WQ0041748_Application (FTSE) Modification_20240404

PARAMOUNTE
E N C3 I N- E E F2 1 N C3 . 1 N C.
1 2 2 CINEMA DRIVE
W I L M I N G T O N, N C 2 8 4 0 3
9 1 0- 7 9 1- 6 7 0 7( O) 9 1 0- 7 9 1- 6 7 6 0 ( F)
T. F T T F R O F T R A N S M I T T A L
To:
CDEQ
Date
05/03/2024
943 Washington Square Mall
Vlashington, NC 27889
Re:
New Rem Affinity Assisted Living
252-946-6481
1
Modification to W 1748
Attn:
Sarah Toppen
Project No.
I 18491.PE
e are sendingi
❑ Originals
❑ Prints
❑ Shop Drawings
❑ Calculations
❑ Correspondence
❑ Plans
❑ Specifications
® Other as listed below
trhe follows items
Quantity
Date
Dw . No.
Description
1
$120 check(remaining amount of $600 review flee
ssue Statue. ❑ For Approval ❑ As Requested ❑ Construction ❑ Bid
® For Your Use ❑ For Review and Comment ❑ Approved as Noted ❑ See Remarks
don Taken ❑ No Exceptions Taken ❑ Make Corrections Noted ❑ Amend & Resubmit
❑ Rejected - See Remarks ❑ Approved as Submitted ❑ Other
marks•
Cc.
MAY - 6 2024
Water oualtty
Regional OpFrations Sedan
Washington Regional OfAoe
Signed:

�Division of Water Resources
Application Number:
State of North Carolina
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 10-23 & SUPPORTING DOCUMENTATION
(to be completed by DWR)
Ali items must be completed or the application will be returned
L APPLICANT INFORMATION:
1. Applicant's name: Craven Propco, LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ❑ Municipal ❑ Other
3. Signature authority's name: Charles E. Trefzger, Jr. per 15A NCAC 02T .0106(b)
Title: Mana>zer
4. Applicant's mailing address: PO Box 2568
City: Hickory State: NC Zip: 28604-
5. Applicant's contact information:
Phone number: (_) _- Email Address: carter.kellerAcarolinacommercialnc.com
H. PROJECT INFORMATION:
1. Project name: New Bern Affinity Assisted Living
2. Application/Project status: ❑ Proposed (New Permit) ® Existing Permit/Project
If a modification, provide the existing permit number: WQ0041748 and issued date: 06/16/2020,
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: WQ00
3. County where project is located: Craven
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.028013' Longitude:-77.009541°
5. Parcel ID (if applicable): 7-104-24000 (or Parcel ID to closest downstream sewer)
M. CONSULTANT INFORMATION:
1. Professional Engineer: Andrew Richards License Number: Q52507
Firm: Paramounte En ig neerin&. Inc.
Mailing address: 122 Cinema Drive
City: Wilmington State: NQ Zip: 28403-
Phone number: (21Q) 721-6707 Email Address: arichardsgparamounte-eng cam
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: City of New Bcm WWTF Permit Number: NC 0025348
Owner Name: City of New Bern
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ
2. Downstream (Receiving) Sewer Information: inch ❑ Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s):
FORM: FTA 10-23 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 Developgr'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) ❑ Car Wash
❑ Residential (Leased) ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool/Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ® Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic % Commercial % Industrial (See 15A NCAC 02T .0103(20))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(fl? ❑ Yes ®No
➢ If yes provide a Copy of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow a.b
No. of Units
Flow
Nursing Home
60 gal/bed
160
9,600 GPD
gall
GPD
gal/
GPD
gal/
GPD
gall
GPD
gal/
GPD
Total
9,600 GPD
a See 15A NCAC 02T 0114(b) (d). (e)(1) and (e)(2) for caveats to wastewater design flow rates (i.e. proposed unknown
non-residential development uses; public access facilities located new high public use areas; and residential property
located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined in G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.01141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 9.600 GPD (per 15A NCAC 02T .0114 and G.S. 143-215.1)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, please indicate why:
❑ 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.
❑ Flow has already been allocated in Permit Number: Issuance Date:
❑ Rehabilitation or replacement of existing sewers with no new flow expected
❑ Other (Explain):
FORM: FTA 10-23 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
509
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:
2. Approximate Coordinates (Decimal Degrees): Latitude: 0Longitude: - °
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.l.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 ❑ 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 10-23 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations/altematives found in 15A NCAC 02T .0305(f) & (a)? ® Yes ❑ No
1 c A NT(' A (' MT 0'10c,(f) contains minimum gPnarations that shall be provided for sewer systems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
18 inches
'Water mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
'Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
**Any private or public water supply source, including any wells, WS-I waters of Class I or
Class 1I impounded reservoirs used as a source of drinking water, and associated wetlands.
**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)
100 feet
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.
Any building foundation (horizontal)
10 feet
5 feet
Any basement (horizontal)
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
Drainage systems and interceptor drains
10 feet
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
➢ If noncompliance with 02T.0305(fl or (a), 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.
➢ Seethe 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: Neuse ❑ 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.02-02
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 0210105(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 10-23 Page 4 of 5

