WQ0040730_Regional Office Historical File Pre 2018

Resources
State of No .th Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T ,0300 -- FA `Im I HACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number::'
All Items most he completed or the appllcat
APPLICANT INFORMATION:
c complet d by D'WR)
i11 Ire retu
Applicant's name: Cl-MY OF H1CKO.R4 (co paany, municipality. HOA, tatilit
2. Applicant type: © Individual [] Corporation El General Partnership
L] Federal El StatelCounty Municipal
3. Signature authority's name: Warren Weed per 115A NCAC 02"1" ,0106(b)
Title: City Manager
4, Applicant's mailing - : 14411 9th Ave
City: Hickory State: NC Zip: 28601-_
5. Applicant's contact information:
Phone number: (28) 323-7427 Email Address: KGP±ERtutHICKQ:L NC,GOV
Other
PROJECT INFORMATION;
1. Project name: J&H DEVELOP . SE.WER EXTENSION
2- Application/Project status: ® Proposed (New Permit) 0 Existing Pernnt^'Project
If a modification, provide the existing permit number: WQ(� ., and issued date: __.._.-.-
Tfne v construction but part of a master plan, provide the existing permit number: WQOQ
3, County where project is located: CA"TAWBA
4, Approximate Coordinates (Decimal .Degrees): Latitude: 35,46" 06' Longitude: -18 L , 1.9' 25'
5, Parcel ID (ifapplicable):
(or Parcel ID to closest downstream sewer)
ned
III. CONSULTANT INFORMATION:
1. Professional Engineer: WILLIAM S, CLAYTON License Nurttber: € iI756,
firm: CLAYTON ENGINEERING & DESIGN, PLLC
Mailing address: PO BQX 235T
City: HICKORY State: NC Zip: 28633m-_,
Phone number: (82 t) 455-3456 Email Address: WCLAYTON(diC..AYTON-ENi"rINEERING,,NET
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMA'I'IONr
1, Facility Name: NORTHEAST W"WT'1, Permit Number: NC0020401
Owner Name: CITY OF HICKORY
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1, Permit Nuntber(s): WQ _ Downstream (Receiving) Sewer Size: inch
SyLtemWideCollection System PermitNurnber(s) {if applicable): WQCS_.
Owner Narne(s): CITY OP HICKORY

VI. GENERAL REQUIREMENTS
1, Hike Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
LI Yes ElNo ]N/A
2. If the Applicant is a Developer of lots to bc sold, has a Developer's Operational Agreement (FORIvE DEV) been attached?
0 Yes nNo FIN/A
3. If the Applicant is .rs' Association: has an Operational A cement (FORM: HOA1 been attached?
Yes ONo N/A
4. OriginOrigio ofwastewater (check all that apply):
El Residential Owned
El Residential Leased
0 School / preschool / day care
Food and drink facilities
0 Businesses / offices / factories
Lj Retail (stores, centers, malls)
fl Retail with food preparation/service
Medical / dental / veterinary facilities
LI Church
D Nursing Horne
5. Nature of wastewater : 100,% Domestic/Commercial
% Commercial
Car Wash
LI Hotel andlur Motels
El Swimming Pool /Clubhouse
0 Swimming Pool/Filter Backwash
0 Other (Explain in Attachment)
% Industrial (See I5A NCAC 02T ,0 I 3(20))
Is there a Pretreatment Program in effect? El Yes CI No
6. Has a flow reduction been approved under 15,A NCAC 021" ,0114(f)? LI Yes
> If ves, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
No
Establishment Type (s 02T.0114ifi)
SINGLE FAMILY RESIDENTIAL (3 br
Daily Design noW '°11
360 gal/DAY
gal/
gal/
gal/
gal/
gall
No, o U
Flow
720 GPD
OP[)
GPD
GPD
GPD
Total 720 GPD
a See I5.A NCAC 02T .01.14(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 located south or east of the Atlantic Intracoa.stal Waterway to be used as vacation rentals as defined
in 'G.S. 42A-4).
h Per I5.A NCAC 02T .01 14(c)„ design flow rates for establishments not identified in table ISA NCAC 02T„01141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data,
8, Wastewater generated by project :720 OPD (per ISA NCAC 021 :01.141
> Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
L] Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
El Flow has already been allocated in Permit Number. _
[1 Rehabilitation or replacement of existing sewer with no new flow expected
El Other (Explain):

