WQ0041352_Modification_20211129

Initial Review
Reviewer Thornburg, Nathaniel D
Is this submittal an application? (Excluding additional information.)*
Yes No
Permit Number (IR) * WQ0041352
Applicant/Permittee Town of Holly Springs
Applicant/Permittee Address 128 S. Main Street Holly Springs NC 27540
Is the owner in BIMS? Yes No Is the facility in BIMS?
Owner Type
Facility Name
County
Fee Category RW Distribution Line
Is this a complete application?*
Yes No
Signature Authority
Signature Authority Title
Signature Authority Email
Document Type (if non -application)
Email Notifications
Municipal
Ferguson Warehouse Center RWDL
Wake
Does this need review by the hydrogeologist? * Yes No
Regional Office
CO Reviewer
Admin Reviewer
llr�ore
Fee Amount $0
Complete App Date 11/29/2021
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* Theresa Randall
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*
9195573150
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: * WQ0041352
Has Current Existing permit number
Applicant/Permittee* Town of Holly Springs
Applicant/Permittee Address* 128 S. Main Street Holly Springs NC 27540
Facility Name* Ferguson Warehouse Center RWDL
Please provide comments/notes on your current submittal below.
Please let us know if we need to provide any additional information. Thank you!
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.)
Ferguson Reclaimed Minor Mod Submittal to State.pdf 3.83MB
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 11/29/2021

DocuSign Envelope ID: 466CFCBC-8CA1-483B-A9BF-EC34239236D4
T H E T OW N OF
November 24, 2021
Willy O'prings
Nathaniel Thornburg
North Carolina Department of Environmental Quality
Division of Water Resources, Non -Discharge Branch
512 North Salisbury Street
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Reclaimed Water Distribution Facilities — Minor Permit Modification Request
Permit No. — WQ0041352
Issue Date — June 4, 2020
Project — Ferguson Warehouse Center RWDL
Dear Mr. Thornburg:
Please accept the enclosed:
• Engineers Certification, and
• Plat,
as requested by Schedules 1. and 2. of Reclaimed Water Distribution Permit WQ0041352 issued
on June 4, 2020 for Ferguson Warehouse Center RWDL. With the submission of this
documentation, we are seeking issuance of a permit for the construction and operation of the
subject reclaimed water distribution facilities.
Thank you for your assistance. If you need additional information, please contact Rachel Ingham
(Rachel.In hg am(c�r�,hollyspringsnc.gov) and Theresa Randall (Theresa.Randall(c�r�,holl. ssprings.gov).
Sincerely,
DocuSigned by: DS DS
03C05669FC34440...
Kendra D. Parrish, P.E., C.F.M
Executive Director of Utilities and Infrastructure Services
cc: Rachel Ingham, P.E., Utility Engineer
Drew Johnson, Development Construction Manager
Project File/Electronic file/Correspondence 941926
Utilities and Infrastructure Services
P.O. Box 8 • 128 S. Main Street • Holly Springs, NC 27540 • www.hollyspringsnc.gov

DocuSign Envelope ID: 466CFCBC-8CA1-483B-A9BF-EC34239236D4
T H E TOWN OF
August 26, 2021
NC Department of Environmental Quality
Division of Water Resources
Water Quality Permitting Section
Non -Discharge Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
�lly Springs
Re: Engineers Certification of Reclaimed Water System
Project: Ferguson Warehouse Center
Permit #WQ0041352
Dear Sir/Madam:
Enclosed is the FINAL PE Certification for the Reclaimed Water System Installation of Ferguson
Waterhouse, #WQ0041352 for your records. A copy of the PE Certification has been retained in
the Town of Holly Springs' records.
Thank you for your assistance with this matter. Feel free to contact me at [phone] should
you have any questions.
Sincerely, DS
DocuSigned by: ^
tick ��H �J 8/26/2021
a(c 5 1 ffAlhin Drew Johnson
Utility Engineer Development construction Manager
RI/tr
cc: Kendra D. Parrish, P.E., C.F.M, Executive Director of Utilities and Infrastructure Services
Drew Johnson, Development Construction Manager
Project file/Correspondence 910035
3018
11.24.20
Utilities and Infrastructure Services
P.O. Box 8 • 128 S. Main Street • Holly Springs, NC 27540 • www.hollyspringsnc.gov

