Loading...
HomeMy WebLinkAboutNC0036269_Application (ATC)_20231018RRRWWTP Phase 4 Expansion Attachment A: Application for Authorization to Construct Permit (Form ATC-12-14) Brown —Caldwell State of North Carolina Department of Environmental Quality Division of Water Resources Water Resources ENVIRONMENTAL QUALITY APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14) SECTION 1: INSTRUCTIONS AND INFORMATION A. The Division of Water Resources will accept this application package for review only if all of the items are provided and the application is complete. Failure to submit all of the required items will result in the application package being returned as incomplete per 15A NCAC 02T .0105(b). B. Plans and specifications must be prepared in accordance with 15 NCAC 02H. 0100, 15A NCAC 02T, North Carolina General Statute 133-3, North Carolina General Statute 143-215.1, and Division of Water Resources Minimum Design Criteria for NPDES Wastewater Treatment Facilities. C. The plans and specifications submitted must represent a completed final design that is ready to advertise for bid. D. Any content changes made to this Form ATC-12-14 shall result in the application package being returned. E. The Applicant shall submit ONE ORIGINAL and ONE DIGITAL COPY (CD) of the application, all supporting documentation and attachments. All information must be submitted bound or in a 3-ring binder, with a Section tab for each Section, except the Engineering Plans. F. Check the boxes below to indicate that the information is provided and the requirements are met. G. If attachments are necessary for clarity or due to space limitations, such attachments are considered part of the application package and must be numbered to correspond to the item referenced. H. For any project that requires review under the State Environmental Policy Act (SEPA), an Authorization to Construct cannot be issued prior to the completion of a State Clearinghouse advertisement period for a FONSI, EIS, etc. unless the project qualifies for a Determination of Minor Construction Activity. I. For more information, visit the Division of Water Resources web site at: https://deg.nc.gov/about/divisions/water-resources/water- resources-permits/wastewater-branch/npdes-wastewater/authorization-to-construct. J. In addition to this Authorization to Construct, the Applicant should be aware that other permits may be required from other Sections of the Division of Water Resources (for example: reclaimed water facilities permits; Class A or B biosolids residuals permit). SECTION 2: APPLICANT INFORMATION AND PROJECT DESCRIPTION A. APPLICANT Applicant's name Water and Sewer Authority of Cabarrus County Signature authority's name per 15A NCAC 02T .0106(b) Chad VonCannon Signature authority's title Engineering Director Complete mailing address 232 Davidson Highway, Concord, NC 28027 Telephone number 704-786-1783 Email address CVonCannon@wsacc.org B. PROFESSIONAL ENGINEER Professional Engineer's name George Anipsitakis Professional Engineer's title Managing Principal North Carolina Professional Engineer's License No. 036485 Firm name Brown and Caldwell Firm License number F-0785 Complete mailing address 309 E. Morehead St. Suite 220, Charlotte, NC 28202 Application for Authorization to Construct Permit (FORM ATC-12-14) Page 1 Water Resources ENVIRONMENTAL QUALITY State of North Carolina Department of Environmental Quality Division of Water Resources APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14) Telephone number 704-373-7137 Email address ganipsitakis@brwncald.com C. NPDES PERMIT NPDES Permit number NCO036269 Current Permitted flow (MGD) — include permit 26.5 MGD Max Month flow phases if applicable D. PROJECT DESCRIPTION Provide a brief description of the project: The RRRWWTP Phase 4 Expansion will include improvements that will allow the plant to expand to 34 MGD. These include replacing two influent pumps with new in the Main Pump Station, constructing new wet weather Influent Flow Equalization (EQ), grit removal improvements including replacement of grit pumps, washers, and classifiers, constructing new anoxic zones for Aeration Basins (ABs) No. 3-5, installing four new aeration blowers, piping, and fine bubble diffusers to convert ABs No. 3-5 from high purity oxygen to diffused air, in -kind replacement of five existing screw pumps in RAS