WQCS00093_Renewal (Application)_20240923 (2)

PubBe Uffides
CoBecdov System Penl2itApplication

832 Main Street
North Wilkesboro, NC 28659
336-667-7129
David Poore
Public Utilities Director
(336) 928w5377
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Danny Porter
Utility Maintenance Supervisor
[phone]
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?ach .Stines
Utility System Operator
[phone]
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Dear Mom. Schneider,
Enclosed please find the completed form CSA04-16, System -wide
Wastewater Collection System Application for the Town of North
Wilkesboro Public Utilities. The Town of North Wilkesboro is
requesting a renewal of our collection system permit.
We have included a complete application form, pump station list,
high priority line xist, ia full map of the coilection system, the
operating budget for fiscal year of 2024, the sewer overflow
response plan, and the contingency plan.
Please don't hesitate to confact us if you need any additional
information. Thank you for your assistance in this matter.

State of North Carolina
Department of Environmental Quality
D WIR Division of Water Resources
15A NCAC 02`I' .0400 — SYSTEM -WIDE WASTEWATER COLLECTION SYSTEMS
Division of Water Resources INSTRUCTIONS FOR )CORM CSA 04-16 & SUPPORTING DOCUMENTATION
Documents shalt be prepared in accordance with 15A NCAC 02T .0100. 15A NCAC 02T .0400. and all relevant
Division Policies. Failure to submit all required items will necessitate additional processing and review time.
.For more information, visit the Si-steal-w 1e Collection S stgni Perinittirig fiebsite:
General — When Submitting an application to the Municipal.Permitting Unit, please use the following instructions as a
checklist in order to ensure all required items are submitted. Adherence to these instructions and checking the provided
boxes will help produce a. quicker review time and reduce the amount of requested additional idfotanation.
The An�licant shall. submit one original and one cony of the application and,uogortin#; documentation.
The copy may be submitted in digital format.
A. Cover Letter
x Submit a cover letter listing all items and attachments included in the permit application package
B. No Application Fee Required.
No application. fee is necessary. The permittee will be billed an annual fee upon issuance of the permit
The appropriate annual .fee for systemwide 'wastewater collection system permits may be found at:
Annual lion- 3 schan�e Fees
C. System -Wide Wastewater Collection. System (FORTI: CSA 04-16) Application:
X Submit the completed and appropriately executed System -wide Wastewater Collection System (FORM; CSA 04-
16) application. Any unauthorized content changes to this fonn shall result in the application package being
returned, :If nee essary 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.
x If the Applicant Type in Section. 1.3 .is a Privately -Owned Public, Utility, provide the Certificate of Public
Convenience and Necessity (CPCN) from. the North Carolina Utilities Commission demonstrating the Applicant is
authorized to hold the utility franchise for the area to be served by the wastewater collection system, or
X Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an
application for a franchise has been received and that the service area is contiguous to an existing franchised area
or that franchise approval is expected.
x If the Applicant Type in Section 1.3 is a corporation or company, provide documentation if it is registered for
business with the North Carolina Secretary of State.
D. General Information:
The Authorized signing official listed in. Section 1.4 should match with that of the Applicant certification page in
accordance with 15A NCAC 02T .0106(b . Per .I SA ?`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).
i NOTE - Public Works Directors are not authorized to sign this permit application, according to the rule,
unless they are formally delegated.
INSTRUCTIONS FOR APPLICATION CSA 04-16 & SUPPORTING DOCUMENTATION Page I of 5

E. Summary of Attachments Required:
x Instruction A: Cover Letter
x Instruction C: Application
❑ Instruction C: Ownership Documentation (i.e. CPCN) (If necessary)
❑ Instruction D: Delegation Letter (If necessary for signing official)
x Section IV.3 Pump Station List
x Section IVA High Priority Lines List
x Section VA Annual Budget for Collection System (Updated and Approved)
x Section V.6 Capital Improvement Plan (Updated and Approved)
x Section VI.2 Response Action Plan
x Section VI.4 Contingency Plan
x Section VI.6 Comprehensive Collection System Map
© Section VII Note Any Potential Compliance Issues
THE COMPLETED APPLICATION PACKAGE, INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO:
NCDEQ-DWR
Water Quality Permitting Section
MUNICIPAL. PERMITTING UNIT
By U.S. Postal Service: B Courier/Special Deliver)
1617 MAIL SERVICE CENTER 512 N. SALISBURY ST. Suite 925
RALEIGH, NORTH CAROLINA 27699-1617 RALEIGH, NORTH CAROLINA 27604
TELEPHONE NUMBER: [phone] TELEPHONE NUMBER: [phone]
INSTRUCTIONS FOR APPLICATION CSA 0446 & SUPPORTING DOCUMEN i ATION Page 2 of 5

