WQ0036155_Permit (Issuance)_20120924

(
ATA
rDR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P. E. Dee Freeman
Govemor Director Secretary
September 24, 2012
Henry Braswell, Chairman
Fork Township Sanitary District
PO Box 1515
Goldsboro, NC 27533
Subject: Permit No. WQ0036155
Fork Township Sanitary District
Goldsboro Wellness Center Sewer
Wastewater Collection System Extension
Wayne County
Dear Mr. Braswell:
In accordance with your application received September 17, 2012, we are forwarding herewith
Permit No. WQ0036155, dated September 24, 2012, to Fork Township Sanitary District for the construction
and operation of the subject wastewater collection system extension. This permit shall be effective from
the date of issuance, until rescinded, and shall be subject to the conditions and limitations as specified
therein. This cover letter shall be considered a part of this permit and is therefore incorporated therein
by reference.
Please pay particular attention to Permit Condition 3, which requires that the wastewater
collection facilities be properly operated and maintained in accordance with 15A NCAC 2T .0403 or
any individual system -wide collection system permit issued to the Permittcc.
Permitting of this project does not constitute an acceptance of any part of the project that does
not meet 15A NCAC 2T; the Division of Water Quality's (Division) Gravity Sewer Minimum Design Criteria
adopted February 12, 1996 as applicable; and the Division's Minimum Design 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. Failure to
comply may result in penalties in accordance with North Carolina General Statute § 143-215.6A through
§143-215.6C, construction of additional or replacement wastewater collection facilities, and/or referral
of the North Carolina -licensed Professional Engineer to the licensing board.
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 Fork Township Sanitary District for the construction and operation of a 12-gallon per minute pump
station with duplex pumps, on -site audible and visual high water alarms, and a portable generator
receptacle with telemetry; as well as approximately 575 linear feet of 1.25-inch force main to serve 6
North Carolina Divas on of Water Quality
943 Washington Square Mall
Washington, NC 27889
Internet www,ncwateraualttv.orq
Phone: [phone]
FAX: [phone]
One
NhCarolina
Naturally

medical practitioners, as part of the Goldsboro Wellness Center Sewer project, and the discharge of
1,500 gallons per day of collected wastewater into the City of Goldsboro's existing sewerage system,
pursuant to the application received September 17, 2012, 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 -Track 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 permit.
The sewage and wastewater collected by this system shall be treated in the City of Goldsboro
Wastewater Treatment Facility (NPDES Permit No. NC0023949) prior to being discharged into the
receiving stream.
This permit shall become voidable unless the agreement between Fork Township Sanitary District
and the City of Goldsboro for the collection and final treatment of wastewater is in full force and effect.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the
right to request an adjudicatory hearing upon written request within 30 days following receipt of this
permit. This request must be in the form of a written petition, conforming to Chapter 150B of North
Carolina General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service Center,
Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and binding.
If you need additional information concerning this matter, please contact Thom Edgerton at
[phone] or via E-mail at [e-mail].
Sincerely,
For Charles Wakild, P. E.
cc: Wayne County Health Department
Washington Regional Office, Surface Water Protection Section (City of Goldsboro Collection
System)
Cecil G. Madden, Jr., PE (McDavid Associates, Inc., PO Box 1776, Goldsboro, NC 27533)
City of Goldsboro, 200 North Center Street, Goldsboro, NC 27530
PERCS (formerly NDPU) Files (Permit only)
Water Quality Central Files (w/out plan)

n
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
This permit shall be effective from the date of issuance until rescinded and shall be subject to the following
specified conditions and limitations:
1 This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 15A NCAC 2T; the Division of Water Quality's (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 1, 2000 as
applicable; and other supporting materials unless specifically mentioned herein.
2. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data.
3. The wastewater collection facilities shall be property maintained and operated at all times. The Permittee
shall maintain compliance with an individual system -wide collection system permit for 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 as provided in 15A NCAC 2T .0403:
a. The sewer system shall be effectively maintained and operated at all times to prevent discharge to
land or surface waters, and any contravention of the groundwater standards In 15A NCAC 2L .0200 or
the surface water standards in 15A NCAC 2B .0200.
b. A map of the sewer system shall be developed and shall be actively maintained.
c. An operation and maintenance plan shall be 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. High -priority sewer lines shall be inspected at least once per every six-month period of time.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. Inspection and maintenance records shall be maintained for a period of at least three years.
h. 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 § 143-215.1 C.
4. This permit shall not be transferable. In the event there is a desire for the wastewater collection facilities to
change ownership, or there is a name change of the Perrnittee, a formal permit request shall be submitted
to the Division accompanied by documentation from the parties involved, and other supporting materials
as may be appropriate. The approval of this request shall be considered on its merits and may or may not
be approved.

