WQ0037881_Permit (Issuance)_20150702

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NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
July 2, 2015
Letitia Edens, Interim County Manager
Hoke County
227 N. Main St.
Raeford, NC 28376
Subject: Permit No. WQ0037881
Hoke County
Scurlock School Pump Station Rehabilitation
Wastewater Collection System Extension Permit
Hoke County
Dear Ms. Edens:
Donald R. van der Vaart
Secretary
In accordance with your application received June 12, 2015, we are forwarding herewith Permit No.
WQ0037881 dated July 2, 2015, to Hoke County for the construction and operation upon certification of
the subject wastewater collection system extension. This permit shall be effective from the date of
issuance until rescinded, and shall be subject to the conditions and limitations as specified therein. This
cover letter shall be considered a part of this permit and is therefore incorporated therein by reference.
Please pay particular attention to the following conditions contained within this permit:
Condition 11.1: This permit shall not be automatically transferable; a request must be made and
approved.
Condition 11.4: Requires that the wastewater collection facilities be properly operated and maintained
in accordance with 15A NCAC 2T .0403 or any individual system -wide collection system
permit issued to the Permittee.
It shall be responsibility of the Permittee to ensure that the as -constructed project meets the
appropriate design criteria and rules. Failure to comply may result in penalties in accordance with North
Carolina General Statute §143-215.6A through §143-215.6C, construction of additional or replacement
wastewater collection facilities, and/or referral of the North Carolina -licensed Professional Engineer to
the licensing board.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right
to request an adjudicatory hearing upon written request within 30 days following receipt of this permit.
This request must be in the form of a written petition, conforming to Chapter 150B of North Carolina
General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh,
NC 27699-6714. Unless such demands are made, this permit shall be final and binding.
If you need additional information concerning this matter, please contact Trent Allen at [phone]
or via e-mail at [e-mail].
225 Green Street, Suite 714, Fayetteville, NC 28301
Phone: [phone] \ Internet: www.ncwaterguality.org
An Equal Opportunity \ Affirmative Action Employer — Made in part by recycled paper

Hoke County
Permit No. WQ0037881
Sincerely,
for S. Jay Zimmerman, Director
Division of Water Resources, NCDENR
by Trent Allen
Fayetteville Region Surface Water Resources Assistant Supervisor
cc: Adam P. Kiker, P.E., LKC Engineering, PLLC, 140 Aqua Shed Court, Aberdeen, NC 28315
Fayetteville Regional Office Files
Water Resources Central Files
PERCS (electronic copy)
Page 2 of 8

LPIWA
NCDENR
STATE OF NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
WASTEWATER COLLECTION SYSTEM EXTENSION 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 the
Hoke County
Hoke County
for the construction and operation of approximately 80 linear feet of 8-inch gravity sewer; 195 linear
feet of 10-inch force main; and a 580 GPM @ 39' TDH pump station with a permanent generator w/ATS
as part of the Scurlock School Pump Station Rehabilitation project, and the discharge of 20,100 gallons
per day of collected domestic wastewater into the Hoke County Wastewater Treatment Plant existing
sewerage system, pursuant to the application received June 12, 2015, and in conformity with 15A NCAC
2T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as applicable; the
Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains
adopted June 1, 2000 as applicable; and other supporting data subsequently filed and approved by the
Department of Environment and Natural Resources and considered a part of this permit.
This permit shall be effective from the date of issuance until rescinded and shall be subject to the
specified conditions and limitations contained therein.
for S. Jay Zimmerman, Director
Division of Water Resources, NCDENR
By Authority of The Environmental Management Commission
Permit Number: WQ0037881
Permit Issued: July 2, 2015
Page 3 of 8

SUPPLEMENT TO PERMIT COVER SHEET
Hoke County is hereby authorized to:
Construct, and then operate upon certification the aforementioned wastewater collection extension.
The sewage and wastewater collected by this system shall be treated in the Hoke County Wastewater
Treatment Plant in accordance with Permit Number NC0089176.
Permitting of this project does not constitute an acceptance of any part of the project that does not
meet 15A NCAC 2T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as
applicable; and the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations
and Force Mains adopted June 1, 2000 as applicable, unless specifically mentioned herein. Division
approval is based on acceptance of the certification provided by a North Carolina -licensed Professional
Engineer in the application. It shall be the Permittee's responsibility to ensure that the as -constructed
project meets the appropriate design criteria and rules.
II. STANDARD CONDITIONS
I. This permit shall not be transferable. In the event there is a desire for the wastewater collection
facilities to change ownership, or there is a name change of the Permittee, a formal permit request
shall be submitted to the Division accompanied by documentation from the parties involved, and
other supporting materials as may be appropriate. The approval of this request shall be considered
on its merits and may or may not be approved. [15A NCAC 02T.0104; G.S 143-215.1(d3)]
2. This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 15A NCAC 2T; the Division's Gravity Sewer Minimum
Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for
the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and
other supporting materials unless specifically mentioned herein. [15A NCAC 02T.0110]
3. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data. [15A NCAC 02T .0110)
4. The wastewater collection facilities shall be properly maintained and operated at all times. The
Permittee shall maintain compliance with an individual system -wide collection system permit for the
operation and maintenance of these facilities as required by 15A NCAC 2T .0403. If an individual
permit is not required, the following performance criteria shall be met: [15A NCAC 02T .0108(b)]:
a. The sewer system shall be effectively maintained and operated at all times to prevent discharge
to land or surface waters, and to prevent any contravention of groundwater standards or
surface water standards.
b. A map of the sewer system shall be developed and shall be actively maintained.
c. An operation and maintenance plan including pump station inspection frequency, preventative
maintenance schedule, spare parts inventory and overflow response has been developed and
implemented.
Page 4 of 8

