WQ0019705_Regional Office Historical File Pre 2018 (2)

State of North Carolina
Department of Environmental Quality
Division of Water Resources
I.5A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
P tV firtetivpi
Application 'Number: o(_±91,_
„
•�Tpktedhy DWR)
All items must be completed or the application will be returned
t,hrtt4A; ett'xr
I. APPLICANT INFORMATION:
Applicant's name: City of Locust (company, municipality, HOA, utility, etc.)
2, Applicant type: LJ individual LI Corporation [1] General Partnership El Privately -Owned Public Utility
El Federal
El State/County El .Municipal
3. Signature authority's name: Cesar Correa per 15AN(Li,,vc0.21,,110,0(11)
Title: City Administrator
4. Applicant's mailing address: 1.86 R.ay Kennedy Drive
City: „Locust State: NC Zip: 28097-
5. Applicant's contact information:
Phone number: [phone] Email Address: ityadrniniocusnc,com
It. PROJECT INFORMATION:
1. Project name: North Basin Sanitary Sewer Improvements
2. Application/Project status:
Ei Other
1,1 Proposed (New Pe niit) Existing Permit/Project
If a:modification, provide the existing permit number: WQ0019705 and issued date: 8/29/2001
If new constructionbut part of a master plan„ provide the existing permit number: WQ00
3. County where project is located: Stanly
4. Approximate Coordinates (Decimal Degrees): Latitude: ' Longitude: - 0
5, Parcel ID (if applicable):
(or Parcel„ID to closest downstream sewer)
11.I. CONSULTANT INFORMATION:
1. Professional Engineer: Steph.en. Chambers License Number: 17943
Firm: chambe En ,ineering,, PA.
Mailing address: 129,N. First Street
City. Albemarle State: NC 28001-___
Phone number: (704) 984,-6427 Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: West Stanly Wastewater Treatment Plant .Permit Number: NC0043532
Owner Name: Stanly County Utilities
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: inch
SN, item Pittrin t ber( s WQCS
Owner Name(s):
FORM: FTA 04-16 Page 1. of 5

