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WQ0021840_Application (FTSE)_20230505
Received 5-5-2023 State of North Carolina Department of Environmental Quality DWR Division of Water Resources FAST TRACK SEWER SYSTEM EXTENSION APPLICATION Division of Water Resources FTA 06-21 & SUPPORTING DOCUMENTATION WQ0021840 MOD Application Number. (to be completed by DWR) All items must be completed or the application will be returned I. APPLICANT INFORMATION: 1. Applicant's name: High Point Christian Academy (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: Keith Curlee per 15A NCAC 02T .0106(b) Title: Headmaster 4. Applicant's mailing address: 800 Phillips Ave. City: High State: NC Zip: 27262- 5. Applicant's contact information: Phone number: (336) 841-8702 Email Address: kcurlee@hpcacougars.org II. PROJECT INFORMATION: 1. Project name: HPCA Gymnasium 2. Application/Project status: ❑ Proposed (New Permit) ® Existing Permit/Project If a modification, provide the existing permit number: WQ0021840 and issued date: October 28 2002, 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: Guilford 4. Approximate Coordinates (Decimal Degrees): Latitude: 35.9514' Longitude:-80.0265' 5. Parcel ID (if applicable): 194035 (or Parcel ID to closest downstream sewer) III. CONSULTANT INFORMATION: 1. Professional Engineer: Norris Z. Clayton License Number: 10727 Firm: Hugh Creed Associates, Inc., P.A. Mailing address: PO Box 9623 City: Greensboro State: NC Zip: 27408- Phone number: (336) 275-9826 Email Address: hca@hughcreedassociates.com IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION: 1. Facility Name: Westside WWTP Permit Number: 0033285 Owner Name: City of High Point V. RECEIVING DOWNSTREAM SEWER INFORMATION: 1. Permit Number(s): WQ0024228 2. Downstream (Receiving) Sewer Information: 12 inch ® Gravity ❑ Force Main 3. System Wide Collection System Permit Number(s) (if applicable): WQCS0024228 Owner Name(s): City of Hiizh Point 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',b No. of Units Flow gal/ GPD gal/ GPD gal/ GPD gal/ GPD gal/ GPD gal/ GPD Total 0 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: 0 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): Proposed gymnasium is incidental to existing school, no additional wastewater will be produced. 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" 339 8" SDR PVC ➢ 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 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 sewers stems: Setback Parameter* Separation Required Storm sewers and other utilities not listed below (vertical) 18 inches ZWater 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 11 impounded reservoirs used as a source of drinking water, and associated wetlands. 100 feet **Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal high water (or tide elevation) and wetlands associated with these waters (see item IX.2) 50 feet **Any other stream, lake, impoundment, or ground water lowering and surface drainage ditches, as well as wetlands associated with these waters or classified as WL. 10 feet Any building foundation (horizontal) 5 feet Any basement (horizontal) 10 feet Top slope of embankment or cuts of 2 feet or more vertical height 10 feet Drainage systems and interceptor drains 5 feet Any swimming pools 10 feet Final earth grade (vertical) 36 inches ➢ If noncompliance with 02T.0305(f) or (g), see Section X.1 of this application *15A NCAC 02T.0305(y) 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. ➢ 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 2B.0202 5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ❑ Yes ® No or 401 Water Quality Certifications? ➢ Please provide the permit number/permitting status in the cover letter if coverage/authorization is required. 6. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications must be being prepared, have been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and sedimentation control plans, stormwater management plans, etc.). 7. Does this project include any sewer collection lines that are deemed "high -priority?" ❑ Yes ® No Per 15A NCAC 02T.0402, "high -priority sewer" means any aerial sewer, sewer contacting surface waters, siphon, or sewers positioned parallel to streambanks that are subject to erosion that undermines or deteriorates the sewer. Siphons and sewers suspended through interference/conflict boxes require a variance approval. ➢ If yes, include an attachment with details for each line, including type (aerial line, size, material, and location). High priority lines shall be inspected by the 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 CERTIFICATIONS: 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 subiect to longer review times. For protects requiring two or more variances or where the variance is determined by the Division to be a significant portion of the protect the full technical review is required 2. Professional Engineer's Certification: 1, l(le"I -5 Z . C i�'i �r/ , attest that this application for_&&-4 !