d. Pump stations that are not connected to a telemetry system shall be inspected every day (i.e.
365 days per year). Pump stations that are connected to a telemetry system shall be inspected
at least once per week.
e. High -priority sewer lines shall be inspected at least once per every six -months and inspections
are documented.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. Overflows and bypasses shall be reported to the appropriate Division regional office in
accordance with 15A NCAC 213.0506(a), and public notice shall be provided as required by North
Carolina General Statute §143-215.1C.
h. A Grease Control Program is in place as follows:
1. For public owned collection systems, the Grease Control Program shall include at least
biannual distribution of educational materials for both commercial and residential users and
the legal means to require grease interceptors at existing establishments. The plan shall also
include legal means for inspections of the grease interceptors, enforcement for violators and
the legal means to control grease entering the system from other public and private satellite
sewer systems.
2. For privately owned collection systems, the Grease Control Program shall include at least bi-
annual distribution of grease education materials to users of the collection system by the
permittee or its representative.
3. Grease education materials shall be distributed more often than required in Parts (1) and (2)
of this Subparagraph if necessary to prevent grease -related sanitary sewer overflows.
i. Right-of-ways and easements shall be maintained in the full easement width for personnel and
equipment accessibility.
j. Documentation shall be kept for Subparagraphs (a) through (i) of this Rule for a minimum of
three years with exception of the map, which shall be maintained for the life of the system.
5. The Permittee shall report by telephone to a water resources staff member at the Fayetteville
Regional Office, telephone number [phone], as soon as possible, but in no case more than 24
hours, following the occurrence or first knowledge of the occurrence of either of the following:
a. Any process unit failure, due to known or unknown reasons, that renders the facility
incapable of adequate wastewater transport, such as mechanical or electrical failures of
pumps, line blockage or breakage, etc.; or
b. Any SSO and/or spill over 1,000 gallons; or
c. Any SSO and/or spill, regardless of volume, that reaches surface water
Voice mail messages or faxed information is permissible, but this shall not be considered as the
initial verbal report. Overflows and spills occurring outside normal business hours may also be
reported to the Division of Emergency Management at telephone number [phone] or (919)
733-3300. Persons reporting any of the above occurrences shall file a spill report by completing and
submitting Part I of Form CS-SSO (or the most current Division approved form) within five days
following first knowledge of the occurrence. This report must outline the actions taken or proposed
Page 5 of 8

to be taken to ensure that the problem does not recur. Part II of Form CS-SSO (or the most current
Division approved form) can also be completed to show that the SSO was beyond control. [G.S. 143-
215AC(a1)]
6. Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to
interrupt service by the existing utilities nor result in an overflow or bypass discharge of wastewater
to the surface waters of the State. [15A NCAC 02T.0108(b)]
7. Upon completion of construction and prior to operation of these permitted facilities, the completed
Engineering Certification form attached to this permit shall be submitted with the required
supporting documents to the address provided on the form. A complete certification is one where
the form is fully executed and the supporting documents are provided as applicable. Any
wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Engineer's Certification shall be considered a violation of the permit and shall subject the
Permittee to appropriate enforcement actions.
If the permit is issued to a private entity with an Operational Agreement, then a copy of the
Articles of Incorporation, Declarations/Covenants/Restrictions, and Bylaws that have been
appropriately filed with the applicable County's Register of Deeds office shall be submitted with
the certification.
A complete certification is one where the form is fully executed and the supporting documents are
provided as applicable. Supporting documentation shall include the following:
a. One copy of the project construction record drawings (plan & profile views of sewer lines &
force mains) of the wastewater collection system extension. Final record drawings should be
clear on the plans or on digital media (CD or DVD disk) and are defined as the design drawings
that are marked up or annotated with after construction information and show required buffers,
separation distances, material changes, etc.
b. One copy of the supporting applicable design calculations including pipe and pump sizing,
velocity, pump cycle times, and level control settings, pump station buoyancy, wet well storage,
surge protection, detention time in the wet well, and force main, ability to flush low points in
force mains with a pump cycle, and downstream sewer capacity analysis. If a portable power
source or pump is dedicated to multiple stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, include travel
timeframes, shall be provided.
c. Changes to the project that do not result in non-compliance with this permit, regulations, or the
Minimum Design Criteria should be clearly identified on the record drawings, on the certification
in the space provided, or in written summary form.
Prior to Certification (Final or Partial): Permit modifications are required for any changes resulting
in non-compliance with this permit (including pipe length increases of 10% or greater, increased
flow, pump station design capacity design increases of 5% or greater, and increases in the
number/type of connections), regulations, or the Minimum Design Criteria. Requested
modifications or variances to the Minimum Design Criteria will be reviewed on a case -by -case basis
and each on its own merit. Please note that variances to the Minimum Design Criteria should be
requested and approved during the permitting process prior to construction. After -construction
Page 6 of 8

