WQCS00297_Permit (Issuance)_20240910

State of North Carolina
Department of Environmental Quality DWR Division of Water Resources
15A NCAC 02T .0200 — WASTEWATER PUMP AND HAUL SYSTEMS
Division of Water Resources INSTRUCTIONS FOR FORM P&H 11-23 & SUPPORTING DOCUMENTATION
Documents shall be prepared in accordance with ISA NCAC 02T.0100, ISA NCAC 02T.0200, and Division policies. Failure to submit
all required items will necessitate additional processing and review time. For more information, visit the Wastewater Branch's
website or contact the Regional Office serving your county.
General —This permit application applies to all pump and haul activities of wastewater under the authority of the Division on Water
Resources. Permit coverage is required for the system producing the wastewater. This permit does not apply to the transport of
animal waste from an animal waste management systems, nor the transport of wastewater residuals or biosolids.
NOTE: Pump and haul permits are not acceptable long term domestic wastewater treatment alternatives and shall only be issued
In cases of environmental emergencies, nuisance conditions, health problems, or for unavoidable delays in construction of system
previously permitted by the Division.
A. Pre -submittal Contact & Cover Letter RECEIVED
❑ Contact the appropriate Regional Office prior to submittal SFP 0 3 2024
® Submit a cover letter explaining the circumstances associated with this pump and haul permit reques L ,1-714-1
B. Application Fee (Domestic Wastewater Only) DEQ•FAYETTEVILLE RE IONALOFFICE
® Submit a check made payable to: North Carolina Department of Environmental Quality (NCDEQ)
➢ The appropriate application fee is: $1,160.00 for flows < 10,000 GPD and $1,760.00 for flows > 10,000 GPD
C. Wastewater Pump and Haul (FORM: P&H 11-23) Application:
® Submit the completed and appropriately executed Wastewater Pump and Haul (FORM: P&H 11-23) application. Any
unauthorized content changes to this form shall result in the application package being returned. If necessary for clarity or
due to space restrictions, attachments to the application may be made, as long as the attachments are numbered to
correspond to the section and item to which they refer
D. Receiving Facility Letter:
® Submit a letter from the owner/authority of the receiving wastewater treatment facility, as required by 15A NCAC 02T.0204
(b), stating that the pumped and hauled wastewater will be accepted and specifying the volume and type of wastewater that
will be accepted. The letter should be signed by an authorized signing official in accordance with 15A NCAC 02T.0106(b)
E. Contract Hauler Letter:
iD Submit a letter from the hauler stating their capability and willingness to perform the pump and haul activity
® Letter shall include: Owner/Company Name, Contact Information, & Hauling Volume of Vehicle(s)
F. Certifications:
❑ The Applicant's Certification on Page 4 of the application shall be signed in accordance with 15A NCAC 02T.0106(b). Per 15A
NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is provided from a
person who meets the criteria in 15A NCAC 02T.0106(b)
❑ The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North Carolina
licensed Professional Engineer (if required)
G. Plans and Specifications (Required for activities that result in the Practice of Engineering per G.S. 89C-3):
® Submit one set of printed plans and specifications (signed, sealed and dated by a N.C. Licensed Professional Engineer) and
provide one copy in digital electronic format (PDF file)
® Plans must include:
➢ A general location map
➢ Diagram of the components associated with the pump and haul activity (drains, piping, tanks, pumps, etc)
➢ Tank Details that indicate high water alarm
➢ Other items as required
INSTRUCTIONS FOR APPLICATION P&H 11-23 Page 1 of 5

