WQ0035079_Sewer Extension_20101022

W AT,69 State of North Carolina
Department of Environment and Natural Resources
� t)uja v DENR-FRS Division of Water Quality
oi� " ` OCT 2 1 2010 FAST -TRACK APPLICATION
(FTA 12/07 )
QWQAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
(Pressure & Vacuum sewer systems are not to be included as part of this application package)
INSTRUCTIONS: Indicate that you have included/addressed the following list of required application package items by
checking the space provided next to each applicable item. Failure to submit all required items will lead to your application
being returned as incomplete. Forms are available from the web site or by calling the Regional Office serving your county:
http://h2o. enr. state. nc. uslperes/Collection % 2OSystemsICollectionSystemApplications. html
® A. Application Form - Submit one original and one copy of the completed and appropriately executed application
form. The application should include a project narrative describing the final build -out design (i.e. system and/or
pump station to ultimately serve 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 line size/length, etc.). Only
include the modified information in this permit application - do not duplicate project information that has already
been included in the original permit.
Any changes to this form will result in the application being returned. The Division of Water Quality (Division) will
only accept application packages that have been fully completed with all applicable items addressed. You do not
need to submit detailed plans and specifications unless you respond NO to Item 13(13).
Separate applications should be made for non-contiguous sewer systems
® B. Application Fee - Submit a check in the amount of $480 made payable to: North Carolina Department of
Environment and Natural Resources (NCDENR). Checks shall be dated within 90 days of application submittal.
❑ C. Certificates of Public Convenience and Necessity — If the application is being submitted in the name of a
privately -owned public utility, submit two copies of the Certificate of Public Convenience and Necessity (CPCN)
which demonstrates that the public utility is authorized to hold the utility franchise for the area to be served by the
sewer extension. If a CPCN has not been issued, provide two copies of a letter from the North Carolina Utilities
Commission's Public Staff that states that an application for a franchise has been received, that the service area
is contiguous to an existing franchised area, and/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.
❑ D. Operational Agreements — Submit one original and two copies of a properly executed operational agreement, as
per 15A NCAC 02T .0115, if the application is submitted by a private applicant and will be serving residential or
commercial lots (e.g., houses, condominiums, townhomes, outparcels, etc.) that will be sold to another entity. If
the applicant is a home or property owner's association, use Form HOA 02/03. If the applicant is a developer,
use Form DEV 02/03. EVEN IF THE PROJECT MAY BE TURNED OVER TO A MUNICIPALITY UPON
COMPLETION, FORM DEV 02/03 IS REQUIRED.
® E. Downstream Sewer, WWTF Capacity and Flow Tracking/Acceptance — FORM FTSE 10/07 (Flow
Tracking/Acceptance for Sewer Extension Permit Applications) is required with every application. The applicant
(and owners of downstream sewers, pump stations and/or treatment facilities submitting FORM FTSE-10/07)
certifies that the addition of the volume of wastewater to be permitted in this project has been evaluated along the
route to the receiving 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
plant. Where the applicant is not the owner of the downstream sewer, submit two copies of FORM FTSE 10/07
from the owner of the downstream sewer and owner of the WWTF, if different. The flow acceptance indicated in
FORM FTSE-10/07 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-10/07 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 project -specific FTSE 10/07.
❑ F Map — Submit an 8.5-inch by 11-inch COLOR copy of a USGS Topographic Map of sufficient scale to identify the
entire project area and the closest surface waters. Each map or maps must show the location of the sewer line
and pump stations and be of reproducible quality. Include a street level map showing the downstream connection
point, and the permit number for the downstream sewer, if known.
FTA 12 /07