No
:GENERAL REQUIREMENT'S
If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
El Yes E1No N/A.
2. If the Applicant is a Developer of lots to be sold, has a .Developeris Operational Aorement „;,JL: attached?
D Yes DNo N/A
3. If the Applicant is a Home/ roperOwne s° .Associa(ion, has an Qp.prational Agreement LFORM: FIO.A) been attached?
O Yes DNo N/A.
4. Origin of wastewater: (check all that apply):
El Residential Owned
E] Residential Leased
School / preschool / day care
O Food and drink facilities
El Businesses/ offices / factories
El Retail (stores, centers, malls)
Retail with food preparation/service
O Medical / dental / 'veterinary facilities
El Church
Nursing Home
5. Nature of wastewater : % Domestic/Commercial
El Car Wash
0 Hotel and/or Motels
LI Swinuning Pool /Clubhouse
LI Swimming Pool/Filter Backwash
0 Other (Explain in Attachment)
(,)/0Commercial
% Industrial (See 15A NCAC 02T ,0103L2)j)
s there a Pretreatment Program. in effect? 0 Ye
6. Has a flow reduction been approved under 1.5A, NCAC 021 .0 141D? El Yes .No
)• If yes, provide a copy of flow reduction approval let -ter
7. Summarize wastewater generated by project:
Establishment Type (see 02I.01141).)
Daily Design Flow °''
See 15A, NCAC 02T ..0114(b),11),10( I) and le)(2) for caveats to wastewater design flow rates (i.e., .ininimumflow 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 ( 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates :for establishments not identified [in table 15A NCAC ozroi 14] shall be
determined using availableflow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 0 GPD (per I 5A NCAC (121 .01,14)
5e Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
Purn.p Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
El Flow has already been, allocated in Permit Number:
0 Rehabilitation or replacement of existing sewer with no ne
El Other (Explain):
10
expected
FORM: ETA 04-16
Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 112 V .ILY05 & Ntpc Gray ill sew ;
I. Summarize gravity sewer to be permitted:
Size (inches) Length (feet)
» Section 11 & 111 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)
fr Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIM PUMP STATION DESIGN CRITERIA (If Applicable) —02T .0305 & MD(,(Purip Stations:11E1)m Mains):
COMPLETE FOR .EACH PUMP STATION INCLUDED IN THIS PROJECT
1, .Pump station number or name: SEE ATTACHED
Approximate Coordinates (Decimal Degrees): Latitude: Longitude: -
3. Design flow of the pump station: millions gallons per day (firm capacity)
,40. Operational point(s) of the pump(s): gallons per minute at _ feet total dynamic head (TDH)
5. Summarize the force main to be permitted (fix. this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 05,A Nt (02T .030Sto i
Standby power source or pump with automatic activation and telemetry - ISA. NCAC 02T .0.305(h)(1)(B)
Required for all pump stations with an. average daily flow greater than or equal to 15,000 gallons per day
.);.- Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
El Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 021
.0305(h)(1)(C)
or
Ej Portable pumping unit with plugged emergency pump connection and .telemetry - 1 5A NCAC 02T .0305(h)(1)(C):
• It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station,
> If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timetiames, shall be provided
in the case of a 'multiple station power outage,
FORM: ETA 04-16
Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & -I5A NCAC 02T .0305(1
1. Does the project cornply with all separations found in i ` Er, i .r 11.E
I5A NCAC 023 030$(t`) contains minimum separations that shall be provided for sewe
Setback Parameter.*
listed below (r^ert%ct
-over' sewer including in benched tre
airs (vertac
orizontal1_
Reclaimed water lines (vertical reclaimed over sewer)
Reclaimed water IinesJjrorizontalIT- reclaimed over sewer)
*Any private or public water supply source, including any wells, WS-I waters of Class 1. or
Class I1 itta otrnded reservoirs used as a source of drinking water
aters classified WS (except WS-I or WS-V). 13, SA, ORW, HQW, tar SB from normal
high water (or tide elevatio)and wetlands (see item IX.2),
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
itcites
Any buildt`n; foundat
Any basement
Top slope of embankment or cuts of 2 feet or more, ve
rainage systems and interceptor drains
An swimming pools
grade (vertical)
al height
contains alternatives where separations in 621
**Stream classifications can he identified using the Division's ' t' Spa
Y If noncompliance with�.__i� > t� t e?rsee Section X of this application
ann
j Yes 'Q No
on Required
24 inches
hes
0 feet
inches
2 feet
100 feet
0 feet
l0 feet
5 feet
10 feet
10 feet
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) Yes
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
Does the project comply with setbacks found in the river basin rules per
This would include Trout Buffered Streams per
4, Does the project require coveragedauthorization under a 404 Nationwide or
individual permits or 401 Water Quality Certifications?
Information can be obtained from the
Z Yes © No
E No
E N/A
Does project comply with J. _ t" ,' i �� r ) (additional permitslcerttfications)°? ® Yes 0 No
Per al_ 1 , _ 'tt 02„11 01'1Jv% , directly related environmental permits or certification. applications are being prepared, have
been applied for, or have been obtained, Issuance ofthis permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, storrnwa.ter management plans, etc.),
Does this project include any sewer collection lines that are deemed. "high -priority?"'
Per s 5 1 NCAC 02 1-.0 try. , "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambank', that is subject to erosion that undermines or deteriorates the sewer,
❑ Yes
If yes, inelude an attachment with details for each lin
Z No El N/A
including type (aer'i'al line, size, material, and location).
High priority lines shall be inspected by the perm ittee 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; 1 1'A 04-16
Page 4 of 5

X. CERTIFICATIONS:
1. Does the suhrnitted system comply vvi
and Force_Mttinti ver,=sron.,),, and t.
Z Yes
the Minorttuni Desiit
LI No
pt
If No, complete and submit the Variance`Alternative Design Request application (VA DC 10-I4) and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents
Professional Engineer°s Certification:
(Professional Engineer's name f'tont Applic-ation
attest that this application for
htrs been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
eragiraeering calculations, trnd all other supporting documentation to the best of nay knowledge. 1 further attest that to the hest
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest. version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that 1 have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE In accordance with General Statutes 143-215.OA and 1.43-215.613, any pers�
statement, representation, or certification in any application package shall he guilty° o'f
include a fine not to exceed S 10,000, as well as civil penalties up to $'25,000 per vlolatiot
North Carolina Professional Engineer's seal, signature, and date:
;ertitication per 15A NCAC' 02T° .ti1(l6(b):
Ce5c1r COctea C.
(Signature Authority' nurrte & title from Application Item I,3,)
has been reviewed by me and i;
�Crrti►.tip silic0+_(
who makes any false
Class 2 misdemeanor, which may
but this application for
,urate and complete to the 'best of my knowledge, i understand that if all rerlt fired 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 returraetl 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, 1 will make no claim against the Division of Water Resources should a condition
of this permit be violated, 1 also understand that if all required parts of this application package are not completed. and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete,
NOTE -- In accordance with General Statutes 1 I t?.@ rand 0t any person who knowingly makes any
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which
occlude a fine not to exceed SS t)0 as well Tit penalties up to S25,O00 per violation.
Signature:
Date:
A
6
Page 5 of 5

