WQ0041772_Application (FTSE)_20200622

State of North Carolina
DWR Department of Environmental Quality
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
1. APPLICANT INFORMATION:
1. Applicant's name: City of Graham (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: Frankie Maness per 15A NCAC OYf .0106(b)
Title: Ci[v Manager NC Department of
4. Applicant's mailing address: P.O. Box 357,201 South Main Street. Environmental Quality
Received
City: Graham State: NC Zip: 27253 - _ FEB 10 2020
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail] Winston-Salem
Regional Office
II. PROJECT INFORMATION: "
1. Project name: Rogers Spring - Phase I B
2. Applicatien/Project status: ® Proposed (New Permit) ❑ Existing Permit/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: WQOO_
3. County where project is located: Alamance
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.029047° Longitude: -79 411 02°
5. Parcel ID (if applicable): 8883022350
(or Parcel ID to closest downstream sewer)
Ili. CONSULTANT INFORMATION:
1. Professional Engineer: Joseph V. O'Buch License Number: 029999
Firm: Green Mountain Engineering. PLLC
Mailing address: 7A Wendy Ct.
City: Greensboro State: NC Zip: 27409-_
Phone number: (33�6 294-9394 Email Address: vine «)greenmountuincngineers.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I. Facility Name: South Burlington W WTP Permit Number: NCO023876
Owner Name: City of Burlington
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
I. Permit Number(s): WQ N/A Downstream (Receiving) Sewer Size: 42 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS_
Owner Name(s): City of Graham
FORM: FTA 04-16 Pagel of 5

VI. GENERAL REQUIREMENTS
I. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑No ®N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM; DGV) been attached?
❑ Yes ❑No ®N/A
3. If the Applicant is a) tome/Property Owners• Association, [ins an Oncralional Agreement (FORM: I IOAI been attached?
❑ Yes [-]No ®N/A
4. Origin of wastewater: (check all that apply):
® Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool /Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: I0 % Domestic/Commercial % Commercial
_ % Industrial (See I SA NCAC 02T .0103(20))
"is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .01 14(t)? ❑ Yes ® No
➢ If yes, nrovide a cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.01141t))
Daily Design Flow °•s
No. of Units
Flow
Dwelling Unit - 3 bedroom
360 gal/day
23
8,280 GPD
gall
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
8,280 GPD
a See 15A NCAC OTT .01 14(b). (d). (c)(I) and (e)(2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0114] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: R 280 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

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
S
1,042
PVC
S
1,321
DIP
�$
DIP
�SIVNON
➢ Section 11 & III of the MDC for Permitting of Gravity Sewers contains information related to design c
➢ 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
Vill. PUMP STATION DESIGN CRITERIA (If Applicable)-02T .0305 & MDC (Puma Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: -
3. Design Dow 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) 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)
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(f)):
I. Does the project comply with all separations found in I SA NCAC 02T .0305(t) & (a)
➢ 15A NCAC 02T.0305(f) contains minimum senamtions that shall be nrovided 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-1 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, H()W, 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
Any swimming pools
10 feet
Final earth grade vertical
36 inches
➢ ISA NCAC 02T.0305(a) contains alternatives where separations in 021'.0305(t) cannot be achieved.
➢ "Stream classifications can be identified using the Division's NCSurface Water Classifications w•ebnaae
➢ If noncompliance with 02T.0305(I) or (R). 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 ISA NCAC 0211.0200? ® Yes ❑ No
➢ This would include Trout Buffered Streams per 15A NCAC 213.0202
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 ISA NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0105(e)(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 ISA NCAC 021'.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 ® 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:
I. Does the submitted system comply with 15A NCAC 021, the Minimum Design Criteria for the Permitting of Point) 4talions
and Force Mulns flatest version), and the Gravity Sewer Minimum Design Criteria flatesl version) as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Altemative Design Request application (VADC 10.14) and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Amplicatlon and supporting documents
2. Professional Engineer's Certification:
1, J05*11// V 09UCN X.E. attest that this application for
name from Anolication Item Ill.I
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:
3. Applicant's Certification per 15A NCAC 02T.0106(b):
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 subject 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: Date: ld ` S ^ /I
FORM: FTA 04-16 Page 5 of 5

