WQ0042236_Regional Office Historical File Pre 2018

APPLICANT INF-OI
1, Applicant's name:
Applicant type:
Department
State of North ('arol(I.
n ° ronniental Quality.
Division of Water Resources
Iax•'1NCAC`01T".'BOO-..-} TTRACK SEWER SYSTEM EXTENSION APPLICATION
ETA (.1-1.6 I& SUPPORTING DOCUMENTATION
RECEIVEQa1AIC ITttrtt
A
U individual
Federal
`'s tonne: Ste
4. Applicant's mai
City: `frcltt rt) rt
Applicant's contact ittftrtttntrttt°
Phone number: (704) S28 ✓600 Email Address:
PROJECT INFORMATION:
J:, t i `e�yc Lcnneeti a t€ ")f.' I3 ritttt�Canrpus Project otaane �<'t1w__
Application°'Prc,riect status: Ei Proposer (Ne t Permit)
if"tt ant alific ttion provide the e\istit is intit: 'number 4VQ0(}.._
but part oftt tttastet° pl;ttt, previcle tltc e i tita ; permit n
3. County There pioieet r le catrtl: [,reel l
4. Approximate Coon:litts:ttes ( )ee,ia tttl lt� xre.e
Parcel If) (if applicable): 4731 Sr?
(or Parcel IC) to closest downstream sewer)
if new ce
at.ic:n Number:,l
eak Per I r1 !C °_() I" .tll_I)f (h)
20
Zip:
III. CONSULTANT II\FORMA FION:
1. Professional I rt t,in e 13 tt tr¢tit?
Finn: W' ,01 C"oni ullttt°tts.
Nlailin. address:
City: Morganton State
Pltttne t�tnuber 11°'
IV. WASTEWATER TREAT 1 NT F
l_ )Facility Name
Owner Name:
RECEIVING DO AS"
1_ Permit Numbers
Pet:mit `Prot
0 '' 1. e>at truck 80 $9i9,
I.aeense Nunrlrer: 792.51
INEORMA'FIOtN:
NC0020501
`t)RNI"t1ON (i
1) v nstre:mt
rr? 1..k 1141
JAN 1 3 2021
WQAOS
MOORESVILLE REGIONAL OFFICE
ed 'Public Utility

L
THE COMPLETED APPLICATION PACKAGE. INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
Asheville Regional Office
Water quality Section
Fayetteville Regional Office
Water Quality Section
Mooresville Regional Office
Water quality Section
Raleigh Regional Office
Water quality Section
Washington Regional Office
Section
7-ADDRESS
2090 US Highway 70
Swannanoa, North Carolina 28778
[phone]
[phone] Fax
225 Green Street Suite 714
Fayetteville, North Carolina 28301-5094,
[phone]
[phone] Fax
COUNTIES SERVED
Avery, Buncombe, Burke, Caldwell, Cherokee,
Clay, Graham, Haywood, Henderson, Jackson,
Macon, Madison, McDowelt, Mitchell, Polk,
Rutherford, Swain, Transylvania, Yancey
Anson, Bladen, Cumberland, Harnett, Hoke,
Montgomery, Moore, Robeson, Richmond,
Sampson, Scotland
610 E. Center Avenue Alexander, Cabarrus, Catawba Cleveland,
Mooresville, North Carolina 28115 Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone] Stanly, Union
[phone] Fax
1628 Mail Service Center
Raleigh, North Carolina 27699-1628
[phone]
[phone] Fax
943 Washington Square Mall
Washington, North Carolina 27889
[phone]
[phone] Fax
ilminqton Regional Office 127 Cardinal Drive Extension
Water Quality Section Wilmington, North Carolina 28405
(910) 796,-7215
[phone] Fax
inston-Salern Regional Office 450 W. Hanes MiII Road
Water Quality Section Suite 300
Winston-Salem, North Carolina 27105
[phone]
Chatham, Durham, Edgecombe, Franklin,
Granville, Halifax, Johnston, Lee, Nash,
Northampton, Orange, Person, Vance, Wake,
Warren, Wilson
Beaufort, Bertre, Camden, Chowan, Craven,
rituck, Dare, Gates, Greene, Hertford, Hyde,
Jones, Lenoir, Martin, Pamlico, Pasquotank,
Perquimans, Pitt, Tyrrell, Washington, Wayne
Brunswick, Carteret, Columbus, Dublin, New
Hanover, Onslow, Pender
Alamance„ Alleghany, Ashe, Caswell Davidson,
Davie, Forsyth, Guilford, Rockingham, Randolph,
Stokes, Surry, Watauga, Wilkes, Yadkin
INSTRUCTIONS FORFORM: FTA 04-10 & SUPPORTING 7UNIEN1 KI
Page 3 of 3

