WQ0039803_Final Permit_20180212

0
Permit Number W00039803
Central Files APS _ SWP
2/12/2018
Permit Tracking Slip
Program Category
Status
Protect Type
Non -discharge
In review
New Project
Permit Type
Version
Permit Classification
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
A
Individual
Primary Reviewer
Permit Contact Affiliation
ted cashion
Cary NC 27511
Scheduled
Coastal SWRule
Ong Issue App Received Draft Initiated Issuance
Public Notice Issue Effective Expiration
Permitted Flow
2/14/2018 2/14/2018
Regulated Activities
0
Subdivision
Additional information requested 2/5/18
Facility
Additional information received 2/6/18
Outfall
Facility Name Ma/or/Minor Region
Utility Relocation for NCDOT Minor Raleigh
Location Address County
Chatham
Facility Contact Affiliation
Owner
Owner Name
Owner Type
Aqua North Carolina Inc
Non -Government
Owner Affiliation
Shannon V Becker
President
202 Mackenan Ct
Dates/Events
Cary NC 27511
Scheduled
Ong Issue App Received Draft Initiated Issuance
Public Notice Issue Effective Expiration
2/14/2018 1/5/2018
2/14/2018 2/14/2018
Regulated Activities
Requested /Received Events
Subdivision
Additional information requested 2/5/18
Wastewater collection
Additional information received 2/6/18
Outfall
Waterbody Name Streamindex Number Current Class Subbasm

Water Resources
ENVIRONMENTAL QUALITY
February 14, 2018
Moses A Thompson, Director of Operations
Aqua North Carolina, Inc
202 MacKenan Court
Cary, NC 27511
Subject Permit No WQ0039803
Aqua North Carolina, Inc
Utility Relocation for NCDOT
Wastewater Collection System Extension Permit
Chatham County
Dear Mr Thompson
ROY COOPER
cove, no,
MICHAEL S REGAN
Sea etmy
LINDA CULPEPPER
Into un Du ectoi
In accordance with your application received January 5, 2018, and additional information received on
February 6, 2018, we are forwarding herewith Permit No WQ0039803 dated February 14, 2018, to Aqua
North Carolina, Inc (Permittee) for the construction and operation upon certification of the subject
wastewater collection system extension This permit shall be effective from the date of issuance until
rescinded and shall be subject to the conditions and limitations as specified therein This cover letter shall
be considered a part of this permit and is therefore incorporated therein by reference
This force main project was originally permitted as part of permit number WQ0023620 This permit is
needed in order to relocate the force main due to replacement of an NCDOT bridge on SR 1520.
Please pay particular attention to the following conditions contained within this permit.
Condition II 1• This permit shall not be automatically transferable, a permit modification request for a
name change must first be approved by this office
Condition II 4 Requires that the wastewater collection facilities be properly operated and maintained
in accordance with 15A NCAC 2T 0403 or any individual system -wide collection system
permit issued to the Permittee
It shall be the responsibility of the Permittee to ensure that the as -constructed project meets the
appropriate design criteria and rules Failure to comply may result in penalties in accordance with North
Carolina General Statute §143-215 6A through §143-215 6C, construction of additional or replacement
wastewater collection facilities, and/or referral of the North Carolina -licensed Professional Engineer to
the licensing board.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to
request an adjudicatory hearing upon written request within 30 days following receipt of this permit This
request must be in the form of a written petition, conforming to Chapter 1506 of North Carolina General
Division of Water Resources. Raleigh Regional Office, Water Quality Opeiatlom Section www ncwaterquality org
1628 Mail Service Centel, Raleigh NC 27699-1628 Phone [phone]
1 ncntlnn 100 Rnrnett Drive Rnlell?h NC 27009 F, -i), [phone]

