WQ0039941_Issuance of Permit_20180430

ROY COOPER
Govet not
- MICHAEL S. REGAN
Sect etm y
LINDA CULPEPPER
Inlet tot Du ector
Water Resources
ENVIRONMENTAL QUALITY
April 30, 2018
Ted Credle, Public Utilities Director
Town of Smithfield
P.O. Box 761
Smithfield, NC 27577
Subject: Permit No.WQ0039941
Town of Smithfield Department of Public Utilities
Kellie Drive Water and Sewer Extension
Wastewater Collection System Extension Permit
Johnston County
Dear Mr. Credle:
In accordance with your application received March 28, 2018, we are forwarding herewith Permit No.
WQ0039941 dated April 30, 2018,to the Town of Smithfield Department of Public Utilities(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This permit shall be effective from the date of issuance until rescinded and shall be subject to the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.
Please pay particular attention to the following conditions contained within this permit:
Condition 1.1: This permit shall become voidable unless the agreement between the Town of Smithfield
Department of Public Utilities and Johnston County for the collection and final treatment
of wastewater is in full force and effect.
Condition 1.2: Each pump station shall be clearly and conspicuously posted using a weatherproof sign
with a pump station identifying name/number, 24-Hour Emergency telephone number,
and name of the owner/operator of the sewer system/pump station and instructions to
call the number in the event of alarm activation or other emergency.
Condition 11.1: This permit shall not be automatically transferable; a permit modification request for a
name change must first be approved by this office.
Condition 11.4: 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
Division of Water Resources,Raleigh Regional Office,Water Quality Operations Section www ncwaterquality.org
1628 Mail Service Center,Raleigh,NC 27699-1628 Phone:[phone]
T.,...,r,.,,,• 2Q00 Mr 1'7(.t10 C,...°/tli tl\'700 '71 CCI

Town of Smithfield Department of Public Utilities
Permit No.WQ0039941
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 150B of North Carolina General
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-bin-ding.
If you need additional information concerning this matter, please contact Ted Cashion at [phone]
or via e-mail at [e-mail].
Sincerely, (_ / :7-
c.- i--29,
for Linda Culpepper
Interim Director, Division of Water Resources
by S. Daniel Smith, Regional Supervisor
Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ
cc: C.Tyrus Clayton,Jr., P.E., Draper Aden Associates (via email: [e-mail])
Chandra C. Farmer, P.E., Director of Johnston County Public Utilities (via email:
[e-mail])
Johnston 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 the
Town of Smithfield Department of Public Utilities
Johnston County
for the construction and operation of approximately 3,090 linear feet of 8-inch gravity sewer, a 80—gallon
per minute pump station with duplex pumps,on-site audible and visual high water alarms,telemetry, and
a permanent generator with automatic transfer switch, as well as approximately 1,340 linear feet of 4-
inch force main to serve a 66 bed nursing home with laundry facilities as part of the Kellie Drive Water
and Sewer Extension project,and the discharge of 7,920 gallons per day of collected domestic/commercial
wastewater into the Town of Smithfield's and Johnston County's existing sewerage system, pursuant to
the application received March 28,2018 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 t date of suance until rescinded and shall be subject to the specified
conditions an imitations co t''ned th- ei .
f /...-P--r2 V
Linda Culpepper
Interim Director, Division of Water Resources
By Authority of The Environmental Management Commission
Permit Number: WQ0039941
Permit Issued: April 30, 2018
Page 3 of 8

t
SUPPLEMENT TO PERMIT COVER SHEET
The Town of Smithfield Department of Public Utilities is hereby authorized to:
Construct,and then operate upon certification the aforementioned wastewater collection extension. The
sewage and wastewater collected by this system shall be treated in the Central Johnston County Regional
Wastewater Treatment Facility in accordance with Permit Number NC0030716.
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
1. This permit shall become voidable unless the agreement between the Town of Smithfield Department
of Public Utilities and Johnston County for the collection and final treatment of wastewater is in full
force and effect. [15A NCAC 02T.0304(h)]
2. Each pump station shall be clearly and conspicuously posted using a weatherproof sign with a pump
station identifying name/number, 24-Hour Emergency telephone number, and name of the
owner/operator of the sewer system/pump station and instructions to call the number in the event
of alarm activation or other emergency. [15A NCAC 02T.0305(h)(2)]
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]
Page 4 of 8

r
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)]:
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.
j. Documentation shall be kept for Subparagraphs(a)through (i)of this Rule fora minimum of three
years with exception of the map, which shall be maintained for the life of the system.
Page 5 of 8

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:
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 that 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 documentation 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
Page 6 of 8

and the rotation schedule of the portable power source or pump, including travel timeframes,
shall be provided.
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 greater than 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: Town of Smithfield Department of Public Utilities
PERMIT#: WQ0039941
PROJECT: Kellie Drive Water and Sewer Extension
ISSUE DATE: April 30, 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.perations_Section-at_the _
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 Date
ENGINEER'S CERTIFICATION
I, , as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe ( periodically, weekly, I full time) the construction of the
project name and location as referenced above 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 within 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:
n Final Partial (include description)
•
Certification Comments/Qualifiers (attach if necessary):
Division of Water Resources,Raleigh Regional Office,Water Quality Operations Section www.ncwaterquality.org
1628 Mail Service Center,Raleigh,NC 27699-1628 Phone:[phone]
T 77(41Q Fn.• /C1 01 7SR.271 40