M,isiun of Water Re=,our,, ,,,
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 Graham
Project Name for which flow is being requested: Rogers Springs -Phase IB
More than one FTSE maybe 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. W WTP Facility Name: City of Graham Collection System
b. W WTP Facility Permit #: _ _W_QCS 00065
All flows are in MGD
c. W WTP facility's permitted flow 0.500 Allocation to COB
d. Estimated obligated flow not yet tributary to the W WTP 0.061 to COB
e. W WTP facility's actual avg. flow 0.202 to COB
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
It. Percent of permitted flow used
.00828
.271680 to COB
54.3%
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 W WTP:
(A)
(B) (C) (D)=(B+C)
(E)=(A-D)
Design
Obligated,
Pump Pump Average
Approx. Not Yet Total Current
Station Station Firm Daily Flow**
Current Tributary Flow Plus
(Name or Permit Capacity, * (Firm / pt),
Avg. Daily Daily Flow, Obligated
Available
Number) No. MGD MGD
Flow, MGD MGD Flow
Capacity***
* 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 W WTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): Burlington's Little Alamance Creek OF
Downstream Permit Number: N/A
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Frankie Maness 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.
Official Signature
C,')(;�e `" 14 k
Title of Signing Official'
Page 2 of 6
s- /e
Date
FTSE 10-18

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE 10-18)
Enity Requesting Allocation City of Burlington
Project Name for which flow is being requested: Rogers Springs Phase 1 B
More than one FTSE-10107 may be required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewaterflow.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: South Burlington WWTP
b. WWTP Facility Permit #; NC0023876
All flows are in GPD
c. WWTP facility's permitted flow 12,000,000
d. Estimated obligated flow not yet tributary to the WWTP 1,617,923
e. WWTP facility's actual avg. flow 8,752,000
f. Total flow for this specific request (8,280) Graham 0
g. Total actual and obligated flows to the facility 10,369,923
h. Percent of permitted flow used 86.4%
11. Complete this section for each pump station you are responsible for along the route of this
proposed wastewater flow.
List pump stations located between the project connection point and the WWTP
(A)
(B)
(C)
(D)=(B+C) (E)=(A-D)
Design
Obligated,
Average Daily
Approx.
Not Yet
Total Current
Pump Station Firm Flow**
Current Avg.
Tributary
Flow Plus
(Name or Capacity, * (Firm/pf),
Daily Flow,
Daily Flow,
Obligated Available
Number) GPD GPD
GPD
GPD
Flow Capacity***
None
* The Firm Capacity of any pump station is defined as the maximum pumped flow that
can be achieved with the largest pump taken out of service.
** Design Average Daily Flow Is the firm capacity of the pumpstation divided by a
peaking factor (pf) not less than 2.6.
*** A Planning Assessment Addendum shall be attached for each pump station
located between the project connection point and the W WTP where the Available
Capacity!; 0.
Downstream Facility Name (Sewer) : Little Alamance Creek Outfall
Downstream Permit Number: unknown
1 of FTSF MIA

III. Certification Statement:
1, W. Todd Lambert, P.E. certify to the best of my knowledge that the addition of the
volume o wastewater to a 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 asssessment 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 trea he proposed new wastewater.
Signing OXcial Signature Date
City Engineer
Title of Signing Official
2 of 2 FTSE 10-18

