wq0028587_Permit (Modification)_20061103

North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
November 3, 2006
William Farris, Interim Town Manager
Town of Leland
102 Town Hall Drive
Leland, NC 28451
Subject:
Dear Mr. Farris:
William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
Permit No. WQ0028587 MODIFICATION
Town of Leland
Brunswick Forest Sewer
Wastewater Collection System Extension
Brunswick County
In accordance with your application received September 25, 2006, we are forwarding
herewith Permit No. WQ0028587, dated November 3, 2006, to the Town of Leland for the
construction and operation of the subject wastewater collection system extension. This permit
shall be effective from the date of issuance until rescinded, shall void Permit No. WQ0028587
issued October 27, 2006, and shall be subject to the conditions and limitations as specified
therein. This cover letter shall be considered a part of this permit and is therefore incorporated
therein by reference.
This modification includes the addition of approximately 1,094 linear feet of 6-inch force
main associated with Jefferson Landing at Brunswick Forest Phase 2 (aka Phase 1 Section 1-B)
with no additional flow allocation.
By copy of this permit, the Town of Leland Building Inspections Department is hereby notified
that building or occupancy permits shall only be issued for the 280 residences (described by
phases/section on subsequent pages) associated with Brunswick Forest project until a
modified permit is issued by the Division indicating additional connections. In addition, no
certificates of occupancy are to be granted prior to the submittal of a sealed enaineer's
certification per Condition 6 of this permit.
Wilmington Regional Office
127 Cardinal Drive Extension Wilmington, NC 28405
Phone: [phone] / FAX: [phone]
Internet: www.ncwaferquality.org
Nne
orthCarolina
naturally
An Equal Opportunity/Affirmative Action Employer
50% Recycled/10% Post Consumer Paper
Customer Service 1-877-623-6748

Town of Leland
W Q0028587
Page 2
Please note the following standard conditions that are contained in this permit.
Condition 3: Requires that the wastewater collection facilities be properly operated
and maintained in accordance with 15A NCAC 2H .0227 or any individual
system -wide collection system permit issued to the Permittee.
Condition 6: Requires that the system be certified upon completion of construction
and prior to being placed into operation. Please note that if an
Operational Agreement accompanies this permit then a copy of the
Articles of Incorporation, Declarations, and Bylaws that have been
appropriately filed shall be submitted with the engineer's certification prior
to operation.
Condition 9: Regarding the installation of gravity sewer at greater than ten percent
below the minimum required slope per the Division's Gravity Sewer
Minimum Design Criteria shall not be acceptable and shall not be
certified until corrected.
Condition 12: Regarding Division notification should the system fail to operate including
the loss of wastewater from the collection system. In addition, note Permit
Condition 13 regarding the posting of pump stations with emergency
contact information.
Permitting of this project does not constitute an acceptance of any part of the project
that does not meet 15A NCAC 2T; the Division of Water Quality's (Division) Gravity Sewer
Minimum Design Criteria adopted February 12, 1996 as applicable; and the Division's Minimum
Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1,
2000 as applicable, unless specifically mentioned herein. Division approval is based on
acceptance of the certification provided by the North Carolina -licensed Professional Engineer
named in the application. It shall be the Permittee's responsibility to ensure that the as -
constructed project meets the appropriate design criteria and rules. Failure to comply may
result in penalties in accordance with North Carolina General Statute § 143-215.6A through
§ 143-215.6C, construction of additional or replacement wastewater collection facilities,
and/or referral of the North Carolina -licensed Professional Engineer to the licensing board.
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of
North Carolina'as amended, and other applicable Laws, Rules, and Regulations, permission is
hereby granted to the Town of Leland for the 'construction and operation of approximately
1,008 linear feet of 8-inch gravity sewer to serve future development in Phase 6 Section 1 as
part of the Brunswick Forest project with no additional discharge of collected wastewater into
the Town of Leland's existing sewerage system, pursuant to the application received
September 15, 2006 and in conformity with 15A NCAC 2T; the Division's Gravity Sewer Minimum
Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design
Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000
as applicable; and other supporting data subsequently filed and approved by the
Department of Environment and Natural Resources and considered a part of this permit.

