WQ0042818_Application (FTSE)_20220628

tP stimmel
June 27, 2022
601 N. TRADE STREET SUITE 200
WINSTON-SALEM, NC'27101
www.stimmelpa.com 336.723.1067
NC DEQ — Winston-Salem Regional Office
Division of Water Resources
450 W. Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
Re:
Fast -Track Sewer System Extension Modification for a
Private Sewer System at Wake Forest Baptist Health Hospital Campus
Medical Center Blvd, Winston-Salem, NC
To whom it may concern:
NC Department of
Environmental Quality
Received
JUN 7 8 2022
Winston-Salem
Regional Office
Attached you will find a Fast -Track Sewer System Extension Application and supporting information for a
modification to an existing permit. The design includes new 12-inch gravity sewer that will discharge to a City
of Winston Salem 12-inch public sewer main. The system will serve existing facilities and a new patient bed
tower currently under design. New sewer flows are 100% commercial and are estimated at 36,550 gallons per
day.
Permit modification summary
• 691f of 12-inch sewer is being deleted from the previous permit (WQ0042818)
• 214lf of 12-inch is being added to the permit
• Summary of sewer mains to be permitted
O 451f of 8-inch DI
O 6251f of 12-inch DI
The following information is included for your review and approval:
# Copies Description
2 Fast -Track Application Form FTA 06-21 (original & copy)
1 Review fee check in the amount of $480
2 Flow Tracking / Acceptance Form FTSE 04-18 (signed by City of Winston-Salem)
2 Site Map on 8.5" x 11" USGS Quad Map
2 Site Map on 8.5" x 11" Aerial Map
1 NC Secretary of State document for Wake Forest University Health Sciences
If you have questions or need additional information, please contact me at [phone] or
KHoward@stimmel pa.com
Since9rely,
\,CAROIA I �%i
�pQ �ESS%6••4
{a SEAL 7•
r r I — . O97712
Kelway L. Howard III, PE 1c . 9i,� .`
Vice President i,fy�'1'GINE�' O\��
LANDSCAPE ARCHITECTURE CIVIL ENGINEERING LAND PLANNING

