WQ0039783_Regional Office Historical File Pre 2018

Water Resources
ENVIRONMENTAL. QUAL11"Y
February 13, 2018
Warren'ood, City Manager
City of Hickory
76 North Center Street
Hickory, NC 28601
ROY COOPER.
Governor
MICt"fAFL ti, REGAN
Secrerwy
LINDA CULPEPPFR.
Interim Director
Subject: Permit No, \ Q003f 78"3
City of Hickory
Sherrills Stream
Wastewater Collection System Extension Permit
Catawba County
Dear Mr. Wood:
In accordance w.h your application received February 1, 201 we are forwarding; herewith Permit No,
WQ0030783 dated February 1.2. 2018 to the City of Hickory (Pertttitteej Ior the construction and c_peration
upon certitkation of the suhject wastewater collection system ext. t sion. 'l his permit shall be effective
from the date of issuance until, rescinded and shall he subject to the conditions and limitations as specified
tlaere:in, This cover letter shall be considered a part of this permit and is therefore incorporated therein by
reference,
ase pay particul
Condition ILI: 1�
n
the fol€owing conditions contained within this permit:
of he automatic ally° transferahle a request must be made and approved.
Condition 1I,4: Requires that the wastewater collection facilities he properly operated and maintained in
accordance with 15A NC"r'\C:w 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 complymay result in penalties in accordance with. North Carolina
General Statute § 143-215,61 through '§ 143-715.6C, construction of additional or replacement wastewater
collection tac,ilities, and/or referral of the North Carolina -licensed Professional Engineer to the licensing
board.
SL
499
Narlh Caraina 2811.5

Il" ariy parts, retinlretnent"s, car limitations ccrntaineci in this perirrit are rrnacc pt.ak,le yc rr hay e the right to
request an arljudicatory hearing upon written request wit1 in 30 clays following receipt of this permit, "1"his
request rtIiust be in the forn1 of a written petition, conformirrg to (hater 1501 of North Carolina General
Statutes, and filed with the Office as1 \dininistrati =e rings, 6714 Mail Service tenter; Raleigh, NC
27699-67151s Unless such demands titre made, this permit shall be final and binding
If you n
via esma
Sine r ly,
l ivisl n "P1'
:t rntat i n c.c ncernin „ this matter, plea contact Lon r Snider at (7O 1 23S " 116 or
ilncde
ainr r, l eitial'
girInal, Operation,
r Resources, \t'.I _iQ
en, ILL lip.
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Environmental
Quality
STATE OF NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALIFY
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
City of Hickory
Catawba County
for the construction and operation of approximately 6,535 linear feet of 8-inch public gravity
.sewer; 50 gallons per minute pump station with duplex pumps, onsite audible and visual high.
water alarms„ telemetry and a permanent generator with automatic transfer switch; as well as
2,602 linear feet of 3-inch forcemain to serve Sherrills Stream, a 68 parcel single family
subdivision, and the discharge of 24,480 gallons per day of collected wastewater into the City
of Hickory existing sewerage system, pursuant to the application received February'', 2018, 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-
Tiack '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 penuit.
This permit shall be effective from the date of issuance untilrescinded and shail be subject to
the specified conditions and limitations contained therein,
kv W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, 'NCDEQ
By authority of the Environmental Management Commission
Permit Number: WQ0039783
Permit Issued: February 12, 2018
Page 3 of 8