Aqua North Carolina, Inc
Permit No WQ0039803
Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC
27699-6714. Unless such demands are made, this permit shall be final and binding
If you need additional information concer-iing this matter, please contact Ted Cashion at [phone]
or via e-mail at ted cashion@ncdenr gov
/f
Sincerely, ,
�a22'1
for Linda Culpepper
Interim Director, Division of Water Resources
by S Daniel Smith, Regional Supervisor
Water Quality Regional Operations Secticn
Raleigh Regional Office
Division of Water Resources, NCDEQ
cc Scott Haberstroh, P E , Freese and Nichols, Inc (via email scott haberstroh@freese com)
Chatham County Health Department
Raleigh Regional Office Files
Water Resources Central Files
Page 2 of 8

North Carolina Department of Environmental Quality
STATE OF NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations, permission is hereby granted to
Aqua North Carolina, Inc
Chatham County
for the construction and operation of approximately 500 linear feet of 8 -inch force main to relocate a
sewer line as part of the Utility Relocation for NCDOT project, and the discharge of no additional gallons
per day (flow has been allocated In a previous permit) of collected domestic wastewater into the Aqua
North Carolina, Inc 's existing sewerage system, pursuant to the application received January 5, 2018, and
additional information received on February 6, 2018, and in conformity with 15A NCAC 2T, the Division's
Gravity Sewer Minimum Design Criteria adopted February 12, 1996 and updated in March 2008, as
applicable, the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and
Force Mains adopted June 1, 2000 and updated March 2008, as applicable, and other supporting data
subsequently filed and approved by the Department of Environmental Quality and considered a part of
this permit
This permit shall be effective from the tee Issuanc til rescinded and shall be subject to the specified
conditions Mrd limit tions contained rein
-5
Linda Culpepper
Interim Director, Division of Water Resources
By Authority of The Environmental Management Commission
Permit Number: WQ0039803
Permit Issued: February 14, 2018
Page 3 of 8

SUPPLEMENT TO PERMIT COVER SKEET
Aqua North Carolina, Inc. is hereby authorized to:
Construct, and then operate upon certification the aforementioned wastewater collection extension The
sewage and wastewater collected by th's system shall be treated in the Buck Mountain Reclaimed
Wastewater Treatment Facility in accordance with Permit Number WQ0022870
Permitting of this project does not constitute an acceptance of any part of the project that does not meet
15A NCAC 2T, the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996 and
updated March 2008, as applicable, and the Division's Minimum Design Criteria for the Fast -Track
Permitting of Pump Stations and Force Mains adopted June 1, 2000 and updated March 2008, as
applicable, unless specifically mentioned herein Division approval is based on acceptance of the
certification provided by a North Carolina -licensed Professional Engineer in the application It shall be the
Permittee's responsibility to ensure that the as -constructed project meets the appropriate design criteria
and rules
Construction and operation is contingent upon compliance with the Standard Conditions and any Special
Conditions identified below
I. SPECIAL CONDITIONS
NONE
II. STANDARD CONDITIONS
1 This permit shall not be transferable In the event there is a desire for the wastewater collection
facilities to change ownership, or there is a name change of the Permittee, a formal permit request
shall be submitted to the Division accompanied by documentation from the parties involved, and
other supporting materials as may be appropriate The approval of this request shall be considered
on its merits and may or may not be approved [15A NCAC 02T.0104, G.S 143-215 1(d3)]
2 This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit, 15A NCAC 2T, the Division's Gravity Sewer Minimum
Design Criteria adopted February 12, 1996 and updated March 2008, as applicable, the Division's
Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted
June 1, 2000 and updated March 2008, as applicable, and other supporting materials unless
specifically mentioned herein. [15A NCAC 02T 0110]
3. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data. [15A NCAC 02T 0110]
4 The wastewater collection facilities shall be properly maintained and operated at all times The
Permittee shall maintain compliance with an individual system -wide collection system permit for the
operation and maintenance of these facilities as required by 15A NCAC 2T .0403 If an individual
permit is not required, the following performance criteria shall be met [15A NCAC 02T 0108(b)]
Page 4 of 8

