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Home My WebLink AboutWQ0044252_Application_20230323NC Den r*.;� r Entnrcr�r� State of North Carolina AR 2 7 13 Department of Environmental Quality Winstor;-`;,;? Division of Water Resources Redo,,, Pump and Haul Application Form INSTRUCTIONS FOR FORM: P&H 3/17 The Division of Water Resources will not accept this application unless all the instructions are followed. Plans and specifications must be prepared in accordance with 15A NCAC 2T .0200, all applicable general statutes, and good engineering practices. Failure to submit all of the required items will lead to additional processing time for the permit application or in the application being returned as incomplete. A. Application Form: ✓ Submit one original and one copy of the completed and appropriately executed application form. The Division of Water Resources (Division) will only accept complete application packages. ,"The project name should be consistent with the project name on any plans, letter of flow acceptance, operational agreements, etc. B. Application Fee (New and Renewal Packages): ✓The appropriate application fee is $810 for flows <10,000 GPD and $1,310 for flows>10,000 GPD. ✓ Submit the check payable to: North Carolina Department of Environmental Quality (NC DEQ). C. Cover Letter: ✓ Submit a cover letter explaining the circumstances associated with this pump and haul request. Please note that pump and haul permits are not acceptable as a long-term domestic wastewater treatment alternatives. D. Receiving Facility: ✓ Submit a letter from the owner/authority of the receiving wastewater treatment facility stating that the pumped and hauled wastewater (type and quantity) will be accepted. E. Contract Hauler: ✓ Submit a letter or contract from the hauler stating his capability and willingness to perform the pumping and hauling. F. Detailed Plans and Specifications: ✓ Submit two sets of detailed plans and specifications that have been signed, sealed, and dated by a Licensed NC Professional Engineer. ✓Plans must include the following minimum items: a general location map and a diagram of the components associated with the pump and haul activity (drains, piping, tanks, pumps). ,/The tank detail should indicate the high water alarm (both audible and visual or an auto dialer). THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING INFORMATION AND MATERIALS, SHOULD BE SENT TO THE FOLLOWING ADDRESS: Lon T. Snider Water Quality Regional Operations Supervisor Winston-Salem Regional Office 450 West Hanes Mill Rd., Suite 300 Winston-Salem, NC 27105 Telephone (336) 776-9800 Form: P&H 9/07 Page 1 of 4 NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY Division of Water Resources Winston-Salem Regional Office Non -Discharge Pump and Haul Permit Application Application Number: (to be completed by DWR) I. GENERAL INFORMATION: 1. Applicant (corporation, individual, other): City of King, NC 2. Print owners or signing official's name and title (person legally responsible for the facility and its compliance): Scott Barrow — City Engineer/Interim City Manager 3. Mailing address of applicant: PO Box 1132 City: King State: NC Zip: 27021 Telephone number: ( 336) 983-8265 Facsimile number: ( ) Email Address: sbarrow2ci.king.nc.us 4. Project name (facility or establishment): Muddy Creek Pump Station Replacement 5. County where project is located: Stokes/Forsyth 6. Fee submitted: $ 810.00 (See Instruction B.) 7. Name and complete address of engineering firm: KCI Associates of NC 7015 Albert Pick Road — Suite A City: Greensboro State: NC Zip: 27409 Telephone number: ( 336) 402-6708 Facsimile number: ( ) 8. Name and affiliation of contact person who can answer questions about project: Matthew Broderick Project Manager - KCI Email Address: matthew.broderick(r�kci.com 11. PERMIT INFORMATION: 1. If this application is being