WQ0043796_Application (FTSE)_20220921

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State of North Carolina
DWWIM Department of Environmental Quality
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IM Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
`Division of Water Resources FTA 06-21 & SUPPORTING DOCUMENTATION
Application Number: mil) C44 J-717`0 (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: City of Burlington ( municipality)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: David Cheek per 15A NCAC 02T .0106(b)
Title: Burlington Interim City Manager
4. Applicant's mailing address: PO Box 1358
City: Burlington State: NC Zip: 27216
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail]
II. PROJECT INFORMATION:
1. Project name: The Stables at Harris Farm Phase 2
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: W000_ and issued date: _,
For modifications, also attach a detailed narrative description as described in Item G of the checklist.
If new construction, but part of amaster plan, provide the existing permit number: W000_
3. County where project is located: Alamance
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.0615' Longitude:-79.4741'
5. Parcel ID (if applicable): 114544 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: B. Bruce None License Number: 23544
Firm: Stoltzfus Engineering Inc.
Mailing address: 683 Gralin Street
City: Kemersville State: NC
Phone number: [phone]
Zip: 27284-_
Email Address: brute@seiengineering corn
IV. WASTEWATER TREATMENT FACILITY (W WTF) INFORMATION:
1. Facility Name: South Burlington WWTP Permit Number: NCO023876
Owner Name: CCU of Burlington
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Ncmrber(s): WQ_
2. Downstream (Receiving) Sewer Information: 12 inch ® Gravity
3. System Wide Collection System Permit Number(s) (if applicable): WQCS_
Owner Name(s): City of Burlington
NC Departrne-
Environmental Q.,,:
Recc_ived
SEP 21 2022
Winston-Sc,!,'nl
Regional Off,`
❑ Force Main
FORM: FTA 06.21 Page 1 of 5

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: 100 % Domestic % Commercial _ % Industrial (See 15A NCAC 02T .0103(20))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes[] No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(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(f))
Daily Design Flow ",°
No. of Units
Flow
3 Bedroom unit
360 gal/day
12
4,320 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
4,320 GPD
a See 15A NCAC 02T .0114(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 sliall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: _ GPD (per 15A NCAC 02T .0114)
➢ 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):
FORM: FTA 06-21 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T.0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
321
SDR-21
8
60
D.I.P.
➢ 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 minintunt 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):
PROVIDE 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: 0Longitude: -
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.1.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify) _
6. Power reliability in accordance with 15A NCAC 021.0305(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
➢ Mast 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 punnp, including travel timeframes, shall be provided
as part of this permit application in the case of a multiple station power outage.
FORM: FTA 06-21 Page 3 of 5

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 & (e)? ® Yes ❑ No
1 SA NCAC 09T.0105(fl contains minimum sennratinns that shall be m'ovided for sewer systems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
18 inches
'--Water mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
'-Water mains (horizontal)
10 feet
Reclaimed water 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 101
Class li 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
Any building foundation (horizontal)
5 feet
Any basement (horizontal)
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
➢ If noncompliance with 02T.0305(f) or (e). see Section X.1 of this application
*15A NCAC 021.0305(e) contains alternatives where separations in 02T.030 cannot be achieved. Please check "yes"
above if these alternatives are used and provide narrative information to explain.
**Stream classifications call be identified using the Division's NC Surface Water Classifications webnase
2. Does this project comply with the minimum separation requirements for water mains? ® Yes ❑ No ❑ N/A
➢ If no, please refer to 15A NCAC 18C.0906(t) for documentation requirements and submit a separate document,
signed/sealed 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
➢ Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft separation requirements for situations where separation cannot be met.
➢ 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: Cape Fear ❑ No
If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .02002 ® Yes ❑ No
➢ 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?
➢ Please provide the permit number/permitting status in the cover letter if coverage/authorization is required.
6. 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 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 perinittee 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.
FORM: FTA 06-21 Page 4 of 5

KIN
1. 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?
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 request will be issued
2. Professional Engineer's Certification:
I, B. Bruce Nooe attestthatthis application for The Stables at Harris Farm Phase 2
(Professional Engineer's name from Application Item III. I.) (Project Name from Application Item ILq
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 seat 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 143-215.613, 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: i o��1i CAgO "r''.,
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SEAL A
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3. Applicant's Certification per 15A NCAC 02T .0106(b):
Z.
f, David Cheek attest that this application for The Stables at Harris Farm Phase 2
(signature Authority Name from Application Item 1.3.) (Project Name from Application Item 11.1)
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 143-215.6B, 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 free not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: Date: S f S 2Z
FORM: FTA 06-21 Page 5 of 5

