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HomeMy WebLinkAboutNC0085812_Application (ATC)_20240216DWR Division of Water Resources State of North Carolina Department of Environmental Quality Division of Water Resources APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT FORM ATC 10-23 SECTION 1: INSTRUCTIONS AND INFORMATION A. The Division of Water Resources will accept this application package for review only if all of the items are provided and the application is complete. Failure to submit all of the required items will result in the application package being returned as incomplete per 15A NCAC 02T .0105(b). B. A check or money order must be submitted in the amount of $1000.00 dated within 90 days of application submittal and made payable to North Carolina Department of Environmental Quality (NCDEQ). C. Plans and specifications must be prepared in accordance with 15 NCAC 02H. 0100, 15A NCAC 02T, North Carolina General Statute 133-3, North Carolina General Statute 143-215.11 and Division of Water Resources Minimum Design Criteria for NPDES Wastewater Treatment Facilities. D. The plans and specifications submitted must represent a completed final design that is ready to advertise for bid. E. Any content changes made to this Form ATC 10-23 shall result in the application package being returned. F. The Applicant shall submit ONE ORIGINAL and ONE DIGITAL COPY (CD) of the application, all supporting documentation and attachments. All information must be submitted bound or in a 3-ring binder, with a Section tab for each Section, except the Engineering Plans. G. Check the boxes below to indicate that the information is provided and the requirements are met. H. If attachments are necessary for clarity or due to space limitations, such attachments are considered part of the application package and must be numbered to correspond to the item referenced. I. For any project that requires review under the State Environmental Policy Act (SEPA), an Authorization to Construct cannot be issued prior to the completion of a State Clearinghouse advertisement period for a FONSI, EIS, etc. unless the project qualifies for a Determination of Minor Construction Activity. J. For more information, visit the Division of Water Resources web site at: hltp://portal.ncdenr.oriz/web/wq/swm/ps/npdes. K. In addition to this Authorization to Construct, the Applicant should be aware that other permits may be required from other Sections of the Division of Water Resources (for example: reclaimed water facilities permits; Class A or B biosolids residuals permit). SECTION 2: APPLICANT INFORMATION AND PROJECT DESCRIPTION A. APPLICANT Applicant's name Union County Water Signature authority's name per 15A NCAC 02T .0106(b) Thomas Mann Signature authority's title CIP Program Manager Complete mailing address 500 North Main Street, Suite 600, Monroe, NC 28112-4730 Telephone number 704-292-2560 Email address thomas.mann@unioncountync.gov B. PROFESSIONAL ENGINEER Professional Engineer's name Michael Parker Professional Engineer's title Associate Vice President North Carolina Professional Engineer's License No. 026432 Firm name Hazen and Sawyer Firm License number C-0381 Complete mailing address 9101 Southern Pine Blvd, Suite 250, Charlotte, NC 28273 Telephone number 704-940-8910 Email address mparker@hazenandsawyer.com APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC 10-23) Page 1 DWR Division of Water Resources C. NPDES PERMIT State of North Carolina Department of Environmental Quality Division of Water Resources APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT FORM ATC 10-23 NPDES Permit number NCO085812 Current Permitted flow (MGD) — include permit flow phases if applicable 0.05 MGD (Current NPDES Permit) 0.12 MGD (Updated NPDES Permit for plant expansion) D. PROJECT DESCRIPTION Provide a brief description of the project: The Grassy Branch Water Reclamation Facility (WRF) Expansion project will expand the treatment capacity of the WRF from 50,000 gallons per day (gpd) to 120,000 gpd. New 120,000 gpd aeration tanks and clarifiers will be installed. The existing package plant will be reconfigured to operate as flow equalization volume. The project will also include new influent. pumping, chemical storage and feed, blowers, cloth disk filters, ultraviolet (UV) disinfection, electrical service and switchgear, instrumentation & controls, and general site work._ SECTION 3: APPLICATION ITEMS REQUIRED FOR SUBMITTAL FOR ALL PROJECTS A. Cover Letter ® The letter must include a request for the Authorization to Construct; the facility NPDES Number; a brief project description that indicates whether the project is a new facility, facility modification, treatment process modification, or facility