)k
DENR
Controller
Revised 1-6-04
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
Daily Check Log
Division FRO
Date of Receipt
Check Number/
Receipt Number
Vendor/Payee
Originator
Bank
Amount
Purpose of Payment
If Known/Comments
Initials
10/27/2010
Rec. # 636616
JPEG
Cash
$0.75
UST File copies
MLA
10/28/2010
1691
Stafford Land Company, Inc.
Cresent State
$480.00
WQ - Fast Track
LLO
10/28/2010
70084
Hobbs, Upchurch and Associates
BB&T
$480.00
WQ - Fast Track
LLO
10/28/2010
1836
Stafford Land Company, Inc.
Cresent State
$480.00
WQ - Fast Track
LLO
10/28/2010
1022
Wellons Energy
Wells Faro
$400.00
AQ-Permit
RGW
10/29/2010
Rec. # 636618
The El Group
Cash
$7.50
HIS /// .............................
MLA
10/29/2010
18417625637
International Paper
Money Order
S50.00
AQ-Permit
RGW
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® G. Stream Classifications — Watershed Classification Attachment (Form WACAS-12/07) If any portion of the
project boundary is within 100 feet of any surface water or wetlands, the Watershed Classification Attachment
must be completed.
❑ H Environmental Assessments — If this project is subject to an Environmental Assessment (EA) [15A NCAC
01C], this application cannot be used. Send the project application on the most current version of Form
PSFMGSA to the Design Management Unit, 1633 Mail Service Center, Raleigh, NC 27699-1633. Applications
cannot be accepted until a Finding of No Significant Impact (FONSI) or Environmental Impact Statement (EIS)
has been issued. A copy is to be submitted with that permit application.
❑ I. 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 this project, please indicate in B(12) and give the permit
number of the second treatment facility.
® J. 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 Fast -Track
Permitting of Pump Stations and Force Mains (most recent version), as applicable to the project.
THE COMPLETED FTA 12/07 APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
DOCUMENTS AND $480 FEE, 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,
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,
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,
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,
Raleigh, North Carolina 27699-1628
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
Beaufort, Bertie, Camden, Chowan, Craven,
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
Wilmington, North Carolina 28405
Hanover, Onslow, Pender
[phone]
[phone] Fax
Winston-Salem Regional Office
585 Waughtown Street
Alamance, Alleghany, Ashe, Caswell, Davidson,
Winston-Salem, North Carolina 27107
Davie, Forsyth, Guilford, Rockingham, Randolph,
[phone]
Stokes, Surry, Watauga, Wilkes, Yadkin
[phone] Fax
For more information, please visit our web site at., httpJ/h2o.enr.state.nc.us/peres/
or contact the Regional Office serving your county.
FTA 12/07

USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number: n
(to be completed by DWQ)
............. ..., ............_.................. _
t. Owner/Permittee:
1a. MooreCounty_
Full Legal Name (company, municipality. HOA, utility, etc.)
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1 b. Dennis Brobst, Director
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials!)
1 c. The legal entity who will own this system is:
❑ Individual ❑ Federal ® Municipality ❑ State/County ❑ Private Partnership ❑ Corporation F-1 Other (specify):
1d. Post Office Box 905 -�_1e. Carthage
Mailing Address City
1f. North Carolina
State
19. 28327
Zip Code
1 h. 910-947-6363 1 L 910-947-1874
Telephone Facsimile
2. Project (Facility) Information:
2a. Sanitary Sewer Impr. ATEX Technologies, Inc. 2b,
Brief Project Name (permit will refer to this name)
3. Contact Person:
E-mail
Moore
County Where Project is Located
3a. _Bill Lester, Jr., P.E. - Hobbs, Upchurch & Associates, P.A. _____
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. 910.692-5616 3c. [e-mail]
Phone Number E-mail
1. Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.:
2. Owner is ® Public (skip to Item B(3)) ❑ Private (go to Item 2(a))
2a. If private, applicant will be: 2b. If sold, facilities owned by a (must choose onei
❑ Retaining Ownership (i.e. store, church, single office, etc.) or ❑ Public Utility (instruction C)
❑ Leasing units (lots, townhomes, etc. - skip to Item S(3)) ❑ Homeowner Assoc./Developer (Instruction D)
❑ Selling units (lots, townhomes, etc. - go to Item B(2b))
..............................................
3. Moore Countv Public Utilities
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
4a. Moore County Water Pollution Control Facility 4b. NCO037508
W Name of WWTF WWTF WWTF Permit No.
.......... ... .............................. ...._._...... ... ... ............................ .......... ............. ..... ....... .... ...................... _.-..................................................... ... . . .........
5a. Moore County 5b. 84nch 0 Gravity 5c. N/A
Owner of Downstream Sewer Receiving Sewer Size . Force Main Permit # of Downstream Sewer (Instruction E)
The origin of this wastewater is (check all that apply):
❑ Residential Subdivision
❑ Apartments/Condominiums
❑ Mobile Home Park
❑ School
❑ Restaurant
❑ Office
® Retail (Stores, shopping centers)
❑ Institution
❑ Hospital
❑ Church
❑ Nursing Home
® Other (specify): Industrial
30 % Domestic/Commercial
70 % Industrial (attach
description.)
(RO: contact your Regional Office
Pretreatment staff)
% Other (specify):
7. Volume of wastewater to be allocated or permitted for this particular project: 35,000 gallons per day
`Do not include future flows or previously permitted allocations
8. If the permitted flow is zero, indicate why:
❑ Pump Station, Outfall or Interceptor Line where flow will be permitted in subsequent 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 15A NCAC 02T .0303 to determine if a
permit is required)
F'TA 12/07

