WQ0004972_Application_20201022

-82:1547A.7;36893A0--'A,("'&/'$A/%s.A$& &A+i),,A&##&+'#( $('
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
NON -DISCHARGE SYSTEM RENEWAL
FORM: NDSR 01-20
This form is for renewal without modification for all non -discharge system permits, except Residuals Management and Single -
Family Residence Wastewater Irrigation System permits.
For more information, visit the Water Quality Permitting Section's Non -Discharge Branch Website.
L PERMITTEE INFORMATION:
1. Permittee: M H C TT, L.P.
2
3
Signature authority's name: George Gudgeon
Primary Telephone number: [phone] Secondary number: k ) -
EmailAddress: [e-mail]
per 15A NCAC 02T .0106(b) Title: Sr. Vice President
813 282 5934
mailing address: 2 N Riverside Plaza, Suite 800
City: Chicago State: IL Zip: 60606
4. Billing address (if different from above):
5
City:
State:
Zip:
Contact person's name (if different from signature authority): Henry Lue Title: Environmental Engineer
Primary Telephone number: [phone] Secondary number: [phone]
Email Address: [e-mail]
IL PERMIT INFORMATION:
1. Existing permit number: WQ00 4972
2. Has the facility been constructed? 0 Yes or ❑ No
If yes, has the facility been constructed in accordance with the permit and the Division -approved plans and specifications?
[15A NCAC 02T .01101 0 Yes or ❑ No
If no, a formal permit modification request shall be submitted to the Division.
3. Has any of the property ownership within the facility and/or disposal area changed from what is indicated in the current permit
(Attachment B — disposal field owner/lessee)? ❑ Yes or 0 No
Has the Permittee had a name change or has the permit changed ownership? 0 Yes or ❑ No
If yes to either, a permit modification request shall be submitted to the Division. [15A NCAC 02T .0105]
4. Is this facility a Privately -Owned Public Utility? ❑ Yes or 0 No
If yes, provide two copies of the Certificate of Public Convenience and Necessity from the North Carolina Utilities Commission
demonstrating the Applicant is authorized to hold the utility franchise. [15A NCAC 02T .0115(a)(1)]
5. Is the Permittee a Home/Property Owners' Associations or Developers of lots to be sold? ❑ Yes or 0 No
If yes, provide the following:
• For Home/Property Owners' Associations — Operational Agreement (FORM: HOA) and a copy of the proposed or
approved Articles of Incorporation, Declarations, and By-laws [ 15A NCAC 02T .0115(c)]
• For Developers of lots to be sold —Operational Agreement (FORM: DEV) [15A NCAC 02T .0115(b)1
FORM: NDSR 01-20 Page 1 of 4

-82:1547A.7;36893A0--'A,("'&/'$A/%s.A$& &A+i),,A&##&+'#( $('
State of North Carolina
Division of Water Resources
6. Does the facility treat and dispose of industrial wastewater? Yes or ■ No
If yes, complete items below. If no, skip to the next section.
Indicate the approximate percentage of wastewater makeup:
Industrial: % Domestic: % Stormwater: %
Department of Environmental Quality
Division of Water Resources
NON -DISCHARGE SYSTEM RENEWAL
FORM: NDSR 01-20
For all industrial wastewater sources (excluding those permitted under a pretreatment permit), provide a detailed industrial
process description including:
• An overview of the manufacturing process
• An inventory of all materials used for manufacture, including chemicals and biological matter
• An overview of cleaning and treatment methodology, including an inventory of treatment materials and compounds
Has the nature of wastes (e.g., change in industrial processes, introduction of new materials or chemicals, etc.) described in the
approved permit application(s) changed? ❑ Yes or ❑ No
If yes, a permit modification request shall be submitted to the Division. [G.S. 143.-215.1(d)]
III. SITE MAP:
1. Provide an updated site map in accordance with 15A NCAC 02T .0105(d) that shows the following (if applicable):
The site map is not required to be signed or sealed by a Professional Engineer. However, the map must indicate the source of
information. For example, parcel lines taken from a county GIS map should reference the GIS website.
p Legend, north arrow, and scale
p Topographic contours on all disposal sites
0 Soil mapping units on all disposal sites
❑ All facility -related structures and fences within the treatment, storage, and disposal areas
p All habitable residences and places of assembly within 500 feet of all treatment, storage, and irrigations sites
p Location of all wells, streams (ephemeral, intermittent, and perennial), springs, lakes, ponds, ditches, and other surface
drainage features within 500 feet of all waste treatment, storage, and disposal site(s)
❑ Latitude and longitude coordinates of all monitoring wells (decimal degrees to 6 digits)
p Location and identification of major components of the waste disposal system
p The wetted perimeter of all irrigation fields with field names (named according to the approved permit)
p Location and ownership of property boundaries within 500 feet of the disposal area (including road/rail right-of-ways)
p The delineation of compliance and review boundaries
p Distance measurements verifying all setbacks are being met
❑ Stormwater drainage controls
p 100-year floodplain
❑ For reclaimed water generation permits, provide a separate map showing all distribution lines and utilization permit
locations that are connected to the water generation facility and are permitted by the Non -Discharge Branch (excludes
Local Program permitted facilities). Include all reclaimed water distribution line and reclaimed water utilization permit
numbers.
FORM: NDSR 01-20 Page 2 of 4

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State of North Carolina
Division of Water Resources
IV. GROUNDWATER MONITORING WELLS
Department of Environmental Quality
Division of Water Resources
NON -DISCHARGE SYSTEM RENEWAL
FORM: NDSR 01-20
1. Does the facility have a proposed or existing groundwater monitoring well network? 0 Yes or ❑ No
If no, skip to next section.
If yes, complete the following table (NOTE — This table may be expanded for additional wells):
Well Name
Status
Latitude a
Longitude a
Gradient
Location
MW-1
Active
35.864651
80.398306
Upgradient
Davie Count
MW-2
Active
35.864056
80.395924
Downgradient
Davie Count
MW-3
Active
35.866993
80.394662
Downgradient
Davie Count
MW-4
Active
35.865407
80.394071
Downgradient
Davie Count
a. Coordinates must be in NAD83 and have 6 decimal degrees
V. SETBACK WAIVERS, EASEMENTS, AND LEASES:
1. Does the permit have any setback waivers, easements, or leases? ❑ Yes or 0 No
If yes, provide copies of all documents and complete the table below:
Document
Type
Grantor or
Parcel No.
Grantee
Expiration
Date
County
Registered
Deed
Book
Deed Page
Document
Description a
a. The document description shall list any reduced setbacks with distance, etc.
2. For reclaimed water utilization permits:
Is reclaimed water utilized on property not controlled by the generator? ❑ Yes or 0 No
A lease, easement, or agreement must be provided allowing for the utilization of reclaimed water on the property or within the
facility. For irrigation of reclaimed water, an easement is required per 15A NCAC 02U .0501(6). All documents shall be listed
in the table above.
FORM: NDSR 01-20 Page 3 of 4

-82:1547A.7;36893A0--'A,("'&/'$A/%s.A$& &A+i),,A&##&+'#( $('
State of North Carolina
Division of Water Resources
VI. RELATED PERMITS
Department of Environmental Quality
Division of Water Resources
NON -DISCHARGE SYSTEM RENEWAL
FORM: NDSR 01-20
1. If this permit has interactions with other wastewater permits (collection systems, NPDES, etc.), complete the table below
(provide additional pages if necessary):
Permit Type Permit No. Description
2. Does the facility have an approved flow reduction f 15A NCAC 02T .0114(I)1? ❑ Yes or ❑■ No
If yes, attach the measured monthly average amount of wastewater flow contributed per unit for the 12 months prior to permit
renewal. If any of these monthly averages are within 20% of the approved value, the Permittee shall provide a reevaluation of
the reduced flow value using the methodology applied to the original flow reduction application. Also, attach a copy of the
flow reduction approval letter.
APPLICANT'S CERTIFICATION 15A NCAC 02T .0106(b)
I George Gudgeon attest that this renewal application has been reviewed by me, and is accurate and complete to the best of my
knowledge. I understand that any unauthorized discharge of wastewater from this non -discharge system to surface waters or the land
may result in an 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 are not completed, this application may be returned to me as incomplete. I further certify that the Applicant or any parent,
subsidiary, or other affiliate of the Applicant has not been convicted of an environmental crime, has not abandoned a wastewater facility
without proper closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant
with any active compliance schedule, and does not have any overdue annual fees.
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. The Applicant's Certification shall be signed in accordance with
15A NCAC 02T .0106(b). Per 15A NCAC 02T .0106(c), an alternate person maybe designated as the signing official if a delegation
letter is provided from a person who meets the criteria in 15A NCAC 02T .0106(b)
DocuSigned by:
Signature: EzA-hrf, 4o t& Date: 1012212020
BOBB4A06F2C44C0...
THE COMPLETED APPLICATION AND SUPPORTING DOCUMENTATION SHALL BE SUBMITTED TO:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE BRANCH
By U.S. Postal Service: By Courier: By Email:
Non -Discharge Branch Non -Discharge Branch —Archdale 942W Non-Discharge.Reports&cdenr.gov
1617 Mail Service Center 512 N. Salisbury St.
Raleigh, NC 27699-1617 Raleigh, NC 27604
TELEPHONE NUMBER: [phone]
FORM: NDSR 01-20 Page 4 of 4

