WQ0018416_Modification_Application (FTSE)_20240111

DWR
Division of Water Resources
I. APPLICANT
State of North Carolina
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
VIA 10-23 & SUPPORTING DOCUMENTATION
��00/fv/6 't'(° v
Application Number: (to be completed by DWR)
All items must be completed or the application will be returned
1. Applicant'sname: Davie County (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal 0 StatelCoumy ❑ Municipal ❑ Other
3. Signature authority's name: Brian Barnett per 15A NCAC 02T .0106(b)
Title: County Manager
4. Applicant's mailing address: 123 S. Main Street
City: Mocksville State: NC Zip: 27028-_
5. Applicant's contact information:
Phone number: [phone] Email Address: Bbamett(a),daviecountvnc.gov
IL PROJECT INFORMATION:
1. Project name: Kinderton Pump Station
2. Application/Project status: ❑ Proposed (New Permit) ® Existing Permit/Project
If a modification, provide the existing permit number. WQ0018416 and issued date: 12/29/2000 (Original Issue).
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: Davie
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.011845' Longitude:-80.4330660
5. Parcel ID (if applicable): 5872663332 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer. J. Neal Tucker P E License Number: 014985
Firm: Stimmel Associates, PA
Mailing address: 601 N. Trade Street Suite 200
City: Winston-Salem State: NC Zip: 27101-
Phone number: 3( 336) 723-1067 Email Address: mucker(a),stimmelpa.com
tV. WASTEWATER TREATMENT FACILITY (WWTF)
1. Facility Name: Muddy Creek W WTP Permit Number: NCO050342
Owner Name: City of Winston-Salem
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): W00013390
2. Downstream (Receiving) Sewer Information: 10 inch ® Gravity/ ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00106
Owner Name(s): Davie County
FORM: FTA 10-23 Page I of 5
A
A iM1

VL 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: 100 % 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(f)? ❑ Yes ® No
➢ If yes. provide a cony of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow 8,b
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(4 (d). (e)(1) and (e)(2) for caveats to wastewater design flow rates (i.e. 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.01141 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 and G.S. 143-215.1)
➢ 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): This is a modification to an existing pump station to increase the pumping capacity for future
development and to reroute the force main to a different discharge point. No new gravity mains are being constructed as part
of this project and no new tributary flows are being added. See attached narrative.
FORM: FTA 10-23 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable)- 02T .0305 & MDC (GravitN Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 40 PVC
➢ Section II & ID 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: Kinderton Pump Station
2. Approximate Coordinates (Decimal Degrees): Latitude: 36.011845° Longitude:-80.4330660
3. Total number of pumps at the pump station: 2
3. Design flow of the pump station: 0.862560 m Ilion 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): 599 gallons per minute (GPM) at 106.4 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
6
170
DI
6
805
PVC
8
85
DI
8
1237
PVC
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)(l ):
® 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(hXlXQ:
❑ 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 timefiames, shall be provided
as part of this permit application in the case of a multiple station power outage.
FORM: FTA 10-23 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(fl & (g)? ® Yes []No
15A NCAC 02T.0305(fl contains minimum separations that shall be provided for sewer systems:
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 Il 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(fl or (g). see Section X.1 of this application
"15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(fl 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 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 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications 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 permfttee 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 10-23 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?
If no, for projects requiring a single variance, complete and submit the Variance/Altemative Design Request application
(VADC 10-14) and supporting documents for review to the Central Office. Approval of the request will be issued
2. Professional Engineer's Certification:
I J. Neal Tucker, P.E. attest that this application for Kinderton Pump Station
(Professional Engineer's name from Application Item III.1 J (Project Name from Application Item H.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 143-215.6B, 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. 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: .`CAR
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I Brian Barnett , attest that this application for
(Signature Authority Name from Application Item 1.3.)
SEAL
14985
Kinderton Pump Station
(Project Name from Application Item 11.1)
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.
Signature: t+ " " Date: Z 1 6 Z
FORM: FTA 10-23 Page 5 of 5