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 06-21 & SUPPORTING DOCUMENTATION
I.
Application Number:
(to be completed by DWR)
All items must be completed or the application will be returned
APPLICANT INFORMATION:
1.
2.
3.
4.
5.
Applicant's name: WFU Health Sciences (company, municipality, HOA, utility, etc.)
Applicant type: ❑ Individual ® Corporation ❑ General Partnership
❑ Federal ❑ State/County
Signature authority's name• Amanda Mewbom per 15A NCAC 02T .0106(b)
Title: Vice President Planning, Design and Construction
Applicant's mailing address: P.O. Box 32861
City: Charlotte State: NC
Applicant's contact information:
Phone number: 678-894-5879
Zip: 28232-2861
❑ Privately -Owned Public Utility
❑ Municipal 0 Other
II. PROJECT INFORMATION:
1. Project name: WFBH— Helipad Relocation
2. Application/Project status: ❑ Proposed (New Permit)
Email Address: Amanda.Mewborn(nhatriumhealth.org
Z Existing Permit/Project
If a modification, provide the existing permit number: W00042818 and issued date: Sept 14, 2021.
For modifications, also attach a detailed narrative description as described in Item G of the checklist.
If new construction, but part of a master plan, provide the existing permit number: W000
3. County where project is located: Forsyth
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.090172° Longitude: -80.271139°
5. Parcel ID (if applicable): Forsyth County PIN 6825-44-5008.000 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
I. Professional Engineer: Kelway L. Howard III, PE
Firm: Stimmel Associates, PA
Mailing address: 601 N. Trade Street, Suite 200
City: Winston Salem State: NC Zip: 27101-
Phone number: [phone] Email Address: [e-mail]
License Number: 027912
TV. WASTEWATER TREATMENT FACILITY (W WTF) INFORMATION:
I. Facility Name: Archie Elledge WWTP Permit Number: NC0037834
Owner Name: WS/FC Utility Commission
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. PermitNumber(s): WQCS00003
2. Downstream (Receiving) Sewer Information: 12- inch Z Gravity D Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00003
Owner Name(s): WS/FC Utility Commission
FORM: FTA 06-21
Page 1 of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑ No ®N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been attached?
❑ Yes ❑ No ®N/A
3. If the Applicant is a Home/Property Owners' Association, has an HOA/POA Operational Agreement (FORM: HOA) and
supplementary documentation as required by 15A NCAC 02T.0115(c) been attached?
❑ Yes No ®N/A
4. Origin of wastewater: (check all that apply):
❑ Residential (Individually Owned)
❑ Residential (Leased)
❑ School / preschool / day care
❑ Food and drink facilities
❑ Businesses / offices / factories
❑ Retail (stores, centers, malls)
❑ Retail with food preparation/service
Z Medical / dental / veterinary facilities
❑ Church
❑ Nursing Home
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool/Clubhouse
❑ Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
5. Nature of wastewater : _% Domestic 100 % Commercial % Industrial (See 15A NCAC 02T .0103(20))
If Industrial, is there a Pretreatment Program in I'effect? ❑ Yes No
6. Has a flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes ® No J
➢ If yes, provide a copy of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(0)
Daily Design Flow a'b
No. of Units
Flow
Patient Tower (Hospital)
300 gal/bed
56
16,800 GPD
Employees
25 gal/employee/largest shift
790
19,750 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
36,550 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 Atlant,ic 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: 36,550 GPD (per 15A NCAC 02T .0114)
> Do not include future flows or previously permitted allocations
If permitted flow is zero, please indicate why:
❑ Pump Station/Force Main or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line.
Please provide supplementary information indicating the approximate timeframe for permitting upstream sewers with flow.
❑ Flow has already been allocated in Permit Number: Issuance Date:
❑ Rehabilitation or replacement of existing sewers with no new flow expected
❑ Other (Explain): Private sewer main is being installed under proposed roadway to serve a portion of the campus that will
be developed in the future.
FORM: FTA 06-21
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-inch
45
D.I.
12-inch
625
D.I.
> 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 requirements is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUjED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: . Longitude: -
3. Total number of pumps at the pump station:
3. Design flow of the pump station: millions gallons per day (firm capacity)
> This should reflect the total GPM for the pump station with the largest pump out of service.
4. Operational point(s) per pump(s): gallons per minute (GPM) at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
If any portion of the force main is less than 4-inches in diameter, please identify the method of solids reduction per
MDCPSFM Section 2.01 C.1.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
❑ Standby power source or ❑ Standby pump
> Must have automatic activation and telemetry - 15ANCAC 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 and may not be portable
Or if the pump station has an average daily flow Less than 15,000 gallons per day 15A NCACO2T.0305(h)(1)(C):
❑ Portable power source with manual activation, quick -connection receptacle and telemetry -
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry:
➢ Include documentation that the portable source is owned or contracted by the applicant 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
as part of this permit application in the case of a multiple station power outage.
FORM: FTA 06-21 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T .0305(f) & (g)?
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)
18 inches
Water mains (vertical - water over sewer preferred, 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, and associated wetlands.
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 associated with these waters (see item IX.2) '�
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches, as well as wetlands associated with these waters or classified as WL.
10 feet
Any building foundation (horizontal)
5 feet
Any basement (horizontal)
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains J
5 feet
Any swimming pools
10 feet
Final earth grade (vertical) '
36 inches
> If noncompliance with 02T.0305(f) or (g), see Section X.1 of this application
*15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved. Please check "yes"
above if these alternatives are used and provide narrative information to explain.
**Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
2. Does this project comply with the minimum separation requirements for water mains? ® Yes D No ❑ N/A
S. If no, please refer to 15A NCAC 18C.0906(f) for documentation requirements and submit a separate document,
signed/sealed by an NC licensed PE, verifying the criteria outlined in that Rule.
3. Does the project comply with separation requirements for wetlands? ❑ Yes ❑ No ® N/A
> Please provide supplementary information identifying the areas of non-conformance.
> See the Division's draft separation requirements for situations where separation cannot be met.
> No variance is required if the alternative design criteria specified is utilized in design and construction.
4. Is the project located in a river basin subject to any State buffer rules? ® Yes Basin name: Yadkin Pee -Dee ❑ No
If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ® Yes ❑ No
> This includes Trout Buffered Streams per 15A NCAC 2B.0202
5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ❑ Yes ® No
or 401 Water Quality Certifications?
> Please provide the permit number/permitting status in the cover letter if coverage/authorization is required.
6. Does project comply with 15ANCAC 02T.0105(c)(6) (additional permits/certifications)? Z Yes ❑ No
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications must be 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.).
7. Does this project include any sewer collection lines that are deemed "high -priority?" ❑ Yes ® No
Per 15A NCAC 02T.0402 "high -priority sewer" means any aerial sewer, sewer contacting surface waters,
siphon, or sewers positioned parallel to streambanks that are subject to erosion that undermines or deteriorates the sewer.
Siphons and sewers suspended through interference/conflict boxes require a variance approval.
> 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 permittee's individual System -Wide Collection permit.
FORM: ETA 06-21 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, for projects requiring a single variance, complete and submit the Variance/Alternative Design Request application
(VADC 10-14) and supporting documents for review to the Central Office. Approval of the request will be issued
concurrently with the approval of the permit, and projects requiring a variance approval may be subject to longer
review times. For projects requiring two or more variances or where the variance is determined by the Division to be a
significant portion of the project, the full technical review is required.
2. Professional Engineer's Certification:
I, Kelway L. Howard, III, P.E. attest that this application for WFBH— Helipad Relocation
(Professional Engineer's name from Application Item 111.1.) (Project Name from Application Item II.1)
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,
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 I1 have reviewed this material and
have judged it to be consistent with the proposed design. J
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, of 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. Misrepresentation of the application
information, including failure to disclose any design non-compliance with the applicable Rules and design criteria, may subject
the North Carolina -licensed Professional Engineer to referral to the licensing board. (21 NCAC 56.0701)
North Carolina Professional Engineer's seal, signature, and date:
SEAL 9r:
027912
$'. 6-26-2022 � if
Fa;GIN �QrP9s'`
Orrnnnurr``
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, Amanda Mewborn , attest that this application for WFBH — Helipad Relocation
(Signature Authority Name from Application Item I.3.) (Project Name from Application Item IL1)
attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge.
I understand that if all required parts of this application are not completed and that if all required supporting documentation
and attachments are not included, this application package is subject to being returned as incomplete. I understand that any
discharge of wastewater from this non -discharge system to surface waters or the land will result in an immediate enforcement
action that may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division
of Water Resources should a condition of this permit be violated. I also understand that if all required parts of this application
package are not completed and that if all required supporting information and attachments are not included, this application
package will be returned to me as incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification n any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as we I as civil penalties up to $25,000 per violation.
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Date:
6/27/2022
FORM: FTA 06-21 Page 5 of 5

