WQ0042293_Application (FTSE)_20201222

DWR
Division of Water Resources
9r4-f-tvi
04-4 a -(° d
�m• I4 toTyza - �' d 1, State of North Carolina
Department of Environmental Quality
Division of Water Resources
1 SA NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-I6 & SUPPORTING DOCUMENTATION
Application Number: L/tiq20 0 1 CM13 (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
I. Applicant's name: Eli Lilly and Company (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ❑ MunicipaI ❑ Other
3. Signature authority's name: Daniel Lee VonDielingen per 15A NCAC 02T .0106(b)
Title: Owner Representation
4. Applicant's mailing address: 893 Delaware Street
City: Indianapolis State: IN Zip:46225-
5. Applicant's contact information:
Phone number: [phone] Email Address: vondielingen daniel [e-mail]
I1. PROJECT INFORMATION:
I. Project name: Project Blue Jay
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If modification, provide the existing permit number: WQ00 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Durham
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.9355' Longitude:-78.8714'
5. Parcel ID (if applicable): 228347
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Wyatt Bone License Number: 040241
Firm: Bohler Engineering
Mailing address: 4130 Parklake Ave, Suite 130
City: Raleigh State: NC Zip: 27615-
Phone number: (91 1) 578-9000 Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I. Facility Name: Triange WWTP Permit Number: NC002605 1
Owner Name: Durham County
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
I. Permit Number(s): WOUnknown Downstream (Receiving) Sewer Size: 21 inch
System Wide Collection 5zeslegn Permit Numl►er(s) (if applicable is WQCS00038
Owner Name(s): Durham County
NC Dept of Environmental Quaiitn
Raleigh Regional Office
FORM: FTA 04-16
Page I 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 EN,'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 Aereement (FORM: HOA) been attached?
❑ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
❑ Residential Owned
❑ Residential Leased
❑ School / preschool / day care
❑ Food and drink facilities
® Businesses / offices / factories
❑ Retail (stores, centers, malls)
❑ Retail with food preparation/service
❑ Medical / dental / veterinary facilities
❑ Church
❑ Nursing Home
5. Nature of wastewater : % Domestic/Commercial
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool /Clubhouse
❑ Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
% Commercial
100 % Industrial (See 15A NCAC 021 _0103(20))
�Is there a Pretreatment Program in effect? ® Yes
6. Has a flow reduction been approved under I5A NCAC 02T .0114( fl? ❑ Yes ® No
> lives. provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
❑ No
Establishment Type (see CZT.0114(f1)
Daily Design Flow ..e
No. of Units
Flow
Non -Residential Development
105,236 gal:day
1 day
105,236 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
I05,236 GPD
a See 15A NCAC 02T .0114(b). (d), (e)( I) 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 Iocated south or east of the Atlantic Intracoastal Waterway 10 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 ISA 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: 105.236 GPD (per I5A NC'.. C 02I .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

VI1. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewer*:
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8"
2,035
PVC
8"
1,868
DIP
3 ciO3
➢ Section II & I11 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. OperationaI 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)i I);
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)( I)(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 - I SA 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.
D 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(I)):
1. Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (e)
• 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer ssyste
® Yes ❑ No
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
24 inches
Water mains (vertical -water over sewer including in benched trenches)
I8 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
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
> 15A NCAC 02T.0305(g1 contains alternatives where separations in 02T.0305(f) cannot be achieved.
• **Stream classifications can be identified using the Division's NC Surface Water Classifications webpagc
t If noncompliance with 02T.0305(f1 or (g). see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No ❑ NA
): 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
S- As built documents should reference the Iocation of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ® Yes ❑ No ❑ NIA
D This would include Trout Buffered Streams per I5A NCAC 2B.0202
4. Does the project require coverage/authorization under a 404 Nationwide or
individual permits or 401 Water Quality Certifications?
• Information can be obtained from the 401 &Buffer Permitting Branch
❑ Yes ®No
5. Does project comply with 15A NCAC 02T.0I0c6) (additional permits/certifications)? ® Yes ❑ No
Per I5A 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 ❑ NIA
• If yes, include an attachment with details for each line, including type (aerial line, size, material, and Iocation).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and inspections
documented per I5A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

