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HomeMy WebLinkAboutWQ0044280_Application (FTSE)_20230405;exvt6 q - G-Zo 3 State of North Carolina Department of Environmental Quality -D-W R Division of Water Resources FAST TRACK SEWER SYSTEM EXTENSION APPLICATION Division of Water Resources FTA 06-21 & SUPPORTING DOCUMENTATION Application Number '�-AOD'H w./ (to be completed by DWR) All items must be completed or the application will be returned I. APPLICANT INFORMATION: 1. Applicant's name: Aqua N.C. (company, municipality, HOA, utility, etc.) 2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Federal ❑ State/County ❑ Municipal 3. Signature authority's name: Michael A. Melton per 15A NCAC 02T .0106(b) Title: Engineering Manager 4. Applicant's mailing address: 202 Mackenan Ct. City: Cary State: NC Zip: 27511- 5. Applicant's contact information: Phone number: (919) 460-1788 Email Address: mamelton@aquaamerica.com II. PROJECT INFORMATION: ® Privately -Owned Public Utility ❑ Other 1. Project name: Havenbrooke Subdivision 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: Forsyth 4. Approximate Coordinates (Decimal Degrees): Latitude: 36.175744' Longitude:-80.046372' 5. Parcel ID (if applicable): 6898-04-3849.000 (or Parcel ID to closest downstream sewer) III. CONSULTANT INFORMATION: l . Professional Engineer: James L. Walters, P.E. License Number: 18584 Firm: Latham -Walters Engineering, Inc. Mailing address: 16507-A Northcross Drive-" City: Huntersville State: NC Zip: 28078- Phone number: (704) 895-8484 Email Address: jimna,lweneineer.com IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION: 1. Facility Name: Mikkola Downs Subdivision WWTP Permit Number: NCO067091 Owner Name: AQUA North Carolina, Inc. E, V. RECEIVING DOWNSTREAM SEWER INFORMATION: 1. Permit Number(s): WQ (unknown) 2. Downstream (Receiving) Sewer Information: 8 inch © Gravity ❑ Force Main 3. System Wide Collection System Permit Number(s) (if applicable): WQCSD0204 Owner Name(s): AQUA North Carolina, Inc. 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(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.0114(f)) Daily Design Flow 1,b No. of Units I Flow Single family 3 bedrm. home 360 gal/day 71 25,560 GPD gal/ GPD gal/ GPD gal/ GPD gal/ GPD gal/ GPD Total 25,560 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.0114] shall be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data. 8. Wastewater generated by project: 25,560 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 5640 PVC 8 63 DIP ➢ 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 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 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 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.l.b. ❑ 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 ➢ 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 - 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 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 X. CERTIFICATIONS: 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? ® 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 Engineer's Certification: 1 James L. Walters, P.E. , attest that this application for Havenbrooke Subdivision (Professional Engineer's name from Application Item III. I.) (Project Name from 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 143-215.613, 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) 1 North Carolina Professional Engineer's seal, signature, and date: 3. Applicant's Certification per 15A NCAC 02T .0106(b): 1 Michael A. Melton , attest that this application for (Signature Authority Name from Application Item 1.3.) Havenbrooke Subdivision (Project Name from Application 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: �3131 `202-3 FORM: FTA 06-21 Page 5 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(f) & (g)? ® Yes ❑ No 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems: Setback Parameter* Separation Required Storm sewers and other utilities not listed below (vertical) 18 inches 2Water 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 ➢ If noncompliance with 02T.0305( or (g), see Section X.1 of this application *I5ANCAC 02T.0305(g) 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 webnaQe 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. ➢ 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: ® No If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No ➢ 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 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.0 I 05(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 VINAlk MY MLAr Division of Water Re%otir(e% State of North Carolina Department of Environmental Quality Division of Water Resources Flow Tracking for Sewer Extension Applications (FTSE 10-18) Entity Requesting Allocation: Aqua North Carolina, Inc. Project Name for which flow is being requested: Havenbrooke Subdivision 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: Mikkola Dows WWTP b. WWTP Facility Permit #: NC0067091 All flows are in MGD c. WWTP facility's permitted flow 0.072 d. Estimated obligated flow not yet tributary to the WWTP 0.004 e. WWTP facility's actual avg. flow 0.0056 f. Total flow for this specific request .0263 g. Total actual and obligated