WQ0041766_Application (FTSE)_20200618

State of North Carolina
Department of Environmental Quality
10V R Division of Water Resources
15A NCAC 02T .0300 —FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources INSTRUCTIONS FOR FORM: FTA 04-16 &SUPPORTING DOCUMENTATION
This application is for sewer extensions involving gravity sewers, pump stations and force mains, or any combination that has been
certified by a professional engineer and the applicant that the project meets the requirements of 15A NCAC 02T and the Division's
Minimum Design Criteria and that plans, specifications and supporting documents have been prepared in accordance with, 15A
NCAC 02T, 15A NCAC 02T .0300, Division policies and good engineeriLig practices.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design
documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans, design
calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimum design criteria. These
documents shall be available upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T.0303.
Projects not eligible for review via the fast track process (must be submitted for full technical review):
➢ Projects that require an environmental assessment in accordance with 15A NCAC 1 C .0100;
➢ Projects that do not meet any part of the minimum design criteria (MDC) document;
➢ Projects that involve a variance from the requirements of 15A NCAC 2T;
➢ Pressure sewer systems utilizing septic tank -effluent pumps (STEPS) or simplex grinder pumps;
➢ STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains);
➢ Vacuum sewer systems.
General — When submitting an application, 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. Failure to submit all required items will necessitate additional
processing and review time, and may result in return of the application. Unless otherwise noted the Applicant shall submit
pp pP
one original and one copy of the application and supporting documentation.
A. one original and one Copy of Application and Supporting Documents
❑ Required unless otherwise noted
B. Cover Letter (Required for All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
➢ Be specific as to the system type, number of homes served, flow allocation required, etc.
➢ If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Major Modification Application Packages):
® Submit a check or money order in the amount of $480.00 dated within 90 days of application submittal.
➢ Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track (Form: FTA 04-16) Application (Required for All Application Packages):
® Submit the completed and appropriately executed application.
➢ If necessary for clarity or due to space restrictions, attachments to the application may be made.
❑ If the Applicant Type in Item 1.2 is a corporation or company, provide documentation it is registered for business with
the North Carolina Secretary of State.
❑ If the Applicant Type in Item 1.2 is a partnership or dlbla, enclose a copy of the certificate filed with the Register of
Deeds in the county of business.
® The Project Name in Item II.1 shall be consistent with the project name on the flow acceptance letters, agreements, etc.
® The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North
Carolina licensed Professional En ineer.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106 b .
Per 15A NCAC 02T .0106(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 02T .0106(b).
STRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Pagel of 3

0
E. Flow Tracking/Acceptance Form (Form: FTSE 04-16) (If Applicable):
® Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility.
➢ Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
➢ The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one
year prior to the application date.
Y Submittal of this application and form FTSE 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.
F. Site Maps (All Application Packages):
® 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.
➢ Location of the project (gravity sewer, pump stations & force main)
➢ Downstream connection points and permit number (if known) for the receiving sewer
® Include a street level map (aerial) showing general project area so that Division staff can easily locate it in the field.
O. 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., permit description, flow allocation, treatment facility, etc.).
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T .0305 h 1 , submit documentation of power reliability for pumping stations.
➢ This alternative is only available for average daily flows less than 15,000 gallons per day
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible
with the station. The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or proposed
contractor, stating that "the portable power generation unit or portable, independently -powered pumping units, associated
appurtenances and personnel are available for distribution and operation of this pump station."
➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump
stations' storage capacities and the rotation schedule of the portable power source or pump, including travel
timeframes, shall be provided in the case of a multiple station power outage. (Required at time of certification)
1. Certificate of Public Convenience and Necessity (All Application Packages for Privately -owned Public Utilities):
❑ Per 15A NCAC o2T .0115 a 1 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 sewer extension, 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.
J. operational Agreements (Applications from HOAIPOA and Developers for lots to be sold):
❑ HomelPrope!U Owners' Associations
El Per 15A NCAC o2T .0115 c , submit the properly executed Operational Agreement FORM: HGA .
❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and Sy -laws.
❑ Developers of lots to be sold
❑ Per 15A NCAC 02T .0115(b), submit the properly executed Operational Agreement FORM: DEV .
For more information, visit the Division's collection systems website
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 2 of 3

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,
WaterAgallity 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 uality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
Ralei h Regional Office
1628 Mail Service Center
Chatham, Durham, Edgecombe, Franklin,
Water Quality Sects
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,
Water Quality Section
Washington, North Carolina 27889
Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
(252) 975--3716 Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Re ional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section
Wilmington, North Carolina 28405
Hanover, Onslow, Pender
[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 FORM: FTA 04-1 G & SUPPORTING DOCUMENTATION Page 3 of 3

State of North Carolina
Department of Environmental Quality
DIVR Division of Water Resources
15A NCAC 02T .0300 —FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 &SUPPORTING DOCUMENTATION
Application Number:
(to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: City of Lexington (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal Ej State/County ® Municipal
3. Signature authority's name: Roger Jones per 15A NCAC 02T .010�b
Title: Public Services Manager
4. Applicant's mailing address: 28 West Center St/
City: Lexington State: NC Zip: 27292-
5. Applicant's contact information:
Phone number: [phone] Email Address: RDJones Lexin tonNC.GOV
II. PROJECT INFORMATION:
❑ Privately -Owned Public Utility
El Other
1. Project name: Kerle 's Barbecue Public Sewer Extension
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQOo and issued date:
If new construction but part of a master plan, provide the existing permit number: WQoo
3. County where project is located: Davidson
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.8949'
5. Parcel ID (if applicable): 6728-04-83-4149
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Wesle Kimbreli License Number: 046877
Firm: WK Environmental PLLC
Longitude:-80.2544"
Mailing address: 1781 Helmstetler Rd.
City: Lexington State: NC Zip: 27295-
Phone number: [phone] Email Address: WKEnvironmentalAmail.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
L Facility Name: City of Lexington WWTP Permit Number: NCO055786
Owner Name: City of Lexington
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ,
Downstream (Receiving) Sewer Size: inch
System Wide Collection System Permit Number(s) (if applicable : WQCS
Owner Name(s):
FORM: FTA 04-16 Page l of 5

VI.
1.
2.
3.
11
5.
GENERAL REQUIREMENTS
If the Applicant is a Privately -owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
El Yes E]No ZN/A
If the Applicant is a Developer of lots to be sold, has a Developer's Operational A reement FORM: DEV been attached?
[:] Yes [:]No ZN/A
If the Applicant is a Home/Property owners', Association.,_ has an Operational Agreement FORM: Hbeen attached?
Origin of wastewater: (check all that apply):
❑ Residential Owned
❑ Residential Leased
❑ School / preschool / day care
E Food and drink facilities
❑ Businesses / offices / factories
El Yes E]No ZN/A
El Retail (stores, centers, malls)
❑ Retail with food preparation/service
El Medical / dental / veterinary facilities
El Church
[:1 Nursing Home
Nature of wastewater: % Domestic/Commercial
100 % Commercial
❑ Car wash
El Hotel and/or Motels
EJ Swimming Pool /Clubhouse
[:1 Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
Industrial (See 15A NCAC 02T .0103(20))
*Is there a Pretreatment Program in effect? Ej Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114 ? ❑ Yes ® No
➢ If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0 I L10
Daily Design Flow a,b
No. of Units
Flow
Resturaunt, full service
40 gal/seat
120
400 GPD
gall
GPD
gall
GPD
gall
GPD
gall
GPD
gall
GPD
Total
41800 GPD
a See 15A NCAC 02T .0114 b d e 1 and (e)Q for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.01141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 4,800 GPD (per 15A NCAC 02T .0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain). -
FORM: FTA 04-16 Page 2 of 5

VI1.
GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC(Gravity Sewers1.
1.
VIII.
I.
Summarize gravity sewer to be permitted:
Size (inches)
rV
Length (feet)
209
Material
SDR 26 PVC
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
PUMP STATION DESIGN CRITERIA (If Applicable) — 02T ,0305 & ,MDC Pump Stations/Force Mains ;
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: QLongitude:
3. Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) I Length (feet) I Material
6. Power reliability in accordance with 15A NCAC 02T .0305 h 1 :
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(S)*.
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, Quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C):
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0204 & 15A NCAC 02T .0305(f)):
l . Does the project comply with all separations found in 15A NCAC 02T .0305(f) &}
➢ 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
EI Yes ❑ No
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below vertical
24 inches
Water mains vertical -water over sewer including in benched trenches
18 inches
Water mains horizontal
10 feet
Reclaimed water lines vertical - reclaimed over sewer
18 inches
Reclaimed water lines horizontal - reclaimed over sewer
2 feet
**Any private or public water supply source, including any wells, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water or tide elevation and wetlands see item IX.2
50 feet
"Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interce for drains
5 feet
Any swimming pools
10 feet
Final earth grade vertical
36 inches
➢ 15A NCAC 02T.030contains alternatives where separations in 02T.0305(f1 cannot be achieved.
);-I. **Stream classifications can be identified using the Division's NC Surface Water Classifications webt�a�e
➢ If noncompliance with 02T.0305(i) or (g), see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) El Yes
➢ See the Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
[—]No 0 N/A
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? Ej Yes [:1 No ® NIA
➢ This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project require coverage/authorization under a 404 Nationwide or E]Yes Z No
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.01) (additional permits/certifications)? Z Yes [:]No
Per 15A NCAC 02T.0105(c)(6, directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
[:]Yes E No ❑ N/A
➢ If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and inspections
documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Vide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. C:ERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains latest version and the Gravity.Sewer Minimum Design Criteria latest version as applicable?
2.
3.
