WQ0040417_Application (FTSE)_20191112

Central Files: APS _ SWP _
11 /1 /2019
Permit Number W00040417
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
helen.perez
Coastal SWRule
Permitted Flow
12,960
Facility
Facility Name
Blendin Meadows Subdivision
Location Address
Owner
Permit Tracking Slip
Status
Project Tye
In review
Majo modificatio
Version
Permit Classification
B
Individual
Permit Contact Affiliation
Major/Minor Region
Minor Wilmington
County
New Hanover
Facility Contact Affiliation
Owner Name
Owner Type
Cape Fear Public Utility Authority
Government - Municipal
Owner Affiliation
James R. Flechtner
PE
235 Government Center Dr
Dates/Events
Wilmington
NC 28403
Scheduled
Ong Issue App Received Draft Initiated Issuance
Public Notice Issue Effective
Expiration
11 /27/2018 10/ 18/2019

State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources 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 I �.A NC A( 0_'"1 and the Division's
Minimum Design Criteria and that plans, specifications and supporting documents have been prepared in accordance with, 15_A
NCAC 112_r, 1=.A NC'AC 02T .0300, Division policies and - ood eneineerint; practices.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design
documents must be prepared prior to submittal of a fast track permit application to the Division, This would include plans, design
calculations, and project specifications referenced in 1 �.A NCAC 01-1 030j 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 I ,A NCAC 0' l I1301.
Projects not eligible for review via the fast track process (must be submitted for full technical review):
➢ Projects that require an environmental assessment in accordance with 15A NCAC 1C .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 to ensure all required items
are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and
reduce the amount of requested additional information. Failure to submit all required items will necessitate additional
processing and review time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit
one original and one copy of the application and supporting documentation.
A. One Original and One Copy of Application and Supporting Documents
❑ Required unless otherwise noted
B. Cover Letter (Required for All Application Packages):
❑ List all items included in the application package, as well as a brief description of the requested permitting action.
➢ Be specific as to the system type, number of homes served, Flow allocation required, etc.
➢ If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Major Modification Application Packages):
❑ Submit a check or money order in the amount of $480.00 dated within 90 days of application submittal.
➢ Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track (Form: ETA 04-16) Application (Required for All Application Packages):
❑ Submit the completed and appropriately executed application.
➢ If necessary for clarity or due to space restrictions, attachments to the application may be made.
❑ If the Applicant Type in Item 1.2 is a corporation or company, provide documentation it is registered for business with
the Noith C,iiohna Sccrrlarn of Stow.
❑ If the Applicant Type in Item I.2 is a partnership or d/b/a, enclose a copy of the certificate filed with the Register of
Deeds in the county of business.
❑ The Project Name in Item II.I shall be consistent with the project name on the flow acceptance letters, agreements, etc.
❑ The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a Noith
Carolina hcen,Cd Prnle�shonal F.neinccr. _
❑ The Applicant's Certification on Page 5 of the application shall be signed in accordance with I' V NCAC 0' I' 01_06 h).
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: FCA 04-16 & SUPPORTING DOCUMENTATION Page I of 3

E. Flow Tracking/Acceptance Form (Form: FTSE 04-16) (If 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. I I 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 I 1-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 known) 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 � A NCAC 021 0 A05(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 available for 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)
I. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per I S A NCAC 02 f .01 I S(el( I ) provide the Certificate of Public Convenience and Necessity from the with Carolina
Ulilio., Commi.,ion 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 Aouh Conlin t Utditic, Conuni„io}V'an , tci end SCPCI Dni ion PLINiC 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 I5,A AC AC 011101 l>(c), submit the properly executed Opcia[mmil__A_iccm.m l OR\1: 1 10A).
❑ 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 Upci,mowiI A,, i c: mcnt_ i t OR %I DP,y i.
For more information, visit the Division's collection systems a eb ite
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 :APYROPRI:CI'1: RI?GIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Ouality Section
Swannanoa, North Carolina 28778
Clay, Graham, Haywood, Henderson, Jackson,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section
Fayetteville, North Carolina 28301-5094
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[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
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
Beaufort, Bertie, Camden, Chowan, 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, Pender
[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, Surry, Watauga, Wilkes, Yadkin
[phone]
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 3 of 3

