WQ0041036_Regional Office Historical File Pre 2018

Division of Water Rsour
State of North Carolina
Department of Environmental Quality
Division of Water Resources
iSA NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
ETA 04-16 & SUPPORTING DOCUMENTATION
QECENEDNODENROWN
Application Num
tent must be d o
to be completed by t)WT()
j a 1 8 1
' at' n will be returned
moORESVILLE REGiONAL OIRCE
L APPLICANT INFORMATION;
1, Applicant's name. City of -Hickory .(company, municipality, HOA, utility, etc.)
2. Applicant type: .0 Individual Corporation 0 General Partnership 0 Privately -Owned Public Utility
0 Federal.
El State/County
0 Municipal 0 Other
3. Signature authority's name: Warren Wood per 15A NCAC 02T .0 i 06 .
Title: City -Manager,
4. Applicant's mailing address: PO Box .398
City.: Hickory State: NC Zip: 28603-
5, Applicant's contact information:
Phone number..[phone] Email Address: [e-mail]
IL PROJECT INFORMATION:
1, Project name: The Village_at SherrillsFord..C-store Outfall
2.,Application/Project status: Proposed (New Permit) .Existing Permit/Project
If a iMidification, provide the existing permit number: WQOO and issued date:
If new construction but part of a master plan. provide the existing permit number: WQ(X)____
3, County where project is located: Catawba
4, Approximate Coordinates (Decimal Degrees): Latitude: 35..5861" Longitude: -80,9864'
5. Parcel ID (if applicable): 460716832252
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Christopher Wood License Number: 28617
Firm: Joel E. Wood & Associates
Mailing address: P.O. Box 296
City: Clover State: SC Zip: 29745,-
Phone number: [phone] Email Address: ce‘vood ci,jewood.org,
IN% WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I_ Facility Name: Flickory-Caowba WWTP Permit Number: NC 0025542
Owner Name: City of Hickory
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): Vs'QCS00256
Owner Name(s): City of Hickory
FORM: FTA 04-16 Page 1 of 5

