WQ0044538_MOD_I-74_Industrial_Center_Sewer_Improvements_FTSSE_App_20241001

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
`- FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 10-23 & SUPPORTING DOCUMENTATION
n
Application Number: �jbdb�fs35 obewmpietedbyDWR)2kLk
All items must be completed or the application will be returned
1. APPLICANT INFORMATION:
1. Applicant's name: City of Randleman (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State/County Z Municipal
3. Signature authority's name: Shain Sexton per 15A NCAC 02T .0106(b)
Title: Town Manager
4. Applicant's mailing address: 204 S Main Street
City: RandlemadState: NC( Zip: 271f7-_
5. Applicant's contact information:
Phone number: (336) 495-750k Email Address: sse (tton(a)tandlemanoolice.org
II. PROJECT INFORMATION:
'% 3v s I//, s/2 L/
❑ Privately -Owned Public Utility
❑ Other
1. Project name: I-74Industrial Cenfer Sewer Improvements
2. Application/Project status: ❑ Proposed (New Permit) ZExisting Permit/Project ❑ ARPA funded
If a modification, provide the existing permit number: W00044538 and issued date: August 2023,
For modifications, also attach a detailed narrative description as described in Item G of the checklist.
If new construction, but part of a master plan, provide the existing permit number: W000_
3. County where project is located: Randolph '/
1-1
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.829019' Longitude:-79.839766'
5. Parcel ID (if applicable): 7755170517 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: John C. Grey License Number: 18097
Firm: The Wooten Company
Mailing address: 119 Brookstown Ave Suite 1100
City: Winston-Salem State: NC Zip: 27101-
Phone number: [phone] Email Address: huey .thewootencompanv.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: City of Randleman W WTP Permit Number: NCO025445
Owner Name: City of Randleman
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. PermitNumber(s): WQ_
11
2. Downstream (Receiving) Sewer Information: 16 inch ® Gravity ❑ Force Main
3. System Wide Collection System PermitNumber(s) (if applicable): WQCS00099
Owner Name(s): City of Randleman
FORM: FTA 10-23 Paget of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑ No ® N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been attached?
❑ Yes [:)No ® N/A
3. If the Applicant is a Home/Property Owners' Association, has an HOA/POA Operational Agreement (FORM: HOA) and
supplementary documentation as required by 15A NCAC 02T.0I15(c) been attached?
❑ Yes ❑ No ®N/A /
4. Origin of wastewater: (check all that apply):
❑ Residential (Individually Owned) ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential (Leased) ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool/Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
® Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater : % Domestic % Commercial 100 % Industrial (See 15A NCAC 02T .0103(20))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(fl? ❑ Yes ®No
➢ If yes, provide a copy of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow'"
No. of Units
Flow
Future Industrial Park
880 gal/Acre
30
26400 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
GPD
a See 15A NCAC 02T .0114(b). (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):
FORM: FTA 10-23 Page 2 of 5

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
12
4173 l
PVC
12 t
398
DIP
16
114
PVC
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirements is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: I-74 Industrial Center Sewer Pump Station
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.829019. , Longitude:-79.839766'
3. Total number of pumps at the pump station: 2
3. Design flow of the pump station: 1.05121nillions 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): 730 gallons per minute (GPM) at 141 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
12 .f
12322
PVC
12
80 -
DIP
If any portion of the force main is less than 4-inches in diameter, please identify the method of solids reduction per
MDCPSFM Section 2.01 C.l.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with I5A NCAC 02T .0305(h)(I ):
❑ Standby power source or ® Standby pump
➢ Must have automatic activation and telemetry - 15A NCAC 02T.0305(h)(1)(B)_
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility and may not be portable
Or if the pump station has an average daily flow less than 15,000 gallons per day 15A NCACO2T.0305(h)(1)(C):
❑ Portable power source with manual activation, quick -connection receptacle and telemetry -
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry:
➢ Include documentation that the portable source is owned or contracted by the applicant and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
as part of this permit application in the case of a multiple station power outage.
FORM: FTA 10-23 Page 3 of 5

M. SETBACKS & SEPARATIONS - (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations/altematives found in 15A NCAC 02T.0305(f) & (g)? ® Yes [-]No
15A NCAC 02T.0305(f) 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 II impounded reservoirs used as a source of drinking water, and associated wetlands.
100 feet
**Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water (or tide elevation) and wetlands associated with these waters (see item IX.2)
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches, as well as wetlands associated with these waters or classified as WL.
10 feet
Any building foundation (horizontal)
5 feet
Any basement (horizontal)
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
➢ If noncompliance with 02T.0305(f) or (e). see Section X.1 of this application
"15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved. Please check "yes"
above if these alternatives are used and provide narrative information to explain.
"Stream classifications can be identified using the Division's NC Surface Water Classifications weboage
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: Randleman Lake - ❑ No
If yes, does the project comply with setbacks found in the river basin rules per I5A NCAC 02B .0200? ® Yes ❑ No
➢ This includes Trout Buffered Streams per 15A NCAC 213.0202
5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ❑ Yes ® No
or 401 Water Quality Certifications?
➢ Please provide the permit number/permitting status in the cover letter if coverage/authorization is required.
6. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.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.). i
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 permttee 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
1. Does the submitted system comply with 15A NCAC 02T. the Minimum Desi® Criteria for the Permitting of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria (latest version) as applicable?
® Yes ❑ No
If no, for projects requiring a single variance, complete and submit the Variance/Altemative Design Request application
(VADC 10-14) and supporting documents for review to the Central Office. Approval of the request will be issued
concurrently with the approval of the permit, and proiects reauiring a variance approval may be subject to longer
review times. For projects requiring two or more variances or where the variance is determined by the Division to be a
significant portion of the project, the full technical review is required.
2. Professional Engineer's Certification:
I, Qo 1%A G. Grew attest that this application for
(Pmfmsional Eng n 's namefrdm Application Item M.1.) (Project Nerve from Application Item ILl)
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 Pmno 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.10,0:701) _
North Carolina Professional Engineer's seal, signature, and date:
."GIWE4t
C. I111
If31` n`.1M1
3. Applicant's Certification per 15A NCAC 02T .0106(b):
1 Shain Sexton / , attest that this application for I-74 Industrial Center Sewer Improvements
(Signatm Authority Name from Application item 1.3.) (Project Name from Application Item IL 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: Q,� Date:
FORM: FTA 10-23 Page 5 of 5