�7%1y1N,451 1yL (Professional Engineer's name from Application Item III.1.) (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) North Carolina Professional Engineer's seal, signature, and date: I•'••"""'•'......... 3. Applicant's Certification per 15A NCAC 02T .0106(b): I, 1 44oy Wes- , attest that this application for t—A to v,,, %A 6L-9i 1, ^_ (Signature Authority Name from Application Item I.3.) (Project Namtlrom 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. ;�. 1 CF W A 7F9 Michael F. Easley, Governor William G. Ross Jr., Secretary . co r North Carolina Department of Environment and Natural Resources p Alan W. Klimek, P.E., Director Division of Water Duality October 28, 2002 RICHARD HARDEE, HEAD MASTER HIGH POINT CHRISTIAN ACADEMY 307 NORTH ROTARY DRIVE HIGH POINT, NC 27261-2443 Subject: Permit No. WQ0021840 High Point Christian Academy Wastewater Collection System Extension Guilford County Dear Mr. Hardee: In accordance with your application received September 16, 2002, we are forwarding herewith Permit No. WQ0021840, dated October 28, 2002, to High Point Christian Academy for the construction and operation of the subject wastewater collection system extension. This permit shall be effective from the date of issuance until rescinded and shall be subject to the conditions and limitations as •specified therein. This cover letter shall be considered a part of this permit and is therefore incorporated therein by reference. Please pay particular attention to Permit Condition 3 which requires that the wastewater collection facilities be properly operated and maintained in accordance with 15A NCAC 2H .0227 or any individual system -wide collection system permit issued to the Permittee. (--Please note Permit Condition 12 regarding future flow allocation to the subject wastewater -collection- system —Delete this item if not needed or call attention to other special conditions as needed.) Permitting of this project does not constitute an acceptance of any part of the project that does not meet 15A NCAC 2H .0200; the Division of Water Quality's (Division) Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as applicable; and the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable, unless specifically mentioned herein. Division approval is based on acceptance of the certification provided by a North Carolina -licensed Professional Engineer in the application. It shall be the Permittee's responsibility to ensure that the as -constructed project meets the appropriate design criteria and rules. Failure to comply may result in penalties in accordance with North Carolina General Statute §143-215.6A through §143-215.6C, construction of additional or replacement wastewater collection facilities, and/or referral of the North Carolina -licensed Professional Engineer to the licensing board. In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as amended, and other applicable laws, Rules, and Regulations, permission is hereby granted to High Point Christian Academy for the construction and operation of approximately 380 linear feet of 8-inch gravity sewer to serve employees and students as part of the High Point Christian . Academy project, and the discharge of 2,650 gallons per day of collected domestic wastewat o Non -Discharge Permitting Unit Internet http1/h2o.enr.state.nc.us/ndpu N 1617 Mail Service Center, Raleigh, NC 27699-1617 Telephone (919) 733-5083 Fax (919) 715-6048 DENR Customer Service Center Telephone 1 800 623-7748 An Equal Opportunity Action Employer 50% recycled/10% post -consumer paper Ao 14 the City of High Point's existing sewerage system, pursuant to the application received September 16, 2002, and in conformity with 15A NCAC 2H .0200; the Division's Gravity Sewer Minimum Design . Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast - Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting data subsequently filed and approved by the Department of Environment and Natural Resources and considered a part of this permit. The sewage and wastewater collected by this system shall be treated in the City of High Point Wastewater Treatment Facility (NPDES Permit No. NC0024210) prior to being discharged into the receiving stream. This permit shall become voidable unless the agreement between High Point Christian Academy and the City of High Point for the collection and final treatment of wastewater is in full force and effect. If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to request an adjudicatory hearing upon written request within 30 days following receipt of this permit. This request must be in the form of a written petition, conforming to Chapter 150B of North Carolina General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and binding. If