WQ0011003_Application_19950508

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
• May 8, 1995
MR JAMES R. HARRINGTON
TOWN OF LILESVILLE
114 E. WALL STREET
PO BOX 451
LILES VII.LE, NORTH CAROLINA 28091
Dear MR HARRINGTON:
QEHNR
RECEIDE�
MAY 15 1995
ENV. AfIANAGEMEN I,
FAMTEVILLE AEG. wim
Subject: Application No. WQ0011003
Eighth Street Wtr & Swr Imp
Sewers -Public
Anson County
The Division's Permits and Engineering Unit acknowledges receipt of your permit application and
supporting materials on May 4, 1995. This application has been assigned the number listed above.
PLEASE REFER TO THE ABOVE WATER QUALITY NUMBER WHEN MAKING
INQUIRES ON THIS PROJECT.
Your project has been assigned to Liz Kovasckitz for a detailed engineering review. Should there be any
questions concerning your project, the reviewer will contact you with an additional information letter.
Be aware that the Division's regional office, copied below, must provide recommendations from the
Regional Supervisor or a Procedure Four Evaluation for this project, prior to final action by the
Division.
If you have any questions, please contact Liz Kovasckitz at [phone] extension 516. If the
engineer is unavailable, you may leave a message on their voice mail and they will respond promptly.
Please reference the above application number when leaving a message.
cc: Fayetteville Regional Office
Finkbeiner, Pettis & Strout
Sincerely,
aro yn McC kill
Supervisor, State Engineering Review Group
Pollution Prevention Pays
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

State of North Carolina
Department of Environment, Health, and Natural Resources
Division of Environmental Management
Non -Discharge Permit Application
(THIS FORM MAYBE PHOTOCOPIED FOR USE AS AN ORIGINAL)
GRAVITY SEWER EXTENSION
I. GENERAL INFORMATION:
1. Applicant (corporation, individual, or other ):
Town of r ; 1 cv; 11 P ntr
2. Print Owners or Signing Official's Name and Title (the person who is legally ^, _
responsible for the facility and its compliance): James R Harrington -
Mayor, Lilesville Town Hall
3. Mailing Address: 1 1 4 East Wall Street (P OL. Bc�x 451 1
City-
Lilesville State: NC Zip: 28091 -0451
Telephone No.: 7( 0 4 ) 8 4 8- 4 711
4. Project Name n plans/specs.,
(subdivision, facility, lettersof flow establishment
Operational Agreements, etc.
project name on p /sp
water and Sewer Extensions
5. Application Date:
1- 2 3- 9 5 6. Fee Submitted: $ i n n n n
7. County where project is located: Anson County,
H. PERMIT INFORMATION:
1. Permit No. (wilt be completed by DEM): \QQ (�Ol k (� O "3
x new; renewal*; modification.
2. Specify whether project is: -
*If renewal, complete only sections I through III and applicant signature
(on pg.5). Submit only pgs. 1, 2, 5 (original and 3 copies of each). Engineer
signature not required for renewal.
3. If this application is being submitted as a result of a renewal or modification to an
existing permit, list the existing permit number and issue date__
4. Specify whether the applicant is X public or private.
FORM: GSEA 4/91 Page 1 of 6

GRAM"1 Y Jt:wr-rc rr�l�l��l�l�
PAGE 2 (4/91)
III. INFORMATION ON WASTEWATER:
1. Nature of Wastewater. 1 0 0 % Domestic; % Commercial;
% Industrial; % Other waste (specify):
2. Please provide a one or two word description specifying,the origin of the wastewater,
such as school, subdivision, hospital, commercial, industrial, apartments, etc.:
Subdivision
3. Indicate any parameter (and its concentration) that will be greater than normal domestic
levels: None
4. If wastewater is not domestic nature,
wasr ,w hatter level f facility?pretreatment
tnt has been provided to
ensure protection of theg
N/A
5. Volume of wastewater generated by this project: 7, 2 0 0 gallons per day
6. Explanation of how wastewater volume was determined: 20 homes, a 3 6 n GPD
20 x 360 = 7,200 GPD
IV. DESIGN INFORMATION:
1. Brief project description: 3216 LF of 8" Gravity Sewer and 5067 r.F
of 6" water main.
2. Name of wastewater treatment facility receiving wastewater. Anson County WWTP
a. Facility permit no.: NC 0041408
b. Engineer should provide statement of his evaluation of downstream sewers to
accept the wastewater: Downstream sewers are adequate to accept
anticipated flows.
2of6