expansion; the construction timeline; and a list of all items and attachments included in the application package. ❑ If any of the requirements of 15 NCAC 02H. 0100, 15A NCAC 02T, North Carolina General Statute 133-3, North Carolina General Statute 143-215.1, and Division of Water Resources Minimum Design Criteria for NPDES Wastewater Treatment Facilities are not met by the proposed design, the letter must include an itemized list of the requirements that are not met. B. Application Fee (All New and Modification Application Packages): ® Submit a check or money order in the amount of $1,000.00, dated no more than 90 days prior to application submittal. ➢ Payable to North Carolina Department of Environmental Quality (NCDEQ) C. NPDES Permit ® Submit Part I of the Final NPDES permit for this facility that includes Part A (Effluent Limitations and Monitoring Requirements) for the monthly average flow limit that corresponds to the work that is requested for this project. D. Special Order by Consent ® If the facility is subject to any Special Orders by Consent (SOC), submit the applicable SOC. ❑ Not Applicable. E. Finding of No Significant Impact or Record of Decision ❑ Submit a copy of the Finding of No Significant Impact or Record of Decision for this project. ❑ Provide a brief description of any of the mitigating factors or activities included in the approved Environmental Document that impact any aspect of design of this project, if not specified in the Finding of No Significant Impact or Record of Decision. ® Not Applicable. F. Engineering Plans ® Per 15A NCAC 02T .0504(c)(1), submit one set of detailed plans that have been signed, sealed and dated by a North Carolina Licensed Professional Engineer. APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC 10-23) Page 2 State of North Carolina DWR Department of Environmental Quality Division of Water Resources Division of Water Resources APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT FORM ATC 10-23 ® Per 21 NCAC 56 .1103(a)(6), the name, address and License number of the Licensee's firm shall be included on each sheet of the engineering drawings. ® Plans must be labeled as follows: FINAL DRAWING — FOR REVIEW PURPOSES ONLY — NOT RELEASED FOR CONSTRUCTION. ® 15A NCAC 02H .0124 requires multiple (dual at a minimum) components such as pumps, chemical feed systems, aeration equipment and disinfection equipment. Is this requirement met by the design? ® Yes or ❑ No. If no, provide an explanation: Plans shall include: ® Plans for all applicable disciplines needed for bidding and construction of the proposed project (check as appropriate): ® Civil ❑ Not Applicable ® Process Mechanical ❑ Not Applicable ® Structural ❑ Not Applicable ® Electrical ❑ Not Applicable ® Instrumentation/Controls ❑ Not Applicable ❑ Architectural ® Not Applicable ❑ Building Mechanical ® Not Applicable ❑ Building Plumbing ® Not Applicable ® Plan and profile views and associated details of all modified treatment units including piping, valves, and equipment (pumps, blowers, mixers, diffusers, etc.) ® Are any modifications proposed that impact the hydraulic profile of the treatment facility? ® Yes or ❑ No. If yes, provide a hydraulic profile drawing on one sheet that includes all impacted upstream and downstream units. The profile shall include the top of wall elevations of each impacted treatment unit and the water surface elevations within each impacted treatment unit for two flow conditions: (1) the NPDES permitted flow with all trains in service and (2) the peak hourly flow with one treatment train removed from service. ® Are any modifications proposed that impact the process flow diagram or process flow schematic of the treatment facility? Yes or ❑ No. If yes, provide the process flow diagram or process flow schematic showing all modified flow paths including aeration, recycle/return, wasting, and chemical feed, with the location of all monitoring and control instruments noted. G. ® Engineering Specifications ® Per 15A NCAC 02T .0504(c)(2), submit one set of specifications that have been signed, sealed and dated by a North Carolina Licensed Professional Engineer. ® Specifications must be labeled as follows: FINAL SPECIFICATIONS — FOR REVIEW PURPOSES ONLY — NOT RELEASED FOR CONSTRUCTION. Specifications shall include: ® Specifications for all applicable disciplines needed for bidding and construction of the proposed project (check as appropriate): ® Civil ❑ Not Applicable ® Instrumentation/Controls ❑ Not Applicable ® Process Mechanical ❑ Not Applicable ❑ Architectural ® Not Applicable ® Structural ❑ Not Applicable ❑ Building Mechanical ® Not Applicable ® Electrical ❑ Not Applicable ❑ Building Plumbing ® Not Applicable ® Detailed specifications