WQ0033031_Regional Office Historical File Pre 2018

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WAr ic,
II
O G
June 3, 2008
Mr. David High, Director of Plant Operations
Aldersgate United Methodist Retirement Community, Inc.
3800 Shamrock Drive
Charlotte, NC 28215
Subject:
Dear Mr. High,
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
Permit No. WQ0033031
Aldersgate-Wesley Glen Phase 2
Wastewater Collection System Extension
CMU Tracking #600-08-566
Mecklenburg County, North Carolina
In accordance with your application received on May 14, 2008, we are forwarding herewith Permit No.
WQ0033031, dated June 3, 2008, to Aldersgate United Methodist Retirement Community, Inc. for the
construction and operation of the subject wastewater collection system extension. This permit shall be
effective from the date of issuance until rescinded, and shall be subject to the conditions and limitations
as specified therein. This cover letter shall be considered a part of this permit and is therefore
incorporated therein by reference.
Please pay particular attention to Permit Condition 3 which requires that the wastewater
collection facilities be properly operated and maintained in accordance with 15A NCAC 2T .0403 or any
individual system -wide collection system permit issued to the Permittee.
Permitting of this project does not constitute an acceptance of any part of the project that does
not meet 1) 15A NCAC 2T; 2) the Division of Water Quality's (Division) Gravity Sewer Minimum Design
Criteria adopted February 12, 1996, as applicable; 3) and the Division's Minimum Design Criteria for
the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000, as applicable,
unless specifically mentioned herein. Division approval is based on acceptance of the certification
provided by a North Carolina -licensed Professional Engineer in the application. It shall be the
Permittee's responsibility to ensure that the as -constructed project meets the appropriate design criteria
and rules. Failure to comply may result in penalties in accordance with North Carolina General Statute
§143-215.6A through §143-215.6C, construction of additional or replacement wastewater collection
facilities, andfor referral of the North Carolina -licensed Professional Engineer to the licensing board.
Mooresville Regional Office 610 East Center Ave., Suite 301 Mooresville, NC 28115 Phone: [phone] Fax: [phone]
Internet: www.ncmwaterquality,org Customer Service: 1-877-623-6748
An Equal Opportunity/Affirmative Action Employer —50% Recycled/10% Post Consumer Paper
No `Carolina
Viura!!y

Mr. High
Page 2
June 3, 2008
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 for the construction and operation of approximately 317 linear feet of 8-inch gravity sewer and
the discharge of 2,090 gallons per day of collected domestic wastewater into the Charlotte Mecklenburg
Utilities existing sewerage system and in conformity with 15A NCAC 2T; the Division's Gravity Sewer
Minimum Design Criteria adopted February 12, 1996, as applicable; the Division's Minimum Design
Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000, as
applicable; and other supporting data subsequently filed and approved by the Department of
Environment and Natural Resources and considered a part of this permit.
The sewage and wastewater collected by this system shall be treated in the Charlotte
Mecklenburg Utilities WWTP (Sugar Creek NPDES No. NC0024937) prior to being discharged into the
receiving stream.
Assessing subsequent impacts to the downstream collection system and treatment facility is
the complete responsibility of Charlotte Mecklenburg Utilities. Charlotte Mecklenburg Utilities
must utilize whatever tracking tools necessary for planning additions of sewer flow in order to
maintain compliance with the WWTP permitted limits.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the
right to request an adjudicatory hearing upon written request within 30 days following receipt of this
permit. This request must be in the form of a written petition, conforming to Chapter 150B of North
Carolina General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service
Center, Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and
binding.
If you need additional information concerning this matter, please contact Dee Browder at (704)
663-1699.
Sincerely,
for Coleen H. Sullins
cc: Mecklenburg County Land Use and Environmental Services Agency (LUESA)
Steve Miller, CMU
Philip Edward, Mecklenburg County
Mooresville Regional Office, Collection System Permit File
Biemann A. Martin, Site Solution
Surface Water Protection Central Files
PERCS

