02T.0116] It shall be responsibility of the Permittee to ensure that the as -constructed project meets the appropriate design criteria and rules. Failure to comply may result in penalties in accordance with North Carolina General Statute §143-215.6A through §143-215.6C, construction of additional or replacement wastewater collection facilities, and/or referral of the North Carolina -licensed Professional Engineer to the licensing board. Depertm<M pI (1MInMMlasl OuRR� North Carolina Department of Environmental Quality 1 Division of Water Resources Winston-Salem Regional Office 1 450 West Fianes Mill Road, Suite 300 I Winston-Salem, North Carolina 27105 336.776.9800 MHC TT, L.P. Permit No. WQ0042371 If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to request an adjudicatory hearing upon written request within 30 days following receipt of this permit. This request must be in the form of a written petition, conforming to Chapter 150E of North Carolina General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and binding. If you need additional information concerning this matter, please contact Mike Mickey at (336) 776-9692 or via e-mail at mike.mickev@ncdenr.gov. Sincerely, Docalpned by: c OD2D3CE3F1B7458... for S. Daniel Smith Director, Division of Water Resources by Jennifer F. Graznak, Assistant Regional Supervisor Water Quality Regional Operations Section Winston-Salem Regional Office Division of Water Resources, NCDEQ cc: W. Jordan Brewer, PE (Jordan.brewer@kimley-horn.com) Winston-Salem Regional Office Files Water Resources Central Files PERCS (electronic copy) Page 2 of 8 NORTH CAROLINA Environmental Quality — WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as amended, and other applicable Laws, Rules, and Regulations, permission is hereby granted to the MHC TT, L.P. Davie County for the construction and operation of approximately 4,994 linear feet of 8-inch gravity sewer and the following pump stations: • Pump Station #2: a 77-gallon per minute pump station with duplex pumps, on -site audible and visual high water alarms, telemetry, and a portable generator receptacle; as well as approximately 2,800 linear feet of 3-inch force main • Pump Station #3: a 34-gallon per minute pump station with duplex pumps, on -site audible and visual high water alarms, telemetry, and a portable generator receptacle; as well as approximately 200 linear feet of 2-inch force main • Pump Station #4: a 204-gallon per minute pump station with duplex pumps, on -site audible and visual high water alarms, telemetry, and a permanent generator with automatic transfer switch; as well as approximately 967 linear feet of 6-inch force main; to serve 89 new recreational vehicle sites as part of the Forest Lake RV Park Expansion project, and the discharge of 8,900 gallons per day of collected domestic wastewater into the MHC TT, Inc., existing irrigation sewerage system, pursuant to the application received March 8, 2021, and in conformity with 15A NCAC 02T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting data subsequently filed and approved by the Department of Environmental Quality and considered a part of this permit. This permit shall be effective from the date of issuance until rescinded and shall be subject to the specified conditions and limitations contained therein. DocuSigned by: 0D2D3CE3F1B7450... for S. Daniel Smith Director, Division of Water Resources By Authority of The Environmental Management Commission Permit Number: WQ0042371 Permit Issued: March 11, 2021 Page 3 of 8 SUPPLEMENT TO PERMIT COVER SHEET MHC TT, L.P. is hereby authorized to: Construct, and then operate upon certification the aforementioned wastewater collection extension. The sewage and wastewater collected by this system shall be treated in the MHC TT, Inc. Wastewater Irrigation Treatment Facility in accordance with Permit Number WQ0004972. Permitting of this project does not constitute an acceptance of any part of the project that does not meet 15A NCAC 02T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as applicable; and the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable, unless specifically mentioned herein. Division approval is based on acceptance of the certification provided by a North Carolina -licensed Professional Engineer in the application. It shall be the Permittee's responsibility to ensure that the as -constructed project meets the appropriate design criteria and rules. Construction and operation is contingent upon compliance with the Standard Conditions and any Special Conditions identified below. I. SPECIAL CONDITIONS 1. No flow in excess of the quantity permitted herein, 8,900 GPD, shall be made tributary to the subject sewer system until an application for permit modification for an increase in flow has been submitted to and approved by the Division. [15A NCAC 02T.0304(b)] 2. Each pump station shall be clearly