WQ0034102_Minor Modification_20190409

INITIAL REVIEW
Reviewer Thornburg, Nathaniel
Project Number* WQ0034102
SUBMITTAL DATED: 4/9/2019
Project Contact Information
Rease provide inforrration on the person to be contacted by MB Staff regarding electronic subnittal, confirmation of receipt, and other issues.
......................................................................................................................................................................................................................................................................................................................................................................................................
Name * Michael L. McAllister
Email Address*
[e-mail]
Project Information
Application Type* r
New
r
Renewal
r
Annual Report
Permit Type * r
Wastewater Irrigation
r
Other Wastewater
r
Closed -Loop Recycle
r
Single -Family Residence
Wastewater Irrigation
Is a paper copy of the application being submitted?*
r Yes r Nor N/A
Permit Number WQ0034102
currently has project
Permittee * Town of Fremont
Phone Number*
919-772-5393
r Modification (Major or Minor)
r Additional Information
r Other
r High -Rate Infiltration
r Reclaimed Water
r Residuals
r Other
Facility Name * Fremont WWTP Wastewater Irrigation System
Please provide comments/notes on your current submittal below.
Please attach all information required or requested for this submittal to be review here.
Application Form Engineering Rans, Specifications, Calculations, Etc.)
WQ0034102 Fremont Minor Modification NCDEQ
17.31 MB
Submittal.pdf
upload only 1 FDF document. K/Uliple docurrents rust be corrbined into one PDF file.

For neiv and modif cation permit applications, the paper copy is required to be submitted to the
Di,,isiom Be advised, applications will not be considered complete until both the paper and electronic
applications. have been received_ The paper copy shall include the follm ping:
• Application Farm
• All relevant attachments (talcs, soils report, specs, etc_)
• 1 full-size engineering plan set
• 2 11-17" engineering plan sets
• 1 extras set of specifications (in addition to the set of specifications provided in the
attachments)
• Fee (if required)
This shall be mailed to the following address:
By US_ Postal Service-
Di,,ision of Water Resources- Non -Discharge Branch
1617 Mail Service Center Raleigh NC 27699-1617
By Courier, -Special Delivery:
Division of Water Resources- Non -Discharge Branch
Nathaniel Thornburg- 9th Floor, Office #942 M
512 N_ Salisbury St_ Raleigh, NC 27604
For questions or problems contact Tessa Monday at 919.7073660 or Tessa_X%nday(dncdem_gov or
Sonia Graves at 919.707.3657 or Sonia Graves(dpcdenr.gov.
* I40 By checking this box I am acknowledging that I have read the above statement and agree
to send these documents as required to one of the address given above.
Signature
Submission Date 4/9/2019

Water Resources
ENVIRONMENTAL QUALITY
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Secretary
S. JAY ZIMMERMAN
Drreclor
September 15, 2016
THE HONORABLE W. DARRON FLOWERS
TOWN OF FREMONT
POST OFFICE BOX 4
FREMONT, NORTH CAROLINA 27 83 M818
Dear Mayor Flowers:
Subject: Permit No. WQ0034102
Fremont WWTP
Wastewater Irrigation System
Wayne County
In accordance with your permit minor modification request received May 5, 2016, we are
forwarding herewith Permit No. WQ0034102 dated September 15, 2016, to the Town of Fremont for the
continued operation of the subject wastewater treatment and irrigation facilities.
The minor modification to the subject permit consists of installing a new HDPE liner to repair a
leaking Lagoon # 1 and #2 as well as eliminating an unauthorized by-pass which allowed untreated waste
to flow to the creek by way of an outlet at Lagoon # 1.
This permit shall be effective from the date of issuance until August 31, 2021, shall void Permit
No. WQ0034102 issued December 18, 2009, and shall be subject to the conditions and limitations as
specified therein. Please pay particular attention to the monitoring requirements listed in Attachments A,
B and C for they may differ from the previous permit issuance. Failure to establish an adequate system for
collecting and maintaining the required operational information shall result in future compliance problems.
Please note the following permit conditions have been removed since the last permit issuance
dated December 18, 2009:
➢ Old Conditions I.I. through I.6. —The requirements of these conditions have been met.
➢ Old Condition IV.] 1. —The requirement of this condition has been met.
Please note the following permit conditions are new since the last permit issuance dated
December 18, 2009:
➢ Condition I.1. —This condition requires the Permittee to combine parcels within 120 days of
the permit issuance owned by the Town in order to comply with setback requirements and to
ensure that compliance and review boundaries are maintained.
➢ Condition I.2. —This condition requires that the Permittee submit an amended Operation and
Maintenance Plan to address the modified storage structures and the new liners approved in
this permit with 60 days of the permit issuance.
State of North i;arolina � Environmental Quality � Water Resources � Water Quality Permitting � Non -Discharge Pemutting
1617 Mail Service Center � Raleigh, North Cazolina 27699-1617
919 $07 6464

The Honorable W. Darron Flowers
September 15, 2016
Page 2 of 2
➢ Condition I.3. — This condition explains the requirements for the disposal of the residuals from
the treatment lagoons.
➢ Attachment A —Monitoring for Total Nitrogen, Total Kjeldahl Nitrogen and Total Phosphorus
has been added to the effluent monitoring requirements to be consistent with our Non.
Discharge Effluent Monitoring for Domestic Wastewater guidelines based on the average
effluent of less than 91,629 gallons per day in a passive treatment system.
➢ Attachment C —Monitoring for Total Phosphorus has been added to the groundwater
monitoring.
If any parts, requirements or limitations contained in this permit are unacceptable, the Permlttee
has the right to request an adjudicatory hearing upon written request within 30 days following receipt of
this permit. This request shall be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings at 6714 Mail Service
Center, Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and binding.
One set of approved plans and specifications is being forwarded to you. If you need additional
information concerning this permit, please contact Alice M. Wessner at [phone] or
a lice.wessnera,ncdenr. gov.
Sincerely,
S. Jay Zimmerman, P.G., Director
Division of Water Resources
cc: Wayne County Health Department, Environmental Health Director, Kevin Whitley,
kevin.whitleUL t!ynegov.com (Electronic Copy)
Washington Regional Office, Water Quality Regional Operations Section (Electronic Copy)
Michael McAllister — Municipal Engineering Services, Co., PA, mmcallister(a)mesco.com
(Electronic Copy)
Beth Buffington, Public Water Supply Section — Protection and Enforcement Branch (Electronic
Copy)
Digital Permit Archive (Electronic Copy)
Central Files

NORTn CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
RALEIGH
WASTEWATER IRRIGATION SYSTEM PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules and Regulations
PERMISSION IS HEREBY GRANTED TO
Town of Fremont
Wayne County
FOR THE
operation of a 91,629 gallon per day {GPD) wastewater treatment and irrigation facility consisting of the:
rehabilitation and subsequent operation of the existing dual treatment lagoons consisting of the installation
of anew HDPE liner to repair the 11.1 million gallon (MG) Lagoon 41 and the 10.5 MG Lagoon #2, as
well. as the elimination an unauthorized by-pass outlet in Lagoon #1; and the
continued operation of: the post chlorination facilities; a flow measuring device; dua12 i 0 gallon per minute
(GPM) irrigation pumps; approximately 23,4501wear feet (LF) of spray irrigation laterals; a 31.9 acre spray
irrigation area; and all associated piping, valves, controls and appurtenances
to serve the Fremont WWTP, with no discharge of wastes to surface waters, pursuant to the application
received May 51 2016, and in conformity with the project plans, specifications, and other supporting data
subsequently filed and approved by the Department of Environmental Quality and considered a part of this
permit.
This permit shall be effective from the date of issuance until August 31, 2021, shall void Permit No.
WQ0034102 issued December 18, 2009, and shall be subject to the following specified conditions and
limitations:
I. SCHEDULES
1. Within 120 days of permit issuance, the Pennittee shall combine Parcels 3605943631 and 3615044392,
which shall be recorded in the Wayne County Register of Deeds. This combination is being required
in order for the Permttee to comply with setback requirements in Condition 1I.11., and the compliance
and review boundary requirements in Conditions 11.6. and II.7. Documentation of this parcel
combination shall be submitted to the Division of Water Resources, Water Quality Permitting Section,
1617 Mail Service Center, Raleigh, NC 27699-1617. [15A NCAC 02T .0108(b)(2)]
2. Within 60 days of permit issuance, the Perrnittee shall submit an amended Operation and Maintenance
(O&M) Plan to address the modified storage structures and the new liners approved in this permit. This
O&M Plan shall be submitted to the Division of Water Resources, Water Quality Permitting Section,
1617 Mail Service Center, Raleigh, NC 27699-1617. [15A NCAC 02T .0108(b)(2)]
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3. Prior to certification of the permitted modifications, the Permittee shall provide documentation that the
residuals from the lagoons has been disposed of properly in accordance with 15A NCAC 02T .1100.
If it is disposed of in a landfill, disposal records from the landfill shall be provided. If it is disposed of
through a permitted wastewater residuals disposal facility, documentation shall be provided stating that
the Town of Fremont facility has been included in the disposal facility's permit as a new source. This
documentation shall be submitted to the Division of Water Resources, Water Quality Permitting
Section, 1617 Mail Service Center, Raleigh, NC 276994617. [15A NCAC 02T .0108(b)(2)]
4. Upon completion of construction and prior to operation of Lite permitted modifications, a certification
(attached) shall be submitted from a licensed North Carolina Professional Engineer certifying that the
permitted facility has been installed in accordance with this permit, Division approved plans and
specifications, and other supporting documentation, including the location of all monitoring wells as
applicable. If this project is to be completed in phases and partially certified the Permittee shall retain
the responsibility to track further construction approved under the same permit and shall provide a
final certificate of completion once the entire project has been completed. Mail the Certification to the
Division of Water Resources, Water Quality Permitting Section, 1617 Mail Service Center, Raleigh,
NC 27699461T [15A NCAC 02T .0116(a)]
5. The Washington Regional Office, telephone number [phone], shall be notified at least 48 hours
in advance (excluding weekends and holidays) of operation of the installed facilities such that an in -
place inspection can be made. Notification to the regional supervisor shall be made from 8:00 a.m.
until 5:00 p.m. on Monday through Friday, excluding State Holidays. [ 15A NCAC 02T .0108(b)(2)]
6. No later than six months prior to the expiration of this permit, the Permittee shall request renewal of
this permit on official Division forms. Upon receipt of the request, the Division will review the
adequacy of the facilities described therein, and if warranted, will renew the permit for such period of
time and under such conditions and limitations as it may deem appropriate. Please note Rule 15A
NCAC 02T .0105(d) requires an updated site map to be submitted with the permit renewal application.
II. PERFORMANCE STANDARDS
1. The subject non -discharge facilities shall be effectively maintained and operated at all times so there is
no discharge to surface waters, nor any contravention of groundwater or surface water standards. In
the event the facilities fail to perform satisfactorily, including the creation of nuisance conditions due
to improper operation and maintenance, or failure of the irrigation areas to adequately assimilate the
effluent, the Permittee shall take immediate corrective actions including Division required actions, such
as the construction of additional or replacement wastewater treatment or irrigation facilities. [G.S. 143-
215.1, 143-213.3(a)]
2. This permit shall not relieve the Permittee of their responsibility for damages to groundwater or surface
water resulting from the operation of this facility. [15A NCAC 02B .0200, 02L A100]
3. All wells constructed for purposes of groundwater monitoring shall be constructed in accordance with
15A NCAC 02C .0108 (Standards of Construction for Wells Other than Water Supply}, and any other
jurisdictional laws and regulations pertaining to well construction. [15A NCAC 02C .0108]
4. Effluent quality shall not exceed the limitations specified in Attachment A. [15A NCAC 02T
.0108(b)(1}, 02T
5. Application rates, whether hydraulic, nutrient or other pollutant, shall not exceed those specified in
Attachment B. [15A NCAC 02T.0505{n)
WQ(}034102 Version 2,0 Shell Version 151201
Page 2 of 10