DocuSign Envelope ID: 42B14818-5A52-4785-BB47-2DEl59FCDD27
State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
NON -DISCHARGE PERMIT OWNERSHIPINAME CHANGE
Dh4slon of Water Resources INSTRUCTIONS FOR FORM: NDPONC 06-16 & SUPPORTING DOCUMENTATION
This form is for ownership changes or name changes of a non -discharge system permit. Please note that "Permittee"
references the existing permit holder, and that "Applicant" references the entity applying for the ownership/name change.
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit website
A. Non -Discharge Permit Ownership/Name Change (FORM: NDPONC 06-16) Application (All Applications):
❑� Submit an original completed and appropriately executed Non -Discharge Permit Ownership/Name Change (FORM: NDPONC
06-16) application.
❑r The Existing Permittee's Certification shall be signed in accordance with 15A NCAC 02T .0106(b). Per 15A NCAC 02T
.0 106c , an alternate person may be designated as the signing official if a delegation letter is provided from a person who
meets the criteria in 15A NCAC 02T .0106(b).
❑ The Applicant's Certification shall be signed in accordance with 15A NCAC 02T ,. 0106(b). Per 15A NCAC 02T .0106(c), an
alternate person may be designated as the signing official if a delegation letter is provided from a person who meets the criteria
in 15A NCAC 02T .010602).
B. Existing Permit (All Applications):
❑✓ Submit a copy of the most recently issued permit.
C. Property Ownership Documentation (All Applications):
➢ Per 15A NCAC 02T .0504(f), 15A NCAC 02T .0604(e), 15A NCAC 02T .0704(f), 15A NCAC 02T .0804, 15A NCAC 02T
.1004 d 15A NCAC 02T .1104(d)(7), 15A NCAC 02T .1104(e)(5), 15A NCAC 02U .0201(e) or 15A NCAC 02U .0202(f),
the Applicant shall demonstrate they are the owner of all property containing the non -discharge system facilities:
❑� Legal documentation of ownership (i.e., GIS deed or article of incorporation), or
❑ Written notarized intent to purchase agreement signed by both parties with a plat or survey map, or
❑ Written notarized lease agreement that specifically indicates the intended use of the property and has been signed by both
parties, as well as a plat or survey map. Lease agreements shall adhere to the requirements of 15A NCAC 02L .0107.
D. Certificate of Public Convenience and Necessity (All Applications where the Applicant is a Privately -Owned Public Utility):
❑ Per 15A NCAC 02T .4115(a)(1), provide one copy of the Certificate of Public Convenience and Necessity from the North
Carolina Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served
by the non -discharge system.
E. Operational Agreements (All Applications where the Applicant is a Home/Property Owners' Association or Developer of lots to
be sold):
➢ Home/Pr0 e Owners' Associations
❑ Per 15A .NCAC 02T .0115(c), submit an original properly executed Operational Agreement FORM: HOA .
❑ Per 15A NCAC 02T .0115(c), submit an original proposed or approved Articles of Incorporation, Declarations and By-
laws.
➢ Developers of lots to be sold
❑ Per 15A NCAC 02T .0115(b), submit an original of the properly executed Operational Aueement (FORM: DEV).
F. Operation and Maintenance Agreement (All Applications for Single -Family Wastewater Irrigation Systems):
❑ Per 15A NCAC 02T .0604(h), submit an original of a notarized Operation and Maintenance Agreement „(FORM: SFRWWIS
O& that has been signed and dated by all deeded property owners.
THE COMPLETED APPLICATION AND SUPPORTING DOCUMENTATION SHALL BE SUBMITTED TO:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE PERMITTING UNIT
By U.S. Postal „Service: By Courier/Special Delivery:
1617 MAIL SERVICE CENTER 512 N. SALISBURY ST.
RALEIGH, NORTH CAROLINA 27699-1617 RALEIGH NORTH CAROLINA 27604
TELEPHONE NUMBER: [phone] FAX NUMBER: [phone]
INSTRUCTIONS FOR FORM: NDPONC 06-16 & SUPPORTING DOCUMENTATION Page 1 of 1

DocuSign Envelope ID: 42B14818-5A52-4785-BB47-2OE159FCDD27
State of North Carolina
nAA1V Department of Environmental Quality
Division of Water Resources
NON -DISCHARGE PERMIT OWNERSHIPINAME CHANGE
Division of Water Resources FORM: NDPONC 06-16
I. EXISTING PERMITTEE INFORMATION:
1. Permittee's name: MHC TT Inc.
2. Signature authority's name: George Cjudgeon per 15A NCAC 02T .0106(b) Title: Senior Vice President
3. Permittee's mailing address: 2 N Riverside Plaza Suite 800
City: Chicago State: IL Zip: 60606 -
4. Permittee's contact information: Phone number: (813 ) 2g2 - 5934 Email Address: permits licenses a us fifes ie.com
5. Demonstration of historical consideration for permit approval —15A NCAC 02T A 120:
Has the Permittee or any parent, subsidiary or other affiliate exhibited the following?
a. Has been convicted of environmental crimes under Federal law or G.S. 143-215.6B? ❑ Yes or 0 No
b. Has previously abandoned a wastewater treatment facility without properly closing that facility? ❑ Yes or 0 No
c. Has unpaid civil penalty where all appeals have been abandoned or exhausted? ❑ Yes or ✓❑ No
d. Is non -compliant with an existing non -discharge permit, settlement agreement or order? ❑ Yes or 0 No
e. Has unpaid annual fees in accordance with 15A NCAC 02T .0105_ e 2 ? ❑ Yes or ❑ No
II. FACILITY INFORMATION.-
1. Facility name: Forest
2. Facility's physical address: 192 Thousand 'trails Dr
City: Advance _ State: NC Zip: 27006 - County: Davie
III. PERMIT INFORMATION:
1. Existing permit number: WQ00 4972 and most recent issuance date: 4/29/2016
2. Existing permit type: Wastewater Irrigation
3. Reason for the permit application: Name Change
4. Has the facility been constructed? ❑/ Yes or ❑ No
IV. APPLICANT INFORMATION:
1. Applicant's name:
2. Signature authority's name: George Gudgeon per I SA NCAC 02T .0106 Title: Senior VP
3. Applicant's mailing address:
City: Chicago State: IL Zip: 60606 -
4. Applicant's contact information: Phone number: (813 2 2 - 5934 Email Address: permits licensesP-e4uitylifeMle.com
5. Demonstration of historical consideration for permit approval —15A NCAC 02T .0120:
Has the Applicant or any parent, subsidiary or other affiliate exhibited the following?
a. Has been convicted of environmental crimes under Federal law or G.S. 143-215.6B? ❑ Yes or ,❑ No
b. Has previously abandoned a wastewater treatment facility without property closing that facility? ❑ Yes or 0 No
c. Has unpaid civil penalty where all appeals have been abandoned or exhausted? ❑ Yes or 0 No
d. Is non -compliant with an existing non -discharge permit, settlement agreement or order? ❑ Yes or ❑� No
e. Has unpaid annual fees in accordance with 15A NCAC 02T .0105 e 2 ? ❑ Yes or 0 No
FORM: NDPONC 06-16 Page 1 of 2