DocuSign Envelope ID: 466CFCBC-8CA1-483B-A9BF-EC34239236D4
Permit No. WQ0041352 Reclaimed Water Distribution
Town of Holly Springs June 4, 2020
Ferguson Warehouse Center RWDL Wake County
ENGINEERING CERTIFICATION
❑ Partial © Final
I, Grant M. Livengood , as a duly licensed North Carolina Professional
Engineer, having ® periodically / ❑ fully observed the construction of the permitted facilities, do hereby
state to the best of my abilities that the facility was constructed in compliance with G.S. 143-215.1,
Administrative Code Title 15A Subchapter 02U, this permit, and the Division -approved plans and
specifications.
Documentation of any variation to this permit, and the Division -approved plans and specifications, is in the
attached as -built drawings.
Description of variations:
Grant M. Livengood
�� ' p 55/Q •% f'
ti qq; 'ss
McKim & Creed, Inc.
F-1222
1730 Varsity Drive, Suite 500
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r'�<s4j'�Q`��
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Raleigh
N.C. 27606
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[phone]
[e-mail] _
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THE COMPLETED ENGINEERING CERTIFICATION, INCLUDING ALL SUPPORTING
DOCUMENTATION, SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
NON -DISCHARGE BRANCH
By U-S. Postal Service By Courier/Speeial Delivery
1617 MAIL SERVICE CENTER 512 N. SALISBURY ST.
RALEIGH, NORTH CAROLINA 27699-1617 RALEIGH, NORTH CAROLINA 27604
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DocuSign Envelope ID: 466CFCBC-8CA1-483B-A9BF-EC34239236D4
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Director
NORTH CAROLINA
Environmental Quality
June 4, 2020
KENDRA D. PARRISH, PE — DIRECTOR OF ENGINEERING
TOWN OF HOLLY SPRINGS
POST OFFICE BOX 8
HOLLY SPRINGS, NORTH CAROLINA 27540
Subject: Permit No. WQ0041352
Ferguson Warehouse Center RWDL
Reclaimed Water Distribution
Wake County
Dear Ms. Parrish:
In accordance with your permit application request received December 5, 2019, and subsequent
additional information received March 11, 2020, we are forwarding herewith Permit No. WQ0041352 dated
June 4, 2020, to the Town of Holly Springs for the construction only of the subject reclaimed water
distribution facilities.
This permit shall be effective from the date of issuance until rescinded, and shall be subject to the
conditions and limitations therein.
If any parts, requirements, or limitations contained in this permit are unacceptable, the Permittee
has the right to request an adjudicatory hearing upon written request within 30 days following receipt of
this permit. This request shall be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings at 6714 Mail Service
Center, Raleigh, NC 27699-6714. Otherwise, this permit shall be final and binding.
One set of approved plans and specifications is being forwarded to you. If you need additional
information concerning this permit, please contact Ranveer Katyal at [phone] or
ranveer.katyal&ncdenr. og_v.
Sincerely,
S. Daniel Smith, Director
Division of Water Resources
cc: Wake County Health Department (Electronic Copy)
Raleigh Regional Office, Water Quality Regional Operations Section (Electronic Copy)
James M. Smith, PE — McKim and Creed (Electronic Copy)
Laserfiche File (Electronic Copy)
Digital Permit Archive (Electronic Copy)
D Q713—�
3 North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1 1617 Mail Service Center J Raleigh, North Carolina 27699-1617
NORTH CAROLINA i
919.707.9000