YL CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria (latest version) as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's
QQCertifi/I cation:
I, �n ci r-�-t� 1�1�'1 attest that this application for
(Professional Engineer's name from Application Item Elf.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, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.613, 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. n
North Carolina Professional Engineer's seal, signature, and date:
SW
:y-MAW -p=
Off- 1N- - 6' P-e
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, Charles E. Trefzger, Jr., Manager attest that this application for
(Signature Authority's name & title from Application Item I.3.)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
of this permit be violated. I also understand that if all required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as w94 as civil penalties up to $25,000 per violation.
Signature: By: v �JIG�x� Date:Mdoeti�S
Charles E. Tr ger, Jr., Manag
FORM: FTA 04-16 Page 5 of 5

R5CENED/NCDENR/DWR
APR _ 4 2024
z� �atlor�
11riim, jtmn k3e�lora1 L�'ir�a
NEW BERN AFFINITY ASSSITED LIVING
MODIFICATION TO W00041748
CRAVEN COUNTY, NORTH CAROLINA
SANITARY SEWER DESIGN NARRATIVE
Prepared for:
CAROLINA COMMERCIAL CONTRACTORS, LLC
PO Box 130
Sanford, NC 27331
Prepared by:
PARAMOUNTS
E N C3 1 N E E R I N Q, I N C.
122 Cinema Drive
Wilmington, NC 28403
Project #18491.PE
April 2024
Nc R°4
Z 052507 : /
� quu ❑11Pttt\

PROTECT NARRATIVE
The property served by this proposed sewer extension lies off of Waterscape Way in the City of
New Bern. The latitude and longitude of 35°01'41'N, 77°00'35"W. The project is within a drainage
basin which drains to the Neuse River. The receiving stream is the Brice Creek (C;Sw, NSW). Per
the NRCS Soil Survey of Craven County the soil across the site consists of Grantham silt loam (Gr)
and Rains fine sandy loam (Ra), while the ground cover consists of fair woodlands.
Carolina Commercial Contractors, LLC desires to install a gravity sewer system to serve a
�j commercial assisted living complex. It is proposed that wastewater from the development,
calculated to be 9,600 GPD, be ultimately collected and carried to the City of New Bern WWTF and
�v downstream pump station. Per town request, all the flow is placed on the private application with
the public sewer application having zero flow.
This project is permitted through NCDEQ by existing permit WQ0041748. The permit will need to
be odified since the linear feet listed on the permit (845 LF of 8'�
mis not within the 10% allowance
shown on the as-builts (509 LF). We are requesting the modified permit to allow for 509 LF of 8"
private gravity sewer. I

