WQ0039251_Application (FTSE)_20170505

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Dlvislon of Writer Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: �✓ko 0 X� ;to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Old North State Water Company, 1.1.0 (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: Michael J. Myers per 15A NCAC 02T _0106(b)
Title: President
4. Applicant's mailing address: 4700 Homewood Court, Suite 108
City: Raleigh State: NC Zip: 27609-
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail]
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IL PROJECT INFORMATION: �?
. Project name: Briar Chapel - SD East
2. Application/Project status: ®Proposed (New Permit) ❑Existing PermitlProject
If a modification, provide the existing permit number: WQ00 and issued date: E5
If new construction but part of a master plan, provide the existing permit number: WQ00 O•
n
3. County where project is located: ChathamH.
ro
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.8086' Longitude: 79.0904
le
5. Parcel I (if applicable): 00 18911
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
I. Professional Engineer: Gareth Avant License Number: 036348
Firm: McKim & Creed Inc.
Mailing address: 1730 Varsity Drive, Suite 500
City: Raleigh State: NC Zip: 27606-
Phone number: [phone] Email Address: [e-mail]
1V. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Briar Chapel Utilities Wastewater Treatment Facility Phases A and B Permit Number: WQ0028552
Owner Name: Old North State Water Company, LLC
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
I. Permit Number(s): WQ0029867 (Puma Station "A")
System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s): Old North State Water Company, LLC
FORM: FTA 04- l6 Page I of 5

VI. GENERAL REQUIREMENTS
L If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached'?
® Yes ❑No ❑NIA
2. If the Applicant is a Developer of lots to be sold, has a Di�vcloper's Operational Agreement (FORM. DEV} been attached?
❑ Yes ®No ❑N!A
3. If the Applicant is a Homc/Property Owners' Associatign. has an Operational Aereemcnt (FORM: HOA) been attached?
❑ Yes ®No ®N/A
4. Origin of wastewater: (check all that apply):
❑ Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School I 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 % Commercial
% Industrial (See 15A NCAC 02T .0103(20))
�Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T ,01 14( fl? ®Yes ❑ No
i If yes, provide a cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 021.01141f))
Daily Design Flow e'n
No. of Units
Flow
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
galf
GPD
gal/
GPD
Total
GPD
a See 15A NCAC 02T _0I 14(bj, id), f el[ _land and { L; 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. 4244).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table I SA NCAC 02T.01 141 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)
Z Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
® Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain): _
FORM: FTA 04-16 Page 2 of 5

V11. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
1462
PVC
8
432
DIP
7 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 requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude:
3. Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station).
Size (inches) Length (feet) Material
6. Power reliability in accordance with I5A NCAC 02T ,0305(h)(l):
❑ Standby power source or pump with 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
s Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C):
It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
{ if the portable power source or pump is dedicated to multip?c pump stations, an evaluation of all the pump stationti
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.
FORM- FTA 04 16 Page 3 of 5

IX., SETBACKS & SEPARATIONS— (02B .0200 & 15A NCAC 02T.0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T-U305,, 0 &
➢ 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
® Yes ❑ No
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
24 inches
Water mains (vertical -water over sewer 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 If impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-1 or WS-V), B, SA, ORW, HQW, or SB from normal
high water (or tide elevation) and wetlands (see item IX.2)
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any buildin& foundation
5 feet
Any basement
10 feet
To slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimminE pools
10 feet
Final earth grade (vertical)
36 inches
➢ 15A NCAC: 02T.0305litl contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ "Stream classifications can be identified using the Division's NC Surface Water Classifications webpaV-
➢ if noncompliance with 02T.030Jf f) or , see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No
➢ See the Division's draft separation requirements for situations where separation cannot be meet
No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with all setbacks found in the river basin rules per 15A NCAC 02B .02W'.1 ® Yes ❑ No
S- This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project comply with an individual 404 Permit or any 401 Certifications? ® Yes [:)No
➢ Wetland -related permits shall be requested, obtained, and adhered to for projects that impact wetlands or surface waters
s Information can be obtained from the 401. & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02TA 10,aQ 6) (additional permits/certifications)? ® Yes [:]No
Per 15A NCAC 02T.0105tcIL61, directly related environmental permits or certification applications are 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.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.0402, "high priority sewer' means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ® No
➢ 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 permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
I. Does the submitted system comply with 136 tjCAC 022L the 14littit'utttat,2;gSt1.Critgria for ttre Pcrrnittias of ParnIa Stations
and Furce Mains ilu!cst version), and the gaLvity.acwUimu is flaresi version as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents
for review. Approval of the request is required prior to submittal of the Fast Track Application and supportine
documents.
2. Professional Engineer's Certification:
I, Gareth C. Avant attest that this application for
(Professional Engineer's name from Application Item III.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, Gravity Sewer
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.
North Carolina Professional Engineer's seal, signature, and date:
K
I = 036348 -
i s:y�. fNCfHEE�. •�Q=� 3
3. AppIicant's Certification per 15A NCAC 02T .0106(b):
I Michael J. Myers attest that this application for
(Signature Authority's name & title from Application Item I.3.)
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 143-215.6% 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: Date: May 1, 2017
FORM: FTA 04.16 Page 5 of 5

