WQ0002638_Renewal Application_20211110

Initial Review
Reviewer Thornburg, Nathaniel D
Is this submittal an application? (Excluding additional information.)*
Yes No
Permit Number (IR) * WQ0002638
ApplicantlPermittee Town of Angier
ApplicantlPermittee Address PO Box 278 Angier, NC 27501
Is the owner in BIMS? Yes No Is the facility in BIMS? Yes No
Owner Type
Facility Name
County
Fee Category
Is this a complete application?*
Yes No
Signature Authority
Signature Authority Title
Signature Authority Email
Document Type (if non -application)
Email Notifications
Municipal
Town of Angier WWTF
Harnett
Does this need review by the hydrogeologist? * Yes No
Regional Office
CO Reviewer
Admin Reviewer
Fee Amount
Complete App Date
$0
Below list any additional email address that need notification about a new project.
... ... ..
Email Address
Comments to be added to email notfication
Comments for Admin
Comments for RO

Comments for Reviewer
Comments for Applicant

Submittal Form
Project Contact Information
Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence.
............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Name* Brandon Lee Johnson
Email Address*
[e-mail]
Project Information
Application/Document Type*
New (Fee Required)
Modification - Major (Fee Required)
Renewal with Major Modification (Fee
Required)
Annual Report
Additional Information
Other
Phone Number*
9193316712
Modification - Minor
Renewal
GW-59, NDMR, NDMLR, NDAR-1,
N DAR-2
Residual Annual Report
Change of Ownership
We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form.
hftps://edocs.deq.nc.gov/Forms/NonDischarge_Monitoring_Report
Permit Type: * Wastewater Irrigation
Other Wastewater
Closed -Loop Recycle
Single -Family Residence Wastewater
Irrigation
Permit Number: * WQ0002638
Has Current Existing permit number
Applicant/Permittee* Town of Angier
Applicant/Permittee Address* PO Box 278 Angier, NC 27501
Facility Name* Town of Angier WWTF
Please provide comments/notes on your current submittal below.
High -Rate Infiltration
Reclaimed Water
Residuals
Other
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.
(Application Form, Engineering Plans, Specifications, Calculations, Etc.)
2021 permit renewal.pdf 3.23MB
Upload only 1 PDF document (less than 250 MB). Multiple documents must be combined into one PDF file unless file is larger
than upload limit.
* By checking this box, I acknowledge that I understand the application will not be
accepted for pre -review until the fee (if required) has been received by the Non -
Discharge Branch. Application fees must be submitted by check or money order and
made payable to the North Carolina Department of Environmental Quality (NCDEQ).
I also confirm that the uploaded document is a single PDF with all parts of the
application in correct order (as specified by the application).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Signature

Submission Date 11/10/2021

State of North Carolina
DWR Department of Environmental Quality
Division of Water Resources
Dtvlsioo of Water Resources 15A NCAC 02T .0500 — WASTEWATER IRRIGATION SYSTEM — RENEWAL
FORM: WWIS-R 02-21
Pursuant to 15A NCAC 02T .0107 b , if the application does not include all required information and the necessary supporting
documentation, the application shall be returned. The application and attachments shall be prepared in accordance with 15A
NCAC 02T .0100, 15A NCAC 02T .0500, and Division Policies. For more information, visit the Water Quality Permitting
Section's Non -Discharge Branch website. The Applicant shall submit an electronic copy of the application and attachments
uploaded as a single Portable Document Format (PDF) file to htt s:/iedoes.de .nc. ov/FormsINonDischar e-Branch-Submittal-
Form-Ver2, or emailed to Non-DischarQe.Reports!a ncdenrgov if less than 20 megabytes (MB).
SECTION I — APPLICANT INFORMATION
1. Applicant: Town of Angier
2. Permit No.: WQ002638
3. Signature authority: Gerry Vincent
Phone number: [phone] Office
4. Mailing address: PO Box 278
City: Angier
5. Contact person: Brandon Johnson
Primary phone number: [phone] Cell
-- .... ...
1
Title: Town Manager
Email: [e-mail]
State: NC Zip: 27501-
Email: [e-mail]
Secondary phone number: [phone] Office
SECTION H — FACILITY INFORMATION
Physical address: 420 Campbell St. County: Harnett
City: Angier State: NC
2. Treatment facility coordinates to the sixth decimal degree:
Latitude: 35.489961' Longitude:-78.7213130 Method: Address matching
SECTION III — FLOW INFORMATION
Parcel No.: 0683-05-3184.000
Zip: 27501-
Permitted flow: 199357 GPD (The maximum allowable flow based on what has been permitted)
2_ As -built flow: 199357 GPD (The maximum allowable flow based on what has been constructed
3. Average flow: 44816 GPD (The average of all reported flows on the previous calendar year's NDAd&)
4. Hydraulic capacity: 20 % (Divide the average flaw in Item 3 by the As -built flow in Item 2)
5. Wastewater composition: Domestic., 100 % Industrial: % Stormwater: 0 %
1. Billing address: PO Box 278
City: Angier
SECTION IV — BILLING INFORMATION
State: NC Zip: 27501-
2. Verify the Applicant does not have any overdue annual fees:
hit is:!/de .ne. -,ov/about/divisions/water-resources/water-resources- rmits/wG -e a� ments
Pursuant to 15A NCAC 02T .0120(c , permits for renewing facilities shall not be granted if the Applicant or any affiliation has
an unpaid annual fee.
FORM: VMS-R 02-21 Page 1 of 6