submitted as a result of a modification to or renewal of an existing permit, please provide the existing permit number WQ0043759 and the issuance date September 23, 2022 2. Specify whether the applicant is: public ✓ or private Form: P&H 3/17 Page 2 of 4 III. INFORMATION ON WASTEWATER: I . Nature of wastewater: 100 %Domestic 0 %Commercial 0 %Industrial %Other waste (specify): 2. Please provide a one or two -word description specifying the origin of the wastewater (school, restaurant, apartments, commercial): Residential 3. Volume of wastewater generated by this project: 2,400 gallons per day. 4. Explanation of how wastewater flow was determined (15A NCAC 2T .0114): 20 homes at 120 gpd/ 4 bedroom home = 2,400 gpd The applicant is seeking a variance to the 120 gpd/bedroom formula because these homes are new construction and furnished with appliances that are very efficient and result in low water usage The formula used in this case is a conservative reflection of actual expected flow and is suitable especially for a temporary application. Description of any pretreatment of wastewater prior to pumping and hauling: N/A IV. TREATMENT FACILITY INFORMATION: 1. Name of treatment facility receiving wastewater: Muddy Creek WWTP 2. NPDES permit number of treatment facility: NCO050342 3. Treatment facility contact person and telephone no: 336-727-8000 4. County where treatment facility is located: Forsyth V. CONTRACT HAULER INFORMATION: 1. Name of owner/company of transporting (hauler) vehicle: Affordable Septic & Grease Cleaning, Inc. 2. Mailing address of hauler: P.O. Box 395 Walkerton, NC 27051 3. Telephone number of hauler: (336) 462-6228 4. Provide the typical hauling volume of the vehicle: 2,400 gallons VI. GENERAL PROJECT INFORMATION 1. Brief project description: 2. Explanation of why pump and haul is being requested: 20 homes currently under construction will need sewer service prior to the installation of a new pump station and force main which will serve the entire community in the future. 3. Specify how long the pump and haul permit will be needed (maximum of six months): 6 Months 4. What will be the permanent method of wastewater disposal once the pump and haul activities have ceased?: The wastewater will be collected at a new pump station to be constructed near the proposed pump and haul site and conveved via a newly constructed 12-inch FM and connected to an existing 14-inch FM along King-Tobaccoville P-1 5. Date that permanent disposal method will be available: November 2023 6. Have permits/approvals for the permanent disposal method been obtained? Form: P&H 3/17 Page 3 of 4 VII. VIIl, Yes; Permit No. Permitting agency ✓No; Pending permit No. N/A Permitting agency NC DEO What type of tank or container will the wastewater be pumped from and what is the volume of this container? 2 10' diameter concrete manholes will be connected to provide approximately 3,500 gallons minimum 24 hour storage_ Is the tank or container already in place or will it be installed for these activities? To be installed. What type of high water alarm does the container have? Audible and visual ✓ Auto dialer OWNER'S SIGNATURE: Applicant's Signature and Certification: I, Scott Barrow , attest that this application for Muddy Creek Pump Station Replacement 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 ax-e 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 NC General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor which may include a fine tto $10,000 as well as civil penalties up to $25,000 per violation. or 10 <— /7 Signature: Date: F,3 ENGINEER'S CERTIFICATION: Professional Engineer's Certification: I, Matthew Broderick , attest that this application for has been reviewed by me and is accurate, complete and consistent with the information supplied in the engineering plans, 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. Although