WQCS00301_Renewal (Application)_20180228

RECEIVE®10 RIDWR
MAR 13 2018
To Steve Lewis and concerned parties
Water Resources
Re The Town of Jackson Wastewater Collection System Permit Renewal Permitting Section
February 28, 2018
The Town of Jackson Wastewater Collection System Permit Renewal Application here before you consists
of information pertaining to those responsible for maintaining the Town's WWCS, including it's
infrastructure and facilities You will find that there are contact numbers and information of those
responsible for daily operations and maintenance of the facilities, along with contact information of
contractors and other outside resources the Town can call upon in case of emergency and repair There are
maps of the Collection System available to describe in detail the infrastructure of the System On the actual
facilities such as the System's pumping stations,there is information placed on these facilities in order that
citizens can use for contacting proper authorities in case of emergency. There are visual and audible alarms
on these stations to alert passing citizens of problems that may be ongoing with that particular station
Attached to this process are Response Action Plans,budget information and Capital Improvement concerns
along with other general requirements noted with this application Be assured the Town of Jackson's
Administrators,takes seriously,the proper care,maintenance and operations of the Town's Wastewater
Collections System.

I. APPLICANT INFORMATION
1 Applicant's name(Municipality, Public Utility, etc) Town of Jackson
2 Facility Information Name Town of Jackson Collection System Permit No WQCS00301
3 Applicant type X❑ Municipal ❑ State ❑ Privately-Owned Public Utility
❑ County ❑ Other
4 Signature authority's name Jason Morris per ISA NCAC 02T 0106(b)
Title Mayor
5 Applicant's mailing address P 0 Box 614
City Jackson State NC Zip 27845-0614
6 Applicant's contact information
Phone number (252_)534-3811 Fax number [phone] Email address jacksontownhall
@mchsi corn
II. CONTACT/CONSULTANT INFORMATION:
1 Contact Name John Young
2 Title/Affiliation. ORC
3. Contact's mailing address PO Box 614
4 City Jackson State NC Zip 27845-0614
5. Contact's information.
Phone number ( 252)534-3811 Fax number (252) 534-3811 Email address.Jacksontownhall iimchsi corn
III. GENERAL REQUIREMENTS:
1 New Permit or Premit Renewal9 ❑New X❑ Renewal
2 County System is located in Northampton County
3 Owner&Name of Wastewater Treatment Facility(ies)receiving wastewater from this collection system
Owner(s)&Name(s) Town of Jackson
4 WWTF Permit Number(s) WQ0000948
5 What is the wastewater type9 100%Domestic or % Industrial(See 15A NCAC 02T 0103(20))
1_j Is there a Pretreatment Program in effect? ❑ Yes or❑ No
6 Wastewater flow 14 MGD(Current average flow of wastewater generated by collection system)
7 Combined permitted flow of all treatment plants 202 MGD
8 Explain how the wastewater flow was determined ❑ ISA NCAC 02T 0114 or X❑ Representative Data
9 Population served by the collection system 695
IV. COLLECTION SYSTEM INFORMATION:
The Town of Jackson operates and maintains a Wastewater Collection System consisting of approximately 5 miles of
gravity sewer,approximately 3 miles of force main,with 3 duplex pump stations, and all associated piping,valves,and
appurtenances required to make a complete and operational wastewater collection system to serve the Town and any
deemed satellite communities. The town sends by forceline from a main duplex pumping station , it's collected sanitary
sewer to a Wastewater Treatment Facility located outside of Jackson that includes a 5.2 acre storage lagoon with close to
70 acres of spray irrigation field and a pumping complex for the spray field operation. The Town's 3 pump stations are
located on Atherton St.,Jefferson St. and the main pump station on Depot St. ,with this being the main station to pump
sanitary sewer to the Town's Wastewater Treatment Facility located on 6223 Bryantown Rd.
APPLICATION CSA 04-16 Page 3 of
5

