WQ0041295_Application (FTSE)_20191113

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FAST -TRACK SEWER PERMiII
APPLICATION NOV --12019
VVQHQS
MOORESV Ilir REGIONALOFFIGE
SUTTON PLACE SEWER EXTENSION
TOWN OF CAJAH'S MOUNTAIN, NORTH CAROLINA
33EeeivEt�iNcoewwrnwF
WGROS
MOORESVILLE REGIONAL OFFICE
OCTOBER 2019
PREPARED BY:
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THE WOOTEN COMPANY
1430-B Old Lenoir Road
Hickory, NC28601
License No. F-0115
NOV U6 2019
Water Quality Rogioaal Operations
Asheville Regional Office

1430 B Old Lenoir Road NW
Hickory, NC 2B801
828,322,5533
fax 828.322,5242
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October 31, 2019
Water Qua,
Mr, On Trivia gti17 Y /por 8[iGpg
N.C. Division of Water Quality
FxtJhUrL3I Office
Mooresville Regional Office
610 E. Center Avenue
Mooresville, NC 28115
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RE: Application for Pump Station, Gravity Sewer and Force Main for:
Sutton Place Sewer Line Extension
Town of Cajah's Mountain, NC
TWC Project No.: 2808-W
Mr. Trivia:
On behalf of the Town of Cajah's Mountain, we are sending you the following
documents for your review and approval for the above -referenced project:
• One (1) original and one (1) copy of the FTA 04-16 permit application w/
appendices;
o A — Cover Letter
o B — Application Form (FTA 04-16)
o C — Application Fee
o D — Project Narrative
o E — Flow Tracking/Acceptance Form (FTSE 08-13)
o F — Site Map
o G—Existing Permit — (N/A — Not Included)
o H — Power Reliability Plan — ( N/A — Not Included)
o I —Certificate of Public Convenience/Necessity (N/A — Not
Included)
0 J Operational Agreements (N/A —Not Included)
• One (1) check for $480.00 made payable to NCDENR;
The project includes a new duplex pump station, approximately'7,800 linear feet of
8-inch gravity sewer line and approximately 5,600 linear feet of 4-inch force main
sewer line to serve the Sutton Place Subdivision area in the Town of Cajah's
Mountain. The collected sewer will be conveyed to the City of Lenoir's WWTP
for treatment. This sewer line extension was designed to service the proposed
existing sewer basin and the limited potential for future growth within the
surrounding sewer basin.

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JTRANSMITTAL
THE WOOTEN COMPANY
ENGINEERING PLANNING PIiCPITECiUHE
1430 B Old Lenoir Road NW Hickory NC 28601
828.322.6533 fax [phone]
DATE: 10/31/2019
JOB NO. 2808-W
To:
ATTENTION: Ori Trivia
N.C. Department of Environment & Natural Resources
Division of Water Quality
Application for Gravity Sewers, Pump Station
Mooresville Regional Office
& Force Mains for the
610 E. Center Avenue
Sutton Place Sewer Extension
Mooresville, NC 28115
Re: Sutton Place Sewer Extension
Town of Ca'ah's Mountain, NC
WE ARE SENDING: ® Enclosed ❑ Under separate cover via the following items:
❑ Shop Drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications
❑ Copy of Letter ❑ Change Order ❑ Other
COPIES
DATE
DESCRIPTION
Enclosed for your review is the Fast -Track Application (FTA 04-16) for
I Original
l0/31/2019
Pump Station, Gravity Sewer, and Force Main along with supporting
and 1 Copy
documentation as indicated in Section A, Cover Letter. Also included is
the application fee in the amount of $480.00
Please let us know if you have any questions or if further information is
needed.
Thank You.
THESE ARE TRANSMITTED as checked below
® For Review/Approval ❑ Reviewed ❑ Revise and resubmit
❑ For Your Use ❑ Rejected ❑ Submit _copies for distribution
❑ As Requested ❑ Corrected ❑ Return corrected print
❑ For Review and comment ❑ Non -Refundable Bid Deposit of $25.00 is required.
❑ FORBIDS DUE 1131/12 ❑ PRINTS RETURNED AFTER LOAN TO US
SIGNED:
Copy to Project d19,It8A H2O19
V
V'1/�il:;r G2t,;�iify Regional OPefations
Asheville Regiofi,,il Office
PE