SUPPLEIVIEN
TO PERMIT COVER SHEET
City ofHickory 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 City of Hickory Catawba. Waste
Water 'freatment 1 aclity in accordance with Permit Number NC:0025542,
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 Minim.um Design Criteria adopted February 12, 1996, as
applicable; and the Division's Minimum 'Desigm 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.
. SPECIAL CONDITIONS
1) No flow in excess of the quantity permitted herein, 24,480 GPD„ shall be made tributary. to the
subject sewer system until an application for permit modification for an increase in flow has been
submitted to and approved by.. the Division, [15A. NCAC 021.0304 (b)].
2) Each pump station shall be clearly and conspicuously posted using a weatherproof sign with a pump
station identifying name/number, 24-Hour Emergency telephone number, and name of the
ownerloperator of the sewer system/pump station and instructions to call the number in the event of
alarm activation or other emergency. Simplex pump stations or vacuum sewer pits serving a single-
family residence may have a placard or sticker on the control panel in lieu of a sign. [15A NCAC 02T
.0305(4)(2)1
II. STANDARD CONDITIONS
1, 'This permit is not 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 appropriateThe approval of this request shall be considered on its
merits and may or ma,/ not be approved, [15A NC AC 02T,0104; G,S 143-215,103)f
This permit shall become voidable unless the wastewater collection .facilities are constructed in
accordance with the conditions of this permit; 1.5.A 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.0110]
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 0217,0110]
Page 4 of 8

4. 'Fite wastewater collection facilities shall be properly maintained and operated at all times. 'Ihe
Permittee shall maintain compliance with an individual system -wide collection system permitfor 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 021 .01,08(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
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. Fligh-priority sewer lines shall be inspected at eds1 once per every six months and inspections
documented.
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 2B .0506(a), and public notice shall be provided as required by
North Carolina General Statute §1,13-215.1.C.
h. ,A Grease Control Program is in place as follows:
1. 1-or 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 ofthe 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 'Progam 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.
Right-of-ways and easements shall. be maintained in the full easement width for personnel and.
equipment accessibility„
-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,
The Permittee shallreport by telephone to a water resources staff member at the Mooresville 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:
Page 5 of 8

,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 SS() and/or spill over 1,000 gallons, or
An.y 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 he reported to
the Division of .Emergency Management at telephone number [phone] or [phone],
Persons reporting any of the above occurrences shall file a spill. report by completing and submitting
Part I of Fonn 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 he taken to
ensure that the problem does not recur, Part I of .Form ('S-SSO (or the most current Division
approved -form) can also be completed to show that the SSO was beyond control. [G.S, 143.-
215, 1 gal )]
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
toibe sairface waters of the State, [15A NCAC 021.0108(b)l
7, Upon completion of construction and prior to operation of these permitted facilities, the completed
Engineering Certification form attached to this permit shall he 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
Certificationshall he considered a violation of the permit and shall subject the Perrnittee 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 Conn ,'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 on the plans or on digital media (Cl) or DVD disk) and are defined. as the design drawings
that are marked up or annotated with after constructioninformation 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 stationsstorage
capacities and the rotation schedule of the 'portable power source or pump, include travel
timeframes, shall. be provided.
Page 6 of 8

c. Changes to the project that do not result in non-compliance with this pemnt, regulations, or the
Minimum Design Criteria should be clearly identified on the record drawings, on the certification
in the space provided, or in written summ.ary 'form.
Prior to Certification (Final or Partial): Permit, modifications are requiredfor 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 con,nections), regulations, or the Mininturn Design Criteria., Requested 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 (.4?z: activation, [15A NCAC 02T ,0.1.16]
Gravity sewers installed greater titan ten percent below the minimumrequired 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 'firin 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 02'f .0105(n)]
9. A copy of the construction ecord drawings shall be maintained on file by the Permittee for the life
of the wastewater collection facilities, [15A NCAC 02'1' .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 §
through 1 T3-215„6C, construction of additional or replacement wastewater collection facilities,
and/or referral of the North Carolina -licensed Professional Engineer to the licensing board, {15A
NC:AC 02T .0104; 15A NCA.0 02[ .01,08(b-c)]
11. In the event that the wastewater collection facilities fail to perform satisfactorily, including the
creation of nuisance conditions, the Pennittee shall take immediate corrective action, including those
as may be required by this Division, such as the construction of additional or replacement facilities,
[1.5A NCAC 02T .0110; 15A NCAC 02T .0108(b)]
1.2. 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. 1.43-215.1(b)]
Page '7 of 8