GRAVITY SEWER EXTENSION
PAGE 3 (4/91)
3. Summary of sewer pipe by diameter size and pipe material. Indicate here whether C
factor or N factor is used and circle C or N below: n n, ,
Dia. Length Pipe. C or N Min. Max. Minimum Max. Minimum
(In.) (Lin. Ft) Material Factor Slope % Slope % Velocity (fps) Vel.(fps) Cover (in)
8 3215.7 PVC 0.011 0.41 19.66 2— 4.64 31
NOTE: The minimum velocity must not be less than 2 fps.
For public sewers the minimum diameter is 8 inches.
4. Anchors shall be provided for sewers with slopes greater than 20 %. The anchor
spacing shall be as follows:
a. 36 feet separation for slopes of 21% to 35%;
b. 24 feet separation for slopes of 36% to 50%;
c. 16 feet separation for slopes of 50% and greater.
For velocities greater than 15 fps, it is strongly recommended that measures be
considered which will protect the sewers and manholes from erosion. For velocities
greater than 20 fps, erosion control measures must be specified.
For any excessive slopes or velocities that will occur in any sewer line segment, what
measures have been taken to protect the sewer pipe and manholes?
N/A
5. Maximum sewer reach length between manholes: 3 a _ n 6 linear feet.
6. This sewer line segment occurs between manhole no. 1_ and manhole no.�-
7 . Does the owner/operator have the ability to clean this length? X Yes No.
8. Sewer subject to existing or planned traffic bearing loads? X Yes No.
if yes, what measures are being taken to enable the sewers to withstand the loads?
use of steel encasement pipe
9. Outside drop manholes are provided where invert separations exceed: 2 feet.
10. Identify (by manhole number) those manholes that have drop connections: N/A
3of6

♦J 1"i1-A� � --
PAGE 4 (4/91)
Maximum allowable infiltration/exfiitraa�on ale 10— GPD/ pipe dia. in./ mile.
Note: Must not exceed 200 GPD/ pipe
12. Minimum separation distances as shown on the plans or addressed in the specifications:
a) 100 ft. horizontal separation from wells or other water supplies? _-j Yes _No
b) 12 in. vertical separation from storm sewer or ferrous pipe yes — No
sanitary sewer specified?
c) 10 ft horizontal separation ftoom ferrouslp pipe Specified?mil x- Yes _No
separation (water over sewer)
Yes _)L- No
13. Are manholes subject to flooding? Yes — No
14. If yes, are manhole rim elevations 1 foot above 100-year' flood level, —
(100 year flood elevation should be indicated on plans)
15. Or are manholes watertight and vented 1 foot above the 100-yam _Yes _ No
flood elevation (should be shown on plans):
16. Identify (by manhole number) those manholes that are vented: N/A
es, what precautions
17. Does this project involve been utilized util zedtream to ensure protection of the sewer line and not
ror e special features have be
restrict stream flow? Identify the sheet of the plans and station number where
crossings are located:EBYTHE
N A
THIS APPLICATION PACKAGE WILL NOT B MANAGEMENT ACCEPT ESS ALL OF
DIVISION OF ENVIRONMENTAL
THE APPLICABLE ITEMS ARE INCLUDED WITH THE SUBMITTAL
0
Lei
C.
0
C.
Required Items
copies of the completed and appropriately executed application form.
One original and three
a North Carolina
Three sets of detailed plans and specificationsude a general location mapned and sealed , a plan view of the
Professional Engineer. The plans must inc $
sewer extension, a profile of the sewer extension, and pe ifications lmay be omitted for
sewer extension to other utilities and natural features. Spy _
delegated authorities. Each sheet of the plans and the mfirst pag e f al or m�f�t°on must be
g copies of the existing per
signed and sealed. Three p
The appropriate permit processing fee, in accordance with 15A NCAC 2H .0205(c)(5).
astewater treatment facility
that will be accepting
if the owner/authority of the wvolume of
the wastewater flow from this project is owner/authority
of thethe TF specifying pthe vol then a
letter must be provided from the owner/auth y
flow that will be accepted• The letter should beahe project
and the plans/specifications
by the same name as that identified on the application
An Operational Agreement (original and two copies) must be submitted if the sewer
extension will be serving single famiresidences, iscondominiums,
dthe i individual homes,
ortso,� a
houses and if the subject sewer extension
homeowners association, or a developer. 4 of 6