and conspicuously posted using a weatherproof sign with a pump station identifying name/number, 24-Hour Emergency telephone number, and name of the owner/operator of the sewer system/pump station and instructions to call the number in the event of alarm activation or other emergency. Simplex pump stations or vacuum sewer pits serving a single- family residence may have a placard or sticker on the control panel in lieu of a sign. (15A NCAC 02T .0305(h)(2)] II. STANDARD CONDITIONS 1. This permit shall not be transferable. In the event there is a desire for the wastewater collection facilities to change ownership, or there is a name change of the Permittee, a formal permit request shall be submitted to the Division accompanied by documentation from the parties involved, and other supporting materials as may be appropriate. The approval of this request shall be considered on its merits and may or may not be approved. [15A NCAC 02T.0116; G.S 143-215.1(d3)] 2. This permit shall become voidable unless the wastewater collection facilities are constructed in accordance with the conditions of this permit; 15A NCAC 02T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting materials unless specifically mentioned herein. (15A NCAC 02T.0110] 3. This permit shall be effective only with respect to the nature and volume of wastes described in the application and other supporting data. [15A NCAC 02T .0110] Page 4 of 8 4. The wastewater collection facilities shall be properly maintained and operated at all times. The Permittee shall maintain compliance with an individual system -wide collection system permit for the operation and maintenance of these facilities as required by 15A NCAC 02T .0403. If an individual permit is not required, the following performance criteria shall be met: a. The sewer system shall be effectively maintained and operated at all times to prevent discharge to land or surface waters, and to prevent any contravention of groundwater standards or surface water standards. b. A map of the sewer system shall be developed and shall be actively maintained. c. An operation and maintenance plan including pump station inspection frequency, preventative maintenance schedule, spare parts inventory and overflow response has been developed and implemented. d. Pump stations that are not connected to a telemetry system shall be inspected every day (i.e. 365 days per year). Pump stations that are connected to a telemetry system shall be inspected at least once per week. e. High -priority sewer lines shall be inspected at least once per every six -months and inspections are documented. f. A general observation of the entire sewer system shall be conducted at least once per year. g. Overflows and bypasses shall be reported to the appropriate Division regional office in accordance with 15A NCAC 2B .0506(a), and public notice shall be provided as required by North Carolina General Statute §143-215.1C. h. A Grease Control Program is in place as follows: 1. For public owned collection systems, the Grease Control Program shall include at least biannual distribution of educational materials for both commercial and residential users and the legal means to require grease interceptors at existing establishments. The plan shall also include legal means for inspections of the grease interceptors, enforcement for violators and the legal means to control grease entering the system from other public and private satellite sewer systems. 2. For privately owned collection systems, the Grease Control Program shall include at least bi- annual distribution of grease education materials to users of the collection system by the permittee or its representative. 3. Grease education materials shall be distributed more often than required in Parts (1) and (2) of this Subparagraph if necessary to prevent grease -related sanitary sewer overflows. i. Right-of-ways and easements shall be maintained in the full easement width for personnel and equipment accessibility. j. Documentation shall be kept for Subparagraphs (a) through (i) of this Rule for a minimum of three years with exception of the map, which shall be maintained for the life of the system. 5. The Permittee shall report by telephone to a water resources staff member at the Winston-Salem Regional Office, telephone number (336) 776-9800, as soon as possible, but in no case more than 24 hours, following the occurrence or first knowledge of the occurrence of either of the following: Page 5 of 8 a. Any process unit failure, due to known or unknown reasons, that renders the facility incapable of adequate wastewater transport, such as mechanical or electrical failures of pumps, line blockage or breakage, etc.; or b. Any SSO and/or spill over 1,000 gallons; or c. Any SSO and/or spill, regardless of volume, that reaches surface water Voice mail messages or faxed information is permissible, but this shall not be considered as the initial verbal report. Overflows and spills occurring outside normal business hours may also be reported to the Division of Emergency Management at telephone number (800) 858-0368 or (919) 733-3300. Persons reporting any of the above occurrences shall file a spill report by completing and submitting Part I of Form CS-SSO (or the most current Division approved form) within five days following first knowledge of the occurrence. This report must outline the actions taken or proposed to be taken to ensure that the problem does not recur. Part II of Form CS-SSO (or the most current Division approved form) can also be completed to show that the SSO was beyond control. [G.S. 143-215.1C(a1)] 6. Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to interrupt service by the existing utilities nor result in an overflow or bypass discharge of wastewater to the surface waters of the State. [15A NCAC 02T.0108(b)] 7. Upon completion of construction and prior to operation of these permitted facilities, the completed Engineering Certification form with checklist attached to this permit shall be submitted with the required supporting documents to the address provided on the form. A complete certification is one where the form is fully executed and the supporting documents are provided as applicable. Any wastewater flow made tributary to the wastewater collection system extension prior to completion of this Engineer's Certification shall be considered a violation of the permit and shall subject the Permittee to appropriate enforcement actions. If the permit is issued to a private entity with an Operational Agreement, then a copy of the Articles of Incorporation, Declarations/Covenants/Restrictions, and Bylaws that have been appropriately filed with the applicable County's Register of Deeds office shall be submitted with the certification. A complete certification is one where the form is fully executed and the supporting documents are provided as applicable. Supporting documentation shall include the following: a. One copy of the project construction record drawings (plan & profile views of sewer lines & force mains) of the wastewater collection system extension. Final record drawings should be clear on the plans or on digital media (CD or DVD disk) and are defined as the design drawings that are marked up or annotated with after construction information and show required buffers, separation distances, material changes, etc. b. One copy of the supporting applicable design calculations including pipe and pump sizing, velocity, pump cycle times, and level control settings, pump station buoyancy, wet well storage, surge protection, detention time in the wet well, and force main, ability to flush low points in force mains with a pump cycle, and downstream sewer capacity analysis. If a portable power source or pump is dedicated to multiple stations, an evaluation of all the pump stations' storage capacities and the rotation schedule of the portable power source or pump, include travel timeframes, shall be provided. Page 6 of 8 c. Changes to the project that do not result in non-compliance with this permit, regulations, or the Minimum Design Criteria should be clearly identified on the record drawings, on the certification in the space provided, or in written summary form. Prior to Certification (Final or Partial): Permit modifications are required for any changes resulting in non-compliance with this permit (including but not limited to pipe length changes of 10% or greater, increased flow, pump station design capacity design increases of 5% or greater, and increases in the number/type of connections), regulations, or the Minimum Design Criteria. Requested modifications or variances to the Minimum Design Criteria will be reviewed on a case -by - case basis and each on its own merit. Please note that variances to the Minimum Design Criteria should be requested and approved during the permitting process prior to construction. After - construction requests are discouraged by the Division and may not be approved, thus requiring replacement or repair prior to certification & activation. [15A NCAC 02T .0116] 8. Gravity sewers installed greater than ten percent below the minimum required slope per the Division's Gravity Sewer Minimum Design Criteria shall not be acceptable and shall not be certified until corrected. If there is an unforeseen obstacle in the field where all viable solutions have been examined, a slope variance can be requested from the Division with firm supporting documentation. This shall be done through a permit modification with fee. Such variance requests will be evaluated on a case -by -case basis. Resolution of such request shall be evident prior to completing and submitting the construction certification. [ 15A NCAC 02T.0105(n)] 9. A copy of the individual permit and construction record drawings shall be maintained on file by the Permittee for the life of the wastewater collection facilities. [15A NCAC 02T .0116] 10. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 02T; the Division's Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Station and Force Mains adopted June 1, 2000 as applicable; and other supporting materials may subject the Permittee to an enforcement action by the Division, in accordance with North Carolina General Statutes §143-215.6A through §143- 215.6C, construction of additional or replacement wastewater collection facilities, and/or referral of the North Carolina -licensed Professional Engineer to the licensing board. [15A NCAC 02T .0108(b-c)] 11. In the event that the wastewater collection facilities fail to perform satisfactorily, including the creation of nuisance conditions, the Permittee shall take immediate corrective action, including those as may be required by this Division, such as the construction of additional or replacement facilities. [15A NCAC 02T .0110; 15A NCAC 02T .0108(b)] 12. The issuance of this permit shall not exempt the Permittee from complying with any and all statutes, rules, regulations, or ordinances that may be imposed by the Division any other Federal, State, or Local government agencies which have jurisdiction or obtaining other permits which maybe required by the Division or any other Federal, State, of Local government agencies. [G.S. 143-215.1(b)] Page 7 of 8 CERTIFICATION CHECKLIST To be completed by the certifying engineer prior to operation of the permitted sewers, per 15A NCAC 02T.0116. Certifying Engineer: Certification Review Date: Project: Forest Lake RV Park Expansion Permit No. WQ0042371 Project County: Davie County 1) Has permittee information changed since the permit was issued (or last modified): change of mailing address, change of ownership, transfer from developer to HOA/POA, etc. ❑ Yes n No • If yes, please provide either a change of ownership form or new contact information. Note that transfer of permits from the developer to the HOA/POA must occur with the first certification. 2) Have the as -built drawings have been signed, sealed, and dated by an N.C. PE? ❑ Yes ❑ No 3) Final Engineering certification? n Yes n No • If Partial Engineering certification, provide detailed narrative including what is being certified in the current phase, what was previously certified (if applicable), and what is left to be certified. 4) Adequate information related to sewer lines: n Yes n No n N/A • Three feet minimum cover has been provided for all sewers unless ferrous pipe was installed. • Minimum diameters for gravity sewers are 8-inches for public lines and 6-inches for private lines. • Manholes have been installed: At the end of each line, at all changes in grade, size, or alignment, at all intersections, and at distances not greater than 425 feet; minimum diameter shall be 4 feet (48-inches). 5) Adequate information related to pump stations: n Yes n No n N/A • Ensure power reliability option was selected per 15A NCAC 02T.0305(h). 6) Was project construction completed in accordance with all of the following: ❑ Yes ❑ No ❑ N/A • 15A NCAC 02T, Minimum Design Criteria (MDC) for the permitting of Gravity Sewers (latest version), and MDC for the Permitting of Pump Stations and Force Mains (latest version)? If not, a variance approval is required in accordance with 15A NCAC 02T.0105(b), prior to certification and operation. • Contact the Central Office to discuss the variance to determine a course of action. • Applicant must submit two copies of the variance request form, plans, specifications, calculations, and any other pertinent information to the Central Office (one hard copy, one digital copy). • The central office will review the variance request, and if approvable, specific language regarding the variance will be incorporated into the permit, either via a special condition or a supplementary letter. A copy of the reissued permit with variance language or the variance letter must be maintained with the original documents. 7) Does the project contains high priority lines (15A NCAC 02T .0402(2))? ❑ Yes ❑ No • If yes, ensure that the permit already contains the necessary condition related to high priority lines 15A NCAC 02T.0403 (a)(5). If the permit does not include this language, the Fast Track reviewer will reissue the permit with the appropriate language. 