WQ0041944_Application (FTSE)_20200828

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of Water, Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & 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: Wake Forest University Health Sciences (company, municipality, FICA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ❑ Municipal ❑ Other
3. Signature authority's name: Ms. Karen H. Huey per 15A NCAC 02T .0106(b)
Title: Vice President of Facilities
4. Applicant's mailing address: Medical Center Blvd
City: Winston Salem State: NC Zip: 27157
NC Department of
Environmental Quality
*.. Received
AUG 2 8 2020
5. Applicant's contact information:
Winston-Salem
Phone number: 336) 716-2963 Email Address: [e-mail] Regional Office
II. PROJECT INFORMATION:
1. Project name: WFBH - Clarkson Campus Modular Lab
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: W000_ and issued date:
If new construction but part of a master plan, provide the existing permit number: W000_
3. County where project is located: Forsyth
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.000016' Longitude:-80.324420'
5. Parcel ID (if applicable): Forsyth County GIS PIN 6802-71-5081.00
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Kelway L. Howard III, P.E. License Number: 027912
Firm: Stimmel Associates, P.A.
Mailing address: 601 N. Trade St., Suite 200
City: Winston-Salem State: NC Zip: 27101-
Phone number: [phone] Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Lower Muddy Creek Permit Number: NCO050342
Owner Name: WS/FC Utility Commission
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQCS00003 Downstream (Receiving) Sewer Size: 36 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS00003
Owner Name(s): WS/FC Utility Commission
FORM: FTA 04-16 Page] of 5

Vl. GENERAL REQUIREMENTS
I. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑No ®N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been attached?
❑ Yes ❑No ®N/A
3. If the Applicant is a Home/Property Owners' Association has an Operational Agreement (FORM: HOA) been attached?
❑ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
❑ Residential Owned ❑ 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 : % Domestic/Commercial 100 % Commercial
_ % Industrial (See 15A NCAC 02T .0103(20))
L---*Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes ®No
➢ If Yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 021.0114(fll
Daily Design Flow °,b
No. of Units
Flow
Medical /Veterinary Lab
250 gal/practitioner/shift
6
1,500 GPD
Animal Boarding
20 gal/cage
20
400 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
1,900 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.01141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 1 900 GPD (per 15A NCAC 02T .0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04- l6 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
8 352 D.I.
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIIL PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: - °
3. Design flow of the pump station: _ millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): _ gallons per minute at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(I):
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B)_
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C):
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T.0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T.0305(f) & (g)
➢ 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
® Yes ❑ No
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
24 inches
Water mains (vertical -water over sewer including in benched trenches)
18 inches
Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
**Any private or public water supply source, including any wells, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water (or tide elevation) and wetlands (see item IX.2)
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
An s immingpools
10 feet
Final earth grade (vertical)
36 inches
➢ 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
➢ If noncompliance with 02T.0305(f) or (2), see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes []No ❑ N/A
➢ See the Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .02009 ® Yes ❑ No ❑ N/A
➢ This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project require coverage/authorization under a 404 Nationwide or [—]Yes ® No
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ® No ❑ N/A
➢ If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and inspections
documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
I. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria (latest version) as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
L-
M
Engineer's name from Application Item III.1.)
that this application for
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.613, 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. h ^
North Carolina Professional Engineer's seal, signature, and date:
a 'SEAL r.'_� _
02791
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3. Applicant's Certification per 15A NCAC 02T .0106(b):
VI L''G 'Rj 6erI1JJE=-r1 T , Md 1W T 16;5 attest that this application for
SSSignature Authorily's name & title from Application Item I.3.)
WAKE ASS7= V Ut~.11V1r--Re-LTA' NEAL'TK SO(6NGt;5
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.
(NflKE GF QN(0.�R51 i Y HC-AUTH SC-VF ICe5 Q lGy
Signature : / 1 Date: O C I ov")v
�f l �' f: 'P'I�j.ESI DE�1`f , 'F1{�' I I- lT►'(✓S
FORM: FTA 04-16 Page 5 of 5

