WQ0040730_Application_20190325

Transmittal Sheet
CLAYTON ENGINEERING & DESIGN, PLLC
PO BOX 2351
304 15T" ST SE, Hickory, NC 28603
T 828.455.3456
To: NCDEQ
WATER QUALITY SECTION
610 E. Center Avenue
Mooresville, NC 28115
704-663-1699
CLAYTON
ENGINEERING & DESIGN
FIEC EIVEMCDENRIDVVI _
MAR 21 7019
WOROS
MOORESVILL.E REGIONAL OFFICE
Date 3/19/19
RE: J&H Dev. Sewer
Hickory, NC
Project No. 18055 Phase:
We are sending you 1 copies of the following enumerated
®Prints
❑Sepias
❑Shop Drawing
❑Samples ❑Brochures ❑Cat. Cuts
❑
❑Letters
❑Specifications
1-Fast Track
1-Check
Our Comment:
Please see enclosed submittal package for Stonebrook Sewer.
Thanks,
Distribution
1.
2.
3.
4.
5.
For Your ®Action ❑Corrections
❑Request ❑Resubmission
El
❑General Information
Clayton Engine ing & Design, PLLC
Transmitted By ❑Mail Signature
®UPS Name
❑ Title

CLAYTON
ENGINEERING & DESIGN
March 6, 2019
NCDEQ - DWR
610 East Center Avenue
Mooresville, NC 28115
Re: Rainey Sewer Extension — New Sewer Service
Project Narrative
CED Job # 2018055
Dear Sir or Madam,
Clayton Engineering & Design has been selected by J&H Development to prepare plans and
specifications for the proposed sewer extension to serve three single family residences along 281"
Ave PL NE in Hickory, NC. Site development will require the construction of 8" gravity sewer line
to serve the single family homes. Approximately 233 LF of 8" gravity sewer is to be constructed.
The proposed development will generate 720 gpd (360 per dwelling unit). The existing parcel will
be subdivided into three individual parcels. Because one (the original) parcel had already been
allocated in the future possible flow to the WWTP, this development will only generate two
additional allocations totaling 720 gpd.
If you have any questions or need additional information, please feel free to call me at
[phone] or email wclayton(aDclayton-engineering.net.
Sincerely,
Clayton Engineering & Design, PLLC
W1111ax c), e4geoll
William S. Clayton, PE
President
304 151h Street SE/PO Box 2351 Hickory, NC 28603 [828] 455-3456 P-1463
Page 11

State of North Carolina
A;
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
jai f� 20 iPCEIVE INCI)CNR/DWR --
Application Number: 7� J (to be completed by Dwtt)
MAR 21 M9
All Items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: CITY OF HICKORY (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State/County ® Municipal
3. Signature authority's name: Warren Wood per 15A NCAC 02T .0106(b)
Title: City Manager
4. Applicant's mailing address: 144191 Ave
City: Hickory State: NC Zip: 28601-
5. AppIicant's contact information:
Phone number: [phone] Email Address: KGREER a HICKORYNC.GOV
WQROS
VIIOORESVILLF- REGIONAL OFFICE
❑ Privately -Owned Public Utility
❑ Other
II. PROJECT INFORMATION:
1. Project name: J&H DEVELOPMENT 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: CATAWBA
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.46' 06° Longitude:-81.19' 25°
5, Parcel ID (if applicable):
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: WILLIAMS. CLAYTON License Number: 040758
Firm: CLAYTON ENGINEERING & DESIGN. PLLC
Mailing address: PO BOX 2351
City: HICKORY State: NC Zip: 28603
Phone number: [phone] Email Address: WCLAYTONCcOCLAYTON-ENGINEERING.NET
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: NORTHEAST WWTF Permit Number: NCO020401
Owner Name: CITY OF HICKORY
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: inch
System Wide Collection System Pennit Number(s) (if applicable): WQCS
Owner Name(s): CITY OF HICKORY

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/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
❑ 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 .0114(fl? ❑ Yes ®No
➢ If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114 )
Daily Design Flow a,n
No, of Units
Flow
SINGLE FAMILY RESIDENTIAL (3 br)
360 gal/DAY
2
720 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
720 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.01141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: .720 GPD (per 1SA 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):

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
_ ____ Size Sfnches) Length (feet) Material
8 233 PVC
➢ Section H & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section RI 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
VIH. 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:
2. Approximate Coordinates (Decimal Degrees): Latitude: 0Longitude: -
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 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) I Length (feet) I Material
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 titneframes, shall be provided
in the case of a multiple station power outage.

