WQ0045727_Application (FTSE)_20240819

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 10-23 & SUPPORTING DOCUMENTATION
�C ,g7A RECEIVED/NCDEO/DWR
Application Number: (to be comP�eted by �wR)
All items must be completed or the application will be returned AUG 19 .2024
I. APPLICANT INFORMATION: WGROS
MOORESVILLE REGIONAL OFFICE
1. Applicant's name: CITY OF HICKORY (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: WARREN WOOD per 15A NCAC 02T .0106(b)
Title: CITY MANAGER
4. Applicant's mailing address: PO BOX 398
City: HICKORY State: NC Zip: 28603-
5. Applicant's contact information:
Phone number: [phone] Email Address: WHAMBLIN n,HICKORYNC.GOV
11. PROJECT INFORMATION:
I. Project name: TRIVIUM I HORIZON
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project ❑ ARPA funded
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: CATAWBA
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.6852' Longitude:-81.2769'
5. Parcel ID (if applicable): 3721 18413201, 372118413185, 372118417510 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: WILLIAM CLAYTON License Number: 040758
Firm: CLAYTON ENGINEERING AND DESIGN
Mailing address: PO BOX 2351
City: HICKORY State: NC Zip: 28603-
Phone number: [phone] Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: HENRY FORK W WTP Permit Number: NCO040797
Owner Name: CITY OF HICKORY
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): WQCS00020
Owner Name(s): CITY OF HICKORY
FORM: FTA 10-23 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 Developer's Operational Agreement FORM: DEV) been attached?
❑ Yes ❑ No ® N/A
3. If the Applicant is a Home/Property Owners' Association, has an HOA/POA Operational Aareement (FORM: HOA) and
supplementary documentation as required by 15A NCAC 02T.0115(c) been attached?
❑ Yes ❑ No ® N/A
4. Origin of wastewater: (check all that apply):
® Residential (Individually 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 / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic % Commercial % Industrial (See 15A NCAC 02T .0103(20))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes El No
6. Has a flow reduction been approved under 15A NCAC 02T .0114(fl? ❑ Yes ® No
➢ If Yes, provide a copy of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow a,n
No. of Units
Flow
RESIDENTIAL (74 - 3 BEDROOM
HOUSES
180 gal/DAY
74
13320 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
13320 GPD
a See 15A NCAC 02T .0114(b), (d), (e)(1) and (e)(2) for caveats to wastewater design flow rates (i.e. 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. 42A-4).
b Per 15A NCAC 02T .01 14(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0114] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 13320 GPD (per 15A NCAC 02T .0114 and G.S. 143-215.1)
➢ 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 timeframe 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 10-23 Page 2 of 5

V11. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & NIDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 2400 PVC
➢ Section 11 & 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
Vlll. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Puma 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 15A NCAC 02T .0305(h)(1):
❑ 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. FTA 10-23 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T.0305(f)):
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T.0305(f) & (g)? ® Yes ❑ No
15A NCAC 02T.0305(f) contains minimum separations that shall be provided 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
'--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, 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 02T.0305(f) or (g), see Section X.I of this application
* 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.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 webpaee
2. Does this project comply with the minimum separation requirements for water mains? ® Yes ❑ No ❑ N/A
➢ If no, please refer to 15A NCAC l 8C.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 ® N/A
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: CATAWBA RIVER BASIN
❑ 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 213.0202
5. Does the project require coverage/authorization under a 404 Nationwide/individual 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.0 I 05(c)(6) (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 interference/conflict boxes require a variance approval.
➢ If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
FORM: FTA 10-23 Page 4 of 5

X. CERTIFICATIONS:
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 version) as applicable?
es ❑ No 6Y1
o
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 permit and proiects requiring a variance approval may be subject to longer
review times For proiects requiring 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:
I, WowAN 1 • 6& n— , attest that this application for Ti':WIU4 /8 Mtamso#j
(Professional Engineer's name from Application Item 111.1.) (Project Name from Application Item ll.l )
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 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 1 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 143-215.6B, 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. 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 Engineers seal, signature, and date: r �1��•�,Ch ?W 1/fJ
J�-`/
�°�p�
3. Applicant's Certification per 15A NCAC 02T .0106(b):
1, iVyeyi ood attest that this application for 1rly (UfY) � H(Sf Mon
(Signature Authority Namc from Application Item 1.3.) (Project Name from Application Item 11.1)
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. 1 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.
�\ -�, "z
Signature: — `.. Date.
FORM: FTA 10-23 Page 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-23)
Entity Requesting Allocation: City of Hickory
Project Name for which flow is being requested: Trivium 1B Horizon
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for al1 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: Henry Fork Wastewater Treatment Plant
b. WWTP Facility Permit 4: NCO040797
All flows are in MGD
c. WWTP facility's permitted flow 9.0
d. Estimated obligated flow not yet tributary to the WWTP 1.2441
e. WWTP facility's actual avg. flow 2.8988
£ Total flow for this specific request 0.0133
g. Total actual and obligated flows to the facility 4.1562
h. Percent of permitted flow used 46.18
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) (E)=(A-D)
Design Obligated,
Pump Pump Average Approx. Not Yet Total Current
Station Station Firm Daily Flow** Current Tributary Flow Plus
(Name or Permit Capacity, * (Firm / pf), Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***
Sandy 4.32 1.728 0.9684 0.4132 1.3816 0.3464
* 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): Hickory Collection System
Downstream Permit Number: WQCS00020
Page 1 of 6
FTqF I n_?'l

III. Certification Statement:
I Warren Wood 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.
Official Signature
Title of
71
Date
Page 2 of 6

