WQ0045137_Southpoint_Pump_Station_and_Force_Main_20240212 (2)

kee ivre -2/1,411, &2y State of North Carolina
DWR Department of Environmental Qualih
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 10-23 & SUPPORTING DOCUMENTATION
f
Application Number: (} 5137 Itoikcomploedb%DWRI
All items must be completed or the application w ill be returned
1. APPLICANT INFORMATION:
I. Applicant's name: T w ksvill (company, municipality, fJOA. utilit), etc.)
2. Applicant type: ❑ Individual ❑ Corporation
rpo ❑General Partnership El Privately -Owned Public Utility
❑ Federal ❑ SlaWcounty ® Municipal ❑ Other
3. Signature authority's name: Kenneth Gamble/
gn ty' perISAVCACO?T.0106(bl
Title: Town Manager/ Called Johnny Lambert 20240214 to
get Cooleemee flow form corrected.
4. Applicant's mailing address: 171 South Clement Street Need to Speak with Chuck Willis
City: v'll State: NC lip: 27028 = about how flows were estimated.
5. Applicant's contact information: Johnny sending email to CC me and
Phone number: Q& M-y7QT Email Address: k an�ii mocksvillenc.gov Chuck and start conversation about
flow estimation. Johnny says this
H. PROJECT INFORMATION: project is using ARPA monies.
I. Project name: figift2int Pump Station and Force Main' Johnny's # is 336-753-6091.
2. Applicatiom/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If modification, provide the existing permit number: W000 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: WQOO_
3. County where project is located: Qr' /
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.932273 � Longitude: -8 .60 03327'
5. Parcel ID (if applicable): 572958019 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
I. Professional Engineer: Charles A. Willis. Jr/ License Number: 17710
Firm: Willis Engineers
.p Mailing address: 10700 Sikes Place, Suite 115 5 \5JJ
City: Charlotte State: NC Zip: 28277-_ IYtO bf/y
Phone number: (704) IL8-4668 Email Address: chuck,ii willisenaineers.corri L i
QV
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Cooleemee W WTP Permit Number: NC0024872 \V
Owner Name: Davie County V'
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
I. Permit Number(s): WQCSW 156
2. Downstream (Receiving) Sewer Information: 8 inch/ ® Gravity :3 Force Main
3. System Wide Collection System Permit Number(s)(if applicable):WQCS_
Owner Name(s): Town of Mocksville
FORM: ETA 10-23 Page I of 5

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Vl. 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: DE Vl 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 I SA NCAC 02T.0115(c) been attached?
❑ Yes ❑ No ON/A'
4. Origin of wastewater: (check at I that apply ):
❑ Residential (Individually Owned) ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential (Leased) ❑ Retail with food preparation/service ❑ Hotel andlor Motels
❑ School ! preschool / day care ❑ Medical / dental , veterinary facilities ❑ Swimming Peal/Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
® Businesses ! offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: j (V) % Domestic Q%Commercial Q °° 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 .01 1410? ❑ Yes ®No
> If yes, provide a copy of flow reduction approval letter with this notification
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow
No. of Units
Flow
Unknown Use and Occupancy
880 gal/ac
16.8
14,784 GPD
Unknown Use and Occupancy
880 gallac
16.3
14,335 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
30,000 GPD
7
a See 15A NCAC 02T .0114(b). (d). (ek 1) and (ckl) 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 G.S. 42A4).
b Per 15A NCAC 02T .01 14(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.
b 8. Wastewater generated by project: 30 000 GPD (per 15A NCAC 02T .0114 and G.S. 143-215.1)
Do not include future flows or previously permitted allocations
/ If permitted flow is zero, please indicate why:
V ❑ 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.
0 ❑ 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