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
➢ 1.SA NCAC. n2T.n3n5(f) cnntnins minimum .qeniratinns that shall he nrnvirlerl fnr cewr r .evstema-
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 foot
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-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(u) 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 02T.0305 fO or (e). 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 I SA 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 the 401 & Buffer Pennitting 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 perntittee 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.

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Pennitting 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 te Variance/Alternative Design Request application ADS - an suppor m ocumen s or R
review. Approval of the request Is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
c4ja! ?t �'t'-, r attest that this application for
(Professional Engineer's name from Application Item II1.1.)
has been reviewed by rue 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:
Applicant's Certification per 15A NCAC 02T .0106(b):
I,
(Signature Authority's name & title from Application Item I.3.)
S S�
��NttlFI1��`
that this application 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: Date? Iq

t
s r
State of North Carolina
Department of Environmental Quality
Division of Water Resources
DIVISlon of MteT IiesoorceN Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: CITY OF HICKORY
Project Name for which flow is being requested: J&H DEVELOPMENT
Vlore 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: Northeast WWTF
b. WWTP Facility Permit #: NCO020401
All flows are in MGD
c. WWTP facility's permitted flow 6.0
d. Estimated obligated flow not yet tributary to the WWTP 0.7477
e. WWTP facility's actual avg. flow 3.084
f. Total flow for this specific request .00072
g. Total actual and obligated flows to the facility 3.8324
h. Percent of permitted flow used 63.9 %
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 / p fl, Daily Flow,
Daily Flow, Obligated Available
Number) MGD MGD MGD
MGD Flow Capacity***
N/A
* 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 located
between the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): Hickory Collection system
Downstream Permit Number: WQCS00020
Page 1 of 6
FTSE 04-16

III. Certification Statement:
I Warren Wood 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 thi$wastewater flow.
Official Signature
Date
Page 2 of 6
FTSE 04-16

7
Fe:07fl
I�
Lti
1y17 51B I'Ie
.,4A2
,!'M
`_
9'
iry:Gniincr z>., _-
Park J+nJ
Ia,y
0
—J
zz,b
ru'I
��9y
UlonmC.
Lak€� f Iickory '•,
ia,a
2 Hllto I, Jr,
Country Club
�,,M
PROJECT
n Mr nturi<il Pork
LOCATION
r
(,i,
,jov limpton Heights
stl,lvo Aty
c,ul( Club
t } =
r} Hlckor}t.Filgh Sdm l
i. r �'12tB
AYe tiNJ
VIIWM0N T
v�
cl�1)
Lonoir-Rhyne
UnlVnf511y
s
a�sl
91111vQtt-
Pie taf:
,aar�ol�a
3z1
Catawba Sdnlm ! Contor
1(d Ave N''J
2n d Ave NyJ
-
I-1 i ck o:ry
tY
h
1st AveSpi
;tn,l Avo SW
- -
-
Tate illyt{ st
Tn
.r
4
to
(, z,)
nr ��
f
Go' :ogle
NOT TO SCALE
Owner
Project ' ltle
Date
318055
CLAYTON
J&H DEVELOPMENT
J&H DEVELOPMENT
SEWER EXT
Job No.
18055
Drawing Title
C-002
ENGINEERING & DESIGN
Project Location
STREET VIEW
HICKORY, NC
Sbt. 1 of 1

' A
:1
1
f�
� ;b � ' �- ��% (\
-sibLi
JSrN 6rrS';4 y�
� �•� `!
��
��� �� 33RD:AV£,fyW
31NDAV£.
• „ '• H�it,
kYorry.
C3
,
L
n
YC
910
VENUEI DR;
��`•�
`•y rH;
UEN£
PL'NE
� f
�
127
� •�.RO AVEN
-:
��� �
�
a1 ,
23RD AVE
L7'�-
F'VF� /"_�
t�-v. 1. 57.AVE NE•
���
� �
:2f
z� Q
- In7y;4
% V£
477y£.
19TNAVE;NE
d6TNAV
X. NW ^ � 16TN;AVE NE
}
`+\ 48TH AVE-ME
�
t
�.
w
-
!,
NOT TO SCALE
Owner
J&H DEVELOPMENT
Project Title
J&H DEVELOPMENT
Date
3/1/19
Job No.
CLAYTON
SEWER EXT
18055
Drawing Title
C-001
ENGINEERING & DESIGN
Project Location
USGS MAP
HICKORY, NC
snt. 1 ar 1