VII, GRAVITY SEWER. DESIGN CRITERIA (I'f Applicable) - 02T .0305 & MDC (Gra
I. Surtrrimari:e gravity sewer to be permitted:
Se.etion II & 111 of the MDC for Pernnitting of Gravity mowers containns info
r Section III contains information related to rmnininnrrrnm slopes for gravity sewer(s)
Oversizing lines to meet minimum slope requirement is not allowed and a viol
VIII. PUMP STATION DESIGN CRITERIA ('If Applicable) — 02T .0305 & MDC (Pump Stations/F.'
COMPLETE FOR EACH PUMP STATION INCI,UDEI3 Iiti THIS PROJECT
Pump station number or name:
2. Approximate C. ordinates (Decimal Degrees). Latitude: longitude:
3. Design flow of the pump station: millions gallons per day (firm capacity))
4. Operational point(s) ef the purnp(s): gallons per minute at. feet total dynamic head (LOIl)
5, Summarize the force main to be permitted (for this Pump Station):
7
Size (inches) I
n
6. Power reliability in accordance with 15A l*lCAf'.(}2T 03.05tkij(] ).
[] Standby power source or pump with automatic activation and telemetry - 1 S A NCAC 02T .O305(h)(I)(B),
Y Required for al'] pump stations with an average daily flow greater than or equal to 15,000 gallons per day
Y Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000gallons per day:
El 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 connect: otn and telemetry - 1.5A NCAC 02T ,0305(h)(1)(C):
1t shall be dernonstrated to the Division that the portable source is ow ed 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 slatevaluation of all the pump stud ons° storage
capacities and the rotation schedule of the portable power source or pump. including travel timnefrannes, shall be provided
in the case of a multiple station power outage.

IX, SETBACKS & SEPARATIONS — (02B .0Z00 & '1SA NCAC
project comply �p C "2 I. Does the � r�� eci with all s�. an�ltrot><v aa�ttrrd in 1�5r1 NC;AC
15A NCAC 021-.0305 con tatns natrz mut
Setback Parameter*
Storttt sewers aztd Rather utrhtie not listed lreloe (°er`tict
water txtauts lveritcut..
Water ttrrrarts hori4 ont
leclaimed water lines
Reclaht to
ckuding in
at ret°lainted o
d wader lanes 'ltorizcntal - reclaimed ov
shall be provided for sewer
**Any private or public wutev suppl:yscatuce, including any wells, WS-I waters al Class 1 or
Class 11 impounded reserwou treed aid t source of ciriatkitr vvater
*Waters classified \VS (except WS "I or WS-V),
ater or true elevation),and wetlands see r
*Any other stream, lake, irripoundtnent, or groun
hes
Any building Fo
Any basement
5ope of�einba
i em embankment or cuts of 2
etennis and interceptor dt
Any swim tt in .. p1s
atilt grade tvertteal)
SA, ORW, HQW, or S13 .from normal
1C.2j
or more v
d surface drainage
Yes [] No
100 feet
50 feet
10 feet
htcites
15A. NCAC 02T.0305(g contain aiternatives where separations in M'2T.030y(t) cannot be achieved.
**Stream classifications can be identified using the Division's NC ;urfac " aaier C"lslasslie ttiaatatc wehmage
If noncompliance with Q?T.0305( or(g), see Section X of this application
Does the pproject comply with separation requirements for wetlands"? (50 feet of serattz) [ ] Yes FE No N/A
Y See the Division's draft ;separation requirements for situations where separation eerrrrot be rrrct
No variance is required tithe alternative design criteria specified is utilized in design and construction
Y As built documents should reference the location of areas effected
C)taes die project comply with setbacks found in the river basin rttlee
I`his would include Trout Buffered Streams per 15A NCAC 2
4. Does the project require co eraget°authonzunder a 404 Nation'wvade of
individual perrrtits or 401 Water Quality Cerilftcatsons`?
Information can he obtained from the 401 lie Buffer Pennon mg Branch
'AC (2B.02©0?
Does project corttpky with 15A 5(cJl6) (additional permits/ccrtihcattcrr
Per 15A NCAC" 02"1,0105.(c1(b)„ directly related environmental permits or ee,rdfrcation applications. are being prepared, have
been appiietl for, or have been obtained„ Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimental eorntr)1 plans, stornnwater management plans, etc..).
.N/A
No
Does this project iri htiie arty° e-w°et° collectiaatt tin e that are deemed `°high -priority'?'"
Per l5 '4 NCAC 02Tt1 02, "high•pncavity sewer" means "any aerial sewer, sewer contacting surface waters, sipk otz, er sew°er
positioned parallel to strearnbanks that is subject to erosion that undermines or deteriorates the sewer.
El Yes ® No LJ N/A
if yes, include an attachment.witkv details for each line, including type (aerial line, size, material, and iocaticn),
High priority lines shall be inspected by the per ntittee or its representative at least once every six -months tend Inspections
documented per 15A NCAC 02"r.0403(a)(5) or the pernnitee's individual System -Wide Collection per
In

