WQ0036463_Application_20240605

Quible
Quible & Associates, P.C.
ENGINEERING • ENVIRONMENTAL SCIENCES • PLANNING • SURVEYING
SINCE 1959
June 1, 2024
RECEIVED
J U N 0 5 2024
NCDEQ/DWR/NPDES
Mr. Dale Crisp, P.E.
NCDENR, Water Quality Regional Operations Section
943 Washington Square Mall
Washington, NC 27889
Re: Permit Modification for Sewer Extension by
Swan Quarter Sanitary District (WQ0036463 Modification)
375 & 434 Creekside Dr., 0 NC 45, 0, 290, 1272 Main St.,
245 Academy, & 59 Third Street
Swan Quarter, Hyde County, NC
Dear Mr. Crisp,
P.O. Drawer 870
a11y Hawk NC 27949
Phone: [phone]
Fax: [phone]
web: qulble.com
Thank you for the DEQ review comments for the submittal of the above referenced project
dated May 14, 2024. On behalf of Swan Quarter Sanitary District (SQSD), Quible & Associates,
P.C., hereby submits, for your review and approval, the following documentation:
1. One (1) copy of the signed revised Application Form ASEA 10-23 with Section X & XI;
2. One (1) copy of the signed revised Flow Tracking / Acceptance for Sewer Extension
Permit Application;
3. Two (2) copies of the signed and sealed Plan Set;
Please find our responses listed below in italics to your review comments.
The permit application submitted for the proposed project is signed by Mr. Jeffery
Stotesberry, indicated as Manager of Swan Quarter Sanitary District. The FTSE
submitted for this project is also signed by Mr. Stotesberry, but on that form his title is
indicated as Secretary / Treasurer of the SQSD. Please confirm what Mr. Stotesberry's
title and position actually is with the SQSD, resubmit the form that is not correct and if he
is Secretary / Treasurer of SQSD, that he has signature authority to apply for the permit
per 15A NCAC 02T .106(b) and (c)a. Acknowledged. After further discussions with
SQSD, the forms have been updated to reflect "Joseph C Williams" current
president/chair of SQSD.
2. The proposed additional sewer flowrate requested in the permit application indicates
2,760 GPD based on 23 bedrooms in the 7 residential units, one with a "residential
garage" which apparently contains 3 of the 23 bedrooms, displayed on the permit
application at a flowrate of 120 GPD per bedroom, with the additional sewer flowrate to
be treated at the SQSD WWTF permit WQ0019665. The proposed project submittal
letter also lists 2,000 GPD generated by 20 campsites but indicates this flowrate has
been previously permitted. However, the copy of the permit WQ0036463 that was

included in the proposed project submittal package indicates only 360 GPD was
previously permitted and from one 3-bedroom single family residential unit. Please
provide clarification as to what the proposed project consists of and what the additional
wastewater flowrate to the SQSD WWTF will be. Please submit a revised permit
application and FTSE if the proposed additional flowrate for the proposed project is not
2,760 GPD.
The new flow rate summary is 2,760 gpd as summarized in the following table:
Address
PIN
Type
Flows GPD
375 Creekside Drive
7691-35-5517
2-BR house with pump
station in front yard.
240
Richard Braman
7691-34-5706
3-BR house with pump
360
along NC 45
station in front yard.
290 Main St (next to
(J11D 111A) 7691-64-
3-BR house with pump
360
264 Main St)
7512
station in front yard.
#1272 Main Street
7691-98-4853
3-BR house with pump
station in front yard.
360
0 Main Street
7691-88-3203 (A) and (B)
3 BR SFD and
360 (each)
previously 7691-88-0859
Residential garage
245 Academy Street
Parcel ID #7691-54-9601
3-BR house with pump
station in front yard.
360
59 Third Street
Parcel ID #7691-63-3183
3-BR house with pump
station in front yard.
360
Total New Residential Flow: 2,760
Four (4) existing 3-bedroom single family residential units already serviced by the SQSD
WWTP are proposed to be repurposed to serve a total of 20 campsite. These campsites
will be grouped into 4 or 6 campsites to each pump station and directed into the four (4)
existing pump stations as summarized in the following table for a total flow of 2, 000 gpd
to be reallocated. The repurposed pump stations associated with the new campsites will
maintain a minimum of 3.28 hours of storage (per 434 Creekside Drive flow calculations
on pg 98 of the application package)
Previously Permitted Pump Station flows (per
"Swan Quarter Wastewater System Proj.
#A19702.00 plans prepared by MacConnell &
Associates, P.C. dated 0810612001)
Proposed
# campsites
Proposed
Flows at 100
GPD/Campsite
(GPD
1
400 GPD Grinder Station
4
400
2
400 GPD Grinder Station
4
400
3
600 GPD Grinder Station
6
600
4
600 GPD Grinder Station
6
600
Total Reallocated Flow: z,uvu
3. Please provided the total length proposed 1.25-inch pressure sewer and the total length
of proposed 2 -inch pressure in the permit application. Also, after reviewing the
submitted engineering plans there is no profile information included in the engineering
plans for the proposed pressure sewer. Please provide the profile information for the
proposed 2-inch pressure sewer main in the road right of way. Notes must be added on