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE: CITY OF HICKORY
PERMIT #: WQ0039783
PROJECT: SHERR1LLS STREAM
ISSUE DATE: FEBRAURY 12, 2018
This project shall not be considered complete nor allowed to operate in accordance with standard
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. to the Regional Supervisor, Water Quality Regional Operations Section at the
address noted in the page footer.
Any wa.stewater 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 by the Division. A Final Certification shall be a complete set of
record drawings and design calculations regardless of whether partials have been submitted,
PERMIT'FEE'S CERTIFICATION
the undersigned agent for the Permirtee, hereby state that thi.s 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 Perm ittee is prepared to operate & maintain the
wastewater collection system. permitted herein or portions thereof,
Printed Name, Title
Signature Date
ENGINEER'S CERTIFICATION
1. , as a du.) registered Professional Engineer in the State of North Carolina,
having been authorized to observe (L1 periodically, Ell 'weekly, r7 full time) the construction of the
project name 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 I, 2000, as applicable; and other supporting materials,
North Carolina Professional Engineer's Seat w/signature & date,
ri Final 1 Partial (include description)
Certification Contments/Qualiliers (attach if necessary):
NC DWR — Water Quality Regional Operations :Section 610 East Center Avenue, Suite 301,, Mooresville, NC 28115
Mooresville Regional Office Phone: (704) 663-'1699 FAX: (704i-633-6040

Division of Water Resources
State of North Carolina
'Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM 'EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCC.MENTATION
Application Nurnber:
be completed by T_MR
All items must be completed or the application will be returned
I. APPLICANT INFORMATION,
1-8.pplicant's name: CITY OF HICKORY (company, immicipality, HO,.A., utility, etc.)
APPHcant-t-Pe:Individual .0 Corporation Ej General Partnership LJ Privately -Owned Public Utility
Federal El State/County Municipal El Other
3. Signature authority's name: WARREN WOOD per :15A NCAC 02T .0106(b)
Title: CITY MANAGER
4, Applicant's mailing address: PO BOX 389
City: HICKORY State: NC Zip: 28603-
5. Applicant's contact information:
Phone number: [phone] Email Address: w,..c1(ii.,,hicko
11. PROJECT INFORMATION:
1. Project name: SHERRILLSSTREAt
2. Application/Project status: Proposed (New Permit) El Existing Permit/Project
If a modification, provide the existinu permit number: WOO° and issued date,
If flew construction but part of a master plan, provide theexisting permit number, WQ00
3. County where project is located: CikTAWB,A
4. Approximate Coordinates (Decimal Degree). Latitude: 35.62Longitude: -80.98'
Parcel ID (if applicable): 46080285742.4
(or Parcel ID to closest downstream sewer)
1111. CONSULTANT INFORMATION:
I. Professional .Engineer: MEIN DARDEN 111
Firm: DAR„DEN ENGINEERING SERIVICES, PLEC
Nlailing address: 862 BRAWEEY SCHOOL RD, SUITE 202
City: .MOORESNILEE State: NC Zip: 28117-
Phone number: [phone] Email Address: john3rii!dardeneng,com
License Number: 38583
I', WASTEWATER TREATMENT FACILITY (WWTE) INFORMATION:
I. Facility Name: HICKORY CATAWBA Permit Number: NC0025542
Owner Naine CITY OF .HICKORY
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWIT):
L. Permit Number(s): WO Downstream (Receivinu) Sewer Size: 15 inch
System Wide Collection System Permit Number(s) (ilapplicablej: WQCS00256
Owner Nameis 1: CITY OF HICKORY
FORM: FIA 04-16 Page 1 of 5