Docu5ign Envelope ID: 2C434C52-C997-47E1-86B4-2188B1C955EF
ROY COOPER
Governo,
ELIZABETH S. BISER
Secretory
RICHARD E. ROGERS, JR-
Director
Brian Barnett, County Manager
Davie County
123 S. Main Street
Mocksville, NC 27028
NOR I H CAROLINA
Environmental Quality
December 20, 2023
Subject: Change of Ownership Approval
Permit No. W00018416
Kinderton Phase I
Davie County
Dear Brian Barnett:
visiop-personnel have reviewed and approved your permit modification request for Permit No.
s modification -is to change ownership from the Adams Egloff Avant Properties
LLC to the Davie County, and Davie County is now responsible for the continued operation and
maintenance of the subject wastewater collection extension. Our database has been revised to
reflect the ownership change. This cover letter shall be considered a part of this permit and is
therefore incorporated therein by reference.
The Permittee shall maintain compliance with its individual system -wide collection system permit
for the operation and maintenance of these facilities as required by 15A NCAC 2T .0400 and G.S
143-215.9B. If you have any other questions regarding this matter, please contact Matthew Nevills
at [phone] [email: Matthew. [e-mail]].
Sincerely,
0ecu81anW Ey:
E
ticumw Mekit,IwLlO
G6/5311316 'FE_.
Michael Montebello
NPDES Branch Chief, Division of Water Resources, DEQ
enclosures: Permit No. W00018416
.0403 Supplement
cc: Avant Kerry, Owner
Winston-Salem Regional Office, Water Quality Regional Operations Section
Municipal Permitting Unit Files (electronic copy)
North Carolina Department of Envrtoum.ial Quality I Division of W.w Resources
D ��� 512 North Salisbury Street 1 1611 Mail Service Center I Raleigh. North Carolina 27699-1611
e a� 919.707.9n00

DocuSign Envelope ID: 2C434C52-C997-47El-86B4-218BBiC955EF
FMA
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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
April 26, 2007
Mr. Kerry Avant
Adams, Egloff, Avant Properties, LLC
1645 Westbrook Plaza Drive
Winston-Salem, NC 27103
William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
Subject: Permit No. W00018416 (V Modification)
Adams, Egloff, Avant Properties, LLC
Kinderton Village Phase 3D
Wastewater Collection System Extension
Davie County
Dear Mr. Avant:
In accordance with your application received April 13, 2007, and additional information received
on April 24, 2007, we are forwarding herewith modified Permit No. WQ0018416, dated April 26, 2007, to
Adams, Egloff, Avant Properties, LLC for the construction and operation of the subject wastewater
collection system extension. This permit shall be effective from the date of issuance until rescinded, shall
void Permit No. WQ0018416 issued 11/13/2006 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. This permit modification is for the addition of Phase 3D to Kinderton Village with a
flow of 10,220 GPD.
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, and/or
referral of the North Carolina -licensed Professional Engineer to the licensing board.
Winston-Salem Regional Office
585 Waughtown Street, Winston-Salem, North Cardin 27107
Phone: [phone] / Fax: [phone] / Internet: www.ncwatemueli_� ro
One
NorthCarolina
Naturally
An Equal Opportunity/Affirmative Action Employer - 50% Recyded110% Post Consumer Paper

` DocuSign Envelope to: 2C434C52-C99747E7-86B4-2188B1C955EF
Adams, Egloff, Avant Properties, LLC
April 26, 2007
Page 2
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina
as amended, and otherapplicable Laws, Rules, and Regulations, permission is hereby granted to Adams,
Egloff, Avant Properties, LLC for the construction and operation of approximately 3,843 linear feet of 8-
inch gravity sewer to serve 43 3-bedroom residences and 30 duplexes as part of the Kinderton Village
Phase 3D project, and the discharge of 10,220 gallons per day of collected domestic wastewater into the
Davie County and City of Winston-Salem's existing sewerage system, pursuant to the application
received April 13, 2007 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, and the continued operation of the following previously
permitted components:
1) Initial permit issued 12/29/2000 for Phase 1 - 11,913 linear feet of 8-inch gravity sewer and a
200-gallon per minute pump station with duplex pumps, on -site audible and visual high water
alarms, an automatically activated on -site generator; as well as approximately 1,731 linear feet of
4-inch force main and 1,058 linear feet of 6-inch force main to serve 200 three -bedroom
residences, 8 three -bedroom townhomes, 36 two -bedroom condominiums, as well as a clubhouse
and pool for 185 bathers per day with the discharge of 36,010 gallons per day of collected
domestic wastewater into the Davie County collection system and then to the City of Winston-
Salem collection system (Note: The Division approved a retroactive flow reduction request for the
Kinderton Development on April 28, 2006 for 140 gallons per day per residential unit and 60
gallons per day per 1,000 square feet for all non-residential/non-food service establishments).
2) Permit modified 12/8/04 for Phase 2 — 2,352 linear feet of 8-inch gravity sewer to serve 66 three -
bedroom residences with the discharge of 9,240 gallons per day of collected domestic wastewater
into the Davie County and City of Winston-Salem existing sewerage system, pursuant to the
application received September 27, 2004.
3) Permit modified 11/13/06 for Phase 1 additions and Phase 3B — 540 linear feet of 8-inch
gravity sewer to serve eight three -bedroom residences and 60 three -bedroom quads (additions
to Phase 1) and 16 three -bedroom residences (Phase 3B) with the discharge of 11,760 gallons
per day of collected domestic wastewater into the Davie County and City of Winston-Salem
existing sewerage system, pursuant to the application received November 8, 2006.
(To date, the total wastewater flow volume approved for the Kinderton project is 67,230 gallons per day.
The total gravity line length approved is 18,648 linear feet).
The sewage and wastewater collected by this system shall be treated in the City of Winston-
Salem Muddy Creek Wastewater Treatment Facility (Permit No. NC0050342) prior to being discharged
into the receiving stream.
This permit shall become voidable unless the agreement between Adams, Egloff. Avant
Properties, LLC, Davie County and the City of Winston-Salem for the collection and final treatment of
wastewater is in full force and effect.