Sutton Place Sewer Extension
Town of Cajah's Mountain, NC
Page 2 of 2
I trust the above information is sufficient for your review; however, if you should
have any questions or require additional information, please do not hesitate to
contact us.
Best Regards,
THE WOOTEN COMP Y
A. Slade Ha in, P.E
Enclosures: As noted above
cc: Randy Feierabend, Town Manager, Town of Cajah's Mountain
TWC File

State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T.0300— FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
'Division of Water Resources ®® q�y �� ETA 04-16 & SUPPORTING DOCUMENTATION
wo
Application Number: �YqA 44 (m be completed by DWR) a7ECE'IV6f5/IVCIANI'lloWk
All items must be completed or the application will be returned Moo _ Y 7C19
1. APPLICANT INFORMATION: Wbitios
I. Applicant's name: Town of Cajah's Mountain (company, municipality, FICA, utility, etc.) al00WSVII-LL=9EGc)K1AL OFFICE
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: Randy Feierabend per 15A NCAC 02T .0106(b)
Title: Town Manager
4. Applicant's mailing address: 1800 Connelly Springs Road -
City: Lenoir State' NC Zip: 28645-_ ��I 4
5. Applicant's contact information:0)
Phone number. [phone] Email Address: townnrer r ca)'airmtn.com \u(,)v 6 Za,�
If. PROJECT INFORMATION:
Water ql�
I. Project name: Sutton Place Sewer Extension RNgI011di Opelabon8
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project ,a RO(��OpSI omiC'
If a modification, provide the existing permit number: W000 and issued date:
If new construction but part of master plan, provide the existing permit number: W000
3. County where project is located: Caldwell
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.841774° Longitude:-81.542909°
5. Parcel ID (if applicable): 2746392885
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION: -
1. Professional Engineer: A. Slade Harvin PE License Number: NC 032587
Firm: The Wooten Company
Mailing address: 1430-B Old Lenoir Road NW
City: Hickory State: NC Zip: 28601-
Phone number: [phone] Email Address: shuvin(@,thewootencommy.com
IV. WASTEWATER TREATMENT FACILITY(WWTF) INFORMATION:
1. Facility Name: Gunpowder Creek Wasetwater Treatment Plant Permit Number: NCO023736
Owner Name: City of Lenoir
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: inch
_ System Wide Collection System Permit Numbers) (if applicable): WQCS
Owner Name(s):
FORM: FTA 04-16 Page I of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate f`Public Convenience and Necessity been attached?
❑ Yes ❑No A
2. If the Applicant is a Developer of lots to be sold, has a Develouer': O or tional A reement FORM: DEV been attached?
❑ Yes ❑No ® A
3. Ifthe Applicant is a H /P art O '' A� C h np •rat onal Aereement (FORM' HOAI been attached?
❑ Yes ❑No
®d7/A
IL//
4. O''igtkn of wastewater. (check all that
apply):
,Residential Owned
El Retail (stores, centers, malls)
❑ Car Wash
Residential Leased
❑ Retail with food preparation/service
❑ Hotel and/or Motels
❑ School / preschool / day care
❑ Medical / dental / veterinary facilities
❑ Swimming Pool /Clubhouse
❑ Food and drink facilities
❑ Church
❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories
❑ Nursing Home
❑ Other (Explain in Attachment)
5. Nature of wastewater: 100% Domestic/Commercial %Commercial
Industrial (See 15A NCAC 02T .0103(20))
"Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T 0114(t)? [:]yes ❑ No
D If yes, provide p f flow redaction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(D)
Daily Design Flow a,b
No. of Units
Flow
Residential (2&3 Bdrm) Houses
120 gal/Bdrtn
173
20,760 D
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
2 7760 PD
a See I SA NCAC 02T OI 140e) (d)(el(11 and (e)(2) 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-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0114] shall
be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
S. Wastewater generated by project: 20760.GPD (per 15A NCAC 02T.0114)
D Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: ETA 04-16 Page 2 of

