WQ0042795_Application (FTSE)_20210818

State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T ,0300 FAST`TRACK SEWER SYSTEM EXTENSION APPLICATION
01vidon of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
it
Application Number � to' beeompletObyDWp)
All items must be completed or the application will be returned
1. APPLICANT INFORMATION:
1. Applicant's natne: Brighterwood Crossing. LLC (company, munieipality, HOA, utility, cto.)
2. Applicant type: ❑ Individual 9 Corporation ❑ General Partnership ❑ Privately -Owned Public, Utility
❑ Federal ❑ State/County ❑ Municipal ❑ Other
3. Signature authority's name: Barry Siegal per 15A NCAC 02T .0106(b)
Title. Managing Member
4. Applicant's mailing address: P.O. Box 16168
City: High Point State: NC Zip: 27261-_
5. Applicant's contact information;
Phone number: [phone] EmailAddress: bshol 'ng@a aaLcom
11, PROJECT INFORMATION:
1. Project name: Brighterwood @ Brightwood Farms
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: Guilford
4. Approximate Coordinates (Decimal Degrees): Latitude: 36,0682490 Longitude:-79,592677'
S. Parcel ID (if applicable): 0106292
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Anthony D. Lester License Number: 1 V7
Firm: Evans Eneineeriug Inc.
Mailing address: 4609 Dundas Drive
City; Greensboro State: IBC Zip: 27407-_
Phone number: 336) 854-8877 Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION,
1. Facility Name: T.Z.OSBORNE Permit Number:N00047384
Owner Name: City of Greensboro
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. PermitNumber(s): WQ_ Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Perrnit Num er(s) (if applicable): WQCS—
Owner Name(s): City of Burl ington
FORM: FTA 04-15 Page l 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 ERMA
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/Pro e�rty 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(f)? ❑ Yes ® No
yes, prove e a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow °,b
No. of Units
Flow
one bedroom units
Minimum 240 gal/Bedroom
76
18,240 GPD
two bedroom units
120 gal/Bedroom
50
12,000 GPD
three bedroom units
120 gal/Bedroom
16
5,760 GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
36,000 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.
8. Wastewater generated by project: 36 000 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"
2,385 LF
SDR-21
8"
1,109 L.F.
D.I.P.
➢ 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 timefratnes, 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)
➢ 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
®Yes ❑ No
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
24 inches
Water mains (vertical -water over sewer including in benched trenches)
18 inches
Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
**Any private or public water supply source, including any wells, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water (or tide elevation) and wetlands (see item IX.2)
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and erdrai}i
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 webpage
➢ If noncompliance with 02T.0305(f) or (a). see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No ❑ N/A
➢ Seethe Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .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 Permitting Branch
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ® No ❑ N/A
➢ If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and inspections
documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria (latest version) as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
name from Application Item III.1.)
that this application for
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
:^^'^a� � ane—netiae�eeed�rl-0�00� as-well-aseiyi-penalties-xp-te-$23000-per�ielation.
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
s name & title from Application Item I.3.)
ca
s SEAL
19773
oi�) 7-t9-ZI
attest that this application for
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 —
statement,
representation, or certifi�on in any
include a fine not to exceed $10,0 00 as well as ci
Signature:
and 143-215.6B, any person who knowingly makes any false
package shall be guilty of a Class 2 misdemeanor, which may
up to $25,000 per violation.
Date: 71:,-�/>-/
FORM: FTA 04-16 Page 5 of 5

