WQ0041386_Application_20200727

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Engineers and Soil Scientists
Agri -Waste Technology, Inc.
501 N. Salem Street, Suite 203
Apex, North Carolina 27502
919-859-0669
www.agriwaste.com
Erick Saunders
NC Department of Environmental Quality
Division of Water Resources
512 N. Salisbury Street
Raleigh, NC 27699
July 27, 2020
Subject: Permit No. WQ0041386
Permit Modification Request
2162 Brogden Rd. SFR
Single -Family Residence Wastewater Irrigation System
Granville County
Dear Mr. Saunders;
Please consider this letter as a Modification Request of the permit issued for the 2162
Brogden Road SFR wastewater irrigation system (Permit No. WQ0041386) from
"Construction Only" to "Construction and Operation". The North Carolina Department
of Transportation (NCDOT) approved a request for a Right of Way Encroachment
Agreement to transfer effluent beneath Brogden Road to serve this system on July 23,
2020 (NCDOT Approval E052-039-20-00188 attached).
Thank you for your assistance with this matter. If you have any further questions or
comments please feel free to contact me at 919-859-0669 or via email at
si onesgagriwaste. com.
Sincerely;
Scott Jones, P.E.
Project Engineer

Attachment 1.
NCDOT Encroachment Agreement Approval

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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Roy COOPER
GOVERNOR
July 23, 2020
Barry T. Street
210 Valley View Court
Creedmoor, NC 27522
COUNTY: Granville
SUBJECT: Encroachment Contract E052-039-20-00188
ROUTE(S): SR 1127 (Brogden Road)
Dear Applicant:
J. ERIC BOYETTE
SECRETARY
Attached for your files is a copy of Right of Way Encroachment Agreement, which has been properly
executed. This contract covers the following:
Private Sewer at 2162 Brogden Rd (Five 3" Steel Encasements)
This encroachment is approved subject to the Standard and Special Provisions which are attached to and
made a part of the Encroachment Contract.
Please refer to Encroachment Contract E052-039-20-00188 in all future correspondance with this office
about this project.
A PERFORMANCE AND INDEMNITY BOND IN THE VALUE OF S5,000 IS REQUIRED
AND SHALL BE POSTED WITH THE DISTRICT OFFICE PRIOR TO THE START OF WORK.
Sincerely,
DocuSigned by:
r
8A3F 6AF7 4E7...
John an or, P
District Engineer
for J.R. Hopkins, PE, Division Engineer
cc:
Attachment
Mailing Address:
NC DEPARTMENT OF TRANSPORTATION
DIVISION 5 —DISTRICT 2
815 STADIUM DRIVE
DURHAM, NC 27704
Telephone: [phone]
Fax: [phone]
Customer Service: 1-877-368-4968
Website: www.ncdot.gov
Location:
815 STADIUM DRIVE
DURHAM, NC 27704

Encroachment Special Provisions
The encroaching party's construction contractor must submit the NCDOT Workforce Safety Plan for
Encroachment Activities: COVID-19 form to the District Engineer prior to construction.
No lane of traffic shall be closed or restricted between the hours of 6:00 AM to 9:00 AM and 4:00 PM
to 7:00 PM Monday through Friday. Traffic shall be maintained at all times. Any violation of these
hours will result in termination of the encroachment agreement.
In addition, the Contractor shall not close or narrow a lane of traffic on all roads, detain and/or alter the
traffic flow on or during holidays, holiday weekends, special events, or any other time when traffic is
unusually heavy, including the following schedules:
A) For unexpected occurrence that creates unusually high traffic volumes, as directed by the Engineer.
B) For New Year's Day, between the hours of 9:00 a.m. December 31st and 4:00 p.m. January 2nd. If
New Year's Day is on a Friday, Saturday, Sunday or Monday, then until 9:00 p.m. the following
Tuesday.
C) For Easter, between the hours of 9:00 a.m. Thursday and 4:00 p.m. Monday.
D) For Memorial Day, between the hours of 9:00 a.m. Friday and 4:00 p.m. Tuesday.
E) For Independence Day, between the hours of 9:00 a.m. the day before Independence Day and 4:00
p.m. the day after Independence Day.
If Independence Day is on a Friday, Saturday, Sunday or Monday, then between the hours of 9:00 a.m.
the Thursday before Independence Day and 4:00 p.m. the Tuesday after Independence Day.
F) For Labor Day, between the hours of 9:00 a.m. Friday and 4:00 p.m. Tuesday.
G) For Thanksgiving Day, between the hours of 9:00 a.m. Tuesday and 4:00 p.m. Monday.
H) For Christmas, between the hours of 9:00 a.m. the Friday before the week of Christmas Day and
4:00 p.m. the following Tuesday after the week of Christmas Day.
Holidays and holiday weekends shall include New Year's, Easter, Memorial Day, Independence Day,
Labor Day, Thanksgiving, and Christmas. The Contractor shall schedule his work so that lane closures
will not be required during these periods, unless otherwise directed by the Engineer.
A $5,000.00 Performance and Indemnity Bond shall be executed and posted with the District Engineer
at 815 Stadium Drive, Durham, NC 27704, prior to beginning any work on the right-of-way. When
construction of the required roadway improvements/ utility installation are completed for one (1) year,
upon written request by the Encroacher to the District Engineer, a final inspection and review will be
conducted by NCDOT, and if all work is found to be satisfactory, NCDOT will issue a release of the
bond.
All crossings of state roads shall be by bore only.
Where any underground utility is installed in the right-of-way and is not ferrous material, locating tape
or detection wire shall be installed with the utility.
E052-039-20-00188 Page 2 of 7