GRAVITY SEWER EXTENSION
PAGE 5 (4191)
Name and Complete Address of Engineering Firm: Finkbeiner, Pettis & Str^ott, Inc .
One Centerview Drive
City: Greensboro
Telephone No.
[phone]
Professional Engineer's Certification:
I,
Robert K. Russell
State:
NC
Zip: 27407
,attest that this application for Sanitary
Sewer Extensions has been reviewed by me and is accurate
and complete 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. 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.
North Carolina Professional Engineers Registration No.
Print Name of Engineer
Robert K. Russell
11317
o%1®1 n 1 ei.#ss'
Seal and Signature (specify date): •@ r`. �� �° �'�
Applicant's Certification:
I, S�i►n�� �, f��R r2.`n�g i'�� , attest that' fhi's6application for S•¢.sr %�a
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand
that if all required pans of this application are not completed and that if all required supporting
information and attachments are not included, this application package will be returned as
incomplete.
Signature
Date /- z -/- 9's'
E COMPLETED APPLICA71ON PACKAGE, INCLUDING ALL SUPPORTING
NATION AND MATERIA , SHOULD BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DIVISION OF ENVIRONMENTAL MANAGEMENT
WATER QUALITY SECTION
PERMITS AND ENGINEERING UNIT
POST OFFICE BOX 29535
512 NORTH SALISBURY STREET
RALEIGH, NORTH CAROLINA 27626-0535
TELEPHONE NUMBER: 919/733-5083
5of6

GRAVITY SEWEK VA1L'1VJ1kJ1N
PAGE 6 (4/91) '
PERMIT APPLICATION PROCESSING FEES
(effective October 1,1990)
CATEGORY NEW APPLICATIONS RENEWAL WtIHOiJT
MODIFICATIONS MODIFICATIONS
> 1,000,000 GPD $300
Industrial
$300
DomesticJCooling Water $400
10,001 - 1,000,000 GPD $250
Industrial
Domestic/Cooling Water $400
$250
1,001 - 10,000 GPD $200
Industrial
$200
Domestic/Cooling Water $400
< or = 1,000 GPD and $120
Single Family Dwelling $240
Sludge < or = 300 Acres $400 $250
Sludge > 300 Acres
$400 $250
Sewer Extensions 0
(nondelegated) $400
Sewer Extensions 0
(delegated) $200
Closed -Loop Recycle $200
or Evaporative $400
NOTE: The Fees for Soil Remediation Projects are the same as for Sludges.
Under the Sewer Extension Fee, "delegated to municipalities" applies
only to those governmental jurisdictions that have of acifEnvironmenic t t
on
review authority, as granted by
the DivisionManagement. 6 of 6

• State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
7�.NWA *
i101, ; rat,
APR 2
April 25, 1995
MR JAMES R. HARRINGTON�;�
TOWN OF LILES VILLE
114 E. WALL STREET PO BOX 451
LILESVILLE, NORTH CAROLINA 28091-0451 Subject: Return of Incomplete Application
Water & Sewer Extensions
Sewers -Private
Anson County
Dear MR HARRINGTON:
In accordance with Division policy, the enclosed application package, which was received on April
17, 1995, is being returned as incomplete.The following checked items are lacking:
-Two sets of plans/specifications signed and sealed by an N.C. Professional Engineer.
-Five sets of plans/specifications signed and sealed by an N.C. Professional Engineer.
-Two copies of all required supporting materials.
-Appropriately completed and signed application form plus one copy.
-Letter from current permit holder requesting name change.
,J -Letter of flow acceptance (SPECIFYING FLOW) from owner of receiving treatment
facility. This letter must be included in package when re -submitted.
-Operational Agreement for sewers owned by individual residents, a homeowners
association, or a developer.
-Permit application processing fee of $..
-Subsurface evaluation/soil scientist's report for surface and subsurface waste disposal
permits, including loading rate calculations.
-Waste analyses and Toxicity Characteristic Leachate Procedure (TCLP) Analysis.
-Other Items:
Please ensure the package is complete with flow acceptance letter, as specified in
Instructions to the Engineer, before resubmittal. No flow acceptance has been received at
this time and therefore, package is still incomplete and cannot be logged.
After all required submittal information has been obtained, the completed application package may be
resubmitted in accordance with the submittal instructions included on the application form. Be sure to
submit all originally submitted information (and copies) along with the required additional information.
If you have any questions, please contact Michael Allen at [phone], ext. 547.
cc: Fayetteville Regional Office Sincerely,
Finkbeiner, Pettis &Strout, Inc. /
SERG Return File ��C� ��--
arolyn McCaskill, Supervisor
n l 1ZcQ ur ST State EnRineeriniz Review Group
Pollution Prevention Pays
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer