WQ0040093_Application (FTSE)_20180807

Central Files: APS ____ SWP
6/20/2018
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Permit Numaer
Program Category
Non -discharge
Permit Type
n pump Stations, &Pressure Sewer Extensions
Gravity Sewer Extension,
P
Primary Rev iewe r
dean.hunkele
Coastal SW'Rule
Permitted Flow
Permit Tracking Slip
s..,.o.-t TvnE±
Status
In review New Project
Version Permit Classification
A Individual
Permit Contact Affiliation
Facility Major/Minor Kegwt,
Minor Wilmington
Facility Name County
Cypress Grove Townhomes Pender
Location Address
Facility Contact Affiliation
Owner
Owner Name
Pluris Hampstead LLC
Owner Type
Non -Government
Owner Affiliation
Maurice W. Gallarda
PE
2100 McKinney Ave
Dallas
TX 75201
Dates/Events
Scheduled Public Notice Issue Effective Expiration
App Received Draft initiated issuance
Orig issue
6/20/2018
Requested /Received Events
Regulated Activities Additional information requested
Additional information received
G►. ehi17C In

Michael C. Gallant PE, PA
Engineering / Consulting / Design
NC Firm C-1989, AL Firm CA - 4338 - E
NC Reg. No. - 25572, AL Reg. No. - 32178
Dean Hunkele
Senior Environmental Specialist
Surface Water Protection
NCDENR-DWQ, WiRO
127 Cardinal Drive
Wilmington, NC 28403
Re: Cypress Grove Townhomes
June 20, 2018
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Dean,
Please find attached a fast track application package for the Hampstead Station Outparcel B
project. This package includes the application fee and two copies of:
• Two copies of application form FTA 04-16.
• Two USGS maps showing the site.
• Two sets of the utility master plan.
• Two copies of the FTSE for the project.
• A letter from the NCUC concerning the project.
• The application fee of $480.
Please let the following serve as a brief narrative for the project:
This project proposed 56 Townhome residences. This site was formerly permitted with a
package treatment system that is no longer in use. (Plant serving McDonald's in Hampstead). The plan
includes one lift station that will pump to the existing Pluris Hampstead force main on US HWY 17.
If you have any questions please feel free to call me at 910.448.1046.
Sincerely,
Michael C. Gallant, PE
[e-mail]
tel [phone]
P.C.Q. Box 4039
Surf City, NC 28445

State of North Carolina
Yam; Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 -- FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: (to be completed b DWR
)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Pluris Hampstead, LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual E Corporation ❑ General Partnership
❑ Federal ❑ State/County ❑ Municipal
3. Signature authority's name: Randy Hoffer per 15A NCAC 02T .0106(b)
Title: Regional Manager
4. Applicant's mailing address: 1095 Hwa210
City: Sneads Ferry State: NC Zip: 28460-
5. Applicant's contact information:
Phone number: [phone] Email Address:
II. PROJECT INFORMATION:
1. Project name: Cypress Grove Townhomes
� Privately -Owned Public Utility
❑ Other
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2. Application/Project status: Z Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Pender
4. Approximate Coordinates (Decimal Degrees): Latitude: 34.3709' Longitude:-77.71170
5. Parcel ID (if applicable): 3292-88-7589-0000
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Michael C. Gallant, PE License Number: 25572
Firm: Michael C. Gallant, PE
Mailing address: PO Box 4039
City: Surf Cily State: NC Zip: 28445-
Phone number: [phone] Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Pluris Hampstead WWTF Permit Number: WQ0037287
Owner Name: Pluris Hampstead, LLC
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ0037324 Downstream (Receiving) Sewer Size: 10 inch
System Wide Collection System Permit Number(s) (if. applicable): WQCS
Owner Name(s): Pluris Hampstead, LLC
FORM: FTA 04-16 Page 1 of 5

VI.
GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
0 Yes nNo FIN/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM.: been attached?
❑ Yes ❑No nN/A
3. If the Applicant is a Home/Property Owners' Association, has an Operational Agreement (FORM: HOAR been attached?
❑ 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. Nature of wastewater: 100 % Domestic/Commercial % Commercial
% Industrial (See 15A NCAC 02T .0103(20))
Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 1.5A NCAC 02T .0114(f}? ❑ Yes E No
➢ If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.01.1.40
Daily Design Flow a'b
No. of Units
Flow
56 Townhomes (3bdr @ 120 gpd/bdr=360)
360 gal/unit
56
20160 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
20160 GPD
a See 15A NCAC 02T .0114(b) (d),(e)(1) and (e)(2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use
areas; and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals
as defined in G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.01141 shall
be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 20160 GPD (per 15A NCAC 02T .0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16 Page 2 of 5