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4

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3l'JM'tlMf-0Ib%Mlx

RECEMED/NCDENR/DWR
APR m 4 2024
State of North Carolina
Water O
ions! O eratti� "upi onent of Environmental Quality
on
-'r''::?:` ' Washington Regional office Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: City of New Bern
Project Name for which flow is being requested: New Bern Affinity Assisted Living
More than one FTSF may be required for a single project tf the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: City of New Berms
b. WWTP Facility Permit #: NCO025348
All flows are in MGD
c. WWTP facility's permitted flow 6.500
d. Estimated obligated flow not yet tributary to the WWTP 0.556
e. WWTP facility's actual avg. flow 4.026
f. Total flow for this specific request 0.0096
g. Total actual and obligated flows to the facility 4.5916
h. Percent of peimitted flow used 70.64%
H. 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:
(A)
M
(C)
(D)=(B+C)
(EMA-D)
Design
Obligated,
PUMP Average Daily
Approx.
Not Yet
Total Current
Station Firm Flow* *
Current Avg.
Tributary
Flow Plus
(Name or Capacity, * (Firm / p f),
Daily Flow,
Daily Flow,
Obligated
Available
Number) MGD MGD
MGD
MGD
Flow
Capacity's**
LS No. 95 0.769 0.301
0.108
0,010
0.118
0.183
EQ Basin 1,775 0.710
0.503
0.220
0.723
-0.013
LS No. 10 2.160 0.864
0.729
0.250
0.979
-0.115
* The Firm Capacity of any pump station is defined as the maximum pumped flow that
can be achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station divided by a pealing
factor (pf) not less than 2.5.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): New Bern WWTP
Downstream Peamit Number: NCO025348
Page 1 of 6
T—ro T,T nA iL

III, Cerii_fm4on Statement:
I Mark Stephens, City Manager 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 theplanning assessment where applicable. Ibis 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 addendum for which I am the responsible party. Signature of this
form indicates acceptance of this wastewater flow.
Signing Official
Date
Page 2of6
T-710r AA 7 --

PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum for each pump station listed in Section II where Available
Capacity is < 0.
Pump Station (Name or Number):
Given that:
a. The proportion and amount of Obligated, Not Yet Tributary Daily Flow (C) accounts for
31 % and 0.220 MGD of the Available Capacity (B) in Pump Station
EO Basin ; and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately
0.021. MGD per year; and that
c. A funded Capital Project that will provide the required planned capacity, namely
Township No. Phase -III Sewer Imporvements is in design or under construction with
planned completion in 2021 ; and/or
d. The following applies:
_The City of New Bern has established a project fund for the Township No. 7 - Phase III
Sewer Improvements proejct and the project is currently in the permitting phase. The design
is complete and the City is working to obtain the permits & easements for the project
construction Ths project will add 1.20 MGD of caicity to the EQ Basin. Inclusion of this
proposed capital project as a condition of this Flow Tracking/Acceptance for Sewer
Extension Permit. Application elevates this project's priority for funding and construction
to be implemented ahead of the activaion of obligated, not yet tributary flows in amounts
that exceed the firm pump station capacities identified in Section II above.
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to
allow this flow to be permitted, without a significant likelihood of over -allocating capacity in the
system infrastructure.
I understand that this does not relieve the collection system owner R-om complying with G.S. 143-
215.67(a) which prohibits the introduction of any waste in excess of the capacity of the waste
disposal system.
Signing
S
Page 3 of 6

PLANNING- ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum for each pump station listed in Section IT where Available
Capacity is < 0.
Pump Station (Name or Number):
Given that:
a.. The proportion and amount of Obligated, Not Yet Tributary Daily Flow (C) accounts for
29 % and 0.250 MGD of the Available Capacity (E) in Pump Station
LS No. 10 ; and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately
0.021 MGD per year; and that
c. A funded Capital Project that will provide the required planned capacity, namely
Township No. Phase -III Sewer Imporvements is in design or under construction with
planned completion in 2021 ; and/or
d. The following applies:
The City of New Bern has established a project fund for the Township No. 7 - Phase III
Sewer Improvements proejct and the project is currently in the design phase. The design
is currently 80% and the City is working to obtain the easements needed for the project
construction. Ths project will add 0.550 MGD of caicity to LS No. 10. Inclusion of this
proposed capital project as a condition of this Flow Tracking/Acceptance for Sewer
Extension Permit Application elevates this project's priority for .funding and construction
to be implemented ahead of the activaion of obligated, not yet tributary flows in amounts
that exceed the frnn pump station capacities identified in Section II above.
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to
allow this flow to he permitted, without a significant likelihood of over -allocating capacity in the
system infrastructure.
I understand that this does not relieve the collection system owner from complying with G.S. 143-
215.67(a) which prohibits the introduction of any waste in excess of the capacity of the waste
disposal system.
Signing
-rh't/La
Page 3 of 6
T Tn l, A A 1