' State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of Water. r3VUF%.CS Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Old North State Water Company, LLC
Project Name for which flow is being requested: Briar Chapel SD East
More than one FTSE inav be required for a single project if the owner of the HWP is Plot responsible for all punnp
stations along the route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Briar Chapel Utilities Wastewater Facility Phases A and B
b. WWTP Facility Permit #: WQ0028552
All flows are in MGD
c. WWTP facility's permitted flow 0.330
d. Estimated obligated flow not yet tributary to the WWTP 0.169
e. WWTP facility's actual avg. flow 0.116
f. Total flow for this specific request 0
g. Total actual and obligated flows to the facility 0.285 M
h. Percent of permitted flow used 86.4% O
I1. Complete this section for each pump station you are responsible for along the route of this
proposed wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A) (B) (C) (D)=(B+C) (E)=(A-D)
Design Obligated,
Pump Averapc Daily Approx. Not Yet Total Current
Station Firm Flow" Current Avg. Tributary Flow Plus
(Name or Capacity, * (Firm! pf), Daily Flow, Daily Flow, Obligated Available
Number) MGD MGD MGD MGD Flow Capacity"*:
LS A 0.983 0.28 0.10 0.049 0.149 0.131
* The Firm Capacity of any pump station is defined as the maximum pumped flow that
can be achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking
factor (pf) not less than 2.5.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): Pump Station "A"
Downstream Permit Number: WQ0029867
Page I of 6
FTSE 04-16

III. Certification Statement:
I _Michael Myers (President) certify to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the
receiving wastewater treatment facility and that the flow from this project is not anticipated to
cause any capacity related sanitary sewer overflows or overburden any downstream pump station
en route to the receiving treatment plant under normal circumstances, given the implementation
of the planned improvements identified in the planning assessment where applicable. This
analysis has been performed in accordance with local established policies and procedures using
the best available data. This certification applies to those items listed above in Sections I and II
plus all attached planning assessment addendums for which I am the responsible party.
Signature of this form indicates acceptance of this wastewater flow.
%?
Date
Page 2 of 6
F FS E 04- 16

STATE OF NORTH CAROLINA
UTILITIES COMMISSION
RALEIGH
DOCKET NO. W-1300, SUB 9
DOCKET NO. W-1230, SUB 1
BEFORE THE NORTH CAROLINA UTILITIES COMMISSION
In the Matter of
Application by Old North State Water Company, }
LLC, and Briar Chapel Utilities, LLC, for Authority to } ORDER ALLOWING
Transfer Sewer Utility Franchise in Briar Chapel } RECOMMENDED
Subdivision in Chatham County, North Carolina, to ) ORDER TO BECOME
Old North State Water Company, LLC, and for ) EFFECTIVE AND FINAL
Approval of Rates )
BY THE COMMISSION: On April 20, 2015, Hearing Examiner Ronald D. Brown
issued in the above -captioned docket a Recommended Order Approving Transfer,
Granting Franchise, Approving Rates, and Requiring Customer Notice. The parties have
jointly requested that the Commission adopt the Recommended Order as a Final Order.
Based upon the foregoing, the Commission is of the opinion that the request that
the Recommended Order be adopted as the Final Order should be granted.
IT IS, THEREFORE, ORDERED that the Recommended Order entered in this
docket on April 20, 2015, is hereby adopted as the Final Order of the Commission.
ISSUED BY ORDER OF THE COMMISSION.
This the 20th day of April , 2015.
NORTH CAROLINA UTILITIES COMMISSION
�.cul l •'f'(low�t
Gail L. Mount, Chief Clerk
Commissioners Susan W. Rabon and ToNola D. Brown -Bland did not participate.

