WQ0040650_Application (FTSE)_20200522

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: dL�Q70(uo be complcicd by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Town of Fuu uav-Varina (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: Jay T. Mevers. PE per 15A NCAC 02T .0I06(b)
Title: Public Utilities Director
4. Applicant's mailing address: 134 N. Main Street
City: Fuquay-Varina State: NC Zip: 27526-__
5. Applicant's contact information:
Phone number: (919) 567-391 I Email Address: jmeyersO fuctuay-varina.ore
II. PROJECT INFORMATION:
1. Project name: Trilogy Farms Pump Station for NCDOT U-5746 -Road Widenin +Tm rovements
2. Application/Project status: ❑ Proposed (New Permit) ® Existing Permit/Project
If a modification, provide the existing permit number: WQ0040650 and issued date: 0121 19 6" Force Main FM
W00041148 and issued date: 10?17r 19, 8" Gravity_sanitary sewer permitted previously (W00013912) 03.26'97.
If new construction but part of a master plan, provide the existing permit number: WQ00_
3. County where project is located: Wake
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.6636, Longitude:-78.7015
5. Parcel ID (if applicable):
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. ProfessionaI Engineer: Joe L. Lans ton Jr. PE License Number: 024128
Firm: HDR Engineering Inc. of the Carolinas
Mailing address: 555 Fayetteville Street Suite 900
City: Raleigh State: NC Zip: 27615-
Phone number: [phone] Email Address: 'oi e.langston Cet hdrinc.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Terrible Creek WWTP Permit Number: NOC 0066516
Owner Name: Town of Fuquay-Varina
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
L Permit Number(s): WQ112U Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Numbers if applicable): WQCS00193
Owner Name(s): Town of Fuquay_Varina
FORM- FTA W-16 pq„P t „r5

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 tFORM: DEV) been attached?
❑ Yes ❑No ®N. A
3. If the Applicant is a Home,Tro erty Owners' Association has an Operational Agreement FORM: HOA been attached'?
❑ Yes ❑No ®N; A
4. Origin of wastewater: (check all that apply):
® Residential Owned ® Retail (stores, centers, malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School i preschool / day care ❑ Medical dental veterinary facilities ❑ Swimming Pool 'Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
® Businesses ! offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater : % DomesticiCommercial _% Commercial
% Industrial (See 15A NCAC 02T .0103(20))
4Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .01.14(t)? ❑ Yes ®No
i if ves, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0I14(f))
Daily Design Flog °''
No. of Units
Flow
gal/
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., 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. 42A4).
b Per 15A NCAC 02T .0I 14(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.
8. Wastewater generated by project: 0 GPD (per 15A NCAC 02T .01 14)
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
® FIow has already been allocated in Permit Number: Gravity sanitary sewer permit number 0013912 (0126?97)
® Rehabilitation or replacement of existing sewer with no new flow expected
® Other (Explain): SanitarySewer and Force Main Relocation
POR NA • t=T A nd. t F
pine ? nf 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
541
DIP
8
414
PVC
C S
Section It & 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)
i 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 StationsiForce Main:
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: Trilogy Farm
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.669543" Longitude:-78.714366'
3. Design flow of the pump station: .072 millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 245 gallons per minute at 96 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
6
5880
SDR 21 PVC
6
314
CL 350 DIP
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(I ):
® Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(13)_
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 .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.
i 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.
_�"k . . ^A t r Pave 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T.0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T .0305 & N)
15A NCAC 01T_0305(f) contains minimum separations that shall be provided for sewer syslems:
® Yes ❑ No
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
24 inches
Water mains (vertical -water over sewer including in benched trenches)
18 inches
Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
"Any private or public water supply source, including any wells, WS-1 waters of Class I or
Class 11 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
i 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 web a e
i- If noncompliance with 02T.0305(f) or q), 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
i 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 0213.0200? ® Yes ❑ No ❑ MA
:- 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 Permittin Branch
5. 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 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.04021 "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
e If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and inspections
documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
cnn %A. r-r A nA 14 Paue 4 of 5