6. This disposal system was individually permitted on or after December 30, 1983; therefore, the
compliance boundary is established at either 250 feet from the effluent disposal area, or 50 feet within
the property boundary, whichever is closest to the effluent disposal area. An exceedance of
groundwater standards at or beyond the compliance boundary is subject to remediation action according
to 15A NCAC 02L .0106(d)(2) as well as enforcement actions in accordance with North Carolina
General Statute 143-215.6A through 143-215.6C. [ 15A NCAC 02L .0106(d)(2), 02L .0107(b)]
7. In accordance with 15A NCAC 02L .0108, the review boundary is established midway between the
compliance boundary and the effluent disposal area. Any exceedance of groundwater standards at the
review boundary shall require action in accordance with 15A NCAC 02L .0106. [15A NCAC 02L
.0106, 02L .0108]
8. The Permittee shall apply for a permit modification to establish a new compliance boundary prior to
any sale or transfer of property affecting a compliance boundary. [15A NCAC 02L .0107(c)]
9. In accordance with 15ANCAC 02L .0107(d), no wells, excluding Division approved monitoring wells,
shall be constructed within the compliance boundary except as provided for in 15A NCAC 02L
.0107(g). [15A NCAC 02L .0107]
10. Except as provided for in 15A NCAC 02L .0107(g), the Permittee shall ensure any landowner who is
not the Permittee and owns land within the compliance boundary shall execute and file with the Wayne
County Register of Deeds an easement running with the land containing the following items:
a. A notice of the permit and number or other description as allowed in 15A NCAC 02L A107(fj(1};
b. Prohibits construction and operation of water supply wells within the compliance boundary; and
c. Reserves the right of the Permittee or the State to enter the property within the compliance boundary
for purposes related to the permit.
The Director may terminate the easement when its purpose has been fulfilled or is no longer needed.
[15A NCAC 02L .0107(f)]
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11. The facilities permitted herein shall be constructed according to the following setbacks:
a. The setbacks for irrigation sites permitted under 15A NCAC 02T .0500 shall be as follows (all
distances in feet):
i. Any habitable residence or place of public assembly under separate ownership: 400
*is Any habitable residence or place of public assembly owned by the Permittee: 200
iii. Any private or public water supply source: 100
iv. Surface waters: 100
v. Groundwater lowering ditches: 100
vi. Surface water diversions: 25
vii. Any well with exception of monitoring wells: 100
viii. Any property line: 150
ix. Top of slope of embankments or cuts of two feet or more in vertical height: 15
x. Any water line from a disposal system: 10
xi. Subsurface groundwater lowering drainage systems: 100
xii. Any swimming pool: 100
xiii. Public right of way: 50
xiv. Nitrification field: 20
xv. Any building foundation or basement: 15
[15A NCAC 02T .0506(a)]
b. The setbacks for storage and treatment units permitted under 15A NCAC 02T .0500 shall be as
follows (all distances in feet):
i. Any habitable residence or place of public assembly under separate ownership: 100
ii. Any private or public water supply source: 100
His Surface waters: 50
iv. Any well with exception of monitoring wells: 100
V. Any property line: 50
[15A NCAC 02T .0506(b)]
III. OPERATION AND MAINTENANCE REQUIREMENTS
1. The facilities shall be properly maintained and operated at all times. The facilities shall be effectively
maintained and operated as a non -discharge system to prevent the discharge of any wastewater resulting
from the operation of this facility. The Permittee shall maintain an Operation and Maintenance Plan,
which at a minimum shall include operational functions, maintenance schedules, safety measures and
a spill response plan. [ 15A NCAC 02T .0507]
2. Upon the Water Pollution Control System Operators Certification Commission's (WPCSOCC)
classification of the subject non -discharge facilities, in accordance with 1SA NCAC 08G .0200 the
Permittee shall designate and employ a certified operator in responsible charge (ORC) and one or more
certified operator(s) as back-up ORC(s). The ORC or their back-up shall visit the facilities in
accordance with 15A NCAC 08G .0200, and shall comply with all other conditions specified in the
previously cited rules. [15A NCAC 02T .0117]
3. A suitable year round vegetative cover shall be maintained at all times, such that crop health is
optimized, allows for even distribution o£ effluent and allows inspection of the irrigation system. [ 15A
NCAC 02T .0108(b)(1)j
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4. Adequate measures shall be taken to prevent effluent ponding in or runoff from the irrigation sites listed
in Attachment B. [15A NCAC 02T .0108(b)(1)]
5. Irrigation shall not be performed during inclement weather or when the ground is in a condition that
will cause ponding or runoff. [15A NCAC 02T .0108(b)(1)]
b. All gation equipment shall be tested and calibrated at least once per permit cycle. Calibration records
shall be maintained at the facility for a period of no less than five years, and shall be made available to
the Division upon request. [15A NCAC 02T .0108(b)(1)]
7. Only effluent ftom the Fremont WWTP shall be 143-215.1] gated on the sites listed in Attachment
8. No automobiles or machinery shall be allowed on the gation sites except during equipment
installation or while maintenance is being performed. [15A NCAC 02T .0108(b)(1)]
9. Public access to the irrigation sites and wastewater treatment facilities shall be prohibited. [I SA NCAC
02T .0505(q)]
10. The residuals generated from the wastewater treatment facilities shall be disposed or utilized in
accordance with 15A NCAC 02T .1100. The Permittee shall maintain a residual management plan
pursuant to 15A NCAC 02T .0508. [15A NCAC 02T .05083 02T .1100]
11. Diversion or bypassing of untreated or partially treated wastewater from the treatment facilities is
prohibited. [15A NCAC 02T .05050)]
12. Freeboard in the 11.1 million gallon (MG) Lagoon # 1 and the 10.5 MG Lagoon #2 shall not be less
than two feet at anytime. [15A NCAC 02T .0505(d)]
13. Gauges to monitor waste levels in the 11.1 million gallon (MG) Lagoon #1 and the 10.5 MG Lagoon
#2 shall be provided. These gauges shall have readily visible permanent markings, at inch or tenth of
a foot increments, indicating the following elevations: maximum liquid level at the top of the temporary
liquid storage volume; minimum liquid level at the bottom of the temporary liquid storage volume; and
the lowest point on top of the dam. [15A NCAC 02T .0108(b)(1)]
14. A protective vegetative cover shall be established and maintained on all earthen embankments
outside toe of embankment to maximum allowable temporary storage elevation on the inside of the
embankment), berms, pipe runs, erosion control areas, and surface water diversions. Trees, shrubs, and
other woody vegetation shall not be allowed to grow on the earthen dikes or embankments. Earthen
embankment areas shall be kept mowed or otherwise controlled and accessible. [15A NCAC 02T
.0108(b)(1)]
IV. MO>\TITORING AND REPORTING REQUIREMENTS
1. Any Division required monitoring (including groundwater, plant tissue, soil and surface water analyses)
necessary to ensure groundwater and surface water protection shall be established, and an acceptable
sampling reporting schedule shall be followed. [15A NCAC 02T 90108(c)]
2. A Division certified laboratory shall conduct all laboratory analyses for the required effluent,
groundwater or surface water parameters. [i5A NCAC 02H .0800]
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3. Flow through the treatment facility shall be continuously monitored, and daily flow values shall be
reported on Form NDMR.
The Permittee shall install and maintain an appropriate flow measurement device to ensure the accuracy
and reliability of flow measurement consistent with accepted engineering and scientific practices.
Selected flow measurement devices shall be capable of measuring flows with a maximum deviation of
less than ten percent from true flow; accurately calibrated at a minimum of once per year; and
maintained to ensure the accuracy of measurements is consistent with the selected device's accepted
capability. The Permittee shall maintain records of flow measurement device calibration on file for a
period of at least five years. At a minimum, documentation shall include:
a. Date of flow measurement device calibration,
b. Name of person performing calibration, and
c. Percent from true flow.
[15A NCAC 02T .OI05(k)]
4. The Permittee shall monitor the effluent from the subject facilities at the frequencies and locations for
the parameters specified in Attachment A. [15A NCAC 02T .0108(c)]
5. The Permittee shall maintain adequate records tracking the amount of effluent irrigated. At a minimum,
these records shall include the following information for each irrigation site listed in Attachment B:
a. Date of irrigation;
b. Volume of effluent -irrigated;
c. Site irrigated;
d. Length of time site is irrigated;
e. Continuous weekly, monthly, and yearAo-date hydraulic (inches/acre) loadings;
f. Continuous monthly and year-to-date loadings for any non -hydraulic parameter specifically
limited in Attachment B;
g. Weather conditions; and
h. Maintenance of cover crops.
[15A NCAC 02T .0108(c)]
6. Freeboard (i.e., waste level to the lowest embankment elevation) in the 11.1 million gallon (MG}
Lagoon #1 and the 10.5 MG Lagoon #2 shalt be measured to the nearest inch or tenth of a foot, and
recorded weekly. Weekly freeboard records shall be maintained at the facility for a period of no less
than five years, and shall be made available to the Division upon request. [15A NCAC 02T .0108(c)]
7. Three copies of all monitoring data (as specified in Conditions N.3. and N.4.) on Form NDMR for
each PPI and three copies of all operation and disposal records (as specified in Conditions N.S. and
IV.6.) on Form NDAR-1] for every site in Attachment B shall be submitted on or before the last day of
the following month. If no activities occurred during the monitoring month, monitoring reports are still
required documenting the absence of the activity. All information shall be submitted to the following
address:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[15A NCAC 02T .0105(1)]
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8. A record shall be maintained of all residuals removed from this facility. This record shall be maintained
at the facility for a period of no less than five years, and shall be made available to the Division upon
request. At a minimum, this record shall include:
a. Name of the residuals hauler;
b. Non -Discharge permit number authorizing the residuals disposal, or a letter from a municipality
agreeing to accept the residuals;
c. Date the residuals were hauled; and
d. Volume of residuals removed.
[15A NCAC 02T .0108{b}{lj]
9. A maintenance log shall be maintained at this facility. This log shall be maintained at the facility for a
period of no less than five years, and shall be made available to the Division upon request. At a
minimum, this log shall include:
a. Date of calibration of flow measurement device;
b: Visual observations of the plant and plant site; and
c. Record of preventative maintenance (e.g., changing of equipment, adjustments, testing, inspections
and cleanings, etc.).
[15A NCAC 02T .0108(b)(1)]
10. Monitoring wells shall be sampled at the frequencies and for the parameters specified in Attachment
C. All mapping, well construction forms, well abandonment forms and monitoring data shall refer to
the permit number and the well nomenclature as provided in Attachment C. [15A NCAC 02T
.0105(m)]
11. Two copies of the monitoring well sampling and analysis results shall be submitted on a Compliance
Monitoring Form (GW-59), along with attached copies of laboratory analyses, on or before the last
working day of the month following the sampling month. The Compliance Monitoring Form (GW-59)
shall include this permit number, the appropriate well identification number, and one GW-59a
certification form shall be submitted with each set of sampling results. All information shall be
submitted to the following address:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 276994617
[15A NCAC 02T .0105(m}]
12. An annual representative soils analysis (i.e., Standard Soil Fertility Analysis) shall be conducted on
each irrigation site listed in Attachment B. These results shall be maintained at the facility for a period
of no less than five years, and shall be made available to the Division upon request. At a minimum, the
Standard Soil Fertility Analysis shall include the following parameters:
Acidity
Exchangeable Sodium Percentage
Phosphorus
Base Saturation (by calculation)
Magnesium
Potassium
Calcium
Manganese
Sodium
Cation Exchange Capacity
Percent Humic Matter
Zinc
Copper
pH
[15A NCAC 02T A108(c)]
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1 I Noncompliance Notification:
The Permittee shall report by telephone to the Washington Regional Office, telephone number (252)
946=6481, as soon as possible, but in no case more than 24 hours, or on the next working day following
the occurrence or first knowledge of the occurrence of any of the following:
a. Treatment of wastes abnormal in quantity or characteristic, including the known passage of a
hazardous substance.
b. Any process unit failure (e.g., mechanical, electrical, etc.), due to known or unknown reasons,
rendering the facility incapable of adequate wastewater treatment.
c. Any facility failure resulting in a by-pass directly to receiving surface waters.
d. Any time self -monitoring indicates the facility has gone out of compliance with its permit
limitations.
e. Ponding in or runoff from the irrigation sites.
Any emergency requiring immediate reporting (e.g., discharges to surface waters, imminent failure of
a storage structure, etc.) outside normal business hours shall be reported to the Division's Emergency
Response personnel at telephone number [phone], [phone], or (919) 733=3300. Persons
reporting such occurrences by telephone shall also file a written report in letter form within five days
following first knowledge of the occurrence. This report shall outline the actions taken or proposed to
be taken to ensure the problem does not recur. [15A NCAC 02T .0105(1), 02T .0108(b)(1)]
V. INSPECTIONS
1. The Permittee shall provide adequate inspection and maintenance to ensure proper operation of the
wastewater treatment and irrigation facilities. [15A NCAC 02T .0108(b)]
2. The Permittee or their designee shall inspect the wastewater treatment and irrigation facilities to prevent
malfunctions, facility deterioration and operator errors resulting in discharges, which may cause the
release of wastes to the environment, a threat to human health or a public nuisance. The Permittee shall
maintain an inspection log that includes, at a minimum, the date and time of inspection, observations
made, and any maintenance, repairs, or corrective actions taken. The Permittee shall maintain this
inspection log for a period of five years from the date of the inspection, and this log shall be made
available to the Division upon request. [15A NCAC 02T .0108(b)]
3. Any duly authorized Division representative may, upon presentation of credentials, enter and inspect
any property, premises or place on or related to the wastewater treatment and irrigation facilities
permitted herein at any reasonable time for the purpose of determining compliance with this permit,
may inspect or copy any records required to be maintained under the terms and conditions of this permit,
and may collect groundwater, surface water or leachate samples. [G.S. 143-21.5.3(a)(2)]
VI. GENERAL CONDITIONS
1. Failure to comply with the conditions and limitations contained herein may subject the Permittee to an
enforcement action by the Division in accordance with North Carolina General Statutes 143-215.6A to
143-215.6C. [G.S. 143-215.6A to 143-215.6C]
2. This permit shall become voidable if the permitted facilities are not constructed in accordance with the
conditions of this permit, the Division approved plans and specifications, and other supporting
documentation. [15A NCAC 02T .0110]
3. This permit is effective only with respect to the nature and volume of wastes described in the permit
application, Division approved plans and specifications, and other supporting documentation. No
variances to applicable rules governing the construction or operation of the permitted facilities are
granted, unless specifically requested and approved in this permit pursuant to 15A NCAC 02T .0105(n).
[G.S. 143-21.5.1]
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4. The issuance of this permit does not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances, which may be imposed by other jurisdictional government agencies
(e.g., local, state, and federal). Of particular concern to the Division are applicable river buffer rules in
15A NCAC 02B .0200; erosion and sedimentation control requirements in 15A NCAC Chapter 4 and
under General Permit NCG010000; any requirements pertaining to wetlands under 15A NCAC 02B
.0200 and 02H .0500; and documentation of compliance with Article 21 Part 6 of Chapter 143 of the
General Statutes. [15A NCAC 02T .0105(c)(6)]
5. In the event the permitted facilities change ownership or the Permittee changes their name, a formal
permit modification request shall be submitted to the Division. This request shall be made on official
Division forms, and shall include appropriate property ownership documentation and other supporting
documentation as necessary. The Permittee of record shall remain fully responsible for maintaining
and operating the facilities permitted herein until a permit is issued to the new owner. [15A NCAC
02T .0104]
6. The Penmittee shall retain a set of Division approved plans and specifications for the life of the facilities
permitted herein. [15A NCAC 02T .0108(b)(1)]
7. The Perrrtittee shall maintain this permit until all permitted facilities herein are properly closed or
permitted under another permit issued by the appropriate permitting authority. [15A NCAC 02T
.01050)]
$. This permit is subject to revocation or unilateral modification upon 60 days notice from the Division
Director, in whole or part for the requirements listed in 15A NCAC 02T .0110. [ 15A NCAC 02T .0110]
9. Unless the Division Director grants a variance, expansion of the permitted facilities contained herein
shall not be granted if the Permittee exemplifies any of the criteria in 15A NCAC 02T .0120(b). [15A
NCAC 02T .0120]
10. The Permittee shall pay the annual fee within 30 days after being billed by the Division. Failure to pay
the annual fee accordingly shall be cause for the Division to revoke this permit. [15A NCAC 02T
.0105(e)(3)]
Permit issued this the 15�' day of September 2016
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
�S. Jay Zimmerman, P.G., Directo
Division of Water Resources
By Authority of the Environmental Management Commission
Permit Number WQ0034102
WQ0034102 Version 2.0 Shell Version 151201 Page 9 of 10