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T ,0305 & MDC tGnvb Sewers):
I. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
12
71
DIP
r Section 11 R 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)
v 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 (Pump Stations/Force Mainsl:
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: Southooint Pump Station
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.8 1611 Longitude:-80.540756
3. Total number of pumps at the pump station: 2
3. Design Flow of the pump station: 0.360 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): 2$Q gallons per minute (GPM) at 70 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
8
1.165
RJ DIP
8
1.931
PVC DIP
25s- MO : 3Lo,',
If any portion of the force main is less than 4-inches in diameter, please identify the method of solids reduction per
MDCPSFM Section 2.01 C. Lb. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify) _
6. Power reliability in accordance with 15A NCAC 02T .0305(h8 I I:
® Standby power source or ❑ Standby pump
i Must have automatic activation and telemetry - 15A NCAC 02T.0305(hx 1 XB)_
Y Required for all pump stations with an average daily Flow greater than or equal to 15.000 gallons per day
> Most 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(hx I XC):
❑ Portable power source with manual activation, quick -connection receptacle and telemetry -
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry:
r Include documentation that the portable source is owned or contracted by the applicant and is compatible with the station.
r 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

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
I. Does the project comply with all separationsialtematives found in 15A NCAC 02T .0305(fl & (11)? ® Yes ❑ No
15A NCAC 02T.0305 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
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-1 waters of Class I or
Class If impounded reservoirs used as a source of drinking water, and associated wetlands.
100 feet
"Waters classified WS (except WS-1 or WS-V), B, SA. OR W, 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 stems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
i If noncompliance with 02T.03051I1 or (g). see Section X.I of this application
' 15A NCAC 02T.0305(g) contains alternatives where separations in 02"f.0305(fl cannot be achieved. Please check "yes"
above if these alternatives are used and provide narrative information to explain.
"Stream classifications can he identified using the Division's NC Surface Water Classifications webpage
2. Does this project comply with the minimum separation requirements for water mains? 01Yes [:]No ❑ N/A
> If no, please refer to 15A NCAC I8C.0906(f) for documentation requirements and submit a separate document,
signed/sealed by an NC licensed PE. verifying the criteria outlined in that Rule.
3. Does the project comply with separation requirements for wetlands? ❑ Yes ❑ No ®N/A
Please provide supplementary information identifying the areas of non-conformance.
i Seethe 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 I SA NCAC 0213.02001 ❑ Yes ❑ No
i 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
or401 Water Quality Certifications?
Y 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(cN6), 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 10-23 Page 4 of 5

X. CERTEVICAT1ONSt
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains (latesixeEgggl and the Gravity Sewer Minimum Design Criteria (latest version) as applicable?
® Yes ❑ \o
If no, for projects requiring a single variance, complete and submit the Variance Altemative Design Request application
(VADC 10-14) and supporting documents for review to the Central Oft -we. Approval of the request will be issued
concurrently with the approval of the permit, and projects requirine a variance approval may be subject to loneer
review times. For projects requirine two or more variances or where the variance is determined by the Division to be a
sieniffcant portion of the project. the full technical rcv iew is reuuired.
2. Professional Engineer's Certification:
1, Charles A. Willis, Jr. . attest that this application for Southpoint Pump Station and Force Main
(Professional Fngu,eer's name trap Application Item 111 I.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 colculatioas, and all other supporting documentation to the best of my knowledge. I further
attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE - In accordance with General Statutes 143-215.6A and 143.215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed 510.000, 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 hoard, (21 NCAC 56.0701)
_.._---- ......
...._:�ss<rtt*rrr-__
North Carolina Professional Engineer's seal, signature. and date: JP4 Ci
0�: i{pSSIQ
:°O
' a 1771
3. Applicants Certification per 15A NCAC 02T .0106(b):
4- Fogo 'Z4
1, Kenneth Gamble - , attest that this application for Southpoint Pump Station and Force Main
(Signature Authority Name from Application Item 1,3.1 (Project Name from Application Item 11 1)
attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge.
1 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. 1 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. 1 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 143-215.66, 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 as well a jvil penalties up to S25,000 per violation.
Signature: _ Dare. QZ'OS Z�
FORM: ETA 10-23 Page 5 of 5