X. CERTIFICATIONS:
i. Does the submitted system comply with 15A N('AC 021', the Minimum Design Criteria for the Permitting of I'unto Stations
and_rorce Mains (latest version), and the Gravity Sewnintut f)esi �n r'teri (latest version) as applicable?
® Yes ❑ No
ICNo, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of lite request is required Prior to submittal -of the „Fast Track Application and supporting documents.
2. Professional Engineer's Certification;
1, _ Jt _ L_. 4-4 AV Ir. 3Td A) _ .J/4 - _ attest that this application for
(Professional Engineer's nat a from Application Item TrI.1.)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE - In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, represcntation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed S 10,000, as well as civil penalties up to $25,000 per violation.
North Carolina Professional Engineer's seal, signature, and dot
3. Applicant's Certification per 15A NCACC 02T ..0106(b):
I, _ � -Fr. ?o L,rr le$ t!, attest that this application for
(Signat a Au ority's name & title from Application Item I.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 sub;cct 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 pens".ties,
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 nc,t cnmplcted 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 1.43-215,613, 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 $25,000 per violation.
Signature:
ntrte; Z$ QPt e-o2 _
FORM: FTA 04-16 Page 6 of 5

WArFR
QG
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE 06-13)
Project Applicant Name: Town of Fuquay-Varina
Project Name for which flow is being requested: NCDOT U-5746 (US40IISRI010)
Uore than one PT5E may be required fo1- a single project if the owner of the IV I P7'P is not responsible for all prunp
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: Terrible Creek WWTP
b. WWTP Facility Permit #: NCO066516
All flows are in MGD
c. WWTP facility's permitted flow 3.000
d. Estimated obligated flow not yet tributary to the WWTP 0.855
c. WW,I"P facility's actual avg. flow 1.353
f. Total flow for this specific request 0.000
g. Total actual and obligated flows to the facility 2.208
h. Percent of permitted flow used 73.60%
❑. Complete this section for each pump station you are responsible for along the route of this
proposed wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A) (B) (C) (D)=(B+C) (E)=(A-D)
Design Obligated,
Pump Aver-ige Daily Approx. Not Yet Total Current
Station Firm Flow" Current Avg. Tributary Flow Plus
(Name or Capacity," (Firrr) p0, Daily Flow, Daily Flow, Obligated Available
Number) MGD MGD MGD MGD 1:[Ow Capacity***
Mills D*:as*ah-
0.504 0.202 0.144 0.057 0.201 0.001
i Mddlc
0.720 0.288 0.157 0.057 0.214 0.074
* 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.
Page 1 of 6
FTSE 06-13

Certification Statement:
I Jay T. Meyers, P.E., Public Utilities certify to the best of my knowledge that the addition of
Director
the volume of wastewater to be pennitted 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 1I
plus all attached planning assessment addendums for which I am the responsible party.
Signature of this form indicates acceptance of this wastewater flow.
Signature
Date
Page ? of 6
FTSF. 06-13

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02
hdrinc.corn
April 15, 2020
Raleigh Regional Office
Water Quality Section
1628 Mail Service Center
Raleigh, NC 27699-1628
NC ]Dept of Environmental Quality
MAY 2 2 2920
Raleigh Regional Office
Re: 15A NCAC 02T .0300 - Fast Track Sewer System Extension Application
U5746 Road Widening Project
Town of Fuquay-Varina - Relocation of 8" Gravity Sanitary Sewer Main and 6"
Force Main
To Whom It May Concern:
The U5746 Road Widening Project includes the proposed relocation of an 8" gravity
sanitary sewer and 6" force main near the intersection of Gelder Drive and US 401, owned
and maintained by the Town of Fuquay-Varina, North Carolina.
Due to the proposed U5746 road widening construction and improvements (i.e., the
placement of additional fill, potential conflict with an existing water main, potential conflicts
with new storm drainage infrastructure/dry utilities and/or conflict with new roadway
structural appurtenances approximately, approximately 955 LF of 8" gravity sanitary sewer
main and approximately 54 LF of 6" force main and associated appurtenances will need to
be relocated/installed.
The existing gravity sanitary sewer system and force main were previously permitted
through the State (NCDEQ). No changes to existing hydraulics should be effected by the
relocation of the aforementioned infrastructure and no additional flow is anticipated to be
generated from this project_
HDR Engineering, Inc, of the Carolinas (HDR) is submitting the following for NCDEQ's
review:
• Fast Track Sewer System Extension Application
• Modification Fee $480.00
• Original and Copy of Construction Drawings
• Original and Copy of Special Provisions (Specifications)
• Fast Track Sewer System Extension Application
555 Fayetteville Street Suite 900, Raleigh NC 27601-:303.1
T 919 985 8920 F 9 19. 232 66.12

