HomeMy WebLinkAboutWQ0043890_Application_20221102OCT 25122
DWR
Division of Water Resources
State of North Carolina
MOORESi%1LLE REGIOIRALOFFICE Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 06-21 & SUPPORTING DOCUMENTATION
RECE
Application Number: L%'i- (O Ito be completed t,y DWRI
All items must be completed or the application will be returned
APPLICANT INFORMATION:
1. Applicant's name: City of Belmont (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State/County Municipal
3. Signature authority's name: Adrian Miller per I5A NCAC 02T,;,Q1,06tbl
Title: City Manager
4. Applicant's mailing address: PO Box 431
City: Belmont
State: NC Zip: 28012-
5. Applicant's contact information:
Phone number: (704) 825-5586 Email Address: amiller@cityofbelmont.org
[1. PROJECT INFORMATION:
I. Project name: TKC Double Oak
2. Application/Project status: ® Proposed (New Permit)
If a modification, provide the existing permit number: WQ00
❑ Privately -Owned Public Utility
❑ Other
RECEIVED/NCDEO/DWR
NOV --22022
WOROS
MOORESVILLE REGIONAL OFFICE
❑ Existing Permii/Project
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 a master plan, provide the existing permit number:
3. County where project is located: Gaston
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.26771 Longitude: -81.05734
5. Parcel ID (if applicable): 305366 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Carlton T. Burton License Number. 12557
Firm: Burton Engineering Associates
Mailing address: 5950 Fairview Road
City: Charlotte State: NC Zip: 28210-
Phone number: (704) 553 8881 Email Address: chburton@burtoneng.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: City of Belmont WWTP Permit Number: NC0021181
Owner Name: Belmont
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
. Permit Numher(s): WQ_... . .
2. Downstream (Receiving) Sewer Information: inch
Gravity Force Main
3. System Wide. Collection System Permit Number(s) (if applicable): WQCS
Owner Narne(s): City of Belmont
FORM: FTA 06-21
Page 1 of 5
VI. GENERAL REQUIREMENTS
I. If the Applicant is a Privately -Owned Puhlic Utility, has a Certificate of Puhlic Convenience and Necessity been attached?
❑ Yes ❑ No ►/ NIA
2. If the Applicant is a Developer of lots to he sold, has a Developer's Operational Agreement (FORM: DEVI been attached?
❑ Yes ❑ No N/A
3. If the Applicant is a Home/Property Owners' Association, has an HOA/,POA Operational Arccment (FORM, HOA) and
supplementary documentation as required by I5A NCAC 02T.01 l5(c) been attached?
0 Yes [] No N/A
4. Origin of wastewater: (check all that apply):
❑ Residential (Individually Owned)
❑ Residential (Leased)
❑ School / preschool / day care
❑ Food and drink facilities
Businesses / offices / factories
❑ Retail (stores, centers, malls)
❑ Retail with food preparation/service
[] Medical / dental / veterinary facilities
0 Church
❑ Nursing Horne
❑ Car Wash
0 Hotel and/or Motels
❑ Swimming Pool/Clubhouse
0 Swimming Pool/Filter Backwash
0 Other (Explain in Attachment)
5. Nature of wastewater : % Domestic % Commercial 100 % Industrial (See 15A NCAC 02T .010k20J)
If Industrial, is there a Pretreatment Program in effect? ❑ Yes No
6. Has a flow reduction been approved under 15A NCAC 02T m01 14(f)'? ❑ 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.01 l4(f))
Daily Design Flow "•b
No. of Units
Flow
Warehouse
100 gal/Day
14
1400 GPD
25 gal/Shift
10
250 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
1650 GPD
a See 15A NCAC 02T .01 14(h7, (d}, (e) 1 j. ands .2) for caveats to wastewater design flow rates (i.e_, minimum fl rw per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public ttst. areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to he used as vacation rentals as defined
in.;,
h Per 15A NCAC 02T .01 14(c), design flow rates for establishments not identified (in table 15A NCAC 021.01141 shall he
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 1650 GPD (per 15A NCAC 02T .0114)
Do not include future flows or previously permitted allocations
if permitted flow is zero, please indicate why:
❑ Purnp Station/Force Main or Gravity Sewer where flow will he 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
0 Other (Explain): _
FORM: I-7A 06 21
Page 2 of 5
VI1. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to he permitted:
Size (inches)
Length (feet)
Material
8
267
PVC
Section II & Ill 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
VIIL 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: ..,, _,. 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
5. Summarize the force main to be permitted (for this Pump Station):
feet total dynamic head (TDH)
Size (inches)
Length (feet)
Material
If any portion of the force main is less than 4-inches in diameter, please identify the me hod of solids reduction per
MDCPSFM Section 2.01C.1.b. ❑ Grinder Pump El Mechanical Bar Screen El Other (please specify)
6. Power reliability in accordance with 15A NCAC 02T .0305ihj„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 he 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 tirneframes, shall he 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 — (028.0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations/alternatives found in 5A NCAC 02T.0l05(.tf, .(g)? ❑ Yes ❑ No
15A NCAC 02T 0305t;f1 contains minimum separations that shall he provided for sewer sterns:
Setback Parameter*
Storm sewers and other utilities not listed below (vertical)
2Water mains (vertical - water over sewer preferred, including in benched trenches)
2Water mains (horizontal)
Reclaimed water lines (vertical - reclaimed over sewer)
Reclaimed water lines (horizontal - reclaimed over sewer)
**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.
**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)
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches, as well as wetlands associated with these waters or classified as WI..