DocuSign Envelope ID: 42B14818-5A52-4785-BB47-20E159FCDD27
Existing Permittee's Certification per 15A NCAC 02T .0106 b :
1, George Gudgeon attest that this application for
(Signature Authority's name &title from Application Item L2.)
Forest Lake RV & Camping Resort
(Facility name from Application Item II. I.)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that prior to reissuance of the permit
into the Applicant's name, any discharge of wastewater from this non -discharge system to surface waters or the land will result in an
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 the existing 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 as incomplete. I further certify that the existing Permittee or any affiliate has not been convicted of an
environmental crime, has not abandoned a wastewater facility without proper closure, does not have an outstanding civil penalty where
all appeals have been exhausted or abandoned, are compliant with any active compliance schedule, and do not have any overdue annual
fees per 15A NCAC 02T .0105 e .
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.
aocu5i ned by:
10/22/2020
Signature: Date:
80BB4A06F2C44C0...
Applicant's Certification per 15A NCAC 02T .0106 b :
1, George Gudgeon attest that this application for
(Signature Authority's name & title from Application Item IV.2.)
Forest Lake RV & Camping Resort
(Facility name from Application Item II.1.)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that after reissuance of the permit
into the Applicant's name, any discharge of wastewater from this non -discharge system to surface waters or the land will result in an
enforcement action that may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the
Division of Water Resources should a condition of this permit be violated. I also understand that if all required parts of this application
package are not completed and that if all required supporting information and attachments are not included, this application package
will be returned to me as incomplete. I further certify that the Applicant or any affiliate has not been convicted of an environmental
crime, has not abandoned a wastewater facility without proper closure, does not have an outstanding civil penalty where all appeals have
been exhausted or abandoned, are compliant with any active compliance schedule, and do not have any overdue annual fees per 15A
NCAC 02T .0105 e .
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,OO-%n as well gy civil penalties up to 12�,uuu per violation.
10/22/2020
Signature: _— Date:
GF2C44CO...
FORM: NDPONC 06-16 Page 2 of 2

Water Resources
ENVttiONMENTAL QUALITY
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
secretary
S. JAY ZIMMERMAN
Direclor
April 29, 2016
DAVID KOZY— SENIOR VICE PRESIDENT
MHC TT, INC.
2 NORTH RIVERSIDE PLAZA, SUITE 800
CHICAGO, ILLINOIS 60606
Dear Mr. Kozy:
Subject: Permit No. WQ0004972
Forest Lake Preserve
Wastewater Irrigation System
Davie County
In accordance with your permit renewal request received May 4, 2015, we are forwarding herewith
Permit No. WQ0004972 dated April 29, 2016, to MHC TT, Inc. for the continued operation of the subject
wastewater collection, treatment and irrigation facilities.
This permit shall be effective from the date of issuance until March 31, 2021, shall void Permit No.
WQ0004972 issued September 11, 2009, and shall be subject to the conditions and limitations as specified
therein. Please pay particular attention to the monitoring requirements listed in Attachments A, B and C.
Failure to establish an adequate system for collecting and maintaining the required operational information
shall result in future compliance problems.
Please note the following permit conditions are new since the last permit issuance dated
September 11, 2009:
A Condition 111,13. — This condition requires that the Permittee maintain a gauge to monitor waste
levels in the effluent storage lagoon.
Condition N.Z. — This condition requires an annual representative soils analysis to be
conducted on each irrigation site listed in Attachment B.
➢ Attachment A — PPI 001 and PPI 002 have been combined under PPI 001. Monitoring for
Chloride, Total Chlorine, Total Nitrogen, Total Dissolved Solids and Total Suspended Solids
has been added to the effluent monitoring requirements; the monitoring frequency has been
increased from 3 times a year to monthly and monitoring for pH has increased from 3 times a
year to 5 x week to be consistent with our Non -Discharge Effluent Monitoring for Domestic
Wastewater guidelines based on the average effluent of less than 24,400 gallons per day.
If any parts, requirements or limitations contained in this permit are unacceptable, the Permittee
has the right to request an adjudicatory hearing upon written request within 30 days following receipt of
this permit. This request shall be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings at 6714 Mail Service
Center, Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and binding.
State of North Carolina I Environmental Quality I Water Resources I Water Quality Permitting I Non -Discharge Permitting
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919 807 6464

Mr. David Kozy
April 29, 2016
Page 2 of 2
If you need additional information concerning this permit, please contact Alice M. Wessner at (919)
807-6425 or alice.wessner ncdenr, ov.
Sincerely,
i S. Jay Zimmerman, P.G., Director
Division of Water Resources
cc: Davie County Health Department Suzanne Wright, MPH, suzanne.wri ht co.davie.nc.us
(Electronic Copy)
Winston Salem Regional Office, Water Quality Regional Operations Section (Electronic Copy)
Digital Permit Archive (Electronic Copy)
Central Files

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
RALEIGH
WASTEWATER IRRIGATION SYSTEM 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
MHC TT, Inc.
Davie County
FOR THE
operation of a 24,400 gallon per day (GPD) wastewater collection, treatment and irrigation facility
consisting of the:
continued operation of a wastewater collection system serving 283 camp sites and 19 cabins consisting of:
seven grinder pump stations with associated collection piping; 430 linear feet (LF) of 3-inch force main;
455 LF of 4-inch force main; 935 LF of 6-inch force main; and all associated piping, valves, controls and
appurtenances; and the
continued operation of a wastewater treatment and irrigation facility consisting of: an extended aeration
wastewater treatment facility with a treatment capacity of 45,000 GPD which includes one 14,800 gallon
aerated surge tank with influent bar screen served by two 74 gallon per minute (GPM) submersible pumps
and a high water alarm; a 45,000 gallon aeration tank served by two 285 cubic feet per minute (CFM)
blowers; a 4,500 gallon sludge holding tank; a 7,500 gallon clarifier; a 940 gallon baffled chlorine contact
tank with a hypochlorinator; a 0.408 million gallon (MG) synthetically lined effluent storage lagoon; two
142 GPM effluent dosing pumps; a 9.0 acre spray irrigation area with 18 sprinklers; and all associated
piping, valves, controls and appurtenances
to serve Forest Lake Preserve, with no discharge of wastes to surface waters, pursuant to the application
received May 4, 2015, and in conformity with the project plans, specifications, 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 permit issuance until March 31, 2021, shall void Permit No.
WQ0004972 issued September 11, 2009 and shall be subject to the following specified conditions and
limitations:
WQ0004972 Version 3.0 Shell Version 151201 Page l of 9

I. SCHEDULES
No later than six months prior to the expiration of this permit, the Permittec shall request renewal of
this permit on official Division forms. Upon receipt of the request, the Division will review the
adequacy of the facilities described therein, and if warranted, will renew the permit for such period of
time and under such conditions and limitations as it may deem appropriate. Please note Rule 15A
NCAC 02T .0105(d) requires an updated site map to be submitted with the permit renewal application.
[15A NCAC 02T .0105(d), 02T .0106, 02T .0109, 02T .0115(c)]
II. PERFORMANCE STANDARDS
The subject non -discharge facilities shall be effectively maintained and operated at all times so there is
no discharge to surface waters, nor any contravention of groundwater or surface water standards. In
the event the facilities fail to perform satisfactorily, including the creation of nuisance conditions due
to improper operation and maintenance, or failure of the irrigation areas to adequately assimilate the
effluent, the Permittee shall take immediate corrective actions including Division required actions, such
as the construction of additional or replacement wastewater treatment or irrigation facilities. [G.S. 143-
215.1, 143-213.3(a)]
2. This permit shall not relieve the Permittee of their responsibility for damages to groundwater or surface
water resulting from the operation of this facility. [15A NCAC 02B .0200, 02L .0100]
3. All wells constructed for purposes of groundwater monitoring shall be constructed in accordance with
15A NCAC 02C .0108 (Standards of Construction for Wells Other than Water Supply), and any other
jurisdictional laws and regulations pertaining to well construction. [15A NCAC 02C .0108]
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 in accordance with 15A NCAC 02T .0400. 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 any contravention of groundwater or surface water standards,
b. A map of the sewer system shall be developed and actively maintained.
c. An operation and maintenance plan shall be developed, implemented and maintained.
d. Pump stations not connected to a telemetry system shall be inspected every day (Le., 365 days per
year). Pump stations connected to a telemetry system shall be inspected at least once per week.
e. High -priority sewers shall be inspected at least once every six months.
f. A general observation of the entire sewer systemm shall be conducted at least once per year.
g. Overflows and bypasses shall be reported to the Winston Salem Regional Office in accordance
with 15A NCAC 02B .0506(a), and public notice shall be provided as required per North Carolina
General Statute § 143-215.1 C.
h. A grease control program shall be developed, implemented and maintained.
i. Right-of-ways and easements shall be maintained.
j. Inspection and maintenance records for Conditions 11.4.a. through 11.4.i. shall be maintained for a
period of at least three years, except for Conditions 11.4.b. and II.4,c., which shall be maintained
for the life of the system.
[15A NCAC 02T .0403]
5. Effluent quality shall not exceed the limitations specified in Attachment A. [15A NCAC 02T
.0108(b)(1)]
WQ0004972 Version 3.0 Shell Version 151201 Page 2 of 9