tiCDC p, IPTcili G'i
Environmental Quality
Received
OCT 2 1 2024 State of North Carolina
DWR Winston-Salem Department of Environmental Quality
Regional Office Division of Water Resources
Division of Water Resource% Flow Tracking for Sewer Extension Applications
(FTSE 10-23)
Entity Requesting Allocation: City of Randleman
Project Name for which flow is being requested: I74 Industrial Center Sewer Improvement
More than one FTSE maybe required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: City of Randleman Waste Water Treatment Plant
b. WWTP Facility Permit #: NCO025445
All flows are in MGD
c. WWTP facility's permitted flow 1.745
d. Estimated obligated flow not yet tributary to the WWTP .013
e. WWTP facility's actual avg. flow .618
f. Total flow for this specific request .026
g. Total actual and obligated flows to the facility .657
It. Percent of permitted flow used 37.65%
II. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP:
PS Permitted under
(A)
(B) (C) (D)=(B+C)
(E)-(A-D)
collection system permit
Design
Obligated,
Pump Pump
Average
Approx. Not Yet Total Current
Station Station Firm
Daily Flow**
Current Tributary Flow Plus
(Name or Permit Capacity, *
(Firm / pt),
Avg. Daily Daily Flow, Obligated
Available
Number) No. MGD
MGD
Flow, MGD MGD Flow
Capacity***
Main PS WQCS00099 2 MGD
0.8
0.5 0.039 0.539
0.261
* The Firm Capacity (design flow) of any pump station is defined as the maximum pumped flow that can be
achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pt) not
less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
*** A Planning Assessment Addendum shall be attached for each pump station located between the
project connection point and the WWTP where the Available Capacity is <0.
Downstream Facility Name (Sewer): City of Randleman
Downstream Permit Number: WQCS00099
Page 1 of 6
FTSE 10-23

III. Certification Statement:
I Michael Glass certify to the best of my knowledge that the addition of
the volume ofwastewater to be permitted in this project has been evaluated along the mute to the receiving
wastewater treatment facility and that the flow from this project is not anticipated to cause any capacity
related sanitary sewer overflows or overburden any downstream pump station en route to the receiving
treatment plant under normal circumstances, given the implementation of the planned improvements
identified in the planning assessment where applicable. This analysis has been performed in accordance
with local established policies and procedures using the best available data. This certification applies to
those items listed above in Sections I and II plus all attached planning assessment addendums for which I
am the responsible party. Signature of this form certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
Signature
'K% ' '
Page 2 of 6
FCSE 10-23

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of WArer €tesourx es Flow Tracking for Sewer Extension Applications
(FTSE 10-23)
Entity Requesting Allocation: City of Randleman
Project Name for which flow is being requested: 174 Industrial Center Sewer Improvement
More than one FTSE maybe required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route ofthe proposed wastewaterJlow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: City of Randleman Waste Water Treatment Plant
b. WWTP Facility Permit #: NC0025445 ,
All flows are in MGD
c. WWTP facility's permitted flow 1.745 `
d. Estimated obligated flow not yet tributary to the WWTP .013
e. WWTP facility's actual avg. flow .618 -
f. Total flow for this specific request .026 -
g. Total actual and obligated flows to the facility .657 ,
h. Percent of permitted flow used 37.65%
II. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A)
(B)
(C)
(D)=(B+C)
(EH-D)
Pump
Station
(Name or
Number)
Pump
Station
Permit
No.
Firm
Capacity,'
MGD
Design
Average
Daily Flow"
(Firm / pf),
MGD
Approx.
Current
Avg. Daily
Flow, MGD
Obligated,
Not Yet
Tributary
Daily Flow,
MGD
Total Current
Flow P
O gate
ow
Available
Capacity***
Main PS
2 MGD
0.8 MGD
.500
.039
.539
.539
.261
*The Firm Capacity (design flow) of any pump station is defined as the maximum pumped flow that can be
achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pf) not
less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
*** A Planning Assessment Addendum shall be attached for each pump station located between the
project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): City of Randleman
Downstream Permit Number: WQCS00099
Page 1 of 6
FTSE 10-23

Ill. Certification Statement:
I Michael Glass 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 11 plus all attached planning assessment addendums for which I
am the responsible party. Signature of this form certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
Signature
Title
%© :
Date
Page 2 of 6
FTSE 10-23

