WQ0042263_Application (FTSE)_20210126

DocuSign Envelope ID: CE5FD9FO-F449-4078-88BB-FCA5EBD69D7E
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: `+ ` (1)'T 1 3 (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: WTH Times, LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership
❑ Federal
❑ State/County ❑ Municipal
3. Signature authority's name: David Boyd per 15A NCAC 02T .0106(b)
Title: Registered Agent/Managing Member
4. Applicant's mailing address: P.O. Box 795
City: Lincolnton State: NC Zip: 28093-
5. Applicant's contact information:
Phone number: [phone] Email Address: david(a,timesoil.com
RECEIVED/NCDEQ/DINR
JAN 2 5 2021
MOORESVILLECIROS
REGIONAL OFFICE
❑ Privately -Owned Public Utility
❑ Other
II. PROJECT INFORMATION:
1. Project name: Moores Chapel Road
2. Application/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: WQ00
3. County where project is located: Mecklenburg
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.274° Longitude:-80.969°
5. Parcel ID (if applicable): 05549114
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Josh Butler License Number: 048418
Firm: Gateway Design Group, PLLC
Mailing address: 15126 Castlebridge Lane
City: Matthews State: NC Zip: 28104-
Phone number: [phone] Email Address: josh(cgatewaydesigngroup.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: McAlpine Creek, Inwin Creek, Sugar Creek Permit Number: NC0024970, NC0024945, NC0024937
Owner Name: Charlotte Water
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1.
Permit Number(s): WQunknown Downstream (Receiving) Sewer Size: 8" inch
System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s): Charlotte Water
FORM: FTA 04-16
Page 1 of 5

DocuSign Envelope ID: CE5FD9FO-F449-4078-88BB-FCA5EBD69D7E
VI. GENERAL REQUIREMENTS
1. 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: DEV) been attached?
❑ Yes No ®N/A
3. If the Applicant is a Home/Property Owners' Association, has an Operational Agreement (FORM: HOA) been attached?
❑ Yes ❑No ❑N/A
4. Origin of wastewater: (check all that apply):
❑ Residential Owned ❑ Retail (stores, centers, malls)
❑ Residential Leased ❑ Retail with food preparation/service
0 School / preschool / day care ❑ Medical / dental / veterinary facilities
0 Food and drink facilities ❑ Church
® Businesses / offices / factories 0 Nursing Home
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool /Clubhouse
0 Swimming Pool/Filter Backwash
0 Other (Explain in Attachment)
5. Nature of wastewater : % Domestic/Commercial 100 % Commercial
% Industrial (See 15A NCAC 02T .0103(20))
1 >Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes ❑ No
➢ If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow a,b
No. of Units
Flow
Convenience store
250 gal/plumbing fixture
9
2,250 GPD
Car wash
1,200 gal/car wash
1
1,200 GPD
Resturant
40 gal/seat
60
2,400 GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
5,580 GPD
a See 15A NCAC 02T .0114(b), (d), (e)(1) and (e)(2) for caveats to wastewater des gn 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: 5,580 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
0 Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
0 Other (Explain):
FORM: FTA 04-16
Page 2 of 5

DocuSign Envelope ID: CE5FD9FO-F449-4078-88BB-FCA5EBD69D7E
VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8"
352.2
PVC
8"
125.3
DIP
➢ 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
VHI. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
COMPLE IL FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: PS-1
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.274° Longitude: -80.969°
3. Design flow of the pump station: .007 millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 14 gallons per minute at 12 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
1.25
157
PVC
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

DocuSign Envelope ID: CE5FD9F0-F449-4078-88BB-FCA5EBD69D7E
IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (g)
D. 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
® 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
**My 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
**My 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
➢ 15A NCAC 02T.0305(g) contains altematives where separations in 02T.0305(f) cannot be achieved.
D. **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
D. 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 ® N/A
D. 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 setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No ® N/A
➢ This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project require coverage/authorization under a 404 Nationwide or
individual permits or 401 Water Quality Certifications?
D. Information can be obtained from the 401 & Buffer Permitting Branch
❑ Yes ® No
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® 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 No ZN/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 -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

DocuSign Envelope ID: CE5FD9FO-F449-4078-88BB-FCA5EBD69D7E
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. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification: DocuSigned by:
I,
jsL Liu ,r
(Professional Enginee,C1La eliaaItem III.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 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be gu'.► laeOcutOtseityys, which may
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 p violation.
North Carolina Professional Engineer's seal, signature, and date
3. Applicant's Certification per 15A NCAC 02T .0106(b):
.06tkif\JI V`j\ V"{ i
(Signature Authority's name & title om Application Item I.3.)
attest that this application for
attest that t 's app rcation 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. 1 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 I43-215.6B, 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:
FORM: FTA 04-16 Page 5 of 5