,
33(• 753

CORRECTED
--S�, is rA N I
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-23)
Entity Requesting Allocation: Town of Mocksville
Project Name for which flow is being requested: Southpoint Pump Station and Force Main
More than one FME maybe required for a single project if the owner of the WJ# P 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: Cooleemee W WTP
b. WWTP Facility Permit #: NCO024872
All flows are in MGD
c. WWTP facility's permitted flow 1.5
d. Estimated obligated flow not yet tributary to the WWTP 0.504
e. WWTP facility's actual avg. flow .400
f. Total flow for this specific request 0.03
g. Total actual and obligated flows to the facility .934
h. Percent of permitted flow used 62%
I1. 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)
Design
Pump
Pump
Average
Approx.
Station
Station
Firm Daily Flow**
Current
(Name or
Permit
Capacity, + (Firm / pf),
Avg. Daily
Number)
No.
MGD MGD
Flow, MGD
(C)
(D)-(B+C) (E)=(A-D)
Obligated,
Not Yet
Total Current
Tributary
Flow Plus
Daily Flow,
Obligated Available
MGD
Flow Capacity***
" The Firm Capacity (design flow) of any —pump is defined as the maximum pumped now that can be
achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pf) not
less than 2.5, 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): Cooleemee Collections Sytem
Downstream Permit Number: WQCS00106
Page 1 of 8
FTSE 10-23

III. Certification Statement:
I Johnny Lambert 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 1 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.
Signature
Signing
Dale
Page 2 of 8
FINE, 10-23

Wit W
ONWon of NN'mer Resomtes
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-23)
Entity Requesting Allocation: Town of Mocksville
Project Name for which flow is being requested: Southpoint Pump Station and Force Main
More than one f7NE mar he required for a single project if the owner of the If 11TP is not responsible for an putgp
stations along the route of the proposed wastewater flow.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Cooleemee WWTP
b. WWTP Facility Permit #: NC0024872
AllJlotcs are in .IIGD
c. WWTP facility's permitted flow 1.5
d. Estimated obligated flow not yet tributary to the WWTP 0.132
e. WWTP facilitv's actual avg. flow 0.400
f. Total flow for this specific request 0.030
g. Total actual and obligated flows to the facility 4444
h. Percent of permitted flow used *@W
11. 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)
Design
Pump
Pump
Average
Approx.
Station
Station
Firm Daily Flow••
Current
(Name or
Permit
Capacity, • (Firm / pt),
Avg. Daily
Number)
No.
MGD MGD
Flow, MGD
(C)
(DHB+C) (E)-(A-D)
Obligated,
Not Yet
Total Current
Tributary
Flow Plus
Daily Flow,
Obligated Available
MGD
Flow Capacity***
* The Firm Capacity (design lbw) of any pump station is defined as the maximum pumped now that can be
achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacih of the pump station divided b% a peaking factor (pf) nut
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 hetween the
project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): Cooleemee Collection System
Downstream Permit Number: WQCS00106
Page 1 of 8
FTSE 10-23

WT. ' W
10. Certification $Iatemenf:
I JohnfiYLambert ceftify'lo the best of my knowledge that
the addition.(jf
-thb volume of wastewater to be permitted in thig,project hat -been biralUted alohgthb receiving
masteft* treatment facility .. . tddWto the rdeel I
.y find that the flow from this projedtis not anticipate.dId cause any capacity
'related- s4pitary -sewer overflows or overburden any downstij'am pump station q1t ro.UA e to the receiving
treatment plant -under normal circumstances, given the implementation of the plannedimprovements
Adeniffied in the planning assessment where applicable. This analysis has been performed . m`.a6bbrdah6e
with local established policies and proopdures.-Aisifig the best avallabld data. This, OptiiiRctdoft applies to
those -items - listed hb6vq in cations fand ApIuslallattached planning assessment addendums for which I
am the;usports.ible 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.
Mle of Signing Official
Page. 2 of 9
FT8,8 to.23

