WQ0041067_Application (FTSE)_20190719

Greenville
Utilities
July 19, 2019
Mr. Allen Clark
Environmental Specialist
NCDENR
943 Washington Square Mall
Washington, North Carolina 27889
Subject: Jolly Roger's Revenge
Sewer Main Extension
Dear Mr. Clark:
We are submitting herewith one (1) original and one (1) copy of the executed Non -Discharge
Permit Application and Flow Tracking/Acceptance for Sewer Extension Permit Applications
along with a check for $480.00 for the subject project. We request your approval of the sewer
improvements.
We trust that you will find this submittal to be in order and that your approval will be
forthcoming. In the meantime, should you have any questions or require any additional
information, please let us know.
Sincerely,
Clifton H. Cahoon, PE
Construction 1 Contracts Engineer
Enclosures
c: Mr. Randall D. Emory, PE, Director Water Resources
Mr. Bryan C. Fagundus, PE, Ark Consulting Group, PLLC.
PO Box 1.847
Greenville, NC 27835
www.guc.com
Your Local
Advantage

nr
11 X t3 Ku u F', :PLLC .
Engineers & Planners Firm License No. P-1199
June 10, 2019
Mr.:Clay Johnston
Engineering Coordinator
Greenville Utilities Commission -_Water Resources Department.
PO Box 1847
Greenville, North Carolina 27835
Subject: Fast -Track Application
Jolly Roger's Revenge
Public and Private Sanitary Sewer Main. Extensions. .
City of. Greenville,. Pitt County, North Carolina:
Dear Mr. Johnston:
On behalf of Jolly:Roger's Revenge,.LLC we respectfully submit two Fast -Track Applications for the Jolly Roger's Revenge
private dormitory project. located at the northwest corner of,Charles Boulevard and 14`h Street -in Greenville.
The project area consists of a 2 City.block area that's bound on the:east /.west.by Charles Boulevard and Cotanche Street
and on the north / south by 13th Street and 14th.Street. There were previously 21 homes,.a church and a convenience
store containing a. carry -out restaurant located on the old parcels. The existing structures have all been demolished and. .
the old parcels have been reco.nibined to create a single building lot bound by the four public streets. As calculated per
15A NCAC 2T .0114,.the flow generated by the prior uses that we'll: be replacing with the new projeeC-t-s-9-725_�pd: The
prior flow generation is based on 2�:es.at 3.60.gpd-yieIdingr7;.56.0 gpdt�_cla.u.reh-with 100 ats a 3 gal%seat/day
yielding 300 gpd and a 2,275 sf convenience store_(.604a1%1Q0_sfwith-a:j;aurant �50-gal/1-00-sfi)�
contained within the same -bull • ing-that=wou.l.d:bave_ge.perated.1,865-gpd.=-7
The proposed.project consists of an 804 bed privately owned.dormitory building together with 10,000 sf of non-residential
space contained within the sam.e.building along with a, new parking garage and ancillary, site. and utility improvements..
The proposed project is provided sanitary sewer service by existing GUC owned 8" gravity sanitary sewer mains located
within the Charles Boulevard and 14th Street public rights of way. The project proposes tying into an existing 8" GUC
sanitary sewer main located within 14th Street with the extension of a short section of new 8" public main that GUC will
own and maintain pproximateIII y 1.3_of_8'�m.aJ and then.a proposed extension of approximately 471 private
a.i.n._will provide service to the: majority of the building. The remaihing portion of the building not flowing through the .
new 8:' private sewer will flow north to an existing GUC main located at the Charles Blvd / 13th Street intersection. As
calculated. using 15A NCAC 2T.0114,,the new flow generated by the proposed project.i5-9 ,980 gp�_a.nd is comprised-d
r804-beds at 1'' 20 gpd and 12-pPa'mb"ing fixtures at 125 gpd/fixture as shown on the project WEP plan _f; r:the non-residential
space..�TheJotall new net low generatedby the replacement.of-the-p4n, .lows -by -the -new p.ro.j ct-#low-is-88-2.55-gpd and
will be allocated on the public portion of 8".main. The private portion of 8" main will not allocate new flow.
PHONE WEB.