1X ooten
October 11, 2024 -
Jenny Graznak
Winston-Salem Regional Office
450 West Hanes Mill Rd
Suite 300
Winston-Salem, NC 27105
Re: Revision to Fast Track Permit No. WQ0044538
City of Randleman
I-74 Industrial Center Sewer Improvements
TWC No. 3190-K
Dear Ms. Graznak,
119 Brookstown Avenue, Suite 100
Winston-Salem, NC 27101
[phone]
The intent of this letter is to update the information included in Fast Track Permit No. WQ0044538 based on
changes that have been made to the design since the permit was originally issued in August 2023.
Justification for Design Change
The goal of this project was to provide sewer infrastructure to the proposed industrial center being developed
along old Highway 311 at the I-74 interchange in the Town of Randleman. Through various discussions with
the land developer, it was determined that the original alignment of the gravity sewer would conflict with the
proposed development of the site. Working with the developer, the alignment was adjusted to avoid any
potential conflicts.
Updates to Permit Application
The proposed 12-inch gravity sewer will be adjusted so as to bring the alignment from MH 11 to the end more
to the east. The new alignment will have (1) one less manhole with a reduction in overall length from 5064
LF to 4571 LF. Approximately 398 LF of the proposed sewer line will consist of 12-inch DIP while the
remaining 4173 LF will be 12-inch PVC.
Additionally, 114 LF of 16-inch PVC Gravity Sewer was mistakenly omitted from the original application
form. This information has been added to the updated application.
All other information included in the original permit application will remain the same with the minimum
design criteria, as presented in NCAC 15A Chapter 18, being adhered to throughout the project.
If you should have any questions or need additional information, please do not hesitate to contact us at
[phone].
Regards,
THE WOOTEN COMPANY
John C. Grey, P.E.
Project Manager

DWR
Division of Water Resources
NC Depart ^ni of State of North Carolina
m Environcnral QU�11ity Department of Environmental Quality
Y
Division of Water Resources
OCT O 1 2024 FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Winston-Salem FTA 10-23 & SUPPORTING DOCUMENTATION
ApplicationNumber. o F (to be completed byDWR) A Sc,n�'Z62`i1d Oif
All items must be completed or the application will be returned 4- 33 = 74 Z'H/ 67
1. APPLICANT INFORMATION:
I. Applicant's name: City of Randleman (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑Privately-Owned Public Utility
❑ Federal ❑ State/County 01municipal ❑ Other
3. Signature authority's name: Shain Sexton/ per 15A NCAC 02T .0106(b)
Title: Town Manager
4. Applicant's mailing address: 204 S Main Street
City: Randlema State: NE Zip. 27317-
5. Applicant's contact information: ,
i
Phone number: [phone] Email Address: ssexton(iitrandlemanpolice org
11. PROJECT INFORMATION:
I. Project name: 1.74 Industrial Center Sewer Imrllovements
2. Application/Project status: ❑ Proposed (New Permit) ® Existing Permit/Project ❑ ARPA funded
If a modification, provide the existing permit number: W00044538 and issued date: August 2023,
For modifications, also attach a detailed narrative description as described in Item G of the checklist.
If new construction, but part of a master plan, provide the existing permit number: W000_
3. County where project is located: Randolph / ,
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.829019 Longitude:-79.839766'
5. Parcel ID (if applicable): 7755170517 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
I. Professional Engineer: John C. Grey /License Number: 18097
Firm: The Wooten Comoanv �
Mailing address: 119 Brookstown Ave Suite 100
City: Winston-Salem State: NC Zip: 27101-_
Phone number: (336) 722-532Z6 Email Address: jgrey(a),thewootencompany.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION: i
I. Facility Name: City of Randleman WWTP '� Permit Number: NCO025445
Owner Name: City of Randleman
V. RECEIVING DOWNSTREAM SEWER INFORMATION: _ -
1. Permit Number(s): WQCS0009 -
2. Downstream (Receiving) Sewer Information: 16 inch Gray{ty ❑Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS C_I
Owner Name(s): City of Randleman
FORM: FTA 10-23 Pagel of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Pubfi�-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 Aereement (FORM HOA) and
supplementary documentation as required by 15A NCAC 02T.0115(c) been attached?
❑ Yes ❑ No ® N/A /
4. Origin of wastewater: (check all that apply):
❑ Residential (Individually Owned) ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential (Leased) ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool/Clubhouse
❑ Food and drink facilities / ❑ Church ❑ Swimming Pool/Filter Backwash
® Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: % Domestic % Commercial 100 % Industrial (See 15A NCAC 02T .0103(20))
If Industrial, is there a Pretreatment Pro am in effect? ❑ Yes No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes ® No
➢ If yes, Provide a copy of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(1))
Daily Design Flow •s
No. of Units
Flow
Future Industrial Park
880 gal/Acre
30
26400 GPD
gal/
GPD
gal/
GPD
gal/
GPD
Sal/
GPD
gal/
GPD
Total
GPD
a See 15A NCAC 02T .0114(b), (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 water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by pro- c . 0 GP (per 15A NCAC 02T .0114 and G.S. 143-215 1)
➢ Do not include future flows or pre ously permitted allocations
If permitted flow is zero, please' cate why:
�— 1\ ® 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):
FORM: FTA 10-23 Page 2 of 5

