WQ0038971_ROPermitFile_20200922

o-� E._��. a. ROY COOPER
.x`. - Governor
WILLIAM G. ROSS, JR.
n Acting Secretary
Water Resources
ENVIRONMENTAL QUALITY 'I
January 17, 2017
Ben Turnmire,Town Manager
Town of Rhodhiss
P.O. Box 40
Rhodhiss, NC, 28667-0400
Subject: Permit No. WQ0038971
Town of Rhodhiss
System-Wide Water and Sewer Improvements
Wastewater Collection System Extension Permit
Burke&Caldwell County
Dear Mr. Turnmire:
In accordance with your application received January 4, 2017, we are forwarding herewith Permit No.
WQ0038971 dated Issued January 17, 2017, to the Town of Rhodhiss (Permittee) for the construction
and operation upon certification of the subject wastewater collection system extension. This permit
shall be effective from the date of issuance until rescinded, and shall be subject to the conditions and
limitations as specified therein. This cover letter shall be considered a part of this permit and is
therefore incorporated therein by reference.
Please pay particular attention to the following conditions contained within this permit:
Condition 11.1: This permit shall not be automatically transferable; a request must be made and
approved.
Condition 11.4: Requires that the wastewater collection facilities be properly operated and maintained
in accordance with 15A NCAC 2T.0403 or any individual system-wide collection system
permit issued to the Permittee.
It shall be the responsibility of the Permittee to ensure that the as-constructed project meets the
appropriate design criteria and rules. Failure to comply may result in penalties in accordance with North
Carolina General Statute §143-215.6A through §143-215.6C, construction of additional or replacement
wastewater collection facilities, and/or referral of the North Carolina-licensed Professional Engineer to
the licensing board.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right
to request an adjudicatory hearing upon written request within 30 days following receipt of this permit.
This request must be in the form of a written petition, conforming to Chapter 150E of North Carolina
General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh,
NC 27699-6714. Unless such demands are made,this permit shall be final and binding.
2090 U.S.70 Highway,Swannanoa,NC 28778
Phone:[phone]\Internet:www.ncwaterguality.org
An Equal Opportunity\Affirmative Action Employer—Made in part by recycled paper

tl
Town of Rhodhiss
Permit No.WQ0038971 ,
If you need additional information concerning this matter, please contact Tim Heim at 82$ 296-4500 or
via e-mail at [e-mail].
Sincerely,
for S.Jay Zimmerman, P.G.
Director, Division of Water Resources
G. Landon Davidson, Regional Supervisor
Water Quality Regional Operations Section
Asheville Regional Office
Division of Water Resources, NCDEQ
1
cc: Benjamin B.Thomas, P.E.—West Consultants, PLLC(electronic copy)
Regional Office Files
Water Resources Central Files
PERCS(electronic copy)
- G:\WR\WQ\Burke\Collection Systems\Rhodhiss Collection System\WQ0038971 System Wide Water&Sewer Imp.docz
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Page 2 of 9

fU
Environmental
Quality
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations, permission is hereby granted to the
Town of Rhodhiss
Burke &Caldwell County
for the construction and operation of approximately 4,959 linear feet of 8-inch gravity sewer to serve
the Town of Rhodhiss collection system as part of the System-Wide Water and Sewer Improvements
project, and the discharge of zero additional gallons per day of collected domestic and commercial
wastewater into the Town of Rhodhiss's existing sewerage system, pursuant to the application received
January 4, 2017 and in conformity with 15A NCAC 2T; the Division's Gravity Sewer Minimum Design
Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast-
Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other
supporting data subsequently filed and approved by the Department of Environmental Quality and
considered a part of this permit. '
This permit shall be effective from the date of issuance until rescinded and shall be subject to the
specified conditions and limitations contained therein.
for S.Jay Zimmerman, P.G.
Director, Division of Water Resources
By Authority of The Environmental Management Commission
Permit Number: WQ0038971
Permit Issued: January 17,2017
Page 3 of 9

SUPPLEMENT TO PERMIT COVER SHEET
Town of Rhodhiss is hereby authorized to:
Construct, and then operate upon certification the aforementioned wastewater collection extension.
The sewage and wastewater collected by this system shall be treated in the WWTF Owner Wastewater
Treatment Facility in accordance with Permit Number NC0040797.
Permitting of this project does not constitute an acceptance of any part of the project that does not
meet 15A NCAC 2T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as
applicable; and the Division's Minimum Design Criteria for the Fast-Track Permitting of Pump Stations
and Force Mains adopted June 1, 2000 as applicable, unless specifically mentioned herein. Division
approval is based on acceptance of the certification provided by a North Carolina-licensed Professional
Engineer in the application. It shall be the Permittee's responsibility to ensure that the as-constructed
project meets the appropriate design criteria and rules.
Construction and operation is contingent upon compliance with the Standard Conditions and any Special
Conditions identified below.
I. STANDARD CONDITIONS
1. This permit shall not be transferable. In the event there is a desire for the wastewater collection
facilities to change ownership, or there is a name change of the Permittee, a formal permit request
shall be submitted to the Division accompanied by documentation from the parties involved, and
other supporting materials as may be appropriate. The approval of this request shall be considered
on its merits and may or may not be approved. [15A NCAC 02T.0104;G.S 143-215.1(d3)]
2. This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 15A NCAC 2T, the Division's Gravity Sewer Minimum
Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for
the Fast-Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and
other supporting materials unless specifically mentioned herein. [15A NCAC 02T.01101
3. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data. [15A NCAC 02T.0110]
4. The wastewater collection facilities shall be properly maintained and operated at all times. The
Permittee shall maintain compliance with an individual system-wide collection system permit for the
operation and maintenance of these facilities as required by 15A NCAC 2T .0403. If an individual
permit is not required,the following performance criteria shall be met: [15A NCAC 02T.0108(b)]:
a. The sewer system shall be effectively maintained and operated at all times to prevent discharge
to land or surface waters, and to prevent any contravention of groundwater standards or
surface water standards.
b. A map of the sewer system shall be developed and shall be actively maintained.
i
Page 4 of 9

c. An operation and maintenance plan including pump station inspection frequency, preventative
maintenance schedule, spare parts inventory and overflow response has been developed and
implemented.
d. Pump stations that are not connected to a telemetry system shall be inspected every day (i.e.
365 days per year). Pump stations that are connected to a telemetry system shall be inspected
at least once per week.
e. High-priority sewer lines shall be inspected at least once per every six-months and inspections
are documented.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. Overflows and bypasses shall be reported to the appropriate Division regional office in
accordance with 15A NCAC 28.0506(a), and public notice shall be provided as required by North
Carolina General Statute §143-215.1C.
h. A Grease Control Program is in place as follows:
1. For public owned collection systems, the Grease Control Program shall include at least
biannual distribution of educational materials for both commercial and residential users and
the legal means to require grease interceptors at existing establishments. The plan shall also
include legal means for inspections of the grease interceptors,enforcement for violators and
the legal means to control grease entering the system from other public and private satellite
sewer systems.
2. For privately owned collection systems,the Grease Control Program shall include at least bi-
annual distribution of grease education materials to users of the collection system by the
permittee or its representative.
3. Grease education materials shall be distributed more often than required in Parts (1) and (2)
of this Subparagraph if necessary to prevent grease-related sanitary sewer overflows.
i. Right-of-ways and easements shall be maintained in the full easement width for personnel and
equipment accessibility.
j. Documentation shall be kept for Subparagraphs (a) through (i) of this Rule for a minimum of
three years with exception of the map,which shall be maintained for the life of the system.
5. The Permittee shall report by telephone to a water resources staff member at the Asheville Regional
Office, telephone number [phone], as soon as possible, but in no case more than 24 hours,
following the occurrence or first knowledge of the occurrence of either of the following:
a. Any process unit failure, due to known or unknown reasons, that renders the facility
incapable of adequate wastewater transport, such as mechanical or electrical failures of
pumps, line blockage or breakage, etc.;or
b. Any SSO and/or spill over 1,000 gallons;or
c. Any SSO and/or spill, regardless of volume,that reaches surface water
Voice mail messages or faxed information is permissible, but this shall not be considered as the
initial verbal report. Overflows and spills occurring outside normal business hours may also be
reported to the Division of Emergency Management at telephone number [phone] or (919)
Page 5 of 9

733-3300. Persons reporting any of the above occurrences shall file a spill report by completing and
submitting Part I of Form CS-SSO (or the most current_Division approved form) within five_days_
following first knowledge of the occurrence. This report must outline the actions taken or proposed
to be taken to ensure that the problem does not recur. Part II of Form CS-SSO (or the most current
Division approved form) can also be completed to show that the SSO was beyond control. [G.S. 143-
215.1C(a1)]
6. Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to
interrupt service by the existing utilities nor result in an overflow or bypass discharge of wastewater
to the surface waters of the State. [15A NCAC 02T.0108(b)]
7. Upon completion of construction and prior to operation of these permitted facilities,the completed
Engineering Certification form attached to this permit shall be submitted with the required
supporting documents to the address provided on the form. A complete certification is one where
the form is fully executed and the supporting documents are provided as applicable. Any
wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Engineer's Certification shall be considered a violation of the permit and shall subject the
Permittee to appropriate enforcement actions.
If the permit is issued to a private entity with an Operational Agreement, then a copy of the
Articles of Incorporation, Declarations/Covenants/Restrictions, and Bylaws that have been
appropriately filed with the applicable County's Register of Deeds office shall be submitted with
the certification.
A complete certification is one where the form is fully executed and the supporting documents are
provided as applicable. Supporting documentation shall include the following:
a. One copy of the project construction record drawings (plan & profile views of sewer lines &
force mains) of the wastewater collection system extension. Final record drawings should be
,.; clear.oh the.plans or on digital media (CD or DVD disk) and are defined as the design drawings
that are marked up or annotated with after construction information and show required buffers,
separation distances, material changes, etc.
b. One copy of the supporting applicable design calculations including pipe and pump sizing,
velocity, pump cycle times, and level control settings, pump station buoyancy, wet well storage,
surge protection, detention time in the wet well, and force main, ability to flush low points in
force mains with a pump cycle, and downstream sewer capacity analysis. If a portable power
source or pump is dedicated to multiple stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, include travel
timeframes,shall be provided.
c. Changes to the project that do not result in non-compliance with this permit, regulations, or the
Minimum Design Criteria should be clearly identified on the record drawings,on the certification
in the space provided, or in written summary form.
Prior to Certification (Final or Partial): Permit modifications are required for any changes resulting
in non-compliance with this permit (including pipe length increases of 10% or greater, increased
flow, pump station design capacity design increases of 5% or greater, and increases in the
number/type of connections), regulations, or the Minimum Design Criteria. Requested
Page 6 of 9

modifications or variances to the Minimum Design Criteria will be reviewed on a case-by-case basis
and each on its own merit. Please note that variances to the Minimum Design Criteria should be
requested and approved during the permitting process prior to construction. After-construction
requests are discouraged by the Division and may not be approved, thus requiring replacement or
repair prior to certification &activation. [15A NCAC 02T.0116]
8. Gravity sewers installed greater than ten percent below the minimum required slope per the
Division's Gravity Sewer Minimum Design Criteria shall not be acceptable and shall not be certified
until corrected. If there is an unforeseen obstacle in the field where all viable solutions have been
examined, a slope variance can be requested from the Division with firm supporting documentation.
This shall be done through a permit modification with fee. Such variance requests will be evaluated
on a case-by-case basis. Resolution of such request shall be evident prior to completing and
submitting the construction certification. [ 15A NCAC 02T.0105(n)]
9. A copy of the construction record drawings shall be maintained on file by the Permittee for the life
of the wastewater collection facilities. [15A NCAC 02T.0116]
10. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 2T; the
Division's Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the Division's
Minimum Design Criteria for the Fast-Track Permitting of Pump Station and Force Mains adopted
June 1, 2000 as applicable; and other supporting materials may subject the Permittee to an
enforcement action by the Division, in accordance with North Carolina General Statutes§143-215.6A
through §143-215.6C, construction of additional or replacement wastewater collection facilities,
and/or referral of the North Carolina-licensed Professional Engineer to the licensing board. [15A
NCAC 02T.0104; 15A NCAC 02T.0108(b-c)]
11. In the event that the wastewater collection facilities fail to perform satisfactorily, including the
creation of nuisance conditions, the Permittee shall take immediate corrective action, including
those as may be required by this Division, such as the construction of additional or replacement
..facilities. [15A NCACO2T.0110; 15A NCAC 02T.0108(b)]
12. The issuance of this permit shall not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances that may be imposed by the Division any other Federal, State, or
Local government agencies which have jurisdiction or obtaining other permits which maybe required
by the Division or any other Federal,State, of Local government agencies. [G.S. 143-215.1(b)]
Page 7 of 9

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE:TOWN OF RHODHISS
PERMIT#:WQ0038971
PROJECT: SYSTEM-WIDE WATER AND SEWER IMPROVEMENTS
ISSUE DATE:January 17,2017
This project shall not be considered complete nor allowed to operate in accordance with Condition 7"of
this permit until the Division has received this Certification and all required supporting documentation.
It should be submitted in a manner that documents the Division's receipt. Send the required
documentation the Regional Supervisor, Water Quality Regional Operations Section at the address at
the bottom.
Any wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Certification shall be considered a violation of the permit and shall subject the Permittee to
appropriate enforcement actions. The Permittee is responsible for tracking all partial certifications up
until a final certification is received. A Final Certification shall be a complete set of record drawings and
design calculations regardless of whether partials have been submitted.
PERMITTEE'S CERTIFICATION
I, the undersigned agent for the Permittee, hereby state that this project has been constructed pursuant
to the applicable standards & requirements, the Professional Engineer below has provided applicable
design/construction information to the Permittee, and the Permittee is prepared to operate & maintain
the wastewater collection system permitted herein or portions thereof.
Printed Name,Title Signature Date
ENGINEER'S CERTIFICATION
as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe (periodically, ❑ weekly, ❑ full time) the construction of the
System-Wide Water and Sewer Improvements and location as referenced above for the above
Permittee hereby state that, to the best of my abilities, due care and diligence was used in the
observation of the construction such that the construction was observed to be built within substantial
compliance of this permit; 15A NCAC 02T; the Division of Water Resources' (Division) Gravity Sewer
Minimum Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design
Criteria for the Fast-Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as
applicable; and other supporting materials.
....................................................
North Carolina Professional Engineer's Seal w/signature &date:
❑ Final ❑ Partial (include description)
...............................................................
Certification Comments/Qualifiers(attach if necessary): ..........:
NC DWR—Water Quality Regional Operations Section 2090 US Hwy 70,Swannanoa, NC 28778
Asheville Regional Office Phone: [phone] FAX:[phone]

Division of Water Resources `
Fast Track Application forfor Sewer Systems—Revie kecl�k�s
Project Name: �t m.Vu'`t1[. W A4r- a Sl j4 tm e. Application Number: ,n
Application Completeness Review R,,j l/$�C7 17 3fi S"11
Project is located in a County currently covered by the regional office VWGs ❑No O
Application and supporting documentation submitted in duplicate? es ❑No
One Original and One Copy
11 y I ( rl Correct application fee submitted? See G.S. 143-215.3D es ❑No ❑N/A
Ensure that a check for$480 is submitted and made out to NC DEQ.
II 5' 1 All new projects and major modifications to existing projects require licafion fee. A major modification
includes any changes to permitted flow volumes, changes in pipe dia ges in pipe length greater than 10 %
III,)I in of the originally permitted length, changes in operating points of a ation, etc. If unclear, contact the Central
Office.
Application package is complete?
Current application version(See website) es No
Brief project narrative(per Section B ofFTA, tions) es ❑No
Certification of Public Convenience and Noce provided Yes ❑No ❑N/A
(if applicable)
Operational Agreements,signed and dated [—]No ❑N/A
(if applicable)
Flow Tracking/Acceptance Form igned and da []Yes E< ❑N/A
Flow Tracking/Acceptance PI t Addend []Yes ❑No ❑N/A
(if applicable)
Site Map and Street Level Map(per Se F o cfions `�es ❑No
PE Certification of is signed, d and C.P es ❑No
Applicant Corti and dated ele rovi d) &�V—es ❑No
If any portion of the ap n is not plete, or equired instruction items have been omitted, and the
return of an application is ' t,the f wing steps s be taken:
• C ant ( an ho email for very minor completeness deficiencies.
e app' d co t)48 ho
• e application p is fo be incomp uring this completeness review, fill out a checklist that
r ' res the deficien d re a application to the applicant with a copy to the consultant. If the
app. ' n fee has not b eposite it as well.
Any projects that be returned 1 be returned prior to accepting the application (i.e., before logging in the
application and dep the chec er a project has been accepted, any information that is found to be
incorrect and/or lackin f be re d via an Additional Information Request in accordance with 15A NCAC
02T.0107.
i

Permit Information
❑New Permit ❑Permit Modification
If the project is a modification to an existing permit, be sure to enter the application into BIMS as a permit
modification (i.e. "renew/modify application" and not "create new project"). BIMS will pull the previous signing
official and affiliations information. Modify all tabs and enter updated information.
Does the project require a permit for the activity? EJVes ❑No
See Permitting by Regulation(15A NCAC 02T.0303)for projects deemed permitted
If No,return fee and application package
Is the project eligible for the Fast Track Program? Ves ❑No
Projects not permitted through the fast track program:
➢ 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);
1 ➢ Vacuum sewer systems.
If No,return fee and application package and advise applicant what to do
Information entered into BIMS?(Project details, affiliations,etc) Yes ❑No
Applicant(Owner/Permittee)signature meets requirement of 15A NCAC.0106(b)? Q/es
If No,request revised application with an appropriate official,or a letter from an
,j appropriate official that indicates the person in question is delegated to sign the
application on the applicant's behalf. If a new delegated signing official is listed,
add the person to BIMS
Is the applicant is a public entity(county,city,sanitary district,etc.)? e 'n Vs ❑No
If Yes,move to Wastewater Flow Information Section N
Is the applicant is a private entity and intends to retain ownership(store, church,etc.)? ❑Yes ❑No
If Yes,move to Wastewater Flow Information Section
1 Is the applicant is a private entity(private utility)? ❑Yes ❑No
If Yes,Applicant has been designated as a public utility by the NC Utilities Commission ❑Yes []No
Has submitted a Certificate of Public Convenience and Necessity(CPCN)
or Letter from the Public Staff of the NC Utilities Commission(contact Central Office)
The project name on the application and CPCN must match ❑Yes ❑No
Is the applicant is a private entity(Developer)that will be selling units? ❑Yes ❑No
If Yes,Applicant has submitted an executed Operational Agreement(DEV) ❑Yes ❑No
A developer may be responsible for the system for an interim period until the HOA is forme ,
at which time a name change/change of ownership form is required to transfer the permit to the HOA
The operational agreement should be attached to the permit and incorporated into the langua a of the permit.
Is the applicant is a Homeowner's or Property Owner's Association selling units? ❑Yes ❑No
If Yes,Applicant has submitted an executed Operational Agreement(HOA) ❑Yes ❑No
and,Copy of the Articles of Incorporation,Declarations and By-laws ❑Yes ❑No
The operational agreement should be attached to the permit and incorporated into the language of the permit.
2

Wastewater Flow Information
Has submitted Flow Tracking/Acceptance Form(FTSE Form) ❑Yes ❑No NKIA
Ensure form is complete with all required information and that the owner L 0 DIX U11-0
has accepted the entire volume of flow listed L
Proper certification per 15A NCAC 02T .0106(b) ❑Yes ❑No
Form is dated within one year of receipt of application package ❑Yes ❑No
Is FTSE Planning Assessment Addendum Required? ❑Yes []No BN/A
Required only for projects where available pump station capacity is<0.
(Contact Central Office if needed)
Additional forms(FTSE 06-13)required? ❑Yes ❑No I /A
Required only if the owner of downstream sewer different then owner of W WTF
Receiving W WTF and downstream sewers have adequate capacity ❑Yes [:]No
Ensure no compliance issues(SSOs or W WTF compliance issues)
Wastewater domestic in nature Yes ❑No
If item B.6 indicates industrial wastewater,notify the regional pretreatment coordinator or
contact the Central Office to determine if a pretreatment permit is needed or if it is in place and compliant,
Has the wastewater flow volume been calculated correctly(section 11.7 of FTA)? 2Qrt []Yes ❑No�1'(�/�dt
Flow is calculated per 15A NCAC 02T.0114
or
If daily design flow is not based on regulations ensure that the applicant has an approved flow reduction of daily
design flow rate on file with the Division.
or
If other than 2T.0114,values must be supported with flow data per 15A NCAC 02T.0114(f)
(Contact Central Office if this is the case)
Design Information
Adequate information related to sewer lines(Section VII of FTA) E/es ❑No ❑N/A
Note that per the 2T and MDC,there is a minimum 8"for public gravity or
minimum 6"for private gravity
Adequate information related to pump stations(Section VIII of FTA) ❑Yes ❑No N /A
Ensure power reliability option is selected(see 15A NCAC 02T.0305(h))
Has Setbacks&Separations Section been completed? es ❑No [-]N/A
Required if any portion of project is within 100 feet of any surface water or wetlands
Note, 15A NCAC 02T.0305(f)contains minimum separations required for sewer
A variance is required if minimum separations cannot be attained(see below)
Is Project design is in accordance with(see section X of FTA) L�Wes ❑No
15A NCAC 02T Qy ,
Gravity Sewer Minimum Design Criteria(latest version)
Minimum Design Criteria for Permitting,of PLuno Stations and Force Mains(latest version)
If no,a variance approval is required per the requirements of 15A NCAC 02T.0105(b)
• Applicant must submit TWO copies of the plans,specifications,and calculations
• Contact the Central Office to discuss the variance request to determine a course of action. The central
office will review the variance request, and if approvable, specific language regarding the variance will be
forwarded to the Regional Office reviewer to incorporate into the permit. A copy of the variance letter(or
email correspondence)should be kept with the application file.
Project contains high priority lines(15A NCAC 02T.0402(2)) ❑Yes �o
If Yes,insure that the permit contains the necessary condition related to high priority lines
15A NCAC 02T.0403 (a)(5)
3

