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HomeMy WebLinkAboutWQ0023336_Application (FTSE)_20031126,.ACKAPPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 1 USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number: (to be completed by DWQ) tO Q 61!)a 33 3 j 1. Owner: 1 a. Public Works Commission of the City of Fayetteville Full Legal Name (company, municipality, HOA, utility, etc.) Ib. Joseph E. Glass, P.E. - Water Resources Engineering Manager Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorized signing officials!) 1 c. The legal entity who will own this system is: El Individual ❑ Federal ® Municipality ❑ State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify): ld. 955 Old Wilmington Road le. Fa etteville Street Address If. North Carolina z Q 1 h. (910) 223-4740 1 i. (910) 829-0203 QTelephone Facsimile O 2. Project (Facility) Information: a2a. King's Grant Subdivision -Multifamily Tract (Section C) 2b. Cumberland State G. Brief Project Name (permit will refer to this name) < 13. Contact Person: Pimna Chomchai, P.E. Q 3a. The Rose Group, Inc. City lg. 28301 Zip Code 1j. 'oe.•lass • fa •wc.com E-mail County Where Project is Located Almm. nn'i Affilinfinn of Cnmiv.nn \AIk- l'nn Aneu.n.• ll.,enfi...... AM..t at.... A....G....a..., THE ROSE GROUP. ENGINEERS • PLANNERS • SURVEYORS P.O. Box 103 Fayetteville, NC 28302 THE SUM OF FOUR HUNDRED U.S. Dollars 00/100 ONLY PAY TO THE ORDER OF NC DENR 225 Green Street Fayetteville, NC 28301-5043 tp[Poo 3�3k BB&T Branch Banking and Trust Company 66-1121531 45755 DATE AMOUNT 10/20/2003 $400.00 THE ROSE GROUP. INC. Caart & BOTTOM BORDERS - COLORED PATTERN ARTIFICIAL `;4ATERMARK. ON REVERSE SIDE. - MI SING FEATURE IND CATES .A COP',' Ce LAI rcesiuenuai auoaivision ll.l ElApartments/Condominiums 0- 0 Mobile Home Park 0 School m 0 Restaurant O Office u uar vvasn ❑ Institution ❑ Hospital ❑ Church ❑ Nursing Home ❑ Other (specify): 100 % Domestic/Commercial % Industrial % Other (specify): . Volume of wastewater to be permitted in this project: 13.740 gallons per day . 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 VVA A' /M NOV ?. State of North Carolina Department of Environment and Natural Resources Division of Water Quality FAST -TRACK APPLICATION for GRAVITY SEWERS, 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 will be serving residential or commercial lots (e.g., houses, condominiums, townhomes, outparcels, etc.) that will be owned by a homeowners' association or developer (Item B(2b)). 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 WVVTF, 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/WVVTF. 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 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, 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 for each different waterbody (where the sewer line is within 100 feet of such waterbody - see Instruction VII). ❑ VII. Watershed 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. INSTRUCTIONS FOR FORM FTA 02/03 • ❑ VIII. Environmental Assessments — If this project is subject to an Environmental Assessment (EA) ]15A NCAC 01C .0500], this application can not be used. Send the project application on Form PSFMGSA 10/99 to the Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. Applications can not be processed until a Finding of No Significant Impact (FONSI) or Environmental Impact Statement (EIS) 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 Professional Engineer (PE). The applicant signature must match the signing official listed in Item A(1 b). The PE should NOT certify the application if he/she is unfamiliar with 15A NCAC 2H .0200, the Gravity Sewer Minimum Design Criteria (most recent version) and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains (most recent version), as applicable to the project. Certification by a PE who is unfamiliar with these documents is subject to NC Board referral. THE COMPLETED FTA 02/03 APPLICATION PACKAGE, INCLUDING ALL SUPPORTING DOCUMENTS AND $400 FEE, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE ADDRESS COUNTIES SERVED Asheville Regional Office 59 Woodfin Place