I, .APPLICANT INFORMATION:
1. Applicant's name (Municipality, Public Utility, etc): Town of North Wilkeslaoz'o
2. Facility .Information: Name: North Wilkesboro Collection System Permit No.: WQCS0093
3. Applicant type: x Municipal ❑ State El- Privately -Owned Public Utility
❑ County ❑ Other:
4. Signature authority's name: Danny Porter per 15A NCAC 02T .0106f )
Title: Utility Maintenance Supervisor
5. Applicant's mailing address: 83.2 Main St
City: North Wilkesboro Stater NC Zip: 28659
6. Applicant's contact information;
Phone number: (33L466-6061 Email address: uttli:°,-mait2i�ct7l orffiwil esbgo n
I.I. CONTACTlCONSULTAINT INFORMATION:
1. Contact Name: Zach Stines
2, TitlelAEFiliatiom Utility System Operator.
3. Contact's mailing address: 932 Main St
4. City: North Wilkesboro State. NC Zip: 28659
5. Contact's information:
Phone number: 336) 466-5262 Email address: waterseWer:.dyiioithwilkesboronq.gdv
III. GENERAL REQUIREMENTS:
1. New Permit or Permit Renewal? F 1 New x Renewal
2. County System is"located in: Vdilkes County
3. Owner & Name of Wastewater Treatment Fatility(ies) receiving wastewater from this collection system:
Owners) & Name(s): Town of North Wilkesboro
=1. WWTF Permit Number(s): NC0020761
5. What is the wastewater type? 95.3 % Domestic or 4.7 %.Industrial (See 5A NCAAC 02T ,0103 20
is tllen a .Pretreatment Program in effect? x Yes or No
6. Wastewater flow: 1.09 MOD (Current average flow of wastewater. generated by collection system)
7. Combined permitted flow of all treatment plants: 2 M(D
8. Explain how the wastewater flow was determined: C{ 1.5A NCAC 02T .0114 or x Representative Data
9. Population served by the collection system: A - x. 5.000
IV. COLLECTION SYSTEM. INFORMATION:
APPLICATION CSA. 04-16 Page 3 of 5

1. Line Lengths for Collection System:
Sewer Line Descri on
Length
i _Gravity Sewer
64 miles)
Force Main
12 ( miles)
Vacuum Sewer
_
0 miles
Pressure Sewer !
0 (miles)
2. Pump Stations for Collection
Stations
Station Tree tilt
18
3. Submit a list of all major (i.e. not simplex pump station serving a single family home) pump stations. Include the following
information:
A Pump Station Name
Physical Location
Alarm Type (i.e. audible, visual; telemetry, SCADA)
i� Pump Reliability (Can convey peak hourly wastewater flow ,with largest single pump out of service)
Reliability Source (permanent/portable generator, portable pumps)
Capacity of Station (Pump Station Capacity in GPM)
4. Submit a list of all high priority lines according per 15A NCAC 02T .0402i 2; known to exist in the collection system. Head
the list with "Attachment A for Condition V(4)" and include the system. name.
➢ Use the same line identification regularly used by the applicant
Indicate type of high priority line (i.e. aerial), material and general location
V. COLLECTION SYSTEM ADMINISTRATION:
I. Provide a brief description of the organizational structure that is responsible for management, operation and maintenance of
the collection system,
Town Mana_er — Public Utilities Director — Utilia: Maintenance Su ervisdr
2. indicate the current designated collection system operators for the collection system per 15A NCAC 0 '.0201
Main ORC Na ne: Danny Porter _ Certification. Number: 1013986
Back-CJp ©itC Name: each Stines ti Certification Number: _1008455
See the " WQCS Contacts and ORC Re0ort" for a current listing of the ORC(s) the Division has on file for WQCS permit
3. Approximate annual budget for collection system only: $ 167.050
4. Submit a copy of your.current annual budget.
5. Approximate capital improvement budge for the collection system only: S �
6. Submit a copy of your current capital. improvement plan,
7. Is this collection system currently a satellite system ❑ Yes or >, No
& Do any satellite systems discharge to this collection system ❑ Yes or x No (If yes complete table below)
APPLICATION CSA 04-16 Page 4 of 5