Application Certification
Has a N.C.PE stamped,signed,and dated the application? �L�� e []No
PE with active license in North Carolina? des ❑No-
Check the NCBELS to ensure Engineer is currently registered to practice
NCBELS License Lookup
If the owner is a corporation,is the corporation registered in N.C.? Dyes ❑No
N.C. Secretary of State(Corporation Search)
Applicant should be registered to conduct business as a corporation in NC(Private Owners,Developers,HOAs,etc.)
If No,see return application guidance
Issuing a Permit
Most current version of the Fast-Track permit shell used? ❑Yes ❑No
Special conditions utilized within permit? ❑Yes ❑No ❑N/A
High Priority Lines(Aerials)
Variance Language(Approved by the Central Office)
Regional Conditions(i.e. Stormwater Plans for Coastal Counties)
Construction Only Language("Dry Lines")
Other instances(contact the central office if required)
If permit modification: ❑Yes ❑No ❑N/A
Include Permit History
Void Previously Issued Permit in language
Permit signed only by those delegated to sign for the Director ❑Yes ❑No
Permit distributed as follows: []Yes ❑No
• Original to Permittee
• Copy to Consulting Engineer
• Copy to County Health Department(if applicable)
• Copy to Mecklenburg County Department of Environmental Protections
(Only for projects located in Mecklenburg County)
• Copy to the applicable Building Inspections Authority(if applicable)
• Copy(ies)to the owner of the W WTF and owner of the downstream sewers
(Only if different than the Permittee)
• Copy to Regional Office Files
• Copy to Water Quality Central Files(see Central Files Permit Package below)
• Electronic copy to PERCS unit
Electronic version shall preferably a signed,scanned copy of the permit in pdf format.
If not,the electronic version can be a final version of the permit in word format. Regardless,
the permit should follow the naming convention of WQOO)D=-YY.MM.DD.
Electronic copies should be forwarded to the PERCS unit contact on a frequent basis(once a month is fine).
• Signed Operational Agreements should be distributed with the permit(if applicable)
Finalizing BIMS
Permit issued in BIMS? ❑Yes ❑No
All relevant Event Dates Entered? []Yes ❑No
(add info request,add info received,variance granted,variance denied,etc)
Central Files Permit Package
Complete package forwarded to Central Files ❑Yes ❑No
• Finalized Tracking Slip(BIMS Report)
• Copy of signed,issued permit(with operational agreements,if applicable)
• Copy of permit application package(application,supporting documentation,etc.)
• Review comments, calculations,notes,review checklist, etc.
• All other correspondence(email,phone logs, cover sheets,etc.)
All material in the permit package should be stapled together. Plans and specifications should not
be included in the permit package sent to central files.
4

WEST CONSULTANTS, PLLC LETTER OF
Consulting Engineers and Surveyors
4 South Sterling Street TRANSMITTAL
Morganton, North Carolina 28655
Phone [phone] Fax [phone]
TO NCDEQ - Div. Of Water Resources (Ashe JO@pllyd9ERWHONE l %E30/ZO16
2090 US Highway 70 A1TT6EN.TIO/N
Swannanoa .NO 28778
RE:
Town of Rhodhiss - System-Wide Water &
Sewer Improvements
Caldwell County Portion
WE ARE SENDING YOU Attached Under separate cover via the following items.
Shop drawings Prints Plans Specifications Samples
Copy of letter Change order Other: -
COPIES DATE NUMBER DESCRIPTION
2 Fast Track Application (FTA 04-16) (1 Original, 1 Copy)
.1 12/28/16 119 Permit Application Fee ($400) Paid By Town Of Rhodhiss
RECEIVED
Division of Water Resources -
JAN - 4 2017
Water Ousfity Regional Operations
Asheville,R-r.ional Office �
THESE ARE TRANSMITTED as checked below:
X For your.approval Approved as submitted Resubmit copies for approval
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As requested Returned for corrections Return corrected prints
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FOR BIDS DUE/DATE: 12/30/2016 PRINTS RETURNED AFTER LOAN TO US
REMARKS
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PROOUCT13127G USE WrH 771C ENVELOPE Deluxe For Business 1-800-225-6380 or www.nebs.com PRINTED IN U.SA. A
.I A

FN;CAC
IVED
State of North Carolina
DWR
Department of Environmental Quality
4 2017 Division of Water Resources
300—FAST TRA K SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16& SUPPORTING DOCUMENTATION
alclnal Ottice
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.
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 I.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 En ig neer.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106(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: FTA 04-16& SUPPORTING DOCUMENTATION Page 1 of 3

Flow Tracking/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.
➢ Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-
215.67 a .
➢ 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 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project
area and closest surface waters.
➢ 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 level map showing general project area.
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
➢ 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 letter 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 Pubic 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):
❑ Home/Property 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 15A NCAC 02T .0115(b),submit the properly executed Operational Agreement(FORM: DEV).
For more information, visit the Division's collection systems website
INSTRUCTIONS FOR FORM: ETA 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,
[phone] 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, Cabarrus, Catawba,Cleveland,
Water Quality Section Mooresville, North Carolina 28115 Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone] Stanly, Union
[phone] Fax
Raleigh Regional Office 1628 Mail Service Center Chatham, Durham, Edgecombe, Franklin,
Water Quality Section Raleigh, North Carolina 27699-1628 Granville, Halifax,Johnston, Lee, Nash,
[phone] Northampton, Orange, Person,Vance,Wake,
[phone] Fax Warren,Wilson
Washington Regional Office 943 Washington Square Mall Beaufort, Bertie, Camden, Chowan, Craven,
Water Quality Section Washington, North Carolina 27889 Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone] Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax Perquimans, Pitt,Tyrrell,Washington,Wayne
Wilminaton Regional Office 127 Cardinal Drive Extension Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section Wilmington, North Carolina 28405 Hanover, Onslow, Fender
[phone]
[phone] 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 3

State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T.0300—FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources 'w/ _ FT 04-16&SUPPORTING DOCUMENTATION
Application Number:`ram �A � (to be completed by DWR)
384 71
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1.Applicant's name: Town of Rhodhiss(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: Ben Turnmire per 15A NCAC 02T.0106(b)
Title:Town Manager Xmail.co
ECEIVE
4.Applicant's mailing address:PO Box 40 n of Water Resources
City: Rhodhiss State:NC Zip:28667-0040
5. Applicant's contact information: N — 4 2017
Phone number:(8�396-8400 Email Address:townofrhodhissnllty Regional Opemftne
II. PROJECT INFORMATION: ille Regional Office
1. Project name: System-Wide Water and Sewer Improvements
2. Application/Project status: ®Proposed(New Permit) ❑ Existing Permit/Project
If a modification,provide the existing permit number: W000 and issued date:
If new construction but part of a master plan,provide the existing permit number: WQOo_
3. County where project is located: Burke and Caldwell
4. Approximate Coordinates(Decimal Degrees): Latitude: 35.824°Longitude:-81.484'
5. Parcel ID(if applicable):
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Benjamin B.Thomas,P.E. License Number: 20757
Firm:West Consultants,PLLC
Mailing address:405 S. Sterling St
City:Morganton State: nc Zip:28655-
Phone number:[phone] Email Address:[e-mail]
IV. WASTEWATER TREATMENT FACILITY(WWTF)INFORMATION:
1. Facility Name:Henry Fork W WTP Permit Number:NCO040797
Owner Name: City of Hickory
V. RECEIVING DOWNSTREAM SEWER INFORMATION(if different than WWTF):
1. Permit Number(s): WQ Downstream(Receiving) Sewer Size: _inch
System Wide Collection System Permit Number(s)(if applicable): WQCS_
Owner Name(s):
FORM: FTA 04-16 Pagel of 5

V1. 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 Aereement(FORM DEV)been attached?
❑Yes ❑No ❑N/A
3. If the Applicant is a Home/Property Owners'Association.has an Operational Aereement(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/preschool/day care ❑Medical/dental/veterinary facilities ❑ Swimming Pool/Clubhouse
❑Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑Businesses/offices/factories ❑Nursing Home ❑ Other(Explain in Attachment)
5. Nature of wastewater: 100%Domestic/Commercial %Commercial
%Industrial(See 15A NCAC 02T.0103(20))
l•Is there a Pretreatment Program in effect? ❑ Yes ❑No
6. Hasa flow reduction been approved under 15A NCAC 02T.0114(fl? ❑ Yes ❑No
➢ If yes,provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type(see 02T.0114(f)) Daily Design Flow a.b No.of Units Flow
gal/ 0 GPD
gaU GPD
gal/ GPD
gal/ GPD
gal/ GPD
gal/ GPD
Total 0 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.42A-4).
b Per 15A NCAC 02T.0114(c),design flow rates for establishments not identified [in table 15A NCAC 02T.0114]shall be
determined using available flow data,water using fixtures, occupancy or operation patterns,and other measured data.
8. Wastewater generated by project: 0 GPD(per 15A NCAC 02T.0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
® Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other(Explain):
FORM:FTA 04-16 Page 2 of 5

VIL GRAVITY SEWER DESIGN CRITERIA(If Applicable)-02T.0305& MDC(Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size(inches) Length(feet) Material
8 4,959 PVC
➢ Section II&III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA(If Applicable)—02T.0305&MDC(Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates(Decimal Degrees):Latitude: Longitude:- °
3. Design flow of the pump station: millions gallons per day(firm capacity)
4. Operational point(s)of the pump(s): gallons per minute at feet total dynamic head(TDH)
5. Summarize the force main to be permitted(for this Pump Station):
Size(inches) Length(feet) Material
6. Power reliability in accordance with 15A NCAC 02T.0305(h)(1):
❑ Standby power source or pump with automatic activation and telemetry- 15A NCAC 02T.0305(h)(1)(B),.
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick-connection receptacle and telemetry- 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry- 15A NCAC 02T.0305(h)(1)(C):
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant(draft agreement)
and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations,an evaluation of all the pump stations'storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

IX. SETBACKS& SEPARATIONS—(02B.0200 & 15A NCAC 02T.0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T.0305(f)&(a) ® Yes ❑No
➢ 15A NCAC 02T.0305(f)contains minimum separations that shall be provided for sewers stems:
Setback Parameter* Separation Required
Storm sewers and other utilities not listed below(vertical) 24 inches
Water mains(vertical-water over sewer including in benched trenches) 18 inches
Water mains(horizontal) 10 feet
Reclaimed water lines(vertical-reclaimed over sewer) 18 inches
Reclaimed water lines(horizontal-reclaimed over sewer) 2 feet
**Any private or public water supply source, including any wells,WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water 100 feet
**Waters classified WS (except WS-I or WS-V),B, SA,ORW,HOW, 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 Uade(vertical) 36 inches
➢ 15A NCAC 02T.0305(g)contains alternatives where separations in 02T.0305(fl cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webnage
➢ If noncompliance with 02T.0305(f)or M,see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ®Yes ❑No
➢ See the Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with all setbacks found in the river basin rules per 15A NCAC 02B .0200? ®Yes ❑No
➢ This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project comply with an individual 404 Permit or any 401 Certifications? ® Yes [:]No
➢ Wetland-related permits shall be requested,obtained,and adhered to for projects that impact wetlands or surface waters
➢ Information can be obtained from the 401 &Buffer Permitting 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.0402, "high-priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑Yes ®No
➢ 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.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T,the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains(latest version), and the Gravity Sewer Minimum Design Criteria(latest version)as applicable?
®Yes ❑No
If No,complete and submit the Variance/Alternative Design Request application(VADC 10-14)and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
I, e K wu _ 7Lt pWcwS attest that this application for
(Professional Engineer's name from Application Item I11.1.)
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 143-215.6E, 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.
..................��J",@ tAS@ndgpg+�'..........................
North Carolina Professional Engineer's seal,signature,and date: pme Q�kA UIR0,0;?z,,
�:4EAL
° 20757 t
3. Applicant's Certification per 15A NCAC 02TT..0106(b):
1, ��1 /6, rflmtye /�1� /'cG tee" attest that this application for
(Signature Authority's name&title from A lication Item I.3.)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non-
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief,and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
of this permit be violated. I also understand that if all required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6E, 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.
RECEIVED
Division of Water Resources /
Signature:
JAN - 4 2017
Water Ouslity Reglonal Operations j
Asheville Rpdonal Office
FORM: FTA 04-16 Page 5 of 5

Town of Rhodhiss
System-Wide Water and Sewer Improvements:
This is a CDGB-I funded project(CDGB-1 NO. 13-1-2634& 13-1-2635)that consists primarily of
addressing pipe defects and deterioration of 6"VCP sewers within the collection system by replacement
(in place) with 8" PVC piping. However,due to sewer lines having been added on to the Rhodhiss
collection system with no systematic planning and that the land has been developed over the years, has
resulted in some sewer lines now being located under structures (garages, houses,trailers),orjust feet
from existing structures.
Therefore, relocating lines to the street,or away from existing structures if a street is not an option, is
the best option for addressing the issue with replacing these deteriorated lines, as well as being a better
option for accessing and maintaining the gravity line.
The new 8" lines shown on the enclosed map are to replace existing 6" lines that are under, or near
existing structures, but no new flow is being added.
Since no new flow is being added, a USE form was not completed.

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State of North Carolina
DWR Department of Environmental Quality
Division of Water Resources
15A NCAC 02T.0300—FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources INSTRUCTIONS FOR FORM: 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.
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 I.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 02T.0106(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: FTA 04-16&SUPPORTING DOCUMENTATION Page 1 of 3

E. Flow Tracking/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.
➢ Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-
215.67(a).
➢ 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 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project
area and closest surface waters.
➢ 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 level map showing general project area.
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
➢ 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 letter 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):
❑ Home/Property 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 15A NCAC 02T .0115(b), submit the properly executed Operational Agreement(FORM:DEV).
For more 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,
[phone] 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, Cabarrus, Catawba, Cleveland,
Water Quality Section Mooresville, North Carolina 28115 Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone] Stanly, Union
[phone] Fax
Raleigh Regional Office 1628 Mail Service Center Chatham, Durham, Edgecombe, Franklin,
Water Quality Section Raleigh, North Carolina 27699-1628 Granville, Halifax,Johnston, Lee, Nash,
[phone] Northampton, Orange, Person,Vance,Wake,
[phone] Fax Warren,Wilson
Washington Regional Office 943 Washington Square Mall Beaufort, Bertie, Camden, Chowan, Craven,
Water Quality Section Washington, North Carolina 27889 Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone] Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax Perquimans, Pitt,Tyrrell,Washington,Wayne
Wilmington Reaional Office 127 Cardinal Drive Extension Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section Wilmington, North Carolina 28405 Hanover,Onslow, Pander
[phone]
[phone] Fax
Winston-Salem Reaional 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 3

State of North Carolina
Department of Environmental Quality
DER
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: (to be completed by DwR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1.Applicant's name: Town of Rhodhiss(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:Ben Turnmire per 15A NCAC 02T.0106(b)
Title:Town Manager
4.Applicant's mailing address: PO Box 40 RECEIVED
Division of Water Resource9
City:Rhodhiss State:NC Zip:28667-0040
5. Applicant's contact information: JAN — 4 2017
Phone number:[phone] Email Address:[e-mail]
II. PROJECT INFORMATION: Water Quality Reglonal Operdons
Ashev618 Reeion_al Offl„�_._
1. Project name: System-Wide Water and Sewer Improvements
2. Application/Project status: ®Proposed(New Permit) ❑ Existing Permit/Project
If a modification,provide the existing permit number: W000 and issued date:
If new construction but part of a master plan,provide the existing permit number: WQ00_
3. County where project is located:Burke and Caldwell
4. Approximate Coordinates(Decimal Degrees): Latitude: 35.824°Longitude: -81.484'
5. Parcel ID(if applicable):
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
I. Professional Engineer: Benjamin B. Thomas, P.E. License Number:20757
Firm:West Consultants,PLLC
Mailing address:405 S. Sterling St
City:Mor ag nton State:ne Zip: 28655-
Phone number: 828 522-4728 Email Address:bthomas(a-),west-consultants.com
IV. WASTEWATER TREATMENT FACILITY(WWTF)INFORMATION:
1. Facility Name:Henry Fork W WTP Permit Number:NCO040797
Owner Name: City of Hickory
V. RECEIVING DOWNSTREAM SEWER INFORMATION(if different than WWTF):
1. Permit Number(s): WQ_ Downstream(Receiving) Sewer Size: _inch
System Wide Collection System Permit Number(s)(if applicable): WQCS_
Owner Name(s):
FORM: FTA 04-16 Pagel of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately-Owned Public Utility,has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑No ❑N/A
2. If the Applicant is a Developer of lots to be sold,has a Developer's Operational Agreement(FORM'DEV)been attached?
❑Yes [:]No ❑N/A
3. If the Applicant is a Home/Property 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/preschool/day care ❑Medical/dental/veterinary facilities ❑ Swimming Pool/Clubhouse
❑Food and drink facilities ❑Church ❑ Swimming Pool/Filter Backwash
❑Businesses/offices/factories ❑Nursing Home ❑ Other(Explain in Attachment)
5. Nature of wastewater: 100%Domestic/Commercial %Commercial
%Industrial(See 15A NCAC 02T.0103(20))
"Is there a Pretreatment Program in effect? ❑ Yes ❑No
6. Has a flow reduction been approved under 15A NCAC 02T.0114(f)? ❑Yes ❑No
➢ If yes,urovide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type(see 02T.0114(f)) Daily Design Flow s,b No.of Units Flow
gal/ 0 GPD
gall GPD
gall GPD
gal/ GPD
gal/ GPD
gal/ GPD
Total 0 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.42A-4).
b Per 15A NCAC 02T.0114(c),design flow rates for establishments not identified[in table 15A NCAC 02T.01147 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.0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
® Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other(Explain):
FORM: FTA 04-16 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA(If Applicable)-02T.0305&MDC(Gravity Sewers):
I. Summarize gravity sewer to be permitted:
Size(inches) Length(feet) Material
8 4,959 PVC
➢ Section II &III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA(If Applicable)—02T.0305&MDC(Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:_
2. Approximate Coordinates(Decimal Degrees): Latitude: Longitude: - °
3. Design flow of the pump station: millions gallons per day(firm capacity)
4. Operational point(s)of the pump(s): _gallons per minute at_feet total dynamic head(TDH)
5. Summarize the force main to be permitted(for this Pump Station):
Size(inches) Length(feet) Material
6. Power reliability in accordance with 15A NCAC 02T.0305(h)(1):
❑ Standby power source or pump with automatic activation and telemetry- 15A NCAC 02T.0305(h)(1)(B).*
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick-connection receptacle and telemetry- 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry- 15A NCAC 02T.0305(h)(1)(C):
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant(draft agreement)
and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations,an evaluation of all the pump stations'storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

IX. SETBACKS& SEPARATIONS—(02B.0200 & 15A NCAC 02T.0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T.0305(f)&(g) ® Yes ❑No
➢ 15A NCAC 02T.0305( contains minimum separations that shall be provided for sewers stems:
Setback Parameter* Separation Required
Storm sewers and other utilities not listed below(vertical) 24 inches
Water mains(vertical-water over sewer including in benched trenches) 18 inches
Water mains(horizontal) 10 feet
Reclaimed water lines(vertical-reclaimed over sewer) 18 inches
Reclaimed water lines(horizontal-reclaimed over sewer) 2 feet
**Any private or public water supply source,including any wells, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water 100 feet
**Waters classified WS(except WS-I or WS-V),B, SA,ORW,HQW, or SB from normal
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
An swimming pools 10 feet
Final earth grade(vertical) 36 inches
➢ 15A NCAC 02T.0305(g)contains alternatives where separations in 02T.0305(f)cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webnage
➢ If noncompliance with 02T.0305(f)or(g),see Section X of this application
2. Does the project comply with separation requirements for wetlands?(50 feet of separation) ®Yes ❑No
➢ See the Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with all setbacks found in the river basin rules per 15A NCAC 02B .0200? ® Yes ❑No
➢ This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project comply with an individual 404 Permit or any 401 Certifications? ®Yes ❑No
➢ Wetland-related permits shall be requested,obtained,and adhered to for projects that impact wetlands or surface waters
➢ Information can be obtained from the 401 &Buffer Permittine 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.0402, "high-priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ®No
➢ 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.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains(latest version), and the Gravity Sewer Minimum Design Criteria(latest version)as applicable?
® Yes ❑No
If No,complete and submit the Variance/Altemative Design Request application(VADC 10-14)and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
I, Cw1AaMil1 _S 7(tayvawS attest that this application for
(Professional Engineer's name from Application Item III.1.)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers(latest version), and the Minimum Design Criteria for the Fast-Track Permitting
of Pump Stations and Force Mains(latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed$10,000,as well as civil penalties up to$25,000 per violation.
......_.............._ asaann..
North Carolina Professional Engineer's seal,signature,and date: peRe�®��� �pU+�A+Ryt�+),
SEAL
S ,
g 20757
�I {iI NYC,
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3. Applicant's Certification per 15A NCAC 0
'2TT.0106(b):
1, Pr/1 �(vc_ /n In m�, �� attest that this application for
(Signature Authority's name&title from A lication Item I.3.)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non-
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief,and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
of this permit be violated. I also understand that if all required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed$10,000 as well as civil penalties up to$25,000 per violation.
Signature: ��„u c Date:
FORM: FTA 04-16 Page 5 of 5

Town of Rhodhiss
System-Wide Water and Sewer Improvements:
This is a CDGB-I funded project(CDGB-1 NO. 13-1-2634& 13-1-2635)that consists primarily of
addressing pipe defects and deterioration of 6" VCP sewers within the collection system by replacement
(in place)with 8" PVC piping. However, due to sewer lines having been added on to the Rhodhiss
collection system with no systematic planning and that the land has been developed over the years, has
resulted in some sewer lines now being located under structures(garages, houses,trailers),or just feet
from existing structures.
Therefore, relocating lines to the street, or away from existing structures if a street is not an option, is
the best option for addressing the issue with replacing these deteriorated lines, as well as being a better
option for accessing and maintaining the gravity line.
The new 8" lines shown on the enclosed map are to replace existing 6" lines that are under, or near
existing structures, but no new flow is being added.
Since no new flow is being added, a FTSE form was not completed.