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J
Adams, Egloff, Avant Properties, LLC
Apnl 26, 2007
Page 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.
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 150E 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 Mike Mickey at (336)
771-5000.
Sincerely,
for Alan W. Klimek, P.E.
cc: Kelway Howard, PE (Stimmel Associates, PA, 601 N. Trade Street, Winston-Salem, NC 27101)
Davie County Building Inspections
WSRO - WQS (NPDES No. NC0050342)
PERCS Files
SWP - Central Files

DocuSign Envelope ID: 2C434C52-C997.47E1.8684-218BB1C955EF
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:
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:
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 NCAC
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.

DocuSlgn Envelope ID: 2C434C52-C997.47E1-86B4-216BB1C955EF
4. 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.
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.
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 26.0200, 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 213.0200 and 15A NCAC 2H .0500.
11. Noncompliance Notification:
The Permittee shall verbally report to a Division of Water Quality employee at the Winston-Salem
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.
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

DocuSign Envelope ID: 2C434C52-C997-47Et-86B4-218BB1C955EF
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.
12. 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 a 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.
Permit issued this the 26" day of April, 2007.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0018416 (3rtl Modification)

DocuSign Envelope ID: 2C434C52-C997.47E1-8664-218BB1C955EF
Fast Track Engineering Certification
Permit No. WO0018416 (3t' Modification)
Adams, Egloff, Avant Properties, LLC
April 26, 2007
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
as a duly registered Professional Engineer in the State of North Carolina, having
been authorized to observe (❑ periodically, ❑ weekly, ❑ full time) the construction of the Kinderton Village Phase
3D project in Davie County 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:
Winston-Salem Regional Office
685 Waughtown Street
Winston-Salem, NC 27107
Attn: Steve Tedder
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.

DoduSign Envelope ID:2C434C52-C997.47E1-86B4-218BB1C955EF
15A NCAC 02T .0403 PERMITTING BY REGULATION
(a) Collection systems having an actual, permitted or Division approved average daily flow less than
200,000 gallons per day are deemed permitted pursuant to Rule .0113 of this Subchapter provided
the system meets the criteria in Rule .0113 of this Subchapter and all specific criteria required in this
Rule:
(1) The sewer system is effectively maintained and operated at all times to prevent discharge to
land or surface waters, and to prevent any contravention of groundwater standards or
surface water standards.
(2) A map of the sewer system has been developed and is actively maintained.
(3) An operation and maintenance plan including pump station inspection frequency,
preventative maintenance schedule, spare parts inventory and overflow response has been
developed and implemented.
(4) Pump stations that are not connected to a telemetry system (i.e., remote alarm system) are
inspected by the permittee or its representative every day (i.e., 365 days per year). Pump
stations that are connected to a telemetry system are inspected at least once per week.
(5) High -priority sewers are inspected by the permittee or its representative at least once every
six -months and inspections are documented.
(6) A general observation by the permittee or its representative of the entire sewer system is
conducted at least once per year.
(7) Overflows and bypasses are reported to the appropriate Division regional office in
accordance with 15A NCAC 02B .0506(a), and public notice is provided as required by G.S.
143-215.1C.
(8) A Grease Control Program is in place as follows:
(A) For publicly owned collection systems, the Grease Control Program shall include at
least biannual distribution of educational materials for both commercial and
residential users and the legal means to require grease interceptors for new
construction and retrofit, if necessary, of grease interceptors at existing
establishments. The plan shall also include legal means for inspections of the grease
interceptors, enforcement for violators and the legal means to control grease
entering the system from other public and private satellite sewer systems.
(B) For privately owned collection systems, the Grease Control Program shall include at
least biannual distribution of grease education materials to users of the collection
system by the permittee or its representative.
(C) Grease education materials shall be distributed more often than required in Parts
(A) and (B) of this Subparagraph if necessary to prevent grease -related sanitary
sewer overflows.
(9) Right-of-ways and easements are maintained in the full easement width for personnel and
equipment accessibility.
(10)Documentation shall be kept for Subparagraphs (a)(1) through (a)(9) of this Rule for a
minimum of three years with exception of the map, which shall be maintained for the life of
the system.
(b) Private collection systems on a single property serving an industrial facility where the domestic
wastewater contribution is less than 200,000 gallons per day shall be deemed permitted.
(c) The Director may determine that a collection system should not be deemed to be permitted in
accordance with this Rule and Rule .0113 of this Subchapter. This determination shall be made in
accordance with Rule .0113(e) of this Subchapter.
History Note: Authority G.S. 143-215.1(a); 143-215.3(a); 143-215.913;
Eff. September 1, 2006.

