WQ0040485_Application (FTSE)_20181015

State of North Carolina
1)
Department of Environmental Quality WRDivision of Water Resources
Division of Water Resources ISA NCAC 02T .0300 - FAST TRACK SEWER SYSTEMEXTENSION APPLICATION
FTA 04-I6 & SUPPORTING DOCiJMTNTATION
Application Number. —yV w40-4 YStto be c(nMtcted by MR)
All items must be com ilcted nr the a nlicstion Fvill be returned
L APPLICANT INFORMATION:
I. Applicant's name: 1"own of Cla%ton (company, municipality, I IOA, utility, etc.)
2. Applicant type: ❑ Individual^ ❑ Corporation rp El General Partnership ❑Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: Adam-Lindsa% per 15A_NCAC 0_T-0106(bi NC Dept of Environmental Quallty
Title: Tawyn k4anaeer
4. Applicant's mailing address- PO Box 879 OCT 15 2U18
City: Clayton State: NC Zip: 27528- ,,
5. Applicant's contact information: Raleigh Regionw Quo
Phone number: [phone] Email Address: nlindsayra to�vnofcla� tonnc.or�
- -- ---
11. PROJECT INFORMATION:
1. Project name: Bristol at Cobblestpne Phase 5
2. Application/Project status: ® Proposed (New Permit) ❑Existing Permit/Project
Ifa modification, provide the existing permit number: WQ00 and issued date:
ltrtew construction but part ot'a master plan, provide the existing permit number: WQOO
3. County where project is located-, Johnston
4. Approximate Coordinates (Decimal Degrees): Latitudc:35.63744" Longitude:-78.4558V
5. Parcel I (if applicable): 051103027 _ 1668-17-7509
(or Parcel ID to closest downstream sewer)
Ili. CONSULTANT INFORMATION
i. Professional Engineer: Daniel W. Blackburn
- License Number: PL9486
Firm: Blackburn Consultio,. Fnagneerin,
Mailing address- 305 East - Main Street
City: Cla on State: NC Zip: 27520-
Phone number: 919) 553-29oo Email Address: blackburnemgf_e-� embarrlmail.cotn
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
L Facility Name: Little t.r Tk' WRF Permit Number: NC0025453
Owner Narne: Town of Clad i.oil
V. RECEIVING: DOWNSTREAM SEWER INFORMATION (if different than WWTF):
L Permit Number(s): WQ(t17.392:15 Downstream (Receiving) Sewer Size R inch
5�stem L4 iElc CnllectiOlt , stem -Permit Numbcris.r if�tl,i tic+tl�iWQCS
Owner Namc(s): ;own ot'ClaN ton -
FORM: FTA 04-16
Page I of 5

17�'
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 ®NIA
2. If the Applicant is a Developer of lots to be sold, has a Develo %er's Operttional A.rrcment FORT. DEV i been attached?
El Yes ❑No ZMA
3. If the Applicant is a Hone.'Propert, Owner' A., aciar.on has an Ol er1tion�,11 Aercement FORM. . 1I A been attached?
❑ Yes ❑No ®NIA
4. Origin of wastewater; (check all that apply):
®Residential Owned []Retail (stores, centers, malls) ❑Car Wash
❑Residential Leased ❑Retail with food prcparationrsery ce ❑Hotel and/or Motels
❑ School / preschool / day care ❑Medical I dental ' veterinary facilities ❑Swimming Pool /Clubhouse
❑Food and drink facilities ❑Church ❑Swimming Pool/Filter Backwash
El Businesses/ offices/ factories []Nursing Home
❑Other (Explain in Attachment)
5. Nature of wastewater: 100% Domestic/Commercial % Commercial
% Industrial (ace 1 AA NCAC 02T . 1101, 20 :)
�Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC MT .01 t-:yp ❑ Yes ❑ No
D If %es. rovide a col2vof now reduction ariproval letter
7. Summarize wastewater generated by project:
Establishment Type (sec OyT.OE 14Lf1) Daily Design Flow''e �Nu, of Units Flow
Single Family Home — I 250 gal/day 40 1 10,000 GPD
gall i GPD j
-- gall GPD
-- — gall GPD
gall GPD
L— gall �I GPD
Tonal 10,000 GPD DWg
a See 15A NCAC 02T .01 14, bi d . ei(l i and [e t2 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 151 NCAC 02 r.0114] shall
be determined using available flow data, water using fixtures, occupancy or operation allems, and other measured data-
$. Wastewater generated by project:,o o00 GPD (per l 5A NCAC 02'f=01.l_-_I) dW0
D Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
[]Flow has already been allocated in Permit Number,
❑Rehabilitation or replacement of existing sewer with no new flow expected
❑Other (Explain):
FORM; FTA 04-16
Page 2 of5