Pavement cuts made to expose existing utilities shall be 2 feet by 2 feet or less, and out of the wheel
path as much as possible. Pavement cuts shall be repaired the same day they are made with a minimum
of 10-inches of Asphalt Concrete Base Course Type B25.00 and 2.0-inches of Asphalt Concrete
Surface Course Type S9.5C after proper backfilling has been achieved. If an asphalt patch cannot be
accomplished the same day due to material availability or time restrictions, the cut shall be completely
filled to the surface with ABC stone or Flowable Fill per NCDOT's Standards and Specifications. Once
the cut is filled, a minimum 3/4-inch steel plate shall be placed and pinned to prevent moving. Plates
shall be designed large enough to span a minimum of 1-foot on all sides on the pavement cut. The
proper asphalt repair shall be completed as soon as conditions allow. Alternatively, the Department
recommends coring the pavement to expose existing utilities. The core shall be no larger than 18" and
should be outside of the wheel path whenever possible. Vacuum excavation shall be utilized to expose
underground utilities. Pavement cores shall be repaired within the same working day. The pavement
core shall be retained and reused to fill the core hole. The excavation shall be backfilled and
compacted with select material to the bottom of the existing pavement structure or as indicated on the
manufacturer's specifications. The retained core shall be placed in the hole and secured with a
waterproof, mechanical joint. All materials must be listed on the NCDOT Approved Products List. If
the pavement core is damaged and cannot be re -used, the core may be replaced with plant mix asphalt.
The asphalt patch shall match the thickness of the existing asphalt or four inches, whichever is greater.
Crossing of SR1127 shall be by bore only with encasement extending from right-of-way line to right-of-
way line. Adjust separation as needed to prevent material loss/voids during the installation.
Seeding and mulching shall be performed in accordance with section 1660 of The North Carolina
Department of Transportation Standard Specifications for Roads and Structures. Application rates per
acre shall be as follows:
Dolomitic Limestone -------------------
4000lbs.
Fertilizer 10-20- 20----------------------- 500 lbs.
Bermuda Grass ----------------------------- 35 lbs.
KY 31 Tall Fescue ------------------------- 75 lbs.
Encroacher shall be responsible for positive flow of the ditch line and/or curb and gutter.
10. Prior to commencement of construction, a preconstruction conference shall be held with all contractors
associated with the construction in attendance. Contact Jason Watson or Ed Shiplett at [phone]
to schedule this meeting.
11. In occurrence with this agreement, if at any time required by NCDOT, facilities approved by this
agreement shall be removed and/ or relocated at the expense of the encroaching party. However, this
shall be limited to those facilities actually installed within the NCDOT right of way. Facilities that are a
part of this installation but are located outside of the NCDOT right of way which require removal and/
or relocation by NCDOT shall be removed and/ or relocated at the expense of NCDOT.
E052-039-20-00188 Page 3 of 7

Encroachment Standard Provisions
An executed copy of this encroachment agreement and approved plan(s) stamped by NCDOT will be
onsite and available for inspection by NCDOT personnel while construction is in progress. NCDOT
reserves the right to stop all work unless evidence of approval can be shown.
This encroachment agreement only covers work within NCDOT Right -of -Way. The encroacher is
responsible for verifying all right of way. NCDOT does not guarantee the right of way on this road. If
the right of way was not obtained by the fee simple method, it is the responsibility of the encroacher to
obtain permission from the underlying property owner(s)when a utility installation is by a private entity
as defined in NCDOT's Utility Policy Manual. When road widening or construction will occur that will
be turned over to NCDOT for maintenance, then permission from underlying property owners does not
apply.
Encroacher shall be responsible for obtaining all necessary permanent and/or temporary construction,
drainage, utility and/or sight distance easements. All Right of Way and easements necessary for
construction and maintenance shall be dedicated to NCDOT with proof of dedication furnished to the
District Engineer prior to beginning work.
3. NCDOT reserves the right to revise, restrict, suspend and/or void this encroachment agreement if the
execution and/or operation of said permit is found to be a hazard to the traveling public.
4. This approved Encroachment Agreement must start construction within one year of approval date.
Notify the District Engineer's Office at [phone] or at 815 Stadium Drive, Durham, NC 27704,
prior to beginning any work within the right-of-way.
5. All materials and construction shall be in accordance with the latest version of the NCDOT standards
and specifications, including but not limited to, the NCDOT Standard Specifications for Roads and
Structures, the NCDOT Roadway Standards Drawings, and NCDOT Policies and Procedures for
Accommodating Utilities on Highway Rights of Way.
6. The Encroacher shall notify all adjacent property owners and businesses a minimum of 2 weeks prior to
beginning work. Public notification may be required as directed by the District Engineer.
7. Any changes noted in red on the plans shall be incorporated into and made part of the approved permit.
8. The District Engineer's Office shall be notified at least 48 hours prior to the beginning of work at (919)
220-4750.
9. All personnel shall wear NCDOT approved Class 2 - Level 2 orange safety vests or similar apparel with
same standards.
10. The encroacher shall provide traffic control devices, lane closures, road closures, positive protection
and/or any other warning or positive protection devices necessary for the safety of road users during
construction and any subsequent maintenance. This shall be performed in conformance with the latest
NCDOT Roadway Standard Drawings and Standard Specifications for Roads and Structures and
Amendments or Supplements thereof. When there is no guidance provided in the Roadway Standard
Drawings or Specifications, comply with the Manual on Uniform Traffic Control Devices for Streets
and Highways and Amendments or Supplements thereof. No work shall be performed in the Right of
Way unless this requirement is satisfied. NCDOT reserves the right to require a written traffic control
plan for encroachment operations.
E052-039-20-00188 Page 4 of 7