Yes [:1 No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
Professional Engineer's Certification:
45�
I, ee- e el
(Profe ional Engineer's name from Application Item I11.1.)
attest that this application for
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, 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 .0106(b):
I,
Roger Jones Public Services Manager
(Signature Authority's name & title from Application Item I.3.)
.......................`... .........................................
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attest that this application for
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is sub j ect to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
of this permit be violated. I also understand that if all required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
NOTE -- In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature:
Digitally signed by Roger Jones
DN: rn=Roger Jones, o=City of Lexington,
Roger
Jones
ou=Water Resources,
[e-mail], c=US
Date: 2020.06.16 09:51:23-04'00'
pa1e: 6/16/2020
FORM: FTA 04-16 Page 5 of 5

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: City of Lexington
Project Name for which flow is being requested: Kerley's BBQ Public Sewer Extension
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Lexington Regional Wastewater Treatment Plant
b. WWTP Facility Permit #: NC0055786
All flows are in MGD
c. WWTP facility's permitted flow 6.5
d. Estimated obligated flow not yet tributary to the WWTP 0.16
e. WWTP facility's actual avg. flow 2.8
f. Total flow for this specific request 0.0048
g. Total actual and obligated flows to the facility 2.9648
h. Percent of permitted flow used 45.61
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)
Design
Pump
Pump
Average
Approx.
Station
Station
Firm
Daily Flow**
Current
(Name or
Permit
Capacity, *
(Firm / pf),
Avg. Daily
Number)
No.
MGD
MGD
Flow, MGD
Swearing
5.91
2.36
1.5
Creek
(C)
(D)=(B+C)
(E)=(A-D)
Obligated,
Not Yet
Total Current
Tributary
Flow Plus
Daily Flow,
Obligated
Available
MGD
Flow
Capacity***
0.14
1.64
0.72
* The Firm Capacity (design flow) 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, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer):
Downstream Permit Number:
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Roger Jones 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 certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
Digitally signed by RogerJones
RogerJones Res cn=Roger Jones, o=City Lexington, ou=Water
Resources, email=[e-mail], c=US
Date: 2020.06.16 09:55:57-04'00'
Signing Official Signature
Title of Signing Official
Date
Page 2 of 6
FTSE 10-18

PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum for each pump station listed in Section II where Available Capacity is <
0.
Pump Station (Name or Number):
Given that:
a. The proportion and amount of Obligated, Not Yet Tributary Daily Flow (C) accounts for
% and MGD of the Available Capacity (E) in Pump Station
; and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately
MGD per year; and that
c. A funded Capital Project that will provide the required planned capacity, namely
is in design or under construction with
planned completion in ; and/or
d. The following applies:
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to allow
this flow to be permitted, without a significant likelihood of over -allocating capacity in the system
infrastructure.
I understand that this does not relieve the collection system owner from complying with G.S. 143-
215.67(a) which prohibits the introduction of any waste in excess of the capacity of the waste disposal
system.
Signing Official Signature
Date
Page 3 of 6
FTSE 10-18

Instructions for Flow Tracking form (FTSE) and Planning Assessment Addendum (PAA)
Section I
a. WWTP Facility Name: Enter the name of the WWTP that will receive the wastewater flow.
b. WWTP Facility Permit #: Enter the NPDES or Non -Discharge number for the WWTP receiving the
wastewater flow.
c. WWTP facility's permitted flow, MGD: From WWTP owner's NPDES or Non -Discharge permit.
d. Estimated obligated flow not yet tributary to the WWTP, MGD: This includes flows allocated to other
construction projects not yet contributing flow to the collection system. Flows allocated through interlocal
agreements or other contracts not yet contributing flow to the collection system are also included. For POTWs
that implement a pretreatment program, include flows allocated to industrial users who may not be using all of
their flow allocation. Please contact your Pretreatment Coordinator for information on industrial flow tributary
to your WWTP.
As of January 15, 2008 the POTW should have reviewed flow allocations made over the last two years and
reconciled their flow records, to the best of their ability, so it is known how much flow has been obligated and
is not yet been made tributary to the WWTP, in accordance with local policies and procedures employed by the
reporting entity.
e. WWTP facility's actual avg. flow, MGD: Previous 12 month average.
f. Total flow for this specific request, MGD: Enter the requested flow volume.
g. Total actual and obligated flows to the facility, MGD Equals [d + e + f]
h. Percent of permitted flow used: Equals [(g / c)* 100]
For example:
On January 15 a POTW with a permitted flow of 6.0 MGD, reported to the Regional Office that there is 0.5
MGD of flow that is obligated but not yet tributary. The annual average flow for 2007 is 2.7 MGD. There is a
proposed flow expansion of 0.015 MGD.
The first Form FTSE submitted after January 15, 2008 may have numbers like this:
c. = 6.0 MGD
d. = 0.5 MGD
e. = 2.7 MGD
£ = 0.015 MGD
g. = 3.215 MGD
h. = 53.6 %
The next Form FTSE may be updated like this with a proposed flow expansion of 0.102 MGD:
c. = 6.0 MGD
d. = 0.515 MGD
e. = 2.73 MGD
£ = 0.102 MGD
g. = 3.349 MGD
h. = 55.8 %
Each subsequent FTSE form will be updated in the same manner.
Page 4 of 6
FTSE 10-18

Section II
List the pump station name or number and approximate pump station firm capacity, approximate design average
daily flow (A) approximate current average daily flow (B), and the obligated, not yet tributary flow through the
pump station (C) for each pump station that will be impacted by the proposed sewer extension project. Calculate
the total current flow plus obligated flow (D=B+C) and the available capacity (E=A-D). Include the proposed flow
for this project with other obligated flows that have been approved for the pump station but are not yet tributary
(C).
Firm capacity is the maximum pumped flow that can be achieved with the largest pump out of service as per the
Minimum Design Criteria.
Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pf) of not less than
2.5.
If the available capacity (E) for any pump station is < 0, then prepare a planning assessment for that pump station
if the system has future specific plans related to capacity that should be considered in the permitting process.
(A)
(B)
(C)
(D)=(B+C)
(E)=(A-D)
Obligated,
Design
Approx.
Not Yet
Total Current
Firm
Average
Current Avg.
Tributary
Flow Plus
Pump Station
Capacity
Daily Flow
Daily Flow,
Daily Flow,
Obligated
Available
(Name or Number)
MGD
(Firm / pf)
MGD
MGD
Flow
Capacity*
Kaw Creek PS
0.800
0.320
0.252
0.080
0.332
-0.012
Valley Road PS
1.895
0.758
0.472
0.135
0.607
0.151
Page 5 of 6
FTSE 10-18

Planning Assessment Addendum Instructions
Submit a planning assessment addendum for each pump station listed in Section II where available capacity is < 0.
A planning assessment for Kaw Creek PS (see example data above) may be performed to evaluate whether there is
significant likelihood that needed improvements or reductions in obligated flows will be in place prior to activating
the flows from the proposed sewer extension project.
If the system decides to accept the flow based on a planning assessment addendum, it is responsible to manage the
flow without capacity related sanitary overflows and must take all steps necessary to complete the project or control
the rate of flow to prevent sanitary sewer overflows.
The planning assessment may identify a funded project currently in design or construction, or a planned project in
the future not yet funded but in a formal plan adopted by the system. The system should carefully weigh the
certainty of successful timely project completion for any expansion, flow management diversion or infiltration and
inflow elimination projects that are the foundation of a planned solution to capacity tracking and acceptance
compliance.
For example:
Given that:
a. The proportion and amount of obligated, not yet tributary flow accounts for 24 % and 0.080 MGD of the
committed flow in Pump Station Kaw Creek; and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately 0.01 MGD
per year; and that
c. A funded capital project that will provide the required planned capacity, namely
is in design or under construction with planned
completion in ; and/or
d. The following applies:
The master plan and ten year pital plan contain recommended scope and funding for a capital project entitled
Kaw Creek Pump Station upgrade with funding planned in July 2014. This project is planned to add 0.100 MGD
to the firm capacity of the pump station by October 2015. Inclusion of this proposed capital project as a condition
of this Flow Tracking/Acceptance for Sewer Extension Permit Application elevates this project's priority for
funding and construction to be implemented ahead of the activation of obligated, not yet tributary flows in amounts
that exceed the firm pump station capacities identified in Section II above.
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to allow this flow
to be permitted, without a significant likelihood of over -allocating capacity in the system infrastructure.
Page 6 of 6
FTSE 10-18

KERLEY'S
SEWER MAIN EXTENSION
WELCOME, NORTH CAROLINA
GENERAL SITE NOTES
1. CARE SHALL BE TAKEN TO PREVENT DAMAGE TO EXISTING UTILITIES OR INFRASTRUCTURE
DURING CONSTRUCTION. ANY DAMAGE TO THESE UTILITIES OR INFRASTRUCTURE SHALL BE
REPAIRED AT THE CONTRACTORS EXPENSE.
2. THE CONTRACTOR SHALL BE RESPONSIBLE FOR FIELD VERIFYING ALL ILLUSTRATED KNOWN
UNDERGROUND ELEMENTS. THE CONTRACTOR SHALL NOTIFY THE ENGINEER, IMMEDIATELY,
IF UNKNOWN ELEMENTS ARE DISCOVERED THAT WOULD NECESSITATE MODIFICATION TO THE
ILLUSTRATED DESIGN.
3. PROTECT ALL ADJACENT PROPERTIES, THE GENERAL PUBLIC, AND ALL OTHER FACILITIES.
SHOULD DAMAGES OCCUR, CONTRACTOR SHALL REPAIR IMMEDIATELY AS DIRECTED BY THE
ENGINEER. CONTRACTOR IS FINANCIALLY RESPONSIBLE FOR ALL REPAIRS, AND REPAIRS
ARE TO BE PERFORMED TO THE GOVERNING MUNICIPALITIES APPROVAL.