October 18, 2019
Dean Hunkele
North Carolina Department of
Environmental Quality
Division of Water Resources
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
Re: Blendin Meadows
Sewer Permit Modification (WQ0040417)
New Hanover County
CSD Project No. 16-0384
Dear Mr. Hunkele:
CSD
ENGINEERING
ftECIE IV Dn"i I ;D*PAR/DWR
OCT 18 ang
Water Quality rtegional
Operations Section
Wilmington Regional Office
ECEIVE
OM ziljsJ
The enclosed permit application is for an addition of +/- 341 If of 8" DIP gravity sewer main to serve exit
homes on Daniel Boone Trail, adjacent to Blendin Meadows, located off Gordon Road in New Hanover Co. This
new main will connect to an existing CFPUA manhole in the right-of-way of Daniel Boone Trail that was
installed under the original permit. The main will be installed by the developer and owned and maintained by
CFPUA. Enclosed please find:
- One (1) original and one (1) copy of Fast Track Sewer Application (FTA 04-16)
- One (1) original and one (1) copy of Flow Tracking/Acceptance form (FTSE 04-16)
- One (1) copy of current permit WQ0040417
- $480.00 application fee, check #25830
- Street view map
- USGS map
If you have any questions or comments, please feel free to contact us. Thank you for your assistance.
Sincerely,
/�W� 6S
Mike Broyhill
Encl.: As noted above
Cc: Cape Fear Habitat for Humanity, Inc.
3805 Cherry Avenue - Wilmington, NC 28403 - 910 7914441 - www.csd-engineering.com — License # C-2710 ��JJ & I CSD
MUNEENNO

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: Wn 00-1 l JH 1- (to be wmpieted by DWR)
All items must be completed or the application will be returned
1. APPLICANT INFORMATION:
1. Applicant's name: CFPUA (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ❑ Municipal ❑ Other
3. Signature authority's name: Jeff Thebeme. P.E per I5A NCAC 02T .0106(b)
Title: Engineering Manager
4. Applicant's mailing address: 235 Government Center Dr.
City: Wilmington State: NC Zip: 28403-
5. Applicant's contact information:
Phone number: [phone] Email Address: ieff.theberge6bcfoua.org
11. PROJECT INFORMATION:
I. Project name: Blendin Meadows
2. Application/Project status: ❑ Proposed (New Permit) ® Existing Permit/Project 1
If a modification, provide the existing permit number: W00040417 and issued date: 11-27-18 ✓ N01 Cef-k&�
If new construction but part of a master plan, provide the existing permit number: W000
3. County where project is located: New Hanover
4. Approximate Coordinates (Decimal Degrees): Latitude: 34.270079` Longitude:-77.844756'
5. Parcel ID (if applicable): R04300-003-004-001
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Howard Resnik License Number: 25483
Firm: CSD Engineering
Mailing address: PO BOX 4041
City: Wilmington State: NC Zip: 28406-
Phone number: [phone] Email Address: howardna,csd-engineering com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Northside W WTP Permit Number: NCO023965
Owner Name: CFPUA
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. PermitNumber(s): WQ_ Downstream (Receiving) Sewer Size: 30 inch
Svstem Wide Collection Sv stern Permit Numher(sl(if applicable): WQCS
Owner Name(s): CFPUA
FORM: FTA 04-16 Page 1 of 5

VI. GENERAL REQUIREMENTS
I. 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 Deg cIopc i . ()perrnuon 1I _Asrccment (I t k,VI 1A.V) been attached?
❑ Yes ❑No ❑N/A
3. If the Applicant is aIlon0piop,i 11ci. A"nciation ha, all Opciororal \ rc.mcnt(H)RVLI1():Ubeen 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 (ti c_ 1 �A AC VC 011 010Ai__(h)
"Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 1 5 A A'C A( 01 I_ di 1 14(f)? ❑ Yes ® No
➢ If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project
Establishment Type (see 02"F.0114tt))
Daily Design Flow s,b
No. of Units
Flow
single family
360 gal/day
17
6,120 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
6,120 GPD
a See la A N( \( 0_11.01140)). Id). (c)1 h and (e)(?I 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 (.;.S. 4 _ -4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15.-A. N(':A( 01"1 .01 1-1] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 6 120 GPD (per I S, V AC V(' 01 1 01 1_)
➢ 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: ETA 04-16 Page 2 of 5

