WQ0041298_Application (FTSE)_20191112

State of North Carolina
DWR 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: I. ) d UOlA1" no be completed by DWR)
All Items must be completed or the application will be returned
1. APPLICANT INFORMATION:
I. Applicant's name: Town of Elon (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State/County ® Municipal
3. Signature authority's name: Robert Morgan per 15A NCAC 02T .0106tb1
Title: Interim Town Manager
4. Applicant's mailing address: 104 S. Williamson Ave
City: Elon State: NC Zip: 24244-
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail]
❑ Privately -Owned Public Utility
❑ Other
NC Department of
Environmental Quality
Received
NOV 12 2019
Winston-Salem
Regional Office
It. PROJECT INFORMATION:
I. Project name: Shallowford
2. Application/Project status: ® 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: W000_
3. County where project is located: Alamance
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.1155' Longitude:-79.50430
5. Parcel ID (if applicable): _
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Jay Matev License Number: 039577
Firm: Timmons Group
Mailing address: 9642 W. Market St.. Suite 136
City: Greensboro State: NC Zip: 27409-_
Phone number: [phone] Email Address: itty mateyrPtimmons.cont
IV. WASTEWATER TREATMENT FACILITY (W WTF) INFORMATION:
I. Facility Name: Burlington East Plant Permit Number: N00023868
Owner Name: City of Burlington
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ_ Downstream (Receiving) Sewer Size: 8 inch
Sstem Wide Collection System Collection Stem Permit Number(s) (if applicable): WQCS00226
Owner Name(s): Town of Eton
FORM: FTA 04-16 Page I of 5

VI. GENERAL REQUIREMENTS
I. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Puhlic 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 (FORNh DEV) been attached'?
❑ Yes ❑No ®N/A
3. If the Applicant is a Ilome/Pronerty Owners' Association has an Operational Aereentent (FORM' HOAI 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. Hasa Flow reduction been approved under 15A NCAC 02T .0114(D? ❑ Yes ®No
➢ If yes, provide a cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114M)
Daily Design Flow °,b
No. of Units
Flow
4-Bedroom Dwelling Unit
480 gal/unit
20
.9,600 GPD
3-Bedroom Dwelling Unit
360 gal/unit
25
9.000 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
18,600 T71
a See 15A NCAC 02T .01 1416). (d), (e)(1) and (0)(2) for caveats to wastewater design now 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
inG S. 42A-4).
b Per 15A NCAC 02T .0114(c), design Flow rates for establishments not identified [in table ISA NCAC 02T.0I 14] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project 18 600 GPD (per 15A NCAC o2T .0114)
y Do not include future flows or previously permitted allocations
If permitted now is zero, indicate why:
❑ Pump Station or Gravity Sewer where now 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: FfA 04-16 Page 2 of 5

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 021' .0305 & ND(' (Gravih Sewers):
Summarize gravity sewer to be permitted:
I�Size (inches)
Length (feet)
Material
I g
I,R40
Class 50 Ductile It
II R
535
PVC I
I
�
> Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
'> Section ITT 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
Vill. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .113115 & NIDC (Pum) Stations/Force Mains):
COMPLETE. FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
I. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: 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) FLength (feet) Material
6. Power reliability in accordance with I5A NCAC 02T 03051h)(1 ):
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(I)(B):
Y Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
Y 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):
Y 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.
Y Tf 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: ETA OJ-16 Page 3 of 5

IX. SETBACKS& SEPARATIONS — (02B.0200 &I SA NCACO2T.0305(f)):
I. Does the project comply with all separations found in 15A NCAC 02T .0305(1) & 0Z) ® Yes ❑ No
D 15A NCAC 02T.0305(I) contains minimum separations that shall be provided for sewers stems:
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)
IS 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 If impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water or tide elevation and wetlands see item IX.2)
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
10 feet
Top sloe of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Anv swimminR pools
10 feet
Final earth grade (vertical)
36 inches
➢ 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(t) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water ('lassilicatiuns webpec
D If noncompliance with 02T.03050) 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 02R .0200't ® Yes ❑ No ❑ N/A
➢ This would include Trout Buffered Streams per 15A NCAC 28.0202
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.0 I 05tc)(6) (additional permits/certifications)? ® Yes ❑ No
Per ISA 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 streambmnks 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

X. CERTIFICATIONS:
I. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitling of Punnr Stations
and Force Mains /latest version). and the CirnvitySewer Alinin uin Design Criteria! latest version) as applicable'?
® Yes ❑ No
if No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the renuest is required prior to submittal of the Fast Trnek Application and supporting documents.
2. Professional Engineer's Certification:
Jay Matey attest that this application for
(Professional Engineer's name from Application Item ITi.1.)
has been reviewed by me and is acemate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supponing 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. Applicant's Certification per 15A NCAC 02T .0106(b):
(Signature Aulhorfly's name & title from Application Item 1.3.)
tQ
I SEAL
039577
;�y�,FNQIN�
,''••�` SCO'fC
10/16/2019
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 $25,000 per violation.
Signature: cAZ 22 ftgyz--[, _ Date:
FORM: FTA 04-16 Page 5 of 5