L7 stimme! wwst' mD com 3� 7231067
Kinderton Village Pump Station Upgrades
Davie County, NC
Preliminary Engineering Report
September 20, 2023
Revised January 9, 2024
Proiect Description
The Kinderton Village Sanitary Pump Station, located on the east side of Lakeside Crossing adjacent to Fred
Bahnson Number One Lake in Davie County, pumps wastewater that originates from three sources (1) the
Kinderton Village Residential development, (2) an adjacent shopping center with restaurants, retail, and a grocery
store to the west of the residential development, (3) and an athletic facility to the east of the residential
development. The area served by the pump station is located in the northeast quadrant of the intersection of
Interstate 40 (1-40) and NC Hwy 801. The pump station is owned and maintained by Davie County Utilities. The
pump station is permitted for a maximum flowrate of 260 gpm and consists of the following:
• 8-foot diameter precast concrete wet well
• 4-inch Gorman Rupp 'suction lift pumps in above ground fiber glass enclosure
• 2,700 If— 6-inch & 4-inch force main
Standby generator
Meter for measuring the volume of wastewater pumped by the station
• Pump controls including an auto dialer to notify the operator in the event of a problem
The pump station discharges to 1,025 If of 6-inch ductile iron and PVC force main which runs in a southwesterly
direction along Lakeside Crossing and then under 1-40. On the south side of 1-40, the force main reduces to 4-inch
PVC. From this point the 4-inch force main turns east and runs through a public easement 1,275 If and then turns
due south and runs an additional 4001f to a gravity manhole in W. Kinderton Way.
Study of Current Pump Station Capacity
Calculations obtained from Davie County Utilities indicate that the current pumping rate (capacity) for the existing
pump station is 240 gpm for one pump. Davie County Utilities has compiled actual daily flow data for the pump
station over the past several years. Seven months of that data has been provided to Stimmel Associates for review
along with a 90%Confidence Interval calculation based on that same data. The calculated 90% Confidence Interval
for the metered daily flow is 91,803 gpd. This is the accepted average daily flow by Davie County Utilities as being
pumped by the station. Based on.the current capacity of 240 gpm, Davie County Utilities calculates the existing
station could provide a maximum capacity of 345,600 gpd which equates to maximum design flow of 115,200
gpd based on a peaking factor of 3.0. With current buildout contributing 91,803 gpd to the maximum design flow
of 115,200 gpd that leaves 23,397 gpd of available capacity in the pump station.
Proposed Future Development
There are currently 64.76 acres of undeveloped property in the Kinderton Village area being considered for
development. Site 1 is 22.54 acres zoned Commercial Mixed (CM) and Site 2 is 42.22 acres zoned Residential
Mixed (RM). Site 2 has approximately 22.50 acres of developable divided area into 2 parcels (9.50 ac+/- in Parcel
#1 and 13.00 ac +/- in Parel 2). See attached exhibit for reference to site locations. Maximum developmental
density for both zoning classifications is 8 units/acre. Assuming that proposed development is maximized over
LANDSCAPE ARCHITECTURE CIVIL ENGINEERING LANDPLANNING Pagel