8) Are Permit modifications are required for any changes resulting in non-compliance with this permit (including but not limited to pipe length changes of 10% or greater, change in flow, pump station design capacity design change of 5% or greater, and/or change in the number/type of connections)? ❑ Yes ❑ No • If yes, a permit modification request must be submitted to the appropriate Regional Office, and a modified permit with revised certification must be issued prior to certification and operation. NC DWR — Water Quality Regional Operations Section 450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105 Winston-Salem Regional Office Phone: (336) 776-9800 FAX: (336) 776-9798 FAST TRACK SEWER ENGINEERING CERTIFICATION PERMITTEE: MHC TT, L.P. PERMIT #: WQ0042371 PROJECT: Forest Lake RV Park Expansion ISSUE DATE: March 11, 2021 This project shall not be considered complete nor allowed to operate in accordance with Condition 7 of this permit until the Division has received this Certification and all required supporting documentation. It should be submitted in a manner that documents the Division's receipt. Send the required documentation the Regional Supervisor, Water Quality Regional Operations Section at the address at the bottom. Any wastewater flow made tributary to the wastewater collection system extension prior to completion of this Certification shall be considered a violation of the permit and shall subject the Permittee to appropriate enforcement actions. The Permittee is responsible for tracking all partial certifications up until a final certification is received. A Final Certification shall be a complete set of record drawings and design calculations regardless of whether partials have been submitted. PERMITTEE'S CERTIFICATION I, the undersigned agent for the Permittee, hereby state that this project has been constructed pursuant to the applicable standards & requirements, the Professional Engineer below has provided applicable design/construction information to the Permittee, and the Permittee is prepared to operate & maintain the wastewater collection system permitted herein or portions thereof. Printed Name, Title Signature ENGINEERS CERTIFICATION Date I, , as a duly registered Professional Engineer in the State of North Carolina, having been authorized to observe (❑ periodically, n weekly, ❑ full time) the construction of the Forest Lake RV Park Expansion and location as referenced above for the above Permittee hereby state that, to the best of my abilities, due care and diligence was used in the observation of the following construction: approximately 4,994 linear feet of 8-inch gravity sewer and the following pump stations: Pump Station #2: a 77-gallon per minute pump station with duplex pumps, on -site audible and visual high water alarms, telemetry, and a portable generator receptacle; as well as approximately 2,800 linear feet of 3-inch force main: Pump Station #3: a 34-gallon per minute pump station with duplex pumps, on -site audible and visual high water alarms, telemetry, and a portable generator receptacle; as well as approximately 200 linear feet of 2-inch force main: Pump Station #4: a 204-gallon per minute pump station with duplex pumps, on -site audible and visual high water alarms, telemetry, and a permanent generator with automatic transfer switch; as well as approximately 967 linear feet of 6-inch force main; to serve 89 new recreational vehicle sites as part of the Forest Lake RV Park Expansion project, and the discharge of 8,900 gallons per day of collected domestic wastewater into the MHC TT, Inc., existing irrigation sewerage system, pursuant to the application received March 8, 2021; such that the construction was observed to be built within substantial compliance of this permit; 15A NCAC 02T; the Division of Water Resources' (Division) Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting materials. North Carolina Professional Engineer's Seal w/signature & date: ❑ Final ❑ Partial (include description) Certification Comments/Qualifiers (attach if necessary): NC DWR — Water Quality Regional Operations Section 450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105 Winston-Salem Regional Office Phone: (336) 776-9800 FAX: (336) 776-9798 5. Name of Registered Agent: DocuSign Envelope ID: 4A577F99-195C-433D-9B32-C320E201 DC88 State of North Carolina Department of the Secretary of State SOSID: 2016964 Date Filed: 7/27/2020 11:17:00 AM Elaine F. Marshall North Carolina Secretary of State C2020 206 00984 APPLICATION FOR REGISTRATION AS A FOREIGN LIMITED PARTNERSHIP Pursuant to §59-902 of the General Statutes of North Carolina, the undersigned hereby submits this application for Registration as a Foreign Limited Partnership for the purpose of obtaining a Certificate of Authority to transact business in this State. MHC TT, L.P. 1. The name of the foreign limited partnership is: 2. If the name of the foreign limited partnership is unavailable for use in the State of North Carolina, the name the limited partnership wishes to use is: (The name must contain the words "Limited Partnership," or the abbreviation "L.P." or "LP," or the combination "Ltd. Partnership".) Delaware 3. The jurisdiction in which the limited partnership was formed is and the date of formation was 10/1/1996 perpetual 4. The street address of the principal office is: Two N. Riverside Plaza, Suite 800 