X. CERTIFICATIONS:
1. Does the submitted systetn comply with 15A NCAC 021, the Minimum Design Criteria for the Permitting 5;1a_tions
and Force Mains (latest rirQ. and the Gravity . v rMjj»Qesign Criteria (late,st version). as applicable?
El Yes
El No
11No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Aprtyalof he re c u at of the Fast Track . '
2. Professional Engineer's Certification:
1, ql_...LijArt C attest that this application for
(Professional Eigiiioers name from Application hem 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 my knowledge, 1 further attest that to the best
of my knowledge the proposeddesign 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 East -Track Permitting
of Pump Stations and Force Mains (latest version). .Although other professionals linty have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that 1 have reviewed this material and
have judged it to be consistent with the proposed design,
NOTE — In accordance with General Statutes 143-21.5,6A 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 inisdemealmr, which may
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per violation,
A011.1/4/-
North Carolina Professional Engineer's seal, signature, and date:
C AR of*
•-•
3. Applicant's Certification per 1..5A NCAC 02T .0 I 06(h)i
(Signat
re Authority'
- ___ _attest that this application for
ante ti1e from Applitation item 1,3)
has been reviewed by me and is accurate and complete to the best of my knowledge, I understand that if all requiredparts. of
this application are not com:itteted and that if all required supporting documentation and attachments am not included, this
applicationpackage 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, andlor 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 'requiredparts of this application package are not completed and that if
all required supporting information and attachments are not includ.ed, this application: package will be returned to me as
inc.omplete.
NOTE — In accordance with General Statutes 143-215,6.A and 143-215.61, 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:
Date:
vrm CF A el t
—1' 4:

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
0105,k)o Watcl -?.esourc
(ELSE 04-16)
Entity Requesting Allocation. ITV OF HICKOR
Project Name .for which flow is being requested: .1&17.1. DEVELOPMENT
More than one FTSE may be required fir a single project ff the owneroJ the PVI417) is not responsible "by
stations along the route of the proposed wastewater . C714°.
1. Complete this section only if you are the •ovner ofthe wastewater treatmenttla •
a. WWTP Facility 'Name: Northeast WWTF
b. WVTP Facility Permit #: NC0020401
All flows are in MGD
c. WWTP facility's permitted. flow 6.0
d. Estimated obligated flow not yet tributary to the W TP 0.7477
e,. WWTP facility's actual avg. flow 3,084
f. Total flow for this specific request .00072
g. Total actual and obligated flows to the facility 3.8324
h. Percent of permitted flow used 63..9 ')/9
11. Complete tilts section for each pump station you are responsible for along the route of this
proposed wastewater now..
List pump stations located between the project eonnection poiint and the WWTP:
(A) (8) (C) (D)----(B+() (E)=(A-D)
Design Obligated,
Pump Average Daily Approx, Not Yet Total Current
Station Firm Flow" Current Avg, Tributary Flow Plus
(Narne or Capacity, * (Firm I pt), Daily Flow„ Daily Flow, Obligated Available
Number) MGD MGD MGD MGD Flow Capacity*"
N/A
* The Firm Capacity of any pump station is defined as the maximuni 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 (pi) not less than 2.5.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWII' where the Available Capacity is < O.
Downstream Facility Name (Sewer): Hickory Collection system
Downstream Permit Number:. WQCS00020
Page 1 of 6
FTSE 04-16