A .r
L'0 st i m m e I 601 N. TRADE STREET, SUITE 200
WINSTON-SALEM, 27101
wwwstimmelpa.comNC 336.72 3.106 7
both areas, that would equate to a possible 360 units. North Carolina Administrative Code (NCAC) 15A NCAC 02T
.0114 Wastewater Design Flow Rates states that,
In determining the volume of sewage from dwelling units, the flow rate shall be 120 gallons per day per bedroom.
The minimum volume of sewage from each dwelling unit shall be 240 gallons per day and each additional bedroom
above two bedrooms shall increase the volume by 110 gallons per day. Each bedroom or any other room or addition
that can reasonably be expected to function as a bedroom shall be considered a bedroom for design purposes.
Although the maximum number of units allowed per zoning is 518 units, we have based the average daily flow on
360 units, or 8 units per developable acre. We assume all units will be 4-bedroom units @ 480 gpd/unit totaling
172,800 gpd of additional wastewater flow to the pump station. This additional flow added to the existing 90%
Confidence Interval flow of 91,803 gpd totals 264,603 gpd.
Pump Station Upgrades
The existing pump station will be upgraded to handle the new total flow of 264,603 gpd. Davie County Utilities
requires a minimum Peaking Factor of 3.0 which requires a minimum pumping capacity of 551 gpm for each pump.
The station upgrades will be achieved by replacing the two existing suction lift pumps with two larger non -clog
submersible pumps and replacing the existing 4-inch section of force main with an 8-inch force main. The existing
1,025 If of 6-inch force main between the pump station and the south side of 1-40 will remain in service and the
existing 1,675 If of 4-inch force main will be disconnected and abandoned in place. A new 8-inch force main will
be connected to the existing 6-inch force main on the south side of 1-40 and will run due south to an existing
manhole installed in an existing 10-inch gravity sewer within the US Hwy 158 R/W. The new 8-inch force main will
be C-900 PVC (DR-14) pipe. The larger pumps will require upgrading/replacement of the electrical service and
controls, and replacement of the existing discharge pipes and valves between the pumps and the existing force
main. The existing generator is of sufficient size power the new pumps. The existing 8-foot diameter wet well
will remain in service, however the top slab will be replaced with a precast concrete top to provide adequate
access for removal of the new pumps for maintenance. We anticipate the existing valve vault will need to be
replaced as well.
Summary Calculations Results
Sulzer XFP100G C81 pumps will be used to replace the existing pumps. These pumps have a 33-hp motor
operating at 1766 rpm and have a 11-inch impeller. The pump station calculations reflect the pump's operating
point at 599 gpm @ 106.4 ft TDH. At this flowrate the flow velocity is 7.13 fps in the 6-inch force main, and 4.15
fps in the 8-inch force main and pump discharge pipes. The wet well level will beset to provide an active storage
depth of 2.68 feet and active storage volume of 1,006 gallons. At the average daily flow of 184 gpm (future
developed condition), the system will operate at 7.59 pump starts per hour and a cycle time of 7.90 minutes
between pump starts and a pump run time 2.42 minutes. Prior to additional sewer flow from the new
development areas coming online, the current flowrate into the station will be 91,803 gpd (64 gpm average) and
with the proposed control levels in the wet well, the system will operate at 3.11 pump starts per hour and a cycle
time of 19.28 minutes between pump starts and a pump run time of 3.01 minutes.
Pump Motor Controls
The pumps will be controlled by variable frequency drives, which will provide soft starts and stops, allow the
pumps to operate at a lower speed and capacity until the additional future flows are added and provide for more
efficient operation.
Supervisory Control and Data Acquisition System
LANDSCAPE ARCHITECTURE CIVIL ENGINEERING LANDPLANNING Paget

E STRE17
U� stimmel I.W11 O D pMm � 36!723/067
A supervisory control and data acquisition (SCADA) system will be incorporated into the system. The details of
this system are unknown at this time but will be designed and installed in accordance with Davie County Utilities
standards.
Receiving Gravity Sewer
The receiving gravity sewer is an existing 10-inch main within the US Hwy 158 R/W. This main received flow from
the Smith Creek Pump Station until it was decommissioned. This main currently receives no wastewater flow,
therefore its full capacity is available for flow from the Kinderton Pump Station. The 10-inch gravity main varies
in slope from 0.43%to 7.02%. The main was modeled using an incoming flowrate of 600 gpm from the Kinderton
Pump Station. At this flowrate, the flow depth in the main range from 6.12 inches to 7.68 inches and flow
velocities range from 2.99 fps to 6.07 fps. The full -flow capacity of the flattest section of sewer main is 642 gpm.
See the attached flow calculations. The calculations were modeled in Stormwater Studio 2023 software. The
software calculates flowrates in cubic feet per second (cfs) units. The input flowrate of 600 gpm is equivalent to
1.34 cfs.
Other Improvements
Other improvements to the pump station include the following:
• Grading of the pump station site to raise to tops of the wet well and valve vault.
• Addition of a building for the future chemical feed equipment for odor control and storage of chemicals
• Addition of an electric winch to lift the pumps out of the wet well for maintenance.
General Sequence of Construction
The general sequence of construction for the improvements project is as follows:
1. Obtain all necessary permits.
2. Install new 8-inch force main.
3. Perform leakage testing on new force main and cap line near the tie-in pointto the existing force main.
4. Install bypass pumping tap and valve on existing force main and set up equipment to temporarily bypass
pump from manhole upstream of the pump station.
5. Pump out and clean wet well.
6. Remove existing pumps and controls.
7. Remove existing piping from the wet well through the valve box and remove valve box.
8. Remove.existing site fencing, grade site and replace fencing.
9. Install new valve box, piping and valves.
10. Perform leakage testing on the new piping.
11. Install new pumps and controls.
12. Disconnect the existing 4-inch force main from 6-inch force main and connect new 8-inch force main.
Flush 4-inch force main with clean water, cap and abandon in place.
13. Perform start-up on pump station.
14. Remove temporary bypass pumping equipment.
15. Install chemical feed building.
We would be pleased to answer any additional questions that you may have and again want to thank you for the
opportunity to provide this service to you.
LANDSCAPE ARCHITECTURE CIVIL ENGINEERING LANDPLANNING Page

