WQ0041252_Application (FTSE)_20191011

State of North Carolina
D. Department of Environmental Quality RDivision of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Btvtston of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: "`J [)
(to be compieted by pWR)
All items must be cam leted or the aj2plication will he returned �(
1. APPLICANT INFORMATION-
1. Applicant's name: Town of Benson (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: Jerry M. Medlin per 15A NCAC 0 T .0106(b)
Title: Mavor
4. Applicant's mailing address: P.O. Box 69
City: Benson State: NC Zip: 27504-
5. Applicant's contact information:
ro
Phone number: 919 ;344-3553 Email Address: #robbinsetownofbenson.com C
a
11. PROJECT INFORMATION: v
I. Project name: Main St. Water/Wastewater System Improvements E N
hcation/Pro'ect status: o o
2. A
Pp 1 ®Proposed (New Permit) ❑Existing Permit/Project •� 'qA
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: WQ00_ ° c
'Q •a�
3. County where project is located: Johnston Q
CU
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.380 Longitude.-78.547° Z
5. Panel ID (if applicable): N A - inside ROW or Town Easern
(or Parcel ID to closest downstream sewer)
M. CONSULTANT INFORMATION:
l . Professional Engineer: W. Brian Johnson License Number. 025933
Firm: The Wooten Company
Mailing address: lam. Boylan Ave,
City: Ralei State: NC Zip: 27603-
Phone number: (21 D L 8-0531 Email Address: biohnson a.thewootencom an .com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Town of Benson WWTP Permit Number. NCO020389
Owner Name: Town of Benson
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
I . Permit Number(s): WQNlA
System Wide Collection System Permit Number(s) (if applicable): mWQCS1 I 01
TzOwner Nae{s): NIA 1 � 1
FORM; FTA 04-16 Page 1 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 ®NIA
2, If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FQPUMM: DEVl been attached?
❑ Yes ❑No ®N/A
3. If the Applicant is a Home/Pro a Owners'Associafion, has an Oneratignal A emenl (FORM: HOA been attached?
❑ Yes []No ®NIA
4. Origin of wastewater: (check all that apply):
® Residential Owned ® Retail (stores, centers, malls) ❑ Car Wash
® Residential Leased ® Retail with food preparadon/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool /Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming PootTilter Backwash
® Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic/Commercial 50 % Commercial
0 % lndustrial See 15A NCAC 02T .0103 20
I 'i Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAQ 02T .01 14 ? ❑ Yes ®No
7 If provide a copy of flow reduction aotaroval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f)?
Daily Design Flow
No. of Units
Flow
NIA
N/A gal/N/A
NIA
0 GPD
gal/
GPD
gal/
GPD
gall
GPD
gal/
GPD
gal
I GPD
Total
0 GPD
a See 15A NCAC 02T .0114(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).
b 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: 0 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 04-1 b Page 2 of 5

VIL
►n
GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & AIDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted.
Size (inches) Length (feet) Material
8" 575 PVC
> Section H & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
A Section M 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
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:
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) I Length (feet) I Material
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)_
7 Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
9 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(b)(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 timeliames, shall be
provided in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

LAC. SETBACKS & SEPARATIONS — (028.0200 & 15A NCAC 02T.0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T.0305(f) & M
> 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems-
� tl.�fYy�x'�✓�y
D�- v
❑ Yes ®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 1 or
Class lI 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 DC2)
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
> 15A NCAC 02T.030560 contains alternatives where separations in 02T.0305(f) cannot be achieved.
> **Stream classifications can be identified using the Division's NC, Surface Water Classifications weboage
> 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
> 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 all setbacks found in the river basin rules per 15A NCAC 02B .0200? ® Yes ❑ No
> This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project comply with an individual 404 Permit or any 401 Certifications? ® Yes ❑ No
> Wetland -related permits shall be requested, obtained, and adhered to for projects that impact wetlands or surface waters
Information can be obtained from the 401 _& Buffer_ Permitting Branch
5. Does project comply with 15A NCAC 02T.01,05(c)(6) (additional permitslcertifications)? ® Yes [:]No
Per 15A NCAC 02T.0105(c)(6). directly related environmental permits or certification applications arc 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 streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ® No
> 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 Collcedon permit
FORM- FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Wnimum DesigLi Criteria for the Permitting of Pump Stations
and Force MgjM (latest version), and the Gravity Sewer Minimum, Design Criteria (latest version) as applicable?
® Yes ❑ No
If No, complete and submit the Variance..'Alternative Design Request application (VADC 10-141 and supporting documents
for review. Approval of the request is required prior to submittal of the Fast Track Application and suppordne
documents.
2. Professional Engineer's Certification:
I, W. 8 S r-j attest that this application for
(Professional Engineer's name from Application Item Ill. 1.)
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 143-215.613, 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 M0,000, as well as civil penalties up to $25,000 per violation. ;..rtlett�■,._
Narth Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per I 5A NCAC 02T .O I06(b):
1, J *1r t n o r 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 arc 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 S 10,000 as well as civil penalties up to $25,000 per violation-
1
9 J
FORM: FTA 04-16 Page 5 of 5

