WQ0041771_Application (FTSE)_20200622

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T,0300— FAS'i" rRACIC SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FT'A 04-16 & SUPPORTING DOCUMENTATION
Application Number ..........._ po be cmnpleted by DWR)
All items must he completed or the anolication will be returned
1. APPLICANTINFORMATION:
I, Applicant's mane: City of High Point (company, municipality, IIOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authol ity's name: Terry Houk per 15A NC AC02'I _20I,06 11)
tei, uapartment of
Title: Public services Director Environmental Quality
4. Applicant's mailing address: PO Box 230 Received
City: I'ligh Point State: NC Z.ip:27261 JUN 2 2 2020
5. Applicant's contact informatiott:
Phone number: [phone] Email Addrry h ess ferouk@hieitpointnc cov Winston-Salem
Regional Office
IL PROJECT INFORMATION:
L Project mane: Waterford Sprin s Sgbdivision
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Pcrmit/Project
if a modification, provide the existing permit number: WQ00_ and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00_
3. County where project is located: G tilford_Coulity
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.0418440 Longitude:-79.975106°
5. Parcel ID (if applicable): 169942
(or Parcel ID to closest downstrenm sewer)
Ill. CONSULTANTINFORMATION:
Professional Engineer: Thomas R. Glover Jr, PI License Number: 27465
Firm: Jamestown Engineet;tl Grou 1_, nc.
Mailing address: 117 E. M@in Street. P.O Box 365
City: Jamestown State: NC Zip: 27282-__
Phone number: [phone] Email Address: r Ioye..rrA'amesto�yttengineedngcoml
1V. WASTEWATER TREATME;NTFACILITY(WWTF)INFORMATION:
Facility Name: High_Point F. qst ,; Je'freatment PLTnt Permit Number: NC 0024210
Owner Name: City of Hi b Point
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than W WTF):
I. Permit Number(s): WQ
System Wide Collection System Permit Number(s)(if applicable): WQCS,_
Owner Nante(s):
FORM: FTA 04-16 Page I of5

VI. GENERAL, REQUIRFAEN'Ps
I. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenionce and Necessity been attached?
❑ Yes ❑No MN/A
2. 1 'the Applicant is a Developer of lots to be sold, has a'De lopei':, Operati,gn 11 A, eenwnt (FORM:, f)I?V) bcen attached?
❑ Yes ONO MN/A
3. If the Applicant is a I lumgll'rnpci,y Ownu Asgociefion, lmi all Operational, Ailceroelt (FOR NJ: I10A been attached?
❑ Yes ❑No MN/A
4. Origin of wastewater: (check all that apply)
M Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wasll
❑ Residential Leased ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / clay care ❑ Medical / dental / veterinary facilities ❑ Swimming fool /Clubhouse
❑ Food and drink facilities ❑ C:hurch �
ElBusinesses / offices / factories ❑ Swimming I ltBackwash
❑ Nursing Home ❑Other (Explain
n in n Attachment)
chment)
5. Nature of Wastewater: 100 % Domestic/Commercial % Commercial
_ % Industrial (Sec 15A NCAC 02T .01103(),0))
"Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 1,5A NCAC„02T 01140? M Yes ElNo
➢ If Yes, provide a cmw of flow reduction apmroval letter
7. Sunupm'ize wastewater gencratecl by project:
Establishment ( Type see (12'I',0114 4M)
( -__
Single family homes with 4 bedrooms/unit
Daly Design Flow °'� --
90 gal/day/bedroom
No. of Units
42
flow ,.
15,120 GPD
gal/
GPD
gal/
GPD
gal/
GPD
- gal/
GPD
----- .....__... gal/
7ala!
GPD
15,120 GPD
a See 1 5ANC'AC' 02f �, I I'�L�(tl],.(c)t 1) and (e)(2) for caveats to 5vnstewater design flow tales (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located new high public use
areas; and residential property located south or cast of the Atlantic Intracoastal Waterway to be used as vacation rentals
as defined in G.S. 42A}).
b Per 15A NCAC 02T .01 14(c), design flow rates for establishments not identified [in table 15A NCAC 02] zo I 1-11 shall
be determined using available flow data, water using f istures, occupancy or operation pattoms, and other measured data.
Wastewater gencratecl by project:.15,120 GPD (per ISA NCAC 02'1 to I It)
Y Do riot include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where now 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 uo new flow expected
❑ Other (Explain): —
FORM: F"FA 04-16 Page 2 of 5