• a The sewer system shall be effectively maintained and operated at all times to prevent discharge
to land or surface waters, and to prevent any contravention of groundwater standards or surface
water standards
b A map of the sewer system shall be developed and shall be actively maintained
c An operation and maintenance plan including pump station inspection frequency, preventative
maintenance schedule, spare parts inventory and overflow response has been developed and
implemented.
d Pump stations that are not connected to a telemetry system shall be inspected every day (i e 365
days per year) Pump stations that are connected to a telemetry system shall be inspected at
least once per week
e High-priority sewer lines shall be inspected at least once per every six -months and inspections are
documented.
f A general observation of the entire sewer system shall be conducted at least once per year
g Overflows and bypasses shall be reported to the appropriate Division regional office in accordance
with 15A NCAC 2B 0506(a), and public notice shall be provided as required by North Carolina
General Statute §143-215 1C
h A Grease Control Program is in place as follows
1. For public owned collection systems, the Grease Control Program shall include at least
biannual distribution of educational materials for both commercial and residential users and
the legal means to require grease interceptors at existing establishments The plan shall also
include legal means for inspections of the grease interceptors, enforcement for violators and
the legal means to control grease entering the system from other public and private satellite
sewer systems
2 For privately owned collection systems, the Grease Control Program shall include at least bi-
annual distribution of grease education materials to users of the collection system by the
permittee or its representative
3 Grease education materials shall be distributed more often than required in Parts (1) and (2)
of this Subparagraph if necessary to prevent grease -related sanitary sewer overflows
I Right-of-ways and easements shall be maintained in the full easement width for personnel and
equipment accessibility
Documentation shall be kept for Subparagraphs (a) through (i) of this Rule for a minimum of three
years with exception of the map, which shall be maintained for the life of the system.
5 The Permittee shall report by telephone to a water resources staff member at the Raleigh Regional
Office, telephone number [phone], as soon as possible, but in no case more than 24 hours,
following the occurrence or first knowledge of the occurrence of either of the following
Page 5 of 8

a Any process unit failure, due to known or unknown reasons, that renders the facility incapable
of adequate wastewater transport, such as mechanical or electrical failures of pumps, line
blockage or breakage, etc , or
b. Any SSO and/or spill over 1,000 gallons, or
c Any SSO and/or spill, regardless of volume, that reaches surface water
Voice mail messages or faxed information is permissible, but this shall not be considered as the initial
verbal report Overflows and spills occurring outside normal business hours may also be reported to
the Division of Emergency Management at telephone number [phone] or -[phone]
Persons reporting any of the above occurrences shall file a spill report by completing and submitting
Part I of Form CS-SSO (or the most current Division approved form) within five days following first
knowledge of the occurrence This report must outline the actions taken or proposed to be taken to
ensure that the problem does not recur Part II of Form CS-SSO (or the most current Division approved
form) can also be completed to show chat the SSO was beyond control [G S 143-215 1C(a1)]
6 Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to
interrupt service by the existing utilities nor result in an overflow or bypass discharge of wastewater
to the surface waters of the State [15A NCAC 02T 0108(b)]
7 Upon completion of construction and prior to operation of these permitted facilities, the completed
Engineering Certification form attached to this permit shall be submitted with the required supporting
documents to the address provided on the form. A complete certification is one where the form is
fully executed and the supporting documents are provided as applicable Any wastewater flow made
tributary to the wastewater collection system extension prior to completion of this Engineer's
Certification shall be considered a violation of the permit and shall subject the Permittee to
appropriate enforcement actions
If the permit is issued to a private entity with an Operational Agreement, then a copy of the Articles
of Incorporation, Declarations/Covenants/Restrictions, and Bylaws that have been appropriately
filed with the applicable County's Register of Deeds office shall be submitted with the certification.
A complete certification is one where the form is fully executed and the supporting documents are
provided as applicable Supporting eocumentation shall include the following
a One copy of the project construction record drawings (plan & profile views of sewer lines & force
mains) of the wastewater collection system extension Final record drawings should be clear on
the plans or on digital media (CD or DVD disk) and are defined as the design drawings that are
marked up or annotated with after construction information and show required buffers,
separation distances, material changes, etc.
b One copy of the supporting applicable design calculations including pipe and pump sizing, velocity,
pump cycle times, and level control settings, pump station buoyancy, wet well storage, surge
protection, detention time in the wet well, and force main, ability to flush low points in force
mains with a pump cycle, and downstream sewer capacity analysis If a portable power source or
pump is dedicated to multiple 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
Page 6 of 8