461 it
DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-23)
Entity Requesting Allocation: Town of Mocksville
Project Name for which flow is being requested: Southpoint Pump Station and Force Main
More than one FTSE may be required for a singleproject if the owner of rite RVTP is not responsible for ail 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:
b. WWTP Facility Permit #:
All flows are in AfGD
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
11. 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:
Pump
Pump
Station
Station
Firm
(Name or
Permit
Capacity. "
Number)
No.
MGD
Bear
I ,. OP
1.814
(A)
(B)
(C)
(D)-(B+C)
(E)m(A-D)
Design
Obligated,
Average
Approx.
Not Yet
Total Current
Daily Flow*"
Current
Tributary
Flow Plus
(Firm / pf).
Avg. Daily
Daily Flow,
Obligated
Available
MGD
Flow, MGD
MGD
Flow
Capacity***
0.726
0.277
0.000
0.277
0.440
* The Firm Capacity (design Dow) of any pump station is defined as the maximum pumped Dow that can be
achieved eith the largest pump taken out of scnice.
** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pf) wo
less than 2.5, per Section 2.02(Ag4pc) of the Minimum Design Criteria.
*** A Planning Assessment Addendum shall be attached for each pump station located bctssecn the
project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): Cooleemee WWTP (Davie County)
Downstream Permit Number: NCO024872
Page I of 8
FTSE 10-23

J g
DownsftAdiPetantNu-z lteii: NC0024fi72
III. CcOti atiop Statements
I dM6tli:Gazdble' cerfifyto the best of my..lmowledge that the oddii oar of
be,Voli me ofwastbvvdtdt to be•permitted-ihtM9 prdjecthas.bamgygluated along;hgrouteio the rmeiviag.
wasfeyea£eYtreBhitept faoi)ity.dud'that �li�_flow'from this:;irojecfi's"notdnticipated•'fo cause anycapaaty-
aelated:s. ' sewer'oyerflov.s.o;,overbu_rddg ,4o stahonea°iviite:tdtlie.recei '
afi t y _ . vmstieam pump _ _ ' ft.
tieiitment•plan}.undernormai cirenmetu^ces;.lgiven tfi@'implementalion of tlia Awcd'impmveinenfs
identified!in t1Ye :planning assessment where: appligahle. This analysis has been;per'formed;ia acgordance
with Tot at!estalilislied goliaies:and ptocednie"s using the best?available data This certificafibn applies to
Those items iistgd.a6ove in•Seati0n5I dud II plus .all:attached;pla6ning assessment Odeiidubt for whi6h Is
amthexesponsibleParly. Signature;ofiFiis.iorut.EeFtifiesthatthe:teceivIng:coll046As7stemiortreatm tit,
woiksilias iideq�n tdb�acity to transport and teat the proposed new was'tewater:,
Paget of 9
TTSE;10=23

Town of Mocksville
Wastewater Facilities
Southpoint Pump Station and Pump Station
Separation Alternative Narrative
At approximately Sta. 0+25 on Sheet 10, the proposed force main will have less than the 36
Inches separation from final earth grade required by 15A NCAC 02T.0305(j. The crossing below the.
existing grass -lined ditch will provide 24 inches of separation from final earth grade. Accordingly,
ductile iron pipe will be used and the ditch will be armored with rip rap following construction.
Willis Engineers
1984.027 (34) 1 February 2024

QUALITY DRIVE
EXISTING AND PROPOSED
SOUTHPOINT PUMP STATION
3,100 LF OF 8-INCH
FORCE MAIN
Legend
Proposed Pump Station
Existing Pump Station
*��■ Proposed Force Main
--- Existing Force Main
— Existing Gravity Sewer
®Willis
p 1 INCH = 1,000 FEET
`I FEBRUARY 2024
c
EXISTING 4-INCH FORCE
MAIN TO BE ABANDONED
fp0.Mtt0
BOYCE DRIVE
TOWN OF MOCKSVILLE
SOUTHPOINT PUMP STATION AND FORCE MAIN
STREET LEVEL MAP
�qt�

Y
jjJ,,QUALITY'DRIVE
hkz-
EXISTING 4-INCH FORCE r -,.�.- -'N
` �-- .^ - MAIN TO BE ABANDONED ` 1.
EXISTING AND PROPOSED �3 ;
SOUTHPO IN_
PUMP STATION %?` � � - �.\`., �� -JA
rr
J1.�
J BOYCE DRIVE _
.� ,.:a _ (� \ •. !'"! 3,100 LF Of 8-INCH �., _.... - •. y. _ •
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® Willis TOWN OF MOCKSVILLE
I�1INCH -1,000FEET SOUTHPOINT PUMP STATION AND FORCE MAIN
1 FEBRUARY 2024 USGS SITE MAP