1 Line Lengths for Collection System
Sewer Line Description Length
Gravity Sewer 5 (miles)
Force Main 3 (miles)
Vacuum Sewer 0 (miles)
Pressure Sewer 0(miles)
2 Pump Stations for Collection System
Pump Station Type Number
Simplex Pump Stations(Serving Single Building)
Simplex Pump Stations(Serving Multiple Buildings)
Duplex Pump Stations 3
3 Submit a list of all major(i e.not simplex pump station serving a single family home)pump stations Include the following
information
> Pump Station Name Atherton St-pump station,Jefferson St pump station, Depot St pump station
> Physical Location 612 Atherton St, 505 Jefferson St,401 Depot St
> Alarm Type(i e audible,visual,telemetry, SCADA)audible, visual
> Pump Reliability(Can convey peak hourly wastewater flow with largest single pump out of service)yes
> Reliability Source(permanent/portable generator,portable pumps)permanent generator at Depot St,portable genei ator
available
> Capacity of Station (Pump Station Capacity in GPM)350 GPM
4 Submit a list of all high priority lines according per 15A NCAC 02T 0402 (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:
1 Provide a brief description of the organizational structure that is responsible for management, operation and maintenance of
the collection system
ORC,John Young, Maintenance staff Earlie Boone(foreman), Brian Payne(staff)
2 Indicate the current designated collection system operators for the collection system per 15A NCAC 08G 0201
Main ORC Name John Young Certification Number CS 1 22670
Back-Up ORC Name Chris Wheeler Certification Number CS 1001922
See the"WOCS Contacts and ORC Report"for a current listing of the ORC(s)the Division has on file for WQCS permit
3 Approximate annual budget for collection system only $ 54,000
4 Submit a copy of your current annual budget.
5 Approximate capital improvement budge for the collection system only: $1500
6 Submit a copy of your current capital improvement plan.
7 Is this collection system currently a satellite system ❑ Yes or X❑No
8 Do any satellite systems discharge to this collection system X❑ Yes or❑No(If yes complete table below)
APPLICATION CSA 04-16 Page 4 of
5

Satellite System Contact Information (Name,Address, Phone Number)
Jackson Eastside Community Northampton Co Chris Wheeler, 9371 NC Hwy 305,Jackson 252-534-
6341
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
Purchase/Use Agreement with Northampton County Public Woiks Dept (metered)
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 place9 X ❑ Yes or❑No
4. If Yes,submit a copy of the pump station contingency plan or see table 6 below.
5 Is a comprehensive collection system map 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 System Permit Conditions. Typically compliance schedules
are only offered to NEW permit applicants and NOT permit renewals. Any compliance dates must be included within
the permit prior to issuance or the permit holder will be found in violation upon inspection.
Current If no, Indicate a Typical
Permit Condition Compliance? Compliance Compliance
Date Schedule
I(4)—Grease ordinance with legal author ity to inspect/enforce X❑Nos El12— 18 mo
1(5)— Grease inspection and enforcement program X❑Nos ❑ 12— 18 mo
I(6)—Three to five year current Capital Improvement Plan XD
Nos ❑ 20yr CIP 12— 18 mo
1(8)—Pump station contingency plan X❑Nos ❑ 3 mo
X❑ Yes ❑
1(9)—Pump station identification signs No 3 mo
1(11)—Functional and conspicuous audible and visual alarms X❑Nos ❑ 3—6 mo
11(5)—Spare pumps for any station where one pump cannot X❑ Yes ❑
handle peak flows alone(in a duplex station,the 2nd pump isNo 6—9 mo
the spare if pump reliability is met)
1I(7)—Accessible right-of-ways and easements X❑Nos El6— 12 mo
II(9)—Response action plan with Items 9 (a—h) YES 3 mo
III(3)—Comprehensive collection system map X❑Nos El10%per year
APPLICATION CSA 04-16 Page 5 of
5

For conditions not listed, compliance dates are not typically offered List any permit conditions that may be difficult for the
applicant to meet(attach clarification if needed)
N/A
VII. APPLICANT'S CERTIFICATION per 15A NCAC 02T.0106(b):
I, ���v1?�i4 �� y�2 attest that this application for Town of Jackson Collection System
ature Authorlt< 's Name&Title from Item 1 (Facilityname from Item 11)
(Si Y 4)
h 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 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 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
Signatureeffitm iff/40 Date ,//g
APPLICATION CSA 04-16 Page 6 of
5