4. UTILIZE SIGNS, BARRICADES, FLAGMEN OR GUARDS AS REQUIRED TO ENSURE THE SAFETY
OF ALL VEHICULAR AND PEDESTRIAN TRAFFIC DURING ALL CONSTRUCTION ACTIVITIES.
5. THE CONTRACTOR SHALL BE RESPONSIBLE FOR LAYOUT OF ALL WORK AS ILLUSTRATED ON
PLANS. IF EXISTING CONDITIONS DIFFER FROM THOSE ILLUSTRATED ON PLANS, NOTIFY THE
ENGINEER PRIOR TO CONSTRUCTION.
6. PRIOR TO BEGINNING CONSTRUCTION, THE GENERAL CONTRACTOR SHALL BE RESPONSIBLE
FOR VERIFYING THAT ALL REQUIRED PERMITS AND APPROVALS HAVE BEEN OBTAINED FROM
ALL REGULATORY AUTHORITIES.
7. THE CONTRACTOR SHALL MAINTAIN THE SITE IN A MANNER SO THAT WORKERS AND THE
PUBLIC SHALL BE PROTECTED FROM INJURY, BY OSHA STANDARDS.
8. THE ENGINEER AND GOVERNING DEPARTMENT SHALL BE NOTIFIED PRIOR TO ANY
INTERRUPTION OF EXISTING UTILITIES, EXISTING DRIVEWAYS, OR EXISTING ROADWAYS TO
ENSURE CONTINUOUS SERVICE AND TO KEEP PUBLIC UTILITY INTERRUPTIONS TO A
MINIMUM.
9. IF A UTILITY IS TO BE RELOCATED, TEMPORARILY DISABLED, OR ELIMINATED, THE ENGINEER
SHALL BE NOTIFIED IN ADVANCE BEFORE UTILITY WORK CAN BEGIN. ALL PROPERTY
OWNERS AFFECTED BY A UTILITY RELOCATE, TEMPORARY DISABLING, OR ELIMINATION
SHALL BE GIVEN A WRITTEN NOTICE NO LESS THAN 14 DAYS PRIOR TO THE DESIRED
UTILITY WORK DATE.
10. ALL WORK SHALL COMPLY WITH ALL APPLICABLE CODES, REGULATIONS, AND/OR LOCAL
STANDARDS IMPOSED BY THE GOVERNING MUNICIPALITY, NCDEQ, NCDOT AND/OR ANY
UTILITY OWNERS SPECIFICATIONS FOR THOSE UTILITIES AFFECTED.
11. THE CONTRACTOR SHALL CONTACT THE APPROPRIATE AGENCY FOR THE EXACT FIELD
LOCATIONS OF ALL WATER, SEWER, ELECTRIC, TELEPHONE, TELEVISION, OR ANY OTHER
UNDERGROUND OR OVERHEAD UTILITY BEFORE STARTING CONSTRUCTION. IT SHALL BE THE
RESPONSIBILITY OF THE CONTRACTOR TO FIELD VERIFY THE LOCATION AND DEPTH OF ALL
UTILITIES WITHIN THE LIMITS OF THIS PROJECT.
12. THE CONTRACTOR AND ALL SUBS ON SITE SHALL MAINTAIN THE SITE IN A MANNER TO
PREVENT ANY TRASH OR SEDIMENT FROM LEAVING THE SITE. ALL VEHICLE TIRES SHALL
BE CLEANED/WASHED TO PREVENT CARRYING SEDIMENT OFF SITE.
13. THE CONTRACTOR MUST INSTALL ALL UTILITIES (STORM, WATER, SEWER, ETC.) PER ALL
MATERIAL MANUFACTURERS SPECIFICATIONS. ANY ITEM NOT INSTALLED PER
MANUFACTURERS SPECIFICATIONS SHALL BE THE LIABILITY OF THE CONTRACTOR.
14. THE CONTRACTOR SHALL BE RESPONSIBLE FOR PERFORMING AND FOLLOWING UP WITH THE
LOCAL MUNICIPALITY REGARDING ANY INSPECTIONS DURING OR NEAR COMPLETION OF THE
14.1. MANDATORY PRE -CONSTRUCTION CONFERENCE: THE CONTRACTOR SHALL SCHEDULE
AND ATTEND A PRE -CONSTRUCTION CONFERENCE WITH THE CITY OF LEXINGTON
PUBLIC WORKS DEPARTMENT FOLLOWING CITY APPROVAL OF ALL SEWER MAIN
EXTENSION MATERIALS. THE LICENSED PUBLIC UTILITIES CONTRACTOR(S) AND
O SUB-CONTRACTOR(S) PERFORMING THE PUBLIC SEWER WORK SHALL BE IN
ATTENDANCE. ALL OTHER AFFECTED CITY UTILITIES MUST BE PROVIDED NOTICE OF THE
MEETING A MINIMUM OF THREE WORKING DAYS PRIOR TO THE MEETING DATE. NO
PUBLIC SEWER WORK SHALL COMMENCE UNTIL NOTICE OF THE PROPOSED START DATE
IS PROVIDED TO THE CITY OF LEXINGTON PUBLIC WORKS DEPARTMENT AND THE START
DATE IS APPROVED BY THE PUBLIC SERVICES MANAGER. CONTACT ROGER JONES, CITY
PU LIC ERVI ES ANA R, T 33 -24 -39 0.
15. TH ON AC LL R M E- L A A
EXTENSIONS PRIOR TO CONTACTING THE ENGINEER OF RECORD AND CITY OF LEXINGTON
STAFF TO ENSURE ADEQUATE INSTALLATION. THE CONTRACTOR WILL BE BILLED HOURLY,
BY THE ENGINEER OF RECORD, FOR MULTIPLE FAILED TESTING ATTEMPTS.
16. ALL PIPES/MANHOLES SHALL BE TESTED PER THE SPECS. ON SHEET C-3.
17. CONTRACTOR IS RESPONSIBLE FOR ENSURING NO DAMAGES TO THE HIGH PRESSURE GAS
MAIN THAT FALLS WITHIN PROXIMITY OF THIS PROJECT.
18. CONTRATOR IS RESPONSIBLE FOR ENSURING NO DAMAGES TO THE 8" AC WATER LINE
THAT FALLS WITHIN PROXIMITY OF THIS PROJECT.
19. CONTRACTOR SHALL CONSIDER USING AS TALL OF A TRENCH BOX THAT THEY CAN OBTAIN
TO REDUCE BENCH BACK WIDTHS AND ASPHALT/UTILITY IMPACTS.
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VICINITY MAP NTS
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BEFORE YOU DIG!
CALL 811 N.C. ONE -CALL CENTER
IT'S THE LAW!
KNOW WHAT'S BELOW.
CALL BEFORE YOU DIG.
NORTH CAROLINA ONE —CALL CENTER, INC.
Call 1-800-632-4949 before you dig: It's the law!
By law, everyone MUST contact the North Carolina One -Call Center, 1-800-632-4949, at least 48 hours but
no more than 10 working days (excluding weekends and legal holidays) before beginning ANY digging project.
WK ENVIRONMENTAL PLLC.
THESE DRAWINGS, PLANS, AND SPECIFICATIONS ARE INSTRUMENTS OF
SERVICE AND ARE AND SHALL REMAIN THE PROPERTY OF WK
ENVIRONMENTAL PLLC. THEY ARE TO BE USED ONLY FOR THE
DEVELOPMENT OF THE PROJECT DESCRIBED HEREIN AND ONLY UNDER
SUPERVISION OF CARROL FISHER CONSTRUCTION CO. INC. & WK
ENVIRONMENTAL PLLC. OR WITH ITS EXPRESS WRITTEN CONSENT.
ENGINEER INFORMATION
WK ENVIRONMENTAL PLLC
PE FIRM NO.: P-1897
WESLEY S. KIMBRELL, PE
[e-mail] CELL: 336-239-5148
BUSINESS HOURS: MON-FRI (3:30pm-8pm)
OWNER INFORMATION
KERLEYS BARBECUE
JACK KERLEY-336-249-4590
BUDDY KERLEY-336-731-8245
5114 OLD US HWY 52
LEXINGTON, NC 27295
SCHEDULE OF DRAWINGS �
C-1 . . . . . COVER SHEET
C-2 . . . . EXISTING CONDITIONS PLAN
C-3 . . . . . DEMOLITION/EROSION CONTROL PLAN PH 1
SITE DATA
JURISDICTION:
DAVIDSON, NC
WELCOME TOWNSHIP
TAX DATA:
PIN NO.:6728-04-83-4149
TAX ID.:11-312-125
DB:927 PG:863
SITE LOCATION:
5114 OLD US HWY 52
LEXINGTON NC 27295
EXISTING ZONING:
HC
FLOOD INFORMATION:
THIS PROPERTY IS OUTSIDE OF THE FEMA FLOODWAY/ZONE ACCORDING TO
FEAM FIRMETTE PANEL 3710672800J (EFFECTIVE 3/16/2009)
SOIL TYPE:
ACCORDING TO USDA MAPS THE SITE IS COMPOSED OF THE FOLLOWING SOIL
TYPES.