Pump Station No. 1 and 2, limited Secondary Clarifier (SC) No. 3-10 improvements, new dedicated RAS Pump Stations No. 3-10 for each SC, new Scum Pump Station, new Dissolved Air Flotation Thickeners, in -kind replacement of two pumps in the Plant Drain Puma Station. in -kind replacement of two polvmer sumps for dewaterine. and a new hvbrid biofilter unit for odor control replacing a chemical scrubber. SECTION 3: APPLICATION ITEMS REQUIRED FOR SUBMITTAL FOR ALL PROJECTS A. Cover Letter ® The letter must include a request for the Authorization to Construct; the facility NPDES Number; a brief project description that indicates whether the project is a new facility, facility modification, treatment process modification, or facility expansion; the construction timeline; and a list of all items and attachments included in the application package. ❑ If any of the requirements of 15 NCAC 02H. 0100, 15A NCAC 02T, North Carolina General Statute 133-3, North Carolina General Statute 143-215.1, and Division of Water Resources Minimum Design Criteria for NPDES Wastewater Treatment Facilities are not met by the proposed design, the letter must include an itemized list of the requirements that are not met. B. NPDES Permit ® Submit Part I of the Final NPDES permit for this facility that includes Part A (Effluent Limitations and Monitoring Requirements) for the monthly average flow limit that corresponds to the work that is requested for this project. C. Special Order by Consent ❑ If the facility is subject to any Special Orders by Consent (SOC), submit the applicable SOC. ® Not Applicable. D. Finding of No Significant Impact or Record of Decision ❑ Submit a copy of the Finding of No Significant Impact or Record of Decision for this project. ❑ Provide a brief description of any of the mitigating factors or activities included in the approved Environmental Document that impact any aspect of design of this project, if not specified in the Finding of No Significant Impact or Record of Decision. Application for Authorization to Construct Permit (FORM ATC-12-14) Page 2 State of North Carolina Department of Environmental Quality Division of Water Resources Water Resources ENVIRONMENTAL QUALITY APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14) ® Not Applicable. E. Engineering Plans ® Per 15A NCAC 02T .0504(c)(1), submit one set of detailed plans that have been signed, sealed and dated by a North Carolina Licensed Professional Engineer. ® Per 21 NCAC 56 .1103(a)(6), the name, address and License number of the Licensee's firm shall be included on each sheet of the engineering drawings. ® Plans must be labeled as follows: FINAL DRAWING — FOR REVIEW PURPOSES ONLY— NOT RELEASED FOR CONSTRUCTION. ® 15A NCAC 02H .0124 requires multiple (dual at a minimum) components such as pumps, chemical feed systems, aeration equipment and disinfection equipment. Is this requirement met by the design? ® Yes or ❑ No. If no, provide an explanation: Plans shall include: ® Plans for all applicable disciplines needed for bidding and construction of the proposed project (check as appropriate): ® Civil ❑ Not Applicable ® Process Mechanical ❑ Not Applicable ® Structural ❑ Not Applicable ® Electrical ❑ Not Applicable ® Instrumentation/Controls ❑ Not Applicable ® Architectural ❑ Not Applicable ® Building Mechanical ❑ Not Applicable ® Building Plumbing ❑ Not Applicable ® Plan and profile views and associated details of all modified treatment units including piping, valves, and equipment (pumps, blowers, mixers, diffusers, etc.) ® Are any modifications proposed that impact the hydraulic profile of the treatment facility? ® Yes or ❑ No. If yes, provide a hydraulic profile drawing on one sheet that includes all impacted upstream and downstream units. The profile shall include the top of wall elevations of each impacted treatment unit and the water surface elevations within each impacted treatment unit for two flow conditions: (1) the NPDES permitted flow with all trains in service and (2) the peak hourly flow with one treatment train removed from service. ® Are any modifications proposed that impact the process flow diagram or process flow schematic of the treatment facility? ® Yes or ❑ No. If yes, provide the process flow diagram or process flow schematic showing all modified flow paths including aeration, recycle/return, wasting, and