DocuSign Envelope ID: 466CFCBC-8CA1-483B-A9BF-EC34239236D4
THIS PAGE BLANK

DocuSign Envelope ID: 466CFCBC-8CA1-483B-A9BF-EC34239236D4
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
RALEIGH
RECLAIMED WATER DISTRIBUTION 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
Town of Holly Springs
Wake County
FOR THE
construction only of a reclaimed water distribution system extension consisting of
531 linear feet (LF) of 8-inch PVC reclaimed water distribution line; and all associated piping, valves,
controls, and appurtenances
to serve the Ferguson Warehouse Center RWDL, with no discharge of wastes to surface waters, pursuant
to the application received December 5, 2019, subsequent additional information received March 11, 2020,
and in conformity with the Division -approved plans and specifications considered a part of this permit.
This permit shall be effective from the date of issuance until rescinded, and shall be subject to the following
conditions and limitations:
I. SCHEDULES
Upon completion of construction and prior to operation of the permitted distribution facilities, the
Permittee shall submit an engineering certification from a North Carolina licensed Professional
Engineer certifying that the permitted facilities have been constructed in accordance with G.S. 143-
215.1, Administrative Code Title 15A Subchapter 02U, this permit, and the Division -approved plans
and specifications. For phased and partially certified facilities, the Permittee shall retain the
responsibility to track further construction approved under this permit, and shall provide a final
engineering certification upon project completion. Mail the Engineering Certification to the Division
of Water Resources, Non -Discharge Branch, 1617 Mail Service Center, Raleigh, NC 27699-1617, or
Non-Dischar.ge.Reports&ncdenr.gov. [15A NCAC 02T .0116(a)]
2. The facilities permitted herein are for construction only. The Permittee shall submit the following
documentation as a minor permit modification request:
a. Easements for all the properties on which the distribution line is to be located.
b. A map showing the distribution line and all properties with a table referencing all easements (Deed
Book and Page).
Mail the documentation to the Division of Water Resources, Non -Discharge Branch, 1617 Mail Service
Center, Raleigh, NC 27699-1617, or Non-Discharge.Reports&ncdenr.gov [15A NCAC 02T .0116(a)]
WQ0041352 Version 1.0 Shell Version 200201 Page 1 of 6

DocuSign Envelope ID: 466CFCBC-8CA1-483B-A9BF-EC34239236D4
Operation of the reclaimed water distribution facilities shall be contingent upon construction and
operation of permitted reclaimed water distribution lines immediately upstream and downstream of the
reclaimed water distribution facilities permitted herein. Specifications for future upstream and
downstream reclaimed water distribution lines shall include quality assurance testing procedures, which
shall be adhered to prior to operation of the reclaimed water distribution facilities permitted herein.
[G. S. 143-215.1 ]
IL PERFORMANCE STANDARDS
1. The Permittee shall maintain and operate the subject reclaimed water distribution facilities so there is
no discharge to surface waters, nor any contravention of groundwater or surface water standards. In
the event the facilities fail to perform satisfactorily, including the creation of nuisance conditions due
to improper operation and maintenance, the Permittee shall take immediate corrective actions, including
Division required actions, such as the construction of additional or replacement reclaimed water
distribution facilities, or cessation of reclaimed water distribution. [15A NCAC 02T .0108(b)(1)(A)]
2. This permit shall not relieve the Permittee of their responsibility for damages to groundwater or surface
water resulting from the operation of this facility. [15A NCAC 02T .0108(b)(1)(A)]
3. Construction of the reclaimed water distribution facilities permitted herein shall be scheduled as not to
interrupt service of existing utilities. [15A NCAC 02T .0108(b)(1)(A)]
4. All reclaimed water valves, storage facilities, and outlets shall be tagged or labeled to warn the public
or employees that the water is not intended for drinking. [15A NCAC 02U .0403(b)]
5. All reclaimed water piping, valves, outlets, and other appurtenances shall be color -coded, taped, or
otherwise marked to identify the source of the water as being reclaimed water as follows:
a. All reclaimed water piping and appurtenances shall be either colored purple (Pantone 522 or
equivalent) and embossed or integrally stamped or marked "CAUTION: RECLAIMED WATER -
DO NOT DRINK" or be installed with a purple (Pantone 522 or equivalent) identification tape or
polyethylene vinyl wrap. The warning shall be stamped on opposite sides of the pipe and repeated
every three feet or less;
b. Identification tape shall be at least three inches wide and have white or black lettering on purple
(Pantone 522 or equivalent) field stating "CAUTION: RECLAIMED WATER - DO NOT
DRINK". Identification tape shall be installed on top of reclaimed water pipelines, fastened at least
every 10 feet to each pipe length and run continuously the entire length of the pipe; and
c. Existing underground distribution systems retrofitted for the purpose of convey reclaimed water
shall be taped or otherwise identified as noted in IL5.a. and IL5.b. This identification need not
extend the entire length of the distribution system but shall be incorporated within 10 feet of
crossing any potable water supply line or sanitary sewer line.
[15A NCAC 02U .0403(c)]
6. All reclaimed water valves and outlets shall be of a type, or secured in a manner, that permits operation
by personnel authorized by the entity that operates the reclaimed water system. [15A NCAC 02U
.0403(d)]
7. Hose bibs shall be located in locked, below grade vaults that shall be labeled as being of non -potable
quality. As an alternative to the use of locked vaults with standard hose bib services, other locking
mechanisms such as hose bibs that can only be operated by a tool may be placed above ground and
labeled as non -potable water. [15A NCAC 02U .0403(e)]
8. There shall be no direct cross -connections between the reclaimed water and potable water systems,
unless such connection has been approved by the Department pursuant to 15A NCAC 18C .0406. [15A
NCAC 02U .0403(f)]
WQ0041352 Version 1.0 Shell Version 200201 Page 2 of 6