requests are discouraged by the Division and may not be approved, thus requiring replacement or
repair prior to certification & activation. [15A NCAC 02T .0116]
8. Gravity sewers installed greater than ten percent below the minimum required slope per the
Division's Gravity Sewer Minimum Design Criteria shall not be acceptable and shall not be certified
until corrected. If there is an unforeseen obstacle in the field where all viable solutions have been
examined, a slope variance can be requested from the Division with firm supporting documentation.
This shall be done through a permit modification with fee. Such variance requests will be evaluated
on a case -by -case basis. Resolution of such request shall be evident prior to completing and
submitting the construction certification. [ 15A NCAC 02T.0105(n)]
9. A copy of the construction record drawings shall be maintained on file by the Permittee for the life
of the wastewater collection facilities. [15A NCAC 02T .0116]
10. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 2T; the
Division's Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the Division's
Minimum Design Criteria for the Fast -Track Permitting of Pump Station and Force Mains adopted
June 1, 2000 as applicable; and other supporting materials may subject the Permittee to an
enforcement action by the Division, in accordance with North Carolina General Statutes §143-215.6A
through §143-215.6C, construction of additional or replacement wastewater collection facilities,
and/or referral of the North Carolina -licensed Professional Engineer to the licensing board. [15A
NCAC 02T .0104; 15A NCAC 02T .0108(b-c)]
11. In the event that the wastewater collection facilities fail to perform satisfactorily, including the
creation of nuisance conditions, the Permittee shall take immediate corrective action, including
those as may be required by this Division, such as the construction of additional or replacement
facilities. [15A NCAC 02T .0110; 15A NCAC 02T .0108(b)]
12. The issuance of this permit shall not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances that may be imposed by the Division any other Federal, State, or
Local government agencies which have jurisdiction or obtaining other permits which maybe required
by the Division or any other Federal, State, of Local government agencies. [G.S. 143-215.1(b)]
Page 7 of 8

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE:
Hoke County
PERMIT #:
WQ0037881
PROJECT:
Scurlock School Pump Station Rehabilitation
ISSUE DATE:
July 2, 2015
This project shall not be considered complete nor allowed to operate in accordance with Condition 7 of
this permit until the Division has received this Certification and all required supporting documentation.
It should be submitted in a manner that documents the Division's receipt. Send the required
documentation the Regional Supervisor, Water Quality Regional Operations Section at the address at
the bottom.
Any wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Certification shall be considered a violation of the permit and shall subject the Permittee to
appropriate enforcement actions. The Permittee is responsible for tracking all partial certifications up
until a final certification is received. A Final Certification shall be a complete set of record drawings and
design calculations regardless of whether partials have been submitted.
PERMITTEE'S CERTIFICATION
I, the undersigned agent for the Permittee, hereby state that this project has been constructed pursuant
to the applicable standards & requirements, the Professional Engineer below has provided applicable
design/construction information to the Permittee, and the Permittee is prepared to operate & maintain
the wastewater collection system permitted herein or portions thereof.
Printed Name, Title Signature Date
ENGINEERS CERTIFICATION
1, , as a duly registered Professional En
neer in the State of North Carolina,
having been authorized to observe (❑ periodically, ❑ weekly, full time) the construction of the
project name and location as referenced above for the above Permittee hereby state that, to the best of
my abilities, due care and diligence was used in the observation of the construction such that the
construction was observed to be built within substantial compliance of this permit; 15A NCAC 02T; the
Division of Water Resources' (Division) Gravity Sewer Minimum Design Criteria adopted February 12,
1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump
Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting materials.
North Carolina Professional Engineer's Seal w/signature & date:
❑ Final ❑ Partial (include description)
Certification Comments/Qualifiers (attach if necessary):
NC DWR — Water Quality Regional Operations Section 225 Green Street, Suite 714, Fayetteville, NC 28301
Fayetteville Regional Office Phone: [phone] FAX: [phone]