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DECLINATION AT CENTER Of SHEET NORTH AMERICAN VERTICAL DATUM OF 19.88
Project Mgr,: BCF Project NO-: 18007 NC Ucer . P-1194 SITE LOCATION PLAN EXHIBIT
Drawn By: KLG scale: ASSHO1lVN ING CONSULT
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ENGINEERS Jolly Rogers Revenge
ClTeckeif By: ??? Date: 06/67/18 \ KGROUP&PLANNERS
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2755•B Charles BWd. I Greenville, NC 27858 E. envi Street and nty, North Carolina

State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
0DIvislon kofWateNCesources INSTRUCTIONS FOR FORM: FTA 04-16.& 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 I5A NCAC 62T and the Division's
Minimum Design Criteria and that plans, specifications and supporting documents have been prepared in accordance with, 15A
NCAC 02T, 15A 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 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.0303.
Projects not eligible for review via the fast track process (must be submitted for full technical review):
➢ Projects that require an environmental assessment in accordance with I SA NCAC 1 C .0100;
➢ Projects that do not meet any part of the minimum design criteria (MDC) document;
➢ Projects that involve a variance from the requirements of I5A NCAC 2T;
➢ Pressure sewer systems utilizing septic tank, -effluent pumps (STEPS) or simplex grinder pumps;
➢ STEP or simplex grinder pumps connecting to pressurized systems (e.g, force mains);
➢ 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 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.
C. Application Fee (All New and Major Modification Application Packages):
® Submit a check or money order in the amount of $480.00 dated within 90 days of application submittal.
➢ Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track (Form: FTA 04-16) 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. I 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 Applicant's Certification on Page 5 of the application shall be signed in accordance witfi 15A NCAC 02T .0106(bl.
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).
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Pagel of 3

E. Flow Tracking/Acceptance Form (Form: FTSE 04-16) (if Applicable):
0 Submit the completed
ed and executed FTSE form ft6m the owners of the dowmtream sewers and treatment facility.
> Multiple forms maybe required where the downstream sewer owner and Wastewater treatment facility are different.
> The flow acceptance expire prior to permit issuance and must be dated less than one
�tance indicated in form FTSE must not ex_ erm
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. 1 1 43=
215.67(a).
> Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific FTSE.
F. Site Maps (Ali Application P,gckages):
0 Submit an 8 .5-inch x I I"inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project
area and closest, surface waters.
> U6ation of the project gravity sewer, pump stations & force main
> Downstream connection points and permit number (if known) for the receiving sewer
0 Include a street level map (Aerial) showing general project area so that Division staff can easily locate it in the field.
G. Existing Permit (Ali Modification Packages):
Submit the most recently issued existing permit.
0 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;),
A, Power Reliability Plan (Required if portable reliability *option utilized for Pump Station):
0 Per 15A NCAC 02T.0305(h)(1), submit documentation of power reliability far 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 f6r distribution and operation of this pump station."
> If the portable power source or pumpis dedicated to multiple pump stations an evaluation of all the pump
p
stations' storage capacities and the rotation schedule of the portable power source or pu mp, includine travel
timeframesi shall be provided in the case of a multiple station power outage. tage. (Required at time of certification)
I. Certificate of Public Convenience and Necessity (AD Application Packages for Privately -Owned Public Utilities):
0 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
0 Provide
de 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
fi-anchise approval is expected.
J. Operational Agreements (Applications from HOA/POA and Developers
elopers for lots to be sold):
• Home/Property Owners' Associations
0 Per 15A NCAC 02T.01 15(c), submit the properly executed Operational Agreement (FORM: HOA).
0 Per 15A NCAC 02T.01.15(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
• Developers of lots to be sold
O Per 15A NCAC 02T .0 1 15(b), submit the properly executed Operational Agreement (FORM- DEW
For more information, visit the Division's collection. systems website
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page of