Fast Track Sewer System Extension Application
U5746 Road Widening Project
April 15, 2020
Page 2
• Modification Fee $480.00
• Flow Tracking Acceptance Form
• Site Maps
• Available Existing Permits
Please let us know of any questions.
Sincerely,
HDR Engineering, Inc. of the Carolinas
Joe L. Langston, ,
Project Manager
Enclosures
cc: Jeremy Potter, HDR
Justin Hill, HDR

DWR
Division of Water Resources
N O (lob �;_U N10,0
F ! State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 - FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
INSTRUCTIONS FOR FOR I: FTA 04-16 & SUPPORTING DOCUMENTATION
This application is for sewer extensions involving gravity sewers, pump stations and force mains, or any combination that has been
certified by a professional engineer and the applicant that the project meets the requirements of 15A NCAC 02T and the Division's
Minimum Design Criteria and that plans, specifications and supporting documents have been prepared in accordance with, 15A
NCAC 02T, 15A NCAC 02T .0300, Division policies and good engineering practices.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design
documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans, design
calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimum design criteria. These
documents shall be available upon request by the Division.
..Y Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T.0303.
Projects not eligible for review via the fast track process (must be submitted for full technical review):
Projects that require an environmental assessment in accordance with 15A NCAC 1C .0100;
Projects that do not meet any part of the minimum design criteria (MDC) document;
Projects that involve a variance from the requirements of 15A NCAC 2T;
Pressure sewer systems utilizing septic tank -effluent pumps (STEPs) or simplex grinder pumps;
STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains);
Vacuum sewer systems.
General - When submitting an application, please use the following instructions as a checklist in order to ensure all required items
are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and
reduce the amount of requested additional information. Failure to submit all required items will necessitate additional
processing and review time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit
one original and one copy of the application and supporting documentation.
A. One Original and One Copy of Application and Supporting Documents
® Required unless otherwise noted
B. Cover Letter (Required for All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
Be specific as to the system type, number of homes served, flow allocation required, etc.
If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Major Modification Application Packages):
® Submit a check or money order in the amount of $480.00 dated within 90 days of application submittal.
Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track (Form: FTA 04-16) Application (Required for All Application Packages):
® Submit the completed and appropriately executed application.
If necessary for clarity or due to space restrictions, attachments to the application may be made.
❑ If the Applicant Type in Item 1.2 is a corporation or company, provide documentation it is registered for business with
the North Carolina Secretary of State.
❑ If the Applicant Type in Item 1.2 is a partnership or d/b:-a, enclose a copy of the certificate filed with the Register of
Deeds in the county of business.
❑ The Project Name in Item II.1 shall be consistent with the project name on the flow acceptance letters, agreements, etc.
® The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North
Carolina licensed Professional Engineer.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02_T.01.06(b).
Per 15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is
provided from a person who meets the criteria in 15A NCAC 02T .0106(b).
INSTRUCTIONS FOR FORM: ETA 04-16 & SUPPORTING DOCUMENTATION Pagel of 3