Industrial Pump and Haul Activities
Per 15A NCAC 02T.0203(A)(21. Industrial pump and haul activities are deemed permitted provided the following criteria Is met:
➢ The facility notifies the appropriate Division regional office in writing advising of the type of operation, type and quantity of
wastewater generated, location, and the receiving wastewater treatment facility. A letter from the facility accepting the
wastewater (type and quantity) specifically agreeing to accept wastewater from the applicant shall be included.
➢ The wastewater does not contain any human waste.
➢ The waste is collected and discharged into a sewer or treatment system designed and permitted to accept the type of
wastewater being pumped and hauled.
➢ The pump and haul activity is not to alleviate a failing wastewater system.
➢ The Division regional office concurs in writing that the activity meets the criteria in this Rule.
CONTACT THE REGIONAL OFFICE PRIOR TO INITIATING ANY INDUSTRIAL PUMP AND HAUL ACTIVITIES. SUBMITTAL OF THIS
APPLICATION/DOCUMENTS AND WRITTEN APPROVAL IS STILL REQUIRED FOR INDUSTRIAL PUMP AND HAUL ACTIVITIES
THE COMPLETED APPLICATION PACKAGE INCLUDING ALL SUPPORTING INFORMATION AND MATERIALS, SHOULD BE SENT TO THE
APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Quality Operations
Swannanoa, North Carolina 28778
Clay, Graham, Haywood, Henderson, Jackson,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Operations
Fayetteville, North Carolina 28301
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[phone] Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Water Quality Operations
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
Raleigh Regional Office
1628 Mail Service Center
Chatham, Durham, Edgecombe, Franklin,
Water Quality Operations
Raleigh, North Carolina 27699-1628
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
Beaufort, Bertie, Camden, Chowan, Craven,
Water Quality Operations
Washington, North Carolina 27889
Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Water Quality Operations
Wilmington, North Carolina 28405
Hanover, Onslow, Fender
[phone]
[phone] Fax
Winston-Salem Regional Office
450 W. Hanes Mill Road
Alamance, Alleghany, Ashe, Caswell, Davidson,
Suite 300
Davie, Forsyth, Guilford, Rockingham, Randolph,
Winston-Salem, North Carolina 27105
Stokes, Surry, Watauga, Wilkes, Yadkin
(336)-776-9800
INSTRUCTIONS FOR APPLICATION P&H 11-23 Page 2 of 5

V. PROJECT INFORMATION:
1. Project Name: Nathans Ridge
2. Project Location: 670 Tripp Road Lillington NC
3. Duration of Pump and Haul Request (not to exceed 6 months): 6 months
4. Hasa prior permit been issued?
® New ❑ Prior Pump & Haul Permit
Permit No.:
5. Permanent Method of Wastewater Disposal: OJIg p Y.=t�7d8
6. Date Permanent Disposal will be available: . Zfl2
7. Have permits / approvals for permanent disposal been obtained?
a. 5� Yes ❑ No Permit Number: &,r*�0961 6
8. Is there a Pretreatment Program in effect? ❑ Yes ❑ No
9. Describe any pretreatment prior to pumping and hauling:
10. Volume of Wastewater Generated: 22,275 (99 Residential Homes @ 75gpd/br) Gallons per Day
11. Explain how the wastewater flow was determined: ® 15A NCAC 02T .0114 or ❑ Representative Data
If representative data, describe: or 75 gpd/bedroom, if applicable (House Bill 600 Section 18)
12. Describe Tank / Container wastewater will be pumped from (attach description if necessary):
21,000gpd frac tank. Description attached. Additional storage wtihin sewer system (see attached calculations)
13. Is Tank / Container in place or will it be installed (attach description if necessary):
It will be installed. Descriptions attached.
manhole and gravity sewer system is currently installed under WQ0043868.
14. What type of high water alarm does the container have:
2. ® Audible and Visual ® Telemetry (Auto Dialer / SCADA)
VI. CERTIFICATION:
1. Applicant's Certification: (Signature of Signing Official and Project Name)
I,Ashlev Wimberiv, attest that this application for Nathans Ridge 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 issuance of a permit will require pump and haul facilities or activities to be inspected at least
daily by me or a designated representative. Note: In accordance with North Carolina General Statutes 143-215.6A and 143-
215.66, any person who knowingly makes any false statement, representation, or certification in any application 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.
1a. O j v - 1
Signinq#fficial Signature Date
APPLICATION P&H 11-23 Page 4 of 5