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
This permit shall be effective from the date of issuance until rescinded and shall be subject to the
following specified conditions and limitations:
1. This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 15A NCAC 2T; the Division of Water Quality's
(Division) Gravity Sewer Minimum Design Criteria adopted February 12, 1996, as applicable; the
Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force
Mains adopted June 1, 2000, as applicable; and other supporting materials unless specifically
mentioned herein.
2. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data.
3. 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 as required by 15A NCAC 2T .0403. If an individual
permit is not required, the following performance criteria shall be met as provided in 15A NCAC 2T
.0403:
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 the groundwater standards in
15A NCAG 2L .0200 or the surface water standards in 15A NCAC 2B .0200.
b. A map of the sewer system shall be developed and shall be actively maintained.
c. An operation and maintenance plan shall be developed and implemented.
d. Pump stations that are not connected to a telemetry system shall be inspected every day (i.e.
365 days per year). Pump stations that are connected to a telemetry system shall be
inspected at least once per week.
e. High -priority sewer lines shall be inspected at least once per every six-month period of time.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. Inspection and maintenance records shall be maintained for a period of at least three years.
h. Overflows and bypasses shall be reported to the appropriate Division regional office in
accordance with 15A NCAC 2B .0506(a), and public notice shall be provided as required by
North Carolina General Statute §143-215.1C.
1

rh. permit shall not be transferable. In the event there is a desire for the wastewater collection
facilities to change ownership, or there is a name change of the Permittee, a formal permit request
shall be submitted to the Division accompanied by documentation from the parties involved, and
other supporting materials as may be appropriate. The approval of this request shall be
considered on its merits and may or may not be approved.
5. Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to
interrupt service by the existing utilities nor result in an overflow or bypass discharge of wastewater
to the surface waters of the State.
6. Per 15A NCAC 2T .0116, upon completion of construction and prior to operation of these
permitted facilities, the completed Engineering Certification form attached to this permit shall be
submitted with the required supporting documents to the address provided on the form. A complete
certification is one where the form is fully executed and the supporting documents are provided as
applicable.
7. A copy of the construction record drawings shall be maintained on file by the Permittee for the life
of the wastewater collection facilities.
8. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 2T; the
Division's Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the Division's
Minimum Design Criteria for the Fast -Track Permitting of Pump Station and Force Mains adopted
June 1, 2000 as applicable; and other supporting materials may subject the Permittee to an
enforcement action by the Division, in accordance with North Carolina General Statutes §143-
215.6A through §143-215.6C.
9. In the event that the wastewater collection facilities fail to perform satisfactorily, including the
creation of nuisance conditions, the Permittee shall take immediate corrective action, including
those as may be required by this Division, such as the construction of additional or replacement
facilities.
10. The issuance of this permit shall not exempt the Permittee from complying with any and all
statutes, rules, regulations, or ordinances that may be imposed by other government agencies
(local, state and federal) which have jurisdiction, including but not limited to applicable river buffer
rules in 15A NCAC 2B .0200, erosion and sedimentation control requirements in 15A NCAC Ch. 4
and under the Division's General Permit NCG010000, and any requirements pertaining to wetlands
under 15A NCAC 2B .0200 and 15A NCAC 2H .0500.
11. Noncompliance Notification:
The Permittee shall verbally report to a Division of Water Quality employee at the Mooresville
Regional Office, telephone number [phone], 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 either of the following:
a. Any process unit failure, due to known or unknown reasons, that renders the facility incapable
of adequate wastewater transport, such as mechanical or electrical failures of pumps, line
blockage or breakage, etc.; or
b. Any failure of a pumping station or sewer line resulting in a by-pass directly to receiving waters
without treatment of all or any portion of the influent to such station or facility.
2

Voice mail messages or faxed information is permissible, but shall not be considered as the
initial verbal report. Overflows and spills occurring outside normal business hours may also be
reported to the Division of Emergency Management at telephone number [phone] or
[phone]. Persons reporting any of the above occurrences shall file a spill report by
completing Part I of Form CS-SSO (or the most current Division approved form), within five days
following first knowledge of the occurrence. This report shall outline the actions taken or
proposed to ensure that the problem does not recur. Part II of Form CS-SSO (or the most
current Division approved form) can also be completed to show that the SSO was beyond
control.
Permit issued this the 3rd day of June, 2008.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0033031
3