VIL
GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
Vill
I. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8"
2,264' +/-
SDR-26
8"
198'+/-
DI
➢ Section 11 & 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
I. Pump station number or name: NA
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: - °
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
5. Summarize the force main to be permitted (for this Pump Station):
feet total dynamic head (TDH)
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B):
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
�A
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 .0200 & 15A NCAC 02T .0305(Q):
® Yes ❑ No
I. Does the project comply with all separations found in 15A NCAC 02T_0305 fL& (g)
➢ I SA NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
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 11 impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-1 or WS-V), B, SA, ORW, HOW, or SB from normal
high water (or tide elevation) and wetlands (see item IX.2)
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
An swimmin ools
10 feet
Final earth grade (vertical)
36 inches
➢ 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(fl cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
➢ If noncompliance with 02T.0305(f) or (g), see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No
➢ See the Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with all setbacks found in the river basin rules per 15A NCAC 02B .0200? ® Yes ❑ No
➢ This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project comply with an individual 404 Permit or any 401 Certifications? ® Yes ❑ No
➢ Wetland -related permits shall be requested, obtained, and adhered to for projects that impact wetlands or surface waters
➢ Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T 0105(c)(6) (additional permits/certifications)?
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 plaits, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.04021 "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ® No
➢ 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 -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
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?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents
for review. Anoroval of the reauest is required prior to submittal of the Fast Track Application and supporting
documents.
2. Professional Engineer's Certification:
T2 attest that this application for
Engineer's name1rom Application Item 111.1
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 143-215.68, 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
3. Applicant's Certification per 15A NCAC 02T .0106(b):
that this application for
Authority's name & title
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. 1 understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a
condition of this permit be violated. I also understand that if all required parts of this application package are not completed
and that if all required supporting information and attachments are not included, this application package will be returned to
me as incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature:
Date:
1-,2aza
FORM: FTA 04-16 Page 5 of 5

Michael F. Easley, Govenor
William G. Ross Jr., Secretary
Noah Carolina Department of Environment and Natural Resources
June 27, 2007
Terry L. Houk, Asst, Director of Public Services
City of High Point
P.O. Box 230
High Point, North Carolina 27261
Dear Mr. Houk:
Careen Ff. Sullins, Director
Division of Water Cuali:y
_'N
I W:nstun.Safem
2eglonar rxrw
Subject: Eastside WWTP (N00024210)
& Westside WWTP (N('0024228)
Residential Flow Reduction Approval
Guilford County
On June 25, 2007, the Division of Water Quality received a flow reduction request for residences in
the city of high Point served by the Fastside WWTP (NC0024210) & the Westside WWTP
(NC0024228). 'The letter requests an allowable flow rate of 240 GPI) per 3 bedroom residential
connection based on the evaluated data from the WWTP and the active number of residential
connections.
The DMR data provided between January 2005 and December 2006 with doily readings taken during
November 2006 was analyzed by central office and regional office staff, Based upon this data the
Division hereby approves the use of 90 GPD per residential bedroom, with a minimum of 180 ffid
for one and two bedroom units in all applicable non-clischarge permit applications. Flow shall be
incremented by 90/gpd for each bedroom above two. Regardless of the adiusted.desien daily
wastewater flow rate at no time shall the wastewater flows exceed the effluent limits den
NPDES pennit for the treatment facility nr_exceed the capacity of the sewers tow rst ern of anynew
sewer extension or service connection s .
The residential water usage data include 13 residences with "0" flow. These residences were excluded
from the calculations. This resulted in an average daily flow of 150 GPD.
If you have any questions or comments regarding this matter, please contact Deborah Clore at
[phone] ext. 593 [email: Deborah.Gore@,)ncmail.netj,
Sincerely,
tCoIcea H. Sullins
cc: Steve Tedder, WinstonRegional Office \�
Steve Mauney, Winston-Salem Regional Office
NPDES Permit File No. NCO024228
PERCS Flow Reduction File
One Pretreatment, Emergency Response and Collection Systems Unit Internet http!/h2o.encnc.state.usrPERCS
NorthCarolina 1617 Mail Service Center, Raleigh, NC 27699-1617 An Equal opportunity Action Employer
Naturally
p Fi ra ly Telephone (gi%7335083 Fax [phone]%recycled/l0 postoonsumer paper

Public Services Department
Terry L. Houk
DIRECTOR
NORTH CAROLDWS INTERNATIONAL CITY""
June 4, 2020
NCDENR
Winston-Salem Regional Office
450 W. Hanes Mill Rd, Suite 300
Winston-Salem, NC 27105
Project: Waterford Springs Subdivision
Public Sewer
Applicant: City of High Point, NC
Dear Sir or Madam:
This is to acknowledge that the City of High Point will accept for treatment in the Eastside
Wastewater Treatment Plant (Permit #NC0024210), wastewater flow from the above referenced
project in the amount of 15,120 GPD, which will be discharged to facilities operated and
maintained by the City of High Point.
If further information is needed, please let me know.
Very truly yours,
L.
Terry L. H&k
Director of Public Services
TLH/tab
City of High Point, P.O. Box 230, 211 South Hamilton Street, High Point, NC 27261 USA
Fax:[phone] Phone:[phone] TDD:336.883.8517

