WQ0039100_Permit (Issuance)_20170315

Water Resources
ENVIRONMENTAL QUALITY
March 15, 2017
W. Scott Wallace, President
Keystone Group, Inc.
3708 Alliance Drive
Greensboro, NC 27407
Subject: Permit No.W00039100
Keystone Group, Inc.
Northborough .
Wastewater Collection System Extension Permit
Guilford County
Dear Mr. Wallace:
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. JAY ZIMMERMAN
Director
In accordance with your application received March 2, 2017, we are forwarding herewith Permit No.
WQ0039100 dated March 15, 2017 to the Keystone Group, Inc. (Permittee) for the construction and
operation upon certification 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be effective from the date of issuance until rescinded, and shall be subject to the conditions and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 the following conditions contained within this permit:
Condition IIA: This permit shall not be automatically transferable; a request must be made and
approved.
Condition IIA: 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.
It shall be responsibility of the Permittee 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, and/or referral of the North Carolina -licensed
Professional Engineer to the licensing board.
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.
450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105
Phone: [phone] \ Internet: www.ncwatercivality.org
State of North Carolina I Environmental Quality I Water Resources

Keystone Group, Inc.
Permit No. WQ0039100
If you need additional information concerning this matter, please contact Justin Henderson at (336)
776-9697 or via e-mail at [e-mail].
Sincerely,
56
1
for S. Jay Zimmerman, P.G.
Director, Division of Water Resources
by Sherri V. Knight, PE, Regional Supervisor
Water Quality Regional Operations Section
Winston-Salem Regional Office
Division of Water Resources, NCDEQ
enclosure: Operational Agreement
cc: Bruce Noce, P.E.-CPT Engineering and Surveying, Inc.- brucen@cpten ig neering.com
Terry Houk, Director -City of High Point- [e-mail]
QNiEon Salemeg>yonal ®ffrce,Flg
Water Resources Central Files
PERCS (electronic copy)
Page 2 of 8

STATE OF NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations, permission is hereby granted to the
Keystone Group, Inc.
Guilford County
for the construction and operation of approximately 4,143 linear feet of 8-inch gravity sewer to serve
74 three -bedroom homes and 72 two -bedroom homes as part of the Northborough project, and the
discharge of 32,940 gallons per day of collected domestic wastewater into the City of High Point's
existing sewerage system, pursuant to the application received March 2, 2017 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 Environmental Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until rescinded and shall be subject to the
specified conditions and limitations contained therein.
for S. Jay Zimmerman, P.G
Director, Division of Water Resources
ByAuthority of The Environmental Management Commission
Permit Number: WO0039100
Permit Issued: March 15, 2017
Page 3 of 8

SUPPLEMENT TO PERMIT COVER SHEET
Keystone Group, Inc. is hereby authorized to:
Construct, and then operate upon certification the aforementioned wastewater collection extension.
The sewage and wastewater collected by this system shall be treated in the City of High Point's
Eastside Wastewater Treatment Facility in accordance with Permit Number NC0024210.
Permitting of this project does not constitute an acceptance of any part of the project that does not
meet 15A NCAC 2T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12,
1996 as applicable; 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.
Construction and operation is contingent upon compliance with the Standard Conditions and the
Special Conditions identified below.
I. SPECIAL CONDITIONS
1. This permit shall become voidable unless the agreement between Keystone Group, Inc. and City
of High Point for the collection and final treatment of wastewater is in full force and effect. [15A
NCAC 02T.0304(h)]
2.. No flow in excess of the quantity permitted herein, 32,940 GPD, shall be made tributary to the
subject sewer system until an application for permit modification for an increase in flow has been
submitted to and approved by the Division. [15A NCAC 02T.0304(b)]
3. The Operational Agreement between the Permittee and the Environmental Management
Commission is incorporated herein by reference and shall be a condition of this permit.
Noncompliance with the terms of the Operational Agreement shall subject the Permittee to all
sanctions provided by North Carolina General Statutes §143-215.6A to §143-215.6C for violation
of or failure to act in accordance with the terms and conditions of this permit. [15A NCAC
02T.0115]
II. STANDARD CONDITIONS
1. This 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. [15A NCAC 02T.0104; G.S 143-
215.1(d3)]
2. 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'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,
Page 4 of 8