chemical feed, with the location of all monitoring and control instruments noted. F. ® Engineering Specifications ® Per 15A NCAC 02T .0504(c)(2), submit one set of specifications that have been signed, sealed and dated by a North Carolina Licensed Professional Engineer. ® Specifications must be labeled as follows: FINAL SPECIFICATIONS — FOR REVIEW PURPOSES ONLY — NOT RELEASED FOR CONSTRUCTION. Specifications shall include: ® Specifications for all applicable disciplines needed for bidding and construction of the proposed project (check as appropriate): ® Civil ❑ Not Applicable Application for Authorization to Construct Permit (FORM ATC-12-14) Page 3 State of North Carolina Department of Environmental Quality Division of Water Resources Water Resources ENVIRONMENTAL QUALITY APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14) ® Process Mechanical ❑ Not Applicable ® Structural ❑ Not Applicable ® Electrical ❑ Not Applicable ® Instrumentation/Controls ❑ Not Applicable ® Architectural ❑ Not Applicable ® Building Mechanical ❑ Not Applicable ® Building Plumbing ❑ Not Applicable ® Detailed specifications for all treatment units and processes including piping, valves, equipment (pumps, blowers, mixers, diffusers, etc.), and instrumentation. ® Means of ensuring quality and integrity of the finished product including leakage testing requirements for structures and pipelines, and performance testing requirements for equipment. ❑ Bid Form for publicly bid projects. This is a design -build project. There is no public bid. G. Construction Sequence Plan ® Construction Sequence Plan such that construction activities will not result in overflows or bypasses to waters of the State. The Plan must not imply that the Contractor is responsible for operation of treatment facilities. List the location of the Construction Sequence Plan as in the Engineering Plans or in the Engineering Specifications or in both: Engineering Specifications Section 01 1216. H. Engineering Calculations ® Per 15A NCAC 02T .0504(c)(3), submit one set of engineering calculations that have been signed, sealed and dated by a North Carolina Licensed Professional Engineer; the seal, signature and date shall be placed on the cover sheet of the calculations. For new or expanding facilities and for treatment process modifications that are included in Section 4.C, the calculations shall include at a minimum: ® Demonstration of how peak hour design flow was determined with a justification of the selected peaking factor. See RRRWWTP Phase 4 Expansion to 34 MGD Preliminary Enaineerina Report Section 1.2 (Att. Cl. See TM 4 Influent Flows. Loads. and Proiections (Att. D). ® Influent pollutant loading demonstrating how the design influent characteristics in Section 4.6.2 of this form were determined. See RRRWWTP Phase 4 Expansion to 34 MGD Preliminary Engineering Report Section 1.2 (Att. Q. See TM 4 Influent Flows, Loads, and Projections (Att. D). ® Pollutant loading for each treatment unit demonstrating how the design effluent concentrations in Section 4.6.2 of this form were determined. See RRRWWTP Phase 4 Expansion to 34 MGD Preliminary Engineering Report Section 1.2 (Att. C). ® Hydraulic loading for each treatment unit. See process flow diagram G-000-302 and mass balance sheet G-000-402 for hydraulic loading (flowrates) to each treatment unit (Att. H). ® Sizing criteria for each treatment unit and associated equipment (blowers, mixers, pumps, etc.) See RRRWWTP Phase 4 Expansion to 34 MGD Preliminary Engineering Report (Att. C) and Attachment E for additional calculations. ® Total dynamic head (TDH) calculations and system curve analysis for each pump specified that is included in Section 4.C.6. See Main Pump Station (Att. C), Grit (Att. C), RAS, Scum, and Plant Drain Pump Calculations (Att. C and E). Calculations for the Internal Mixed Liquor Recycle pumps (formerly the existing RAS PS No. 1 and 2, names changed as part of the proiect) are not provided as they are replace -in -kind. These new IMLR pumps match the operating points of the existing Archimedes screw pumps, where three pumps operate at 21,400 qpm at 25 feet, and two pumps operate at 16,700 qpm at 23 feet. Calculations for the polymer pumps in the Dewatering Building are not provided as they are replace -in -kind. The new Polymer Pump match the operating points of the existing progressing