for all treatment units and processes including piping, valves, equipment (pumps, blowers, mixers, diffusers, etc.), and instrumentation. ® Means of ensuring quality and integrity of the finished product including leakage testing requirements for structures and pipelines, and performance testing requirements for equipment. ® Bid Form for publicly bid projects. APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC 10-23) Page 3 DWR Division of Water Resources H. Construction Sequence Plan State of North Carolina Department of Environmental Quality Division of Water Resources APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT FORM ATC 10-23 ® Construction Sequence Plan such that construction activities will not result in overflows or bypasses to waters of the State. The Plan must not imply that the Contractor is responsible for operation of treatment facilities. List the location of the Construction Sequence Plan as in the Engineering Plans or in the Engineering Specifications or in both: Specification: 011400 Section 0.06) I. Engineering Calculations ® Per 15A NCAC 02T .0504(c)(3), submit one set of engineering calculations that have been signed, sealed and dated by a North Carolina Licensed Professional Engineer; the seal, signature and date shall be placed on the cover sheet of the calculations. For new or expanding facilities and for treatment process modifications that are included in Section 4.C, the calculations shall include at a minimum: ® Demonstration of how peak hour design flow was determined with a justification of the selected peaking factor. ® Influent pollutant loading demonstrating how the design influent characteristics in Section 4.13.2 of this form were determined. ® Pollutant loading for each treatment unit demonstrating how the design effluent concentrations in Section 4.13.2 of this form were determined. ® Hydraulic loading for each treatment unit. ® Sizing criteria for each treatment unit and associated equipment (blowers, mixers, pumps, etc.) ® Total dynamic head (TDH) calculations and system curve analysis for each pump specified that is included in Section 4.C.6. ® Buoyancy calculations for all below grade structures. ® Supporting documentation that the specified auxiliary power source is capable of powering all essential treatment units. J. Permits ❑ Provide the following information for each permit and/or certification required for this project: Permit/Certification Not Applicable Date Submitted Date Approved Permit/ Certification Number If Not Issued Provide Status and Expected Issuance Date Dam Safety X Soil Erosion and Sediment Control 1 /31 /24 USCOE / Section 404 Permit X Water Quality Certification (401) X USCOE / Section 10 X Stormwater Management Plan X CAMA X NCDOT Encroachment Agreement X Railroad Encroachment Agreement X Other: Union County Permitting 1/31/24 K. Residuals Management Plan ® For all new facilities, expanding facilities, or modifications that result in a change to sludge production and/or sludge processes, provide a Residuals Management Plan meeting the requirements of 15A NCAC 02T .0504(i) and .0508; the Plan must include: ® A detailed explanation as to how the generated residuals (including trash, sediment and grit) will be collected, handled, processed, stored, treated, and disposed. APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC 10-23) Page 4 State of North Carolina DWR Department of Environmental Quality Division of Water Resources Division of Water Resources APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT FORM ATC 10-23 ® An evaluation of the treatment facility's residuals storage requirements based upon the maximum anticipated residuals production rate and ability to remove residuals. ❑ A permit for residuals utilization or a written commitment to the Applicant from a Permittee of a Department approved residuals disposal/utilization program that has adequate permitted capacity to accept the residuals or has submitted a residuals/utilization program application. ❑ If oil, grease, grit or screenings removal and collection is a designated unit process, a detailed explanation as to how the oil/grease will be collected, handled, processed, stored and disposed. ❑ Not Applicable. SECTION 4: PROJECT INFORMATION A. WASTEWATER TREATMENT PLANT FLOW INFORMATION — COMPLETE FOR NEW OR EXPANDING FACILITIES 1. Provide the following flow information: Plant Flows Existing Plant Design 0.050 MGD Current NPDES Permit Limit 0.050 MGD Current Annual Average (past 12 months) 0.042 MGD For Past 12 Months: Start Date: Jan/2022 End Date: Dec/2022 For Past 24 Months: Start Date: Jan/2021 End Date: Dec/2022 Maximum Month 0.064 MGD 0.104 MGD Maximum Day 0.179 MGD 0.180 MGD Peak Hour 0.179 MGD 0.180 MGD APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC 10-23) Page 5 DWR Division of Water Resources State of North Carolina Department of Environmental Quality Division of Water Resources APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT FORM ATC 10-23 B. WASTEWATER TREATMENT FACILITY DESIGN INFORMATION — COMPLETE FOR NEW OR EXPANDING FACILITIES AND FOR TREATMENT PROCESS MODIFICATIONS Have all of the requirements of 15 NCAC 02H. 0100, 15A NCAC 02T, North Carolina General Statute 133-3, North Carolina General Statute 143-215.11 and Division of Water Resources Minimum Design Criteria for NPDES Wastewater Treatment Facilities been met by the proposed design and specifications? ® Yes or ❑ No. If no, provide justification as to why the requirements are not met, consistent with 15A NCAC 02T .0105(n): 2. Provide the design influent and effluent characteristics that are used as the basis for the project design, and the NPDES permit limits for the following parameters: Project Basis of Design Influent Design Influent Design Influent Concentration Concentration Load - Current (Must be (Must be Annual supported by supported by Design Effluent Average (past Engineering Engineering Concentration and/or NPDES Permit Limits 12 months) if Calculations Calculations Load (monthly average) Parameter Available [Section 3.H] [Section 3.111 Ammonia Nitrogen 1 mg/L Summer 2 mg/L Summer (NH3-N) 33 mg/L 33 mg/L 18 lb/day 1 mg/L Winter 4 mg/L Winter Biochemical 5 mg/L Summer 5 mg/L Summer Oxygen Demand 194 mg/L 250 mg/L 140 lb/day (BOD5) 10 mg/L Winter 10 mg/L Winter Fecal Coliform 200 per 100 mL 200 per 100 mL Nitrate + Nitrite Nitrogen (NO3-N + N/A mg/L N/A mg/L NO2-N Total Kjeldahl N/A mg/L Nitrogen N/A mg/L N/A mg/L Total Nitrogen N/A lb/year N/A lb/year N/A mg/L N/A mg/L Total Phosphorus N/A mg/L 5 mg/L 2.8 lb/day N/A lb/year N/A lb/year Total Suspended Solids (TSS) 232 mg/L 250 mg/L 140 lb/day 5 mg/L 30 mg/L 3. Based on the "Project Basis of Design" parameters listed above, will the proposed design allow the treatment facility to meet the NPDES Permit Limits listed above? ® Yes or ❑ No. If no, describe how and why the Permit Limits will not be met 4. Per 15A NCAC 02T .0505(i), by-pass and overflow lines are prohibited. Is this condition met by the design? ® Yes or ❑ No If no, describe the treatment units bypassed, why this is necessary, and where the bypass discharges: APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC 10-23) Page 6 State of North Carolina DWR Department of Environmental Quality Division of Water Resources Division of Water Resources APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT FORM ATC 10-23 5. Per 15A NCAC 02T .0505(k), multiple pumps shall be provided wherever pumps are used. Is this condition met by the design? ® Yes or ❑ No. If no, provide an explanation: 6. Per 15A NCAC 02T .0505(1), power reliability shall be provided consisting of automatically activated standby power supply onsite capable of powering all essential treatment units under design conditions, or dual power supply shall be provided per 15A NCAC 02H. 0124(2)(a). Is this condition met by the design? ® Yes or ❑ No. If no, provide (as an attachment to this Application) written approval from the Director that the facility: ➢ Has a private water supply that automatically shuts off during power failures and does not contain elevated water storage tanks, and ➢ Has sufficient storage capacity that no potential for overflow exists, and ➢ Can tolerate septic wastewater due to prolonged detention. 7 Per 15A NCAC 02T .0505(o), a minimum of 30 days of residual storage shall be provided. Is this condition met by the design? ® Yes or ❑ No. If no, explain the alternative design criteria proposed for this project in accordance 15A NCAC 02T .105(n): 8. Per 15A NCAC 02T .0505(g), the public shall be prohibited from access to the wastewater treatment facilities. Explain how the design complies with this requirement: Fencing is around the perimeter of the plant with restricted entry gates at the entrance. 