VL GENERAL REQUIREMENTS
If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
El Ve JNu N/A
2. If the Applicant is a Developer of tot s to he sod, has a .Developer's OperationalAerceme ,RM: DEV) been attached.?
0 Yes No N/A
3, If the Applicant is a Ho lie:Property Owners' Assiiciation„ has all Operational Aereement WORM; ROA t been attached?
E1 Yes 0No N/A
4., Origin of wastewater: (check all that apply):
0 Residential Owned
0 Residential Leased
Ej School / preschool / day care
E Food and drink facilities
El Businesses / offices / factories
0 Retail (stores, centers, malls)
Retail with food preparation/service
.0 Medical / dental / veterinary facilities
O Church
Nursing Horne
5. Nature of wastewater 100 % Domestic/Commercial % Commercial
% Industrial (Seci5A NCAC )2T .0103,0111
s there a Pretreatment Program in effect?
6. Has a flow reduction been approved under 15A NCAC 02T .01144)? D Yes 0 No
If yes, provide a copy of flow redt:tc:ti©n approval letter
7, Summarize wastewater generated by project:
Establishment Type (see O2'l'.O11311)
Restaraunt
Convenience
Daily Design Flow
40 gal/seat.
60 gal/100 sf
gal/
,gal/
gal/
0 Car Wash
Hotel and/or !violets
El Swimming Pool /Clubhouse
0 Swimming Pool/Filter Backwash
II Other (Explain in Attachment)
No
No. of Units Flow
54 2,160 GPD
1930 1,158 GPD
Total
GPD
3,318 GPD
See 15.A N 7.AC 02T 01 14J jd jSjJ,4ilQJ,ti2l for caveats to wastewater design flow rates minimum flow per
dwelling; proposed unknown non-residential developmern uses; public access facilities located near high public use areas,
and residentialproperty located south or east of the Atlantic Intracoastal 'Waterway to be used as vacation rentals as defined
in G.S. 42A-41.
b Per '15A NCAC 02T .0114(c), design flow rates for establishments not identified fin table .15A NCAC 02....111-11 shall be
determined using available flow data. water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 3,318 GPD (per 15.A NCAC 02T .0 I 14)
Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
0 Pump Station or Gravity Sewer where flow will he .permitted in subsequent permits that connect to this line
Flow has already been allocated in Permit Number:
0 Rehabilit-
on or replacement of existing sewer with no new flow expected
0 Other (Explain):
FORM: FTA 04-16
Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 1)2T .0305 .& MDC (Gravity Sewerst:
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
134
Material
PVC
`. Section R & HI of the MDC for Permitting of Gravity Sewers contains information related to design criteria
Section 111 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
Vi PUMP STATION DESIGN CRITERIA (if Applicable), — 02T .0305 & MDC (Pump Stations/ForteMans):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
Approximate Coordinates (Decimal Degrees): Latitude: Longitude: -
3. Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (Ttm)
5. Summarize the force main to be permitted (for this Pump Station):
6. Power reliability in accordance with I:5A NC:A:71.12T .0346 hirjj:
Standby power source or pump with automatic activation and telemetry - I5A NCAC 02.T .030500(1)(13)
Required for all pump stations with an average daily now greater than or equal to 15,000 gallons per day
Must be permanent to facility
Or if the pump station has an average daily now less than 1.5,000 gallons per day:
EJ Portable power source with manual activation, quick -connection receptacle and telemetry - 1.5A NCAC 02T
.0305(h)(I)(C)
or
El Portable pumping unit with plugged emergency pump connection and telemetry - 1.5A NCAC 02T .0305(h)(I)(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 tirneframes, 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 .03050:
I. Does the project comply with all separations found in J 5A NCAC 02T .0305u1, &LgJ
'fr 15A NCAC 02.T,0305(1) contains minimum separations that shall beprovided for sewer systems:___
Yes E1No
Setback Parameter* Separation Required
Storm sewers and other utilities not listed below (vertical) 24 inches
a er main (vertical -water ovcr sewer including in benched trenches) 18 inches
Reclaimed water lines (vertical reclaimed over sewer),
Reclaimed water lines (horizontal - reclaimedover sew
**Any private or public water supply source, including any wells,
Class 'II impounded reservoirs used a. a source ot dnnking'ate
Wc
18 tactics
2 feet
'..rsof Class I or
ssified 'WS (except WS-I or WS-V), B, SA, ORW, HQW, ar SB from normal
gh watertide elevat' and wetlands see item I.X.2)
*Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
An building foundation
op sio '. ofemhimkrnent or cuts of 2 feet 1 Ti vertteiil height
Drainage sems andinterceptor drains
An swimmrnif, 1-
Final earth grade (ve
feet
50 feet
5 feet
0 feel
• 15A NCAC 02T,0305(g) contains alternatives where separations in 02T.0305(ft cannot be achieved,
**Stream classifications can he identified using the Division's NC Surface Water Classifications webpage
• If noncompliance with 02T.0305(1) or (e). see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation)
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 area effected
3. Does the project comply with all setbacks found in the river basin rules per I5A NCAC 0213 .0200?
7... This would include Trout Buffered Streams per 15A NCAC /B.0202
Yes
No
No
4. Dots the project comply with an individual 404 Permit or any 401 Certifications? Yes U No
• Wetland -related permits shall be requested, obtained, and adhered to for projects that impact„ wetlands or surface waters
• Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 122— (additional permits/certifications)? Yes Ej No
Per .15A NCAC 02-1,0105(061, 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, storinwater management plans, etc,).
t. 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, ar 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 locatio.n).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and inspections
documented per 1.5A NCAC 011.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FrA 04-16 Page 4 of 5

X. CERTIFICATIONS:
Does the submitted system comply with I.5A KAC 02T, the
and rUrCe Mains (latest verstont. and the Gravity Sewer NI:Minim Deshin Criteria ..at-st version', as applicable?
Yes Ej No
If No, complete and submit the Variance/Alternative Design Request application (V ADC 10-14) and supporting documents for
review. .A_Rproval of the request is required prior to submittal of the Fast Track Application and supporting documents
2, Professional Engineer's Certification:
e,14O attest that this application for
:s'ona1 Engineer's name from Application Item 111.1,)
has been reviewed by me and is accurate, completeand 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 Purnp 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 arid 143-215.68, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a. Class 2 misdemeanor, which may
include a fine not to exceed $10,000„ as well as civil penalties up to $25,000 per violation.
North Carolina Professional Engineer's seal, signature, and dater
3. Applicant's Certification per ISA NCAC ( .2T .0106(b):
\INla
(Signature Authoritys
_attesi that this application for
has been reviewed by rue 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, andlor 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 anti 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 make 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 as civil penalties up to $25,000 per violation.
\ °I\
Date:
FORM: FTA 04-16 Page 5 of 5