j. Documentation shall be kept for Subparagraphs (a) through (i) of this Rule for a minimum of
three years with exception of the map, which shall be maintained for the life of the system.
5. The Permittee shall report by telephone to a water resources staff member at the Winston-Salem
Regional Office, telephone number [phone], as soon as possible, but in no case more than
24 hours, following the occurrence or first knowledge of the occurrence of either ofthe 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 SSO and/or spill over 1,000 gallons; or
c. Any SSO and/or spill, regardless of volume, that reaches surface water
Voice mail messages or faxed information is permissible, but this 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 and submitting Part I of Form CS-SSO (or the most current Division approved form)
within five days following first knowledge of the occurrence. This report must outline the actions
taken or proposed to be taken to ensure that the problem does not recur. Part 11 of Form CS-SSO
(or the most current Division approved form) can also be completed to show that the SSO was
beyond control. [G.S.143-215.1C(a1)]
6. 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. [15A NCAC 02T.0108(b)]
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.
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.
If the permit is issued to a private entity with an Operational Agreement, then a copy of
the Articles of Incorporation, Declarations/Covenants/Restrictions, and Bylaws that have
been appropriately filed with the applicable County's Register of Deeds office shall be
submitted with the certification.
A complete certification is one where the form is fully executed and the supporting documents
are provided as applicable. Supporting documentation shall include the following:
a. One copy of the project construction record drawings (plan & profile views of sewer lines &
force mains) of the wastewater collection system extension. Final record drawings should be
clear on the plans or on digital media (CD or DVD disk) and are defined as the design drawings
that are marked up or annotated with after construction information and show required
buffers, separation distances, material changes, etc.
b. One copy of the supporting applicable design calculations including pipe and pump sizing,
velocity, pump cycle times, and level control settings, pump station buoyancy, wet well
Page 6 of 8

storage, surge protection, detention time in the wet well, and force main, ability to flush low
points in force mains with a pump cycle, and downstream sewer capacity analysis. If a
portable power source or pump is dedicated to multiple stations, an evaluation of all the
pump stations' storage capacities and the rotation schedule of the portable power source or
pump, include travel timeframes, shall be provided.
c. Changes to the project that do not result in non-compliance with this permit, regulations, or
the Minimum Design Criteria should be clearly identified on the record drawings, on the
certification in the space provided, or in written summary form.
Prior to Certification (Final or Partial): Permit modifications are required for any changes
resulting in non-compliance with this permit (including pipe length increases of 10% or greater,
increased flow, pump station design capacity design increases of 5% or greater, and increases in
the number/type of connections), regulations, or the Minimum Design Criteria. Requested
modifications or variances to the Minimum Design Criteria will be reviewed on a case -by -case
basis and each on its own merit. Please note that variances to the Minimum Design Criteria
should be requested and approved during the permitting process prior to construction. After -
construction requests are discouraged by the Division and may not be approved, thus requiring
replacement or repair prior to certification & activation. [15A NCAC 02T .0116]
B. Gravity sewers installed greater than ten percent below the minimum required slope per the
Division's Gravity Sewer Minimum Design Criteria shall not be acceptable and shall not be
certified until corrected. If there is an unforeseen obstacle in the field where all viable solutions
have been examined, a slope variance can be requested from the Division with firm supporting
documentation. This shall be done through a permit modification with fee. Such variance
requests will be evaluated on a case -by -case basis. Resolution of such request shall be evident
prior to completing and submitting the construction certification. [ 15A NCAC 02T.0105(n)]
9. A copy of the construction record drawings shall be maintained on file by the Permittee for the
life of the wastewater collection facilities. [15A NCAC 02T .0116]
10. 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, construction of additional or replacement wastewater collection
facilities, and/or referral of the North Carolina -licensed Professional Engineer to the licensing
board. [15A NCAC 02T .0104; 15A NCAC 02T .0108(b-c)]
11. 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. [15A NCAC 02T .0110; 15A NCAC 02T .0108(b)]
12. The issuance of this permit shall not exempt the Permittee from complying with any and all
statutes, rules, regulations, or ordinances that maybe imposed by the Division any other Federal,
State, or Local government agencies which have jurisdiction or obtaining other permits which
maybe required by the Division or any other Federal, State, of Local government agencies. [G.S.
143-215.1(b)]
Page 7 of 8