State of North Carolina
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: ((A)aDO4"rO�I (to becompleted byDWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Greenville Utilities Commission (company, municipality, HOA, utility, etc.)
2. Applicant type: E] individual El Corporation El General Partnership El Privately -Owned Public Utility
R Federal El State/County Municipal ❑ Other
3. Signature authority's name: Clifton H. Cahoon.. PE pet 15A NCAC 02T 0 1 06(b)
Title: Construction / Contracts Engineer
4. Applicant's mailing address: PO Box 1847
City: Greenville State: N-C Zip: 27835-
5. Applicant's contact information:
Phone number: [phone] Email Address: caboondh4guc.com
II. PROJECT INFORMATION:
1. Project name: Jolly Rogefs Revenge
2. Application/Project status: Proposed (New Permit) Existing Perrnit/Proiect
If a modification, provide the existing
ng permit number? WQOOand issued date -
If new construction but part of a master plan, provide the existing permit number: WQOO
3. County where project is located: Pitt
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.6011' Longitude: -77,3714'
S. Parcel ID (if applicable): 85455
(or Parcel ID to closest downstream sewer)
111. CONSULTANT INFORMATION:
I Professional Engineer: Bryan C. Fagundus. P.E License Number: 31970
Firm: Ark Consulting Group . PLLC
Mailing address: 2755-B Charles Boulevard
City: Greenvill State: NC Zip: 2785&
Phone number: [phone] Email Address: brvgnQaftofisulting-grooxom
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Greenville Utilities Commission- - Permit Number: NC 0023931
Owner Name: Greenville Utilities Commission
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Nurftbcr(§): WQ Unknown Downstream (Receiving) Sewer Size: 8" inch
System Wide Collectiot! System Permit Number(s) (if applicable): WQCS
Owner Na'me(s); Greenville Utilities Co mmission
FORM: FTA 04-16 Page I of 5

V l.::.
.GENERAL.REQUIREMENTS :. .
1::
If the A PPlicant is a Privatel Owned Public Utility, has a Certificate of Public Convenience and Necessitybeen attached?.
. y' :. �..
❑ Yes ❑No: . ®N/A
2.:.
If the Applicant is a Developer of lots. to be sold, has a"Developer's Operational Agreement (FORM: DEV) been attached? ... .
0 Yes ❑No: ®N/A .
3.:
If the Applicant is a Home/Propedy Owners' Association, has an Operational A
leereernent (FORM: HOA) been attached?.
❑ -]No: No: ®N/A
4. -
Origin of wastewater: (check all that; apply):
Q Residential Owned EIRetail (stores, centers, malls)
'❑ Car Wash "
® Residential Leased ® Retail with food preparation/service
❑ Hotel and/or:Motels.
❑ School ./ preschool: / day care :.. ❑ Medical / denial /: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 15A NCAC 02T .0114(f)? ❑Yes
®No
➢ If yes, provide a coax of flowreduction approval letter
7.:.
Summarize.wastewater generated;by:project: :. .
Establishment Type (see 221.0114(f))" :
Daily Design Flow','
No. of Units
Flow
804 Residential Beds ;....
120.gal/bed ..
804
96,4$0 GPD
10,000 sf Retail Space
125 gal/fixture
12
1,500 GPD
Deduct for Existing Flow -Refer to cover
letter
gal/
-9,725 GPD
gall
GPD
gall
GPD
gal/ pGPD
.
Total
88,255 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: 8 8,25 5 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.exi'sting sewer with no new flow expected
❑ Other (Explain):. .
FORM: FTA 04-16 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T.0305 & MDC. (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
> Section 11 & III of the MDC for Pernuitting 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 slop*e.requirernent is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T.0305 & MDC (Pump Stations/Force Mains
COMPLETE. FOR EACH PUMP STATION INC I LUDED IN THIS PROJECT
I Pump station number or name:
.7- Approximate Coordinates (Decimal Degrees):. La.titude:, 0 Longitude: -
3. Design flow of the Pump station: millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s)' gallons Per minute at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with I 5A NCAC 02T,0305(h)(1):
El Standbyor pump with automatic activation and teleme -� I 5A NCAC 02T.03'05(h)(1)(B) power source try
> Required for all pump stations with an Average daily flow greater than or equal to 15,000 gallons per
er day
➢ Must be permanenttofacility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
F1 Portable power source with manual activation, quick -connection receptacle and telemetry = 15A NCAC 02T
:0305(h)(1)(C)
or
El Portable purnping unit with plugged emergency pump connection and telemetry - I SA 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
9 .

