WQ0041294_Application (FTSE)_20191113

November 6, 2019
North Carolina Dept. of Environment Quality
Division of Water Resources
Water Quality Section
Asheville Regional Office
2090 US Hwy 70
Swannanoa, NC 28778
RE: Tate House Sanitary Sewer Improvements
Tuckaseigee Water and Sewer Authority
Cashiers, NC
SUBJECT: FTA PROJECT NARRATIVE
Dear Sir or Madam:
Stiliwel I Eng ineering. net
1
NOV 0 7 2019
Waler Gualily Regional Operations
Asheville Regional Office
The above referenced project is forthe permitting of a 2 inch diameter sanitary sewer force main to
serve an existing development that will be expanded. The force main is located on North Carolina Dept.
of Transportation Right of Way and therefore must be permitted by a municipality. Permitted flow for
this application is 0. The flow for the development will be applied for in a subsequent permit application
for the oonsite sewer lift station and collection sewer system which will be privately owned.
Included in this submittal are the following:
a. Application(FTA 4-16)
b. Application Fee
c. Form FTSE 4-16
d. 8-1/2" x 11" USGS topographical vicinity map
e. Street map
If you have any questions, please contact me at your convenience.
Sincerely,
L't. j, O`�`--1-'
a
W. Alec Stillwell, P.E.
Cc: Mr. Dan Schaeffer, Interim Executive Director TWSA
Attachments
Marsh Lily Drive Ph: 828.586.6066 PO Box 838
,Iva NC 28779 Fx: 828.586.6566 Sylva NC 28779

State of North Carolina
Q ® 0 .� 9 Department of Environmental Quality
Division of Water Resources
,W9 0
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
'Division of Water Resources 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 15A NCAC 02T and the Division's
Minimum Design Criteria and that plans, specifications and supporting documents have been prepared in accordance with, ISA
NCAC 02T, 15A NCAC 02T.0300, Divtsiar policies and good engineeringpractices.
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 hack process (must be submitted for full technical review):
➢ Projects that require an environmental assessment in accordance with 15A NCAC IC .0100;
➢ Projects that do not meet any part of the minimum design criteria (MDC) document;
➢ Projects that involve a variance from the requirements of 15A 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 in ensue all required
items are submitted. Adherence to these instructions and checking the provided boureslvt)�lbel�ltrtr,,tullycWn., midasi,review time
and reduce the amount of requested additional information. Failure to submit al�6c�ttdd++ i �e 0dditionr l
processing and review time, and may result in return of the application. Unless c(tlt6rwise noted the Appllgar'I all submit
one original and one copy of the application and supporting documentation. F.
A. One Original and One Copy of Application and Supporting Documents NOV��)�
® Required unless otherwise noted
ll'ai i h t,y R. ,awn ll O;n,iaBons
B. Cover Letter (Required for All Application Packages): r""��'�Ilil Regbrt:�Oh`iCe.
® 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):
0 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):
0 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 1.2 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.1 shall be consistent withthe 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
Carotin. licensed Professional Engineer.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106Ub
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 Page I of 3

E. Flow Tracking/Acceptance Form (Form: FTSE 04-16) Of Applicable):
® Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility.
➢ Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
➢ The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one
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. 143-
215.67 a .
➢ Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific FTSE.
F. Site Maps (All Application Packages):
® Submit an 8.5-inch x 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project
area and closest surface waters.
➢ Location of the project (gravity sewer, pump stations & force main)
➢ Downstream connection points and permit number (if (mown) for the receiving sewer
® Include a street level map (aerial) showing general project area so that Division staff can easily locate it in the field.
G. Existing Permit (All Modification Packages):
❑ Submit the most recently issued existing permit.
❑ 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.).
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per I SA NCAC 02T .0305(h)(I ), submit documentation of power reliability for 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 availablefor distribution and operation of this pump 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. (Required at time of certification)
Certificate of Public Convenience and Necessity (Ali Application Packages for Privately -Owned Public Utilities):
❑ Per I SA 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
❑ Provide 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 franchise approval is expected.
J. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold):
❑ Home/Property Owners' Associations
❑ Per 15A_NCAC 02T 0 IS(cl submit the properly executed Oner do al Agreement (FORM. HOA).
❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 15A NCAC 02T .0115(b), submit the properly executed O�rerational Agreeme n (FORM. DEVI.
For more information, visit the Division's collection systems website
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 2 of 3