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[e-mail]
From: Fertenbaugh, Christyn L <[e-mail]>
Sent: Monday, June 08, 2020 6:48 PM
To: [e-mail]
Cc: Henderson, Justin L
Subject: RE: [External] Rogers Spring - Phase 1 B , VADC
Hello,
Since a separate application is not being submitted to cover the siphon, it must be written into a permit in order for it to
be authorized for construction and operation upon certification. Therefore, if a majority of the project meets the MDC
(which it does), it may be Fast Tracked and the variance will be written directly into the permit. I apologize that there
was some earlier miscommunication that resulted in the previously submitted Fast Track application being returned —
typically, variance requests should be submitted (and approved if possible) prior to permit application to avoid
delays/issues with the permitting process, but we do occasionally allow concurrent requests to speed the process.
Olease submit a new Fast Track applicatia that includes all components of the system to be installed, including the
siphon — please list the lengths of gravity line associate with the siphon as separate line items in the application and note
them as the siphon structure. Please note that any additional information requested as part of the variance review shall
constitute a request for additional information for the permit application in accordance with 15A NCAC 02T.0107, as the
permit cannot be issued without approval of the alternative design for the siphon. Therefore, issuance of the permit will
be on hold until all additional information is received for the variance.
If you have any questions regarding the above, please let me know. Thanks!
Christyn L. Fertenbaugh, P.E.
Environmental Engineer
PERCS Unit
Division of Water Resources
Department of Environmental Quality
**Subscribe to Collection Svstem & Sewer Permittina Updates**
919-707-3625 — Office
919-807-6489 — Fax
christvn.fertenbaughna ncdenr.gov
Mailing: 1617 Mail Service Center
Raleigh, NC 27699-1617
Physical: 512 N. Salisbury Street. Rm. 925S
Raleigh. NC 27604-1170
Email correspondence to and from this address is subject to the
North Carolina Public Records Low and may be disclosed to third parties.
From:[e-mail] [mailto:[e-mail]]
Sent: Monday, June 8, 2020 2:14 PM

Green Mountain Engineering, PLLC Civil Engineering Consultants
Project Narrative
For
Rogers Spring — Phase 1B
Located in Graham, NC
January 23, 2020
To Whom It May Concern:
N C Department of
Environmental Quality d
Received
FEB 10 2020
Winston-Salem
Regional Office
Rogers Spring is a proposed 166 unit +/- single family subdivision. The Project is
being phased into multiple parts. The sewer outfall serving Phase 1B of this subdivision
will tie into an existing 42" sewer main along an outfall following Little Alamance
Creek. Approximately 2,664 linear feet of new 8 inch sewer mains with 23 new services
will connect to the existing 42" main for Phase 113. For Phase 113, a total of 23 new
residences are planned for this subdivision.
The design and plan review was done in accordance with NCDEQ's Gravity
Sewer Minimum Design Criteria and the City of Graham's standards and specifications.
The siphon was designed in accordance with the "Recommended Standards for
Wastewater Facilities", known as the Ten State Standards, Chapter 30, Section 35 -
Inverted Siphons. Work on the sewer installation is planned to begin in spring of 2020.
Please contact me if you require additional information. You can reach me via email
[e-mail] or by telephone [phone] at your convenience.
Respectfully submitted,
Jordan . Yo , E.I.
Green Mountain Engineering, PLLC
7A Wendy Court - Greensboro, NC 27409 - [phone]
Page 1 of 1

Green Mountain En
PLLC
Civil
To: NCDEQ — Water Quality Section
Address: 450 W. Hanes Mill Rd — Suite 300., Winston-Salem, NC 27105
From: Jordan D. Young, E.I., Green Mountain Engineering, PLLC
oate: 2020-06-18
Re: Rogers Spring — Phase 1 B
Messages
of
3lity
JUN 19 2020
Winston-Salem
Regional Office
Attached please find application packages for sewer extension off Rogers Rd. near Lacy
Holt Rd. to serve 23 residential homes in Phase 1 B of the Rogers Spring Subdivision.
Included are two (2) copies of the Application Package, and one (1) check for $480.00.
Please note, the applicant has requested variances to the Minimum Design Criteria due to
a requested sanitary sewer siphon which fails to meet minimum slope and minimum size
requirements. We are aware the state will not be able to approve this application until the
variance is signed and approved. Attached is the letter from "PERCS Unit" stating we
should move forward with submitting the fast track approval application as it is currently
under review.
Please let us know if you have any questions or require additional information. I can be
reached via email Jordan greenmountainen¢ineers.com or by cell phone [phone])
at your convenience.
Best
� Regards,
Jordan oung, E.I.
Green Mountain Engineering, PLLC
7A Wendy Court - Greensboro, NC 27409 - [phone]