ApB—APPUNG SANDY LOAM 2-8% SLOPES (21.9%)
VaB—VANCE SANDY LOAM 2-8% SLOPES (78.1%)
SITE ACREAGE:
TOTAL AREA: 3.121 AC
TRACT 1: 1.328 AC
TRACT 2: 1.793 AC
SETBACKS:
FRONT:50' (min)
REAR: 2D'
SIDE: 0'
WATERSHED INFORMATION:
THE SITE DOES NOT DISCHARGE DIRECTLY INTO A WS—IV SURFACE WATER
EXISTING USE:
RESTAURANT AND PARKING LOT
PROPOSED USE:
RESTAURANT AND PARKING LOT (SELLING OFF LARGER LOT)
GENERAL SURVEY NOTES
1. TRI—COUNTY LAND SURVEYING PROVIDED THIS PRELIMINARY SURVEY AS AN
ELECTRIC COPY OF A DRAWING ORIGINALLY CREATED BY LEE COMER ON 2-17-2020
(DWG# 204485) AND IS NOT TO BE CONSIDERED CERTIFIED. THIS DRAWING SHOWS
BOUNDARY AND TOPO—GRAPHIC CONDITIONS OF THE SITE AT THE TIME OF THE
SURVEY.
2. THIS PROPERTY IS SUBJECT TO ANY EASEMENTS, AGREEMENTS, OR
RIGHTS —OF —WAY OF RECORD PRIOR TO THE DATE OF THIS MAP WHICH WERE NOT
APPARENT AT THE TIME OF MY INSPECTION. DECLARATION IS MADE TO THE ORIGINAL
PURCHASER OF THE SURVEY, IT IS NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS
OR OWNERS.
3. WK ENVIRONMENTAL PLLC, SHALL NOT BE HELD ACCOUNTABLE FOR ANY DAMAGES
OR HARM CAUSED BY THIS MAP THAT WAS PROVIDED BY OTHERS. THIS MAP WAS
PROVIDED BY THE OWNER AS AN EXISTING CONDITIONS SET.
4. ALL UTILITIES WERE NOT LOCATED WHEN SURVEY WAS SUBMITTED, CONTRACTOR
SHALL BE RESPONSIBLE FOR FIELD VERIFYING ALL LOCATIONS AND DEPTHS OF ALL
UTILITIES WITHIN THE WORK ZONE. IF ANY NON —LOCATED UTILITIES ARE WITHIN
CONFLICT WITH THE PROPOSED WORK, CONTRACTOR SHALL STOP ALL WORK AND
REPORT CONFLICTS TO DESIGN ENGINEER IMMEDIATELY.
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1
275.98' \ o
272.44' w
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Shed
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0 PROPOSED LOD I 1 I /
12,000 SF I ^v
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CURRENT SEWER CONNECTION o <0 /�'O-
TO PUMP AND TIE INTO PROPOSED /
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TO BE INSTALLED PER
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APPROXIMATE LOC.
OF SERVICE LINE
------------- -- -
SEWER TESTING SPECS.
1. THE DESIGN ENGINEER, NOR THE CITY OF LEXINGTON,
WILL SUPPLY TESTING EQUIPMENT OR GAGES.
CONTRACTOR IS RESPONSIBLE FOR ALL TESTING
EQUIPMENT.
2. THE DESIGN ENGINEER AND THE CITY OF LEXINGTON
STAFF SHALL BE PRESENT FOR ALL FINAL TESTING AND
SHALL INSPECT ALL TESTING EQUIPMENT.
3. ANY EQUIPMENT DEEMED INADEQUATE OR
UNACCEPTABLE BY THE DESIGN ENGINEER OR THE CITY
OF LEXINGTON SHALL NOT BE USED FOR TESTING. ANY
TESTS PERFORMED WITH UNAPPROVED EQUIPMENT WILL
NOT BE ACCEPTED.
4. ALL SEWER LINES SHALL BE BUILT PER MANUFACTURERS
SPECS AND THOSE PROVIDED IN THESE PLANS.
5. ALL LINES SHALL BE INSTALLED IN A WATER TIGHT
MANNER WITH APPROPRIATE SLOPE.
6. CITY OF LEXINGTON STAFF WILL REQUIRE THAT A CCTV
INSPECTION BE PERFORMED. CONTRACTOR TO CONTACT
ROGER JONES AT 336-248-3930 TO SET UP CCTV
INSPECTION.
7. CONTRACTOR TO PRE -TEST BOTH THE MANHOLE
VACUUM TESTS AND THE PIPE PRESSURE TEST BEFORE
CONTACTING DESIGN ENGINEER FOR FINAL INSPECTION.
8. AN ADEQUATELY SIZED MANDREL, APPROVED BY CITY OF
LEXINGTON STAFF, SHALL BE USED AT THE TIME OF THE
FINAL INSPECTION.
9. EXMH-1 SHALL BE VACUUM TESTED IN ACCORDANCE
WITH ASTM C-1244 AFTER ALL GRADE RINGS, AND
RINGS AND COVERS HAVE BEEN INSTALLED. TESTING
SHALL BE AT A VACUUM OF 10 INCHES MERCURY DRAWN
{ PROPOSED LOD /
12,000 SF \ / / PROPOSED LOD
C ai PROPOSED UTILITY EASEMENT \ PROPOSED UTILITY EASEMENT EX C/O \ 12,000 SF
I PROPOSED C/O \ PROPOSED 8 SDR 26 EXMH-1
PROPOSED MH-1
\ .0 - - -SEWER MAIN EXT. - - - - - \ - -
�- - �� - - -
SVS SVS SVS sis E -Mir 0 SV-q SVS SVS SVS SVS SbS S` s SVS SvS
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EX. WATER METER ,
APPROXIMATE L `\ \ 1 Wl S� V o APPROXIMATE LOC.
OF SERVICE LINES / \ - 0 OF 8" AC WATER LINE
Old US Highway 52
1 00' PUBLIC R/W
SR 2932
844
840
836
832
828
825
0 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 190 200 210 215
EX. GRADE
EX. GRADE
EX. GRADE
ROP MH-1
RIM: 842.31
INVERT
INVERT
IN (6"): 829.10
OUT (8"): 828.85
EXMH-
RIM: 839.27
INVERT IN (8"): 826.75
INVERT OUT (8"): 826.56
.
PROPOSED
209
LF OF 8" SDR
26 PIPE
�
FROM THE MANHOLE AND THE TIME FOR THE VACUUM TO 11.
THE NEW 8" SDR 26 SEWER MAIN SHALL BE PRESSURE
DROP TO 9 INCHES SHALL NOT BE SOONER THAN 75
TESTED IN ACCORDANCE WITH ASTM C-828. BOTH THE
SECONDS AFTER THE 10 INCH MERCURY VACUUM IS SET.
UP AN DOWNSTREAM ENDS OF THE PIPE, AT THE
VACUUM EQUIPMENT MAY NOT BE ACTIVE WHILE TESTING,
MANHOLE CONNECTION POINTS, SHALL BE PLUGGED. THE
IF EQUIPMENT IS RUNNING DURING THE TEST, THE TEST
PIPE SHALL BE PRESSURIZED TO 4.0 PSI BEFORE THE
IS AUTOMATICALLY FAILED.
TEST MAY BEGIN. THE 209 LF OF SDR 26 PIPE SHALL
10. MH-1 SHALL BE VACUUM TESTED IN ACCORDANCE WITH
REMAIN WITHIN 1 PSI OF THE INITIAL TEST START
ASTM C-1244 AFTER ALL GRADE RINGS, AND RINGS AND
PRESSURE FOR A MINIMUM OF 3 MINUTES AND 30
COVERS HAVE BEEN INSTALLED. TESTING SHALL BE AT A
SECONDS (210 SECONDS). ANY PIPE THAT CANT
VACUUM OF 10 INCHES MERCURY DRAWN FROM THE
MAINTAIN PRESSURE WITHIN 1 PSI OF THE START
MANHOLE AND THE TIME FOR THE VACUUM TO DROP TO
PRESSURE, WILL BE PRESUMED AS FAILED, AND IT SHALL
9 INCHES SHALL NOT BE SOONER THAN 75 SECONDS
BE THE CONTRACTORS RESPONSIBILITY TO LOCATE ALL
AFTER THE 10 INCH MERCURY VACUUM IS SET. VACUUM
LEAKS AND REPAIR THEM PRIOR TO RETESTING.
EQUIPMENT MAY NOT BE ACTIVE WHILE TESTING, IF
EQUIPMENT IS RUNNING DURING THE TEST, THE TEST IS
AUTOMATICALLY FAILED.
SVS SVS -
r/w
s SVS
� N 14.55'44"W 707.98'
GENERAL SURVEY NOTES
1. TRI-COUNTY LAND SURVEYING PROVIDED THIS
PRELIMINARY SURVEY AS AN ELECTRIC COPY OF A
DRAWING ORIGINALLY CREATED BY LEE COMER ON
2-17-2020 (DWG# 204485) AND IS NOT TO BE
CONSIDERED CERTIFIED. THIS DRAWING SHOWS
BOUNDARY AND TOPO-GRAPHIC CONDITIONS OF THE
SITE AT THE TIME OF THE SURVEY.
2. THIS PROPERTY IS SUBJECT TO ANY EASEMENTS,
AGREEMENTS, OR RIGHTS -OF -WAY OF RECORD PRIOR
TO THE DATE OF THIS MAP WHICH WERE NOT
APPARENT AT THE TIME OF MY INSPECTION.
DECLARATION IS MADE TO THE ORIGINAL PURCHASER
OF THE SURVEY, IT IS NOT TRANSFERABLE TO
ADDITIONAL INSTITUTIONS OR OWNERS.
3. WK ENVIRONMENTAL PLLC, SHALL NOT BE HELD
ACCOUNTABLE FOR ANY DAMAGES OR HARM CAUSED
BY THIS MAP THAT WAS PROVIDED BY OTHERS. THIS
MAP WAS PROVIDED BY THE OWNER AS AN EXISTING
CONDITIONS SET.