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
12
4173
PVC
12 i
398 i
DIP f
16 1
114
PVC
{ t t.S
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section IH 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
VUL 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: I-74 Industrial Center Sewer Pump Station
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.829019° / Longitude:-79.839766'
3. Total number of pumps at the pump station: 2
i
3. Design flow of the pump station: 1.0512 millions gallons per day (firm capacity)
➢ This should reflect the total GPM for the pump station with the largest pump out of service.
i
4. Operational point(s) per pump(s): 730 gallons per minute (GPM) at 141 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
12
12322
PVC
12 t
80 i
DIP
r 'Z
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.I.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
❑ Standby power source or ®i Standby pump
➢ Must have automatic activation and telemetry - 15A NCAC 02T.0305(h)(1)(B);
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility and may not be portable
Or if the pump station has an average daily flow less than 15,000 gallons per day 15A NCACO2T.0305(h)(1)(C):
❑ Portable power source with manual activation, quick -connection receptacle and telemetry -
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry:
➢ Include documentation that the portable source is owned or contracted by the applicant and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
as part of this permit application in the case of a multiple station power outage.
FORM: FTA 10-23 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T.0305(f)):
1. Does the project comply with all separations/altematives found in 15A NCAC 02T.0305(f) & (14,)7 ® )?es ❑ No
15A NCAC 02T.0305(f) contains minimum A.t .>su do ..«..,:ava r _-e.....- ------ _.
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
18 inches
'Water mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
'Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
"Any private or public water supply source, including any wells, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water, and associated wetlands.
100 feet
"Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water (or tide elevation) and wetlands associated with these waters (see item IX.2)
50 feet
"Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches, as well as wetlands associated with these waters or classified as WL.
10 feet
Any building foundation (horizontal)
5 feet
Any basement (horizontal)
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
➢ If noncompliance with 02T.0305(fl or W, see Section X.1 of this application
s15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved. Please check `yes"
above if these alternatives are used and provide narrative information to explain.
"Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
2. Does this project comply with the minimum separation requirements for water mains? ® Ves ❑ 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.
i
4. Is the project located in a river basin subject to any State buffer rules? ® Yes Basin name: Randleman Lake ❑ 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.).
J
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/coaflfct boxes require a variance approval.
D If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and
inspections documented per 15A NCAC 02T.0403(a)(5) or the permittee's individual System -Wide Collection permit.
FORM: FTA 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?
® Yes ❑ No
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
concurrently with the approval of the Permit and Projects requiring a variance approval may be subject to longer
review times. For Projects requiring two or more variances or where the variance is determined by the Division to be a
significant Portion of the project. the full technical review is required
2. Professional Engineer's Certification:
I, CFO kA c, 4,0V attest that this application for 1-1 f ul cel, P fftr ,Lku�'.
(Professional Engineer's name fisfin Application Item HE.1.) (Project Name from Application Item 111) 1
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans,
specifications, engineering calculations, and all other supporting documentation to the best of my knowledge. I further
attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per violation. Misrepresentation of the application
information, including failure to disclose any design noncompliance with the applicable Rules and design criteria, may subject
the North Carolina -licensed Professional Engineer to referral to the licensing board. (21 NCAG,%0,701)
North Carolina Professional Engineer's seal, signature, and date: ��O-NnEss:`t7
0* ( I
4•
AL r _
8097 —
•�'GINCs4*•'
i�i/, % C GR�` \\
��/lllllll)1�
Applicant's Certification per 15A NCAC 02T .0106(b):
I Shain Sexton attest that this application for 1-74 Industrial Center Sewer Improvements
(signature Authority Name from Application Item I.3.) (Project Name from Application Item H.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;'t..(_ Date:
9 a9�a6AY
FORM: FTA 10-23 Page 5 of 5

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
Division of Wate I r Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: The Wooten Company
Project Name for which flow is being requested: 1-74 Industrial Center Sewer
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: City of Randleman Waste Water Treatment Plant
b. WWTP Facility Permit #: NC0025445 '
All flows are in MGD
c. WWTP facility's permitted flow 1.745
d. Estimated obligated flow not yet tributary to the WWTP .013
e. WWTP facility's actual avg. flow .618
f. Total flow for this specific request .026
g. Total actual and obligated flows to the facility .657
h. Percent of permitted flow used 37.65%
11. 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+Q (E)=(A-D)
Design Obligated,
Pump Average Daily Approx. Not Yet Total Current
Station Firm Flow" Current Avg. Tributary Flow Plus
(Name or Capacity,(Firm I pf), Daily Flow, Daily Flow, Obligated Available
Number) MGD MOD MGD MGD Flow Capac#y
Main PS 2 MGD 0.8 MGD .500 .039 .539 .261
* 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): _City of Randleman
Downstream Permit Number: WQCS00099
Page 1 of 6
FTSE 04 I

III. Certification Statement:
I Michael Glass 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 parry. Signature of this
form indicates acceptance of this wastewater flow.
Signing Official Signature
Date
Page 2 of 6
FTSE 04-16

» oo�ten Envv�onmentalQuali TRANSMITTAL
Received Quality
119 Brookstown Avenue, Suite 100 Sent via:
Winston-Salem, NC 27101 OCT t 2024 ❑ Regular Mail ❑ Fed Ex ® UPS
❑ Certified Mail El courier ❑ Pick-up
Winston-Salem'
Regional Officfl
T0: NCDEQ DATE: September 30, 2024 Job No.: 3190-K
Water Quality Section
Winston-Salem Regional Office RE: Randolph Co. / Randleman 1-74 Industrial Center
450 W. Hanes Mill Rd., Suite 300 Sewer Improvements
Winston-Salem, NC 27105
WE ARE SENDING:
® Attached
❑ Under separate cover via _
the following items:
❑ Shop Drawings
❑ Prints
❑ Plans ❑ Samples
❑ Specifications
❑ Copy of Letter
❑ Change Order
® Fast Track application and supporting
documents
COPIES
DATE
NO.
DESCRIPTION
1 set
9-30-24
1
Printed — Cover letter, check, Application, narrative, maps
1 set
9-30-24
2
Flash drive — Cover letter, check, Application, narrative, maps
THESE ARE TRANSMITTED as checked below:
® For Approval
❑ Reviewed ❑ Revise and Resubmit
® For Your Use
❑ Rejected ❑ Submit _ Copies for Distribution
❑ As Requested
❑ Corrected ❑ Return _ Corrected Print
® For Review and Comment
❑ Other:
❑
❑ Prints Returned after Loan to Us
Remarks: Thank You -
Via: UPS
Signed: Jennifer Perry
If enclosures are not as noted, kindly notify us at once.

