WQ0017822_Application (FTSE)_20201213

State of North Carolina
Department of Environmental Quality,
Division of Water Resources
FAST" I'ItACIC SI WGR SYSTEM EXTENSION APPLICATION
FTA 06-21 & SUPPORTING DOCUMENTATION
Application Number: WO0i 17b'ZZ (to becompleted byDWR)
All items trust he completed or the application will be returned
I. APPLICANT INFORMATION:
I, Applicant's name: Johnston County (company, municipality, I-IOA, utility, etc.)
2. Applicant type: ❑ Individual El Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ® State/County ❑ Municipal
3. Signature authority's name: Chandra C. Fanner, PE per 15A NC AC 02 l .0I.O6(IJ
'Vida: : Director ofl,ltilitics
4- Applicant's mailing address, 309 E. Market Street PO Box 2263
City: Smithfield State: NC: Lip:22577
5. Applicant's contact information:
Phone number: [phone] Email Address: chandra.farmer(johnstonnc.cnnt
I1. PROJECT INFORMATION:
1. Project name: Poprar Creek WWPS Upgr,ide
2. Application/Project status: ❑ Propo.;ed (New Permit)
❑ Other
E Existing Permit. Project
If modification, provide the existing permit number: WQ0017822 and issued date: 2/10/2000,
For modifications, also attach a detailed narrative description as described in Item G attic checklist.
if new construction, but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Johnston Courtly
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.553008' Longitude: -78.382606
5. Parcel ID (if applicable): 15079004 (or Parcel 1D to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Kimberly C. Rineer P.H. License Number: 025511
Firm: Johnston County Public Utilities
Mailing address: 309 E. Market Street PO Box 2263
City: Stnitlificld State: NC Zip: 27577
Phone number: (9I9) 989-5725 Email Address: kim.rtneer(johnstortnc.coni
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I. Facility Name: Central Johnston County Regional Wastewater Facility Permit Number: NC0030716
Owner Name: Johnston County
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): W00007923
2. Downstream (Receiving) Sewer Information: 12 inch ri Gravity
3. System Wide Collection System Permit Number(s) (ifapplicable): WQCS00060
Owner Name(s): Johnston County
FORM: FTA 06-21
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