4. ALL UTILITIES WERE NOT LOCATED WHEN SURVEY
WAS SUBMITTED, CONTRACTOR SHALL BE RESPONSIBLE
FOR FIELD VERIFYING ALL LOCATIONS AND DEPTHS OF
ALL UTILITIES WITHIN THE WORK ZONE. IF ANY
NON -LOCATED UTILITIES ARE WITHIN CONFLICT WITH
THE PROPOSED WORK, CONTRACTOR SHALL STOP ALL
WORK AND REPORT CONFLICTS TO DESIGN ENGINEER
IMMEDIATELY.
SURVEY LEGEND
EIP EXISTING IRON PIN
IPS IRON PIN SET
R/W RIGHT-OF-WAY
E/P EDGE OF PAVEMENT
E/G EDGE OF GRAVEL
CM CONCRETE MONUMENT
PP POWER POLE
M.B.L. MINIMUM BUILDING LINE
LP LIGHT POLE
--E-- OVERHEAD SERVICE LINES
PT. POINT
LEGEND
PROPOSED
EXISTING
�R/;"'
RIGHT OF WAY
-
-
PROPERTY LINE
=PDE
EASEMENT
000
=�E
=
CONTOURS
PAVEMENT
X
FENCE
RIP RAP
SS
SANITARY SERVICE
■■■■■■■■■■■■■■
---------�-
STORM SERVICE
wM
W
WATER MAIN
T
COMMUNICATION LINE
- FO
-
FIBER OPTIC
-GM-
GAS SERVICE LINE
- E
-
UNDERGROUND ELECTRIC LINE
- OHE
-
OVERHEAD ELECTRIC LINE
- OHW
-
OVERHEAD UTILITY WIRE
TELEPHONE POLE
<
GUY WIRE
LIGHT POLE
m
GAS VALVE
p
GAS MARKER
FIBER OPTIC BOX
®
WATER VALVE
FIRE HYDRANT
°
FDC CONNECTION
aCO
SANITARY CLEANOUT
FLOW ARROW
F
-1
F_
7
LIGHT DUTY ASPHALT
(SEE DETAIL ON C-3)
Go � UTiury aR0?Z6,& o
1
Bethesda
BEFORE YOU DIG! VICINITY MAP NTS
CALL 811 N.C. ONE -CALL CENTER
IT'S THE LAW!
ALL RIGHTS RESERVED. THIS DRAWING IS THE
PROPERTY OF WK ENVIRONMENTAL PLLC. AND
SHALL NOT BE REPRODUCED IN WHOLE OR IN
PART WITHOUT PERMISSION.
SITE DATA
JURISDICTION:
DAVIDSON, NC
WELCOME TOWNSHIP
TAX DATA:
PIN NO.:6728-04-83-4149
TAX ID.:11-312-125
DB:927 PG:883
SITE LOCATION:
5114 OLD US HWY 52
LEXINGTON NC 27295
EXISTING ZONING:
HC
FLOOD INFORMATION:
THIS PROPERTY IS OUTSIDE OF THE FEMA FLOODWAY/ZONE ACCORDING TO
FEAM FIRMETTE PANEL 3710672800J (EFFECTIVE 3/16/2009)
SOIL TYPE:
ACCORDING TO USDA MAPS THE SITE IS COMPOSED OF THE FOLLOWING SOIL
TYPES.
ApB-APPLING SANDY LOAM 2-8% SLOPES (21.9%)
VaB-VANCE SANDY LOAM 2-8% SLOPES (78.1%)
SITE ACREAGE:
TOTAL AREA: 3.121 AC
TRACT 1: 1.328 AC
TRACT 2: 1.793 AC
SETBACKS:
FRONT:50' (min)
REAR: 20'
SIDE: 0'
WATERSHED INFORMATION:
THE SITE DOES NOT DISCHARGE DIRECTLY INTO A WS-IV SURFACE WATER.
EXISTING USE:
RESTAURANT AND PARKING LOT
PROPOSED USE:
RESTAURANT AND PARKING LOT (SELLING OFF LARGER LOT)
GENERAL SITE NOTES
1. CARE SHALL BE TAKEN TO PREVENT DAMAGE TO EXISTING UTILITIES OR INFRASTRUCTURE
DURING CONSTRUCTION. ANY DAMAGE TO THESE UTILITIES OR INFRASTRUCTURE SHALL BE
REPAIRED AT THE CONTRACTORS EXPENSE.
2. THE CONTRACTOR SHALL BE RESPONSIBLE FOR FIELD VERIFYING ALL ILLUSTRATED KNOWN
UNDERGROUND ELEMENTS. THE CONTRACTOR SHALL NOTIFY THE ENGINEER, IMMEDIATELY,
IF UNKNOWN ELEMENTS ARE DISCOVERED THAT WOULD NECESSITATE MODIFICATION TO THE
ILLUSTRATED DESIGN.
3. PROTECT ALL ADJACENT PROPERTIES, THE GENERAL PUBLIC, AND ALL OTHER FACILITIES.
SHOULD DAMAGES OCCUR, CONTRACTOR SHALL REPAIR IMMEDIATELY AS DIRECTED BY THE
ENGINEER. CONTRACTOR IS FINANCIALLY RESPONSIBLE FOR ALL REPAIRS, AND REPAIRS
ARE TO BE PERFORMED TO THE GOVERNING MUNICIPALITIES APPROVAL.
4. UTILIZE SIGNS, BARRICADES, FLAGMEN OR GUARDS AS REQUIRED TO ENSURE THE SAFETY
OF ALL VEHICULAR AND PEDESTRIAN TRAFFIC DURING ALL CONSTRUCTION ACTIVITIES.
5. THE CONTRACTOR SHALL BE RESPONSIBLE FOR LAYOUT OF ALL WORK AS ILLUSTRATED ON
PLANS. IF EXISTING CONDITIONS DIFFER FROM THOSE ILLUSTRATED ON PLANS, NOTIFY THE
ENGINEER PRIOR TO CONSTRUCTION.
6. PRIOR TO BEGINNING CONSTRUCTION, THE GENERAL CONTRACTOR SHALL BE RESPONSIBLE
FOR VERIFYING THAT ALL REQUIRED PERMITS AND APPROVALS HAVE BEEN OBTAINED FROM
ALL REGULATORY AUTHORITIES.
7. THE CONTRACTOR SHALL MAINTAIN THE SITE IN A MANNER SO THAT WORKERS AND THE
PUBLIC SHALL BE PROTECTED FROM INJURY, BY OSHA STANDARDS.
8. THE ENGINEER AND GOVERNING DEPARTMENT SHALL BE NOTIFIED PRIOR TO ANY
INTERRUPTION OF EXISTING UTILITIES, EXISTING DRIVEWAYS, OR EXISTING ROADWAYS TO
ENSURE CONTINUOUS SERVICE AND TO KEEP PUBLIC UTILITY INTERRUPTIONS TO A
MINIMUM.
9. IF A UTILITY IS TO BE RELOCATED, TEMPORARILY DISABLED, OR ELIMINATED, THE ENGINEER
SHALL BE NOTIFIED IN ADVANCE BEFORE UTILITY WORK CAN BEGIN. ALL PROPERTY
OWNERS AFFECTED BY A UTILITY RELOCATE, TEMPORARY DISABLING, OR ELIMINATION
SHALL BE GIVEN A WRITTEN NOTICE NO LESS THAN 14 DAYS PRIOR TO THE DESIRED
UTILITY WORK DATE.
10. ALL WORK SHALL COMPLY WITH ALL APPLICABLE CODES, REGULATIONS, AND/OR LOCAL
STANDARDS IMPOSED BY THE GOVERNING MUNICIPALITY, NCDEQ, NCDOT AND/OR ANY
UTILITY OWNERS SPECIFICATIONS FOR THOSE UTILITIES AFFECTED.
11. THE CONTRACTOR SHALL CONTACT THE APPROPRIATE AGENCY FOR THE EXACT FIELD
LOCATIONS OF ALL WATER, SEWER, ELECTRIC, TELEPHONE, TELEVISION, OR ANY OTHER
UNDERGROUND OR OVERHEAD UTILITY BEFORE STARTING CONSTRUCTION. IT SHALL BE THE
RESPONSIBILITY OF THE CONTRACTOR TO FIELD VERIFY THE LOCATION AND DEPTH OF ALL
UTILITIES WITHIN THE LIMITS OF THIS PROJECT.
12. THE CONTRACTOR AND ALL SUBS ON SITE SHALL MAINTAIN THE SITE IN A MANNER TO
PREVENT ANY TRASH OR SEDIMENT FROM LEAVING THE SITE. ALL VEHICLE TIRES SHALL
BE CLEANED/WASHED TO PREVENT CARRYING SEDIMENT OFF SITE.
13. THE CONTRACTOR MUST INSTALL ALL UTILITIES (STORM, WATER, SEWER, ETC.) PER ALL
MATERIAL MANUFACTURERS SPECIFICATIONS. ANY ITEM NOT INSTALLED PER
MANUFACTURERS SPECIFICATIONS SHALL BE THE LIABILITY OF THE CONTRACTOR.
14. THE CONTRACTOR SHALL BE RESPONSIBLE FOR PERFORMING AND FOLLOWING UP WITH THE
LOCAL MUNICIPALITY REGARDING ANY INSPECTIONS DURING OR NEAR COMPLETION OF THE
PROJECT (CITY OF LEXINGTON PUBLIC WORKS- 336-248-3930).
15. THE CONTRACTOR SHALL PERFORM PRE -TESTING OF ALL MANHOLES AND MAIN
EXTENSIONS PRIOR TO CONTACTING THE ENGINEER OF RECORD AND CITY OF LEXINGTON
STAFF TO ENSURE ADEQUATE INSTALLATION. THE CONTRACTOR WILL BE BILLED HOURLY,
BY THE ENGINEER OF RECORD, FOR MULTIPLE FAILED TESTING ATTEMPTS.