CJI
I

State of North Carolina
Department of Environmental Quality
Division of Water Resources
DIVI on of Water ttcsouice-- Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: City of Burlington
Project Name for which flow is being requested: Brighterwood Briglitwood Farms
More than one FTSE maybe required far a single project if the owner of the WWTP is not responsible for al1 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: T.Z. Osborne
b. WWTP Facility Permit #: NCO047384
A11 flows are in MGD
c. WWTP facility's permitted flow 56.0
d. Estimated obligated flow not yet tributary to the WWTP
f. Total flow for this specific request 0.036
g. Total actual and obligated flows to the facility 35.6983
It. Percent of permitted flow used 63.75
Il. 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 / pfl,
Avg. Daily
Daily Flow,
Obligated
Available
Number)
No.
MGD
MGD
Flow, MGD
MGD
Flow
Capacity***
Rock
37034
4.32
1.728
0.3192
0.3984
0.7176
1.010
Stewart
_;,,
38555
10.224
4.544
0.1002
0.05577
0.1560
4.388
* 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): City of Greensboro T.Z. Osborne
Downstream Permit Number: NCO047384
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Wendy Messer 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.
Title
Page 2 of 6
FTSE 10-18

State of North Carolina
A T Department of Environment and Natural Resources
NY x
Division of Water Resources
Division or Water Resources Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE 04-16)
Enity Requesting Allocation City of Burlington
Project Name for which flow is being requested: Brighterwood at Brightwood Farms
More than one F7SE-10/07 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: City of Burlington Collection System
b.WWTPFacility Permit#: WQCS00008
All flows are in GPD
c. WWTP facility's permitted flow Allocation from Greensboro 900,000
d. Estimated obligated flow not yet tributary to the WWTP 164,688
e. WWTP facility's actual avg. flow 341,622
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
U. Complete this section for each pump station you are responsible for along the route of this
List pump stations located between the project connection point and the W WTP
: None
(A) (B) (C)
(D)=(B+C) (E)=('A-D)
Obligated,
Total
Design Approx. Not Yet
Current Flow
Firm Average Daily Current Avg. Tributary
Plus
Pump Station Capacity, * Flow** Daily Flow, Daily Flow,
Obligated Available
Name GPD (Firm/pf), GPD GPD GPD
Flow Capacity"**
None
* The Firm Capacity of any pump station is defined as the maximum pumped flow that can be
achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pumpstation divided by a peaking;
factor(pf) not less than 2.5.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity <_A.
Downstream Facility Name (Sewer): Preakness Parkway Outfall
Downstream Permit Number: WQ0030416
Page 1 of 2 FTSE 04-16

Certification Statement:
I, W. Todd Lambert, P.E. certify to the best of my knowledge that the addition of the
volume of wastewater to be permitted in this project has been evaluated along the route to the receiving
wastewater treatment facility and that the flow from this project is not anticipated to cause any
capacity related sanitary sewer overflows or overburden any downstream pump station en route to the
receiving treatment plant under normal circumstances, given the implementation of the planned
improvements identified in the planning asssessment 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 11 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
/7
Date
Page 2 of 2 FTSE 04-16

—Since 1974—
Surveyors Planners
August 18, 2021
Mike Mickey
Division of Water Resources
Department of Environmental Quality
450 W. Hanes Mill Road N Suite 300
Winston-Salem, NC 27105
Re: FTA for Brightwood @ Brightwood Farms
Mike,
NC Department of
Enviro Received quality
Please find attached the Application Package for this proposed project.
AUG 18 2021
Winston-Salem
Regional Office
1. Original Application & one copy
2. Application Fee ($480 check)
3. FTSE from City of Greensboro (Wastewater Flows to their Treatment Plant)
4. FTSE from City of Burlington (Wastewater will tie into their piping Network)
Let me know if you need any additional information
Sin
cerel
t�
Anthony Les r E, PLS
Vice Preside
4:�
Evans Engineering, Inc.
106-11
4609 Dundas Drive
Greensboro, NC 27407
Phone [phone]
Fax [phone]
License #C-0168