ulvl•,Iou DI Water t w'irur(w
State of North Carolina
Department of Bilvirowncntal Quality
Division of Water Resources
Flow Tracking for Sewcr Extension Applications
(FTSH 10-18)
Application Number: 2020-153
Entity Requesting Allocation: City of High Point
Project Name for which flow is being requested: Waterford Springs
Mom Gems one FTSB oagr be required for a single profecl (fthe olvaer ojthe 1YIYTP Is not responsible for ell parnp
stations along the route of the piwimsed wastevnterflosv.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Pacility name: flaslside WWTP
It. WWTP Facility Permit th NC-0024210
c. WWTP facility permitted flow:
d. Estimated obligated flow not yet tributary to the WWTP:
e. WWTP facility's actual average flow:
f Total flow for this specific request:
g. Total actual and obligated flows to the facility:
It. Percent of permitted flow used:
Apporps are !D MGD
26.0000
0.7767
16.3917
0.0151
17.1835
66.09%
IL Complete this section for each pump station you are iponsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP,
(A)
(n)
(C)
(D)e(I54C)
(a)=(A-D)
Pump
Punip
Finn
Design
Approx.
Obligated.
Total Current
Available
Station
Station
Capacity'
Average
Current -
Not Yet
Flaw Plus
Capacgy5
(Namo or
Pennll
Daily Flaws
Avg Dolly
Tributary
Obligated
Number)
Number
(Finulpq,
Flow,
Dolly Plow,
Flow
MGD
MGD
hIGD
MGD
AIGD
MGD
eulraik
%Y00013051
5.0100
3.0160
0.8611
0.24"
1.1110
O."no
nivuAde
IYQODOn71
recurs
IIA940
I.I995
0.7591
9.1517
2.1255
•• IWA YWA MlA M/A MA
MA IWA IWA NWA M/A MA
NWA IWA MA MA MIA IWA
•'fire Firm 6 FlAcIty (dalgn nosy) ofAuy punlp 5lnnon Is denned as Ibe nmNI"anil panlpal flow unit
can be achieved with fire largest pmnp Inken out of service.
•" Design Average Flory Is the nrm capacity of the pmnp station divided by the perking lotto• (po not
less flints 2.5, per Section 2.02(A)(4)(c) ar tiro Mbdnuan Design Crilerin,
••a A Planning Assessment Addelubun shall be nitaelled for each pump sinllon located between the
project connection pohd and the WWTP where the Available Cnpnelly Its 0,
Downstream Facility Name (Sewer):
Downshemn Permit Number:
IWA IWA
IWA IWA
IWA MIA
Page 1 of 0 FTSE 10-18

III. Certification Statement:
Teny Houk, City of High Point certify to the best of my knowledge that the addition of
Public Services Director
the volume of wastewater to be permitted in this project has been evaluated along the route to the
receiving wastewater treatment facility and that the flow from this project is not anticipated to
cause any capacity related sanitary sewer overflows or overburden any downstream pump station
en route to the receiving treatment plant under normal circumstances, given the implementation
of the planned improvements identified in the planning assessment where applicable, This
analysis has been performed in accordance with local established policies and procedures using
the best available data. This certification applies to those items listed above in Sections I and II
plus all attached planning assessment addendums for which I am the responsible party.
Signature of this form indicates acceptance of this wastewater flow.
Signing
Page 2 of 6
Date
FTSE 04-16

SpWER OR
c` M1 u
" N
��v L
� N
U
V
t
i-

u
ob
S
jig
t+
m
o =
a
o"
vn a
ra .wa
v...n xe
w
cnM
N
N
h
o

JAMESTOWN ENGINEERING GROUP, INC.
AE,
CIVIL ENGINEERS &SURVEYORS
LAND PLANNING • MUNICIPAL CONSULTING
inc. 117 East Main Street • P.O. Box 365 • Jamestown, N.C. 27282
Telephone [phone] Fax [phone]
www j amestownengineering.com
June 19, 2020
Re: Sewer Line Extensions
Servicing Waterford Springs Subdivision
City of High Point
Guilford County
JEG File No. 2018-119
Mr. Justin Henderson
Division of Water Quality
NC Department of Environment and Natural Resources
450 W. Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
Dear Mr. Henderson:
NC Department of
Environmental Quality
Received
JUN 2 2 2020
Winston-Salem
Regional Office
With regards to the referenced project, and on behalf of the City of High Point, we have
enclosed one original and one copy of the following for your review:
- Fast Track Sewer Application
- $480.00 Application Fee
- Form FTSE 04-16 completed by the City of High Point
- 8.5" X 11" color USGS topographic map
- Street level map
Sewer service to the Waterford Springs Subdivision includes 42 residential homes
(15,120 gpd) located along Village Springs Drive, Village Springs Court and Waterford
Oak Court. Flow allocations are included in the attached FTSE 04-16 form for the
additional 42 residential lots. Upon completion of the sewer line installation and testing,
the system will be maintained by the City of High Point. The downstream sewer system
and treatment facility are owned by the City of High Point.
If there are any questions or additional information required, please call.
Sincerely,
JAMESTOWN ENGINEERING GROUP, INC.
omasGlover, Jr., PE
Enclosures