State of North Carolina
a
t3iv's•st�s� ts: t��/<;i'a�r R;�=�t>tarF.���;
Entity Requesting Allocation:
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
WFU Health Sciences
Project Name for which flow is being requested: WFBH-Clarkson Campus Modular Lab
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all puntp
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: MUDDY CREEK
b. WWTP Facility Permit #: NC0050342
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
All flows are in MGD
21.000000
2.998035
16.690 )00
0.001900
19.689935
93.8%
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:
(A)
(B)
(C) (D)=(B+C)
(r)=(A-D)
Design
Obligated,
Pump
Pump
Average
Approx.
Not Yet Total Current
Station
Station
Firm Daily Flow**
Current
Tributary Flow Plus
(Name or
Permit
Capacity, * (Firm / pf),
Avg. Daily
Daily Flow, Obligated
Available
Number)
No.
MGD MGD
Flow, MGD
MGD Flow
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): Lower Muddy Creek
Downstream Permit Number: WQCS00003
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Courtney Driver, P.E. 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
/I $ 51 S771&q-
Title of Signing
0120 20
Date
Page 2 of 6
FTSE 10-18

Winston-Salem / Forsyth County
Uties
Water •Wastewater • Solid Waste
Administration, P,O. Box 2511, Winston-Salem, NC 27102
0: 336.727-8000, F: 336-727-8432, wsfcutllities.org
December 20, 2019
Jenny Graznak, Assistant Regional Supervisor
North Carolina Department of Environmental Quality
Division of Water Resources
450 West Hanes Mill Road, Suite 300
Winston Salem, NC 27105
Dear Ms. Graznak,
Please allow this letter to serve as documentation that Winston-Salem/Forsyth County Utilities is
currently engaged in a project at the Muddy Creek Wastewater Treatment plant to address future
wastewater capacity needs. Upgrades to the plant are expected to be completed by December 2020.
The project was originally scheduled to be completed in July 2017, however significant unforeseen
delays have caused the construction to be extended longer than anticipated. The upgrades Include
replacement of the existing headworks, grit removal and influent pumping facilities, 3.75 million gallons
of storm equalization storage, and 2 million gallons of diurnal equalization storage. The equalization
storage will reduce treatment impacts due to heavy wet weather events and provide for a more uniform
flow to the plant. The project will also allow excess flows from the Muddy Creek WWTP to be
transferred to the Archie Elledge WWTP for treatment to utilize excess capacity at that plant. This
opportunity is unique and provides our system the ability to optimize efficiency at both plants by setting
a baseline flow at the Muddy Creek WWTP, based off of hydraulic and financial considerations, and send
any remaining flow to either the Archie Elledge WWTP or the storm equalization facilities. The
integrated influent system and flow storage provides significant reliability, allows us to balance flows
between plants, and provides optimum treatment performance during dry and wet weather.
Please let this letter serve as justification to continue permitting wastewater flows to the Muddy Creek
Wastewater Treatment Plant.
B�a Jrd's,h `PPE.
_
�W v
Courtney D
Utilities Director
XL [Ily Councll: MayorAllen lolnes; VNlan H. Burke, Mayor Pro Tempore, Northeast Ward; Denise D. Adam,, Hurth Ward; Dan Be,,., Southwest Ward; Robert C. Clark,
West Ward; John C. laram, South Ward;Jeff MadntcsN Northwest Ward;Anrwtte Sdpplo, East Ward;James Tayl.r,ln, Southeast Ward; CRY Manager: Lee D. Garrity
[ounty Commissioners: David R Plyler, Chair Don Martln, Vlce Chair; Fleming EW1mIn;Ted Kaplan; Rkhard V. Umigejona McDaniel; Gloria D. Whisenhunl,County
Manager.D.dhryW.tn,J,
Ca11311or336.727.8000
Wlmt,m'Salem/F.nyth Ceunly Utlllty Comml$$bm: Randall5. Tuttle, fAair, L. Wsley Curtis,le, Viw Chen; Narold E. Day; Tom GrHM; Worm. H. Hines; Duane tong;
[e-mail] HMhW.Jernigan;ChrisParkes;JamesRufen;DonaldR.Stewart;AllanYoungar

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SOSID: 0610112
Date Filed: 3/23/2011 10:25:00 AM
Elaine F. Marshall
North Carolina Secretary of State
tr201104500069
ARTICLES OF RESTATEMENT
OF
WAKE FOREST UNIVERSITY HEALTH SCIENCES
The undersigned nonprofit corporation, for the purpose of restating its Articles of Incorporation in
accordance with the provisions of §55A-10-06 of the North Carolina General Statutes, hereby submits
the following:
1. The name of the corporation is Wake Forest University Health Sciences.
2. Attached as an exhibit is the text of the Restated Articles of Incorporation.
3. The Restated Articles of Incorporation contain an amendment to the Articles of Incorporation
requiring member approval and member approval was obtained as required by the North
Carolina Nonprofit Corporation Act.
4. The Restated Articles of Incorporation contain an amendment to the Articles of Incorporation
requiring approval by Wake Forest University, and that approval was obtained as required by
the North Carolina Nonprofit Corporation Act.
5. The Restated Articles of Incorporation are effective upon filing.
zi
This the / 'day of 2011.
Wake Forest University Health Sciences
By: —
J. Reid organ
Secretary
8346-26