GENERAL 'REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
El Yes ,01No
2, If the Applicant is a Developer of lots to be sold, has a Developer's OperationalAgreement (FORM: DEV...:) been attached?
0 Yes LJo NSA
3, If the A.pplicant is. a F1om Prpt OwnersAssociation,. has an Operational, A.greementAFORM: HOA) been attached'?
0 Yes ENo ZNIA
4. Origin of wastewater (check all that apply):
IZ Residential Owned
O Residential 1„.„eased
O School preschool day care
O Food and drink facilities
[I] Businesses / offices factories
El Retail (stores, centers, malls)
Ej 'Retail with food preparationiserice
.Medical / dental / veterinary facilities
0 Church
0 Nursing Home
5, Nature of wastewater % Domestic/Commercial % Commercial
°o Industrial (See 15A 'NCAC 02T.' .010.3(20))
s there a Pretreatment Program in effect?
6. Has a flow reduction been approved under .t 5A NCAC 02T ,011,4(13? LI Yes
tfyes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.01 I 4(f))
RESEDENTIAL - SINGLE FAMILY
0 Car Wash
Ej Hotel and or Motels
LIJ Swimming Pool /Clubhouse
0 Swimming Pool/Filter Backwash
[1] Other (Explain in ,Attachinent)
Yes LJ No
No
ablyaiI Desgii Flow '14)
360 eal/DAY
No, of Cnits
68
How
24480 GPD
gal
t1PD
gal
gal/
gal
GPD
GPD
GPD
gal./
CiPD
Tot al GPD
a See 15.A NCAC 02T .01.14(b), (d), (e)(1) and (0(2) for caveats to wasteater design 'flow rates. (Le., minimum tlow 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 he used as vacation rentals as defined
in G.S. 42A-4).
b Per I5A NCAC 02T .0114(c), design flow rates for establishments not identified [in table ;15,A NCAC 02T.0 114] shall be
determined using available flow data, water using fixtures,occupancy or operation patterns, and other measured data.
8. Wastewater generated, by project: 24480 GPD (per 1 NCAC 02T ,01,14)
Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why
0 Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect, to thk line
0 Flow has already been allocated in Permit Number:
LJ Rehabilitation or replacement ofe'xisting sewer with no nes flow e<pected
0 Other (Explaii*
.1ORM: FLA. 04-16 Page '2 of 5

