WQ0044350_Application (FTSE)_20230427

te6e"tve'c� State of North Carolina
DWRq,ZD'2_3 ,Zi.Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 06-21 & SUPPORTING DOCUMENTATION
Application Number: `l (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Toyota (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ❑ Municipal ❑ Other
3. Signature authority's name: Kevin Kerwin per 15A NCAC 02T .0106(b)
Title: Manager
4. Applicant's mailing address: 5938 Julian Airport Road
City: Liber1y State: NC Zip: 27298-
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail]
II. PROJECT INFORMATION:
1. Project name: TBMNC BEV Phase 1 503/803
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ and issued date: ,
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: WQ00
3. County where project is located: Randolph
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.8947854' Longitude:-079.6335583'
5. Parcel ID (if applicable): 8718029180 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Matthew W Watt License Number: 037518
Firm: HDR Engineering Inc. of the Carolinas
Mailing address: 440 S. Church St. Suite 1200
City: Charlotte State: NC Zip: 28202-2075
Phone number: 336) 955-8259 Email Address: matthew.watt(u,hdrinc.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: T.Z. Osborne Water reclamation Facility Permit Number: NCO047384
Owner Name: City of Greensboro
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQCS00006
2. Downstream (Receiving) Sewer Information: 24" inch ® Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00006
Owner Name(s): City of Greensboro
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) ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential (Leased) ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool/Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
® Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater : % Domestic % Commercial % Industrial (See 15A NCAC 02T .0103(20))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(fl? ❑ Yes ® No
➢ If Yes, provide a copy of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow a.n
No. of Units
Flow
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
0 GPD
a See 15A NCAC 02T .0114(b), (d), (e,)(1) and (e)(2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0114] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 0 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: W00040884 Issuance Date: 1/5/2023
❑ Rehabilitation or replacement of existing sewers with no new flow expected
❑ Other (Explain):
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"
39
C-900
➢ 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 INCLUDED IN THIS PROJECT
1. Pump station number or name: 503/803
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.8947854' Longitude:-079.6335583'
3. Total number of pumps at the pump station: 2
3. Design flow of the pump station: .33 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): 600 gallons per minute (GPM) at 100 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
6
100
C-900
If any portion of the force main is less than 4-inches in diameter, please identify the method of solids reduction per
MDCPSFM Section 2.01C.l.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 - 15A NCAC 02T.0305(h)(1)(B);
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility 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) & (Q)? ® Yes ❑ No
15A NCAC 02T.0305 contains minimum separations that shall be provided for sewers stems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
18 inches
ZWater mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
ZWater 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
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 ❑ No ® N/A
➢ 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: ® 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 213.0202
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 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ❑ Yes ® No
Per 15A NCAC 02T.0I05(c)(6), directly related environmental permits or certification applications 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: FTA 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 proiect, the full technical review is required.
2. Professional Engineer's Certification:
I, Matthew Watt, attest that this application for City of Greensboro Megasite Water and Sewer Improvements Phase II
(Professional Engineer's name from Application Item III.1.) (Project Name from Application Item I1.1)
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 I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000, 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)
.%X1
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, Kevin Kerwin, attest that this application for TBMNC BEV Phase 1 503/803
(Signature Authority Name from Application Item I.3.) (Project Name from Application Item II.1)
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 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.
Signatur . Date: z
FORM: FTA 06-21 Page 5 of 5

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ocu ign Envelope ID: D8AFAF69-D23E-4920-BB24-9E767644DB5E
SOSID: 2322759
Date Filed: 12/17/2021 11:36:00 AM
State of North Carolina Elaine F. Marshall
Department of the Secretary of State North Carolina Secretary of State
C2021 351 00036
APPLICATION FOR CERTIFICATE OF AUTHORITY
Pursuant to §55-15-03 of the General Statutes of North Carolina, the undersigned corporation hereby applies for a Certificate of
Authority to transact business in the State of North Carolina, and for that purpose submits the following:
1. The name of the corporation is Toyota Battery Manufacturing, Inc.
and if the corporate name is unavailable for use in the State of North Carolina, the name the corporation wishes to use is:
2. The state or country under whose laws the corporation was organized is:
3. The date of incorporation was November 9, 2021
Delaware
4. Its period of duration is: Z perpetual or El a date certain (mm/dd/yyyy)
5. Principal office information: (Select either a or b.)
a. The corporation has a principal office.
The street address and county of the principal office of the corporation is:
Number and Street 6565 Headquarters Drive
City, State, Zip Code Plano, TX 75024 county
Collin
The mailing address, if different from the street address, of the principal office of the corporation is:
Number and Street
City, State, Zip Code
b.F�The corporation does not have a principal office.
County
6. The street address and county of the registered office in the State of North Carolina is:
Number and Street 160 Mine Lake Ct, Suite 200
City, Raleigh
State NC , Zip Code: 27615 County:
Wake
7. The mailing address, if different from the street address, of the registered office in the State of North Carolina is:
Number and Street
City:
State NC , Zip Code:
8. The name of the registered agent in the State of North Carolina is:
County:
CT Corporation System
BUSINESS REGISTRATION DIVISION P. 0. BOX 29622 RALEIGH, NC 27626-0622
(Revised July 2017) (Form B-09)