» ooten
September 30, 2024
Winston-Salem Regional Office
Water Quality Section
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Re: Revised Fast Track Sewer System Extension Application (FTA 10-23)
Modifying Existing Permit: WQ0044538
Town of Randleman
1-74 Industrial Center Sewer Improvements
TWC No. 3190-K
Dear Sir or Madam:
119 Brookstown Avenue, Suite 100
Winston-Salem, NC 27101
[phone]
On behalf of the Town of Randleman, we are forwarding copies of the following documents for your review
and to request approval of the above referenced project:
➢ Revised Narrative Description
➢ Letter Describing Revisions
➢ Application Fee - Check in the amount of $600.00 made payable to NCDEQ to cover the permit
application fee.
➢ One Original and One Digital Copy of Fast Track Sewer System Application (FTA 10-23)
➢ Original Permit
➢ Flow Tracking/Acceptance Form (FTSE 10-23)
➢ 8.5-inch x 1 I -inch color copy of USGS Topographic Map
➢ General location map
If you should have any questions or need additional information, please do not hesitate to contact us at
[phone].
Regards,
THE WOOTEN COMPANY
John C Grey, P.E.
Project Manager
cc: Shain Sexton, Town of Randleman — Town Manager

REVISED NARRATIVE
RANDOLPH COUNTY
I-74 INDUSTRIAL CENTER SEWER IMPROVEMENTS
DESCRIPTION OF PROJECT
Location of Project
Randolph County is located in central North Carolina. The project area is generally bounded to the west
by Interstate 74 and to the north by Randleman Lake and to the east by Randolph Street. The force main
portion of the project will be within the Town limits whereas the gravity sewer portion will generally be
directly adjacent to the western Town limits. The general topography is gradual slopes throughout the
project. The project area will be along roadsides with ditches sloping between 0-S percent and through
wooded areas with limited areas of large gradients. Manmade drainage features such as swales and
roadside ditches collect and route the majority of runoff.
Most of the land and soil disturbance will result from trench excavation and backfill associated with
installing the gravity sewer and force mains. The installation and construction will take place within
NCDOT right-of-way, City of Randleman right-of-way and permanent utility easements. Most of this work
is within the road shoulder, outside of pavement, in the road right-of-way with the remainder occurring
through wooded areas.
TYPE OF DEVELOPMENT
Gravity Sewer Line, Lift Station and Force Main Construction
• 12,402 LF of 12-Inch Force Main
• 4,571 LF of 12- Inch Gravity Sewer Lines
• 114 LF of 16-inch Gravity Sewer Lines
• A 730 GPM Sewer Pump Station
• Associated appurtenances, site work and restorations
Existing Permits
This pr ' wi be modifyF existing permit WQ0044538
Additions er
• NCDOT Encroachment Agreement for Primary & Secondary Roads
• NCDOT Encroachment Agreement for Controlled Access Highways
• NCDOT Driveway Permit
• Erosion & Sedimentation Control Permit

» ooten
September 30, 2024
Jenny Graznak
Winston-Salem Regional Office
450 West Hanes Mill Rd
Suite 300
Winston-Salem, NC 27105
Re: Revision to Fast Track Permit No. WQ0044538
City of Randleman
I-74 Industrial Center Sewer Improvements
TWC No. 3190-K
Dear Ms. Graznak,
119 Brookstown Avenue, Suite too
Winston-Salem, NC 27101
[phone]
The intent of this letter is to update the information included in Fast Track Permit No. WQ0044538 based on
changes that have been made to the design since the permit was originally issued in August 2023.
Justification for Design Change
The goal of this project was to provide sewer infrastructure to the proposed industrial center being developed
along old Highway 311 at the I-74 interchange in the Town of Randleman. Through various discussions with
the land developer, it was determined that the original alignment of the gravity sewer would conflict with the
proposed development of the site. Working with the developer, the alignment was adjusted to avoid any
potential conflicts.
Updates to Permit Application
The proposed 12-inch gravity sewer will be adjusted so as to bring the alignment from MH 11 to the end more
to the east. The new alignment will have (1) one less manhole with a reduction in overall length from 5064
LF to 4571 LF. Approximately 398 LF of the proposed sewer line will consist of 12-inch DIP while the
remaining 4173 LF will be 12-inch PVC.
All other information included in the original permit application will remain the same with the minimum
design criteria, as presented in NCAC 15A Chapter 18, being adhered to throughout the project.
If you should have any questions or need additional information, please do not hesitate to contact us at
[phone].
Regards,
THE WOOTEN COMPANY
John C. Grey, P.E.
Project Manager

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Walker Mi// Rd STATION • '
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Center Phase 1 GRAVITY C-2.01 ^ J1
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82
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Figure 7 -Location Map