V1, 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 De_vclot,er's Operational &-reement r FORM DFV � been attached'
❑ Yes ❑Nn ®NIA
3. If the Applicant is a Iiortte'Properr Owners' Association, j,as are 4peratiuniil Agreement F( URML n1 been attached'?
❑ Yes ❑No ®N/A
4- Origin of wastewater: (check al I that apply):
®Residential Owned ❑Retail (stores, centers, malls)
❑Residential Leased ❑Car Wash
❑Retail with food preparation/service ❑Hotel and/or Motels
❑ School / preschool / day care ❑Medical / dental / veterinary facilities
❑Food and drink facilities ❑Church ❑Swimming Pool /Clubhouse
❑ Businesses / offices / factories ❑Nursing Home ❑Swimming Pool/Filter Backwash
❑Other (Explain in Attachment)
5. Nature of wastewater; J —00p/o Domestic/Commercial % Commercial
% Industrial (See 15A NCAC 02T .()103 20 )
,Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02.1' .Q ] l-tfi)? Yes ONo
If ves, rovide a co v of flow reduction a i roval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.011 0
Single Family Home
Daily Design Flow''' lNo. of Units Flaw
250 gal/day
40 10,000 GPD
gall
GPD
gall
GPD
gall
GPD
gal/
GPD
gall
GPD
To,,/ a See ISA NCAC 02T ,pl 14ib} a I! and 0 i2i 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 02'r.001 141shall
be determined using available now data, water using fixtures, occupancy Or operation patterns, and other measured data,
B. Wastewater generated by project: _ GPD (per 15A NCAC 02T .00114)
Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why-
❑Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
[]Flow has already been allocated in Permit Number -
❑Rehabilitation or replacement of existing sewer with no new flow expected
❑Other (Explain):
FORM: FTA 04-16
Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305&MI)C t (:ravfty Sewercl:
I . Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
fi 51 ! SDR35 PVC
9 1030 C900 PVC
8 197 DIP
D Section II & Ili of the MDC for permitting of Gravity Sewers contains information related to design criteria
D Section Ill contains information related to minimunr slopes for gravity sewer(s)
> Oversizing lines to meet minimum slope requirement is not allowed and a violation of file MDC
VII1. PUMP STATION DESIGN CRITERIA (If Applicable)—02T.03t15&MDC lPijrnRi St;itions/Farce Mains
COMPLETro FOR EACH POMP STATION INCLUDED IN THIS PROJECT
I- 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 purnp(s): gallons per minute at _ feet total dynamic head (TDI-1)
5. Summarize the force main to be permitted (for this Pump Station).
He
inches
�^--�
( Lcngth (feet) Material
6, Power reliabilityin accordance with t 5A NCAC 02`l' .03U5 h t l :
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(I)(B)_
D Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
Y 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 - 1 SA NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC: 02T _0305(h)(I)(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 tltestation.
If the portable power source or pump is dedicated to multiple pump stations, anevaluation 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.i multiple station power outage.
FORM: FFA 04-16
page 3 of 5