State of ?forth Carolina
DWR,
JV14 1
parations Section.
1`0"Itt VIPe Reoicnal Ofi9cci
DkIsion of Waxer Resources
Department of F ns ironment and '.natural Resources
Division of Water Resources
FAST -TRACK APPLICATION (FTA 10-14)
for GRAVITY SEWERS, PUMPSTATIO:NS. AND FORCE MAINS
General — When submitting this appllicatiion, pllease use the following instnxtcos as a cheddist on order to ensure
all requiired items are submitted. Adherence to these instructions and checking the provided Foxes wiillll hellp
produce a quicker review time and reduce the amount of requested additional information
For more information, visit the Water Quality Permitting Section's website or,
contact the Regional Office serving your county
Unless otherwise noted. the Applicant shall submit one original and one copy of the appllication and supporting
documentation to the appropriate Regional Office (see page 3)_
A. Crier Letter:
Include a brief project narrative describing the final design (i_e system and/or pump station to ultimately
serge 500 homes, but flow for only 100 homes being requested now). For modifications, clearly explain
the reason for the modification (i.e. adding another phase_ changing Erne size, length, etc)_
Application Form (FTA 10-14):
0 Submit the completed and appropriately executed Fast -Track (FTA 10-14) Application. Any unauthorized
content changes to this form shall result in the application being retumed If necessary for clarity or due
to space restrictions, attachment to the application may be made, as long as the attachments are
numbered to correspond to the section and item to which they refer. You do not need to submit detailed
plans and specifications unless you respond NO to item B(13).
M The Professional Engineers Certification of the application shall be signed, sealed and dated by a North
Carolina licensed Professional Engineer.
U/The Applicant's Certification of the application shall be signed in accordance with 15A NCAC 02T
.0106(b). Per 15A NCAC 02T .0106(c), an alternate person maybe designated as the signing official if
a delegation letter is provided from a person who meets the criteria in 15A NCAC 02T .0106(b)_
fL` Application Fee:
El Submit a check in the amount of $480 to= North Carolina Department of Environment and Natural
Resources (NCDENR).
Checks shall be dated within 90 days of application submittal.
Certificate of Public Convenience and Necessity (For Privately -Owned Public Utilities Only):
❑ Per 15A NCAC 02T .0115(a)(1), provide two copies of 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 sewer extension, or
❑ Provide two copies of 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.
❑ The project name in the CPCN or letter must match that provided in Item A(2)a of this application.
Operational Agreements (For Home/Property Owners' Associations and Developers of lots to be sold):
Home/Property Owners' Associations
❑ Per 15A NCAC 02T .0115(c), submit the properly executed Operational Agreement (HOA 08-13).
❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
Developers of lots to be sold
❑ Per 15A NCAC 02T .0115(b), submit the properly executed Operational Agreement (DEV 08-13).
Even if the project may be turned over to a municipality upon completion, Form DEV 08-13 is required.
INSTRUCTIONS FOR APPLICATION FTA 10-11 R SUPPORTING DOCUMENTATION Paue I of

Downstream Sewer, WWTF Capacity and Flow TraciunglAcceptance Form (FTSE 08-13)
® Submit the cormpleted and appropriately executed Flow Trackinx30Acceptance for Sewer Extension Permit
(FTSE 08-13) Form for all applications_
The applicant (and owners of downstream sewers, pump stations and/or treatment faalifies submitting
form FTSE 08-13 certifies that the addition of the volume of wastewater to be permltted in this project
has been evaluated along the route to the mum" treatment plant,. and that the flow from this project
will not cause capacity related sanitary sewer overflows or overburden any downstream pump station en
route to the receiving wastewater treatment plan..
Where the applicant is not the owner of the downstream sewer, submit two copes of form FTSE 08-13
from the owner of the downstream sewer and owner of the WWTF, if diffem*
The flow acceptance indicated in form FTSE 08-13 must not expire prior to permit issuance and must be
dated less than one year prior to the application date.
Submittal of this application and form FTSE 08-13 indicates that owner has adequate capacity
and will not violate G.S. 143-215.67(a)-
Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific
FTSE 08-13.
Site Map (Alt Application Packages):
0 Submit an 8.5-inch x 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the
entire project area and closest surface waters. Each map must include at a minimum:
i- The location of the sewer line and pump stations and be of reproducible quality.
y Downstream connection points and the permit number for the receiving sewer (if known)
Pump Station Locations and the longitude and latitude for each pump station (if applicable)
® Include a street level map showing all relevant project areas.
H. S am Classfication (WSCAS 01-151
Submit the completed and appropriately executed Watershed Classification Attachment form
(WSCAS 01-15) if any portion of the sewer system project is within 100 feet of any surface water or
wetlands.
A variance must be requested for encroachment within required setbacks or buffers pursuant to 15A
NCAC 02T .0305(f)
�. Environmental Assessments (Projects subject to an Environmental Assessment (EA)):
y Projects involving an Environmental Assessment per 15A NCAC 01 C .0408, must be submitted for a full
technical review and must be submitted to the PERCS Unit on application forms provided by the Division.
�(1 Alternative Sewer Systems
Projects involving low pressure sewer systems, vacuum sewer systems and other alternative sewer
systems must be submitted for a full technical review and must be submitted to the PERCS Unit on
application forms provided by the Division.
,IX. Flow Direction
:- Many wastewater treatment systems are entering into agreements for regionalization efforts and
emergency treatment capacity. Parts of the system are installed so that the wastewater flow can be
directed to more than one treatment facility. If this is the case with the project, please indicate in B(12)
and give the permit number of the second facility.
L. Certifications Section C
The application must be certified by both the applicant and the design engineer who is a North Carolina
Registered Professional Engineer (PE). The applicant signature must match the signing official listed in
Item A(lb). The PE should NOT certify the application if he/she is unfamiliar with 15A NCAC Chapter
2T, The Gravity Sewer Minimum Design Criteria (most recent version) and the Minimum Design Criteria
for the Permitting of Pump Stations and Force Mains (most recent version), as applicable to the project.
INSTRUCTIONS FOR APPLICATION FTA 10-14 R. SUPPORTING DOCUMENTATION Page 2 of 6