the engineering plans confirming minimum depth of 3 feet of cover over all proposed
pressure sewers and a minimum of 18-inches of vertical separation will be maintained
between all the proposed pressure sewers laterals and mains and any storm drains or
water mains at the crossing locations. A summary of the total length of 2" and 1.25"
HDPE pipe has been added to item V.
Totals
Inch
Material
Total Length feet
1.25
HDPE SDR 11
432
2
HDPE SDR 11
1395
In addition, a profile of the sewer main extension within the right-of-way has been added
to Sheet 4. Utility note #2 addresses the requirement for 3. 0' of cover min. and
separation to storm piping.
4. Pump station emergency storage calculations confirm 24 hours of storage capacity is not
provided. Therefore, 3 years of local utility electrical power outage history is required to
confirm the emergency storage provided is adequate to meet regulatory
requirements. Below is a summary of the three-year outage summary received from
Tideland EMC on 11412024. Not including scheduled outages, the average outage is
approx. 1 hr 16 minutes. New pump stations have been to maintain approx. 8 hours
throughout. The repurposed pump stations associated with the new campsites will
maintain a minimum of 3.28 hours of storage (per 434 Creekside Drive flow calculations
on pg 98 of the application package).
AtAive
Interruotian Outaoe Name Time Of Outaoe Time Restore( Duration Customer Responsible Cause
► 1
2023-07-07-0
7172023 5:52:10 F
7/72023 6:35
0 day 0 hr 43 min
❑
Deterioration
1
2023-06-01-0
611202312:01:23
6t12023 3:06
0 day 3 hr 5 min
❑
Scheduled
1
2022-12-13-0
12/132022 5:27:2
12/1320226,
0day 1 hr 13 min
❑
Unknown Cau
1
2022-05-10-0
5/102022 11:03:1.
5/102022 11:
0 day 0 hr 12 min
❑
Scheduled
1
2021-10-11-0
10/11=21 4:07:1
10/112021 6:
0 day 2 hr 0 min
❑
AnimaWBird-(
1
2021-0f-11-0
61112021 12:59:5
61112021 2:4
0 day 1 hr 46 min
❑
Scheduled
1
D5-12-0
5/122021 12:05:0
5/122D21 6:1'
0day6 hr 12 min
❑
Scheduled
1
�2021
2021-01-28-0
1282D21 8:22:16
123/2021 9:3
0 day 1 hr 10 m
❑-
IcelSnesw
Please do not hesitate to contact Michael W. Strader, Jr., PE, or myself by phone at (252) 491-
8147 or by email at csaunders(a)-guible.com should you have any questions and/or concerns.
Thank you for your attention to this project.
Sincerely,
Quible & Associates, P.C.
Ar4�-7z
Cathleen M. Saunders
End: as stated
Cc: Jeffrey Stotesberry, Swan Quarter Sanitary District

