WQ0033904_Application (FTSE)_20090417

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Full Legal Name (company, municipality, HOA, utility, etc.)
Application Number:
(to be completed by DWQ) O /// oo 3 3
1 b. Dewey F. Weir Jr '..
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials!)
I1 c. The legal entity who will own this system is:
® Individual ❑ Federal ❑ Municipality ❑ State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify):
Itd. 7904 Madison Park Ln. - 1e. Raleigh
Mailing Address City
if. NC 1g _ 27615
State Zip Code
_1h. 919-616-5924 !1i. --.. 1j
Telephone Facsimile
2. Proiect (Facility) Information:
2a. Great OakDrive _(,-,�„�0 Sc�w)e,' 2b.
Brief Project Name (permit will refer to this name)
3. Contact Person:
Em
E-mail
County Where Project is Located
RECID MAR 12 2009
Name and Affiliation of Someone Who Can Answer Questions About this Application
910-270-8617 3c. dadamsto
Phone Number E-mail
Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.:
2. Owner is LJ Public (skip to Item B(3)) ® Private (go to Item 2(a))
2a. If private, applicant will be: 2b. If sold, facilities owned by a (must choose
® Retaining Ownership (i.e. store, church, single office, etc.) or
❑ Leasing units (lots, townhomes, etc. - skip to Item B(3))
❑ Selling units (lots, townhomes, etc. - go to Item B(2b))
3. Deuce Investments, LLC
Owner of Wastewater Treatment Facilit
❑ Public Utility (instruction C)
❑ Homeowner Assoc./Developer (Instruction D)
Treating Wastewater From This
4a. Majestic Oaks Subdivision 4b. WQ 0030088
Name of WWTF WWTF Permit No.
5a. Deuce Investments, LLC ,5b. 8" ® Gravity 5c. WQ 0030883
Owner of Downstream Sewer ,Receiving Sewer Size ❑ Force Main Permit H of Downstream Sewer (Instruction E)
6. The origin of this wastewater is (check all that. apply): -
® Residential Subdivision ❑ Retail (Stores, shopping centers) % Domestic/Commercial
❑ Apartments/Condominiums ❑ Institution % Industrial (attach
❑ Mobile Home Park ❑ Hospital
❑ School ❑ Church description.)
❑ Restaurant ❑ Nursing Home (RO: contact your Regional Office
❑ Office ❑ Other (specify): Pretreatment staff)
% Other (specify):
77. Volume of wastewater to be allocated or oermitted for this particular project: 360 gallons per day
*Do not include future flows or previously permitted allocations
8. If the permitted flow is zero, indicate why:
❑ Pump Station, Ouffall or Interceptor Line where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit No.
❑ Rehabilitation or replacement of existing sewer with no new flow expected (see 15A NCAC 02T .0303 to determine if a
permit is required)
- - i
FTA12/07

9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T .0114 for
the value in Item B(7) AND/OR the design flow for line or pump station sizing if a reduced or zero flow is being requested in
Item 8(7). Values other than that in 15A NCAC 2T .0114 (b) and (c) must be supported with actual water or wastewater use
data in accordance with 15A NCAC 2T .0114 (f).
1 existing lot - 3 bedroom home @ 120gpd/bdrm = 360gpd
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches) Length (feet) New Gravity or Additional
Force Main
6 _.. 95 New gravity _...
Q 11. Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
W
ZPump Station Location ID (self chosen - as shown on,plans/map for reference)
H Design Flow OpPower Reliability Option
Operational Point
Z (MGD) GPM @TDH 1 - permanent generator w/ATS; Force Main Size Force Main Length
O 2 - portable generator w/MTS
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QPump Station Location ID _.. (self chosen - as shown on plans/map for reference)
Design Flow Operational Point Power Reliability Option
(MGD) GPM @TDH 1 - permanent generator w/ATS; Force Main Size Force Main Length
2 - portable generator w/MTS
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Pump Station Location ID (self chosen - as shown on plans/map for reference)
W
d Design Flow Power Reliability Option
(MGD) Operational Point 1 - permanent generator w/ATS; Force Main Size Force Main Length
m GPM @TDH 2 - portable generator w/MTS
12. Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
El Yes ® No If Yes, permit number of 2°d treatment facility
(RO — if "yes" to B,12 please contact the Central Office PERCS Unit)
13. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force
Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chapter 2T as
applicable?
® Yes ❑ No If No, please reference the pertinent minimum design criteria or regulation and indicate why a
'.. variance is requested. SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS
PERTINENT TO THE VARIANCE WITH YOUR APPLICATION
FTA12/07