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE:
Keystone Group, Inc.
PERMIT #:
W00039100
PROJECT:
Northborough
ISSUE DATE:
March 15, 2017
This project shall not be considered complete nor allowed to operate in accordance with Condition 7
of this permit until the Division has received this Certification and all required supporting
documentation. It should be submitted in a manner that documents the Division's receipt. Send the
required documentation the Regional Supervisor, Water Quality Regional Operations Section at the
address at the bottom.
Any wastewater flow made tributary to the wastewater collection system extension prior to
completion of this Certification shall be considered a violation of the permit and shall subject the
Permittee to appropriate enforcement actions. The Permittee is responsible for tracking all partial
certifications up until a final certification is received. A Final Certification shall be a complete set of
record drawings and design calculations regardless of whether partials have been submitted.
PERMITTEE'S CERTIFICATION
I, the undersigned agent for the Permittee, hereby state that this project has been constructed
pursuant to the applicable standards & requirements, the Professional Engineer below has provided
applicable design/construction information to the Permittee, and the Permittee is prepared to
operate & maintain the wastewater collection system permitted herein or portions thereof.
Printed Name, Title Signature Date
ENGINEER'S CERTIFICATION
I, as a duly re istered Professional Engineer in the State of North Carolina,
having been authorized to observe (� periodically, ❑ weekly, ❑ full time) the construction of the
Northborough and location as referenced above for the above 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 02T;
the Division of Water Resources' (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 w/signature & date:
❑ Final ❑ Partial (include description)
Certification Comments/Qualifiers (attach if necessary):
NC DWR - Water Quality Regional Operations Section 450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105
Winston-Salem Regional Office Phone: [phone] FAX: [phone]

STATE OF NORTH CAROLINA
COUNTY OF GuiOroRD PennitNo,
HOME/PROPERTY OWNERS' OPERATIONAL AGREEMENT
This AGREEMENT made pursuant to G.S. 143-215.1 (dl) and entered into this 2'8 Tw day of
FEsizoAKY e zoo , by and between the North Carolina Environmental Management
Commission, an agency of the State of North Carolina, hereinafter known as the COMMISSION; and
1J©g7mT&goy6a HASTt;I2 pomeowdEP-5 A56XIAMO&Ij INC. , a nonprofit corporation organized
and existing under and by virtue of the laws of the State of North Carolina,• hereinafter known as the
ASSOCIATION.
WITNESSETH:
1, The ASSOCIATION was formed for the purpose,among others, of handling the property, affairs and
business of the development known as /daP-7rl B0F BUG 1-i
(hereinafter the Development); of operating, maintaining, re -constructing and repairing the common
elements of the lands and improvements subject to unit ownership, including the wastewater collection
system with pumps, wastewater treatment works, and/or disposal facilities (hereinafter Disposal System);
and of collecting dues and assessment to provide funds for such operation, maintenance, re -construction
and repair.
2. The ASSOCIATION desires, to construct and/or operate a Disposal System to provide sanitary sewage
disposal to serve the Development on said lands.
3. The ASSOCIATION has applied to the COMMISSION for the issuance of a permit pursuant to G.S. 143-
215.1 to construct, maintain, and/or operate -the -Disposal System.
4. The Development was created subject to unit ownership in the dwellings. units, other improvements and
lands through filing of a Declaration-- rut oOwnership (hereinafter Declaration), pursuant to_Chapter 47C -
or 47F of the North Carolina General Statutes.
5. The COMMISSION desires to assure _that the Disposal System of the Development is properly
constructed; maintained and operated in accordance with law and permit provisions in order to protect the
quality of the waters of the State and the public interest therein.
NOW, THEREFORE, in consideration of the promises and the benefits to be derived by each of the parties
hereto, the COMMISSION and ASSOCIATION do hereby mutually agree as follows:
1. The ASSOCIATION shall construct the Disposal System and/or make any additions or modifications to
the Disposal System in accordance with the permit and plans and specifications hereafter issued and
approved by the COMMISSION, and shall thereafter properly operate and maintain such systems and
facilities in accordance with applicable permit provisions and law.
2. The ASSOCIATION shall provide in the Declaration and Association Bylaws that the Disposal System
and appurtenances thereto are part of the common elements and shall thereafter 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.
FORM: HOA 08-13 Page 1 of 2