Gate!,
910-840-2661
josl (i gate. 'a
January 11, 2021
oe
Mooresville Regional Office
Water Quality Section
610 E. Center Avenue, #301
Mooresville, NC 28115
04
coQ i RECEIVED/NCDEQ/DWR
JAN '',1 2021
AT3 AY
E - N
V
G l
I D/NCDEQ/DWR
JAN 1 021
MOORESVILWQRO
LE REG ©MOORESVILLE NAL OFFICE WQEE REGIONAL FICE
RECEIVED/NCDEQIDWR
Project: Moores Chapel Road
Project Location: Mecklenburg County, North Carolina
Dear Sir or Madam,
On behalf of WTH Times, LLC, please find attached the following:
JAN252021
WQROS
MOORESVILLE REGIONAL OFFICE
1. One original and one copy of the Sewer System Extension Applications (FTA-04-16)
2. Cover letter
3. Application fee of S48o payable to North Carolina Department of Environmental Quality
(NCDEQ) (under separate cover)
4. 8.5 x 11— USGS topographic map/Street level map
5. Flow Tracking Form (FTSE 10-18)
6. Proof of business entity
This project involves the construction of gravity sewer and low pressure force main for a
commercial site.
Please contact me with any questions/comments.
Sincerely,
Josh Butler, P.E.
President / Owner

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
I5A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION\\PPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number:
I. APPLICANT INFORMATION:
1.
items must be co
(to be completed by DWR)
leted or the application evil) be returne
Applicant's name: 11'TH Times. LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership
❑ Federal ❑ State/County ❑ Municipal
3. Signature authority's name: Dean Brown per 15A NCAC 02T .0106,(
Title: Vice President
4. Applicant's mailing address: P.O. Box 795
City: Lincolnton State: NC Zip: 23093-
5. Applicant's contact information:
Phone number: [phone] Email Address: deanstimesoil.com
1I. PROJECT INFORMATION:
I. Project name: Moores Chapel Road
2. Application/Project status: ® Proposed (New Permit)
If modification, provide the existing permit number: 1\'Q00
If new construction but part of a master plan, provide the existii
3. County where project is located: 'Mecklenburg
4: Approximate Coordinates (Decimal Degrees): Latitude: 35.274 Longitude:-80.969'
5. Parcel ID (if applicable): 055491 14
(or Parcel ID to closest downstream sever)
I11. CONSULTANT INFORMATION:
I. Professional Engineer: Josh Butler License Number: 048418
Firm: Gateway Desi,n Group. PLLC
Mailing address: 15126 Castlebridge Lane
City: Matthews State: NC Zip: 28104-
Phone number: [phone]- Email Address: iosh4 eatewavdesigngroup.com
IV. WASTEWATER TREATMENT FACILITY (W'WTF) INFORMATION:
I . Facility Name: McAlpine Creek. Irvin Creek. Sugar Creek Permit Number:
Owner Name: CharlotteWater
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than \\'\\`TF):
I . Permit Number(s): \VQunknown
EQ/DWR
1 4 2021
MOORESVILWQ
LE REO ONAL OFFICE
❑ Privately-f Wi`i3tNQ 9/DWR
❑ Other
JAN I
MOORESVILLE REGIONA:. OFFICE
RECEIVEDINCDEQ/DWR
JAN 2 5 2021
WQROS
MOORESVILLE REGIONAL OFFICE
❑ Existing Permit/Project
and issued date:
permit number: \VQ00___
C0024970. NC0024945.
Downstream (Receiving) Sever Size: 8" inch
Wide Collection System Permit Number(s) (if applicable): \VQCS
Owner Name(s): Charlotte \\'ater
FORM: FTA 04-16
C002-1937
Page 1 of 5

