WQ0041183_Application (FTSE)_20190916

DW'R
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
I5A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: totl, do ) {to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
I.
Applicant's name: Johnston County Public Utilities (company, municipality, HOA, utility, etc,)
2.
Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned
Public Utility
❑ Federal ® State/County ❑ Municipal ❑ Other
3.
Signature authority's name: Chandra C. Farmer, PE per 15A NCAC 02T _010&bl
Title: Public Utility Director
4.
Applicant's mailing address: PO Box 2263
City: Smithfield State: NC Zip. 27577-
5.
Applicant's contact information:
Phone number: (2U9 989-5075 Email Address. chandra.farmer a�johnstonnc_com
'
I1. PROJECT INFORMATION:
a
01
1.
Project name: Mason Park Phase 3
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2.
n.
ApplicatioProject status: ® Proposed (New Permit) El Permit/Project
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If a modification, provide the existing permit number. WQ00_ and issued date:
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If new construction but part of a master plan, provide the existing permit number: WQ00
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3.
County where project is located: Johnston
4.
Approximate Coordinates (Decimal Degrees): Latitude: 35.57340'- Longitude:-78.51055
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5.
Parcel ID (if applicable): 164600-53-7883
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(or Parcel ID to closest downstream sewer)
111. CONSULTANT INFORMATION:
I. Professional Engineer: Andrew Hodge. PE License Number: 21094
Firm: Adams & Hodge Engineering, PC
Mailing address: 314 East Main Street
City: CI. ayton State: NC Zip: 27520-1.
Phone number: [phone] Email Address: andrew cr,adamsandhods e.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Central_ Johnston County WWTP Permit Number: NCO030716
Owner Name: Johnston County Public Utilities
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
60
1. Permit Number(s): WQ28867 Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection Sy._ tem.Permit Number(sj {ifa1101 cable); WQCS3
Owner Name(s): Johnston County Public Utilities
FORM: FTA 04-16 Pagel 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 [RN. -'A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV1 been attached?
❑ Yes ❑No ®N/A
3. If the Applicant is a Home/Property Owners' Association, has an Operational Agreement (FORM: HGA} been attached?
❑ Yes ❑No ®NIA
4. Origin of wastewater: (check all that apply):
® Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food preparation;`service ❑ Hotel and/or Motels
❑ SchooI / preschool / day care ❑ Medical / dental ; veterinary facilities ❑ Swimming Pool !Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic/Commercial �% Commercial
% Industrial ( See I5A NC AC. 02T .0103(20))
,Is there a Pretreatment Program in effect? [:]Yes [:]No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(f) ® Yes ❑ No
If Yes, provide a cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f11
Daily Design Flow
No. of Units
Flow
31 - 3 bedroom homes
240 gal/dayl3 bedroom home
31
7,440 GPD
gal/
GPD
gall
GPD
gall
GPD
gall
GPD
gall
GPD
Tola!
7,440 GPD
a See 15A NCAC 02T .0114(1t1..(d)..(e)(.I1rapd. k) 21 for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-41.
b Per 15A NCAC 02T.01 14(c), design flow rates for establishments not identified [in table 15.E NCAC 02T.01 141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
Wastewater generated by project: 7.440 GPD (per 15A NCAC 02T .01 14) /
Do not include future flows or previously permitted allocations v
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC(Gravity Sewers),:
I. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
1,435
SDR-35
8
60
C-900
8
1,319
DIP
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section Ill contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VI11. PUMP STATION DESIGN CRITERIA (If Applicable)—02T.0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: -
3. Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 02T .0305fii)(1):
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B)
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - ISA NCAC 02T .0305(h)(1)(C):
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & I5A NCAC 02T .0305(f)):
I. Does the project comply with all separations found in 15A NCAC 02T .030{(!} &fie ® Yes ❑ No
i- 15A NCAC 02T.0305(f) contains minimum senarations flint ahnll he. nrnvirlerl fnr cPwPr cv<tPmc-
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
24 inches
Water mains vertical -water over sewer including in benched trenches)
18 inches
Water mains (horizontal)
10 feet
Reclaimed water lines vertical - reclaimed over sewer)
18 inches
Reclaimed water lines horizontal - reclaimed over sewer
2 feet
**Any private or public water supply source, including any wells, WS-1 waters of Class I or
Class If impounded reservoirs used as a source of drinking water
100 feet
"Waters classified WS (except WS-1 or WS-V), B, SA, ORW, HQW, or SB from normal
high water or tide elevation and wetlands see item IX.2
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
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
D 15 A NCAC 11'T.0305[LuJ contains alternatives where separations in 02T.0305(f) cannot be achieved.
**Stream classifications can be identified using the Division's NC Surface Water Classifications weblag"e
> If noncompliance with 02T.0305(f) or (L). see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ®Yes [-]No ❑ NIA
Y Seethe Division's draft separation requirements for situations where separation cannot be meet
D No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ® Yes ❑ No ❑ NIA
This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project require coverage/authorization under a 404 Nationwide or ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
Information can be obtained from the 401 & Buffer Permitting Brarrcls
5. Does project comply with 15A NCAC 62T_ 105 c 6 (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0105 c 6 , directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per I SA NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
® Yes ❑ No ❑ N,A
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-ntonths and inspections
documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Puma Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Desi n Criteria latest version as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Arwroval of the request is required prior to submittal of the Fast Track Aprilication and supwortinLy documents.
2. Professional Engineer's Certification:
i, ANDREW HODGE, PE attest that this application for
(Professional Engineer's name from Application Item III.1.)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.613, 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.
North Carolina Professional Engineer's seal, signature, and date:
X!J1ii± K01P1
3. Applicant's Certification per 15A NCAC 02T .0106(b):
ICHANDRA C. FARMER, PE; PUBLIC UTILITY DIRECTOR attest that this application for
(Signature Authority's name & title from Application Item 1.3.)
has been reviewed by me and is accurate and complete to the best of my knowledge. 1 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 141�-215.6A and 143-215.63, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: Date:
FORM: FTA 04-16 Page 5 of 5