FAST TRACK SEWER APPLICATION NARRATIVE
Briar Chapel Development
SD East
Chatham County, North Carolina
April 28, 2017
Prepared for:
BRIAR ZCHAPEL'S
Newland commuN rnEs
NNP Briar Chapel, LLC
16 Windy Knoll Circle
Chapel Mill, North Carolina 27516
Prepared By:
v MCKIM&CREED
1730 Varsity Drive, Suite 500
Raleigh, North Carolina 27606
Phone: [phone]
Fax: [phone]
M&C Project No. 02735-0187
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BRIAR CHAPEL DEVELOPMENT
SD East
April 28, 2017
PROJECT NARRATIVE
The purpose of the project is to construct basic utility infrastructure to support
future commercial developments within the SD East section of Briar Chapel in
Chatham County, NC. The improvements planned in this phase are internal to the
SD East parcel and will connect to previously designed infrastructure
(WQ0038847). All flows in the system will ultimately tie to an existing pump
station that was approved through previous permits (WQ0033227).
At this time, due to the uncertain nature of the future outparcels and tenants, the
future sewer flows can only be estimated and preliminary modeling has provided
an appropriate sizing for the gravity sewer to serve future development. A table
calculating future expected flows has been included with this submittal. The
system will gravity to a future pump station located onsite. This pump station will
be designed and permitted at a later date by others.
The sewage and wastewater collected by this system will be treated in the on -site
wastewater treatment facility:
WWTP Facility Name: Briar Chapel Utilities, LLC
WWTP Facility Permit #WQ0028552

Summary of future anticipated sewer flows to be permitted:
Briar Chapel — SD East
Anticipated Sewer Flows
Per 15A NCAC 02T.0114 Guidelines
Anticipated Tenant
Daily Flow
Rate
Anticipated
Multiplier
Anticipated Flows
Office Building
0.15 GSF
50,000 SF
7,500 GPD
Out -Parcel
4,000 GPD
2 parcels
8,000 GPD
Skilled Nursing
120gal/day
120 beds
14,400 GPD
Assisted Living
56gal/day
120 beds
6,720 GPD
Total Anticipated Flows:
36,620 GPD

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STATE OF NORTH CAROLINA
UTILITIES COMMISSION
RALEIGH
APPENDIX A
DOCKET NO. W-1300, SUB 9
BEFORE THE NORTH CAROLINA UTILITIES COMMISSION
OLD NORTH STATE WATER COMPANY. LLC
is granted this
CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY
to provide sewer utility service
in
BRIAR CHAPEL SUBDIVISION SERVICE AREA
(including HERNDON WOODS SUBDIVISION)
Chatham County, North Carolina
subject to any orders, rules, regulations,
and conditions nor or hereafter lawfully made
by the North Carolina Utilities Commission
ISSUED BY ORDER OF THE COMMISSION.
This the loth day of April , 2015.
NORTH CAROLINA UTILITIES COMMISSION
A6 L � - Moum*
Gail L. Mount. Chief Clerk

MCKIM&CREED
TO Division of Water Resources
Raleigh Regional Office
3800 Barrett Drive
Raleigh, N.C. 27609
AMNT'DN: Mr. Danny Smith
LETTER OF TRANSMITTAL
DATE. April 28, 2017
PFc4Ec ,\O- 2735-0187
TASK \o- EXP
RE Briar Chapel -- SD East
'kANSMITTAI- \o
PAGE 1 OF 1
WE ARE SENDING: ® Originals ❑ Prints ❑ Shop Drawings ❑ Samples
❑ Specifications ❑ Calculations ® Other - Fee
Quantity
Drawing No.
Rev
Description
Status
2 EA
Fast Track Application for Gravity Sewers, Pump Stations and
Force Mains
G
2 EA
Project Narrative & USGS Map
C
1 EA
Permit Application Fee ($480.00)
C
2 EA
Certificate of Public Convenience and Necessity
C
Issue Status Code: A. Preliminary B. Fabrication Only C. For Information D. 8d
E. Construction F. For Review & Comments G. For Approval H. p
Remarks {:7
w
N
Action Status Code: 1. No Exceptions Taken 2. Make Corrections Noted 3. Other �'=•
a
4. Amend & Resubmit 5. Rejected - See Remarks
W
r.
iJ
1730 Varsity Drive, Suite 500, Raleigh, SIC 27606 9191143-8091 Fax 919/11i-8031
Cc: File McKIM & CREED, INC.
Signed
,CLIS4
Chris Seamster, RLA
Project Manager
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W

0
y Fast Track AnVal Checkllst
the.'porrect application font been used? It should be FTA
. '4='i6 if- accept oIdQr.version for h6w}. The form and version
nlumb'er'are-'at the top right of the first page under the words
= yr "Fast Track Application" as shown below.
.. State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
v; FAST -TRACK APPLICATION
(FTA 4116)
for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
Pressure & Vacuum sewer s stems are not to be induded as pert of this a piicatlon dca e
2 Is the check amount $480?
5 '
F I. Is the check dated within 180 days?
as the application been signed by the owner and engineer,.. .
and sealed by the engineer?
5. Is the county location in the Raleigh region? (item A.2b)
If all the above items have been met, check can be deposited.
If any of the above items have not been met, send the application vyith check
attached to me for returning to the applicant.
Please attach this form to the application and return to me.
Jason Robinson '
Environmental Engineer
NCDr=NR-DWR
Raleigh Regional Office
(Voice) 919-7914249
(Fax) 919-788-7159
REVISED 416116