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NCDENR
North Carolina Department of Environment aftd'Natural Resources.
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins f Dee Freeman it
Governor Director �) (J i� Secretanj
August 26, 2009
Ms. Barbara Harmon Vn- r —Al R
Town of Rhodhiss
I c r9
P.O. Box 40 _.r
Rhodhiss, North Carolina 28667
SUBJECT: Town of Rhodhiss
Sanitary Sewer System Rehabilitation
Project No. 2W370737-01
Change Order No: 1 Contract No. 1
Locke-Lane Construction
Dear Ms. Harmon:
The Construction Grants &Loans Section of the North Carolina Division of Water
Quality has concluded the review of the subject change order and supporting documents.
Therefore, the following determination has been made:
Change Order No. 1
Contract No. 1
Total Change: $8,296.10
STAG Eligible Part: $8,296.10
New Total Contract: $153,885.10
Total Eligible Contract Participation: $153,885.10
This change order covers the cost of additional erosion control, fill dirt and ductile iron
pipe and unexpected conditions. There was no contract time extension associated with
this change order.
This change order with related procurement documentation has been found to be in
compliance with applicable ARRA regulations- However, it should be understood that this
approval is administrative only and does not relieve the recipient of the responsibility to ensure
the validity of the supporting documentation including the corresponding cost and pricing data.
Accordingly, this approval is without prejudice to a redetermination of allowable/unallowable
costs should a post approval review or audit disclose facts not now discernible.
Mailing Address Phone[phone] Location NorthCarolirtu
1633 Mail Service Center - Fax [phone] 2728 Capital Blvd. Natm-allb
Raleigh,NC 27699-1617 Raleigh,NC 27604
Internet: wa,w.ncc^_6nel Customer Service 1.877-6234748
An Equal Opportunity/Affirmative Action Employer—50%Recycled/10%Post Consumer Paper

Ms. Barbara Harmon
Aug 26, 2009
Page 2
This document should be filed with the other ARRA project documents in your
possession. If you should have any questions, please contact Antonio Evans at(919)715-6220.
Sincerely,
Mark L. Hubbard,P.E., Assistant Chief
Project Management Branch
I'
AVE/sd
cc: West Consultants, PLLC
j Asheville Regional Office
Leslie Rogers
CIG—Antonio Evans
ARRA
i
1
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R°.
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H.Sullins Dee Freeman
Governor Director Secretary
July 13, 2009
Ms. Barbara Harmon
Town of Rhodhiss
P.O. Box 40
Rhodhiss,North Carolina 28667
SUBJECT: Town of Rhodhiss
Sanitary Sewer System Rehabilitation
Project No. 2W370737-01
Preconstrucdon Conference
Dear Ms. Harmon:
A preconstruction conference was held on July 2, 2009 for the subject project. Attached
is the agenda presented by the Construction Grants &Loans Section representative. Please
review and file in your records.
If you and/or your engineer have any questions regarding this inspection, please contact
me at [phone].
Sincerely,
Antonio V. Evans,P.E.
Environmental Engineer
Construction Inspection Group
AVE/sd
Attachments
cc: West Consultants, PLLC
ARO w/a
w/a CIG w
CIG /a—Antonio Evans JI
JUL 16 2009
WATER QUALITY SECTION
Construction Grants and Loans Section
1633 Mail Service Center Raleigh NC 27699-1633 TOne 1
Phone:[phone]/FAX:[phone]/Internet:www;nccgi.net """ v. �y�Q//}J"h;/ y+ ollina
An Equal Opportunity/Affirmative Action Employer—50%Recycled/10%Post Consumer Paper f •"� m Q`•y

Page I of 6
(Attachment A)
LIST OF ATTENDEES
NAME REPRESENTING PHONE# FAX# EMAIL
Antonio Evans DENR-DWQ-CG&L 919-715-6220 919-715-6229 [e-mail]
Ron Lynn West Consultants 828-433-5661
John Abernethy West Consultants 828-413-7383
Benjie Thomas West Consultants 828-433-5661
III Rick Justice Town of Rhodhiss 828-396-8400
Drew Sherill Locke-Lane Construction 704-902-9083
Henry Pitts Locke-Lane Construction 828-238-8756
Barbra Harmon Town of Rhodhiss 828-396-8400
i
i
1

Page 2 of 6
(Attachment B)
NCDENR/DWQ STATE REVOLVING LOAN/GRANT PROGRAM
CONSTRUCTION INSPECTION GROUP
PRECONSTRUCTION CONFERENCE REPORT
Name of Project: Sanitary Sewer System Rehabilitation
Project Number: 2W370737-01
Grant Recipient: Town of Rhodhiss
Description of Work:
Eligible
Sewer rehabilitation consisting of replacement of approximately 350 linear feet of
8-inch gravity sewer, and rehabilitation of approximately 95 manholes, and
reconnection of service laterals within and up to the existing right-of-way.
Non Eligible
Any installation of sewer service laterals outside the right-of-way.
Authorized Representatives:
1. Grant Recipient: Ms. Barbara Marmon,Town Administrator
2. State: Daniel Blaisdale,P.E./Mark L.Hubbard,P.E.
3. Consulting Engineer: West Consultants
4. A/E Inspector: John Abernethy
Date and Time of Conference: July 2, 2009 9:00 AM at Rhodhiss Town Hall
CONSTRUCTION CONTRACT NO. I
Contractor Name—Locke-Lane Construction, Inc.
Address—2508 South Chipley Ford Road,Statesville NC 28625
Contract Amount-$145,589.00 Eligible Contract Amount - $145,589.00
Contract Description -General Construction
Superintendent at Site—Henry Pitts
Date of Notice To Proceed—07/13/09
Contract Time- 120 calendar days Completion Date— 11/10/09
Liquidated Damages $500 per day until final completion
ROLE OF THE CONSTRUCTION INSPECTION GROUP (CIG)
1. Conduct periodic inspections of the project.
2. Review change orders for necessity and reasonableness to determine eligibility for
funding.

Page 3 of 6
a. To assure that the overall objectives of the ARRA Funds (Funds) are realized.
b. To assure that the Funds and project will be administered in accordance with
Federal Laws regulations.
C. To advise and offer assistance to the Owner, hereafter referred to as Recipient.
d. To ensure contract compliance and construction in accordance with the approved
contract documents.
CIG INSPECTIONS
1. Prior notice will be given; however, unannounced inspections will also be conducted.
2. Inspections will be conducted in two phases:
P
a. Fund Administration
b. Project Construction
3. During inspections, CIG will usually review at the job site for completeness and accuracy
all shop drawings,submittals, inspector's field reports, as-built drawings, revised
construction schedules and records of testing of materials and equipment, and discuss
pending or executed change orders.
4. All equipment and materials on job site are requested to be properly stored, stockpiled,
and protected. The job site is to be maintained in an acceptable manner.
5. Safe working conditions should be maintained at all times. The CIG will discuss safety
violations which are potentially life endangering or threatening serious injury. If
necessary, the CIG will take prompt action to notify State and OSHA regional
representatives of any noted conditions.
6. Results of the inspection will be discussed at the job site upon completion of the
inspection.
7. Formal copies of the inspection report will be sent to the Recipient, A/E and other parties,
if so desired.
1 8. In order to avoid the situation where the contractor is provided a final punch list of
deficiencies by both A/E and CIG,CIG will accompany the ME on his final punch list
inspection.
CHANGE ORDERS
1. Recipient should notify DENR-DWQ prior to commencement of any change order work,
except for emergency situations, that change the scope of the project.
2. Recipient must obtain prior DENR-DWQ approval for any change orders in excess of
$100,000 or any change orders that would necessitate an increase in the Fund amount.
3. Recipient should submit two (2)properly executed copies of change orders to DENR-
DWQ. Change order forms should indicate the Federal project number, the correct
change order number, name of contractor, contract number, and the date the change order
was signed by all parties.
4. A complete detailed justification and clear description must be submitted with each
change order to identify the need for the change. This submittal shall include
justification and proper documentation for any requested time extensions.
5. Copies of new or revised contract drawings and/or specifications must be submitted with
each change order.

Page 4 of 6
6. Unless previously agreed unit prices are used, complete records of price negotiations
shall be submitted with each change order. This should include such items as: a copy of
the engineer's independent cost estimate, the construction contractor's cost breakdown,
and the basis for the final negotiated settlement which would be a Memorandum of
Negotiation.
7. The change order checklist should be completed and submitted with each change order.
A copy has been included at the end of this report.
8. Change orders will be disapproved until the above backup documentation is submitted.
Work in place required by a non-State approved change order shall not be included in a
contractor's partial payment request until the change order is approved.
9. Once the Recipient signs a change order, he obligates himself to the Contractor. The
State is not obligated to approve the change order or reimburse the Recipient. The CIG
will perform preliminary reviews of unexecuted change orders and provide preliminary
eligibility determinations upon 'request.
RECIPIENT &A/E RESPONSIBILITY
1. The Recipient and A/E should become familiar with their responsibilities as defined by
40 CFR.
2. Fund conditions must be met and Fund objectives achieved including but not limited to:
a. Display Davis Bacon wage Yates in an area accessible to contractor employees.
b. Provide certified payrolls with each pay request.
c. Provide documentation on file verifying that"Buy American"requirements are met.
d. Provide job creation numbers as wells as job loss prevention numbers when and/or if
asked for them.
RECIPIENT PAYMENT REQUEST
1. Recipient should submit all payment requests (SF271) to the State with backup
documentation when requested,
2. Fund Agreement/Amendments and all conditions placed on them, if applicable, must be
satisfied prior to payment of funds.
ENVIRONMENTAL PROTECTIOII
The Recipient was advised that the protection of the environment is a Fund requirement. It is
necessary to comply with all environmental pollution control programs established by the city,
State, and EPA. This includes, but is not limited to:
1. Protection of existing trees, shrubs, and grass.
2. Dust control of haul roads, excavation, work areas, and borrow areas.
3. Conformance with an approved erosion control plan.
4. Required treatment of Recipient's water during construction.
VARIOUS ITEMS
1. The approved set of contract drawings should be furnished to the Recipient, A/E
inspector, and to each contractor's supervisor or foreman. These drawings are to be

Page 5 of 6
-- --------mar-ked-up-as-author-ized-changes-occur-and-are-to-be-used-in-preparing-as-built(record) - - —
drawings. These marked-up drawings shall be maintained and made available for review
by State inspectors.
2. Prior to commencement of work, each contractor shall submit a "Construction Progress
Schedule" (i.e. Bargraph,CPM, etc.) showing a breakdown of the principal features of
construction with the contract costs. The schedule shall be prepared in such a way that
the percentage of work completed and the work scheduled for completion at any given
date may be determined. Also at the same time,each contractor shall submit an itemized
breakdown that shall be the basis on which the contractor's monthly estimates and
progress payments will be made. This office is requesting copies of these submittals
upon authorization of the Recipient's engineer.
3. The Recipient and A/E should confirm that all required permits and encroachment
agreements have been obtained, including COE 464 Wetlands Permit,COE Section 10
Navigable Waterways Permit, DENR Erosion Control Permit, DWQ Water Quality
Certification, NCDOT and Railroad Encroachment Agreements, etc.
4. The Recipient and A/E should confirm that all addenda have been submitted for approval.
5. Addenda Approval:
Addendum Number Date Received Date Approved
1 --------- 4/29/09
2 5/14/09 5/15/09
3 --------- 5/18/09
i

Page 6 of 6
CONSTRUCTION GRANTS & LOANS
CHANGE ORDER CHECKLIST
The following checklist must be completed and all information must be submitted prior to
approval. Incomplete submittals will not be reviewed.
Owner
Project Name
Project No.
Change Order No.
Contract No.
Contractor
Change Order Documents
Two (2) copies of the properly executed change order(an unexecuted copy may
be submitted for a preliminary review, however all supporting documentation
must be included);
Federal and/or State Project number(s) shown on the change order;
Clear description of each change;
Detailed justification to identify the need for each change;
Justification and documentation for any contract time extensions (Time
extensions for weather should be for above average precipitation. The average
number of days with precipitation greater than 0.10" for each month can be
obtained from NOAA Report No. 20.)
Copies of new or revised contract drawings and/or specifications for the change;
Cost Documentation: The degree of cost documentation required is directly proportional to the
cost of the change. However, each of the following items should be addressed regardless of the
cost:
Engineer's independent cost estimate;
Contractor's detailed cost breakdown for labor, material, equipment, tax,
overhead, and profit;
Copies of suppliers' invoices for major items;
Memorandum of negotiation which documents the negotiation process and the
basis for the final negotiated settlement

r4iLA
NCD NR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman---
Governor Director Secretary
May 15, 2009
Ms. Barbara Harmon Town Administrator 11 �I i MAY 1 9 2009
Town of Rhodhiss �__._...___.._-._.._..... ..._.,..._.J
Post Office Box 40 vd.ATGn(--Al CE holy
Rhodhiss,North Carolina 28667
SUBJECT: Town of Rhodhiss
Sanitary Sewer System Rehabilitation
Approval of Addendum No. 2
American Recovery and Reinvestment Act of 2009
Project No. 2W370737-01
Dear Ms. Harmon:
Reference is made to Addendum No. 2, received May 14, 2009, from the engineer for
revisions to the subject project.
The proposed addendum, as described in the attachment, has been reviewed by this
office, and is hereby approved, and eligible for funding in accordance with the loan offer and
conditions thereof.
The approval of this addendum does not constitute any change in the amount of your loan
for this project.
It is the responsibility of the recipient and the consulting engineer to insure that the
project plan documents are in compliance with Amended N.C.G.S. 133-3 (ratified July 13,
1993). The administrative review and approval of addenda do not imply approval of a restrictive
specification for bidding purposes; nor is it an authorization for noncompetitive procurement
actions.
Adequate time must be allowed for the potential bidders and this office to receive and act
on addenda prior to the receipt of bids for subject project.
A copy of the approved addendum is attached for your files, and one (1) copy retained for
our files.
1633 Mail Service Center,Raleigh,North Carolina 27699-1633 One 1 Location:2728 Capital Blvd.Raleigh,North Carolina 27604 NOrtflCarOhna
Phone:[phone] FAX:[phone] Customer Service:1877-623.6748 Internet:www.ncwaterquahty.org �QturQ{//
[1/
An Equal Opportunity\Affirmative Action Employer ,/

Ms. Barbara Hannon, Town Administrator
Page 2
May 15, 2009
Should you have any questions regarding this matter,please do not hesitate to contact
Ken Pohlig, P.E. at(919) 715-6221.
Sincerely,
e'�'"" ��
Seth Robertson, P.E., Supervisor
Design Management Unit
Construction Grants & Loans Section
kp/sr
Attachment
cc: Benjamin B. Thomas, P.E., West Consultants, PLLC, Morganton,NC
DWQ Asheville Regional Office
Mark Hubbard, P.E.
Ken Pohlig, P.E.
ARRA File
l
1
i
I

WEST405 South Sterling Street,Morganton NC 28655 .
CONSULTANTS Pac 828 433 5661 / fa.828 433 5662 / [e-mail]
aY MAY 14 2009
ADDENDUM NO. 2 OWN
L �nt71{�
This ADDENDUM NO. 2 is being issued May 8,2009,to all parties who hold a set of CONTRACT
DOCUMENTS on the project entitled:
TOWN OF R}IODHISS
SANITARY SEWER REHABILITATION
AMERICAN REINVESTMENT&RECOVERY ACT FUNDING
BURKE COUNTY,NORTH CAROLINA
This ADDENDUM NO.2 shall become part of the CONTRACT DOCUMENTS and its receipt
acknowledged on the BID DOCUMENTS at the time of bidding.
1. Water will be available for product application at no charge from fire hydrants on the Owner's
system. Contractor must provide and use backflow preventer.
2. Section 07310 Protective Coating and Lining for Manholes:
a. Technical Specification Section 07310.7 shall allow microsilicate.
b. Technical Specification Section 073 10.1 I —Corrosion protection shall be epoxy and shall
be 100%solids, The epoxy shall have the following properties:compressive strength of
8800 psi,flexural strength of 12,400 psi,and tensile strength of 7700 psi. The epoxy
coating shall be Madewell Mainstay DS-5,Tnemec equal,Sherwin Williams equal,
Sprayroq equal,or other approved equal.
3. BID FORM: The BID FORM has been revised to add a separate item for the epoxy corrosion
protection. Bid Item No. 3 shall not include the corrosion protection. Bid Item No.4 shall be for
epoxy corrosion protection of manholes that are relined. No manholes are to be coated with epoxy
that are not also relined. However,the Owner may elect to omit epoxy corrosion protection from
some relined manholes.
4. SRF Standard Conditions: The Office of Economic Recovery and Investment has requested that
additional provisions be included in projects funded by the American Reinvestment&Recovery
Act Funding of 2009 to clarify the process required to meet the requirements of the DBE Program.
These Conditions shall replace the existing SRF Special Conditions issued with the Contract
Documents.
ADDENDUM NO.2 ` yyfr S l zy F;
Issued this 8 a day of May,2009 q SEAL `g
210757
m E.• •e� s
�a$A.' aeewepe m$.
Benjamin B. Thomas,PE �d'a®ap� BNaiCb�b$`4ae
West Consultants,PLLC
Morganton,North Carolina
/kj
Page 1 of 1

Addendum No.2,dated May 8,2008
BID FORM
Bid Submilled by
(Insert Company Name)
TOWN OF RHODHISS
SANITARY SEWER SYSTEM REHABILITATION
BURKE COUNTY,NORTH CAROLINA
West Consultants,PLLC Project No. 08151
TABLE OF ARTICLES
Page
1 Article I—Bid Recipient......................................................................................................................................................................2
Article 2—Bidder's Acknowledgements..............................................................................................................................................2
Article3—Bidder's Representations....................................................................................................................................................2
Article4—Further Representations......................................................................................................................................................3
Article5—Basis of Bid.........................................................................................................................................................................4
Article6—Time of Completion............................................................................................................................................................4
Article7—Attachments To This Bid....................................................................................................................................................4
Article8—Defined Terms....................................................................................................................................................................5
Aticle9—Bid Submittal......................................................................................................................................................................6
EJCDC C-410 Suggested Bid Form for Construction Contracts
Copyright C 2002 National Society orProfessionat Engineers for EJCDC.all rights reserved.
00410-1
yl