VII. GRAVITY SEWER DESIGN CRITERLk (If Applicable) - 02T .0305 & DC (Gravity Seers)
Summarize gravity sewer to be permitted:
Size (inches)
Length (feet) Cklaterial
8
8
8
8
1'76
PVC
2110
[30
1.919
PVC
DIP
P VC
Section If & 111 of the MDC for Permitting of Gravity Sewers contains nformation related to design criteria
,- Section 111 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
. PUMP STATION DESIGN .CRITERIA (If ,Applicable)— 02T .0305 & MDC (Pump Stations/Force
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS 'PROJECT
Pump staUon nunlhcr or name: SHERRILLS STREAM
2, Approximate Coordinates (Decimal Degrees) Latitude: 35.6.2Longitude: -80.99'
3. Design flow of the pump station: 01.8 millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 50 gallons per minute at 1„21 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (far this Pump Station):
6. Power reliability in accordance with 15, NC! .7 02T .030.5(h)(11:
Standby power source or pump with automatic activation and telemetry - 15,k NCAC 02T .0305(h)(1)(B):
Required for all pump stations with an average daily flow greater than or equal to 1.5,000 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:
Ej Portable power source with manual activation, quick -connection receptacle and telemetry - 5A NCAC 021
.030501)(1')C)
or.
LJ Portable puttying unit with plugged emergency' pump connection and telemetry - 15A NCAC 021' 030.5{11)(11)(C):
IL shall he demonstrated to the Di -vision that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
Ifthe portable power source or pump is dedicated to multiple pinup stations, an evaluation of ail the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timefraines, shall be provided
in the case of a multiple station power outage.
FORM: F 04-16
Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02,B, .0200 & 1.5A NCAC 02T .0305());
1, Does the project comply with all separations found in 15.A. NCAC 02T .0305(1)& (g)
• NCAC 02T.0305(f) contains ini separations that shall be provided tor s
seers and other u
ater mains (
Setback Paramete
caI-water over sewer eluding in benched trenches
Yes
systems.
Separation Required
24 inches
18 inches
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
Reclaimed water lines .(torizontal reclaimed over sewer)
18
**Any pr•ivate or public water supply source, including any wells, WS-I waters of Class I o
Class 11 impounded reservoirs used as a source of drinking water
**\aters classified WS (except WS-t or WS-V), B, SA, ORW, HOW, or SB :from normal
high water (or tide elevation') and wetlands (see item 1X2
other stream, lake, impoundment, or ground water lowering an.d. surface drainage
litches
Any building :foundatio
Any basen
00 feet
50 tee
10 feet
5 feet
Top slope of emban.k.rnent or cuts of 2 feet or morei
Drainage systems and interceptor drains
Any swimming. pools
1
5 •feet
s'e
et
Final earth grade (vertical.)
36 inches
1.5A .NCAC 0271.0305(g • contains alternatives where separations in 02T,0305(0 cannot be achieved.
**Stream cla.ssitications can be identified using the Division's NC Surface Water Classifications webpage
• if noncompliance with 02T,0305(f) or rgt, see Section X of this application
2, Does the project comply with separation requirements for wetlands? (50 feet of separation) Yes LI No El 'N/A
• See the Divisio.n's draft separation requirements for situations where separation cannot be meet
variance is required if the alternative design criteria specified is utilized in design and construction
As built documents should reference the location of areas effected
3. Does the project comply with setbacks fOund in the river basin rules per 15A NCAC 02.B .0200? Yes Ej No LI N/A
• This would include Trout Buffered Streams per 15,A_N(2Ac 2B.020.2
4, Does the project require coverage/authorization under a 404 Nationwide or
individual permits or 401 Water Quality Certifications?
▪ Information can be ohtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15 A NCAC 02T.01.05(c)(6) (additional permits/certifications)?
El Yes No
Yes 1 INo
Per 1.5A NC,AC 021-.0105(0(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.
E YeS No N/A
• If yes. include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least, once every six -months and inspections
documented per 15A. NCAC 02T.0403(a)(5) or the perntitee'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 0.21, the Minimum Design Criteria for the Permitting of Pump Stations
and Force .Mains (latest version), and the Gravity Sewer Nfinimum Design ( riteria. (latest version} as applicable?
Yes ill No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review„Approval ofthe request is required prior to submittal of the Fast Track Application and supporting documents,
. Professional Engineer's. Certification:
attest that this application far
(Professional Engineer's name from Application, Item 111.1.)
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 in knowledge, 1. 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 Purnp Stations and Force .Mains (latest version). Although other professionals may have developedcertain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have jud.ged. it to be consistent with the proposed design.
NOTE .— In accordance with General Statutes 143-21.5..6A and I.43-215,.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.
North Carolina Professional. Engineer's seal, signature, and date:
3, Applicant's Certification per 15A NC AC 021 ,0106(b):
vi klo_cdt,
(Signature uthorir'sinan1e & ke from Application. Item LI.)
attes
is application for
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. 1 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.. 1 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 143-2_15.6B, 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 tine not to exceed $10,000 as well as civil penalties up to $25,000 per violation,
Date:
FORM: FTA 04-16
Page 5 of 5

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Flow, Tracking/Acceptance for Sewer Extension Applications
(FTSE 08-13)
Project Applicant Name: City of Hickory
Project Name for which flow is being requested: Sherrills Stream
More than one FTSE may be required for a single project if the owner of the WWTP is not responsiblePr alt purnp
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: Ifickory-Catawba Wastewater Treatment Plant
b. WWTP Facility Permit #: NC0025542
All flows are in .MGD
c. WWTP facility's permitted flow 1.5
d. Estimated obligated flow not yet tributary to the WWTP 0.3684
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
0.0800
0.02448-This amount was
included in the previously
allocated 0.300 MGD
0.4484
3 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:
(c) (D)=(B+C)
Obiluated,
Not Yet Total Current
Firm Tributary Flow Plus.
Capacity,* Daily Flow, Obligated
MGD M.GD Flow
Pump
Station
(Name or
Number)
Browns
Chapel
Terripan
Creek
0.73
(A)
Design
Average Daily
Flow* *
(Firm / pf),
G D
0.73
0.73 0.73
Sherrilis Fordt 0,692 0.692
(B)
Approx.
Current Avg.
Daily Flow,
MGD
0.003
0.003
0.003
0.072
0.072
0.072
(E)=(A-D)
Available,
Capacity***
0.075 0.655
0,075 0.655
0.075 0.617
* The Firm Capacity of any pump station is defined as the maximum pumped flow that
can be achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking
factor (pf) not less than 2.5.
Page 1 of '7
FTSE 08-13