E. Flow Trucking/Acceptance Form (Form: FTSE 04-16) (If Applicable):
® Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility.
Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one
year prior to the application date.
i Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-
215.67(a).
i Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific FTSE.
F. Site Maps (All Application Packages):
® Submit an 8.5-inch x 1 l-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project
area and closest surface waters.
t.
Location of the project (gravity sewer, pump stations & force main)
Downstream connection points and permit number (if known) for the receiving sewer
® Include a street Ievel map (aerial) showing general project area so that Division staff can easily locate it in the field.
G. Existing Permit (All Modification Packages):
® Submit the most recently issued existing permit.
❑ Provide a list of any items within the permit the Applicant would like the Division to address during the permit
modification (i.e., permit description, flow allocation, treatment facility, etc.).
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T .0305 h 1 , submit documentation of power reliability for pumping stations.
This alternative is only available for average daily flows less than 15,000 gallons per day
i It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible
with the station. The Division will accept a Ietter signed by the applicant (see 15A NCAC 02T .0106(b)) or proposed
contractor, stating that "the portable power generation unit or portable, independently -powered pumping units, associated
appurtenances and personnel are available for distribution and operation of this pump 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. (Required at time of certification)
I. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per 15A NCAC 02T .0115(a)(1) provide the Certificate of Public Convenience and Necessity from the North Carolina
Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by
the sewer extension, or
❑ Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an
application for a franchise has been received and that the service area is contiguous to an existing franchised area or that
franchise approval is expected.
J. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold):
❑ HomefProperty Owners' Associations
❑ Per 15A NCAC 02T .0115(c), submit the properly executed Operational Agreement (FORM: HOA).
❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 15ANCAC 02T .0115(b), submit the properly executed Operational Agreement (FORM: DEV).
For moa-e information, visit the Division's collection systems website
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 2 of 3

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Quality Section
Swannanoa, North Carolina 28778
Clay, Graham, Haywood, Henderson, Jackson,
(828) 2964500
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section
Fayetteville, North Carolina 28301-5094
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[phone] Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabanrus, Catawba, Cleveland,
Water Quality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
Raleigh Regional Office
162E Mail Service Center
Chatham, Durham, Edgecombe, Franklin,
Water Quality Section
Raleigh, North Carolina 27699-1628
Granville, Halifax, Johnston, Lee, Nash,
(919) 7914200
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Warren, Wilson
943 Washington) Square Mall
Beaufort, Bertie, Camden, Chowan, Craven,
Washington Regional Office
Water Quality Section
Washington, North Carolina 27889
Curriluck, Dare, Gates, Greene, Hertford, Hyde,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section
Wilmington, North Carolina 28405
Hanover, Onslow, Pender
[phone]
(9 10) 350-2004 Fax
Winston-Salem Regional Office
450 W. Hanes Mill Road
Alamance, Alleghany, Ashe, Caswell, Davidson,
Water Quality Section
Suite 300
Davie, Forsyth, Guilford, Rockingham, Randolph,
Winston-Salem, North Carolina 27105
Stokes, Surry, Watauga, Wilkes, Yadkin
[phone]
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 3 of

Robinson, Jason
From: Jay T. Meyers, PE <[e-mail]>
Sent: Monday, July 13, 2020 3:36 PM
To: Langston, Joe; Robinson, Jason
Cc: Cashion, Ted; Hill, Justin
Subject: [External] Re: Sewer Extension Permit (Trilogy Farms P5 (U-5746 Widening)
OPPERZkExternal'emall. b7i notdlialinks or.oQen attachments unlessyou veri€y. Send affsuspicious email -as aria en&to.
r&gn6PamLTnc.P,oY
Agreed
Jay T. Meyers, PE I Public Utilities Director
Town of Fuquay-Varina
1415 Holland Road 1 Mailing Address: 134 N. Main St
Fuquay-Varina, NC 27526
'me ers fu ua-varina.or
919-567-3911
www.fuquay,-varina.ora
From: Langston, Joe <[e-mail]>
Sent: Monday, July 13, 2020 3:32 PM
To: 'Robinson, Jason' <[e-mail]>
Cc: Cashion, Ted <[e-mail]>; Hill, Justin <[e-mail]>; Jay T. Meyers, PE <jmeyers@fuquay-
varina.org>
Subject: Re: Sewer Extension Permit [Trilogy Farms PS (U-5746 Widening)
CAUTION: This email originated from outside of the organization. Do not click links or open attachments
unless you recognize the sender and know the content is safe.
agree that the force main length is decreased by 65LF and that there is 955 LF of sanitary sewer to be installed due to
the road widening project; Jay do you agree?
Thanks,
Joe
Joe L. Langston, Jr., PE', LEED AP
'AL, GA, NC, SC, TN TX VA
HDR
555 Fayetteville Street
Suite 900
Rveigh, NC 27601
D 919.985.8920 M 919.376-5510
Lae langslon(Whdrinc com