Addendum No.2,doted May 8,2008
ARTICLE 1—BID RECIPIENT
1.o 1 This Bid is submitted to:
Town of Rhodhiss
PO Box 40
200 Burke Sheet
Rhodhiss,NC 28667-0040
1.02 The undersigned Bidder proposes and agrees,if this Bid is accepted,to enter into an Agreement with Owner in the form
included in the Bidding Documents to perform all Work as specified or indicated in the Bidding Documents for the
prices and within the times indicated in this Bid and in accordance with the other terms and conditions of the Bidding
Documents.
ARTICLE 2—BEDDER'S ACKNOWLEDGEMENTS
2.01 Bidder accepts all of the terms and conditions of the Instructions to Bidders,including without limitation those dealing
with the disposition of Bid security.This Bid will remain subject to acceptance for 60 days after the Bid opening,or for
such longer period of time that Bidder may agree to in writing upon request of Owner.
ARTICLE 3—BIDDER'S REPRESENTATIONS
3.01 in submitting this Bid,Bidder represents that:
A. Bidder has examined and carefully studied the Bidding Documents,the other related data identified in the Bidding
Documents,and the following Addenda,receipt of which is hereby acknowledged.
Addendum No. Addendum Date
1 04/29/09
B. Bidder has visited the Site and become familiar with and is satisfied as to the general,local and Site conditions that
may affect cost,progress,and performance of the Work.
C. Bidder is familiar with and is satisfied as to all federal,state and local Laws and Regulations that may affect cost,
progress and performance of the Work.
D. Bidder has carefully studied all: (1)reports of explorations and tests of subsurface conditions at or contiguous to
the Site and all drawings of physical conditions in or relating to existing surface or subsurface structures at or
contiguous to the Site(except Underground Facilities)which have been identified in SC-4.02,if any,and(2)reports
and drawings of Hazardous Environmental Conditions that have been identified in SC4.06,if any.
E. Bidder has obtained and carefully studied (or accepts the consequences for not doing so) all additional or
supplementary examinations, investigations, explorations, tests, studies and data concerning conditions (surface,
subsurface and Underground Facilities)at or contiguous to the Site which may affect cost,progress,or performance
of the Work or which relate to any aspect of the means, imethods, techniques, sequences, and procedures of
construction to be employed by Bidder,including applying the specific means,methods,techniques,sequences,and
procedures of construction expressly required by the Bidding Documents to be employed by Bidder, and safety
precautions and programs incident thereto.
F. Bidder does not consider that any further examinations, investigations, explorations, tests, studies, or data are
necessary for the determination of this Bid for performance of the Work at the price(s)bid and within the times and
in accordance with the other terms and conditions of the Bidding Documents.
EJCDC C-410 Suggested Bid Form for Construction Contracts
Copyright®2002 National Society of Professional Engineers for HJCDC.All rights reserved.
00410-2

Addendum No.2,dared May 8,1008
G. Bidder is aware of the general nature of work to be performed by Owner and others at the Site that relates to the
Work as indicated in the Bidding Documents.
H. Bidder has correlated the information known to Bidder, information and observations obtained from visits to the
Site, reports and drawings identified in the Bidding Documents, and all additional examinations, investigations,
explorations,tests,studies,and data with the Bidding Documents.
1. Bidder has given Engineer written notice of all conflicts, errors, ambiguities, or discrepancies that Bidder has
discovered in the Bidding Documents,and the written resolution thereof by Engineer is acceptable to Bidder.
J. The Bidding Documents are generally sufficient to indicate and convey understanding of all terms and conditions
for the performance of the Work for which this Bid is submitted.
I
K. Bidder will submit written evidence of its authority to do business in the state where the Project is located not later
than the date of its execution ofthe Agreement.
ARTICLE 4—FURTHER REPRESENTATIONS
4.01 Bidder further represents that:
A. this Bid is genuine and not made in the interest of or on behalf of any undisclosed individual or entity and is not
submitted in conformity with any agreement or rules of any group,association,organization or corporation;
B. Bidder has not directly or indirectly induced or solicited any other Bidder to submit a false or sham Bid;
C. Bidder has not solicited or induced any individual or entity to refrain from bidding;and
I D. Bidder has not sought by collusion to obtain for itself any advantage over any other Bidder or over Owner.
I
EJCDC C410 Suggested Bid Form for Construction Contracts
Copyright®2002 National Society of Professional Engineers for EJCDC.All rights reseed.
00410-3

Atldendunt No.2,dated May 8,2008
ARTICLE 5—BASIS OF BID
5.01 Bidder will complete the Work in accordance with the Contract Documents for the following price(s):
Item Quantity Unit Unit Price Total Bid
1. Reseal Manhole Frame 33 EA $ $
2. New Frame&Cover It EA $ $
3. Reline Manhole-Cementitious 494 VF $ $
4. Conosion Protection-Epoxy Coating 494 VF $ $
5. Riser Addition or Replacement 8 VF $ $
6 Replace 8"Gravity Line* 350 LF $ $
7. Reconnect Existing Services to New
Gravity Line(Item#5),include New
Wye,4"Pipe and Fittings,and
Cleanout 4 EA $ S
S. Project Sign(See SRF Attachment
No.8) 1 EA $ $
TOTAL BID $
*NOTE: Costs for all mobilization,fertilizing,seeding,and rmdching,landscaping,culvert and fence replacements,
and stone foundation conditioning,ifany,shall be included in the various bid items. No separate payment will be made
for these items.
Unit Prices have been computed in accordance with Paragraph 11.03.13 of the General Conditions.
Bidder acknowledges that estimated quantities are not guaranteed,and are solely for the purpose of comparison of Bids,
and final payment for all Unit Price Bid items will be based on actual quantities,determined as provided in the Contract
Documents.
ARTICLE 6—TIME OF COMPLETION
6.01 Bidder agrees that the Work will be substantially complete within 90 calendar days after the date when the Contract
Times commence to run as provided in Paragraph 2.03 of the General Conditions,and will be completed and ready for
final payment in accordance with Paragraph 14.07.E of the General Conditions within 120 calendar days after the date
when the Contract Times commence to run.
6.02 Bidder accepts the provisions of the Agreement as to liquidated damages in the event of failure to complete the Work
within the Contract Tunes.
ARTICLE 7—ATTACHMENTS TO THIS BID
7.01 The following documents are attached to and made a condition of this Bid:
A. Required Bid security.
EJCDC C-410 Suggested Bid Form for Construction Contracts
Copyright®2002 National Society of Professional Engineers for EJCDC.All rights reserved
00410-4

Addendum No.2,dated May 8,2008
B. "Affidavit A—Listing of Good Faith Efforts"or"Affidavit B—Intent to Perform Contract with Own Workforce"
I
C. Identification of Minority Business Participation,if applicable.
D. For building contracts:
A list of proposed Subcontractors for Heating,Ventilating,and Air Conditioning;Plumbing;and Electrical.
E. For any Subcontractors proposed to perform more than 25%of the total work,provide a list of such Subcontractors
with the following information as a minimum:
Name, address, telephone number, license type and number, five references, experience history, and a list of
current projects.
ARTICLE 8—DEFINED TERMS
8.01 The terms used in this Bid with initial capital letters have the meanings stated in the Instructions to Bidders,the General
Conditions,and the Supplementary Conditions.
i
i
EJCDC C410 Suggested Bid Form for Construction Contracts
Copyright®2002 National Society of Prorenionat Engineers far EJCDC.All rights reserved.
00410-5
J

Addendum No.2,dated May 8,2008
ARTICLE 9—BID SUBMITTAL
9.01 This Bid submitted by:
If Bidder is:
An Individual
Name(typed or printed):
By: (SEAL)
(Individual's signature)
Doing business as:
A Partnershin {
Partnership Name: (SEAL)
By:
(Signature ofgeneral partner—attach evidence of authority to sign)
Name(typed or printed):
A Comoration
Corporation Name: (SEAL)
State of Incorporation:
Type(General Business,Professional,Service,Limited Liability):
By:
(Signature—attach evidence of authority to sign)
Name(typed or printed):
Title:
(CORPORATE SEAL)
Attest:
(Signature of Corporate Secretary)
Date of Qualification to do business in [State Where Project is Located]is_\ \�
EJCDC C410 Suggested Bid Form for Construction Contracts
Copyright 0 2002 National Society of Professional Engineers for FJCDC..All rights reserved.
00410-6

Addendurn No.2,dated May 8,2008
A Joint Venture
Name of Joint Venturer:
First Joint Venturer Name: (SEAL)
By:
(Signature offrrst joint venture partner—attach evidence of authoritY to sign)
Name(typed or printed):
Title:
Second Joint Venturer Name: (SEAL)
By: '
(Signature ofsecond joint venture partner—attach evidence ofauthority to sign)
-�, Name(typed or printed):
Title:
(Each joint venturer must sign.The manner of signing for each individual,partnership,and corporation that is a party to
the joint venture should be in the manner indicated above.)
I
Bidder's Business address:
Phone: Facsimile:
Submitted on 120 .
State Contractor License No. (If applicable)
1
EJCDC C410 Suggested Bid Form for Construction Contracts
Copyrights)2002 National Society of Professional Engineers for EJCDC.All rights reserved.
09410-7

AZ
NC ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins pee Freeman
Governor Director — Secret ry
May 7, 2009 .I `f Il MAY 1 2 2009 l
i I '
Ms. Barbara Harmon, Town Administrator ---�
Town of Rhodhiss _ f
Post Office Box 40 - V'A1 eh C!-I=,LlTr sec rich
Rhodhiss,North Carolina 28667 A I, . " `-` ` 1Ori�' o ImE—
SUBJECT: Town of Rhodhiss
Sanitary Sewer System Rehabilitation
Approval of the Funding Application for
American Recovery and Reinvestment Act of 2009
Project No.2W370737-01
Dear Ms. Harmon:
The subject project was submitted for funding under the American Recovery and
Reinvestment Act of 2009 (ARRA). Some ARRA conditions are different than base Clean
Water State Revolving Fund(CWSRF)projects—please carefully read this entire letter.
The review for completeness and adequacy of the funding application including the project
engineering report and construction documents has been concluded by the Construction Grants &
Loans Section(Section) of the North Carolina Division of Water Quality. This includes
Addendum No. 1,received April 29, 2009, submitted for consideration of funding under the
ARRA. Therefore, said documents are hereby approved. A Determination of Minor Construction
Activities for the project is attached for your files. A loan offer will be transmitted to you
separately, contingent upon approval by the Local Government Commission at their May 5, 2009
or May 14, 2009 meetings.
Eligibility for Revolving Loan funding is determined as follows:
Eli ible
Sewer rehabilitation consisting of replacement of approximately 350 linear feet of 8-inch gravity
sewer, and rehabilitation of approximately 95 manholes, and reconnection of service laterals
within and up to the existing right-of-way.
Non Eligible
Any installation of sewer service laterals outside the right-of-way.
1633 Mail Service Center,Raleigh,North Carolina 27699-1633 OaC
Location:2728 Capital Blvd.Raleigh,North Carolina 27604 NorthCarolina
Phone:[phone]q FAX:[phone] Customer Service:1-877-623-6748 �ry��N����
Internet:www.nnity XA Affirmative
c {,L
An Equal Opportunity 1 Affirmative Action Employer

Ms. Barbara Harmon, Town Administrator
May 7, 2009
--Page-T-wo—-. ---
In the event that received bids exceed the amount established through the funding offer,
and local funds are not adequate to award contract(s), it will be necessary to consider all
alternatives including redesign, re-advertising, and rebidding. Please note that the specifications
must include the special provisions of the ARRA(i.e., buy American.Davis-Bacon wage
requirements,job reporting) in addition to the regularly required SRF Special Conditions. Job
reporting requirements have not been established by the US EPA at this time, but will likely
include jobs created or retained,hours worked, type of jobs, etc.
Attached is one(1)copy of the Project Bid Information(Authority to Award)which is to
be completed after bids have been received, and submitted to Mr. Mark Hubbard,P.E.,
Assistant Section Chief,Construction Grants and Loans Section by June 10`h for review.
Upon review and approval of this information,the Section will authorize the Recipient to award
contracts. All elements required for a complete Bid Information package must be submitted to
ensure a timely review by the Section.
In accordance with a goal of the ARRA, contracts are expected to be executed by June
17`h. If these dates cannot be met,you must contact the Section with a detailed explanation and
proposed alternative deadlines. Upon execution of contracts and issuance of Notice to Proceed, a
bound set of contract documents must be submitted to the Section for approval. Funds cannot be
dispersed until executed contracts are approved. While rejection of all bids is possible, such
action may be taken only with prior Section concurrence, and only for good cause.
In the event that progress on the approved ARRA CWSRF project is not made in
accordance with the loan agreement, construction contracts,or other pertinent
requirements reimbursements may be withheld or suspended indefinitely. Funds not
requested for reimbursement in a timely manner may also be reallocated to other ARRA
ready-to-go projects on the final State project list.
Once the project costs are established, final awards may be adjusted downward in the case
of low bids. Five percent contingency is included in the final amount to accommodate change
orders and amendments to the engineering contract. In no case will awards be increased.
Neither the State nor Federal Government, nor any of its departments, agencies or
employees is or will be a party to the invitation to bids, addenda, any resulting contracts or
contract negotiations/changes.
Your project is subject to the one-year performance certification requirements. By this,
you are required on the date one year after the completion of construction and initial operation of
the subject treatment facilities,to certify, based on your consulting engineer's advisement,
whether or not such treatment works meet the design performance, specifications and the permit
conditions and effluent limitations.
In accordance with the Federal Regulations, the Recipient is required to assure compliance
with the OSHA safety regulations on the subject project. In complying with this regulatory
responsibility, the Recipient should, by letter, invite the Bureau Chief, Education Training and

Ms. Barbara Harmon, Town Administrator
May 7, 2009
Page Three
Technical Assistance Unit, NC OSHA Division, 1101 Mail Service Center, Raleigh,NC 27699-
1101 at(919) 807-2890, to participate in the Preconstruction Conference to assure that proper
emphasis is given on understanding and adhering to the OSHA regulations.
It is the responsibility of the Recipient and the Consulting Engineer to insure that the
project plan documents are in compliance with Amended N. C. G. S. 133-3 (ratified July 13,
1993). The administrative review and approval of these plans and specifications, and any
subsequent addenda or change order,do not imply approval of a restrictive specification for
bidding purposes; nor is it an authorization for noncompetitive procurement actions.
Any addenda to be issued for subject project plans and specifications must be submitted by
the Recipient for review/approval action by the Section.
It is mandatory for project facilities to be constructed in accordance with the North
Carolina Sedimentation Pollution Control Act, and, when applicable,the North Carolina Dam
Safety Act. In addition, the specifications must clearly state what the contractors'responsibilities
shall be in complying with these Acts.
A goal of 8%of the contract price is established for Minority Business Enterprise (MBE)
participation in this project, and a goal of 5% of the contract price is established for Women's
Business Enterprise (WBE)participation in this project. The Recipient and Bidders shall make a
good faith effort to assure that MBE's and WBE's are utilized, when possible, as sources of
goods and services. The good faith effort must include the following affirmative steps: (a)
including small, minority, and women's businesses on solicitation lists; (b)assuring that small,
minority, and women's businesses are solicited whenever they are potential sources; (c) dividing
total requirements, when economically feasible, into small tasks or quantities to permit
maximum participation by small, minority, and women's businesses; (d) establishing delivery
schedules, and (e)using the services of the Small Business Administration and the Minority
Business Development Agency of the U.S. Department of Commerce. Please note that the
solicitation efforts should include documentable follow-up phone calls.
The Recipient shall comply with the provisions of 40 CFR, Part 7, Subpart C -
Discrimination Prohibited on the Basis of Handicap.
Two (2) copies of any change order must be promptly submitted by the Recipient to the
Section. If additional information is requested by the Section, a response is required within two
(2) weeks, or the change order will be returned without further or final action.
One (1) set of plans and specifications identical to the approved set must be available at
the project site at all times. Upon completion of the project construction, the Recipient shall
submit a letter confirming that the project has been constructed in accordance with the plans and
specifications approved by the Section. "As-built" plans will need to be submitted with any
changes clearly documented on the plans if the above confirmation cannot be made.

Ms. Barbara Harmon, Town Administrator
May 7,2009
— --Page Four--- — —
If there are any questions concerning this matter,please do not hesitate to contact Kim H.
Colson, P.E. at(919) 715-6212 or Mark Hubbard, P.E. at(919) 715-6224.
Sincerely
Daniel M. Blaisdell, P.E., Section Chief
Construction Grants & Loans Section
Attachments: Determination of Minimum Construction Activity
Bid Information Form
{ Addendum No. 1
KHC:KOP
cc: Benjamin B. Thomas, P.E., West Consultants, PLLC, Morganton,NC
OSHA Bureau Chief, Wanda Lagoe
DWQ Asheville Regional Office
Daniel Blaisdell, P.E.
Mark Hubbard, P.E.
Jennifer Haynie
CIG
SRF
1

Determination of Minor Construction Activity
North Carolina Division of Water Quality
Construction Grants and Loans Section
Project Applicant: Town of Rhodhiss
Date: April 29, 2009
Project Number: 2W370737-01
Estimated Project Cost: $ 188,764
Estimated Funding Amount: $ 188,764
Project Description: The proposed project consists of sewer rehabilitation including the
replacement of approximately 350 linear feet of 8-inch gravity sewer, and rehabilitation
of approximately 95 manholes.
The above named applicant intends to apply for assistance from the State Revolving Fund
program associated with the American Recovery and Reinvestment Act of 2009 to
construct the wastewater facilities described above. The North Carolina Division of
Water Quality (DWQ)has conducted a review of the project in accordance with the
procedures (NCAC 15A Subchapter 1C) for conformance with the North Carolina
Environmental Policy Act. The DWQ has determined that this project is a minor
construction activity, and that the preparation of additional environmental documents is
not required.
This determination shall become effective upon its distribution by DWQ. This
determination can be revoked at any time adverse information is made available. The
documentation to support this decision will be on file with the North Carolina
Department of Environment and Natural Resources, Division of Water Quality,
Construction Grants and Loans Section, and is available for public review at
www.nccgl.net.
Comments concerning this decision may be addressed to Mr. Kim H. Colson, P.E.,
Assistant Chief, Construction Grants and Loans Section, Division of Water Quality, 1633
Mail Service Center, Raleigh,North Carolina 27699-1633, or he may be reached by
phone at(919) 715-6212.
Sincerely,
Daniel M. Blaisdell, P.E., Chief
Construction Grants and Loans Section
Division of Water Quality

PROJECT BID INFORMATION
Previously referred to as the"Part B" in State programs
Previously referred to as the"Project Review and Cost Summary" in Federal programs
WARD RECIPIENT INFORMATIO
Name Project Number
Address
ID INFORMATIO
Attach the following supplemental information and submit with this form:
(a) Tabulations of all bids received (sealed by engineer).
(b) Copies of the bid(s)and bid bond the applicant wishes to accept.
(c) Resolution of tentative award.
(d) Engineer's recommendation of award letter.
(e) Proof of advertisement
(f) MBE/WBE Requirements:
State Programs
■ Include affidavits A,B, C or D as required.
• Submit certification of subcontract awards to minority business firms
with documentation to comply with G.S. 143-128.2. (Complete attached form)
Federal Programs(SRF and STAG)
■ Documentation of Contractor's "good faith" effort to procure MBEIWBE
subcontractors.
■ Certification regarding debarment, suspension and other responsibility matters
for each prime and subcontractor.
�
D r
DITI LL INFORMATIO
Addenda
All addenda must be submitted to CG&L for approval prior to opening bids. Changes to the
scope of the project may require a permit modification.
Site Certificates(2)
Submit if not previously submitted or if changes have occurred.
Additional Items
• Land Costs (State Loans& Grants Only) Submit form if seeking payment.
• A/E Contracts—Submit for approval if seeking payment.
• Sewer Use Ordinance, User Charge System and Sewer budget(SRF Only) Payments
stop at 90% of total project costs if not approved.
• 4700 Form (SRF Only)
0 Submit proof of adequate resident inspection (resume of inspector).

List contractor names below: TOTAL ELIGIBLE
L $ $
2.
3.
4.
5.
E UIPMENT AND MATERIALS
TECHNICAL SERVICES attach contract
LEGAL
ADMINISTRATIVE
CONTINGENCY 5%of construction
OTHER(specify)
REAL PROPERTY AC UISTION COSTS
CLOSING COSTS
i
i
i
List funds that are available for this project: AMOUNT
CASH $
GENERAL OBLIGATION BONDS
j REVENUE BONDS
OTHER(specify)
FEDERAL LOAN/GRANT(specify agency) b
STATE LOAN
STATE GRANT
Y y 4�v • � � ��Q Y` Q
fiti W
The undersigned representative of the Recipient certifies that the information contained above and in
any attached statements and material in support thereof is true and correct to the best of his or her
knowledge.
Signature of Authorized Representative Name and Title(type or print) Date

INSTRUCTIONS FOR SUBMITTING
PROJECT BID INFORMATION FORM
This information must be submitted as soon as possible after construction bids are opened.
For STAG and State projects send to: For SRF Projects send to:
Don Evans Steve Tsadwa
Construction Grants and Loans Section Construction Grants and Loans Section
1633 Mail Service Center 1633 Mail Service Center
Raleigh,NC 27699-1633 Raleigh,NC 27699-1633
Page 1
Enter all requested information such as,Name,Address, and Project Number. Documentation
listed from(a)to (f)must be submitted. Addenda should be submitted before bids are opened
with enough time for CG&L to approve them(7 days). Site information should be attached if
not previously submitted.
Page 2
PROJECT COST SUMMARY
(1) Enter the contractor's company or corporate name. Enter the amount of the
bid or bids the applicant wishes to accept.
(2) If equipment or materials are to be or have been purchased outside the
construction contracts, enter the estimated or actual costs as applicable.
(3) If not previously submitted, attach copies of any engineering contracts or
agreements. Formal agreements are required for disbursement of funds.
(4) Contingency is limited to 5%of the total construction bid amount.
(5) Appraisals and a copy of the Deed are required for disbursement of real
property costs.
(6) Closing costs are not eligible for reimbursement under the SRF. They are 1.5%for
State Grants, 2%for SRF Loans and 2.5%for State Loans.
REVENUE SOURCES FOR PROJECT CONSTRUCTION
(1) Enter the amount of general obligation bonds and revenue bonds authorized
but not yet sold for this project.
(2) Enter the amount of the grant, if any, offered by Federal or State Agency(s)
and list name of agency(s).
(3) Enter the amount of the loan or grant offered.
(4) Total funds available must equal or exceed the Total Project Cost.
The form must be signed by the applicant's authorized representative.