6. Application rates, whether hydraulic, nutrient or other pollutant, shall not exceed those specified in
Attachment B. [15A NCAC 02T .0505(c), 02T .0505(n)]
7. This disposal system was individually permitted on or after December 30, 1983; therefore, the
compliance boundary is established at either 250 feet from the effluent disposal area, or 50 feet within
the property boundary, whichever is closest to the effluent disposal area. An exceedance of
groundwater standards at or beyond the compliance boundary is subject to remediation action according
to 15A NCAC 02L .0106(d)(2) as well as enforcement actions in accordance with North Carolina
General Statute 143-215.6A through 143-215.6C. [15A NCAC 02L .0106(d)(2), 02L .0107(b)]
8. In accordance with 15A NCAC 02L .0108, the review boundary is established midway between the
compliance boundary and the effluent disposal area. Any exceedance of groundwater standards at the
review boundary shall require action in accordance with 15A NCAC 02L .0106. [15A NCAC 02L
.0106, 02L .0108]
9. The Permittee shall apply for a permit modification to establish a new compliance boundary prior to
any sale or transfer of property affecting a compliance boundary. [ 15A NCAC 02L .0107(c)]
10. In accordance with 15A NCAC 02L .0107(d), no wells, excluding Division approved monitoring wells,
shall be constructed within the compliance boundary except as provided for in 15A NCAC 02L
.0107(g). [15A NCAC 02L .0107]
11. Except as provided for in 15A NCAC 02L .0107(g), the Permittee shall ensure any landowner who is
not the Permittee and owns land within the compliance boundary shall execute and file with the Davie
County Register of Deeds an easement running with the land containing the following items:
a. A notice of the permit and number or other description as allowed in 15A NCAC 02L .0107(fl(1);
b. Prohibits construction and operation of water supply wells within the compliance boundary; and
c. Reserves the right of the Pennittee or the State to enter the property within the compliance boundary
for purposes related to the permit.
The Director may terminate the casement when its purpose has been fulfilled or is no longer needed.
[15ANCAC 02L .0107(f)]
12. The facilities permitted herein shall be constructed according to the following setbacks:
a. The setbacks for irrigation sites permitted under 15A NCAC 02H .0200 shall be as follows (all
distances in feet):
i. Any habitable residence or place of public assembly under separate ownership: 400
ii. Surface waters: 100
iii. Any well with exception of monitoring wells: 100
iv. Any property line: 150
v. Public right of way: 50
[15A NCAC 02H .02190)]
b. The setbacks for storage and treatment units permitted under 15A NCAC 02H .0200 shall be as
follows (all distances in feet):
i. Any well with exception of monitoring wells:
ii. Any property line:
[15A NCAC 02H .02190)]
100
50
WQ0004972 Version 3.0 Shell Version 151201 Page 3 of 9

M. OPERATION AND MAINTENANCE REOVIREMENTS
I. The facilities shall be properly maintained and operated at all times. The facilities shall be effectively
maintained and operated as a non -discharge system to prevent the discharge of any wastewater resulting
from the operation of this facility, The Permittee shall maintain an Operation and Maintenance Plan,
which at a minimum shall include operational functions, maintenance schedules, safety measures and
a spill response plan. [15A NCAC 02T .0507]
2. Upon the Water Pollution Control System Operators Certification Commission's (WPCSOCC)
classification of the subject non -discharge facilities, in accordance with 15A NCAC 08G .0200 the
Permittee shall designate and employ a certified operator in responsible charge (ORC) and one or more
certified operator(s) as back-up ORC(s). The ORC or their back-up shall visit the facilities in
accordance with 15A NCAC 08G .0200, and shall comply with all other conditions specified in the
previously cited rules. [15A NCAC 02T .0117]
3. A suitable year round vegetative cover shall be maintained at all times, such that crop health is
optimized, allows for even distribution of effluent and allows inspection of the irrigation system. [15A
NCAC 02T .0108(b)(1)]
4. Adequate measures shall be taken to prevent effluent ponding in or runoff from the irrigation sites listed
in Attachment B. [15A NCAC 02T .0108(b)(1)]
5. Irrigation shall not be performed during inclement weather or when the ground is in a condition that
will cause ponding or runoff. [ 15A NCAC 02T .0108(b)(1)]
6. All irrigation equipment shall be tested and calibrated at least once per permit cycle. Calibration records
shall be maintained at the facility for a period of no less than five years, and shall be made available to
the Division upon request. [15A NCAC 02T .0108(b)(1)]
7. Only effluent from Forest Lake Preserve shall be irrigated on the sites listed in Attachment B. [G.S.
143-215.1]
8. No automobiles or machinery shall be allowed on the irrigation sites except during equipment
installation or while maintenance is being performed. [15A NCAC 02T ,0108(b)(1)]
9. Public access to the irrigation sites and wastewater treatment facilities shall be prohibited. [ 15A NCAC
02T .0505(q)]
10. The residuals generated from the wastewater treatment facilities shall be disposed or utilized in
accordance with 15A NCAC 02T .1100. The Permittee shall maintain a residual management plan
pursuant to 15A NCAC 02T .0508. [15A NCAC 02T .0508, 02T .1100]
11. Diversion or bypassing of untreated or partially treated wastewater from the treatment facilities is
prohibited. (15A NCAC 02T .05050)]
12. Freeboard in the 0.408 million gallon (MG) synthetically lined effluent storage lagoon shall not be less
than two feet at any time. [15A NCAC 02T .0505(d)]
13. A gauge to monitor waste levels in the 0.408 million gallon (MG) synthetically lined effluent storage
lagoon shall be provided. This gauge shall have readily visible permanent markings, at inch or tenth
of a foot increments, indicating the following elevations: maximum liquid level at the top of the
temporary Iiquid storage volume; minimum liquid level at the bottom of the temporary liquid storage
volume; and the lowest point on top of the dam. [15A NCAC 02T .0108(b)(1)]
WQ0004972 Version 3.0 Shell Version 151201 Page 4 of 9

