WQ0042445_Application (FTSE)_20210413

Surface Water Protection Supervisor
North Carolina Department of Environmental Quality
Winston-Salem Regional Office
Water Quality Section
450 W. Hanes Mill Road — Suite 300
Winston-Salem, NC 27105
[phone]
Regarding: Old Fields Subdivision — Pod 2
1774 Post Oak Drive
Graham, NC
Dear Sir or Madam:
APR 12 2021
Winston-Salem
Regional Office
Please find attached fast track application for the gravity sewer line for the above referenced
project. Included in this package are the following:
1. One original and one copy of the Fast Track Application
2. One check for $480 (#1088)
3. One original and one copy of the Downstream Sewer Flow Tracking/Acceptance
Form
4. One original and one copy of the USGS Topographic map and street level map.
5. Deed
6. N.C. Secretary of State LLC documentation.
The project will include 3,361 L.F. of 8" public sanitary sewer line and 20 new manholes. The total
project will be constructed in one (1) phase. The project will connect into the existing public
sanitary sewer lines located existing City streets and will be extended the distances as required to
service the proposed Old Fields Subdivision — Pod 2 (87 — 3 BR detached single family
ownership lots), 31,320 gal per day. All construction will be in accordance with the requirements
of the City of Graham, NC and NCDEQ Standards and Specifications. The City of Graham, NC
has confirmed that adequate capacity is available at the City of Graham Wastewater Treatment
Plant to treat the wastewater discharge from this project (see attached FTSE).
Please call if you have any questions.
Very Truly Yours,
A4 090
Mike Otto
Enclosures
621 Eugene Court, Suite 100, Greensboro, NC 27401-2711 • PO Box 21882, Greensboro, NC 27420-1882
Phone [phone] • Fax [phone]
Website: www boruna-fcadc corn
N.C. License #: C-0868

April 9, 2021
ENGINEERING_ PROJECT NARRATIVE FOR INSTALLATION OF PUBLIC SEWER
Project: Old Fields Subdivision — Pod 2 Subdivision, 87 units
Developer: KG Plaza, LLC
Public Utility: City of Graham
County: Alamance County
WWTP Facility: City of Graham Wastewater Treatment Plant (NC 0021211)
Existing Conditions:
The City of Graham has the line capacity and the allocation availability to accept the sewer flows
from this project. The anticipated flows from this project are not expected to cause any capacity
related sanitary sewer overflows or to overburden any downstream pump stations en route to the
receiving treatment plant under normal circumstances. There are existing 8" public sanitary sewer
mains to serve the project.
Proposed Project:
The project will include 3,361 L.F. of 8" public sanitary sewer line and 20 new manholes. The total
project will be constructed in one (1) phase. The project will connect into the existing public
sanitary sewer lines located existing City streets and will be extended the distances as required to
service the proposed Old Fields Subdivision — Pod 2 (87 — 3 BR detached single family
ownership lots), 31,320 gal per day. All construction will be in accordance with the requirements
of the City of Graham, NC and NCDEQ Standards and Specifications. The City of Graham, NC
has confirmed that adequate capacity is available at the City of Graham Wastewater Treatment
Plant to treat the wastewater discharge from this project (see attached FTSE).
Owner/Operator:
The sewer lines extended within this project will be public maintained through The City of Graham
Permits:
Prior to beginning construction of the proposed sewer line the appropriate NCDEQ Gravity Sewer
Permit will be acquired.
621 Eugene Court, Suite 100, Greensboro, NC 27401-2711 • PO Box 21882, Greensboro, NC 27420-1882
Phone [phone] • Fax [phone]
Website: ww.borum-scade.com
N.C. License #: C-0868