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: WFU Health Sciences
Project Name for which flow is being requested: 12545- - WFBH Heliport Relocation
More than one FTSE may be required for a single project if the owner of the WW1P 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: Archie Elledge
b. WWTP Facility Permit #: NC0037834
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent ofpermitted flow used
All flaws are in MGD
30.000000
2.108130,
21.270000
J
0.036550
23.414680
78.0%
II. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A) (B) (C) (D)=(B+C) (E)=(A-D)
Design Obligated,
Pump Pump Average Approx. Not Yet Total Current
Station Station Firm Daily Flow** Current Tributary Flow Plus
(Name or Permit Capacity, * (Finn / pf), Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***
* The Firm Capacity (design flow) of any pump station is defined as the maximum pumped flow
that can be achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor
(pf) not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): Archie Elledge
Downstream Permit Number: WQCS00003
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Courtney Driver, 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 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.
YrO
is l.4—y'i 1919 xCzrL
8/18/2021
Signing Official Signature Date
Capital Projects Engineer
Title of Signing Official
Page 2 of 6
FTSE 10-18

Tax Parcel Viewer
9/1/2021, 10:07:55 AM
= Forsyth County Boundary Parcels - Mailing Labels
1
Streets
Parcels
2018 Aerial Imagery
Red: Band_1
Green: Band_2
Blue: Band_3
1:4,514
0 0.04 0.09
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0.2 km
Forsyth County, NC

The National Map Advanced Viewer
9/1/2021, 9:33:04 AM
1:9,028
0.07 0.15
0.3 mi
0.13 0.25
0.5 km
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SOSID: 0610112
Date Filed: 3/23/2011 10:25:00 AM
Elaine F. Marshall
North Carolina Secretary of State
c201104500069
ARTICLES OF RESTATEMENT
OF
WAKE FOREST UNIVERSITY HEALTH SCIENCES
The undersigned nonprofit corporation, for the purpose of restating its Articles of Incorporation in
accordance with the provisions of §55A-10-06 of the North Carolina General Statutes, hereby submits
the following:
1. The name of the corporation is Wake Forest University Health Sciences,
2. ' Attached as an exhibit is the text of the Restated Articles of Incorporatioiji.
3. The Restated Articles of Incorporation contain an amendment to the Articles of Incorporation
requiring member approval and member approval was obtained as required by the North
Carolina Nonprofit Corporation Act.
4. The Restated Articles of Incorporation contain an amendment to the Articles of Incorporation
requiring approval by Wake Forest University, and that approval was obtained as required by
the North Carolina Nonprofit Corporation Act.
5. The Restated Articles of Incorporation are effective upon filing.
Ci
This the ) 'day of f rSRUrtRIt 2011.
Wake Forest University Health Sciences
B
J. Reid organ
Secretary
8346-26