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NOT TO SCALE
Owner
Project Title
Date
10-25-19
CLAYTON
HORIZON
REI GROUP, LLC
STARTOWN SUBDIVISION
Job No.
18029
Drawing Title
C-002
ENGINEERING & DESIGN
Project Location
STREET VIEW
HICKORY, NC
snt. 1 of 1

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NOT TO SCALE
Owner
Project Title
Date
10-25-19
HORIZON REI GROUP, LLC
STARTOWN SUBDIVISION
Job No.
CLAYTON
18029
Drawing Title
C-001
ENGINEERING S DESIGN
Project Location
USGS MAP
HICKORY, NC
Sht. 1 of 1

DocuSign Envelope ID: 6A93B137-F8E1-4D98-930C-1F938027D89E
ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Mr. Warren Wood, City Manager
City of Hickory
P.O. Box 398
Hickory, NC 28603
NORTH CAROLINA
Environmental Quality
August 9, 2022
Subject: Residential Flow Reduction Approval
City of Hickory Collection System (WQCS00020)
Catawba County
Dear Mr. Wood:
On June 13, 2022, the Division of Water Resources (Division) received a request for an adjusted
daily sewage flow rate (flow reduction) that would apply to all permitted but not yet tributary
residential connections and all future residential connections within the City of Hickory service
area. Additional information was requested by the Division and was received on August 3, 2022.
In accordance with 15A NCAC 02T .01 14(f)(2), the Division has evaluated the request, and
based on the data submitted, the Division hereby approves for use by the City of Hickory an
adjusted daily sewage design flow rate with the following conditions:
• The, flow reduction is applicable to residential single-family dwellings only.
• The minimum flow for 1- and 2- bedroom dwellings shall be 120 gallons per day.
• Each additional bedroom above two bedrooms shall increase the volume by 60 gallons
per day per bedroom.
• This flow reduction shall not apply to sewer extension applications and/or permits for any
other public or private organizations whose wastewater flows are or might become
tributary to the City of Hickory collection system (WQCS00020).
Future sewer extension applications should be made using the flow reduction amount stated
above. All other aspects of the permitting process remain unchanged, and all applications must
be in compliance with the statutes, rules, regulations and minimum design criteria as certified by
the owner and engineer.
Regardless of the adjusted design daily wastewater flow rate, at no time shall the wastewater
flows exceed the effluent limits defined in the permit for the treatment facility or exceed the
capacity of the sewers downstream of any new sewer extension or service connection(s).
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1 1611 Mail Service Center I Raleigh. North Carolina 27699-161 1
919.707.9000

DocuSign Envelope ID: 6A93B137-F8E1-4D98-930C-1F938027D89E
In accordance with 15A NCAC 02T .0114(f), the Division periodically requires reassessment of
wastewater flow data associated with the collection system or the receiving wastewater treatment
plant as applicable to confirm the suitability of the approved flow reduction value. The City of
Hickory shall submit documented, representative data in accordance with 15A NCAC 02T
.01 14(f)(1 (�A-H) prior to February 28, 2033. Failure to submit the required data by this date will
result in this flow reduction approval letter becoming null and void. Upon review of the data, the
Division shall either reapprove, modify or not grant reapproval for the previously approved flow
reduction value.
The granting of this flow reduction does not prohibit the Division from reopening, revoking,
reissuing and/or modifying the flow reduction as allowed by the laws, rules, and regulations
contained in 15A NCAC 02T, NCGS 143-215.1, or as needed to address changes in State and/or
Federal regulations with respect to wastewater collection systems, protection of surface waters,
and/or wastewater treatment.
If you have any questions, please contact Charlie Miller, P.E. at [phone] or by email at
Charlie.MillerL?ncdenr.gov.
Sincerely,
CDocuSigned by:
AU�Wh
C484531431644FE...
for Richard E. Rogers, Jr.
Director, Division of Water Resources
by Michael Montebello
NPDES Branch Chief, Division of Water Resources, DEQ
CC: Rick Rudin, P.E., Withers Ravenel (rrudin a,withersravenel.com)
Andrew Foy, City of Hickory (afoyghickoryne.gov)
Mooresville Regional Office, Water Quality Regional Operations
Municipal Permitting Unit (electronic copy)
�Lftl/'-
Dq.North Carolina DepartmentofEnviromnental Quality I Digision of Wa[er Resources
512 North Salisbury Street 11611 Mail Service Center I Raleigh,Nm1hCarolina27699-1611
NORr:'I ;tofFm �aa�.u\ / 919.707.9000

CLAYTON-
ENGINEERING & DESIGN
August 15, 2024
NCDEQ - DWR
610 East Center Avenue
Mooresville, NC 28115
Re: Trivium 1 B Horizon — New Sewer Services
Project Narrative
Dear Sir or Madam,
RECEIVENNCDEO/DWR
wo.RUS
MOORESVILLE REGIONAL. OFFICE
Clayton Engineering & Design has been selected by the developer to prepare plans and
specifications for the proposed Trivium 1 B Horizon Development on a vacant parcel of land on
Startown Road N.E. in Hickory, NC. Site development will require the construction of 8" gravity
sewer line to serve the residential development.
If you have any questions or need additional information, please feel free to call me at
[phone] or email wclayton(D-clayton-engineerinq.net.
Sincerely,
Clayton Engineering & Design, PLLC
Adzaw Y,, ufilaGytaft
William S. Clayton, PE
President
304 151h Street SE/PO Box 2351 Hickory, NC 28603 [8281455-3456 P-1463
Page 11