Draper Aden Associates
Engineering • Surveying • Environmental Services
930 Ma
Campus Drive,Suite
Rale gh11North Carolina 27606 151 NCDept of Pnvlronmental
[phone]•Fax[phone] Qua1ftY
www.daa.com MAR 2 8 201$
3.3.18
Raleigh regional Offi
NCDEQ ce
Raleigh Regional Office
Division of Water Resources
3800 Barrett Drive
Raleigh, NC 27609
RE: Fast Track Application for Gravity Sewer with Pump Station and Force Main
Kellie Drive Water and Sewer Extension
Smithfield,NC
Draper Aden Associates Project No. 17080434-01
Please find attached our application to install approximately 3090 feet of 8" gravity sewer and
associated manholes, 1340 feet of 4" force main, and a pump station for Kellie Drive Water and Sewer
Extension with flow allocation for 66 units.
Enclosed with this letter you will fmd the following:
1. $480 Application Fee
2. Fast Track Application(FTA 04-16)
3. Downstream Flow Tracking Form(FTSE 04-16) - 2 -1-04R,1
4. USGS Exhibit Map
5. Street Level Vicinity Map
Should you require any additional infoiniation or wish to discuss this project,please do not hesitate to call
or email ([e-mail]).
Sincerely,
DRAPER ADEN ASSOCIATES
NKL. //t/
C. Tyrus Clayton, ., PE
Senior Project Manager
Enclosures
cc: file, Ted Credle Town of Smithfield DPU
Blacksburg, VA • Charlottesville, VA •Hampton Roads, VA •Northern Virginia•Richmond, VA
Fayetteville,NC•Raleigh,NC

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
_ 15A NCAC 02T.0300—FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources INSTRUCTIONS FOR FORM: FTA 04-16&SUPPORTING DOCUMENTATION
This application is for sewer extensions involving gravity sewers, pump stations and force mains, or any combination that has been
certified by a professional engineer and the applicant that the project meets the requirements of 15A NCAC 02T and the Division's
Minimum Design Criteria and that plans, specifications and supporting documents have been prepared in accordance with, 15A
NCAC 02T, 15A NCAC 02T.0300,Division policies and good engineering practices.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design
documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans, design
calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimum design criteria. These
documents shall be available upon request by the Division.
Projects that are deemed permitted(do not require a permit from the Division)are explained in 15A NCAC 02T.0303.
Projects not eligible for review via the fast track process(must be submitted for full technical review):
> Projects that require an environmental assessment in accordance with 15A NCAC 1C.0100;
> Projects that do not meet any part of the minimum design criteria(MDC)document;
> Projects that involve a variance from the requirements of 15A NCAC 2T;
> Pressure sewer systems utilizing septic tank-effluent pumps(STEPs)or simplex grinder pumps;
> STEP or simplex grinder pumps connecting to pressurized systems(e.g.force mains);
> Vacuum sewer systems.
General—When submitting an application,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 information. Failure to submit all required items will necessitate additional
processing and review time,and may result in return of the application. Unless otherwise noted,the Applicant shall submit
one original and one copy of the application and supporting documentation.
A. One Original and One Copy of Application and Supporting Documents
® Required unless otherwise noted
B. Cover Letter(Required for All Application Packages):
El List all items included in the application package, as well as a brief description of the requested permitting action.
> Be specific as to the system type,number of homes served,flow allocation required, etc.
> If necessary for clarity,include attachments to the application form.
C. Application Fee(All New and Major Modification Application Packages):
El Submit a check or money order in the amount of$480.00 dated within 90 days of application submittal.
> Payable to North Carolina Department of Environmental Quality(NCDEQ)
D. Fast Track(Form: FTA 04-16)Application(Required for All Application Packages):
® Submit the completed and appropriately executed application.
> If necessary for clarity or due to space restrictions, attachments to the application may be made.
❑ If the Applicant Type in Item I.2 is a corporation or company,provide documentation it is registered for business with
the North Carolina Secretary of State.
❑ If the Applicant Type in Item I.2 is a partnership or d/b/a, enclose a copy of the certificate filed with the Register of
Deeds in the county of business.
El The Project Name in Item 1t.1 shall be consistent with the project name on the flow acceptance letters, agreements, etc.
® The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North
Carolina licensed Professional Engineer.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T.0106(b).
Per 15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is
provided from a person who meets the criteria in 15A NCAC 02T.0106(b).
INSTRUCTIONS FOR FORM:FTA 04-16&SUPPORTING DOCUMENTATION Page 1 of 3

E. now Tracking/Acceptance Form(Form: FTSE 04-16)(If Applicable):
® Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility.
> Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
> The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one
year prior to the application date.
> Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-
215.67(a).
> Intergovernmental agreements or other contracts will not be accepted in lieu of a project-specific FTSE.
F. Site Maps(All Application Packages):
® Submit an 8.5-inch x 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project
area and closest surface waters.
> Location of the project(gravity sewer,pump stations&force main)
> Downstream connection points and permit number(if known)for the receiving sewer
® Include a street level map(aerial)showing general project area so that Division staff can easily locate it in the field.
G. Existing Permit(All Modification Packages):
El Submit the most recently issued existing permit.
❑ Provide a list of any items within the permit the Applicant would like the Division to address during the permit
modification(i.e.,permit description,flow allocation,treatment facility, etc.).
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
® Per 15A NCAC 02T.0305(h)(1), submit documentation of power reliability for pumping stations.
> This alternative is only available for average daily flows less than 15,000 gallons per day
> It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible
with the station. The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or proposed
contractor,stating that"the portable power generation unit or portable,independently-powered pumping units,associated
appurtenances and personnel are available for distribution and operation of this pump 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 in the case of a multiple station power outage. (Required at time of certification)
I. Certificate of Public Convenience and Necessity(All Application Packages for Privately-Owned Public Utilities):
❑ Per 15A NCAC 02T .0115(a)(1)provide the Certificate of Public Convenience and Necessity from the North Carolina
Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by
the sewer extension, or
❑ 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.
J. Operational Agreements(Applications from HOA/POA and Developers for lots to be sold):
❑ Home/Property Owners' Associations
❑ Per 15A NCAC 02T.0115(c),submit the properly executed Operational Agreement(FORM:HOA).
❑ Per 15A NCAC 02T.0115(c), submit a copy of the Articles of Incorporation,Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 15A NCAC 02T.0115(b), submit the properly executed Operational Agreement(FORM:DEV).
For more information, visit the Division's collection systems website
INSTRUCTIONS FOR FORM:FTA 04-16&SUPPORTING DOCUMENTATION Page 2 of 3

