WQ0044172_Application (FTSE)_20230301

DocuSign Envelope ID: A9CCBADB-DE09-4481-133H-OD1D070803FS
N in NC Dept of Environmental Quality State of North Carolina
Department of Environmental Quality
&�WL Division of Water Resources
MAR 1 2023 FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources VIA 06-21 & SUPPORTING DOCUMENTATION
Raleigh
Application I
:VJq0V44LAV1Z— (to be oompleW by DWR)
All items must be completed or the aDolication will be returned
I�AWWgCOFAll01ua141'IME11rCINA
1. Applicant's name: Town of Clayton
(company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual
❑ Corporation ❑ General Partnership
❑ Federal
❑ State/County ® Municipal
3. Signature authority's name: Joshua Baird per 1 SA NCAC 02T _0106(h
Title: Engineering Director
4. Applicant's mailing address: I I I E. Second Street
City: CIULon State: K
Zip: 27520-
5. Applicant's contact information:
Phone number: �) 553-5002
Email Address: JbairdCa�townefclaytonnc.org
H. PROJECT INFORMATION:
❑ Privately -Owned Public Utility
❑ Other
1. Project name: Clayton Streets Utility Construction Plans
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date:
For modifications, also attach a detailed narrative description as described in Item G of the checklist.
If new construction, but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Johnston
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.651521 Longitude: - 87 .4633 '
5. Parcel ID (if applicable): (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Edward_G _Wetherill. PE License Number: 10773
Firm: Wetherill Engineering. Inc.
Mailing address: 1223 Jones Franklin Road
City: Raleigh State: NC Zip: 27606-
Phone number: Qj_9) 851-8077 Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Little Creek WRF Permit Number: 00-25453
Owner Name: Town of Clayton
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ_
2. Downstream (Receiving) Sewer Information: 8" inch ® Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00110
Owner Name(s): Town of Clayton
FORM: FTA 06-21 Page] of 5

DocuSlgn Envelope ID: A9CC8ADB-DE09-4481-B3F7-0D10070803F5
VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ® No ❑ NIA
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Aprecmrnt (FORM: DEV M been attached?
[:]Yes [:]No ® N/A
3. If the Applicant is a Home/Property Owners' Association, has an HOAJI'OA Operwional A�:reensetik [FORA: 110A) and
supplementary documentation as required by 15A NCAC 02T.0115(c) been attached?
❑ Yes ❑ No ® NIA
4. Origin of wastewater: (check all that apply):
® Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical I dental / veterinary facilities ❑ Swimming Pool/Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic % Commercial % Industrial (See 15 A NCAC 02T .0103 (201)
If Industrial, is there a Pretreatment Program in effect? ❑ Yes❑ No
G. Has a flow reduction been approved under 15A NCAC 02T .0l 14(f)? ❑ Yes ® No
➢ If Yes, provide a cony of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(t))
Daily Design Flow''''
No. of Units
Flow
No additional flow
0 gal/
GPD
gaU
GPD
gaU
GPD
gaU
GPD
gaU
GPD
gal/
GPD
Total
0 GPD
a See 15A NC'AC 02T ,U 1 14(b). (d). (e)(1I 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 ofthe Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table t 5A 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: 0 GPD (per 15A NCAC 02T .01141
D Do not include future flows or previously permitted allocations
If permitted flow is zero, please indicate why:
❑ Pump Station/Force Main or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line.
Please provide supplementary information indicating the approximate timefi-ame for permitting upstream sewers with flow.
❑ Flow has already been allocated in Permit Number: Issuance Date:
® Rehabilitation or replacement of existing sewers with no new flow expected
❑ Other (Explain):
FORM: FTA 06-21 Page 2 of 5