(�7 st i m m e I 601 N. TRADE STREET, 7 101 200
WINSTON-SALEM, NC 27101
www.stimmelpa.com 336.723.1067
Sincerely,
•` 2q�0 tir 9
_ SEAL _
14986
J. Neal Tucker, PE `
Vice President/Director of Civil Engineering'`cvGIN�.. i�e�.•'�_
Stimmel Associates, PA 'ti FA f TUCK o`�
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Cc: File
LANDSCAPE ARCHITECTURE CIVIL ENGINEERING LANDPLANNING Page

Pump Station Site
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bal Ecosystems; U.S. Census Bureau TIGER/Line data; USES Road Data; Natural
ment of State Humanitarian Information Unit, and NCAA National Centers for
rironmental Information, U.S. Coastal Relief Model. Data refreshed April, 2023.

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
April 26, 2007
Mr. Kerry Avant
Adams, Egloff, Avant Properties, LLC
1645 Westbrook Plaza Drive
Winston-Salem, NC 27103
Subject: Permit No. WQ0018416 (3rd Modification)
Adams, Egloff, Avant Properties, LLC
Kinderton Village Phase 3D
Wastewater Collection System Extension
Davie County
Dear Mr. Avant:
In accordance with your application received April 13, 2007, and additional information received
on April 24, 2007, we are forwarding herewith modified Permit No. WQ0018416, dated April 26, 2007, to
Adams, Egloff, Avant Properties, LLC for the construction and operation of the subject wastewater
collection system extension. This permit shall be effective from the date of issuance until rescinded, shall
void Permit No. W00018416 issued 11/13/2006 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. This permit modification is for the addition of Phase 3D to Kinderton Village with a
flow of 10,220 GPD.
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, and/or
referral of the North Carolina -licensed Professional Engineer to the licensing board.
Winston-Salem Regional Office
585 Waughtown Street, Winston-Salem, North Carolina 27107
Phone: [phone] / Fax: [phone] / Internet: www.ncwaterguality.org
NorthCarofina
Naturally
An Equal Opportunity/Affirmative Action Employer- 50% Recycled/10% Post Consumer Paper

Adams, Egloff, Avant Properties, LLC
April 26, 2007
Page 2
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 Adams,
Egloff, Avant Properties, LLC for the construction and operation of approximately 3,843 linear feet of 8-
inch gravity sewer to serve 43 3-bedroom residences and 30 duplexes as part of the Kinderton Village
Phase 3D project, and the discharge of 10,220 gallons per day of collected domestic wastewater into the
Davie County and City of Winston-Salem's existing sewerage system, pursuant to the application
received April 13, 2007 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, and the continued operation of the following previously
permitted components:
1) Initial permit issued 12/2912000 for Phase 1 - 11,913 linear feet of 8-inch gravity sewer and a
200-gallon per minute pump station with duplex pumps, on -site audible and visual high water
alarms, an automatically activated on -site generator; as well as approximately 1,731 linear feet of
4-inch force main and 1,058 linear feet of 6-inch force main to serve 200 three -bedroom
residences, 8 three -bedroom townhomes, 36 two -bedroom condominiums, as well as a clubhouse
and pool for 185 bathers per day with the discharge of 36,010 gallons per day of collected
domestic wastewater into the Davie County collection system and then to the City of Winston-
Salem collection system (Note: The Division approved a retroactive flow reduction request for the
Kinderton Development on April 28, 2006 for 140 gallons per day per residential unit and 60
gallons per day per 1,000 square feet for all non-residential/non-food service establishments).
2) Permit modified 12/8/04 for Phase 2 — 2,352 linear feet of 8-inch gravity sewer to serve 66 three -
bedroom residences with the discharge of 9,240 gallons per day of collected domestic wastewater
into the Davie County and City of Winston-Salem existing sewerage system, pursuant to the
application received September 27, 2004.
3) Permit modified 11/13/06 for Phase 1 additions and Phase 3B — 540 linear feet of 8-inch
gravity sewer to serve eight three -bedroom residences and 60 three -bedroom quads (additions
to Phase 1) and 16 three -bedroom residences (Phase 313) with the discharge of 11,760 gallons
per day of collected domestic wastewater into the Davie County and City of Winston-Salem
existing sewerage system, pursuant to the application received November 8, 2006.
(To date, the total wastewater flow volume approved for the Kinderton project is 67,230 gallons per day.
The total gravity line length approved is 18,648 linear feet).
The sewage and wastewater collected by this system shall be treated in the City of Winston-
Salem Muddy Creek Wastewater Treatment Facility (Permit No. NC0050342) prior to being discharged
into the receiving stream.
This permit shall become voidable unless the agreement between Adams, Egloff, Avant
Properties, LLC, Davie County and the City of Winston-Salem for the collection and final treatment of
wastewater is in full force and effect.