9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T .0114 for
the value in Item B(7) AND/OR the design flow for line or pump station sizing if a reduced or zero flow is being requested in
Item 13(7). Values other than that in 15A NCAC 2T .0114 (b) and (c) must be supported with actual water or wastewater use.
data in accordance with 15A NCAC 2T .0114 (f).
See Attached Flow Calculation Summary
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches)
8-inch
Length (feet) New Gravity or Additional
Force Main
2,978 New Gravity
0 11. Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
W
D Pump Station Location ID #1 (ATEX) (self chosen - as shown on plans/map for reference)
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Design Flow
Operational Point
Power Reliability Option
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(MGD)
GPM @TDH
1 -permanent generator w/ATS; Force Main Size Force Main Length
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2 - portable generator w/MTS
V
0.45
180 gpm @ 45.98'
1 — Permanent Generator 6-inch 11,756
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QPump
Station Location ID
(self chosen - as shown on plans/map for reference)
Design Flow
Operational Point
Power Reliability Option
(MGD)
GPM @TDH
1 - permanent generator w/ATS; Force Main Size Force Main Length
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2 - portable generator w/MTS
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Z
f-
WPump Station Location ID (self chosen - as shown on plans/map for reference)
aDesign Flow Power Reliability Option
(MGD) Operational Point 1 -permanent generator w/ATS; Force Main Size Force Main Length
ad GPM @TDH 2 - portable generator w/MTS
12. Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
❑ Yes Z No If Yes, permit number of 2nd treatment facility _
(RO — if "yes" to 13,12 please contact the Central Office PERCS Unit)
13. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force
Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chapter 2T as
applicable?
Z Yes ❑ No If No, please reference the pertinent minimum design criteria or regulation and indicate why a
variance is requested. SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS
PERTINENT TO THE VARIANCE WITH YOUR APPLICATION
FTA 12/07

14. Have the following permits/certifications been submitted for approval for the system or project to be served?
Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes ❑ No ® N/A
Sedimentation and Erosion Control Plan? ® Yes ❑ No ❑ N/A
Stormwater?
® Yes ❑ No ❑ N/A
15. Does this project include any high priority lines, [see 15A NCAC 02T .0402 (2)] involve aerial lines, siphons, or interference
manholes)? These lines will be considered high priority and must be checked once every six months
Check if Yes: ❑ and provide details
1. Owner/Permittee's Certification: (Signature of Signing Official and Project Name)
1, Dennis Brobst, attest that this application for Sanitary Sewer Improvements ATEX Technologies, Inc. has been
reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of this
application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. Note: In accordance with North Carolina General
Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or
certification in any application 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.
1 a. Xr,�/dIylAwd
Signing Official Signature Date
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
Z
O
H 2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
Q
V 1, Bill Lester, Jr., P.E., attest that this application for Sanitary Sewer Improvements ATEX Technologies, Inc. has been'
LL reviewed by me and is accurate, complete and consistent with the information in the engineering plans, calculations, and
all other supporting documentation to the best of my knowledge. I further attest that to the best of my knowledge the
proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer Minimum Design Criteria,
W for Gravity Sewers adopted February 12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump
V Stations and Force Mains adopted June 1, 2000 and the watershed classification in accordance with Division guidance.
Although other professionals may have developed certain portions of this submittal package, inclusion of these materials
V 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 NC General Statutes 143-215.6A and 143-215.6B, any person who knowingly
makes any false statement, representation, or certification in any application 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.
2a. Bill Lester, Jr., P.E.
Professional Engineer Name
2b. Hobbs, Upchurch & Associates, P.A.
Engineering Firm
2c. Post Office Box 1737
Mailing Address
2d. Southern Pines 2e. NC 2f. 28388
City
2g. 910-692-5616
Telephone
2h. 910-692-4795
Facsimile
Mate Lip
2i. [e-mail]
E-mail
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NC PE Seal, Sig re & Date
FTA 12/07