11. Pedestrian movements shall be maintained at all times during this project. Any pedestrian barricades
and/or detours shall conform to NCDOT, MUTCD, and ADA Standards. Contact the Local
Municipality prior to any sidewalk disturbance.
12. Two-way traffic shall be maintained at all times, unless otherwise approved, in advance, by NCDOT
and with signed, and approved, detours which are to be maintained by the encroacher.
13. All portable or stationary Work Zone Signing shall use Type VII, VIII, or IX fluorescent orange
retroreflective sheeting or better without adhesive backing for roll -up or composite portable work zone
signs. Signs and sign stands assemblies must meet or exceed the requirements of the NCHRP 350 for
Work Zone Category II Devices.
14. WORK ZONE TRAFFIC CONTROL QUALIFICATIONS AND TRAINING PROGRAM
All personnel performing any activity inside the highway right of way are required to be familiar with
the NCDOT Maintenance / Utility Traffic Control Guidelines (MUTCG). No specific training course or
test is required for qualification in the Maintenance /Utility Traffic Control Guidelines (MUTCG).
All flagging, spotting, or operating Automated Flagger Assist Devices (AFAD) inside the highway right
of way requires qualified and trained Work Zone Flaggers. Training for this certification is provided by
NCDOT approved training resources and by private entities that have been pre -approved to train
themselves.
All personnel in charge of overseeing work zone Temporary Traffic Control operations and installations
inside the highway right of way are required to be qualified and trained Work Zone Supervisors.
Training for this certification is provided by NCDOT approved training resources.
For questions and/or additional information regarding this training program please refer to our web site
at https:Hcomect.ncdot.gov/projects/WZTC/Pages/Trabiing.aspx or call J.S. (Steve) Kite, PE at (919)
814-4937 or [e-mail] or Roger Garrett at [phone] or [e-mail], both with
the NCDOT Work Zone Traffic Control Section.
15. Work shall not be performed on both sides of the road simultaneously within the same area.
16. Ingress and egress shall be maintained to all businesses and dwellings at all times. The encroacher shall
maintain clear sight distance for vehicles utilizing driveway connections during construction and any
future maintenance activities.
17. During non -working hours, equipment shall be parked outside of the NCDOT right-of-way. If an offsitc
option is not available, any equipment parked inside of the right-of-way shall be parked as close to the
right of way line as possible and be properly barricaded if any equipment obstruction is within the Clear
Recovery Area. No parking or material storage shall be allowed along the shoulders of any NCDOT
roadway.
18. Any existing driveways, pavement, sidewalk, curb and gutter, drainage structures, pavement striping,
reflective pavement markers, signs, shoulders, or guardrail that is damaged during construction shall be
repaired to their original condition. Any traffic signs moved shall be reinstalled as soon as possible to
meet NCDOT specifications.
19. If any pavement failures occur along any state maintained roadway impacted by this encroachment, the
existing pavement will be repaired with material approved by the Division of Highways and to a
strength equivalent to the existing pavement.
E052-039-20-00188 Page 5 of 7

20. The encroaching party shall comply with all applicable local, state and federal environmental
regulations, and shall obtain all necessary state and federal environmental permits, including but not
limited to, those related to sediment control, storm water, wetland, streams, endangered species, and
historical sites.
21. When surface area in excess of one acre will be disturbed, the Encroacher shall submit a Sediment and
Erosion Control Plan which has been approved by the appropriate regulatory agency or authority prior
to beginning any work on the Right of Way. Failure to provide this information shall be grounds for
suspension of operations.
22. All erosion control devices and measures shall be constructed, installed, maintained, and removed by
the Encroacher in accordance with all applicable Federal, State, and Local laws, regulations,
ordinances, and policies. Proper maintenance of erosion control measures is required during
construction, prior to and after each event of inclement weather, or as required due to safety concerns or
loss of sedimentation.
23. The applicant is responsible for identifying project impacts to waters of the United States (wetlands,
intermittent streams, perennial streams and ponds) and regulated riparian buffers located within the
NCDOT Right of Way. The discharge of dredged or fill material into waters of the United States
requires authorization from the United States Army Corps of Engineers (USACE) and certification from
the North Carolina Division of Water Quality (NCDWQ). Impacts to the regulated riparian buffer
require authorization from the NCDWQ. The applicant is required to obtain pertinent permits or
certification from these regulatory agencies if construction of the project impacts waters of the United
States or regulated riparian buffers within the NCDOT Right of Way. Additional information can be
obtained by contacting the USACE or NCDWQ.
24. The applicant is responsible for avoiding impacts to federally protected species during project
construction. Bald eagle, Michaux's sumac, smooth coneflower, dwarf wedge mussel, harperella, red -
cockaded woodpecker and tar spinymussel are federally protected species that have been identified
within NCDOT right-of-way in Durham, Person, Granville, Wake, Franklin, Vance, and Warren
counties. Additional information can be obtained by contacting the North Carolina Natural Heritage
Program or the United States Fish and Wildlife Services.
25. Existing drainage patterns shall be maintained at all times throughout the proposed construction. The
encroacher shall keep the roadway clean of dirt and debris at all times throughout the duration of the
project. Excavated material shall not be placed on the roadway at any time. Any drainage structure
disturbed or damaged shall be repaired/replaced to its original condition at the discretion of the District
Engineer.
26. The contractor shall not begin the construction until after the traffic control and erosion control devices
have been installed to the satisfaction of the District Engineer.
27. Owner/Agent shall have site inspected and approved by the County Maintenance Engineer/ District
Office prior to seeding. Failure to do so will jeopardize the acceptance of this project.
28. If there are any existing traffic signals, signal equipment, or NCDOT signs in the area of proposed
work, you shall contact Ron Garrett at [phone], in Durham, prior to beginning any work on
State Right of Way. All traffic signal or detection cables must be located prior to excavation. All
signal work and traffic signs shall be coordinated with the Division Traffic Engineer. Costs to relocate,
replace, or repair NCDOT signs, signals, or associated equipment shall be the responsibility of the
Encroacher.
E052-039-20-00188 Page 6 of 7