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS,SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE ADDRESS COUNTIES SERVED
Asheville Regional Office 2090 US Highway 70 Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Quality Section Swannanoa, North Carolina 28778 Clay, Graham, Haywood, Henderson, Jackson,
[phone] Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax Rutherford, Swain,Transylvania,Yancey
Fayetteville Regional Office 225 Green Street Suite 714 Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section Fayetteville, North Carolina 28301-5094 Montgomery, Moore, Robeson, Richmond,
[phone] Sampson, Scotland
[phone] Fax
Mooresville Regional Office 610 E. Center Avenue Alexander, Cabarrus, Catawba, Cleveland,
Water Quality Section Mooresville, North Carolina 28115 Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone] Stanly, Union
[phone] Fax
Raleigh Regional Office 1628 Mail Service Center Chatham, Durham, Edgecombe, Franklin,
Water Quality Section Raleigh, North Carolina 27699-1628 Granville, Halifax, Johnston, Lee, Nash,
[phone] Northampton, Orange, Person,Vance,Wake,
[phone] Fax Warren,Wilson
Washington Regional Office 943 Washington Square Mall Beaufort, Bertie, Camden, Chowan, Craven,
Water Quality Section Washington, North Carolina 27889 Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone] Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax Perquimans, Pitt,Tyrrell,Washington,Wayne
Wilmington Regional Office 127 Cardinal Drive Extension Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section Wilmington, North Carolina 28405 Hanover, Onslow, Pender
[phone]
[phone] Fax
Winston-Salem Regional Office 450 W. Hanes Mill Road Alamance,Alleghany,Ashe, Caswell, Davidson,
Water Quality Section Suite 300 Davie, Forsyth, Guilford, Rockingham, Randolph,
Winston-Salem, North Carolina 27105 Stokes, Surry,Watauga,Wilkes, Yadkin
[phone]
INSTRUCTIONS FOR FORM:FTA 04-16&SUPPORTING DOCUMENTATION Page 3 of 3

•
State of North Carolina
Department of Environmental Quality
Division of Water Resources
DWR
15A NCAC 02T.0300—FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 0446&SUPPORTING DOCUMENTATION
Application Number: iAj6�DO 3 g q l I (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1.Applicant's name: Town of Smithfield Department of Public Utilities(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: Ted Credle per 15A NCAC 02T.0106(b)
Title:Director
4. Applicant's mailing address:PO Box 761
City: Smithfield State:NC Zip:27577-
5. Applicant's contact information:
Phone number: [phone] Email Address:[e-mail]
II. PROJECT INFORMATION:
1. Project name:Kellie Drive Water and Sewer Extension
2. Application/Project status: ®Proposed(New Permit) ❑Existing Permit/Project
If a modification,provide the existing permit number:WQ00 and issued date:
If new construction but part of a master plan,provide the existing permit number: WQ00
3. County where project is located:Johnston
4. Approximate Coordinates(Decimal Degrees):Latitude: 35.421304° Longitude: -78.733585°
5. Parcel ID(if applicable):
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: C.Tyrus Clayton Jr,PE License Number: 028909
Firm:Draper Aden Associates
Mailing address: 930 Main Campus Drive, Suite 151
City:Raleigh State:NC Zip:27606-
Phone number: [phone] Email Address:tclayton(nidaa.com
IV. WASTEWATER TREATMENT FACILITY(WWTF)INFORMATION:
1. Facility Name: Central Johnston County WWTF Permit Number:NC0030716
Owner Name:Johnston County
V. RECEIVING DOWNSTREAM SEWER INFORMATION(if different than WWTF):
1. Permit Number(s): WQ Downstream(Receiving)Sewer Size: 8 inch
System Wide Collection System Permit Number(s)(if applicable): WQCS00270
Owner Name(s):Town of Smithfield
FORM:FTA 04-16 Page 1 of 5