16. ALL PIPES/MANHOLES SHALL BE TESTED PER THE SPECS. ON SHEET C-3.
17. CONTRACTOR IS RESPONSIBLE FOR ENSURING NO DAMAGES TO THE HIGH PRESSURE GAS
MAIN THAT FALLS WITHIN PROXIMITY OF THIS PROJECT.
18. CONTRATOR IS RESPONSIBLE FOR ENSURING NO DAMAGES TO THE 8" AC WATER LINE
THAT FALLS WITHIN PROXIMITY OF THIS PROJECT.
19. CONTRACTOR SHALL CONSIDER USING AS TALL OF A TRENCH BOX THAT THEY CAN OBTAIN
TO REDUCE BENCH BACK WIDTHS AND ASPHALT/UTILITY IMPACTS.
20. CONTRACTOR RESPONSIBLE FOR COMPACTION IN ADEQUATE LIFTS TO OBTAIN COMPACTION
REQUIREMENTS SET FORTH BY NCDOT.
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DRAWN BY:WK
CHECKED BY:WK
DATE:6/12/2020
PROJECT NO.:KBBQ-1
JOB NO.:27
SCALE:N/A
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CENTER OF PATCH
NOTE: FLEXIBLE MANHOLE CONNECTORS TO BE FURNISHED AS SPECIFIED
IN THE TECHNICAL SPECIFICATIONS. MAXIMUM DEFLECTION FOR
CONNECTOR IS 70 (12%). SLOPES GREATER THAN 12% MUST HAVE
CONNECTORS DESIGNED FOR HIGHER DEFLECTION,
MIN. 5"
WALL
ALL STAINLESS STEEL
EXPANSION RING
STAINLESS STEEL CLAMP
(2 REQUIRED FOR 15" V.C.
AND ABOVE)
FLEXIBLE MANHOLE CONNECTOR
MONOLITHIC
MANHOLE BASE
CITY OF WINSTON-SALEM
DEPARTMENT OF PUBLIC WORKS
ENGINEERING DIVISION
N.T,S. REVISED 3-1-17
\Dutc\Utllity\Utility Spec Drawings\C-16 flexible mh connector.dwg
Xx
EMBEDMENT
AREA
LPN I r��
`50� 11_
DETAIL "C C"-
MATCH GROOVES -
TOP OF COvFR
4 - 1" DIA.
ANCHOR HOLES
2 - 1/2" x 1 3/4" HEXHEAD,
STAINLESS STEEL BOLTS AT 1 B0�
COUNTERSUNK, BOLTS TO BE
TYPE 316 STAINLESS STEEL.
NOTE:TWO HOLES TO BE SPACED
OPPOSITE TO EACH OTHER IN
0 THE OUTER RING AS SHOWN.
(HOLES TO BE 1" DIAMETER)_
BOTTOM OF CCVER ��
NOTE:
1"R
RING AND COVER WILL
0
o
HAVE MACHINED SEAT
AND WILL CONFORM TO
L
ASTM A48, CLASS 35B.
RING AND COVER WILL
BE DESIGNED TO SUPPORT
.
AN H-20 WHEEL LOAD.
q T �@
PLAN
DETAIL "B B"
25 1 4"
MINIMUM AVERAGE WEIGHTS
RING 190 LBS.
3/4'
23 3/4"
COVER 120 LBS.
23 1/2-
310 LBS.
Cl
m ` T
M �
2
N
3 3/4 TIN
22 1/4"
4 3/a" 24 1 /2"
33 1/4"
SECTION
CITY OF WINSTON-SALEM
DEPARTMENT OF PUBLIC WORKS
ENGINEERING DIVISION
N.T.S. REVISED 3-1-17
:\Data\Utility\Utility Spec ❑rowings\C-18 mh ring & cover type 2.dwg
C-1
BEDDING REQUIREMENTS FOR SDR 26 PVC SEWER PIPE
N.T.S.
24" FOR 8" SDR 26 PVC PIPE
I� EXCAVATED TRENCH WIDTH �I
1/2" GRADE 60 STE
REINFORCEMENT
2' I 2'
EXISTING i
PAVEMENT
TCTAL WIDTH OF PAVEMENT CUT = WIDTH OF
SAW CUT TRENCH BOX + 4'
FO R PATCH
2" S9.5B
12 SUBGRADE
J:.
�yI l l
TRENCH BOX
MAXIMUM WIDTH 5'
r
i SUITABLE BACKFILL
(SEE NOTES)
ri l
ry
MIN MIN
PROPOSED
�iii4�44 1 UTILITY 1'
-
44 STABILIZATION 5TON
CIF REOUIRED RY ENGINEER]
SECTION A -A
CITY OF WINSTCN SALEM
DEPARTMENT OF PUBLIC WORKS
ENGINEERING DIVISION
N.T.S. REVISED 3-1-17
:\Data\Utility\Utility Spec Draw7ngs\C-20 mh step.dwg
PLASTIC PIPE SHOULD ALWAYS BE BURIED IN STRICT ACCORDANCE WITH THE ASTM STANDARD RELEVANT TO THE TYPE OF
\
PLASTIC PIPING SYSTEM BEING INSTALLED. THOSE STANDARDS ARE:
ASTM D2321 STANDARD PRACTICE FOR UNDERGROUND INSTALLATION OF THERMOPLASTIC PIPE FOR SEWERS AND OTHER
GRAVITY-FLOW APPLICATIONS.
ASTM D2774 STANDARD PRACTICE FOR UNDERGROUND INSTALLATION OF THERMOPLASTIC PRESSURE PIPING.
NOTE: IN ADDITION TO THESE STANDARDS, PIPE SHOULD ALWAYS BE INSTALLED IN ACCORDANCE WITH ALL LOCAL CODE
REQUIREMENTS.
14 - 30 FT OF DEPTH
INSTALLATION OF SDR 26 PVC SEWER PIPE
1. THE MINIMUM WIDTH OF THE TRENCH SHALL BE THE PIPE OD (OUTSIDE DIAMETER) PLUS 16 INCHES OR THE PIPE OUTSIDE
DIAMETER TIMES 1.25 PLUS 12 INCHES. THIS WILL ALLOW ADEQUATE ROOM FOR JOINING THE PIPE, SNAKING THE PIPE IN THE
6 INCH
TRENCH TO ALLOW FOR EXPANSION AND CONTRACTION WHERE APPROPRIATE AND SPACE FOR BACKFILLING AND
COMPACTION OF BACKFILL. THE SPACE BETWEEN THE PIPE AND TRENCH WALL MUST BE WIDER THAN THE COMPACTION
EQUIPMENT USED TO COMPACT THE BACKFILL.
2. BEDDING AND EMBEDMENT FOR SDR26 PVC GRAVITY SEWERS, 4-FT TO 14-FT IN DEPTH:
a. BEDDING SHALL CONSIST OF MINIMUM 4-INCHES OF NO. 67 OR NO. 78 STONE INSTALLED UNDER THE PIPE EXTENDING UP TO
THE SPRINGLINE.
b. BEDDING AND EMBEDMENT SHALL BE COMPACTED TO 95% STANDARD PROCTOR DENSITY.
c. CAREFUL ATTENTION SHALL BE PLACED ON COMPACTING EMBEDMENT UNDER THE HAUNCHES OF THE PIPE TO PREVENT ANY
POTENTIAL VOIDS.
SPRINGLINE
3. BEDDING AND EMBEDMENT FOR SDR26 PVC GRAVITY SEWERS, 14-FT TO 30-FT IN DEPTH:
PIPE ZONE
a. BEDDING SHALL CONSIST OF MINIMUM 6-INCHES OF NO. 67 OR NO. 78 STONE INSTALLED UNDER THE PIPE EXTENDING
4 - 14 FT OF DEPTH
6-INCHES ABOVE THE CROWN OF THE PIPE.
b. BEDDING AND EMBEDMENT SHALL BE COMPACTED TO 95% STANDARD PROCTOR DENSITY.
c. CAREFUL ATTENTION SHALL BE PLACED ON COMPACTING EMBEDMENT UNDER THE HAUNCHES TO PREVENT ANY POTENTIAL
VOIDS.
4. IF ROCK OR UNYIELDING MATERIAL IS ENCOUNTERED, A MINIMUM OF 6 INCHES OF BEDDING SHALL BE USED. BLOCKING
SHOULD NOT BE USED TO CHANGE PIPE GRADE OR TO INTERMITTENTLY SUPPORT PIPE OVER LOW SECTIONS IN THE
TRENCH.
5. BACKFILLING SHOULD BE PERFORMED IN LAYERS OF 6 INCHES WITH EACH LAYER BEING SUFFICIENTLY COMPACTED TO 85%
TO 95% COMPACTION.
6. A MECHANICAL TAMPER IS RECOMMENDED FOR COMPACTING SAND AND GRAVEL. THESE MATERIALS CONTAIN FINE -GRAINS,
SUCH AS SILT AND CLAY. IF A TAMPER IS NOT AVAILABLE, COMPACTING SHALL BE DONE BY HAND.
7. THE TRENCH SHOULD BE COMPLETELY FILLED. THE BACKFILL SHALL BE PLACED AND SPREAD IN UNIFORM LAYERS TO
PREVENT ANY UNFILLED SPACES OR VOIDS. LARGE ROCKS, STONES, FROZEN CLODS, OR OTHER LARGE DEBRIS SHALL BE
REMOVED. HEAVY TAMPERS OR ROLLING EQUIPMENT SHALL ONLY BE USED TO CONSOLIDATE THE FINAL BACKFILL.