cavity pumps at 15 qpm and a discharge head of 104 feet. Application for Authorization to Construct Permit (FORM ATC-12-14) Page 4 State of North Carolina Department of Environmental Quality Division of Water Resources Water Resources ENVIRONMENTAL QUALITY APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14) ® Buoyancy calculations for all below grade structures. None of the new structures have potential influence from groundwater, see Geotechnical Engineering Report (Att. G) and, as such, Buoyancy Calculations are not included. ® Supporting documentation that the specified auxiliary power source is capable of powering all essential treatment units. See Generator Sizing Calculation (Att. E.6). I. Permits J. ® Provide the following information for each permit and/or certification required for this project: Permit/Certification Not Applicable Date Submitted Date Approved Permit/ Certification Number If Not Issued Provide Status and Expected Issuance Date Dam Safety N/A Soil Erosion and Sediment Control tentative 12/2023 USCOE / Section 404 Permit N/A Water Quality Certification (401) N/A USCOE / Section 10 N/A Stormwater Management Plan N/A CAMA N/A NCDOT or Railroad Encroachment Agreement N/A City of Concord Site Plan Review and Building Standards incl. Stormwater Management tentative 12/2023 Residuals Management Plan ❑ For all new facilities, expanding facilities, or modifications that result in a change to sludge production and/or sludge processes, provide a Residuals Management Plan meeting the requirements of 15A NCAC 02T .0504(I) and 15A NCAC 02T .0508; the Plan must include: ❑ A detailed explanation as to how the generated residuals (including trash, sediment and grit) will be collected, handled, processed, stored, treated, and disposed. ❑ An evaluation of the treatment facility's residuals storage requirements based upon the maximum anticipated residuals production rate and ability to remove residuals. ❑ A permit for residuals utilization or a written commitment to the Applicant from a Permittee of a Department approved residuals disposal/utilization program that has adequate permitted capacity to accept the residuals or has submitted a residuals/utilization program application. ❑ If oil, grease, grit or screenings removal and collection is a designated unit process, a detailed explanation as to how the oil/grease will be collected, handled, processed, stored and disposed. ® Not Applicable. Dewatering and Incineration have sufficient capacity to accommodate this expansion. WAS pumping and Gravity Thickening were expanded in Phase 3. Application for Authorization to Construct Permit (FORM ATC-12-14) Page 5 State of North Carolina ,- Department of Environmental Quality Division of Water Resources Water Resources ENVIRONMENTAL QUALITY APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14) SECTION 4: PROJECT INFORMATION A. WASTEWATER TREATMENT PLANT FLOW INFORMATION —COMPLETE FOR NEW OR EXPANDING FACILITIES 1. Provide the following flow information: Plant Flows Existing Plant Design 26.5 MGD Current NPDES Permit Limit 26.5 MGD Current Annual Average (past 12 months) 22.4 MGD For Past 12 Months: Start Date: August/2022 End Date: July/2023 For Past 24 Months: Start Date: August/2021 End Date: July/2023 Maximum Month 27.3 MGD 27.3 MGD Maximum Day 53.1 MGD 53.1 MGD Peak Hour 78.9 MGD 78.9 MGD Application for Authorization to Construct Permit (FORM ATC-12-14) Page 6 State of North Carolina Department of Environmental Quality Division of Water Resources Water Resources ENVIRONMENTAL QUALITY APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14) B. WASTEWATER TREATMENT FACILITY DESIGN INFORMATION —COMPLETE FOR NEW OR EXPANDING FACILITIES AND FOR TREATMENT PROCESS MODIFICATIONS 1. Have all of the requirements of 15 NCAC 02H. 0100, 15A NCAC 02T, North Carolina General Statute 133-3, North Carolina General Statute 143-215.1, and Division of Water Resources Minimum Design Criteria for NPDES Wastewater Treatment Facilities been met by the proposed design and specifications? ® Yes or ❑ No. If no, provide justification as to why the requirements are not met, consistent with 15A NCAC 02T .0105(n): 2. Provide the design influent and effluent characteristics that are used as the basis for the project design, and the NPDES permit limits for the following parameters: Project Basis of