SPILL RESPONSE ACTION PLAN
TOWN OF JACKSON
A Contact numbers regarding a SSO, are posted on the front gate of each of the Town's Sanitary Sewei Lift
Stations.The Northampton County 911 Center has each of the Town Public Works Staff's contact
numbers as well as the Town's Mayor, in case a citizen calls in response to alarms at the stations
B Response time for an SSO or any other emergency is usually less than ten (10)minutes due to each Town
Public Works Staff lives within The Town limits
C The Town has on hand, a spare parts inventory and spare equipment inventory kept at the Town Hall
Office
D The Town also has access through agreements with outside contractors as well as with the Northampton
County Public Works Department, and other Town's in and around Northampton County,that the Town
may call upon in case of an emergency need
E Contractors that the Town may call upon for their services are Rightmeyer Construction Co , Roanoke
Builders Const Co , Bryant Lassiter's Septic System Co,James Flythe Const Co, Pete Parks Const
Co , and as mentioned,the Northampton Co Public Works Dept for emergency response The Town has
on call, Mark Russell , of Mack Gay and Assoc as the Town's Engineer
F The Town has contingency funds budgeted from it's General Funds along with several"CD"accounts
for emergency use
G Site sanitation and clean-up materials(Spill Response Kits),are kept at the Town's Wastewater
Treatment Facility Upon the occurrence of an emergency SSO,the Town's Staff will respond as
needed Depending on size of SSO that may result the Town Staff requiring assistance from outside
Contractors such as Bryant Lassiter's Septic Systems of Woodland,their response time is usually 20
minutes, as they are a 24 hours a day service provider and they, being in such close proximity of Jackson
makes Bryant Lassiter SS an ideal resource for the Town to call upon in case of an emergency Upon
Mr Bryant's arrival,the blockage or SSO, will be pumped out and in turn the contents will be pumped
into the Town's Storage Lagoon located at the Town's Wastewater Treatment Facility. Any soil that
requires excavation, will be spaced/spread out on the Spray Irrigation Field.The excavated soil will be
replaced with fresh soil,treated with lime, seeded and covered with straw as needed.
H Post Assessment will be made by the Town's ORC Proper documentation will be made and if needed/
required,will be sent to pertinent individuals at the DWQ Offices in Raleigh as soon as possible (24
Hrs) also followed by a phone call to pertinent individuals will be made(again,within 24 Hrs)

EMERGENCY PHONE#'S FOR CONTRACTORS/SERVICE WORK CONTACTS
Town of Jackson Public Works Dept (Town Hall )252-534-3811
----Jason Morris(H)252-534-5351 ©532-0945 (mayor)
----John Young(H) 534-1077©578-6751 (ORC, supervisor)
----Earlie Boone(H,C) 578-6753 (foreman)
----Brian Payne(H,C) 578-1971
----Andy Jenkins(H) 534-1546©532-2390
SPILL,OVERFLOW SERVICE,
----Bryant Lassiter SS (OFF)587-4321 ©209-1002
----No'Hampton Pub Wks(OFF)534-6341
Chris Wheeler(superv)(H) 585-3691 ©536-8451
TECH SUPPORT
----TOWN ENGINEER Mack Gay and Assoc (OFF)446-3017 (engineer) Mark Russell ©813-3201
----Tencarva- Dale Atkinson (tech) 1-800-849-5764© 1-843-222-8680
----ISI (TELEMETRY) Richard Brown 1-919-645-7643
----Farrow and Sons(electrician, pump work,generato► repair)(H)585-1513 ©536-1396
----TV PIPE SERVICE(OFF) 399-0704(tech)230-5199
----Electric Motor Service(OFF)332-4364 (tech)332-9444
----GENERATOR SERVICES Ron Renfrow(OFF) 1-919-284-9111 (H)1-919-621-5814
----MaJette Well Sery (OFF)332-2265 Bill Majette©209-4676
JETTER SERVICES,
----No'H Co P/wks Chris Wheeler(OFF) 534-6341 ©536-8451
----Town of Weldon (OFF)536-3478
----Town of Woodland(OFF)587-7161 John Ruppe©396-3306
HEAVY EQUIPMENT
----Roanoke Builders(Ray Rightmeyer)©532-0702
----Rightmeyer Machine(David Rightmeyer) (OFF) 537-3223 ©578-0485
----James Flythe©578-0426
----Pete Parks©578-7751
----Vernon Jones©308-2086
OTHER
----Cockes Garage(towing,motor work)(H) 534-0341,©396-1301 (OFF)534-3721
----Bob's Garage (heavy equipment repair)(H) 534-3961 (OFF)534-3721
----Jackson VFD(Chf) Monte Hux©536-1915 (H)534-7891
Cliff Johnson©678-3933
Jim Bain (H)534-7791
----Dept of Xport 534-4031 (Jack Thompson, superv)
----ULOCO 811 or 1-800-632-4949
----Dominion Power 1-888-667-3000 Area Lineman(Ed True)©326-4538
----Water Guard(chemicals) 1-800-872-7665
----DWQ(OFF) 1-919-791-4200 (Main Contact)Jerry Rimmer 1-919-791-4237
----No'H Co Emergency Mngt Coordinator-Ronnie Storey 574-1041 OR©578-5139
----Roanoke Rapids Sanitary District 537-3319