VL , 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 Operational Agreement(FORM:HOA)been attached?
❑Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
❑Residential Owned ❑Retail(stores, centers,malls) ❑ Car Wash
❑Residential Leased ❑Retail with food preparation/service ❑Hotel and/or Motels
El 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: %Domestic/Commercial 100%Commercial
%Industrial(See 15A NCAC 02T.0103(20))
I >Is there a Pretreatment Program in effect? ❑Yes ❑No
6. Has a flow reduction been approved under 15A NCAC 02T.0114(f)? ❑Yes ®No
> If yes,provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type(see 02T.0114(t)) Daily Design Flow a,b No. of Units Flow
Nursing Home w/laundry 120 gal/bed 66 7,920 GPD
gal/ GPD
gal/ GPD
gal/ GPD
gall GPD
gal/ GPD
Total 7,920 GPD
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: 7,920 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
El 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) Length(feet) Material
8 2877 SDR 35 PVC
8 213 C900 PVC
> Section II&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 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:PUMP STATION 1
2. Approximate Coordinates(Decimal Degrees):Latitude:35.534557° Longitude: -78.323318°
3. Design flow of the pump station: 0.0598 millions gallons per day(firm capacity)
4. Operational point(s)of the pump(s): 80 gallons per minute at 38 feet total dynamic head(TDH)
5. Summarize the force main to be permitted(for this Pump Station):
Size(inches) Length(feet) Material
4 1340 C900 PVC
6. Power reliability in accordance with 15A NCAC 02T.0305(h)(1):
® Standby power source or 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
.0305(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 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
in the case of a multiple station power outage.
FORM:FTA 04-16 Page 3 of 5

•
IX. SET$ACKS&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
➢ 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) 24 inches
Water mains(vertical-water over sewer 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 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(f)cannot be achieved.
> **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
> If noncompliance with 021.0305W or(g),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 .0200? ❑Yes ❑No ®N/A
➢ This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project require coverage/authorization 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 021.0105(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-priority 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(latest version)as applicable?
®Yes ❑No
If No,complete and submit the Variance/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
I, C, 'Si, f 5 )cty ar, P1 attest that this application for
1,(Professional Efiginee?'s name from Application Item III.1.)
ke ii:a /2f;✓e Seu/er and Wal-e( Ey4e-iiT
5 a vr1
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(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 I have reviewed this material and
have judged it to be consistent with the proposed design.
NO lb — 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.
,,,, .inns& ,r.
North Carolina Professional Engineer's seal,signature,and date: ,,.�`‘�'( °/ �,j '
ci9.0„._
SEAL ',
S 028909 1
�
n 3-2/--/e9 , s
v''I� ,� �'GINE �
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rf11i,,,, ,,,,,,,%\A�. . ... .
3. Applicant's Certification per 15A NCAC 02T.0106(b):� 1 I`
I, ltd)
C fee)ie p;r eel-7) Ort Pv h) � U i-. ), 4-1,es attest that this application for
(Signature Authority's name&title from Application Item 1.3.)
ke he Dr:,re Sewer ot..-t ) 6-10,4 ,rki`e"-sl on
has been reviewed by me and is accurate and complete to the est 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.
i
Signature: 6Date: 3 -Z�--/5J
FORM:FTA 04-16 Page 5 of 5

{
State of North Carolina
• "���a 4 Department of Environmental Quality
,ugm. Division of Water Resources
Division of hila er Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Johnston County Public Utilities 1
Project Name for which flow is being requested: Kellie Drive Water and Sewer Extension
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all 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: Central Johnston County WWTF
• b. WWTP Facility Permit#: NC0030716
All flows are in MGD
c. WWTP facility's permitted flow 9.5
d. Estimated obligated flow not yet tributary to the WWTP 2.05
e. WWTP facility's actual avg.flow 5.492
f. Total flow for this specific request 0.00792
g. Total actual and obligated flows to the facility 7.545
h. Percent of permitted flow used 79.5
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 Average Daily Approx. Not Yet Total Current
Station Firm Flow** Current Avg. Tributary Flow Plus
(Name or Capacity,* (Firm/pf), Daily Flow, Daily Flow, Obligated Available
Number) MGD MGD MGD MGD Flow Capacity***
Buffalo 4.291 1.716 1.447 0.08414 1.531 • 0. 185*
/'�snnrr _
4.14.6.0A-ALwaLL_ j,tLat
2.
tizAJA 5 n,..o±ko aon, c +.o ri &O
*The Firm Capacity 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.
***A Planning Assessment Addendum shall be attached for each pump station Iocated
between the project connection point and the WWTP where the Available Capacity is<0.
Downstream Facility Name(Sewer): Buffalo Creek WWPS
Downstream Permit Number: Unknown
Page 1 of 6
FTSE 04-16

III. Certification Statement:
I Chandra C.Farmer,P.E. 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 addendurns for which I am the responsible party.
Signature of this form indicates acceptance of this wastewater flow.
C AO.AlbrAika 31D
Signing Official Signature Date
•
•
•
Page 2 of 6
FTSE 04-16

State of North Carolina
I
Department of Environmental Quality
j 1\ 1 1 Division of Water Resources
Division of Water Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: "�a1.tri J St,i;�,i j /ul/�. _Ufi) �'ic5
Project Name for which flow is being requested: Kellie Drive Water and Sewer Extension
More than one FTSE may be required for a single project if-the owner of the NPYTP is not responsible for all 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:
b. WWTP Facility Permit#: •
All flows are in MGD
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
f. Total flow for this specific request 0,60-79),
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
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 Average Daily Approx. Not Yet Total Current
Station Firm Flow'* Current Avg. Tributary Flow Plus
(Name or Capacity,* (Firm/pf), Daily Flow, Daily Flow, Obligated Available
Nurriber) MGD MGD MGD MGD Flow Capacity***
4`0N0( Ci RA /T( UetJTtt- 7' EJreaUAJTY z^iaE
*The Firm Capacity of any pump station is defined as the maximum pumped flow that
can be achieved with the largest pump taken out of service.
*Y Design Average Daily Flow is the firm capacity of the pump station divided by a peaking
factor(pf)not less than 2.5.
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): Tvw,,t of 5 1THFI 1-. W4$TEwr1TE12. Co LLE&Tto'l SYSTEM
Downstream Permit Number: WQCS00270
Page 1 of 6
FTSE 04-16

f
III. Certification Statement:
I Ted Credle 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 indicates acceptance of this wastewater flow.
1--J\ i(it'l- 7-5-d
Signing Official Signature Date
Page 2 of 6
FTSE 04-16