Permit No. WQ0034102
Town of Fremont
Fremont WWTP
ENGINEERING CERTIFICATION
❑ Partial ❑ F inal
Wastewater Irrigation System
September 15, 2016
Wayne County
In accordance with I SA NCAC 02T .0116, I, , as
a duly registered Professional Engineer in the State ofNorth Carolina, having the Permittee's authorization
to ❑ periodically ❑ weekly ❑ fully observe the construction of the permitted facility, hereby state to the
best of my abilities that due care and diligence was used in the observation of the construction, such that
the facility was built within substantial compliance and intent of this permit, the Division -approved plans
and specifications, and other supporting documentation.
❑ Any variation to this permit, the Division -approved plans and specifications, and other supporting
documentation has been documented in the attached as -built drawings, and shall serve as the
Permittee's minor modification request to amend the permit accordingly.
Provide a brief narrative description of any variations:
Professional Engineer's Name
Engineering Firm
i
Mailing Address
_...._..--......._._.-_.....................................
City State Zip
Telephone I E-mail NC PE Seal, Signature &Date
THE COMPLETED ENGINEERING CERTIFICATION, INCLUDING ALL SUPPORTING
INFORMATION AND MATERIALS, SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE PERMITTING UNIT
By U.S. Postal Service:
1617 MAIL SERVICE CENTER
By Courier/Special Delivery:
512 N. SALISBURY ST.
RALEIGH, NORTH CAROLINA 27699-1617 RALEIGH, NORTH CAROLINA 27604
WQ0034102 Version 2.0 Shell Version 151201
Page 10 of 10

ATTACHMENT A — LI IITATIONS AND MONITORING REQUIREMENTS Permit Number: WQ0034102 Version: 2.0
PPI 001— WWTP Effluent
EFFLUENT CHARACTERISTICS
EFFLUENT LIMITS
MONITORING REQUIREMENTS
PCS
Code
Parameter Description
Units of
Measure
Monthly
Average
Monthly
Geometric Mean
Daily Minimum
Daily Maximum
Measurement
Frequency
Sample
Type
00310
BOD, 5-Day (20 °C)
mg/L
30
4 x Year
Grab
00940
Chloride (as Cl)
mg/L
3 x Year'
Grab
50060
Chlorine, Total Residual
mg/L
Per Event 3
Grab
31616
Coliform, Fecal MF, M-FC Broth, 44.5 °C
#/100 mL
200
4 x Year
Grab
50050
Flow, in Conduit or thru Treatment Plant
GPD
91,629
Continuous
Recorder
00610
Nitrogen, Ammonia Total (as N)
mg/L
15
4 x Year 1
Grab
00625
Nitrogen, Kieldahl, Total (as N)
mg/L
4 x Year
Grab
00620
Nitrogen, Nitrate Total (as N)
mg/L
4 x Year
Grab
00600
Nitrogen, Total (as N)
mg/L
4 x Year
Grab
00400
pH
Sul
Per Events
Grab
00665
Phosphorus, Total (as P)
mg/L
4 x Year
Grab
70300
Solids, Total Dissolved —180 °C
mg/L
3 x Year z
Grab
00530
Solids, Total Suspended
mg/L
30
4 x Year
Grab
1.
4 x
Year sampling shall
be conducted in March,
June, September and December.
2.
3 x
Year sampling shall
be conducted in
March,
July and November.
3.
Per
Event sampling shall
be conducted during
each
irrigation event, but not to exceed 5 x Week.
WQ0034102 Version 2.0 Attachment A Page 1 of 1