RV: ci EvvE.11 State of North Carolina
Department of Environmental Quality
UWKJU OF) Z , Division of Water Resources
15A NCAC 02T .0300 — ALTERNATIVE SEWER EXTENSION APPLICATION
Division of Water Resources INSTRUCTI JSM.JVEO: ASEA 10-23 & SUPPORTING DOCUMENTATION
1 �V 1'
Plans, specifications and supporting documents shall be prepared in accordance with, 15A NCAC 02T .01009 15A NCAC 02T
.0300, Division Policies and good engineering practices. Failure to submit all required items will necessitate additional
processing and review time, and may result in return of the application.
For more information, visit the Water Quality Permitting Section's collection systems website
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.
Unless otherwise noted, the Applicant shall submit one original and one copy of the application and supporting documentation.
A. One Original and One Copy of Application and Supporting Documents
® Required unless otherwise noted
B. Cover Letter (Required for All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
➢ Be specific as to the system type, number of homes served, flow allocation required, etc.
➢ If necessary for clarity, include attachments to the application form.
➢ If the project is funded by American Rescue Plan Act (ARPA) funds, please include the ARPA project number in the
cover letter and in parentheses under Project Name (Section II.1. of the application).
C. Application Fee (All New and Major Modification Application Packages):
® Submit a check or money order in the amount of $600.00 dated within 90 days of application submittal.
➢ Payable to North Carolina Department of Environmental Quality (NCDEQ).
D. Alternative Sewer Extension (Form: ASEA 10-23) Application (Required for All Application Packages):
® 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 I.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 I.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 II.1 shall be consistent with the project name on the plans, specifications, 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 En ig neer.
❑ The Applicant's 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 be designated as the signing official if a delegation letter is
provided from a person who meets the criteria in 15A NCAC 02T .0106(b).
E. Section X & XI Attachment (If Applicable):
® If the project includes gravity sewer, pump stations with multiple pumps and force mains, include the Section X & XI
attachment(s).
F. Flow Tracking/Acceptance Form (Form: FTSE 10-23) (If Applicable):
® Submit the completed and appropriately executed Flow Tracking/Acceptance for Sewer Extension Permit Form from the
owners of the downstream sewers and treatment facility.
➢ The flow acceptance indicated in form FTSE 10-23must not expire prior to permit issuance and must be dated less than
one year prior to the application date.
INSTRUCTIONS FOR FORM: ASEA 10-23 & SUPPORTING DOCUMENTATION Pagel of 4