VIL GRAVITY SEWER DESIGN CRITERIA (if Applicable) - 02T.0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
R
Length (feet) Material
7,800 PVC
➢ Section Il & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T.0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: Sutton Place Pump Station
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.837264' Longitude:-81.559131°
3. Design flow of the pump station: 0.037287 millions gallons per day Ginn capacity)
4. Operational point(s) of the pump(s): 108 gallons per minute at 192 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
4-inch
5,600
PVC
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(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- 15A NCAC 02T .03 05(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 — (028.0200 & 15A NCAC 02T.0305(t)):
1. Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (RI ® Yes ❑ No
➢ 15A NCAC 02T.0305 contains minimum separations that shall be provided for sewers stems:
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 11 impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
hi h 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 buildinR foundation
5 feet
Any basement
10 feet
Top sloe 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
➢ 15A NCAC 02T.0305(e) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications weboage
➢ If noncompliance with 02T 0305(t) or W see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No ❑ N/A
➢ See the Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .02007 ® Yes ❑ No ❑ N/A
➢ This would include Trout Buffered Streams per 15A NCAC 2B.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 Branch
5. Does project comply with 15A NCAC 02T 0105(c)(6) (additional permits/certificatiored? ® Yes ❑ No
Per 15A NCAC 02T.0105(e)(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 15A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ® No ❑ 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 permitter or its representative at least once every six -months and
inspections documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X.
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, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents
for review. Approval of the reauest is reunited Prior to submittal of the Fast Track Application and supporting
documents.
2. Professional Engineer's Certification:
I, W. ;5YAM pJ.gRJT.eJ attest that this application for
(Professional Engineer's time from Application Item Ill.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 desigp.
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 airy 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 par violation.
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
�/�a sn a c _nC attest that this application for
( 'gnature Authority's name & trda from Application Item L3.)
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 retuned 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
ttto exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: I \ Date: 10 ( z6 1
FORM: FTA 04-16 Page 5 of 5

Section C
Application Fee

TOWN OF CAJAHS MOUNTAIN
1800 CONNELLY SPRINGS RD.
LENOIR, NORTH CAROLINA 28645
PH(828)728-5053
7454
AuatCidaevs
66-30/531 @Qr msy�
10/18/2019
PAY
TO THE NC-DEQ $—480.00
ORDER OF
Four Hundred Eighty and 001100"'"""""""'""""'"'""""""""""""""""""""""""""".."""""""" DOLLARS 5
8
Pfl0VI510H FOR ME PAYMENT OF MIS WA. OR ORDER AMFORIBEEN NC-DEQ MADE ITHELOC LGOVERNUEYMAOE ETAGpNGpL CONTROL ORIZEO
By THE LOCAL GOVERNMENT BUDGET AN AL CONTROL ACT. p
MEMO AuixoxaEoslGxATURs
Sewer permit- Sutton Place Ext.
I'm 007454110 1: 0531003001:00755151.32140
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Section D
Project Narrative

k)0,o6W!Z15-
Project Narrative
for the
Sutton Place Sewer Line Extension
Town of Cajah's Mountain
Caldwell County, North Carolina
OCTOBER 2019
Prepared By:
pM1
1
1• , 1� _THEWOOTENCOMPANY
NOV 0 6 2019
Wator QHcI iiy Regional Oheraiione
Asheville Regional Office
1430-B Old Lenoir Road
Hickory, NC 28601
License No. F-0116
TWC Project No.: 2808-W

A. DESCRIPTION OF PROJECT
Location of Protect
The proposed Sutton Place Sewer Extension project is located in the Town of Cajah's Mountain within
Caldwell County. The majority of the work will take place within Town property, Town right-of-ways and
private utility easements. A vicinity map has been included, which shows the general project location in
Caldwell County.
Figure 1: Vicinity Map Overview
Sutton Place Sewer Extension
Cajah's Mountain, NC
October 2019

Figure 2: Vicinity Map Close-up
Sutton Place Sewer Extension
Cajah's Mountain, NC
October 2019

TYPE OF DEVELOPMENT
Pump Station — Gravity Line - Force Main Line
The Sutton Place Sewer Line Extension project for the Town of Cajah's Mountain will extend the
Town's wastewater collection system and increase wastewater capacity of the Town by providing
a means which will accommodate the current and future growth of the Town. The new
wastewater system will convey wastewater from the Sutton Place Subdivision to the City of
Lenoir's WWTP for treatment. This will provide a wastewater system that meets current
environment code and regulations. The scope of work includes, but is not limited to the
following:
• New duplex pump station w/standby generator
• Approximately 7,800 linear feet of 8-inch Gravity Sewer line
• Approximately 5,600 linear feet of 4-inch Force Main Sewer line
Improvements requiring permit approval will include the installation of new 4-inch force main
and 8-inch gravity sewer lines to convey wastewater to/from the new duplex pump station.
Calculations were performed to confirm the size of the pump station to be installed.
Treatment
Wastewater collected from Cajah's Mountain sewer collection system is currently conveyed
through an existing gravity collection and sewer force main network to the City of Lenoir's
W WTP. The current project will not include any improvements or direct impacts to the City of
Lenoir's existing wastewater facilities.
Sutton Place Sewer Extension
Cajah's Mountain, NC
October 2019