29. It shall be the responsibility of the Encroacher to determine the location of utilities within the
encroachment area prior to beginning work. The encroacher shall be responsible for notifying all utility
owners and providing protection and safeguards to prevent damage or interruption to existing facilities
and maintain accessibility to existing utilities. The encroacher shall be responsible for facilitating the
adjustment and/or relocation of all utilities in conflict with the proposed work.
30. Trenching, bore pits and/or other excavations shall not be left open or unsafe overnight. The Contractor
shall comply with all OSHA requirements and provide a competent person on site to supervise
excavation at all times.
31. It is the responsibility of the encroaching party to make sufficient investigation outside state maintained
right of way and to perform the required work outside the right of way to ensure positive drainage so as
not to be detrimental to private properties downstream.
32. Excavated areas adjacent to pavement having more than a 2 inch drop shall be made safe with a 6:1 or
flatter slope and shall be designated by appropriate delineation during periods of construction inactivity,
including, but not limited to, night and weekend hours.
33. The construction engineering, inspection, and supervision will be furnished by the
Developer/Encroacher and staffing of same will be adequate to ensure sampling, testing, inspection,
quality control, etc. is performed to the Department's satisfaction. Private engineering firms must be on
the Department's preapproved consultant list.
34. The encroacher is responsible for any claim for damages brought by any property owner by reason of
the installation.
35. If any work is proposed within a municipal limit, the encroaching party shall give notice to the
municipality prior to beginning work.
36. This encroachment does not authorize any work or access within any railroad right-of-way. The
encroacher shall obtain approval from the appropriate railroad prior to any work, including traffic
control.
37. Prior to construction, right-of-way monuments shall be referenced with offsets, by a Professional Land
Surveyor, and if disturbed during construction, shall be reset to their original position after construction.
38. Written notification of the completion of the encroachment will be given to Jason Watson, Assistant
District Engineer, Division of Highways, 815 Stadium Drive, Durham, NC 27704. Once the final
inspection has been completed and the project meets our specs, Construction Approval will be granted.
E052-039-20-00188 Page 7 of 7

E052-039-20-00188
Workforce Safety Plan CDVID 19 NCDOT Encroachment IDa
WORKFORCE SAFETY PLAN
FOR ENCROACHMENT ACTIVITIES: COVI D-19
EFFORTS THE N.C. TRANSPORTATION INOUSTRY 15 TAKING TO 5TOP THE SPREAD OF CDVID-19
The North Carolina Department of Transportation (NCDOT) and their partners expect all parties involved in
the delivery of transportation projects to abide by the guidelines issued from the Centers for Disease
Control and Prevention (CDC) and the North Carolina Department of Health and Human Services (NCDHHS).
Response to CDVID-19 is rapidly evolving; new information and guidelines may be issued from the CDC,
NCDHHS, or other state or federal agencies. NCOOT and their partners should review the current CDC and
NCO HHS guidance, including the resources listed at the end of this document, for up-to-date information
on how to respond to CDVID-19. Additional guidelines may be issued by state or federal agencies that
should be followed in addition to the guidance included in this document.
Though certain Americans with Disabilities Act (ADA) requirements have been relaxed in response to the
pandemic, employers must still maintain all information about employee illness as a confidential medical
record in compliance with the ADA. If an employee is suspected of having or tests positive for CDVID-19, it
is essential that management keep the identity of the employee and details re fated to the employee's
health confidential.
Below are precautions required by NCDOT and from encroaching parties and their contractors performing
construction within NCDOT Rights of Way. The term employee refers to any person on a job site within
NCDOT right of way for the purpose of constructing or inspecting the work related to Construction of a
facility under an approved encroachment agreement and where that employee may or may not be under
employment by or under contract to NCDOT.
[ Flu' II�H [��',TJ ��?E►i �ii
■ If an employee has not yet reported to work and develops any CDVID-19 symptoms (i.e. fever,
coughing, or shortness of breath) — STAY HOME and immediately:
* Cali a health care provider
o Self -Isolate
o Communicate with your supervisor
a Remain calm and follow all instructions from your health care provider
• Employees who appear to have acute respiratory illness symptoms (i.e. cough, shortness of breath)
upon arrival to work, or become sick during the day, should be separated from others and sent
home immediately. The potentially affected employees should immediately follow the steps
outlined above, which includes immediately contacting a health care provider.
■ Should an employee show symptoms of acute respiratory illness or be diagnosed with CDVID-19, all
other employees who have worked in close proximity to the affected employee during the last 14
Updated: All ]/2A7a Page 1

Workforce Safety Plan: COVID•19
NCDOT Encroachment IDk: E052-039-20-00188
days and all encroachment points of contact indicated at the end of this plan should be notified of
potential exposure to the disease without identifying the affected employee.
• Consideration should be given to employees at "High Risk" of severe illness from COVID-19, who,
per NCDHHS, include employees:
o Over 65 years of age, OR
o With underlying health conditions including heart disease, lung disease, or diabetes, OR
o With weakened immune system
• "High Risk" Employees should be given the opportunity to discuss alternate work
arrangements/duties with their employer or take leave according to their company policies.
• For guidance on confirmed positive tests for COVID-19, refer to the most recent version of the
"COVID-19 Guidance for Employees on Encroachment Job Sites within NCOOT Right of Way"
located on last page of this plan,
PERSONAL HYGIENE
• Clean hands often by washing with soap and water for 20 seconds. If soap and water are not
available and hands are not visibly dirty, an alcohol -based hand sanitizer that contains 60%-95%
alcohol may be used,
• Avoid touching your eyes, nose, mouth, or other parts of your face.
• Do not breathe, cough, or sneeze on another person or into the open air. Employees should cover
their noses and mouth with a tissue when coughing or sneezing (or an elbow or shoulder if no
tissue is available).
• A facemask for covering nose and mouth is encouraged on the job site.
• Appropriate gloves are encouraged white performing functions of the job.
CLEANING/DISINFECTING
• Wash stations and/or hand sanitizer are encouraged on each project site.
• Appropriate cleaning staff should clean frequently touched surfaces and objects with disinfectants
at a minimum of once per day.
o Off ice/buildinrts: doorknobs, light switches, phones, computers/keyboards, copy machines,
elevator buttons, toilets, faucets, sinks, countertops, paper towel dispensers, desktops,
handrails, folders, vending machines, counters, tables, cabinets/knobs, etc.
o Shop Yard/lobsite: vehicle/equipment door handles, keys, gear shifts, steering
wheel/operator controls and levers, fuel pump dispensers, touch points on machinery, etc.
o Electronic equipmer}_t: cell phones, computers, keyboards, etc.
• Appropriate cleaning staff should sanitize/disinfect facilities and work areas after persons
suspected/confirmed to have COVID-19 have been in the facility or work area.
Updoted:411112020 Page 2