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Quality Section
Swannanoa, North Carolina 28778
Clay, Graham, Haywood, Henderson, Jackson,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section
Fayetteville, North Carolina 28301-5094
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[phone] Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Water Quality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
Raleigh Regional Office
1628 Mail Service Center
Chatham, Durham, Edgecombe, Franklin,
Water Quality Section
Raleigh, North Carolina 27699-1628
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
Beaufort, Bettie, Camden, Chowan, Craven,
Water Quality Section
Washington, North Carolina 27889
Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section
Wilmington, North Carolina 28405
Hanover, Onslow, Pander
[phone]
[phone] Fax
Winston-Salem Regional Office
450 W. Hanes Mill Road
Alamance, Alleghany, Ashe, Caswell, Davidson,
Water Quality Section
Suite 300
Davie, Forsyth, Guilford, Rockingham, Randolph,
Winston-Salem, North Carolina 27105
Stokes, Surry, Watauga, Wilkes, Yadkin
[phone]
INSTRUCTIONS FOR APPLICATION FTA 10-14 & SUPPORTING DOCUMENTATION Page 3 of 6

J&
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD -
- Applitallim (m M� ' i1 ) oD
1.
1a. Hoke Courtly
Fug Legal Name (company munidpWy. HGA uillly, etc.)
1
Z
1b. Lelia Edens. interim County Manager
Signing Official Name and Tile (Please review 15A NCAC
2T .0106 (b) for audwrized signig officials)
H
Q
1c. The kgd entity who wit own this systern is:
❑ knividual ❑ Federal 0 Nunicvmy ❑ saa cm0y ❑
Private Part nerslrp ❑ Corporation ❑ Odw (specify):
0
1d.. 227 N. Main Street
le. Raeford
Mairg Address
city i
Z
1L Nof Camino
1g_ 28376
Z
Stale
7in Cade
0
1h. 910-975-8751 1i.
1j org
QTelephone
Facsimile
E-mail
U
2- Proiect (Facility) Mom ation:
j
J
2a Scurlock School Pump Station Rehabilitation
21). Hoke
d
brief Project Name (permit wit refer to this name)
County Where Project is Located
a
Q
3. Contact Person:
;
Q
3a. Adam P. Kilter, P.E.
Name and Afifiation of Someone Who Can Answer Questions About this Application
3b. 910-42D-1437
3c .corn
Phone Number
E-mail
1. Project is ® New - ❑ Modification (of an existing permirt)
If Modif�ation. Permit No.:
2. Owner is ® Pubic (slap to Item B(3)) ❑ Private (go to Item 2(a))
2a. N private, appkwd will be: 2b. 0 sold facilities owned by a (must choose one)
❑ Retaining Ownership (i.e. store, church, single office, etc.) or ❑ Pubic Utility (Instruction D)
❑ Leasing units (lots. townhomes, etc. - skip to Item B(3)) ❑ Homeowner AssocJDevekhper (Instruction E)
❑ Selling units (lots, townhomes, etc. - go to Item B(2b))
0 3. Hoke County
0 - - - -- -
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project — -- --- -
Q 4a. Hoke County WWTP ---- 4b. NC 0089176
Name of WWTF WWTF Permit No.
5a. Hoke CountT __24 — - --- Gravity WOW36140
0 Owner of Downstream Sewer ecemng Sewer Size Force Make Permit # of Downstream Sewer (Instruction F)
LL
Z_ 6. The origin of this wastewater is (check all that apply):
H ❑ Residential Subdivision ❑ Retail (Stores, shopping centers) 100% Domestic/Commercial
❑ Apartments/Condominiums ❑ Institution 9'o Industrial
❑ Mobile Home Park ❑ Hospital
d School
�❑ Church (Attach Description)
❑ Restaurant ❑ Nursing Home % Other
❑Office ❑Other (specify): (Attach Descriotionl
7. Volume of wastewater to be allocated or permitted for this particular project: 20,100 gallons per day
'Do not include future flows or previously permitted allocations
8. If the permitted flow is zero, indicate wh
i pe y:
i
f
❑ Pump Station, Outfall or Interceptor Line where flow will be permitted in subsequent permits that conned to this line
❑Flow has already been allocated in Permit No.
❑ Rehabilitation or replacement of existing sewer with no new flow expected
i (see 15A NCAC 02T .0303 to determine if a permit is required)
FTA 10-14 APPLICATION Page 4 of 6