IX. SETBACKS & SEPARATIONS — (0213 -0200&15A NCAC 02T .0305(f)):
I. Does the project comply with all separations found in _[ 5A NCAC 02,um, t{ i &
®Yes El No
D 15A NCAC 02T•0305(f) contains minimum separations that shall be arovided far sewer systems:
Setback Parameter* - Se oration Re aired
LSto�nnsewers and other utilities not listed below (vertical) —�
Water mains (vertical -water over sewer including in benched trenches) 24 inches
Water mains ( horizontal) — -- - ---�- 1 8 aches
Reclaimed water lines vertical - reclaimed over sewer-- 10 feet
Reclaimed water lines (horizontal - reclaimed over sewer) 18 inches
2 feet
"Any private or public water supply source, including any wells, WS-I waters of Class f or
Class if im sounded reservoirs used as a source of drinkim.; water
*Waters classified WS (except WS-1 or WS-V), B, SA, ORW, HQW, or SS from normal _ 100 feet =
high water or tide elevation and wetlands (see item IX.2)
**Any other stream, lake, impoundment, or ground water lowering and surface drainage 50 feet 1
ditches
Anv building; foundation 10 feet
An basement 5 feet
�
0 feet
To slo a of embankment or cuts oft feet or more vertical height � 0 feet
Drainage systems and interceptor drains
Any swimming gaols
__�_ __.—�_ 5 feet
Final earth �,rade (vertical) _! 10 feet
36 inches
Y 15A NCAC 02T.030 iZJ contains alternatives where separations in OyT.0305f 11 cannot be achieved.
**Stream classifications can he identified using the Division's SIC Surface loll,?ter C_i_assitications aiei�l�asc
If noncompliance with 02'I0a05f or see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of sepamtion)
D See the Division's drall separation requirements for situations where Separation cannot be meet Yes ®No N/A
fa No variance is required if the alternative design criteria specified is utilized in design and construction 4rSit? t%f
D As built documents should reference the location of areas effected ct ,v i 441 fyoy
3. Does the project comply with setbacks found in the river basin rules per I.�A NgAC_pB 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 i104 Nationwide or
individual permits or 401 Water Quality Certifications? Yes ❑ No
D Information can be obtained from the 401 & Buffer Pernuttinz Branch
5. Does project comply with 15A NCAC 02T.01051C 6) (additional permits/certifications)? ZYes
❑ No
Per 15A NCAC 02T.()lOS(c)(G), 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 ❑ 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 every six -months and
inspections documented per i5A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16
Page 4 of 5

X CERTIFICATIONS:
Does the submitted system comply with 15A NCAC 02�1', the l'Airtrmurn Desi<.n Crittr[a for the i'ermittiitL of PumIT Static>ns
and Force Mains (latest versi�n1 and the Gravity Sewer MinimcimDcsign-Cr'ireria ; lntcstve�siun► as applicable?
Yes ❑ No '
IfNo, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents
for review.A t rovttl of tlse rec uest is ree uired )rior to submittal of the Fast Track AnEtitir:art.,,, .... , ....___
dacuments.
2. Professional Engineer's Certification:
(Professional Engineer's name from Application ltem 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 hest 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 Portions of this submittal package, inclusion ofthese materials under mys'igna signature and sea[ signifi sythat I have revewedttaill
his
material and have judged it to be consistent with the proposed design.
NOTE-- In accordance with General Statutes 143-215.6A and 143-215.613statement, representation, or certification in any application package shall be guilty e01, a Class 2rson who nm stdemeanorewh which fmay
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per violation.
North Carolina Professional Engineer's setrl, signature, and dote:
Applicant's Certification per iSA NCAC 021 1 o6(b):
.o
(SignatureAuthority s name& titl foe rr m App is t o �etn 1.3.) - attest that this application fi r
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 Ivastewater From this non -
discharge systent to surface waters or the [and will result in an immediate enforcement action that may include civil penalties,
iniunctive relief; and/or criminal prosecution. i will make no claim against the Division of W,7ter Resources should a
condition ol'this permit be violated. I also understand that Wall 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 he returned to
me as incomplete.
NOTE - In accordance with General Statutes 143-215.6A and Itil 15.013, an statement, representation, or certification in an p b Y person who knowingly [Hakes any false
include a fine not to exceed $10,000 as well as civilpenal[ es up to S25,000 per violltatrorr.a Class 2 misdemeanor, which may
Signature:
`'�-- — — Date.
FORM: FTA 04-16
Page 5 of 5