Workforce Safety Plan: COVID-19
GENERAL
EO52-039-20-00188
NCDOT Encroachment ION: _
o It is recommended to close off access to areas used by the ill persons and wait as long as
practical, 24 hours If possible, before beginning cleaning and disinfection to minimize
potential for exposure to respiratory droplets. Open outside doors and windows to increase
air circulation In the area if possible.
o Appropriate cleaning staff should clean and disinfect all areas used by the ill persons,
focusing especially on frequently touched surfaces,
• Increase communication measures between all parties regarding schedule, daily activities, etc. to
reduce/minimize worker exposure In accordance with but not limited to the requirements below.
• Minimize on -site personnel such as subcontractors, work crews, QC personnel, and inspection staff
to those required for that day's activities. If work is postponed or cancelled, immediately notify
appropriate parties.
• Practice "Social Distancing" whenever feasible. Social Distancing is designed to limit the spread of a
disease by reducing the opportunities for close contact between people. All personnel have the
responsibility to remind each other to stay 6 feet or more apart. Examples of Social Distancing
include:
o Reducing face-to-face exposure by using conference calls and video conferencing
■ If an In -person meeting is absolutely required and cannot be rescheduled or
attended remotely, the meeting is limited to a maximum of 10 people while
maintaining Social Distancing of 6 feet or more.
o Avoiding unnecessary travel
• Do not congregate at lunch or breaks. Bringing your lunch is encouraged.
■ No communal coolers or drink stations are allowed. Supervisors should confirm with employees
prior to beginning work for appropriate hydration and nutrition availability to employees for the
duration of the employee's shift and without direct contact with others on the job site.
• First line of communication should be by phone, rather than in -person.
• Do not shake hands.
• Do not share (Pads, tablets, pens, or clipboards for signing or any other purpose. Take pictures as
proof of attendance at meetings.
• Sharing of Personal Protective Equipment (PPE) is strictly prohibited.
• Vehicles, equipment, and tools
o Limit the number of people riding in a vehicle together.
o Wipe down and disinfect vehicles after each trip.
o As much as possible, do not share tools or equipment. If a tool or piece of equipment must
be shared, the parts of it that are touched should be sanitized between uses.
Updated: 411112020 Page 3

E052-039-20-00188
Workforce Safety Plan COVID-19 NCDOT Encroachment IDA:
RETURN TO WORK
• The following criteria must be followed for an employee who is tested for Covid-19, or asked to
self -quarantine by health officials, or has contact with another employee with a positive test result
to return to work:
c, at least a 14-day quarantine, OR
o release by a health care provider.
• In accordance with CDC guidance, the following criteria must be followed for an employee with a
positive_ test result to return to work:
o at least 14 days from positive test notification; AND
o at least 3 days (72 hours) have passed since recovery defined as resolution of fever without
the use of fever -reducing medications and improvement in respiratory symptoms (e.g.,
cough, shortness of breath); AND
at least 7 days have passed since symptoms first appeared.
NCDOT may require certification of fitness to work from a health care provider_
ADDITIONAL. RESOURCES
NCDOT and their partners should review the CDC and NCDHHS resources fisted below for up-to-date
information on how to respond to COVID-19. Additional guidelines may be issued by state or federal
agencies that should be followed in addition to the guidelines included in this document.
• NCDHHS COVID-19 Resources:
o https://www.ncdhhs.gov/divisions/public-health/coronavirus-disease-2019-covid-19-
res onse-north-Carolina
• NCOSHR Communicable Disease Emergency Policy
o htt s: oshr.nc. ov olicies-forms work lace -wellness communicable-disease-emer enc
• OSHA Guidance on Preparing Workplaces for COVID-19
o https://www osha.eov/Publications/OSHA3990.pdf
• CDC COVID-19 Resources:
o https://www.cdc.pov/coronavirus/2019-ncov/index.html
AGREEMENT
The encroaching party shall adhere to the requirements of this plan in order to continue work under their
approved encroachment agreement. Violations to this plan could result in the violating entity not being
allowed to continue work or all work ceasing as determined by the NCDOT District Engineer or Resident
Engineer.
PROJECT POINTS OF CONTACT
Updated: 4/11/2020 Page 4

Workforce Safety Plan: COVID-19
MCDot Encroachment ID97 E052-039-20-00188
MOOT DocuSigned by:
Syr
Name: John Sandor, PE�;��
F3b'7C�75A4F7..
Phone M 919-220-4750
Encroaching Party (Primary Contact)
Marne:
r ",V JT� I C 7L
Phone #: 7-c 6", 11 9 y17
Primary Contractor to Encroaching Party
(Point of Contact)
Name:
Prone #:
Updated 411112020 Page 5

COYib-19 Guidance for Employees on Encroachment Job sates within NCbOT RiSM al' Way
Rebbons'hip to
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CONTACT GROUP
What PROJECT SITE Personae!
Confb red
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What YOU Should Do
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Removed from
Contzct
NCDOT District Engineer/Resident Engineer nottfrts Encroaching Partes primary posit of contaa and Contractor Pwnt d
NC OOT employee / agent tests
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Joint Workforce Safety Play: C04 {b-Lg rage E

