WQ0040467_Application (FTSE)_20181009

State of North Carolina
Department of Environmental Quality
IT 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&AC 0Zi and the Division's
Minimum Design Criteria and that plans,specifications and supporting documents have been prepared in accordance with, BA
NCAC 02T. 15A NCAC 02T_03I10.Division_yolicies and good engineering practices.
While no upfront engineering design documents are required for submittal, in accordance with I5A 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 N__f�.AC 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 1 C.0100,
➢ Projects that do not meet any part of the minimum design criteria(1vIDC)document;
➢ Projects that involve a variance from the requirements of I5A 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};
9 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):
® 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
❑ 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 H.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 Eneineer.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15 A NCAC 02T.01_ 06(b).
Per 15A NCAC 02T .0I06(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.0I06(b).
INSTRUCTIONS FOR FORM:FTA 04-16&SUPPORTING DOCUMENTATION Page I of 3

Tw 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-
15 67 .
➢ 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.
7 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):
❑ 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 I submit documentation of power reliability for pumping stations.
➢ This alternative is only available for average daily flows Iess 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 I A,NCAC 02T..0115(alJ)provide the Certificate of Public Convenience and Necessity from the North Carolina
l] 'lities 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 _Utifi6Cs Commission's Vater_and Sewer Division Public S+aff 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):
❑ HomeTLo a Owners'Associations
❑ Per 15A NCAC 0?T .01 12c),submit the properly executed(),eraiiri al Agi�emeij[(F{}RIV._. (• 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 Aereement iFORML DEV}.
For more information, visit the Division's collection systems websile
INSTRUCTIONS FOR FORM:FTA 04-I6&SUPPORTING DOCUMENTATION Page 2 of 3

� s
THG 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 QualiW 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 QualitySection Mooresville, North Carolina 28115 Gaston, Iredell, Lincoln, Mecklenburg,Rowan,
[phone] Stanly, Union
[phone] Fax
Raleigh Re Tonal 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, hare, Gates,Greene, Hertford, Hyde,
[phone] Jones, Lenoir, Martin,Pamlico,Pasquotank,
[phone] Fax Perquimans,Pitt,Tyrrell,Washington,Wayne
Wilminaton Regional Office 127 Cardinal Drive Extension Brunswick, Carteret, Columbus, Duplin, New
Water QualiN Section Wilmington, North Carolina 28405 Hanover,Onslow,Pender
[phone]
[phone] Fax
Winston-Salem Re ional Office 450 W. Hanes Mill Road Alamance,Allegheny,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
DWR
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T.0300—FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16& SUPPORTING DOCUMENTATION
Application Number: bL completed by DWR)
All items must be com leled or the application will be returned
1. APPLICANT INFORMATION:
I. Applicant's name: Town of Clayton(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:Adam Lindsay per _JA NIC'AC 02T_0106(i
Title:Town Manacer
4. Applicant's mailing address: I I I E.Second Street NC Dept of Environmental Quality
City:Clayton State:NC Zip:27520-
5. Applicant's contact information: OCT 0 9 20M
Phone number:[phone] Email Address:crow]and_,townofclaytonnc.ore
I1. PROJECT INFORMATION:
Raleigh Regional Office
I. Project name: Parkview Phases 16& 17
2. Application/Project status: ®Proposed(New Permit) ❑ Existing Permit/Project
If a modification,provide the existing permit number:WQOO and issued date:
If new construction but part of a master plan,provide the existing permit number: WQOO
3. County where project is located:Johnston
4. Approximate Coordinates(Decimal Degrees): Latitude: 35.66358 Longitude:-78.46833
5. Parcel ID(if applicable): 165912-86-2754
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer:Donald C.Adams Jr PE. License Number.25469
Firm:Adams&Hodge Engineering. PC(Firm#C-4187)
Mailing address:314 East Main Street
City:Clayton State:NC Zip:27520-
Phone number:[phone] Email Address:donnic0adamsandhodge.corn
IV. WASTEWATER TREATMENT FACILITY(WWTF) INFORMATION:
I. Facility Name: Little Creek WRF Permit Number:00-25453
Owner Name:Town of Clayton
V. RECEIVING DOWNSTREAM SEWER INFORMATION(if different than WWTF):
I. Permit Number(s):WQ0039354 Downstream(Receiving)Sewer Size: 8 inch
System Wide Collection Svslgm.fernsit Numbers] iifanplicable:WQCS00147
Owner Name(s): Town ofClayton
FORM:FTA 04-16 Pagel of5