I
SECTION V — OPERATOR IN RESPONSIBLE CHARGE (ORC) INFORMATION
ORC: Brandon Johnson Grade: SI Certification No.: 998516
Mailing address: 8209 NC 42
City: Holly Springs
Phone number: [phone] Cell
2. Back -Up ORC: Jimmy Cook
Mailing address. PO Box 278
City: Angier
Phone number: [phone] Cell
State: NC Zip: 27540-
Email: [e-mail]
Gracie: Sl Certification No.: 18548
State: NC Zip: 27501-
Email: [e-mail]
SECTION VI — OPEN -ATMOSPHERE STRUCTURES -
1. List all open -atmosphere treatment and storage structures associated with the renewing permit. Attach additional sheets if
necessary.
Type
Parcel No.
Volume (gal)
Liner Type
Freeboard (ft)
Latitude
Longitude
Treatment/Storage
0683-05-3184.000
2,892,384
Apron, concrete
4
35.4950510
-78.729766°
Select
Select
°
_ °
Select
Select
r
Select
°
_ °
Select
-- - SECTION VU — RELATED PERMITS
1. List all wastewater permits (i.e., sewer, collection system, NPDES, residuals) that have interactions with the renewing permit.
Attach additional sheets if necessary.
Permit 'Type Permit No. Relationship Type
Collection System WQCS00183 Discharging collection system
Select Select
Select Select
Select Select
SECTION VIII — MONITORING WELLS TT i
,
1. List all groundwater monitoring wells associated with the renewing permit. Attach additional sheets if necessary.
Well Name I Parcel No. Status Gradient Location Latitude Longitude
#1
0683-05-3194,000
Active
Upgradient
Select
35.494333° I-78.728688°
#2
0683-05-3184.000
Active
Downgradient
Select
35.494653°'-78.7308780
#3
0683-33-2576.000
Active
Upgradient
Select
35.4931260-78.7242520
#4
0683-33-2576.000
Active
Cross gradient
Select
35.491087°-78.722396°�
#5
0683-33-2576.000
Active Downgradient
Select
35.4891400-78.7251160
select Select
Select
0°
Select
Select Select
°
Select
Select
Select
` - °
Select
Select
Select
° - °
Select
Select
Select
° - °
Select
Select
Select
FORM: WWIS-R 02-21 Page 2 of 6

SECTION IX --IRRIGATION FIELDS
1. List all irrigation fields associated with the renewing permit. Attach additional sheets if necessary.
Field
County
Parcel No.
Deeded Owner
Area
Cover Crop Latitude Longitude
#1
Harnett
0683-33-
2576.000
Town of Angier
4.23
Sycamore Trees
35.4920030'-78.7251310
#2
Harnett
0683-33-
2576.000
Town of Aniger
6.89 Sycamore Trees
35.4920580 -78.7232060
#3
Harnett
0683-33-
2576.000
Town of Angier
5.98
Bermuda Grass
35.4923500 -78.720739°
#4
Harnett
0683-33-
2576.000
Town of Angier
8.72 Bermuda Grass
35.490045°-78.721268°
#5
Harnett
0683-33-
2576.000
Town of Angier
12.48
Bermuda Grass
35.490$72°-78.7240720
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FORM. WW1S-R 02-21 Page 3 of 6

