WQ0040011_Application_20180518

E
May 15, 2018
Technical Memorandum
To: Review Officer
NCDEQ — Division of Water Resources — Asheville Regional Office
2090 US Highway 70
Swannanoa, NC 28778
From: Jeffrey T. Brown, PE
President �r
Cc: Josh Nickol
General Manager
RE: Hwy. 209 — I-40 Sewer Fast -Track Application (Pump Station)
Haywood County, NC
Attached please find the following documents:
WQ0040011
1. Fast -Track Application (FTA 04-16) for a pumps at Richland Creek Pump Station
2. Flow tracking/Acceptance for Sewer Extension Application (FTSE 04-16)
3. An application fee Check in the amount of $480. Payable to NCDEQ
4. Site Map
Purpose for Gravity Sewer Replacement:
The purpose of the proposed project is to eliminate a confined space entry into a dry well by
replacing the existing pumps with Gorman -Rupp suction lift pumps. The existing pump station
serves businesses in the downtown Lake Junaluska area in the Junaluska Sanitary District. The
project will not increase capacity at the existing pump station.
Should you have any questions, please advise.
30 Ben Lippen School Road, Asheville, NC 28806 X828.350.7683 (office], 828.350.7684 [fax] , www, brown pa.net

State of North Carolina
`> WQ0040011 Department of Environmental Quality
DWR w„ 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 Hood 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 1 A NC 0303.
nk,ry
Projects not eligible for review via the fast track process (must be submitted for full technical r iew): /hn 'C R�®
➢ Projects that require an environmental assessment in accordance with 15A NCAC 1C 0100; °sovmr
➢ 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; M�y %
➢ Pressure sewer systems utilizing septic tank -effluent pumps (STEPS) or simplex grdevs mps;
➢ STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mai 01,0111,
➢ Vacuum sewer systems. Ashovift�oP10
General — When submitting an application, please use the following instructions as a checklist in order to ensure aller quired
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):
M 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):
® 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.
® The Project Name in Item II.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 Pagel of 3

E. Flow 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 GS. 11419-
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
N 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):
❑ 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)
L 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 theNinitlhCluallma
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 Scwvr WwRArsm Flifi fiic Slff 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.01 15(c), submit the properly executed Orall ons (IlN11::11)).
❑ Per 15A NCAC 02T.01 15(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 15A NCAC 02T.01 15(b), submit the properly executed Opera inial B Mmzmnd (11'iX1t: M EM).
information, visit the Division's collection systems niwdiwkre
MAY 15 2018
waver Llualiiy Regional opemilms I
ASFP.Vi!i@ I?.nn!grp,l O{{Irg
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION
Page 2 of 3