DocuSign Envelope ID: D8AFAFB9-D23E-4920-BB24-9E767644DB5E
9. The names, titles, and usual business addresses of the current officers of the corporation are (attach if necessary):
Name Title Business Address
F. Norman Bafunno, III President 6565 Headquarters Drive, Plano, TX 75024
Thibaut de Barros Conti Secretary 6565 Headquarters Drive, Plano, TX 75024
Shingo Fujioka Treasurer 6565 Headquarters Drive, Plano, TX 75024
10. Attached is a Certificate of Existence (or document of similar import) duly authenticated by the Secretary of State or other official
having custody of corporate records in the state or country of incorporation. The Certificate of Existence must be an
orizinal and less than six months old.
11. If the corporation is required to use a fictitious name in order to transact business in this State, a copy of the resolution of its board
of directors, certified by its secretary, adopting the fictitious name is attached.
12. This application will be effective upon filing, unless a delayed date and/or time is
This is the 16th day of December 20 21
Toyota Battery Manufacturing, Inc
NAME OF CORPORATION
DocuSigned by:
5970F�84C14E4E9...
Signature
F. Norman Bafunno, III President
Type or Print Name and Title
NOTES:
1. Filing fee is $250. This document must be filed with the Secretary of State.
BUSINESS REGISTRATION DIVISION P. O. BOX 29622 RALEIGH, NC 27626-0622
(Revised July 2017) (Form B-09)

Delaware Page
The First State
1, JEFFREY W . BULLOCK, SECRETARY OF STATE OF THE STATE OF
DELAWARE, DO HEREBY CERTIFY "TOYOTA BATTERY MANUFACTURING, INC." IS
DULY INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE AND IS IN
GOOD STANDING AND HAS A LEGAL CORPORATE EXISTENCE SO FAR AS THE
RECORDS OF THIS OFFICE SHOW, AS OF THE NINTH DAY OF DECEMBER, A.D.
2021.
AND I DO HEREBY FURTHER CERTIFY THAT THE ANNUAL FRANCHISE TAXES
HAVE BEEN ASSESSED TO DATE.
0'
6378840 8300
S R# 20214043118`
You may verify this certificate online at corp.delaware.gov/authver.shtml
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Authentication: 204931176
Date: 12-09-21

NC Depa,•tment of
Environmental Quality
Received
APR 2 7 2023
Winston-Salem
Regional Office
April 28, 2023
N.C. Department of Environmental Quality
Division of Water Resources
Winston-Salem Regional Office
450 West Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Re: Guilford/Randolph Megasite
City of Greensboro Megasite Water and Sewer Improvements Phase II
15A NCAC 02T .0300 — Sewer Extension Application
HDR Project Number 10328292
On behalf of Toyota, enclosed please find the following permit application and supporting
documents for the City of Greensboro Megasite Water and Sewer Improvements Phase II Project
for your review and approval:
1. One original and one copy of the Fast Track Sewer System Extension Application
2. $480 Application Fee
3. Two (2) Copies of USGS Site Map
4. Two (2) Copies of Aerial Map
5. Certificate of Authority from Toyota
We are requesting to permit the 803 lift station along with the associate piping to convey the sewer
to an offsite manhole owned by the City of Greensboro.
Should you have any questions or need additional information, please do not hesitate to contact
me.
Sincerely,
HDR Engineering, Inc., of the Carolinas
Matthew Watt, PE
Water/Wastewater Engineer
440 S Church Street, Suites 800, 900 & 1000, Charlotte, NC 28202-2075
[phone]