W11115
E N G I N E E R S
February 8, 2024
NC Department of Environmental Quality
Water Quality Section
450 W. Hanes Mill Road, Suite 300
Winston-Salem, North Carolina 27105
Em continental Quality
Received
FEB 12 Z0P4
Winston-Salem 1984,027 (34)
Regional Office
Subject: Town of Mocksville
Wastewater Facilities
Contract 15.0 — Southpoint Pump Station and Force Main
To Whom It May Concern:
The Town of Mocksville is planning to construct a new duplex, submersible pump station and
approximately 3,096 linear feet of 8-inch force main to serve current and anticipated growth in
the Southpoint Business Park area. The new pump station will replace an existing, smaller pump
station to be demolished at the project site on Enterprise Way in Mocksville, NC.
On behalf of the Town, attached please find two sets of the following documents for your review
and approval:
• The executed Fast -Track Application (FTA 10-23).
• Two executed Flow Tracking/Acceptance Forms (FTSE 10-23).
• A USGS Site Map illustrating the proposed location.
• Street Level Site Map showing the general project area.
• A check in the amount of $600 for the Application Fee.
Should you have any questions or need additional information, please feel free to call me at
704.338.4668 or email me at [e-mail].
Yours very truly,
WILLIS ENGINEERS
6'"�wA�
Charles A. Willis, Jr., PE, BCEE
Attachments
cc w/Attachments: Mr. Kenneth Gamble, Town of Mocksville
10700 Sikes Place, Suite 115
Charlotte, North Carolina 28277
704.377,9844 / NC License F-0114

State North Carolina
DWR
Departm
ent of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION
This application is for sewer extensions involving gravity sewers, pump stations and force mains, or any combination that has been
certified by a professional engineer and the applicant that the project meets the requirements of 15A NCAC 02T and the Division's
Minimum Design Criteria (Gravity Sewer & Pump Stations/Force Mains) and that plans, specifications and supporting documents
have been prepared in accordance with 15A NCAC 02T. I SA NCAC 02T .0300. Division policies, and good engineering practices.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design
documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans, design
calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimum design criteria. These
documents shall be immediately available upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T.030
Projects not eligible for review via the fast track process (must be submitted for full technical review):
r Projects that do not meet any part of the minimum design criteria (MDC) documents;
L Projects that involve more than one variance from the requirements of I SA NCAC 02T;
Y Pressure sewer systems utilizing simplex septic tank -effluent pumps (STEPS) or simplex grinder pumps;
i Simplex STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains);
i Vacuum sewer systems.
General - When submitting an application, please use the following instructions as a checklist in order to ensure all required items are
submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the
amount of requested additional information. Failure to submit all required Items will necessitate additional processing and review
time, and may result in return of the application. Unless otherwise noted. the Applicant shall submit one original and one copy of
the application and supporting documentation.
A. One Original and One Copy (second copy maybe digital) of Application and Supporting Documents
® Required unless otherwise noted. Signatures on original must be"wet ink" or secure digital signatures.
Please do not submit engineering design plans with the application unless speciticall% requested.
B. Cover Letter/Narrative Description (Required for All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
r Be specific as to the system type, number of homes served, flow allocation required. etc.
Include the permit number/status of any other required sewer permits (downstream, upstream)
Y If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Modification Application Packages):
® Submit a check or money order in the amount of $600.00, dated no more than 90 days prior to application submittal.
Y Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track Application (Required for All Application Packages, Form FTA 10-23):
® Submit the completed and appropriately executed application.
If necessary for clarity or due to space restrictions, attachments to the application may be made.
❑ If the Applicant Type in Item 1.2 is a corporation or company, provide documentation it is registered for business with the
North Carolina Secretary of State.
❑ If the Applicant Type in Item 1.2 is a partnership or d/b/a, enclose a copy of the certificate filed with the Register of Deeds in
the county of business.
® The Project Name in Item If.1 shall be consistent with the project name on the flow acceptance letters, agreements, etc.
® The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North Carolina
licensed Professional Engineer.
® The Applicants Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106(b). Per
15A NCAC 02T .0106(c), an alternate person may he designated as the signing official if a delegation letter is provided from
a person who meets the criteria in I SA NCAC 02T .0106(b).
INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION Page I of 3