State of North Carolina
DWR
Division of Water Resources
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting AIlocation: Johnston County
Project Name for which flow is being requested: Mason Park Phase 3
More titan one FTSE may be required for a single project if lire owner of file WWTP is not responsible far all pturrp
stations along the route of the proposed wastervaterflow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Central Johnston County Regional WW Facility _
b. WWTP Facility Permit #: NC 030716
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
f Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
All Jloips are in MGD
�1
2.2294
5.841
0.00744
8.0779
61.5% actual, 88.6% paper
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)
Design
Pump
Pump
Average
Station
Station
Firm
Daily Flow**
(Name or
Permit
Capacity, "
(Firm / pf),
Number)
No.
MGD
MGD
Josephine
28867
3.3840
1.3536
LandfillUri
_
20340
1.9296
1.6718
(B)
(C)
(D)=(B+C)
(E)=(A-D)
Obligated,
Approx.
Not Yet
Total Current
Current
Tributary
Flow Plus
Avg. Daily
Daily Flow,
Obligated
Available
Flow, MGD
MGD
Flow
Capacity***
0.6789
0.4848
1.1636
0.1900
0.8359
0.6614
1.4972
0.1746
* 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): Josephine WWPS
Downstream Permit Number: WQ0029967
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Chandra C. Farmer, P.E. certify to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the receiving
wastewater treatment facility and that the flow from this project is not anticipated to cause any capacity
related sanitary sewer overflows or overburden any downstream pump station en route to the receiving
treatment plant under normal circumstances, given the implementation of the planned improvements
identified in the planning assessment where applicable. This analysis has been performed in accordance
with local established policies and procedures using the best available data. This certification applies to
those items listed above in Sections I and II plus all attached planning assessment addendums for which I
am the responsible party. Signature of this form certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
Title of Signing Ojfkial
Page 2 of 6
FTSE 10-18

_0 00 WAr��Q�
N6chael F. Easley, Governor
rr� y_ WidBam G. Ross Jr., Secretary
j G North Carolina Department of Environment and Natural Resources
Alan W. K*neK P.E., Director
DMsion of Water Quality
May 18, 2005
Timothy Broome, PE, Director of Infrastructure and Engineering
Johnston County Public Utilities
PO Box 2263
Smithfield, NC 27577
Subject: Johnston County
Residential Flow Reduction Approval
Johnston County
Dear Mr. Broome:
On February 22, 2005, the Division of Water Quality received a flow reduction request for
residences in Johnston County. The letter requests an allowable flow rate of 80 GPD per residential
bedroom based on the evaluated data for three similar existing subdivisions.
The water use data provided between November 2003 and October 2004 with daily readings
taken during November 2004 was analyzed by central office and regional office staff with additional
information requested. Based upon this data and the County response to our additional information
requests, the Division hereby approves the use of 80 GIRD per residential bedroom, with a minimum
of 160 gpd for one and two bedroom units in all applicable non -discharge permit applications.
Flow shall be incremented by 801gpd for each bedroom above two.. Regardless of the ad tasted
downstream of any new sewer extension or service connections . A permit modification and fee is
required to apply this flow reduction to any existing permits where flows have been allocated.
If you have any questions or comments regarding this matter, please contact Marie Doklovic
at [phone] ext. 371.
Sincerely,
(Alan W. Klimek, P.E.
cc: Ken Schuster, Raleigh Regional Office
Barry Herzberg, Raleigh Regional Office
Mark McIntire, NPDES East Program
Kimberly Rineer, PE, Johnston County Public Utilities
PERCS Flow Reduction File
,��ne Pretreatment, Emergency Response and Cotes on Systems Uidt Internet httpJlh2o.enrncstate.uslndpu
lr [ Quolina 1617 Mail Service Center, Raleigh, NC 27699-1617 An Equal oppodunlly Action Employer
wmaal Telephone (919) M5083 Fax [phone]% recyr led/10% post -consumer paper

USGS MAP - MASON PARK PHASE 3
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ADAMS&HODGE
ENGINEERING,, PC
September 23, 2019
Ted Cashion
NC D WQ
3800 Barrett Dr
Raleigh, North Carolina 27609
Subject: Mason Park Phase 3
Johnston County
Please find attached one original and one copy of the following:
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1. Complete Fast Track Sewer System Extension Application (Form FTA 04-16), signed by
Engineer & County
2. $480.00 Check for Application Fee
3. Flow Tracking/Acceptance for Sewer Extension (Form FTSE 10-18)
4. USGS Quad Map showing approximate site location
5. Street Level Map
This application is for the addition of 2,814 LF of 8" gravity sewer to be installed through the proposed
Mason Park Phase 3 subdivision to serve 31 residential homes with a required flow of 7,440 GPD. The
line will cross Josephine Road approximately 3,100 feet north of the intersection with Cleveland Road in
Johnston County. There is an aerial crossi west of Josephine Road before tying in with the existing 8"
sanitary sewer (permit #WQ 028867). See attached plan & profile sheet for additional information.
If you have any questions or comments, please give me a call at 919-369-1938 or email to
andrewadamsandhodge.com.
Sincerely,
Andrew Hodge, PE
ADAMS & HODGE ENGINEERING, PC 9 314 East Main Street, Clayton, NC 27520 • 919-243-1332 0 Firm # C-4187