J
Town of Leland
W Q0028587
Page 3
AND
The continued construction and operation of the sewer infrastructure as described
below and previously permitted In accordance with the provisions of Article 21 of Chapter
143, General Statutes of North Carolina as amended, and other applicable Laws, Rules, and
Regulations and in conformity with 15A NCAC 2T; the Division's Gravity Sewer Minimum Design
Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for
the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as
applicable; and other supporting data subsequently filed and approved by the Department
of Environment and Natural Resources and considered a part of this permit:
May 26, 2006 Modification
Construction and operation of approximately 5,926 linear feet of 8-inch gravity sewer; a 380-
gallon per minute pump station with duplex pumps, on -site audible and visual high water
alarms, telemetry, and on -site generator with automatic transfer switch; as well as
approximately 3,915 (increased from 2,821 feet per modification request) linear feet of 6-inch
force main to serve 149 three -bedroom residences as part of the Jefferson Landing at
Brunswick Forest Phase 2 (aka Phase 1 Section 1-B) project, with no additional discharge (flow
allocated in original permit) of collected domestic wastewater into the Town of Leland's
existing sewerage system, pursuant to the application originally received April 24, 2006 and
subsequent modification request received September 25, 2006.
April 7, 2006 Modification
Construction and operation of approximately 100 linear feet of 8-inch, 793 linear feet of 10-
inch, and 3,830 linear feet of 12-inch gravity sewer to serve as a gravity sewer outfall or
interceptor line for future upstream or tributary sewer systems as part of the Brunswick Forest
Phase 3 project with no additional discharge of collected domestic wastewater into the Town'
of Leland's existing sewerage system, pursuant to the application received February 16, 2006.
March 10, 2006 Modification
Construction and operation of approximately 6,741 linear feet of 8-inch gravity sewer to serve
131 three -bedroom residences as part of the Jefferson Landing at Brunswick Forest (aka Phase
1 Section 1-A) project with no additional discharge of collected domestic wastewater into the
Town of Leland's existing sewerage system, pursuant to the application received February 14,
2006.
July 21, 2005 Modification
Construction and operation of approximately 25 linear feet of 8-inch and 3,290 linear feet of
12-inch gravity sewer to serve as a gravity sewer outfall 'or interceptor line for future
development upstream of the previously approved sewer listed below as part of the Brunswick
Forest Phase 2 project, and with no additional discharge of collected wastewater into the
Town of Leland's existing sewerage system, pursuant to the application received June 15,
2005.

i
Town of Leland
WQ0028587 `
Page 4
March 24, 2005 Original Permit
Construction and operation of approximately 868 linear feet of 8-inch, 3,414 linear feet of 10-
inch, and 3,141 linear feet of 12-inch gravity sewer; a 1500-gallon per minute pump "station
with duplex pumps, on -site audible and visual high water alarms, telemetry/a.uto dialer, and
on -site generator with automatic transfer switch; as well as approximately 20,650 linear feet of
10-inch force main to serve 300 three -bedroom homes (108,000 gpd), a 100,000 ft2 shopping
center with a grocery store (12,000 gpd), a two-story restaurant with 10,000 ft2 of dining area
(26,700 gpd), and a 30,000 ft2 office building (3,000 gpd) as part of the Brunswick Forest Phase
1 project, and the total discharge of 149,700 gallons per day of collected domestic
wastewater into the Town of Leland's existing sewerage system, pursuant to the application
received March 11, 2005.
The sewage and wastewater collected by this system shall be treated in the Northeast
Brunswick Regional Wastewater Treatment Facility (Permit No. NC0086819) prior to being
discharged into the receiving stream.
This permit shall become voidable unless the agreement between the Town of Leland
and Brunswick County for the collection and final treatment of wastewater is in full force and
effect.
A stormwater management plan shall be submitted to and approved by the
Wilmington Regional Office in accordance with 15A NCAC 2H .1000.
If any parts, requirements, or limitations contained in this permit are unacceptable, you
have the right to request an adjudicatory hearing upon written request within 30 days
following receipt of this permit. - This request must, be in the form of a' written petition,
conforming to Chapter 150B of North Carolina General Statutes, and filed with the Office of
Administrative Hearings, 6714 Mail Service Center, Raleigh, NC 27699-6714. Unless such
demands are made, this permit shall be final and binding.
If you need additional information concerning this matter, please contact Dean
Hunkele at [phone].
,r�
Sir�erely,
for Alan W. Klimek, P.E.
Cc: Jeff Malpass, Malpass Engineering
Tim Evans, Town of Leland Building Inspections Department
Jerry Pierce, Brunswick County Public Utilities
WIRO uS rfac.e Lahr Prote,ian _NEBr-uns_wicK: egional-(NG008681-9) Sewer-(NCF�Le�
Central Files, Surface Water Protection Section
,Pretreatment, Emergency Response and Collection Systems Unit Files