8. TO PREVENT DAMAGE TO THE PIPE AND DISTURBANCE TO PIPE EMBEDMENT, A 2.0' DEPTH OF BACKFILL ABOVE THE PIPE
SHALL BE MAINTAINED.
TRENCHING & SHORING
N.T.S.
EXCAVATING AND BACKFILLING TRENCHES FOR ALL PIPE LINES (INCLUDING OPEN CUT ENCASEMENT): of two hundred (200) feet of water and/or sewer main trench at one time. Backfilling shall be completed at the end of
each day's work.
Screenings shall be placed on all paved roadways prior to beginning any trenching activities. Screenings shall be
placed on the affected pavement area as directed by the Inspector. All screenings shall be removed once backfilling All trench backfill under existing or proposed pavement, curb and gutter, sidewalk, and roadway shoulders shall be
has been completed. compacted to at least 95% of the maximum dry density as determined by AASHTO T99 and the NCDOT. The final
12" of subgrade under paved areas and under curb and gutter shall be compacted to 100% (see pavement repair
All excavation will be of one classification regardless of the nature of the material encountered, except for solid rock detail drawings). Cross country water lines or sanitary sewer outfalls shall have backfill compacted to 90% density
formation in trenches. Rock excavation will include the excavation of all solid ledge rock which cannot be removed by unless otherwise directed by the Engineer. Density tests by an independent testing lab are to be made as directed by
ordinary excavating equipment. All boulders greater than one cubic yard in size will also be considered rock the Inspector at the Owners expense.
excavation. Rock encountered in trenches will be uncovered by the Contractor in sections not less than fifty feet (50')
in length and the Engineer immediately notified in order to enable him to obtain a record of it. Rock removed without Suitable backfill shall be defined as loam, clay, sand, gravel or other materials satisfactory to the Engineer.
such record having been made shall not be paid for. Rock excavation shall be carried six inches (6") below the
bottom of the pipe. Rock excavation for manholes shall be carried six inches (6") below the bottom of the manhole. SHORING:
The trenches will be brought back to grade by the pipe laying crew with suitable material, properly compacted.
1. Follow all OSHA guidelines for safety. For shoring, field determine soil classification type.
All blasting operations will be conducted in strict conformance with the existing ordinances of Davidson County (or 2. Trench Boxes are intended primarily to protect workers from cave-ins and similar incidents. The excavated area
any other governing authority) and accepted safe practices relative to the storage and use of explosives. Blasting will between the outside of the trench box and the face of the trench should be as small as possible. The space
be done only by experienced personnel. Extreme care and precaution will be used to prevent injury to workmen and between the trench boxes and the excavation side are backfilled to prevent lateral movement of the box. Shields
to existing pipe, buildings or other structures either below or above the surface of the ground. Sufficient warning will may not be subjected to loads exceeding those which the system was designed to withstand.
be given to all persons in the area prior to blasting. The Contractor will be responsible for all damage due to blasting 3. Trench boxes are generally used in open areas, but they also may be used in combination with sloping and
operations. benching. The box should extend at least 18 in (0.45 m) above the surrounding area if there is sloping toward
excavation. This can be accomplished by providing a benched area adjacent to the box.
Trenches shall be carefully excavated to the proper grade so that it will not be necessary to fill-in under the pipe. Pipe 4. Earth excavation to a depth of 2 ft (0.61 m) below the shield is permitted, but only if the shield is designed to
shall be placed on a firm foundation so as to prevent subsequent settlement. The Contractor shall undercut and resist the forces calculated for the full depth of the trench and there are no indications while the trench is open
replace weak or saturated soils below the pipe trench with stabilization stone or other approved material, as directed of possible loss of soil from behind or below the bottom of the support system. Conditions of this type require
by the Engineer, to provide a firm foundation. Under no circumstances shall pipe be laid in water and no pipe shall be observation on the effects of bulging, heaving, and boiling as well as Surcharging, vibration, adjacent structures,
laid under unsuitable weather or trench conditions. etc., on excavating below the bottom of a shield. Careful visual inspection of the conditions mentioned above is
the primary and most prudent approach to hazard identification and control.
Trenches for pressure lines (water or sanitary sewer) will, wherever possible, have continuous grades between air
valves and blow offs or hydrants so as to avoid air pockets and will be of sufficient width to give room for properly
TYPE ri501L
TYPE Lx SOIL
makingthe joints. Trenches will be of such depth as to provide a minimum of 36 inches of cover above the to of all TYPE cso1L
) P p P Supported -of shielded Supported of shielded Supported of shielded
pressure lines unless otherwise approved by the Engineer. Vertically side-d lower portion Vertiaallgsided lower portion verticallgsided lower portion
Backfilling along the sides of the pipe and immediately above the pipe will be done by hand with extreme care. On T
support or :nicla Supp
ort ¢r ;hitld.7
`4''I'o t" riLicld
large pipe lines (12" and above), backhoes or other equipment may be used upon approval by the Engineer. In order sy:[cm I j ppsy [em a-n;laxi u •• .• J1
20' Maximum ; G' ivlsximum j 1 U2
3Id
to insure proper grade and alignment and to insure that backfill material is distributed under the pipeproperly,each T T
P P 9 9 P P I I I � I �`'
- - I ss••Nr,.
If
joint of pipe shall be backfilled to the center of the pipe and hand tamped as each joint is laid. From one (1) foot L
18" Min. t 18" Min.
above the top of the pipe to the subgrade, material containing rocks or stones up to 2 inches in their greatest ---
dimension may be used. Otherwise, rock shall not be used as backfill. The Contractor shall not have open in excess
SAW CUT FOR
TRENCH BOX
SAW CUT
-OR PATCH
SAW CUTS TO BE PERPENDICULAR
TO SURFACE, FACE OF CUTS TO
BE NEAT, CLEAN AND STRAIGHT.
TACK COAT TO BE APPLIED TO
ALL EXISTING ASPHALT SURFACES
PRIOR TO PLACING NEW ASPHALT.
UNDISTURBED
SOIL
THE SUITABLE BACKFILL SHALL DE MADE IN 6" LAYERS AND SHALL DC COMPACTED TO AT LEAST 9s% Or
STANDARD DENSITY (AASHTO METHOD T-99). EACH LAYER MUST BE THOROUGHLY TAMPED BY A
MCCIIANICAL TAMP BEFORE THE NEXT LAYER fS PLACED. ALL ASPHALT PAVEMENT REPLACED SHALL DE IN
ACCORDANCE WITH THE MOST CURRENT N.C.D.O.T. STANDARD SPECIFICATIONS. STONE BASE DENSITY AND
SUBGRADE DENSITY SHALL BE 10C%.
CITY OF WINSTON-SALEM
DEPARTMENT OF PUBLIC WORKS
ENGINEERING DIVISION
N.T.S. REVISED 3-1-17
C-20 R:\Data\Utility\Utility Spec Drawings\C-3 asphalt dw repa!r.dwg
4' OR 5' MANHOLE
`I �ONCRETE TROUGH TO BE BUILT TO DIRECT
'-0" OR 5'-0' I / FLOW FROM 5" CONNECTION TO EFFLUENT PIPE.
SDR 26 PVC GASKETED PIPE
MIN. 1% SLOPE MAX_ 2% SLOPE
VFLEXIBLE MANHOLE JOINTS SHALL BE
CONNECTOR RUBBER GASKET
CITY OF VVINSTON-SALEM
DEPARTMENT OF PUBLIC WORKS
ENGINEERING DIVISION
n
I
C-3
FLAT TOP SECTIONS USEDJK
SHALL BE 'DESIGNED TOFOUR
FOOT MANHOLE TO BE
SUPPORT AN H-20 WHEELUSED
FOR PIPE WITH A DIAMETER
LOAD. USE OF A FLAT TOOF
LESS THAN 18" UNLESS OTHER -
MUST BE APPROVED BYWISE
SPECIFIED BY THE ENGINEER,
THE ENGINEER.SEE
DETAIL DRAWING FOR
"MANHOLE RING AND CO
VETYPE
1" AND "MANHOLERING
AND COVER TYPE 2"PRECAST
CONCRETE MANHOLES SHALL
TYPE 2 TO BE BOLTED
CONFORM TO ASTM C-478. MANHOLESTO
GONE W/ 4-TYPE 304MUST
BE ALLOWED TO CURE A MIN -
STAINLESS STEEL
IMUM OF 3 DAYS PRIOR TO SHIPMENTEXPANSION
ANCHORS
THE DATE OF MANUFACTURE AND NAME
(3/4" HILTI KWIK BOLT IIOF
MANUFACTURER SHALL BE ON ALL
OR APPROVE❑ EQUAL)
MANHOLE SECTIONS. CONCRETE SHALL
BE 4,000 PSI. CIRCUMFERENTIAL
REINFORCEMENT WILL BE PLACED AT A
MINIMUM OF 0.12 SO. INS. PER
MAX. 3 COURSES OF BRICLINEAL
FOOT.
(8 1N.) OR 2-5" GRADE
RI NGS MAY BE ADDED
VERTICALLY.
(NOT ALLOWED WITH1-
TYPE 2 RING & COVER) 2'-0"
BUTYL RUBBER GASKET UNDER RING
AND ALL GRADE RINGS
O-RING OR BUTYL RUBBER
GASKET IN ALL JOINTS. JOINT'S ON
SEE DETAIL DRAWING OUTSIDE OF MANHOLE TO BE
WRAPPED WITH 6" WIDE BUTYL
FOR "POLYPROPYLENE ADHESIVE TAPE. ALL LIFT HOLES
MANHOLE STEP" SHALL BE COMPLETELY FILLED WITH
MAX 24" FROM NON -SHRINK GROUT AFTER
TOP OF RING & MANHOLE IS SET.