Vl. GENERAL REQUIREMENTS
I. 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 17C.N+eloper's c7peraiiunal A rcernent[FORM: DEVi been attached?
❑Yes [:]No ®N;'A
3. If the Applicant is a Hnmt Pruprrty Owners'Assur.iation,has an.OperMional Agreeir,ent FORA4: HOAI 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 andlor Motels
❑ School I preschool I day care ❑Medical/dental/veterinary facilities ❑Swimming Pool,'Clubhouse
❑ Food and drink facilities ❑Church ❑Swimming PoollFllter Backwash
❑ Businesses 1 offices i factories ❑Nursing Home ❑Other(Explain in Attachment)
5. Nature of wastewater: 100%Domestic/Commercial °ro Commercial
_%Industrial(, e 15A NCAC#i?'T'.0103(20�}
"Is there a Pretreatment Program in effect? ❑Yes ❑No
G. Hasa Flow reduction been approved under 15A NCAC'.01 ,0114ff1? ®Yes ❑No
i If yes,nrovide a-copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type(see 02T.0114(f1) Daily Design Flow No.of Units Flow
Single Family Homes 250 galldayiunit 17 4,250 GPD
gall GPD
gal/ GPD
gaU GAD
gall GPD
gal/ GPD
Total 4,250 GPD
a See 15A NCAC 021' ,0114 d e 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 .42,E-4)
b Per I5A NCAC 02T.0I 14(c),design flow rates for establishments not identified[in table 15A NCAC 02T.01141 shall be
determined using available flow data,water using fixtures,occupancy or operation patterns,and other measured data.
8. Wastewater generated by project:4.250 GPD(per 15 A NCAC D2T.0I 141
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 now expected
❑Other(Explain):
FORM: FTA 04-15 Page 2 of 5

