WQ0041300_Application (FTSE)_20191212

Permit Number WQ0041300
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
dean.hunkele
Coastal SWRule
Permitted Flow
Facility
Facility Name
Grand Bay at Beau Rivage Condominiums
Location Address
Owner
Central Files: APS _ SWP
11/13/2019
Permit Tracking Slip
Status
Project Type
In review
New Project
Version
Permit Classification
A
Individual
Permit Contact Affiliation
Major/Minor Region
Minor Wilmington
County
New Hanover
Facility Contact Affiliation
Owner Name
Owner Type
Aqua North Carolina Inc
Non -Government
Owner Affiliation
Shannon V. Becker
President
202 Mackenan Ct
Dates/Events
Cary
NO 27511
Scheduled
Orig Issue App Received Draft Initiated Issuance
Public Notice Issue Effective
Expiration
11/12/2019
Regulated Activities
Requested /Received Events

State of North Carolina
R Department of Environmental Quality
PN�® Division of Water Resources
ArO
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
'Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: () �v1 �360 (to be completed byDWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Aqua North Carolina (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: Michael A. Melton per 15A NCAC 02T .0106(b)
Title: Engineering Manager
4. Applicant's mailing address: 202 MacKenan Court
City: Cary State: NC Zip: 27511-_
5. Applicant's contact information:
Phone number: (919 653-6977 Email Address: mamelton(r_,aguaamerica.com
II. PROJECT INFORMATION:
1. Project name: Grand Bay at Beau Rivage
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: W000 and issued date: dr,
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: 34.113°Longitude:-77.923'
5. Parcel ID (if applicable): R07800-005-013-000
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Christopher Millis License Number: 036235
Firm: Paramounte En ing eering Inc.
Mailing address: 122 Cinema Drive
City: Wilmington State: NC Zip: 28403-_
Phone number: 910 791-6707 Email Address: cmillisAnaramounte-ena.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Beau Rivage Permit Number: NCO065480
Owner Name: Aqua NC
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ7 Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS00335
Owner Name(s): Aqua NC
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 ❑N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been attached?
❑ Yes ❑No ®N/A
3. If the Applicant is a Home/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) ❑ 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)]
L---*Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under I5A NCAC 02T .01 14(fl? ®Yes ❑ No
➢ If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 021.0114ff1)
Daily Design Flow a.b
No. of Units
Flow
gal/
GPD,
3 Bdr. Multifamily Units
360 gal/unit
76
27,360 GPD
Clubhouse
5 gal/seat
60
300 GPD
Pool Area
10 gal/person
40
400 GPD
gal/
GPD
gal/
GPD
Total
28,060 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-41.
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: 28 060 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 04-16 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 1,300 LF C-900 (DR-18) PVC
➢ 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 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: I
2. Approximate Coordinates (Decimal Degrees): Latitude: 34.1120 Longitude:-77.923'
3. Design flow of the pump station: 0.044 millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 123 gallons per minute at 30 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
4
70
C-900 (DR-18)
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
® 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 -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 15A NCAC 02T.0305(f) & (R)
➢ 15A NCAC 02T.0305 contains minimum separations that shall be provided for sewers stems:
® 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 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 swinuning pools
10 feet
Final earth grade vertical
36 inches
➢ 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpaee
➢ 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 213.0202
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.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A 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.04021 "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 Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
I. Des the submitted system comply with 15A NCAC 1121, the Minimum De%iun Criteria I'm the I'cnniuinc of hump Saniun,
and I orec Main, ilute,t \0.11011t. and the Grons Suter Minimums W,ian C'rmeria tlaicst ter,ioni as applicable',
® Yes ❑ No
If No. complete and submit the Variance/AltematiNe Design Request application (VADC 10-14) and supponing documents for
re%ice. ADDroyal of the reauest is required prior to submittal of the Fast Track Application and su000rtina documents.
2. Professional Engineer's Certification:
that this application for
(Professional Engineer's name from Application Item 111.1.)
has been reviewrd 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 I'uriher attest that to the ties(
of my knowledge the proposed design has been prepared in accordance with the applicable regulations. Gravity Sc%er
Minimum Design Criteria for Gravity Sewers (latest version). and the Minimum Design Criteria for the Pus( -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 he consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and I43-215.6B. any person who knowingly makes any false
statement. representation. or certification in any application package shall he guilty of a Class 2 misdemeanor. which may
include a fine not m exceed 510.000, as well as civil penalties up to 525.000 per violation.
N CAi�
North Carolina Professional Engineer's seah signature, and date: '� O
O�
2 QRI
AL
vN
3. Applicant's Certification per 15A \CAC 02T .01061b):
I Michael A. Melton, Engineering Manager
attest that this application for
(Signature Authority's name & title from Application Item I.3.)
has been reviewed hp me and is accurate and complete to the hest of my knoscledge. 1 understand that ifall 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 wasichcater 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 Hill make no claim against the Division of Rater Resource, should a condition
of this pennit 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 b, returned to me as
incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B. any person xho knowingly makes any false
statement, representation. or certification in any application package shall he guilty of a Class 2 misdemeanor. which nha%
include a fine not io exceed S 10.000 as well as civil penalties up to 525.000 per violation.
Signature: ) I(((� f OLAIDate:
FORM: FTA 04-16 Pace 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Aqua NC
Project Name for which flow is being requested: Grand bay
More than one FTSE may be required for a single project if the owner of Cite WWTP is not responsible for all pump
stations along the route of the proposed wasiewater,Jlow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Beau Rivage WWTP
b. WWTP Facility Permit #: NC0065480
All flows are in MGD
c. WWTP facility's permitted flow 0.200
d. Estimated obligated flow not yet tributary to the WWTP 0.00
e. WWTP facility's actual avg. flow .132974
f. Total flow for this specific request 0.02806
g. Total actual and obligated flows to the facility 0.161034
It. Percent of permitted flow used 80.52%
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:
(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 Pennit Capacity, * (Firm / pf), Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***
* 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):
Downstream Permit Number:
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Michael A. Melton 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.
Signing
Title of Signing Official
5 bb19
Date
Page 2 of 6
PLSF 10-18

