WQ0042262_Application (FTSE)_20210125

��], ,ndDe o v urban design planning civil engineering branding landscape architecture
January 25, 2021
Mooresville Regional Office
Water Quality Section
610 E. Center Avenue
Mooresville, NC 28115
RE: Evoke Living at Arrowood
LandDesign PN: 1018136
Dear Sir/Madam,
RsceV�O`lvco�Qlt)w
JAN22021
'10®Ri�-Svx(' o OO
SAC OFF/C'e
Crosland Southeast LLC, is in the process of developing and constructing 168 apartment units.
It will be served by approximately 97 LF of 8" DIP and 858 LF of 6" PVC. We are estimating
22,930 gallons per day of gravity sewage. Attached is a letter from Charlotte Water agreeing to
accept our flow to the McAlpine Creek WWTP. Also attached is our FTA 04-16 application and
associated check for $480.
We respectfully request your review and welcome any questions or comments. Thank you for
your assistance with this project. Please feel free to contact me directly via telephone at
704.333.0325 or email at [e-mail] should you have any questions and/or
comments.
Respectfully Submitted,
Frank McMahan, PE
LandDesign, Inc.
PO Box 36959 Charlotte, NC 28236-6959 223 North Graham Street Charlotte, NC 28202 V:704.333.0325 F; 704.376.8235
N:\_2018\1018136\Docs\Pennitting\Private SewerUndividual\NCDENR Fast Track Letter.doc

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number:Ito be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Crosland Southeast LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual
® Corporation ❑ General Partnership
❑ Federal
❑ State/County ❑ Municipal
3. Signature authority's name: Barry James per 15A NCAC 027 .01011-1
Title: Partner
4. Applicant's mailing address: 121 W Trade Street Suite 2550
City: Charlotte State: NC
Zip: 28202-
5. Applicant's contact information:
Phone number: [phone]
Email Address: bjamespcsere.com
II. PROJECT INFORMATION:
JAN 2 5 2021
WOROS
MOORESVILLE REGIONAL
❑ Privately -Owned Public Utility
❑ Other
L Project name: Evoke Living at Arrowood
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Mecklenburg
4. Approximate Coordinates (Decimal Degrees): Latitude: 35,133720' Longitude:-80.895726'
5. Parcel ID (if applicable): 20318901
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Frank McMahan License Number: 037773
Firm: LandDesign, Inc
Mailing address: 223 N. Graham Street
City: Charlotte State: NC Zip: 28202-
Phone number: [phone] Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: McAlpine Creek Wastewater Treatment Facility Permit Number: N00024970
Owner Name:
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: inch
System Wide Collection System Permit Number(s� if aprplicablel: WQCS
Owner Name(s):
FORM: FTA 04-16 Page 1 of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes [:]No ®N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been attached?
❑ Yes [:]No ®N/A
3. If the Applicant is a Home/Property Owners' Association. has an 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 % Commercial
% Industrial (See 15A NCAC 02T .0103(20))
�pIs there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 021.0114(fl? ❑ Yes ❑ No
➢ If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(fl)
Daily Design Flow a,b
No. of Units
Flow
Residential Dwelling Units
135 gal/day
168
22,680 GPD
Office/Leasing
25 gal/day
10
250 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
22,930 GPD
a See 15A NCAC 02T .0114(b, (d). (e)LI) and (e)(2i 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: 22.930 GPD (per 15A NCAC 021 .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 04-16 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 97 DIP
6 858 PVC
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIII. 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)(1):
❑ 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 .0305LQ &AM
➢ 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
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
Any swimming pools
10 feet
Final earth grade vertical
36 inches
➢ 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(fl cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webnage
➢ If noncompliance with 02T.0305(1) or (g). 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 0213.0200? ❑ 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 PermittiniBranch
5. Does project comply with 15A NCAC 02T.0105(cl(6) (additional permits/certifications)? ® Yes [:]No
Per 15A NCAC 02T.0105(cl(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:
1. Does the submitted system comply with 15A N{'r102T, the Minimum Design Criteria for the Perini i of Putakions
and Force Mains /latest y�rsion) and the Gravity Sewer Minimum Design C( atyersionl as applicable?
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:
I, Frank McMahan attest that this application for
(Professional Engineer's name from Application Item III.I.)
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 143-215.611, 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.
North Carolina Professional Engineer's seal, signature, and date:
037? 13
ftk(#31174 E�'�� ff
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, Barry James, Partner attest that this application for
(Signature Authority's name & title from Application Item I.3)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
of this permit be violated. I also understand that if all required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
NOTE — In accordance with General Statutes 143-2i5.6A and 143-2151B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: Date:
[11��
FORM: FTA 04-16 Page 5 of 5