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 EN/A
3. If the Applicant is a Hume/PropertyOwners' Association. has an Operational Agreement (FORM; HOAI been attached?
❑ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
® Residential Owned
❑ Residential Leased
0 School / preschool / day care
❑ Food and drink facilities
® Businesses / offices / factories
❑ Retail (stores, centers, malls)
❑ Retail with food preparation/service
❑ Medical f dental / veterinary facilities
Church
❑ Nursing Home
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool /Clubhouse
® Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
5. Nature of wastewater : 100 °io Domestic/Commercial °'° Commercial
% Industrial (See 15A NCAC 02T ,0103(201)
there a Pretreatment Program in effect? ❑ Yes 0 No
6. Has a flow reduction been approved under I5A NCAC 02T .0I 14(fr D Yes ® No
> If Yes, provide a eopv of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(fl)
Daily Design Flow"
No. of Units
Flow
Residential (children's home)
60 gal/person
40
2,400 GPD
Staff
25 gal/person
100
2,500 GPD
Church
3 gal/seat
200
G- GPD
Fitness Center
50 gal/100 s1, fi-,
5,000
2,500 GPD
Gymnasium
50 gal/100 S. , ff.
5,000
2,500 GPD
Swimming Pool
10 gal/person
200
2,000 GPD
Total
12,500 GPD
t/
a Sea I S A NCAC 02T .01 14(b), (d), (el(11 and (e)(2' far caveats to wastewater design 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: 12.500, GPD (per 15A NCAC 02T .0114)
A 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 be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
0 Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16
Page 2 of 5

GRAVITY SEWER DESIGN d %RITERFA (lf Applicable) 02T .0305 &
Sauutitariz
r
be pertn itted:
DC
es to meet niintnllll.fn
la
.ing of Gravi
o minimum slope
i n l cat°
Sewers):
�r design criteria
ed and a violation of the MDC
VIII. I. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .030- MI)C (Pump Statiola /Force l�I
OI PLE"IE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Purnp statio
2. Approximate Coordinates (Dec atra t1 Degrees): l.ati
Design flow of the pump station: 54 millions g
4. Operational points) of tl'ic. pttrral )s). 1 gallons per 1
5. Summarize the force mai
Power reliability in accorcla.alce vit1
E Standby power source or pump
Required .for all pump stations with
Must be permanent to facility
Or if the pump station has an average da
Portable power source 1.A. ntantaal
.0305(1)(4 )(C.)
c
or
A, NC",
5 720308
I on4uitude
r't capacity)
160 feet total dynamic head TM()
eras daily flint fret
n.
'Material
wt or equal to 15,t)f)0 gallons per
ns per day:
ion, eltaick-connection receptacle and teleinctty 15A NCAC 02T
nier cttcy pump connec
It shall he demonstrated to the Divisiondrat t@le 1
and is compatible with the station.
If the portable power source or pump is dedicatee
capacities and the rotation schedule of portal
in the case of a multiple station power outage,
n and tel :meta -A NCAC 02T .0 305(h)(
n
red by tl'ie applicant (draft agreernetl't)
tataalliple putttp stations, atn esath.aattt)n of all the pump stations' storar „c
power source or pump, including travel timelrames, shall he provided
FORM: FTA O l--16