9t
THE TOWN DOES HEREBY CERTIFY THAT IT HAS MET THE REQUIREMENTS OF G.S. 143-128.2 IN
REFERENCE TO MINORITY BUSINESS CONTRACTS FOR THIS CONSTRUCTION PROJECT. THE
CONTRACTOR HAS MET THE GOALS ESTABLISHED BY RESOLUTION OF THE TOWN AND THE
FOLLOWING CONTRACTS MEET THE REQUIREMENTS ADOPTED BY THE TOWN:
i
signature of authorized representative name of authorized representative
PLEASE LIST CONTRACTORS AND MINORITY SUBCONTRACTORS:
1
1. CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
2. CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
$
MINORITY CONTRACT: AMOUNT
3. CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
MINORITY CONTRACT: AMOUNT
CONTINUE IF MORE THAN THREE CONTRACTS

� 1 OF WArFR IL. Michael F. Easley,Governor
Q William G. Ross Jr.,Secretary
' q° yr North Carolina Department of Environment and Natural Resources
O Y Alan W. Klimek, P.E., Director
Division of Water Quality
Asheville
July 25, 2006
Ms. Rose Waldroup, Town Administrator
Town of Rhodhiss
Post Office Box 40
Rhodhiss, North Carolina 28667-0040
Subject: Permit No. WQ0030542
Town of Rhodhiss
NC Urgent Needs
Wastewater Collection System Extension
Burke County
Dear Ms. Waldroup:
In accordance with your application received on July 13, 2006 we are forwarding herewith
Permit No. WQ0030542, dated July 25, 2006, to the Town of Rhodhiss for the construction and
operation of the subject wastewater collection system extension. This permit shall be effective from the
date of issuance until rescinded and shall be subject to the conditions and limitations as specified
therein. This cover letter shall be considered a part of this permit and is incorporated therein by
reference.
Please pay particular attention to Permit Condition 3 which requires that the wastewater
collection facilities be properly operated and maintained in accordance with 15A NCAC 2H .0227 or any
individual system-wide collection system permit issued to the Permittee.
Permitting of this project does not constitute an acceptance of any part of the project that does
not meet 15A NCAC 2H .0200; the Division of Water Quality's (Division) Gravity Sewer Minimum
Design Criteria adopted February 12, 1996 as applicable; and the Division's Minimum Design Criteria
for the Fast-Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable,
unless specifically mentioned herein. Division approval is based on acceptance of the certification
provided by the North Carolina-licensed Professional Engineer named in the application. It shall be the
Permittee's responsibility to ensure that the as-constructed project meets the appropriate design criteria
and rules. Failure to comply may result in penalties in accordance with North Carolina General Statute
§143-215.6A through §143-215.6C, construction of additional or replacement wastewater collection
facilities, and/or referral of the North Carolina-licensed Professional Engineer to the licensing board.
Asheville Regional Office Internet www.ncwaterquality.org
2090 US Highway 70,Swannanoa, NC 28778 Telephone [phone] Fax [phone] One
NorthCarolina
DENR Customer Service Center Telephone [phone] Naturally
An Equal Opportunity Action Employer 50%recycled/10%post-consumer paper

�r
Town of Rhodhiss July 25, 2006 Page 2
-- In accordance-with-the-provisions-of-Article-2-1-of-Chapter-1 43, General-Statutes-of-North-Carolina as — ----
amended, and other applicable Laws, Rules, and Regulations, permission is hereby granted to the
Town of Rhodhiss for the construction and operation of approximately 1,241 linear feet of 8-inch
diameter gravity sewer; a 250—gallon per minute pump station with duplex pumps, audible and visual
high water alarms, telemetry and an on-site generator with automatic transfer switch; a 300-gallon per
minute pump station with duplex pumps, audible and visual high water alarms, telemetry and an on-
site generator with automatic transfer switch as well as approximately 380 linear feet of 4-inch
diameter force main to replace existing storm damaged sewage pumping stations and the discharge of
1,800 gallons per day of additional domestic wastewater into the Town of Rhodhiss' existing sewerage
system, pursuant to the application received on July 13, 2006 and in conformity with 15A NCAC 2H
.0200; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as applicable;
the Division's Minimum Design Criteria for the Fast-Track Permitting of Pump Stations and Force Mains
adopted June 1, 2000 as applicable; and other supporting data subsequently filed and approved by the
Department of Environment and Natural Resources and considered a part of this permit.
The sewage and wastewater collected by this system shall be treated in the Town of Rhodhiss'
Wastewater Treatment Facility (Permit No. NC0025917) prior to being discharged into the receiving
stream.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the
right to request an adjudicatory hearing upon written request within 30 days following receipt of this
permit. This request must be in the form of a written petition, conforming to Chapter 150B of North
Carolina General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service
Center, Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and
binding.
If you need additional information concerning this matter, please contact Roy Davis at (828)
i
296-4500.
Sincerely,
fortlan We P.E., Director
Division of Water Quality
cc: Burke County Building Inspector
ARO, Surface Water Protection (WWTF Permit No. NC0025917)
Benjamin B. Thomas, PE
PERCS Files
i
,I
_I

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
TOWN OF RHODHISS
NC URGENT NEEDS
BURKE COUNTY
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
This permit shall be effective from the date of issuance until rescinded and shall be subject to the
following specified conditions and limitations:
1. This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 15A NCAC 2H .0200; the Division of Water Quality's
(Division) Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as applicable; the
Division's Minimum Design Criteria for the Fast-Track Permitting of Pump Stations and Force
Mains adopted June 1, 2000 as applicable; and other supporting materials unless specifically
mentioned herein.
2. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data.
3. The wastewater collection facilities shall be properly maintained and operated at all times. The
Permittee shall maintain compliance with an individual system-wide collection system permit for the
operation and maintenance of these facilities as required by 15A NCAC 2H .0227. If an individual
permit is not required, the following performance criteria shall be met as provided in 15A NCAC 2H
.0227:
a. The sewer system shall be effectively maintained and operated at all times to prevent
discharge to land or surface waters, and any contravention of the groundwater standards in
15A NCAC 2L .0200 or the surface water standards in 15A NCAC 213 .0200.
b. A map of the sewer system shall be developed and shall be actively maintained.
c. An operation and maintenance plan shall be developed and implemented.
d. Pump stations that are not connected to a telemetry system shall be inspected every day (i.e.
365 days per year). Pump stations that are connected to a telemetry system shall be
inspected at least once per week.
e. High-priority sewer lines shall be inspected at least once per every six-month period of time.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. Inspection and maintenance records shall be maintained for a period of at least three years.
h. Overflows and bypasses shall be reported to the appropriate Division regional office in
accordance with 15A NCAC 2B .0506(a), and public notice shall be provided as required by
North Carolina General Statute §143-215.1C.
1

Permit No VVQ0030542 Town of Rhodhiss NC Urgent Needs Burke County, uly 25 2006
4. This permit shall not be transferable. In the event there is a desire for the wastewater collection
facilities to change ownership, or there is a name change of the Permittee, a formal permit request
shall be submitted to the Division accompanied by documentation from the parties involved, and
other supporting materials as may be appropriate. The approval of this request shall be
considered on its merits and may or may not be approved.
5. Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to
interrupt service by the existing utilities nor result in an overflow or bypass discharge of wastewater
to the surface waters of the State.
6. Upon completion of construction and prior to operation of these permitted facilities, a certification, a
copy of the construction record drawings, as well as supporting design calculations for any pump
stations permitted as part of this project shall be received from a North Carolina-licensed
Professional Engineer certifying that the facilities have been installed in accordance with this
permit; 15A NCAC 2H .0200; the Division's Gravity Sewer Design Criteria adopted February 12,
- 1996 as applicable; the Division's Minimum Design Criteria for the Fast-Track Permitting of Pump
Station and Force Main adopted June 1, 2000 as applicable; and other supporting materials. If this
project is to be completed in phases and partially certified, you shall retain the responsibility to
track further construction approved under the same permit, and shall provide a final certificate of
completion once the entire project has been completed. A copy of the construction record
drawings, indicating the facilities constructed in the phase being certified, shall be submitted with
each partial certification. Mail the Engineer's Certification, one copy of the "Construction Record
Drawings," and one copy of the supporting design calculations to the Non-Discharge Permitting
Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617.
7. A copy of the construction record drawings shall be maintained on file by the Permittee for the life
of the wastewater collection facilities.
8. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 2H .0200; the
Division's Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the Division's
Minimum Design Criteria for the Fast-Track Permitting of Pump Station and Force Mains adopted
June 1, 2000 as applicable; and other supporting materials may subject the Permittee to an
enforcement action by the Division, in accordance with North Carolina General Statutes §143-
215.6A through §143-215.6C.
9. In the event that the wastewater collection facilities fail to perform satisfactorily, including the
creation of nuisance conditions, the Permittee shall take immediate corrective action, including
those as may be required by this Division, such as the construction of additional or replacement
facilities.
10. The issuance of this permit shall not exempt the Permittee from complying with any and all
statutes, rules, regulations, or ordinances that may be imposed by other government agencies
(local, state and federal) which have jurisdiction, including but not limited to applicable river buffer
rules in 15A NCAC 2B .0200, erosion and sedimentation control requirements in 15A NCAC Ch. 4
and under the Division's General Permit NCG010000, and any requirements pertaining to wetlands
under 15A NCAC 2B .0200 and 15A NCAC 2H .0500.
11. Noncompliance Notification:
The Permittee shall report by telephone to a water quality staff member at the Asheville Regional
Office, telephone number [phone], as soon as possible, but in no case more than 24 hours
or on the next working day, following the occurrence or first knowledge of the occurrence of either
of the following:
2

Permit No. W00030542. Town of Rhodhiss. NC Urgent Needs, Burke County, July 25 2006
a. Any process unit failure, due to known or unknown reasons, that renders the facility incapable
of adequate wastewater transport, such as mechanical or electrical failures of pumps, line
blockage or breakage, etc.; or
b. Any failure of a pumping station or sewer line resulting in a by-pass directly to receiving waters
without treatment of all or any portion of the influent to such station or facility.
Voice mail messages or faxed information is permissible but this shall not be considered as the
initial verbal report. Overflows and spills occurring outside normal business hours may also be
reported to the Division of Emergency Management at telephone number [phone] or(919)
733-3300. Persons reporting any of the above occurrences shall file a spill report by completing
Part I of Form CS-SSO (or the most current Division approved form), within five days following first
knowledge of the occurrence. This report shall outline the actions taken or proposed to ensure that
the problem does not recur. Per Condition 1(2), Part II of Form CS-SSO (or the most current
Division approved form) can also be completed to show that the SSO was beyond control.
Permit issued this the 25`h day of July, 2006
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
a )a ' /&LUZLoAi_
for Ala W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0030542
3

Permit No W00030542 Town of Rhodhiss NC Urgent Needs Burke County July 25 2006
ENGINEERING CERTIFICATION - POST CONSTRUCTION
System Description:
1,241 linear feet of 8-inch diameter gravity seer, a 250 GPM sewage pumping station and a 300 GPM sewage
pumping station both with audible and visual high water alarms, telemetry, on-site standby generators with ATSs
and 380 linear feet of 4-inch diameter force main
Complete and submit this form to the Asheville regional office with the following:
• One copy of the project record drawings (plan & profile views of sewer lines) of the wastewater collection
system extension
• supporting design calculations (selected pumps, system curve, operating point, available storage if portable
generator(s)or storage greater than longest past three year outage reliability option selected)for any pump
stations permitted as part of this project
• Changes to the project should be clearly identified on the record drawings or in written summary form.Permit
modifications are required for any changes resulting in non-compliance with this permit regulations or
minimum design criteria.
This project shall not be considered complete nor allowed to operate until this Engineer's Certification and all
required supporting documentation have been received by the Division. Therefore, it is highly recommended
that this certification be sent in a manner that provides proof of receipt by the Division.
ENGINEER'S CERTIFICATION
❑ Partial ❑ Final
I, as a duly registered Professional Engineer in the State of North Carolina, having
been authorized to observe (❑ periodically, ❑ weekly, ❑full time)the construction of the above referenced
project for the Permittee hereby state that, to the best of my abilities, due care and diligence was used in the
observation of the construction such that the construction was observed to be built within substantial compliance
of this permit; 15A NCAC 2H .0200; the Division of Water Quality's (Division) Gravity Sewer Minimum Design
Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast-Track
Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting
materials.
North Carolina Professional Engineer's
seal, signature, and date:
SEND THIS FORM &SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
ROGER C. EDWARDS
SURFACE WATER PROTECTION SUPERVISOR
ASHEVILLE REGIONAL OFFICE
2090 US HIGHWAY 70
SWANNANOA, NC 28778
.............
The Permittee is responsible for tracking all partial certifications up until a final certification is received.Any wastewater flow
made tributary to the wastewater collection system extension prior to completion of this Engineer's Certification shall be
considered a violation of the permit and shall subject the Permittee to appropriate enforcement actions.

77777
I)epartment of Environment and Natural Resources
State of North Carolina
Division of Water Quality
FAST-TRACK APPLICATION
for TY SEWERS,PUMP STATIONS,AND FORCE MAINS
(Pressure sewers systems are not to be included as part of this application package)
INSTRUCTIONS: Indicate that you have included/add ressed.'the following list of required application package items by
checking the space.provided r0ex"or each applicable item� Failure to submit all required items will lead to your application
being returned as i6b46MOlete. This form may be photocopied�6r use as an originaL
ZU. Application Form - Submit one original and one copy of the completed and appropriately executed application
form. Any changes to this form will result in the application being returned. The Division of Water Quality
(Division) will only accept application packages that have been fully completed with all applicable itanou
addressed. You do not need to submit detailed plans and specifications unless you respond NO to Item 1302).
It. Application Fee ^ Submit o check in the amount of $400 made payable to: North Conn|ino Department of
Environment and Natural Resources (NCDENR). Checks shall be dated within 90 days of application submittal.
7111. Certificates of Public Convenience and Necessity — If the application is being submitted in the name of a
privately-owned public utility, submit two copies of the Certificate of Public Convenience and Necessity (CPCN)
which demonstrates that the public utility is authorized to hold the utility franchise for the area to be served by the
sewer extension. If a CPCN has not been issued, provide two copies of a letter from the North Carolina Utilities
Commission's Public Staff that states that an application for a franchise has been received, that the service area
is contiguous to an existing franchised area, and/or that franchise approval is expected. The project name in the
CPCN or letter must match that provided in Item A(2a) of this application.
7UV. Operational Agreements — Submit one original and two copies of a properly executed operational agreement if
the sewer extension is permitted by a private applicant and will be serving residential or commercial lots (e.g.,
houses, condominiums, townhomes, outparcels, etc.) that will be sold to another entity. |f the applicant ioo
homeowners' association, use Form HOA 02/03. If the applicant is a developer, use Form DEV 02/03. EVEN IF
THE PROJECTWILL BE TURNED OVER TO A MUNICIPALITY, FORM DEV 02/03 IS REQUIRED.
Fl V. Flow Acceptance Letters — If the owner of the downstream sewers and/or WW7F is different from the applicant,
submit two copies of a flow acceptance letter from the owner of the downstream sewers and WWTF, if different.
Flow acceptance letters must contain the following minimum information: applicant and project name, amount of
flow accepted, and name and permit number ofthe receiving aewmro/VVVVTF. The flow acceptance must not
expire prior to permit issuance and must be dated less than o year prior to the application date.
Intergovernmental agreements or other contracts will not be accepted in lieu of a project-specific flow acceptance
letter.
V|. Map— Submit an 8.5-inch by 1 1-inch COLOR copy of the portion of a 7.5-minute USGS Topographic Map along
with this form. The map should identify the entire project area location as well as the closest downslope surface
waters as clearly as possible. Each map portion must be labeled with the map name and number, the identified
location of the sewer line and pump stations, and be of clear and reproducible quality. For instance, if the project
involves 4 miles of interceptor sewer that traverses over or near several different waterbodies (or counties,
basins, etc.), the map should have location ID's shown for each different waterbody (where the sewer line is within
100 feet of such waterbody - see Instruction VII). This location ID is self chosen and used to cross reference the
location in Section Cnf the permit application.
V/|. StrmammC|assifications—Smctien C
w |f any portion of the project iovvithin1UOfeetofonydowns|opeourfaoow/oter' GentionCnnuatbenonop|ated
for the pertinent sections.
w If the entire project area is a minimum of 100 feet away from any down slope surface waters BUT there is a
pump station involved where o history of power outage is to be used to provide adequate design storage
instead of dual feed or permanent or portable generator, Section C must be completed to demonstrate that
the closest down slope surface water is Class C (see 15ANCAC2H .021S(h)(3)(D)\.
* Use the guidance document entitled, "Determining Watershed Classifications for Form FTA 02/03 (Fast-Track
Sewer Syatemu)' available from orby contacting the appropriate regional
office.
. .A.~.. Rev. . .4,..

FAST-TRACK APPLICATION for GRAVITY SEWERS,PUMP STATIONS,AND FORCE MAINS PAGE 2
❑ Vill. Environmental Assessments— If this project is subject to an Environmental Assessment(EA) [15A NCAC
01C], this application can not be used. Send the project application on Form PSFMGSA 10199 to the PERCS
Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. Applications can not be accepted until a Finding of No
Significant Impact (FONSI) or Environmental Impact Statement (EIS) has been issued. A copy is to be submitted
with that permit application.
® IX. Certifications—SectionD
The application must be certified by both the applicant and a North Carolina Registered Professional Engineer
(PE). The applicant signature must match the signing official listed in Item A(1b). The PE should NOT certify the
application if he/she is unfamiliar with 15A NCAC 2H .0200, the Gravity Sewer Minimum Design Criteria (most
recent version) and the Minimum Design Criteria for the Fast-Track Permitting of Pump Stations and Force Mains
(most recent version), as applicable to the project. Certification by a PE who is unfamiliar with these documents
is subject to NC Board referral.
® X. Downstream Sewer&Wastewater Treatment Plant Capacity
The applicant has assured downstream pipe, pump station and treatment plant capacity. The addition of new
sources of wastewater from this project has been evaluated along the route to the receiving treatment plant. The
flow from this project will not cause capacity related sanitary sewer overflows or overburden any downstream
pump station an route to the receiving wastewater treatment plant. If the applicant is not the owner of the
downstream sewer or receiving treatment plant, submittal of flow acceptance letter(s) indicates that owner has
adequate capacity and will not violate G.S. 143-215.67(a).
THE COMPLETED FTA 02/03 APPLICATION PACKAGE, INCLUDING ALL SUPPORTING DOCUMENTS AND$400
FEE, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE
REGIONAL OFFICE ADDRESS COUNTIES SERVED
Asheville Regional Office 2090 US Highway 70 Avery, Buncombe, Burke, Caldwell,
Swannanoa, North Carolina 28778 Cherokee, Clay, Graham, Haywood,
[phone] Henderson,Jackson, Macon, Madison,
[phone] Fax McDowell, Mitchell, Polk, Rutherford,
Swain,Transylvania,Yancey
Fayetteville Regional Office 225 Green Street Suite 714 Anson, Bladen, Cumberland, Harnett,
Fayetteville, North Carolina 28301 Hoke, Montgomery, Moore, Robeson,
[phone] Richmond,Sampson, Scotland
[phone] Fax
Mooresville Regional Office 610 E. Center Avenue,Suite 301 Alexander, Cabarrus,Catawba,
Mooresville, North Carolina 28115 Cleveland,Gaston, Iredell, Lincoln,
[phone] Mecklenburg, Rowan,Stanly, Union
[phone] Fax
Raleigh Regional Office 1628 Mail Service Center Chatham, Durham, Edgecombe, Franklin,
Raleigh,North Carolina 27699-1628 Granville, Halifax,Johnston, Lee, Nash,
[phone] Northampton, Orange, Person,Vance,
[phone] Fax Wake,Warren,Wilson
Washington Regional Office 943 Washington Square Mall Beaufort, Bartle,Camden, Chowan,
Washington, North Carolina 27889 Craven, Currituck, Dare, Gates, Greene,
[phone] Hertford, Hyde,Jones, Lenoir, Martin,
[phone] Fax Pamlico, Pasquotank, Perquimans, Pitt,
Tyrrell,Washington,Wayne
Wilmington Regional Office 127 Cardinal Drive Extension Brunswick, Carteret, Columbus, Duplin,
Wilmington, North Carolina 28405 New Hanover, Onslow, Pander
[phone]
[phone] Fax
Winston-Salem Regional Office 585 Waughtown Street Alamance,Alleghany,Ashe, Caswell,
Winston-Salem, North Carolina 27107 Davidson, Davie, Forsyth, Guilford,
[phone] Rockingham, Randolph, Stokes, Surry,
[phone] Fax Watauga,Wilkes,Yadkin
For more information, visit our web site at http.//h2o.enr.state.nc.us/peres/
FTA 02/03 -Rev.3 04/05