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Water Resources LINDA CULPEPPER
ENVIRONMENTAL QUALITY
Int-prim()work"
April 24, 2018
Thom Schmalzbauer, Site Support Track Director
Novo Nordisk
3612 Powhatan Road
Clayton, NC 27527
Subject: Permit No. WQ0039900
Novo Nordisk
Novo Nordisk Pump and,Haul
Domestic Wastewater Pump & Haul Permit
Johnston County
Dear Mr.Schmalzbauer:
In accordance with your application received February 16, 2018, we are forwarding herewith Permit No.
WQ0039900, dated April 24, 2018, to Novo Nordisk for the time-limited operation of a domestic
wastewater pump and haul operation. This permit shall be effective from April 24, 2018, will expire on
October 24, 2018,shall void Permit No.WQ0039536 issued October 10,2017, and shall be subject to the
conations and limitations as specified therein. This cover letter and supplement shall be considered a
part of this permit and are therefore incorporated therein by reference.
Please pay particular attention to the following conditions contained within this permit:
Condition 1.1: The Permittee or its representative shall inspect the permitted pump and haul facilities at
least daily to prevent malfunctions and deterioration, operator errors, and discharges
that may cause or lead to the release of wastes to the environment, a threat to human
health, or a nuisance condition. Records shall be submitted monthly to the Supervisor
of the Water Quality Regional Operations of the Raleigh Regional Office.
Condition 11.1: An accurate record of the pump and haul activities must be maintained by the Permittee,
indicating; Date and time wastewater is removed from the facility; Name of contract
hauler; Name of facility receiving wastewater; & Volume of wastewater removed.
Records shall be submitted monthly to the Supervisor of the Water Quality Regional
Operations of the Raleigh Regional Office, 3800 Barrett Drive, Raleigh, NC 27609.
Condition 11.14: This permit shall expire October 24,2018. Should the pump and haul activities cease prior
to the date of expiration send written notification to the Raleigh Regional Office, Water
Quality Section notifying that the permit is no longer required and detailing the final
disposal solution.
Division of Watei Resources,Raleigh Regional Office, Water Quality Operations Section www ncwaterquality org
1628 Mail Service Center,Raleigh,NC 27699-1628 Phone:[phone]
Location. 3800 Barrett Drive,Raleigh,NC 27609 Fax• [phone]

•
- Novo Nordisk
Permit No.WQ0039900 -
The wastewater collected by this system shall be pumped and hauled to the Town of Clayton's Water
Reclamation Facility(N00025453),the North Durham Water Reclamation Facility(NC0023841),and the
South Durham Water Reclamation Facility (N00047597) for final treatment. Wastewater shall not be
pumped and hauled to any other location/facility for disposal/final treatment without prior approval
from this Division.
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 1508 of North Carolina General____`_._--� -
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 concerhing this matter, please contact Ted Cashion at [phone]
or via e-mail at [e-mail].
Sincerely,
X,-d2/// . /
for Linda Culpepper
Interim Director, Division of Water Resources
by S. Daniel Smith, Regional Supervisor
Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ
cc: Jonathan Heald, EFDEE Engineering Professional Corporation (Fluor) (via email:
jonathan.heald @fluor.com)
Tyrone Battle, Industrial Waste Control Administrator,Water Management, City of Durham (via
email: [e-mail])
James Warren, Superintendent,Town of Clayton (via email:[e-mail])
Raleigh Regional Office Files
Water Resources Central Files: Attention Diane Rodman
Page2 of7

Water Resources
ENVIRONMENTAL QUALITY
DOMESTIC WASTEWATER PUMP & HAUL 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
Novo Nordisk
for the construction and operation of a domestic wastewater pump and haul operation to serve Novo
Nordisk, located at 3611 Powhatan Road, Clayton, NC, consisting of nine—7,000 gallons storage tanks
with a total underground storage tank capacity of 63,000 gallons. These tanks from which pumping will
occur shall include a minimum 24 hours storage with on-site audible and visual high water alarms and
telemetry. The nine underground storage tanks will be supplemented with portable chemical toilets
onsite. The waste from these toilets shall be regulated by the Septage Management Firm Permit held by
the appropriate responsible party. The anticipated flow for this pump and haul operation is expected to
be 63,000 gallons per day of domestic wastewater, pursuant to the application received February 16,
2018, and in conformity with 15A NCAC 02T 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 April 24, 2018, will expire on October 24, 2018, and shall be subject to
the conditions and limitations as specified therei .
for Linda Culpepper
Interim Director, Division of Water Resources
By Authority of The Environmental Management Commission
Permit Number: WQ0039900
Permit Issued: April 24, 2018
Page 3 of7