G. Engineering Plans (Required for All Application Packages):
® Per 15A NCAC 02T .0305(b)(1), submit two sets of detailed plan sets that have been signed, sealed and dated by a North
Carolina licensed Professional Engineer, and shall include at a minimum:
➢ Table of contents with each sheet numbered.
➢ A general location map with at least two geographic references and a vicinity map.
➢ Plan and profile views of the sewer extension as well as the proximity of the sewer extension to other utilities and natural
features
➢ Detail drawings of all items pertinent to the sewer extension (including clean -out locations) and pump stations.
➢ The location of all wells (including usage and construction details if available), streams (ephemeral, intermittent, and
perennial), springs, lakes, ponds, and other surface drainage features within 100 feet of the project.
➢ Minimum separations required per 15A NCAC 02T.0305(f), and where separations cannot be maintained, alternative
criteria per 15A NCAC 02T.0305(g).
➢ Minimum cover for sewer extensions required per 15A NCAC 02T.0305(f) must also be shown clearly on the plans.
➢ Nodes/Zones listed in calculations and computer models must be accurately reflected on the plans.
➢ Plans must include lot numbers, zones, approximate pump and top of wet well elevations, and pump model number and
capacity in a table format.
® Plans shall represent a completed design and not be labeled with preliminary phrases (e.g., FOR REVIEW ONLY, NOT
FOR CONSTRUCTION, etc.) that indicate they are anything other than final plans. However, the plans may be labeled
with the phrase: FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION.
H. Specifications (Required for All Application Packages):
® Per 15A NCAC 02T .0305(b)(3), submit specifications that have been signed, sealed and dated by a North Carolina
licensed Professional En ig neer, and shall include at a minimum:
➢ Table of contents with each section/page numbered.
➢ Detailed specifications for pump stations (i.e. packaged grinder pump requirements, valves, controls, etc.)
➢ Site Work (i.e., earthwork, clearing, grubbing, excavation, trenching, backfilling, compacting, fencing, seeding, etc.)
➢ Materials (i.e., low pressure mains and laterals, force main, gravity, concrete, method of construction, etc.)
➢ Electrical (i.e., control panels, transfer switches, automatically activated standby power source, etc.)
➢ Means for ensuring quality and integrity of the finished product in accordance with the Minimum Design Criteria,
including leakage and pressure testing for the sewer extension.
® Specifications shall represent a completed design and not be labeled with preliminary phrases (e.g., FOR REVIEW
ONLY, NOT FOR CONSTRUCTION, etc.) that indicate they are anything other than final specifications. However, the
specifications may be labeled with the phrase: FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION.
® Specifications for standard equipment may only be omitted for municipalities with approved standard specifications, but
the use of the standard specifications must be noted on each sheet of the plans.
I. Engineering Calculations (All Application Packages):
® Per 15A NCAC 02T .0305(b)(2) and 15A NCAC 02T .0305(j)(1), submit engineering calculations that have been signed,
sealed and dated by a North Carolina licensed Professional Engineer, and shall include at a minimum:
➢ Friction/Total Dynamic Head calculations and system curve analysis (with one pump running, two pumps running, etc.)
➢ Pump selection information including pump curves, manufacturer's information, and recommended installation
guidelines.
➢ Pump station cycle times and pump run times.
➢ Minimum velocities in the sewer extension in accordance with the Minimum Design Criteria
➢ Flotation calculations for all units constructed partially or entirely below grade (i.e. pump stations)
® If computer models are provided to document system design, the model and corresponding node/zone nomenclature must
clearly and accurately reflect the plans and specifications.
Note that upon completion of the review process and prior to permit issuance, a request for the final plans and
specifications will be requested on digital media (CD, DVD, Jump Drive, etc.) for our records. You will be notified when
this information is requested, as the review may necessitate changes
INSTRUCTIONS FOR FORM: ASEA 10-23 & SUPPORTING DOCUMENTATION Page 3 of 4

J. Downstream Sewer Evaluations (All Application Packages)
® Per 15A NCAC 02T .0305(b)(2) and 15A NCAC 02T .0304(h)(1), submit engineering calculations that have been signed,
sealed and dated by a North Carolina licensed Professional Engineer, for receiving collection systems:
❑ For connection to a gravity sewer, submit:
An evaluation of the gravity sewer based on peak flow from the proposed project and peak flows already tributary to the
existing gravity sewer. Provide calculations and detail how existing peak flows were determined.
❑ For connection to a pump station, submit:
An evaluation of the existing pump station to pump peak flow from the proposed project and peak flows already tributary
to the existing pump station. Provide calculations and detail how existing peak flows were determined.
® For connection to a force main/low pressures sewer, submit:
An evaluation of the existing system based on peak flows from the proposed project and peak flows already tributary to
the existing system. In addition, evaluate the ability of each pump station tributary to the existing system to pump against
additional head created by greater flows through the system. Evaluation may include alternative designs such as telemetry
to coordinate pumping between pump stations (provided sufficient storage is available). Also include an evaluation of
the discharge point of the existing force main/pressure sewer.
K. Site Maps (All Application Packages):
® Submit an 8.5-inch x 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project
area and closest surface waters.
➢ Location of the project (gravity sewer, pump stations & force main)
➢ Downstream connection points and permit number (if known) for the receiving sewer
® Include a street level map showing general project area.
L. Existing Permit (All Modification Packages):
® Submit the most recently issued existing permit.
® Provide a list of any items within the permit the Applicant would like the Division to address during the permit
modification (i.e., permit description, flow allocation, treatment facility, etc.).
M. Power Reliability Plan (All Application Packages):
® Per 15A NCAC 02T .0305(h)( 1)(D), submit documentation of power reliability for simplex/vacuum units.
❑ Per 15A NCAC 02T .0305(h)(1), 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)
N. Final Environmental Document (If Applicable):
❑ Per 15A NCAC 02T .0105(c)(4), submit one copy of the environmental assessment and one copy of the final
environmental document (i.e., Finding of No Significant Impact or Record of Decision).
❑ Include information on any mitigating factors from the Environmental Assessment that impact the design and/or
construction of the subject sewer.
O. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per 15A NCAC 02T .0115(a)(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.
INSTRUCTIONS FOR FORM: ASEA 10-23 & SUPPORTING DOCUMENTATION Page 4 of 4

P. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold):
❑ Home/Property Owners' Associations
❑ Per 15A NCAC 02T .0115(c), submit the properly executed Operational Agreement (FORM: HOA).
❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 15A NCAC 02T .0115(b), submit the properly executed Operational Agreement (FORM: DES.
THE COMPLETED APPLICATION AND SUPPORTING DOCUMENTATION SHALL BE SUBMITTED TO:
NCDEQ/DWR
WATER QUALITY SECTION
PERCS UNIT
By U.S. Postal Service:
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1636
TELEPHONE NUMBER: [phone]
By Courier/Special Delivery:
512 N. SALISBURY ST. SUITE 925
RALEIGH, NORTH CAROLINA 27604
INSTRUCTIONS FOR FORM: ASEA 10-23 & SUPPORTING DOCUMENTATION Page 5 of 4

Divislon of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — ALTERNATIVE SEWER EXTENSION APPLICATION
ASEA 10-23 & SUPPORTING DOCUMENTATION
Application Number:
I. APPLICANT INFORMATION:
(to be completed by DWR)
1. Applicant's name: Swan Quarter Sanitary District (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State ® Municipal ❑ County
3. Signature authority's name: Joseph C. Williams per 15A NCAC 02T .0106(bl
Title: Chairman/President
4. Applicant's mailing address: P.O. Box 21
City: Swan Quarter State: NC Zip: 27885-0021
5. Applicant's contact information:
Phone number: [phone] Email Address: firechiefefMembargmail.com
II. PROJECT INFORMATION:
1. Project name: SOSD W00036463 Modification
2. Application/Project status: ❑ Proposed (New Permit) ® Existing Permit/Project ❑ ARPA funded
If a modification, provide the existing permit number: WQ0036463 and issued date: 2013
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Hyde County
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.4203' Longitude:-76.3176'
III. CONSULTANT INFORMATION:
1. Professional Engineer: Cathleen M. Saunders, P.E. License Number: 043652
Firm: Ouible & Associates. P.C.
Mailing address: P.O. Drawer 870
City: Kitty Hawk State: NC Zip: 27949-
Phone number: [phone] Email Address: csaundersna,auible.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Swan Quarter Sanitary District Permit Number: W00019665
Owner Name: Swan Quarter Sanitary District
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): W00019699
System Wide Collection System Permit Number(s): WQ0036463
Owner Name(s): Swan Quarter Sanitary District
FORM: ASEA 10-23 Pagel of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been submitted?
❑ 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 submitted?
❑ Yes [:]No ®N/A
3. If the Applicant is a Home/Property Owners' Association, has an Operational Agreement (FORM: HOA) been submitted?
❑ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
® Residential 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. Is/was an Environmental Assessment required under 15A NCAC 01C? ❑ Yes ® No
If yes, submit the appropriate final environmental document (FONSI, ROD, etc.)
6. Nature of wastewater: 100 % Domestic/Commercial % Other waste — specify:
% Industrial (See 15A NCAC 02T .0103(20))
7. Wastewater generated by project: 2.760 GPD (per 15A NCAC 02T .0114 and G.S. 143-215.1)
Hasa flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes ®No
If yes, provide a copy of approval
8. Summarize wastewater generated by project:
Establishment Type
Dail, Design Flow'
No. of Units
Flow
Single -Family Dwelling (2 BR)
120 gal/ bedroom
2
240 GPD
Single -Family Dwelling (3 BR) & Garage
120 gal/bedroom
6
720 GPD
Five (5) Single -Family Dwellings (313R)
120 gal/bedroom
15
1800 GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
2,760 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 below shall be determined using available
flow data, water using fixtures, occupancy or operation patterns, and other measured data.
FORM: ASEA 10-23 Page 2 of 5