ATTACHMENT A - SITE MAP
Was the facility originally permitted or had a major modification issued after September 1, 2006?
❑ Yes -Pursuant to 15A NCAC 02T .01051d►, submit a site map pursuant to the requirements in 15A NCAC 02T .0504[di. These
requirements are:
❑ A scaled map of the site with topographic contour intervals not exceeding 10 feet or 25 percent of total site relief and showing
all facility -related structures and fences within the wastewater treatment, storage, and irrigation areas.
❑ Soil mapping units shown on all irrigation sites.
❑ The location of all wells (including usage and construction details if available), streams (ephemeral, intermittent, and
perennial), springs, lakes, ponds, and other surface drainage features within 500 feet of all wastewater treatment, storage,
and irrigation sites.
❑ Delineation of the compliance and review boundaries per 15A NCAC 02L .0107 and .0108, and 15A NCAC 02T .05061c1
if applicable.
❑ Setbacks as required by 15A NCAC 02T .0506.
❑ Site property boundaries within 500 feet of all wastewater treatment, storage, and irrigation sites.
❑ All habitable residences or places of public assembly within 500 feet of all treatment, storage, and irrigation sites.
® No - Skip Attachment A.
ATTACHMENT B - SIGNATURE AUTHORITY DELEGATION
Does the signature authority in Section 1, Item 3 meet the requirements pursuant to 15A NCAC 02T .0106 b i?
® Yes - Skip Attachment B.
❑ No - Submit a delegation letter pursuant to 15A NCAC 02T .0106[c s authorizing the signature authority to sign.
ATTACHMENT C-FLOW REDUCTION - - — -
Does the existing permit include an approved flow reduction?
❑ Yes - Submit a copy of the flow reduction approval letter, as well as the measured monthly average amount of wastewater flow
contributed per unit for the 12 months prior to permit renewal. If any of these monthly averages are within 20% of the approved
flow reduction value, the Permittee shall provide a reevaluation of the reduced flow value pursuant to the requirements in 15A
NCAC 02T .0114( 1*�.
® No -- Skip Attachment C.
ATTACHMENT D - CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY I
Is the Applicant a Privately -Owned Public Utility?
❑ Yes - Pursuant to 15A NCAC 02T .0115(aN i ), submit the Certificate of Public Convenience and Necessity from the -ol h
Carolina Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise.
® No - Skip Attachment D.
ATTACHMENT E - OPERATIONAL AGREEMENT
Is the Applicant a Home/Property Owners' Association or Developer of Lots to be Sold?
❑ Yes (Home/Property Owners' Association) -Pursuant to 15A NCAC 02-T .0101 a )121, submit an executed Operational Agreernent
J FOR141: HOA s. Pursuant to 15A NCAC 02T .01151c J, if the applicant is a legally formed Homeowners' or Property Owner's
Association, submit a copy of the Articles of Incorporation, Declarations, and By-laws.
❑ Yes (Developer of Lots to be Sold) - Pursuant to 15A NCAC 02T .01.15(a)52 3, submit an executed Operational Agreement
F012Iti1: DEV .Pursuant to 15A NCAC- 02T .0115�, if the applicant is a developer of lots to be sold, submit a copy of the
Lrticles of Incorporation, Declarations, and By-laws-
Ao- Skip Attachment E.
FORM: W WiS-R 02-21 Page 4 of 6