Ceaificatcta tatenaenf
Warren WOod certify to the best of my knowledge that the addition of
the volume of waste eater to be permitted in this project has been evalaratcd along the route to the
receiving wastewater treatment facility and that the flow from this project is not anticipated to
apacity 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 polies and procedures using the hest
available data. This certification applies to those items listed above in Sections I and I[ plus all
attached planning assessment add ndurs for which I am the responsible party. Signature of this
form indicates acceptance of thi^wastewater flow
!pat
Page 2 of

Pt�rk
raW
(Item t` i.. r Hickory`
Hlifran, Pub
rrTul r
:NI Ave SW
CLAYTON
ENGINEERING & DESIGN
Hn ptvr Hei4
Goii
T
C stQw
3sdArc NW'
Hickory
°statwt !:roki
Owner
J&H DEVELOPMENT
Drawing Title
STREET VIEW
rr r
DTTil
T,ite ryd 5E.
Pro
J&H DEVELOPMENT
SEWER EXT
Project LocotIon
HICKORY, NC
NOT TO SCALE
Job No.
18055
C-02

CLAYTON
ENGINEERING & DESIGN
Owner
DEVELOPMENT
Drcvetng Title
USGS MAP
NOT TO SCALE'
ProJecl Title
J&f-1 DEVELOPMENT
SEWER EXT
Protect L.ocolaon
HICKORY, NC
Dote
3/Vie
job tea.
18055

C LAYT IN
ENGINEERING & DESIGN
March 6, 2019
NCDEQ - DWR
610 East Center Avenue
Mooresville, NC 28115
Re: Rainey Sewer Extension — New Sewer Service
Project Narrative
COED Job # 2018055
Dear Sir or Madam,
Clayton Engineering & Design has been selected by J&H Development to prepare plans and
specifications for the proposed sewer extension to serve three single family residencesalong 28'h
Ave PL NE in Hickory, NC. Site development will require the construction of 8°' gravity sewer line
to serve the single family homes. Approximately 233 LEof 8" gravity sewer is to be constructed,
The proposed development will generate 720 gpd (360 per dwelling unit). The existing parcel will
be subdivided into three individual parcels, Because one (the original) parcel had already been
allocated in the future possible flow to the Wir'VTP, this development will only generate two
additional allocations totaling 720 gpd.
If you have any questions or need additional information, please feel free to calf me at
[phone] or email wclaytonAclaytgn-enoineerinq.net.
Sincerely,
Clayton Engineering & Design, PLLC
M'l'ax <C (Aye -off
William S. Clayton, PE
President
304 15°' Slreet SE!P° Box 2351 Hickory, NC 28603 l828145 -'3456 P•1463
Page 1

Transmittal Sheet
CLAYTON ENGINEERING & DESIGN, PUG
PO BOX 2351
304 15 ST SE, Hickory, NC 28603
T 828,455 3456
To NCDEQ
WATER QUALITY SECTION
610 E. Center Avenue
Mooresville, NC 28115
704-663-1699
N 1NG & DESIGN
Date 3/19/19
RE J&H Dev. Sewer
Hickory, NC
Project No. 18055 Phase:
We are sending you 1 copies of the following enumerated EPrints 0Seplas 0Shop Drawing
[ISamples 0BR:tenures LICat. Cuts 0 OLetters Specification
1-Fast Track Package
1-Check
Our Comment:
Pease see enclosed submittal package for Stonebrook Sewer,
Thanks,
Distribution
2,
3.
4,
5,
For Your Action ['Corrections ['General Information
0Request 0Resubmission
Clayton Engine ing & Design, PLLC
Transmitted By [Wail Signature
UPS Name
Title