14. A protective vegetative cover shall be established and maintained on all earthen embankments (i.e.,
outside toe of embankment to maximum allowable temporary storage elevation on the inside of the
embankment), berms, pipe runs, erosion control areas, and surface water diversions. Trees, shrubs, and
other woody vegetation shall not be allowed to grow on the earthen dikes or embankments. Earthen
embankment areas shall be kept mowed or otherwise controlled and accessible. [15A NCAC 02T
.0108(b)(1)]
IV. MONITORING AND REPORTING REQUIREMENTS
1. Any Division required monitoring (including groundwater, plant tissue, soil and surface water analyses)
necessary to ensure groundwater and surface water protection shall be established, and an acceptable
sampling reporting schedule shall be followed. [ 15A NCAC 02T .0108(c)]
A Division certified laboratory shall conduct all laboratory analyses for the required effluent,
groundwater or surface water parameters. [15A NCAC 02H .0800]
3. Flow through the treatment facility shall be continuously monitored, and daily flow values shall be
reported on Form NDMR.
The Permittee shall install and maintain an appropriate flow measurement device to ensure the accuracy
and reliability of flow measurement consistent with accepted engineering and scientific practices.
Selected flow measurement devices shall be capable of measuring flows with a maximum deviation of
less than ten percent from true flow; accurately calibrated at a minimum of once per year; and
maintained to ensure the accuracy of measurements is consistent with the selected device's accepted
capability. The Permittee shall maintain records of flow measurement device calibration on file for a
period of at least five years. At a minimum, documentation shall include:
a. Date of flow measurement device calibration,
b. Name of person performing calibration, and
c. Percent from true flow.
[15A NCAC 02T .0105(k)]
4. The Permittee shall monitor the effluent from the subject facilities at the frequencies and locations for
the parameters specified in Attachment A. [ 15A NCAC 02T .0108(c)]
5. The Permittee shall maintain adequate records tracking the amount of effluent irrigated. At a minimum,
these records shall include the following information for each irrigation site listed in Attachment B:
a. Date of infiltration/irrigation;
b. Volume of effluent infiltrated/irrigated;
c. Site infiltrated/irrigated;
d. Length of time site is irrigated;
e. Continuous weekly, monthly, and year-to-date hydraulic (inches/acre) loadings;
f. Continuous monthly and year-to-date loadings for any non -hydraulic parameter specifically
limited in Attachment B;
g. Weather conditions; and
h. Maintenance of cover crops.
[ 15A NCAC 02T .0108(c)]
6. Freeboard (i.e., waste level to the lowest embankment elevation) in the 0.408 million gallon (MG)
synthetically lined effluent storage lagoon shall be measured to the nearest inch or tenth of a foot, and
recorded weekly. Weekly freeboard records shall be maintained at the facility for a period of no less
than five years, and shall be made available to the Division upon request. [15A NCAC 02T .0108(c)]
WQ0004972 Version 3.0 Shell Version 151201 Page 5 of 9

Three copies of all monitoring data (as specified in Conditions 1V.3. and IVA.) on Form NDMR for
each PPI and three copies of all operation and disposal records (as specified in Conditions IV.5. and
IV.6.) on Form NDAR-I ] for every site in Attachment B shall be submitted on or before the last day of
the following month. If no activities occurred during the monitoring month, monitoring reports are still
required documenting the absence of the activity. All information shall be submitted to the following
address:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
(15A NCAC 02T .0105(1)]
A record shall be maintained of all residuals removed from this facility. This record shall be maintained
at the facility for a period of no less than five years, and shall be made available to the Division upon
request. At a minimum, this record shal l include:
a. Name of the residuals hauler;
b. Non -Discharge permit number authorizing the residuals disposal, or a letter from a municipality
agreeing to accept the residuals;
c. Date the residuals were hauled; and
d. Volume of residuals removed.
f 15A NCAC 02T .0108(b)(1)]
9. A maintenance log shall be maintained at this facility. This log shall be maintained at the facility for a
period of no less than five years, and shall be made available to the Division upon request. At a
minimum, this log shall include:
a. Date of calibration of flow measurement device;
b. Visual observations of the plant and plant site; and
c. Record of preventative maintenance (e.g., changing of equipment, adjustments, testing, inspections
and cleanings, etc.).
[15A NCAC 02T .0I08(b)(1)]
10. Monitoring wells shall be sampled at the frequencies and for the parameters specified in Attachment
C. All mapping, well construction forms, well abandonment forms and monitoring data shall refer to
the permit number and the well nomenclature as provided in Attachment C and Figure A. [15A NCAC
02T .0105(m)]
11. Two copies of the monitoring well sampling and analysis results shall be submitted on a Compliance
Monitoring Form (GW-59), along with attached copies of laboratory analyses, on or before the last
working day of the month following the sampling month. The Compliance Monitoring Form (GW-59)
shall include this permit number, the appropriate well identification number, and one GW-59a
certification farm shall be submitted with each set of sampling results. All information shall be
submitted to the following address:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[15A NCAC 02T .0105(m)]
WQ0004972 Version 3.0 Shell Version 151201 Page 6 of 9

12. An annual representative soils analysis (i,e., Standard Soil Fertility Analysis) shall be conducted on
each irrigation site listed in Attachment B. These results shall be maintained at the facility for a period
of no less than five years, and shall be made available to the Division upon request. At a minimum, the
Standard Soil Fertility Analysis shall include the following parameters:
Acidity
Exchangeable Sodium Percentage
Phosphorus
Base Saturation (by calculation)
Magnesium
Potassium
Calcium
Manganese
Sodium
Cation Exchange Capacity
Percent Humic Matter
Zinc
Copper
tpH
[ 15A NCAC 02T .4108(c)]
13. Noncompliance Notification:
The Permittee shall report by telephone to the Winston-Salem Regional Office, telephone number (336)
776-9800, as soon as possible, but in no case more than 24 hours, or on the next working day following
the occurrence or first knowledge of the occurrence of any of the following:
a. Treatment of wastes abnormal in quantity or characteristic, including the known passage of a
hazardous substance.
b. Any process unit failure (e.g., mechanical, electrical, etc.), due to known or unknown reasons,
rendering the facility incapable of adequate wastewater treatment.
c. Any facility failure resulting in a by-pass directly to receiving surface waters.
d. Any time self -monitoring indicates the facility has gone out of compliance with its permit
limitations.
e. Ponding in or runoff from the irrigation sites.
Any emergency requiring immediate reporting (e.g., discharges to surface waters, imminent failure of
a storage structure, etc.) outside normal business hours shall be reported to the Division's Emergency
Response personnel at telephone number [phone], [phone], or [phone]. Persons
reporting such occurrences by telephone shall also file a written report in letter form within five days
following first knowledge of the occurrence. This report shall outline the actions taken or proposed to
betaken to ensure the problem does not recur. [15A NCAC 02T .0105(1), 02T .0108(b)(1)]
WQ0004972 Version 3.0 Shell Version 151201 Page 7 of 9

V. INSPECTIONS
I. The Permittee shall provide adequate inspection and maintenance to ensure proper operation of the
wastewater treatment and irrigation facilities. [15A NCAC 02T .0108(b)]
The Permittee or their designee shall inspect the wastewater treatment and irrigation facilities to prevent
malfunctions, facility deterioration and operator errors resulting in discharges, which may cause the
release of wastes to the environment, a threat to human health or a public nuisance. The Permittee shall
maintain an inspection log that includes, at a minimum, the date and time of inspection, observations
made, and any maintenance, repairs, or corrective actions taken. The Permittee shall maintain this
inspection log for a period of five years from the date of the inspection, and this log shall be made
available to the Division upon request. [15A NCAC 02T .0108(b)]
3. Any duly authorized Division representative may, upon presentation of credentials, enter and inspect
any property, premises or place on or related to the wastewater treatment and irrigation facilities
permitted herein at any reasonable time for the purpose of determining compliance with this permit;
may inspect or copy any records required to be maintained under the terms and conditions of this permit,
and may collect groundwater, surface water or leachate samples. [G.S. 143-21.5.3(a)(2)]
VI. GENERAL CONDITIONS
1. Failure to comply with the conditions and limitations contained herein may subject the Permittee to an
enforcement action by the Division in accordance with North Carolina General Statutes 143-215.6A to
143-215.6C. [G.S. 143-2I5.6A to 143-215.6C]
2. This permit shall become voidable if the permitted facilities are not constructed in accordance with the
conditions of this permit, the Division approved plans and specifications, and other supporting
documentation. [15A NCAC 02T .0110]
3. This permit is effective only with respect to the nature and volume of wastes described in the permit
application, Division approved plans and specifications, and other supporting documentation. No
variances to applicable rules governing the construction or operation of the permitted facilities are
granted, unless specifically requested and approved in this permit pursuant to 15A NCAC 02T .0105(n).
[G.S. 143-21.5.1 ]
4. The issuance of this permit does not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances, which may be imposed by other jurisdictional government agencies
(e.g., local, state, and federal). Of particular concern to the Division are applicable river buffer rules in
15A NCAC 02B .0200; erosion and sedimentation control requirements in 15A NCAC Chapter 4 and
under General Permit NCG010000; any requirements pertaining to wetlands under 15A NCAC 02B
.0200 and 02H .0500; and documentation of compliance with Article 21 Part 6 of Chapter 143 of the
General Statutes. [15A NCAC 02T .0105(c)(6)]
In the event the permitted facilities change ownership or the Permittee changes their name, a formal
permit modification request shall be submitted to the Division. This request shall be made on official
Division forms, and shall include appropriate property ownership documentation and other supporting
documentation as necessary. The Permittee of record shall remain fully responsible for maintaining
and operating the facilities permitted herein until a permit is issued to the new owner. [15ANCAC
02T .0104J
6. The Permittee shall retain a set of Division approved plans and specifications for the life of the facilities
permitted herein. [15A NCAC 02T .0108(b)(1)]
7. The Permittee shall maintain this permit until all permitted facilities herein are property closed or
permitted under another permit issued by the appropriate permitting authority. [15A NCAC 02T
.01050)]
WQ0004972 Version 3.0 Shell Version 151201 Page 8 of 9