Contact Information i Name, Address -Phone N
Complete for Satellite Systems that have a flow or capacity greater than 200,000 GPD (Average daily flow)
9. List any agreements or ordinances currently in place to address flows from satellite systems:
VI. COLLECTION SYSTEM COMPLIANCE:
1. Is a Response Action Plan currently in place X Yes or [] No
2. If Yes, submit a copy of the Response:Action Plan or see table 6 below.
3. Is a pump station contingency plan currently in place? X Yes or [Q No
4. If Yes, submit a copy of the pump station contingency plan or see table 6 below.
5. Is a comprehensive collection system snap currently in place? x Yes or ❑ No
6. Submit a submit a copy of the collection system map (CD or hardcopy) or indicate a schedule for completion
7. Thoroughly read and review the System -Wide Collection Svstern Permit Conditions. Types row4&mce scleeduls
are only offered to NEW perms app&ants =d NOT pewit renewal. Any compliance dates trust be included within
the permit prior to issuance or the permit holder will be found in violation upon inspection.
_
Permit Condition
Current
?
Compliance,?
IPno, Indicate a
Compliance
Date
- Typical
Compliance
Schedule
1(4) - Grease ordinance with legal authority to .inspectfenforce
X Yes ❑ No
i
12 - 18 mo.
12 - 18 mo.
1(5) - Grease inspection and enforcement program
x Yes El No
1(6) - Three to five year current Capital Improvement Plan.
x. Yes No
12 - l8. mo.
I(8) -Pump station contingency plan
X Yes ❑ No
3 mo.
1(9) - Pump station identification signs. X Yes ❑ No
3 mo.
1(] 1) - Functional and conspicuous audible and visual alarms.
f x Yes n No
3 -- 6 mo.
11(5) - Spare pumps for any station where one pump cannot
handle peak flows alone (in a duplex station, the 211 pump is
the spare if pump reliability is met),
1.1(7) - Accessible right-of-ways and easements. - -
Yes No
x 'Sees ❑ No
6 - 9 ma.
6 - 12 mo.
II(9) - Response action plan with Items 9 (a - h).
j X Yes ❑ No
3 mo.
10% per year
M(3) - Comprehensive collection system map
X Yes ❑ No
For conditions not listed, compliance dates are not typically offered. List any permit conditions that may be difficult for the
applicant to ineet (attach clarification if needed):
VIL APPLICANT'S CERTIFICATION per 15A NCAC 02T .01+96(b}:
I, Anoy "ironrxr -rd hw Atmom attest that this application for -751WA e.V&
APPLICATION CSA.04-16 Page 5 of 5

(Signature Authority's Name & Title from Item 1_4)
(Facility name from Item 1.1)
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 requiredsupporting, information and attachments are not included, this application. package
will be returned to me as. incomplete.
Note: In accordance with NC General Statutes 143-215.6.A and 4 r-2I 1.013, any person who knowingly makes any false statement,
represcntation, or eertifigation in any application shall be guilty of f Class 2 misdemeanor which may include a fine not. to exceed
S 10,000 as well as civil
—p�'na sup to $2 ,000 Per violation.
._.D.._.....Signature: ��- .._._._Bate:
f
APPLICATION CSA 04-16 Page 6 of 5

Town of North Wilkesboro Lift Stations
Station Name
Address
Alarm Type'
Reliability uReliability
Source
Portable Generator
Portable Generator
Portable Generator
Portable Generator
Portable Generator
Portable Generator
GPM
268
444 Elkin Highway
SCADA
YES
420
Shady Lane
8 Shady Lane SCADA
200 Northwest Reservoir Road SCADA
1098 Coffey Ave T SCADA
3025 Pearson Street SCADA
3237 River Road SCADA
YES
Reddies River
YES
300
40
Finley Park
The Rock
River Road 4
YES
YES
YES
River Road 3
River Road 2
River Road 1
�T VFW
2125 River Road
SCADA
YES �'
Portable Generator
i
400
1185 River Road
SCADA
SCADA
SCADA
YES
YES
YES
ll_._...P...ortable Generator
Portable Generators
S ant dby Generator
829 River Road
904 Veterans Drive
Lincoln Heights
379 Lincoln Heights Road
SCADA
YES Standby Generator
W�
Carolina Motel
150 Carolina Motel Circle
SCADA
YES Portable Generator
160
Speedway Road 25 Speedway Road
SCADA
YES I Portable Generator
�Sojangles(MK) 145 Kite road
SCADA
YES Portable Generator
YES Standby Generator
YES Portable Generator
v
Congo
659 Union Methodist Church
Road
SCADA
��
West Park
526 West Park Circle
SCADA
200 I
L AQC
251 Wilkesboro Avenue
SCADA
YES i Standby Generator _