between the project conne
Certification Statement:
A Planning Assessment . Addendum shall be attached for each pump station located
n point and the WAVTP where the Available Capacity is < tf
en Wood certiI` to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the
receiving aste -ater treatment facilityand 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 addendurns for which I am the responsible party. Signature of this
form indicates acceptance of this wastewater flow®
Signing Official gnzt2.arp Date
Page 2 of 7
F - 1

TO EXIST,
PUMP STATION
PUMP STATION
SCALE: 1 " 1000'

U•
Post"ervi

PENTAIR
RE)! rztIrtv Conditions
Customer : City of Hickory
Project name Sherrill's Ford PS
How, fated . 50.00 U
Differential head pressure rated 1requested) 121 0 ft
biffrerentiai head I pressure, rated 1actual) . 123.9 ft
Suction pressure. rated I max ' 0 00 / 0,00 psi 9
NPSH available, rated , Ample
Frequency 60 Hz
Performance
— --
Speed_ rated 3500 rpm
1mpeiler diameter rated
Impeller diameter, maximum
impeller diameter. minimum
Efficiency
NPSH required marqtr) required.
rq (imp eye flow} S (imp eye dowi
Minimum Continuous Stable Flow
Head, maximum,, rated diameter
Head rise to shutoff
Hcw, best eft point
How ratio. r9Aed EhEP
Diameter ratio ;rated ima,x)
Head ratio (rated dial max dia)
Cq:ChJCe/Cn [ANSIIHI 9 67-20101
Selection status
6,25 in
687 4p
4,25 in
r 0.00
13 - Metric units
10,00 USgpm
154_4 ti
27.549
90,98 3444
74.52 )144i.
1,00 i"1,00 1.001 1,00
: Acceptable
250 ' !
225
4):.i„__._
— ' , 4:347,4+444.
Liquid
iquid type
Additional liquKi description
Pump Performance Datasheet
Encompass 2.0 - 17.5,0.0
Sewage
Sotids diameter, max 0 00 in
Solids concentration, by volume 0.00 II,
Temperature„ max 68.00 deg
Fluid density, rated max 1 000 1,000 SG
Viscosity, rated 1 00 cP
Vapor pressure, rated „ 0.34 psi.a
Material
Material selected „ Standard
Pressure Data
---„.
Maximum working pressure 66,81 psi q
Maximum allowable working pressure :
Maximum allowable suction pressure N/A
Hydrostatic, test pressure N/A
Driver & Power Data (©Max density)
Driider sizing specification Rated power
Margin over specification
SPrvice factor
Power, hydraulic
Power, rated
Pcwer, maximum, rated diameter
Minimum recommended motor rating
0,00 %
1 00
: 1,53 hp
4.16 hp
4,89 hp
7.50 hp; 5 6010N (Fixed}
20 4- , 0444f 0-00 —444+ ; L.4.44,440,444440444-044
, 4
. ,
175 —4.--44—
15
4 . ,
)
= ti---
4 ) ,
, .
- -1- i
i . 4 ri „ ii '
125 .
' -44 - 4 , 40000,0 0 i.:00,.0. 0;1,
0 ;
' ' ' , .: ,
4' 1' '' '
44
100
75 0.444 , 4
:
, -
. ,
, .
t--
-4 4
25
4 ,
- 4 '
" 414-44
)
4454+A,
444_ —.44.14-4
0 )
0 10 20 30 40 50
: ) -
6
Flow - USgpm
110 120 130 140
PENTAIR
CLEARAA0ER. INC PHONE' 4528! 355-3 3".2 FAX [phone]
PO BOX 1439 HCKOR447 NC 23602