m
9.
Pmvide the wastewater ilow cakzdalions wax!in debe rmining the pearrittert float in accordance wM 15A NCAC 2T .0114 for
re in the vaitherm BM ANOIIOR the design few forr tine air pwmp stallion siding it a reduced or zero flow is being reapeuested in
Bern B(7)_ Vaises other than that in 15A NICAC 2T .0114 (b) and (c) miu st be sespprnrted with actual wateer ar warstewaterr usei
data in aooadarhoe wilt 15A NCAC 26.01141(tfj. j
Scurlock School = 9,300 gpd =15 galdtudsast - 620 sbdemts
Don Steed School=10,800 gpd =15 galfsltudemt - 720 shWkm is
(rotal Flow = 20,100 GPD)
10_ Summary Of Sewer Imes to be Permitted (attach adtiMor>ah sheets it necessary)
Sae (Mches)
10
a
Length fleel)
195
80
New Gravity or Ad lib -oral
Force Main
New Force Wain
New Gm* Sewer
11. Sur nrnary of Pump Stations wit associated Force Pains to be Permitted (attach adriho nal sheets as necessary)
Pump Station Location ID: Scudock School PS (self d osen - as shown on plansknap for reference)
Longibxle: 79.10'45.01"W Latibde: 34`596.73N
Design Flow erational Point Power Reliability Option
(MGD) GPM @TDH 1 - permanent generator WATS; Force Main Sae Force Main Length
2 - portable generator wIMTS
0.020 580@391
Pump Station Location ID:
Longitude:
1
10 6,700
(self chosen - as shown on planshnap for reference)
Design Flow Operational Point Power Reliability Option
(MGD) GPM @TDH 1 - permanent generator w1ATS; Fong Main Sae Force Main Length
2 - portable generator wfMTS
12. Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
❑ Yes ® No If Yes, permit number of 21° treatment facility:
(RO — if `yes- to B,12 please contact the Central Office PERCS Unit)
13. Does the sewer system comply with the Minimum Design Criteria for the Permitting of Pumo Stations and Force Mains
(latest version), the Gravity Sewer Minimum Design Criteria patest version) and 15A NCAC Chapter 2T as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Deshtn Request (VADC 10-141 application and supporting
documents for review. Approval of the request is required prior to submittal of the Fast Track Application and
supporting documents.
FTA 10-14 APPLICATION Page 5 of 6

14.. Have the foMceeng pearribsl(r F " ii t been su bn*bed for approval for the system our project to be serwedl?
Vieftd&jemCmsmnp-GamoWPenotot4MCe*ftabon7 ® Yes Q No O WA
Sedimemlabon and Erosion Conn rd Pllarn? ❑ Yes [3 No EJ WA
Trout Buhr Waivers Yes Qi No 9 WA
Yes Q No 0 WA
15. Does this pry include any high prior* heroes (15A NCAC 02T ,0402 (2)) involve aerial lines, siQ wm or inlerferersoe
rnarntoles)? Theme Cures will be considered high pFkw to and must be checked once every sbr monnda
i
Check if Yes: ® and provide detail
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1. Owner/Permillee's Catilicabon: (Signalize of Signing Official and Project Namme)
1, LefiW Edens, Interim County IlM alter, attest that this 40kalion for Scurlock Schod Puiny Station
Rehabilitation has been reviewed by me and is accurate and complete to the best of my knowftW. I understand tAat AT
all required parts of this appica6on are not completed and that it all ►egmW supportirg doc rnenfation and dtarirnents
are not included, this appkabon package its subject to besg returned as ireor Wkfe- Able: In accordance *0 Abrift
CaroAm General Statutes 143-215,6A and 143-215,68, any person who knowkx* makes any fatty statement
representahm or cedifica orr in any application shall be guilty of a Class 2 misdemeanor which may include aline not to
exceed $ 0,000 as well as kiwi penalties up to 325, 000 per violation.
0
ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THIS
APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMITY
TO OTHER UTILITIES, DESIGN CALCULATIONS, ETC. REFER TO 15A NCAC 02T ,0305
2. Professional Engineers Certification: (Signature of Design Engineer and Project Name)
►, Adam P. Kiker, P. E. ,attest that this application forScurkxk School Pump Station Rehabiitation has been reviewed
by me and is accurate, complete and consistent with the i►k rmation in the engineering pfhns, calculations, and aN other
supporting documentation to the best of my knowledge. I further attest that to the best of my knowledge the proposed
design has been prepared in accordance with the appicable regulations, Gravity SewerMinimum Design Criteria for Gravity
Sewers adopted February 12, 1996, and the Ayirrwwm Design Criteria for the Fast -Track Pie►miMiivg of Pump Stations and
Force Mains adopted June 1, 2000 and the watershed classification in accordance with Derision guidance. Although other
professionals may have developed certain portions of this submittal package, inclusion of these materials under my
signature and seal signfies that I have reviewed this material and have judged it to be consistent with the proposed design.
Note: In accordance with NC General Statutes 143-215,6A and 143-215.68, any person who knowirx�ly makes any false
statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor which may indude a
fine not to exceed $10,000 as wet/ as civil penalties up to $25,000 per violation.
2a. Professional Engineer Name ��%\ N l CA
1j, 7
2b. LKC Engineering, PLLC S
< J
Engineering Finn
_ S AL _
2c. 140 Aqua Shed Court 0 3
Mailing Address
2d. Aberdeen 2e. NC 2f. 28315 • °��'rN�C��. ��
City State Zip 'P
2g. 910-420-1437 2h. 910-637-0096 2i. [e-mail]
Telephone Facsimile E-mail NC PE Seal, Sig ure &Date
FTA 10-14 APPLICATION Page 6 of 6