VI. GENERAL REQUIREMENTS
I. lithe Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑No EIN/A
2. If the Applicant is a Developer of lots to be sold, has a Develoer's 0 erational Aureentent (FORM: DEV) been attached?
❑ Yes ❑No N/A
3. If the Applicant is a ome/Property Owners' Association, has an Operational_Agreentent (FORM I-tOA) been attached?
❑ Yes ❑No ❑N/A
4. Origin of wastewater: (check all that apply):
❑ Residential Owned ❑ Retail (stores, centers, malls)
❑ Residential Leased ❑ Retail with food preparation/service
❑ School / preschool / day care ❑ Medical /dental / veterinary facilities
❑ Food and drink facilities ❑ Church
Businesses / offices / factories ❑ Nursing Home
❑ Car Wash
❑ Hotel and/or Motels
❑ SWiniming Pool /Clubhouse
❑ Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
5. Nature of Nvastew % Domestic/Commercial 100 % Commercial
%Industrial [See I5A NCAC 02T .0103(201)
> Is there a Pretreatment Program in effect? C] Yes
6. Has a flow reduction been approved under 15A NCAC 02T 0114(f1? ❑ Yes ® No
➢ IfVesotrovide a corm' of flow reduction approval letter
7. Summarize wastewater generated by project:
❑ No
Establishment Type (see 02T.01 f4}
Convenience store
Daily Design Flow 0
No. of units
IMMI
1
Flow
2,250 GPD
1,200 GPD
250 gal/plumbing fixture
Car wash
1,200 gal/car \vdash
Resturant
40 gal/seat
60
2,400 GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
5,580 GPD
a See 15A NCAC 02T .0114(b) (d) fe)(1) and (e)(2) for caveats to wastewater des gn 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.42_A-4).
b Per I5A NCAC 02T .01 14(c), design flow rates for establishments not identified [in table 15A NCAC 023.01 141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 5.580 GPD (per 15A NCAC 02T .01 14)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where Holy 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

1'1I. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .00;
1. Summarize gravity sewer to be permitted:
C (Gra
Size (inches)
Length (feet)
352.2
Material
8"
PVC
8"
1253
DIP
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 ininimuut slope requirement is not allowed and a violation of the t1IDC
VI I I. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & i1iD% (rum Stations/For+
COMPLETE FOR EACH PUNIP STATION INCLUDED IN THIS PROJECT
I. Pump station number or name: PS-1
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.274' Longitude: -80.969'
3. Design flow of the pump station: .007 millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 14 gallons per minute at 12 feet total dynamic head (TD1-l)
5. Summarize the force main to be permitted (for this Pump Station):
sp:
6. Power reliability in accordance with 15A NCAC 02T .0305 I 1
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(I)(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:
OX Portable power source with manual activation, quick -connection receptacle and telemetry - I5A 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 %Vitt 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 timefranies, 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 15A NCAC 02T .0305(f) &. g)
I5A NCAC 02T.0305(t) contains minimum separations that shall be provided for sever systems:
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 \eater 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, \VS -I waters of Class' or
Class 11 impounded reservoirs used as a source of shrinking water
100 feet
**Waters classified WS (except \VS -I or WS-V), B, SA, OR\V, HQ\V, or SB from normal
high water (or tide elevation) and wetland s (see item 1X.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
• I5A NCAC 02T.0305contains alternatives where separations in 02T.0305(f1 cannot be achieved.
• "'`Stream classifications can be identified using the Division's NC Surface Water Classifications web
➢ If noncompliance with 02T.0305(f) or (g), see Section X of this applicatioi
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ❑ Yes ❑ No ® N/A
➢ See the Division's draft separation requirements for situations where separation cannot be meet
i 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
Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No ® N/A
• This would include Trout Buffered Streams per 15ANCAC 213,0202
4. Does the project require coveragelauthorization under a 404 Nationwide or ❑ Yes I No
individual permits or 401 Water Quality Certifications?
• Information can be obtained from the 401 & Buffer Perm ittingBranch
Does project comply with I5A NCAC 02T.01051s1 ) (additional perntitslcertifications)?
\'es ❑ too
Per 15A NCAC 02T.0105(461 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, storntwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per I5A 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.
❑ 1'es ❑ No El N/A
➢ If yes, include an attachment ‘vith details for each line, including type (aerial line, size, material, and location).
IIigh priority lines shall be inspected by the permit tee omits representative at least once everysix-months and inspections
documented per 15A NCAC 02T.0403(a)(5) or the permitec'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 D
and Force Mains jlatest versions and the Gravity Sewer Minimum Design_Criter
ElYes El] No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. A rroval of the request is required prior to submittal of the Fast Track Application and supporting documents,
2. Professional Engineer's Certi fication:
ls>i Aer--
(Professional Engineer's name from Application Item 111.1.)
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 1 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 S 10,000, as well as civil penalties up to S25,000 per violation.
North Carolina Professional Engineer's seal, signature, and state:
Applicant's Certification per I5A NCAC 02T .0106(b):
0.Q et"
(Signature Auth rity's name&: title om Application Item 1.3.)
'sN CARS,,',.
j�,��
tiZ;Q ,2�Z
448418®
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 witt be returned to me as
incomplete.
NOTE - In accordance svith General Statutes 143-215.6A and 143 215.6 E3_, 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 tine not to exceed S 10,000 as well as civil penalties up to S25,000 per violation.
Signature:
FOR\'I: FTA 0.1-16
Date: I 2-�
Page 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: WTH Times, LLC
Project Name for which flow is being requested: Moores Chapel Road (Store)
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.
Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: McAlpine Creek, Irwin Creek, Sugar Creek
b. WWTP Facility Permit #: NC0024970, NC0024945, NC0024937
All flows are in MGD
c. WWTP facility's permitted flow 99.00
d. Estimated obligated flow not yet tributary to the WWTP 10.377
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
73.817
0.00585
84.194
85.0%
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) (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 / pf), Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***
Paw Creek 11.4 4.56 6.612 0.867 7.479 -2.919
* 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 < O.
Downstream Facility Name (Sewer): Rhyne Road
Downstream Permit Number: Unknown
Page 1of6
FTSJ10--18