hdri nc. comlfol low -us
From: Robinson, Jason [mailto:[e-mail]]
Sent: Monday, July 13, 2020 1:54 PM
To: Langston, Joe <[e-mail]>
Cc: Cashion, Ted <[e-mail]>; Hill, Justin <[e-mail]>; [e-mail]
Subject: RE: Re: Sewer Extension Permit (Trilogy Farms PS (U-5746 Widening)
CAUTION: [EXTERNAL] This email originated from outside of the organization. Do not click links or open attachments
unless you recognize the sender and know the content is safe.
Hi Joe/Jay,
I want to make sure we've got this right. The modification to the Trilogy Farms Pump Station (U-5746 Widening) is
proposed to do the following:
This modification is to decrease the length of 6-inch force main from 6,259 to 6,194 linear feet, and add 955
linear feet of 8-inch gravity sewer due to an NCDOT Road Widening Project. The pump station will remain
unchanged at a 245-gallons per minute operational point.
Jason T. Robinson, P.E.
Raleigh Regional Office
Water Quality Regional Operations
NC Division of Water Resources, DEQ
919-791-4200
""Subscribe to Collection System & Sewer Permitting Updates—
E-mail correspondence to and from this address may bo subj_;ct to the North Coro6na Public Records Low and may be drsdosed to
third parties.
Based on the current guidance to minimize the spread of COVID-19, the Department of Environmental Quality has
adjusted operations to protect the health and safety of the staff and public. Many employees are working remotely or
are on staggered shifts. To accommodate these staffing changes, all DEQ office locations are limiting public access to
appointments only. Please check with the appropriate staff before visiting our offices, as we may be able to handle your
requests by phone or email. We appreciate your patience as we continue to serve the public during this challenging
time.
From: Langston, Joe[mailto:[e-mail]]
Sent: Wednesday, July 8, 2020 5:48 PM
To: Robinson, Jason <[e-mail]>
Cc: Cashion, Ted <[e-mail]>; Hill, Justin <[e-mail]>; [e-mail]
Subject: RE: [External] Re: Sewer Extension Permit
Erderoal-email. Do not click links or -open attachments unless you verify. Send all.susplcious email as an attachment to
+r "a .s , n1ov ,
Thanks!

Joe L. Langston, Jr., PE', LEED AP
'AL, GA, NC, SC. TN, TX, VA
HDR
555 Fayetteville Street
Suite 900
Raleigh, NC 27601
D 919.985.8920 M 919.376-5510
loe Ian stop hdrinc.com
hdrinc.comlfollow-us thdrinc.coml
From: Robinson, Jason [mailto:[e-mail]
Sent: Wednesday, July 8, 2020 4:29 PM
To: Langston, Joe <[e-mail]>
Cc: Cashion, Ted <ted.cashion ncdenr. ov>; Hill, Justin <[e-mail]>; 'me ers fu ua-varina.or
Subject: RE: [External] Re: Sewer Extension Permit
CAUTION: [EXTERNAL] This email originated from outside of the organization. Do not click links or open attachments
unless you recognize the sender and know the content is safe.
During these Covid-times, we'll accept this revised electronic version, and Jays already responded, so that's fine, unless
he has any issues.
------------
Jason T. Robinson, P.E.
Raleigh Regional Office
Water Quality Regional Operations
NC Division of Water Resources, DEQ
919-791-4200
"Subscribe to Collection System & Sewer Permitting Updates nam12.safelinks. rotection.outlook.com `*
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to
third parties.
Based on the current guidance to minimize the spread of COVID-19, the Department of Environmental Quality has
adjusted operations to protect the health and safety of the staff and public. Many employees are working remotely or
are on staggered shifts. To accommodate these staffing changes, all DEQ office locations are limiting public access to
appointments only. Please check with the appropriate staff before visiting our offices, as we may be able to handle your
requests by phone or email. We appreciate your patience as we continue to serve the public during this challenging
time.
From: Langston, Joe[ma ilto:Joe.Langston 0hdrinc.com]
Sent: Wednesday, July 8, 2020 3:06 PM
To: Robinson, Jason <'ason.t.robinson ncdenr. ov>
Cc: Cashion, Ted <[e-mail]>; Hill, Justin <Justin.HillPhdrinc.com>; [e-mail]
Subject: RE: [External] Re: Sewer Extension Permit
_ _
fikternal ehsafl� oo notllt;Fa.linlsar open attacitimeitts�uriless you verify. Send allsilsplciolis email as aniatta' �
.mer�t•to;
trUQrt.spamPnc.goy —