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE: CITY OF HICKORY
PERMIT #: Q0040730
PROJECT: J&II DEVELOPMEN-F SEWER EX
ISSUE DATE: MARCH 2019
RECElVEt OENR/DWR
WOROS
MOORESVILLE REGIONAL .OFFICE
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 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 by the Division. A Final Certification shall be a complete set of
record drawings and design calculations regardless of whether partials have been submitted.
PERMITFEE'S CERTIFICA'TIQN
1, 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 tv. maintain the
wastewater collection system permitted herein or portions thereof.
C.)
Ma -
Printed Name. 71 itle Signature
ENGINEER'S CERTIFICATION
Date
r`,:as a duly registered Professional Engineer in the State of -North Carolina,
having been authorized to observe (ktperiodically,LJW cc k ly, Li full time) the construction of the
project name and location as referenced above the above Permittee hereby state that, to the best of
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; 233 linear 'feet of 8-ineh gravity
sewer 15A NCAC 021; the Division of Water Resources' (Division) Gravity Sewer Minimum Design
Criteria adopted February12, 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 wIsignature & date:
Winal LI Partial (include description)
Certification Comments/Qualifiers (attach if necessary):
NC DWR — Water Quality Regional Operations Section 610 East Center Avenue, Suite 301, Mooresville, NC 28115
Mooresville Regional Office Phone: [phone] FAX [phone]

CERTIFICATION CHECKLIST
To be completed by the certilYing engineer prior to operation of the permitted SCWers, per I 5A NCAC 02E0116,
RECEECDRPJWP
Certifying Engineer: \Millar-11 S. ClaYton, PE
Certification Review Date: 10/30/19
Project Name: J&H Dev. Sewer Ext
wQ00 40730 Project County: Catawba
wvOROS
MOOWSViLLE R(GIoNAL, OFFICE
1) Has pennittee information changed since the permit was issued (or :Willed): change of mailing address,
change of ownership, transfer from developer to HOA/P0A, etc. No
yes„ please provide either a change of ownersThip form or new contact infonnation, Note that transfer of
permits from the developer to the HOA/POA must occur with the first certification.
2) Have the as -built drawings have been signed, sealed, and dated by an N.C. PE'? Ye L No
3) Final -Engineering certification? Yes LJ No
• If Partial Engineering certification, provide detailed narrative including what is being certified in the current
phase, what was previously certified (if applicable), and what is left to be certified.
4) .Adequate information related to seer Yes E No El N/A
• Three feet minimum cover has been provided for all sewers unless ferrous pipe was installed.
• Minimurn. diameters for gravity sewers are 8-inches for public lines and 6-inches for private lines,
• Manholes have been installed; At the end of each line, at all changes in grade, size, or alignment, at all
intersections, and at distancesnot greater than 425 feet; minimum diameter shall be 4 feet (48-inches).
5) Adequate information related to pump stations: Yes C No N/A
• Ensure power reliability option was selected per I 5A NCAC„02T.0305(h).
6) Was project construction completed in accordance with all of the .following Ycs No
• I 5A 'NCAC 02T, Minimum Desn:T Criteria. (MDC1 for the permitting of_ciravity Sewers (latest version), an.d
MDC for the Permitting of Pun Stations at 1 Force Mains (latest version)?
If not., a variance approval is required in accordance with -I5,A .N( IAC 021-.0105(1), prior to certification and
operation.
• Contact the Central Office to discuss the variance to determine a course of action.
• Applicant must submit two copies of the variance request form, plans, specifications, calculations, and any other
pertinent information to the Central Office (one hard copy, one digital copy
• The central office will review the variance .request„ and if approvable, specific language regarding the variance
will be incorporated into the permit„ either via a special condition or a supplementary letter. A copy of the
reissued permit with variance language or the variance letter must be maintained with the original documents,
7) Does the project contains high priority lines (15A Nc.,AC 02T ,0402(2))? Yes No
• If yes, ensure that the permit already contains the necessary condition related to high priority lines I 5A NCAC
02T.0403 (a)(5). lithe permitdoes not include this language, the Fast Track reviewer will reissue the permit with
the appropriate language.
8) Are Permit modifications are required for any changes resulting in non-compliance with this permit eluding but not
limited to pipe length changes of 1.0% or greater, change in flow, pump station design capacity design change (4'5% or
greater, andlor change in the number/type of connections)? fl Yes [21 No
• If yes. a permit modification request must be submitted .n.) the appropriate Regional Office, and a modified
permit with revised certification must be issued prior to certification and operation.
NC DWR — Water Quality Regional Operations Section 610 East Center Avenue, Suite 301, Mooresville, NC 28115
Mooresville Regional Office Phone: [phone] FAX [phone]