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: (to be completed by DWR)
All items must be completed or the apnlication will be returned
I. APPLICANT INFORMATION:
I. Applicant's name: City of Graham, N.0 (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ❑ Municipal ❑ Other
3. Signature authority's name: Frankie Manass per 15A NCAC 02T .0106(b)
Title: City Manager
4. Applicant's mailing address: 201 South Main Street
City: Graham State: N.C.. Zip: 27253-3301
5. Applicant's contact information:
Phone number: 336 570-6700 Email Address: fmanessAcitvofgraham.com
H. PROJECT INFORMATION:
1. Project name: Old Fields Subdivision - POD 2
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: W000_ and issued date:
If new construction but part of a master plan, provide the existing permit number: W000_
3. County where project is located: Alamance
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.0062'
5. Parcel ID (if applicable): 152958
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
Professional Engineer: Homer S. Wade License Number: 10771
Firm: Borum, Wade and Associates, P.A.
Mailing address: 621 Eugene Court - Suite 100
City: Greensboro State: N.C. Zip: 27401-2711
Longitude:-79.350'
Phone number: 336) 275-0471 Email Address: hswadeAborum-wade.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: City of Graham Wastewater Treatment Plant Permit Number: NCO021211
Owner Name: City of Graham
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): W 000 24872 Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS00065
Owner Name(s): City of Graham
FORM: ETA 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/Pronerty 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: 100 % Domestic/Commercial % Commercial
_ % Industrial (See 15A NCAC 02T .0103(20))
"Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(fl? [-]Yes ®No
➢ If yes, provide a cony of flow reduction aonroval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.01140
Daily Design Flow "'h
No. of Units
Flow
87 Lots @ 3 Bedrooms/Lot
360 gal/day
87
31,320 GPD,
gal/day
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
31,320 GPD
a See 15A NCAC 02T .0114(b),(d), (e)(1) and (e,)(2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0114] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
S. Wastewater generated by project: 31,320 GPD (per 15A NCAC 02T .0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16 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
1897
PVC
8
1464
DIP
➢ 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)
Y 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 (Pumo 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.0305(f) & (a) ® Yes ❑ No
➢ 15A NCAC 02T.0305(f) contains minimum separations that shall be Drovided 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 tenches)
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 buildiniz 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(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications weboage
➢ If noncompliance with 02T.0305(f) 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 roles per 15A NCAC 02B .0200? ❑ Yes ❑ No ® N/A
➢ This would include Trout Buffered Streams per 15A NCAC 2B.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 Pennittine Branch
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0I05(c)(6), directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.04021 "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 ISA NCAC 02T, the Minimum Desit.n Critcrin for the Permitting of Puron Stations
and Force Mains (latest version), and the Cr tvity Sewer Mhtimuln Design Critoria (latest version) as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Anyrovelafthereatiestisrequired prior tQ submittal of the Fast Track Auplication and sunoortine documents.
2. Professional Engineer's Certification:
name from Application Item
that this application for
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000, a$ well as civil penalties up to $25,000 per violation. 0pt.+n0"Odpo,
North Carolina Professional Engineer's seal, signature, and date:
SEAL
10771
3. Applicant's Certification per ISA NCAC 02T .0106(b):
that this application for
name & title from Application Item
ties 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 reigned as incomplete. I understand that any discharge of wastewater from this non-
diacharge system to surface waters or the land will result in an immediate enfotaement action that may include civil penalties,
htjunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
of this permit be violated. 1 also understand that if all required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
NOTE — in accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, reprosentntion, 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.
/'r Date: a
Signature:
Page 5 of 5
FORM: PTA 04-16

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: City of Graham
Project Name for which flow is being requested: Old Fields Pod 2
More than one FTSE maybe required far 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: City of Graham WWTP
b. WWTP Facility Permit #: NC 0021211
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
All flows are in MGD
3.50
0.941
f. Total flow for this specific request .0313
g. Total actual and obligated flows to the facility 2.815
h. Percent of permitted flow used 80%
H. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A)
(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 / pf),
Avg. Daily
Daily Flow,
Obligated
Available
Number)
No.
MGD
MGD
Flow, MGD
MGD
Flow
Capacity***
Old Field
.180
.072
.002
.0313
.033356
.038644
BC #1
.252
.100
.0234
.0313
.054783
.046017
Haw Riv 1.008 .403 .295 .0547 .3502 .053174
* 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 W WTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): Old Fields Phase 1
Downstream Permit Number: WQ 0024872
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Frankie Maness 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 ally 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 Date
Official
Page 2 of 6
FTSE 10-18

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Limited Liability Company
Legal Name
KG Plaza LLC
Information
SOsld: 1410798
Status: Current -Active O
Date Formed: 11/5/2014
Citizenship: Domestic
Annual Report Due Date: April 15th
Registered Agent: Carlisle, Michelle,
Addresses
Mailing
8620 River Rd
Wilmington, NC 28412-3334
Reg MaiLing
8620 River Rd
Wilmington, NC 28412-3334
Company Officials
Principal Office
8620 River Rd
Wilmington, NC 28412-3334
Reg Office
8620 River Rd
Wilmington, NC 28412-3334
All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20.

Managing Member Managing Member Administrative Member
Lisa Beaman Jack J. Carlisle Michelle Carlisle
6025 Tarin Road 8620 River Rd 8620 River Road
Wilmington NC 28409 Wilmington NC 28412 Wilmington NC 28412
Administrative Member
Zita Lewis
8620 river road
Wilmington NC 28412