USE THE TAB KEY TO MOVE FROM FIELD TO FIELD!
Application Number: 1�
(to be completed by DWQ) r�/QQ,35o7 9
�—
1.
Owner/Permittee:
1 a.
Moore County
Full Legal Name (company, municipality, HOA, utility, etc.)
1 b.
Cary McSwain, County Manager
' O
Signing Official Name and Title (Please review 15A NCAC 2T .0106
(b) for authorized signing officials!)
1 c.
The legal entity who will own this system is:
❑ Individual ❑ Federal ® Municipality ❑ State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify):
O
1 d.
Post Office Box 905
le. Carthage
LL
Mailing Address
City
—
1f.
North Carolina
1g. 28327
Z
State
Zip Code
0
1 h.
910-947-6363 11 i. 910-947-1874
1 j.
QTelephone
Facsimile
E-mail
U
2.
Proiect (Facility) Information:
i
2a.
Sanitary Sewer Impr. ATEX Technologies, Inc.
2b. Moore
(L
Brief Project Name (permit will refer to this name)
County Where Project is Located
0.
Q
3.
Contact Person:
3a.
Bill Lester, Jr., P.E. - Hobbs, Upchurch & Associates, P.A.
Q
Name and Affiliation of Someone Who Can Answer Questions About
this Application
3b.
910.692-5616
3c. [e-mail]
Phone Number
E-mail
j
1.
Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.:
2.
Owner is ® Public (skip to Item B(3)) ❑ Private (go
to Item 2(a))
2a.
If private, applicant will be:
2b. If sold, facilities owned by a (must choose one)
❑ Retaining Ownership (i.e. store, church, single office, etc.) or
❑ Public Utility (Instruction C)
❑ Leasing units (lots, townhomes, etc. - skip to Item B(3))
❑ Homeowner Assoc./Developer (Instruction D)
❑ Selling units (lots, townhomes, etc. - go to Item B(2b))
Z
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F—
a
3. Moore County Public Utilities
Owner of Wastewater Treatment Facility (WWtF) Treating Wastewater From This Project
4a. Moore County Water Pollution Control Facility 4b. NCO037508
Name of WWfF WWTF Permit No.
5a. Moore County 15b. 8-inch '® Gravity 5c. N/A
Owner of Downstream Sewer Receiving Sewer Size ❑ Force Main I Permit # of Downstream Sewer (Instruction E)
0 c r� _ -... a ♦H t .. << so is /. V,or4 n11 ►hnf nnnlvl-
�fOBBS, 'ZIPC�f21 C�! ey �SSOCIs12`�5, p �L. $W
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CONSULTING ENGINEERP.O. BOX 1737. 300 S.W. BROAD STREET NORTH CAROLINA
-SOUTHERN PINES, NC 28388 �'112'��
[phone]
70084�
70084
Exactly Four hundred eighty and no / 100 Dollars DATE AMOUNT
10/1/2010 $4801.00 9
a
PAY
TO THE
ORDER N . C . DENR B
OF: V ER 90 DAYS '
NC
UTHORIZED SIGNATURE
�

HOBBS, upcH41RcH&ASSOCIATES, P.J1..
N. C. DENR
Tran # Invoice Type Date Reference
49361 10/01/10 Invoice 09/30/10 M01010-Atex
k4q5,5ozi-
Date: 10/1/2010
Balance
$480.00
1qjHOBBS, UPCHMCH & ASSOCIATES, P.A. Bw
CONSULTING ENGINEER.w.�...a.....
P.O. BOX 1737, 300 S.W. BROAD STREET NORTH CAROLINA
SOUTHERN PINES, NC 28388 W112-53I
[phone]
Exactly Four hundred ei ht and no / 100 Dollars
PAY
TO THE
ORDER
OF:
I
g Y DATE
Check Number
Check Amt:
Discount
$0.00
OCT 21 2010
70084
70084
$480.00
Pay Amount
$480.00
70084
70084 1
AMOUNT i
10/1/2010 $480.00
n
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N . C . DENR Z
7�ER 90 DAYS 8
NC
UTHORIZED SIGNATURE