We? 00XO-7t17
I. PRESUBMITTAL INFORMATION:
1. Contacted representative from regional office (Pre -submittal)?: ® Yes ❑ No
2. Contact name (For Regional Office): Trent Allen
II. APPLICANT INFORMATION:
1. Applicant's name (Municipality, Individual, Corporation, etc): Town of Lillington
2. Applicant type: ®Municipal ❑ State ❑ Privately -Owned Public Utility
❑ County ❑ Other:
3. Origin of Wastewater:
® Residential Subdivision
❑ Apartments/Condominiums
❑ Mobile Home Park
❑ School
❑ Restaurant
❑ Office
❑ Retail (Stores, Shopping Centers)
❑ Institution
❑ Hospital
❑ Church
❑ Nursing Home
❑ Other (specify)
4. Signature authority's name: Ashley Wimberly per 15A NCAC 02T.0106(b)
Title: Public Works Director
5. Applicant's mailing address: 102 E Front Street
City: Lillington State: NC Zip: 27546-_
6. Applicant's contact information:
Phone number: [phone]
III. CONTACT/CONSULTANT INFORMATION:
1. Contact name: Shane Cummings
Title/Affiliation: Town Engineer
2. Contact's information:
Phone number: [phone]
IV. RECEIVING FACILITY INFORMATION:
Domestic:
Commercial:
Industrial:
Other:
Email: awimberly(@lillingtonnc.org
Email: scummings0lillingtonnc.org
100 %
%
If more than 1 facility has agreed to accept the wastewater, please list all the owners, facility names, and permit
numbers as a separate. attachment)
1. Owner: Harnett Regional Water
2. Facility name: North Harnett Regional WWTP
3. Facility permit number: NCO021636
4. WWTF permit number: NCO021636
5. WWTF contact name: Kenneth Fail
Title/Affiliation: Wastewater Superintendent
6. WWTF contact information:
Phone number: [phone] Email: [e-mail]
APPLICATION P&H 11-23 Page 3 of 5

ENGINEERING DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL,
ACTIVITIES SHALL BE INSPECTED AT LEAST DAILY BY THE PERMITTEE OR IT'S REPRESENTATIVE PER 15A NCAC 02T.0204(d).
THE ENGINEER'S CERTIFICATION IS REQUIRED FOR ACTIVITIES THAT RESULT IN THE PRACTICE OF ENGINEERING PER G.S. 89C-3.
ENGINEERING DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL. IF CERTIFICATION BY AND ENGINEER IS REQUIRED,
THIS PAGE IS NOT NECESSARY.
Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
I, Thomas Cummings ,attest that this application for Nathan's Ridge has been reviewed by me and is accurate, complete and
consistent with the information in the engineering plans, 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
all the applicable regulations. 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 NC General Statutes 143-215.6A and 143-215.6B, any person
who knowingly makes any false statement, representation, or certification in any application 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.
Thomas S Cummings
Professional Engineer Name
Town of Lillington
Engineering Firm
102 E Front Street
Mailing Address
Lillington 2e. NC 2f. 27546
City State Zip
910-893-0314 2h. 21. [e-mail]
Telephone Facsimile E-mail
i SEAL
046016 CO
,�,aINEER
''9s S....CL)V. ?
NC PF Seal. Signature 9, Data
APPLICATION P&H 11-23 Page 5 of 5

l
HARNETT
REGIONAL
WATER
To: Shane Cummings 7/8/2024
Town Engineer
Town of Lillington
Subject: Pump and Haul Request (Nathan's Ridge Subdivision)
Mr. Cummings,
m .harnettwater.org
PO BOX 1119
700 McKinney Parkway
Lillirgton, NO 27546
ph: 910-893-7575
tax: 910 893-6643
I have reviewed your pump and haul permit document request and hereby agree to take
this flow as outlined at North Harnett Regional W WTP. Below you will find the
information necessary to complete your permit.
Owner: Harnett County
Facility Name: North Harnett Regional W WTP
Facility Permit M NCO021636
WWTF #: NCO021636
Contact: Kenneth W. Fail
Title/AFF: Wastewater Supt.
Phone:[phone]
Email: kfail0hamett.or-,
Please do not hesitate to contact me if you have any questions or concerns.
Regards, p
Kenneth W. Fail
Wastewater Supt.
Harnett Regional Water
Dr-0110WR
AUG 16 2.o-2d
WQROS
cAYET7F1111 I cvcrtnhial nFrICF