FAST-TRACK APPLICATION for GRAVITY SEWERS,PUMP STATIONS,AND FORCE MAINS PAGE 3
USE THE TAB KEY TO MOVE FROM FIELD TO FIELDI Application Number: I , �y o�qZ
(to be completed by DWQ)
1. Owner:
la. Town of Rhodhiss _
Z Full Legal Name(company, municipality, HOA, utility,etc.)
Q 1b. Rose Waldroup,Town Administrator
P Signing Official Name and Title(Please review 15A NCAC 2H .0206(b)for authorized signing officials!)
1 c. The legal entity who will own this system is.
El Individual 0 Federal® Municpality .State/County, Private Partnership El Corporation El Other(specify):
0 ',1d. PO Box40 le. Rhodhiss
LL Mailing Address City
Z _
1f. NC 1g. -286670040
Z State Zip Code
F 1h. 828-396-8400 1i. 1j. rhodhiss hotmail.com
Q Telephone I Facsimile E-mail
Q 2. Project(Facility) Information:
J 2a. NC Urgent Needs CDBG Sanitary Sewer Improvements 2b. Caldwell and Burke
IL Brief Project Name(permit will refer to this name) County Where Project is Located
IL _
Q 3. Contact Person:
Q3a. Benjamin B.Thomas,PE-project engineer
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. 828-433-5661 3c. ben'iethomas bellsouth.net
Phone Number E-mail
_.. -----... .......-. --- -..-.-_ ------- ------. _..-............................................... ........
1. Project is® New ❑ Modification (of an existing permit) If Modification, Permit No.:
_ ----- ...--._ ---------------------------- .__........ .---- ............-..................................... _.-..- ......................
For modifications,attach a separate sheet clearly explaining the reason for the modification (i.e.adding another
phase,changing line size/length,etc.). Only include the modified information in this permit application -do not
duplicate project information in B(7)and B(10-11)that has already been included in the original permit.
.... — - ---
2 Owner is ® Public(skip to Item B(3)) ❑ Private(go to Item 2(a))
......... ......... .. ..............
2a. If private, applicant will be: 2b. If sold,facilities owned by a (must choose one
❑ Retaining Ownership(i.e.store, church,single office,etc.)or El Public Utility(Instruction III)
Z ❑ Leasing units(lots,townhomes, etc.-skip to Item B(3)) ❑ Homeowner Assoc./Developer(Instruction IV) t
0 ❑ Selling units(lots,townhomes, etc.-go to Item B(2b))
3.H
_..Townn ofRhodhiss -...---
_ .. ..-.....
Owner of
ter
his Project
4a. Name of Town of Rhodhiss
saWWTPatment Facility(WWTF)Treating Wastewater r�)CO025917
Permit No.
WWT
LL 5a. Town of Rhodhiss )5b. n/a ® Gravity 5c. discharge is direct) to wwt
0 9 Y P
Z Owner of Downstream Sewer Receiving Sewer Size�❑ Force Main I permit Number of Downstream Sewer(if known)
(- 6. The origin of this wastewater is(check all that apply): j
® Residential Subdivision i ❑ Car Wash
WElApartments/Condominiums El Institution 100 9/6Domestic/Commercial
d ❑ Mobile Home Park ❑ Hospital ,
❑ School i ❑ Church l Ifidustrtal -
❑ Restaurant ❑ Nursing Home
m %Other(specify)
❑ Office ❑ Other(specify)
.......... ....--.... ........ ........ ..........._ .......... ..... b .. ,ILI Vim.•L II V ..
7. Volume of wastewater to be allocated for this particular project 1800 gallons r fIJ*Do not include previously permitted allocations
8. If the permitted flow is zero, indicate why: I J U L 13 2006
❑ Interceptor Line-Flow will be permitted in subsequent permits that connect to thi line I
❑ Flaw has already been allocated in Permit No._ ,
WATER CL A LI Y CFCTION
❑ Rehabilitation or replacement of existing sewer with no new flow expected Ag17vit.L6 G!ON \L OFF ICE
..- ...... — ---- — --.__. _
"" FTA 02/03 -Rev. 3 04/05

FAST-TRACK APPLICATION for GRAVITY SEWERS,PUMP STATIONS,AND FORCE MAINS PAGE 4
9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2H
.0219(1)for Item B(7)or the design flow for line or pump station sizing if zero flow in the space below.Values other than
that in 15A NCAC 2H .0219(I)(1-2)must be supported with actual water or wastewater use data in accordance with 15A
NCAC 2H .0219(1)(3).
5 homes x 3 bedrooms each x 120 GPD/each= 1,800 GPD.All other flow is pre-existing and will diverted to the new
pump stations.
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size(inches) Length (feet) Gravity or Force Main
(use the pull down menu)
8 1241 Gravity
4 380 Force Main
_.._-----
O
LLJ
-----
Z '! _
H '
Z ENTER TOTAL LINE LENGTH IN MILES 0.31
V11. Summary of Pump Stations to be Permitted(attach additional sheets as necessary)
Location ID Power Reliability Option
(self chosen -as shown on.Design Flow Operational Point (1-dual line feed; 2-permanent generator w/ATS; 3-
plans for cross-reference)_ _ (MGD) GPM @ TDH portable generator w/telemetry;4-wet well storage)
northside 0.360 250@62' 2
LL southside 0.432 300@ 48' 2
Z
H
12. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force
Mains(latest version),the Gravity Sewer Minimum Design Criteria(latest version) and 15A NCAC 2H .0200 as applicable?
LU ! ®Yes ❑ No If no, please reference the pertinent minimum design criteria or regulation and indicate why a
CL variance is requested.SUBMIT TWO COPIES OF PLANS,SPECIFICATIONS OR CALCULATIONS
PERTINENT TO THE VARIANCE WITH YOUR APPLICATION
m
13. Have the following permits/certifications been submitted for approval?
Wetland/Stream Crossings-General Permit or 401 Certification? ❑Yes ❑ No ® N/A
Sedimentation and Erosion Control Plan? ❑Yes ❑ No ® N/A
Stormwater? ❑Yes ❑ No ® N/A
14. Does this project involve aerial lines or siphons? Check if yes: ❑
These lines will be_consldered high nrtority and.must.he checked.onoe every six months .......
15. Does this project have gravity sewer lines designed at minimum slopes? ❑
Be aware that the Division will not accept installed lines more than 10%flatter than the minimum slope. Lines installed outside this tolerance should be
corrected prior to submitting the final engineering certification..
FTA 02/03 -Rev. 3 04/05

FAST-TRACK APPLICATION for GRAVITY SEWERS,PUMP STATIONS,AND FORCE MAINS PAGE 5
1. Use the Division's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02103
(FAST-TRACK SEWER SYSTEMS)"to collect and record the stream classification data below(attach additional sheets as
necessary).This document is available from our web site or by contacting the appropriate Division of Water Quality
Z regional office(see instructions for addresses)OR indicate the following:
O
❑ A Stream Classification is not needed because all parts of the project are at least 100 feet away from any down slope
Q --- waterbody;AND, .... __.. --_ --.- --... ........ ..
(� ! ❑ A Stream Classification is not needed because the design does not depend on wet well storage as a power reliability
option for any pump station near a Class C down slope waterbody.
Location ID on Map
Q (self chosen-as shown on Name of Waterbody Stream Waterbody
J map for cross-reference) Waterbody County River Basin Index Classification
V northside pump sta. Catawba River Burke Catawba 11-(51) WS-IV,B;CA
southsde pump sta. Catawba River Burke Catawba 11-(51) WS-IV,B;CA
W
U ,
Submit the 8.5"x II COLOR topographic map as required in Instruction VI
regardless of whether a classification is provided!
.............................. _ .....------ .......I.. ......_... ......... ......... __......_. ..........
1. Applicant's Certification:
1, Rose Weldroup, attest that this application for NC Urgent Needs CDBG Sanitary Sewer System Improvements
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required
parts of this application are not completed and that if all required supporting documentation and attachments are not
included, this application package is subject to being returned as incomplete. Note: In accordance with North Carolina
General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or
certification in any application shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed$10,000
as we civil penalties up to$25,000 per violation.
1 a. 0 g e ��G2. or/u 6) 7h),S 9,6
Signing—Official Signature Date
2. Professional Engineer's Certification:
Z I attest that this application for NC Urgent Needs CDBG Sanitary Sewer System Improvements
0 has been reviewed by me and is accurate, complete and consistent with the information in the engineering plans,
calculations,and all other supporting documentation to the best of my knowledge. I further attest that to the best of my
Q knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer Minimum
V Design Criteria for Gravity Sewers adopted February 12, 1996, and the Minimum Design Criteria for the Fast-Track
LL Permitting of Pump Stations and Force Mains adopted June 1, 2000 and the watershed classification in accordance with
Division guidance. Although certain portions of this submittal package may have been developed by other professionals,
inclusion of these materials under my signature and seal signifies that 1 have reviewed this material and have judged it to
RI be consistent with the proposed design. Note: In accordance with NC General Statutes 143-215.6A and 143-215.6B, any
V person who knowingly makes any false statement,representation, or certification in any application shall be guilty of a
Q Class 2 misdemeanor which may include a fine not to exceed$10,000 as well as civil penalties up to$25,000 per violation.
2a. Benjamin B.Thomas, PE
r s�
Professional Engineer Name
2b.West Consultants, PLLC {M fie"a m
Engineering Firm
2c.405 S.Sterling Street
Mailing Address ss ,
A,
2d. Morganton 2e. NC 2f. 28655
City State Zip 2g. 828-433-5661 2h. 828-433-5662 2i. [e-mail]
Telephone Facsimile E-mail Seal,Signature&Date
FTA 02/03 -Rev. 3 04/05

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WEST CONSULTANTS, PLLC
Consulting Engineers
405 South Sterling Street
Morganton, North Carolina 28655
Phone [phone] Fax [phone]
JOB NUMBER/PHONE DATE
TO Div. Of Water Quality (Asheville) /10/2006
N CD EN R ATTENTION
2090 US Hwy 70 RE:
Swannanoa NC 288787 Rhodhiss, NC - NC Urgent Needs CDBG
Sanitary Sewer Improvements
WE ARE SENDING YOU X Attached Under separate cover via the following items.
Shop drawings Prints Plans Specifications Samples
Copy of letter Change order Other:
COPIES DATE NUMBER DESCRIPTION
2 Fast Track Application For Gravity Sewer Application
1 1416 Application Fee
THESE ARE TRANSMITTED as checked below:
X For your approval Approved as submitted Resubmit copies for approval
For your use Approved as noted Submit copies for distribution
As requested Returned for corrections Return corrected prints
For review and comment Other
FOR BIDS DUE/DATE: PRIG� sFi>=r�RNLh�IyrER�oAN To•�lt� ,
REMARKS
y, �l JUL 1 3 2006
Ve4 rr rl 4U/Uil ThN i
AEI '/II LT 4� Iil1lrt
c =r CIE
yy � '
COPY TO SIGNED Y t CIA` i ��`.'. ��k�..K',Vi
If enclosures are not as noted,please notify us at once.
PRODUCT 13127M USE WITH 771 ENVELOPE NEES TO Reorder:1-800-225-6380 or WWW.l1¢bS.COR1 PRINTED IN U.S.A. A

c to -r�3lo� �ImS; 7l/1/p
FAST-TRACK APPL�IC/1ATION REVIEW PROCEDURES
Project Name: N e l fu Q Review Date:
Project Number: Reviewer:
All fast-track projects should be submitted on the application entitled "Fast-Track Application for
Gravity Sewers, Pump Stations, and Force Mains" (FORM: FTA 02103 Rev 3,currently) unless
otherwise directed by the PERCS. Any pump station/force main projects that require an
Environmental Assessment(EA) are excluded from the Fast-Track review process, and should be
submitted for full review to the Central Office (PERCS) on FORM: PSFMGSA 10/99. Additionally,
any projects involving a flow reduction request must receive approval for the flow reduction from
the central office.
PR!-REV W
Does the application package appear to be generally complete (i.e. all attachments, check, key
questions answered)? If any portion of the application is not complete, or if any required
instruction items have been omitted, RETURN the application package and supporting
documents to the applicant using the Project Return Letter template. Send the package and
letter via certified mail to the applicant,and a copy of the letter to the engineering consultant.
Any projects that are to be returned shall be returned prior to accepting the application (i.e.,
before logging in the application and depositing the check). After a project has been accepted,
any information that is found to be incorrect and/or lacking must be requested via an Additional
Information Request in accordance with 15A NCAC 2H .0208(e).
t_ Ensure that a check for$400 is submitted and made out to NCDENR. All new projects and major
modifications to existing projects require an application fee. A major modification includes any
changes to permitted flow volumes, changes in pipe diameter, changes in pipe length greater that
10% of the originally permitted length, changes in the operating points of a pump station, etc.
SECTION A—Application Information
l�--t the applicant is private(Item B(2)) and listed as a corporation, check the NC Department of the
Secretary of State's web site at http://www.secretary.state.nc.us/Corporations/to ensure that the
Applicant is registered with the Secretary of State to conduct business as a corporation in the
State of NC. Developer's and HOA's should be listed.
L/ Ensure that the signing official meets the requirements of 15A NCAC 2H .0206(b). If they do not,
request a revised application that has been completed by an appropriate official or a letter from
an appropriate official that indicates the person in question is delegated to sign the application on
the applicant's behalf. A current list of Delegated Signing Officials can be obtained from the
PERCS. If a new delegated sighing official letter is presented with the application, forward a copy
to the central office so that the person may be added to the Delegated Signing Official list. The
central office will send E-mails to the appropriate region if a new signing official has been added
so that the most current list can be used. The Non-Discharge Permitting Unit has an example
delegated signing official letter from http://h2o.enr.state.nc.us/PERCS/spraypol.htm]#DELEG.
SECT —Per ormation
Project ne . Modification? If the project is a modification to an existing permit, be sure to
enter the application into BIMS as a permit modification (i.e. "renew/modify application" and not
"create new project'). BIMS will pull the previous signing official and affiliations information.
Please go through all the tabs and ensure the information is correct for the current project.
L//Applicant a public entity (e.g.county, town, sanitary district)?
/VA�pplicant a private entity?
Own (i.e. lease) units, lots, parcels, etc?
1
FAST-TRACK Application Review Procedures 2003(Rev 2/06)

Sell units, lots, pa els, etc?
Certificate o Public Convenience and Necessity? 2H.0205(d)(2)
�Rzqu rezi iYt �applicant-is a-public utility-ln-lieu of-a Certificate-of Public —- -
Convenience d Necessity, they may submit written approval from the
North Carolina lities Commission's Public Staff that states that the utility is
allowed to provide tility service in the subject project area. Note that the
project name on the plication and on the CPCN must match. Contact the
NCUC Public Staff if q stions arise. This is NOT REQUIRED for a
municipality or county! amples of companies that would provide a CPCN
are Heater Will
or Caro' a Water Service, etc.
*'***.OR******.
Operational Agreement? 2H.0205 (2
♦ Operational Agreements are only r uired if the applicant is not a public
entity (i.e. Town, County, etc.) or publ utility as designated by the North
Carolina Utilities Commission AND the is beingserved b the collection
Y
system are to be sold to individual ow er .
♦ If the applicant is a developer, ey must fill out the DEVELOPER
J, Operational Agreement(FOR : DEV 02/03). A developer may be
responsible for the system f an interim period until the homeowners
association is formed, at w ch time a Permit Name/Ownership Change
request(FORM: PNOCF /00)will be needed to transfer the permit to
the HOA.
♦ If the applicant is a h eowners' association (HOA), they must fill out
the ASSOCIATION perational Agreement(FORM: HOA 02/03 The
HOA must be regis red with the Secretary of State's office and must
provide a copy of a Associations' Bylaws and Articles of Incorporation.
These documen should be reviewed to ensure that all applicable
language regar ing the collection system is included as is required by
the Operatio I Agreement.
♦ The Operation I Agreement should be attached to the permit and
ncorporated ' to the language of the permit. Please note that Operational
I Agreement nguage should not be altered without approval from the
Attorney eneral's Office. Operational Agreements are available at
.enr.state.nc.us/PERCS/from the collection system applications
page.
Approval of flow to receiving sewers and WVVTF? (i.e. P4 procedure, but now in-house!)
♦ Ensure that the receiving sewers and VWVTF have adequate capacity available to accept the
flow volume that is being requested, and that the WWTF has been in compliance with their
treatment and disposal permit.
(-�Flow acceptance letter(s) from the owner of the WVVTF and owner of any intermediate sewers (if
different from WWTF owner and applicant)? 2H.0205(d)(3)(C)
♦ Required only if the applicant and the owner of the WWTF/intermediate sewers are not the
same entity.
♦ Project specific flow acceptance letters are required.
♦ Ensure that the following items appear in the flow acceptance letter: applicant's name,
project name, amount of wastewater flow accepted, date that the flow acceptance was
granted, expiration date of the acceptance, and name/permit number of the receiving WWTF.
Do not accept a flow acceptance letter that was issued more than one year prior to the
receipt of the package.
♦ Ensure that the owner accepted the entire volume of flow listed in application.
7I' 2
FAST-TRACK Application Review Procedures 2003(Rev 2/06)

Main Problems Noted: A flow acceptance letter is provided by the receiving WWTP owner but
not the downstream sewer owner, which both are different from the applicant. Example, private
developer in Knightdale. Both Knightdale and Raleigh would need to provide a flow acceptance
letter as Knightdale will transport the wastewater and Raleigh will treat the wastewater.
(--Wastewater industrial r dome in nature?
♦ Most projects will b r�wastewater that is domestic in nature, however, if Item B.6 indicates
that the wastewater is industrial in nature, notify the Regional Office Pretreatment
Coordinator or the WQ Pretreatment Unit Central Office to determine if a pretreatment permit
is needed or if a program already in place and compliant.
� Flow volume calculated correctly? 2H.0219(l)
♦ Ensure that the daily design flow in the application is based on the guidance provided in the
regulations or existing flow, and that the explanation as to how this volume was determined is
very specific (i.e., 22 three-bedroom homes, 50,000 s.f. of retail space, 18 employees, etc).
This information will be included in the description of the system in the permit. Our regs say
120 gpd/bedroom for residential. Note that for one-bedroom the minimum they can use is
240 gpd.
♦ If daily design flow is not based on regulations, ensure that the applicant has an approved
flow reduction of daily design flow rate on file with the Division. A list of approved flow
reductions may be obtained from the DWQ Intranet or by contacting the PERCS. Flow
reduction requests are to be reviewed by the central office, and must be reviewed and
approved before the application is accepted by the regional office for review.
♦ On occasion, there may be an instance where supporting documentation is submitted with
the application for a specific facility. Contact PERCS to determine a course of action.
♦ Ensure that the flows shown on the application match up to what is shown on the plans (if
available for review). For example, if the application states that 100 lots are to be developed,
ensure that there are 100 lots, and not 150 lots, shown on the plans. Plans are only required
for review if the applicant is requesting a variance to the MDC or the .0200's.
♦ Do not allocate"future"wastewater flows (i.e., that based on speculative development).
These would be permitted in future wastewater collection system extensions. Although, we
do allocate"unknown"flows on a per acre basis for industrial/commercial park applications.
Generally, the Division has accepted between 900 gpd/acre— 1500 gpd/acre. Let the
engineer support his calculation.
Adequate information provided regarding the proposed gravity sewer and/or force main (if
applicable)?
Note 1: An Environmental Assessment may be required if there are 3 miles of gravity sewer over
18-inches in diameter(15A NCAC 1 C .0100). Environmental Assessment projects can NOT go
Fast-Track!
Main Problems Noted: A public entity specifies 6-inch line when 8-inch is required; 4-inch line is
specified and no variance requested
Adequate information provided regarding the proposed pump station(s) (if applicable)?
Note: An Environmental Assessment may be required if the pump station(s) have a firm capacity
of 1,750 GPM or greater (15A NCAC 1 C .0100). If there are any questions about whether an EA
may be required, discuss with your supervisor or contact Alex Marks of the Planning Branch's
Local Government Assistance Unit.
♦ Power reliability at the pump station provided in accordance with Section 5.04 of the
Minimum Design Criteria for the Fast-Track Permitting of Pump Stations and Force Mains
document (i.e. dual line feed, portable generator w/telemetry, permanent generator with
automatic transfer switch, wet well storage if near Class C waters)? Note 1: Section C of the
FTA has to be completed and show a Class C down slope water in order to use wet well
storage as a reliability option. Include the special condition in the permit. You will need to
ask for storage calculations and the power outage data. Note 2: Ensure telemetry is specified
if a portable generator is called out. Check with the engineer if unsure. Note 3: Ensure an
automatic transfer switch (ATS) is specified if a permanent(standby) generator is specified.
Check with the engineer if unsure.
Main Problems Noted: Failure to specify appropriate or applicable power reliability option
3
FAST-TRACK Application Review Procedures 2003(Rev 2/06)