r
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flo►►• TrackinglAceeptance for Sewer Extension Applications
(FTS E 04-16 )
Entity Requesting Allocation: _ Town of ClaXton
Project Name for which Ito►%, is being reclt.tested' Bristol ,'ir'. Cobblestone Ph 5
More than one FT,SE emir he+ rc lrrrr cl Jor a . h)gle proje t l rJ Nrr mriwr of Mc. tl'll' 1, is 11o1 a// Pump
slations (dong the rrmli of Me propri.ec d u•rcvierroter Jl;nr.
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
A11 flows are hi MGD
c. WWTP facility's permitted flow
2.5 + 1.3
d. Estimated obligated flow not yet tributary to tile WWTP
0.7937
e. WWTP facility's actual avg. flow
1.6874
f. Total flow for this specific request
0.0100
g. 'Total actual and obligated flows to the facility
2.4911
h. Percent of permitted flow used
65.56%
11. Complete this section for each pump station )Oil are responsible 16r along the route of'tllis
proposed wastewater flow.
List pump stations located between (he project connection point and the WWTP:
(A)
(13)
(C)
(D)=(a+Q
(E)=(A-D)
Design
ON igatcd.
Avera�lye Daily
Approx.
Not Yet
Dotal Current
Purnp Station
Firm
Flow**
Current Avg.
Tributary
Flow Plus
(Name or
Capacity, *
(Firm ply,
Daily Floky,
DaHN Flo%v.
Obligated
Available
Number)
MGD
MGD
MGD
MGD
Flow
Capacity***
Cobblestone
0.720
0.288
0.116
0.072
0.188
0.100
* The firm Capacity ofany puntp station is defined as the maximum pumped Row that
can be achieved with (lie largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of llte pomp station divided by a peaking
factor (pf) not less than 2.5.
*** A Planning, Assessment Addendum shall he attached for each pump station located
between file project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Nanle (Sewer): Bristol ,cr; Cobblestone 3 & 4
Downstream Permit Number; WQ{}Q39748
Pzioe 1 o1•6
1_1sx W -I(,

J . K -
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. '['his 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 11 plus all
attached planning assessment addendurns for Which I am the responsible party. Signature of this
form indicates acceptance of this wastewater Ilow-
Sfg1ri1kq O�Jrc' 11, i��=1rcr111, c�
3 ! 8- --
Dc Ie
Page ? of 6

BLACKBURN CONSULTING ENGINEERING F-0219
305 E. Main Street
Clayton, North Carolina 27520
Ph. [phone] Fax [phone]
02/13/2018
Fast -track Application Cover Letter for Bristol Phase 5
This application is for extension of Town of Clayton sewer service to serve the proposed
Bristol Phase 5. Phase 5 consists of 40 single family homes and requires 1,738 linear feet
of 8" collection main extensions.
There is a short portion of sewer main between manholes #57 and #56 which do not meet
the 50' separation requirement for wetlands. This encroachment is a wetland crossing to
be constructed in with Phase 5 which has been granted US 404 permit SAW-2015-02607
and NC 401 permit DWR#07-1344 v3. The encroachment is Gravity Sewer 42 on these
environmental permits. The design is consist with the referenced permits and the
specifications for the sewer main and manhole follow the design criteria specified in
Division's draft separation requirements (15A NCAC 2T .0305(f)).
Daniel W. Blackburn, PE

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Kerr T. Stevens, Director
July 2, 2001
Mr. Steve Biggs, Town Manager
Town of Clayton
Post Office Box 879
Clayton, North Carolina 27520
' CAl 4
. [{
• . rN.�..,,• `iJ
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
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, 2001 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. Rggardless of the adjusted design daily wastewater flow rate,
at no time shall the wastewater flows exceed the effluent limits defined in the Town's NPDES hermit for the
treatmentfacilityor exceed the capacity 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.
Sit •c ely, /
/KerrT. Stevens
cc; Raleigh Regional Office
16I7 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] Fax [phone]
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