ti CERIIFIC IIONti:
1 Ikrs the submitted yucin comply with J + L N.l .1LII1I the titturi n I ksirrir sir:; o frir itc .rmrnrn cif r!T1p SoaPsmb
Pd I in (layo tt (1,741,11, and thct.rastr. motoriA.tralnisrntlil, )t:rtQuiasapplicable'
05[s ❑Nu
If No. complete and submit the h'anarut. Ahermitn c Ikugn Request application 11 IIX Ir)-I 1I and roppanrri d.xvmtms for
rn iCs. tnnrus al of ihr region. H mtalrrsI prior to %ohmItral of the Fist leach tpplirstioo and xupportfne document+,
2 Promo:analLnguseeriCrntt rirtan
i, Wyatt Bone, PE
IPrulcsuurul hnl user's lurnc limn Application Item III
auras that du+ app'rcatwo fur
his been resins ed by me and 1: accurate. nnrtpletc and cumrtt tit with the mf trrnatwn suppled m the pLuu spertfunr..-rs.
engrncerurg suletlationc. oral all other supporting Jucumtcnutl.rn to the hew of n) lnuwlcdye 1 further wilt that fit the best
of cry taboo ledge the unmixed des,fm his born prrparctil in acnsd.utce malt the apptinhk regulations. (,nsa) Sewer
1lrmmu'n lk-ugn t ntena for t irasuy Sewers aunt tcniani. and the htuurnu n 13cstg t 4 nitro for the Fast -Track Pant tong
of Pump Stations and Fame Muni 'Lux, ,anoint Although other pmfcnianals Ituy tuts Jcsclopcd ccruin ptxunns of dill
submittal package.,n:Iuumi of these maieruh under my signature and seal signifies that I fuse mimed Ilses material aril
'use polgrJ it to he cerisrstent %ail the prop.s.nd design
NOTE — In a:a,rtixkc nulh (icnmi Statutes 1411-2I5 hA rind 141= 15 nIT any person uhn L ws%m .) nukes any false
statement rrprewta_sttun. ar cerufi:auon man) application package thrill tic guilty of a Coatis 2 mndentcanar, w hsch nuy
.mood: s fine ntu to e.cred CIO OM. at well as [n d perutues up to S25 IIU(1 per' iol tr,on.
r+'sa, 7
North Carolina Professional I:ncinccr'+seal, signature. and date: ` ,,.o,t' C�Slpr._
.1,-:'---_, .
, -
oft 4'L�.:I• „
e4131140'
.C•
i'1?. L `sa,
3 Applicant's Ccrtrftcatton per I5A \CAL' 02T IiIOt01-
I. Datsie Lte Vie"..-11e r.'+A/s , e�r,r+r� •f-ear•+,•:y ancrdui this application for
(Signature Authnntl •+ ate & title m ,Ipphcalrnn Item 13 1
e. Js re, /44 C-s�. i.et�.,, „.e•6h+JC�
lus bait rsstoic-4 by me un1 is act me and complete to the boa of my Imam ledge. I undrnlanJ that if all requrr:'parts or
it is application air nut completed and that Ball required suppurtmg ducumcntauon and atueluncnts air nut insluJnl. this
appirtaiurn package is suhlcct I,t bong returned as incomplete I nos:rstand that ant discharge of wast_watcr from ihts nan-
1i .chsryrc system to surface waicrs or the land will result in an immediate enforcement action that nu) Include en it penalticr_
misutctne relief. anst or cnmtrul prnsccuuon. I will make no claim against the Donlon of W,'ter Resources +lipoid a cnndtttnn
of this permit be I IQIaiCJ I aim understand that tail required part: of this appIrcatran ,package arc not completed and ih:a if
Ell required mipponmg mfornration and anachmcnls are lint included. this application package mull he ictumed to me as
rn:an•plcic
\OTF — In occurdarce with General Sululrs tam--'ill±t and I 0-71 s r 11. any person who hnuwmils snakes arts take
statement Iepresenuimn, as scmftcatiun in any application package shall be gushy of a Cla.% 2 nu.demeanor• which male
in::ude a tune nal to exceed S!UJKS' as w ell as cis tl peuuII.cc up to 525.000 per s uotat:on
Signature
2),4014.
Dat: - ZdZ.o
a8-J4M- Zoe 1
FORM I -TA 0-1-14 Pagc 5 of 5