certaiii portions of this submittal package may have been developed by other professionals, 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 NC General Statutes 143-215.6A and 143-215.613, any person who knowingly makes any false statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor which may include a line not to exceed $10,000 as well as civil penalties up to $25,000 per violation. Muddy Creek Pump Station Replacement North Carolina Professional Engineer's seal, signature, and date: `ov.11. till/// ,�`N•.GA� 0 f. SEAL 037,69 Form: P&H 3/17 Page 4 of 4 KCI AssoCIATES of NC KC I ENGINEERS I PLANNERS I S[IENTISTS I CONSTRUCTION MANAGERS March 20, 2023 Jennifer F. Graznak Water Quality Regional Operations Division of Water Resources, NCDEQ 450 W. Hanes Mill Road Suite 300 Winston-Salem, North Carolina RE: Permit No. WQ0043759 Pump and Haul Permit Extension City of King Muddy Creek Pump Station King, North Carolina Dear Ms. Graznak, On behalf of the City of King (City), KCI would like to request a permit extension for Pump and Haul permit No. WQ0043759. The permit became effective on September 23, 2022 and expires on March 23, 2023. Pump and Haul operations did not begin until December 22, 2022 just after flow from the contributing residential subdivision commenced. Therefore, there were three inactive months where the permit was not actively being used. Currently, there are 5 homes built with only 3 being occupied in the subdivision. In the 3 months since flow to the pump and haul vaults commenced, it has only been pumped 8 times. Those records are included with this letter. Delays during the Muddy Creek Pump Station Design has pushed the project bid date to the end of March. It is anticipated that construction of the pump station will take a year to complete. The City of King requests to extend the Pump and Haul Permit through March 2024. If you have any questions or require additional information regarding this project, please contact me at (864) 714-1291 or matthew.broderick@kci.com. Sincerely, KCI Matt Broderick, PE Project Manager Cc: Scott Barrow, City of King Steve Barbian, KCI Attachments: Pump & Haul Records from City of King Affordable Septic & Grease Cleaning, l�c P.O. P w Walkertown, n, NCC 27051 336-462.6228 cV$roMEq's oi,.Eq uo SOLD 9v SOLD, gOOgE55 MDSE. SOLD MDSE. RET'D REO'DON ADCT. NOTE MSC'L PAID OUT CAGIi CHARGE CASH CHARGE OTV. PART NO. I ARtTICCLES PRICE AMOUNT L1 7" �w.9 i✓t 1�4 t�So `A3 l TAX gecemeo ev TOTAL C PRODUCT en All claims eoa remrneo goods MIA9 be axam0anext by this hill. 7301 `7hank`You Affordable Septic & Grease cle gin , Inc I t' P.O. Box 395 Walkertown, NC 27051 _ 336-462-6228 Sy 7 7 LVHiOMER'S OROER NO. SOl➢6Y SCLOTO D-6 A AOVRE33 � SE SOLD MDSE. RETD RELV Ory MISC'L PAID OUT AccT.-NOTE CASH CHARGE CASH// CHARGE OTY. PART NO. ARTICLES - PRICE AMOUNT X OTC SOOT TAX nECENEID ev _'L�,Z3 TOTAL c cnooum eu All Claims and returned Wds MUST be nuompaniad by this We 9731 `Thank`You Affordable Septic & Grease Cleaning, Inc P.O. Box 395 Walkertown, NC 27051 336-462.6228 CUSTOMFA'S ORBEB NO. SOLD BY ^ O R/ ` nooRsss � q. M SE. SOLD MDSE. RET'D RECD ON ACCT NOTE MISC'L PAID OUT CASH CHARGE CASH CHARpE OTY. PART NO. ARTICLES PRICES AMOUNT �rdJ c� w SGr i I� TAX RECENEO BY TOTAL C alVOUaTen NI darts and mmrn,d gaada MAST bammmGanbd by thia bill. 9752 `?LankWou Affordable Septic & Grease C "gn P.O. Box 395 Walkertilm, NC 27051 336-462.6228 L0 5 S a d CUSTOMFA'S ORDER NO. SOLO BY OP BOLBro (/ AOOPE8$ MDS .SOLD E. RET'D REco oN ACCT-NOTE MISC'L PAID OUT CASH CHARGE CASH CHANGE QTY. PART NO. ARTICLES li PRICE AMOUNT I� I� I TAX RECEIVED BY TOTAL C `,O Ten All claims and reWmatl 9octle MUST be ucompcmed by this bill. 9734 `?hank`You Affordable Septic & Grease Clea g,,lric P.O. Box 395 oZ , .5 WalkertowR, NC 27051 336462-6228 (o-SS 8-) CUSTOMER'$OROER NQ SOLD BY $OLO TO / IJ( !mil