9. Is the treatment facility located within the 100-year flood plain? ❑ Yes or ® No. If yes, describe how the facility is protected from the 100-year flood: Site ,grading will bring new facilities outside of 100-year floodplain elevation._ C. WASTEWATER TREATMENT UNIT AND MECHANICAL EQUIPMENT INFORMATION — COMPLETE FOR NEW OR EXPANDING FACILITIES AND FOR MODIFIED TREATMENT UNITS PRELIMINARY AND PRIMARY TREATMENT (i.e., vhvsical removal overations and flow equalization): No. of Plan Sheet Specification Calculations Treatment Unit Units Type :L Size per Unit Reference Reference Provided. (Yes or No) Manual Bar Screen 1 Manual Bar Rack 0.47 MGD at peak daily flow M200-M205 46 07 53 No Mechanical Bar I Perforated 0.47 MGD at peak daily flow M140 46 21 83 Yes Screen Plate Grit Removal MGD at peak hourly flow Flow Equalization 1 74,000 gallons M160- 4651 33 Yes M 163 Primary Clarifier Circular ft diameter; ft side water depth Primary Clarifier Rectangular square feet; ft side water depth Other APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC 10-23) Page 7 DWR Division of Water Resources State of North Carolina Department of Environmental Quality Division of Water Resources APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT FORM ATC 10-23 2. SECONDARY TREATMENT (BIOLOGICAL REACTORS AND CLARIFIERS) (i.e., biological and chemical processes to remove or 3,anics and nutrients No. of Plan Sheet Specification Calculations Treatment Unit Units Type Size per Unit Reference Reference Provided. (Yes or No) Aerobic Zones/ 2 Extended aeration / single stage 60,000 gallons M200- 46 07 53 Yes Tanks nitrification M203 46 51 33 Anoxic Zones/ gallons Tanks Anaerobic gallons Zones/Tanks Sequencing Batch -- gallons Reactor SBR Membrane gallons Bioreactor MBR Secondary 2 Circular 16 ft diameter; 12.5 ft side M200- 46 07 53 Yes Clarifier water depth M203 Secondary Rectangular square feet; ft Clarifier side water depth Other TERTIARY TREATMENT No. of Plan Sheet Specification Calculations Treatment Unit Units Type Size per Unit Reference Reference Provided. (Yes or No) Tertiary Clarifier Circular ft diameter; ft side water depth Tertiary Clarifier Rectangular square feet; ft side water depth Tertiary Filter square feet Tertiary Membrane 1 Disk 39 square foot per disk M240 46 61 41 Yes Filtration 78 square foot total (2 disks per unit) Post -Treatment gallons Flow Equalization Post -Aeration gallons Other 4. DISINFECTION No. of Plan Sheet Specification Calculations Treatment Unit Units Type Size per Unit Reference Reference Provided. (Yes or No) 235,000 gal/day per bank at Ultraviolet Light 1 1 (Parallel; in peak hourly flow; 2 number of M260 466600 Yes series) banks; 4 number of lamps/bank Chlorination (Gas; gallons of contact tablet; liquid) tank/unit Dechlorination (Gas; gallons of contact tablet; liquid) tank/unit APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC 10-23) Page 8 DWR Division of Water Resources 5. RESIDUALS TREATMENT State of North Carolina Department of Environmental Quality Division of Water Resources APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT FORM ATC 10-23 No. of Plan Sheet Specification Calculations Treatment Unit Units Type Size per Unit Reference Reference Provided. Yes or No Gravity Thickening square feet; ft side Tank water depth Mechanical Thickening/ dry lb/hour Dewaterin Aerobic Digestion 1 Sludge Holding 19,000 gallons M200-M205 46 07 53 Yes Anaerobic gallons Digestion Composting dry lb/hour Drying dry lb/hour Other 6. PUMP SYSTEMS (include influent, intermediate, effluent, major recycles, waste sludge, thickened waste sludge and plant drain DumDS) Location No. of pumps Purpose Type Capacity of each pump Plan Sheet Reference Specification Reference GPM TDH Influent 3 Influent Pumping Submersible Solids- Handling 165 30 M110-Ml l l 4325 13 Alkalinity Facility 2 Chemical Feed Peristaltic Hose 0.027 9 M300-M301 46 33 45 7. MIXERS Location No. of Mixers purpose Type Power of each Mixer HP plan Sheet Reference Specification Reference Alkalinity Facility 1 Lime Slurry mixing Vertical Turbine Mixer 2 M300-M301 46 4127.11 APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC 10-23) Page 9 DWR Division of Water Resources 8. BLOWERS State of North Carolina Department of Environmental Quality Division of Water Resources APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT FORM ATC 10-23 Location No. of Blowers Purpose Type Capacity of each Blower Plan Sheet Reference Specification Reference Aeration 3 Package Treatment Plant Positive Displacement 200 M220 43 1133.13 Plow EQ / Blower slag (EXISTING) 4 Flow E Q(2) Positive Displacement (2) 7.5 HP, 452 cfm / 2 HP, 69 eft N/A N/A 9. ODOR CONTROL Location No. of Units Purpose Type Plan Sheet Reference Specification Reference D. SETBACKS — COMPLETE FOR NEW WASTEWATER TREATMENT STRUCTURES 1. The minimum distance for each setback parameter to the wastewater treatment/storage units per 15A NCAC 02T .0506(b) are as follows: Minimum Distance Is Minimum Distance Required from Nearest Requirement met by the Setback Parameter Treatment/Storage Design. If "No", identify Unit Setback Waivers in Item D.2 Below Any habitable residence or place of assembly under separate 100 ft ® Yes ❑ No ownership or not to be maintained as part of the project site Any private or public water supply source 100 ft ® Yes ❑ No Surface waters (streams — intermittent and perennial, perennial 50 ft ® Yes ❑ No