r
State of North Carolina
Department of Environment and Natural Resources
E Division of Water Resources
Divi%it,,, of Water Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 08-13)
Project Applicant Name: Hoke County
Project Name for which flow is being requested: Scurlock School Pump Station.
More than one ME may be required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Hoke County WWTP
b. WWTP Facility Permit #: NC 0089176
A!lflows are in MGD
c. WWTP facility's permitted flow
1.500
d. Estimated obligated flow not yet tributary to the WWTP 0.500
e. WWTP facility's actual avg. flow
0.300
f. Total flow for this specific request
0.020
g. Total actual and obligated flows to the facility
0.820
h. Percent of permitted flow used
55%
II. Complete this section for each pump station you are responsible for along the route of this
proposed wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A) (B)
(C) (D)(B+C) (E)=(A-D)
Design
Obligated,
Pump Average Daily Approx.
Not Yet Total Current
Station Firm Flow** Current Avg.
Tributary Flow Plus
(Name or Capacity,* (Firm / p0, Daily Flow,
Daily Flow, Obligated Available
Number) MGD MGD MGD
MGD Flow Capacity***
Beaver Creek 0.720 0.288 0.034
0.100 0.134 0.154
Influent 3.750 1.500 0.300
0.500 0.800 0.700
* The Firm Capacity of any pump station is defined as the maximum pumped flow that
can be achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking
factor (pf) not less than 2.5.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is < 0.
Page 1 of 6
FI'SE 08-13

III. Certification Statement:
I Letitia Edens, County Manager certify to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the
receiving wastewater treatment facility and that the flow from this project is not anticipated to
cause any capacity related sanitary sewer overflows or overburden any downstream pump station
en route to the receiving treatment plant under normal circumstances, given the implementation of
the planned improvements identified in the planning assessment where applicable. This analysis
has been performed in accordance with local established policies and procedures using the best
available data. This certification applies to those items listed above in Sections I and II plus all
attached planning assessment addendums for which I am the responsible party. Signature of this
form in4icates acceptance of this wastewater flow.
Official
:5) z Joal &
Date
Page 2 of 6
FTSE 08-13

State of North Carolina
DWR
Department of Environment and Natural Resources
Division of Water Resources
Division of Watrr Resources Watershed Classification Attachment (WSCAS 01-15)
Along with this form, submit a color copy of a USGS Topographic Map to identify the project area and
waterbodies. Each map or maps must show the location of the sewer system and include location identifiers
where the system traverses over or near waterbodies. The map should have location ID's for each different
waterbody and corresponding classifications should be recorded.
Include the completed form and map portions with the permit application for submittal to the appropriate review
agency. A list of the Division's regional offices, their county coverage, and contact information can be obtained
from: http://portal.ncdenr.org/web/wq/home/ro
Location ID Name of Waterbody" River Waterbody Waterbody
Basin Index No. Classification
001 Black Branch CPF 18-31-19-5-1 C
1 If unnamed, indicate "unnamed tributary to X", where X is the named waterbody to which the unnamed tributary joins.
1 certify that as a Registered Professional Engineer in the State of
North Carolina that I have diligently followed the Division's
instructions for classifying waterbodies and that the above
classifications are inclusive of the stated project, complete and
correct to the best of my knowledge and belief.
PE Seal, Signature and Date
CARO
01
c� E
� ,'•m a c��;`�♦

N
_i _ _ _ „
Existing Beaver Creek
Pump Station Location
1�
' 1
N
0--
1�
Proposed Scurlock School
Pump Station Improvements .•
ram. e 9
��
Feet
0 500 1,000 2,000
1
A
N HOKE COUNTY, NC
w*E SCURLOCK SCHOOL PUMP STATION IMPROVEMENTS
S USGS TOPOGRAPHIC PROJECT MAP

