WQ0045004_Application (FTSE)_20231211

�Lce;Je� 1 Z1 f ( /10-23
State of North Carolina
DWR Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources r /� FTA 10-23 & SUPPORTING DOCUMENTATION
/N Application Number: & 40/ , a44lu be WMPICIM by DWR)
All items must be completed or the application will be returned
1. APPLICANT INFORMATION:
I. Applicant's name: City of Asheboro (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: John N. Oabum. III per 15A NCAC 02T A I06(b)
Title: City Manager
4. Applicant's mailing address: 146 N. Church Street
City: Asheboro State: NC Zip: 27204-11
5. Applicant's contact information:
Phone number. (836�626-1201 Email Address: iogbum_s_axLasheboro.nc.us
11. PROJECT INFORMATION:
1. Project name: North Meadows Phase 2
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number. W000 and issued date:
For modifrestions, also attach a detailed narrative description as described in Item G of the cbecklist
If new construction, but part of a master plan, provide the existing permit number: W000_
3. County where project is located: Randolph
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.764219* Longitude:-79.792173'
5. Parcel ID (if applicable): 7663.544550 (or Parcel ID to closest downstream sewer)
Ill. CONSULTANT INFORMATION:
I. Professional Engineer. H. Mack Summev. Jr.. PE License Number: 26447
Firm: Summey Engineerine Associates. PLLC
Mailing address: PO Box 968
City: Asheboro State: hK Zip: 27204-1106
Phone number: 3( 36) 62f-Q 02 Email Address: mack,a summeyengineering.com
32,11
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION-
1. Facility Name: City of Asheboro W WTF Permit Number: NCO026123
Owner Name: Ciqof Asheboro
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQNC0026123
2. Downstream (Receiving) Sewer Information: 8 inch ® Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS_
Owner Name(s): _
FORM: PTA 10-23 Page I of 5

VI. GENERAL REQUIREMENTS
I. 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 Dcvelotxr's O�eraftgn .AIN _wI tF—_pEy3 been attached?
❑ Yes ❑ No ®N/A
3. If the Applicant is a Home/Property Owners' Association, has an QA'Po&DI e tt� ionA1 Agreeracnt i 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 prepetatiodurvice ❑ 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 .0103t201)
If Industrial, is there a Pretreatment Program in effect? 0 Yes [I No
6. Has a flow reduction been approved under ' 5A NCAC .01 I Ott 0 ❑ Yes ® No
D If ves, provide a cons of flow reduction approval letter with this apolicatien
7. Summarize wastewater generated by project:
l� n Pe'eh CC
14
✓E6fM A�
Towel, r h
roles
3 bdevn
JAVI; y -
Establishment Type (see 02T.0114(t)) Daily Design Flow' °
No. of Un"I
Flow
Single Family Residential Ael
360 gaVday
107
38,520 GPD
Pit
GPD
gav
GPD
PV
GPD
Pi/
GPD
gay
GPD
23
Total
38,520 GPD
See 15,q �;r- AC 02T .01 I4(b), (d), tea 1) and te)12) for caveats to wastewater design flow rates (i.e. 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 Cam. 2AA4 ).
Per 15A NCAC 02T .01 I4(c), design flow rates for establishments not identified [in table t5A NCAC 02T.01 I41 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data
8. Wastewater generated by project: 38520 GPD (per 15A NCAC 02T N_L4 4nd Ci1. la3_-215.1)
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 10-23 Page 2 of 5

VI1. GRAVITY SEWER DESIGN CRITERIA (if Applicable) -02T.0305&MDC tGravit% Sewers):
I. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
5214
SDR 26
Section 11 & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
i0 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
Vlll. PUMP STATION DESIGN CRITERIA (if Applicable) 02T.0305&MDC tPumnStations/Force Mains:
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
I. 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 (voches) I Length (feet) I 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.I .b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify) _
6. Power reliability in accordance with i5A NCAC 02T.03051hN l t:
❑ Standby power source or ❑ Standby pump
➢ Must have automatic activation and telemetry - 15A NCAC 02T.0305ft1)(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:
Y 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 10-23 Page 3 of 5

IV SETBACKS & SEPARATIONS - (02B .0200 & 15A NCAC 02T.0303(f)):
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T .0305(f) & (Ell" ® Yes ❑ No
DAn4-At uLr.usUX0contains minimum separations matsnam_Deprovmearorseworsystems:
_
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
I8 inches
'--Water mains (vertical - water over sewer preferred, including in benched trenches)
19 inches
'--Water mains (horizontal)
10 fat
Reclaimed water lines (vertical - reclaimed over sewer)
10 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 fees
**Any private or public water supply source, includingany wells, WS-1 waters of Class I or
Class 11 impounded reservoirs used as a source of drinking water, and associated wetlands.
"Waters classified WS (except WS-1 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)
100 fed
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 fed
Any building foundation (horizontal)
Any basement (horizontal)
Top slope of embankment or tarts of 2 feet or more vertical height
Drainage systems and interceptor drains
Any swimming pools
Final earth grade (vertical)
5 fed
10 fat
10 fat
5 feet
10 Peet
36 inches
D If noncompliance with 02T.0305(f) or (e), sec Section XA of this application
• 15A NCAC O'_T.0305tej contains alternatives where separations in 02T.030& 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 WkIer Classifications webpgg:
2. Does this project comply with the minimum separation requirements for water mains? ®Yes [:]No ❑ N/A
D 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
D Please provide supplementary information identifying the areas of non-conformance.
D See the Division's 1jrayj_scoration requiremet 1 for situations where separation cannot be met.
D 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 I5A NCAC 02B . 2Q__00? ❑Yes ❑ No
D This includes Trout Buffered Streams per t cA NCAC'_2B 0202
5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ❑ Yes ® No
or 401 Water Quality Certifications?
D Please provide the permit number/permitting status in the cover letter if coverage/authorization is required.
6. Does project comply with 15A NCtNC jL2 D105nc 6) (additional pennits/certifications)? ® Yes ❑ No
Per 15A_N.CAg 0' f 010�gc3L61, 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.).
T Does this project include any sewer collection lines that are deemed "high -priority?" ❑ Yes ® No
Per I15g NCAC 02T., "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 interferencelconflid boxes require a variance approval.
v 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 I SA NCAC 02T.0403(ax5) or the permittee's Individual System -Wide Collection permit.
FORM: FTA I0-23 Page 4 of 5

