WQ0044171_Application (FTSE)_20230317

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 06-21 & SUPPORTING DOCUMENTATION
Application Number: vo be completed by DWR)
, q-X 7\
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Harnett Regional Water (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ® State/County ❑ Municipal ❑ Other
3. Signature authority's name: Steve Ward per 15A NCAC 02T .0106(b)
Title: Director of Harnett County Public Utilities
4. Applicant's mailing address: P.O. Box 1119 / 700 McKinney Parkway
City: Lillington State: NC Zip: 27546-
5. Applicant's contact information:
Phone number: [phone] Email Address: sward(a,harnett.org
II. PROJECT INFORMATION:
1. Project name: Serenity Subdivision -Phase 2 A&B
2. Application/Project status: ® Proposed (New Permit)
MA - ' 2
DEC. -FAY, ETTEUlULF, REGIONAL OFFU
❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 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: WQ00
3. County where project is located: Harnett
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.5457' Longitude:-78.823235
5. Parcel ID (if applicable): (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1 Prnfec.cinnnl F.nainPPr• Mike 7arcnrrin T 1C'PncP NnmhPr C1772,) 1
92562
TIMMONS GROUP TowNEBANK
1001 Boulders Pkwy., Suite 300
North Chesterfield, Virginia 23225 68-894/514 February 22, 2023
[phone] Fax [phone]
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FED I.D.# 54-1301413 p
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Four Hundred Eighty and 00/100 Dollars
71
PAY =
$480.00
TO THE NCDEQ -
ORDER NC Department of Environmental Quality
OF 1628 Mall Service Center �JPQo sFrG
Raleigh, NC 27699-1601
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TIMMONS GROUP
YOUR VISION ACHIEVED THROUGH OURS.
TRANSMITTAL
TO: NCDEQ DWR — Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301
ATTN: SS Fast Track Permitting personnel
® ENCLOSED PLEASE FIND:
❑ WE ARE SENDING UNDER SEPARATE COVER:
Date: 02/28/2023 Job #: 41158
Project: Serenity Phases 2A & 2B
Reference:
Copies Sent To:
COPIES
DATE
NUMBER
DESCRIPTION
1
1
Fast Track Sewer Application (Incl. Flow Acceptance Form/
Certification Statement
1
2
Check for $480 ,� t;= < •RU,-
1
3
Project Narrative_h
1
4
USGS ma
1
5
Vicinity MapY
THESE ITEMS ARE TRANSMITTED:
If enclosures are not as noted, please notify us at once.
COMMENTS:
Feel free to contact me with any questions at 984-222-1613 or @ [e-mail].
Thank you,
Clay Oliver, PE
Project Manager
SIGNED:
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State of North Carolina
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources INSTRUCTIONS FOR FORM: FTA 06-21 & SUPPORTING DOCUMENTATION
This application is for sewer extensions involving gravity sewers, pump stations and force mains, or any combination that has been
certified by a professional engineer and the applicant that the project meets the requirements of 15A NCAC 02T and the Division's
Minimum Design Criteria (Gravity Sewer & Pump Stations Force Mains) and that plans, specifications and supporting documents
have been prepared in accordance with 15A NCAC 02T, 15A NCAC 02T .0300, Division policies, and food enVinecrint! practices.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design
documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans, design
calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimum design criteria. These
documents shall be immediately available upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A
Projects not eligible for review via the fast track process (must be submitted for full technical review):
Y Projects that do not meet any part of the minimum design criteria (MDC) documents;
Y Projects that involve more than one variance from the requirements of 15A NCAC 02T;
Pressure sewer systems utilizing simplex septic tank -effluent pumps (STEPs) or simplex grind( f[F_P ,, � ��A,
Simplex STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains),' Pp
y Vacuum sewer systems.
General — When submitting an application, please use the following instructions as a checklist in order to ensure all required items are
submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the
amount of requested additional information. Failure to submit all required items will necessitate additional processing and review
time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit one original and one copy of
the application and supporting documentation.
A. One Original and One Copy (second copy may be digital) of Application and Supporting Documents
® Required unless otherwise noted. Signatures on original must be "wet ink" or secure digital signatures.
Please do not submit engineering design plans with the application unless specifically requested.
B. Cover Letter/Narrative Description (Required for All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
i Be specific as to the system type, number of homes served, flow allocation required, etc.
Include the permit number/status of any other required sewer permits (downstream/upstream)
If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Modification Application Packages):
® Submit a check or money order in the amount of $480.00, dated no more than 90 days prior to application submittal.
Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track Application (Required for All Application Packages, Form FTA 05-21):
® Submit the completed and appropriately executed application.
If necessary for clarity or due to space restrictions, attachments to the application may be made.
❑ If the Applicant Type in Item 1.2 is a corporation or company, provide documentation it is registered for business with the
North Carolina Sccretary of Statc.
❑ If the Applicant Type in Item 1.2 is a partnership or d/b/a, enclose a copy of the certificate filed with the Register of Deeds in
the county of business.
® The Project Name in Item II.1 shall be consistent with the project name on the floe acceptance letters, agreements, etc.
® The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North Carolina
licensed Professional Ens_)inecr.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106(b). Per
15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is provided from
a person who meets the criteria in 15A NCAC 02T .0106(b).
INSTRUCTIONS FOR FORM: FTA 06-21 & SUPPORTING DOCUMENTATION Pagc 1 of 3