ROY COOPER
Governor
ELIZABETH S. BISER
Semerary
RICHARD E. ROGERS, JR.
Dire, lar
Gary Betts, Mayor
Email: betsman52(@Rmail.com
City of Randleman
204 South Main Street
Randleman, NC 27317
Subject: Permit No. W00044538
Dear Mr. Betts:
NORTH CAROLINA
Environmental Quality
August 10, 2023
City of Randleman
1-74 Industrial Center Sewer Improvements
Wastewater Collection System Extension Permit
Randolph County
In accordance with your application received June 26, 2023, and additional information received on July
10, 2023 and August 9, 2023, we are forwarding herewith Permit No. WQ0044538 dated August 10, 2023
to the City of Randleman (Permittee) for the construction and operation upon certification of the subject
wastewater collection system extension. This permit shall be effective from the date of issuance until
rescinded and shall be subject to the conditions and limitations as specified therein. This cover letter shall
be considered a part of this permit and is therefore incorporated therein by reference.
Please pay particular attention to the following conditions contained within this permit:
ConditionIA: No flow in excess of the quantity permitted herein, 26,400 GPD, shall be made
tributary to the subject sewer system until an application for permit modification for an
increase in flow has been submitted to and approved by the Division. [15A NCAC
02T.0304(b)]
Condition ILL: This permit shall not be automatically transferable; a request must be made and
approved.
Condition 11.4: Requires that the wastewater collection facilities be properly operated and maintained
in accordance with 15A NCAC 02T.0403 or any individual system -wide collection system
Permit issued to the Permittee.
Condition 11.7: Upon completion of construction and prior to operation of these permitted facilities, the
completed Engineering Certification form with checklist attached to this permit shall be
submitted with the required supporting documents to the address provided on the form.
Permit modifications are required for any changes resulting in non-compliance with
this permit, regulations, or the Minimum Design Criteria. [15A NCAC 02T.01161
�f) North Carolina Department of Envtronmental Quality , Division of Water Resources
D E Q�y Winston Salem Regional ice 1 450 West Hanes Mill Road Suite 300 Winston Salem. North Carofina 27105

City of Randleman
Permit No. WQ0044538
It shall be responsibility of the Permittee to ensure that the as -constructed project meets the appropriate
design criteria and rules. Failure to comply may result in penalties in accordance with North Carolina
General Statute §143-215.6A through §143-215.6C, construction of additional or replacement
wastewater collection facilities, and/or referral of the North Carolina -licensed Professional Engineer to
the licensing board.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to
request an adjudicatory hearing upon written request within 30 days following receipt of this permit. This
request must be in the form of a written petition, conforming to Chapter 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 Jenny Graznak at (336) 776-
9695 or via e-mail at'e1 nny,[e-mail].
Sincerely,
EIWMIIB746
nCO
for Richard E. Rogers, Jr.
Director, Division of Water Resources
by Jennifer F. Graznak, Assistant Regional Supervisor
Water Quality Regional Operations Section
Winston-Salem Regional Office
Division of Water Resources, NCDEQ
cc: John C. Grey, The Wooten Company
Page 2 of 7

NORTH CAROLINA
Environmental Quality
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations, permission is hereby granted to the
City of Randleman
Randolph County
for the construction and operation of approximately 5,064 linear feet of 12-inch gravity sewer; a 730-
gallon per minute pump station with duplex pumps, on -site audible and visual high water alarms,
telemetry, and a permanent generator with automatic transfer switch; as well as approximately 12,546
linear feet of 12-inch force main to serve a 30-acre future industrial park as part of the 1-74 Industrial
Center Sewer Improvements project, and the discharge of 26,400 gallons per day of collected industrial
wastewater into the City of Randleman's existing sewerage system, pursuant to the application received
June 26, 2023, and additional information received on July 10, 2023 and August 9, 2023 and in conformity
with 15A NCAC 02T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as
applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and
Force Mains adopted June 1, 2000 as applicable; and other supporting data subsequently filed and
approved by the Department of Environmental Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until rescinded and shall be subject to the specified
conditions and limitations contained therein.
:EE 3CE3F18]658...
for Richard E. Rogers, Jr.
Director, Division of Water Resources
By Authority of The Environmental Management Commission
Permit Number: WQ0044538
Permit Issued: August 10, 2023
Page 3 of 7

SUPPLEMENT TO PERMIT COVER SHEET
City of Randleman is hereby authorized to:
Construct, and then operate upon certification the aforementioned wastewater collection extension. The
sewage and wastewater collected by this system shall be treated in the City of Randleman Wastewater
Treatment Facility in accordance with Permit Number NC0025445.
Permitting of this project does not constitute an acceptance of any part of the project that does not meet
1SA NCAC 02T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as
applicable; and the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and
Force Mains adopted June 1, 2000 as applicable, unless specifically mentioned herein. Division approval
is based on acceptance of the certification provided by a North Carolina -licensed Professional Engineer in
the application. It shall be the Permittee's responsibility to ensure that the as -constructed project meets
the appropriate design criteria and rules.
Construction and operation is contingent upon compliance with the Standard Conditions and any Special
Conditions identified below.
I. SPECIAL CONDITIONS
1. No flow in excess of the quantity permitted herein, 26,400 GPD, shall be made tributary to the subject
sewer system until an application for permit modification for an increase in flow has been submitted
to and approved by the Division. [15A NCAC 02T.0304(b)]
II. STANDARD CONDITIONS
I. This permit shall not be transferable. In the event there is a desire for the wastewater collection
facilities to change ownership, or there is a name change of the Permittee, a formal permit request
shall be submitted to the Division accompanied by documentation from the parties involved, and
other supporting materials as may be appropriate. The approval of this request shall be considered
on its merits and may or may not be approved. [15A NCAC 02T.0116; G.S 143-215.1(d3)]
2. This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit, 15A NCAC 02T; 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 materials unless specifically mentioned herein. [15A NCAC 02T.0110]
3. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data. [15A NCAC 02T .0110]
4. 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 02T .0403. If an individual
permit is not required, the following performance criteria shall be met:
Page 4 of 7