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES. SERVED
Asheville Regional Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
in
Water Quality Section
Swennanoa, North Carolina 28778
Clay, Graham, Haywood, Henderson, Jackson,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford Swain, Transylvania, Yancey
Fayetteville Regional Optics
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section
Fayetteville, North Carolina 2S301-5094
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson,
[phone] Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Water Quality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
Raleigh Regional Office
1628 Mail Service Center -
Chatham, Durham, Edgecombe, Franklin,
Water Quality Section
Raleigh, North Carolina 27699-1628
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Women, Wilson
Washington Regional Office
943 Washington Square Mall
Beaufort, Barbs, Camden, Chewer. Craven,
Water Quality Section
Washington, North Carolina 27889
Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section
Wilmington, North Carolina 28405
Hanover, Onslow, Pander
[phone]
[phone] Fax
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Alamance, Allegheny, Ashe, Caswell, Davidson,
Davie, Forsyth, Guilford, Rockingham, Randolph,
Water. Quality Section
Winston-Salem, North Carolina 27105
Stokes, Burry, Watauga, Wilkes, Yadkin
[phone]
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 3 of 3

State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T.0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Wider Resources PTA 04-16 & SUPPORTING DOCUMENTATION
Qo be completed by DWR)
All items mast he completed or the application Will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Tuckaseigee Water and Sewer Authority
(company, municipality, FICA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation
❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County
® Municipal ❑ Other
3. Signature authority's name: Dan Schaeffer per 15A NCAC 02T 0I06(b)
Title: Executive Director
4. Applicant's mailing address: 1246 West Main Street
City: Svlva State: NC Zip: 28779-_
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail]
II. PROJECT INFORMATION:
1. Project name: Tate House Sanitary Sewer Improvements
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
if a modification, provide the existing permit number: WON and issued date:
If new construction but part of a master plan, provide the existing permit number: WO
3. County where project is located: Jackson
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.103207o Longitude:-83..09613'
5. Parcel ID (if applicable): 7571-57-1318
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION
1. Professional Engineer: William A. Stilwell License Number: 026081
Firm: Stillwell Engineering, PA
Mailing address: PO Box 838
City: Sylva State: NC Zip: 28779-_
Phone number: 828 586-6066 Email Address: w stillwell(),stillwellengineering net
IV. WASTEWATER TREATMENT FACILITY (WWTF)INFO N:
1. Facility Name: TWSA Plant #3 Permit Numbe NC0063321
Owner Name: Tuckaseigee Water and Sewer Authority
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQUnknowm Downstream (Recei(v�gg)_Sewet-Si�e: 8 inch
System Wide Coll i System PerritNumberis) irapolicaliie)• W00500108
Owner Name(s): Tuckaseige Water and Sewer Authority
FORM: FTA 04-16 Page 1 0£ 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 Devolopor's Onerationzl Agreement (FORM: DBV) been attached?
[]Yes []No ®N/A
3. If the Applicant is a Hume/Property Owners' Association. has an Operational Agreement (FORM: HOA) been attached?
❑ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
® Residential Owned
❑ Retail (stores, centers, malls)
❑ Residential Leased
❑ Retail with food preparation/service
❑ School / preschool / day cue
❑ Medical / dental / veterinary facilities
❑ Food and drink facilities
❑ Church
❑ Businesses / offices / factories
❑ Nursing Home
5. Nature of wastewater: 100% Domesfic/Commercial %Commercial
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool /Clubhouse
❑ Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
Industrial (See 15A NCAC 02T.0103(20))
"Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under I SA NCAC 02T .Ol 14(fl? ❑ Yes ® No
➢ If Yes, provide a copy of Dow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(fl)
Daily Design Flow '•a
No. of Units
Flow
Residential
120 gal/Bed
28
3360 GPD
gal/GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
3360 GPD
a Sae ISA NCAC 02T 0114(bl (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 021.0114] shall
be determined using available
-fl\ow�. a water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project:_ ¢PD (per l5A NCAC 02T .0114)
➢ Do not include future flow 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: ETA 04-16 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) -02T�0305.&MDf, (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
N/A N/A N/A
Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) —02T.0305&MDCPopp Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: N/A - Pump Station to be permitted in subsequent application
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.102795' Longitude:-83.096132'
3. Design flow of the pump station:.03 millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 30 gallons per minute at 41 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
2
1,300
SDR21PVC
6. Power reliability in accordance with 15A NCAC 02T 0305(h)(I):
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B).
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
® Portable power source with manual activation, quick-coonection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - ISA 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 timeftames, 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(i)):
1. Does the project comply with all separations found in I SA NCAC 0ZI .0305 & UP ® Yes ❑ No
➢ 15A NCAC 02T 0305(h contains minimum seoarations 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 trenches
18 inches
Water mains horizontal
10 feet
Reclaimed water lines vertical - reclaimed over sewer
18 inches
Reclaimed water lines horizontal - reclaimed over sewer
2 feet
**Any private or public water supply source, including any wells, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water
100 feet
**Waters 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 feat
Any building foundation
5 feet
Any basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade vertical
36 inches
➢ 15A NCAC 02T 0305(¢) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications weboa&e
➢ If noncompliance with 02T 0305(tl in (2), 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 mess effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No ® N/A
➢ This would include Trout Buffered Streams per 1.5A 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 Pe' railing Branch
5. Does project comply with 15ANCACO2T.0105(c)(6)(additional permits/certifications)? ®Yes [-I No
Per 15A NCAC 02T.0105(e)(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-priorityP'
Per 15A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to stresnrbanks 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 sin -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:
1. Does the submitted system comply with 15A NCAC 02' the Minimum Des an Criteria for the PemiitC m of Pump Stations
and Face Mains (latest version), and the Gravity Sewer Minimum Design Criteria (latest version) as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternafive Design Request application (VADC 10-14) and supporting documents
for review. Approval of the inguest is re uired Prior to submittal of the Fast Track Application and supportin
documents.
2. Professional Enuineer's Certification
I, IA II i11,)i,l attest that this application for
(Professional r
Engineer's name from Application Item IlL1.)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track
Permitting of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain
portions of this submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this
material and havejudged 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 fins 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:
Applicant's Certification per 15A NrCyACC 02T.0106(b): ""rrrlipinnn.
I, IJctv1 Sr— ��ctP'C1r—a—Url�'%//0%�yr�C r attest that this application for
(Signature Authority's name & title from. Application 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 143-215.613, 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 $�10,00�00 as
well as civil penalties up to $25,000 per violation. p
Signat Date:
FORM: PTA 04-16 Page 5 of