7
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
This permit shall be effective from the date of issuance until rescinded and shall be subject to
the following specified conditions and limitations:
This permit shall become voidable unless the wastewater collection facilities are
constructed in accordance with the conditions of this permit; 15A NCAC 2T; the Division of
Water Quality's (Division) Gravity Sewer Minimum Design Criteria adopted February 12,
1996 as applicable; the` Division's Minimum Design 'Criteria for the Fast -Track Permitting of
Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting
materials unless specifically mentioned herein.
2. This permit shall be effective only with respect to the nature and volume of wastes
described in the application and other supporting data.
3. The wastewater collection facilities shall be properly maintained and operated at all times.
The Permittee shall maintain compliance with an individual system -wide collection system
permit for the operation and maintenance of these facilities as required by 15A NCAC 2T
.0403. If an individual permit is not required, the following performance criteria shall be met
as provided in 15A NCAC 2T .0403:
a. The sewer system shall be effectively maintained and operated at all times to prevent
discharge to land or surface waters, and any contravention of the groundwater
standards in 15A NCAC 2L .0200 or the surface water standards in 15A NCAC 2B .0200.
b. A map of the sewer system shall be developed and shall be actively maintained
c. An operation and maintenance plan including pump station, inspection frequency,
preventative maintenance schedule, spare parts inventory, and overflow response
shall be developed and implemented.
d. Pump stations that are not connected to a telemetry system (i.e. remote alarm
system) shall be inspected by the Permittee or its representative every day (i.e. 365
days per year). Pump stations that are connected to a telemetry system shall be
inspected at least once per week.
e. High -priority sewer lines shall be inspected by the Permittee or its representative at
least once per every six-month period of time.
f. A general observation of the entire sewer system shall be conducted by the Permittee
or its representative at least once per year.
g. Overflows and bypasses shall be reported to the appropriate Division regional office in
accordance with 15A NCAC 2B .0506(a), and public notice shall be provided as
required by North Carolina General Statute § 143-215.1 C.