State of North Carolina
Department of Environmental Quality
DWR,, Division of Water Resources
n.
15A NCAC 02T.0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources r 04-16 & SUPPORTING DOCUMENTATION
ApplicationNW
completed by DWR)
I. APPLICANT INFORMATION:
1. Applicant's name: Junaluska Sanitary District (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: Josh Nickol per 15A NCAC 02T .0106(b)
Title: General Manager/ CFO �l~
nrvsfon � �,y P Bil�'Q
4. Applicant's mailing address: Po Box 35 pasourcps
City: Lake Junaluska State: NC Zip: 28745- MAY
5. Applicant's contact information: 1 5 ZOlB
Phone number: 828) 452-1178 Email Address: inickol@'sdwater.ore 11'nter pull/iv RrgbAe! Ae
Il. PROJECT INFORMATION: -� �naiQt"
1. Project name: Hwv 209 Sewer
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: W000 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Haywood
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.55060 Longitude: -82.9449°
5. Parcel ID (if applicable): 8627-68-8521
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Jeffrey T. Brown License Number: 28289
Firm: Brown Consultants, PA
Mailing address: 30 Ben Lippert School Road
City: Asheville State: NC Zip: 28806 -
Phone number: 828) 350-7683 Email Address: jtrown e brown
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Waynesville WWTP Permit Number: NCO025321
Owner Name: Waynesville
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: inch
System Wide Collection System Permit Number(s) (if applicable): WQCS00182
Owner Name(s): Junaluska Sanitary District
FORM: FTA 04-16 Page 1 of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes [-]No ®N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been attached?
❑ Yes ❑No ®N/A
3. If the Applicant is a Home/Pro��ty 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
® School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool /Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic/Commercial % Commercial
Industrial (See 15A NCAC 02T.0103(20 )
"Is there a Pretreatment Program in effect? ® Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T.01 14(f)? ❑ Yes ❑ No
➢ If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(fl)
Daily Design Flow °'b
No. of Units
Flow
Riverbend School
1,200 gal/
1
1200 GPD
Sams Mart
2880 gal/
1
2880 GPD
Pilot Travel Center
5,400 gal/
1
5400 GPD
gal/
GPD
gal/
GPD
gal/
GPD
To
9480 PD
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.01 141 shall
be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 9480, PD (per 15A NCAC 02T.0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16
MAY , r' 2018
Water QualityRegfonetOperaAfons I
ASfev�'�x P^oional ('Kine
Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T.030 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
➢ 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: Richland Creek Pump Station
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.5506° Longitude: -82.9449°
3. Design flow of the pump station: .864 MGD millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 10 gallons per minute at 81.1 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
n/a
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. SETBACKS & SEPARATIONS — (02B.0200 & 15A NCAC 02T.0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T.0305(f) & (g) ® Yes ❑ No
➢ 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 ce drainage
ditches
10 feet
Any building foundation g�*36/nches
t
Any basement Katerqt
Top slope of embankment or cuts of 2 feet or more vertical height
t
Drainages stems and interceptor drains St
Any swimmingpools
t
Final earth grade (vertical) Any
➢ 15A NCAC 02T.0305(g) conta ns alternatives here separations in 02T.0305 f��� V�iev�d. p
**Stream classifications can be identified usingthe Division's NC Surface Water Classy atiQn�s Vt.
age
➢ If noncompliance with 02T.0305(f) or ( 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 .02009 ® 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 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high-priority?"
Per 15A NCAC 02T.0402, "high-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:
name from Application Item 111. 1.)
attest that this application for
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.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per violation.
A
I,
ration for
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a
condition of this permit be violated. I also understand that if all required parts of this application package are not completed
and that if all required supporting information and attachments are not included, this application package will be returned to
me as incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: y Date: .5/451ZD78
FORM: FTA 04-16 Page 5 of 5

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PROJECT:
OWNER:
ENGINEER:
CONTRACTOR:
DESCR[PTIONJ
Jtjnaluska Sanitary District Pump Station
Improvements -Richland Pump Station,
Retrofit and Highway 209 Pump Statioa
Retrofit
Clyde; NC
McGill Associates
Blytheco Construction
TWG)i(2,)))FaIWban ks.Wors& modWW' B5442 T,20 t verticaF dry pit n, onrclbg, sewag.8
pum- P9,41111cast, iron vwluta; linpelfbran& bearing framej, 4""1'259-flbrngjad
dikhergo;-4,pamilically., balkneedArnpeller,. 316 stainless;steel wear rimgt% high,
striera&t Ilist0aEs 1418ft'r,bronZa shaft,slee-v%.stqndbrd]doubIe, mechanical.* seal' (kwithi
dead ifteaTdL-diftlitiarsystem)}.RL-xlb]L---,coupling i guard i drlVen)byr,25,,HFI,,1176SRPM'
2-8'4',VPZ'firam,e, stand8rdr�of,ftcit)nt:.motorwithWpliencibsur.eand Clas&F
Insulation, �
T!wo(R),.,:cefk,ff,led�n.on,Withess,pump hydrostatic tests
Two ,,(,2).,oas,tiir,oniior,,stoetpump.,bases with separate suction elbow„ 4"'x:6!'
swetio-welbaw andlelt-anout
Spare parts4o.be one (1) o-ring/gasket kit.
Four (',4),S5E)N0 5W, 'mercury float switches
One, (1!) stainless steel float bracket
MAY 15 2018
Water OtIRIM/ "99bnal C)peFWjc)rjs
Regional I
_qLlllLal (Iffce