DocuSign Envelope ID: 466CFCBC-8CA1-483B-A9BF-EC34239236D4
9. Reclaimed water distribution lines shall be located at least 5 feet horizontally from and 18 inches below
any water line if practicable. If these separation distances cannot be met, the piping and integrity testing
procedures shall meet water main standards in accordance with 15A NCAC 18C. [15A NCAC 02U
.0403(h)]
10. Reclaimed water distribution lines shall not be less than 50 feet from a well unless the piping and
integrity testing procedures meet water main standards in accordance with 15A NCAC 18C, but in no
case shall they be less than 25 feet from a private well. [15A NCAC 02U .0403(i)]
11. Reclaimed water distribution lines shall meet the separation distances to sewer lines in accordance with
15A NCAC 02T .0305. [15A NCAC 02U .04030)]
III. OPERATION AND MAINTENANCE REQUIREMENTS
1. The Permittee shall operate and maintain the subject facilities as anon -discharge system. [15A NCAC
02U .0101]
2. The Permittee shall maintain an Operation and Maintenance Plan, which shall include:
a. A description of the operation of the system in detail to show what operations are necessary for the
system to function and by whom the operations are to be conducted;
b. A sampling and monitoring plan to evaluate quality of reclaimed water within the distribution
system to provide quality assurance at the time of reuse, and specify actions to be taken in response
to unsatisfactory monitoring results;
c. A map of all reclaimed water distribution lines;
d. A description of anticipated maintenance of the system;
e. Provisions for safety measures, including restriction of access to the site and equipment; and
f. Spill control provisions that include response to upsets and bypasses, including control,
containment, and remediation, and contact information for personnel, emergency responders, and
regulatory agencies.
[15A NCAC 02U .0801(a)]
Only reclaimed water generated from the Utley Creek WWTP (Permit No. WQ0032289) shall be
conveyed in the reclaimed water distribution facilities permitted herein. [15A NCAC 02U .0101]
WQ0041352 Version 1.0 Shell Version 200201 Page 3 of 6

DocuSign Envelope ID: 466CFCBC-8CA1-483B-A9BF-EC34239236D4
IV. MONITORING AND REPORTING REQUIREMENTS
The Permittee shall conduct and report any Division required monitoring necessary to evaluate this
facility's impact on groundwater and surface water. [15A NCAC 02T .0108(c)]
2. Noncompliance Notification:
The Permittee shall report to the Raleigh Regional Office, telephone number [phone], within
24 hours of first knowledge of the following:
a. Any failure rendering the reclaimed water distribution facilities incapable of adequately conveying
the reclaimed water (e.g., mechanical or electrical failures, line blockages or breaks, etc.).
b. Any failure resulting in a discharge to surface waters.
c. Any discharge to land surface greater than or equal to 5,000 gallons. The Permittee shall document
discharges less than 5,000 gallons to land surface, but do not require Regional Office notification.
Emergencies requiring reporting outside normal business hours shall call the Division's Emergency
Response personnel at telephone number [phone], [phone], or [phone]. All
noncompliance notifications shall file a written report to the Raleigh Regional Office within five days
of first knowledge of the occurrence, and this report shall outline the actions proposed or taken to ensure
the problem does not recur. [15A NCAC 02T .0108(b)(1)(A)]
V. INSPECTIONS
1. The Permittee shall perform inspections and maintenance to ensure proper operation of the reclaimed
water distribution facilities. [15A NCAC 02U .0801(i)]
2. The Permittee shall inspect the reclaimed water distribution facilities to prevent malfunctions, facility
deterioration, and operator errors that may result in discharges of wastes to the environment, threats to
human health, or public nuisances. The Permittee shall maintain an inspection log that includes the
date and time of inspection, observations made, and maintenance, repairs, or corrective actions taken.
The Permittee shall maintain this inspection log for a period of five years from the date of the inspection,
and this log shall be made available to the Division upon request. [15A NCAC 02U .0801(h), 02U
.0801(1)]
Division authorized representatives may, upon presentation of credentials, enter and inspect any
property, premises, or place related to the reclaimed water distribution facilities permitted herein at any
reasonable time for determining compliance with this permit. Division authorized representatives may
inspect or copy records maintained under the terms and conditions of this permit, and may collect
groundwater, surface water, or leachate samples. [G.S. 143-215.3(a)(2)]
WQ0041352 Version 1.0 Shell Version 200201 Page 4 of 6