E. Flow Tracking/Acceptance Form (Form: FTSE 10-23) (If Applicable):
® Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility.
Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
➢ The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one year
prior to the application date.
➢ Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-2I5.67(a).
➢ Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific FTSE.
F. Site Maps (All Application Packages):
® Submit an 8.5-inch x 1 1-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project area,
including the closest surface waters.
General location of the project components (gravity sewer, pump stations, & force main)
i+ Downstream connection points and permit number (if known) for the receiving sewer
® Include an aerial location map showing general project area (such as street names or latitude/longitude) so that Division staff
can easily locate it in the field.
G. Existing Permit (Application Packages for Modifications to an Existing Permit):
❑ Submit a copy of the most recently issued existing permit.
❑ Include a descriptive and clear narrative identifying the previously permitted items to remain in the permit, items to be
added, and/or items to be modified (the application form itself should include only include items to be added/modified). The
narrative should also include whether any previously permitted items have been certified.
❑ The narrative should clearly identify the requested permitting action and accurately describe the sewers to be listed in
the final permit.
H. Power Reliability Plan (Required if portable reliability option utilised for Pump Station):
❑ Per 15A NCAC 02T .0305(h)(11, submit documentation of power reliability for pumping stations.
This alternative is only available for average daily flows less than 15.000 gallons per day
It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible with
the station. The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or proposed contractor,
stating that "the portable power generation unit or portable, independently -powered pumping units, associated appurtenances
and personnel are available for distribution and operation of this pump station."
If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations'
storage capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall
be provided in the case of a multiple station power outage. (Required at time of certification)
1. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per 15A NCAC 02T .0115(aX I 1 provide the Certificate of Public Convenience and Necessity from the North Carolina Utilities
Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by the sewer
extension, or
❑ Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an application
for a franchise has been received and that the service area is contiguous to an existing franchised area or that franchise approval
is expected.
J. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold):
❑ Home/Property Owners' Associations
❑ Per I SA NCAC 02T .0115(c). submit the properly executed Operational Ac+reement (FORM: HOA).
❑ Per 15A NCAC 02T .01 15(c), submit a copy of the Articles of Incorporation. Declarations and By-iaws.
❑ Developers of lots to be sold
❑ Per ISA NCAC 02T.0115(b). submit the properly executed Operational Agreement (FORM: DEV)
For more information, visit the Division's collection .systems website
INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION Page 2 of 3

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Reaional Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Quality Section
Swannanoa, North Carolina 28778-8211
Clay, Graham, Haywood, Henderson, Jackson,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section
Fayetteville, North Carolina 28301-5095
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[phone] Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Water Quality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg. Rowan,
[phone]
Stanly, Union
[phone] Fax
Raleigh Regional Office
3800 Barrett Drive
Chatham, Durham, Edgecombe, Franklin,
Water Quality Section
Raleigh, North Carolina 27609
Granville, Halifax, Johnston, Lee, Nash.
[phone]
Northampton, Orange, Person, Vance. Wake.
[phone] Fax
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
Beaufort, Bertie, Camden, Chowan, Craven,
Water Quality Section
Washington, North Carolina 27889
Currituck, Dare, Gates, Greene. Hertford, Hyde,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilminaton Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Ouplin, New
Water Quality Section
Wilmington, North Carolina 28405
Hanover. Onslow, Pander
[phone]
[phone] Fax
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Alamance, Allegheny, Ashe, Caswell, Davidson,
Davie, Forsyth, Guilford, Rockingham, Randolph,
Water Quality Section
Winston-Salem, North Carolina 27105
Stokes. Surry, Watauga, Wilkes. Yadkin
[phone]
[phone] Fax
INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION Page 3 of