COVER TO TOP STEP -
TOP STEP MUST BE
IN CONE SECTION RISER SECTION
16" D.C.
5"
ECCENTRIC SEE DETAIL DRAWING FOR
CONE SECTION 4'-fl" "FLEXIBLE MANHOLE CONNECTOR"
STEPS NOT TO BE PLACED
{
OVER INFLUENT OR EF-
''
FLUENT PIPES. STEPS TO
ii. MAX_22"
BE ALONG VERTICAL WALL
SURFACE FROM SHELF TO
TOP OF CONE.
NOTE: DO NOT BOLT RING
r_ ' .." ' `` - 6'
BASE SECTION
TO CONE IF DIRT OR
CONCRETE SURROUNDS
MIN. 6" #57 STONE
THE RING (EX: YARD.
UNDER MH BASE
SHOULDER' ETC.)
CITY OF WINSTON-SALEM
DEPARTMENT OF PUBLIC
WORKS
ENGINEERING DIVISION
N.T.S. REVISED 3-1-17
R:\Dcta\UtiIity\UtiIity Spec C
SAND:
All sand used in mortar or as fine aggregate in concrete will be clean, sharp, practically free from loam, clay
or vegetable mater and so graded as to insure workability and water tightness when mixed with other
-BRASS CLEANOUT ingredients. Sand will conform to ASTM C33 and when mad into mortar will have a compressive strength at
SCE DETAIL DRAWING FOR "JINCH
RESTAURANT SEWER CCNPdEC7 and 28 days of not less than 100 percent of mortar made with standard sand. Independent laboratory
tests will be submitted for approval of the Engineer.
4 D.I. DOUBLE HUB_ SCREENINGS:
11 -111 11 I -i i 1
- - Screenings shall be placed on all paved roadways prior to beginning any trenching activities. Screenings
"I
IIFII�i i IIIIII1 ,III-'
shall be placed on the affected pavement area at a depth of inch. All screenings shall be removed once
backfilling has been completed.
ON MUST Cp
LrCILITY PR69*O
TFc1�9 �y
CUO
BEFORE YOU DIG!
STONE (MISCELLANEOUS): CALL 811 N.C. ONE -CALL CENTER
4" SDR 26 PVC IT'S THE LAW!
CASKFTFD PIPE Miscellaneous stone shall be ABC stone. This stone shall be used for driveways, streets, parking lots, etc.
ALL IGHTS RESERVED. THIS DRAWING IS THE
STONE (STABILIZATION): PRO ERTY OF WK ENVIRONMENTAL PLLC. AND
Stabilization stone shall be 5 or 57 stone. This stone shall be used in unstable soil, under or around e, S LL NOT BE REPRODUCED IN WHOLE OR IN
pipe, PART WITHOUT PERMISSION.
under manholes, etc.
PLUG AS PER 4" -
RESTAURANT SEWER
CONNECTION DETAIL
DRAWING
4"
6°
6"
6" X 4" SDR 26 PVC
GASKLTED COME31NATION
'AYE AND 1/8 BEND.
CAST IRON SOIL PIPE AND FITTINGS:
All cast iron soil pipe and fittings will conform to ASTM A74 and be classified as SV (service weight). Single
or double hub is acceptable. No -hub pipe shall not be used. All pipe and fittings shall conform to ASTM
C564. 4" x 4" combination Wye and eighth bends shall be short pattern -Fig. No. SV-32 by Charlotte Pipe
and Foundry (or approved equal). 4" cleanouts shall consist of a 4" service weight cast iron ferrule (with 3"
iron pipe size tap) and 3" brass plug. The plug shall have a low raised square head (Southern Code).
Cleanouts shall be Part Number 184 by Jumbo Manufacturing Company (or approved equal).
CEMENT:
All cement used on the work will meet ASTM C150. Brand will be subject to the approval of the Engineer
upon submission of typical test reports. Type I or II may be used in all work. Where high early strength
concrete may be required, Type III cement may be used with permission of the Engineer.
CONCRETE:
All concrete will be made of cement, water and aggregate as herein specified and will further be in
accordance with the following definite requirements for the various classes.
A design of the mix made by an independent laboratory for each class of concrete will be submitted to the
Engineer for approval before concreting is started. During the progress of work, standard compressive
strength test specimens will be made, cured in accordance with ASTM C31 and tested by an independent
testing laboratory in accordance with ASTM C39. At least three cylinders will be made for each test. Tests
will be submitted for each 150 cubic yards or fraction thereof for each class of concrete used, one test will
be furnished for each 100 cubic yards and for all over 500 cubic yards, one test for each 500 cubic yards.
Should there be any evidence that concrete is not up to standard, a strength test may be required at any
time.
Class AA concrete will have minimum 28-day compressive strength of 4,500 pounds per square inch and a
slump not to exceed 3-1/2 inches.
LIME:
Lime for cement mortar will meet ASTM C207, Type N
MANHOLE RINGS AND COVERS (TYPE 2):
Rings and covers shall meet all specifications for Type 1 rings and covers and shall conform to the detail
drawing for Type 2. Rings and covers shall be manufactured by one of the following:
U.S. Foundry & Manufacturing Corp. ( Ring - Part No. 669-2; Cover - Part No. KL-2)
MANHOLE STEPS:
All manhole steps shall conform to current OSHA standards and ASTM C478. The approved step is shown
on a detail drawing. All other steps must be approved by the Engineer prior to being installed.
POLYVINYL CHLORIDE (PVC) SANITARY SEWER PIPE AND FITTINGS:
PVC sewer pipe in sizes 4" - 15" shall meet the requirements of ASTM D3034 "Standard Specification for
Type PSM Poly (Vinyl Chloride) (PVC) Sewer Pipe and Fittings". The standard dimension ratio (SDR) shall
not exceed 26 unless specifically authorized by Engineer.
The pipe shall be made and joined with an integral bell, bell -and -spigot rubber gasketed joint. Each integral
bell joint shall consist of formed bell complete with a single rubber gasket. Gaskets shall conform to ASTM
F477 and shall meet ASTM D3212 "Standard Specification for Joints for Drain and Sewer Plastic Pipes
Using Flexible Elastomeric Seal". No solvent cement joints will be permitted in field construction except as
may specifically be authorized by Engineer. Fittings for gravity PVC sewer pipe shall be fabricated from pipe
meeting the respective ASTM/PVC pipe standard or molded PVC. The wall thickness of the waterway and
bell of molded fittings shall be no less than the 10 respective minimum thickness for the equivalent pipe. All
fittings shall be compatible with the pipe to which they are attached.
All PVC sewer pipe shall have a minimum pipe stiffness that equals or exceeds 46 lbs./in-in and shall be
furnished in laying lengths of 13' minimum with markings in accordance with the applicable ASTM standard
specification marking. Intervals shall not exceed 5 feet.
SEWER CONNECTIONS:
Sewer connections shall be installed as shown on detail drawings. Wyes will not be allowed within 10 feet
of a manhole. If more than one bend is needed ( Ex: bored sewer connection), the road shall be open cut
and the connection installed properly. Connections into manholes will require a flexible sleeve at the
manhole. Connections into manholes must be at least 6" from the nearest manhole step. Sewer
connections shall be a maximum of 75 feet from the sewer main to the cleanout.
SEWER PIPE DEFLECTION:
The Engineer shall require deflection testing to be performed no sooner than 30 days after the backfilling of
each section to be tested. If the test section fails the test for excessive deflection, the Contractor shall repair
or replace all defective materials and/or workmanship at no additional cost to the governing authority.
Deflection tests should be conducted using a go/no-go mandrel. The mandrels outside dimension shall be
sized to permit no more than 5.0 percent deflection. The percent deflection shall be established from the
base inside diameter of the pipe as measured in compliance with ASTM D 2122 "Standard Test Method of
Determining Dimensions of Thermoplastic Pipe and Fittings. The mandrel shall be approved by the
engineer prior to use.
VACUUM TESTING OF MANHOLES:
Each manhole constructed by the Contractor shall be vacuum tested by the Contractor after assembly of
the manhole. The test shall be conducted in accordance with ASTM C-1244. The test shall be performed
after all grade rings and rings and covers have been installed. After the testing equipment is in place, a
vacuum of 10 inches of mercury shall be drawn on the manhole. The time for the vacuum to drop to 9
inches of mercury must be greater than the minimum time listed below:
MINIMUM VACUUM TEST TIME (Seconds)
Manhole Depth 4.0' Manhole
0 -10, 60 sec.
10' - 15' 75 sec.
The Engineer shall be present during the entire testing process. Any repairs to manholes, which fail the
vacuum test, must be made on the inside and outside of each manhole.
ACCEPTANCE TESTING:
After the pipeline is completely backfilled and before being placed into service, a low-pressure air test will
be conducted by the Contractor in accordance with ASTM F-1417-92 as modified herein. Each section of
pipeline (including connections) between manholes will be tested by plugging the upstream manhole and
the downstream manhole. Air is added to the line until the pressure is 4.0 psi. If the pressure drops more
than 1.0 psi during the time shown in the chart below, the line has failed the test. If the top of the pipe to be
tested is below the ground water table, an infiltration test may be required. Infiltration shall not exceed 50
gallons per inch diameter per mile of pipe per 24 hours. An obvious leak in any section will be corrected
even if the section passes testing. The Engineer must be present during the entire testing process. Any
work done without his supervision will not be accepted. Air testing will only be required for pipelines 24" and
smaller. Larger pipelines will require infiltration and/or exfiltration testing. Exfiltration limits shall be the same
as infiltration.
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DRAWN BY:WK
CHECKED BY:WK
DATE:6/12/2020
PROJECT NO.:KBBQ-1
JOB NO.:27
SCALE:N/A
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