5. 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 to the surface
waters of the State.
6. Per 15A NCAC 2T.0116, upon completion of construction and prior to operation of these permitted facilities,
the completed Engineering Certification form attached to this permit shall be 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.
7. A copy of the construction record drawings shall be maintained on file by the Permittee for the life of the
wastewater collection facilities.
8. 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 §143-215.6A through §143-215.6C.
9. In the event that the wastewater collection facilities fail to perform satisfactorily, including the creation of
nuisance conditions, the Permittee shall take immediate corrective action, including those as may be
required by this Division, such as the construction of additional or replacement facilities.
10. 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 other govemment agencies (local, state and federal)
which have jurisdiction, including but not limited to applicable river buffer rules in 15A NCAC 28 .0200,
erosion and sedimentation control requirements in 15A NCAC Ch. 4 and under the Division's General
Permit NCG010000, and any requirements pertaining to wetlands under 15A NCAC 2B .0200 and 15A
NCAC 2H .0500.
11. Noncompliance Notification:
The Permittee shall report by telephone to a water quality staff member at the Washington Regional
Office, telephone number 252-946-6-481, as soon as possible, but in no case more than 24 hours or on the
next working day, following the occurrence or first knowledge of the occurrence of either of the following:
a. 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 failure of a pumping station or sewer line resulting in a by-pass directly to receiving waters without
treatment of all or any portion of the influent to such station or facility.
Overflows and spills occurring outside normal business hours may also be reported to the Division of
Emergency Management at telephone number [phone] or [phone]. Voice mail messages or
faxed information shall not be considered as the initial verbal report. Persons reporting any of the above
occurrences shall file a spill report by completing and submitting Part I of Form 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 be taken to ensure that the problem does not recur. Part II of
Form CS-SSO (or the most current Division approved form) can also be completed to show that the SSO
was beyond control.

Art
12. Gravity sewers installed below the minimum required 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 firm 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.
Permit issued this the twenty fourth day of September, 2012
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
For Charles Wakild, P. E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number W00036155

1
Permit No. WQ0036155
September 24, 2012
ENGINEER'S CERT1RCATloN
Complete and submit this form to the permit issuing office (address below) with the following:
• One copy of the project record drawings (plan/profile views and detail drawings of sewer lines) of the wastewater
collecfion system extension. Final record drawings should be dear on the plans. Record drawings should indicate the
design and the marked up changes during construction.
• Supporting design calculations (selected pumps, system curve, operating point, available storage 11 portable
generator(s) or storage greater than longest past three year outage reliability option solocted) for any pump stations
permitted as part of this project
• Changes to the project should be clearly identified on the record drawings or in written summary form. Permit
modifications are required for anv changes resulting in non-compliance with this permit. regulations or minimum design
criteria. Modifications should be submitted prior to certification,
This project shall not be considered complete nor allowed to operate until this Engineer's Certification and at required
supporting documentation have been received by the Division. Therefore, It Is highly recommended that this cert lcatlon
be sent in a manner that provides proof of receipt by the Division.
ENGINEER'S CERTIFICATION
❑ Partial ❑ Final
, as a duty registered Professional Engineer in the State of North Carolina, having been authorized
to observe (❑ periodically, ❑ weekly, ❑ full time) the construction of the Goldsboro Wellness Center Sewer, Wayne
County project, consisting of a 12-gallon per minute pump station with duplex pumps, on -site audible and visual high water
alarms, and a portable generator receptacle with telemetry; as well as approximately 575 linear feet of 1.25-Inch force
main to serve 6 medical practitioners, for the 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 2T; the Division of Water Quality's (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 1, 2000 as applicable; and other supporting materials.
North Carolina Professional Engineer's
seal, signature, and date:
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
NORTH CAROUNA DIVISION OF WAR QUALITY
WASHINGTON REGIONAL OFHCE - SURFACE WATER PROTECTION SECTION
AIM: REGIONAL SUPERVISOR
943 WASHINGTON SQUARE MALL
WASHINGTON, NC 27889
The Permittee is responsible for tracking atl partial certifications up until a final certification is received. Any wastewater flow made Tributary
to the wastewater collection system extension prior to completion of this Engineer's Certification shall be considered a violation of the
permit and shag subject the Permittee to appropriate enforcement actions.