Engineers and Soil Scientists
Agri -Waste Technology, Inc_
501 N. Salem Street, Suite 203
Apex, North Carolina 27502
919-859-0669
www.agriwaste.com
Dane Barber
Assistant District Engineer
Division 5, District 2 Office
North Carolina Department of Transportation
Subject: Revision To
July 2, 2020
NCDOT Right of Way Encroachment Agreement Application
Barry Street Property
2162 Brogden Road, Creedmor, NC 27522
Granville County
Encroachment ID E052-039-20-00188
Dear Mr. Barber;
Thank you for your comments regarding the application for an NCDOT Right of Way
Encroachment Agreement at Brogden Road (Encroachment ID E052-039-20-00188). A
total of five (5) 1.5" Sch. 40 PVC pipes will be bored beneath Brogden Road. These
utilities will run between the septic treatment system located at the proposed residence
and the proposed dripfield located across Brogden Road. Per your comments, the
attached plans have been updated to reflect an encasement for the PVC pipes extending
the entire width of the Right of Way. The 1.5" PVC pipes will each be encased in an
individual 3" steel sleeve (5 sleeves total). The attached agreement document has also
been updated to reflect these proposed changes.
Thank you for your assistance with this application. If you have any further questions or
comments please feel free to contact me at 919-859-0669 or via email at
si onesgagriwaste. com.
Sincerely;
Scott Jones, P.E.
Project Engineer
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045605
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ROUTE SR 1127 PROJECT Street Property WWTS
DEPARTMENT OF TRANSPORTATION
-AND-
Barry T. Street
210 Valley View Ct., Creedmoor, NC 27522
THIS AGREEMENT, made and entered into this 23 day of
the
of Transportation, party of the first part; and Barry T. Street
STATE OF NORTH CAROLINA
COUNTY OF Granville
RIGHT OF WAY ENCROACHMENT AGREEMENT
PRIMARY AND SECONDARY HIGHWAYS
E052-039-20-00188
July 20 20 by and between the Department
party of the second part,
WITNESSETH
THAT WHEREAS, the party of the second part desires to encroach on the right of way of the public road designated as
Route(s) SR 1127 located at 2162 Brogden Road, Creedmor, NC, 27522
(Map No. 088602987210)
with the construction and/or erection of: Five solid 1.5" Schedule 40 PVC pipelines designed to convey treated effluent, each
encased in individual 3" steel sleeves beneath Brogden Rd (total of 5 steel sleeves).
WHEREAS, it is to the material advantage of the party of the second part to effect this encroachment, and the party of
the first part in the exercise of authority conferred upon it by statute, is willing to permit the encroachment within the limits of the
right of way as indicated, subject to the conditions of this agreement;
NOW, THEREFORE, IT IS AGREED that the party of the first part hereby grants to the party of the second part the right
and privilege to make this encroachment as shown on attached plan sheet(s), specifications and special provisions which are
made a part hereof upon the following conditions, to wit:
That the installation, operation, and maintenance of the above described facility will be accomplished in accordance with the party of
the first part's latest POLICIES AND PROCEDURES FOR ACCOMMODATING UTILITIES ON HIGHWAY RIGHTS -OF -WAY, and such
revisions and amendments thereto as may be in effect at the date of this agreement. Information as to these policies and procedures
may be obtained from the Division Engineer or State Utility Agent of the party of the first part.
That the said party of the second part binds and obligates himself to install and maintain the encroaching facility in such safe and
proper condition that it will not interfere with or endanger travel upon said highway, nor obstruct nor interfere with the proper maintenance
thereof, to reimburse the party of the first part for the cost incurred for any repairs or maintenance to its roadways and structures
necessary due to the installation and existence of the facilities of the party of the second part, and if at any time the party of the first part
shall require the removal of or changes in the location of the said facilities, that the said party of the second part binds himself, his
successors and assigns, to promptly remove or alter the said facilities, in order to conform to the said requirement, without any cost to the
party of the first part.
That the party of the second part agrees to provide during construction and any subsequent maintenance proper signs, signal lights,
flagmen and other warning devices for the protection of traffic in conformance with the latest Manual on Uniform Traffic Control Devices
for Streets and Highways and Amendments or Supplements thereto. Information as to the above rules and regulations maybe obtained
from the Division Engineer of the party of the first part.
That the party of the second part hereby agrees to indemnify and save harmless the party of the first part from all damages and
claims for damage that may arise by reason of the installation and maintenance of this encroachment.
That the party of the second part agrees to restore all areas disturbed during installation and maintenance to the satisfaction of the
Division Engineer of the party of the first part. The party of the second part agrees to exercise every reasonable precaution during
construction and maintenance to prevent eroding of soil, silting or pollution of rivers, streams, lakes, reservoirs, other water
impoundments, ground surfaces or other property, or pollution of the air. There shall be compliance with applicable rules and regulations
of the North Carolina Division of Environmental Management, North Carolina Sedimentation Control Commission, and with ordinances
and regulations of various counties, municipalities and other official agencies relating to pollution prevention and control. When any
installation or maintenance operation disturbs the ground surface and existing ground cover, the party of the second part agrees to
remove and replace the sod or otherwise reestablish the grass cover to meet the satisfaction of the Division Engineer of the party of the
first part.
That the party of the second part agrees to assume the actual cost of any inspection of the work considered to be necessary by the
Division Engineer of the party of the first part.
That the party of the second part agrees to have available at the construction site, at all times during construction, a copy of this
agreement showing evidence of approval by the party of the first part. The party of the first part reserves the right to stop all work unless
evidence of approval can be shown.
Provided the work contained in this agreement is being performed on a completed highway open to traffic, the party of the second part
agrees to give written notice to the Division Engineer of the party of the first part when all work contained herein has been completed.
Unless specifically requested by the party of the first part, written notice of completion of work on highway projects under construction will
not be required.
That in the case of noncompliance with the terms of this agreement by the party of the second part, the party of the first part reserves
the right to stop all work until the facility has been brought into compliance or removed from the right of way at no cost to the party of the
first part.
That it is agreed by both parties that this agreement shall become void if actual construction of the work contemplated herein is not
begun within one (1) year from the date of authorization by the party of the first part unless written waiver is secured by the party of the
second part from the party of the first part.
During the performance of this contract, the second party, for itself, its assignees and successors in interest (hereinafter referred to as
the "contractor"), agrees as follows:
a. Compliance with Regulations: The contractor shall comply with the Regulations relative to nondiscrimination in Federally -
assisted programs of the U. S. Department of Transportation, Title 49, Code of Federal Regulations, Part 21, as they may be
amended from time to time, (hereinafter referred to as the Regulations), which are herein incorporated by reference and
made a part of this contract.
b. Nondiscrimination: The contractor, with regard to the work performed by it during the contract, shall not discriminate on the
FORM RM/ 16.1 (Rev. July 1, 1977)