VI. GENERAL REQUIREMENTS
I. If the Applicant is a Privately -Owned Public tittlity„ has a Cernficate of Pub ic Convenience and Necessity been attached?
Yes [IN° NIA
2, If the Applicant is a Developer of lots to he sold, has a Developers Operational AzreetrientlEORM:, DLV,) been attached?
ri Yes JNo NIA
3, If the Applicant is a Home/Property Owners" Association, has an Operational .A.D. einem (FORNE flak) been attached?
El Yes LINo N/A
4. Origin of WaStewater: (check all that apply):
[E] Residential Owned
Ej Residential I,eased
Ei School / preschool I day care
El Food and drink facilities
El Businesses offices / factories
LI Retail (stores, centers, malls)
El Retail with food preparation/service
El N4edical / dental I veterinary 'facilities
N Church
El Nursing Home
5. Nature of Nvastewater 100 Dom.estic/Commercial 0 Cormilercial
'Indu.strial. (See I 5A. NCA.0 02T .010.300I)
1 Is there a Pretreatment Program in effect?
6,. Elas a flow reduction been approved under 15ANCAC 021 .0114(0?
If yes, provide a copv of flow reduction approval letter
Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Residntial (children's home)
Staff
Church.
Fitness Center
Gymnasium
Svvim.min.g Pool
60 gal/person
25 gal/person
3 gal seat
50 gall100
50 gall 00
10 tot/person
Car Wash.
ri :Hotel and/or Motels
Swimming Pool /Club,house
NI Swimming Pool/Filter Ba,ckwash
El] Other (Explain in Attachment)
'No. of Units
40
Flow
2,400 GP)
i 00 2,500 GP.D
200 12,5.00 GPD
5,000 2,500 GPI)
5,000 2,500 GPI)
200 2,000 GPI)
Toted 12,500 GPD
a See 15.A NC AC 021 .01144b1„,;(_cille)( ) and (c),(2J for caveats to wastewater design .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 k'action rentals as defined
in (i.S. 42A-4).
h Per 15A NCAC 021 .01.I 4(c), design flow rates for estahlishinents not identified fin table 1.5A NCAC 02/f 01 f4,j shall he
determined using available flow data, water using .fixtures, occupancy or operation patterns, and other measured data.
8, Wastewater generated by project: 12,500 GPI) (per 15.ANC,Acf.)2I,0114)
Do not include future flows or previously permitted allocations
If permitted flow is rero, indicate why:
El Pump Station or Gravity Sewer where flow will be peril:lined in subsequent permits that connect to if
Li Flow has already been allocated in Permit Number:
El Rehabilitation or rep cement of existing sewer v th no new tloss e.,- e-ft.:!d
El Other (Explain):
1ORM: Ff A 04-16 Page 2 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(0:
1. Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (g)
➢ 15A NCAC 02T.0305(fl contains minimum separations that shall be provided for sewer systems:
® Yes El 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)
. I8 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
**Any 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
**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.0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
➢ 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 ® NIA
➢ 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?
➢ Information can be obtained from the 401 & Buffer Permitting Branch
❑ Yes ® No
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 El No ❑N/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

X. CERTIFICATIO;NS:
I. Does the submitted system ,comply wit
and Force Mams,.f,latcst )ersiot tend the
L No
estnCrateria
Criteria (latest v
ipplica
tat[
If No, ornplete and submit the Variance/Al e ative Design Ftawtpuest application (VA f)( I.Ci-14) and supporting documents for
review, Approval of the request is required prior to submittal (Attie Fast Track Application and supportin documents.,
Professional rtt ttcer's CertiGic:;ation:
(Prolc'ssicmal °tigineer.s nartee Errant A application 11
BHA
s Breit re l vved by me ra.aad is accurate, complete and consistent with the in
engine calculations, and all other supporting documentation to the best of
of ni knowledge the proposed design has been prepared in accordance vi
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum
of Pump Stations and Force 'Nit -tins (latest version? A.lthouth other professionals
submittal package, inclusion of these materials under my signature and seal sag
have,lud.ged it to be consistent with the proposed design.
NO'1 F, •- En accordance with (:;eraeral Statutes 14a3-2 15.6A. ar
statement, representation. or ceriiIica
include a fine not to exceed S10:000, as sell as civil
Applteat
cation pa
aloes tr
North Carolina Professional Engincter's scal,
AC:
has been reviewed by rt•
this application are not
application package is subvi
and is acct
p
and/or criminal
of this lertrait be viealated. 1 also understand that if
porting information. and attachments are not
application for
nation supplied in the plans, specific: Lions.
knowledge, I further attest that to the befit
the applicable regulations, Gravity Sewer
the ''as't-Track. Permitting
ed certain portions of this
?.6fi, any person who knosviu
11 be gt:rilty of a Class .
ure, and date:
1plete to the hest
NOTE -, In accord:aneem c�itla C;eraertal Sttattates ld
statement, representation, or certiftc.ta,tic n in. any ap
include a fine not to exceed S 10,000 as well as civil penal
aI.s6A al
y knowledge. 1 understand 11'
entatioaa aani attachments ar
and that an) dkL1
ction that
water il.e,
against the Diva
parts of this application package are not completed and that if
this application package will be returned to me as
Mich may
applica
d I42ry2I .6B,
ckatc sl°tall be gu
to S2 3.000 per vio
equtred parts Lai
included, this
tee- ti ona t'W-
ade et v'tl penalties,
should a condition
in.`rli' makes any tal.se
which naay
FORM: ETA 04-I(
e5of5