c Changes to the project that do not result in non-compliance with this permit, regulations, or the
Minimum Design Criteria should be clearly identified on the record drawings, on the certification
in the space provided, or in written summary form
Prior to Certification (Final or Partial) Permit modifications are required for any changes resulting in
non-compliance with this permit (including pipe length increases of 10% or greater, increased flow,
pump station design capacity design increases of 5% or greater, and increases in the number/type of
connections), regulations, or the Minimum Design Criteria Requested modifications or variances to
the Minimum Design Criteria will be reviewed on a case-by-case basis and each on its own merit
Please note that variances to the Minimum Design Criteria should be requested and approved during
the permitting process prior to construction After -construction requests are discouraged by the
Division and may not be approved, thus requiring replacement or repair prior to certification &
activation [15A NCAC 02T 0116]
8 Gravity sewers installed greaterthan ten percent below the minimum required slope per the Division's
Gravity Sewer Minimum Design Criteria shall not be acceptable and shall not be certified until
corrected If there is an unforeseen obstacle in the field where all viable solutions have been
examined, a slope variance can be requested from the Division with firm supporting documentation.
This shall be done through a permit modification with fee Such variance requests will be evaluated
on a case-by-case basis Resolution of such request shall be evident prior to completing and submitting
the construction certification [ 15A NCAC 02T 0105(n)]
9 A copy of the construction record drawings shall be maintained on file by the Permittee for the life of
the wastewater collection facilities [15A NCAC 02T 0116]
10 Failure to abide by the conditions and limitations contained in this permit, 15A NCAC 2T, the Division's
Gravity Sewer Design Criteria adopted February 12, 1996 and updated March 2008,
as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Station
and Force Mains adopted June 1, 2000 and updated March 2008 as applicable, and other supporting
materials may subject the Permittee to an enforcement action by the Division, in accordance with
North Carolina General Statutes §143-215 6A through §143-215 6C, construction of additional or
replacement wastewater collection facilities, and/or referral of the North Carolina -licensed
Professional Engineer to the licensing board [15A NCAC 02T 0104; 15A NCAC 02T 0108(b -c)]
11 In the event that the wastewater collection facilities fail to perform satisfactorily, including the
creation of nuisance conditions, the Permittee shall take immediate corrective action, including those
as may be required by this Division, such as the construction of additional or replacement facilities
[15A NCAC 02T 0110, 15A NCAC 02T 0108(b)]
12 The issuance of this permit shall not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances that may be imposed by the Division any other Federal, State, or Local
government agencies which have Jurisdiction or obtaining other permits which may be required by
the Division or any other Federal, State, of Local government agencies [G S 143-215 1(b)]
Page 7 of 8