h. A Grease Control' Plan shall be implemented as follows:
For publicly owned collection systems, the Program shall .include at least bi-annual
distribution of educational materials for both commercial and residential users and the
legal means to require grease interceptors for new construction and retrofit, if necessary, of
grease interceptors at existing establishments. The Program shall also include legal means
for inspections of the grease interceptors, enforcement for violators, and the legal means
to control grease entering the system from other public or private satellite sewer systems.
2. For privately owned collection systems, the Program shall include at least bi-annual
distribution of educational materials to all users of the collection system by the Permittee or
its representative.
3. Grease education materials shall be distributed more often than required in Parts 1 or 2 of
this sub -paragraph if necessary to prevent grease -related sanitary sewer overflows.
Right-of-ways and easements shall be maintained in the full easement width for
personnel and equipment accessibility.
Documentation shall be kept on file for Sections (a.) through (i.) of this rule ,for a
minimum of three (3) years with the exception of the map, which shall be maintained
for the life of the system.
4. This permit shall not be transferable. In the event there is a desire for the wastewater
collection facilities to change ownership, or there is a name change of the Permittee, a
formal permit request shall be submitted to the Division accompanied by documentation
from the parties involved, and other supporting materials as may be appropriate. The
approval of this request shall be considered on its merits and may or may not be
approved.
5. Construction of the gravity sewers, pump stations, and force mains shall be scheduled so
as not to interrupt service by the existing utilities nor result in an overflow or bypass
discharge of wastewater to the,surface waters of the State.
6. Per 15A NCAC 2T .01 16, upon completion of construction and prior to operation of these
permitted facilities, the completed Engineering Certification form attached to this permit
shall be submitted with the required supporting documents (as -built or_ recording drawings
and pump station designs, if applicable) to the address provided on the form. A
complete certification is one where the form is fully executed and the supporting
documents are provided as applicable. If the permit is Issued to a private entity with an
Operational Agreement, then a copy of the Articles of Incorporation, Declarations, and
Bylaws that have been appropriately filed shall be submitted with the certification.
7. A copy of the construction record drawings and pump station designs, if applicable, shall
be maintained on file by the Permittee for the life of the wastewater collection facilities.
8. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 2T;
the Division's Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the
Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Station and Force
Mains adopted June 1, 2000 as applicable; and other supporting materials may subject
the Permittee to an enforcement action by the Division, in accordance with North
Carolina General Statutes § 1-43-215.6A through § 143-215.6C.

9. Gravity sewers'installed greater than ten percent below the minimum required slope per
the Division's Gravity Sewer Minimum Design Criteria shall not be acceptable and shall not
be certified until corrected. If there is an unforeseen obstacle in the field where all viable
solutions have been examined, a slope variance can be requested from the Division with
firm supporting documentation. This shall be done through a permit modification with fee.
Such variance requests will be evaluated on a case -by -case basis. Resolution of such
request shall be evident prior to completing and submitting the construction certification.
10. In the event that the wastewater collection facilities fail to perform satisfactorily, including
the creation of nuisance conditions, the Permittee shall take immediate corrective action,
including those as may be required by this Division, such as the construction of additional
or replacement facilities.
11. The issuance of this permit shall not exempt the Permittee from complying with any and all
statutes, rules, regulations, or ordinances that may be imposed by other government
agencies (local, state and federal) which have jurisdiction, including 'but not limited to
applicable river buffer rules in. 15A NCAC 2B .0200, erosion and sedimentation control
requirements in 15A NCAC Ch. 4 and under the Division's General Permit NCGO10000, and
any requirements pertaining to wetlands under 15A NCAC 2B .0200 and 15A NCAC 2H
.0500. '
12. Noncompliance Notification:
The Permittee shall verbally report to a Division of Water Quality staff member at the
Wilmington Regional Office, telephone number [phone], as soon as possible, but in
no case more than 24 hours or on the next working day, following the occurrence or first
knowledge of the occurrence of either of the following:
a. Any process .unit failure, due to known or unknown reasons, that renders the facility incapable of
adequate wastewater transport, such as mechanical or electrical failures of , pumps, line
blockage or breakage, etc.; or
b. Any failure of a pumping station or sewer line resulting in a by-pass directly to receiving waters
without treatment of all or any portion of the influent to such station or facility.
Voice mail messages or faxed information is permissible, but shall not be considered as the
initial verbal report. Overflows and spills occurring outside normal business hours may also
be reported, to the Division of Emergency Management at telephone number (800) 858-
0368 or [phone]. Persons reporting any of the above occurrences shall file a spill
report by completing Part I of Form CS-SSO (or the most current Division approved form),
within five days following first knowledge of the occurrence. This report shall outline the
actions taken or proposed to ensure that the problem does not recur. Part II of Form CS-
SSO (or the most current Division approved form) can also be completed to show that the
SSO was beyond control. '
13. Each pump station including simplex stations shall be clearly and conspicuously posted
- with the telephone number and name of the owner/operator of the sewer system and
instructions to call the number in the event of alarm activation.