State of North Carolina
Department of the Secretary of State
RESTATED ARTICLES OF INCORPORATION
OF
WAKE FOREST UNIVERSITY HEALTH SCIENCES
Pursuant to §55A-2-02 of the General Statutes of North Carolina, the undersigned corporation
does hereby submit these Restated Articles of Incorporation for a nonprofit corporation.
1. The name of the corporation is:
Wake Forest University Health Sciences.
2. The corporation is a charitable or religious corporation as defined in NCGS §55A-1-40(4).
3. The street address and county of the registered office of the corporation is:
Medical Center Boulevard
Winston-Salem, NC 27157
County of Forsyth
4. The mailing address of the registered office is:
Wake Forest University
P. O. Box 7656
Winston-Salem, NC 27109
5. The name of the registered agent is:
J. Reid Morgan
6. The name and address of the incorporator is as follows:
Wake Forest University
1834 Wake Forest Road
Winston-Salem, NC 27109
7. The sole member of the corporation is Wake Forest University.
8. Provisions regarding the distribution of the corporation's assets upon its dissolution:
8.1.1. The corporation may be dissolved and its business and affairs terminated, but such a
dissolution must be in accordance with the provisions of Chapter 55A of the General
Statutes of North Carolina and Section 1.501(c)(3)4(b)(4) of the United States
Treasury Regulations, or applicable successor statutes or regulations.
8.1.2. Upon dissolution of the corporation and after all its debts and expenses have been paid,
all of its assets shall be distributed in conformity with the Bylaws and the Articles of
Incorporation. All remaining assets of the corporation shall be conveyed or distributed
to Wake Forest University (the "University") if the University at the time of such
conveyance or distribution qualifies as an organization described in Sections 501(c)(3)
and 170(c)(2) of the Internal Revenue Code of 1986, as amended (or the corresponding
8346-27

provisions of any future United States Internal Revenue law). In the event that the
University does not so qualify at the time of such conveyance or distribution, then all
remaining assets of the corporation shall be conveyed or distributed to such of one or
more organizations as may be designated by the governing body of the University so
long as the distributee/entity/organization at the time of such conveyance or
distribution qualifies as an organization described in Sections 501(c)(3) and 170(c)(2)
of the Internal Revenue Code of 1986, as amended (or the corresponding provisions of
any future United States Internal Revenue law).
9. Additional provisions:
9.1. Purposes of the Corporation
The purposes for which the corporation is organized are exclusively religious, charitable,
scientific, literary and educational within the meaning of § 501(c)(3) of the Internal
Revenue Code of 1986, as amended (or the corresponding provisions of any future
United States Internal Revenue law), including, without limitation, the following:
9.1.1. The corporation is organized and shall operate as a supporting organization
exclusively for the benefit of Wake Forest University;
9.1.2. The corporation is organized and shall operate to engage in healthcare related
activities of every kind and nature, to conduct research, and to exist and operate
as a school of medicine and an educational organization the primary function of
which is the presentation of formal instruction and which normally maintains a
regular faculty and curriculum and normally has a regularly enrolled body of
pupils or students in attendance at the place where its educational activities are
regularly carried on;
9.1.3. The corporation shall conduct its operations as a part of the integrated health
system of Wake Forest University Baptist Medical Center (the "Medical
Center"); and
9.1.4. The corporation is organized and shall operate to engage, directly or indirectly,
in any other lawful act or activity for which corporations may be organized
under Chapter 55A of the General Statutes of North Carolina that may, directly
or indirectly, promote the interests of the corporation or enhance the value of
its property; provided, however, that the corporation may not engage, other
than as an insubstantial part of its activities, in activities that are not in
furtherance of one or more of those purposes specifically enumerated above.
9.2. Activities not permitted.
No part of the net earnings of the corporation shall inure to the benefit of, or be
distributable to, its directors, trustees, officers or any "private shareholder or individual'
within the meaning of § 501(c)(3) of the Internal Revenue Code of 1986, as amended (or
8346-27 2