THIS PAGE BLANK

ATTACYEWENT B = APPROVED LAND APPLICATION SITES AND LI IITATIONS Permit Number: WQ0034102 Version: 2.0
Town of Fremont - Fremont WWTP
IRRIGATION AREA INFORMATION
APPLICATION LIMITATIONS
Field
Owner
County
Latitude
Longitude
Net
Acreage
Dominant
Soil Series
Parameter
Weekly
Rate Is 2Max
Yearly
Units
I
Town of Fremont
Wayne
35.545264°
-779583230
2,28
Aycock
01284 - Non Discharge Application Rate
1.0
54.78
in/yr
2
Town of Fremont
Wayne
35,5445960
-77.9580610
3.19
Aycock
01284 -Non Discharge Application Rate
1.0
54,78
in/yr
3
Town of Fremont
Wayne
35.5438280
-77.9580850
1,88
Aycock
01284 - Non Discharge Application Rate
1.0
54,78
in/yr
4
Town of Fremont
Wayne
35.542973'
-77,9580110
2.29
Aycock
01284 - Non Discharge Application Rate
1.0
54.78
in/yr
5
Town of Fremont
Wayne
3565421350
-77.9580230
114
Nahunta
01284 - Non Discharge Application Rate
0.6
28.67
in/yr
6
Town of Fremont
Wayne
35,545401'
-77.9557130
2027
Aycock
01284 -Non Discharge Application Rate
1.0
54.78
in/yr
7
Town of Fremont
Wayne
35.544934'
47.955877°
2.50
Exum
01284 -Non Discharge Application Rate
0.8
43.83
in/yr
8
Town of Fremont
Wayne
35,5444530
-77.9561050
2.39
Exum
01284-Non Discharge Application Rate
0.8
43,83
in/yr
9
Town of Fremont
Wayne
35,5437910
-77.9568080
1.85
Exum
01284-Non Discharge Application Rate
0.8
43,83
in/yr
10
Town of Fremont
Wayne
35.5439770
-7709551240
2,93
Ruston
01284 -Non Discharge Application Rate
1.0
54,78
in/yr
11
Town of Fremont
Wayne
35,5431910
-77.956658°
2.5
Exum
01284 - Non Discharge Application Rate
0.8
43.83
in/yr
12
Town of Fremont
Wayne
35.5429970
-7749547730
2.6
Exum
01284 - Non Discharge Application Rate
0.8
43,83
in/yr
13
Town of Fremont
Wayne
35.542488'
-77.9563090
2064
Exum
01284 -Non Discharge Application Rate
0.8
43,83
in/yr
14
Town of Fremont
Wayne
35.5413561
-77.956728'
A4
Nahunta
01284 -Non Discharge Application Rate
0.6
28.67
in/yr
Totals
31.9
1. Surface irrigation of fields must be applied on a seasonal basis as follows:
➢
January and February to
No
application for the Aycock, Exum and Nahunta soil series. Application rate for the Ruston soil series shall be limited to 0.2 inches/week.
➢
March and December-
0.5
inchmweek
➢ April 151 through November 301 -See application rates in the table above.
2. The operator is required to split the weekly application rates with a minimum of two applications per week
WQ0034102 Version 2.0 Attachment B Page 1 of 1

THIS PAGE BLANK

ATTACHMENT C —GROUNDWATER MONITORING AND LIMITATIONS Permit Number: WQ0034102 Version: 2.0
Monitoring wells: MW4, MW-2, MW-3 and MW-4
GROUNDWATER CHARACTERISTICS
GROUNDWATER STANDARDS
MONITORING REQUIREMENTS
PCS Code
Parameter Description
Daily Maximum
Frequency Measurement
Sample Type
Footnotes
00680
Carbon, Tot Organic (TOC)
mg/L
3 x Year
Grab
15 6
00940
Chloride (as Cl)
250
mg/L
3 x Year
Grab
1
31616
Coliform, Fecal MF, M-FC Broth, 44.5 °C
41100 mL
3 x Year
Grab
1
00610
Nitrogen, Ammonia Total (as N)
L5
mg/L
3 x Year
Grab
1
00620
Nitrogen, Nitrate Total (as N)
10
mg/L
3 x Year
Grab
1
00665
Phosphorus, Total (as P)
mg/L
3 x Year
Grab
I
00400
pH
6.54.5
su
3 x Year
Grab
15 2
70300
Solids, Total Dissolved - 180 °C
500
mg/L
3 x Year
Grab
1
GWVOC
Volatile Compounds (GC/MS)
Present: Yes/No
Annually
Grab
12 4, 5
82546
Water Level, Distance from measuring point
feet
3 x Year
Calculated
1, 2, 3
l . 3 x Year monitoring shall be conducted in March, July &November; Annual monitoring shall be conducted every November.
2. The measurement of water levels shall be made prior to purging the wells. The depth to water in each well shall be measured from the surveyed point on the top of the casing. The measurement of
pH shall be made after purging and prior to sampling for the remaining parameters.
3. 1'he measuring points (top of well casing) of all monitoring wells shall be surveyed to provide the relative elevation of the measuring point for each monitoring well. The measuring points (top of
casing) of all monitoring wells shall be surveyed relative to a common datum.
4. Volatile Organic Compounds (VOC) - In November only, analyze by one of the following methods:
a. Standard Method 6230D, PQL at 0.5 µg/L or less
b. Standard Method 621 OD, PQL at 0.5 µg/L or less
c. EPA Method 8021, Low Concentration, PQL at 0.5 µg/L or less
d. EPA Method 8260, Low Concentration, PQL at 0.5 µg/L or less
e. Another method with prior approval by the Water Quality Permitting Section Chief
Any method used must meet the following qualifications:
a. A laboratory must be DWR certified to run any method used.
b. The method used must, at a minimum, include all the constituents listed in Table VIII of Standard Method 6230D.
c. The method used must provide a PQL of 0.5 µg/L or less that must be supported by laboratory proficiency studies as required by DWR. Any constituents detected above the MDL but below
the PQL of 0.5 µg/L must be qualified (estimated) and reported.
5. If any volatile organic compounds (VOC) are detected as a result of monitoring as provided in Attachment C, then the Washington Regional Office supervisor, telephone number [phone],
must be contacted immediately for further instructions regarding any additional follow-up analyses required.
6. If TOC concentrations greater than 10 mg/L are detected in any downgradient monitoring well, additional sampling and analysis must be conducted to identify the individual constituents comprising
this TOC concentration. If the TOC concentration as measured in the background monitor well exceeds 10 mg/L, this concentration will be taken to represent the naturally occurring TOC
concentration. Any exceedances of this naturally occurring TOC concentration in the downgradient wells shall be subject to the additional sampling and analysis as described above.
7. Monitoring wells shall be reported consistent with the nomenclature and location information provided in this attachment.
WQ0034102 Version 2.0 Attachment C Page 1 of 1

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E Municipal Engineering
Company, P.A.
April 9, 2019
Mr. Nathaniel Thornburg
Branch Chief
NC Department of Environmental Quality
Division of Water Resources
Non -Discharge Permitting Unit
Raleigh, NC 27699-1617
RE: Town of Fremont
Wastewater Irrigation System
Disinfection System Modifications
Permit No: WQ0034102
Wayne County
Dear Nathaniel:
Enclosed please find one the following:
Services
• WWIS —Wastewater Irrigation System Permit Modification Application (one copy)
• Copy of Current Permit No. WQ0034102 (one copy)
• Drawing of Modification (two copies)
We understand the Non -Discharge Branch is transitioning to an electronic permitting system thusly
we have submitted these documents via the portal on the web site.
Recently the Town of Fremont modified the disinfection system located at their wastewater
irrigation system from chlorine gas to sodium hypochlorite. This change was made primarily to
provide for greater safety of their maintenance personnel and reduce the make-up water to operate
the gas chlorine system.
The modification was noted during the last compliance inspection by Mr. Randy Sipe with the
Washington Regional Office. Unfortunately, the Town nor I was aware that this minor modification
now requires a modification to their permit. The Town and I apologize for this oversight.
68 Shipwash Drive Garner, NC 27529 ph: 919-772-5393 fx: 919-772-1176 www.mesco.com
P.O. Box 349 • Boone, NC 28607 ph: 828-262-1767 • fx: 828-265-2601 • www.mesco.com

Mr. Nathaniel Thornburg
Permit No. WQ0034102 Modification
Page 2
Pursuant to my conversation with Mr. Sipe we have prepared the permit application and as -built
drawing on the Town's behalf to request a minor modification to the permit to comply with the
NCDEQ Administrative Rules.
The existing system included 150-lb. chlorine gas cylinders, with scales, rotameter, and other
appurtenances to mix the gas with make-up water and dose the chlorine solution to the existing
chlorine contact chamber.
The modified system will utilize a variable speed peristaltic pump with a pre -mixed 55-gallon drum
of sodium hypochlorite solution. As indicated in the drawing, the system also includes a redundant
pump and 55-gallon drum of sodium hypochlorite solution.
If you have any questions or comments or need additional information, please don't hesitate to
contact me.
Very Respectfully,
MUNICIPAL ENGINEERING SERVICES CO., PA
Michael L. McAllister, M. ASCE
Principal Project Manager
CC: Mrs. Barbara Aycock, Town of Fremont
Hon. W. Darron Flowers, Town of Fremont
Mr. Randy Sipe, NCDEQ Washington Regional Office
Mr. Steven R. Gandy, PE, Ph.D., MESCO

State of North Carolina
Division of Water Resources
Department of Environment and Natural Resources
sion of Water Resources
1511 NCAC 02T ,0500 — WASTEWATER IRRIGATION SYSTEMS
INSTRUCTIONS FOR FORM: WWIS 1143 & SUPPORTING DOCUMENTATION
Plans, specifications and supporting documents shall be prepared in accordance with 15A NCAC 02H .0400 (if necessary), 15A
NCAC 02L .01009 15A NCAC 02T .0100, 15A NCAC 02T .0500, Division Policies and good engineering practices. Failure to
submit all required items will necessitate additional processing and review time.
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit website at.'
b ttp: //Portal. ncdenr. org/web/wg/ays/lau
General —When submitting an application to the Water Quality Permitting Section's Non -Discharge Permitting Unit, 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.
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation.
A. Cover Letter (All Application Packages):
® List all items included in the application package, as well as a brief description of the requested pennitting action.
B. Application Fee (All New and Major Modification Application Packages):
❑ Submit a check, money order or electronic funds transfer made payable to: North Carolina Department of Environment and
Natural Resources (NCDENR). The appropriate fee amount for new and major modification applications may be found at:
Standard Review Project Fees.
C. Wastewater Irrigation Systems (FORM: WWIS 11-13) Application (All Application Packages):
® Submit the completed and appropriately executed Wastewater Irrigation Systems (FORM: WWIS 11-13) application. Any
unauthorized content changes to this form shall result in the application package being returned. If necessary for clarity or
due to space restrictions, attachments to the application may be made, as long as the attachments are numbered to correspond
to the section and item to which they refer.
❑ If the Applicant Type in Item I.2. is a corporation or company, provide documentation it is registered for business with the
North Carolmi Secretary of Statc.
❑ 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 facility name in Item II.1. shall be consistent with the facility name on the plans, specifications, agreements, etc.
® The Professional Engineer's Certification on Page 12 of the application shall be signed, sealed and dated by a North Carolina
licensed Professional L❑<"ineer.
® The Applicant's Certification on Page 12 of the application shall be signed in accordance with 15A NCAC 02T .0106(b). Per
15A NCAC 02T 40106(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'_021' .0106(b).
❑ If this project is for a renewal without modification, use the Non -Discharge System Renewal (FORM: NDSR) application.
D. Property Ownership Documentation (All Application Packages):
➢ Per 15A NCAC 02T .0504(f), the Applicant shall demonstrate they are the owner of all property containing the wastewater
treatment, storage and irrigation facilities:
® Legal documentation of ownership (i.e., GIS, deed or article of incorporation), or
❑ Written notarized intent to purchase agreement signed by both parties with a plat or survey map, or
❑ Written notarized lease agreement that specifically indicates the intended use of the property and has been signed by both
parties, as well as a plat or survey map. Lease agreements shall adhere to the requirements of 15A NCAC 02L, .0107,
❑ Provide all agreements, easements, setback waivers, etc. that have a direct impact on the wastewater treatment, conveyance,
storage and irrigation facilities.
INSTRUCTIONS FOR FORM: WWIS 1 I-13 &SUPPORTING DOCUMENTATION Page 1 of 6