8. This permit is subject to revocation or unilateral modification upon 60 days notice from the Division
Director, in whole or part for the requirements listed in 15A NCAC 02T .0110. [ 15A NCAC 02T .0110]
9. Unless the Division Director grants a variance, expansion of the permitted facilities contained herein
shall not be granted if the Permittee exemplifies any of the criteria in 15A NCAC 02T .0120(b). [15A
NCAC 02T .0120]
10. The Permittee shall pay the annual fee within 30 days after being billed by the Division. Failure to pay
the annual fee accordingly shall be cause for the Division to revoke this permit. [15A NCAC 02T
A105(e)(3)]
Permit issued this the 29" day of April 2016
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
-7 <
Jay Zimmerman, P.G., Director
Division of Water Resources
By Authority of the Environmental Management Commission
Permit Number WQ0004972
WQ0004972 Version 3.0 Shell Version 151201 Page 9 of 9

THIS PAGE BLANK

ATTACHMENT A — LIMITATIONS AND MONITORING REQUIREMENTS
PPI 001— WWTP Effluent
Permit Number: WQ0004972 Version: 3.0
EFFLUENT CHARACTERISTICS
EFFLUENT LIMITS
MONITORING REQUIREMENTS
PCS
Code
parameter Description
Units of
Measure
Monthly
Average
Monthly
Geometric Mean
Daily Minimum
Daily Maximum
Measurement
Frequency
Sample
Type
00310
BOD, 5-Day (20 °C)
mg/1
Monthly
Grab
00940
Chloride (as Cl)
mg/L
3 x Year
Grab
50060
Chlorine, Total Residual
mg/L
5 x Week
Grab
31616
Coliform, Fecal MF, M-FC Broth, 44.5 °C
#/100 mL.
Monthly
Grab
50050
Flow, in Conduit or thru Treatment Plant
GPD
24,400
Continuous
Recorder
00610
Nitrogen, Ammonia Total (as N)
mg/L,
Monthly
Grab
00625
Nitrogen, Kjeldahl, Total (as N)
mg/L
Monthly
Grab
00620
Nitrogen, Nitrate Total (as N)
mg/L
Monthly
Grab
00600
Nitrogen, Total (as N)
mg/L
Monthly
Grab
00400
pH
su
5 x Week
Grab
00665
Phosphorus, Total (as P)
mg/L
Monthly
Grab
70300
Solids, Total Dissolved-180 °C
mg/L
3 x Year
Grab
00530
Solids, Total Suspended
mg/L
Monthly
Grab
3 x Year monitoring shall be conducted in March, July and November.
WQ004972 Version 3.0 Attachment A Page 1 of 1

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ATTACHMENT S - APPROVED LAND APPLICATION SITES AND LIMITATIONS
MHC TT, Inc. — Forest Lake Preserve
Permit Number: WQ0004972 Version: 3.0
IRRIGATION AREA INFORMATION
APPLICATION LIMITATIONS
Field
Owner
County
Latitude
Longitude
Net
Acreage
Dominant
Soil Series
Parameter
Hourly
Rate
Yearly
Max
Units
1
MHC TT, Inc.
Davie
35.8660650
-80.3953020
9.0
01284 —Non Discharge Application Rate
0.11
46.8
inches
WQ0004972 Version 3.0 Attachment B Page 1 of 1

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ATTACHMENT C — GROUNDWATER MONITORING AND LIMITATIONS
Monitoring wells: MW-1, MW-2, MW-3, and MW-4
Permit Number: WQ0004972 Version: 3.0
GROUNDWATER CIiIARACTERISTICS
GROUNDWATER STANDARDS
MONITORING REQUIREMENTS
PCS Code
Parameter Description
Daily Maximutn
Frequency Measurement
Sample Type
Footnotes
00680
00940
31616
Carbon, Tot Organic (TOC)
Chloride (as Cl)
Coliform, Fecal MF, M-FC Broth, 44.5 °C
250
mg/L
mg/L
4/100 mL
3 x Year
3 x Year
3 x Year
Grab
Grab
Grab
L 6
1
I
00620
Nitrogen, Nitrate Total (as N)
10
mg/L
3 x Year
Grab
1
00400
pH
6.5-8.5
su
3 x Year
Grab
1,2
GWVOC
82546
Volatile Compounds (GC/MS)
Water Level, Distance from measuring point
Present: Yes/No
feet
Annually
3 x Year
Grab
Calculated
1, 4, 5
1, 2, 3
I . 3 x Year monitoring shall he conducted in March, July & November; Annual monitoring shall be conducted every November.
2. The measurement of water levels shall be made prior to purging the wells. The depth to water in each well shall be measured from the surveyed point on the top of the casing. The measurement of
pH shall be made after purging and prior to sampling for the remaining parameters.
3. The measuring points (top of well casing) of a]I monitoring wells shall be surveyed to provide the relative elevation of the measuring point for each monitoring well. The measuring points (top of
casing) of all monitoring wells shall be surveyed relative to a common datum.
4. Volatile Organic Compounds (VOC) - In November only, analyze by one of the following methods:
a. Standard Method 6230D, PQL at 0.5 µg/L or less
b. Standard Method 621 OD, PQL at 0.5 lig/L or less
c. EPA Method 8021, Low Concentration, PQL at 0.5 pg/L or less
d. EPA Method 8260, Low Concentration, PQL at 0.5 µg/L or less
e. Another method with prior approval by the Water Quality Permitting Section Chief
Any method used must meet the following qualifications:
a. A laboratory must be DWR certified to run any method used.
b. The method used must, at a minimum, include all the constituents listed in Table VIII of Standard Method 6230D.
c. The method used must provide a .PQL of 0.5 pg/L or less that must be supported by laboratory proficiency studies as required by D WR. Any constituents detected above the MDL but below
the PQL of 0.5 pg/L must be qualified (estimated) and reported.
5. If any volatile organic compounds (VOC) are detected as a result of monitoring as provided in Attachment C, then the Winston Salem Regional Office supervisor, telephone number (336) 776-
9800, must be contacted immediately for further instructions regarding any additional follow-up analyses required.
6. If TOC concentrations greater than 10 mg/L are detected in any downgradient monitoring well, additional sampling and analysis must be conducted to identify the individual constituents comprising
this TOC concentration. If the TOC concentration as measured in the background monitor well exceeds 10 mg/L, this concentration will be taken to represent the naturally occurring TOC
concentration. Any exceedances of this naturally occurring TOC concentration in the downgradient wells shall be subject to the additional sampling and analysis as described above.
7. Monitoring wells shall be reported consistent with the nomenclature and location information provided in Figure A and this attachment.
WQ0004972 Version 3.0 Attachment C Page 1 of I

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Google Maps
Page 1 of 1
Go gle Maps
W00004972 Forest Lake Preserve
Imagery 02016 DigitalGlobe, U.S. Geological Survey, USDA Farm Service Agency, Map data 02016 Google 200 ft
https://www.google.com/maps/@35.8623153,-80.3961242,585m... 2/15/201.6