IX. SETBACKS & SEPAJtt TIONS 0213 .0200 & I5A NC'AC 02T .0305(t`)):
1. Does the project comply with all separations found in 15A NC;\C 0 1, .0305(0 .4z (a)
15A NCAC 02' 0305(f) contains tr, imuni. se p rations that shall be pro
Setback. Parana-.
orm sewers tancf otlni.r tttiiities not listed below (vcrtit:al)
twins dveriical vvatea' oven" evv°er includint in benchcal trenches
ao-ns
izontr
Reclainned ain lrnes (verticalrc-elatnled over scvvcr)
naatcr
Reclaimed avatar lines (hc`rrizontal - rcclaittned over 4evr°er)
*Any private or public water supply source, including any wells,.VV" I lvatcrs of Class 1
C r s Il ina outnded reservoirs used as a source of"drinking
vstiater.
*a tifi'atcrs e.lassit ed WS (except WS-I or WS-V). B. SA„ CONY', tiVrA'', or SB from normal
lti h water or ttcle elt vation) arid. wetlarnds sec. item l X.2)
vAnd° other strcart, take, impottndtaaent, or rour'rd rsater lowering and surface drama *e:•
s% buildi
toesto pot
Drat tt
s'. il11.
eat h a]
AuV
Final
hanktalet
or ca
2 feet err' nitre vfe.r
and interceptor drains
15A NCAC tl(}m(t;) contains altern
**Stream classifications can be identified using
nconrplianec with 0 1 0. 0 t) or_(z), see Se
teal height
24 inches
18 Melnt
10 feet
36 nac
n 02 l 0305JD cannot be achieved.
n's NC Surface.,_ Water Classifications wehparte
is application
Does the project comply with SCatiort rccluirenretnts f'inr vetlaands'i (50 feet o
See the Diivi,sion's draft see,°ia°ttiorl aeetttrrerttnts for situa.tit
, No variance is required if the aliennitir e. clesifn et'iterta specifre
As built documents should reference the location cif arenas effected
Yes riNo
Yes Li No NIA
be meet
and construction
.Does the project comply vrith se:tl+acks t`crut°rci rn the river hasrules pt r ;I5A NCAC 0213 02Q0 LI Yes NIA
• 'This would include Irclut Bul'f"ered Streams per flSANCAC 2B 0202
4. Does the project, require cover, aa e;'arathorizdtion under a 404 Nationwide or
indivxidual permits or 401 Water Quality Certifications`'
Information can be ohtaine-d from the 401 & ):tuner Pci matt iz k twatlrc t
Does project comply
l CAt Oaf 01.05(c)(t) (ad.ditional pernnits'certifica
a5'es No
No
Per ISA NCAC Q2T .O1.051c)(6„), directly related environmental permits or ccrti'tictttion applications are l eitia prepared, have
been applied for, or have been obtained. issuance of this p€:•rmit is contingent on issuan .e of dependent permit, (erosion and
sedimentation control plans, stui111 vrater management Owls, etc.),
Does this project in etude an} sesse•r collection lines that aaa"e dee
Per 15A NCAC( 02E 0402. "hi h priority sewer" means "air
positioned parallel to streaanihanks that is subject to erosion tha
ii
i h-pr
contaetina strrt`atce vvaate rs,. siphon,
N:A
dun ; type (aerial line, size, material, and 1
High priority lines shall iae inspected by the perrnittee or its representative nt feast oc
documented per 15A NCAC: ()2"-.04030)(5) or the perntiiee's individual System-VVic
nouths and .inspections
i nerotit.
6

SULTA TS put-
1)elebitibeif28a2020
405:Sputh.Ste888g $treet„ Morganton,. NC:286575
42.8 43325681 fax .828 •213a. 5662. Nofo@weNt-c828288t821888,828
Mooresville Regional Office
NCDENR - Water Quality Section
610 East Center Avenue
Mooresville, NC 28115
RECEIVED/NODES/EWE
JAN I 3 2021
WI:EROS
MOORESVILLE REGIONAL OFFICE
Seer Pertnitifor Connection.to .CHA Barium-( ataptiS
if° Whom It Ma) Concern.;
The project will consist of the installation of approximately 2,895 let of 8-Mull graVi ty sewer,
pump replacements for Technology Drive PS and approximately 4,245 feet or(" force Italia The
project location is on the north side of the Town of Troutman. The project will serve Childrens
I lope Alliance's Barturn Springs Campus, which will add 12,500 GP!) to ifroutman's system.
Included in this submittal is the 1 ast01 rack Application, Flow Tracking Applicatiem, maps and a
check for S480,00.
Sincerely,
WEST CONSULTANTS, P1I2C
Benjamin B, Thomas, PE
Enclostires