IX. SETBACKS & SEPARATIONS — (02B.0200 & 15A NCAC 02T.0305(f)):
1. Does the project comply with, all separations found in 15A NCAC 02T.0305(f) &
> 15A NCAC 02T.6305(f) contains r1unitnurn separations that shall be provided for sewer systems:
Setback Parameter*
Separation Required
Storm. sewers and other utilities not. listed below (vertical)..
24 inches
Water mains (vertical -water over sewer including in benched trenchesl
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 11 impounded reservoirs used as a source of drinking water
100 feet
"Waters. classified
assificd WS (except WS-1 or . WS-V); B, SA, ORW, HQW, or SB from normal
high water.(or.tidc elevation) and wetlands (see item IX.2)
50 feet
"Any other stream, lake, impoiuidin6rit, or ground water lowering and'surface drainage
ditches,,
10 feet
Any buildifig.f6undation
5.feet
Any basement
10 feet
To slope of embankment oucuts of.2 feet or More Vertical height
10 feet .
Drainage. systems 'and interceptor drains
feet
Any swimming pools
10 feet
Final earth grade (vertical )
36 inches
> 15A NCAC 02T,0305(p-) contains alternatives where separations in 02T.0305(f) cannot be achieved,
> **Stream classifications can be identified using the Division's NC . Surface Water Classifications webRage
> Iffrioncomplian-ce with 02T.0305(f) or-(.Vl see Section X of this application
2. Does the project comply with separation requirements nts 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 0213.02002 OYes E] No E] N/A
> This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project requite coverage/authorization under a 404 Nationwide or El Yes 0 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 021.0105(c)(6) (additional permits/certifications)? ED Yes El 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 I SA NCAC 02T.0402, '.%ighpriority 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.
El Yes 0 No. F1 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 petmittee or its representative at least once every sii-;Mqnths, and inspections
documented per 15A NCAC 02T.i0403(A)(5) or the permitee's individual System -Wide Collection pmnit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
Does the submitted system comply with I SA NCAC 02T, the Minimum Design Criteria for the Permitting of Pumn Stations
and Force Mains (latest version) , and the Gravity Sewer Minimum Design Criteria (latest version) as applicable?
0 Yes Ej No
If No, complete and submit the Variance/Alternative Design Request Application (VADC 1044) and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and suviortirie documents.
2. Profegsional,Enginecr's Certification:
BRYAJ, dJA43U#Jl>U5 attest that this application for
(Professional Engineer's name from Application Item 111. 1.)
1-0 L%_-j IZ0602_S RrVE746,U_
has been reviewed by me And is accurate, complete And consistent with the infohnation, supplied in I 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
est version), and the Minimum Design Criteria for the Fa§t-Track Permitting.
of P , Stations and Force Mains (lat'st version). Although other professionals f thi
ump (latest ve , ssiorials may h d s 'o. 9 Ave developed certain, portion o, s
submittal package, inclusion of these materials under my signature I 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 S,tatutes 143-215..6A and 143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $ 10,000, as well as civil penalties up'to $25,000 per violation.
North Carolina Pr6fess.ional Engineer's seal, signaturej and date:
Applicant's Certification per I SA NCAC 02T .0 1 00(b):
1,
that this application for
MOLL,4 V-06'ER!s zF_V &4 6) C- -
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 attacbments are not included this
application package is, subject to being returned as incoiriplete. 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
al pfoseediion. I will make no claim against the Division of Water Resources
sources should atondition
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 143215,6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in Any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $ 10,000 as well as civil penalties up to $25,000 per Violation.
Signature: Date:
FORM: FTA 04-16 Page 5 of 5

State of North Carolina
Department of.Environmental Quality
Division.of Water Resources
Flow Tracking/Acceptance for Sewer. Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Greenville Utilities, Commission
Project Name for which flow is being requested: Jolly Roger's Revenge
More than one.F'TSE may be required for a single project if the owner of the .WWTP is not responsible far all. pump
stations along the route of the proposed wastewater flow:
L Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Greenville Utilities Commission
b. WWTP Facility Permit #: NC0023931
ACI flows are in MGD
c. WWTP facility's permitted flow 17.5
d. Estimated obligated flow not yet tributary to the WWTP 2.336
e. WWTP facility's. actual avg. flow 11.19
f. Total flow for this specific request .0883 .
g. Total actualand obligated flows to the facility 13.61:4
h. Percent of permitted flow used 77.795 c ,c rod toS%
II. Completethis section for each pump station you are'responsible for along the route of this
proposed wastewater flow.
List pumpstations 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 / pf), Daily Flow, Daily Flow, Obligated Available
Number) MGD MGD MGD MGD. Flow Capacity***
Sauthside 30.2 12.08 7.288 1..143 8.431 3.649
* 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): Not Known
Downstream Permit Number: Not Known
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FTSE 04-16