VII. PRESSURE SEWER DESIGN CRITERIA —15A NCAC 02T .0305:
1. Number of simplex pump stations (STEP tanks/effluent pumps, vacuum pits, etc.) provided: 8
2. What is the nearest 100-year flood elevation to the facility? 4 feet mean sea level.
Is any of the proposed project located within the 100-year flood plain? ® Yes ❑ No
3. If Yes, are the following items provided per 15A NCAC 02T .0305(e):
Water -tight seals on all station hatches and manholes; and
Control panels vents extend two feet above the 100-year flood plain elevation? ® Yes [:]No ❑ N/A
If No, what measures are being taken to protect them against flooding?
4. Volume of storage in wet well above pump on elevation: varies see calculations Gallons (include calculations)
5. How power reliability will be provided in accordance with 15A NCAC 02T .0305(h)(D):
❑ Wet well storage provides 24 hours worth of wastewater storage; or
® Wet well storage provides wastewater storage based on power reliability and response times
(See "Policy for Meeting Reliability Requirements")
➢ Provide 3 years of power history date in the area.
➢ Provide response time to replace a failed pump. This would include travel time, time to replace pump, etc.
➢ Wet well storage would be based on whichever is greater.
All other pump stations meet the reliability requirements of 15A NCAC 02T .0305(h)(1): ® Yes ❑ No ❑ N/A
6. Summarize simplex pump station design elements:
Design Element
Plan Sheet
Reference
Specification
Reference
Emergency Contact Placard or Sticker
8
13300-4
Screened Wet Well Vent
7
11900-4
Restricted Access Details
Control Panel
7
13300-4
High Water Alarms (Audible & Visual)
7
11900-5
Valves (Check, Gate, etc)
8
15100-2&4
Air Relief Valves
7. Summarize the pipe length by diameter to be permitted. Lines from a building to the septic or pump tank should be excluded.
(provide attachments if necessary)
Zone
From Node
To Node
Diameter (in)
Length (feet)
# Pumps in Zone
Pump Model
Specified for Zone
See
attached
for full list
8. Air release valve station locations per 15A NCAC 02T .0305(i) (provide attachments if necessary)
Air Release Valve # Station Plan Sheet Reference
FORM: ASEA 10-23 Page 3 of 5

VIII. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (g)
➢ 15A NCAC 02T_0305(f) contains minimum separations that shall be provided for sewer systems:
® Yes ❑ No
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below vertical
24 inches
Water mains vertical -water over sewer including in benched trenches
18 inches
Water mains horizontal
10 feet
Reclaimed water lines vertical - reclaimed over sewer
18 inches
Reclaimed water lines horizontal - reclaimed over sewer
2 feet
**Any private or public water supply source, including any wells, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water
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 see item IX.2
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
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
➢ 15A NCAC 02T.0305(a) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpa¢e
➢ If noncompliance with 02T.0305(fl or (g). see Section IX of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes [:]No ❑ N/A
➢ See the Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ® Yes ❑ No ❑ N/A
➢ This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project require coverage/authorization under a 404 Nationwide or ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.0105(cN6) (additional permits/certifications)? ® Yes []No
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications are 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.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ® No
➢ 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 permitee's individual System -Wide Collection permit.
FORM: ASEA 10-23 Page 4 of 5