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 021 .0305 & Ntl)(' ((;racitc Sc%wra):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 341 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
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) —02"f .0305 & \IDC(Punu) Stotions/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. 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) Length (feet) Material
6. Power reliability in accordance with I5 A NCAC 021 030.Sd,)(_ 1 ):
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(I )(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 115A NCAC 02T .0305(f) & f
➢ 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
❑ Ye ®No
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 feet
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
➢ I SA NCAC 02T.0,305(e) contains alternatives where separations in 071'.0305(I) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Al ator Cl:usiCictuion� V�r_by�e
➢ If noncompliance with 0.21'.0305(I) or (_j� 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 01 B .0001 ❑ Yes ❑ No ® N/A
➢ This would include Trout Buffered Streams per 15A NCAC 213.0202
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 & Buf Icr Pormiltin� Bcmch
5. Does project comply with 15A NC/\C' 011 .010S(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per I5A NCAC 02T.0105(cl(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.0401_, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ 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 he 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: FIA 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 115A NCAC 02f, the minimum Desivi Criteria liar the Penniuine of Pwut) Stations
and Force Mains (Invest rcr ion . and the Um itv_Se"er Mininrrun DesiL,n Criteria Hales[ cersioni 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 request is required prior to submittal of the Fast Track Application and supporting documents
2. Professional Engineer's Certification:
(Professional Engineer's name from Application Item III.1.)
that this application for
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
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: \\N\\\\\\ill
i�
'EL
?: O .Y
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i iQ ^SINS
3. Applicant's Certification per 15A NCAC 02T .0106(b):
6W GIN Ef tiitk lt'jgNA Ee attest that this application for
(Signature Authority's name & title from Application Item I.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 143-115.6A and 1I411-215.613, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: phiA IIltAGlrA�i Date: I/I
i
FORM: FTA 04-16 Page 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Y
Division ,f Watcl Resomf c% Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Cape Fear Habitat for Humanity
Project Name for which flow is being requested: Blendin Meadows
More than one FTSE maybe required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewaterJlow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: James A. Loughlin (Northside) WWTP
b. WWTP Facility Permit #: NPDES NC 0023965
All flows are in MGD
c. WWTP facility's permitted flow 16.000
d. Estimated obligated flow not yet tributary to the WWTP 3.364
e. WWTP facility's actual avg. flow 10.661
f. Total flow for this specific request 0.006120
g. Total actual and obligated flows to the facility 14.031
h. Percent of permitted flow used 87.7%
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 / pf), Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***
89 N/A 14.583 5.833 4.493 1.678 6.171 -0.338
* 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 Available Capacity is < 0.
Downstream Facility Name (Sewer): Cape Fear Public Utility Authority
Downstream Permit Number: N/A
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Jeff Theberge, CFPUA Eng. Mgr 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.
Official
Title of Signing
Page 2 of 6
1 "ISE 10-18

PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum for each pump station listed in Section II where Available Capacity is <
0.
Pump Station (Name or Number):
Given that:
a. The proportion and amount of Obligated, Not Yet Tributary Daily Flow (C) accounts for
27% total flow % and 1.678 MGD of the Available Capacity (E) in Pump Station
89 ; and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately
MGD per year; and that
c. A funded Capital Project that will provide the required planned capacity, namely
Blue Clay Road Force Main is in design or under construction with
planned completion in complete ; and/or
d. The following applies:
The Blue Clay Road Force Main is able to provide additional capacity at PS 89 by
diverting existing flow that is currently tributary to PS 89 directly to NSWWTP.
Construction of the force main is complete and was certified 4/5/18. The force main is
available for event management. Administrative procedures are required for full activation.
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to allow
this flow to be permitted, without a significant likelihood of over -allocating capacity in the system
infrastructure.
I understand that this does not relieve the collection system owner from complying with G.S. 143-
215.67(a) which prohibits the introduction of any waste in excess of the capacity of the waste disposal
system.
Page 3 of 6
FTSE 10-18

N.
9' 19'
166 ML5
V 35'
SCOTTS HILL, NC
2013
low 0 I= 2M 3109 0000 5tf00 moo m 8YN 9" I=
FM

Perez, Helen I
From:
Howard Resnik <[e-mail]>
Sent:
Thursday, November 7, 2019 3:23 PM
To:
Perez, Helen I
Cc:
Rodney Wright Contact; [e-mail]
Subject:
[External] RE: Blendin Meadows USE Mod
Attachments:
Fast TracK Sewer_mod_pagel.pdf
Helen,
Thanks for your review and comments. My responses are in RED below
Please let us know if you have any further questions. Thanks again.
Howard Resnik, PE, LEED0 AP
G SD
3805 Cherry Avenue
Wilmington, NC 28403
910 791 4441 office
910 540 0959 mobile
910 791 1501 fax
www.csd-engineering.com
It is the professional opinion of CSD Engineering that this electronic information provides design information current as of the date of its release. It is the
responsibility of the receiver of this document to examine it and determine whether it is the information requested. In the deliverance of this file we make
no promise as to the usability or compatibility of this file. This file shall not be considered a certified document.
From: Perez, Helen I <[e-mail]>
Sent: Thursday, November 07, 2019 9:45 AM
To: [e-mail]
Subject: Blendin Meadows FTSE Mod
Howard,
I've been reviewing your application for the FTSE modification for Blendin Meadows and have some questions:
Southside WWTP is listed on the application, but Northside WWTP is on the flow tracker. It should be Northside on
app? It should be Northside. Please see revised page 1.
Section IX.1—comply with separations marked NO. Why? Several sections of gravity main are within 100 FT of private
wells. Ductile iron sewer main has been used in those cases.

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