14. Have the following permits/certifications been submitted for approval for the system or project to be served?
Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes ❑ No ® N/A
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Sedimentation and Erosion Control Plan? ® Yes [-]No ❑ N/A
Stormwater? [-]Yes ❑ No ® N/A
15. Does this project include any high priority lines, [see 15A NCAC 02T .0402 (2)] involve aerial lines, siphons, or interference '..
manholes)? These lines will be considered high riority and must be checked once every six months
Check if Yes: ❑ and provide details
1. Owner/Permittee's Certification: (Signature of Signing Official and Project Name)
1, Dewey F Weir Jr , attest that this application for Great Oak Dr Ext. 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. Note: In accordance with North Carolina General Statutes 143-
215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or certification in any
application shall be guilty of Class 2 misdemeanor, which may include a fine not to exceed $10,000 as well as civil
pe Ities up to $25, 00 per. vio/atio
la. 20 O
Signing Offi ' Signature Date
:ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THIS
APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMITY
TO OTHER UTILITIES, DESIGN CALCULATIONS. ETC. REFER TO 15A NCAC 02T .0305
2,2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
I, Donald C. Adams. Jr attest that this application for Great Oak Dr Ext. has been reviewed by me
and is accurate, complete and consistent with the information in the engineering plans, 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
2a.
Gravity Sewers adopted February 12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump
Stations and Force Mains adopted June 1, 2000 and the watershed classification in accordance with Division guidance.
Although other professionals may have developed certain portions of this submittal package, inclusion of these materials
under my signature and seal signifies that l have reviewed this material and have judged it to be consistent with the
proposed design. Note: In accordance with NC General Statutes 143-215.6A and 143-215.6B, any person who knowingly
makes any false statement, representation, or certification in any application 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.
C. Adams. Jr
Professional Engineer Name
21b. Southwind Surveying and Engineering
Engineering Firm
2c. 95 Hampstead Village
Mailing Address
2d. Hampstead '2e. NC 2f.
City State Zip
2g. _ 910-270-8617 2h. 910-270 8619 2i. dadams@sc
Facsimile E-mail
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FTA12/07

ATF9 State of North Carolina
PG Department of Environment and Natural Resources
KDivision of Water Quality
% c Flow Tracking/Acceptance for Sewer Extension Permit Applications
/► (FTSE—10/07)
Project Applicant Name: Dewey R. Weir, Jr.
Project Name for which flow is being requested: Great Oak Extension
More than one FTSE-10107 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 wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Majestic Oaks Subdivision
b. WWTP Facility Permit #: WQ 0030088
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
All flows are in MGD
0.05972
WWTP 0.04904
0.0036
0.00036
0.053
88.75 %
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 Station Name Approx. Capacity, MGD Approx. Current Avg.
(Firm/Design) Daily Flow, MGD
LS-1
LS-2
LS-3
III. Certification Statement:
0.025
0.025
0.035
0.043
750
1350
1200
I, Linwood Jones, Deuce Investments, Inc, certify that, to the best of my knowledge, 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. 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 for7A ch I am the responsible party. Signature of this form
indicates acceptance of this wastewater flow, � __) (\ k �
Signing Official Signature
11-Zo
Date

FORM WSCAS-12/07
WATERSHED CLASSIFICATION ATTACHMENT
FOR SEWER SYSTEMS
Applicant Name
Project Name
Dewey F. Weir, Jr.
Great Oak Dr Ext
Professional Engineer Name
Engineering Firm Name
Donald C. Adams, Jr.
Southwind Surveying and Engineering
Location
ID
Name of Waterbody'
County
River
Basin
Waterbody Stream
Index No.
Waterbody
Classification
UT to
Intracoastal
Waterway
UT to Intracoastal
Waterway
Fender
Cape Fear
18-87-(11.5)
SA/ORW
1 If unnamed, indicate "unnamed tributary to V, where X is the named waterbody to which the unnamed tributary joins.
1 certify that as a Registered Professional Engineer in the State of
North Carolina that / have diligently followed the Division's instructions
for classifying waterbodies and that the above classifications are
inclusive of the stated project, complete and correct to the best of my
knowledge and belief.
PE Seal, Signature and Date
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*** END OF FORM WSCAS-12/07 ***
FORM: WSCAS-12/07
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