VI1. GRAVITY SEVER DESIGN CRITERIA(if Applicable)-02T.0305&,11DC(Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Sire(inches) Length(feet) Material
S" 662 PVC
Section 11 & 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 i4IDC
VIII. P1UNIP STATION DESIGN CRITERIA(If Applicable)—02T.0305& NIDC.(Pump StationslForce Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
. Pump station number or name:
2. Approximate Coordinates(Decimal Degrees):Latitude:� Longitude:-�
3. Design flow of the pump station: millions gallons per day(firm capacity)
4. Operational point(s)of the pump(s): gallons per minute at i feet total dynamic head(TDI-I)
5. Summarize the force main to be permitted(for this Pump Station):
Size(inches) Length(feet) Material
G. Power reliability in accordance%%ith 15A NCAC 02T.0305(h)f l):
❑ Standby power source or pump with automatic activation and telemetry- 15A NCAC 02T.0305(h)(I)(B)_
i 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 potvcr 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 ofall 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)):
I. Does the project comply with all separations found in 1.5A.1iCAC 02T,0105(fi&(el ®Yes ❑No
15A NCAC 02T.0305 contains minimum separations that shall be provided for sewers stems:
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-1 waters of Class I or
Class II impounded reservoirs used as a source of drinking water 100 feet
**Waters classified WS(except WS-1 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
To2 slope of embankment or cuts of 2 feet or more vertical height 10 feet
Drainage systems and interceptor drains 5 feet
Any swimming pools I0 feet
Final earth grade(vertical) 36 inches
A N 2AC Q.Mp,305(gcontains alternatives where separations in 02T,0305(f)cannot be achieved.
**Stream classifications can be identified using the Division's Nam'Surface Water C'lassif�catinns v�eh :sue
If noncompliance with 02T_0305(1}orta1,see Section X of this application
2. Does the project comply with separation requirements for wetlands?(50 feet of separation) ❑Yes ❑No ®N.-'A
Seethe 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 Q2R .0200? ❑Yes ❑No ®N.-'A
)- This would include Trout Buffered Streams per 15A NCAC 213.0202
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 the40i &Buffer Permitting Branch
5. Does project comply with I SANCAC 02T.0LSfc)ff►1(additional permilslcertifications)? ®Yes ❑No
Per 15A NCAC 02T.0105(cM, 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,stormwaler management plans,etc.).
6. Does this project include any sewer collection lines that are deemed"high-priority?"
Per 15.A NC AC 02T_040?,"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 ❑NIA
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 everysix-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:
I. Does the submitted system comply with 15A NCA . 02T the It?linim n Design t riteria for the Permittinguf Pump Stations
and F+}rwe Mein;i larc.,E 4 r rsiur7),and the G ity Sewer Minimgm Design CriCriteria(lawst version)as applicable?
®Yes ❑No
IfNo,complete and submit the Variance.-'Alternative Design Request application(VADC 10-14)and supporting documents for
review. Approval of the request is required nrior to submittal of the Fast Track A ,.plication and sunportinQ documents;
2. Professional Engineer's Certification:
1, Donald C Adams, Jr., PE _attest that this application for
(Professional Engineer's name from Application Item 111.1.)
has been reviewed by me and is accurate,complete and consistent with the information supplied in the plans,specifications,
engineering calculations,and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers(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.
North Carolina Professional Engineer's seal,signature,and date: AIR
FESSfa '
s 2 a dS
NGIS4E� �y+r
"9�� C• Pa '' 07/2412018
MIIINIIMN
................ .....r
3. Applicant's Certification per 15A NCAC 02T.0106(b):
I Adam Lindsay, Town Manager --attest that this application for
(Signature Authority's name&title from Application Item 1.3.)
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.
t
Signature: Date: •2� •6 $
FORM: FTA 04-16 Page 5 of

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Town of Clayton
Project Name for which flow is being requested: Parkview Phases 16 & 17
More than one FTSE ma),he required for a single project if file owner of the iVIV P is not responsihle for all pump
stations along the ro:rle of lire proposed waslewaler flow.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Little Creek WRF
b. WWTP Facility Permit#: 0025453
All flo►vs are in MGD
c. WWTP facility's permitted flow LCWRF 2.5 +loco 1.34 +
Raleigh 1.0
d. Estimated obligated flow not yet tributary to the WWTP 1.1013
e. WWTP facility's actual avg. flow 2.5203
f. Total flow for this specific request 0.0043
g. Total actual and obligated flows to the facility 3.6259
h. Percent of permitted flow used 74.92%
I1. 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!p0, Daily Flow, Daily Flow, Obligated Available
Number) MGD MGD MGD MGD Flow Capacity***
Clayton-
pot;-,, 2.5056 1.0022 _ 0.2044 0.2355 0.4399 0.5623
*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(pi) 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): Sam's Branch
Downstream Permit Number: WQ0030569
Page 1 of 6
FTSE 04-16

III. Certification Statement:
I Adam Lindsay 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 acce tance of this wastewater flow.
Si ing O idtal Signature Date
Page 2 of 6
FTS E 04-16