Fast Track Engineering Certification
Permit No. W00033031
June 3, 2008
OwnerIWQCS
David High, Dir. of Plant Operations
Aldersgate United Methodist Retirement Community,
3800 Shamrock Drive
Charlotte, NC 28215
PE
Biemann Martin
Inc Site Solutions
2320 W. Morehead St.
Charlotte, NC 28208
WQCS/WWTP
Steven Miller
CMU
5100 Brookshire Blvd.
Charlotte, NC 28216
Complete and submit this form to the permit issuing regional office with the following:
• One copy of the project record drawings (plan & profile views of sewer lines) of the wastewater collection
system extension
• Supporting design calculations (selected pumps, system curve, operating point, available storage if portable
generator(s) or storage greater than longest past three year outage reliability option selected) for any pump
stations permitted as part of this project
• Changes to the project should be clearly identified on the record drawings or in written summary form. Permit
modifications are required for any changes resulting in non-compliance with this permit, regulations or
minimum design criteria.
This project shall not be considered complete nor allowed to operate until this Engineer's Certification and all
required supporting documentation have been received by the Division. Therefore, it is highly recommended
that this certification be sent in a manner that provides proof of receipt by the Division.
ENGINEER'S CERTIFICATION
❑ Partial ❑ Final
1, , as a duly registered Professional Engineer in the State of North Carolina, having been
authorized to observe (❑ periodically, ❑ weekly, ❑ full time) the construction of Aldersgate-Wesley Glen Phase 2, a
Mecklenburg 'County project for the Permittee, hereby state that, to the best of my abilities, due care and diligence
was used in the observation of the construction such that the construction was observed to be built within substantial
compliance of this permit; 15A NCAC 2T; the Division of Water Quality's (Division) Gravity Sewer Minimum Design
Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track
Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting materials.
North Carolina Professional Engineer's
seal, signature, and date:
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
MOORESVILLE REGIONAL OFFICE
SURFACE WATER PROTECTION
610 EAST CENTER AVENUE, SUITE 301
MOORESVILLE NC 28115
The Permittee is responsible for tracking all partial certifications up until a final certification is received. Any
wastewater flow made tributary to the wastewater collection system extension prior to completion of this
Engineer's Certification shall be considered a violation of the permit and shall subject the Permittee to appropriate
enforcement actions.

USE THE TAB KEY TO MOVE FROM FIELD TO FIELD!
Application Number:
Ito be completed by DWQ)
OwnerlPermittee:
la. Aldersgate United Methodist Retirement Community, Inc,
Full Legal Name (company, munipality, HOA, utility, etc.)
1b, nDavid High, Director of Plant Operations
Signing Official Name and Title (Please review 15A NCAC 2T .010
1 c. The legal entity who will own this system is:
Ej Individual ❑ Federal ❑ Municipality 0 State/County 0 Private Partnership i+t. Corporation 0 Other (specify):
0 l d. 3800 Shamrock Drive
▪ Mailing Address
1f, North Carolina
z
INFORMATION
State
1h. 704-532-3000
Telephone
704-532-7370
Facsimile
le, Charlotte
horized signing officials,
City
1 g, 28215
Zip Code
1j. davidh@aldersgater
E-mail
2. Project (Facility) information:
2a, Aldersgate— Wesley Glen Phase 22b. Mecklenburg
County Where Project is Located
Brief Project Name (permit will refer to this name
3. Contact Person:
3a. Anne Scott, ASLA - Site Solutions
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. 704-521-9880
Phone Number
1. Project is New
2 Owner is 0 Public (skip to Item ti(s
2a. If private, applicant will be:
3c. asc©tt sitesolutionspa.com
E-mail �m
an existing permit) If Modification, Permit No.:
Private (go to Item 2(a))
2b, If sold, fa owned by a (must choose one)
Retaining Ownership (i.estore, church, single office, etc.) or ❑ Public Utility (Instruction C)
0 Leasing units (lots, townhomes, etc. - skip to item B(3))
❑ Selling units (lots, townhomes, etc, - go to item B(2b))
3. Charlotte Mecklenbu m Utilities
Owner of Wastewater Treatment Facility (WVTF) Treating
4a. Smear Creek Wastewater Treatment Plant
Name of WWTF
5a. CMU 5b. 8,
Owner of downstream Sewer Receiving Sewer Size
6. The origin of this wastewater is (check all that apply).
0 Residential Subdivision
Apartments/Condominiums
❑ Mobile Home Park
School
Restaurant
© Office
0 Homeowner Assoc./Developer (Instruction D)
astewater From This Project
4b. NPC0024937
.- I�ES N m...._.._
Gravity
0 Force Main
WWTF Permit No.
Permit # of Downstr
O Retail (Stores, shopping centers)
0 Institution
• Hospital
Church
0 Nursing Home
Ej Other (specify):
100, %© Domestic/Commercial
% Industrial (attach
description)
(RO: contact your Regional Office
Pretreatment staff)
Other (specify).
7. Volume of wastewater to be allocated or permitted for this particular project: 2,090 gallons per day
*Do not include future flows or previously permitted allocations
8. If the permitted flow is zero, indicate why:
Pump Station, Outfall or Interceptor Line where flow will be permitted in subsequent permits that connect to this Nine
• Flow has already been allocated in Permit No.
Rehabilitation or replacement of existing sewer with no new flow expected (see 15A NCAC 02T .0303 to determine
permit is required)
a
f T A l 2id 7