EDUCATION,ENFORCEMENT OF FATS,OIL,GREASE(FOG)
TOWN OF JACKSON
a Education of Fats, Oil, and Grease(FOG)and the problems that can be caused if such materials are
improperly disposed of,such as pouring FOG materials down sink drains, will be introduced
bi-annually via notices attached to water/sewer bills as reminders that such activities are not allowed
in the Town. These notices will be sent to non-residential and residential customers. Included in the
notices will be information on how to obtain literature at the Town Hall about FOG and the problems
they cause.
b. The Town requires all schools,restaurants,delis,convenience stores, and grocery stores,that prepare
and/or sell food,to have a Grease Separation Device(GSD)installed in their establishment. Through
Chapter 14 of our Town Ordinances dealing with the Town's Public Utilities which includes our sanitary
sewer services,the Town enforces violations in regards to GSD and FOG. Inspections of GSD will be
quarterly or, as conditions may require, additional inspections to may be made to ensure that the GSD
are being adequately cleaned and maintained.
c. The authority to adopt and enforce an ordinance in regards to FOG and GSD,residential or non-
residential is found in whole or in part in NCGS. 160-174, 160-175, 160-185, 160-193, 160-312, 160-
314, 143-215.6A(j),and 143-215.6B.The Town's authority involving Sanitary Sewer Utilities and all that
It entails, falls under Chapter 14-2(c), Chapter 14-82(cl)and Chapter 14-82(c2)of it's Town
Ordinances. The Town prefers to enforce violations of these Chapters by(1)verbal/written warning,
(first offense), --(2)Town Citation, (second offense)--or(3)NCGS fines or civil penalties as applicable,
(third offense).

WATER&SEWER
BALANCE SHEET
January 31,2018
ASSETS
CASH&INVESTMENTS
PETTY CASH $ 30.00
SOUTHERN BANK&TRUST 90,878.70
CERTIFICATE OF DEPOSIT 131,666 19 .
TOTAL CASH&INVESTMENTS 222,574.89
RECEIVABLES
CUSTOMER W/S BILLED 19,344 03
CUSTOMER W/S UNBILLED 19,152 51
ALLOWANCE FOR BAD DEBTS (4,093.00)
TOTAL RECEIVABLES 34,403.54
FIXED ASSESTS
LAND 8,865.20
EQUIPMENT PLANT 2,753,576.00
TOTAL FIXED ASSETS 2,762,441.20
ACCUMULATED DEPRECIATION
ACCUMULATED DEPRECIATION (1,920,204.00)
TOTAL ACCUMULATED DEPRECIAT (1,920,204.00)
Total Assets $ 1,099,215.63
LIABILITIES AND EQUITY
CURRENT LIABILITIES
ACCOUNTS PAYABLE $ (6,475.99)
RETIREMENT 0.02
Accident Ins (0.13)
ACCRUED VACATION 4,212.22
CUSTOMER DEPOSITS 7,461.74
DEFERRED INFLOWS,.PENSION 1,514 00
TOTAL CURRENT LIABILITIES 6,711.86
TOTAL LIABILITIES 6,711.86
CAPITAL
RETAINED EARNINGS 1,032,712.83
Net Income 61,125.52
TOTAL CAPITAL 1,093,838.35
TOTAL LIABILITIES&CAPITAL $ 1,100,550.21
Unaudited-For Management Purposes Only

Water/Sewer Fund Annual Budget Estimates i I
Fiscal Year 7/1/17 thru 6/30/18 1
I
Expense-Sewer j I
Code- 6900
Page 18
Prior Year Current Budget Officer Board
2015-2016 Year Actual to Estimated Estimated 2017-2018 Approved
Account Number Actual Budget 4/1/2017 30-Jun Entire Year Estimate 2017-2018
Sewer Maintenance&Supplies 6913 22117 10 20000.00 10646.47 2500.00 13146 47 - 20000.00
Sewer Electricity 6914 14331 22 14000 00 7607.55 4800 00 12407 55 14000.00
Sewer Chemicals 6918 3701.63 6000.00 3237 331 2000.00 5237 33 6000.00
Sewer Misc 6919 0 00 0 00 0.001 0 00 0.00 0.00
Sewer Analysis 6920 3644 00 5400.00 2037.20 1000 00 3037.20 5400.00
Sewer Permits 6921 2120.00 2150.00 1360.00 810.00 2170.00 4000.00
Sewer Equipment Purchase 6923 0.00 2700 00 0 00 0 00 0 00 2700.00
Sewer Equipment Maintenance 6924 361 62 1500 00 0.00 0 00 0 00 1500.00
Sewer Certification Classes 6926 90.00 200.00 60.00 85 00 145 00 400.00
-I
1
1
I
TOTAL 46365 57 51950 00 24948 551 11195 00 36143 55 54000.00 000_
Town of Jackson 1 1

- Town of Jackson Population Data -
875
850 1 -
\843
825 - /
800 - - / -- -
/
775 _ 765
/758 762
8
750 \
725 - I - \ \ --
720
700 , - \\ .
Cl.
a 675 - -- \ /
650 - / �v/ t14 C'
625 ---- i
\ /
600 ---- ,
592
575 -- ; -
-
I
550 - ---i- - - ' .
525 4-
1 940
1940 1950 1960 1970 1980 1990 2000
Year
GRAPH NO. 2
-8-