a. The sewer system shall be 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.
b. A map of the sewer system shall be developed and shall be actively maintained.
c. An operation and maintenance plan including pump station inspection frequency, preventative
maintenance schedule, spare parts inventory and overflow response has been 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 -months and inspections are
documented.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. 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.
h. A Grease Control Program is in place as follows:
1. For public 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 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.
2. For privately owned collection systems, the Grease Control Program shall include at least bi-
annual distribution of grease education materials to users of the collection system by the
permittee or its representative.
3. Grease education materials shall be distributed more often than required in Parts (1) and (2)
of this Subparagraph if necessary to prevent grease -related sanitary sewer overflows.
Right-of-ways and easements shall be maintained in the full easement width for personnel and
equipment accessibility.
j. Documentation shall be kept for Subparagraphs (a) through (i) of this Rule for a minimum of three
years with exception of the map, which shall be maintained for the life of the system.
5. The Permittee shall report by telephone to a water resources staff member at the Winston-Salem
Regional Office, telephone number [phone], as soon as possible, but in no case more than 24
hours, following the occurrence or first knowledge of the occurrence of either 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 SSO and/or spill over 1,000 gallons; or
c. Any SSO and/or spill, regardless of volume, that reaches surface water
Page 5 of 7

Voice mail messages or faxed information is permissible, but this shall not be considered as the initial
verbal report. Overflows and spills occurring outside normal business hours may also be reported to
the Division of Emergency Management at telephone number [phone] or [phone].
Persons reporting any of the above occurrences shall file a spill report by completing and submitting
Part I of Form CS-SSO (or the most current Division approved form) within five days following first
knowledge of the occurrence. This report must outline the actions taken or proposed to be taken to
ensure that the problem does not recur. Part II of Form CS-SSO (or the most current Division approved
form) can also be completed to show that the SSO was beyond control. [G.S. 143-215.1C(a1)]
6. Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to
interrupt service by the existing utilities nor result in an overflow or bypass discharge of wastewater
to the surface waters of the State. [15A NCAC 02T.0108(b)]
7. Upon completion of construction and prior to operation of these permitted facilities, the completed
Engineering Certification form with checklist attached to this permit shall be submitted with the
required supporting documents to the address provided on the form. A complete certification is one
where the form is fully executed and the supporting documents are provided as applicable. Any
wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Engineer's Certification, shall be considered a violation of the permit and shall subject the
Permittee to appropriate enforcement actions.
A complete certification is one where the form is fully executed and the supporting documents are
provided as applicable. Supporting documentation shall include the following:
a. One copy of the project construction record drawings (plan & profile views of sewer lines & force
mains) of the wastewater collection system extension. Final record drawings shoul&be clear on
the plans or on digital media '(CD or DVD disk) and are defined as the design drawings that are
marked up or annotated with after construction information and show required buffers,
separation distances, material changes, etc.
b. One copy of the supporting applicable design calculations including pipe and pump sizing, velocity,
pump cycle times, and level control settings, pump station buoyancy, wet well storage, surge
protection, detention time in the wet well, and force main, ability to flush low points in force
mains with a pump cycle, and downstream sewer capacity analysis. If a portable power source or
pump is dedicated to multiple stations, an evaluation of all the pump stations' storage capacities
and the rotation schedule of the portable power source or pump, include travel timeframes, shall
be provided.
c. Changes to the project that do not result in non-compliance with this permit, regulations, or the
Minimum Design Criteria should be clearly identified on the record drawings, on the certification
in the space provided, or in written summary form.
Prior to Certification (Final or Partial): Permit modifications are required for any changes resulting
in non-compliance with this permit (including but not limited to pipe length changes of 10% or
greater, increased flow, pump station design capacity design increases of S% or greater, and
increases in the number/type of connections), regulations; or the Minimum Design Criteria.
Requested modifications or variances to the Minimum Design Criteria will be reviewed on a case -by -
case basis and each on its own merit. Please note that variances to the Minimum Design Criteria
should be requested and approved during the permitting process prior to construction. After -
Page 6 of 7

construction requests are discouraged by the Division and may not be approved, thus requiring
replacement or repair prior to certification & activation. [15A NCAC 02T .0116]
8. Gravity sewers installed greater than ten percent below the minimum required slope per the Division's
Gravity Sewer Minimum Design Criteria shall not be acceptable and shall not be certified until
corrected. If there is an unforeseen obstacle in the field where all viable solutions have been
examined, a slope variance can be requested from the Division with firm supporting documentation.
This shall be done through a permit modification with fee. Such variance requests will be evaluated
on a case -by -case basis. Resolution of such request shall be evident prior to completing and submitting
the construction certification. [ 15A NCAC 02T.0105(n)]
9. A copy of the individual permit and construction record drawings shall be maintained on file by the
Permittee for the life of the wastewater collection facilities. [15A NCAC 02T .0116]
10. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 02T; the
Division's Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the Division's
Minimum Design Criteria for the Fast -Track Permitting of Pump Station and Force Mains adopted June
1, 2000 as applicable; and other supporting materials may subject the Permittee to an enforcement
action by the Division, in accordance with North Carolina General Statutes §143-215.6A through §143-
215.6C, construction of additional or replacement wastewater collection facilities, and/or referral of
the North Carolina -licensed Professional Engineer to the licensing board. [15A NCAC 02T .0108(b-c)]
11. In the event that the wastewater collection facilities fail to perform satisfactorily, including the
creation of nuisance conditions, the Permittee shall take immediate corrective action, including those
as may be required by this Division; such as the construction of additional or replacement facilities.
[15A NCAC 02T .0110; 15A NCAC 02T .0108(b)]
12. The issuance of this permit shall not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances that may be imposed by the Division any other Federal, State, or Local
government agencies which have jurisdiction or obtaining other permits which maybe required by the
Division or any other Federal, State, of Local government agencies. [G.S. 143-215.1(b)]
Page 7 of 7