14. The Permittee shall provide for the pump station and force main the following items:
a. Pump on/off elevations located so that 2-8 pumping cycles may be achieved per hour in
the pump station,
b. An air relief valve located at all high points along the force main,
C. A screened vent for the wetwell,
d. Fillets located in the wetwell at the intersection of the flooring and sidewalls,
e. Three feet of cover (minimum) over the force main or the use of ferrous material where
three feet cannot be maintained,
f. Sufficient devices which will protect the pump station from vandals, and
g. Flood protection if the pump station is located below the 100-year flood elevation.
Permit issued this day: November 3, 2006
NORTH CA LINA ENVIRONMENTAL MANAGEMENT COMMISSION
for Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0028587
a

Fast Track Engineering Certification i
PERMIT NO. WQ0028587
Jefferson Landing at Brunswick Forest Phase 2 (aka Phase 1 Section 1-B)
November 3, 2006
Brunswick County
CERTIFICATION: This project shall not be considered complete nor allowed to operate until the Division has
received this Engineer's Certification and all required supporting documentation. Consequently, the PERMITTEE
should submit this certification in a manner that documents proof -of -receipt by the Division.
Complete and submit this unmodified form to the permit issuing regional office with the following:
• One originally sealed/signed set of the project record drawings (plan & profile views of sewer lines & force
mains) of the wastewater collection system extension. Record drawings are defined as the design drawings
that are marked up or annotated with after construction information and show required buffers, separation
distances, material changes, and other utilities including water lines, stormwater systems, etc.
One originally sealed/signed set of the supporting pump station design calculations (selected pumps, system
curve, operating point, buoyancy calculations, available storage if portable generator(s) or storage greater
than longest past three year outage reliability option selected) for any pump stations permitted under this
permit
• Changes to the project that do not result in non-compliance with this permit, regulations, or the minimum
design criteria should be clearly identified on the record drawings, on this certification in the space provided,
or in written summary form.
PRIOR TO CERTIFICATION (FINAL OR PARTIAL): Permit modifications are required for any changes resulting in non-
compliance with this permit (including total pipe length increase of 10% or greater, increased flow, or increases in
the number/type of connections), regulations, or the minimum design criteria. Requested modifications or
variances to the minimum design criteria will be reviewed on a case -by -case basis and each on its own merit.
Please note that variances to the minimum design criteria should be requested and approved during the
permitting process prior to construction. After -construction requests are discouraged by. the Division and may not
be approved, thus requiring replacement or repair prior to certification & activation.
ENGINEERS CERTIFICATION
❑ Final ❑ Partial
Comments:
I, . , as a duly registered Professional Engineer in the State of North Carolina, having
been authorized to observe (❑ periodically, ❑ weekly, ❑ full time) the construction of the project name and location
as referenced above for the Permittee hereby state that, to the best of my abilities, due care and diligence was
used in the observation of the construction such that the construction was observed to be built within substantial
compliance of this permit; 15A NCAC 2T; the Division of Water Quality's (Division) Gravity Sewer Minimum
Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -
Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting
materials.
North Carolina Professional Engineer's Seal w/signature & date
.......................... ......
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
REGIONAL SUPERVISOR
SURFACE WATER PROTECTION SECTION
DIVISION OF WATER QUALITY
WILMINGTON REGIONAL OFFICE
127 CARDINAL DRIVE EXTENSION
....................................................... WILMINGTON, NC 28405-3845
The PERMITTEE is responsible for tracking all partial certifications up until a final certification is received. A final certification
shall be a complete set of record drawings and design calculations regardless of whether partials have been submitted. Any
wastewater flow made tributary to the wastewater collection system extension prior to completion of this Engineer's
Certification shall be considered a violation of the permit and shall subject the Permittee to appropriate enforcement actions.