you need additional information concerning this matter, please contact Kristin E. Miguez at (919) 733-5083 extension 524. Sincerely, for Alan W. Klimelt, P.E. cc: Guilford County Health Department Winston-Salem Regional Office, Water Quality Section (WWTF Permit No. NCO024210) LandDesign, Inc. City of High Point (PO Box 230, High Point, NC 27261) Water Quality Central Files .NDFU_F.iles~ l f • NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES RALEIGH WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT This permit shall be effective from the date of issuance until rescinded and shall be subject to the following specified conditions and limitations: 1. This permit shall become voidable unless the wastewater collection facilities are constructed in accordance with the conditions of this permit; 15A NCAC 2H .0200; the Division of Water Quality's (Division) Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting materials unless specifically mentioned herein. 2. This permit shall be effective only with respect to the nature and volume of wastes described in the application and other supporting data. 3. The wastewater collection facilities shall be properly maintained and operated at all times. The Permittee shall maintain compliance with an individual system -wide collection system permit for the operation and maintenance of these facilities as required by 15A NCAC 2H .0227. If an individual permit is not required, the following performance criteria shall'be met as provided in 15A NCAC 2H .0227: a. The sewer system shall be effectively maintained and operated at all times to prevent discharge to land or surface waters, and any contravention of the groundwater standards in 15A NCAC 2L .0200 or the surface water standards in 15A NCAC 2B .0200. b. A map of the sewer system shall be developed prior to January 1, 2004 and shall be actively maintained. c. An operation and maintenance plan shall be developed and implemented. -d. Pump stations that are not connected to a telemetry system shall be inspected every day (i.e. 365 days per year). Pump stations that are connected to a telemetry system shall be inspected at least once per week. e. High -priority sewer lines shall be inspected at least once per every six-month period of time. f. A general observation of the entire sewer system shall be conducted at least once per year. g. Inspection and maintenance records shall be maintained for a period of at least three years. h. Overflows and bypasses shall be reported to the appropriate Division regional office in accordance with 15A NCAC 2B .0506(a), and public notice shall be provided as required by • North Carolina General Statute §143-215.1 C. 4. This permit shall not be transferable. In the event there is a desire for the wastewater collection facilities to change ownership, or there is a name change of the Permittee, a formal permit request • shall be submitted to the Division accompanied by documentation from the parties involved, and other supporting materials as may be appropriate. The approval of this request shall be considered on its merits and may or may not be approved. 5. Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to interrupt service by the existing utilities nor result in an overflow or bypass discharge of wastewater to the surface waters of the State. 6. Upon completion of construction and prior to operation of these permitted facilities, a certification, a copy of the construction record drawings, as well as supporting design calculations for any pump stations permitted as part of this project shall be received from a North Carolina -licensed Professional Engineer certifying that the facilities have been installed in accordance with this permit; 15A NCAC 2H .0200; the Division's Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Station and Force Main adopted June 1, 2000 as applicable; and other supporting materials. If this project is to be completed in phases and partially certified, you shall retain the responsibility to track further construction approved under the same permit, and shall provide a final certificate of completion once the entire project has been completed. A copy of the construction record drawings, indicating the facilities constructed in the phase being certified, shall be submitted with each partial certification. Mail the Engineer's Certification, one copy of the "Construction Record Drawings," and one copy of the supporting design calculations to the Non -Discharge Permitting Unit, 1617 Mail Service,Center, Raleigh, NC 27699-1617. 7. A copy of the construction record drawings shall be maintained on file by the Permittee for the life • of the wastewater collection facilities. B. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 2H .0200; the Division's Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Station and Force Mains adopted June 1, 2000 as applicable; and other supporting materials may subject. the Permittee, to an enforcement action by the Division, in accordance with North Carolina General Statutes §143- 215.6A through §143-215.6C. 9. In the event that the wastewater collection facilities fail to perform satisfactorily, including the creation of nuisance conditions, the Permittee shall take immediate corrective action, including those as may be required by this Division, such as the construction of additional or replacement facilities. 10. The issuance of this permit shall not exempt the Permittee from complying with any and all statutes, rules, regulations, or ordinances that may be imposed by other government agencies (local, state and federal) which have jurisdiction, including but not limited to applicable river buffer rules in 15A NCAC 2B .0200, erosion and sedimentation control requirements in 15A NCAC Ch. 4 and under the Division's General Permit NCG010000, and any requirements pertaining to wetlands under 15A NCAC 2B .0200 and 15A NCAC 2H .0500. 11. Noncompliance Notification: The Permittee shall report by telephone to the Winston-Salem Regional Office, telephone number (336) 771-4600, as soon as possible, but in no case more than 24 hours or on the next working . day, following the occurrence or first knowledge of the occurrence of either of the following: 2 .,A a. Any process unit failure, due to known or unknown reasons, that renders the facility incapable of adequate wastewater transport, such as mechanical or electrical failures of pumps, line blockage or breakage, etc.; or b. Any failure of a pumping station or sewer line resulting in a by-pass directly to receiving waters without treatment of all or any portion of the influent to such station or facility. Persons reporting such occurrences by telephone shall also file a written report in letter form within five days following first knowledge of the occurrence. This report must outline the actions taken or proposed to be taken to ensure that the problem does not recur. Permit issued this the twenty-eighth day of October, 2002 NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION '214 L� for Alan W. Kli ek, P ., Director Division of Water Quality By Authority of the Environmental Management Commission Permit Number W00021840 • 0 3 •.I Permit No. W 00021840 October 28, 2002 0 ENGINEER'S CERTIFICATION Partial Final as a duly registered Professional Engineer in the State of North Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project, for the Project Name Location and County Permittee hereby state that, to the best of my abilities, due care and diligence was used in the observation of the construction such that the construction was observed to be built within substantial compliance of this permit; 15A NCAC 2H .0200; the Division of Water Quality's (Division) Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting materials. North Carolina Professional Engineer's seal, signature, and date: • The above Engineer's Certification shall be completed and submitted to the address below with one copy of the "Construction Record Drawings" of the wastewater collection system extension as well as supporting design calculations for any pump stations permitted as part of this project. This project shall not be considered complete nor allowed to operate until this Engineer's Certification and all required supporting documentation have been received by the Division. Any wastewater flow made tributary to the wastewater collection system extension prior to completion of this Engineer's Certification shall be considered a violation oll the permit and shall subject the Permittee to appropriate enforcement actions. NORTH CAROLINA DIVISION OF WATER QUALITY WATER QUALITY SECTION NON -DISCHARGE PERMITTING UNIT 1617 MAIL SERVICE CENTER RALEIGH, NORTH CAROLINA 27699-1617 • 4 Hugh Creed Associates, Inc. P.A. Consulting Engineers & Land Surveyors 1306 W. WENDOVER AVENUE P.O. BOX 9623 GREENSBORO, N.C. 27408 GREENSBORO, N.C. 27429 TELE: (336) 275-9826 OR (336) 275-8084 FAX: (336) 275-3379 FIRM LICENSE #C-0551 E-MAIL: HCA@HUGHCREEDASSOCIATES.COM May 4, 2023 Permit #W00021840 Modification Narrative: High Point Christian Academy Gymnasium Project Location: This project is located at 800 Phillips Ave. in High Point, NC. The area where the modification will take place is directly north of the High Point Christian Academy (HPCA) building, which is in the western portion of the subject property. Project Scope: A new gymnasium is proposed to be built directly north of the ex. HPCA building. There is an ex. private sanitary sewer manhole located 43' north of the existing building that serves the HPCA building. This manhole discharges via 8" pipe to another existing manhole located 204' NNE. This sewer line will be removed, and the manholes plugged as it travels directly through the footprint of the proposed gymnasium. Two new, private sewer manholes are proposed. Flow will travel from the existing manhole near the ex. building 95' east to the first proposed manhole, which will be 35' NE of the existing building and 40' S of the prop. gym. Flow will then travel 135' NNE along the eastern side of the prop. Gym to the second proposed manhole, being 49' E of the prop. gym. From there, flow will travel 109' NW to the second existing manhole described above, which is 50' N of the prop. gym. All proposed sewer mains will be 8" SDR 26 PVC. In summary, 204' of existing 8" sewer main will be removed, and 339' of 8" SDR 26 PVC sewer main will be installed. ,*{III NINE �.