3. The ASSOCIATION shall provide in the Declaration and Association Bylaws that the Disposal System
will be maintained out of the common expenses. In order to assure that there shall be funds readily
available to repair, maintain, or construct the Disposal System beyond the routine operation and
maintenance expenses, the Declaration and Association Bylaws shall provide that a fund be created out of
the common expenses. Such fund shall be separate from the routine maintenance fund allocated for the
facility and shall be part of the yearly budget.
4. In the event the common expense allocation and separate fund(s) are not adequate for the construction,
repair, and maintenance of the Disposal System, the Declaration and Association Bylaws shall provide for
special assessments to cover such necessary costs. There shall be no limit on the amount of such
assessments, and the Declaration and Bylaws shall be provided such that special assessments can be made
as necessary at any time.
5. If a wastewater collection system and wastewater treatment and/or disposal facility provided by any city,
town, village, county; water and sewer authorities, or other unit of government shall hereinafter become
available to serve the Development, the ASSOCIATION shall take such action as is necessary to cause the
existing and future wastewater of the Development to be accepted and discharged into said governmental
system, and shall convey or transfer as much of the Disposal System and such necessary easements as the
governmental unit may require as condition of accepting the Developments wastewater.
6. Recognizing that it would be contrary to the public interest and to the public health, safety and welfare for
the•ASSOCIATION to enter into voluntary dissolution without having made adequate provision for the
continued proper maintenance, repair and operation, of its Disposal. System, the ASSOCIATION shall
provide in the ASSOCIATION Bylaws that the ASSOCIATION shall not enter into voluntary dissolution
without first having transferred its said system and facilities to some person, corporation or other entity
--acceptable to and approved by the COMMISSION by the issuance of a permit. -
7. The ASSOCIATION 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
ASSOCIATIONS successor.
S. The agreements set forth in numbered paragraphs 1, 2, 3, 4,--5, 6, and 7 above shall be conditions of any - -
- permit issued by the COMMISSION to the—ASSOCIATION—forr the construction, maintenance, repaif "and
operation of the Disposal System.
9. -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 Secretary of State of North Carolina with the Articles of Incorporation of the
Association_
IN WITNESS WHEREOF, this agreement was :executed in duplicate originals by the duly authorized
representative of the parties hereto on the day and year written as indicated by each of the parties named below:
FOR THE ENVIRONMENTAL
MANAGEMENT COMMISSION
`f S. Jay Zimmerman, B
Director, Division of Water Resources
(Date)
NaP-24809206N MASTOZ PQM owuE_ AssoaArorJ,rue.
Name of/ A,SSOC/IATTIIIOON�
(Signature)
G✓. s a,-T W.a t to c� -Pre 5 rs��nT
Print Name and Title
a L )'7
(Date)
FORM: HOA 08-13 Page 2 of 2

Permit Number WQ0039100
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
justin.henderson
Coastal SWRuIe
Permitted Flow
Facility
Central Files: APS _ SWP _
3/15/2017
Permit Tracking Slip
Status
Project Type
Active
New Project
Version
Permit Classification
1.00
Individual
Permit Contact Affiliation
Facility Name Major/Minor Region
Northborough Minor Winston-Salem
Location Address County
Guilford
Facility Contact Affiliation
Owner
Owner Name
Owner Type
Keystone Group Inc
Non -Government
Owner Affiliation
Scott Wallace
President
3708 Alliance Dr
Dates/Events
Greensboro INC 27407
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
3/15/2017 3/2/2017 3/15/2017 3/15/2017
Regulated Activities Requested /Received Events
Wastewater collection Additional information requested
Additional information received
Outfail
Waterbody Name Streamindex Number Current Class Subbasin