NFORMATION
z.
0
z
0
USE THE TAB KEY T
VE FFttOM FIELD TO FIELD!
c
The legal entity who will own this system
Individual [J Federal 0 Municipality © S
3800 Shamroch Drive
ifing Address
a Carol na
704-532-3000
Telephone
Prohict
l ldecsgate -Wesley Glen Phase 2
Brief Project Marry (permit will refer to this name)
Contact Person:
Anne Scott, Al:,
Name and A'�
704-521-9880
704-532-7370
Facsimile
Phone Number
1 _ Project is + New Q IViodi c ation (o
2. Owner is 0 Public fa* to Item B(3))
2a.
3.
meant will be:
Q
El Schuol
O Restaurant
2T .01
County 0 PrivatePartnership
1 e. Charte
City
8215
tltilita
TatmFec) Tr
Sr w(
LJ Gra
[] Force %Bain
7. Vane of aflocateel +r
Oo not Include wurture fto or prey
8. if the permitted flow is zem, indicate why
2b.
p R (Shares, sl
Instttuttcan
Hosenal
Church
[) Nursing Hearne
Id Other (specify):,_
o Pump Simon„ Outfall or Interceptor Line where flow will be
0 Flaw has already been allocated in Permit No,
0 Other (specify):
S ) 2I37
F Permit
Rehabilitation or replacement of existing sewer with no new flow
permit isrequired)
% industrial (attach
(RO: contact your Regional Office
Pretreatment staff)
% Other (speedy):
galions per day
fNt
A

9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T .0114 for
the value in Item B(7) ANDIOR the design flow for line or pump station sizing if a reduced or zero flow is being requested in
Item B(7). Values other than that in 15A NCAC 2T .0114 (b) and (c) must be supported with actual water or wastewater use
data in accordance with 15A NCAC 2T .0114 (f)_
11 Cottages X 190 gpd/unit = 2,090 gallons per day
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches)
Length (feet)
317
New Gravity or Additional
Force Main
gravity
11._ Summary of Pump Stations wl associated Force Mains to be Permitted (attach additional sheets as necessary)
Pump Station Location ID (self chosen - as shown on planslmap for reference)
Design Flow - - - - - ---- - -Power Reliability Option -- i - - - -- -� - - -
(MGD} Operational Point 1 - permanent generator wIATS; Force Main Size I Force Main Length
GPM @TDH 2 - portable generator w/MTS
Pump Station Location ID (self chosen - as shown on pianslmap for reference)
Design Flow Operational Point: Power Reliability Option
(MGD) I GPM ©TDH 1- permanent generator wIATS; , Force Main Size Force Main Length
1 2 - portable generatorw!MTS ,
- -
Pump Station Location ID (self chosen Tas shown on planslmap for reference)
—
Design Flow Power Reliability Option
(MGD) GPM @TDH Operational Point , 1- permanent generator wlATS; Force Main Size� Force Main Length
2 - portable generatorw!MTS
- - - - - - -- --- -
12 Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
0 Yes ® No If Yes, permit number of 2nd treatment facility
(RO - if 'yes- to B,12 please contact the Central Office PERCS Unit)
13_ Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force
Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chapter 2T as
applicable?
® Yes ❑ No If No, please reference the pertinent minimum design criteria or regulation and indicate why a
variance Is requested. SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS
PERTINENT TO THE VARIANCE WITH YOUR APPLICATION
FTA12J07

14. Have the i lowing perrnitsicertitications sit
�+ �trearr Crossings - General Permit or 401
nsntatier Erosion Control Plan?
Check if Yes: 0 and provide.
ENGINEER
APPL TI
ffn TO OTHER UTILIT
0
Yes D No i N/A
Yes 0 No © NIA
Yes ©No D NIA
d?
ST SE COMPLETED PRIOR TO SUBMITTAL OF THIS
IST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR
LATIONS. ETC. REFER TO 15A NCAC 02T .0305
XI