MDS .SOLD MUSE. FETD Redo ory NOTE ACOT- MISC'L PAID OUT CASH CHARGE CASH CHARGE CITY. PART NO. ARTICLES PRICES AMOUNT pug lz2 d,4 L x I� 0-0 I TAX RECENEO BV TOTAL I C aeovwTEn AIIddlmsaaAret.rrna gwtls MUST be axam,hNiOd by this bill. 9735 `Thank`Yoa Affordable Septic & Grease Cleaning, Inc P.O. Box 395 Walkerlmn, NC 27051 336-462-5228 ODSTDMER'S ORDER NO SOLE BY DATE v) SOLD ro ADDRESS IA I Oh MDSE. SOLD MDSE. RETD REC'DON ACCT NOTE MISC'L PAID OUT CASH CHARGE CASH CHARGE tY QTY. PART NO. ARTICLES3'.. PRICE AMOUNT II ''I 5 ► D-� x 5 I,S TAA RECEIVED BY TOTAL C PAEBFA of All slalms and¢Nmed goods MOST be a MlBnled by this M, 9747 `T wnk`You Affordable Septic & Grease Cleaning, I n,+) P.O. Box 395 Walkertown, NC 27051 336-462.6228 Slealo CUSTOMERS ORDER NO SOLD BY OA ROLDTO— �/+ ADDREss fie.( MDSE. SOLD MDSE. RET'D REC'D ON ACCi -NOTE MISC'L PAID OUT CASH CHARGE CASH CHARGE QW.. PART NO. 0. ARTICLES PRICE AMOUNT fourtp �u o `� I ,16 TAX fl ECEIVED BY TOTAL I C el 1 9737 All claims and real goods MUST be acoamPanieu by ins bill `lhank`You Affordable Septic & Grease I an' g,Jrn P.O. Box 395 g Walkertown, NC 27051 �,•a 3•a 3 336-462.6228 SU Sly - CUSTOMER'S ORDER NO. 5OLD BY SOLOI I %mil �! ADDRESS MDSE. OLD MDSE. RET'D REcD ON AGCT -NOTE MiSC'L PAID OUT CASH CHARGE CASH CHARGE ,4 j OTY. PART NO. ARTICLES PRICE AMOUNT i 9�E ,I TAX REcemeD ev TOTAL C PRDoJCTWI All Claims bD,ewrned g..d, MOST Ire azwmpsweb by this bill. 9788 `?hank`You NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY Division of Water Resources Winston-Salem Regional Office Non -Discharge Pump and Haul Permit Application Application Number: WQ0044252 (to be completed by DWR) I. GENERAL INFORMATION: Applicant (corporation, individual, other): City of King, NC 2. Print owners or signing official's name and title (person legally responsible for the facility and its compliance): Scott Barrow — City Engineer/Interim City Manager 3. Mailing address of applicant: PO Box 1132 City: State: NC Zip: 27021 Telephone number: (336) 983-8265 Facsimile number: ( ) Email Address: sbarrow@ci.king.nc.us 4. Project name (facility or establishment): Muddy Creek Pump Station Replacement 5. County where project is located: Stokes/Forsyth 6. Fee submitted: $ 810.00 (See Instruction B.) 7. Name and complete address of engineering firm: KCI Associates of NC 7015 Albert Pick Road — Suite A City: Greensboro State: NC Zip: 27409 Telephone number: (336) 402-6708 Facsimile number: ( ) 8. Name and affiliation of contact person who can answer questions about project: Matthew Broderick Project Manager - KCI Email Address: matthew.broderickna,kci.com II. PERMIT INFORMATION: If this application is being submitted as a result of a modification to or renewal of an existing permit, please provide the existing permit number WQ0043759 and the issuance date September 23, 2022 2. Specify whether the applicant is: public ✓ or private Form: P&H 3/17 Page 2 of 4 III. INFORMATION ON WASTEWATER: Nature of wastewater: 100 %Domestic 0 %Commercial 0 %Industrial %Other waste (specify): 2. Please provide a one or two -word description specifying the origin of the wastewater (school, restaurant, apartments, commercial): Residential 3. Volume of wastewater generated by this project: 2,400 gallons per day. 4. Explanation of how wastewater flow was determined (15A NCAC 2T .0114): 20 homes at 120 gpd/ 4 bedroom home = 2,400 gpd. The applicant is seeking a variance to the 120 gpd/bedroom formula because these homes are new construction and furnished with appliances that are very efficient and result in low water usage. The formula used in this case, is a conservative reflection of actual expected flow and is suitable especially for a temporary application. Description of any pretreatment of wastewater prior to pumping and hauling: N/A IV. TREATMENT FACILITY INFORMATION: Name of treatment facility receiving