GRAND BAY AT BEAU RIVAGE
NEW HANOVER COUNTY, NORTH CAROLINA
SANITARY SEWER DESIGN NARRATIVE
Prepared for:
Dominion Land Corporation
PO Box 3167
Wilmington, NC 28406
Prepared by:
pARAMOUNTE
E N O 1 N E E R 1 N G. I N G.
122 Cinema Drive
Wilmington, NC 28403
Project #18113.PE
November 2019 ` y\ CARD
(�
2���
- n ' 036235
A0 4A

PROJECT NARRATIVE
Dominion Land Corporation desires to install a gravity sewer system and a 123 GPM pump station
and 4-inch force main to serve a 76-lot single family subdivision. The proposed wastewater is
calculated to be 28,060 GPD, be ultimately collected and carried to the proposed new pump station
on the adjacent wastewater treatment plant property owned by Aqua North Carolina. Enclosed is a
signed waiver by the owner and Aqua agreeing to such. The wastewater will be pumped from the
new pump station to an existing forcemain along River Road and into the Aqua Wastewater
treatment plant.
Gravity collection sewer lines carry the flow from the property to a centralized location where the
pump station is sited and designed per NCAC Title 15A.2T.0100 - .1600. The gravity collection
system is to be owned by Aqua North Carolina. For the permit, it will consist of 1,300 LF of 8"
gravity sewer. The operating point for the pump station will be 123 gpm at 30 TDH.

Project Name: Grand Bay P1ARAMouNTH
�-�f
Client: Dominion Land Corporation
Project Number 18113.PE 1J
Prepared By: TGC
Date: 3/21/19
28,060 GPD

SETBACK WAIVER AGREEMENT
The undersigned property Owners) hereby permits Thomson and Corder to construct a lift station
for the Grand Bay development up to 5 feet from the existing property litre of Aqua North Carolina
and property deeded from Nathan Sanders to Grand Bay Subdivision and at least 25 feet from any
habitable residence or place of assembly located on the property of the undersigned Owners).
The setbacks stated above apply as shown on the "Survey Plat " for the property described as:
Owner. Isabella Holding Company LLC
Address: 6550 River Road, Wilmington, NC 28412
PID: R07800-005-013-000
1 certify that 1 am a deeded property owner of the above described property and am authortzed to
make decisions regarding this property on behalf of other deeded property owners. Furthermore,
I certify that I have read and understand this Agreement and do hereby grant permission to allow
a lift station constructed by Thomson and Corder for ownership and operation by Aqua North
Carolina, Inc. 1 further agree that upon the Division of Water Resources' issuance of an
Autihorvaton to Construct the proposed lit station, 1 will have this Setback Waiver Agreement
recorded in the New Hanover County Register of Deeds office and will provide copies of the
recorded Agreement to the Division of Water Resources and to Aqua North Carolina, Inc.
Signature: )(
Date: $ % — 1— l q
Printed Name:
Sc-.aer.5
Title: me,, E✓
NORTH CAROLINA, COUNTY
I, �l .'�- o o � a Notary Public for k\ . .nnA County, North
Carolina, do hereby certify n ij:)� S G'Y&I U6
personally appeared before me this day and
acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal this the �_ day of i 309 " e u
.•`�� WHeF',
NO Tq SlgnaQee of Notary Public
SEAL m ; TAR),
z 2s °USLIC ..v ' My commission expires 7 0�
vs �y �

GoLgleMaps 34006'46.8"N77055'22.8"W
4
A New World TtarH ,
sv
ppeu: p
q
a
an. P d Park �`•h
C
a yaw Pn<a''
MCIalfeatheraYudio9
a
c+mar ve 0
Tdw Fe o
t atsdatc
s
Channel Won by
BIII Clark Homes 2
tt
Google
r�d.=ae
Map data ©2019 200 ft r