E. Flow Tracking/Acceptance Form (Form: FTSE 04-16) (If Applicable):
® Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility.
Multiple forms maybe required where the downstream sewer owner- and wastewater treatment facility are different.
The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one year
prior to the application date.
Y Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-215.67(a).
Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific FTSE.
F. Site Maps (All Application Packages):
® Submit an 8.5-inch x 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project area,
including the closest surface waters.
General location of the project components (gravity sewer, pump stations, & force main)
i Downstream connection points and permit number (if known) for the receiving sewer
❑ Include an aerial location map showing general project area (such as street names or latitude/longitude) so that Division staff
can easily locate it in the field.
G. Existing Permit (Application Packages for Modifications to an Existing Permit):
❑ Submit a copy of the most recently issued existing permit.
❑ Include a descriptive and clear narrative identifying the previously permitted items to remain in the permit, items to be
added, and/or items to be modified (the application form itself should include only include items to be added/modified). The
narrative should also include whether any previously permitted items have been certified.
❑ The narrative should clearly identify the requested permitting action and accurately describe the sewers to be listed in
the final permit.
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T .0305(h)(1), submit documentation of power reliability for pumping stations.
This alternative is only available for average daily flows less than 15,000 gallons per day
It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible with
the station. The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or proposed contractor,
stating that "the portable power generation unit or portable, independently -powered pumping units, associated appurtenances
and personnel are available for distribution and operation of this pump 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 in the case of a multiple station power outage. (Required at time of certification)
I. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per 15A NCAC 02T .01 15(a)(1 ) provide the Certificate of Public Convenience and Necessity fi-om the North Carolina Utilities
Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by the sewer
extension, or
❑ Provide a letter from the North Carolina Utilities Commission's NN,,atcr and Sewer Division Public Staff stating an application
for a franchise has been received and that the service area is contiguous to an existing franchised area or that franchise approval
is expected.
J. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold):
❑ Home/Property Owners' Associations
❑ Per 15A NCAC 02T .01 15(c), submit the properly executed Operational Agreement (FORM: HOA).
❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 15A NCAC 02T .01 15(b).. submit the properly executed Operational A�,,recment (FORM: DEV).
For »pore in1brination, visit the Division's collection sYstems lAvbsite
INSTRUCTIONS FOR FORM: FTA 0.5-21 & SUPPORTING DOCUMENTATION Page 2 of 3

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Quality Section
Swannanoa, North Carolina 28778-8211
Clay, Graham, Haywood, Henderson, Jackson,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section
Fayetteville, North Carolina 28301-5095
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[phone] Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Water Quality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
Raleigh Regional Office
3800 Barrett Drive
Chatham, Durham, Edgecombe, Franklin,
Water Quality Section
Raleigh, North Carolina 27609
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
Beaufort, Bertie, Camden, Chowan, Craven,
Water Quality Section
Washington, North Carolina 27889
Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section
Wilmington, North Carolina 28405
Hanover, Onslow, Pender
[phone]
[phone] Fax
Winston-Salem Regional Office
450 W. Hanes Mill Road
Alamance, Alleghany, Ashe, Caswell, Davidson,
Water Quality Section
Suite 300
Davie, Forsyth, Guilford, Rockingham, Randolph,
Winston-Salem, North Carolina 27105
Stokes, Surry, Watauga, Wilkes, Yadkin
[phone]
[phone] Fax
INSTRUCTIONS FOR FORM: FTA 05-21 & SUPPORTING DOCUMENTATION Page 3 of 3

