WQ0039495_Application (FTSE)_20170928

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
15A NCAC 02T.0300—FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16&SUPPORTING DOCUMENTATION
Application Number: y/ 2tkuo 1qq) (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name. Town of Clayton(company,municipality,HOA,utility,etc.)
2. Applicant type: ❑ Individual ❑Corporation ❑General Partnership ❑ Privately-O&# ed Public Utility
❑ Federal ❑ State/County ®Municipal ❑ Other u
3. Signature authority's name: Adam Lindsay per 15A NCAC 02T .0106(b) O
Title: own manager
l N
4. Applicant's mailing address: I I IE. Second Street o U--) c
City: Cla on State:N.0 Zip: 27527- w
5. Applicant's contact information: c
M �pl
Phone number:[phone] Email Address: ALindsayAtownofclayton.org Q
CD �
II. PROJECT INFORMATION:
1. Project name: Glen Laurel mixed use/Pines at Glen Laurel
2. Application/Project status: ®Proposed(New Permit) ❑ Existing Permit/Project
If a modification,provide the existing permit number: WQ00 and issued date:
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: 35.64373 Longitude:-78.41520`
5. Parcel ID(if applicable): Tx ID 4745868
(or Parcel ID to closest downstream sewer)
Ill. CONSULTANT INFORMATION:
1. Professional Engineer: X License Number:
Firm: Bass.Nixon and Kennedy
Mailing address: 6310 Chapel Hill Rd Suite 250
City: Raleigh State: N.C.. Zip: 27607-
Phone number: [phone] Email Address: Robbie.bellAbnkinc.com
IV. WASTEWATER TREATMENT FACILITY(WWTF)INFORMATION:
1. Facility Name: Litle Creek WRF Permit Number: NC 00025453
Owner Name: Town of Clayton
V. RECEIVING DOWNSTREAM SEWER INFORMATION(if different than WWTF):
1. Permit Number(s): WQ Downstream(Receiving)Sewer Size: inch
System Wide Collection System Permit Number(s)(if applicable): WQCS
Owner Name(s):
FORM: FTA 04.16 Page 1 of 5

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 ❑N/A
2. If the Applicant is a Developer of lots to be sold,has a De_veloqper's Operational Agreement(FORM. DEV)been attached?
❑ Yes ❑No ❑N/A
3. If the Applicant is a Home.'Propertv Owners'Association,has an Operational Agreement_{FORM: HOAI been attached?
❑Yes [-]No ❑N/A
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 dental veterinary facilities ❑ Swimming Pool/Clubhouse
❑Food and drink facilities ❑Church ❑ Swimming Pool/Filter Backwash
® Businesses offices r'factories ❑Nursing Home ❑ Other(Explain in Attachment)
5. Nature of wastewater: 100%Domestic!Commercial %Commercial
%Industrial(See 15A NCAC 02T .0103(20})
4 Is there a Pretreatment Program in effect? [:]Yes ❑No
6. Has a flow reduction been approved under 15A NCAC 02T .0114(t)? ❑Yes ❑No
➢ If yes,provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type(see 02T.0114(f)) Daily Design Flow°-D No.of Units Flow
Office/storage 1 gal/unit 696 696 GPD
gal/ GPD
gal/ GPD
gall GPD
gal/ GPD
gal/ GPD
Total GPD
a See 15A NCAC 02T_.01 14(bl,id),(e)(1) and(e.X2) for caveats to wastewater design flow rates(i.e., minimum Clow per
dwelling;proposed unknown non-residential development uses;public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S._42A4).
b Per 15A NCAC 02T .0114(c),design flow rates for establishments not identified(in table 15A 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: 696 GPD(per i 5A NCAC 02T.0114)
)r Do not include future flows or previously permitted allocations
If permitted flow is zero,indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑Other(Explain):
FORM: FTA 04-16 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA(If Applicable)-02T.0305&MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size(inches) Length(feet) Material
8 1780 PVC
8 713 DIP
➢ 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 requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA(If Applicable)—02T.0305&MDC(Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:N/A
2. Approximate Coordinates(Decimal Degrees): Latitude: Longitude: -
3. Design flow of the pump station: millions gallons per day(firm capacity)
4. Operational point(s)of the pump(s): gallons per minute at feet total dynamic head(TDH)
5. Summarize the force main to be permitted(for this Pump Station):
Size(inches) Length(feet) Material
6. Power reliability in accordance with 15A NCAC 02T.0305(h)(l):
❑ Standby power source or pump with 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
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation,quick-connection receptacle and telemetry- 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry- 15A NCAC 02T ,0305(h)(1)(C):
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant(draft agreement)
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
in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