� yM: % f'*�+A
Rai e 5°
!i j � U � el ut0
10
E3iv 1>lua uP Water IXrsmnz cs
Entity Requesting
®� " 1 Z q 4 State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Golf and Country Club
Project Name for which flow is being requested: Tate House San. Sewer Improvements
More than one FTSE maybe requiredfor a single project if the owner of the WWTP is not responsible for all pump
stations along the route of theproposed wastewaterflow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a.
WWTP Facility Name: TWSAPlant #3
b.
WWTP Facility Permit #: NC0063321
All flows are in MGD
c.
WWTP facility's permitted flow
20
d.
Estimated obligated flow not yet tributary to the WWTP
.096
e.
WWTP facility's actual avg. flow
.064
f.
Total flow for this specific request
.0336
g.
Total actual and obligated flows to the facility
0.16
h.
Percent of permitted flow used
0.8
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:
Pump
Pump
Station
Station
(Name or
Permit
Number)
No.
(A)
Design
Average
Firm Daily Flow**
Capacity,* (Firm/pi),
MGD MGD
(B)
Approx.
Current
Avg. Daily
Flow, MGD
Hooper unknown 0.2 .08 .064
(C)
(D)=(B+C)
(E)=(A-D)
Obligated,
Not Yet
Total Current
Tributary
Flow Plus
Daily Flow,
Obligated
Available
MGD
Flow
Capacity***
.001
.065
.015
* The Firm Capacity (it esfgo 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
(pt) 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 Available Capacity is < 0.
Downstream Facility Name (Sewer): Tuckaseigee Sewer System
Downstream Permit Number: WQCS00108
Page 1 of 6
FTSE 10-18

111. Certification Statement:
t .—,, �L, ttce,, (— 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 tI 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.
-A�? lit ^
Title of Signing Official
Page 2 of 6
FTSC 10-18

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