WQ0022877_Sewer Extension_20030723

/f-TRACK APPLICATION for GRAVITY SFWk;KS, FUMF STATIONS, AND k VXUr, iviA"'Na rr»r.
/ USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number:
- - - -- --- - - -- - - (to be completed by DWQ) l�(J� U O aoZ 01-'
1. Owner:
la. BUCKEYE LUMBERTON INCORPORATED
Full Legal Name (company, municipality, HOA, utility, etc.)
1b.
F. GRAY CARTER - VICE PRESIDENT OF LUMBERTON OPERATIONS
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Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorized signing officials!)
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The legal entity who will own this system is:
❑ Individual ❑ Federal ❑ Municipality ❑ State/County ❑ Private Partnership ® Corporation ❑ Other (specify):
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1000 EAST NOIR STREET 1e. LUMBERTON
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Street Address City
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NORTH CAROLINA 1g. 28359
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State Zip Code
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910-737-3200 1 i. 910-737-3248 1 j. Gray [e-mail]
QTelephone Facsimile E-mail
0 2. Project (Facility) Information:
2a. BUCKEYE LUMBERTON FIBERLINE FORCE MAIN 2b. ROBESON
a
a Brief Project Name (permit will refer to this name) County Where Project is Located
Q 3. Contact Person:
Q 3a. BRYAN A. LANEY
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. 910-737-3243 3c. Bryan Laney bkitech.com
Phone Number E-mail
1. Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.:
For modifications, attach a separate sheet clearly explaining the reason for the modification (i.e. adding another
phase, changing line size/length, etc.). Only include the modified information in this permit application - do not
duplicate project information in B(7) and B(10-11) that has already been included in the original permit.
66-763 Gv `7 6 o as s
531
BUCKEYE LUMBERTON CORPORATION
1000 East Nair Street Wachovia Bank of North Carolina Winston Salem, NC
Box 1305
Lumberton, North Carolina 28358
CHECK N9 025584
Four Hundred dollars and no/I00******************
PAY
TO THE DATE CONTROL NO, AMOUNT
ORDER OF 07/22/03 025584 $ 400.00
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY (DWQ)

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8. If the permitted flow is zero, indicate why:
❑ Interceptor Line - Flow will be permitted is subsequent permits that connect to this line
❑ Flow has already been allocated in Permit No.
❑ Rehabilitation or replacement of existing sewer with no new flow expected
FTA 02/03 - Rev. 1 06/03

FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE I
pF W A T F9 State of North Carolina
O� pG Department of Environment and Natural Resources
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I Division of Water Quality
o c I FAST TRACK APPLICATION
for GRAVUY.$EWERS, PUMP STATIONS, AND FORCE MAINS
(Pressure sewers systems are not to be included as part of this application package)
INSTRUCTIONS: Indicate that you have included the following list of required application package items by checking the
space provided next to each item. Failure to submit all required items will lead to your application being returned as
incomplete or additional processing and review time. This form may be photocopied for use as an original.
® I. Application Form - Submit one original and one copy of the completed and appropriately executed application
form. Any changes to this form will result in the application being returned. The Division of Water Quality
(Division) will only accept application packages that have been fully completed with all applicable items
addressed. You do not need to submit detailed plans and specifications unless you respond NO to Item B(12)
® II. Application Fee - Submit a check in the amount of $400 made payable to: North Carolina Department of
Environment and Natural Resources (NCDENR).
❑ III. Certificates of Public Convenience and Necessity — If the application is being submitted in the name of a
privately -owned public utility, submit two copies of the Certificate of Public Convenience and Necessity (CPCN)
which demonstrates that the public utility is authorized to hold the utility franchise for the area to be served by the
sewer extension. If a CPCN has not been issued, provide two copies of a letter from the North Carolina Utilities
Commission's Public Staff that states that an application for a franchise has been received, that the service area
is contiguous to an existing franchised area, and/or that franchise approval is expected. The project name in the
CPCN or letter must match that provided in Item A(2a) of this application.
❑ IV. Operational Agreements — Submit one original and two copies of a properly executed operational agreement if
the sewer extension is permitted by a private applicant and will be serving residential or commercial lots (e.g.,
houses, condominiums, townhomes, outparcels, etc.) that will be sold to another entity. If the applicant is a
homeowners' association, use Form HOA 02/03. If the applicant is a developer, use Form DEV 02/03. EVEN IF
THE PROJECT WILL BE TURNED OVER TO A MUNICIPALITY, FORM DEV 02/03 IS REQUIRED.
® V. Flow Acceptance Letters — If the owner of the downstream sewers and/or WWTF is different from the applicant,
submit two copies of a flow acceptance letter from the owner of the downstream sewers and WWTF, if different.
Flow acceptance letters must contain the following minimum information: applicant and project name, amount of
flow accepted and name and permit number of the receiving sewers/WWTF. The flow acceptance must not
expire prior to permit issuance and must be dated less than a year prior to the application date.
Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific flow acceptance
letter.
® VI. Map — Submit an 8.5-inch by 11-inch COLOR copy of the portion of a 7.5-minute USGS Topographic Map along
with this form. The map should identify the entire project area location as well as the closest downslope surface
waters as clearly as possible. Each map portion must be labeled with the map name and number, the identified
location of the sewer line and pump stations, and be of clear and reproducible quality. For instance, if the project
involves 4 miles of interceptor sewer that traverses over or near several different waterbodies (or counties,
basins, etc.), the map should have location ID's shown for each different waterbody (where the sewer line is within
100 feet of such waterbody - see Instruction VII). This location ID is self chosen and used to cross reference the
location in Section C of the permit application.
❑ VII. Stream Classifications — Section C
• If any portion of the project is within 100 feet of any down slope surface water, Section C must be completed
for the pertinent sections.
• If the entire project area is a minimum of 100 feet away from any down slope surface waters BUT there is a
pump station involved where a history of power outage is to be used to provide adequate design storage
instead of dual feed or permanent or portable generator, Section C must be completed to demonstrate that
the closest down slope surface water is Class C (see 15A NCAC 2H .0219(h)(3)(D)).
• Use the guidance document entitled, "Determining Watershed Classifications for Form FTA 02/03 (Fast -Track
Sewer Systems)" available from http://h2o.enr.state. nc. us/ndpu or by contacting the appropriate regional
office.
FT 0'? 0' - Rom.; 1 tlt-O'

FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
PAGE 2
❑ Vlll. Environmental Assessments — If this project is subject to an Environmental Assessment (E,", 115A NCAC
01C .0500], this application can not be used. Send the project application on Form PSFMGS10/99 to the
Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. Applicatic, cl can not be
processed until a Finding of No Significant Impact (FONSI) or Environmental Impact Statement : F'S) has been
issued. A copy is to be submitted with that permit application.
® IX. Certifications — Section D
The application must be certified by both the applicant and a North Carolina Registered Profess .-nal Engineer
(PE). The applicant signature must match the signing official listed in Item A(1b). The PE should i'40T certify the
application if he/she is unfamiliar with 15A NCAC 2H .0200, the Gravity Sewer Minimum Desig `:riteria (mos'
recent version) and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations G Force Mains
(most recent version), as applicable to the project. Certification by a PE who is unfamiliar with tt -?: e documer-',.
is subject to NC Board referral.
THE COMPLETED FTA 02/03 APPLICATION PACKAGE, INCLUDING ALL SUPPORTING DOCUMEN . ti AND $40'
FEE, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional -Office
_
Avery, Buncombe, BU -;e Caldwe
59 Woodfin Place
Cherokee, Clay, Grahz, Haywoc
Asheville, North Carolina 28801
Henderson, Jackson, hOcon,
[phone]
Madison, McDowell, M; hell, Poll
[phone] Fax
Rutherford, Swain, Trat=ylvania,
Yance _
Fayetteville Regional Office
225 Green Street Suite 714
Fayetteville, North Carolina 28301
Anson, Bladen, Cumber:dnd, Harr
[phone]
Hoke, Montgomery, Moore, Robe!
[phone] Fax
Richmond, Sampson, Scotland
Mooresville Regional Office
919 N Main Street
Mooresville, North Carolina 28115
Alexander, Cabarrus, Catawba,
[phone]
Cleveland, Gaston, Iredell, Lincoln
[phone] Fax
Mecklenburg, Rowan, Stanly, Uni
Raleigh Regional Office
1628 Mail Service Center
Chatham, Durham, Edgecombe,
Raleigh, North Carolina 27699-1628
Franklin, Granville, Halifax, Johns
(919) 571-47
Lee, Nash, Northampton, Orange
[phone] Fax
Person, Vance, Wake, Warren,
Wilson
Washington Regional Office
Beaufort, Bertie, Camden, Chowa
943 Washington Square Mall
Craven, Currituck, Dare, Gates,
Washington, North Carolina 27889
Greene, Hertford, Hyde, Jones,
[phone]
Lenoir, Martin, Pamlico, Pasquote
[phone] Fax
Perquimans, Pitt, Tyrrell, Washinc
Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
Brunswick, Carteret, Columbus,
[phone]
Duplin, New Hanover, Onslow,
[phone] Fax
Pender
Winston-Salem Regional Office
585 Waughtown Street
Alamance, Alleghany, Ashe, Cas,.
Winston-Salem, North Carolina 27107
Davidson, Davie, Forsyth, Guilfor
[phone]
Rockingham, Randolph, Stokes,
[phone] Fax
Surry, Watauga, Wilkes, Yadkin
For more information, visit our web site at: http://h2o.enr.state.nc.us/ndpu/
FTA 02/03 - Rev. l t

FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 3
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USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number:
(to be completed by DWQ)
1. Owner:
la. BUCKEYE LUMBERTON INCORPORATED
Full Legal Name (company, municipality, HOA, utility, etc.)--
1b. F. GRAY CARTER- VICE PRESIDENT OF LUMBERTON OPERATIONS
Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorized
1c. The legal entity who will own this system is:
❑ Individual ❑ Federal ❑ Municipality ❑ State/County ❑ Private Partnership
1d. 1000 EAST NOR STREET 1e. LUMBERTON
Street Address City
ing officials!)
2 S 2-om
her (specify):
1f. NORTH CAROLINA 1g. 28359
State Zip Code
1 h. 910-737-3200 1 i. 910-737-3248 1j. [e-mail]
Telephone Facsimile E-mail
2. Project (Facility) Information:
2a. BUCKEYE LUMBERTON FIBERLINE FORCE MAIN 2b. ROBESON
Brief Project Name (permit will refer to this name) County Where Project is Located
3. Contact Person:
3a. BRYAN A. LANEY
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. 910-737-3243 3c. [e-mail]
Phone Number E-mail
1. Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.:
For modifications, attach a separate sheet clearly explaining the reason for the modification (i.e. adding another
phase, changing line size/length, etc.). Only include the modified information in this permit application - do not
duplicate project information in B(7) and B(10-11) that has already been included in the original permit.
2. Owner is ❑ Public (skip to Item B(3)) ® Private (go to Item 2(a))
2a. If private, applicant will be: 2b. If sold, facilities owned by a (must choose one)
3.
4a
5a
® Retaining Ownership (i.e. store, church, single office, etc.) or ❑ Public Utility (Instruction III)
❑ Leasing units (lots, townhomes, etc. - skip to Item B(3)) ❑ Homeowner Assoc./Developer (Instruction IV)
❑ Selling units (lots, townhomes, etc. - go to Item B(2b))
CITY OF LUMBERTON
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
CITY OF LUMBERTON WWTP 4b. NCO024571
Name of WWTF WWTF Permit No.
CITY OF LUMBERTON 5b. 42 INCH 5c.
Owner of Downstream Sewer Receiving Sewer Size
6. The origin of this wastewater is (check all that apply):
❑ Residential Subdivision
❑ Apartments/Condominiums
❑ Mobile Home Park
❑ School
❑ Restaurant
❑ Office
Permit Number of Downstream Sewer (if known)
❑ Car Wash
❑ Institution
❑ Hospital
❑ Church
❑ Nursing Home
® Other (specify): Industrial
7. Volume of wastewater to be permitted in this project: 400,000 gallons per day
% Domestic/Commercial
100 % Industrial
8. If the permitted flow is zero, indicate why:
❑ Interceptor Line - Flow will be permitted is subsequent permits that connect to this line
❑ Flow has already been allocated in Permit No.
❑ Rehabilitation or replacement of existing sewer with no new flow expected
% Other (specify):
PTA 0?%(12 - PP 1 OA/02

FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 4
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9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2H
.0219(I) for Item B(7) or the design flow for line or pump station sizing if zero flow in the space below. Values other than
that in 15A NCAC 2H .0219(Ix1-2) must be approved prior to submittal of this application. Submit a separate request to
the Division of Water Quality, Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617 in
accordance with 15A NCAC 2H .0219(I)(3).
See design report submitted to FRO under separate cover on July 3, 2003.
10. Summary of Sewer Lirres to be Permitted (attach additional sheets if necessary)
Size (inches) Length (feet)
6 inch 1028
ENTER TOTAL LINE LENGTH IN MILES 0.195 miles
11. Summary of Pump Stations to be Permitted (attach additional sheets as necessary)
Gravity or Force Main
(use the pull down menu)
Force Main
Location ID Power Reliability Option
(self chosen - as shown on Design Flow Operational Point (1- dual line feed; 2- permanent generator w/ATS; 3-
plans for cross-reference) (MGD) GPM @ TDH portable generator w/telemetry; 4-wet well storage)
Primary Basin 0.3 208
4
12. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force
Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H .0200 as applicable?
® Yes ❑ No If no, please reference the pertinent minimum design criteria or regulation and indicate why a
variance is requested:
See design report submitted to FRO under separate cover on July 3, 2003.
SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS PERTINENT TO THE VARIANCE WITH YOUR APPLICATION
13. Have the following permits/certifications been submitted for approval?
Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes ❑ No ® N/A
Sedimentation and Erosion Control Plan? ❑ Yes ❑ No ® N/A
Stormwater?
❑ Yes ❑ No ® N/A
FTA 02/03 - Rev. 1 06/03

FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 5
1. Use the Division's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02/03
(FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach additional sheets as
necessary). This document is available from our web site or by contacting the appropriate Division of Water Quality
Z regional office (see instructions for addresses) OR indicate the following:
0 ® A Stream Classification is not needed because all parts of the project are at least 100 feet away from any down slope
Qwaterbody; AND,
V ® A Stream Classification is not needed because the design does not depend on wet well storage as a power reliability
option for any pump station near a Class C down slope waterbody.
Location ID on Map
Q (self chosen - as shown on Name of Waterbody Stream Waterbody
J map for cross-reference) Waterbody County River Basin Index Classification
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Submit the 8.5" x 11" COLOR topographic map as required in Instruction VI
regardless of whether a classification is provided!
1. Applicant's Certification:
la
1, F. Gray Carter, attest that this application for the BUCKEYE LUMBERTON INC. FIBER LINE FORCE MAIN project
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required
parts of this application are not completed and that if all required supporting documentation and attachments are not
included, this application package is subject to being returned as incomplete. Note: In accordance with North Carolina
General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or
certification in any application shall be guilty of a Class 2 misdemeanor which may include a tine not to exceed $10,000
as well as civil penalties up to $25,000 per violation.
Signing Official Signature
2. Professional Engineer's Certification:
Date
I attest that this application for BUCKEYE LUMBERTON INCORPORATED has been reviewed by me and is accurate,
complete and consistent with the information in the engineering plans, calculations, and all other supporting documentation
to the best of my knowledge. I further attest that to the best of my knowledge the proposed design has been prepared in
accordance with the applicable regulations, Gravity Sewer Minimum Design Criteria for Gravity Sewers adopted February
12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June
1, 2000 and the watershed classification in accordance with Division guidance. Although certain portions of this submittal
package may have been developed by other professionals, 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 NC General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement,
representation, or certification in any application shall be guilty of a Class 2 misdemeanor which may include a fine not to
exceed $10,000 as well as civil penalties up to $25,000 per violation.
2a. JOHN M. WILLIAMS, P.E.
Professional Engineer Name
2b. McKIM & CREED
Engineering Firm
2c. 243 NORTH FRONT STREET
Address
2d. WILMINGTON 2e. NC 2f. 28401
City State Zip
2g. 910-343-1048 2h. 910-251-8282 2i. [e-mail]
Telephone Facsimile E-mail
Seal, Signature & Date
FTA 02/03 - Rev. 1 06/03

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July 16, 2003
Mr. Bryan A. Laney
Environmental Manager
Buckeye Lumberton Incorporated
PO Box 1305
1000 East Noir Street
Lumberton, NC 28359
RE: Flow Acceptance Letter
In response to a memo dated 7/14/03, your request for flow acceptance from the City of Lumberton
Wastewater Treatment Plant has been approved.
Applicant Name: Buckeye Lumberton Incorporated
Project Name: Fiberline Force Main Project
Amount of flow accepted: 400,000 gallons per day
SIU Permit Number: 018
Sewer Owner Name: City of Lumberton Wastewater Treatment Plant
NPDES Permit #: NC0024571
Application to the City of Lumberton Significant Industrial User Program for a SIU Permit was received
on 7/14/03. The SILT Permit #018 effective date and the authorization to discharge shall become effective
in September 2003, and the SIU Permit #018 expiration date and the authorization to discharge shall
expire September 2008. The permittee is responsible for filing an application for reissuance of this permit
at least 180 days prior to its expiration date. Upon the reissuance of SIU Permit #018, this original flow
acceptance to the City of Lumberton Wastewater Treatment Plant will still be active.
If you have any questions or need any further assistance, please contact Karen Lewis at [phone].
,.Sincerely,
ope A. Walters
Deputy Director
Environmental Utility Services Department
C: Todd Powell, City Manager
Jim Walters, Director EUSD
Karen Lewis, Laboratory Supervisor
D— 13SS , 1unzCE"ton, <-Nortfz Cazolina 25359 • 9io-671-3S57 • 91 quo -bpi 3SSq • 7ax quo 67i39Sq

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