SUPPLEMENT TO PERMIT COVER SHEET
I
Novo Nordisk is hereby authorized to:
Construct and operate the aforementioned domestic wastewater pump and haul operation. The
wastewater collected by this system shall be pumped and hauled to the North Durham Water Reclamation
Facility, NPDES Permit No. NC0023841, the South Durham Water Reclamation Facility, NPDES Permit No.
NC0047597 or the Town of Clayton's Water Reclamation Facility, NPDES Permit No. NC0025453 for final
_ __ treatment. Wastewater shall not be pumped and hauled to any other location/facility for disposal/final
treatment without prior approval from this Division.
It shall be the Permittee's responsibility to ensure that the as-constructed project meets the appropriate
design criteria and rules. Failure to co ply may result in penalties in accordance with North Carolina
General Statute §143-215.6A through §1,43-215.6C, construction of additional or replacement facilities,
and/or referral of the North Carolina-licensed Professional Engineer to the licensing board.
Construction and operation is contingent upon compliance with the Standard Conditions and any Special
Conditions identified below.
I. SPECIAL CONDITIONS
1. The Permittee or its representative shall inspect the permitted pump and haul facilities at least daily
to prevent malfunctions and deterioration,operator errors, and discharges that may cause or lead to
the release of wastes to the environn%ent, a threat to human health, or a nuisance condition. The
Permittee shall maintain an inspection log or summary including at least:
a. Date and time of inspection;
b. Observations made;
c. Any maintenance, repairs, or corrective actions taken by the Permittee.
The Permittee shall maintain this log of inspections for as long as the pump and haul activities are
being conducted and shall be made available to the Division or other permitting authority, upon
request. Records shall be submitted monthly to the Supervisor of the Water Quality Regional
Operations of the Raleigh Regional Office. The records must be submitted within 30 days of the
end of each month. [15A NCAC 02T.0204(d)]
2. The Raleigh Regional Office, must be nlotified at least 48 hours prior to the commencement of the
pump and haul activities so that a site i I spection can be performed. [15A NCAC 02T .0110]
3. This permit shall become voidable unle s the agreement between Novo Nordisk, the North Durham
Water Reclamation Facility, the South urham Water Reclamation Facility, the Town of Clayton's
Water Reclamation Facility, and Bobby avis Jr.Septic Tank Service for the collection,transportation,
and final treatment of wastewater is in ull force and effect. [15A NCAC 02T.0204(b)]
II. STANDARD CONDITIONS
1. An accurate record of the pump and hau activities must be maintained by the Permittee, indicating:
a. Date and time wastewater is re oved from the facility;
4 of 7

•
b. Name of contract hauler;
c. Name of facility receiving wastewater;
d. Volume of wastewater removed.
The Permittee shall maintain this log for as long as the pump and haul activities are being conducted
and shall be made available to the Division or other permitting authority, upon request. Records shall
be submitted monthly to the Supervisor of the Water Quality Regional Operations of the Raleigh
Regional Office, 3800 Barrett Drive, Raleigh, NC 27609. The records must be submitted within 30
days of the end of each month. [15A NCAC 02T.0108]
2. This permit shall not be transferable. In the event there is a desire for the 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 an application fee, 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)]
3. The Permittee shall provide for the installation and maintenance of an audible and visual high-water
alarm on all storage and pumping facilities associated with this pump and haul operation. [15A NCAC
02T.0204(c)]
4. This permit shall become voidable unless the subject pump and haul activities are carried out in
accordance with the conditions of this permit; 15A NCAC 2T; and other supporting materials unless
specifically mentioned herein. [15A NCAC 02T.0110]
5. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data. No type, kind or quantity of wastewater other than the
pumped and hauled wastewater from the facility shall be included in these pump and haul activities.
[15A NCAC 02T.0110]
6. The wastewater collection facilities shall be properly maintained and operated at all times. Adequate
inspection, maintenance, and cleaning shall be provided by the permittee to insure proper operation
of the subject facilities. [15A NCAC 02T.0403]
7. The Permittee shall report by telephone to a Water Resources staff member at the Raleigh Regional
Water Resources Section,telephone number 919-791-4200, 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:
a. If the flow volume estimated above is exceeded by any amount on any day; or
b. Any process unit failure,due to known or unknown reasons,that renders the facility incapable
of adequate wastewater storage, such as failures of tanks, piping, pumps, aerators,
compressors etc.; or
c. Any failure of a pumping station, sewer line, etc., resulting in a spill or by-pass directly to
receiving waters without treatment of all or any portion of the influent to such station or
facility; or
d. Any SSO and/or spill over 1,000 gallons; or
e. 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].
5 of 7

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 shovel that the SSO was beyond control. [G.S. 143-215.1C(a1)]
8. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 02T; 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-theI licensing_boar_d. [15A_NCA.C_02_T-.0104;_15A NCAC 02T .0108(b-
c)]
9. In the event that the wastewater collection facilities fail to perform satisfactorily, including the
creation of nuisance conditions, the IIPermittee shall cease operation of all pump and haul activities
and 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)]
10 Any duly authorized officer, employee, or representative of the Division of Water Resources may,
upon presentation of credentials, enter and inspect any property, premises, or place on or related to
the pump and haul collection facilities at any reasonable time for the purpose of determining
compliance with the Division's approval; may inspect or copy any records that must be maintained
under the terms and conditions of this permit; and may obtain samples. [15A NCAC 02T.0110]
11. 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 havle 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)]
12. Operation of this permit is based on acceptance of the certification attached to this permit,completed
by the Permittee and a North Carolina licensed Professional Engineer. Note that a completed
certification is only required for activities that met the definition of the Practice of Engineering in
accordance with G.S. 89C-3. In some instances this certification may not be required.
13. A copy of this permit, and approved plans and specifications (if applicable) shall be maintained on file
by the Permittee for the life of the project. [15A NCAC 02T .0104]
14. This permit shall expire October 24,2018. Should the pump and haul activities stop prior to the date
of expiration send written notificatio I to the Raleigh Regional Office,Water Quality Section notifying
them of that the permit is no longer rquired� and detailing the final disposal solution. [15A NCAC 02T
.0105(j), 15A NCAC 02T.0204(a)]
•
6 of 7