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NC Dept of Environmental Quality
October 11, 2019 OCT 11 28S
THE
Reviewer Rl&igh Regioaal Office
WOOTE N
NCDEQ Division of Water Resources
Raleigh Regional Office - Water Quality Permitting Section
COMPANY
1628 Mail Service Center
Raleigh, NC 27699-1628
RE: Sewer Fast -Track Application
Main Street WaterWastewater System Improvements
Benson, North Carolina
TWC No. 2293-CJ
Dear Reviewer:
On behalf of the Town of Benson, we are submitting one (1) original and one (1) copy of
the following items related to the above referenced project for your review and approval:
• Application Fee ($480.00)
• Sewer Fast -Track Application (FTA 04-16)
• Construction Plans (6 sheets, C-0.01 to C-2.02)
' • Cover Letter Narrative (see paragraph below)
• USGS Topographic Map showing proposed utilities
Please note that this project will install approximately 575 linear feet of 8" gravity sewer,
located between S. Market St. and S. Elm St. New gravity sewer is proposed from
existing manhole B011 to proposed manhole 1C, and from proposed manhole I to
proposed manhole l D. It should be noted that additional sewer improvements are shown
on the construction plans, located on NC-50 and between S.W. Railroad St. and S.
Market St. These improvements are replacements in -kind and in -place; as such, a permit
application and review of these portions of the plan sheets is not required.
Section IX.I of the Fast Track Application was answered "no" due to less than 10'
horizontal separation between the proposed sewer and water mains; however, because the
vertical separation requirements will be met, a horizontal separation of less than 10' is
allowable. In addition, because this is a zero -flow project (no new services connected to
the proposed gravity sewer), no Flow Tracking worksheet has been completed.
I trust the above information is sufficient for your review; however, if you should have
any questions or need additional information, please do not hesitate to contact me at 919-
828-0531 or pgalanathewootencompany.com
Sincerely,
THE WOOTEN COMPANY
W
{ Pet . Galan, P.E.
120 North Boylan Ave `
Raleigh, NC 27603 Enclosures: As stated.
919 828 0531 cc: Mr. Fred Nelson, Interim Town Manager, Town of Benson
tax 919 834 3589
TWC Reading File

V/Qaa4as a
Cashion, Ted
From: Cashion, Ted
Sent: Monday, November 18, 2019 3:56 PM
To: Brian Johnson; [e-mail]
Cc: Robinson, Jason
Subject: Main St. Water/Wastewater System Improvements fast track sewer extension application
Brian and Tim,
We are reviewing the subject application. Item V of the application was not completed as required. Please submit this
information; we'll continue drafting the permit upon submittal of the information.
If the downstream sewer is very old, it may not have a permit. If that's the case, please include the size and
approximate age of the line.
ted
Ted Cashion
Water Quality Regional Operations
Division of Water Resources
NC Department of Environmental Quality
Raleigh Regional Office
919-791-4254
ted.cashion(&ncdenr.eov
1628 Mail Service Center
Raleigh, NC 27699-1628
3800 Barrett Drive
Raleigh, NC 27609
RE
PrOsr�ac, a} (rtxrennen•�I pats
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