roject designed in accordance with 15A NCAC 2H .0200, the Gravity Sewer Minimum Design
Criteria and the Minimum Design Criteria for the Fast-Track Permitting of Pump Stations and
Force Mains document(as applicable)? NO will be checked in Item B(12) of the FTA. If NO _
forward one copy of the supporting documents to the Central Office for review indicating the
permit number, owner and pro act name The Central Office will review the variance request and
if approvable specific language regarding the variance will be forwarded to the Regional Office
reviewer to incorporate into the permit A copy of the variance letter provided by the central office
should be kept with the application file. If you catch something in the application or supporting
documents that is not in accordance with our regs or MDC, send an additional information
request.
Main Problems Noted: A public entity specifies 6-inch line when 8-inch is required; 4-inch line is
specified and no variance requested; supporting documents show slope issues...
SECTION C—Watershed Classification
✓ Color topographic map submitted?
Watershed classification required? If YES, you are advised to"spot-check" the classification(s).
If NO, ensure the applicantlengineer has indicated why one is not required. BOTH BOXES IN
SECTION C MUST BE CHECKED TO NOT PROVIDE A CLASSIFICATION!
SECTION D—Applicant Certifications
Signing Official's signature? 2H.0206(b)
♦ Ensure that the applicant's signature is the same person as that listed as the applicant's
signing official on Page 1 of the application form.
_✓PE stamped, signed, and dated application, plans, specifications, and calculations (if applicable)?
2H.0205(d)(1)(A)(iii)
♦ Ensure that the same en
and all the engineer has signed, sealed and dated the application
9 9
items,with the exception of items designed by specialty disciplines (i.e., architectural,
structural, plumbing, and electrical plans). If not, an explanation and/or authorization is
required.
li ✓Adequate information provided for the engineer/engineering firm?
PE with active license in North Carolina? 2H.0205(d)(1)(A)(iii) or2H.0203(28)
♦ Ensure that ALL pertinent P.E's have active licenses by checking the INC Professional
_ Engineer's Board web site (www.ncbels.org -the PE number must be six digits, use leading 0
when needed). .
♦ If the PE seal number does not show up on the web site database, call the PE Board for
verification [phone].
I
- Drafting a Permit
♦ In order to be consistent, use the most current version of the Fast-Track permit shell. This permit
shell contains specific language with respect to the Minimum Design Criteria, regulations, and
collection system permitting. The PERCS will notify you of any changes to this permit shell.
♦ Be specific with respect the system description and information. Indicate the flow, what the project
will be serving, length and size of gravity sewer lines and force mains, etc. For projects involving
pump stations, the size of the pump stations, as well as the reliability option and any additional info
(telemetry, odor control system, etc) should be included. A sample permit is on the DWQ Intranet.
♦ Add or remove any special conditions as necessary. Please call attention to any non-standard permit
conditions in the cover letter of the permit and include the permit condition where necessary. See the
Example Special Conditions document.
j ♦ If the project is a modification, don't forget to include the system description from the previous permit
and void the previous permit in the language! Some of these can be tricky so feel free to run the
drafted permit through PERCS first before issuance.
♦ It is preferable if Fast-Tracks are saved electronically by permit number under issued year and month.
1 4
FAST-TRACK Application Review Procedures 2003 (Rev 2/06)

Denying a Project
♦ If the Reviewer/Supervisor determines that an application package should be denied because it can
not meet NC Statutes, rules or regulations, then a denial letter should be drafted. Special attention
should be paid to the statutory deadline for permitting. If it is thought that a project might be
denied, it is important to review it and draft the denial letter as soon as possible. There must
be time allowed for the denial letter to be sent up to the Director and signed prior to the
statutory date.
♦ The Reviewer should use the Application Denial Letter template to prepare a denial package for the
Supervisor's review and submittal to the Director for signature. The letter should not be dated, but
instead will be dated after the Director signs it. A memo to the Director should be attached to the top
of the denial package summarizing the reasons for denial. This package must be singed off on by the
reviewer, supervisor, Section Chief, and Director. Distribute the letter as directed in "Issuing a
Permit" below.
Issuing a Permit
♦ Permits should be signed only by those delegated to sign for the Director.
♦ Permits should be distributed as follows (include the signed Operational Agreement with the
permit and all distribution copies if applicable!):
✓ Original to the Permittee
✓ Copy to the consulting engineer
✓ Copy to the county health department
✓ Copy to the Mecklenburg County Department of Environmental Protection for all projects located
in Mecklenburg County
✓ Copy(ies) to the owner of the WWTF and owner of the downstream sewers (if different than the
Permittee)
✓ Electronic Copy and Hard Copy to the PERCS for our files
✓ Copy to Central Files (attach application package and any supporting documents with a staple—
do not include any plans unless they are small and can be folded up into an 8.5"x 11" sheet)
✓ Save an electronic version named WQOOXXXXX.doc in a folder on your office shared drive or
hard drive. Try to keep your drafts and issued files separate. SEND ELECTRONIC COPIES TO
PERCS on a frequent basis—weekly or monthly!
Permit Corrections
♦ If a permit has been issued but an error discovered MADE BY US internally or by the Permittee or
their engineer, a permit correction is necessary.
♦ Pull the original permit and make the corrections—do not change issue dates or enter a new
application in BIMS—resave the permit
♦ Prepare the permit correction cover letter modifying as applicable—the corrections need to be
distributed to the same people/agencies who received the orginal permit
♦ Print the corrected permit and permit correction letter—sign if needed
♦ Maintain Permit in BIMS—add permit corrected event date and comments as to what was corrected
♦ Copy and distribute
The Certification
♦ Final engineering certifications will be submitted back to your office when the project is complete.
These should be date stamped (the certification page, record drawings and calculations, if applicable)
♦ Construction, Grants & Loans (CGL) may request and audit some of these certifications
♦ Regardless of whether the region or CGL reviews a certification, the receipt date must be logged into
BIMS. Perform the following: Maintain Permit, Enter Permit No., Go to Events Tab, Add Event, Select
Engineering/Tech Specialist Certification Received, Enter Receipt Date
♦ If the certification sheet is marked partial—put partial in the event comment field.
♦ If the certification seems incomplete—missing plans or calculations or no PE seal—note incomplete
in the comment field. Send an incomplete certification letter. The certification page in the permit
explains exactly what the engineer is to provide.
♦ If the certification is provided to CGL—maintain the engineer certification received event and put"to
CGL for review on DATE" in the event engineer certification received comment field.
5
FAST-TRACK Application Review Procedures 2003 (Rev 2/06)

-look for items not meeting the minimum design
If he region wishes to perform a detailed review o g g
♦ t g
criteria or outside of the permit. For instance, minimum cover; slope; minimum separation distances;
line-age changes;_lengh eroutes; m n alarms; pump cycle
cler
times; no indication of record drawing (as-builts) on plans; no PE seal or not out record drawings
(land surveyor seals are not appropriate). A certification checklist is being developed.
♦ Regardless of review, certifications need to be processed as this closes out the permit. Follow the
processing engineering certifications guidance document.
1
6
FAST-TRACK Application Review Procedures 2003 (Rev 2/06)

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Permi(No.W00030542 Town of Rhodhiss NC Urgent Needs Burke County July 25 2006
I
ENGINEERING CERTIFICATION — POST CONSTRUCTION
system Description:
1,241 linear feet of 8-inch diameter gravity seer, a 250 GPM sewage pumping station and a 300 GPM sewage
pumping station both with audible and visual high water alarms, telemetry, on-site standby generators with ATSs
and 380 linear feet of 4-inch diameter force main
Complete and submit this form to the Asheville regional office with the following:
• One copy of the project record drawings (plan & profile views of sewer lines)of the wastewater collection
system extension
• supporting design calculations (selected pumps, system curve, operating point, available storage if portable
generator(s)or storage greater than longest past three year outage reliability option selected)for any pump
stations permitted as part of this project
• Changes to the project should be clearly identified on the record drawings or in written summary form.Permit
modifications are required for any changes resulting in non-compliance with this Permit regulations or
minimum design criteria.
This project shall not be considered complete nor allowed to operate until this Engineer's Certification and all
required supporting documentation have been received by the Division. Therefore, it is highly recommended
that this certification be sent in a manner that provides proof of receipt by the Division.
ENGINEER'S CERTIFICATION
1 ❑ Partial final
1,3 IJeh, +"rtr a��iq+r r�, as a d registered Professional Engineer in the State of North Carolina, having
,en authorized to observe ( enodically, ❑weekly, ❑full time)the construction of the above referenced
project for the Permittee hereby state that, to the best of my abilities, due care and diligence was used in the
observation of the construction such that the construction was observed to be built within substantial compliance
of this permit; 15A NCAC 2H .0200; the Division of Water Quali�aXQivjsion),Gravity Sewer Minimum Design
,qz ,.
Criteria adopted February 12, 1996 as applicable; the Division'S'l4tinimum Design Criteria for the Fast-Track
Permitting of Pump Stations and Force Mains adopted June If 2 O as�ppliIcabld ehd\�th s p rting
materials. T _ — i
North Carolina Professional Engineer's II Sip 2 5 2008 -u
seal, signature, and date:
,-to BYEi
9�®4 '�\k•C pA,Pt o0, ,%Aa 1 (VI n�CLI r R Irl ()i JF:i C'�O GG
a�gPaSYny� of dA
r SEND,THIS'FORM & SUPPORTING DOCUMEN TION
yl` 1i1 WITH REQUIRED ATTLtCHM.ENTS TO THE FOLLOWING ADD SS
@0 „
07 7 ae
a�R � I •0 ROGER C. EDWARDS
SURFACE WATER PROTECTION SUPERVISOR
`°®B ��y a�q°°•••• °"ne04 ASHEVILLE REGIONAL OFFICE
'®dad®OB®rg® 4QApR`'��& 2090 US HIGHWAY 70
ot
SWANNANOA, NC 28778
fie Permittee is responsible for tracking all partial certifications up until a final certification is received.Any wastewater flow
made tributary to the wastewater collection system extension prior to completion of this Engineer's Certification shall be
considered a violation of the permit and shall subject the Permittee to appropriate enforcement actions.
n
7.•S/a,tJOB
0"YY��

WEST CONSULTANTS, PLLC LETTER OF
Consulting Engineers and Surveyors
405 South Sterling Street TRANSMITTAL
Morganton, North Carolina 28655
Phone [phone] Fax [phone]
JOB NUMBER/PHONE DATE
TO NCDENR - DWQ (Asheville) 04241 9/22/2008
2090 US Highway 70 ATTENTION
Swannanoa NC 28778 Surface Water Protection Sect. Superv.
RE:
Town of Rhodhiss - NC Urgent Needs
Wastewater Collection System Extension
WE ARE SENDING YOU X Attached Under separate cover via the following items.
Shop drawings Prints Plans Specifications Samples
Copy of letter Change order Other:
COPIES DATE NUMBER DESCRIPTION
1 Engineering Certification, WQ0030542
1 As-Built Drawing
THESE ARE TRANSMITTED as checked below:
For your approval Approved as submitted Resubmit copies for approval
X For your use Approved as noted Submit copies for distribution
As requested Returned for corrections Return corrected prints
For review and comment Other
FOR BIDS DUE/DATE: 9/22/2008 PRINTS RETURNED AFTER LOAN TO US j
REMARKS III�1��E V
SEP 2 5 2008 J
' � W\T1 l��I IIrY (ll��iJ
1
11
R Nv��-r � 5 s r ., IIo
_ I O l�E
COPY TO Town Of Rhodhiss SIGNED l�
If enclosures are not as noted,please notify us at once.
PRODUCT 13121G USE WITH 771 C ENVELOPE NEBS TO ReOld2[1-800-225-6380 or wwWAeb5.00111 PRINTED IN US.A. A

ENVIRONMENTAL REVIEW TRA�A ET- oR# 07 01ao
DWO - WATER QUALITY SECTION DWQ# 13765
DATE: 1011312006 TYPE: ERR
TO: Env. Sciences Branch (WQ Lab,MSC 1621)
O Trish MacPherson(Biological Assessment)
O Jay Sauber(Ecosystems)
❑ (Toxicology)
O Dianne Reid(Intensive Survey) Regional Water uality Supervisor
Wetlands/401 Unit
❑ Bradley Bennett(Stormwater) 12a'fl
❑ John Hennessy(DOT)Parkview Bldg,MSC 1650) ,Darlene Kucken (Basinwide Planning) 6 s fl
O Cyndi Karoly(401) Parkview Bldg, MSC 1650) ❑ Jeff Manning(Classifications &Standards)6a'fl
O Boyd DeVane(Water Supply WS) 12`s fl O Rich Gannon(NPS Management Plannini) 6 b fl
O Michelle Woolfolk`(Modeling/TMDL)7 fl
Surface Water Protection Section (Archdale 9th) O Carl Bailey(Groundwater Plannin )
O Matt Matthews Gil Vinzani or Susan Wilson
( ) � Ill {II
s Qeff Poupart(Collection/Pretreatment) ❑ Others:
Aquifer Protection Section 1
O Ted Bush(land application/AFO)
O Kim Colson (land application) „- Tvricri
_ _ ASH�VILLF G11_C IOUA� Off' IGE
A copy of the environmental document for the project described below is attached. Subject to the requirements of the NC
Environmental Policy Act,you are being asked to review the document for potential significant impacts to the
environment, especially pertinent to your jurisdiction,level of expertise, or permit authority. Please return this form,
completed, along with your written comments, if any,by the date indicated. Thank you. IF AN EXTENSION IS
NEEDED,PLEASE EMAIL OR CALL A REQUEST TO THE SEPA COORDINATOR PRIOR TO THE
RESPONSE DEADLINE.
Project: Response.Deadline p(�
This project will involve the installation of 17,000 LF of 8" sewer line to serve 57 households in
Connelly Springs. The homes in the project area are primarily along Israel Chapel Road. The
proposed project will connect to an existing pump station located downstream from the project
area. Some of the proposed lines will be installed alonq existinq DOT rights-of-ways while the
NO COMMENT COMMENTS ATTACHED AND EMAILED
SIGNATURE P O(/Cis O C� DATE
Return To:
Hannah Stallings: [phone] ext. 555; [e-mail]
Basinwide Planning Unit/Planning Section; Archdale 6th; MSC 1617; fax: [phone]
Notes:
11n ,.Ics
hl-C

North Carolina Department of Environment and
Natural Resources
�, DIVISION OF WATER QUALITY oe wnrE9
�►�1 Surface Water Protection
Asheville Regional Office a �`
NCDENK 2090 U.S. Highway 70 '
Swannanoa, North Carolina 28778
Phone: [phone] Fax: [phone]
To:
Fax: I — at1 ^ 7 5 - S 3
From: CSLM.t,o
Date: i7 / �l oZ O d
Number of pages including cover: 3 (�
MESSAGE: If questions. please call 828129E 4500
Ntnally
IX aro. ina

W A�-� , - Michael F.Easley,Governor
� William G.Ross Jr.,Secretary
Carolina Department of Environment and Natural Resources
Alan W.Klimek,P.E.Director
V / Division of Water Quality
Colee Sullins,Deputy Director
. -
... Rrvrsion of Water Quality ..
October 13, 2006 L� E C E- V E
Mr. Roger Edwards
Surface Water Protection Supervisor
N.C. Division of Water Quality W Ai EIR c uALiry SECTION
2090 US Hwy 70 ASNEVIL_LE REGIONAL OFFICE
Swannanoa, NC 28778
Re: Burke County
Installation of 17,000 linear feet of sewer line to serve 17 residences in Connelly Springs
DENR#07-0130, DWQ#13765
Dear Mr. Edwards:
Please find enclosed an Environmental Review document submitted as Phase H of a
CDBG Sewer Project by the Town of Connelly Springs to install 17,000 linear feet of sewer line
that will connect to an existing pump station that is located downstream of the proposed project
area and serve 17 residences. While some of the proposed infrastructure will be installed along
existing rights-of-way, others will require easements. It would be helpful if your staff would
review this report and return any comments they may have regarding this project to me by
Thursday, November 2, 2006.
If there are any concerns or questions,please do not hesitate to contact me.
Sincerely,
Hannah Stallings
SEPA Coordinator
N
N.C.Division of Water Quality 1617 Mail Service Center Raleigh,North Carolina 27699-1617 [phone] Customer Service
1-877-623-6748

ENVIRONMENTAL REVIEWS AT THE COMMUNITY LEVEL
Agency responsible for Project Location:(city and County) Clearinghouse No. Date Completed
Town of Connelly Springs Connelly Springs,Burke County
Contact Person: Address Phone
PO Box 99
Sam Erwin Connelly Springs,NC 28612 82SABS-4229
A. Project Description
Briefly Describe Project:
Phase 11 CDBG Sewer Prolect
This project will involve the installation of 17,000 LF of 8"sewer line to serve 57 households in Connelly Springs. The homes in the project
area are primarily along Israel Chapel Road The proposed project will connect to an existing pump station located downstream from the
project area. Some of the proposed lines will be installed along existing DOT rights-of-ways while the other lines will require easements.
Project Activities CDBG/HOME Funds Other Funds Environmental Impact Status
[��PT
at. Excluded E.A.
1.Sewer Improvements $700.000 $70,050
X
2.Planning $3,500 X
3. Administration $46,500 X
4.
5.
6.
X Original Signature Elected Ofr ill
Revision Dated Elltrired Mayor.Town of Connelly Springs
_ Amendment Dated UUII�� 3 206 Title
r..y` .Town of Connelly Springs.PO Box 99,Connelly Springs.NC 28612
Prior Clearing Review r +`'�- Agency and Address
Has Taken Place

Regulations
III
------ STATUTORY.CHECKLIS_T _ _ checklist of Applicable statutes and 12egu
1. Project Name and Identification No. Connelly Sorinas Phase II CDBG Sewer Protect
2. Attach Project map
3. Are all activities of this project exempt from NEPA Procedures? _Yes No
(If yes,this Statutory Checklist need not be filled out)
4. Are activities of this project categorically excluded from NEPA Procedures? _Yes X No
(If yes, this Statutory Checklist and all required actions must be completed)
Area of Statutory—
Regulatory Compliance E s
r �
c v ur
4 u a `o
Impact Categories
0. € a Note Compliance Documentation
€ c aE
3
z c4 rc a B�
Historic Properties X State Preservation Office
Floodplain Management X FIRM Map
Ili Wetlands Protection X US Army Corp of Engineers
Noise X HUD Noise Guidebook
Air Quality X WPCOG Air Quality Program
Manmade Hazards X None to be used
� Thermal Explosive Hazards
Project more than 5 miles
Airport Clear Zones X from airport
Water Quality X DENR,Asheville
Navigable Waters
Aquifers X None in area
Solid Waste Disposal X Town of Connelly Springs.
Coastal Areas
Coastal Zone Management X N/A
Coastal Barrier Resources X N/A
Endangered Species US Fish &Wildlife, NC Natural
X HAIifnnP.
Environmental Justice X No Impact
Wild and Scenic Rivers X None in area
Farmlands Protection X USDA-NCRS
Fish and Wildlife X I I US Fish &Wildlife NC Natural
Hp itnnp Prnnrpm
State or Local Statues X N/A

Prepared By: _Samuel W. Erwin
Title: Environmental Administrator
_WPCOG
PO Box 9026—Hickory, NC 28603
Date: September 28 2006
• Attach evidence that required actions have been taken

Data Sources and Documentation
Historic Properties State Historic Preservation Office
Flood Plain Management FIRM Map
Wetlands Protection US Army Corps of Engineers
Noise HUD Noise Guide Book
Air Quality WPCOG Air Quality Program
Manmade Hazards N/A
Water Quality DENR, Mooresville
Solid Waste Disposal Town of Connelly Springs
Coastal Areas N/A
Endangered Species US Fish &Wildlife, NC Natural Heritage Program,
Farmlands Protection USDA-NCRS
Wild and Scenic Rivers N/A
I
State and Local Statutes N/A
I
Send 14 Copies of this form and all maps to: Director, Division of Community
Assistance, 4313 Mail Service Center, Raleigh, NC 27699-4313.
The ERR for Economic Development Projects should be sent directly to the State
Clearinghouse: Director, NC State Clearinghouse, Dept. of Administration, 1302 Mail
Service Center, Raleigh, NC 27699-1302.
1

ENVIRONMETNAL ASSESSMENT CHECKLIST
Page 1
Project Name and Identification No. Connelly Springs Phase 11 CDBG Sewer Proiect
v _ �
w o
m 16 g
Impact Categories U m r� a Source or Documentation
a, _m .g m a: (Note date of contact or page reference)
E m m c Additional Material may be attached
z a o01 aoi z rc
Land Development
Conformance With Ron Hancocks,Connelly Springs Planner,See
Comprehensive X Notes
Plans and Zoning
Compatibility and
Urban Impact x
Slope X Burke County Soil survey,See Notes
Erosion x
Soil Suitability x
Hazards and Sam Envin,WPCOG,See Notes
Nuisances,Including X
Site Safety
Energy No Impact is anticipated
Consumption X
Noise
Effects of Ambient HUD Noise Guide Book,See Notes
Noise on project and X
Contribution to Community
Noise Levels