Any building foundation (horizontal)
Any basement (horizontal)
"Top slope of embankment or cuts of 2 feet or more vertical height
Drainage systems and interceptor drains
Any swimming pools
Final earth grade (vertical)
If noncompliance with 02T.03(150)or,(g,), see Section X.1 of this application
* 15A N_C AC ,0,27.01(1510 contains alternatives where separations in 02T.0305(t) cannot he achieved. Please check "yes"
above if these alternatives are used and provide narrative information to explain.
**Stream classifications can he identified using the Division's NC Surface Water Classifications wehpa c
2. Does this project comply with the minimum separation requirements for water mains? Yes ❑ No 0 N/A
- if no, please refer to 15A NCAC 18C.0906(f) for documentation requirements and submit a separate document,
signed/sealed by an NC licensed PE, verifying the criteria outlined in that Rule.
Separation Required
18 inches
2 feet
100 feet
50 feet
10 feet
3. Does the project comply with separation requirements for wetlands? 1:1 Ycs El No ❑ N/A
A Please provide supplementary information identifying the areas of non-conformance.
See the Division's draft separation requirements for situations where separation cannot he 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: M No
If yes, does the project comply with setbacks found in the river basin rules per I5A NCAC 02B .0200? ❑ Yes ❑ No
This includes Trout Buffered Streams per I5A NCAC 2B b202
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 I5A NCACO2T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NC AC 02T.0105ac. 6j, directly related environmental permits or certification applications must he 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?" ❑ Ycs ® No
Per 15A NCACO2T.0402, "high -priority sewer" means any aerial sewer, sewer contacting surface waters,
siphon, or sewers positioned parallel to strearnbanks 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.
FORM: FTA 06-21 Page 4 of 5
X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria tor the Permitting of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Cnteria (latest version) as applicable:'
®Yes No
If no, for projects requiring a single variance, complete and submit the Variance/Alternative Design Request application
(VADC 10-14) and supporting documents for review to the Central Office. Approval of the request will be issued
concurrently with the approval of the permit, and projects requiring a variance approval may be subject to longer
review times. For projects requiring two or more variances or where the variance is determined by the Division to be a
significant portion of the project, the full technical review is required.
2. Professional Enrineer's Certification:
I, Carlton T. Burton , attest that this application for TKC Double Oak
(Professional hneirb is name from Appiic;itian Item 111.1.) (Project Name ftum Application htrnr 11.1)
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. 1 further
attest that to the hest of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
Minimum Design Criteria for Gravity Sewers (latest versiion), 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 he consistent with the proposed design.
NOTE In accordance with General Statutes I43-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall he 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 dsuutesignucriteria, may subject
the North Carolina -licensed Professional Engineer to referral to the licensing hoard. (21 NCAC 56.0701)
.... ._ _ tu
North Carolina Professional Engineer's seal, signature, and date: `v���t¢l1 •
ti,` tO •
Q
SEAL
12557
...4�ii7rl'� niltth��0
Applicant's Certification per 15A NCAC 02T .0106(h):
419
I, ______.___Adrian Miller, City Manager__, attest that this application for TKC Double Oak
(Signature Authority Name from Application Item 11 t (Project Name from Applicatirtat 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. 1 will make no claim against the Division
of Water Resources should a condition of this permit he 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 he 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 he 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:
Dates
FORM: FTA0621
Page 5of5
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: TKC CCLXXIII LLC
Project Name for which flow is being requested: TKC Double Oak Development
More than one FTSE may be required for a single project if the owner of the If WTP is not responsible fi r all pump
stations along the route of the proposed wastewater flow. RECF I\ / E®
I. Complete this section only if you are the owner of the wastewater treatment plant. S F P 2 6 2022
a. WWTP Facility Name: City of Belmont WWTP
b. WWTP Facility Permit #: NC0021181 NCDEQIDWRINPDES
Allflows are in MGD
c. WWTP facility's permitted flow 5.0000
d. Estimated obligated flow not yet tributary to the WWTP 1.1546
e. WWTP facility's actual avg. flow 1.2910 (2021 Average)
f. Total flow for this specific request 0.0017
g. Total actual and obligated flows to the facility 2.4473
h. Percent of permitted flow used 49%
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 i p0, Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***
Stowe
Duncan
0.2376 0.0950 0.0299 0.0000 0.0299 0.0651
0.5040 0.2016 0.0337 0.0000 0.0337 0.1679
* 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 < O.
Downstream Facility Name (Sewer):
Downstream Permit Number:
Page 1 of 6
FTSE 10-18
III. Certification Statement:
I Adrian T. Miller, City Manager 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 c macity to transport and treat the proposed new wastewater.
rQA:TA•trlle't—
Signing Official Signature
C;
Title of Signing 0 ia1
-1/7 tt
Date
Page 2 of 6
ETSE 10-18
S
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USGS The Nationa Map; National Boundaries Dataset,'3DER Elevation Program, Geographic Names Information
System, National;Hydrography Dataset, National Land Cover Daatabase,wNatioxaa14S,tructures Dataset, and Nationall
Transp1ortation1Dllataset;,`USGS Global"Ecosystems; U.S. Census Bureau TIGER/Line data; l .FS Road "Data Natural'
I'Earth, Data, U.S. Department of StatelHumaniitarianInformation Unit and NOAA=Nati_onall Centersfor
it Environmental Information, U.S. Coastal Relief Model_Data refreshed June 2022.
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