E. Soil Evaluation (All Application Packages that include new irrigation sites):
❑ Per 15A NCAC 02T .0504(b) and the Soil Scientist Evaluation Policy, submit a detailed soil evaluation that has been signed,
sealed and dated by a North Carolina Licensed Soil Scientist and includes at a minimum:
❑ The report shall identify all the sites/fields with project name, location, and include a statement that the sites/fields were
recommended for the proposed land application activity.
❑ Field delineated detailed soils map meeting all of the requirements of the Soil Scientist Evaluation Policy.
❑ Soil profile descriptions meeting all of the requirements of the Soil Scientist Evaluation Policy.
❑ Provide all soil boring logs performed at the site.
❑ Standard soil fertility analysis conducted no more than one year prior to permit application for each map unit in the soil
map legend for the following parameters:
❑ Acidity ❑ Exchangeable sodium percentage (by calculation) ❑ Phosphorus
❑ Base saturation (by calculation) ❑ Magnesium ❑ Potassium
❑ Calcium ❑ Manganese ❑ Sodium
❑ Cation exchange capacity ❑ Percent humic matter ❑ Zinc
❑ Copper ❑ pH
➢ Saturated hydraulic conductivity (KSAT) data that shall include at a minimum:
❑ A minimum of three KsAT tests shall be conducted in the most restrictive horizon for each soil series in the soil map.
❑ All KsAT tests shall be conducted in areas representative of the site,
❑ All KsAT tests shall be run until steady-state equilibrium has been achieved.
❑ All collected KsAT data shall be submitted, including copies of field worksheets showing all collected readings.
❑ Submit a soil profile description for each KsAT data point that shall extend at least one foot below the tested horizon.
➢ Soil evaluation recommendations shall include at a minimum:
❑ A brief summary of each map unit and its composition and identification of minor contrasting soils.
❑ Maximum irrigation precipitation rate (in/hr) for each soil/map unit within the proposed irrigation areas.
❑ Seasonal irrigation restrictions, if appropriate.
❑ Identification of areas not suitable for wastewater irrigation.
❑ Recommended geometric mean KsAT rate to be used in the water balance for each soil/map unit based upon in -situ
measurement of the saturated hydraulic conductivity from the most restrictive horizon.
❑ Recommended drainage coefficient to be used in the water balance based upon comprehensive site evaluation,
review of collected onsite data, minor amounts of contrasting soils and the nature of the wastewater to be applied.
❑ Recommended annual hydraulic loading rate (in/yr) for each soil/map unit within the proposed irrigation areas based
upon in -situ KsAT measurements form the most restrictive soil horizon.
NOTE — If the soil evaluation was performed more than one year prior to the submittal of this application package, a statement
shall be included indicating that the site has not changed since the original investigation.
F. Agronomist Evaluation (All Application Packages that include new irrigation sites or new crops for existing irrigation sites):
❑ Per 15A NCAC 02T .0504(i), submit an agronomist evaluation that has been signed, sealed and dated by a qualified
professional and includes at a minimum:
❑ Proposed nutrient uptake values for each cover crop based upon each field's dominant soil series and percent slope.
❑ Plant available nitrogen calculations for each cover crop using the designed effluent concentrations in Application Item
V.1. and proposed mineralization and volatilization rates.
❑ Historical site consideration, soil binding and plant uptake of phosphorus.
❑ Seasonal irrigation restrictions, if appropriate.
❑ A clear and reproducible map showing all areas investigated and their relation to proposed fields and crops.
❑ Maintenance and management plan for all specified crops.
INSTRUCTIONS FOR FORM: WWIS 11-13 &SUPPORTING DOCUMENTATION Page 2 of 6

G. Hydrogeologic Report (All Application Packages treating industrial waste or having a design flow over 25,000 GPD):
❑ Per 15A NCAC 02T .0504(e), the Hydroseologic Investigation and Reporting Policy, the Groundwater Modeling Policy and
the Performance and Analysis of Aquifer Slug Tests and Puinpinf4 Tests Policy, submit a detailed hydrogeologic description
that has been signed, sealed and dated by a qualified professional and includes at a minimum:
❑ A hydrogeologic description to a depth of 20 feet below land surface or bedrock, whichever is less. A greater depth of
investigation is required if the respective depth is used in predictive calculations.
❑ Representative borings within the irrigation areas and all proposed earthen impoundments.
❑ A description of the regional and local geology and hydrogeology.
❑ A description, based on field observations of the site, of the site topographic setting, streams, springs and other
groundwater discharge features, drainage features, existing and abandoned wells, rock outcrops, and other features that
may affect the movement of the contaminant plume and treated wastewater.
❑ Changes in lithology underlying the site.
❑ Depth to bedrock and occurrence of any rock outcrops.
❑ The hydraulic conductivity and transmissivity of the affected aquifer(s).
❑ Depth to the seasonal high water table (SHWT).
❑ A discussion of the relationship between the affected aquifers of the site to local and regional geologic and
hydrogeologic features.
❑ A discussion of the groundwater flow regime of the site prior to operation of the proposed facility and post operation of
the proposed facility focusing on the relationship of the system to groundwater receptors, groundwater discharge
features, and groundwater flow media.
❑ If the SHWT is within six feet of the surface, a mounding analysis to predict the level of the SHWT after wastewater
application,
H. Water Balance (All Application Packages that include new or modified irrigation sites, changes in flow or changes in storage):
❑ Per 15A NCAC 02T .0504(k) and the Water Balance Calculation 2glicy, submit a water balance that has been signed, sealed
and dated by a qualified professional and includes at a ininimum:
❑ At least a two-year iteration of data computation that considers precipitation into and evaporation from all open
atmosphere storage impoundments, and uses a variable number of days per month.
❑ Precipitation based on the 80' percentile and a minimum of 30 years of observed data.
❑ Potential Evapotranspiration (PET) using the Thornthwaite method, or another approved methodology, using a minimum
of 30 years of observed temperature data.
❑ Soil drainage based on the geometric mean of the in -situ KsAT tests in the most restrictive horizon and a drainage
coefficient ranging from 4 to 10% (unless otherwise technically documented).
➢ Other factors that may restrict the hydraulic loading rate when determining a water balance include:
❑ Depth to the SHWT and groundwater lateral movement that may result in groundwater mounding.
❑ Nutrient limitations and seasonal application times to ensure wastewater irrigation does not exceed agronomic rates.
❑ Crop management activities resulting in cessation of irrigation for crop removal.
NOTE — Wastewater Irrigation Systems serving residential facilities shall have a minimum of 14 days of wet weather storage.
I. Engineering Plans (All Application Packages):
® Per 15A NCAC 02T .0504(c)(1), submit standard size and 11 x 17-inch plan sets that have been signed, sealed and dated by a
North Carolina licensed Professional Engineer, and shall include at a minimum:
® Table of contents with each sheet numbered.
® A general location map with at least two geographic references and a vicinity map.
® A process and instrumentation diagram showing all flow, recycle/return, aeration, chemical, electrical and wasting paths.
❑ Plan and profile views of all treatment and storage units, including their piping, valves, and equipment (i.e., pumps,
blowers, mixers, diffusers, flow meters, etc.), as well as their dimensions and elevations.
® Details of all piping, valves, pumps, blowers, mixers, diffusers, recording devices, fencing, auxiliary power, etc.
❑ A hydraulic profile from the treatment plant headworks to the highest irrigation point.
❑ The irrigation area with an overlay of the suitable irrigation areas depicted in the Soil Evaluation.
❑ Each nozzle/emitter and their wetted area influence, and each irrigation zone labeled as it will be operated.
❑ Locations within the irrigation system of air releases, drains, control valves, highest irrigation nozzle/emitter, etc.
❑ For automated irrigation systems, provide the location and details of the precipitation/soil moisture sensor.
® Plans shall represent a completed design and not be labeled with preliminary phrases (e.g., FOR REVIEW ONLY, NOT
FOR CONSTRUCTION, etc.) that indicate they are anything other than final specifications. However, the plans may be
labeled with the phrase: FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION.
INSTRUCTIONS FOR FORM: WWIS 11-13 &SUPPORTING DOCUMENTATION Page 3 of 6