FAST -TRACK APPLICATION for GRAVITY SFWEkS; PUMP STATIONS, AND FORCE MAINS PAGE 3
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD!
Application Number: / ��, ,_ . 4
(to be completed by DWQ)/��,�j t _s
9.
la.
Owner.' -
Tpwi o- L 9.1ohd
Full Legal Name (company, municipality, HOA, utility, etc.)
Z
OSigning
1 b.
_ Wil' i (jm r4rpis In �eri� Tow NI r .
Official Name Ind Title (Please review 15A NCAC 2H .0206(b) for authorized signing officials!)
g
1 c.
The legal entity who will own this system is:
El Individual [I Federal Q"Municipality,0 State/County ❑ Private
Partnership ❑ Corporation ❑ Other (specify):
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1 d.
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102 wn
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Mailing Address
City ;
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Noo-�h C dro Tina
State
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Zip Code
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910-3%l-d I yQ 1i. qlb-371-1073
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2.
Project (Facility) Information:
J
2a.
T;reS} p65'd Sed;on I
-2b. BrKnSw�ck
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Brief Project Name (permit will refer to this name)
County Where Project is Located
Q
3.
Contact Person:
Q
3a.
J4r W J%P44 f
-
About this Application
Name arfd Affiliation of Someone Who Can Answer Questions
3b.
gl'0'-3g242i3.
3c. ,e9ma1p0Ab;zea,r►, com
Phone Number
1.
Project is ❑ New Modification (of an existing permit).
If Modification, Permit No.:
For modifications, attach a separate sheet clearly explaining
the reason for the modification (i.e. adding another
phase, changing line size/length, etc.). Only Include the modified
information in this permit application - do not
duplicate project information in B(7) and B(10-11) that has already been included in the original permit.
2.
Owner is Public (skip to Item B(3)) ❑ Private (go to Item 2(a)) _
2a.
If private, applicant will be: �— --
2b. If sold, facilities owned by a (must choose one
❑ Retaining Ownership (i.e. store, church, single office, etc.) or ❑ Public Utility (Instruction III)
Z ❑ Leasing units (lots, townhomes, etc. - skip to Item B(3)) El Homeowner Assoc./Developer (Instruction IV)
0 ❑ Selling units (lots, townhomes, etc. - go to Item B(2b))
c s� C
Q Owner of Wastewatee Treatment Facility (WWTF) Treating Wastewater From This Project
4a. �orrne�ts�- vPUllSw�ck RQQionul U/ rF... - - 4b. JUC00B68t�
Name of WWTF WWTF Permit No.
IL 5a. _Awn of LelAna 5b. Ix - I[�Gravity i5c.
Z Owner of Downstream Sewer Receiving Sewer Size i❑ Force Main Permit Number of Downstream Sewer (if known)
f— 6. The origin of this wastewater is (check all that apply): - -- _ _ _ .• -_ . _ __ . ___ __.
Q Residential Subdivision ❑ Car Wash
fY ❑ Apartments/Condominiums ❑ Institution t'Qo % Domestic/Commercial
W ❑ Mobile Home Park ❑ Hospital
(L ❑ School ❑ Church % Industrial
❑ Restaurant ❑ Nursing Home % Other (specify):
❑ Office ❑ Other (specify):
7 w�i, ,. . of waeto-wat2r to be allocated for this particular project. gallons per day
`Do not include previously permitted allocations
8. If the permitted flow is zero, indicate why: AfA
❑ Interceptor Line - Flow will be permitted in subseauent permits that connect to this line
Flow has already been allocated in Permit No.
❑ Rehabilitation or replacement of existing sewer with no new flow expected