DocuSign Envelope ID: 466CFCBC-8CA1-483B-A9BF-EC34239236D4
VI. GENERAL CONDITIONS
1. Failure to comply with the conditions and limitations contained herein may subject the Permittee to a
Division enforcement action. [G.S. 143-215.6A, 143-215.613, 143-215.6C]
2. This permit is effective only with respect to the nature and volume of wastes described in the permit
application, and Division -approved plans and specifications. [G.S. 143-215.1(d)]
3. Unless specifically requested and approved in this permit, there are no variances to administrative codes
or general statutes governing the construction or operation of the facilities permitted herein. [15A
NCAC 02T .0105(n)]
4. The issuance of this permit does not exempt the Permittee from complying with all statutes, rules,
regulations, or ordinances that other jurisdictional government agencies (e.g., local, state, and federal)
may require. [15A NCAC 02T .0105(c)(6)]
5. If the permitted facilities change ownership, or the Penmittee changes their name, the Permittee shall
submit a permit modification request on Division -approved forms. The Permittee shall comply with
all terms and conditions of this permit until the permit is transferred to the successor -owner. [G.S. 143-
215.1(d3)]
6. The Permittee shall retain a set of Division -approved plans and specifications for the life of the facilities
permitted herein. [15A NCAC 02T .0105(o)]
7. This permit is subject to revocation or modification upon 60-day notice from the Division Director, in
whole or part for:
a. violation of any terms or conditions of this permit or Administrative Code Title 15A Subchapter
02U;
b. obtaining a permit by misrepresentation or failure to disclose all relevant facts;
c. the Permittee's refusal to allow authorized Department employees upon presentation of credentials:
I. to enter the Permittee's premises where a system is located or where any records are required
to be kept;
ii. to have access to any permit required documents and records;
iii. to inspect any monitoring equipment or method as required in this permit; or
iv. to sample any pollutants; or
d. a Division determination that the conditions of this permit are in conflict with North Carolina
Administrative Code or General Statutes.
[15A NCAC 02T .0110]
Permit issued this the 4`" day of June 2020
NORTH CAROLINA ENVIRONM NTAL MANAGEMENT COMMISSION
7Z.�-a
S. Daniel Smith, Director
Division of Water Resources
By Authority of the Environmental Management Commission
Permit Number WQ0041352
WQ0041352 Version 1.0 Shell Version 200201 Page 5 of 6

DocuSign Envelope ID: 466CFCBC-8CA1-483B-A9BF-EC34239236D4
Permit No. WQ0041352 Reclaimed Water Distribution
Town of Holly Springs June 4, 2020
Ferguson Warehouse Center RWDL Wake County
ENGINEERING CERTIFICATION
❑ Partial ❑ Final
I, , as a duly licensed North Carolina Professional
Engineer, having ❑ periodically / ❑ fully observed the construction of the permitted facilities, do hereby
state to the best of my abilities that the facility was constructed in compliance with G.S. 143-215.1,
Administrative Code Title 15A Subchapter 02U, this permit, and the Division -approved plans and
specifications.
Documentation of any variation to this permit, and the Division -approved plans and specifications, is in the
attached as -built drawings.
Description of variations:
Professional Engineer's Name
Firm Name
Firm No.
Address
City JL
State
Zip Code
Telephone
Email
Seal, Signature, and Date
THE COMPLETED ENGINEERING CERTIFICATION, INCLUDING ALL SUPPORTING
DOCUMENTATION, SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
NON -DISCHARGE BRANCH
By U.S. Postal Service By Courier/Special DelivM
1617 MAIL SERVICE CENTER 512 N. SALISBURY ST.
RALEIGH, NORTH CAROLINA 27699-1617 RALEIGH, NORTH CAROLINA 27604
WQ0041352 Version 1.0 Shell Version 200201
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