Please see attached; the "(of 8271)" was in advertently included from another permit.
Do we need to sign and seal Section X. or is the previous seal/signature and Jay's email approval sufficient?
Thanks for your help,
Joe
Joe L. Langston, Jr., PE' LEEOAP
'AL, GA, NC. 5C, TN. TX VA
HDR
555 Fayetteville Street
Suite 900
Rae gh, NC 27601
D 919.985.6920 M 919 376-5510
Doe Langston _.hdrinc corn
hdrinc.comifollow-us fhdrinc.coml fnami2.safelinks.orotection.outlook coml
From: Robinson, Jason[ma iIto: [e-mail]
Sent: Wednesday, July 8, 2020 12:39 PM
To: Jay T. Meyers, PE <imeyers(cDfuguay-varina.org>; Langston, Joe <Joe,[e-mail]>
Cc: Cashion, Ted <ted.cashion ncdenr. ov>; Hill, Justin <[e-mail]>
Subject: RE: [External] Re: Sewer Extension Permit
CAUTION: [EXTERNAL] This email originated from outside of the organization. Do not click links or open attachments
unless you recognize the sender and know the content is safe.
Just through a quick scan of the revised attached application, I noticed'the following:
1. What does "(of 8271)" mean on Item VII?
2. Item IX was not completed.
------------
Jason T. Robinson, P.E.
Raleigh Regional Office
Water Quality Regional Operations
NC Division of Water Resources, DEQ
919-791-4200
—Subscribe to Collection System_& Sewer Permitting Updates [nam12_safelinks.orotection.outlook.comI
rnaml 2.safelinks.protection.outlook.com]"
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Case and may be drsclosed tc
third parties.
Based on the current guidance to minimize the spread of COVID-19, the Department of Environmental Quality has
adjusted operations to protect the health and safety of the staff and public. Many employees are working remotely or
are on staggered shifts. To accommodate these staffing changes, all DEQ office locations are limiting public access to
appointments only. Please check with the appropriate staff before visiting our offices, as we may be able to handle your