J. Specifications (All Application Packages):
® Per 15A NCAC 02T .0504(c)(2), submit specifications that have been signed, sealed and dated by a North Carolina licensed
Professional Engineer, and shall include at a minimum:
® Table of contents with each section/page numbered.
® Detailed specifications for each treatment/storage/irrigation unit, as well as all piping, valves, equipment (i.e., pumps,
blowers, mixers, diffusers, flow meters, etc.), nozzles/emitters, precipitation/soil moisture sensor (if applicable),
audible/visual high water alarms, liner material, etc.
❑ Site Work (i.e., earthwork, clearing, grubbing, excavation, trenching, backfilling, compacting, fencing, seeding, etc.)
® Materials (i.e., concrete, masonry, steel, painting, method of construction, etc.)
❑ Electrical (i.e., control panels, transfer switches, automatically activated standby power source, etc.)
❑ Means for ensuring quality and integrity of the finished product, including leakage, pressure and liner testing.
Z Specifications shall represent a completed design and not be labeled with preliminary phrases (e.g., FOR REVIEW
ONLY, NOT FOR CONSTRUCTION, etc.) that indicate they are anything other than final specifications. However, the
specifications may be labeled with the phrase: FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION.
K. Engineering Calculations (All Application Packages):
❑ Per 15A NCAC 02T .0504(c)(3), submit engineering calculations that have been signed, sealed and dated by a North
Carolina licensed Professional En i� neer, and shall include at a minimum:
❑ Hydraulic and pollutant loading calculations for each treatment unit demonstrating how the designed effluent
concentrations in Application Item V.1. were determined.
❑ Sizing criteria for each treatment unit and associated equipment (i.e., blowers, mixers, flow meters, pumps, etc.).
❑ Total and effective storage calculations for each storage unit.
❑ Friction/total dynamic head calculations and system curve analysis for each pump used.
❑ Manufacturer's information for all treatment units, pumps, blowers, mixers, diffusers, flow meters, irrigation system, etc.
❑ Flotation calculations for all treatment and storage units constructed partially or entirely below grade.
❑ A demonstration that the designed maximum precipitation and annual loading rates do not exceed the recommended
rates.
❑ A demonstration that the specified auxiliary power source is capable of powering all essential treatment units.
L. Site Map (All Application Packages):
® Per 15A NCAC 02T .0504(d), submit standard size and 11 x 174nch site maps that have been signed, sealed and dated by a
North Carolina licensed Professional Engineer and/or Professional Land Surveyor, and shall include at a minimum:
® A scaled map of the site with topographic contour intervals not exceeding 10 feet or 25 percent of total site relief and
showing all facility -related structures and fences within the wastewater treatment, storage and irrigation areas.
❑ Soil mapping units shown on all irrigation sites.
❑ The location of all wells (including usage and construction details if available), streams (ephemeral, intermittent, and
perennial), springs, lakes, ponds, and other surface drainage features within 500 feet of all wastewater treatment, storage
and irrigation sites.
❑ Delineation of the compliance and review boundaries per 15A NCAC 02L .0107 and .0108, and 15A NCAC 02T
.0506 c if applicable.
❑ Setbacks as required by 15A NCAC 02T .0506.
❑ Site property boundaries within 500 feet of all wastewater treatment, storage and irrigation sites.
❑ All habitable residences or places of public assembly within 500 feet of all treatment, storage and irrigation sites.
NOTE — For clarity, multiple site maps of the facility with cut sheet annotations may be submitted.
M. Power Reliability Plan (All Application Packages):
❑ Per 15A NCAC 02T .0505(l), submit documentation of power reliability that shall consist of at a minimum:
❑ An automatically activated standby power supply onsite that is capable of powering all essential treatment units under
design conditions, OR
➢ Approval from the Director that the facility:
❑ Serves a private water distribution system that has automatic shut-off during power failures and has no elevated
water storage tanks,
❑ Has sufficient storage capacity that no potential for overflow exists, and
❑ Can tolerate septic wastewater due to prolonged detention.
INSTRUCTIONS FOR FORM: WWIS 11-13 &SUPPORTING DOCUMENTATION Page 4 of 6

N. Operation and Maintenance Plan (All Application Packages):
❑ Per 15A NCAC 02T .0507, submit an operation and maintenance (O&M) plan encompassing all wastewater treatment,
storage and irrigation systems that shall include at a minimum a description of
❑ Operation of the wastewater treatment, storage and irrigation systems in sufficient detail to show what operations are
necessary for the system to function and by whom the functions are to be conducted.
❑ Anticipated maintenance of the wastewater treatment, storage and irrigation systems.
❑ Safety measures, including restriction of access to the site and equipment.
❑ Spill prevention provisions such as response to upsets and bypasses, including how to control, contain and remediate.
❑ Contact information for plant personnel, emergency responders and regulatory agencies.
NOTE — A final O&M Plan shall be submitted with the partial and/or final Engineering Certification required under 15A NCAC
02T .0116, however, a preliminary O&M Plan shall be submitted with each application package.
O. Residuals Management Plan (All Application Packages with new, expanding or replacement wastewater treatment systems):
❑ Per 15A NCAC 02T .0504(i) and .0508, submit a Residuals Management Plan that shall include at a minimum:
❑ A detailed explanation of how generated residuals (including trash, sediment and grit) will be collected, handled,
processed, stored, treated, and disposed.
❑ An evaluation of the treatment facility's residuals storage requirements based upon the maximum anticipated residuals
production rate and ability to remove residuals.
❑ A permit for residuals utilization or a written commitment to the Applicant from a Permittee of a Department approved
residuals disposal/utilization program that has adequate permitted capacity to accept the residuals or has submitted a
residuals/utilization program application.
❑ If oil/grease removal and collection are a designed unit process, submit an oil/grease disposal plan detailing how the
oil/grease will be collected, handled, processed, stored and disposed.
NOTE — Per 15A NCAC 02T .0505(o), a minimum of 30 days of residual storage shall be provided.
NOTE — Per 15A NCAC 02T .0504(i), a written commitment to the Applicant from a Permittee of a Department approved
residuals disposal/utilization program is not required at the time of this application, however, it shall be provided prior to
operation of any permitted facilities herein.
NOTE — If an on -site restaurant or other business with food preparation is contributing wastewater to this system, an oil/grease
disposal plan shall be submitted.
P. Additional Documentation:
➢ Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per 15A NCAC 02T .0115(a)(1) and .0504(g), provide the Certificate of Public Convenience and Necessity from the
North Carolina Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area
to be served by the wastewater treatment and irrigation system, or
❑ Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an
application for a franchise has been received and that the service area is contiguous to an existing franchised area or that
franchise approval is expected.
➢ 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., compliance schedules, permit description, monitoring, permit conditions, etc.).
Final Environmental Document (All Application Packages using public monies or lands subject. to the North Carolina
Environmental Policy Act under 15A NCAC 01 G .0100 to .0400):
❑ Per 15A NCAC 02T .0105(c)(4), submit one copy of the environmental assessment and three copies of the final
environmental document (i.e., Finding of No Significant Impact or Record of Decision).
❑ Include information on any mitigating factors from the Environmental Assessment that impact the design and/or
construction of the wastewater treatment and irrigation system.
➢ Floodway Regulation Compliance (All Application Packages where any portion of the wastewater treatment, storage and
irrigation system is located within the 100-year floodplain):
❑ Per 15A NCAC 02T .0105(c)(8), provide written documentation from all local governing entities that the facility is in
compliance with all local ordinances regarding construction or operation of wastewater treatment and/or disposal
facilities within the floodplain.
INSTRUCTIONS FOR FORM: WWIS 11-13 &SUPPORTING DOCUMENTATION Page 5 of 6

P.
Additional Documentation (continued):
➢ Operational Agreements (All Application Packages for Home/Property Owners' Associations and Developers
of lots
and
,
➢ Wastewater Chemical Analysis (All Application Packages treating Industrial Waste):
❑ Per 15A NCAC 02T .0504(h), provide a complete Division certified laboratory chemical analysis of the effluent to be
irrigated for the following parameters (For new facilities, an analysis from a similar facility's effluent is acceptable):
❑ Arnrnonia Nitrogen (NHs-N)
❑
Nitrate Nitrogen ON
❑ Total OrganiCarb
THE COMPLETED APPLICATION AND SUPPORTING DOCUMENTATION SHALL BE SUBMITTED TO:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE PERMITTING UNIT
By U.S. Postal Service: By Courier/Special Delivery:
1617 MAIL SERVICE CENTER 512 N. SALISBURY ST.
RALEIGH, NORTH CAROLINA 276994617 RALEIGH, NORTH CAROLINA 27604
TELEPHONE NUMBER: [phone]
FAX NUMBER: [phone]
INSTRUCTIONS FOR FORM: WWIS 11-13 &SUPPORTING DOCUMENTATION Page 6 of 6

Division of Water Resources
I. APPLICANT INFORMATION:
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
15A NCAC 02T .0500 — WASTEWATER IRRIGATION SYSTEMS
FORM: WWIS 1143
1. Applicant's name: Town of Fremont
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State ® Municipal
3. Signature authority's name: W. Darron Flowers per 15A NCAC 02T .0106(b)
4. Applicant's mailing address: P.O. Box 4
City: Fremont State: NC Zip: 27830-0818
5. Applicant's contact information:
Phone number: [phone] Email Address: baycock ,fremontnc. ov
II. FACILITY INFORMATION:
1. Facility name: Town of Fremont WWTP Spra�eld Wastewater Irrigation Field
2. Facility status: Existing
3. Facility type: Major (> 10,000 GPD or> 300 disposal acres)
4. Facility's physical address: Davis Mill Road
City: Fremont State: NC Zip: 27830.0818 County: Wa ie
5. Wastewater Treatment Facility Coordinates (Decimal Degrees): Latitude: 35.32,440
Datum: NAD83 Level of accuracy: Select Method of measurement: Select
6. USGS Map Name: Fremont
III. CONSULTANT INFORMATION:
❑ Privately -Owned Public Utility
ounty
❑ C
Longitude:-77.57.37°
Title: Maw
I. Professional Engineer: Steven R. Gandv License Number: 31020 Finn: Municipal Engineering Services Co., PA
Mailing address: 68 Shipwash Drive
City: Garner State: NC Zip: 27529-
Phone number: [phone] Email Address: mmcallisterkmesco.com
2. Soil Scientist: N/A License Number: Firm:
Mailing address:
City: State: Zip: -
Phone number: O -
3. Geologist: N/A
Mailing address:
City:
State:
Phone number. O -
4. Agronomist: N/A
Mailing address:
City:
State:
Phone number: O
Email Address:
_
License Number:
Zip: -
Email Address: _
Firm:
Zip: -
Email Address:
Fnni:
FORM: WWIS 11-13 Page 1 of 12

IV. GENERAL REQUIREMENTS— 15A NCAC 02T AIM:
1. Application type: ❑ New ❑ Major Modification ® Minor Modification
If a modification, provide the existing permit number: WQ0034102 and most recent issuance date: December 18, 2009
2. Application fee: $0 - Standard - Minor Modification
3. Does this project utilize public monies or lands? ® Yes or ❑ No
If yes, was an Environmental Assessment required under 15A NCAC O1C? ❑Yes or ®No
If yes, which final environmental document is submitted? ❑ Finding of No Significant Impact or ❑ Record of Decision
Briefly describe any mitigating factors from the Environmental Assessment that may impact this facility: N/A
4. What is the status of the following permits/certifications applicable to the subject facility?
Permit/Certification
Date
Submitted
Date
Approved
Permit/Certification
Number
Agettcy Reviewer
Collection System (Q > 200,000 GPD)
N/A
Dam Safety
N/A
Erosion & Sedimentation Control Plan
N/A
Nationwide 12 / Section 404
N/A
Pretreatment
N/A
Sewer System
N/A
Stormwater Management Plan
N/A
Wetlands 401
N/A
Other:
N/A
5. What is the wastewater type? ®Domestic or Industrial (See 15A NCAC 02T .0103(20))
Is there a Pretreatment Program in effect? ❑ Yes or ❑ No
Has a wastewater chemical analysis been submitted? ❑ Yes or ❑ No
i, Wastewater flow: 119,359 GPD
Limited by: ❑Treatment, El Storage, ®Field Hydraulics, El Field Agronomics or ❑Groundwater Mounding
7. Explain how the wastewater flow was determined: ❑ 15A NCAC 02T .0114 or ®Representative Data
Has a flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes or ® No
Establishment Type
Daily Design Flow a
No. of Units
Flow
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
GPD
a See 15A NCAC 02T .0114(b), Q, e 1 and L0(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),
FORM: WWIS 11-13 Page 2 of 12