leases d Nollimant. 1 he wnlnxior shrl nal partk;yrale elthlM' directly tx Indirectly In Iha dlnarfminotlon prohlhllarl try Socllon
VA of Ilse Ruq�daians, Including employment prncllooe when the conlrscl coven n program @at follh In Appendix n of the
Roguleflms.
a Svlcltnllans fo; Slrbar�l[ncls.lncked[nnPracy�5rmenle of MetadeL+ and [alap�ep{: In aA sdicOntbne dlharby cornpelltiva
bldd'ng or nog rilallon mado by Illecatlredor lorwurk lobe performM under s subcontnct, Inducting procul'OnW x of materiels
of bases of equipment, arch palnnual subcorrbacior ot supplier shellbo notified by the mitractor of Ole contracicra dillgrakx a
undo this eantred and the Ragulollons relative to nondlscrirNnslhxr tin the grounds of race, cola, or rudi n ll orlgln-
d_ Infamradlon and RNpt;. The wnlrador shnl plovdo NI inlormMlon end reports roqulred by the Ragulatbno, Or dlrxhvns
Issued prreuml thereto. and shaapormk access la He hooks, records, accounts, other sources of information, and Its face%Ins
as may be determined by the Doprrimenl of Transportation or the Federal Highway Asdmktlelrollan to ho pertinent to ascarlaln
Cornnlarlae wRh suds RegldaUexts err dvoutives, Where any InformeUon required of neon radar Is In Ilia exduslve pessossfOn of
another who fails Or terlraes to romial this information, the conlraclof shell so corhry to the Depadmant of lnnsportadon, or Ihn
Fadenl WghWay Achlinlatretion As appropnnta, and shrill set forth whorl efforts It has made to Obtain iha inforrnulbn.
c. Serinkinns for honcompLMco In the event d Ihm cmtrarloes noncromploneo with Iho nondlacflminatlen proNelons of Ihls
cantrad, Iha Department of Transportallon shall Impose such contract srndlons es II or the Fed" Highway Administration may
dap.rmehe in be appropriate, lneAuding, but not "led to,
(1) withholding of payments to the conlrador under the contract until the contractor complex. Ondfor
(2) cancellation, lerminsllon of suspension of the contract, In whole or In parl.
I. In2yp4=ion of ptovlebnq: Thu contractor Frail include the provistona ofparagraphs'o' through In every eunconlract.
Including procurements of materials and leases of eg0manl, unless exempt by tho Regulaliefes, of directNes Issued pursuant
lhoralo. rho contractor shall lake such action with respect to any subcontract or procurement as the Department Of
Transportation or the Federal Highway Adminlstrntion may direct as a means or enforcing such provisions Including sanctions for
rtoncomplanae. Provided, however, that, in eta event a conlreclor bocomos Involved In, or Is threatened with, likgallw will a
snhatintractor or suppler as a resell of such direction, the contractor may request the Department of Tran sport ollon to enter into
Slates to Into
such fdigailon to proud the Interests or the Stalo, and, In addllon, the conlreefor may request the United enter
such ligation to protect the Interests of the United Stales,
RNV (161) : Party of the Second Part celli€ies that this agreement IS true and accurate copy of the form
R= (161) Incorporating all revisions to date.
IN WITNESS WHEREOF, each of the parties to this agreement has caused the same to be executed the day and
year first above written.
DEPARTMENT OF TRANSPORTATION
DocuSigned by:
BY; John Sandor, PE, District Engineer
�\ �\
For: DIVISION ENGINEER
ATT ST OR WITNESSi
A8A3F36AF75A4F7...
Laura Street Barry T. Street
210 Valley View Ct., Creedmoor, NC 27522
Second Party
INSTRUCTION i
When the applicant is a corporation or a mun',dpalty, this agreement must have the corporato seat and he attested by the corporation
anuelary or by the empowered city official, unless a walver of cerporalo seal and aasslallon by the saaelary or by the empowered City
ofrirlal is on foe In the Raleigh office of Ihn Manager of Right of Way. In the space pro"ded In this agreement for exemlurn, the name Of the
connotation or munioipAty shall be typnd above the name, and [Ills of all persons signbg the agreement should be typed dlrecW bolo,, Indr
ai,onalure.
When the oppbcan is not a corpaafim, lhPn his signalura must be witnessed by one person. The address should be Included in this
agreement rand the names of all persons signing the agyeemnnl should be typed drWy below In& signature.
INS egreament must be accompany, In the form of an altaament, by plans or drawings showing Ins rdkywtng appllcalubu Information:
1. All roadways and ramps.
2, Right of way tines and whore applicable, the conlyd of access Enos.
3. Localkn or the eidsuag andlor propusedencroachment
4. Length, size and type of encroachment
5. Molhod of h6lolfbtion.
6, Dlmenslarts shaving IN distance from the encroachment to edge Of pavemenl, shoulders, etc.
7. Location by highway survey slaikat number. It station number cannot be obtained, IOCWIon should be shown by dlslanrn
from serve Identifiable paint. such as a bridge, road. Intersection, etc. (-to assist In preparation of the encroacfunanl plan,
the Department's roadway plans may be seen at the varlets Kg1i Division Offices, or at the Raleigh office.)
g_ Oralnage sbuclufos or bridges If affected try encroachment (show verEcal and horizontal dimensions Irom encroachment In
neaeul earl Or slfuclurej.
g, tAuthod of attachment to drainage structures or hMges.
10. Manhoe design.
11. on underground uthlicb, the depth of bury under an traveled lanes, shoulders, ditches, sfdewat m, etc.
12. Length, sizoand type of ence3Drrlont whero required.
13. On underground Gos sings. notatlon as to method of crossing - bating and jacking, open cut, ale.
14. Location of vents.
(g:Nr,R&jtLgUl
1. Any nueehnsant to a hrldga or other drainage structure muss be approved by the Head of Structure Design In Raleigh prior
to subrr9eslon of enrroac'hmenl agreement to the DbAslon Englixior.
2. Al crossings should be as near as possible normal to the cenlofbne of the highway.
3. Minimum veNcaldearancas of overhead wires and cables above at roadways must conform to clearances out out In the
National Flactdc Safely Code.
4. Cornarwhents sod emond from ditch Ens to dauh Ilne in cut sections and 5' beyond too of elopes In rill secllons.
6. AN vents shmyJ be extendud to the right of way Eno or as othervrtso ruquk4d by the Deportment,
a. NI pipe entasomento w le matarlal and strength shop muel iha standards and spocfncallons of iha Deptelmunl.
7. Any special provisions or aparlhcatlons os to Iha parformmce of Ulo work or the method of construction that maybe
riWired by tho Daptylnionl must he shwrn on a separate shoo) sllnched to nncrowhinw[ agra:menl prcMdad that Ouch
Information curnd be shown en pins w drawings.
a. The Department's Division FltgInaer should he given ndldo by the applicant poly to eduat starting of Insiafiallan included In
Ihk agreemonL