Asheville, North Carolina 28801 (828) 251-6208 (828) 251-6152 Fax Avery, Buncombe, Burke, Caldwell, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Yancey Fayetteville Regional Office 225 Green Street Suite 714 Fayetteville, North Carolina 28301 (910) 486-1541 (910) 486-0707 Fax Anson, Bladen, Cumberland, Harnett, Hoke, Montgomery, Moore, Robeson, Richmond, Sampson, Scotland Mooresville Regional Office 919 N Main Street Mooresville, North Carolina 28115 (704) 663-1699 (704) 663-6040 Fax Alexander, Cabarrus, Catawba, Cleveland, Gaston, Iredell, Lincoln, Mecklenburg, Rowan, Stanly, Union Raleigh Regional Office 1628 Mail Service Center Raleigh, North Carolina 27699-1628 (919) 571-4700 (919) 571-4718 Fax Chatham, Durham, Edgecombe, Franklin, Granville, Halifax, Johnston, Lee, Nash, Northampton, Orange, Person, Vance, Wake, Warren, Wilson Washington Regional Office 943 Washington Square Mall Washington, North Carolina 27889 (252) 946-6481 (252) 975-3716 Fax Beaufort, Bertie, Camden, Chowan, Craven, Currituck, Dare, Gates, Greene, Hertford, Hyde, Jones, Lenoir, Martin, Pamlico, Pasquotank, Perquimans, Pitt, Tyrrell, Washington, Wayne Wilmington Regional Office 127 Cardinal Drive Extension Wilmington, North Carolina 28405 (910) 395-3900 (901) 350-2004 Fax Brunswick, Carteret, Columbus, Duplin, New Hanover, Onslow, Pender Winston-Salem Regional Office 585 Waughtown Street Winston-Salem, North Carolina 27107 (336) 771-4600 (336) 771-4631 Fax Alamance, Alleghany, Ashe, Caswell, Davidson, David, Forsyth, Guilford, Rockingham, Randolph, Stokes, Surry, Watauga, Wilkes, Yadkin For more information, visit our web site at: http://h2o.enr.state.nc.us✓ndpu/ INSTRUCTIONS FOR FORM FTA 02/03 FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 1 USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number: -7 (to be completed by DWQ) mitypQ v 33 1. Owner: 1 a. Public Works Commission of the City of Fayetteville Full Legal Name (company, municipality, HOA, utility, etc.) ...___......_. _.__... Z 1 b. Joseph E. Glass, P.E. — Water Resources Engineering Manager 0 Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorized signing officials!) F"" lc. The legal entity who will own this system is: • Individual ■ Federal Municipality ■ State/County ■ Private Partnership ■ Corporation • Other (specify): Fa Ce 1 d. 955 Old Wilmington Road le. Fayetteville 0 Street Address City LL Z If. North Carolina 1g. 28301 z State Zip Code 0 El h. (910) 223-4740 li. (910) 829-0203 1 j. joe.glass©faypwc.com Q Telephone Facsimile E-mail o 2. Project (Facility) Information: 1 a 2a. King's Grant Subdivision -Multifamily Tract (Section C) 2b. Cumberland G. Brief Project Name (permit will refer to this name) County Where Project is Located < 3. Contact Person: Pimna Chomchai, P.E. Q 3a. The Rose Group, Inc. Name and Affiliation of Someone Who Can Answer Questions About this Application 3b. 910-323-3400 Ext. 223 3c. pimna.chomchai@rosegrp.com Phone Number E-mail 1. Project is 0 New • Modification (of an existing permit) If Modification, Permit No.: 2. Owner is 0 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) • Retaining Ownership (i.e. store, church, single office, etc.) • 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)) Z 3. Public Works Commission 0 Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project iH 5 4a. Cross Creek 4b. NC0023957 0 ! Name of WWWTF WTF Permit No. 0 ,5a. Public Works Commission 5b. 15" 6c. Z Owner of Downstream Sewer Receiving Sewer Size Permit Number of Downstream Sewer H 6. The origin of this wastewater is (check all that apply): 22 0 Residential Subdivision ■ Car Wash W■ Apartments/Condominiums IN Institution 100 % Domestic/Commercial 12 ■ Mobile Home Park • Hospital ■ School • Church % Industrial Im • Restaurant • Nursing Home ■ Office % Other (specify): ■ Other (specify): 7. Volume of wastewater to be permitted in this project: 13.740 gallons per day 8. If the permitted flow is zero, indicate why: is subsequent permits that connect to this line in Permit No. • Interceptor Line - Flow will be permitted • Flow has already been allocated ■ Rehabilitation or replacement of existing sewer with no new flow expected CT A A'l /AZ ,.FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 2 I. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2H .0219(1) 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(1)(1-2) 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(1)(3). There will be 112 units of condominiums with 3 bedrooms per unit; 120 gal/unit/day X 112 units =13,440 gal per day. There will be a swimming pool in this Section C. Assume that there will be 30 people using the pool in 1 day; 10 gaUperson/day X 30 people = 300 gal per day. Total wastewater flow =13,440 gallon per day + 300 gallon per day =13,740 gallon per day 10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary) ENTER TOTAL LINE LENGTH IN MILES 0.64 11. Summary of Pump Stations to be Permitted (attach additional sheets as necessary) 2 0 LL Z cc W a E12. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force COMains (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: Location ID (as shown on plans Design Flow (MGD) Operational Point GPM @ TDH Gravity or Force Main (pull down menu) Gravity Power Reliability Option (dual line feed, permanent generator, portable generator, wet well storage) ;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 ICI" A An /AZ ,FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 3 1 attest that this application for King Grant -Multifamily Tract - Section C 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 retumed as incomplete. Note: In accordance with North Carolina General Statutes 143-215.6A and 143-215.68, 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. Signing Official . atu Professional En • sneer's Certification: H Q ❑ A Watershed Classification is not needed because all parts of the project are at least 100 feet away from any down (.) slope waterbody; AND, LL' 0 A Watershed 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. aLocation ID Waterbody Stream Waterbody .J on Map River Basin Index Classification 35078-B8-TF-024 Cape Fear 18-24-3 (1) 0 WS-IV W 1. Use the Division's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02/03 z (FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach additional sheets as O necessary). This document is available from our web site or by contacting the appropriate Division of Water Quality regional office (see instructions for addresses) OR indicate the following: Name of Waterbody County McPherson Creek Cumberland C .2/4, u) I attest that this a pp ion ng u � ami y complete and consistent with the information in the engineering plans, calculations, and all other supporting documentation I —to the best of my knowledge. I further attest that to the best of my knowledge the proposed design has been prepared in Q accordance with the applicable regulations, Gravity Sewer Minimum Design Criteria for Gravity Sewers adopted February V 12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June LL I 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 re signifies that I have reviewed this material and have judged it to be consistent with the proposed design. Note: In W accordance with NC General Statutes 143-215.6A and 143-215.68, any person who knowingly makes any false statement, t 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. Pimna Chomchai, P.E. complete ti for Ki Grant-M ltif 7 Tract - Section C has been reviewed by me and is accurate Professional Engineer Name 2b. The Rose Group, Inc. Engineering Firm 2c. 104 Gillespie Street Address 2d. Fayetteville City 2g. 910-323-3400 2h. 910-323-1028 2i. pimna.chomchai@rosegrp.com 2e. NC 2f. 28301 State Zip Telephone Facsimile E-mail • Submit the 8.5" x 11" topographic map as required in Instruction VI regardless of whether a classification is provided! '1. Applicant's Certification: Date "'-',,�♦4,,7� ■GNS G -4 Seal, Signature & Date LTA Al/A edICUrodInisyR2Orsolividag 10120203SMISMA,12001/ REQUIREMENTS & SPECIFICATIONS FOR Nov 2620 SEWER MAIN EXTENSIONS FOR THE PUBLIC WORKS COMMISSION FAYETTEVILLE, NORTH CAROLINA CUMBERLAND COUNTY PROJECT: Kings Grant Phase I Multi Family Tract DATE SUBMITTED November 24, 2003