Adams, Egloff, Avant Properties, LLC
April 26, 2007
Page 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.
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 Mike Mickey at (336)
771-5000.
Sincerely,
for Alan W. Klimek, P.E.
cc: Kelway Howard, PE (Stimmel Associates, PA, 601 N. Trade Street, Winston-Salem, NC 27101)
Davie County Building Inspections
WSRO - WQS (NPDES No. NC0050342)
PERCS Files
SWP - Central Files

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:
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 NCAC
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.

4. 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.
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 priorto 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.
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 Winston-Salem
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.
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.
12. 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 a 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.
Permit issued this the 261h day of April, 2007.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
,for Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0018416 (3`" Modification)

Fast Track Engineering Certification
Permit No. WO0018416 (3rd Modification)
Adams, Egloff, Avant Properties, LLC
April 26, 2007
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
as a duly registered Professional Engineer in the State of North Carolina, having
been authorized to observe (❑ periodically, ❑ weekly, ❑ full time) the construction of the Kinderton Village Phase
3D project in Davie County 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:
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, NC 27107
Attn: Steve Tedder
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.

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January 10, 2024
North Carolina Department of Environmental Quality
Division of Water Resources
450 W. Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
Attn: Ms. Jenny Graznak
Re: Modification to Permit Number WQ0018416
Kinderton Pump Station
Davie County
Bermuda Run, NC 27006
Dear Ms. Graznak:
NC Department of
Environmental Quality
Received
JAN 11 2024
Winston-Salem
Regional Office
Attached you will find an permit application package for the modification of the above referenced permit for
capacity upgrades to the existing pump station. The pump station will be upgraded to accommodate additional
future wastewater flows. This application does not include the additional future flows. I have attached the
updated Preliminary Engineering Report that includes a detailed description of the proposed upgrades.
Attached you will find the following items for your review and approval.
• Fast Track Permit Application (FTA 10-23) - one original and one copy
• Application fee in the amount of $600
• Change of Ownership Approval Letter
• Preliminary Engineering Report
• USGS Quad Map
• Google Earth aerial location map
• Existing Permit WQ0018416
Let me know if you need any additional information.
Sincerely,
J. Neal Tucker, PE
Stimmel Associates, P.A.
Vice President! Director of Civil Engineering
Attachments
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LANDSCAPE ARCHITECTURE CIVIL ENGINEERING LAND PLANNING