Tec
ca a
MODEL: HPGHH
HOHH
der Pumps Physical Data:
Section GRINDER Page 405
DISCHARGE SIZE
IMPELLER TYPE
CABLE LENGTH
SE
T OfJ I Ir'Ol U(Ht, 3" 125 LB. FLANGE ON HPGHH
-OPEN 5 VANE
5° STANDARD
Liquid Handli:n
MAXIMUI
ACCEPTABLE pH RANGE
SPECIFIC GRAVITY
VISCOSITY
Temperature:
U
D TEMP,
4t 'F
9
28-35SSU
AXIMUM STATOR
OIL FLASH POINT 390°F
HEAT SENSOR Open: 257'F MAX,/ 39°F
Closed. 194'F MAX3149"F
N.
N.
Technical Data:
POWER CORD TYPE
SENSOR CORD TYPE
I MOTOR HOUSING
CASING
t, z i IMPELLER
O}-�.�._.. __
cn YCUTTERS
Q< Stationary:
1 I
EE Upper (Axial):
W c) ` Lower (Radial):
2 a MOTOR SHAFT
HARDWARE
0-RINGS
ECHANICAL SEALS
Standard:
t ptiew+t I:
UPPER BEARING
LOWER BEARING
MIN. B-10 BEARING LIFE
SOOW, W
SOOW
AST IRON ASTM A-48 CLASS 30
ASS #85-5-5-5 ASTM B584-836
0
440C STAINLESS STEEL HARDENED TO 55-60 ROCKWELL C
440C STAINLESS STEEL HARDENED TO 55-60 ROCKWELL C
440C STAINLESS STEEL HARDENED TO 55-60 ROCKWELL C
416 STAINLESS STEEL
300 SERIES STAINLESS STEEL
NITRILE
UPPER AND LOWER CARBON/CERAMICINITRILE, TYPE 21
LOWER TUNOCTCN-CARDIDE/TUNGCTEN GAfDIOE/NIITIlILC: TYPE 21
(RADIAL) SINGLE ROW BALL (6303)
THRUST) SINGLE ROW BALL
50„000 Hrs
40. PENTAIR HYDR©MATIC'

Re herrills Streams Subdivision
Enclosed contains one original signed and one copy of
s the FAA 04-16 Applications
• The FTSE 04-16 Application
• R. x1,1 USGS Topa map locating the proposed gravity sealer, farce rraaanl grad pump station,
A street level map marking the locations of the sits
January 29, 21
Also enclosed is a check made to NCDECt in the arrrount of 0480,00,
The project involves the development of a 8-parcel single family residential subdivision, The sewer system has
been designed fora daily design flow o 60 GPD per unit resulting in a total design flow of 24480 + PD dotal
proposed R inch sewer pipe length of Eaa l'onear feet With 2602 linear feet of "" PVC force main,

Central Flies: APS SWP
2/1212018
Permit Number WQ0039T '3 Permit Tracking Shp
Program Category Status Project Type
Non -discharge Active New Project
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensarsns
Version
1, 00
Permit Classification
Individual
Primary Reviewer Permit Contact Affiliation
lon,snider
Coastal SWRuie
Permitted Flow
24,480
Facility
Facility Name
Shernlis Stream
Location Address
Owner
Owner Name
City of Hickory
Dates/Events
Major/Minor Region
Minor Mooresvlll
County
Catawba
Facility Conte ctAffillation
Owner Type
Government - Municipal
Owner Affiliation
Mick Berry
PO Box 398
Hickory
NC 28601039
Orig Issue
2/122018
Scheduled
App Received Draft Initiated tssrance Public Notice Issue Effective Expiration
21112018 211212018 2/12/2018
Regulated Activities
Requested /Received Events
Subdivision Additional information requested
Wastewater coliection
Outfall
Additional information received
Waterbody Name Streamindex tluamber
Current Class Su basin