CERTIFICATION CHECKLIST
To be completed by the certifying engineer prior to operation of the permitted sewers, per 15A NCAC 02T.0116.
Certifying Engineer:
Certification Review Date:
Project: 1-74 Industrial Center Sewer Improvements
Permit No. WQ0044539 Project County: Randolph County
1) Has permittee information changed since the permit was issued (or last modified): change of mailing address,
change of ownership, transfer from developer to HOA/POA, etc. ❑ Yes ❑ No
• If yes, please provide either a change of ownership form or new contact information. Note that transfer of
permits from the developer to the HOA/POA must occur with the first certification.
2) Have the as -built drawings have been signed, sealed, and dated by an N.C. PE? ❑ Yes ❑ No
3) Final Engineering certification? ❑ Yes ❑ No
If Partial Engineering certification, provide detailed narrative including what is being certified in the current
phase, what was previously certified (if applicable), and what is left to be certified.
4) Adequate information related to sewer lines: ❑ Yes ❑ No ❑ N/A
Three feet minimum cover has been provided for all sewers unless ferrous pipe was installed.
Minimum diameters for gravity sewers are 8-inches for public lines and 6-inches for private lines.
Manholes have been installed: At the end of each line, at all changes in grade, size, or alignment, at all
intersections, and at distances not greater than 425 feet; minimum diameter shall be 4 feet (48-inches).
5) Adequate information related to pump stations: ❑ Yes ❑ No ❑ N/A
• Ensure power reliability option was selected per 15A NCAC 02T.0305(h).
6) Was project construction completed in accordance with all of the following: ❑ Yes ❑ No ❑ N/A
• 15A NCAC 02T. Minimum Design Criteria (MDC) for the permitting of Gravity Sewers (latest version), and MDC
for the Permitting of Pump Stations and Force Mains (latest version)?
If not, a variance approval is required in accordance with 15A NCAC 02T.0105(b)prior to certification and operation.
• Contact the Central Office to discuss the variance to determine a course of action.
• Applicant must submit two copies of the variance request form, plans, specifications, calculations, and any other
pertinent information to the Central Office (one hard copy, one digital copy).
• The central office will review the variance request, and if approvable, specific language regarding the variance
will be incorporated into the permit, either via a special condition or a supplementary letter. A copy of the
reissued permit with variance language or the variance letter must be maintained with the original documents.
7) Does the project contains high priority lines (15A NCAC 02T .0402(2))? ❑ Yes ❑ No
• If yes, ensure that the permit already contains the necessary condition related to high priority lines 15A NCAC
02T.0403 (a)(5). If the permit does not include this language, the Fast Track reviewer will reissue the permit with
the appropriate language.
8) Are Permit modifications are required for any changes resulting in non-compliance with this permit (including but not
limited to pipe length changes of 10% or greater, change in flow, pump station design capacity design change of 5% or
greater, and/or change in the number/type of connections)? ❑ Yes ❑ No
• If yes, a permit modification request must be submitted to the appropriate Regional Office, and a modified
permit with revised certification must be issued prior to certification and operation.
NC DWR - Water Quality Regional Operations Section 450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105
Winston-Salem Regional Office Phone: [phone] FAX: [phone]

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE:
City of Randleman
PERMIT #:
WQ0044538
PROJECT:
1-74 Industrial Center Sewer Improvements
ISSUE DATE:
August 10, 2023
COUNTY:
Randolph County
This project shall not be considered complete nor allowed to operate in accordance with Condition 7 of
this permit until the Division has received this Certification and all required supporting documentation. It
should be submitted in a manner that documents the Division's receipt. Send the required documentation
to the Regional Supervisor, Water Quality Regional Operations Section at the address at the bottom.
Any wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Certification shall be considered a violation of the permit and shall subject the Permittee to
appropriate enforcement actions. The Permittee is responsible for tracking all partial certifications up
until a final certification is received. A Final. Certification shall be a complete set of record drawings and
design calculations regardless of whether partials have been submitted.
PERMwrEE'S CERTIFICATION
I, the undersigned agent for the Permittee, hereby state that this project has been constructed pursuant
to the applicable standards & requirements, the Professional Engineer below has provided applicable
design/construction information to the Permittee, and the Permittee is prepared to operate & maintain
the wastewater collection system permitted herein or portions thereof.
Printed Name, Title
Signature
ENGINEERS CERTIFICATION
Date
1, . 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
project referenced above for the above Permittee, and hereby state that, to the best of my abilities, due
care and diligence was used in the observation of the following construction:
and operation of approximately 5,064 linear feet of 12-inch gravity sewer; a 730—gallon per minute pump
station with duplex pumps, on -site audible and visual high water alarms, telemetry, and a permanent
generator with automatic transfer switch; as well as approximately 12,546 linear feet of 12-inch force
main to serve a 30-acre future industrial park as part -of the 1-74 Industrial Center Sewer Improvements
project, and the discharge of 26,400 gallons per day of collected industrial wastewater into the City of
Randleman's existing sewerage system, pursuant to the application received June 26, 2023, and additional
information received on July 10, 2023 and August 9, 2023; such that the construction was observed to be
built within substantial compliance of this permit; 15A NCAC 02T; the Division of Water Resources'
(Division) Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as applicable; the Division's
Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1,
2000 as applicable; and other supporting materials.
North Carolina Professional Engineer's Seal w/signature & date:
❑ Final ❑ Partial (include description)
Certification Comments/Qualifiers (attach if necessary):
NC DWR — Water Quality Regional Operations Section 450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105
Winston-Salem Regional Office Phone: [phone] FAX: [phone]

FAST TRACK SEWER ENGINEERING CERTIFICATION
NC DWR — Water Quality Regional Operations Section
Winston-Salem Regional Office
450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105
Phone: [phone] FAX: [phone]