wastewater: Muddy Creek WWTP 2. NPDES permit number of treatment facility: NCO050342 3. Treatment facility contact person and telephone no: 336-727-8000 4. County where treatment facility is located: V. CONTRACT HAULER INFORMATION: Name of owner/company of transporting (hauler) vehicle: Affordable Septic & Grease Cleaning, Inc. 2. Mailing address of hauler: P.O. Box 395 Walkerton, NC 27051 3. Telephone number of hauler: (336) 462-6228 4. Provide the typical hauling volume of the vehicle: 2,400 gallons VI. GENERAL PROJECT INFORMATION Brief project description: 2. Explanation of why pump and haul is being requested: 20 homes currently under construction will need sewer service prior to the installation of a new pump station and force main which will serve the entire community in the future. 3. Specify how long the pump and haul permit will be needed (maximum of six months): 6 Months 4. What will be the permanent method of wastewater disposal once the pump and haul activities have ceased?: The wastewater will be collected at a new pump station to be constructed near the proposed pump and haul site and conveyed via a newly constructed 12-inch FM and connected to an existing 14-inch FM along King-Tobaccoville Road. 5. Date that permanent disposal method will be available: November 2023 6. Have permits/approvals for the permanent disposal method been obtained? Form: P&H 3/17 Page 3 of 4 VIII. Yes; Permit No. Permitting agency ✓No; Pending permit No, N/A Permitting agency NC DEO What type of tank or container will the wastewater be pumped from and what is the volume of this container? 2 10' diameter concrete manholes will be connected to provide approximately 3,500 gallons minimum 24 hour storage. Is the tank or container already in place or will it be installed for these activities? To be installed. What type of high water alarm does the container have? Audible and visual ✓ Auto dialer_ OWNER'S SIGNATURE: Applicant's Signature and Certification: I Scott Barrow attest that this application for Muddy Creek Pump Station Replacement 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 information and attachments are not included, this application package will be returned to me as incomplete. Note: In accordance with NC General Statutes 143-215.6A and 143-215.613, any person who knowingly makes any false statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor which may include a fine nottoe eed $10,000 as well as civil penalties up to $25,000 per violation, Signature: _ Date:�� ENGINEER'S CERTIFICATION: Professional Engineer's Certification: I Matthew Broderick , attest that this application for Muddy Creek Pump Station Replacement has been reviewed by me and is accurate, complete and consistent with the information supplied in the engineering plans, 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. Although certain portions of this submittal package may have been developed by other professionals, inclusion of these materials under my signature and seal signifies that I have reviewed this material and havejudged it to be consistent with the proposed design. Note: In accordance with NC General Statutes 143-215.6A and 143-215.6E, any person who knowingly makes any false statement, representation, or certification in any application 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. North Carolina Professional Engineer's seal, signature, and date: Form: P&H 3/17 Page 4 of 4 NJ I.p SIAL 037097 4. 