DivisIon of WAtev esouttes
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 Hickory
Project Name for which flow is being requested: Village at Sherrills Ford, C-store Outfall
More than one FTSE may be required for a single projec1 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: Hickory -Catawba Wastewater Treatment Plant
b. WWTP Facility Permit #: NC0025542
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
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 perrnitted flow used
Allflows are in
1.5
GD
0.3486
0.1043
0.003318 — this amount was
included in the previously
allocated 0.300 MGD (0.1497
MGD total allocated)
0.4529
30.2%
11. Complete this section for each pump station you are responsible for along the route of this proposed wastewater flo
List pump stations located between the project connection point and the WWTP:
Pump
Station
(Name or
Number)
Village
Center
Sherrills
Ford
Pump
Station
Permit
No.
Firm
Capacity, *
MGD
(A)
Design
Average
Daily Flow**
(Firm / pf),
MGD
1.375 0.55
1.73 0.692
Molly's
a 1,825
Brown
Chanel 1.825
(B) (C) (D)=(B+C) (E)=(A-D)
Obligated,
Approx. Not Yet Total Current
Current Tributary Flow Plus
Avg. Daily Daily Flow, Obligated
Flow, MGD MGD Flow
Available
Capacity* * *
0.0144 0.1017 0.1161 0.4339
0.0144 0.1017 0.1161 0.5759
0.73 0.0144 0.1017
0.1161 0.6139
0.73 0.0144 0.1017 0.1161 0.6139
* 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 (pi') 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 < 0.
Downstream Facility Name (Seer) Hickory -Catawba Collection System
Downstream Permit Number WQCS00256
Page 1 of 6
FTSE 10-18

Certification Statement:
Warren Wood, City Manager certify to the best of any 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 1 and 11 plus all attached planning assessment addendurns for which 1
am the responsible party. Signature of this fo.rm certifies that the receiving collection system or treatment
Works has adequate capacity to transport and treat the proposed new wastewater.
Signing Offi
City Manager
Signature Date
Title ofSigning Qfficial
Page
c
6
FTSE I0-1

lC1 E , Water Quality Section
0 E. Center avenue
Mooresville, NC 28115
704-663-1699
TO torn ay Concern:
Enclosed is a Fast Track sewer permit for our VSE -tore Sewer Outfall project in Catawba Coim Included
In the package is one original and I copy of the application, this cover letter, a cheek for $480, Fast Track
d the Site Map on the USGS map.
Please contact tie if you have any cluesbons or r t ttire adcliti > a
Sincerely,
BBC VSFf
Steven Bailey
ntot
often.
21000 Torrence Chapel Road, Suite t itCornelius C 28031
3.
Phone: [phone]

FAST TRACK SEWER ENGINEERING. CERTIFICATION
ProPVEIYNCDENRIDWR
PERMITTEE: CITY OF HICKORY
PERMIT #: WQ004 I 036
PROJECT: IltE VILLAGE AT SHERR
ISSUE DATE: JULY 24, 2019
MAY 1 3 ?ON
OIJ IFALL WQR 0 S
MOON (7S ViLLE REGR)NAL ()MC):
This project shall not be considered complete nor allowed to operate in accordance with standard
Condition 7 of this permit until the Division has received this Certification and all required supporting
documentation,. It. should be submitted in a manner that documents the Division's receipt, Send the
required documentation to the Regional Supervisor. Water Quality Regional Operations Section at the
address noted in .the page footer.
Any wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Certification shall he considered a violation of the permit and shall subject the Permittee to
appropriate enforcement actions. The Permittee is responsible for tracking all partial certifications up
until a 'final certification is received by the Division. A Final Certification shall be a complete set. of
record drawings and desil.m calculations regardless of whether partials have been submitted,
PERMITTEE'S CERTIFICATION
I. the undersigned agent for the Permittee, hereby state that this project has been constructed pursuant to
the applicable standards & requirements, the Professional Engineer below has provided applicable
clesign/construction information to the Permittee, and the Permittee is prepared to operate & maintain the
wastewater collection system permitted herein or portions thereof.
ed Name. Title
Signature
ENGINEER'S CERTIFICATION
Date
1.C,_$4.1.11:4Soett 0- .4300C) , as a v registered Professional Engineer in the State of North Carolina,
having been authorized to observe periodically. weekly, E rum time) the construction of the
project name and location as referenced above for the above Permittee hereby state that, to the hest am)/
abilities, due care and diligence was used in the observation of the construction such that the construction
Was observed to be built within substantial compliance of this permit; 134 linear feet of 8-inch public
gravity sewer; 1 5A NCAC 02T; the Division of Water Resources' (Division) Gravity Sewer Minimum
Design Criteria adopted February 12. 1996, as applicable; the Division's Minimum Design Criteria for
the Fast-Track„Permitting of Pump Stations and Force Mains adopted June 1, 2000, as applicable; and
other supporting materials.
North Carolina Professional Engineer's Seal wisignature & date:
,Final
Partial (include description)
Certification Comments/Qualifiers (attach if necessary):
NC DWR — Water Quality Regional Operations Section 610 East Center Avenue, Suite 301, Mooresville, NC 28115
Mooresville Regional Office Phone: [phone] FAX; (704)-633-6040