ROY COOPER
Governor
MiCHAEL S. REGAN
seaerory
S. DANIEL SMITH
Diredor
Charles E. Trefzger, Jr., Manager
Craven Propco, LLC
P O Box 2568
Hickory, NC 28601
NORTH CAROUNA
Environmental Quattty
June 16, 2020
Subject: Permit No. WQ0041748
Craven Propco, LLC
New Bern Affinity Assisted Living- Private Sewer
Wastewater Collection System Extension Permit
Craven County
Dear Mr. Trefzger:
APR - 4 2024
Reglon,,a .) ar Quality
erado
WashlVol) Regbgl
In accordance with your application received June 12, 2020, we are forwarding herewith Permit No.
WQ0041748 dated June 16, 2020, to Craven Propco, 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.
Please pay particular attention to the following conditions contained within this permit:
Condition IIA: 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 priorto 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 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

Craven Propco, LLC
New Bern Affinity Assisted Living- Private Sewer
Permit No. WQ0041748
June 16, 2020
wastewater collection facilities, and/or referral of the North Carolina -licensed Professional Engineer to
the licensing board.
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 Sarah Toppen at (252) 948-
3845 or via e-mail at [e-mail].
Sincerely,
P16x TA-11"
forS. Daniel Smith
Director, Division of Water Resources
by Robert Tankard, Assistant Regional Supervisor
Water Quality Regional Operations Section
Washington Regional Office
Division of Water Resources, NCDEQ
cc: Tim Clinkscales ([e-mail]
Laserflche
Page 2 of 7

NORTH ftww CAROM'
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
Craven Propco, LLC
Craven County
for the construction and operation of approximately 845 linear feet of 8-Inch gravity sewer; to serve as
part of the New Bern Affinity Assisted Living- Private Sewer project (PROJECT INFO- 160-bed assisted
living/nursing home) and the discharge of 9,600 gallons per day of collected domestic and commercial
wastewater into the City of New Bern's existing sewerage system, pursuant to the application received
June 12, 2020, 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.
forS. Daniel Smith
Director, Division of Water Resources
By Authority of The Environmental Management Commission
Permit Number: WQ0041748
Permit Issued: June 16, 2020
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SUPPLEMENT TO PERMIT COVER SHEET
Craven Propco, 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 New Bern's Wastewater
Treatment Facility In accordance with Permit Number NC0025348.
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. This permit shall become voidable unless the agreement between Craven Propco, LLC and the City of
New Bern's existing sewerage system for the collection and final treatment of wastewater is in full
force and effect. [15A NCAC 02T.0304(g)]
2. No flow in excess of the quantity permitted herein, 9,600 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)]
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 Permiee, 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)]
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]
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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 forthe
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:
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.
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.
The Permittee shall report by telephone to a water resources staff member at the Washington
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:
Page 5 of 7

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 [phone] 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)]
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
Permlttee to appropriate enforcement actions.
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:
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.
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
Page 6 of 7

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 priorto 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 §143-215.6Athrough §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 bythe 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 7

CERTIFICATION CHEC LIST
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: New Bern Affinity Assisted Living- Private Sewer
Permit No. WOQQ41748 Project County: Craven
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 certtflcation, 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 fMv DC
for the Permitting of Pump Stations and Force Mains (latest version)?
If not, a variance approval is required in accordance with 15A NCAC 02T.pip5(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 943 Washington Square Mall, Washington, NC 27889
Washington Regional Office Phone: [phone] FAX: [phone]

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE: Craven Propco, LLC
PERMIT #: WQ0041748
PROJECT: New Bern Affinity Assisted Living- Private Sewer
ISSUE DATE: June 16, 2020
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 En ineer 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:
approximately 845 linear feet of 8-inch gravity sewer; to serve as part of the New Bern Affinity Assisted
Living- Private Sewer project (PROJECT INFO- 160-bed nursing home) and the discharge of 9,600 gallons
per day of collected domestic and commercial wastewater into the City of New Bern's existing sewerage
system; 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/Quallflers (attach if necessary):
NC DWR — Water Quality Regional Operations Section 943 Washington Square Mall, Washington, NC 27889
Washington Regional Office Phone: [phone] FAX: [phone]