Section E
Flow Tracking/Acceptance Form
(FTSE 08-13)

w Q
State of North Carolina
`.'., b l ' Department of Environment and Natural Resources
' ? , " Division of Water Resources
DM51on of'Nat-r Resources Flow Tracking(Acceptance for Sewer Eitension Applications
(FTSE 08-13)
Project Applicant Name: Town of Cajah's Mountain
Project Name for which flow is being requested: Sutton Place Sewer Extension
More than one FTSE maybe requiredfor a single project ifthe owner ofthe WWTP is not responsible far all pump
stations along the route ofthe proposed wastewaterJlow.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a.
W WTP Facility Name: Gunpowder Creek W WTP
b.
W WTP Facility Permit #: NC0023736
All flows are in MGD
c.
W WTP facility's permitted flow
2.0
d.
Estimated obligated flow not yet tributary to the W WTP
0.0
e.
W WTP facility's actual avg. flow
1.373
f
Total flow for this specific request
0.020760'
g.
Total actual and obligated flows to the facility
1.393
It.
Percent of permitted flow used
69.6%
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 W WTP:
(A)
(B)
(C)
(D)=(B+C)
(E)-(A-D)
Design
Obligated,
Pump
Average Daily
Approx.
Not Yet
Total Current
Station
Firm Flow**
Canteen Avg.
Tributary
Flow Plus
(Name or
Capacity,* (Firm / pf),
Daily Flaw,
Daily Flow,
Obligated
Available
Number)
MGD MGD
MGD
MGD
Flow
Capacity***
'_—..'-..
Brandon
Road}lia
0.288 0.1152
0.0717
0.00
0.077
0.0435
-1
3
(D 0
_1
,),-
-
IT a
he 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 peakiug
factor (pi) not less than 2.5.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the W WTP where the Available Capacity is <0.
Page I of 6
FTSE 08-13

III. Certification Statement:
I Radford L. Thomas certify to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the
receiving wastewater treatment facility and that the flow from this project is not anticipated to
cause any capacity related sanitary sewer overflows or overburden any downstream pump station
en route to the receiving treatment plant under normal circumstances, given the implementation
of the planned improvements identified in the planning assessment where applicable. This
analysis has been performed in accordance with local established policies and procedures using
the best available data. This certification applies to those items listed above in Sections I and II
plus all attached planning assessment addendums for which I am the responsible party.
Signature of this form indicates acceptance of this wastewater flow.
Page 2 of 6
FTSE 08-13

Section F
Site Map

tjooayfrq
State of North Carolina
DW
Department of Environment and Natural Resources KOft
Division of Water Resources
Division of Water Resources Watershed Classification Attachment (WSCAS 01-15)
These instructions are to be used when completing form WSCAS for sewer extension projects.
Identifying stream classifications that are affected by the project is necessary:
To determine/confirm the minimum separation distance of sewer system components from
classified waters as specified in 15A NCAC 2T.0305(f)
To determine/confirm any applicable river basin rules that may affect sewer system components
If any portion of the sewer extension comes within 100 feet of any surface water (waterbody) or
wetland a completed form is required. Determine the names of surface waters within 100 feet of the
project or along the project route and utilize either of the below options to determine stream
classification:
Finding Stream Classifications (Map or List)
A map with designated streams and their associated classifications can be obtained at:
http•// cde ap arcgisco / pp / ebaoovie a /' d html7ld=6el25ad7628f494694e259c8Odd64265
• Find/select the waterbody and record the river basn(s), stream index number and classifications
applicable to the project on the form
or
A listing of stream classifications based on river basin can be obtained at:
http,//portal.ncdenr.org/web/wg/ps/csu/classifications (see left hand side of webpage)
• Select the river basin(s) (hydrological or alphabetically sorted) where your project is located
• Locate the name of the identified waterbody on the list for the selected basin
• For multiple listings of the same waterbody name in the report, select and verify the location
description. The term "source' in the description means the beginning of the waterbody segment
(most upstream point)
• Record the river basn(s), stream index number and classification applicable to the project on the
form
Submittal Instructions
Label any unnamed tributaries as "UT tostream name" as the waterbody name on form per 15A NCAC 02B
.0301(1). See page 2 for additional notes on unnamed streams.
Submit a color copy of a USGS Topographic Map to identify the project area and surface waters. Each map or
maps must show the location of the sewer system and include location identifiers where the system traverses
over or near waterbodies. The map should have location In's for each different waterbody and corresponding
classifications should be recorded.
^ Note that these instructions do not need to be submitted
2W9-1-
VUahir0,11a1it tZ(!giooalOperaions
Al ht) illo Rt)jon l O lec