IX. SETBACKS& SEPARATIONS—(02B.0200 & 15A NCAC 02T.0305(f)):
I. Does the project comply with all separations found in 15A NCAC 02T .0305(o&(g) ® Yes ❑No
➢ 15A NCAC 02T.0305(t)contains minimum separations that shall be provided for sewers stems:
Setback Parameter* Separation Required
Storm sewers and other utilities not listed below(vertical) 24 inches
Water mains vertical-water over sewer including in benched trenches) 18 inches
Water 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 100 feet
**Waters classified WS(except WS-1 or WS-V),B,SA,ORW,HQW,or SB from normal
high water(or tide elevation)and wetlands see item IX.2) 50 feet
**Any other stream,lake,impoundment,or ground water lowering and surface drainage
ditches 10 feet
Any building foundation 5 feet
Any basement 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
➢ 15A NCAC 02T.0305(p contains alternatives where separations in 02T.0305(o cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpaRe
➢ If noncompliance with 02T.0305(t)or(g),see Section X of this application
2. Does the project comply with separation requirements for wetlands?(50 feet of separation) ®Yes ❑No ❑NA
➢ Seethe Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ® Yes ❑No ❑NA
➢ This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project require coverageauthorization under a 404 Nationwide or ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 &Buffer Permitting Branch
5. Does project comply with l 5A NCAC 02T.0105(c)(6)(additional permits/certifications)? ®Yes ❑No
Per 15A NCAC 02T.0105(c)(6),directly related environmental permits or certification applications are 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.).
6. Does this project include any sewer collection lines that are deemed"high-priority?"
Per 15A NCAC 02T.0402,"high-priority sewer" means"any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑Yes ❑No 0 MA
➢ 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 permitee's individual System-Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T,the Minimum Design_Criteria for the Permitting of Pump Stations
and Force Mains(latest version),and the Gravity Sewer Minimum Design Criteria latest versions as applicable?
® Yes ❑No
If No,complete and submit the Variance Alternative Design Request application(VADC 10-14)and supporting documents for
review. Approval of the reauest is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
I, •F,1P$L �. Phi. , "�-- . attest that this application for
(Professional Engineer's name from Application Item III.1.)
Public GKavi.tyy Sewer to serve Pines a� Glen LatgeF
i has been reviewed by me and s accurate, complete an consistent wit a 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, Gravity Sewer
Minimum Design Criteria for Gravity Sewers(latest version),and the Minimum Design Criteria for the Fast-Track Permitting
of Pump Stations and Force Mains(latest version). 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.
..........................
North Carolina Professional Engineer's seal,signature,and date: �N
4 E/�L
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3. Applicant's Certification per 15A NCAC 02T.0106(b):
I, Adam �_.,Y1c.1 S a\1 attest that this application for
(Signature Authority's narce&title from Application Item I.3.)
Ge_ots4._ To 56-(LuE 'Pt•-3ES a-( CCt`EN LC,,uRL­-
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: 8 `t - f "►
FORM: FTA 04-16 Page 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
`Dk4ston of Water Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Town of Clayton
Project Name for which flow is being requested: Glen Laurel mixed use
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,
1. Complete this section only if you are the owner of the wastewater treatment plant,
a. WWTP Facility Name: Little Creek
b. WWTP Facility Permit#: 0025453
All flows are in MGD
c. WWTP facility's permitted flow 2.5 + 1.3
d. Estimated obligated flow not yet tributary to the WWTP 0.9061
e. WWTP facility's actual avg. flow 1.6178
fE Total flow for this specific request 0.000696 _
g. Total actual and obligated flows to the facility 2.5246 _
h. Percent of permitted flow used 66.45%
II. 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) (R)=(A-D)
Design Obligated,
Average Daily Approx. Not Yet Total Current
Pump Station Firm Flow" Current Avg. Tributary Flow Plus
(Name or Capacity, * (Firm r pfl, Daily Flow, Daily Flow, Obligated Available
Number) MGD MGD MGD MGD Flow Capacity***
Summerlyn 1.159 0.464 0.221 0.08 0.301 0.163
The Firm Capacity 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.
*** 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): Forest Glen
Downstream Permit Number: WQ0011316
Page 1 of 6
FTSE 04-16