GERALD TEMPLE BACKHOE SERVICE, LLC
1636 Temple Road
Bunnlevel, North Carolina 28323
Phone: [phone] Fax: [phone]
ENI # 27-4265435
NCS 00387 Septic Firm
IV 1178 Installer and Inspector
S.S. 11917 Sub Surface Operator
11781Inspector
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DocuSign Envelope ID: 35239C3B4D67-4A4B-BF54-AB4F6E6CA1 DB
FLEETTEMPLE
ENGINEERING
PLLC
July 3, 2024
5245 Red Hill Church Rd
Coats, NC 27521
910.658.2446
[e-mail]
Firm License P-2357
Town of Lillington RECEIVED
102 E. Front St. SEP 0 3 2024
P.O. Box 296
Lillington, N.C.27546 DEQ•FAYETfEVILLEREGIONAL OFFICE
Re: Nathan's Ridge
Sewer Volume for Pump & Haul @ SSMH#1
The following is calculation for storage volume in 12" & 8" sanitarysewer for Pump &
Haul permit:
Controlling elevation is SSMH#11 with a top elevation of 247.86.
Calculations are based on elevation 246.00 (1.86' below SSMH#11 Top Rim Elevation)
for the installed 12" & 8" sanitary sewer mains and neglects any additional storage
provided by manholes and sewer services.
Linear footage/volume of 12" sewer mains below elevation 246.00:
MH1-2-3-4: 911LF = 71 CF
MH4-5-6-7-8-9-10-11-12-137 1265LF = 993CF
Linear footage/volume of 8" sewer mains below elevation 246.00:
MH4-14-15: 595LF = 207CF
MH7-16: 42LF =14CF
Nicoll•eG • ► • • .••
Sincerely,
7/3/2024

I. PRESUBMITTAL INFORMATION:
1. Contacted representative from regional office (Pre -submittal)?: ® Yes ❑ No
2. Contact name (For Regional Office): Trent Allen
II. APPLICANT INFORMATION:
1. Applicant's name (Municipality, Individual, Corporation, etc): Town of Lillington
2. Applicant type: ®Municipal ❑ State ❑ Privately -Owned Public Utility
❑ County ❑ Other:
3.
Origin of Wastewater:
® Residential Subdivision
❑ Retail (Stores, Shopping Centers)
Domestic: 100 %
❑Apartments/Condominiums
❑Institution
Commercial: %
❑ Mobile Home Park
❑ Hospital
Industrial: %
❑ School
❑ Church
Other: %
❑ Restaurant
❑ Nursing Home
❑ Office
❑ Other (specify)
4.
Signature authority's name: Ashley Wimberly per 15A NCAC 02T .0106(b)
Title: Public Works Director
5.
Applicant's mailing address: 102 E Front Street
City: Lillington State: NC Zip: 27546-
6.
Applicant's contact information:
Phone number: [phone]
Email: [e-mail]
III. CONTACT/CONSULTANT INFORMATION:
RECEIVED 0/
1.
Contact name: Shane Cummings
SEP 0 3 2024
Title/Affiliation: Town Engineer
� r7`���
2.
Contact's information:
DEO-FAA- VILLE REGIDNALOFHCF
Phone number: [phone]
Email: [e-mail]
IV. RECEIVING FACILITY INFORMATION:
t4.-..- a6.... � <....:I:a.. L......�......J a............♦ a4... ...... •.......a,.. ..1.... �.. 6�a ..11 •4... ........� f�Al:a.. o...l n m:a
FIRST BANK, N.A. 050 66-456/531
LILLINGTON, NC 27546
UEN IHAL DATE
08/29/2024
PAY ****1 THOUSAND 760 DOLLARS AND 00 CENTS ****
PAY NCDEQ
TO THE 225 GREEN STREET SUITE 714
ORDER FAYETTEVILLE, NC 28301
OF:
CHECK NO.
60803
CHECKAMOUNT
$1,760.00
This Instrument has been pre -audited in the manner required by the
LOCA GOV&RNMENT BUDGE and FISCAL CONTROL ACT.
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