ATTACHMENT TO FFA 04-16:
VIIL PUMP STATION DESIGN CRITERIA (If Applicable) — 02T.0305 & 3r3.DC:"' (Pump Stations/Force Mains):
1. Pump station number or name: NORTH PUMP STATION
2. Approximate Coordinates (Decimal Degrees): Latitude; 35.29t5879' Longitude:-80.436552"
3. Design 'flow of the pump station: 0.76 million gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 526 gallons per minute at 148.6 feet total dynamic head (TDU)
5. Summarize the force main to be permitted (for this Pump Station):
inches)
8
Length (feet)
,672
Material
PVC
8
326
Existing Line
Size (inches)
DIP
6
6
New or
Replacement
Replacement
Replacement
6. Power reliahility in accordance with 15A NCAC 02T .0305(h)(1):
Standby power source or pump with automatic activation and .telemetry — 15A NCAC 02T ..0305(h)(I XB)
1. Pump station number or name: CREEKVIE.W PUMP STATION
2. Approximate Coordinates (Decimal. Degrees): Latitude: 35.274724` Longitude:-80.440771`
3. Design flow of the pump station: 0.88, million gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 611 gallons per minute at 166.78 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
10
Length (feet)
7,538
340
Material
PVC
DIP
Existing Line
Size (inches)
6
6
New or
Replacement
Replacement (new
alignment)
Replacement (new
alignment
6. Power reliability in accordance with I SA NCAC 02T .0305(hX1):
Standby power source or pump with automatic activation and telemetry — 15A NCAC 02T .0305(h)(1)(B)
Note: The proposed 10" force main replaces an existing 6" force main but in a new alignment/ footprint. Existing 6" force main to
be abandoned.

1, Pump station number or name: EAST PUMP STATION
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.254197' Longitude: -80.408931'°'
3. Design Pow of the pump station: 1,88 million gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 1252 gallons per minute at 155,94 feet total dynamic head (TDI
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
12.
Length (feet)
1,926
40
PVC
DIP
Existing Line
Size (inches)
6
6
New or
Replacement
Replacement
Replacement
6. Power reliability in accordance with 15A NCA,C 02T .0305(h)(1):
klStandby power source or pump with automatic activation and telemetry 1 5A NCAC 02T .0305(h
Note: The proposed 12" force main replaces an existing 6" force main which connects to an existing 12"' force main. Existing 6"
force main to be abandoned
1. Pump station number or name: SOUTH PUMP STATION
2. Approximate Coordinates (Decimal Degrees): Latitude: 35,244840' Longitude:-80.429959'
3. Design flow of the pump station: 0,79 million gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 551 gallons per minute at 147 feet total dynamic head (TDH)
5_ Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material.
Existing Line
Size finches)
New ort
plapemen
5;218
PVC
4
Replacement
360
DIP
4
eplacement
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
Standby power source or pump with automatic activation and telemetry — 15A NCAC 02T ,0305(Ft) (1)(B

NBY: rc
DATE: 9/20 t 9
DWG, NO.:
APPROVED 8Y: sgc
PUtvtP STAT
R ATy
chambers
engineering, pa
Z29 North First Street 70.1.984.5427p
Alberrarle, Nt; 2 kt www,ce pa,carm
North Basin Sanitary Sewer Improvements
USGS Cut Sheet
TA VON

N BY: rcc
DATE 9/2019
DWG, N©.:
APPROVED BY: sgc
129 North First Street 794,984 6427 kph
Albemarle, FFC 21 t w vw.pa.c t
North Basin Sanitary Sewer Improvements
USGS Cut Sheet
OUTH
TATIQ