Aldersgate - Wesley Glen phase 2
Utilities Narrative
Existing Conditions
The subject property consists of approximately 3.8 acres within an overall 205-acre campus
located on Shamrock Drive in Charlotte, North Carolina.
The subject site is currently undeveloped and wooded. The site lies within an existing
developed retirement community. The proposed development will consist of a short private
cul-de-sac street with utilities to serve eleven (11) independent living units. Previously
developed independent cottage units surround the site. Street and utility stubs, and a
storm culvert to this site were designed and installed in 2000. Existing utilities lines are
private; proposed utility extensions will be private. The proposed sewer will consist of
316.9415 of 8" PVC 55 with three new manholes.

CHARLOTTE.
CHARLOTTE-MECKLENBURG
UTILITIES
April 18, 2008
Ms. Anne Scott
Site Solutions
2320 West Morehead Street
Charlotte, NC 28208
SUBJECT: WATER AND SEWER FLOW ACCEPTANCE
ALDERSGATE UNITED METHODIST RETIREMENT COMMUNITY
TAX PARCEL# 101-021-01
C-MU TRACKING# 600-08-566
In response to your request, a flow acceptance study of the subject site has been completed and the
following has been determined:
Charlotte -Mecklenburg Utilities agrees to accept the gravity sewage flow of 2,090 gallons per day (11
Cottages x 190 gpd/unit) from this project for transmission to the Sugar Creek Wastewater Treatment
Plant; NPDES permit number NC0024937, for treatment. This acceptance of flow is based on the existing
capacity of the designated publicly owned treatments works. Please see attached basin map and flow
tracking form.
Charlotte -Mecklenburg Utilities 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, dated October 2005, (WSMP # 05-01702 & PWS ID # 0160010) on file with the Public
Water Supply Section of NCDENR. However, CMU cannot guarantee a constant pressure or quality of
flow. •
Charlotte -Mecklenburg Utilities does not expect any of the above conditions to preclude water or sewer
service to the subject site. However, the applicant should understand that due to the involvement of other
agencies and continuing growth of the water and sewer system, the ability to provide service for future
projects cannot be guaranteed nor reserved. Connection to the CMU system is accepted on a first come,
first served basis.
The applicant should understand that this letter is not authorization to construct 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 and construction has not started within one (1) year of
issuance of this flow acceptance. 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,
Barbara Gross
Engineering Assistant
New Services Section
CHARLOTTE-MECKLENBURG UTILITIES
Customer Service Division • New Services Section
www.cmutilities.com
5100 Brookshire Boulevard
Charlotte, NC 28216
Ph: 704/399-2221
Fax: [phone]

4
•
••
•
*l.* ****
•as **
Charlotte -Mecklenburg Utilites
WWTP Service Areas with Basins

V/ AF State of North Carolina
Department of Environment and Natural Resources
""�• "^� 7 Division of Water Quality
-~r Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE —10/07)
Project Applicant Name: site Solutions
Project Name for which flow is being requested: Aldersqate United Methodist Retirement Community
More than one FTSE-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: McAlpine Creek, Irwin Creek, Sugar Creek WWTP
b. WWTP Facility Permit #: NC0024970, NC0024945 , NC0024937
All flows are in MGD
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
£ Total flow for this specific request
g. TotaI actual and obligated flows to the facility
h. Percent of permitted flow used
99.0
13.17
66.8
0.00209
80.03
80.8a
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
Pump Station Name Approx. Capacity, MGD Approx. Current Avg.
(Firm/Design) Daily Flow, MGD
III. CertificationoStatement:
I, Barry.k pr i _ , certify that, to the best of my knowledge, the addition of the
volume of ivastewater 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. 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 It for which I am the responsible party. Signature of this form indicates
acceptance of this wastewater flow.
8¢/�/
fry S4ear,n d8
Signing Official Signature Date