FORM: WWIS-R 02-21 Page 5 of 6

ATTACHMENT F— DEMONSTRATION OF FUTURE WASTEWATER TREATMENT CAPACITIES
Is the applicant a municipality, county, sanitary district, or public utility?
® Yes — Proceed to the next question.
❑ No — Skip Attachment F.
Does the hydraulic capacity in Section III, Item 4 exceed 70%?
❑ Yes (the hydraulic capacity is greater than 70%, but less than 80%) — Pursuant to 15A NCAC 02T .01 I-8( 1), prior to exceeding
80 percent of the system's permitted hydraulic capacity (based on the average flow during the last calendar year), the permittee
shall submit an engineering evaluation of their future wastewater treatment, utilization, and disposal needs. This evaluation shall
outline plans for meeting future wastewater treatment, utilization, or disposal needs by either expansion of the existing system,
elimination or reduction of extraneous flows, or water conservation and shall include the source of funding for the improvements.
If expansion is not proposed or is proposed for a later date, a justification shall be made that wastewater treatment needs will be
met based on past growth records and future growth projections, and as appropriate, shall include conservation plans or other
measures to achieve waste flow reductions.
i ❑ Yes (the hydraulic capacity greater than 80%) — Proceed to the next question.
I ® No — Skip Attachment F.
If answered Yes above, does the hydraulic capacity in Section III, Item 4 exceed 80%?
❑ Yes (the hydraulic capacity is greater than 80%) — Pursuant to 1 SA NCAC 02T. 0118Q a, prior to exceeding 90 percent of the
system's permitted hydraulic capacity (based on the average flow during the last calendar year), the permittee shall obtain all
permits needed for the expansion of the wastewater treatment, utilization, or disposal system and, if construction is needed,
submit final plans and specifications for expansion, including a construction schedule. If expansion is not proposed or is proposed
for a later date, a justification shall be made that wastewater treatment needs will be met based on past growth records and future
growth projections, and as appropriate, shall include conservation plans or other specific measures to achieve waste flow
reductions.
® No — Skip Attachment F.
ATTACHMENT G — EASEMENT, ENCROACHMENT, AND LEASE AGREEMENTS
Does the Permittee own all of the land associated with the wastewater collection, treatment, conveyance, and irrigation system?
® Yes — Skip Attachment G.
❑ No — Pursuant to 15A NCAC,02T .0116� cj, provide a copy of all easements, lease agreements, and encroachment agreements
allowing the Permittee to operate and maintain the wastewater collection, treatment, conveyance, and irrigation system on
property not owned by the Permittee.
ATTACHMENT H — AFFILIATIONS
Are the Permittee's affiliations of record correct? Check affiliations.
❑ Yes — Skip Attachment H.
® No — Provide the corrected affiliations and their contact information.
ATTACHMENT I — COMPLIANCE SCHEDULES
Does the existing permit include any Compliance Schedules? (See Section I of the most recently issued permit)
❑ Yes — Submit documentation that the compliance schedules have been met.
® No — Skip Attachment I.
ATTACHMENT J — CIVIL PENALTIES AND OUTSTANDING VIOLATIONS
Does the Permittee have any existing civil penalties or outstanding violations?
❑ Yes (civil penalties) — Submit payment for the civil penalty, or proof of remission request.
❑ Yes (violations) — Submit a copy of your response to the Notice of Violation.
® No — Skip Attachment J.
FORM: WWIS-R 02-21 Page 6 of 6

ATTACHMENT K — INDUSTRIAL WASTEWATER
Does the wastewater composition in Section III, Item 5 include any industrial wastewater?
❑ Yes Proceed to the next question.
® No — Skip Attachment K.
Has the nature of the industrial wastewater changed since the last permit issuance (i.e., changes in industrial process, introduction of
new materials or chemicals, etc.)?
❑ Yes — Provide a chemical analysis of the wastewater pursuant to the requirements in 15A NCAC 02T .0504thi. Provide an
overview of the manufacturing process; an inventory of all chemical and biological materials used in the manufacturing process;
and an overview of the cleaning and treatment methodology.
❑ No — Provide an overview of the manufacturing process; an inventory of all chemical and biological materials used in the
manufacturing process; and an overview of the cleaning and treatment methodology.
ATTACHMENT L —SETBACK WAIVERS
Does the existing permit include setback waivers?
❑ Yes — Pursuant to ISA NCAC 02T .0506gdj, provide setbacks waivers that have been written, notarized, signed by all parties
involved, and recorded with the county Register of Deeds. Waivers involving the compliance boundary shall be in accordance
with 15A NCAC 02L .0107.
® No — Skip Attachment L.
APPLICANT'S CERTIFICATION
` J�A — _ attest that this application
(Signature authority's name as noted in Section I, Item 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 package are not completed, and that if all required supporting information and attachments are not included, this
application package will be returned as incomplete. I further certify pursuant to 15A NCAC 02T .01201 b a, that the applicant, or any
parent, subsidiary, or other affiliate of the applicant has: not been convicted of environmental crimes under; not previously abandoned
a wastewater treatment facility without properly closing the facility; not paid a civil penalty; not been compliant with any compliance
schedule in a permit, settlement agreement, or order; not paid an annual fee.
Note: The Applicant's Certification shall be signed pursuant to 15A NCAC 02T .0106tbi. An alternate person may be delegated as
the signing official if a letter is provided pursuant to I5A NCAC 02T .0106ic , Pursuant to § 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 $25,0ff00 per violation.
Signature: ��-JDate: � i• t d- 1. 1
THE COMPLETED APPLICATION AND ATTACHMENTS SHALL BE SUBMITTED AS A SINGLE PDF FILE VIA:
Email: Laserfehe Upload:
Non-Dischar e.Re orts a•nedenr. ov h_ ttps://edoes.deg.nc.gov/Forms/NoitDischarQe-Branch-
Submittal-Form-Vert
FORM: WWIS-R 02-21 Page 7 of 6