the corresponding provisions of any future United States Internal Revenue law);
provided, however, that the corporation shall be authorized and empowered to pay
reasonable compensation for services rendered. No substantial part of the activities of
the corporation shall consist of the carrying on of propaganda or otherwise attempting to
influence legislation, and the corporation shall not participate in or intervene in
(including the publishing or distribution of statements) any political campaign on behalf
of any candidate for public office. Notwithstanding any other provision of these Articles
of Incorporation, the corporation shall not carry on any activities not permitted to be
carried on:
9.2.1. By an organization exempt from federal income tax under § 501(c)(3) of the
Internal Revenue Code of 1986, as amended (or the corresponding provisions of
any future United States Internal Revenue law),
9.2.2. By an organization, contributions to which are deductible under § 170(c)(2) of
the Internal Revenue Code of 1986, as amended, or the corresponding provisions
Of any future United States Internal Revenue law), or
9.2.3. By a "charitable or religious corporation" as that term is defined under the North
Carolina Nonprofit Corporation Act.
9.3. Delegation of Authority
Pursuant to N.C.G.S. §55A-8-01 and as specified in a Medical Center Integration
Agreement entered into among the corporation, the Medical Center, Wake Forest
University, and North Carolina Baptist Hospital, certain powers to operate the
corporation have been delegated to the Medical Center. All corporate powers not so
delegated are retained by the corporation's Board of Directors or by Wake Forest
University.
9.4. Immunity
To the fullest extent permitted by the North Carolina Nonprofit Corporation Act as now
in effect or as it may hereafter be amended, no person who is serving or who has served
as a director of the corporation shall be personally liable to the corporation for monetary
damages for breach of duty as a director. No amendment or repeal of this section, nor the
addition of any provision to these Articles of Incorporation inconsistent with this section,
eliminates or reduces the protection granted herein with respect to any matter that
occurred prior to such amendment, repeal, or addition.
9.5. Election of Directors
The directors shall be elected by the member or shall serve ex ofcio pursuant to
procedures approved by the member, and shall include the persons serving on the Health
Affairs Committee (or its successor, however named) of the Wake Forest University
Board of Trustees.
9.6. Conveyance of real property.
8346-27 3

Real property of the corporation may be conveyed only upon the consent of the member,
given in such manner as may be provided in the bylaws.
9.7. Amendment of articles of incorporation or bylaws.
Neither the articles of incorporation nor the bylaws may be amended without the written
approval of the Wake Forest University Board of Trustees.
10. The street address and county of the principal office of the corporation is:
Medical Center Boulevard
Winston-Salem, NC 27157
County of Forsyth
11. The mailing address of the principal office is:
P. O. Box 7656
Winston-Salem, NC 27109
12. These articles are effective upon filing.
This the day of.� 2011.
W. ake Forest University Health Sciences
M
Approved:
Wake Forest University
By, -- /
Ja es T. Williams, Jr.
air, Board of Trustees
Donald E. Fl
Chair, Board
8346-27

/ .DESTRE. 2S7U1I7
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SALEMN�01st i m me 6mTE3.1067
August 25, 2020
NC DEQ — Winston-Salem Regional Office
Division of Water Resources
450 W. Hanes Mill Road, Suite 300
Winston-Salem, INC 27105
Re: Fast -Track Sewer System Extension Application for
Forsyth County Private Sewer System Extension at
Wake Forest University Health Sciences Modular Lab
Winston-Salem, NC
To whom it may concern:
Environmental Quality
Received
AUG 2 8 2020
1 Winston-Salem
Regional Office
Attached you will find a Fast -Track Sewer System Extension Application and supporting information to extend
the existing Private Sewer System. The design is for 352 LF 8" new gravity sewer that will connect to the
existing 8" sewer within the property, which then discharges to the existing 8" sewer within the property. The
system will serve a modular lab. Sewer flows are 100% commercial and are estimated at 1,900 gallons per
day.
The following information is included for your review and approval:
# Copies Description
2 Fast -Track Application Form FTA 10-16 (original & copy)
1 Review fee check in the amount of $480
2 Flow Tracking / Acceptance Form FTSE 04-18 (signed by City of Winston-Salem)
2 Muddy Creek WWTP justification to continue permitting wastewater flows
2 Site Map on 8.5" x 11" USGS Quad Map
2 Site Map on 8.5" x 11" Aerial Map
If you have questions or need additional information, please contact me at [phone] or
KHowarclaastimmeloa.com
Sincerely,
Kelway L. Howard
Vice President
It
III, PE
LANDSCAPE ARCHITECTURE CIVIL ENGINEERING LAND PLANNING