Letter of Transmit tal
TO NCDENR Mooresville Regional Office
610 E. Center Avenue, Suite 301
Mooresville, NC 28115
DATE
ATTENTION
RE..
5.13.08©sNu
Dee Browder
Aldersgte - Wesley Glen Phase 2
3066
WE ARE SENDING YOU: DAttached, ❑Under separate cover via.
0Shoo drawings ❑Prints ]Plans
DCnpy of letter ©Chaff order QSamples ©Specircations
1E
SOLUTIONS
3 2 0
Morehead Street
Charlotte. NC 28208
P 704,5.21.9880 F 704,571.8955
www,sitesolutionsp .corn
OP IF DATE.
3
3
3
ETA (one original, one copies)
review ft $48€7
Operation Agreement (one original, two copies)
downstream flow tracking/acceptance letter Et form
color map
THESE ARE TRANSMITTED as checkedbelow.
�ror approval [JApproved as submitted
for your use
AS requested
0 For review and comment
REMARKS
El Approved as noted�
❑ Returned for corrections
© Resubmit
L]Subrnit
© Return
COPY TO SIGNED;
PTiON
WED
NC DENR MR0
DWQ-Surface Water Pray o on
Andrew

STATE OF NORTH CAR.OLIN,A
COUNTY OF
This AG
Permit No.
DEVEE°PER'S OPERATIONAL AGREES NT
NT made pursuant to G.S. 143-215.1 (d1) and entered into
Management Commission,
by and between the North Carolina
agency of the State of North Carolina, hereinafter kuo
United M ist Retirement Community , a corporatio /.
o do buses in the State of North Carolina, hereinaft
WITNESSETH:
1. The DEVELOPER is the own
erecting and will erect dwelling
as Alders to - Weal Glen
The DEVELOPER desires, to construct
works, and/or disposal facilities (he
serve the Development on said lands.
to
is
day
ravirmnrnental
to as the COMMISSION;
6ership
the DEVELOPER.
ads lying in Mecklenburg County, upon which it is
provements, said development
the lopment).
ater rl➢ection system
sal System) to provide s
The DEVELOPER has applied to the CO l ION for the issuance of a
215.1 to construct, maintain, and operate the i 1 System.
The DEVELOPER has created or shall create unit ownership in said dwellings units, other impro
and lands through filing of a Declaration of Unit Ownership (hereinafter Declaration), pursuant to
Chapter 47C or 47F oldie North Carolina General Statutes.
5. The DEVELOPER has caused to be formed or will c t0 be fo at
Declaration, the
Association), a non -pro
State of North Carolina,
the Development; of operas' , m
lands and in provetnents subject to unit ownership, i
and assessments to provide funds for such operation, main
o. The COMMISSION res to assure that the Disposal Syst
constructed, maintai and operated in accordance with law
quality of the watersaf the State and the public interest therein.
rtt NOW, THEREFORE, con'+'deration. of the promises and the benefits to
ny
hereto, the COMMISSION and DEVELOPER do hereby mutually ae
1. The DEVELOPER shall construct the Disposal System in accordance
specifications h iasued and approved by the COMMISSION,
and maintain such systems and facilities in accordance with applicable
an
dp
0
ring
lid by the virtue of the laws 0f the
g the property, affairs and business of
airing the common elements of the
;sposal System; and of collecting dues
istruction and repair.
elopment is properly
provisions in order to protect the
o G.S. 143-
filing of the
riv
by each of the part
permit and plans and
thereafter properly operate
provisions and law.
The DEVELOPER shall not transfer ownership dior control of the Disposal. System to the Association.
until construction has been completed in accordance with the permit and approved plans, and the : °ff of
the Division of Water Quality has inspected and approved of the facilities. In order to change the name of
the permit holder, the DEVELOPER must request that the permit be reissued to the Association. The
request roust include a copy of the Association Bylaws and Declaration,.
The DEVELOPER. shall not transfer, convey, assign or otherwise relinquish or release its responsibility
for the operation and maintenance of its Disposal System until a permit has been .reissued to the
DEVELOP -FM successor.
FORM: DEV 02/03 Page 1 of 2