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE: Aqua North Carolina, Inc
PERMIT #: WQ0039803
PROJECT: Utility Relocation for NCDCT
ISSUE DATE: February 14, 2018
This project shall not be considered complete nor allowed to operate in accordance with Condition 7 of
this permit until the Division has received this Certification and all required supporting documentation It
should be submitted in a manner that documents the Division's receipt Send the required documentation
-the-Regional-Supervisor,-Water-Quality Regional Operations Section at the address at the -bottom - - -
Any wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Certification shall be considered a violation of the permit and shall subject the Permittee to
appropriate enforcement actions. The Permittee is responsible for tracking all partial certifications up
until a final certification is received A Final Certification shall be a complete set of record drawings and
design calculations regardless of whether partials have been submitted
PERMITTEE'S CERTIFICATION
I, the undersigned agent for the Permittee, hereby state that this project has been constructed pursuant
to the applicable standards & requirements, the Professional Engineer below has provided applicable
design/construction information to the Permittee, and the Permittee is prepared to operate & maintain
the wastewater collection system permitted herein or portions thereof
Printed Name, Title Signature
ENGINEER'S CERTIFICATION
Date
I, , as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe (❑ periodically, ❑ weekly, ❑ full time) the construction of the
project name and location as referenced aoove for the above Permittee hereby state that, to the best of
my abilities, due care and diligence was used in the observation of the construction such that the
construction was observed to be built witnin substantial compliance of this permit, 15A NCAC 02T, the
Division of Water Resources' (Division) Gravity Sewer Minimum Design Criteria adopted February 12, 1996
and updated March 2008, as applicable, the Division's Minimum Design Criteria for the Fast -Track
Permitting of Pump Stations and Force Mains adopted June 1, 2000 and updated March 2008, as
applicable, and other supporting materials.
North Carolina Professional Engineer's Seal w/signature & date
❑ Final ❑ Partial (include description)
Certification Comments/Qualifiers (attach if necessary):
Division of Nater Resources, Raleigh Regional Office, Watei Quality Opeiztions Section www newateiquality org
1628 Mail Service Center, Raleigh, NC 27699-1628 Phone [phone]
T _onn 0. .— T-1....,. n,.i._.-I- rrr+ Dunn U-. nlO, 700 �1 co

State of North Carolina
DW
DIKepartment of Environmental Quality
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 (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION
1 Applicant's name Aqua North Carolina, Inc (company, municipality, HOA, utility, etc )
2 Applicant type ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State/County ❑ Municipal
3 Signature authority's name Moses A Thompson pel 15A NCAC 021' 0106(b)
Title Director of Operations
4 Applicant's mailing address 202 MacKenan Ct
City Cary State NC Zip 27511-
5 Applicant's contact information
Phone number [phone] Email Address MAThompsonQaAquaamerica com
II. PROJECT INFORMATION-
® Privately -Owned Public Utility
❑ Othei
1 Project name Utility Relocation for NCDOT
2 Application/Project status ® Proposed (New Pei mit) ❑ Existing Permit/Project
If a modification, provide the existing permit number WQ0023620 and issued date February 12. 2009
If new construction but part of a master plan, provide the existing permit number WQ00
3 County where project is located Chatham
4 Approximate Coordinates (Decimal Degrees) Latitude 35 803428° Longitude -79 211282°
5 Pat cel ID (if applicable)
(oi Parcel ID to closest downstream sewer)
III CONSULTANT INFORMATION:
1 Pi ofessional Engineer Scott P Haberstroh License Number 36505
Fu Freese and Nichols, Inc
Mailing address 1017 Main Campus Drive, Suite 1200
City Raleigh State NC Zip 27606 -
Phone number [phone] Email Address Scott Haberstioh(a�freese com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION
1 Facility Name Buck Mountain Reclaimed WWTF Permit Number W00022870
Owner Name Aqua North Cai olma. Inc
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1 PeimitNumber(s) WQ0023620 Downsti earn (Receiving) Sewei Size 8 inch
Svstem Wide Collection Svstem Permit Numbei(s) (it applicable) WQCS
Owner Name(s) Aqua North Calolma
FORM FTA 04-16 Page 1 of 5