IX. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria (latest version) as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
I, CAT� CEeK kA . S A c)M E60.SS attest that this application for
(Professional Engineer's name from Application Item M.1.)
� C3.S(� W C1 p03� � Cn 3 Itilo���co�-11 cw►-•
(Facility 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 this application package and its instructions, as
well as all applicable regulations and statutes. 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 $10 000 as well as civil penalties up to $25 000 per violation-
, ) f
North Carolina Professional Engineer's seal, signature, and date:
Applicant's,Certification per 15A NC*C 02T .0106(b):
................`���a\�I�.. ....�.�.I.l1{ ��....................... A Ro`/y///
OF ESS/p
q
SEAL
43 2 (o�
'� �✓G IN
................... _...................................... ........................ .......
:
that this application for
(Signat re Authority's name & title from Application Item I.3.)
(Facility name from Application Item II.1.)
has been reviewed by me and is accurate and complete to the best of my knowledge. 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. As the permittee for the pressure sewer system, I understand I will be required to
own, maintain, and operate all individual pump stations.
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 $10,00Q asyvei, 7as civil penalties up to $25,000 per violation.
Sig iaLur / -� r , I Date: 3
FORM: ASEA 10-23 Page 5 of 5

7. Summarize the pipe length by diameter to be permitted. Attachment
Zone
From Node
To
Diameter
Length
#
Pump Model Specified for
Node
(in)
(feet)
Pumps
Zone
in Zone
375
375 Creekside
J-5
2
75
1
Barnes SGV Grinder, 2HP,
Creekside
PMP
5.62" impeller SGV 2HP
7691-34-
7691-34-5706
J-17
1.25
147
1
Barnes SGV Grinder, 2HP,
5706
5.62" impeller SGV 2HP
<NONE>
J-17
J-12
2
428
1
n/a
290 Main
290 Main Street
J-18
2
235
1
Barnes SGV Grinder, 2HP, 5"
Street
PMP
impeller SGV 2HP
1272 Main
1272 Main (B)
J-7
2
160
1
Barnes SGV Grinder, 2HP, 4"
(B)
PMP
impeller SGV 2HP
7691-88-
7691-88-0859(A)
J-10
1.25
95
1
Barnes SGV Grinder, 2HP, 5"
0859(A)
PMP
impeller SGV 2HP
7691-88-
7691-88-0859(B)
J-10
1.25
115
1
Barnes SGV Grinder, 2HP, 5"
0859(B)
PMP
impeller SGV 2HP
7691-88-
J-10
J-11
2
122
1
n/a
0859(B)
245 Academy
245 Academy
J-21
2
375
1
Barnes SGV Grinder, 2HP, 5"
PMP
impeller SGV 2HP
59 Third St
59 Third St PMP
J-19
1.25
75
1
Barnes SGV Grinder, 2HP, 5"
1
impeller SGV 2HP
Totals
Inch
Material
Total Length (feet)
1.25
HDPE SDR 11
432
2
HDPE SDR 11
1395

State of North Carolina
CJ Department of Environmental Quality
Q JpWF��NPI)E Division of Water Resources
Nc�E
Division of Ami Flow Tracking for Sewer Extension Applications
(FTSE 10-23)
Entity Requesting Allocation: Swan Quarter Sanitary District
Project Name for which flow is being requested: SQSD WQ0036463 Modification
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of'the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Swan Quarter Sanitary District
b. WWTP Facility Permit #: WQ0019665
All flows are in MGD
c. WWTP facility's permitted flow
0.125
d. Estimated obligated flow not yet tributary to the WWTP
0.004385
e. WWTP facility's actual avg. flow
0.0140
f. Total flow for this specific request
0.00276
g. Total actual and obligated flows to the facility
0.0211
h. Percent of permitted flow used
16.9%
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)
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 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 (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): Swan Quarter Sanitary District
Downstream Permit Number: W 0019699
Page 1 of 6
FTSE 10-23

III. Certification Statement:
I Joseph C Williams, Swan Quarter certify to the best of my knowledge that the addition of
Sanitary District
the volume of wastewater to be permitted in this project has been evaluated along the route to the receiving
wastewater treatment facility and that the flow from this project is not anticipated to cause any capacity
related sanitary sewer overflows or overburden any downstream pump station en route to the receiving
treatment plant under normal circumstances, given the implementation of the planned improvements
identified in the planning assessment where applicable. This analysis has been performed in accordance
with local established policies and procedures using the best available data. This certification applies to
those items listed above in Sections I and II plus all attached planning assessment addendums for which I
am the responsible party. Signature of this form certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
Signing Official Signature
Title of Signing Official
Date
Page 2 of 6
FTSE 10-23