1II. Certification Statement:
I Adam Lindsay 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 indicates acceptance of this wastewater flow.
9-2s. /7
Signing Otc-ia
Date
Page 2of6
FTSE 04-1 6

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BASS, NIXON & KENNEDY, INC., CONSULTING ENGINEERS
6310 CHAPEL HILL ROAD, SUITE 250, RALEIGH, NC 27607
919/851-4422 FAX [phone] [e-mail]
August 15, 2017
NC Department of Environmental Quality NC Dept of Environmental Quality
Division of Water Resources
1628 Mail Service Center
Raleigh, NC 27699-1628
Attn: DWQ Staff Raleigh Regional Office
REF: Glen Laurel Mixed Use/Pines at Glen Laurel
Fast Track Application for Public Sanitary Sewer
Clayton, NC
Dear Staff:
As Engineers of Record, Bass, Nixon & Kennedy, Inc., we hereby submit the following
Public Fast Track Sanitary Sewer Application Package for review and approval. The
Project "Glen Laurel Mixed Use" or "Pines at Glen Laurel" consists of 1 ,780 LF of 8"
PVC and 713 LF of 8" DIP Public Gravity Sewer Main. Said project has been reviewed
by the Town of Clayton. Since this will be the Town of Clayton's Gravity Sewer and the
existing downstream gravity sewer that we are connecting to is also owned by the Town
of Clayton, we have determined that an acceptance form is not required. The contact
at the Town of Clayton is Rich Cappola, PE (919-359-1288) should staff have any
questions. The attached package contains the following information:
1 — Original Application
1 - Copy of Application
2 - Description Letter
2 - USGS Map
2 - Johnston County Map
1 - $480.00 Review Fee
Should you have any questions, please advice
Very truly yours,
Bas , Nixon & Kennedy, Inc.
Irby R. Bell, Jr. PE
KRBjr/rt

�. BASS, NIXON & KENNEDY, INC. DATE: JOB
CONSULTING ENGINEERS 8/15/1 7 No. 03-15060
6310 Chapel Hill Road, Suite 250, Raleigh,NC 27607 ATTN.
Telephone:[phone], Facsimile:[phone] Ted Cashion/Staff
RE:
Pines at Glen Laurel
© Fast Track Public Sanitary Sewer Permit Application
TO: DWR — Raleigh Regional Office
3800 Barrett Drive
Raleigh, NC 27609
WE ARE SENDING YOU: ® ATTACHED ❑ UNDER SEPARATE COVER VIA THE FOLLOWING ITEMS:
❑ SHOP DRAWINGS ❑ PRINTS ❑ PLANS ❑ SAMPLES
❑ SPECIFICATIONS
❑ COPY OF LETTER ❑ CHANGE ORDER ❑
COPIES DATE No. DESCRIPTION:
1 FAST-TRACK PUBLIC APPLICATION —ORIGINAL AND COPY
1 APPLICATION FEE -$480.00 CHECK NO. 2229 NC Dept of Environmental Quality
2 USGS TOPOGRAPHIC MAP
1 COVER LETTER—ORIGINAL AND COPY
2 STREET LEVEL MAP Raleigh Regional Office
THESE ARE TRANSMITTED AS CHECKED BELOW:
® FOR APPROVAL ❑ APPROVED As SUBMITTED ❑ RESUBMIT COPIES FOR APPROVAL
❑ FOR YOUR USE ❑ APPROVED AS NOTED ❑ SUBMIT COPIES FOR DISTRIBUTION
❑ AS REQUESTED ❑ RETURNED FOR CORRECTIONS ❑ RETURN CORRECTED PRINTS
❑ FOR REVIEW AND COMMENT ❑
❑ FOR BIDS DUE 20 ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS:
PLEASE CONTACT ME WITH ANY QUESTIONS OR CONCERNS AT 919-851-4422.
THANKS
COPY TO: SIGNED: KIRBY R. BELL JR. PE CPESC