waterbodies, and wetlands Any well with exception of monitoring wells 100 ft ® Yes ❑ No Any property line 50 ft ® Yes ❑ No 2. Have any setback waivers been obtained per 15A NCAC 02T .0506(d)? ❑ Yes or ® No. If yes, have these waivers been written, notarized and signed by all parties involved and recorded with the County Register of Deeds? ❑ Yes or ❑ No. If no, provide an explanation: APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC 10-23) Page 10 DWR State of North Carolina Department of Environmental Quality Division of Water Resources Division of Water Resources APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT FORM ATC 10-23 SECTION 5: APPLICATION CERTIFICATION BY PROFESSIONAL ENGINEER Professional Engineer's Certification per 15A NCAC 02T .0105: I, Michael D. Parker , attest that this application package for an Authorization to Construct (Typed Name of Professional Engineer) for the Grassy Branch WRF Exuansion Project (Facility and Project Name) was prepared under my direct supervisory control and to the best of my knowledge is accurate, complete and consistent with the information supplied in the engineering plans, specifications, calculations, and all other supporting documentation for this project. I further attest that to the best of my knowledge the proposed design has been prepared in accordance with all applicable regulations and statutes, 15 NCAC 02H. 0100, 15A NCAC 02T, North Carolina General Statute 133-3, North Carolina General Statute 143-215.1, and Division of Water Resources Minimum Design Criteria for NPDES Wastewater Treatment Facilities, and this Authorization to Construct Permit Application, except as provided for and explained in Section 4.B.1 of this Application. I understand that the Division of Water Resources' issuance of the Authorization to Construct Permit may be based solely upon this Certification and that the Division may waive the technical review of the plans, specifications, calculations and other supporting documentation provided in this application package. I further understand that the application package may be subject to a future audit by the Division. Although certain portions of this submittal package may have been prepared, signed and sealed by other professionals licensed in North Carolina, inclusion of these materials under my signature and seal signifies that I have reviewed the materials and have determined that the materials are consistent with the project design. I understand that 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 with written signature placed over or adjacent to the seal and dated: C A Rp���L SEAL 26432 Q� 12:: - -0 '%0 APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC 10-23) Page 11 State of North Carolina DWR Department of Environmental Quality Division of Water Resources Division of Water Resources APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT FORM ATC 10-23 SECTION 6: APPLICATION CERTIFICATION BY APPLICANT Applicant's Certification per 15A NCAC 02T .0106(b): I, Thomas Mann, attest that this application package for an Authorization to Construct (Typed Name of Signature Authority and Title) for the _Grassy Branch WRF Expansion Project (Facility and Project Name) has been reviewed by me and is accurate and complete to the best of my knowledge. 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. I further certify that in accordance with 15A NCAC 02T .0120(12), the Applicant or any affiliate has not been convicted of environmental crimes, has not abandoned a wastewater facility without proper closure, does not have an outstanding civil penalty where all appeals have been abandoned or exhausted, are compliant with any active compliance schedule, and does not have any overdue annual fees. I understand that the Division of Water Resources' issuance of the Authorization to Construct Permit may be based solely upon acceptance of the Licensed Professional Engineer's Certification contained in Section 5, and that the Division may waive the technical review of the plans, specifications, calculations and other supporting documentation provided in this application package. I further understand that the application package may be subject to a future audit. I understand that 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. Signature: 1A' X Date: 12-15-23 THE COMPLETED APPLICATION AND SUPPORTING INFORMATION SHALL BE SUBMITTED TO: NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER RESOURCES/NPDES By U.S. Postal Service By Courier/Special Delivery: 1617 MAIL SERVICE CENTER 512 N. SALISBURY STREET, 9TH FLOOR RALEIGH, NORTH CAROLINA 27699-1617 RALEIGH, NORTH CAROLINA 27604 TELEPHONE NUMBER: (919) 807-6396 APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC 10-23) Page 12