X. CERTIFICATIONS:
I. Does the submitted system comply with 1_5A NgAC 02T, the Minimum peslgn_Criteria for t e Pe rmining�tt_Pu n Statww
and Force Mains ' ,e+ n;r:ioi+ and the rav_ity Sewer Minimum N, ign eij a Lta_igsi_Ler uMias applicable?
_Cr
M 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 ma% be subject to longer
review times. For proiects 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:
i �• MAek SdNvAse r — • attest that this applicationfar _J4.._MG41)W3 44 17- ?h. 2
(Professional Engineers name from Applicatian IWm 111.1.) (Project Name from Application Item 11.1)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans,
specifications, engineering calculations, and all other supporting documentation to the best of my knowledge. I further
attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
Mir imam Deli Criteria for Gravity Sewers t iatesi..versio_n). and the Minimum Design Criteria forth Fast -Track ermittin
of,Pump Cations and Force Mains (latest version 1. 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 S 10,000, as well as civil penalties up to S25,000 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 56 070,1).
North Carolina Professional Engineer's seal, signature, and date:
26"7
3. Applicant's Certification per 15A NCAC 02T .0106(b):
4�$�Tiest that this application for 1V M Pia V1 my -Ph. -z
(Signature Authority Name from Appliarton Item 1.3.) (Project Name from Applicatom Item 11.1)
attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge.
I understand that if all required parts of this application are not completed and that if all required supporting documentation
and attachments are not included this application package is subject to being returned as incomplete. I understand that any
discharge of wastewater from this non -discharge system to surface waters or the land will result in an immediate enforcement
action that may include civil penalties, injunctive relief, and/or criminal prosecution. 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 wil I 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
incht a fine to exceed $ ,000 as well as civil penalties up to 125,000 per violation.
//9 1,2t�d
Signature: _ Date: Z
FORM: FTA 10-23 1 / k I Page 5 of 5

State of North Carolina
Department of Environmental Quality
I
Division of Water Resources
Division of Water Resources Flow Tracking for Sewer Extension Applications
(FTSE 10-23)
Entity Requesting Allocation: City of Asheboro
Project Name for which flow is being requested: North Meadows Phase 2
More than one FTSE maybe 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: City of Asheboro WWTP
b. WWTP Facility Permit #: NC0026123
Ail flows are in MGD
c. WWTP facility's permitted flow 9.0
d. Estimated obligated flow not yet tributary to the WWTP 0.76
e. WWTP facility's actual avg. flow 3.73
f. Total flow for this specific request .03852
g. Total actual and obligated flows to the facility 4.529
h. Percent of permitted flow used 50.3
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 (pt) 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:
Pagel of 8
FTSE 10-23

III. Certification Statement:
I John N. Ogburn, III 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 e responsible party. Signature of this form certifies that the receiving collection system or treatment
, orks has adequate capac" transport and treat the proposed new wastewater.
Page 2 of 8
FTSE 10-23

Summey Engineering Associates, PLLC
Alk Engineering • Land Planning • Consulting
Q!Q�11 PO Box 968 — Asheboro, NC 27204
Date: December 8, 2023
To
[phone] / Fax: [phone] / Mack@sur"qY&06fom
Environmental Quality
TRANSMITTAL Received
Jenny Graznak
NCDEQ-DWR
450 West Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
We are sending you attached the following items:
❑ Shop Drawings ❑ Samples
❑ Prints ❑ Specifications
M Plans ❑ Disk
Winston-Salem
N. Meadows M
Randolph County, NC
Sanitary Sewer Extension
Sea Job No. E-8186
❑ Copy of Letter
❑ Other
# Co ies
Drawin #
I Description
Disposition
1
$600 Application Fee
1
Cover Letter
2
Fast Track Sewer Application
(1 original & 1 copy)
2
Flow Tracking Acceptance Form
(1 original & 1 copy)
1
USGS Topo Map
1
Aerial Photo
Remarks:
We have enclosed the information for your review. Please let us know if you have any
questions, concerns or need any additional information from us/
Thank you, y
Christian Vestal r/
ChristianCcDsummevenaineerina. com
336-328-0902

Project Narrative
For
The City of Asheboro
8" Sewer Line Extension
For the
North Meadows Phase 2
The purpose of this sewer line extension is to provide a new 107 unit single family
mobile home park with an adequate sewage disposal source and to meet the future needs
of these residents. The new subdivision is located off of Hub Morris Road at the
intersection of Meadowgate Dr. in Asheboro NC.
There will be one 8" sewer line connected to an existing 8" Sanitary Sewer outfall line
running along the northeast side the project. There will be a total of 5,214 LF of 8" sewer
main extension with this project. The City of Asheboro waste water treatment System has
the capacity to serve this new development and many other residences. The only other
alternative for this development would be individual septic systems on each lot which
would not be feasible due to unfavorable site conditions when compared to the
advantages provided by this proposed extension.
Prepared By: H. Mack Summey, Jr., P.E.
Address: P.O. Box 968 Asheboro, NC 27204
Phone: [phone]
Project: North Meadows Phase 2

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