flows to the facility 0.036 h. Percent of permitted flow used 49.4% 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 / pf), Avg. Daily Daily Flow, Obligated Available Number) No. MGD MGD Flow, MGD MGD Flow Capacity*** * 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 (pi) 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 < 0. Downstream Facility Name (Sewer): Downstream Permit Number: Page 1 of 6 FTSE 10-18 III. Certification Statement: I Michael A. Melton 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 capacity to transport and treat the proposed new wastewater. Signing'Official Signa Title of 3 Date Page 2 of 6 FTSE 10-18 Existing Mikkola Exis ting Subdivision USGS TOPO MAP NC BELEWS CREEK 2022 BUSINESS CORPORATION ANNUAL REPORT l/6i2022 NAME OF BUSINESS CORPORATION: Aqua North Carolina, Inc. SECRETARY OF STATE ID NUMBER: 0072603 STATE OF FORMATION: NC REPORT FOR THE FISCAL YEAR END: 12/31/2022 SECTION A: REGISTERED AGENT'S INFORMATION 1. NAME OF REGISTERED AGENT: CT Corporation System 2. SIGNATURE OF THE NEW REGISTERED AGENT: Filing Office Use Only E - Filed Annual Report 0072603 CA202304102914 2/10/2023 04:30 Changes SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT 3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS 160 Mine Lake Ct Ste 200 Raleigh, NC 27615 Wake County SECTION B: PRINCIPAL OFFICE INFORMATION 1. DESCRIPTION OF NATURE OF BUSINESS: Water Utility 160 Mine Lake Ct Ste 200 Raleigh, NC 27615 2, PRINCIPAL OFFICE PHONE NUMBER: (877) 858-3855 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction 4. PRINCIPAL OFFICE STREET ADDRESS 202 MacKenan Court NC 27511 5. PRINCIPAL OFFICE MAILING ADDRESS 202 MacKenan Court Cary, NC 27511 6. Select one of the following if applicable. (Optional see instructions) ❑ The company is a veteran -owned small business The company is a service -disabled veteran -owned small business SECTION C: OFFICERS (Enter additional officers in Section E.) NAME: Shannon V. Becker TITLE: President ADDRESS: 762 West Lancaster Avenue Bryn Mawr, PA 19010 NAME: Christopher P. Luning TITLE: Secretary ADDRESS: NAME: Daniel J. Schuller TITLE: Chief Financial Officer ADDRESS: 202 MacKenan Court Cary, NC 27511 SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entit . Nrlstopher P. Luning 2/10/2023 202 MacKenan Court Cary, NC 27511 SIGNATURE Form must be signed by an officer listed under Section C of this form. Christopher P. Luning Secretary DATE Print or Type Name of Officer Print or Type Title of Officer This Annual Report has been filed electronically. MAIL TO: Secretary of State, Business Registration Division. Post Office Box 29525, Raleigh, NC 27626-0525 STATE OF NORTH CAROLINA UTILITIES COMMISSION RALEIGH APPENDIX A-20 DOCKET NO. W-218, SUB 341 BEFORE THE NORTH CAROLINA UTILITIES COMMISSION AQUA NORTH CAROLINA, INC. is granted this CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY to provide sewer utility service in BRIDGEPOINTE, FOREST RIDGE, RIDGECREST AT WELLESLEY, SALEM QUARTERS AND WELLESLEY PLACE SUBDIVISIONS AND to provide water and sewer utility service in GRAYSTONE FOREST AND MIKKOLA DOWNS SUBDIVISIONS Forsyth County, North Carolina subject to any orders, rules, regulations, and conditions now or hereafter lawfully made by the North Carolina Utilities Commission. ISSUED BY ORDER OF THE COMMISSION. This the 29th day of January, 2013. NORTH CAROLINA UTILITIES COMMISSION Gail L. Mount, Chief Clerk LATHAM-WALTERS ENGINEERING, INC. 16507-A Northcross Drive Huntersville, North Carolina 28078 Ph (704) 895-8484 Fax (704) 237-4362 meredith@lwengineer.com LETTER OF TRANSMITTAL NC Department of Environmental Quality Received To: NCDEQ -Division of Water Resources APR 0 5 2023 Winston-Salem Regional Office Address: 450 W. Hanes Mill Rd., Suite 300 Winston-Salem Regional Office Winston-Salem, NC 27105 Job No.: 2021.34 From: Meredith Hammill Date: April 4, 2023 Re: Havenbrooke Subdivision We are sending you: via The following items: specifications X attached copy of letter under separate cover xsubmittal package Copies Date No. Description 2 5 Fast Track Sewer Application (original & copy) 1 4/3/23 1 $480 application fee check payable to NCDEQ 1 12/31/22 1 Aqua North Carolina, Inc. Annual Report filed w/ SoS 1 2 FTSE from Aqua 1 2023 1 8.5xl 1 color 7.5 min. USGS To o with site and waterbodies 1 2023 1 8.5x11 street level ma 1 1/29/2013 2 CPCN for Mikkola Downs (Havenbrooke is an extension of Mikkola Downs utilities 1 3/22/23 1 Structural drawing for aerial crossing 1 3/24/23 1 Plan & Profile sheet for aerial crossing THESE ARE TRANSMITTED as checked below: ✓ For approval o Approved as submitted o For your use o Approved as noted o As requested o Returned as corrections o For review and comment o Forms for signatures & submittal Remarks: AQUA North Carolina, Inc. is requesting a permit for Havenbrooke Subdivision. This is a new section of development adjacent to the Mikkola Downs subdivision for which a CPCN has been granted. It consists of 71 lots @ 360 gpd for a total flow of 25,560 gpd. The project is located in Forsyth Co. and effluent will be treated at the Mikkola Downs WWTP (NC0067091), owned by AQUA North Carolina, Inc. If you have any questions please do not hesitate to call. (704) 895-8484 — Meredith Hammill