State of North Carolina
Department of the Secretary of State
RESTATED ARTICLES OF INCORPORATION
OF
WAKE FOREST UNIVERSITY HEALTH SCIENCES
Pursuant to §55A-2-02 of the General Statutes of North Carolina, the undersigned corporation
does hereby submit these Restated Articles of Incorporation for a nonprofit corporation.
1. The name of the corporation is:
Wake Forest University Health Sciences.
2. The corporation is a charitable or religious corporation as defined in NCGS §55A-1-40(4).
3. The street address and county of the registered office of the corporation is:
Medical Center Boulevard
Winston-Salem, NC 27157
County of Forsyth
4. The mailing address of the registered office is:
Wake Forest University
P. 0. Box 7656
Winston-Salem, NC 27109
5. The name of the registered agent is:
J. Reid Morgan
6. The name and address of the incorporator is as follows:
Wake Forest University
1834 Wake Forest Road
Winston-Salem, NC 27109
7. The sole member of the corporation is Wake Forest University.
8. Provisions regarding the distribution of the corporation's assets upon its dissolution:
8.1.1. The corporation may be dissolved and its business and affairs teinnnated, but such a
dissolution must be in accordance with the provisions of Chapter 55A of the General
Statutes of North Carolina and Section 1.501(c)(3)-1(b)(4) of the United States
Treasury Regulations, or applicable successor statutes or regulations.
8.1.2. Upon dissolution of the corporation and after all its debts and expenses have been paid,
all of its assets shall be distributed in conformity with the Bylaws and the Articles of
Incorporation. All remaining assets of the corporation shall be conveyed or distributed
to Wake Forest University (the "University") if the University at the time of such
conveyance or distribution qualifies as an organization described in Sections 501(c)(3)
and 170(c)(2) of the Internal Revenue Code of 1986, as amended (or the corresponding
8346-27

provisions of any future United States Internal Revenue law). In the event that the
University does not so qualify at the time of such conveyance or distribution, then all
remaining assets of the corporation shall be conveyed or distributed to such of one or
more organizations as may be designated by the governing body of the University so
long as the distributee/entity/organization at the time of such conveyance or
distribution qualifies as an organization described in Sections 501(c)(3) and 170(c)(2)
of the Internal Revenue Code of 1986, as amended (or the.corresponding provisions of
any future United States Internal Revenue law),
9. Additional provisions;
9.1. Purposes of the Corporation
The purposes for which the corporation is organized are exclusively religious, charitable,
scientific, literary and educational within the meaning of § 501(c)(3) of the Internal
Revenue Code of 1986, as amended (or the corresponding provisions of any future
United States Internal Revenue law), including, without limitation,ithe following;
9.1.1. The corporation is organized and shall operate as a supporting organization
exclusively for the benefit of Wake Forest University;
9.1.2. The corporation is organized and shall operate to engage in healthcare related
activities of every kind and nature, to conduct research, and to exist and operate
as a school of medicine and an educational organization the primary function of
which is the presentation of formal instruction and which normally maintains a
regular faculty and curriculum and normally has a regularly enrolled body of
pupils or students in attendance at the place where its educational activities are
regularly carried on;
9,1.3. The corporation shall conduct its operations as a part of the integrated health
system of Wake Forest University Baptist Medical Center (the "Medical
Center"); and
9.1.4. The corporation is organized and shall operate to engage, directly or indirectly,
in any other lawful act or activity for which corporations may be organized
under Chapter 55A of the General Statutes of North Carolina that may, directly
or indirectly, promote the interests of the corporation or enhance the value of
its property; provided, however, that the corporation may not engage, other
than as an insubstantial part of its activities, in activities that are not in
furtherance of one or more of those purposes specifically enumerated above.
9.2. Activities not permitted.
No part of the net earnings of the corporation shall inure to the benefit of, or be
distributable to, its directors, trustees, officers or any "private shareholder or individual"
within the meaning of § 501(c)(3) of the hnternal Revenue Code of 1986, as amended (or
8346-27
2