Design Design Influent Design Influent Influent Concentration Load Concentration - (Must be (Must be Current Annual supported by supported by Design Effluent Average (past Engineering Engineering Concentration and/or NP DES Permit Limits 12 months) if Calculations Calculations Load (monthly average) Parameter Available [Section 3.H]) [Section 3.H]) Ammonia Nitrogen 33.5 mg/L 1.6 mg/L Summer 1.6 mg/L Summer (NH3-N) (Pri. Clar. Infl.) 31 mg/L 7,920 lb/day 3.7 mg/L Winter 3.7 mg/L Winter Biochemical 10.0 mg/L Summer 10.0 mg/L Summer Oxygen Demand 338 mg/L 304 mg/L 76,000 lb/day (BOD5) 20.0 mg/L Winter 20.0 mg/L Winter Fecal Coliform 200 per 100 mL 200 per 100 mL Nitrate + Nitrite Nitrogen (NO3-N + N/A mg/L N/A mg/L N 02-N ) Total Kjeldahl N/A mg/L Nitrogen N/A mg/L N/A mg/L Total Nitrogen N/A lb/year N/A lb/year N/A mg/L N/A mg/L Total Phosphorus N/A mg/L 8.0 mg/L 2,280 lb/day N/A lb/year N/A lb/year Total Suspended 383 mg/L 336 mg/L 95,300 lb/day 30.0 mg/L 30.0 mg/L Solids (TSS) 3. Based on the "Project Basis of Design" parameters listed above, will the proposed design allow the treatment facility to meet the NPDES Permit Limits listed above? ® Yes or ❑ No. If no, describe how and why the Permit Limits will not be met: Application for Authorization to Construct Permit (FORM ATC-12-14) Page 7 State of North Carolina Department of Environmental Quality Division of Water Resources Water Resources ENVIRONMENTAL QUALITY APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14) 4. Per 15A NCAC 02T .0505(I), by-pass and overflow lines are prohibited. Is this condition met by the design? ® Yes or ❑ No If no, describe the treatment units bypassed, why this is necessary, and where the bypass discharges: 5. Per 15A NCAC 02T .0505(k), multiple pumps shall be provided wherever pumps are used. Is this condition met by the design? ® Yes or ❑ No. If no, provide an explanation: 6. Per 15A NCAC 02T .0505(I), power reliability shall be provided consisting of automatically activated standby power supply onsite capable of powering all essential treatment units under design conditions, or dual power supply shall be provided per 15A NCAC 02H. 0124(2)(a). Is this condition met by the design? ® Yes or ❑ No. If no, provide (as an attachment to this Application) written approval from the Director that the facility: ➢ Has a private water supply that automatically shuts off during power failures and does not contain elevated water storage tanks, and ➢ Has sufficient storage capacity that no potential for overflow exists, and ➢ Can tolerate septic wastewater due to prolonged detention. Per 15A NCAC 02T .0505(o), a minimum of 30 days of residual storage shall be provided. Is this condition met by the design? ® Yes or ❑ No. If no, explain the alternative design criteria proposed for this project in accordance 15A NCAC 8. Per 15A NCAC 02T .0505(g , the public shall be prohibited from access to the wastewater treatment facilities. Explain how the design complies with this requirement: No modifications were made to existing perimeter controls that prevent access to the facility by the public. 9. Is the treatment facility located within the 100-year flood plain? ❑ Yes or ® No. If yes, describe how the facility is protected from the 100-year flood: C. WASTEWATER TREATMENT UNIT AND MECHANICAL EQUIPMENT INFORMATION —COMPLETE FOR NEW OR EXPANDING FACILITIES AND FOR MODIFIED TREATMENT UNITS 1. PRELIMINARY AND PRIMARY TREATMENT (i.e., physical removal operations and flow equalization): Calculations No. of Plan Sheet Specification Treatment Unit Type Size per Unit Provided? Units Reference Reference (Yes or No) Grit 300 gpm design flow, 400 gpm No, In -kind Classifier/Washer 2 Conical peak hourly flow D-020-102 462364 replace Flow Equalization 1 Circular 12 million gallons D-080-103 0323 13 Yes (Att. E.1) SECONDARY TREATMENT (BIOLOGICAL REACTORS AND CLARIFIERS) (i.e., biological and chemical processes to remove organics and nutrients) Treatment Unit No. of Units Type Size per Unit Plan Sheet Reference Specification Reference Calculations Provided? (Yes or No) 2 per Activated 0.224 million gallons total D-040-102 D- Yes (Att. C Anoxic Zones train Sludge per train 040-103,,D -040- 46 4123.13 and F) D-040-105, D- 3 per Activated 0.897 million gallons total 040-106, D-040- Yes (Att. C Aerobic Zones train Sludge per train 107D-040-108 , , 