Note on Unnamed Streams (i5A NCAC 02B.0301(i))
Any stream which is not named in the schedule of stream classifications carries the same classification
as that assigned to the stream segment to which it is tributary except:
• unnamed streams specifically described in the schedule of classifications;
• unnamed freshwaters tributary to tidal saltwaters will be classified "C";or
• after November 1, 1936, any newly created areas of tidal saltwater which are connected to Class
SA waters by approved dredging projects will be classified "SC" unless case -by -case
reclassification proceedings are conducted.
The following river basins have different policies for unnamed streams entering other states or for
specific areas of the basin:
HIWASSEE RIVER BASIN
Streams entering Georgia or Tennessee shall be classified
"C Tr."
LITTLE TENN RIVER BASIN AND SAVANNAH RIVER
Streams entering Georgia or Tennessee shall be classified
DRAINAGE AREA
"C Tr." Such streams in the Savannah River drainage area
entering South Carolina shall be classified "B Tr."
FRENCH BROAD RIVER BASIN
Streams entering Tennessee will be classified "B."
WATAUGA RIVER BASIN
Streams entering the State of Tennessee are classified
°C .
BROAD RIVER BASIN
Streams entering South Carolina are classified "C."
NEW RIVER BASIN
Streams entering the State of Tennessee are classified
.0 ..
CATAWBA RIVER BASIN
Streams entering South Carolina are classified "C."
YADKIN-PEE DEE RIVER BASIN
Streams entering Virginia are classified "C," and such
streams entering South Carolina are classified ,C.r,
LUMBER RIVER BASIN
Streams entering South Carolina are classified "C Sw."
ROANOKE RIVER BASIN
Streams entering Virginia are classified "C." Except that all
backwaters of John H. Kerr Reservoir and the North
Carolina portion of streams tributary thereto not
otherwise named or described shall carry the
classification "B," and all backwaters of Lake Gaston and
the North Carolina portion of streams tributary thereto
not otherwise named or described shall carry the
classification "C and B."
CHOWAN RIVER BASIN
Streams entering Virginia are classified "C."
TAR-PAMLICO RIVER BASIN
All drainage canals not noted in the schedule are
classified "C Sw," except the main drainage canals to
Pamlico Sound and its bays which shall be classified "SC."
PASQUOTANK RIVER BA5IN
All drainage canals not noted in the schedule are
classified "C."
**Note that these instructions do not need to be submitted**

p State of North Carolina
m®�tlDepatrintent of Environment and Natural Resources
DWRDivision of Water Resources
Division of Water Resources Watershed Classification Attachment (WSCAS 01-15)
Along with this form, submit a color copy of a USGS Topographic Map to Identify the project area and
waterbodies. Each map or maps must show the location of the sewer system and include location identifiers
where the system traverses over or near waterbodies. The map should have location ID's for each different
waterbody and corresponding classifications should be recorded.
Include the completed form and map portions with the permit application for submittal to the appropriate review
agency. A list of the Division's regional offices, their county coverage, and contact information can be obtained
from: htto //Portal.ncdenr.ora/web/wq/home/ro
Location ID
Name of Waterbody'
River
Basin
Waterbody
Index No.
Waterbody
Classification
1
Unnamed Tributary to Catawba
River
Catawba
11-(37)
WS-IV,B;CA
t If unnamed, indicate "unnamed tributary to X", where X Is the named waterbody to which the unnamed tributary joins.
I certify that as a Registered Professional Engineer in the State of
North Carolina that I have diligently followed the Division's
instructions for classifying waterbodies and that the above
classifications are inclusive of the stated project, complete and
correct to the best of my knowledge and belief.
PE Seal, Signature and Date

Section G
Existing Permit
(Not Applicable for this Project)

Section H
Power Reliability Plan
(Not Applicable for this Project)

Section I
Certificate of Public Convenience/Necessity
(Not Applicable for this Project)

Section J
Operational Agreements
(Not Applicable for this Project)