WQ0037468_Application (FTSE)_20211006

Permit Number WQ0037468
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
dean. hunkele
Coastal SWRuIe
Permitted Flow
10,665
Facility
Facility Name
Shoppes at Carolina Forest Sewer
Location Address
Owner
Central Files: APS _ SWP
9/9/2021
Permit Tracking Slip
Status
Project Type
In review
Major modification
Version
Permit Classification
C
Individual
Permit Contact Affiliation
Major/Minor Region
Minor Wilmington
County
Onslow
Facility Contact Affiliation
Owner Name Owner Type
City of Jacksonville Government - Municipal
Owner Affiliation
Richard L. Woodruff
PO Box 128
Dates/Events Jacksonville NC 2854101:
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
12/11/2014 9f7/2021
Regulated Activities Requested /Received Events
Food preparation, other Additional information requested
Office Additional information received
Re
Re
WF

JOHN L. PIERCE & ASSOCIATES, P.A.
LAND SURVEYING — LAND PLANNING — MAPPING
P.O. BOX 1685
JACKSONVILLE, NC 28541
OFFICE: [phone] FAX: [phone]
E-MAIL: beMb njlonc.com
Or brianilafponc.com
TO: Dean Hunkele
N.C. Department of Enviromnent
And Natural Resources
127 Cardinal Drive Extension
Wilmington, NC 28405
NECEIVEDMCDSNajM
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Letter of Transmittal *
DATE:
September 3 2021
ATTENTION:
Dean Hunkele
Re:
Shoppes at Carolina Forest —Carolina Gifts Stores LLC
COPIES
DATE
NUMBER
DESCRIPTION
2
Fast -Track Applications for Sewer/with Street view map & Quad Ma
1
Copy of existing ernit # W 0037468
1
Copy of Quad Ma
1
Copy of Street View Ma
1
Check in the amount of $480.00
SIGNED: Betty Bullock b3a 0 n ll7

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
Division of Water Resources FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 06-21 & SUPPORTING DOCUMENTATION
Application Number: (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
I. Applicant's name: City of Jacksonville (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
El Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: Ron Massey per 15A NCAC 02T 0106(b)
Title: Deputy City Manager
4. Applicant's mailing address: PO Box 128
City: Jacksonville State: NC Zip: 2854I- 0128
5. Applicant's contact information:
Phone number: 910 938-5233 Email Address: smoore(aliacksonvillenc goy
II. PROJECT INFORMATION:
1. Project name: Shoppes at Carolina Forest
2. Application/Project status: ❑ Proposed (New Permit) ® Existing Permit/Project
If a modification, provide the existing permit number: WQ000037468 and issued date: 12/
For modifications, also attach a detailed narrative description as described in Item G of the checklist.
If new construction, but part of a master plan, provide the existing permit number: WQ00_
3. County where project is located: Onslow
4. Approximate Coordinates (Decimal Degrees): Latitude: 34.8008' Longitude:-77.4167°
5. Parcel ID (if applicable): 159993 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
Professional Engineer: David K. Newsom License Number: 18148
Firm: Crystal Coast En ineering PA
Mailing address: 205-3 Ward Road
City: Swansboro State: NC Zip: 28584-_
Phone number: 910 326-0006 Email Address: crvstalcoastengC&bizec rr com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Land Treatment Facility Permit Number: W00009267
Owner Name: City of Jacksonville
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ000037468
2. Downstream (Receiving) Sewer Information: 8 inch ❑ Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS_
Owner Name(s): City of Jacksonville
FORM: FTA 06-21

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 HOA/POA Operational Agreement (FORM• HOA) and
supplementary documentation as required by 15A NCAC 02T.0115(c) been attached?
❑ Yes ❑ No ❑ N/A
4. Origin of wastewater: (check all that apply)
❑ Residential (Individually Owned) ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential (Leased) ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool/Clubhouse
® Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home
❑ Other (Explain in Attachment)
5. Nature of wastewater: I00 Domestic _% Commercial _ % Industrial (See I SA NCAC 02T .0103(20)
If Industrial, is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .01 14(fl? ❑ Yes ® No
➢ If yes, provide a copy of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(t))
Daily Design Flow °."
No. of Units
Flow
Restaurant, full Service
40 gallseat
61 seats
2,440 GPD
gaV
GPD
gall
GPD
gal/
GPD
gal/
GPD
all
GPD
Total
2,440 GPD
a See I SA NCAC 02T .01 14(b) (d) (e)(1) and (e)(2) 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 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.01141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 2,440 GPD (per 15A NCAC 02T 01 I4)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, please indicate why:
❑ Pump Station/Force Main or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line.
Please provide supplementary information indicating the approximate timeframe for permitting upstream sewers with flow.
❑ Flow has already been allocated in Permit Number: Issuance Date:
❑ Rehabilitation or replacement of existing sewers with no new flow expected
❑ Other (Explain):

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
FLOW ONLY
➢ 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 requirements is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable)-02T.0305 & MDC (Pump Stations/Force Mains):
PROVIDF, A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: 0 Longitude: - °
3. Total number of pumps at the pump station:
3. Design flow of the pump station: _ millions gallons per day (firm capacity)
➢ This should reflect the total GPM for the pump station with the largest pump out of service.
4. Operational point(s) per pump(s): _ gallons per minute (GPM) at _ feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
If any portion of the force main is less than 4-inches in diameter, please identify the method of solids reduction per
MDCPSFM Section 2.01C.I.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
❑ Standby power source or ❑ Standby pump
➢ Must have 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 and may not be portable
Or if the pump station has an average daily flow less than 15,000 gallons per day 15A NCACO2T.0305(h)(1)(C):
❑ Portable power source with manual activation, quick -connection receptacle and telemetry -
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry:
➢ Include documentation that the portable source is owned or contracted by the applicant 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
as part of this permit application in the case of a multiple station power outage.