46 51 33 and F) D-040-109, D- 040-110 Application for Authorization to Construct Permit (FORM ATC-12-14) Page 8 Water Resources ENVIRONMENTAL QUALITY 3. TERTIARY TREATMENT State of North Carolina Department of Environmental Quality Division of Water Resources APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14) Calculations No. of Plan Sheet Specification Treatment Unit Type Size per Unit Provided? Units Reference Reference (Yes or No) n/a 4. DISINFECTION Calculations No. of Plan Sheet Specification Treatment Unit Type Size per Unit Provided? Units Reference Reference (Yes or No) n/a 5. RESIDUALS TREATMENT Calculations No. of Plan Sheet Specification Treatment Unit Type Size per Unit Provided? (Yes Units Reference Reference or No) Dissolved Air Mechanical 500 gpm Peak Day Influent Yes (Att. C) 2 D-130-105 464363 Flotation Thickener Thickening Flow 6. PUMP SYSTEMS (include influent, intermediate, effluent, major recycles, waste sludge, thickened waste sludge and plant drain pumps) Capacity of each No. of Plan Sheet Specification Location Pumps Purpose Type pump Reference Reference GPM TDH Screened raw Main Pump Station 2 wastewater Dry -pit 17,014 118.5' D-010-101, D- 43 23 80.14 Submersible 010-102 conveyance Self -priming, Headworks 2 Grit conveyance Non -clog 383 16.7' D-020-102 43 23 56.11 Centrifugal D-110-105, D- RAS Pump Stations 16 RAS conveyance Submersible 1,493 25' 110-106, D- 43 23 80.15 No. 3 - 10 110-107, D- 110-108 Internal Mixed Liquor 21,400/ 25.4'/ 5 RAS Conveyance Screw Pump D-110-103 43 56 01 Recycle Pump Station 16,700 23.4' Scum Pump Station 3 Scum conveyance Submersible 500 105' D-120-103 43 23 80.15 Thickened scum D-130-105 DAFT Building 2 Rotary Lobe 25 104' 43 24 41 conveyance Polymer Progressing Dewatering Building 2 15 104' D-150-101-A 43 24 51.11 conveyance Cavity Plant Drain Pump Plant drain 2 Submersible 195 31' D-060-102 43 23 80.11 Station conveyance 7. MIXERS Application for Authorization to Construct Permit (FORM ATC-12-14) Page 9 Water Resources ENVIRONMENTAL QUALITY State of North Carolina Department of Environmental Quality Division of Water Resources APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14) Power of No. of plan Sheet Specification Location Purpose Type each MP ixer Mixers Reference Reference Anoxic Zones of D-040-102, D- 1 per zone Aeration Basins No. Solids suspension Submersible 5 040-103, D- 46 41 23.13 (18 total) 3-5 040-104 8. BLOWERS Capacity of No. of plan Sheet Specification Location purpose Type each Blower Blowers Reference Reference (Clo Provide aeration air Blower Building 4 to Aeration Basins High Speed Turbo 9,350 D-070-101 43 11 14 No. 3-5 Existing Biotrickling 1 Air conveyance to FRP Centrifugal Fan 3,300 CD-000-102 43 11 19.13 Filter (BTF) BTF Hybrid Biofilter Unit 1 Air conveyance to FRP Centrifugal Fan 7,300 D-170-101 43 11 19.13 BTF 9. ODOR CONTROL Location No. of Units purpose Type Plan Sheet Reference Specification Reference Treat H2S and other Near Dewatering odorous compounds Hybrid Biofilter with Carbon Building 1 from Dewatering, Polishing D-170-101 443121 Solids Handling and Gravity Thickeners D. SETBACKS —COMPLETE FOR NEW WASTEWATER TREATMENT STRUCTURES The minimum distance for each setback parameter to the wastewater treatment/storage units per 15A NCAC 02T .0506(b) are as follows: Minimum Distance Is Minimum Distance Required from Nearest Requirement met by the Setback Parameter Treatment/Storage Design? If "No", identify Unit Setback Waivers in Item D.2 Below Any habitable residence or place of assembly under separate 100 ft ® Yes ❑ No ownership or not to be maintained as part of the project site Any private or public water supply source 100 ft ® Yes ❑ No Surface waters (streams — intermittent and perennial, perennial 50 ft ® Yes ❑ No waterbodies, and wetlands) Any well with exception of monitoring wells 100 ft ® Yes ❑ No Any property line 50 ft ® Yes ❑ No Have any setback waivers been obtained per 15A NCAC 02T .0506(d)? ❑ Yes or ® No. If yes, have these waivers been written, notarized and signed by all parties involved and recorded with the County Register of Deeds? ❑ Yes or ❑ No. If no, provide an explanation: Application for Authorization to Construct Permit (FORM ATC-12-14) Page 10 Water Resources ENVIRONMENTAL QUAL State of North Carolina Department of Environmental Quality Division of Water