State of North Carolina
" Department of Environment and Natural Resources
Division of Water Resources
1)i" i:,,, >F 1k arar Re+ .ui ..e_ Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE 10-18)
Enity Requesting Allocation City of Burlington
Project Name for which flow is being requested: Shallowford Phase 1 and 2
More than one t ,,4E-10/07 maybe required for a single project if the owner of the {VIVTP is not responsible for all pump stations
along the route of the proposed wastewater flow.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: East Burlington WWTP
b. WWTP Facility Permit #: NC 0023868
All flows are in
GPD
c. WWTP facility's permitted flow
12,000,000
d. Estimated obligated flow not yet tributary to the WWTP
1,950,633
e. WWTP facility's actual avg. flow
5,302,000
f. Total flow for this specific request (18,600) Elan Allocation
0
g. Total actual and obligated flows to the facility
7,252,633
h. Percent of permitted flow used
60.4%
11. 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: None
(A)
(B)
(C)
(D)=(B+C)
(E)=(A-D)
Obligated,
Total
Design
Approx.
Not Yet
Current Flow
Firm
Average Daily
Current Avg.
Tributary
Plus
Pump Station Capacity, '
Flow"
Daily Flow,
Daily Flow,
Obligated
Available
Name GPD
(Firm/pf), GPD
GPD
GPD
Flow
Capacity***
Dry Creek 4,000,000
1,600.000
582,428
0
582,428
1,017,572
* 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 WWTP where the Available Capacitys 0.
Downstream Facility Name (Sewer) : Dry Creek Interceptor
Downstream Permit Number: Not Known
Page 1 of 2 FTSE 10.18

Certification Statement:
I, W. Todd Lambert, P.F. certify to the best of my knowledge that the addition of the
VC, lume 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 11 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 Official
la
Date
Page 2 of 2 FTSE 10-18

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Town of Elon
Project Name for which flow is being requested: Shallowford Phase 1 and 2
More than one FTSE ntay be required for a single project if the owner of the WWTP is not responsible for all pantp
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: Town of Elon Collection System
b. WWTP Facility Permit #: WQCS00226
All flows are in MGD
c. WWTP facility's permitted flow 0.900 Eton EastAlloc
d. Estimated obligated flow not yet tributary to the WWTP 0.00792 ElonEastAll
e. WWTP facility's actual avg. flow 0.245 ElonEastAlloc
f Total flow for this specific request 0.0186 ElonEastAlloc
g. Total actual and obligated flows to the facility 0.272 ElonEastAlloc
It. Percent of permitted flow used 30.2%
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 Pump Average Approx.
Not Yet Total Current
Station Station Firm Daily Flow** Current
Tributary Flow Plus
(Name or Permit Capacity, * (Firm / po, Avg. Daily
Daily Flow, Obligated
Available
Number) No. MGD MGD Flow, MGD
MGD Flow
Capacity***
No Elon Pump Stations are downstream of this project.
* The Firm Capacity (design flow) of any pump station is defined as the maximum pumped flow
that can be achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor
(pf) not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Avaflable Capacity is <0.
Downstream Facility Name (Sewer): Stadium Outfall
Downstream Permit Number:
Page 1 of 6
FTSE 10-I8

III. Certification Statement:
I k o'Z�DeN 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 certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
Jr-5-N
Signature i" Date
�,vleriov9 TGVRJ /ylfFui¢GE�
Title of Signing Official
Page 2 of 6
FTSE 10-18

Elon FTSE Accounting Form - East Plant
Fiscal Year 2018-2019 Flows
Existing Flows
0.245
Total Flow
0.245
Allocated Flows - Non -Tributary
Cable Square
0.00432
Forrest Creek
0.0036
Total Allocated - Non Tributary Flows
0.00792
Proposed Flows
Shallowford - Phase 1 and 2
0.0186
Total Flows
0.272
Permitted Flows
0.900
Percentage of Permitted Flow 1
30.2%

•�0000
NC Department of
Environmental Quality
Received
TIMMONS GROUP NOV 12 2019
YOUR VISION ACHIEVED THROUGH OURS.
Winston-Salem
Regional Office
COVER LETTER
TO: Water Resources — Wastewater Permitting Date: 11/11/19 Job #: 42565
NCDEQ — Winston Salem Regional Office Project: Shallowford — Phase 1
450 Hanes Mill Rd., Suite 300 Reference:
Winston-Salem, NC 27105 Copies Sent To:
® ENCLOSED PLEASE FIND:
❑ WE ARE SENDING UNDER SEPARATE COVER: See below
COPIES
DATE
NUMBER
DESCRIPTION
1
$480 Application fee
2
Set of plans
2
FTA 04-16 Fast Track Sewer Extension Application
2
FTSE 10-18 Flow Tracking Form
1
Street Map Exhibit
1
USGS Map Exhibit
THESE ITEMS ARE TRANSMITTED:
If enclosures are not as noted, please notify us at once.
COMMENTS:
Attached is the extension permit application for the public sanitary sewer system serving the Shallowford
Phase 1 project. We are proposing a public wastewater collection system to serve forty-five (45) single
family lots. The public mains will discharge to the Town of Elon's public sanitary sewer system with a
doghouse manhole. Please let me know if you have any questions.
Thanks!
SIGNED: XY' �'` F.V�
Jay N46tey, P.E., Group Leader
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