Domestic Wastewater Pump & Haul Engineering Certification
PERMITTEE: Novo Nordisk
PERMIT#: WQ0039900
PROJECT: Novo Nordisk Pump and Haul
ISSUE DATE: April 24, 2018
This project shall not be considered complete nor allowed to operate until the Division has received this
Certification. It should be submitted in a manner that documents the Division's receipt. Send the required
documentation to the Regional Supervisor, Water Quality Section at the address at the bottom.
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 pump and haul system permitted herein or portions thereof.
Printed Name,Title Signature Date
ENGINEER'S CERTIFICATION
I, , as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe (I I periodically, n weekly, full time) the construction of the
project name and location as referenced above 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 within substantial compliance of this permit; 15A NCAC 2T and
other supporting materials.
North Carolina Professional Engineer's Seal w/signature & date:
I I Final n Partial (include description)
Certification Comments/Qualifiers (attach if-necessary):
7 of 7

.
I. PRESUBMITTAL INFORMATION: 041647111--'
1. Contacted representative from regional office(Pre-submittal)?: ® Yes ❑ No G® )'Jl/qD
0
2. Contact name(For Regional Office):Ted Cashion f1
II. APPLICANT INFORMATION:
1. Applicant's name(Municipality, Individual, Corporation, etc):Novo Nordisk
2. Applicant type: ❑ Municipal ❑State ❑ Privately-Owned Public Utility
❑ County ®Other: Corporation
3. Origin of Wastewater:
Residential Subdivision ❑ Retail (Stores,Shopping Centers) Domestic:
❑Apartments/Condominiums ❑ Institution Commercial:
❑ Mobile Home Park ❑ Hospital Industrial:
❑School ❑ Church Other: 100
❑ Restaurant ❑ Nursing Home
- ❑Office ® Other(specify)
4. Signature authority's name:Thom Schmalzbauer per 15A NCAC 02T.0106(b)
Title:Site Support Track Director4.1
5. Applicant's mailing address:3612 Powhatan Road CY
City: Clayton State:NC Zip:27527- = ,
6. Applicant's contact information: G o
tO
Phone number: [phone] Email:tmsz(c�novonordisk.com, .? GA.'.
7:D c4
III. CONTACT/CONSULTANT INFORMATION: LLI ,4o
1. Contact name:Jonathan Heald a)
a
a) all
Title/Affiliation:Senior Civil Engineer, EFDEE Engineering Professional Corporation (Fluor)
2. Contact's information: `
Phone number: [phone] Email: [e-mail]
IV. RECEIVING FACILITY INFORMATION:
If more than 1 facility has agreed to accept the wastewater,please list all the owners,facility names, and permit
numbers as a separate attachment)
1. Owner: City of Durham,NC and Town of Clayton NC
2. Facility name:North Durham Water Reclamation Facility, South Durham Water Reclamation Facility,
Little Creek Water Reclamation Facility 4 3S-/
3. Facility permit number: NC0047597, NC094.7-5-97,NC0025453 respectively �" ,,,
4. WWTF permit number: N/A
5. WWTF contact name: Gerald Tyrone Battle, (Durham),James Warren(Clayton)
Title/Affiliation:Industrial Waste Control Administrator/Water Management, City of Durham
6. WWTF contact information: Wastewater Operations Superintendent, Town of Clayton
Phone number: [phone] Email:gerald.battledurhamnc.gov
• [phone] [e-mail]
APPLICATION P&H 01-16 Page 3 of 5

V. PROJECT INFORMATION:
1. Location of Project(physical address): 3611 Powhatan Road Clayton,NC
Approximate Coordinates (Decimal Degrees): Latitude: 35.6201670 Longitude:-78.4106980
2. Duration of Pump and Haul Request(Six Months Typical): six months
3. Has a prior permit been issued? n New ® Prior Pump& Haul Permit
Permit No.: W00038725
4. Permanent Method of Wastewater DisplIosal: Town of Clayton wastewater system
__
5. Date Permanent Disposal will be available: unknown
6. Have permits/approvals for permanent disposal been obtained?
®Yes n No Permit II umber: W00038790
7. Is there a Pretreatment Program in effect? n Yes ® No
8. Describe any pretreatment prior to pumbing and hauling:
9. Volume of Wastewater Generated: II 96,700 Gallons per Day
10. Explain how the wastewater flow was d termined: ® 15A NCAC 02T.0114 or n Representative Data
If representative data,describe:
•
11. Describe Tank/Container wastewater w'll be pumped from (attach description if necessary):
Refer to drawings,number CL XX DAPI-US 3 10 113 sheets 90-94, submitted with this application
12 Is Tank/Container in place or will it be installed (attach description if necessary):
— Tanks are installed. Refer to plans submitted with this application.
13., What;type of high water alarm does the container have (and/or):
®Audible and Visual n Telemetry(Auto Dialer/SCADA)
VI. CERTIFICATION:
1. Applicant's Certification: (Signature of Signing Official and Project Name)
(,Thom Schmalzbauer , attest that this application for Novo Nordisk DAPI-US Project has been reviewed by me and is
accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting documentation and attachments are not included, this application package is
subject to being returned as incomplete. I understand that issuance of a permit will require pump and haul facilities or
activities to be inspected at least daily by me or designated representative. Note: In accordance with North Carolina
General Statutes 143-215.6A and 143-215.66, an\), person who knowingly makes any false statement, representation, or
certificatio2-in any appti9tion shall be guilty of a Class 2 misdemeanor,which may include a fine not to exceed $10,000 as
well as civil p nalt'es up $25,000 per violation.
la. A gAt nfl/ __. 09 r Il? 71
Signing Official Signatur t Date
ENGINEERING DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL.
ACTIVITIES SHALL BE INSPECTED AT LEAST DAILY BY THE PERMITTEE OR IT'S REPRESENTATIVE PER 15A NCAC 02T.0204(d).
APPLICATION P&H 01-16 Page 4 of 5