V'DES GN
SHERRILAS FORD TIMES CONVENIENCE STORE &
FAST
1. Design Flo�a
A. Average ail ° Flow(ADF)
Demand:
-ADF1+ . to rr at eats 40 Oa' Day/ e t
140Minta)
0 (Ta1I1)ayF'1 0 0 .0110 S
1.440
1 i.)1 — 1 f {1 C1 a11I)a} 240(1 Gal/Da
1 4 w.ay
al,a' ='lira.
B. Peak Day
Peak 1)(y ak Factor
1 e rk 1) .y >.t1 al,a'1 °iira 1. ` ea l a - 4,5
1 �1 F'1ir1<
CDENRiDlt
C. Pipe Capacity
Capa
Q = 3tw
f 8 inch PVC lad 0g 4% Mope w Itl = 0.01, HOW i 0.7 Full
9 GPI)
of ° rrc landb uk of PAC Pipe tlrai- ell PVC Pipe: .s ociati�
3 0, 2° GPI) (Capital t\ i `*480)(Peak 1 10\
capacity for the protect
ch PVC i adequate in

CERTIFICATION CHECKLIST
To be completed by the certifying engineer prior to operation of the permitted sewers, per
Certifying Engineer: C..141Lis PIA1Ett._ MAY'
Certification Review Date: 3 (P)
Project Name: Vi
WQ00 Project. County: CA-rAweA
lias permittee information changed since the permit was issued (or last modi led): change of mailing address,
change of ownership, transfer from developer to 110A/P0A, etc. 11 Yes No
• If yes, please provide either a change of ownership form or new contact information. Note that transfer of
permits from the developer to the 11.0A/P0A must occur with the first certification.
2) Have the as -built drawings have been signed, sealed, and dated by an N.C. PE?
3.) Final Engineering certification?
Yes No
Yes
No
(020
Pric,w:NAL OFFICE
If Partial Engineering certification, provide detailed narrative including what is beiniVAIAlgiWiideVtittiiiiid00A
phase, what was previously certified (if applicable), and what is left to be certified. SOk-,10M
4) Adequate information related to sewer lines:
Yes No 1— N/A
• Three feet minimum cover has been provided for all seers unless ferrous pipe was instal
• Minimum diameters for gravity sewers are 8-inches for public lines and 6-inches for private lines.
• Manholes have been installed: At the end, of each line, at all changes in grade, size, or alignment, at all
intersections, and at distances not greater than 425 feet: minimum diameter shall be 4 feet (48-inches).
5) Adequate information related to pump stations: L Ye L No d N/A
• Ensure power reliability option was selected per 15.A N( AC 021 ,030.501).
6) \Vas project construction completed in accordance with all of the following: 'Yes
No L
N/A
• 15,A ( t 1, Minimum 1)esiu.rt .Criteria ['or thepertniu91 Gravity Soe,vrs)latest versio , and
IIX for the Permittino_or lium Stations and Foree Mains (latest version)?
If not, a 'variance approval is required in accordance with t02;11.0 1t)5111't, prior to certification and
(peration.
• Contact the Central Office to discuss the variance to determine a course of action.
• Applicant must submit two copies of the variance request form, plans, specifications, calculations, and any other
pertinent information to the Central Office (one hard copy, one digital copy).
• The central office will -review the variance request, and if approvable, specific language regarding the variance
will be incorporated intothe permit, either via a special condition or a supplementary letter. A copy of the
reissued permit with variance language or the variance letter must be maintained with the original documents.
7) Does the project contains high priority. lines (15.,,\ NtAC (CT .04021211? I Yes [XI No
• [ryes, ensure that the permit already contains the necessary condition related to high priority lines 15A NCAC
02T.0403 (a)(5). If the permit does not include this language, the Fast Track reviewer will reissue the permit with
the appropriate language.
8) Are Permit modifications are required for any changes resulting in non-compliance with this permit (including but not
limited to pipe length changes of 10% or greater, change in flow, pump station design capacitydesign change of 5°/0 or
greater, andlor change in the number/type of connections)? Yes No
• If yes, a permit modification request must he submitted to the appropriate Regional Office, and a modified
permit with revised certification must be issued prior to certification and operation.
NC DWR — Water Quality Regional Operations Section 610 East Center Avenue, Suite 301, Mooresville, NC 28115
Mooresville Regional Office Phone: [phone] FAX: [phone]