DocuSign Envelope ID: A9CCBADB-DE094481-B3F7-0D1D070803F5
VU. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
1249
SDR 35 PVC
8
60
DIP PC350
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirements is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: -
3. Total number of pumps at the pump station:
3. Design flow of the pump station: millions gallons per day (firm capacity)
➢ This should reflect the total GPM for the pump station with the largest pump out of service.
4. Operational point(s) per pump(s): gallons per minute (GPM) at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
If any portion of the force main is less than 4-inches in diameter, please identify the method of solids reduction per
MDCPSFM Section 2.01 C. Lb. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with 115A NCAC.02T..0305jh i[ I ):
❑ Standby power source or ❑ Standby pump
➢ Must have automatic activation and telemetry -15A NCAC 02T.0305(h)(1)(B):
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility and may not be portable
Or if the pump station has an average daily flow less than 15,000 gallons per day 15A NCACO2T.0305(h)(1)(C):
❑ Portable power source with manual activation, quick -connection receptacle and telemetry -
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry:
➢ include documentation that the portable source is owned or contracted by the applicant and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
as part of this permit application in the case of a multiple station power outage.
FORM: ETA 06-21 Page 3 of 5

DocuSign Envelope ID: AOCCBADB-DEO$-448I-B3F7-0D10070803F5
IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T ,0305M & (g)? ® Yes [:]No
15A NCAC 02T.0305(f) contains minimum separations that shall be vrovided for sewer systems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
18 inches
'Water mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
2Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
**Any private or public water supply source, including any wells, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water, and associated wetlands.
100 feet
**Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water (or tide elevation) and wetlands associated with these waters (see item IX.2)
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches, as well as wetlands associated with these waters or classified as WL.
10 feet
Any building foundation (horizontal)
5 feet
Any basement (horizontal)
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
➢ If noncompliance with 02 T_4305{tl or (gh see Section X.1 of this application
*15A NCAC 02T.03. 05 contains alternatives where separations in 027.0305(F) cannot be achieved. Please check "yes"
above if these alternatives are used and provide narrative information to explain.
**Stream classifications can be identified using the Division's NC Surface Water Classifications webaag
2. Does this project comply with the minimum separation requirements for water mains? ® Yes ❑ No ❑ NIA
➢ If no, please refer to 15A NCAC 18C.0906(f) for documentation requirements and submit a separate document,
signed/sealed by an NC licensed PE, verifying the criteria outlined in that Rule.
3. Does the project comply with separation requirements for wetlands? ❑ Yes ❑ No ® NIA
➢ Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft separation requirements for situations where separation cannot be met.
➢ No variance is required if the alternative design criteria specified is utilized in design and construction.
4. Is the project located in a river basin subject to any State buffer rules? ❑ Yes Basin name: ® No
If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? []Yes ❑ No
➢ This includes Trout Buffered Streams per 15A NCAC 2B.0202
5. Does the project require coverage/authorization under a 404 Nationwidelindividual permits ❑ Yes ® No
or 401 Water Quality Certifications?
➢ Please provide the permit number/permitting status in the cover letter if coverage/authorization is required.
6. Does project comply with 15A NCAC 02T,¢105(cJJ6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications must be being prepared,
have been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion
and sedimentation control plans, stormwater management plans, etc.).
7. Does this project include any sewer collection lines that are deemed "high -priority?" ❑ Yes ® No
Per 15A NCAC 02T.0402. "high -priority sewer" means any aerial sewer, sewer contacting surface waters,
siphon, or sewers positioned parallel to streambanks that are subject to erosion that undermines or deteriorates the sewer.
Siphons and sewers suspended through lnterference%onflict boxes require a variance approval.
➢ If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and
Inspections documented per 15A NCAC 02T.0403(a)(5) or the permittee's individual System -Wide Collection permit.
FORM: FTA 06-21 Page 4 of 5