SHEET OF
PROJECT:
SUBJECT:
1'' c®1'7'
BROWN CONSULTANTS, PA
30 Ben Lippen School Rd.
Asheville, NC 28806
o: 828.350.7683
f: 828.350.7684
WORK BY: CHK'D BY:
PROJECT #:
DATE: 41t
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MAY 15 2018
Water oualitY Regional

NC DENR-DIVISON OF WATER RESOURCES
.0304 FRENCH BROAD RIVER BASIN
2B .0300
Name of Stream
Description
Class
Class Date
Index No.
Pisgah Creek
From source to East Fork Pigeon
WS-III;Tr
08/03/92
5-3-11
River
Reed Creek
From source to Pisgah Creek
WS-III;Tr
08/03/92
5-3-11-1
Chinquapin Creek
From source to Pisgah Creek
WS-III;Tr
08/03/92
5-3-11-2
Cold Creek
From source to East Fork Pigeon
WS-III;Tr
08/03/92
5-3-12
River
Long Branch
From source to East Fork Pigeon
WS-III;Tr
08/03/92
5-3-13
River
Harley Branch
From source to East Fork Pigeon
WS -III
08/03/92
5-3-14
River
Burnett Creek
From source to East Fork Pigeon
WS-III;Tr
08/03/92
5-3-15
River
Anderson Creek
From source to Burnett Creek
WS-III;Tr
08/03/92
5-3-15-1
Henderson Branch
From source to Burnett Creek
WS -III
08/03/92
5-3-15-2
Lenoir Creek
From source to East Fork Pigeon
WS-III;Tr
08/03/92
5-3-16
River
Dix Creek
From source to East Fork Pigeon
WS-III;Tr
08/03/92
5-3-17
River
Smoky Cove Branch
From source to Dix Creek
WS -III
08/03/92
5-3-17-1
Poison Cove Branch
From source to Pigeon River
WS -III
08/03/92
5-4
Stamey Cove Branch
From source to Pigeon River
WS -III
08/03/92
5-5
Garden Creek
From source to Pigeon River
WS -III
08/03/92
5-6
Henson Cove Branch
From source to Garden Creek
WS -III
08/03/92
5-6-1
Coffee Branch
From source to Garden Creek
WS -III
08/03/92
5-6-2
PIGEON RIVER
From Garden Creek to Canton Water
WS-III;Tr,CA
08/03/92
5-(6.5)
Intake
PISEGN
a e From Canton Water Supply Intake to
C
09/01/74
5-(7)
below elevation 2258)
North Carolina -Tennessee State Line
Beaverdam ree
From source to Pigeon River
C
07/01/73
5-8
Long Branch
From source to Beaverdam Creek
B
04/01/58
5-8-1
West Cove Branch
From source to Beaverdam Creek
C
09/01/74
5-8-2
Wilson Cove Branch
From source to Beaverdam Creek
C
09/01/74
5-8-3
Rough Creek
From source to dam at Canton
WS-I;Tr,ORW
08/01/00
5-8-4-(1)
Reservoir
Rough Creek
From dam at Canton Reservoir to
C;HQW
08/03/92
5-8-4-(2)
Beaverdam Creek
Rice Cove Creek
From source to Beaverdam Creek
C
09/01/74
5-8-5
Murray Branch
From source to Pigeon River
C
09/01/74
5-9
Thickety Creek
From source to Pigeon River
C
09/01/74
5-10
Bowen Branch
From source to Pigeon River
C
09/01/74
5-10.5
Patton Branch
From source to Pigeon River
C
09/01/74
5-11
Sally Haynes Branch
From source to Pigeon River
C
09/01/74
5-12
Medford Cove Branch
From source to Pigeon River
C
09/01/74
5-13
Conner Mill Branch
From source to Pigeon River
C
08/03/92
5-14
Chambers Branch
From source to Pigeon River
C
09/01/74
5-15
3

111. Certification Statement:
' ` ��� _ certify to the best ofmy knowledge that the addition of
the volume of wastewatc�e 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 is 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 Pl.ow.
,Wgning Of/irinl Signufan e ��-- ___._...____ Dcrle
Page 2 of G
FTSE 04-1G