V. GENERAL REQUIREMENTS —15A NCAC 02T .0100 (continued):
8. What is the nearest 100-year flood elevation to the facility? 112.8 feet mean sea level. Source: FIRM
Are any treatment, storage or irrigation facilities located within the 100-year flood plain? ❑ Yes or ® No
If yes, which facilities are affected and what measures are being taken to protect them against flooding?
If yes, has the Applicant submitted written documentation of compliance with & 143 Article 21 Part 6? ❑ Yes or ❑ No
9. Has the Applicant provided documentation of the presence or absence of threatened or endangered aquatic species utilizing
information provided by the Department's Natural Heritage Program? ® Yes or ❑ No
10. Does the facility have a proposed or existing groundwater monitoring well network? ® Yes or ❑ No
If no, provide an explanation as to why a groundwater monitoring well network is not proposed:
If yes, complete the following table (NOTE — This table may be expanded for additional wells):
Well Name
Status
Latitude a
Longitude e
Gradient
Location
Select
-
Select
Select
Select
-0
Select
Select
Select
-0
Select
Select
Select
°
- °
Select
Select
Select
-0
Select
Select
Select
-0
Select
Select
Select
°
- °
Select
Select
Select
-
Select
Select
Select
-
Select
Select
Select
-
Select
Select
a Provide the following latitude and longitude coordinate determination information:
Datum: Select Level of accuracy: Select Method of measurement: Select
11. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been submitted?
❑ Yes, ❑No or ®N/A
12. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been submitted?
❑ Yes, ❑No or ®N/A
13. If the Applicant is a Home/Property Owners' Association, has an Association Operational Agreement (FORM: HOA) been
submitted? ❑Yes, ❑No or ®N/A
14. Demonstration of historical consideration for permit approval — 15A NCAC 02T .0120:
Has the Applicant or any parent, subsidiary or other affiliate exhibited the following?
a. Has been convicted of environmental crimes under Federal law or G.S. 143-215.6B? ❑Yes or ®No
b. Has previously abandoned a wastewater treatment facility without properly closing that facility? ❑ Yes or ® No
c. Has unpaid civil penalty where all appeals have been abandoned or exhausted? ❑ Yes or ® No
d. Is non -compliant with an existing non -discharge permit, settlement agreement or order? ® Yes or ❑ No
e. Has unpaid annual fees in accordance with 15A NCAC 02T .0105(e)(2)? ❑ Yes or Z No
FORM: WWIS 11-13 Page 3 of 12

v. WASTEWATER TREATMENT FACILITY DESIGN CRITERIA —15A NCAC 02T .0505:
L For the following parameters, provide the estimated influent concentrations and designed effluent concentrations as
determined in the Engineering Calculations, and utilized in the Agronomic Evaluation and Groundwater Modeling (if
applicable):
Parameter
Estimated Influent Concentration
Designed Effluent Concentration
(monthly average)
Ammonia Nitrogen (NH3-N)
mg/L
15 mg/L
Biochemical Oxygen Demand (BOD5)
mg/L
30 mg/L
Fecal Coliforms
200 per 100 mL
Nitrate Nitrogen (NO3-N)
mg/L
mg/L
Nitrite Nitrogen (NO2-N)
mg/L
mg/L
Total Kjeldahl Nitrogen
mg/L
Total Nitrogen
mg/L
mg/L
Total Phosphorus
mg/L
mg/L
Total Suspended Solids (TSS)
mg/L
30 mg/L
2. Is flow equalization of at least 250/o of the average daily flow provided? ®Yes or ❑ No
3. Does the treatment facility include any bypass or overflow lines? ❑ Yes or ® No
If yes, describe what treatment units are bypassed, why this is necessary, and where the bypass discharges:
4. Are multiple pumps provided wherever pumps are used? ®Yes or ❑ No
If no, how does the Applicant intend on complying with 15A NCAC 02T .0505(k)?
5. Check the appropriate box describing how power reliability will be provided in accordance with 15A NCAC 02T .0505(1):
❑ Automatically activated standby power supply onsite capable of powering all essential treatment units; or
® Approval from the Director that the facility:
➢ Has a private water supply that automatically shuts off during power failures and does not contain elevated water
storage tanks;
➢ Has sufficient storage capacity that no potential for overflow exists; and
➢ Can tolerate septic wastewater due to prolonged detention.
6. If the wastewater treatment system is located within the 100-year flood plain, are there water -tight seals on all treatment units
or a minimum of two feet protection fiom the 100-year flood plain elevation? ❑Yes, ❑ No or ®N/A
7. In accordance with 15A NCAC 02T .0505(o), how many days of residuals storage are provided? 30
8. How does the Applicant propose to prohibit public access to the wastewater treatment and storage facilities? Fence
9. If an influent pump station is part of the proposed facility (i.e., within the wastewater treatment plant boundary), does the
influent pump station meet the design criteria in 15A NCAC 02T .0305(h)? ❑ Yes, ❑ No, ® N/A — To be permitted
separately, or ❑ N/A — Gravity fed
10. If septic tanks are part of the wastewater treatment facility, do the septic tanks adhere to the standards in 15A NCAC 18A
1900 ❑ Yes , ❑ No or ®N/A
FORM: WWIS 11-13 Page 4 of 12

V. WASTEWATER TREATMENT FACILITY DESIGN CRITERIA — 15A NCAC 02T .0505 (continued):
11. Provide the requested treatment unit and mechanical equipment information:
a. PRELIMINARY / PRIMARY TREATMENT (i.e., physical removal operations and now equalization):
Treatment Unit
No. of
Units
Manufacturer or
Material
Dimensions (ft) /
S acin s (in)
Volume
(allons)
Plan Sheet
Reference
Specification
Reference
Select
-L
Select
Select
Select
Select
b. SECONDARY /TERTIARY TREATMENT (i.e., biological and chemical processes to remove organics and nutrients)
Treatment Unit
C.
No. of
Units
Manufacturer or
Material
Dimensions (ft)
Volume
(gallons)
Plan Sheet
Reference
Specification
Reference
Select
Select
Select
Select
Select
Select
Select
Select
DISINFECTION
Treatment Unit
No. of
Manufacturer or
Dimensions (ft)
Volume
Plan Sheet
Specification
Units
Material
(gallons)
Reference
Reference
Chlorination Tank
Select
➢ If chlorination is the proposed method of disinfection, specify detention time provided: minutes (NOTE — 30
minutes minimum required), and indicate what treatment unit chlorine contact occurs:
➢ If ultraviolet (UV) light is the proposed method of disinfection, specify the number of banks: ,number of lamps
per bank: and maximum disinfection capacity: GPM.
d. RESIDUAL TREATMENT
Treatment Unit
No. of
Manufacturer or
Dimensions (ft)
Volume
Plan Sheet
Specification
Units
Material
allons)
Reference
Reference
Select
Select
FORM: WWIS 11-13 Page 5 of 12

v WASTEWATER TREATMENT FACILITY DESIGN CRITERIA —15A NCAC 02T .0505 (continued).
e. PUMPS
Location
No. of
Pumps
purpose
Manufacturer /
Type
Capacity
Plan Sheet
Reference
Specification
Reference
GPM
TDH
f. BLOWERS
No. of Manufacturer / Capacity Plan Sheet Specification
Location Blowers Units Served Type (CFM) Reference Reference
g. MIXERS
No. of Manufacturer / Power Plan Sheet Specification
Location Mixers Units Served T e (h) Reference Reference
h. RECORDING DEVICES &RELIABILITY
Device
No. of
Units
Location
Manufacturer
Maximum
Ca aci
Plan Sheet
Reference
Specification
Reference
Select
Select
Select
Select
i. EFFLUENT PUMP /FIELD DOSING TANK (IF APPLICABLE):
Plan Sheet
Reference
Specification
Reference
Internal dimensions (L x W x H or (p x H)
ft I
ft
ft
Total volume
ft3
gallons
Dosing volume
ft,
gallons
Audible & visual alarms
Equipment to prevent irrigation during rain events
FORM: WWIS 1143 Page 6 of 12

VI. EARTHEN IMPOUNDMENT DESIGN CRITERIA —15A NCAC 02T .0505:
IF MORE THAN ONE IMPOUNDMENT. PROVIDE ADDITIONAL COPIES OF THIS PAGE AS NECESSARY.
1. What is the earthen impoundment type? Facultative Lagoon
2. Storage Impoundment Coordinates (Decimal Degrees): Latitude: 35.5475' Longitude:-77.9600
Datum: NAD83 Level of accuracy: Nearest 30 minutes Method of measurement: Address matching
3. Do any impoundments include a discharge point (pipe, spillway, etc)? ❑ Yes or ® No
4. Are subsurface drains present beneath or around the impoundment to control groundwater elevation? ❑Yes or ®No
5. Is the impoundment designed to receive surface runoff? ❑ Yes or ® No
If yes, what is the drainage area? ft2, and was this runoff incorporated into the water balance? ❑ Yes or ❑ No
6. If a liner is present, how will it be protected from wind driven wave action?: HDPE Liner
7. Will the earthen impoundment water be placed directly into or in contact with GA classified groundwater? ❑ Yes or ® No
If yes, has the Applicant provided predictive calculations or modeling demonstrating that such placement will not result in a
contravention of GA groundwater standards? ❑ Yes or ® No
8. What is the depth to bedrock from the earthen impoundment bottom elevation? N/A ft
If the depth to bedrock is less than four feet, has the Applicant provided a liner with a hydraulic conductivity no greater than
1 x 10' cm/s? ❑ Yes, ❑ No or ❑ N/A
ly Has the Applicant provided predictive calculations or modeling demonstrating that surface
water or groundwater standards will not be contravened? ❑ Yes or ❑ No
If the earthen impoundment is excavated into bedrock, has the Applicant provided predictive calculations or modeling
demonstrating that surface water or groundwater standards will not be contravened? ❑ Yes, ❑ No or ❑ N/A
9. If the earthen impoundment is lined and the mean seasonal high water table is higher than the impoundment bottom
elevation, how will the liner be protected (e.g., bubbling, groundwater infiltration, etc.)?
10. If applicable, provide the specification page references for the liner installation and testing requirements: Project Spec. No. 3
11. If the earthen impoundment is located within the 100-year flood plain, has a minimum of two feet of protection (i.e., top of
embankment elevation to 100-year flood plain elevation) been provided? ® Yes or ❑ No
12. Provide the requested earthen impoundment design elements and dimensions:
Earthen Impoundment Design Elements
Earthen Impoundment Dimensions
Liner type:
❑ Clay
®Synthetic
Top of embankment elevation:
133.0 ft
❑ Other
Unlined
Liner hydraulic conductivity:
x cm/s
Freeboard elevation:
131.0 ft
Hazard class:
Not Applicable
Toe of slope elevation:
133.0 ft
Designed freeboard:
2.0 ft
Impoundment bottom elevation:
126.0 ft
Total volume:
11408,752 ft3
10,5375465
gallons
Mean seasonal high water table depth:
N/A ft
Effective volume:
875,860 ft3
65551,432
gallons
Embankment slope:
2: 1
Effective storage time:
72 days
Top of dam water surface area:
272,665 ft2
Plan Sheet Reference:
C-2
Freeboard elevation water surface area:
260,282 ft2
Specification Section:
Proj. Spec No. 3
Bottom of impoundment surface area:
230,307 ft2
NOTE —The effective volume shall be the volume between the two foot freeboard elevation and the: (1) pump intake pipe
elevation; (2) impoundment bottom elevation or (3) mean seasonal high water table, whichever is closest to the two foot
freeboard elevation.
FORM: WWIS 11-13 Page 7 of 12