,.4-L
,Cashion, Ted " �
From: Cashion, Ted
Sent: Wednesday, September 20, 2017 7:22 AM
To: 'Robbie Bell'
Cc: Robinson, Jason
Subject: RE: Glen laurel mixed use/Pines at Glen Laurel fast track sewer extension application
This FTSE form that is needed is for the public application. The private application did contain an FTSE form as
required. The FTSE form must be specific for each project application submitted. Even though the requested flow is
relatively small in the public application, 696 gpd,the FTSE form will complete the application. Please have the town
complete the form for this public application;you can email to me if convenient.
Thx
ted
Ted Cashion,CHMM
NC Department of Environmental quality
Division of Water Resources
Raleigh Regional Office
919-791-4254
NZ. - Nothing Compares -
Email correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties unless the content is exempt by statute or other regulation.
From: Robbie Bell [mailto:[e-mail]]
Sent:Tuesday, September 19,2017 2:00 PM
To:Cashion,Ted <[e-mail]>
Cc: Robinson,Jason <[e-mail]>
Subject: RE: Glen laurel mixed use/Pines at Glen Laurel fast track sewer extension application
Ted,was this for the private or public application. In the private application I included the FTSE 04-16 "Flow
Tracking/Acceptance Application" signed by the Manager. If for the public application I did not think I needed this form
since the Town signed it which acknowledges they have the flow. I guess I am accustom to several decades ago when a
State sewer public extension application did not need this info. Most of my work since then has been in delegated
Municipalities. Is there a problem submitting the same FTSE that I provided with the private since the bulk of the flow is
from the private application is going to this public main application?
Thanks,
K. Robert(Robbie) Bell, Jr., PE, CPESC
President
BASS, NIXON & KENNEDY, INC.,
CONSULTING ENGINEERS
6310 CHAPEL HILL ROAD,SUITE 250,
RALEIGH,NC 27607
PHONE [phone] FAX [phone]
Direct 919/645.3540
1

From: Cashion, Ted [mailto:ted.cashionC&ncdenr.gov]
Sent: Tuesday, September 19, 2017 12:29 PM
To: Robbie Bell
Cc: Robinson, Jason
Subject: Glen laurel mixed use/Pines at Glen Laurel fast track sewer extension application
Robbie,
We are reviewing the subject application and noted that the FTSE form was not included in the application. The FTSE
form is needed to ensure that the Town has adequate capacity at the WWTP to receive this additional flow,and that
downstream sewers and any pump stations involved also have capacity to receive this flow so as not to violate GS 143-
215.67.
Please have the Town complete the FTSE form and email to me.
We'll continue review and drafting of the permit upon submittal of this information.
Thx
ted
Ted Cashion, CHMM
NC Department of Environmental Quality
Division of Water Resources
Raleigh Regional Office
919-791-4254
"'Nothing Compares
Email correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties unless the content is exempt by statute or other regulation.

Cashion, Ted
From: Cashion, Ted
Sent: Tuesday, September 19, 2017 12:29 PM
' To: Robbie Bell
Cc: Robinson, Jason
Subject: Glen laurel mixed use/Pines at Glen Laurel fast track sewer extension application
Robbie,
We are reviewing the subject application and noted that the FTSE form was not included in the application. The FTSE
form is needed to ensure that the Town has adequate capacity at the WWTP to receive this additional flow, and that
downstream sewers and any pump stations involved also have capacity to receive this flow so as not to violate GS 143-
215.67.
Please have the Town complete the FTSE form and email to me.
We'll continue review and drafting of the permit upon submittal of this information.
Thx
ted
Ted Cashion, CHMM
NC Department of Environmental Quality
Division of Water Resources
Raleigh Regional Office
919-791 4254
''Nothing Compares
Email correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties unless the content is exempt by statute or other regulation.

Fast Track A b ro val Checkllst
1. Has the.correct application form been used? It should be FTA
• 4-16 (will accOpt older version for now). The form and version
ndn*er are:at the top right of the first page under the words
°Fast-Track Application" as shown below.
7 r State of North Carolina
p ` Department of Environment and Natural Resources
40` Division of Water Quality
a FAST-TRACK APPLICATION
' EFTA 4/16)
for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
Pressure I Vacuum sewers stems are not to be included as part of this a pllcatlon adage)
2. Is the check amount$480?
F1 3. Is the check dated within 180 days?
4. Has the application been signed by the owner and engineer,
and sealed by the engineer?
5. Is the county location In the Raleigh region? (Item A.2b)
If all the above items have been met, check can be deposited.
If any of the above items have not been met, send the application With check
attached to me for returning to the applicant.
nmenta1 Quality
Please attach this form to the application and return to me.
NC Dept of E
Jason Robinson
Environmental Engineer l0tflce
NCDI;NR-DWR R
Raleigh Regional Office
(Voice) 919-791-4249
(Fax) 919-788-7159
REVISED 416116