State of North Carolina
DWR Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION
This application is for sewer extensions involving gravity sewers, pump stations and force mains, or any combination that has been
certified by a professional engineer and the applicant that the project meets the requirements of 15A NCAC 02T and the Division's
Minimum Design Criteria (Gravity Sewer & Pump Stations/Force Mains) and that plans, specifications and supporting documents
have been prepared in accordance with 15A NCAC 02T, 15A NCAC 02T .0300, Division policies, and good engineering practices.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design
documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans, design
calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimu*(3l©jqpaqt4pk*t'! hese
documents shall be immediately available upon request by the Division. Environmental Quality
Received
Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T.0303.
JAN 11 2024
Projects not eligible for review via the fast track process (must be submitted for full technical review):
➢ Projects that do not meet any part of the minimum design criteria (MDC) documents; Winston-Salem
➢ Projects that involve more than one variance from the requirements of 15A NCAC 02T; Regional Office
➢ Pressure sewer systems utilizing simplex septic tank -effluent pumps (STEPS) or simplex grinder pumps;
D Simplex STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains);
D Vacuum sewer systems.
General — When submitting an application, please use the following instructions as a checklist in order to ensure all required items are
submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the
amount of requested additional information. Failure to submit all required items will necessitate additional processing and review
time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit one original and one copy of
the application and supporting documentation.
A. One Original and Out Copy (second copy may be digitao of Application and Supporting Documents
® Required unless otherwise noted. Signatures on original must be "wet ink" or secure digital signatures.
Please do not submit engineering design plans with the application unless specifically requested.
B. Cover Letter/Narrative Description (Required for All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
➢ Be specific as to the system type, number of homes served, flow allocation required, etc.
➢ Include the permit number/status of any other required sewer permits (downstream/upstream)
➢ If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Modification Application Packages):
® Submit a check or money order in the amount of $600.00, dated no more than 90 days prior to application submittal.
➢ Payable to North Carolina Deparunent of Environmental Quality (NCDEQ)
D. Fast Track Application (Required for All Application Packages, Form FTA 10-23):
® Submit the completed and appropriately executed application.
➢ If necessary for clarity or due to space restrictions, attachments to the application may be made.
❑ If the Applicant Type in Item 1.2 is a corporation or company, provide documentation it is registered for business with the
North Carolina Secretary of State.
❑ If the Applicant Type in Item 1.2 is a partnership or d/b/a, enclose a copy of the certificate filed with the Register of Deeds in
the county of business.
❑ The Project Name in Item II.1 shall be consistent with the project name on the flow acceptance letters, agreements, etc.
® The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North Carolina
licensed Professional Engineer.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106(b). Per
15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is provided from
a person who meets the criteria in 15A NCAC 02T .0106(b).
INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION Pagel of 3

E. Flow Tracking/Acceptance Form (Form: FTSE 10-23) (If Applicable):
❑ Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility.
➢ Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
"r The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one year
prior to the application date.
D Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-215.67(a).
➢ Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific FTSE.
F. Site Maps (All Application Packages):
® Submit an 8.5-inch x 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project area,
including the closest surface waters.
➢ General location of the project components (gravity sewer, pump stations, & force main)
➢ Downstream connection points and permit number (if known) for the receiving sewer
® Include an aerial location map showing general project area (such as street names or latitudellongitude) so that Division staff
can easily locate it in the field.
G. Existing Permit (Application Packages for Modifications to an Existing Permit):
® Submit a copy of the most recently issued existing permit.
® Include a descriptive and clear narrative identifying the previously permitted items to remain in the permit, items to be
added, and/or items to be modified (the application form itself should include only include items to be added/modified). The
narrative should also include whether any previously permitted items have been certified.
® The narrative should clearly identify the requested permitting action and accurately describe the sewers to be listed in
the final permit.
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T .0305(h)(1), submit documentation of power reliability for pumping stations.
D This alternative is only available for average daily flows less than 15,000 gallons per day
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible with
the station. The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or proposed contractor,
stating that "the portable power generation unit or portable, independently -powered pumping units, associated appurtenances
and personnel are available for distribution and operation of this pump 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 in the case of a multiple station power outage. (Required at time of certification)
I. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per 15A NCAC 02T .0I 15(a)(1) provide the Certificate of Public Convenience and Necessity from the North Carolina Utilities
Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by the sewer
extension, or
❑ Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an application
for a franchise has been received and that the service area is contiguous to an existing franchised area or that franchise approval
is expected.
J. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold):
❑ Home/Propertv Owners' Associations
❑ Per 15A NCAC 02T .0115(c). submit the properly executed Operational Agreement (FORM: HOA).
❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 15A NCAC 02T .0115(b). submit the properly executed Operational Agreement (FORM: DEV).
For more information, visit the Division's collection systems website
INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION Page 2 of 3

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Quality Section
Swannanoa, North Carolina 28778-8211
Clay, Graham, Haywood, Henderson, Jackson,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section
Fayetteville, North Carolina 28301-5095
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[phone] Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Water Quality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
Raleigh Regional Office
3800 Barrett Drive
Chatham, Durham, Edgecombe, Franklin,
Water Quality Section
Raleigh, North Carolina 27609
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
Beaufort, Bertie, Camden, Chowan, Craven,
Water Quality Section
Washington, North Carolina 27889
Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section
Wilmington, North Carolina 28405
Hanover, Onslow, Pander
[phone]
[phone] Fax
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Alamance, Allegheny, Ashe, Caswell, Davidson,
Davie, Forsyth, Guilford, Rockingham, Randolph,
Water Quality Section
Winston-Salem, North Carolina 27105
Stokes, Surry, Watauga, Wilkes, Yadkin
[phone]
[phone] Fax
INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION Page 3 of 3