WQ0041209_Application (FTSE)_20190925

Fleming Engineering, Inc.
Consulting Engineers & Land Surveyors
AL MEMO
aDN � 201
Salem Regional Office From: Ravindra Bissram, PE
uality Section
[anes Mill Road
Salem, NC 27105
-9800
5 Date: September 23, 2019
Valley Fast Track Sewer System Extension Application
x Please Comment Please Reply Please Recycle
To Whom it may Concern:
Attached is the submittal package for the Fast Track Application on Shamrock Valley, Phase 3. A total of 27 single
family lots, townhomes, and detached townhomes will be constructed in this phase.
For your review is the following:
1. (1) Original Application FTA 04-16
2.. (1) Copy for FTA 04-16
3. (1) Cover Letter
4. (1) Application fee of $480
5. (1) Flow Tracking/Acceptance Form
6. (1) USGS Site Map
7. (1) Street level map
Please let me know if there are any questions, concerns or additional information required.
Thanks,
Ravindra Bissram, PE
Fleming Engineering, Inc. NC Deroartinent of
Environrnenr:al Quality
Consulting Engineers and Land Surveyors Received
8518 Triad Drive
Colfax, NC 27235 5EP % J 20'N
336-544-6426
www.Flemiitk,Eiiaitieerinjz.com Winston-Salem
Regional OrNee
8518 Triad Drive, Colfax, NC 27235 Phone: [phone] Fax: [phone]

State of North Carolina
Department of Environmental Quality
Division of Water Resources
QW
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
"Divlslon of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number 0 -0Oii (to be completed byDWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: City of Graham (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State/County ® Municipal
3. Signature authority's name: Frankie Maness per 15A NCAC 02T .0106(b)
Title: City Manager
4. Applicant's mailing address: 201 South Main Street
City: Graham State: NC Zip: 27253-_
5. Applicant's contact information:
Phone number: 336 510-6700 Email Address:
11, PROJECT INFORMATION:
❑ Privately -Owned Public Utility
❑ Other
rr,211 e It of
Lnvlronmeirtal Qui-lity
Rece,red
SEA' 2 5 2019
Winston Salen,i
Regional Offlice
L Project name: Shamrock Valley, Phase 3
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Projcot
If a modification, provide the existing permit number: W000_ and issued data: _
If new construction but part of a master plan, provide the existing permit number: W000_
3. County where project is located: Alamance
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.02'24° Longitude: - 97 25,42°
5. Parcel ID (if applicable):
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Ravindra Bissram License Number: 027436
Finn: Fleming Engineering
Mailing address: 8518 Triad Drive
City: Colfax State: NC Zip: 27235
Phone number: [phone] Email Address: rbissram(&.flemingengineerine.com
IV. WASTE- WATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: South BurlinetonWWTF Permit Number:N00023876
Owner Name: City of Burlington
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. PermitNumber(s): WQ_ Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Numbers) (if applicable): WQCS_
Owner Name(s): City of Graham
FORM: FTA 04-16 Page I 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?
[:]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?
❑ Yes ❑No ®N/A
3. If the Applicant is a Home/Property Owners' Association has an Operational Agreement (FORM: BOA I 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))
L-->Is there a Pretreatment Program in effect? ❑ Yes ®No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(0 ❑ Yes ®No
➢ If yes provide a copy of flow reduction approval letter
Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow ° °
No. of Units
Flow
Single Family/Multi-Family
360 gal/day
27
9720 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
9720 GPD
See 15A NCAC 0210114(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).
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: 9720 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

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity. Sewersl:
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 1129 PVC
g 290 DIP
➢ 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
VIR. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Puma Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: NA
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: -
3. Design flow of the pump station: J millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): —gallons per minute at_ feet total dynamic head (TD14)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
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(b)(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(f) & (a)
... .... ,...,... __ ___:_:—...... _.....,-ak:,..,., that shell be "l—ided fnr eewel' 9Vdema:
® Yes ❑ No
➢ 0A Nl:AC UZ1.0305 r cuumuis wuuu.um se a --- - -- -- -
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, W S-i waters of Class I or
Class Il impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-1 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
An 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 ode vertical
36 inches
➢ 15A NCAC 02T.0305(e) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webnaee
➢ if noncompliance with 02T 0305(f) 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
➢ Seethe 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 Buffeted Streams per 15A NCAC 2B.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(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T 0I05(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 sheambanks 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 shag 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

X. CERTIFICATIONS:
I: Does the submitted system comply with 15A NCAC 02T, the Mh
and Force Mains (latest version), and the Gravity SeNverMinintuni
N Yes ❑ No
If No, complete and submit the Variance/Alternative Design
for review. Approval of the request: is renuireil prior t
documents.
2. Professional Engineer's Certification:
as
application (VADC 10-14) and supporting documents
that this application for
(Professional Eiigineer's name from Application Item
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 ofthese materials undermy 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, env
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(4'
k,,c j' A w «g G J /'74 k ♦ cs attest that this application for
(Signature Author* 's name & ti(la from Applica ion Item 1.3.)
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 $25,000 per violation.
Signature: _ Date:
FORM: FTA 04-16 Page 5 of 5

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
DIVI'ion <,r Ma", nv%ot,r. v, Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE 10-18)
Enity Requesting Allocation City of Graham
Project Name for which flow is being requested: Shamrock Valley, Phase 3
More than one ME40/07 maybe required jar a single project if the owner of the WWTP is not responsible for al! pump
stations alone 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: South Burlington W WTP
b. WWTP Facility Permit #: NCO023876
All flows are in GPD
c. WWTP facility's permitted flow 12,000,000
d. Estimated obligated flow not yet tributary to the WWTP 1,617,923
e. WWTP facility's actual avg. flow 9,065,000
f. Total flow for this specific request (9,720) Graham
g. Total actual and obligated flows to the facility 10,682,923
h. Percent of permitted flow used 89.0%
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,
Average Daily Approx. Not Yet Total Current
Pump Station Firm Flow`* Current Avg. Tributary Flow Plus
(Name or Capacity, ` (Firm/pf), Daily Flow, Daily Flow, Obligated Available
Number) GPD GPD GPD GPD Flow Capacity'**
NONE
* 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 pumpstation 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 W WTP where the Available
Capacity5 0.
Downstream Facility Name (Sewer) : Great Alemance creek Gutfali section 1
Downstream Permit Number: WQ0018327
1 of 2 FTSE 10.18

M
Ill. Certification Statement:
1, W. Todd Lambert, P.E. certify to the best of my knowledge that the addition of the
vo ume 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 asssessment 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
City Engineer
Title of Signing Ojficial
Date
2of2
FTSE 10-18

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