WQ0043968_Permit (Issuance)_20221208

ROY COOPER
Governor
ELIZABETH 5. B1SER
secretary
RICHARD E. ROGERS. JR.
Director
NORTH CAROLINA
ErtPfronitmental Qa I1ty
December 8, 2022
John Stubbs, Manager
Davis Moore Acquisition, LLC
2333 Randolph Rd. Suite 115
Charlotte, NC 28207
Subject: Permit No. WQ0043968
Davis Moore Acquisition, LLC
Mt. Holly Medical Park
Wastewater Collection System Extension Permit
Gaston County
Dear Mr. Stubbs:
In accordance with your application received December 2, 2022, we are forwarding herewith Permit
No. WQ0043968 dated December 8, 2022 to Davis Moore Acquisition, LLC (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This permit shall be effective from the date of issuance until rescinded and shall be subject to the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.
following conditions contained within this permit:
Condition II.1: This permit shall not be automatically transferable; a request must be made and
approved.
Condition II.4: Requires that the wastewater collection facilities be properly operated and maintained
in accordance with 15A NCAC 2T .0403 or any individual system -wide collection
system permit issued to the Permittee.
It shall be the 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.
DE
North Carolina Department of Environmental Quality I Division of Water Resource-5
Mooresville RtgloriakOrfOor I fiID East Center Avenue, Stine 301 I Moarrsrdle, NorthCaro/lna 2811S
70 i.663.1691

Davis Moore Acquisition
Permit No. WQ0043968
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 150B 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 Ori Tuvia at [phone]
or via e-mail at [e-mail].
Sincerely,
DocuSigned by:
,44 w H P;zyt'
F161 FB69A2D84A3...
for Richard E. Rodgers, Jr.
Director, Division of Water Resources
by Andrew H. Pitner, P.G., Assistant Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ
cc: David Starkel, P.E. (E-copy)
Mooresville Regional Office Files (Laserfiche)
Water Resources Central Files (Laserfiche)
Municipal Permitting Unit (electronic copy)
Page 2 of 10

NORTH CAROLINA
Ettwlrn i r1ental 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
Davis Moore Acquisition, LLC
Gaston County
for the construction and operation of approximately 795 linear feet of 8-inch gravity sewer, 812
linear feet of 3-inch force main, 53 gallons per minute grinder duplex pump with 42 feet of
TDH, and is equipped with on -site audible and visual high water alarms, telemetry, and a
standby power source with automatic activation, to serve 2 medical buildings as part of Mt.
Holly Medical Park development, and the discharge of 4,000 gallons per day of collected
wastewater into the City of Mount Holly's existing sewerage system, pursuant to the
application received December 2, 2022, and in conformity with 15A NCAC 2T; 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.
Docu Signed by:
p,,Qacw H P;Ue4
F161 FB69A2D84A3...
for Richard E. Rodgers, Jr.
Director, Division of Water Resources
by Andrew H. Pitner, P.G., Assistant Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ
By authority of the Environmental Management Commission
Permit Number: WQ0043968
Permit Issued: December 8, 2022

SUPPLEMENT TO PERMIT COVER SHEET
Davis Moore Acquisition, LLC 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 City of Mount Holly's Regional
Wastewater Treatment Facility in accordance with Permit Number NC0021156.
Permitting of this project does not constitute an acceptance of any part of the project that does not meet
15A NCAC 2T; 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. This permit shall become voidable unless the agreement between Davis Moore Acquisition,
LLC and the City of Mount Holly for the collection and final treatment of wastewater is in
full force and effect. [15A NCAC 02T.0304(h)]
2. No flow in excess of the quantity permitted herein, 4,000 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)]
3. 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)]
4. The Operational Agreement between the Permittee and the Environmental Management
Commission is incorporated herein by reference and shall be a condition of this permit.
Noncompliance with the terms of the Operational Agreement shall subject the Permittee to all
sanctions provided by North Carolina General Statutes § 143-215.6A to § 143-215.6C for
violation of or failure to act in accordance with the terms and conditions of this permit. [15A
NCAC 02T.0115]
II. STANDARD CONDITIONS
1. This permit is not 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.0104;
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 2T; 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]
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 2T
.0403. If an individual permit is not required, the following performance criteria shall be
met: [15A NCAC 02T .0108(b)]:
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 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 § 143-215.1 C.
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 Mooresville
Regional Office, telephone number [phone], 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:
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 [phone]. 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 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.
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 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 2T;
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 .0104; 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)]

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 Name:
WQ00 Project 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 ❑ 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? ❑ Yes ❑ 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: ❑ Yes ❑ No ❑ 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: ❑ Yes ❑ No ❑ 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)? n Yes n 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 610 East Center Avenue, Suite 301, Mooresville, NC 28115
Mooresville Regional Office Phone: [phone] FAX: [phone]

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE: DAVIS MOORE ACQUISITION, LLC
PERMIT #: WQ0043968
PROJECT: MT. HOLLY MEDICAL PARK
ISSUE DATE: DECEMBER 8, 2022
This project shall not be considered complete nor allowed to operate in accordance with standard
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 to the Regional Supervisor, Water Quality Regional Operations Section at the
address noted in the page footer.
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 by the Division. 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 Date
ENGINEER'S CERTIFICATION
I, , as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe (❑ periodically, ❑ weekly, ❑ full time) the construction of the
project name 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:
795 linear feet of 8-inch gravity sewer, 812 linear feet of 3-inch force main, 53 gallons per
minute grinder duplex pump with 42 feet of TDH, and is equipped with on -site audible and
visual high water alarms, telemetry, and a standby power source with automatic
activation,; 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 610 East Center Avenue, Suite 301, Mooresville, NC 28115
Mooresville Regional Office Phone: [phone] FAX: [phone]