FIDELITY NATIONAL TITLE
INSURANCE COMPANY
Fidelity National Title Policy Issued from Raleigh Office
P.O. Box 2209. Raleigh, NC 27602
919 B29-0200 (WATS: B00 662-7729)
TO THE CLOSING ATTORNEY AND/OR INSURED LENDER:
Thank you for giving us the opportunity to provide this coverage.
Attached is the original or your copy o= the policy or endorsement identifi
below:
POLICY NO. 04R202439-00 DATE: 05-24-05
LOAN COVERAGE: OWNER'S COVERAGE: $3,375,000.00
PREMIUM: $2.693,60 PAID: $2,693.60 DUE: $0.00
CHECK: 426110178/54579
OWNER: MHC TT. INC. (SUCCESSOR BY MERGER TO THOUSAND TRAILS, INC.)
Par I - 299.B02A & Par 2 - 6.672A Davie Caty NC
GEORGE E HOLLODICK
110 S STRATFORD RD
PO DRAWER 25009
WINSTON-SALEM NC 27114-5008
Atty File #i: 013255/1
If you have any questions, please do not hesitate to contact us. If possible,
please refer to the policy number shown above when calling or writing.
In Raleigh, call Branch Manager, Sara Boshart, Title Counsel, Natasha
Branch, or Commercial Underwriter, Mary Daggett.
nellcd ta,
—der _
owner
Rctornev
Thank you,
Ken Stone
NC State Manager
Policy No, 04R202439-00
Referral „ NYk04-3706-10894NC[26)

FIDELITY NATIONAL TITLE
INSURANCE COMPANY
P.O. Box 2209. Raleigh, NC 27602
919 829-0200 (WATS: 800 662-7729)
OWNER'S POLICY
SCHEDULE A
Policy Amount: $3,375,DD0.00
policy Date - 19 MAY 2D05 at 9:26AM in Davie County
1, Insured:
MHc TT, INC. (SUCCESSOR BY MERGER TO THOUSAND TRAILS, INC.)
2. The estate or interest in the land described herein and which is covered by this policy
is a Fee Simple and at the policy date the Fee is vested in the insured,
3. The land referred to in this policy is described as follows:
Being that same property as described in that certain Deed from Lucy D,
Hairston and husband, Peter W. Hairston and Forest Lake Family Camp, inc.,
a North Carolina corporation, to Thousand Trails, Inc., a Washington
corporation. dated May 3, 1984, and recorded on May 3, 1984 at 2:20PM, in
Book 122, Page 790, Davie County Registry
NOTE: The following endorsements are attached to and made a part of this
policy; Same As Survey; Access; Subdivision: Tax Parcel; Owner's
Comprehensive: Contiguity; Address; Zoning; Blanket Easement.
The Land referred to in this Policy is located in Davie County, State of
North Carolina, and more particularly described as follows: (SEE EXHISIT A
ATTACHED HERETO)
NOTE: The parties to this contract of insurance declare that it is their point and mutual
intention that this contract shall not be construed as creating a third party beneficiary
contract.
SCHEDULE B - EXCEPTIONS
This policy does not insure against lass or damage by reason of the following EXCEPTIONS:
1. The lien of all taxes for the year 2005 and thereafter, which are not yet due and
payable.
2. Right-of-way to Davidson Mutual Electric Corporation, recorded in Book 40, Page 32,
❑avie County Registry. (Blanket in Nature - Not Plottable)
3. Right-of-way to Yadkin Valley Telephone Membership Corporation, recorded in Book 73,
Page 531, Davie County Registry, (Blanket in Nature - Not Plottable)
(continued on next wage)
Folicy No. O4R2O2439-0
ALTA Owner's Policy (Revised 10-17-92)
Referral: 9"04-3706-1O694NC(26)

FIDELITY NATIONAL TITLE
INSURANCE COMPANY
P.D. Sox 2209, Raleigh, NC 27602
919 829-0200 (WATS: 800 662-7729)
4. Aight-of-way Co the North Carolina Department of Transporation (State Highway Project
#9.1729801), recorded in Soak 116, Page 592, Davie County Registry.
S. Right-of-way to the North Carolina Department of Transporation (State Highway Project
ir0.1729001), recorded in Book 116, Page 59a, Davie County Registry.
i
6. Right-of-way to Davidson Electric Membership Corporation, recorded in Book 124, Page
file, Davie County Registry. As shown on survey entitled °ALTA/ACSM Land Title Survey
for MHC Surveys, Forest Lake, 192 Thousand Trails Drive, Advance, NC 27006, County of
Davie, State of NC" dated August 31, 2004 by Smith Surveyors. Inc., last revised on
February 2, 2005 by J. C. Smith, PLS No. L-3036.
7. Terms, conditions, and rights of others set forth in that certain unrecorded Lease
Agreement dated November 10, 2004, by and between WMC TT, Inc., a Delaware corporation,
and MHC TT Leasing Company, Inc., a Delaware corporation, a Memorandum of which is
recorded in Book 600, Page 521. Davie County Registry.
0. Terms, conditions, and rights of others set forth in that certain unrecorded Lease
Agreement dated November 10, 2004, by and between MHC TT Leasing Company, Incl., a
Delaware corporation, and Thousand Trails Cparations Holding Company, L.P., a Delaware
limited partnership, a Memorandum of which is recorded in Book 608, Page 527, ❑avie
County Registry.
9. Terms, conditions, and rights of others set forth in that certain unrecorded SublIa..
Agreement dated November 10, 2004, by and between Thousand Trails, L.P., a Delaware
limited partnership, and Thousand Trails, L.P., a Delaware limited partnership, a
Memorandum of which is recorded in Book 605, Page 535, Davie County Registry.
10. Riparian rights are neither guaranteed nor insured with respect to the waters of Ya in
River. Laws of the State of North Carolina relating to water front property and,the
rights of the Sate of North Carolina therein. As shown on survey entitled "ALTA/ACSM
Land Title Survey for MHC Surveys, Forest Lake, 192 Thousand Trails Drive, Advance„ NC
27006, County Of Davie, State of NC" dated August 31, 2004 by Smith Surveyors, Inc.,
last revisedonFebruary 2, 2005 by J. C. Smith, PLS No. L-3039,
11. Rights or claims of tenants in apssession under unrecorded leases, if any, as ten€ants
only with no purchase rights.
12. Title to that portion of the Land within the bounds of burial grounds together with' the
rights of ingress, regress and egress. As shown on survey entitled ^ALTA/AGSM (Land
Title Survey for MHC Surveys, Forest Lake, 192 Thousand Trails Drive, Advance, NC
270DG, County of Davie, State of NC" dated August 31, 2004 by Smith Surveyors, IEno.,
last revised On February 2, 2a05 by J. C. Smith, PLS No. L-3030.
{continued on next page)
Policy No_ 04R202439-0
ALTA Owner's Policy (Revised 10-17-921
Referral: NY4D4-37o6-1o894NC(26)

FIDELITY NATIONAL TITLE
INSURANCE COMPANY
P.O. Box 2209, Raleigh, NC 27602
919 829-0200 (WATS: 900 662-77291
13. Survey entitled "ALTA/AGSM Land Title Survey for MHC Surveys, Forest Lake, 192 Thousand
Trails Drive, Advance, NC 27.006, County of Davie, State of NC" dated August 31, 2004 by
Smith Surveyors, Inc., last revised an February 2, 2OD5. by J. C, Smith, PLSINc.
L-3938, reveals: a) poles, catch basins, fire hydrants, water valves and meters, RCR's,
CMP's, sewer iitt station, water and electric hoofs ups, transformers, clean o ts.
manholes, telephone boxes, barns, buildings, sheds, utility boxes, volley ball area,
tennis court, basketball court, pool house and area, playgrounds, guard house,-�ent
sites, waste treatment plant, propane tank(s) situate on and overhead pEoxod
,
underground telephone and sanitary sewer lines crossing subject property; b) rigof
others, if any, in and to use of the private road (River Road)- c) approximate
plane line; d) This Company does not insure that subject property has direct means of
access to a publicly dedicated right of way but rather by way of property adjoining to
the south currently vested in the insured, (as to Parcel One)
14. Survey entitled "ALTA/AGSM Land Title Survey for MHC Surveys, Forest Lake, 192 Thousand
Trails Drive, Advance, NC 27006, County of Davie, State of NC" dated August 31, 200i3 by
Smith Surveyors, Inc., last revised on February 2, 2005 by T, C. Smith, PLS No. L-3 3e,
revenis: a) poles, water meters and valves sitaute on and overhead electric lines
crossing subject property; b) approximate flood plane line: c) right.of way of .S.
Highway 64; d) rights of others, if any, in and to the old road crossing subect
property, (as to Parcel Two)
Countersigned and Validated:
By: COPY
Authorized Representative
05-24-05 MD
Par i - 299.B02A & par 2 - 6.672A Davie Cnty NC
Policy No, 04R202439-0
ALTA Owner's Policy (Revised 10-17-92)
Referral: NYn04-3706-19B94NC(Z6)