- ENVIRONMETNAL ASSESSMENT-C-HECKL-IST-- -- - - -- - --
(Continued,Page 2)
Project Name and Identification No. Connelly Springs Phase II CDBGI Sewer Project
0
a 0
R
w w m' c
to 2 - a Source or Documentation
Impact Categories
W - g
P g Q, 1O — m (Note date of contact or page reference)
E Additional Material may be attached
m v
z i ar acr z rc
1 Air Quality
Effects of Ambient Air WPCOG Air Quality Program,See Notes
Quality on Project and
Contribution to Community X
Pollution Levels
Environmental Design and Historic Values
Visual Quality Ron Hancock,Connelly Springs Planner,See Notes
Coherence,Diversity X
Compatible Use
and Scale
Historic,Guttural State Historic Preservation Office,See Notes
and Archaeological X
Resources
Socioeconomic
Demographic/ X Ron Hancock,Connelly Springs Planner,See Notes
Character changes
Displacement X None expected
i
Employment and X
retained No impact
Community Facilities and Services
Educational Facilities X No impact anticipated
Commercial Facilities X Project should not impact commercial in immediate
araa
Health Care X No Impact
Social Services X No Impact
i
i

ENVIRONMENTAL ASSESSMENT CHECKLIST
(Continued,Page 3)
Project Name and Identification No. Connelly Sorings Phase II CDBG Sewer Project
0
a v
Impact Categories Ixm a a• _W Source Documentation
'5 ' Z' z' w (Note date of contact or page reference)
Additional Material may be attached
E
z a' 0-a1 a'I z rc
Community Facilities and Services(Continued)
Solid Waste X Town of Connelly Springs. see notes
wastewater x Town of Connelly Springs,See Notes
Storm Water X Town of Connelly Springs.,See Notes
Water Supply x Town of Connelly Springst.,See Notes
Public Safety—Police x Burke County Sheriffs Dept.,See Notes
Fire X Burke County Fire Marshall.see Notes
Burke County EMS,See Notes
Emergency x
Medical
Open open space x No Impact anticipated
Space and
Recreation
Recreation x
State Historic Preservation Office,See Notes.
Cultural x
Transportation x John Marshall,WPCOG Transportation Planner,See Notes

ENVIRONMENTAL ASSESSMENT CHECKLIST
(Continued,Page 4)
Project Name and Identification No. Connelly Springs Phase II CDBG Sewer Project
C
a a
y m
Impact Categories i Source Documentation
u v d v o (Note date of contact or page reference)
to > .W o Additional Material may be attached
15
zo a° a oa z 0-:
Natural Features
Water Resources X NC DENR,Asheville See Notes
I
i
iu
Surface Water X
I
a
Floodplains X FIRM Map—See Notes
Wetlands X US Army Corps of Engineers, NWI Map,
Environmental Services Inc. See Notes
Coastal Zone X NIA
I
Unique Natural USDA-NRCS,See Notes
Features and X
Agricultural Lands
-I Vegetation and X US Fish&Wildlife and NC Natural Heritage Program,
Wildlife Environmental Services Inc.See Notes
i

ENVIRONMENTAL ASSESSMENT CHECKLIST
(Continued,Page 5)
Summary of Findings
and Conclusions:
The proposed project will provide sewer service to 57 households. The project will serve families residing on
portions of Israel Chapel Road, Cobbs Place and Chapel Street. The residents have had problems with their
septic systems resulting from poor soile The wastewater would ultimately end up at the Town of Valdese Lake
.Rhodhiss wastewater treatment plant.
Summary of
Environmental Conditions:
The project will follow DOT tights-of-ways and a large portion will go through properties undeveloped. The Town
contracted with Environmental Services to conduct a wetlands delineation and an Endangered Species survey.
There were no wetlands found along the proposed route nor were there any threatened or endangered species.
There are no floodplains in the project area. There will be several creek crossings and a permit will be needed
from the US Army Corps of Engineers.
Project Modifications
and Altematives Considered
There were two alternative considered. The first would be to install new drainfields at each of the 57 houses. This
Was not practical because many of the homes did not have enough suitable space for an additional drainfreld. The
Second alternative was the proposed project which was chosen.

ENVIRONMENTAL ASSESSMENT CHECKLIST
(Continued,Page 6)
Additional Studies Performed
(Attach Study or Summary)
None
J
J
1
I
i
Mitigation Measures Needed:
I
None
I
II
i

ENVIRONMENTAL ASSESSMENT CHECKLIST
(Continued, Page 7)
1. Supply a clear, legible map of the proposed site and surrounding area. Mark area to be acquired and
construction site.
2. Utilities
Utilities to serve Projected Demand Length of Lines to be Capacity of Lines Environmentally Sensitive Areas
Project per day Constructed (inches diameter) to be Cut(for Utility acres)
Electric
Potable Water
Sewage 17,000 S"
Solid Waste
Disposal
Natural Gas
Water
3. Land Alterations
Alteration Present Use Previous Use Acres Percent of
(planned use) (before changes) (historical) Project Area
To Be Acquired
To Be Developed
To Be Originally
Cleared
To Be Landscaped
To Be Covered by
Impermeable Surface
(Square Feet)
To Be Cut
(Cubic Yards)
To Be Filled
(Cubic Yards)
4. Cultural Resources
a)Please give any known archaeological or historical sites on project land: None
b)What kind,if any,site preparation has already been conducted: None
c)Has area been previously surveyed by an archaeologist? If so,give name of principle investigator and date of survey: No
d),yes X no are buildingalstructures on site now?(abandoned bams,farmhouse,tobacco sheds,bridges,etc.)
e)Ages of each buildinglstructure:NIA
f)Will any of these structures be demolished? (indicate which)one house will be cleared NIA
g)Will any of these structures be rehabilitated or renovated? (indicate which) N/A
h)Please include photographs of any buildings constructed prior to WWII if project activities include Rehabilitation,Acquisition,Clearance or
Demolition.

ENVIRONMENTALASS ,SSMENT-CHECKLIST- - - -- - -- -- -- -
(continued,Page 8)
5.Topography Types of Vegetation
%of Soil Types Forested Non-Forested
Slope Acres Area (use USDA and SCS classification) Pine Hardwood Mixed Brush Grassland Other
0 5% 20 Cecil Association X x X X X X
5-10% 35 Cecil Association X X X X X X
10%+ 35 Cecil Association X X X X X X
6.Stream that surface runoff from project area drains into(illustrated relative position on maps in Section)
_Yes Site includes/borders _Yes Site includes/borders on _Yes Site includes/borders on
classified trout waters estuarine waters drinking water sources
X No X No X No
The project will involve impoundment or withdrawal of water. If yes,mark impound on map. If impoundment is planned,the amount of water
to be impounded is approximately acreffeet and surface acresifeet.
Yes X No
i
7. Note classes of wildlife known to exist in the general area:
1 Bear Turkey X Small Game(squirrel,quail,rabbit,raccoon,dove,etc.
Deer —Waterfowl Endangeredrrhreatened Species(osprey eagle,alligator,red cockaded woodpecker,etc)
8.Will proposed forestry practices such as burning,clearcutting, or thinning have adverse effects on any
of the above species?
Explain: No
i
9.Are proposed pesticides or herbicides known to have adverse effects on humans or any of the above
species?
Which species? NIA
I

ENVIRONMENTAL ASSESSMENT CHECKLIST
(continued,Page 9)
1o.Give name, position and office telephone number of an individual in the appropriate local government
unit that can confirm the compatibility of the proposed activity with existing and/or proposed land use
economic development plans:
Name: Sam Erwin Position: Environmental Administrator Phone:[phone]
11. List all N.C. State permits,authorizations and licenses that must be acquired to initiate and complete
the mminnewd artivitian-
Permit NC General Statute Application Date Approval Date
a)Stationary Air Contaminant Source 143.215.108
b)Air Quality Complex Source 143.215.109
c)Construction of Wastewater Pretreatment Facilities 143215.1
d)Wastewater Discharge(to surface waters) 143215
e)Approval to Construct Public Water Systems 130A-315
NCAC T15A.18C.
f)Dredge and Fill 113.229
g)Withdrawal of Water from"Capacity Use Area" 143.215.15
h)Erosion Control Plan 113A.61
i)Zoning Change or Variance
t)Coastal Resource Commission 113A.118
k)Noise Control Regulations 153A.113
1)Others(list) 9753(28)a-k
(supp) (OSHA)
1. Is the project in compliance with applicable laws and regulations? X Yes _No
2. Is an EIS required? _Yes X No
3. A Finding of No Significant Impact(FONSI) can be made.
Project will not significantly affect the quality of the human environment. X Yes _No
4. Send 14 copies of this ERR for State Environmental Clearinghouse review to:
Director, Division of Community Assistance, 1307 Glenwood Avenue, 4313 Mail Service Center,
Raleigh, NC 27699-4313
5. Prepared by: Title:
Samuel W. Erwin Environmental Administrator
WPCOG
PO Box 9026—HicKory NC 28603
Law 9/281106

Town of Connelly Springs Phase 11 CDBG Sewer Project
Environmental Assessment
Notes
Plans and Zoning� Conformance with Comprehensive g—Ron Hancock, Town Planner
The project conforms with plans that the Town has and the proposed project will not
impact zoning
nin for the Town.
Compatibility and Urban Impact—Ron Hancock
The project is compatible with the existing environment. It is designed to serve the
residential area in need.
Soil,Erosion and Soil Suitability—Burke County Soil Survey
A review of the Burke County Soil Survey shows that soils in the project area tend to be
in the Cecil Association. None of these soils should present any problems for the
proposed sewerline construction.
1
Hazards and Nuisances,Including Site Safety—Sam Erwin, WPCOG
i
There should not be any hazards associated with the project other than the usual hazards
for construction projects similar to this type. The Town will monitor the project site for
safety.
Effects of Ambient Noise on Project and Contribution to Community Noise Levels-
HUD Noise Guide Book
There may be a slight increase in noise levels during the construction phase of the project
from the use of heavy construction equipment. This will abate upon completion of the
project. The ambient noise levels in the area are not impacted by a major highway,
airport or train.
Effect of Ambient Air Quality on Project and Contribution to Community Pollution
Levels—WPCOG Air Quality Program
There may be a slight increase in airborne particulates during the construction phase of
the project from the use of heavy construction equipment. This slight increase will abate
1 upon completion of the project. There are no special air quality permits needed for the
project.
Visual Quality Coherence,Diversity Compatible Use and Scale—Ron Hancock
The visual quality of the area should not be impacted. The proposed sewerlines will be
underground.
7

Historic,Cultural and Archeological Resources—State Historic Preservation Office
As part of the State Clearinghouse process, the SHPO will comment on the project.
There are no known historic, cultural or archeological resources along the proposed
project route.
Demographic/Character Changes—Ron Hancock
No impact is expected
Solid Waste—Town of Connelly Springs
The amount of solid waste generated by the project should be minimal. Solid waste pick-
up in the Town is contracted with GDS. The waste will be taken to the Burke County
Transfer Station for ultimate disposal in the Foothills Regional Landfill in Caldwell
County. None of the waste is considered hazardous.
Waste Water—Town of Connelly Springs
The proposed sewerlines will connect with an existing pump station owned by Burke
County on Island Creek. The wastewater will then go to the Lake Rhodhiss Wastewater
Treatment Plant owned an operated by the Town of Valdese. This plant has the capacity
to handle the additional waste generated by the project. The proposed project should
have a beneficial benefit in that homes with faulty septic systems will be brought onto
municipal sewer.
Water Supply—Town of Connelly Springs
The Town gets there water from the Icard Water Corporation. The proposed project
should have no impact on water supply.
Storm Water—Town of Connelly Springs
There should not be any negative impact on storm water.
Public Safety,Police—Burke County Sheriffs Department
Since the project involves existing homes, the response times to the project area should
not change.
Public Safety,Fire—Burke County Fire Marshall
The location of the project is within the response time for the volunteer fire department
that serves the area.

Emergency Medical—Burke County EMS
Since no new houses will result from this project. Emergency or medical response times
to the area should not be negatively impacted.
Cultural— State Historic Preservation Office
As part of the state clearinghouse process,the SHPO will comment on any negative .
impacts on cultural resources. There are no known cultural resources in or near the
project area.
III
Transportation—John Marshall, WPCOG Transportation Planner
Since no new homes will added as a result of the project,transportation patterns should
not change. There may be some delays along the proposed route due to construction, but
these should be minimal since the rural roads do not carry a lot of traffic
Water Resources—NC DENR, Asheville
A section of the proposed project line will follow Island Creek before it connects to an
existing pump station. The proposed project area is not.located in the watershed area.
j Since this is not a water supply project, water resources should not be negatively
'i
impacted.
1
Surface Water—NC DENR, Asheville
j There will be creek crossings involved with the project. The Town will need to apply to
the US Army Corps of Engineers for a permit.
Floodplains—FIRM Map
A review of the appropriate floodplain maps(370034 0150C and 370034 0250C) shows
that there are no floodplains in the project area.
j
Wetlands—NWI Map, Burke County Soil Survey, US Army Corps of Engineers,
Environmental Services Inc.
A review of the National Wetlands Inventory Map shows that there are no wetlands along
-j the proposed sewer line route. In addition none of the soils in the project area are
1 considered hydric. Environmental Services Inc. conducted a wetlands delineation of the
proposed sewer lines and found one small wetland. However, it was located off the
proposed route. Since several creek crossings will be required, a permit from the US
J Army Corps of Engineers will be required.
1

Unique Natural Features and Agricultural Lands—USDA-NRCS
There are no unique natural features or agricultural lands that will be impacted. None of
the proposed sewerline route has been farmed in the last five years.
Vegetation and Wildlife—US Fish&Wildlife,NC Natural Heritage Program and
Environmental Services Inc.
A review of the data base for US Fish&Wildlife and NC Natural Heritage Program
shows that the Dwarf Flowered Heartleaf has found in the county. This plant is
considered threatened. A portion of the proposed sewer line will go through wooded
areas that could provide habitat for the plant. Environmental Services Inc. conducted a
survey of the proposed sewerline route that will go through wooded areas and did not
find any plants and determined that the proposed project would not have no effect on
species..

10/01/2006 20:38 8284335662 WEST & ASSOCIATES PAGE 03
OeL 02 06 Q6a15a jtatl 82g-254-0912 N• �
ENV1koNMENTAL SERVICES, I 4C.
)."PATTON AVENUE SUITE C
AFHEVTLLs,NORTH CAEOLtNA 2MOB
II• FAX 82&-254-C812
62d 254-as
,Mxw.csiac.ee
2 October 7006
Mr.David Poore
West consultants,PLLC
405 South Ster11119 Street
Morganton NC 28655
Re: Connelly Springs CI)BG Sewerlina Investigation ESI Project Number EED6-033
Mr.Poore:
Environmental Services, Inc., (ESI) appreciates the opportunity to offer you our services. Al
your request,ESI has conducted a jurisdictional wetland and stream delineation effort within an
propo
approximately 2,800 linear foot corridor far a sod sewerline project. Additionally,this area
was reviewed to determine the presence or absence of potentially suitable habitat for the
federally Threatated species. dwarf-flowered heartleaf(HexasVis nanii fora). This letter serves
s the deliverable for this project.
� a
The project study area is located within the Catawba River Drainage basin. The proposed
1 corridor is approximately 5D feet in width and 2.800 feet in length. The proposed condor begins
at a tie-in point at an existing seworline located east of Island Crack. The proposed corridor
extends north for approximately 300 feet; crossing an unnamed tributary to Island Creek. The
proposed corridor turns east, paralleling the urmamed tributary for approximately 2,500 feet,
ending at Israel Chapel Road(SR 1607).
The field effort for this project was conducted on 21 September 2006 by ESI biologist,Jan Gay.
Ivtr. Gay is a Senior Project Manager with more than 14 years of professional exeperienee.
Jurlac 'onal Delineation
ESI reviewed the proposed route to determine the presence or absence of jurisdictional wetland
areas using the three-parameter approach hydrophyiic vegetation,hydric soils,and evidence of
jurisdictional hydrology) as outlined by the U.S. Army Corps of Engineers (COE) 1487
Wetlands Delineation Manual. The proposed route was also reviewed for the prese
nce of
jurisdictionsl stream channels using criteria provided by the COE and the N.C.Division of Water
Quality(DWQ)-
Based on this approach, the proposed route includes one jurisdictional wetland area located
o
wwithina llptar depression 'Vegetation within this area was hydrophytic in nature,consisting of
giant cane (Arundinaria g(gantea) and cinnaaton fern (Osmunda cfmtanmmea), as well as
scattered saplings of red maple (Acer rubrum). Soils exhibited hydric ehazacteristics NUMB
1ACMOkgV1:Lr • $T.AVOV•J71NE• COCOA •JUPITER • DEMN • SAVANNAH • ATLANTA• RA1BIGH • M0LOVE •ASHBVILLB
I

10/01/2006 20:38 8284335662 WEST & ASSOCIATES PAGE e4
Oat 02 O6 Oae ]Be jray 820-254-0812 P•8
ENvtRoNmENTAL SERVICES, INC,
Connally springs Delineation
ES06-033
Page 2 of 3 sence of
color 10YR 3/1). Evidence of jurisdictional hydrology was noted, including the pre
redoximorphic featutca.
No other jurisdictional wetland areas were noted within the peed yards
mute. Vegetarian within
the remaining pa WM
rts or the proposed route consisted of maintained yards and fore holly). red map", and Armlican
forest vegetation including ironwood adjace(cwpnt t the unnamed tributary, and areas of virgins
(Ilex opnca) along the existing Levee adjacetrt to the
pine(?irsus vfrgittlura), rod maple,white nak(Qsercus albs), attd sosttexed thickets of Chinese
slips unseil color IOYR
privet (Ltgtistrum slttarsaa). Soils did not exbiR>r� bs of�the snfl spa
4/3). No evidence of]ta]sdjctional hydrology
The prepoeed route contains faun jurisdictional stream❑hamtels.including the trruutmei tributay
to Island Creel and three unnamed tributaries to tills channel. The main channel is a perennial
stxcaat chsnnc1, approximately 20 feet in width with asand/gravel substrate. "L'he throe smaller
chanmels are likely perennial channels, ranging from 1 to 4 feet in width with gravel/sand
substrate.
e..ve,.,!"l+unnel Bum.
The proposed route is located within the Catawba River Drainage basin Currently,b'affers are
dictated for the main stem of the Catawba River below Lake James. This buffer requirement
within the proposed route. The stream channels within the
does not apply to the stream channels
Best Usage Classification and therefore shore the
proposed route do not have a separate
classification of their receiving water, Island Creek (Steam index Number 11-46 (0.5)). This
reach of island Creak has a Bast Usage Classification of wS-IV,indicating a water supply within
IL highly developed watershed. Any buffers on these channels will be regulated through the
Counry sedimcot and erosion control plan.
e.lt Thr�t nod and Eadgg&
Species with the federal etas cation of Endangered, Threatened, officially Proposed for such
listing, am protected under the Endangered Species Act of 1973 (ESA), as amended (16 USC
1531 et seq). EST evaluated the proposed route for potential habitat for one of the federally
listed Threatened species known to occur in Burke County,dwarf-flowered bearded(U.S. Fish
and Wildlife list date, 8 March 2006).
Dwarf-flowered heattleaf has the smallest flower of any North American member of this genus.
Habitat for this species includes acidic sandy loam soils along bllui ad by slopes eswith 8
ris and
generally northern aspect, hillsides and ravines, and in boggyadjacent
stems, This species needs abundant sunlight in early spring for maximum flowering and seed
production. A review of records held by the N.C.Natural Heritage Program indicates no known
occurrences of this species or any other federally listed species documented within 1.0 mile of
the proposed route.

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Oct 02 06 08: t6x ,�Cay 828-254-0812 P-4
ENVIRONMENTAL SI.PvICES. INC.
Connelly Springs Delineation
EE06-033
Page 3 of 3
route. The
Potentially suitable habitat for this species is not present within tb' proposed _
does it contain W '
proposed route does not contain bluffs oroutetindieatcs Oita$•no randhridtA plants of the Genus
ra%6ew conducted within am proposed
flesostylis are present within the proposed route. A Biological Conclusion of No Effect is
warranted for this project.
Summ�c . cbawcis are present within the propoud
Une jurisdictional wetland area and fora stream
sawexline route. The Catawba River buffer rules do not apply to the srcarn chainwithin
in 1h-
proposed route. No potentially suitable
habitat for the feduaily 1'lireatened species
flowered
heartleaf is present within the proposed scwerline route-
Environmental Services. Inc., appreciates the opportunity to offer you our services. I£you have
spy questions or comments,or need any additional information,please tat me know•
Sincerely..
1, EN V9t�AIRN A SERVICES,INC.
]art y '^
nior Pr
anger
Attached!
1 Routine Wetland Determination Forms