THE ENGINEER'S CERTFICATION IS REQUIRED FOR ACTIVITIES THAT RESULT IN THE PRACTICE OF ENGINEERING PER G.S.89C-3.
ENGINEERING DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL. IF CERTIFICATION BY AND ENGINEER IS REQUIRED,
THIS PAGE IS NOT NECESSARY.
2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
I, Jonathan W. Heald ,attest that this application for Ndvo Nordisk DAPI-US Project has been reviewed by me and is
accurate, complete and consistent with the information in the engineering plans, calculations, and all other supporting
documentation to the best of my knowledge. I further attest that to the best of my knowledge the proposed design has
been prepared in accordance with all the applicable regulations. Although other professionals may have developed certain
portions of this submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed
this material and have judged it to be consistent with the proposed design. Note: In accordance with NC General Statutes
143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or certification in any
application shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed $10,000 as well as civil penalties
up to$25,000 per violation.
2a.Jonathan W. Heald ', � �\\\itlI If,rj
f ////
Professional Engineer Name 0-„ ..0.r�rm
4j °2b. EFDEE Engineering Professional Corporation t _i;°.o 0 ,, ..,\ . 9 °
e % -Engineering Firm
_ _ SEAL
2c. 100 Fluor Daniel Drive - 032781
Mailing Address I
2d. Greenville 2e. SC 2f. 29607 v/jj ��G r Id S, ••••"'0""40
City State Zip t / '.. °��G
2g. 864-281-4400 2h. N/A 2i. [e-mail] "° ,,,+i y, ���
Telephone Facsimile , E-mail ; N�P `he
.f,` 'gn:"u ►ate
APPLICATION P&H 01-16 PROP. 5 of 5

h
Additional Receiving Facility Information
1. Owner: Town of Clayton, NC
2. Facility Name: Little Creek Water Reclamation Facility
3. Facility Permit Number: NPDES NC0025453 (LCWRF)
4. WWTF Permit Number: N/A
5. WWTF Contact Name: James Warren
Title/Affiliation: Wastewater Operations Superintendent,Town of Clayton, NC
6. WWTF Contact Information:
Phone Number:919-553-1536

NC Dept of Environmental Quality
FEB 1 iS 2018
February 15, 2018 Novo Nordis`kFDAPQ S Project
Project Definition: A7ND
Mr. Ted Cashion, CHMM
NC Department of Environmental Quality
Division of Water Resources
Raleigh Regional Office
3800 Barrett Drive
Raleigh, NC 27609
Subject: Renewal of Pump and Haul Permit#WQ0039536
Novo Nordisk Diabetes API-US Project
Clayton, NC—Johnston County
Dear Mr. Cashion,
Enclosed are two copies of our application to continue the pump and haul of domestic wastewater
from Novo Nordisk's DAPI-US construction project site in Clayton, North Carolina. At this time we are
actively building the DAPI-US facility, so the wastewater generated is from our construction staff on
site. We anticipate approximately 1,800 personnel on site in April 2018, ramping up to 2,760 in
September 2018. These staffing numbers are split about 30%/70% between office staff supporting
construction and construction labor. These numbers also include an extra 10% contingency for
additional workers.
Using the value of 35 gallons per person from 15A NCAC 02T 0114, we are estimating an average
daily load currently of 63,500 gallons per day in April 2018, reaching a peak of 96,700 gallons per day
in October 2018 Our plan for temporarily handling sanitary sewer utilizes"nine7 7;000 g`a`llon'
Underground storage-tanksisupplementedwith portable•chemical-toilets:around.the:constructibn-site.
Under an agreement with the Town of Clayton we are awaiting an extension of the public wastewater-
system to the site by the Town. When finished, this will serve the completed facility and eliminate the
need to pump and haul wastewater from the site. While the on-site sewer system is nearing .
completion, the off-site extension by the Town is not yet permitted but is scheduled to receive a
Permit to Operate later this year We need to continue hauling wastewater from the site to facilitate
construction of this plant until the public extension is completed and permitted.
Per your previous conversations with Jonathan Heald on the requirements for this application, we are
including the following items in addition to this cover letter to support our application:
1. Drawings of the site indicating the location of the tanks and temporary collection system
2 Updated Authorizations to Discharge letters from the following Receiving Facilities:
a City of Durham, North Durham &South Durham Water Reclamation Facilities
b. Town of Clayton, Little Creek Water Reclamation Facility
3. Updated Pump and Haul Letter and Certifications from Bobby Davis Jr. Septic Tank
Service
4. Application-fee of$1,310.00
Thank you,
Cover Letter-Temp Ph Renewal 180207

Mr Ted Cashion 1'IC Dept of Environmental Quality
February 15, 2018
Page 2 of 2 FEB 16 2018
Kevin O'Riordan
Environmental Coordinator Raleigh Regional Office
, cc. Matt Kuntz—Novo Nordisk
Jason Layne—Novo Nordisk
Thom Schmalzbauer—Novo Nordisk
Amy Herbert—Fluor
Kevin O'Riordan— Novo Nordisk
Michael O'Toole—Fluor .
Sheri Ware—Fluor
Cover Letter-Temp Ph Renewal 180207