June 10, 2015
Ms. Belinda Henson, Regional Supervisor DWR
NCDENR Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301
Re: Scurlock School Pump Station Rehabilitation
Hoke County, NC
Dear Ms. Henson,
Please find enclosed one original and one copy of the Fast Track Application package for the above
referenced project. Please note a check for the $480.00 application fee was sent directly by Hoke
County.
Hoke County Utilities currently owns and operates an existing submersible, duplex pump station that
services the Scurlock Elementary School. A near -by pump station (Don Steed PS), serving Don Steed
Elementary School, discharges into the Scurlock School station. The combined flow of the schools equals
the total flow for the Scurlock School pump station which is approximately 20,100 GPD as shown on the
application.
The project features the complete replacement of the Scurlock School Pump Station by constructing a
new station adjacent to the existing station. The new station will feature a 6-foot diameter concrete
wet well, duplex 10 HP submersible pumps, concrete valve vault, backup generator, emergency bypass
connection, and all associated valves, piping, and electrical. Approximately 80 feet of 8-inch gravity
sewer will be installed to divert the flow to the new station.
The project alters the station's discharge location from City of Raeford WWTP to the Hoke County
WWTP. The alternation includes the installation of approximately 4S feet of 10-inch force main from
the Scurlock School PS site to the existing 10-inch force main located along the north side of Rockfish Rd.
The pump station will utilize the existing 10-inch force main and pump the wastewater approximately
6,500 feet east along Rockfish Rd where approximately 150 feet of new 10-inch force main will direct
the discharge to the existing Beaver Creek Pump Station. The Beaver Creek station pumps into Hoke
County 24-inch gravity outfall.
If you have any questions, please do not hesitate to contact me at [phone] or by email at
[e-mail].
Sincerely,
LKC Engineering, PLLC\\
Adam P. Kiker, P.E.
LKC Engineering, PLLC, 140 Aqua Shed Court, Ab&deen, North Carolina 28315
PI1: 910/420-1437 * FAX: [phone] * License No. P-1095

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USE THE TAKEY TO MOVE FROM FIELD TO FIELD
9�nerreB
Appficafion
(tb be y by MVRr i 19 ' 2 =5
-
1a.
Operations lion
Futtl Lam' Name (any,. municipality, i GA® ulliiiilty, etrr)
ne
0
lib -
Letitia Ethers, Enteni n Couity Manaw
Sgwsq G fi fail Ifaarane and Tiitl (PIS review, 15�4 NCAC 2T .0106_�b� fc r authorized minima oif, calls)
1c-
The Ill entity vA o w li am. this system is:
0 Indvidual Q Federal F1 Maclr dpaliaty Ei Statecouamty' Q
Private Partnership �I Cwporatiivn Cow (spyadfy)..
O
1&
227 N- Main- Street
1e. Raefor<E
LL
Mailing Address
City
Z
1f.
North Carolina
28376
Z
State
Zip Cadee
®
Ito.
9I &875-8-151 1 a.
1 f. lledensahokeawnty.oirg
(—
Telephone Facsimile
E-mai
2.
Piroiect (Facility) Inforrnation:
J
2a..
Scurlock School Pump Station Rehabilitaton
2b-. Hoke �
IL
Brief Project Name (permit will refer to this name)
County 9P here Project is Located
IL
3.
Contact Pelson:
Q
3a.
Adam P. Kiker, P.E.
j
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b.
910-420-1437
3c. adarn'- kcengineering-corn
Phone Number
E-mail
�
1.
------ -----------
Project is ® New ❑ Modfication (of an existing permit)
----
If Modification. Permit No.:
2.
Owner is ® Public (skip to Item B(3)) ® Private
(go to Item 2(a))
gnnIirgnt will be:
2b- If sad, facilities owned by a (roust choose one
PAY
TO THE
ORDER
U
COUNTY OF HOKE
P.O. BOX 580 LUMBEE GUARANTY BANK
RAEFORD, NC 28376 RAEFORD, NC 28376
THIS DISBURSEMENT HAS BEEN APPROVED 66-368-531
AS REQUIRED BY THE LOCAL GOVERNMENT
BUDGET AND FISCAL CONTROL ACT.
********480 DOLLARS AND NO CENTS
9963�p
VOID AFTER 60 DAYS a
0
CHECK AMOUNT 2
m
0
5 $480.00
R
CENTRAL DEPOSITORY
NCDENR B
1617 MAIL SERVICE CENTER FIN
RALEIGH NC 27699-1617
BOAR AN
CHECK NO.
9963
VENDOR CHECK DATE
3911 05/29/201
❑ Pump Station, Outfall or Interceptor Line wneic luent permits that connect to this line
❑ Flow has already been allocated in Permit No.
❑ Rehabilitation or replacement of existing sewer with no new flow expected
(see 156 NCAC 2Q T Q3Q3 to determine if a permit is required)
FTA 10-14 APPLICATION
Page 4 of 6

Central Files: APS _ SWP
7/2/2015
Permit Number W00037881
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
trent.allen
Coastal SWRule
Permitted Flow
20,100
Facility
Permit Tracking Slip
Status
Project Type
Active
New Project
Version
Permit Classification
1.00
Individual
Permit Contact Affiliation
Facility Name Major/Minor Region
Scurlock School Pump Station Rehabilitation Minor Fayetteville
Location Address County
Hoke
Facility Contact Affiliation
Owner
Owner Name Owner Type
Hoke County Non -Government
Owner Affiliation
Letitia Edens
227 N Main St
Dates/Events Raeford NC 28376
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
7/2/2015 6/12/2015 7/2/2015 7/2/2015
Regulated Activities Requested /Received Events
Wastewater collection Additional information requested
Additional information received
Outfall
Waterbody Name Streamindex Number Current Class Subbasin