DocuSign Envelope ID: AOCCBAD13-DE09-4481-133F7-0131D070803F5
X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 021, the Minimum Desittn Criteria for Ilse Fermittiny_ of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Dcsil n Criteria (latest version) as applicable?
® Yes ❑ No
If no, for projects requiring a single variance, complete and submit the Variance/Alternative Design Request application
(VADC 10-14) and supporting documents for review to the Central Office. Approval of the request will be issued
concurrently with the approval of the hermit, and vroiects reguirine a variance approval may be subject to longer
review times_ Forproiects rmuirinQ two or more variances or where the variance is determined by the Division to be a
significant portion of the project, the full technical review is required.
2. Professional Engineer's Certification:
1, Edward G. Wetherill, PE , attest that this application for Clayton Streets Utility Construction Plans
(Professional Engineer's name from Application Item IH.1.) (Project Name from Application Item II.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. I further
attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
Minimum Dcsilm Criteria forCiravity Sewers (latest version , and the Minimum Design Criteria for. the Fast -Track Perrnitti'
of Pump Stations and Force Mains (latest vcrsionj. Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.613, 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. Misrepresentation of the application
information, including failure to disclose any design non-compliance with the applicable Rules and design criteria, may subject
the North Carolina -licensed Professional Engineer to referral to the licensing board. (21 NCAC 56.0701)
North Carolina Professional Engineer's seal, signature, and date: ,.�'"'""'
��• CARD
Vim. SEAL
o: 10773
x
a—swk
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, Joshua Baird , attest that this application for Clayton Streets Utility Construction Plans
(Signature Authority Name from Application Item I.3.) (Project Name from Application Item II.1)
attest that this application 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 are not completed and that if all required supporting documentation
and attachments are not included, this application package is subject to being returned as incomplete. I 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, and/or criminal prosecution. I will make no claim against the Division
of Water Resources should a condition of this permit be violated. I also 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 to me as incomplete.
NOTE -- In accordance with General Statutes 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 $25,000 per violation.
Signature:
Date: 2/9/2023
FORM: FTA 06-21 Page 5 of 5

DocuSign Envelope ID: A9CCBADB-DE064
f13 P2!iN?PJ6entaI Quality
DWR MAR 1 2023
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of Water Resources Raleigh Regional Offiitvow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Town of Clayton
Project Name for which flow is being requested: Clayton Streets Utility Construction Plans
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater flow
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Little Creek
b. WWTP Facility Permit #: NCO025453
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
Aff lows are in MGD
LCWRF 2.5 + JoCo 1.4 +
Raleigh 1.75 = 5.65 MGD
0.9317
3.084
0.00
4.0157
71.1%
H. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A)
(B)
(C)
(D)-(B+C)
Design
Obligated,
Pump
Pump
Average
Approx.
Not Yet
Total Current
Station
Station
Firm Daily Flow**
Current
Tributary
Flow Plus
(Name or
Permit
Capacity, * (Firm i pt),
Avg. Daily
Daily Flow,
Obligated
Number)
No.
MGD MGD
Flow, MGD
MGD
Flow
(E)=(A-D)
Available
Capacity***
* The Firm Capacity (design flow) of any pump station is defined as the maximum 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
(pf) not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer)
Unk
Downstream Permit Number: Unk
Page 1 of 6
FTSE 10-18

DocuSign Envelope ID: A9CCBADB-DE09-4481-B3F7-0DiD070803F5
III. Certification Statement:
I Joshua B. Baird certify to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the receiving
wastewater treatment facility and that the flow from this project is not anticipated to cause any capacity
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 policies and procedures using the best available data. This certification applies to
those items listed above in Sections I and II plus all attached planning assessment addendums for which I
am the responsible party. Signature of this form certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
/M4/
2/9/2023
Signing Oflicial Signature Date
Engineering Director
Title of Signing Official
Page 2 of 6
FTSE 10}18

DocuSign Envelope ID: AOCCBADB-DEb9-4481-B3F7-0D1D070803F5
WV;fjRaleigh IATI [' Dot of Environmental Quality Transportation
NEElRINN Planning
Bridge/Structural
CivII/Site
WE Design Your Tomorrow...
MAR 1 2023 Construction observation
Surveying
February 27, 2023
Engineers Report
Sewer Gravity Main Relocation
S. O'Neil St.1 W. Blanche St. / S. Ellington St.
Town of Clayton Project: Clayton Streets
Johnston County, NC
Sewer System Owner /Applicant:
Town of Clayton
111 E. Second Street
Clayton, NC 27520
[phone]
Joshua Baird, Engineering Director
Project Description
2/27/2023
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The purpose of this 1,309' +/- sanitary sewer gravity main relocation is due to the fact that the
existing gravity sewer system is not functioning properly on S. O'Neil St, W. Blanche St, and S.
Ellington St.
The improvements include the construction of approximately 1,249 LF of 8" SDR 35 PVC gravity
sewer main which will be placed via open cut method, and 60 LF of 8" DIP PC350 gravity sewer
main which will be placed via open cut method. This work will be performed in accordance with
the NCDOT BMP for Construction and Maintenance Activities dated August 2003.
The new relocated sanitary sewer gravity main will be owned, operated, and maintained
by Town of Clayton Water and Sewer Department. All construction will be in
accordance with the latest standards and specifications of the NCDOT, North Carolina
Department of Transportation and the NCDEQ, Division of Water Resources, Water
Quality Permitting, PERCS Unit.
1223 Jones Franklin Road Phone: [phone]
Raleigh, NC 27606 Fax: [phone]