State of North Carolina
DWR Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources ETA 04-16 & SUPPORTING DOCUMENTATION
Application Number: (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMA q
: Vy cO
R.
1 Applicant's name: Ci of Burlin ton company, municipality, HOA, utility, etc.)
2. Applicant type: ❑Corporation El General Partnership El Privately -Owned Public Utility
❑ Federal ❑ State/County ❑ Municipal ❑ Other
3. Si ature authority's name: Barry Siegal per 15A NCAC 02T .0106(b)
Title: wner
4. Applican 's mailing address: P.O. Box 16168 NC Department of
Environmental Quality
City: Hi t State: NC zip: 27261- Received
5. Applicant's con et information: AM. 1 2 onni
Phone number:
II. PROJECT INFORMATION¢
1.
Project name: Bridtcrwoodh 1
2.
Application/Project status:
If a modification, provide the ex
If new construction but part of a
3.
County where project is located:
4.
Approximate Coordinates (Decii
5.
Parcel ID (if applicable): 010 67
(or Parcel ID to closest downs c
III. CONSULTANT INFORM
1. Professional Engineer:
Firm: Evans Enaineeri
Email Address:
b Winston-Salem
Regional office
sed (New Permit) ❑ Existing Permit/Project
number: W000 and issued date:
provide the existing permit number: W000
Degrees): LXitude: 36.068249' Longitude:-79.592677'
sewer)
License Number:
Mailing address: 460 ' Dur Drive \
City: Greensboro S ate: NC Zip: 27407-
Phone number: 6 854-8877 Email Address: [e-mail]
IV. WASTEWATE REATMENT FACILITY (WWTF) INFORMATION:
1. Facility N e: T.Z. OSBORNE Permit Number: NC0047384
Owner ame: City of Greensboro
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s): City of Burlington
FORM: FTA 04-16 Page I of 5

Mickey, Mike M
From: Anthony Lester <[e-mail]>
Sent: Friday, August 27, 2021 8:35 AM
To: Mickey, Mike M
Subject: RE: [External] RE: Brighterwood Farms @ Brightwood Farms
Attachments: 20210827084130797.pdf
Revised Page 1 of 5 showing the correct owner info. Let me know if you need additional info. Thanks.
Anthony D. Lester, PE, PLS
Vice -President
Evans Engineering, Inc.
336-279-7450 (Office)
336-382-4416 (Mobile)
[e-mail]
From: Mickey, Mike M <mike. mickey@ ncden r.gov>
Sent: Thursday, August 26, 20214:17 PM
To: Anthony Lester <[e-mail]>
Subject: RE: [External] RE: Brighterwood Farms @ Brightwood Farms
Anthony —Just email me the revised sheets.
Mike Mickey
Division of Water Resources
Department of Environmental Quality
336-776-9692 office
[e-mail]
450 W. Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Anthony Lester <[e-mail]>
Sent: Thursday, August 26, 20219:21 AM
To: Mickey, Mike M <[e-mail]>
Subject: [External] RE: Brighterwood Farms @ Brightwood Farms

Mike
The city said this system will be private. Therefore, I need to change the ownership info on the application. We thought
it was going to be city maintained but they changed that at the last minute and I forgot to change it on the
application. Barry Siegal, who signed the application, is the managing member of the ownership group, so that part is
correct. Once I change the affected sheets, can I email them to you or do I need to have them delivered? I apologize for
the confusion.
Anthony D. Lester, PE, PLS
Vice -President
Evans Engineering, Inc.
336-279-7450 (Office)
336-382-4416 (Mobile)
[e-mail]
From: Mickey, Mike M <[e-mail]>
Sent: Monday, August 23, 20213:17 PM
To: Anthony Lester <adlpevans-eng.com>
Subject: Brighterwood Farms @ Brightwood Farms
Anthony —Just did a quick perusal of the above sewer extension application that was received last week. The
applicant/owner is listed as City of Burlington but Barry Siegal (Managing Member) signed the application. The
application needs to be signed by someone with Burlington. Should I mail the application backto you or
Burlington? Thanks, Mike.
Mike Mickey
Division of Water Resources
Department of Environmental Quality
336-776-9692 office
[e-mail]
450 W. Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
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