V.I. GENERAL REQUIREMENTS
1 If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached9
® 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 Operational Agreement (FORM: HOA) been attached?
❑ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply) -
0
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 / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5 Nature of wastewater • 100 % Domestic/Commercial ' % Commercial
% Industrial (See 15A NCAC 02T.0103(20))
�" Is there a Pretreatment Program in effect9 ❑ Yes ❑ No
6 Hasa flow reduction been approved under 15A NCAC 02T.01 14(f)? ❑ Yes ❑ No
Y 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 n,b
No. of Units
Flow
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
=GP
a See 15A NCAC 02T .0114(b). (d), (e)(1) and (e)(2) for caveats to wastewater design flow rates (i e., minimum flow 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 42A-4).
b Per 15A NCAC 02T 0114(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: 0 GPD (per 15A NCAC 02T 0114)
➢ 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) FLength (feet) Material
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design ciiteua
➢ 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
2 Approximate Coordinates (Decimal Degrees) Latitude Longitude - °
3 Design flow of the pump station millions gallons pet 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
8
500 PVC - C1200
SDR 21
6 Power reliability in accordance with 15A NCAC 02T 0305(h)(1)
❑ Standby power source of 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
03 05 (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 of 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 of 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)):
1 Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (g) ® Yes ❑ No
➢ 1 SA NrA(: 02T 0305(fl contains minimum separations that shall be provided for sewer systems:
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 Imes 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 1 or
Class II impounded reservoirs used as a source of drinking water
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 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(g) contains alternatives where separations in 02T 0305(fl cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
➢ If noncompliance with 02T 0305(f) or M. see Section X of this application
2 Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No ❑ N/A
➢ See the 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 .02007 ® Yes ❑ No ❑ N/A
➢ This would include Trout Buffered Streams per 15A NCAC 2B 0202
4 Does the project require coverage/authonzatlon 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 15A 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-pnority 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 ❑ N/A
➢ 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 (Iatest version) as applicable?
® Yes ❑ No
If No, complete and submit the Vanance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
2 Professional Engineer's Certification
I, Sec Ty- 1-V cyse fL&T\W t E- attest that this application for
(Professional Engineer's name from Application Item III.1 )
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, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (Iatest 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 sea] 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:
3. Applicant's Certification per 15A NCAC 02T .0106(b)
I, M GSo; A - kc
(Signature
I c OPS,
& title from Application Item 13 )
AR
0 . Q• ti •, i
Z
that this application for
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 V/v Date:-/
FORM: FTA 04-16 Page 5 of 5

STATE OF NORTH CAROLINA
UTILITIES COMMISSION
RALEIGH
APPENDIX A-15
DOCKET NO. W-218, SUB 341
BEFORE THE NORTH CAROLINA UTILITIES COMMISSION
AQUA NORTH CAROLINA. INC.
is granted this
CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY
to provide water and sewer utility service
In
CHAPEL RIDGE INCLUDING PHASES 2A AND 213, COLE PARK PLAZA, COLVARD
FARMS (Durham and Chatham Counties), CREEKSIDE, LAUREL RIDGE, MCBANE
PROJECT, THE BLUFFS PHASE 1, THE PARKS AT MEADOWVIEW AND
WOODLANDS SUBDIVISIONS
Chatham County, North Carolina
subject to any orders, rules, regulations,
and conditions now or hereafter lawfully made
by the North Carolina Utilities Commission.
ISSUED BY ORDER OF THE COMMISSION.
This the 29th day of January, 2013.
NORTH CAROLINA UTILITIES COMMISSION
A6L 1-Mi6u *
Gail L. Mount, Chief Clerk

STATE OF NORTH CAROLINA
UTILITIES COMMISSION
RALEIGH
APPENDIX A-15
DOCKET NO. W-218, SUB 341
BEFORE THE NORTH CAROLINA UTILITIES COMMISSION
AQUA NORTH CAROLINA, INC.
is granted this
CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY
to provide water and sewer utility service
in
CHAPEL RIDGE INCLUDING PHASES 2A AND 213, COLE PARK PLAZA, COLVARD
FARMS (Durham and Chatham Counties), CREEKSIDE, LAUREL RIDGE, MCBANE
PROJECT, THE BLUFFS PHASE 1, THE PARKS AT MEADOWVIEW AND
WOODLANDS SUBDIVISIONS
Chatham County, North Carolina
subject to any orders, rules, regulations,
and conditions now or hereafter lawfully made
by the North Carolina Utilities Commission
ISSUED BY ORDER OF THE COMMISSION
This the 29th day of Januarv, 2013
NORTH CAROLINA UTILITIES COMMISSION
eA6L �-Mmv\*
Gail L. Mount, Chief Clerk