Number and Street: . The limited partnership's period of duration is Chicago IL 60606 Cook City: State: Zip Code: County: The mailing address, if different from the street address, of the principal office: (312) 279-1670 Telephone: Number and Street: City: State: Zip Code: County: C T Corporation System 6. Address of Registered Agent's Office: 160 Mine Lake Ct., Ste. 200 Number and Street: Raleigh 27615-6417 Wake City: State: NC Zip Code: County: The mailing address, if different from the street address, of the registered office: Number and Street: City: State: NC Zip Code: NOTES: Filing fee is $50. This document must be filed with the Secretary of State. County: BUSINESS REGISTRATION DIVISION (Revised August, 2017) NC046 - 1 l/9/2017 Wolters Kluwer Online P.O.BOX 29622 Page 1 RALEIGH, NC 27626-06222 Form LP-04 DocuSign Envelope ID: 4A577F99-195C-433D-9B32-C320E201 DC88 7. In consideration of the issuance of a Certificate of Authority to transact business in North Carolina, the limited partnership appoints the Secretary of State of North Carolina as the agent to receive service of process, notice or demand, whenever the foreign limited partnership fails to appoint or maintain a registered agent in this State, or whenever such registered agent cannot with reasonable diligence be found at the registered office. 8. (Optional): Please provide a business e-mail address: The Secretary of State's Office will e-mail the business automatically at the address provided at no charge when a document is filed. The e-mail provided will not be viewable on the website. For more information on why this service is being offered, please see the instructions for this document. Privacy Redaction 9. Enter the name and address of each general partner: (attach additional sheets if necessary) Name MHC Trails GP, L.L.C. Name Two N. Riverside Plaza, Suite 800 Street/No. Street/No. City Chicago City IL / 60606 State/Zip State/Zip 10. Limited Partners (select 1 or 2, as appropriate) ❑ Attached is a list of the names and addresses of all limited partners (include full name/street address/city/state/zip code/county); or x❑ The location of the office where list of the names and addresses of the limited partners and their capital contributions will be kept as long as the limited partnership transacts business in North Carolina is: Number and Street: Two N. Riverside Plaza, Suite 800 City: Chicago State: IL Zip Code: 60606 County: Cook 11. (Select one) ❑ The foreign limited partnership is a foreign limited liability limited partnership. ❑X The foreign limited partnership is not a foreign limited liability limited partnership. 12. This registration will be effective upon filing, unless a future date and/or time is specified: NOTES: Filing fee is $50. This document must be filed with the Secretary of State. Walter B. Jaccard Typed or printed name rDocusignedeby. w4did C55444DOAAEC46A... Signatur Vice President of MHC Trails GP, L.L.C., general partner Title BUSINESS REGISTRATION DIVISION (Revised August, 2017) NC046 - 1 l/9/2017 Wolters Kluwer Online P.O.BOX 29622 Page 2 RALEIGH, NC 27626-06222 Form LP-04 Delaware The First State Page 1 I, JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF DELAWARE, DO HEREBY CERTIFY "MHC TT, L.P." IS DULY FORMED UNDER THE LAWS OF THE STATE OF DELAWARE AND IS IN GOOD STANDING AND HAS A LEGAL EXISTENCE SO FAR AS THE RECORDS OF THIS OFFICE SHOW, AS OF THE SIXTEENTH DAY OF JULY, A.D. 2020. AND I DO HEREBY FURTHER CERTIFY THAT THE ANNUAL TAXES HAVE BEEN PAID TO DATE. 2669212 8300 SR# 20206262050 Authentication: 203294133 Date: 07-16-20 You may verify this certificate online at corp.delaware.gov/authver.shtml Brewer, Jordan From: Marisa Kolman <marisa_kolman@equitylifestyle.com> Sent: Friday, March 5, 2021 3:08 PM To: Brewer, Jordan Subject: Forest Lake TT Project Categories: External Jordan, Regarding the Forest Lake TT RV expansion project, the portable power generation unit or portable, independently - powered pumping units, associated appurtenances, and personnel are available for distribution and operation of these proposed pump stations. Thanks, else Marisa Kolman Land & Site Development Manager Equity LifeStyle Properties marisa_kolman@equitylifestyle.com p (312) 279-1414 c (708) 705-3980 Chicago Office • Two N. Riverside Plaza Chicago, IL 60606 equitylifestyleproperties.com 1 FOREST LAKE RV PARK AERIAL Google Earth © 2021 Google 1000 ft PARTMENT OF THE USGS U.S. DE U.S. GEOLOGICAL SURVEY soma br. a changing um. USTopo CHURCHLAND QUADRANGLE NORTH CAROLINA 7.5-MINUTE SERIES 1`170111PN 69 68 67 66 65 64 63 62 61 60 59 58 57 377,101 546°TME 46 47 47 Produced by the United States Geological Survey sai 48 48 49 49 50 50 SCALE 1:24 000 0 KILOMETERS 52 52 1000 53 Ile 54 55 55 ROAD CLASSIFICATION 56 556791E milt ,nam x�la [mil a weu,e 0 aam CHURCHLAND, NC 2019 11111111111111111111111111111111111111111111111111111111111111