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T .0305(fl & (a)? ® Yes ❑ No
15A NCAC n?T MAIUA �,..,.,:.,� _:..:_.._ ______.•- ... .. _
_ __ _ _ - _.................."..",,, ,� a,aL,,,,,, uiai snau De proviaea for sewers
stems:
Setback Parameter*
Separation Required
d other utilities not listed below (vertical)
rtical - water over sewer preferred, including in benched trenches)
E
18 inches
18 inches
rizontal)IO
feet
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, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water, and associated wetlands.
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 associated with these waters (see item IX.2)
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches, as well as wetlands associated with these waters or classified as WL.
10 feet
g foundation (horizontal)
5 feet
nt (horizontal)
l0 feet
f embankment or cuts of 2 feet or more vertical height
=pools
10 feet
stems and interceptor drains
5 feet
ing pools10
rade (vertical)
feet
➢ IfnoncomnliancPwtrhmTnanv�
36 inches
.... IL uus appucanon
* I5A NCAC 02T 0305( ) contains alternatives where separations in 02T.0305(fl cannot be achieved. Please check "yes"
above if these alternatives are used and provide narrative information to explain.
**Stream classifications can be identified using the Division's NC Surface Water Classifications weboa"e
2. Does this project comply with the minimum separation requirements for water mains? ❑ Yes ❑ No ®N/A
D If no, please refer to 15A NCAC 18C.0906(f) for documentation requirements and submit a separate document,
signed/seated by an NC licensed PE, verifying the criteria outlined in that Rule.
3. Does the project comply with separation requirements for wetlands? ❑ Yes ❑ No ® N/A
D Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft separation requirements for situations where separation cannot be met.
D No variance is required if the alternative design criteria specified is utilized in design and construction.
4. Is the project located in a river basin subject to any State buffer rules? ❑ Yes Basin name: _ ®No
If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No
D This includes Trout Buffered Streams per 15A NCAC 2B.0202
5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ❑ Yes ® No
or 401 Water Quality Certifications?
D Please provide the permit number/permitting status in the cover letter if coverage/authorization is required.
6. Does project comply with 15A NCAC 02T 0I05(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T 0105(c)(6) directly related environmental permits or certification applications must be 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.).
7. Does this project include any sewer collection lines that are deemed "high -priority?" ❑ Yes ® No
Per 15A NCAC 02T.0402 "high -priority sewer" means any aerial sewer, sewer contacting surface waters,
siphon, or sewers positioned parallel to streambanks that are subject to erosion that undermines or deteriorates the sewer.
Siphons and sewers suspended through interference/conflict boxes require a variance approval.
➢ 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 permittee's individual System -Wide Collection permit.
FOR tvt PTA 06-?1

X. CERTIFICATIONS:
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, for projects requiring a single variance, complete and submit the Variance/Altemative Design Request application
(VADC 10-14) and supporting documents for review to the Central Office. Approval of the renuect will hn
2. Professional on&eer's Certification:
1, , attest that this application for ��12 po n A �� [g,.G � q }
(Pro[essiona P n er's nam plication ttem tlLl.) (Project Name from Application Item it. I)
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,
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 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. Misrepresentation of the application
information, including failure to disclose any design non-compliance with the applicable Rules and design criteria, may subject
the North Carolina -licensed Professional Engineer to referral to the licensing board. (21 NCAC 56.0701)
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, �rau t^naSSe r l attest that this application for - 9Q a r`it(Signature Authority Name from plication Item L3.) tiro t Name from Application Item It.1)
attest that this application 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 will be returned to me as incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6E 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:
FnRM- PTA nF_9i
Date: EN(-�,zJ

State of North Carolina
Department of Environment and Natural Resources
DWR Division of Water Resources
Dlvislon of Water Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 08-13)
Project Applicant Name: City of Jacksonville
Project Name for which flow is being requested: Shoppes at Carolina Forest
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: Land Treatment Facility - Jacksonville WWTP
b. WWTP Facility Permit #: WQ0009267
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
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
9.0
0.523
5.677
0.0024
6.202
68.91
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 Average Daily
Approx.
Not Yet
Total Current
Station Firm Flow**
Current Avg.
Tributary
Flow Plus
(Name or Capacity,* (Firm / pf),
Daily Flow,
Daily Flow,
Obligated
Available
Number) MGD MGD
MGD
MGD
Flow
Capacity***
Carolina
Forest 1.728 .6912
.4145
.0684
.4829
.2083
Henderson 22.3 8.928
2.332
.0047
2.336
6.592
Main 30 12
4.627
.0053
4.6323
7.367
* The Firm Capacity 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.
*** 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.
Page 1 of 6
FTSE 08-13

III. Certification Statement:
I Ronald F. Massey, Deputy City certify to the best of my knowledge that the addition of
Manager
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 indicates acceptance of this wastewater flow.
Signing
Signature
! Z
Date
Page 2 of 6

Sewer Permitting Narrative
Shoppes at Carolina Forest
Permit No. WQ0037468 was issued to City of Jacksonville on December 11, 2014 for "998 linear
feet of 8-inch gravity sewer to serve..... shopping center for general retail and rood services".
However, the permit states that "no full -service restaurants .... on an outparcel may be served".
The shopping center is now proposed to be expanded into the outparcel, on which a 6 unit
building is proposed, on with 5 units will be "general retail" (i.e. flow included in the original
permit). However, one of the units will be a full service restaurant which shall include 61 seats.
We therefore wish to modify the permit to add 2,440 gpd (61 seats @ 40 gpd/seat) of
additional flow to allow the full -service restaurant.
No changes to the collection system itself are proposed in conjunction with this modification.

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