III. Certification Statement:
Keri Cantrell 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.
9/10/2020
Signing Official Signature Date
Chief Engineer
Title of Signing Official
Page 2 of 6

PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum for each pump station listed in Section I1 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
11.6 % and 0.867 MGD of the Available Capacity (E) in Pump Station
Paw Creek ; and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately
0.867 MGD per year; and that
c. A funded Capital Project that will provide the required planned capacity, namely
Paw Creek Force Main Replacement is in design or under construction with
planned completion in Paw Creek Force Main - 2020 ; and/or
d. The following applies:
Charlotte Water's Community Investment Plan has allocated funds for
improvements to the Paw Creek force main and a five -million gallon EQ basin
at Long Creek Pump Station. Long Creek and Paw Creek pump stations operate as
a system using SCADA data to determine the rate of flow delivered from the
upstream pump station, Long Creek, to Paw Creek the downstream facility.
Long Creek pump station has the ability to transfer flows to flow
equalization tanks during peak flow events and then meter out flow to Paw
Creek as flow conditions allow. In addition, the basins for both stations
are large and result in a daily peaking factor of 2.06 at Paw Creek Pump
Station, which allows the stations to operate safely at flows greater than
40% of the firm pumping capacity.
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

o File an Annual Report/Amend an Annual Report - Upload a PDF Filing Order a Document Online - Add
Entity to My Email Notification List - View Filings - Print a Pre -Populated Annual Report form - Print an
Amended a Annual Report form
L ited Lia 'Lay
Legal Name
WTH Times, LLC
Infor ation
OM
•
any
Sosld: 0675131
Status: Current -Active 0
Date Formed: 5/13/2003
Citizenship: Domestic
Annual Report Due Date: April 15th
Registered Agent: Boyd, David M,
Ad
resses
Principal Office Reg Office Mailing Reg Mailing
1500 E Main St 1500 E. Main St PO Box 795 PO Box 795
Lincolnton, NC 28092 Lincolnton, NC 28092 Lincolnton, NC 28093 Lincolnton, NC 28093
Company
•
fficials
All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20.
Manager Manager
David Boyd Sweet Treat Holdings, LLC
1500 East Main Street 1500 East Main Street
Lincolnton NC 28092 Lincolnton NC 28092

2� � �� � � w��/«� � � �� � <

PUMP STATION
C ' CU A TIONS
For
oores C a el
oa
Charlotte, North Carolina
January 5, 2021
Prepared for:
WTH Times
Lincolnton, NC
0•011,191111110
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domino,
Gateway Design Group, PLLC
P-2147
cell: [phone]
Mailing Address:
15126 Castlebridge Lane
Matthews, NC 28104

NARRATIVE
Moores Chapel Road is a new commercial project. The project consists of a
restaurant, convenience store, and car wash. Sewage will leave the site via private
grinder pump station and forcemain emptying into private manhole.
Gateway Design Group, PLLC