State of North Carolina
t Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 06-21 & SUPPORTING DOCUMENTATION
y
Application Number: be completed by DWR)
All items must be completed or the application will be returned
1. APPLICANT INFORMATION:
1. Applicant's name: Harnett Regional Water (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ® State/County ❑ Municipal ❑ Other
3. Signature authority's name: Steve Ward per 15A NCAC 02T .0106(b)
Title: Director of Harnett County Public Utilities
4. Applicant's mailing address: P.O. Box 1119 / 700 McKinney Parkway
City: Lillie ton State: NC Zip: 27546-`�
5. Applicant's contact information: j ; =l a-� ,� IJf i_i_f R GI,( 1Al. ()FFI(,
Phone number: [phone] Email Address: sward(c),hamett.org
11. PROJECT INFORMATION:
1. Project name: Serenity Subdivision - Phase 2 A&B
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 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: WQ00
3. County where project is located: Harnett
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.5457' Longitude:-78.823235"
5. Parcel ID (if applicable): (or- Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
l . Professional Engineer: Mike Zaccardo License Number: 022321
Firm: Timmons Group
Mailing address: 5410 Trinity Road, Suite 102
City: Raleigh State: NC Zip: 27607-
Phone number: [phone] Email Address: Mike.Zaccardo(cc�timmons.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
l . Facility Name: North Harnett Regional Wastewater- Treatment Plant Permit Number: NCO021636
Owner Name: Harnett Regional Water
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ0042471
2. Downstream (Receiving) Sewer Information: 8 inch
❑X Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS 000166
Owner Name(s): Harnett Regional Water -
FORM: FTA 06-21 Page 1 of 5

VI. GENERAL REQUIREMENTS
l . 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 HOAiPOA Operational Agreement (FORM: 1­10A) 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. Has a flow reduction been approved under 15A NCAC 02T .0114(t)? ❑ 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 ',e
No. of Units
Flow
Single-family residences
360 gal/day
32
11,520 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
11,520 GPD
a See 15A NCAC 02T .01 14(b). (d).. (c)(l ) 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-41.
b Per 15A NCAC 02T .01 14(c), design flow rates for establishments not identified [in table 15A NCAC 02T.01 14] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other- measured data.
8. Wastewater generated by project: 11,520 GPD (per 15A NCAC 02T .01 14
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: Tssuance 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 & N'IDC (Gravity Sewers):
l . Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 1,550 PVC
Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
Section III contains information related to rninimum 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):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROD]
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)
10, 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 2.01 C. Lb. ❑ 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
i 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 -
o I'
❑ 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.
FORM: FTA 06-21 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
l . Does the project comply with all separations/alternatives found in 15A NCAC 02T .0305(f) & O? ® Yes ❑ No
15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewers sterns:
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 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
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
r If noncompliance with 02T.0305(f) or (g). see Section X.1 of this application
*15A NCAC 02T.0305(e) contains alternatives where separations in 02T.0305(f) 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 webpage
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(f) 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.
i= See the Division's draft separation requirements for situations where separation cannot be met.
r 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 .0200`? ® Yes El No
10, This includes Trout Buffered Streams per 15A NCAC 213.0202
5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ® Yes ❑ No
or 401 Water- Quality Certifications?
� Please provide the permit nunber/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 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 l 5A 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/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 proiect, the full technical review is required.
Professional Engineer's Certification: r ,
attest that this application for ��%�=� l!/ 2� t'
(Professional Engineer's name from Application Item III.1.) (Project Name frofn Application Item II.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. 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:
Applicant's Certification per 15A NCAC 02T .0106(b):
......................................
1
•o,
V... ZR�+.` `�V•....2-7
,llf110
F C h
attest that this application for i z
(Signature Authority Name from Application Item I.3.) (Project Name fwrdApplication Item II.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 fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: Date: v ��
FORM: FTA 06-21 Page 5 of 5