NC Dept of Environmental Quali
MAR z 2023
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DocuSign Envelope ID: A9CCBADB-DE09-4481-B3F7-0D1 D070803F5 Raleigh
Charlotte
A*"* Transportation
Transportation
Planning
W6.
Planning
OETHERILL
G Bridge/Structural
Bridge/Structural
Cfvivsfte
Civivske
Utilities Utilities
Construction ation Construction Observation
surveylnI IN Of Envirorr
Date: February 27, 2023
To: Scott Vinson MAR Z 2023
NCDWR — Regional Supervisor Ralei h
Raleigh Regional Office Water Quality Section � Regional Office
3800 Barrett Drive
Raleigh, NC 27609
Subject: Fast Track application Permit (Gravity Sewer)
Reference: Clayton Streets Utility Construction Plans O'Neil St., W. Blanche St. and S. Ellington St.
Johnston County
We are sending to you
0 Shop Drawing
0 Submittal Date
0 Progress Drawings
0
Enclosed
®
Prints
❑
Specifications
o
Other
❑ Email
O Tracings
® Documents
0 Under separate Cover
COPIES
DATE
NUMBER
1
02/27/23
UC 1, UC 2, UC 3, UC 31), UC 3E
Sewer line replacement plans, profiles, and
UC 7, UC 8, UC 9
details
2
02/27/23
Fast Track Application (FTA 06-21 }
2
02/27/23
Engineers Report — Gravity Sewer Main
Relocation
1
02/27/23
1889
Check for $480 payable to
NCDEQ for application fee
2
02/27/23
Color USGS map showing site location
and street view
2
02/27/23
Watershed Classification Attachment
form WSCAS-01-15
These are transmitted as follows:
® For Approval
® For Your Use
0 As Requested
0 For Review & Comment
0 Approved as Submitted
0 Approved as Noted
0 Please Return
0 Other
Dear Mr. Vinson,
Enclosed please find our Fast Track application package for the above referenced project. The existing sanitary
pipes along the (3) three streets within project limits will be replaced with an 8" PVC pipe serving the same
number of residential properties. No additional sanitary flow will be added to the system.
Refer to the enclosed Engineer's report for additional information.
Please give us a call at 919-851-8077 if you have any questions or need additional information.
Sincerely
lva4" ioa&l
Pankil K. Patel

DocuSign Envelope ID: A9CCBADB-DE09-4481-B3F7-0DID070803F5
State of North Carolina
DWR
Department of Environment and Natural Resources
Division of Water Resources
Division of Water Resources
Watershed Classification Attachment (WSCAS 01-15)
Along with this form, submit a color copy of a USGS Topographic Map to Identify the project area and
waterbodies. Each map or maps must show the location of the sewer system and Include location identifiers
where the system traverses over or near waterbodies. The map should have location ID's for each different
waterbody and corresponding classifications should be recorded.
Include the completed form and map portions with the permit application for submittal to the appropriate review
agency. A list of the Division's regional offices, their county coverage, and contact information can be obtained
from: httu;// ortaLncdenr.orr eb/we home[ro
Location ID
Name of Waterbody'
River
Basin
Waterbody
Index No.
Waterbody
Classification
A
UT to Neuse River
Neuse
NIA
C;NSW
B
Little Creek
Neuse
27-43-12
C;NSW
If unnamed, indicate "unnamed tributary to X", where X is the named waterbody to which the unnamed tributary joins.
,,—Doauftned by:
1 certify that as a Registered Professional Engineer in the State of
North Carolina that 1 have diligently followed the Division's
instructions for classifying waterbodies and that the above
classifications are inclusive of the stated project, complete and
correct to the best of my knowledge and belief.
PE Seal, Signature and Date No
X ••
• � '•.
i •
�.. .:9
S E A L
pi 10773 _J
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