STATE OF NORTH CAROLINA
UTILITIES COMMISSION
RALEIGH
APPENDIX A-14
DOCKET NO. W-218, SUB 341
BEFORE THE NORTH CAROLINA UTILITIES COMMISSION
AQUA NORTH CAROLINA, INC
is granted this
CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY
to provide water utility service in
BEECHWOOD COVE, CEDAR TERRACE, CHATHAM, HIDDEN VALLEY, POLK'S
LANDING, POLK'S TRAIL AND WOODBRIDGE SUBDIVISIONS
AND
to provide sewer utility service in
CAROLINA MEADOWS, COUNTY LINE PLAZA, GOVERNORS CLUB, GOVERNORS
FOREST, GOVERNORS VILLAGE, THE LEGACY AT JORDAN LAKE,THE
PRESERVE AT JORDAN LAKE AND WESTFALL SUBDIVISIONS
Chatham County, North Carolina
subject to any orders, rules, regulations,
and conditions now or hereafter lawfully made
by the North Carolina Utilities Commission.
ISSUED BY ORDER OF THE COMMISSION
This the 29th day of January, 2013.
NORTH CAROLINA UTILITIES COMMISSION
sail, l.'f'(loum*
Gail L Mount, Chief Clerk
14

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USDA, USES, AeroGRID, IGN, and -the GIS User Community
TOPOGRAPHIC MAP
CHATHAM COUNTY
Utility Relocation for NCDCT
FIGURE 1
1017 Main Campus Dr
Aqua North Carolina, IncFREESE
Raleigh, 27603
EMIM12
0 0.075 0.15 0.3
WICHOLS 919-582-588 50
Miles

AERIAL MAP
CHATHAM COUNTY
Utility Relocation for NCDOT
FIGURE 2
1017 Main Campus Dr
Aqua North Carolina, Inc
FREESE Raleigh NC 27603
Is,,1MICHOLS
0 0.075 0.15 0.3
919-582-5850
Miles

1017 Main Campus Dr, Suite 1200 • Raleigh, North Carolina 27606 • 919-582-5859 • fax [phone] www.freese com
December 21, 2017
North Carolina Department of Environmental Quality
Water Quality Section
1628 Mail Service Center
Raleigh, NC 27699
Re: Aqua North Carolina, Inc
Utility Relocation for NCDOT 17BP.8.R.124
Fast Track Sewer System Extension Application (FTA 04-16)
To Whom it May Concern:
NC Dept of Environmental Quality
JAN - 5 2018
Raleigh Regional Office
On behalf of Aqua North Carolina, Inc, and in accordance with 15A NCAC subchapter 02T and the
Division of Water Resources Minimum Design Criteria, please find enclosed the following documents
associated with the proposed Utility Relocation for NCDOT 17BP.8.R.124:
Fast Track Sewer System Extension Application
Application Fee of $480.00
Existing Permit No. WQ0023620
Proof of Business
Certificate of Public Convenience and Necessity
Figure 1— USGS Topographic Map of Project Area
Figure 2 — Aerial Map of Project Area
Aqua North Carolina, Inc is requesting authorization to relocate approximately 500 feet of existing 8"
PVC force main, permit number NC0023620. This project is being proposed to eliminate conflicts with
the replacement of an NCDOT bridge on SR 1520. The size, material, and flow of the force main will
remain unchanged and will continue to flow to the Buck Mountain Reclaimed WWTF, permit number
WQ0022870.
Please feel free to contact me at [phone] if you have any questions or require additional
information. I can also be reached at [e-mail].
Sincerely,
--�s
Scott P. Haberstroh, P.E.
Senior Project Manager