DocuSign Envelope ID: 4A577F99-195C-433D-9B32-C320E201DC88
State of North Carolina
Department of the Secretary of State
APPLICATION FOR REGISTRATION
AS A FOREIGN LIMITED PARTNERSHIP
SOSID: 2016964
Date Filed: 7/27/2020 11:17:00 AM
Elaine F. Marshall
North Carolina Secretary of State
C2020 206 00984
Pursuant to §59-902 of the General Statutes of North Carolina, the undersigned hereby submits this application
for Registration as a Foreign Limited Partnership for the purpose of obtaining a Certificate of Authority to
transact business in this State.
1
The name of the foreign limited partnership is: MHC TT, L.P.
2. If the name of the foreign limited partnership is unavailable for use in the State of North Carolina, the name the
limited partnership wishes to use is:
(The name must contain the words "Limited Partnership," or the abbreviation "L.P." or "LP," or the combination
"Ltd. Partnership".)
3. The jurisdiction in which the limited partnership was formed is Delaware
and the date of formation was 10/1/1996 The limited partnership's period of duration is
perpetual
M
The street address of the principal office is:
Number and Street: Two N. Riverside Plaza, Suite 800
Chicago IL
City: State: Zip Code
60606
Cook
County:
The mailing address, if different from the street address, of the principal office:
Telephone: [phone]
Number and Street:
City:
5. Name of Registered Agent:
State: Zip Code: County:
C T Corporation System
6. Address of Registered Agent's Office:
umber and Street: 160 Mine Lake Ct., Ste. 200
N
City: Raleigh
State: NC Zip Code: 27615-6417County:
The mailing address, if different from the street address, of the registered office:
Number and Street:
City: State: NC Zip Code: County:
Wake
NOTES:
Filing fee is $50. This document must be filed with the Secretary of State.
BUSINESS REGISTRATION DIVISION P.O.BOX 29622 RALEIGH, NC 27626-06222
(Revised August, 2017) Page 1 Form LP-04
NCO46 - 11/9/2017 Wolters Kluwer Online

DocuSign Envelope ID: 4A577F99-195C-433D-9B32-C320E201DC88
In consideration of the issuance of a Certificate of Authority to transact business in North Carolina, the limited
partnership appoints the Secretary of State of North Carolina as the agent to receive service of process, notice or
demand, whenever the foreign limited partnership fails to appoint or maintain a registered agent in this State, or
whenever such registered agent cannot with reasonable diligence be found at the registered office.
(Optional): Please provide a business e-mail address: Privacy Redaction
The Secretary of State's Office will e-mail the business automatically at the address provided at no charge when a
document is filed. The e-mail provided will not be viewable on the website. For more information on why this
service is being offered, please see the instructions for this document.
Enter the name and address of each general partner: (attach additional sheets if necessary)
Name MHC Trails GP, L.L.C.
Two N. Riverside Plaza, Suite 800
Ciry
Chicago
Name
Street/No
Ciry
IL / 60606
State/Zip State/Zip
10. Limited Partners (select 1 or 2, as appropriate)
❑ Attached is a list of the names and addresses of all limited partners (include full name/street
address/city/state/zip code/county); or
x❑ The location of the office where list of the names and addresses of the limited partners and their capital
contributions will be kept as long as the limited partnership transacts business in North Carolina is:
Number and Street: Two N. Riverside Plaza, Suite 800
City:
11. (Select one)
Chicago
State: IL Zip Code: 60606 County:
❑ The foreign limited partnership is a foreign limited liability limited partnership.
❑X The foreign limited partnership is not a foreign limited liability limited partnership.
Cook
12. This registration will be effective upon filing, unless a future date and/or time is specified:
Walter B. Jaccard
Typed or printed name
OocuSigned by.
WAGift did
Slgnatur C55444DOAAEC46A...
Vice President of MHC Trails GP, L.L.C., general partner
Title
NOTES:
Filing fee is $50. This document must be filed with the Secretary of State.
BUSINESS REGISTRATION DIVISION P.O.BOX 29622 RALEIGH, NC 27626-06222
(Revised August, 2017) Page 2 Form LP-04
NCO46 - 11/9/2017 Wolters Kluwer Online

Delaware Page
The First State
1, JEFFREY W . BULLOCK, SECRETARY OF STATE OF THE STATE OF
DELAWARE, DO HEREBY CERTIFY "AHC TT, L.P." IS DULY FORDED UNDER THE
LAWS OF THE STATE OF DELAWARE AND IS IN GOOD STANDING AND HAS A
LEGAL EXISTENCE SO FAR AS THE RECORDS OF THIS OFFICE SHOW, AS OF
THE SIXTEENTH DAY OF JULY, A.D. 2020.
AND I DO HEREBY FURTHER CERTIFY THAT THE ANNUAL TAXES HAVE BEEN
PAID TO DATE.
2669212 8300
SR# 20206262050 A
You may verify this certificate online at corp.delaware.gov/authver.shtml
�.nF+r w. ewwsF_ S.wM.ry d Sb7r
Authentication: 203294133
Date: 07-16-20

1117WI1f IX11
North Carolina Secretary of State Search Results
Search Results
Records Found: 3 Search Type: Starting Search Criteria: Mhc Tt
Search Time: 10/20/2020 07.06 AM Search Again
Entity Name
Sos Id Date Formed Status
MHC TT, Inc.
Prev Legal Name(s)
THOUSAND TRAILS, INC.
0412953 12/12/1996 Withdrawn by Merger O
MHC TT, L.L.C.
1796655 1/25/2019 Withdrawn O
Type
Business Corporation
Limited Liability Company
MHC TT, L.P.
2016964 7/27/2020 1 Current -Active O Limited Partnerships
https://www.sosnc.gov/online_services/search/Business_Registration_Results 1 /1

Forest Lake RV & Camping Resort
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National Flood Hazard Layer FI RMette *FEMA
8Oo24'W 35o51'56"N
I.V,VVV
0 250 500 1,000 1,500 2,000
Forest Lake RV Camping Resort
Legend
SEE FIS REPORT FOR DETAILED LEGEND AND INDEX MAP FOR FIRM PANEL LAYOUT
Without Base Flood Elevation (BFE)
Zone A, V, A99
SPECIAL FLOOD Wit
hBFE orDepthZoneAE,AO,AH,Ve,Aa
HAZARD AREAS Regulatory Floodway
0.2% Annual Chance Flood Hazard, Areas
of 1% annual chance flood with average
depth less than one foot or with drainage
areas of less than one square mile Zonex
Future Conditions 1% Annual
41L Chance Flood Hazard Zonex
" Area with Reduced Flood Risk due to
OTHER AREAS OF Levee. See Notes. Zonex
FLOOD HAZARD I " Area with Flood Risk due to Leveezone D
NOSCREEN Area of Minimal Flood Hazard
Q Effective LOMRs
OTHER AREAS Area of Undetermined Flood Hazard
GENERAL - — - - Channel, Culvert, or Storm Sewer
STRUCTURES I I I I I I I Levee, Dike, or Floodwall
e zo.z Cross Sections with 1% Annual Chance
17.5 Water Surface Elevation
- - - Coastal Transect
Base Flood Elevation Line (BFE)
Limit of Study
Jurisdiction Boundary
— --- Coastal Transect Baseline
OTHER
_ Profile Baseline
FEATURES
Hydrographic Feature
❑ Digital Data Available AN
0 No Digital Data Available
MAP PANELS
El Unmapped
The pin displayed on the map is an approximate
point selected by the user and does not represent
an authoritative property location.
This map complies with FEMA's standards for the use of
digital flood maps if it is not void as described below.
The basemap shown complies with FEMA's basemap
accuracy standards
The flood hazard information is derived directly from the
authoritative NFHL web services provided by FEMA. This map
was exported on 10/22/2020 at 4:27 PM and does not
reflect changes or amendments subsequent to this date and
time. The NFHL and effective information may change or
become superseded by new data overtime.
This map image is void if the one or more of the following map
elements do not appear: basemap imagery, flood zone labels,
legend, scale bar, map creation date, community identifiers,
FIRM panel number, and FIRM effective date. Map images for
unmapped and unmodernized areas cannot be used for
regulatory purposes.