t if'
State of North Carolina
Department of Environment and Natural Resources
.. t4 Fit if
Division of Water Resources
aa0910ro or, Water ResourcesFlow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE 10.18)
Entity Requesting Allocation City of Burlington
Project Name for which flow is being requested: The Stables at Harris Farm Phase 2
Afore than one FTSE may be re Juiretifor a single project if the owner of the PVWTP 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: South Burlington WWTP
b. WWTP Facility Permit #: NCO023876
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
12.00
1.289270
I1. 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,
Average Daily Approx. Not Yet Total Current
Pump Station Firm Flow** Current Avg. Tributary Flow Plus
(Name or Capacity, * (Firm/po, Daily Flow, Daily Flow, Obligated Available
Number) GPD GPD GPD GPD Flow Capacity***
NONE
* 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 pumpstation 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 5 0.
Downstream Facility Name (Sewer) : May Drive Outfall
Downstream Permit Number: unknown
1 of 6 FTSE 10-18

11I. Certification Statement:
I, W. Todd Lambert, P.E. certify to the best of my knowledge that the addition of the
vohune -o wastewater to e 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 asssessment 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 11 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 neat the proposed new
wastewater.
Signing Official Signature
City Engineer
Title of Signing Official
Date
2 of 6 FTSE 10-18

I\/N 7 7:r I \A
FOR
THE STABLES
AT
HARRIS FARM PHASE 2
ALAMANCE COUNTY
BURLINGTON, NORTH CAROLINA
May 10, 2022
DEVELOPER:
Clayton Properties Group, Inc.
DBA Shugart Homes
221 Jonestown Road
Winston-Salem, N.C. 27104
336-765-9661
Stoltzfus Enaineerine, Inc.
683 Gralin Street Kemersville, NC 27284
Phone [phone]
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PROJECT DESCRIPTION
The project is located on an approximately 17.15-acre tract in Alamance County,
Burlington, NC. The Fast Track Sewer System Extension Application is for providing
gravity sewer services to twelve (12) townhome units in Phase 2. Flow allocated to this
phase of the project is 4,320 gal/day. The proposed water and sewer extensions will be
publicly owned and maintained.
SITE DESCRIPTION
The site consists of 17.15 acres with one existing single family residence and Phase 1
under construction.
Land use in the vicinity is a mix of vacant land, single and multi -family residential. The
lot is a flag type lot with a proposed public road being designed to connect to NC
Highway 62.
SOILS INFORMATION
The soil in the project area is mapped as EnB, Enon sandy loam, 2 to 6% slopes, EnC,
Enon sandy loam, 6 to 10% slopes and RvA, Riverview loam, 0 to 2% slopes,
occasionally flooded per USDA Natural Resources Conservation Service Web Soil
Survey.
EnB and EnC are in hydrologic group "C".
RvA is in hydrologic group "B"

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THE STABLES AT HARRIS FARM PHASE 2 aoo' zoo' o' aoo' soc
SCALE 1" = 400'
St s
Civil Enginee
Aden R. Stoltzfus, PE C-3812
[e-mail]
336-904-0207
683 Gralin Street
Kernersville, NC 27284
STREET LEVEL MAP
NC ONEMAP
CITY: BURLINGTON
COUNTY: ALAMANCE
TOWNSHIP: BURLINGTON
DATE: 7/1/2022

SANIT
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SANITARY
SEWER
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SITE
PHASE
SITE
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EXISTING 744
WARY SEWER
THE STABLES AT HARRIS FARM PHASE 2 400'
Aden R. Stoltzfus, PE C-3812
[e-mail]
336-904-0207
683 Gralin Street
St s Engineering Inc. Kernersville, NC 27284
Civil Engineering Consultants
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200' 0' 400'
SCALE 1" = 400'
USGS QUAD MAP
BURLINGTON QUADRANGLE 2019
CITY: BURLINGTON
COUNTY: ALAMANCE
TOWNSHIP: BURLINGTON
DATE:7/1/2022

Stoltzfus Engineering, Inc.
TRANSMITTAL MEMO
To: NCDENR Winston-Salem Regional Office
Water Quality Section
450 West Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
From: Bruce Nooe, PE
[e-mail]
Date: 9/19/2022
Subject: The Stables at Harris Farm Phase 2
Gravity Sewer Extension -Public
City of Burlington, Alamance County
Attached is one (1) original and one (1) copy of the completed Fast -Track Application including the Fast
Track Form, Flow Tracking Acceptance Form, and the Site Maps along with Check 4075814 in the amount
of $480.00 for the permit fee for The Stables at Harris Farm Phase 2.
The public gravity sewer extension consists of 381 linear feet of gravity sanitary sewer to serve the
12 dwelling units. The design flow for the sanitary sewer is computed to be 4,320 GPD. The flow runs into a
public gravity outfall owned by the City of Burlington.
Please call me at [phone] with any questions.
Pm
Envro L'Partmer,,
Reerytai .
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wfnston_$a
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Regional Offi,
683 Gralin Street ♦ Kernersville, NC 27284 ♦ [phone]