High Priority (Aerial) Line Description
There will be one aerial line for this project. The aerial line is on Sheet 2 of the plans between ex.
manhole 174 and manhole 1. The aerial line will be constructed over Duck Creek and will be 8"
flanged ductile iron with flanges centered with the creek. Concrete anchors will be installed on
each side of the creek.

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Town of Troutman
Project Name for which flow is being requested: Connection to CHA Barium Campus
More than one FTSE may be required for a single project if the owner of the WJVTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name:
b. WWTP Facility Permit #:
All flows are in MGD
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 0.0125
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
11. 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***
Tech. Dr 0.454 0.181 0.0034 0.0243 0.028 0.153
I-L Crk.
1.140 0.455 0.198 0.2435 0.4415 0.0135
* 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 < 0.
Downstream Facility Name (Sewer): Statesville Third Creek WWTP
Downstream Permit Number: - NC0020591
Page 1 of
FTSE 10-18

`Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Town of Troutman
Project Name for which flow is being requested: Connection to CHA Barium Campus
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.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name:
b. WWTP Facility Permit #:
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 permitted flow used
All flows are in MGD
0.0125
II. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations Iocated betsveen 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 / pt), Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***
Tech. Dr 0.454 0.181 0.0034 0.0243 0.028 0.153
I-L Crk. 1.140 0.455 0.198 0.2435 0.4415 0.0135
* The Firm Capacity (design flow) of any pump station is defined as themaximum 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 < 0.
Downstream Facility Name (Sewer): Statesville Third Creek WWTP
Downstream Permit Number: NC0020591
Page 1 of 6
FTSE 10-18

CCertit'acation Statement:
t Steve Shealy
tlae volume of wastewater to he: permitted in this
wastewater treatment facility and that the flow
related sanitary server overflows or overburden a
o the best of
iect has been
ov+ led
the ad
-valuated along the route
cipated to cause any capacity
lip station en route to the receiving
t.naent plant gander normal circumstances, given the iitapletaaentatwn of the planned improvements
ified in the planning assessment where ;applicable. This analysis has been performed in accordance
ocal established policies and procedures using the best avaailaable data, This certification applies to
1 above in Sections 1 and. II plus all attached planning assessment: aaddendums for which l
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.
FTSI' l0-18

W .
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Town of Troutman
Project Name for which flow is being requested: Connection to CHA Barium Campus
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.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name:
Third Creek WWTP
b. WWTP Facility Permit #: NC0020591
Allflows lows are in MGD
c. WWTP facility's permitted flow 6
d. Estimated obligated flow not yet tributary to the WWTP 0.7157
e. WWTP facility's actual avg. flow 1.0
f. Total flow for this specific request 0.0125
g. Total actual and obligated flows to the facility 1.7282
h. Percent of permitted flow used 28.8
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 / PO, Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***
* 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.
V 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 (Sewer):
Downstream Permit Number:
Page 1 of
FTSE 10-18

III. Certification Statement:
I William E. Vaughan, PE 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.
ign`ing Official Signature
Tit e of Signing Official
Date
Page 2 of 6
FTSE 10-18

DUCK CREEK
CLASS C
PROPOSED 8°' GRAVITY SEWER
TECHNOLOGY DRIVE P,S,
PROPOSED 6" F oRC E MAIN
RIMMER FARM ROAD
Tr utrn
USGS MAP
TOWN OF TROUTMAN
SEWER EXTENSION TO ELIMINATE NPDES DISCHARGE AT
CHILDREN'S HOPE ALLIANCE (CHA) PROPERTY
TROUTMAN, NC
NOT TO SCALE

IVE
MER FA
PROJECT LOCATION MAP
TOWN OF TROUTMAN
SEWER EXTENSION TO ELIMINATE NPDES DISCHARGE AT
CHILDREN'S HOPE ALLIANCE (CHA) PROPERTY
TROUTMAN, NC
NOT TO SCALE
404 `h
433,5861
NO 44»5565 No 4,0203