North Carolina Department of Environmental Quality
Division of Water Resources
Permit Number: WQ0002638
Permit Type: Wastewater Irrigation
Facility Name: Town of Angier WWTF
Facility Addressl: 420 Campbell St
Facility Address2:
City, State & Zip: Angier, NC 27501
Owner Information Details:
MUST submit a Change of Name/Ownership form to DWR to make any changes to this Owner information.
(Click here for "Change of Name/Ownership "form)
Owner Name: Town of Angier
Owner Type: Government - Municipal Owner Type Group: Organization
*** Legally Responsible for Permit ***
(Responsible corporate officer/principle executive officer or ranking elected official/ general partner or proprietor;
or any other person with delegated signatory authority from the legally responsible person.)
Owner Affiliation: Gerald D Vincent Title: To„jr,, Mav%a-rr
Addressl: PO Box 278
Address2:
City, State & Zip: Angier, NC 27501-0278
Work Phone: [phone] Fax:
Email Address: [e-mail]
*** Permit Annual Fee Billing ***
Billing Month: April
Invoice Number Invoice Date Invoice Due Date Invoice Amount Invoice Status
Owner Contact Person(s)
Contact Name Title Address Phone Fax
Email
GerrI llinteAi 0- FOx Z"!� �!q-(r3q-2c� l l
vmc-en0—an�ier.01
Facility Contact Person(s)
Contact Name Title Address Phone Fax
Email
?,ruv%JoY% p Re p 0 3ok 2-(8 qkq-331-t91l'L
b jo4knsay.(3? av)t er. iorj
Jclnnso'l Ayxvr IJ.C.2"�Sal
Permit Contact Person(s)
Contact Name Title Address Phone Fax
Email
Jimmy Cook Director of Public PO Box 278, Angier, NC 27501-0278 919-639-2071
[e-mail]
Utilities
Permit Billing Contact Person(s)
Contact Name Title Address Phone Fax
Email
Town of Angier PO Box 278, Angier, NC 27501-0278 919-639-2071 919-639-6130
bjnlnnsan @aN9ie r @porn
Persons with Signatory Authority
Type Contact Name Title Address Phone Fax
Email
11/10/2021 Page 1

Permit Number: WQ0002638
Permit Type: Wastewater Irrigation
Facility Name: Town of Angier WWTF
Facility Addressl: 420 Campbell St
Facility Address2:
City, State & Zip: Angier, NC 27501
Designated Operators
If the designated operators listed below are incorrect or no longer associated with the collection system, the information can be updated by si
a completed "Operator Designation Form' (flit_ k Here for ORC Designation Fnrm1. please provide specific details as to the changes requested,
the addition/removal of designated operators For all other operator questions or issues, please call 919-807-6353.
Facility Classification: SI
Operator Name stole Cert Type Cert Status Cert # Effective Date
Brandon L Johnson ORC SI Active 998516 1/16/2015
Henry James Cook Backup SI Active 18548 1 /23/2015
11/10/2021 Page 2