The DEL PER shall provide in the Declaration and Association Bylaws that the Disposal System and
appurtenances thereto are part of the conunon cl entt « and shall their -after be properly maintained and.
operated in conformity with law and the provisions of the permit for construction, operation, repair, and
maintenance of the system and facilities. The Declaration and Bylaws shall identify the entire wastewater
treatment, collection and disposal system as a common element which will receive the highest priority for
expenditures by the Association except for Federal, State, and local taxes and insurance.
The DEVELOPER shall provide in the Declaration and Association Bylaws that
be maintained out of the common expenses. In order to assure that there
to repair, maintain or construct the Disposal System, beyond the routine on
expenses, the Declaration and Association Bylaws shall provide that a crea
common expenses. Such fund shall be separate from the routine mainteitanct
the yearly budget.
facility and shall be
System wi
ily available
d maintenance
out of the
ed for the
6. In the event the common pense allocation and separate fund are not ction,
repair, and maintenance o ,; a Disposal System, the Declaration and Association Bylaw shall provide for
special m sessments to covet ch necessary costs. There shall be no limit on the aanount of"such
assessments, and the Declares and Bylaws shall provide that such special assessments can be made as
necessary at any time.
". if a wastewater collection system d wastewater trcateimt and/or disposal facility provided by any city,
town, village county, water and M a uthonti ,oar et rntit of government shall hereinafter become
available to serve the Development, . DEVELOPER shall take such action as is necessary to cause the
existing and future wastewater of the Development to be accepted and dischar r fnto .y 'd governmental
system, and shall convey or transfer as much of the Disposal System d such nec sements as the
governmental unit may require as condition of accepting the Development's wastewater.
yr
8. Reeogni'tng that it would be contrary to the public interest and to the public health, safety and welfare for
the Association to enter into voluntary ditrluti without having made adequate provision for the
continued proper maintenance, repair and operation of its Disposal System, the DEVELOPER shall
provide in the Association Bylaws that the Association shall not enter into voluntary dissolution without
first having transferred its said sys ; fl and facilities to some person, corporation or other entity acceptable
to and approved by the COMMISSION by the issuance of a permit.
9. The agreements set forth in numbered paragraphs 1, 2, 3, 4, 5, 6, 7, and 8 above shall be conditions of
any permit issued by the COMMISSION to the DEVELOPER for the construction, maintenance, repair
and operation of the Disposal System.
10. A copy of this agreement ;shall be filed at the Register of Deeds in the County(ies) where the Declaration
is filed and in the offices of the
the Association.
IN FITNESS WHEREOF* ''ttsis agreement
representative of the parties hereto on the day
FOR THE EN VIRON NTAL
MANAGEMENT COM ISSION
of State of North Caro
fins, Director
Division of Water Quality
(Date
ina with the .Articles of Incorporation of
duplicate originals by the duly authorized
ten as indicated by each of the parties r
t Name acid Title
(Date)
FORM: DEV 02/03
Page 2 of 2

North Carolina Secretary of State
Page 1 of 1
North Carolina
Elaine F. Marshall D EPARTM ENT OF THE
Secretary SECRETARY OF STATE
CORPORATIONS
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Date: 5/15/2008
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Corporation Names
Name Name Type
NC ALDERSGATE UNITED Legal
METHODIST RETIREMENT
COMMUNITY FOUNDATION,
INC.
NC THE METHODIST HOME
FOUNDATION, INC.
Non -Profit Corporation Information
Prev Legal
SOSID:
Status:
Date Formed:
Citizenship:
State of Inc.:
Duration:
Registered Agent
0395919
Current -Active
5/13/1996
Domestic
NC
Perpetual
Agent Name:
Registered Office Address:
Registered Mailing Address:
Principal Office Address:
Principal Mailing Address:
Hall, Raymond 0
3420 Shamrock Drive
Charlotte NC 28215
3420 Shamrock Drive
Charlotte NC 28215
No Address
3420 Shamrock Drive
Mecklenburg County
Charlotte NC 28215
http://www.secretary.state.nc.us/corporations/Corp.aspx?PitemId=4856754 5/15/2008

~ Central Files: APS SWP
06/02/08
Permit Number WQ0033031 Permit Tracking Slip
Program Category Status Project Type
Non -discharge Active New Project
Permit Type Fast Track Version Permit Classification
Gravity Sewer Extension, Pump Stations, & Pressure Sewer 1.00 Individual
Extensions
Primary Reviewer Permit Contact Affiliation
dee.browder
Permitted Flow
2090
Facility
....Facility Name
Aldersgate - Wesley Glen Phase 2
Location Address
Owner
Major/Minor Region
Minor Mooresville
County
Mecklenburg
Facility Contact Affiliation
Owner Name Owner Type
Aldersgate United Methodist Retirement Community Non -Government
Owner Affiliation
David High, Director Operations Plant
of
3800 Shamrock Dr
Charlotte NC 28215
Dates/Events
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
06/02/08 05/14/08 06/02/08 06/02/08
Regulated Activities Requested/Received Events
Apartment complex
Condominium
Wastewater collection
Outfall NULL
Additional information requested
Additional information received
Waterbody Name Stream Index Number Current Class Subbasin