:a

Town of North Wilkesboro
High Priority Lines
Location
Size and Material
8" Gravity
Main Type
444 Elkin Highway (at lift station)
Cl
1398 Elkin Highway (beside bridge)
10" Gravity
DI
1398 Elkin Highway (on sewer line right
away)
10" Gravity
DI
802 Beech Street (opposite side of property
from entrance
8" Gravity
CI
118 Peace Street (fine goes across to
highland parK
8" Gravity
Cl
201 Main Street (line goes across to DOT)
_ 8" Gravity. ^�
DI
109 Colonial Drive (line is before colonial 8" Gravity
_ drive)
303 Statesville Road (line is on right away — 12" Gravity
behind DOT salt sired
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Collection
1C.'ontingency Plain for Town of North Wilkesbor-,
Wastewater
The I own's Wastewater Collection System consists of lift stations, light
alarm system, dialer alarms and gravity sewer.11nes.
1. objective of plan: Normal level of service
2. Critearia for Invoicing plan.- Severe Storms, Heavy rains and Power
outages, pump failures to one or more lift stations
3. Life Of Flaw until .electricity is restored aced flowers have peaked and pumps
are working propOtly.
4. Roles, responsibilities, and authority: The Public Utilities Director will be in
charge of operating this contingency plan. Utilities Director will assign workers In the
department as needed. If additional personnel are needed, Utili'tles Director will have
the author,: ty to use personnel starting from the water/wastewater departments,
street department and the parks department. If the Public Utilities director is.
unavailable, the Utility -Superintendent or the Water/Wastewater operators.will
assume the responsibi-ilties outlined In this plan.
S. Procedures for invoking contingency mode: The public utilities director will
assign employees to monitor the system beginning July 1, 2006 on an emergency
basis until It is clear that there are no problems with the -operations of the system.
If an employee discovers a problem, he/she will notify the public Utilities director
immediately and describe the nature of the problem (e.g. no electricity to one or all
lift stations or pump failure). The public utilities director will determine if additional
employees are needed...and if so will notify the other employees to report to duty.
He/she will assign them emergency responsibilities.
6. procedures for operating in contingency made
'�_R ap Isle aeneraetoars The town has two portable generators that can operate
_= the lift stations. The lift stations have the same receptacle so that they can be run
with the portable generator. Based on the storage in the lines and the wet well of the
lift station, the public Utilities director will assign employees to transport and hook up
the portable generator to the lift stations. If more them two lift stations are not
working, the public utilities director will establish a schedule to rotate the generator
between the lift stations. The rain lift station is connected to the wastewater
treatment facilities generator. If necessary; the utilities director will try to obtain an
additional generator -through rental or mutual -aid agreement. • . .
* a m-M Treacle - In cause one lift station that does not have a generator
receptacle so we will use the vacuum truck to pump sewage if need be. Also if the
generators are not able to handle the flow, the city will pump sewage out of the lift
stations with the vacuum truck. The public utilities director- will assign employees to
pump sewage using this truck.
* Lift Station Bypass - Because of the vicinity of two of the lift stations, we could
be able to establish a line to by pass the lift station. If needed, the public utilities

director will contact a contractor to construct this line. Thisis not an option for all lift
stations because either crossing a highway or the distance is too great.
* WMr restriction - If a city-wide or region wide power outage lasts more than
one day, the city will consider restricting community water usage (this is to reduce
flow of wastewater through the system).
7. Resources plan for operating in contingency mode
* Personnel - 14 water/wastewater employees, 12 public works employees.
* Vacuum truck
* Portable generators
Two trash pumps for lift'station bypasses
* Trucks to transport or tow generators
* Sewer jetter
S. Criteria for returning tp normal operation mode: Electricity restored to. all lift
stations and flow returns to normal to wastewater plant.
g. Procedures for returning to. normal operating mode
* Disconnect any portable generators that are connected to lift stations.
• Remove any bypasses from any manhole or lift stations
* Clean up any overflows
10, Post continfgency plan.- The public utilities director will meet. with the
personnel who assisted in operating this plan to determine flow it worked. If
necessary, changes will be made for any future emergencies.
13. Testing.of contingency plan- Prior to July 12006, the water/wastewater
departments will provide training to all employees on how to Implement this plan.

Town of North Wilkesboro Sewer lit Station
Emergencv Pone Numbers
I I y;;pii11
�. ;.
Danny Porter Utilities Supervisor Town Cell 336-466-6061 Personal Cell
336-262-9760
David Poore (Utilities Director) Town cell 336-925-5377
Zach Stines Town Cell 336-466-5262 Personal Cell 336-467-0376
Scott Perry ( Waste Water Plant Supervisor) Town Cell 336-466-5270
Justin Shell ( Waste Water Plant CPO) Town Cell 336-466-5269
Steven ['\McNeil Town Cell 336-466-5274 Personal Cell 336-984-1922
.David Webb (Public Works Director) Town Cell 336-466-1315 Personal
Cell 336-957-1462
Walter Church (Personal Cell) 336-927-3,534
Joe Patrick (Water Plant Supervisor) 336-466-5266 Personal 336-927-
9572

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