Flow Calculation Summary
Sanitary Sewer Improvements to serve ATEX Technologies, Inc.
Location
Flow Calculation
GPD
ATEX
Per Plant Manager/Owner
1125
10,000
CP Store/Rest -
-
Gal per fixture - 2 fixtures per bathroom 2 bathrooms per store
t 500
Restaurant
30 seats x 40 Gal per seat
1,200
Pure Gas Station/Res
- - -
250 Gal per fixture - 2 fixtures per bathroom 2 bathrooms per store
-1,000
Restaurant
10 seats x 40 Gal per seat -
400
Shell Gas Station
�250
Gal per -fixture - 2 fixtures per, bathroom - 2 bathrooms per store
1,000
Restaurant
seats x 40 Gal per seat
- 400
Residential
_10
360 Gal per house x 50 houses (future connections)
18,000
Thift Shop #1
- -i
125 Gal per fixture - 2 fixtures per bathroom _2 bathrooms per store
500
Thift Shoff #2
125 Gal per fixture - 2 fixtures per bathroom - 2 bathrooms per store
500
Thift Shop #3
125 Gal per fixture - 2 fixtures per bathroom - 2 bathrooms per store
500
Car Shop
125 Gal per fixture_ 2 fixtures per bathroom - 2 bathrooms per store
- 500
Pinebluff Auto Glass
125 Gal per fixture - 2 fixtures per bathroom - 2 bathrooms per store
500
Total GPD
35,000

r
FORM WSCAS-12/07
WATERSHED CLASSIFICATION ATTACHMENT
FOR SEWER SYSTEMS
Applicant Name
Project Name
Moore County
Sanitary Sewer Improvements to serve ATEX
Technologies, Inc.
Professional Engineer Name
Engineering Firm Name
Bill Lester, Jr., P.E.
Hobbs, Upchurch & Associates, P.A.
Location
ID
Name of Waterbody'
County
River
Basin
Waterbody Stream
Index No.
Waterbody
Classification
1
UT -Aberdeen Creek
Moore
Lumber
14-2-11-(6)
C
' If unnamed, indicate "unnamed tributary to X", where X is the named waterbody to which the unnamed tributary joins.
I 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
NOTE: ONLY THE PROPOSED FLOW METER MANHOLE AND
SUPPORTING LINE WORK IS LOCATED WITHIN 100' OF THE
NOTED STREAM.
*** END OF FORM WSCAS-12/07 ***
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17651 _
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FORM: WSCAS-12/07 Page 1 of 1

OF W ATFq State of North Carolina
Department of Environment and Natural Resources
col r Division of Water Quality
o"" Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE—10/07)
Project Applicant Name: Moore County
Project Name for which flow is being requested: Sanitary Sewer Improvements to serve ATEX Tech
More than one FTSE-10107 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: Moore County Water Pollution Control Facility
b. WWTP Facility Permit #: NC0037508
All flows are in MGD
c. WWTP facility's permitted flow 4e. -7
d. Estimated obligated flow not yet tributary to the WWTP / . S 4 (o G 7
e. WWTP facility's actual avg. flow 4. 4 s 7
f. Total flow for this specific request 0.035
g. Total actual and obligated flows to the facility , 3 3 S S 7
h. Percent of permitted flow usedg4. 7
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
Pump Station Name Approx. Capacity, MGD Approx. Current Avg.
(Finn/Design) Daily Flow, MGD
N/A
III. Certification Statement:
I,Demi5'- 0*eW 9'Dtr"0— , certify that, to the best of my knowledge, 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. 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 for which I am the responsible party. Signature of this form
indicates acceptance of this wastewater flows-L�
Signing Official Signature
Date

Hobbs, Upchurch & Associates, P.A.
Consulting Engineers
300 S.W. Broad Street - Post Office Box 1737 • Southern Pines, NC 28388
October 21, 2010
Ms. Belinda Hinson
NCDENR — Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301
RE: Sanitary Sewer Improvements to serve ATEX Technologies
Moore County, North Carolina
HUA No.: MO1010.320
Dear Belinda:
Please find enclosed one (1) original, one (1) copy of the Fast -Track Application, Watershed
Classification Attachment and Flow Tracking sheet for the above referenced project. Also
enclosed, please find a check in the amount of $480.00 for the permit fee.
If you should have any questions or concerns regarding this information, please do not hesitate to
contact this office.
Sincerely,
HOBBS, UPCHURCH & ASSOCIATES, P.A.
Bill Lester, Jr., P.E.
Governmental Division Manager
Enclosures
cc: Dennis Brobst, Moore County Public Utilities
Lex Kelly, Moore County Public Utilities
Southern Pines, NC - Telephone [phone] - Fax [phone] - e-mail: [e-mail]
Hampstead • Nags Head - Charlotte - Beaufort

Sanitary Sewer Improvements zyy3
To Seve
Atex Technolo ies Inc
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Moore County
Watershed Classification Attachment 5 ;;
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