State of North Carolina I
Department of Environment ' S
and Natural Resources
Division of Water Quality
Michael F.Easley, Governor
William G.Ross Jr.,Secretary NCDENR
Kerr T.Stevens,Director NORTH CAROUNA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
July 2,2001
Mr.Steve Biggs,Town Manager
Town of Clayton
Post Office Box 879
Clayton,North Carolina 27520
Subject: Town of Clayton
Flow Reduction Approval
Johnston County
Dear Mr.Biggs:
On January 3, 2001, the Division of Water Quality received your flow reduction request for new
single-family dwellings in the Town of Clayton. The letter requests approval of a residential flow value of 250
GPD/residence for any future dwellings that may become tributary to the subject wastewater collection system.
The Division also received additional information on April 3,2001
The information provided flow records between January 1998 and November 2000 for the WWTP.
The evaluation also included the daily wastewater flows for a 33 day period from February 19 through March
23,200I for a select 97 homes in accordance with 15A NCAC 2H.0219(1)(3).
Based upon the information submitted, the Division hereby approves the use of 250 GPD per single-
family residence in all applicable non-discharge permit applications for future sewer line extensions for the
Town of Clayton. This consideration applies to any applicable future projects submitted to the Division as well
as any projects which are currently under review. Re less of the ad`usted design daily wastewater flow rate
at no time shall the wastewater flows exceed the effluent limits defined in the Town's NPDES permit for the
treatment facility or exceed the cgRaci!y of the sewers downstream of any new sewer extension.
If you have any questions or comments regarding this matter,please contact Mr. Kim H. Colson at
[phone] ext. 540.
Si e ely,
/Kerr T.Stevens
cc= Raleigh Regional Office
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50%recycled/10%post-consumer paper

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& HODGE
ENGINEERING , PC
October 8, 2018 NC Dept of Environmental Quality
Ted Cashion OCT 0 9 2018
NC DWQ
3800 Barrett Dr Raleigh Regional Officc
Raleigh,North Carolina 27609
Subject: Parkview Phases 16 & 17
Town of Clayton
Johnston County
Please find attached one original and one copy of the following:
1. Complete Fast Track Application for Gravity Sewers, Pump Stations, and Forcemains
(Form FTA 04-16), signed by Engineer& Town
2. $480.00 Check for Application Fee
3. Flow Tracking/Acceptance for Sewer Extension (Form FTSE 04-16)
4. USGS Quad Map showing approximate site location
5. Street Level Map
Project Narrative:
Phase 16 & 17 includes 17 new residential lots and +/-6621f of new 8"gravity sewer. Requested flow is
4,250 GPD. The project will flow to an existing public gravity system owned and maintained by The
Town of Clayton. The flow will end up at the Little Creek WRF permit# 00-25453.
If you have any questions or comments, please give me a call at 919-763-7278 or email to
donniegadamsandhod ge.com .
Sincerely,
q��� CA4pl�ff''''-,
SEAL
Donnie Adams, PE S x 25469
s
ADAMS&HODGE ENGINEERING,PC + 314 East Main Street,Clayton,NC 27520 • 919-369-1938/919-763-7278 • Firm tt C-4187

Cashion, Ted
From: Andrew Hodge<[e-mail]>
Sent: Wednesday, October 10, 2018 2:29 PM
To: Cashion, Ted
Subject: [External] FAST TRACK APPLICATION -PARKVIEW PH 16 & 17
Attachments: PDF-FAST TRACK SEWER APPLICATION -FTA 04-16-PARKVIEW 16,17 SHEET 3.pdf
ernal email:t]o not click links or open attachments unless verified.Send all suspicious email as an attachmentte
Hey Ted,
As per our phone conversation today, please find attached revised sheet 3 of the FTA.The correct pipe length of 6621f is
on this revised sheet. Please throw away the sheet 3 submitted yesterday and replace with the attached.
Thanks for your cooperation!
Thanks!
Andrew Hodge, PE
Adams& Hodge Engineering, PC
314 E. Main Street
Clayton,NC 27520
(M) 919-369-1938
Firm#C4187
ADAMS & HODGE
E N 0 1 N E E R 1 N G
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