the corresponding provisions of any future United States Internal Revenue law);
provided, however, that the corporation shall be authorized and empowered to pay
reasonable compensation for services rendered. No substantial part of the activities of
the corporation shall consist of the carrying on of propaganda or otherwise attempting to
influence legislation, and the corporation shall not participate in or intervene in
(including the publishing or distribution of statements) any political campaign on behalf
of any candidate for public office. Notwithstanding any other provision of these Articles
of Incorporation, the corporation shall not carry on any activities not permitted to be
carried on:
9.2.1. By an organization exempt from federal income tax under § 501(c)(3) of the
Internal Revenue Code of 1986, as amended (or the corresponding provisions of
any future United States Internal Revenue law),
9.2.2. By an organization, contributions to which are deductible under § 170(c)(2) of
the Internal Revenue Code of 1986, as amended, or the corresponding provisions
of any future United States Internal Revenue law), or
•
9.2.3. By a "charitable or religious corporation" as that term is defined under the North
Carolina Nonprofit Corporation Act.
9.3. Delegation of Authority
Pursuant to N.C.G.S. §55A-8-01 and as specified in a Medical Center Integration
Agreement entered into among the corporation, the Medical Center, Wake Forest
University, and North Carolina Baptist Hospital, certain powers to operate the
corporation have been delegated to the Medical Center. All corporate powers not so
delegated are retained by the corporation's Board of Directors or by Wake Forest
University.
9.4. Immunity
To the fullest extent permitted by the North Carolina Nonprofit Corporation Act as now
in effect or as it may hereafter he amended, no person who is serving or who has served
as a director of the corporation shall be personally liable to the corporation for monetary
damages for breach of duty as a director. No amendment or repeal of this section, nor the
addition of any provision to these Articles of Incorporation inconsistent with this section,
eliminates or reduces the protection granted herein with respect to any matter that
occurred prior to such amendment, repeal, or addition.
9.5. Election of Directors
The directors shall be elected by the member or shall serve ex officio pursuant to
procedures approved by the member, and shall include the persons serving on the Health
Affairs Committee (or its successor, however named) of the Wake Forest University
Board ofTrustees.
9.6. Conveyance of real property.
8346-27 3

Real property of the corporation may be conveyed only upon the consent of the member,
given in such manner as may be provided in the bylaws.
9.7. Amendment of articles of incorporation or bylaws.
Neither the articles of incorporation nor the bylaws may be amended without the written
approval of the Wake Forest University Board of Trustees,
10. The street address and county of the principal office of the corporation is:
Medical Center Boulevard
Winston-Salem, NC 27157
County of Forsyth
11. The mailing address of the principal office is:
P. O. Box 7656
Winston-Salem, NC 27109
12. These articles are effective upon filing,
This the /S it day o
Approved:
Wake Forest University
es T. Williams,
air, Board of Trustees
, 2011.
Wake Forest University Health Sciences
By:
Donald E. Flow
Chair, Board of Directors
8346-27 - 4

Stimmel Associates, PA
Stimmel
Landscape Architecture
Civil Engineering
Land Planning
601 N. Trade Street
Suite 200
Winston Salem, NC
27101-2916
P: 336.723,1067
F: 336.723.1069
date 7/7/2022 job #: 20-335
project: WFBH HeliPort Relocation
letter of transmittal
attn: Alex sent
to: NCDEQ
Winston-Salem Office
We are sending you the following items:
F Prints r Calculations r Base Drawings
J Reproducibles r Information
r Originals r Specifications
Attached
C Under Separate Cover
r U.S. Mail
r Ovei Night Service
r Fax#
FT By Hand
For Pick -Up
# of pages total =
r Correspondence
r Change Order / Addendum
✓ Diskette / CD
✓ Email with Attachments
copies
sheet
dated
description
1
7/6/2022
Signed FTSE
remarks, comments, & details:
NC Department of
Envircnmcntol Quality
Recely : it
JUL. 0 7 2022
Winston-sEdern
Regional Office
If noted enclosures are not received, please notify us.
copies to: File by: Dan Jester

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: WFU Health Sciences
Project Name for which flow is being requested: 12545- - WFBH Heliport Relocation
More than one FTSE may be required for a single project tithe 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: Archie Elledge
b. WWTP Facility Permit #: NC0037834
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
All flows are in MGD
30.000000
2.108130
21.270000
J
0.036550
23.414680
78.0%
II. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A) (B) (C) (D)=(B+C) (E)=(A-D)
Design Obligated,
Pump Pump Average Approx. Not Yet Total Current
Station Station Firm Daily Flow** Current Tributary Flow Plus
(Name or Permit Capacity, * (Firm / pf), Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***
* The Firm Capacity (design flow) of any pump station is defined as the maximum pumped flow
that can be achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor
(pf) not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): Archie Elledge
Downstream Permit Number: WQCS00003
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Courtney Driver, 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 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
;(s!• e coJtdf5
Title of Signing Official
Date
Page 2 of 6
FTSE 10-18