PUMP CALCULATIONS
Gateway Design Group, PLLC

SIZE PUMP STATION, WETWELL AND FORCE MAIN
Project Name:
Project No.
Date:
Calc By:
r000res
2020-002
No. of Services
Daily Flow
Daily Flow, Qddf1
Offsite Additional Flow, Qdf2
Total Daily Flow, Qddf
Peak Flow, Qp
Size of Force Main, d
Velocity, v1 (based on peak flow)
Trial Pump Flow, Qadj
Velocity, v2 (based on pump flow)
Dia. of Wet Well, D
TRIAL CYCLE TIME
20 min. pump down volume, V
20 min. pump down volume, V
20 min. pump down height, h
Wet Well Elevations
Top of Wet Well Elev.
SS Inv. In
High Water Alarm
Pump 1 On
Pump Off
Bottom
Required Depth of Wet Well
5,850 gpd
4.1 gpm
0.0 gpm
4.1 gpm
10.2 gpm
1.25 inches
2.7 ft/sec
_2 gpm
3.1 ft/sec
ft
20 min
53.7 gal
7.2 cf
0.7 ft
Proposed
748.8
744.4
743.8
743.4
741.3
ft
ft
ft
Qp=Qddf x 2.5
v1=0.409Qp/d^2
v2=0.409Qadj/d^2
V=tQddf(1-(Qddf/Qadj), t = 20
V=V*0.1337
h=4V/(3.14D^2)
Ground Elev. + 12"
Gravity Line Invert = Top minus 44.3"
Alarm = 8" Above Pump On
ft Pump On 4" Above Pump Off
ft Pump Off = 13.84" from Bottom
ft
10.2 ft Top Elev.-Bottom Elev.
123 in.

PUMP STATION DESIGN
SYSTEM CURVES
Job Name
Job No.
Date
2020-0302
Starting Pump Elevation, Z1
Force Main Discharge Elevation, Z2
High Point Elevation, Z2max
STATIC HEAD
Length of Force Main (Feet)
Diameter of Force Main (Ft), D
Hazen Williams C for Force Main, C
Discharge (GPM), Q
Moores Chapel
2020-002
1 /6/2021
1.25" PVC
753
753
,, t,,,i
-520
753
753
9
753
}3
91
Velocity (Ft/Sec), v
1.6
2.1
2.6
3.1
3.7
Hazen Williams Equation - HEAD LOSS
Hp= L ((10.44Q1.85)/((Cl.85)(D4.87)))
0
1
1
2
Hp = Total Piping System Head Loss
9 10 10 10 11
Minor Losses
11.25d Bends
22.5d Bends
45d Bends
90d Bends
No. Check Valves
Entrance/Exit
No. Gate Valves
No. Tees / ARV
hl = Total Minor Losses (Feet)
K value
0.0
0.0
0.0
0.0
0.2
0.1
0.0
0.0
0.3
Minor Losses (ft)
0.0 0.0
0.0 0.0
0.0
0.0
0.3
0.1
0.0
0.0
0.5
0.0
0.0
0.5
0.2
0.0
0.0
0.8
0.1
0.0
0.0
0.0
0.8
0.3
0.0
0.0
1.1
0.1
0.0
0.0
0.0
1.0
0.4
0.0
0.0
1.5
TDH (feet) = Hp+hl(minor)
10
10
11
11
12
Pump Curve (TDH)
230 170 120 70 20
Check Pump Cycle - 5322 gal (from Wet Well Sizing Calc)
Volume
Fill Time 3.2 min t=V/Qddf
Pump Time z1.5 min t2=V/Qpump
Total 17.7 min 3 cycles per hour, OK
Total Head, Ft
240
220
200
180
160
140
120
100
80
60
40
20
0
0
4
System Pump Curve
6 8 10
12
14
16
I
1
I
Discharge, GPM
Pump Curve
(TDH)

PUMP CURVE
Gateway Design Group, PLLC

EIONE SPD PUMP PERFORMANCE CURVE
GRINDER PUMP, 1HP, 1725 RPM - 230
100
%
%
-
220
95
90
-
210
85
%
-
200
-
190
80
-
LOW PRESSURE SYSTEM DESIGN PRESSURE
-
180
T._
75
CONSULT
FOR INTERMITTENT
USE ABOVE
OR 185
FACTORY
80 PSI
FEET TOH
-
170
70
-
160
TYPICAL OPERATING PRESSURE
TOTAL DYNAMIC HEAD (H), psig
) n O C� N N W 0C1 O An O n O O)n
1
-
150
-
140
-
130
-
120
-
110
o'
o
-
100 Q
-
90 v-
0
-
-
80 w
w
70 `l
-
z
60 Q
-
Ld
50 =
u
-
40 Q
z
-
>-
30
J
Q
-
20 0
I-
-
10
-
0
-10
-
-20
f
I
-
-30
-
-40
-
-50
LJ -
-60
0 2 4 6 8 10 12 14 16 18
DISCHARGE (Q), GPM
ESD 08-0022 REV. 2, 6/08