January 31, 2020
Mr. Frank J. McMahan
LandDesign, Inc.
223 North Graham Street
Charlotte, NC 28202
SUBJECT: WATER AND SEWER FLOW ACCEPTANCE
EVOKE LIVING AT ARROWOOD
WEST HEBRON STREET & WEST ARROWOOD ROAD, CHARLOTTE, NC
CLTWATER TRACKING# 2019723
After an analysis of the sanitary sewer associated with the proposed design of project, 2019723,
EVOKE LIVING AT ARROWOOD, it was determined that there is sufficient capacity to
accommodate the proposed sewer flow of 2Z930 gallons per day (168 units x 135 gpd; 10
emp/shift x 25 gal/emp/shift) at the connection point(s) indicated on the submitted utility plan for
transmission to the McAlpine Creek Wastewater Treatment Plant; NPDES permit number
NC0024970, for treatment. This acceptance of flow is based upon the existing capacity of the
designated publicly owned treatments works.
Charlotte Water (CLTWater) agrees to furnish water to the subject project. The water quality to the
subject project is regulated by the State Drinking Water Act Amendments of 1986 and The Water
Supply Management Plan, PWS ID # 0160010 on file with the Public Water Supply Section of
NCDEQ. However, CLTWater cannot guarantee a constant pressure or quality of flow.
The applicant should understand that due to the involvement of other agencies and continuing
growth of the water system, the ability to provide service for future projects cannot be guaranteed
nor reserved. Connection to the CLTWater system is accepted on a first come, first served basis.
The applicant should understand that this letter is not authorization to construct or extend private
water or sewer systems, as the appropriate local or State permits are required prior to construction.
If the appropriate authorization to construct permits are not obtained construction has not started
within two j2) years of issuance of this flow acceptance, and payment for any service connections
have not been received within two L) years of issuance of this flow acceptance letter, this flow
acceptance aaaroval shall be rescinded and a new flow acceptance request must be made.
If you have any questions, please do not hesitate to contact me at [phone].
Sincerely,
Guillermo Anzola
Engineering Assistant
Charlotte Water 5100 Brookshire Blvd, Charlotte, NC 28216 cliariottewater.org
„16-4 operated by the City of Charlotte

State of North Carolina
lov
Entity Requesting Allocation:
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
LandDesign, Inc.
Project Name for which flow is being requested: SW Affordable
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all
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: McAlpine Creek, Irwin Creek, Sugar Creek
b. WWTP Facility Permit #: NCo024970, NC0024945, NCO024937
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
99.0
13.01
69.19
0.023
82.22
83.1 %
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) (E)=(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 / p fl, 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): Unknown
Downstream Permit Number: Unknown
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Ker) Cantrell 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
Chief Engineer
Title of Signing Official
2/8/2019
Date
Page 2 of 6
FTSE 10-18

1 • a •

`d1k
Transmittal
PROJECT: 1018136 SW AFFORDABLE DATE: 1/25/2021
1018136
SUBJECT: Evoke Living at Arrowood - Fast TRANSMITTAL ICE: 00013
Track Sewer Application,
1�
PURPOSE: For your approval VIA: Courier
_ �K� _�
FROM \0�lp`
NAME —T
COMPANY
EMAIL.
Dann Bisho
t_LandDesign, Inc.
Dbishop@landdesign.
TO
NAME
L—
CO(9PANY
--__
EMAIL —j F'NON
REMARKS: Mooresville Regional Office -3O1,qqOIVNO'03
Water Quality Section -'066 001N
610 E. Center Avenue
Mooresville, NC 28115 `�oZ Z Nbr
11A4 ®/O-3OON/O3At303jj
Good afternoon Sir/Madam,
Please find enclosed a Fast Track Sewer System Extension Application for
Evoke Living at Arrowood.
Enclosed are the following:
• Cover Letter
• Application Fee
• Application
• Flow Acceptance Documentation
• Site Maps
• Sanitary Sewer Plan
Please reach out to Frank McMahan at 704.333.0325 or email him at
[e-mail] if you have any questions.
Thank you,
Danny Bishop, EI
Page 1 of 1

January 31, 2020
Mr. Frank J. McMahan
LandDesign, Inc.
223 North Graham Street
Charlotte, NC 28202
RECEIVEDINCDEQIDWR
JAN 2 5 2021
WQROS
MOORESVILLE REGIONAL OFFICE
SUBJECT: WATER AND SEWER FLOW ACCEPTANCE
EVOKE LIVING AT ARROWOOD
WEST HEBRON STREET & WEST ARROWOOD ROAD, CHARLOTTE, NC
CLTWATER TRACKING# 2019723
After an analysis of the sanitary sewer associated with the proposed design of project, 2019723,
EVOKE LIVING AT ARROWOOD, it was determined that there is sufficient capacity to
accommodate the proposed sewer flow of 22,930 gallons per day (168 units x 135 gpd; 10
emp/shift x 25 gal/emp/shift) at the connection point(s) indicated on the submitted utility plan for
transmission to the McAlpine Creek Wastewater Treatment Plant; NPDES permit number
NC0024970, for treatment. This acceptance of flow is based upon the existing capacity of the
designated publicly owned treatments works.
Charlotte Water (CLTWater) agrees to furnish water to the subject project. The water quality to the
subject project is regulated by the State Drinking Water Act Amendments of 1986 and The Water
Supply Management Plan, PWS ID # 0160010 on file with the Public Water Supply Section of
NCDEQ. However, CLTWater cannot guarantee a constant pressure or quality of flow.
The applicant should understand that due to the involvement of other agencies and continuing
growth of the water system, the ability to provide service for future projects cannot be guaranteed
nor reserved. Connection to the CLTWater system is accepted on a first come, first served basis.
The applicant should understand that this letter is not authorization to construct or extend private
water or sewer systems, as the appropriate local or State permits are required prior to construction.
If the appropriate authorization to construct permits are not obtained construction has not started
within two (2) years of issuance of this flow acceptance, and payment for any service connections
have not been received within two (2Zyears of issuance of this flow acceptance letter, this flow
acceptance approval shall be rescinded and a new flow acceptance request must be made.
If you have any questions, please do not hesitate to contact me at [phone].
Sincerely,
Guillermo Anzola
Engineering Assistant
Charlotte Water 5100 Brookshire Blvd, Charlotte, NC 28216 Cliarlottewater.org
y Operated by the City of Charlotte

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
RECEIVE q/&-T§)
Entity Requesting Allocation: LandDeSign, Inc. JAN 2021
Project Name for which flow is being requested: SW Affordable nenncaGe,�II WQROS
GIONAL OFFICE
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name
McAlpine Creek, Irwin Creek, Sugar Creek
b. WWTP Facility Permit #: NCo024970, NC0024945, NCO024937
All flows are in MGD
c. WWTP facility's permitted flow 99.0
d. Estimated obligated flow not yet tributary to the WWTP 13.01
e. WWTP facility's actual avg. flow 69.19
f. Total flow for this specific request 0.023
g. Total actual and obligated flows to the facility 82.22
h. Percent of permitted flow used 83.1 %
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) (E)=(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 / p fl, 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): Unknown
Downstream Permit Number: Unknown
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Keri Cantrell 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
Chief Engineer
Title of Signing Official
2/8/2019
Date
Page 2 of 6
FTSE 10-18

• ' � � • � 1 