Resources APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14) SECTION 5: APPLICATION CERTIFICATION BY PROFESSIONAL ENGINEER Professional Engineer's Certification per 15A NCAC 02T .0105: I, George Anipsitakis, attest that this application package for an Authorization to Construct (Typed Name of Professional Engineer) for the RRRWWTP Phase 4 Expansion (Facility and Project Name) was prepared under my direct supervisory control and to the best of my knowledge is accurate, complete and consistent with the information supplied in the engineering plans, specifications, calculations, and all other supporting documentation for this project. I further attest that to the best of my knowledge the proposed design has been prepared in accordance with all applicable regulations and statutes,15 NCAC 02H. 0100, 15A NCAC 02T, North Carolina General Statute 133-3, North Carolina General Statute 143-215.1, and Division of Water Resources Minimum Design Criteria for NPDES Wastewater Treatment Facilities, and this Authorization to Construct Permit Application, except as provided for and explained in Section 4.13.1 of this Application. I understand that the Division of Water Resources' issuance of the Authorization to Construct Permit may be based solely upon this Certification and that the Division may waive the technical review of the plans, specifications, calculations and other supporting documentation provided in this application package. I further understand that the application package may be subject to a future audit by the Division. Although certain portions of this submittal package may have been prepared, signed and sealed by other professionals licensed in North Carolina, inclusion of these materials under my signature and seal signifies that I have reviewed the materials and have determined that the materials are consistent with the project design. I understand that 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. North Carolina Professional Engineer's seal with written signature placed over or adjacent to the seal and dated: \0� N + C A :a SEAL 036485 �al�lU 2 3 O . GINox E�• ��� Application for Authorization to Construct Permit (FORM ATC-12-14) Page 11 State of North Carolina Department of Environmental Quality Division of Water Resources Water Resources ENVIRONMENTAL QUALITY APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14) SECTION 6: APPLICATION CERTIFICATION BY APPLICANT Applicant's Certification per 15A NCAC 02T .0106(b): I, Chad VonCannon, Engineering Director, attest that this application package for an Authorization to Construct (Typed Name of Signature Authority and Title) for the RRRWWTP Phase 4 Expansion (Facility and Project Name) has been reviewed by me and is accurate and complete to the best of my knowledge. 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. I further certify that in accordance with 15A NCAC 02T .0120(b), the Applicant or any affiliate has not been convicted of environmental crimes, has not abandoned a wastewater facility without proper closure, does not have an outstanding civil penalty where all appeals have been abandoned or exhausted, are compliant with any active compliance schedule, and does not have any overdue annual fees. I understand that the Division of Water Resources' issuance of the Authorization to Construct Permit may be based solely upon acceptance of the Licensed Professional Engineer's Certification contained in Section 5, and that the Division may waive the technical review of the plans, specifications, calculations and other supporting documentation provided in this application package. I further understand that the application package may be subject to a future audit. I understand that in accordance with General Statutes 143-215.6A and 143-215.6E 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 jne t to exceed $10,000, as well as civil penalties up to $25,000 per violation. Signature: Date: THE COMPLETED APPLICATION AND SUPPORTING INFORMATION SHALL BE SUBMITTED TO: NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER RESOURCES/NPDES By U.S. Postal Service By Courier/Special Delivery: 1617 MAIL SERVICE CENTER 512 N. SALISBURY STREET, 9TH FLOOR RALEIGH, NORTH CAROLINA 27699-1617 RALEIGH, NORTH CAROLINA 27604 TELEPHONE NUMBER: (919) 707-3644 Application for Authorization to Construct Permit (FORM ATC-12-14) Page 14