FAST -TRACK APPLICATION for GRAVITY SEWEkS,.PUNIP STATIONS, AND FORCE MAINS PAGE 4
9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2H 1
.0219(I) for Item B(7) or the design flow for line or pump station sizing if zero flow in the space below. Values other than .
that in 15A NCAC 2H .0219(1)(1-2) must be supported with actual water or wastewater use data in accordance with 15A
NCAC 2H .0219(1)(3).
4 X 3 b�IP x 120 r5 �G PD
`�vs
I � 1� be��► I
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Length (feet) Gravity or Force Main
Size (inches) (use the pull down menu)
011
w i
z
Z ENTER TOTAL LINE LENGTH IN MILES 1,87
0 11. Summary of Pump Stations to be Permitted (attach additional sheets as necessary)
Z Location ID Power Reliability Option
0 (self chosen - as shown on Design Flow' Operational Point (1- dual line feed; 2- permanent generator WATS, 3-
B plans for cross-reference) (MGD). GPM @ TDH portable generator w/telemetry; 4-wet well storage) !
0� 27 390
O
LL
;Z
F- 12. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Forcel
Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H .0200 as applicable?
LLI 9Yes ❑ No If no, please reference the pertinent minimum design criteria or regulation and indicate why a
a variance is requested. SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS
PERTINENT TO THE VARIANCE WITH'YOUR APPLICATION
i
i
i
13. Have the following permits/certifications been submitted for approval?
Wetland/Stream Crossings - General Permit or401 Certification? ❑ Yes ❑ No ErN/A•
Sedimedtation and Erosion Control Plan? Yes ❑ No ❑ N/A
Stormwater? [Yes ❑ No ❑ N/A
14. Does�this project involve aerial lines or siphons? Check if yes: ❑
These lines will be considered hiah oriorlty and must be checked once every six months
15. Does this project have gravity sewer lines designed at minimum slopes? ❑ I
Be aware that the Division will not accept installed lines more than 10% flatterthan the minimum slope. Lines installed outside this tolerance should be
corrected prior to submitting the final engineering certification-

FAST -TRACK APPLICATION for GRAVITY SEWER4, PUMP STATIONS, AND FORCE MAINS PAGE 5
1. Use the Division's guidance document entitled, DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02103 1
(FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach additional sheets asj
necessary). This document is available from our web site or by contacting the appropriate Division of Water Quality •.
Z regional office (see instructions for addresses) OR indicate the following:
0 A Stteam Classification is not needed because all parts of the project are at least 100 feet away from any down slope
Qwaterbody; AND, I
() &v A Stream Classification is not needed because the design does not depend on wet well storage'as a power reliability j
option for any pump station near a Class C down slope waterbody.
Location ID on Map i
N (self chosen - as shown on Name of Waterbody Stream Waterbody ;
Jmap for cross-reference) Waterbody. County ff River Basin Index Classification
U �4allor�k UI`thh5hncbC Capp rearlJJ
!S -78 C� rjar
a
Submit the 8.5" x 11" COLOR topographic map as required in Instruction VI
regardless of whether a classification is provided! _!
1.� Applicant's Certification: I
�I �n
1 [✓1f� /t-►�� %'r'' ,,S attest that this application for BrtAnsw ck FoNs+ Phased 5eciien I B
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. Note: In accordance with North Carolina
General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or;•
certificatio ' in any application shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed $10,000
as II a civil penalti up to $25,000 per violation. j
L2
W
Signing Official Signature gate f
2. Professional Engineer's Certification:
1 attest that this application for BryrK" Rf%+ fWe I SeLHon I � has been reviewed by me and is accurate, complete i
and consistent with the information in the engineering plans, 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 adopted February i
12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June
1, 2000 and the watershed classification in accordance with Division guidance. Although certain portions of this submittal
package may have been developed by other professionals, 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 NC General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement,
representation, or certification in any application 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.
2a. Jp-*ev &yA /walpvs
Professional Engineer Name 4oe
2b.gasS��Aee�`Hd
Engineering Firm
2c. II3� Sh:Pyar� 91vd i
Mailing Address ;
2d. waminihh 2e. N6 2f. 2$4I2 °
City State Zip°6
2g. 1I0-392-5L43 2h. qI0-392-52-03 2i. iaff malpgs, Obit c.rr.cm
Telephone Facsimile -mail

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http://www.topozone.com/pnnt.asp?lat--34.19755&lon=-78.03217&s=100&size=l&u=4&layer--DRG25... 9/25/2006