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Eli Lilly and Company
Project Name for which flow is being requested: Project Blue Jay
More than one FTSE may be required for a single project Yale owner of the WIVTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Triangle Wastewater Treatment Plant
b. WWTP Facility Permit #: NC0026051
All flaws are in MGD
c. WWTP facility's permitted flow 12
d. Estimated obligated flow not yet tributary to the WWTP 2.032
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
3.503
0.105236
5.640
47.0
II. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A) (B) (C) (D)=(B+C) (E)=(A-D)
Design Obligated,
Pump Pump Average Approx. Not Yet Total Current
Station Station Firm Daily Flow** Current Tributary Flow Plus
(Name or Permit Capacity, * (Firm / pl), Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***
N/A
* The Firm Capacity (design flow) of any pump station is defined as the maximum pumped flow
that can be achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor
(pf) not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): Durham County Sewer
Downstream Permit Number: WQCS00038
Page 1 of 6
FTSF 10-1R

III. Certification Statement:
I 53c i.pi-)a1►Q Ori MAI certify to the best of my knowledge that the addition of
the volume bf wastewater to be permitted in this project has been evaluated along the route to the receiving
wastewater treatment facility and that the flow from this project is not anticipated to cause any capacity
related sanitary sewer overflows or overburden any downstream pump station en route to the receiving
treatment plant under normal circumstances, given the implementation of the planned improvements
identified in the planning assessment where applicable. This analysis has been performed in accordance
with local established policies and procedures using the best available data. This certification applies to
those items listed above in Sections I and II plus all attached planning assessment addendums for which I
am the responsible party. Signature of this form certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
t I �`U�li �Nl I a I 18 I aD
Signing Offal Signature Date
MktLtdriK-
Title of Sign jg Official
Page 2 of ti
PTSV I fl-I R

NORTH CAROLINA
Department of the Secretary of State
CERTIFICATE OF AUTHORIZATION
I, Elaine F. Marshall, Secretary of State of the State of North Carolina, do hereby
certify that
ELI LILLY AND COMPANY
a corporation organized under the laws of Indiana was authorized to transact
business in the State of North Carolina by issuance of a certificate of authority on the
21 st day of July, 1965.
I FURTHER certify that the said corporation's certificate of authority is not
suspended for failure to comply with the Revenue Act of the State of North Carolina; that
the said corporation's certificate of authority is not revoked for failure to comply with the
provisions of the North Carolina Business Corporation Act; that its most recent annual
report required by G.S. 55-16-22 has been delivered to the Secretary of State; and that a
certificate of withdrawal has not been issued in the name of the said corporation as of the
date of this certificate.
Scan to verify online.
Certification## 107012541-1 Reference# 16092188- Page I of 1
Verify this certificate online at http:l/www_sosnc.gov/verification
IN WITNESS WHEREOF, I have hereunto set
my hand and affixed my official seal at the City
of Raleigh, this 9th day of April, 2020.
Row,.� wee
Secretary of State