`' pQ' Foss/p �2''•, SEAL 10727 �,���75 Z CAP, ••�• �rIrIIIInI+��� Sincerely, Hugh Creed Associates, Inc., P.A. Norris Z. Clayton, P.E., P.L.S. 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Boundaries may be 8°22 generalized for this map scale. Private lands within government 149 MILS 0°33' reservations may not be shown. Obtain permission before j 10 MILS entering private lands. Imagery .....................................................NAIP, June 2020 June 2020 Roads ......................................... U.S. Census Bureau, 2016 C NORTH 19 MAGNETIC Names............................................................................GNIS, 1980 - 2022 UTM GRID AND DECLINATION 2020 CENTER TI SHEET Hydrography...............................National Hydrography Dataset, 2002 - 2018 Contours............................................National Elevation Dataset, 2008 U.S. National Grid Boundaries ..............Multiple sources; see metadata file 2019 2021 100,000-In Square ID Wetlands.................FWS National Wetlands Inventory Not Available NV Grid Zone Designation 178 83 84 85 86 SCALE 1:24 000 1 0.5 0 KILOMETERS 1 2 1000 500 0 METERS 1000 2000 1 0.5 0 1 MILES 1000 0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000 FEET CONTOUR INTERVAL10 FEET NORTH AMERICAN VERTICAL DATUM OF 1988 This map was produced to conform with the National Geospatial Program US Topo Product Standard 87 *ORTH CAROLINA QUADRANGLE LOCATION 1 Winston-Salem East 1 2 3 2 Kernersville 3 Guilford 4 5 4 Midway 5 High Point East 6 Lexington East 6 7 8 7 Fair Grove 8 Glenola ADJOINING QUADRANGLES 84 83 82 81 79 78 77 76 75 74 73 72 397100om N 88 89 590000rnE 35.8750' -80.0000' N ROAD CLASSIFICATION M r` Expressway Local Connector M 00 0 Secondary Hwy Local Road 00 N Ramp 4WD Y M � . Interstate Route US Route O State Route co X o � Z r- LL za HIGH POINT WEST, NC z z 2022 Guilford County, NC Parcel Number 194035 6890625730 GREEN STREET BAPTIST CHURCH Card Image PO BOX 2443 HIGH POINT NC 27261 303 N ROTARY DR EXC FOR GREEN ST BAPTIST CHURCH LOA PL153-12 000000-00000 153-12 Total Out Building Value 56000 PIN Total Land Value Total Deferred Value Bldg Card 1016400 Owner 0 Owner History 1 Mail Address Appraisal Model Code 1 Mail City Deed Data 1/1/1900 Mail State Neighborhood 6890004 Mail Zip Property Type INSTITUTIONAL Property Address Structure Size Legal Description Deed Plat Lot Size 24.2 Year Built 1984 Bedrooms Condo Bathrooms Total Assessed 12507700 Grade Very Good Total Building Value 11435300 Disclaimer While every effort is made to keep information provided over the internet accurate and Map Scale up-to-date, Guilford County does not certify the authenticity or accuracy of such information. No warranties, express or implied, are provided for the records and/or mapping data herein, or for their 1 inch = feet use or interpretation by the User 4/10/202023 Hugh Creed Associates, Inc. P.A. Consulting Engineers & Land Surveyors 1306 W. WENDOVER AVENUE P.O. BOX 9623 GREENSBORO, N.C. 27408 GREENSBORO, N.C. 27429 TELE: (336) 275-9826 OR (336) 275-8084 FAX: (336) 275-3379 FIRM LICENSE #C-0551 E-MAIL: HCA(a)HUGHCREEDASSOCIATES.COM May 4, 2023 COVER LETTER State of North Carolina Department of Environmental Quality Division of Water Resources Attn: Jenny Graznak Winston-Salem Regional Office Division of Water Resources North Carolina Department of Environmental Quality Re: Private Sewer Permit Modification/Addition Green Street Baptist Church High Point Christian Academy Gymnasium Permit WQ0021840 Ms. Graznak, The following package has been assembled and submitted for the modification to the Private Sewer Collection System owned by High Point Christian Academy as part of the construction of a Gymnasium for the owner. This collection system currently serves the high school building for HPCA and will serve the new gymnasium after construction, though no additional flow is proposed. The enclosed documents include: Application Fee FTA 06-21 Existing Permit Existing Permit Modification Narrative USGS Topographic Map Aerial Map Still RRRE" CA �.`' pQ' Foss/p �2''•, ` SEAL 10727 #,���75 Z CAP, ••�• 'rRrRRRRn�+��� Sincerely, Hugh Creed Associates, Inc., P.A. Norris Z. Clayton, P.E., P.L.S. May 4, 2023