PROJECT NARRATIVE
Project Name: Serenity Subdivision — Phase 2A & 2B
Location: Piney Grove Rawls Road, Harnett County, NC
Owner: Harnett Regional Water c/o
Steve Ward, Director of Public Utilities
PO Box 1119, 700 McKinney Parkway
Lillington, NC 27546
Developer: Greenfield Serenity, LLC — Matt Brubaker
8601 Six Forks Road, Suite 270
Raleigh, NC 27607
Consultant: Timmons Group
5410 Trinity Road, suite 102
Raleigh, NC 27607
Phone: [phone]
PROJECT DESCRIPTION AND NARRATIVE:
The proposed project is inside Harnett County jurisdictional limits and is located along Piney Grove
Rawls Road, north of the intersection of Piney Grove Rawls Road and US 401. The scope of this
project will include the construction of a 32-lot residential subdivision. The project is anticipated to
generate the following wastewater flows:
32 Units @ 360 GPD = 11,520 GPD
The proposed gravity sanitary sewer system for this Phase consists of approximately 1,550 LF of SDR
35 and C900 DR 18 PVC pipe.
The new gravity sanitary sewer system will be owned, operated, and maintained by Harnett Co.
Regional Water.

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State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Harnett Regional Water
Project Name for which flow is being requested: Serenity Phases 2A and 2B
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: North Harnett Regional WWTP
b. WWTP Facility Permit #: NC0021636
All flows are in MGD
c. WWTP facility's permitted flow 7.5 MGD
Fuquay-Varina Allocated Flow 2.60 MGD
Lillington Allocated Flow 1.20 MGD
Angier Allocated Flow 1.008 MGD
d. Estimated obligated flow not yet tributary to the WWTP 3.332 MGD
FV Obligated Flow NYT
0.761 MGD
Lillington Obligated Flow NYT
0.343 MGD
HC Obligated Flow NYT
1.369 MGD
Angier Obligated Flow NYT
0.859 MGD
e. WWTP facility's actual avg. flow
4.952 MGD
FV Actual Flow
1.224 MGD
Lillington Actual Flow
0.597 MGD
HC Actual Flow
2.568 MGD
Angier Actual Flow
0.563 MGD
f. Total flow for this specific request
0.011 MGD
g. Total actual and obligated flows to the facility
8.295 MGD
FV Actual Avg. + Obligated Flow
1.985 MGD
Lillington Actual Avg. + Obligated Flow
0.940 MGD
HC Actual Avg. + Obligated Flow
3.948 MGD
Angier Actual + Obligated Flow
1.422 MGD
h. Percent of permitted flow used 110.60%*
*A PER to expand the NHRWTTP treatment capacity has been completed and design of the
expansion is currently underway.
Page 1 of 3
FTSL 06-13

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 / p f),
Daily Flow,
Daily Flow,
Obligated
Available
Number)
MGD
MGD
MGD
MGD
Flow
Capacity***
Serenity
nc
1.440
0.576
0
0.143
0.143
0.433
SLS-120
14.4
5.76
2.819
3.265
6.084
-0.324
* 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.
Downstream Facility Name (Sewer): North Harnett Regional WWTP
Downstream Permit Number: NCO021636
III. Certification Statement:
I S+(Ve-, W�Vd 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 assessmentZ
endums for which I am the responsible party. Signature of this
form indicates acceptance ofs wastewater flow.
Signing Official Signature
Date
Page 2 of 3
FTS F 06-1 3

PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum for each pump station listed in Section II where Available
Capacity is < 0.
Pump Station (Name or Number): SLS-120
Given that:
• The proportion and amount of Obligated, -Not -Yet Tributary Daily Flow (C) accounts for
53.66 /o and: 3.265 'MGD of the Available Capacity (E) in Pump Station
SLS-120 ; and that
•
The rate - of activation _ _ on of this obligated, not yet tributary capacity is currently approximately
0.3 MGD per year; and that
• A funded Capital Project that will provide the required planned capacity, namely
TBD j is in design or under construction with
Tanned completion in TBD ; and/or
• The following applies:
HRW is currently reconciling actual and not -yet -tributary flows in January 2023 to
accurately assess available capacity. The reconciliation is expected to be completed in
j March 2023. Given the size of the pump station, the
- percentage of not -yet -tributary, and the rate of activation, this will be the first step to
determine if potential CIP project is needed and timeline for any capacity increase.
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to
allow this flow to be permitted, without a significant likelihood of over -allocating capacity in the
system infrastructure.
I understand that this does not relieve the collection system owner from complying with G.S. 143-
215.67(a) which prohibits the introduction of any waste in excess of the capacity of the waste
disposal system.
Signing Official Signature
Date
Page 3 of 3
F FS E 06-1