E USGS U.S. DEPARTMENT OF THE INTERIOR
U.S. GEOLOGICAL SURVEY
science farachanging world
1 0.5
1000 500
1
0.5
0
0
%�. [I i
KILOMETERS 1
METERS 1000
0
SOUTHEAST DURHAM QUADRANGLE
NORTH CAROLINA
7.5-MINUTE SERIES
2
2000
1
MILES
1000 0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
FEET
CONTOUR INTERVAL 10 FEET
NORTH AMERICAN VERTICAL DATUM OF 198a
This map was produced to conform with the

NC Dept of Environmental Quality
DEC 2 7 2020
RR7)h Regional Office
4130 ParkLako Avenue, Suite 130
Raleigh, NC 27612
PHONE [phone]
BOHLER ENGINEERING NC, PLLC
BOHLER
NCDEQ Water Quality
1628 Mail Service Cent
Raleigh. NC 27(99
Re Project Blue Jay
59 Moore Drive
Durham, NC 27703
Durham County
BE # NCK 192094
NCDEQ Water Quality.
Dale. 12. 02/2020
1 he included package is a submittal for the Project Blue Jay for review and approval, The subject snc is
located at 59 Moore Drive in Durham, NC. Currently the site is undeveloped woodlands and the project is
a Lit Lilly Research and Development Industrial Campus kk th accompanied parking, utilities. and
stormwater system Specifically, the pmject has 2.035' of 8" PVC & 1.868' of 8" DIP sewer line running
across the site and connecting to an existing tnanholc. The total calculated wastewater amount flowing
through the system will be 105,236 GPD which includes all proposed buildings and facilities on site.
There arc no downstream pump stations and the system flous directly to the lVWTP via gravity line
Included in this package is the following.
• Fast track Sewer System Extension Application
• Flow Tracking fur Sewer Extension Application
• Aerial Map of Site
• USGS Topo Map
• Utility Plans
• Check in the amount of S480.00
Should you have any questions regarding ihis project or require additional information please do not
hesitate to contact me at [phone].
Sincerely,
Gary Turawski, P I
l3uhlcr 1'ngm1:cring NI. PLI C
CIVIL AND CONSULTING ENGINEERS d PROJECT MANAGERS • SURVEYORS + ENVIRONMENTAL CON5u>~TANTS
• LANDSCAPE ARCHITECTS
MfW W.eOHLERENG1NEERING.COM

2/8/2021 Mail - Cashion. Ted - Outlook
«) Reply all ' ® Delete ® Junk Block
RE: [External] FW: Action Needed - Lilly Executive Officer in NC - Project Blue Jay fast track
sewer extension application
0 You replied on Mon 2/8/2021 10:32 AM
c
Chirichella II, Vincent J. <[e-mail]>
Mon 2/8/2021 9:40 AM
To: Cashion, Ted; Robinson, Jason; Deck, Erin M
Cc: Brixey, Stephanie; Darner, Elyssa #edarner@dconc.g❑v> +2 others
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an
attachment to Report Spam.
Good morning Ted,
I am following up from your email below regarding the calculation of flow for Project Bluejay. The flows
listed below were provided by an Eli Lilly and Company Engineering Advisor based on their anticipated
flows for this facility.
Process Water 75,492gpd
Domestic 10,000gpd
Boiler/Cooling Tower 18,600gpd
Laboratory 1,000gpd
Other: Compressed Air 144gpd
Total 105,236gpd
Let me know if there are any additional questions. Thank you.
Vincent Chirichella, PE
SR. PROJECT MANAGER
BEODURHAM COUNTY
�a
5926 Highway 55 East
Durham, North Carolina 27713
Office: [phone] I Fax: [phone]
Email: vchirichella@dconc gov
From: Brixey, Stephanie <[e-mail]>
Sent: Sunday, February 7, 2021 4:46 PM
To: Chirichella II, Vincent J. <[e-mail]>; Darner, Elyssa <[e-mail]>
Subject: FW: [External] FW: Action Needed - Lilly Executive Officer in NC - Project Blue Jay fast track
sewer extension application
https:lloutlook.office365.com/mail/deeplink?version=20210201003.10&popoutv2=1 1/1