3-21-:2i ?c�i CITY OF ICING Jack rr Warren, Mayor l l l l' 11la[ �f Scott Barrow, Interim City Manager P.O. Drawer 1132 105 Bob Rierson Street King, NC 27021-1132 Phone(336) 983-4832 Fax (336) 983-0800 September 21, 2022 Affordable Septic Tommy Neal To Affordable Septic: Contract for hauling: I Tommy Neal _ agree to contract with the. City of King to perform the pumping and hauling of waste products as n' eeded from Gentry Farms Development not to exceed $300.00 per load, Tommy Neal Date Signature of contractor If you have any questions pleasefeel free to contact me at 3 3 6 -9 8 3 -48 3 2. Sincerely, Robert Pettitt City of King Superintendent of Public Utilities CITY OF KING Jack Warren, Mayor Scott Barrow, Interim City Manager P.O. Drawer 1132 King, NC 27021-1132 March 21, 2023 NCDEQ-Division of Water Resources 450 W. Hanes Mill Road -Suite 300 Winston-Salem, North Carolina 27105 229 S. Main Street Telephone (336) 983-8265 Fax (336) 983-4675 RE: Muddy Creek Pump Station Replacement — Temporary Pump and Haul Application City of King, NC Dear Division of Water Resources: Ile The City of King is preparing for the installation of the Muddy Creek Pump Station which will replace the existing wastewater pump station near Spainhour Road. This project will include the installation of a sewer pipeline to convey wastewater to and from the pump station. The location of the project is adjacent to the existing pump station near the intersection of Spainhour Road and Moore Road. In order to provide interim sewer service to newly constructed homes in the area while the new pump station is being constructed, a temporary pump and haul service will be established to haul wastewater from temporary wet wells near the location of the new pump station to the existing Spainhour Road Pump Station. This letter serves to confirm that the City of King will accept the wastewater generated from the temporary pump and haul application into the existing collection system. The wastewater will be hauled to and discharged at the Spainhour Road Pump Station (810 Spainhour Road King, NC). All wastewater from the City of King wastewater collection system is ultimately conveyed to the Muddy Creek WWTP in Winston-Salem. After construction of the Muddy Creek Pump Station is completed, the flow of wastewater from the development will be redirected to the new pump station. V� Thank you in advance for your consideration. Please contact the Interim City Manager at 336-983-8265 or sbarrow@ci.king.nc.us if you have questions or need additional information. Sincerely, City of King Scott Barrow, P. E. Interim City Manager KCI ASSOCIATES OF NC KCI ENGINEERS I PLANNERS I SCIENTISTS I CONSTRUCTION MANAGERS March 21, 2023 NCDEQ Division of Water Resources 450 W. Hanes Mill Road Suite 300 Winston-Salem, North Carolina RE: Pump and Haul Application City of King Muddy Creek Pump Station King, North Carolina Dear Division of Water Resources, KCI is pleased to submit the enclosed Pump and Haul application on behalf of the City of King for the temporary pump and haul service during the construction of the new Muddy Creek Pump Station. The design and easement acquisition process associated with the Muddy Creek Pump Station and Force Main project required collaboration with RJ Reynolds Manufacturing to obtain easements and access RJR property for survey and geotechnical investigations. This process took more than a year to complete. In that time, housing developments in the area that had planned to be served by the Muddy Creek Pump Station have been built and are in need of sewer service. The City of King proposes to provide temporary pump and haul service to these homes until the permanent pump station and force main project can be completed. The following documents are enclosed in this submittal per the permit application checklist: • One (1) original and one (1) copy of the Pump and Haul Application Form • One (1) original and one (1) copy of an aerial location site map • One (1) original and one (1) copy of the detailed plans and specifications • Application fee of $810 If you have any questions or require additional information regarding this project, please contact me at (336) 402-6708 or at matthew.broderick @kci.com. Sincerely, KCI Matthew Broderick Project Manager Enclosures as noted