requests by phone or email. We appreciate your patience as we continue to serve the public during this challenging
time.
From: Jay T. Meyers, PE [mailto:[e-mail]]
Sent: Wednesday, July 8, 2020 9:29 AM
To: Langston, Joe <[e-mail]>
Cc: Robinson, Jason <[e-mail]>; Cashion, Ted <ted.cashion@ncdenr;gov>; Hill, Justin
<[e-mail]>
Subject: [External] Re: Sewer Extension Permit
L%jUag E ternal-'emaiE' c6;ndfdlW10s dr bge- h affi@We-nts unless you verify. Send all call suspiclous email -as arkftiff&enf1w,
r rCs am P.aL.Za
I agree
0
.lay T. Meyers, PE [ Public Utilities Director
Town of Fuquay-Varina
1415 Holland Road 1 Mailing Address: 134 N. Main St
Fuquay-Varina, NC 27526
imevers a5fuouay-varina.ora
919-567-3911
www.fuouay-yarina.org [fuauav-varina.orgl[nam12.safelinks.protection.outlook.coml
jnam12.safelinks.orotection.outlook.coml
From: Langston, Joe <Joe.LangstonPhdrinc.com>
Sent: Wednesday, July 8, 2020 9:01 AM
To: Jay T. Meyers, PE 4me ers fu ua-varina.or >
Cc: 'Robinson, Jason' <'aI [e-mail]>; 'Cashion, Ted' <[e-mail]>; Hill, Justin
<Justin.Hili hdrinc.com>
Subject: FW: Sewer Extension Permit
CAUTION: This email originated from outside of the organization. Do not click links or open attachments
unless you recognize the sender and know the content is safe.
Jay -
Please see the attached and below in red. Please let us know if you agree.
Thanks,
Joe
Joe L. Langston, Jr., PE',LEEOAP
'AL, GA, NC, SC, TN, TX, VA
HDR
555 FayetteviVe Street
Suite 900

Raleigh, NC 27601
D 919.985.8920 M 919.376-5510
a oe.lanaston(cDhdrinc.com
hd-inc.comlfoliow-usjhdrinc.coml fnaml2 safelinks.orotection.outlook. coml lnaml2.safelinks orotection.outtook.com
From: Robinson, Jason
Sent: Friday, June 19, 2020 2:36 PN/l
To: joe.langston. -hdrinc.com; Jay T. Meyers, PE <iineversribrug uav-varina.or
Cc: Cashion, Ted <ted.cashion tt ncdenr.t?o%,>
Subject: Sewer Extension Permit
We are reviewing the application that was submitted for the modification to WQ0040650 due to the NCDOT U-
5746 road widening project and have the following questionstcomments:
1. This is a modification to an existing permit. The original permit is named the Trilogy Farms Pump Station. We
would prefer it to stay the same name. In the permit, we would explain that it's being modified due to the
NCDOT U-5746 Road widening project. Jay, are you alright with keeping the name of the original permit (Trilogy
Farms PS)?
2. When a permit is modified, it completely replaces the original permit. Therefore, the modified permit should
contain everything that was in the original permit that will remain in operation, any new lines (or lines being
relocated) and remove any lines that are being abandoned. It should also keep the pump station in it, if the
pump station will remain in operation.
a. Every effort should be made to determine the permit number for permit that included the gravity line,
as the Town should have a record of this. I've attached a list of all permits issued to F-V. If it's not
possible to determine what permit the gravity line was originally included in, then just the portion that is
being relocated will be included in the new modified permit (and therefore should be in the application,
which I think was done in the app that was submitted)
b. Please revise the permit application to include TOTAL length of forcemain that will be in operation (the
original permit had 6,250 LF of 6" FM). Also include the existing pump station in the application, if it is
to stay in operation.
c. The revised permit can be submitted via email, and we'll need Mr. Meyer's approval of the revisions
made to it.
.Jason T. Robinson, P.L.
R,tici-h Rcuionai Office
\Fitter Qualit\- Regional Operations
NC Division ol'%ater Resources, DEQ
9I 9-791-4200
"Subscribe to Collection S stem & Sewer Permitting Updates naml2.safelinks. rotection.outlook.com
fnaml2.safelinks. protection.outlook.coml fnaml2.safelinks.protection.oullook.coml"
E-mail corrt,,V),m:l!,rrre to and from this cuhlre.5s mal ihc- %Uhic'cI trr rlrc, forth Carolina 1'rrhhc lick ord% Lrr,i urid rxur hc- dt.sclowd hr
flrir'tilJcf�'!fc'c. '
Based on the current guidance to ininitnize the spread of COVID-19, the Department of Environmental Quality
has adjusted operations to protect the health and safety of the staff and public. Many employees are working
remotely or are on staggered shifts. To accommodate these staffing changes, all DEQ office locations are
limiting public access to appointments only. Please check with the appropriate staff before visiting our offices,

as we may be able to handle your requests by phone or email. We appreciate your patience as we continue to
serve the public during this challenging time.