VH. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
l . Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 904 PVC
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02'T .0305 & MDC (PumpStations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: LS 1
2. Approximate Coordinates (Decimal Degrees): Latitude: 34.37090 Longitude:-77.7117'
3. Design flow of the pump station: .020160 millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 45 gallons per minute at 112 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
3
1135
PVC
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
® Standby power source or pump with automatic activation and telemetry -15A NCAC 02T .0305(h)(1)(B)_
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C):
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
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 in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS -- (02B .0200 & 15A NCAC 02T :0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T .0305( & (g) ❑ Yes [:]No
➢ 15A NCAC 02T_0305(f) contains minimum separations that �ha11 he nrovided for sewer �vgtem�-
Setback Parameter*
Separation 9equired
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 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(gg) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ "Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
➢ If noncompliance with 02T.0305( or (g), see Section X 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 2B.0202
4. Does the project require coverage/authorization under a 404 Nationwide or El Yes Z 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(c)(6) (additional. permits/certifications)? E 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 ❑N/A
➢ 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: FTA 04-16 Page 4 of 5

'b
X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains (latest version}, and the Gravity Sewer Minimum Desig1l Criteria (latest version} as applicable?
E 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
dncumenk-
2. Professional Engineer's Certification:
I, K attest that this application for
(Professional Engineer's name from Application Item III.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, Gravity Sewer
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 $10,000, as well as civil penalties up to $25,000 per violation.
North Carolina Professional Engineer's seal, signature, and date:
3. A]
I,
attest that this application for
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of water Resources should a
condition of this permit be violated. I also understand that if all required parts of this application package are not completed
and that if all required supporting information and attachments are not included, this application package will be returned to
me as incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25 5000 per violation.
Signature: Date: 449
FORM: FTA 04-16 . Page 5 of 5

Entity Requesting Allocation: Pluris Hampstead, LLC
Project Name for which flow is being requested: Cypress Grove Townhomes
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: Pluris Hampstead, LLC
b. WWTP Facility Permit #: WQ0037287
All f Zows are in MGD
c. WWTP facility's permitted flow 0.250
d. Estimated obligated flow not yet tributary to the WWTP 0.100
e. WWTP facility's actual avg. flow 0.040
f. Total flow for this specific request 0.020160
g. Total actual and obligated flows to the facility 0.160
h. Percent of permitted flow used 64%
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
Average Daily
Approx.
Not Yet
Total Current
Station
Firm Flow* *
Current Avg.
Tributary
Flow Plus
(Name or
Capacity, * (Firm / po,
Daily Flow,
Daily Flow,
Obligated Available
Number)
MGD MGD
MGD
MGD
Flow Capacity* * *
* The Firm Capacity 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.
* * * 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): Pluris Hampstead, LLC
Downstream Permit Number: WQ0037324
Page 1 of 6
FTSE 04-1.6

III. Certification Statement:
I Randy Hoffer, Regional Manager certify to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the
receiving wastewater treatment facility and that the flow from this project is not anticipated to
cause any capacity related sanitary sewer overflows or overburden any downstream pump station
en route to the receiving treatment plant under normal circumstances, given the implementation
of the planned improvements identified in the planning assessment where applicable. This
analysis has been performed in accordance with local established policies and procedures using
the best available data. This certification applies to those items listed above in Sections I and II
plus all attached planning assessment addendums for which I am the responsible party.
Signature of this form indicates acceptance of this wastewater flow.
Signing Official Signature
. F'JV"JA-
Page 2 of 6
FTSE 04-16

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NORTH CAROLINA
PUBLIC STAFF
UTILITIES COMMISSION
June 19, 2018
Mr. Dan Higgins
Attorney at Law
Burns, Day and Preswell, P.A.
P.O. Box 10867
Raleigh, North Carolina 27605
Re: Pluris Hampstead LLC
Docket No. W-1305, Sub 9
Application for a Certificate of Public Convenience and Necessity -
Cypress Grove Town homes-Pender County
TO WHOM IT MAY CONCERN:
The North Carolina Utilities Commission has received an Application for Certificate
of Public - Convenience and Necessity filed by Pluris Hampstead LLC, to provide
wastewater utility service in Cypress Grove Townhomes in Pender County, North
Carolina. The Public Staff anticipates that approval will be granted upon investigation
and review of the submitted application.
Please feel free to call if you have any questions or if I can be of further assistance.
Sincerely,
/s/William E. Grantmyre
Staff Attorney
william.g rantmyre(a�psncuc. nc.gov
WEG/sld
c: Chief Clerk
Freda Hilburn
David Furr
Executive Director
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