VII. IRRIGATION SYSTEM DESIGN CRITERIA —15A NCAC 02T .0505:
1. Provide the minimum depth to the seasonal high water table within the irrigation area:
NOTE — The vertical separation between the seasonal high water table and the ground surface shall be at least one foot.
2. Are there any artificial drainage or water movement structures (e.g., surface water or groundwater) within 200 feet of the
irrigation area? ❑ Yes or ❑ No
If yes, were these structures addressed in the Soil Evaluation and/or Hydrogeologic Report, and are these structures to be
maintained or modified?
3. Soil Evaluation recommended loading rates (NOTE —This table may be expanded for additional soil series):
Soil Series
Fields within
Soil Series
Recommended
Loading Rate
in/hr)
Recommended
Loading Rate
(in/ r)
Annual /Seasonal
Loading
If Seasonal, list
appropriate
months
Select
Select
Select
Select
Select
Select
4. Are the designed loading rates less than or equal to Soil Evaluation recommended loading rates? 71 Yes or ❑ No
If no, how does the Applicant intend on complying with 15A NCAC 02T .0505(n)?
5. How does the Applicant propose to prohibit public access to the irrigation system?
6. Has the irrigation system been equipped with a flow meter to accurately determine the volume of effluent applied to each
field as listed in VII.8.? ❑ Yes or ❑ No
If no, how does the Applicant intend on complying with 15A NCAC 02T .0505(t)?
7. Provide the required cover crop information and demonstrate the effluent will be applied at or below agronomic rates:
Cover Crop
Soil Series
%Slope
Nitrogen Uptake Rate
(lbs/ac•yr)
Phosphorus Uptake
Rate (lbs/ac r)
a. Specify where the nitrogen and phosphorus uptake rates for each cover crop were obtained:
b. Proposed nitrogen mineralization rate:
c. Proposed nitrogen volatilization rate:
d. Minimum irrigation area from the Agronomist Evaluation's nitrogen balance: ftZ
e. Minimum irrigation area from the Agronomist Evaluation's phosphorus balance: ft'-
£ Minimum irrigation area from the water balance: ft2
FORM: WWIS 11-13 Page 8 of 12

VH. IRRIGATION SYSTEM DESIGN CRITERIA —15A NCAC 02T .0505 (continued):
8. Field Information (NOTE — This table maybe expanded for additional fields):
Designed
Designed
Area
Dominant
Loading
Loading
Waterbody
Field
(acres)
Soil Series
Rate
Rate
Latitude a
Longitude a
Stream Index
Classification
in/hr
in/ r
No. b
0
0
0
0
0
0
o
0
0
O
0
0
0
0
0
0
0
a
0
0
o
0
0
O
0
O
0
0
0
o
a
0
O
0
a
0
0
Total
a Provide the following latitude and longitude coordinate determination information:
Datum: Select Level of accuracy: Select Method of measurement: Select
b For assistance determining the waterbody stream index number and its associated classification, instructions maybe
downloaded at: http://nortal.ncdenr.org/web/wq/aps/lau/applications#Agreements
Spray Irrigation Design Elements
Drip Irrigation Design Elements
Nozzle wetted diameter:
ft
Emitter wetted area:
ft2
Nozzle wetted area:
ft2
Distance between laterals:
ft
Nozzle capacity:
GPM
Distance between emitters:
ft
Nozzle manufacturer/model:
/
Emitter capacity:
GPH
Elevation of highest nozzle:
ft
Emitter manufacturer/model:
/
Specification Section:
Elevation of highest emitter:
ft
Specification Section:
FORM: WWIS 11-13 Page 9 of 12

VIII. SETBACKS —15A NCAC 02T .0506:
1. Does the project comply with all setbacks found in the river basin rules (15A NCAC 02B .0200)? ® Yes or ❑ No
If no, list non -compliant setbacks:
2. Have any setback waivers been obtained in order to comply with 15A NCAC 02T .506(a) and .0506 b ? ❑Yes or ® No
If yes, have these waivers been written, notarized and signed by all parties involved and recorded with the County Register of
Deeds? ❑ Yes or ❑ No
3. Provide the minimum field observed distances (ft) for each setback parameter to the irrigation system and treatment/storage
units (NOTE — Distances greater than 500 feet may be marked N/A):
Setback Parameter
Irrigation I
S stem
Treatment /
§torage Units
Any habitable residence or place of assembly under separate ownership or not to be
maintained as part of the project site
Any habitable residence or place of assembly owned by the Permittee to be maintained as
art of the project site
Any private or public water supply source
Surface waters (streams — intermittent and perennial, perennial waterbodies, and wetlands)
Groundwater lowering ditches (where the bottom of the ditch intersects the SHWT)
Subsurface groundwater lowering drainage systems
Surface water diversions (ephemeral streams, waterways, ditches)
Any well with exception of monitoring wells
Any property line
Top of slope of embankments or cuts of two feet or more in vertical height
Any water line from a disposal system
Any swimming pool
Public right of way
Nitrification field
Any building foundation or basement
Impounded public water supplies
Public shallow groundwater supply (less than 50 feet deep)
4. Does the Applicant intend on complying with 15A NCAC 02T .0506(c) in order to have reduced irrigation setbacks to
property lines? ❑Yes or ®No
If yes, complete the following table by providing the required concentrations as determined in the Engineering Calculations:
Parameter
Estimated Influent
Concentration
Designed Effluent
Concentration
(monthly average)
Designed Effluent
Concentration
(daily maximum
Ammonia Nitrogen (NI13-N)
in L
mg/L
mg/L
Biochemical Oxygen Demand (BOD5)
mg/L
mg/L
mg/L
Fecal Coliforms
per 100 mL
per 100 mL
Total Suspended Solids (TSS)
mg/L
mg/L
mg/L
Turbidity
NTU
FORM: WWIS 11-13 Page 10 of 12

IX. COASTAL WASTE TREATMENT DISPOSAL REQUIREMENTS —15A NCAC 02H .0400:
1. Is this facility located in a Coastal Area as defined per 15A NCAC 02H .0403? ❑ Yes or ® No
For assistance determining if the facility is located within the Coastal Area, a reference map may be downloaded at:
http://portal.ncdenr,or web/wq/ns/lau/gpplications#Agreements.
2. Is this an Interim Treatment and Disposal Facility per 15A NCAC 02H .0404(g)? ❑Yes or ® No
NOTE —Interim facilities do not include County and Municipal area -wide collection and treatment systems.
IF ANSWERED YES TO ITEMS IX.1. AND IX.2., THEN COMPLETE ITEMS IX.3. THROUGH IX.17.
3. Is equalization of at least 25% of the average daily flow provided? ® Yes or ❑ No
4. How will noise and odor be controlled? No
5. Is an automatically activated standby power source provided? ❑ Yes or ® No
6. Are all essential treatment units provided in duplicate? ❑ Yes or ❑ No
NOTE —Per 15A NCAC 02T .0103(16), essential treatment units are defined as any unit associated with the wastewater
treatment process whose loss would likely render the facility incapable of meeting the required performance criteria,
including aeration units or other main treatment units, clarification equipment, filters, disinfection equipment, pumps and
blowers.
7. Are the disposal units (i.e., irrigation fields) provided in duplicate (e.g., more than one field)? ®Yes or ❑ No
8. Is there an impounded public surface water supply within 500 feet of the wetted area? ❑ Yes or ® No
9. Is there a public shallow groundwater supply (less than 50 feet deep) within 500 feet of the wetted area? ❑ Yes or ® No
10. Is there a private groundwater supply within 100 feet of the wetted area? ❑ Yes or ® No
11. Are there any SA classified waters within 100 feet of the wetted area? ❑ Yes or ® No
12. Are there any non -SA classified waters within 50 feet of the wetted area? ❑ Yes or ® No
13. Are there any surface water diversions (i.e., drainage ditches) within 25 feet of the wetted area? ❑ Yes or ❑ No
14. Per the requirements in 15A NCAC 02H ,0404(g)(7), how much green area is provided? ft2
15. Is the green area clearly delineated on the plans? ❑ Yes or ❑ No
16. Is the spray irri ag tion wetted area within 200 feet of any adjoining properties? ❑ Yes, ® No or ❑ N/A (i.e., drip irrigation)
17. Does the designed annual loading rate exceed 91 inches? ❑ Yes or ® No
FORM: WWIS 11-13 Page 11 of 12

Professional Engineer's Certification:
I,
(Professional Engineer's name from Application Item III.1.)
L4> roe
(Facility name from Application Item II.1.)
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 fiirther attest that to the best of my
knowledge the proposed design has been prepared in accordance with this application package and its instructions, as well as all
applicable regulations and statutes. 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 143-215.6B, 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.
North Carolina Professional Engineer's seal, signature, and date:
Applicant's Certification per 15A NCAC 02T .0106fb1:
I,
(Signature Authority's
?:T H Cq
31
020
G
i �G. .�/NEEQ;.•••y
title from Application Item L3.)
(Facility name from Application Item IL 1.)
that this application for
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that any discharge of wastewater
from this non -discharge system to surface waters or the land will result in an irmnediate 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.
I further certify that the Applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater
facility without proper closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are
compliant with any active compliance schedule, and do not have any overdue annual fees per 15A NCAC 02T J l OS(_l.
NOTE — In accordance with General Statutes 1 1 �_? 15.6A 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 S 10,000 as well as civil penalties up to $25,000 per violation.
Signature: UWV"\, Date:
FORM: WWIS 11-13 Page 12 of 12