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FIly4L DESIGN
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N.T.S.
R211 C-ET7 De -'it
deneral Notes:
1. All materials and construction shall be in accordance with NCDOT standards and
specifications.
2. All encasements shall extend entire right of way (60' minimum)-
3. All pipe encasements as to material and strength shall meet the standards and
specifications of the Department (see "Materials" Section below).
4. The Department's Division Engineer should be given notice by the applicant prior to
actual starting of installation included included in this design/agreement.
5. The grade of the top of pipe or casing shall provide the following minimum bury:
•Crossing Under Roadways — 3 feet from pavement surface
•Crossing Under Ditches — 2 feet from ditch line
-Other Areas of ROW — 3 feet from finished grade
Materials and Specifications (per W1101 Standard Specifications);
1. Use steel pipe meeting an ASTM specification With the minimum yield strength of
35,00D psi_ Use pipe that is circular in shape and straight in length_
2_ Welded steel pipe shall meet ASTM A139 for the grade of pipe called for in the
plans_
3. Steel encasement pipe to be installed using dry bore and/or jack method.
4. Install carrier pipes through casing using spacers or insulators to support the carrier
pipes. Place spacers at intervals sufficient to support the carrier pipes Without
sagging.
5_ Install spacers sized to raise the carrier pipe bells above the encasement pipe invert_
6_ Stagger bells within carrier pipe as needed_
7_ Seal ends of casing With concrete, brick, or other approved materials_
B. Ensure drainage of encasement by leaving a 1—inch diameter Weep hole in the seal
of the lower end of the encasement.
Site Plan Requirements-
1. All roadways and ramps (see WW-2a).
2. Right of way lines (see WW-20/2b) and where applicable, the control of access lines_
(n/o)-
3. Location of the existing (n/a) and/or proposed encroachment (see WW-20/21b).
4_ Length, size and type of encroachment (see WW-2b and detail above),
5. Method of Installation: Jack and Bore. Boring to be installed per NCDOT specifications
(Standard Specifications Section 1550).
6. Dimensions showing the distance from the encroachment to edge of pavement,
shoulders, etc. (see WW-2b and detail above).
7. Location by highway survey station number (none obtained), If station number
cannot be obtained, location should be shown by distance from some identifiable
point, such as a bridge, road, intersection, etc, (see WW-2o/2b for distance to
property corner).
8. Drainage structures or bridges if affected by encroachment. Show vertical and
horizontal dimensions from encroachment to nearest part of structure (n/a).
9. Method of attachment to drainage structures or bridges (n/a).
10- Manhole design (n/o)-
11. On underground utilities, the depth of bury under all traveled lanes, shoulders,
ditches, sidewalks, etc. (see detail above)
12. Length, size and type of encasement Where required (see WW-2b and detail above).
13. On underground crossings, notation as to method of crossing — boring and jacking,
open cut, etc. (see method of installation notes above).
14- Location of vents (n/o)-
Engineers end Soil Scientists
AgrFWaste Technology, Inc.
'01 N. Salem &reet, Stite 203
Apex, North Carolina 27502
919 859 0669
_ agriw ste com
Street Property
WWTS
IrfDrmrnmn:
It T Street
3800 V� ley Rid Drive
Apex, NCD 27539
(7D4) 692-9417
princel-66®6DtmD1l,com
y InfermDliom
2162 Bragden Rud
Creedmoor, NC 27522
Granville County
Mep No, OBBM87210
IM ESSIDNLI EN6NEER SEAL
This documentwas
originally signed and
sealed by Scott P. Jones,
NC PE #045605
on July 2, 2020. This
medium shall not be
considered a signed and
sealed document.
FINAL DESIGN
NOT RELEASED FOR CONSTRUCTION
REY. NEED 611E DEseel Idf
1,) 7/2/202D Mee,'e•itoxmeiWol
SHEET TfILE
Details
DRAWN CREATED ON;
S. Jones 3/16/202D
RELEASED BY: RELEASED ON:
SHEET NAME.
WW-2c