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HomeMy WebLinkAboutWQ0041376_Application (FTSE)_20191218RCONSULTING KGROURPILLC December 17, 2019 Ms. Sarah Toppen Environmental Specialist NCDEQ — Division of Water Resources 943 Washington Square Mall Washington, NC 27889 Subject: Fast Track Sewer System Extension Application West New Bern - Express Development City of New Bern, Craven County, North Carolina Dear Mr. Clark: On behalf of the project developer, D.R. Horton - Central Carolina, and the sewer system owner, City of New Bern, we respectfully submit the subject Fast Track Sewer System Application for West New Bern — Phase I Express Development in New Bern, Craven County. The proposed project consists of 71-lot single family residential subdivision. Of these lots, 50 lots will be served by new water and gravity sewer mains, and these are the lots for which additional capacity is being permitted as part of this application package. All of the proposed sewer mains are 8" PVC gravity sewer mains tying into the existing permitted sewer main along West Elizabeth Avenue. Enclosed for your review and approval is the application fee ($480.00) and two copies of the following documents: o Fast Track Sewer System Extension Application (FTA 04-16) o Flow Tracking for Sewer Extension Applications (FTSE 10-18) o USGS Topo Site Map o Street Level Map (reduced size sheet C1 of construction plan set) Respectfully submitted, Ark Consulting Group, PLLC Brian T. O'Kane, P.E. Project Manager Enclosures ARK CONSULTING GROUP, PLLC 6176 DATE INVOICE NO. COMMENT AMOUNT NETAMOUNT 12/17/2019 West New Bern - Express - Sewer Fast Track Permit 480.00 DATE 12/17/19 VENDOR NCDEQ TOTAL 480.00 ARK CONSULTING GROUP, PLLC 2755B CHARLES BLVD GREENVILLE, NC 27858 252-558-0888 www.arkconsultinggroup.com PAY Four Hundred Eighty and no/100 TO THE N ORDER CDEQ OF 943 WASHINGTON SQUARE MALL WASHINGTON NC 27889 I r � l FIRST CITIZENS BANK 239 FAYETTEVILLE ST RALEIGH, NC 27601 66-30/531 DATE CHECK 12/17/19 6176 6176 CHECK AMOUNT $480.00 I AUTHORIZED SIGNATURE Average Yearly Flow for: Jan.2018 Feb.2018 Mar.2018 Apr.2018 May2018 Jun2018 Ju12018 Aug2018 Sept2018 Oct2018 Nov2018 Dec2018 City of New Bern WWTP: NCO025348 Permitted Flow: 4.5808065 0 4.3420323 1.2815333 4.5862258 5.1648667 4.6480323 2.5127419 6.3627 4.5924194 5.0946333 5.7920645 4.079838 Avg. Flow 2018 % of Permitted Flow: 6.5 0.627667385 (< 80% / 90% OK) State of North Carolina Department of Environmental Quality DWR 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 15A NCAC 02T and the Division's Minimum Design Criteria and that plans, specifications and supporting documents have been prepared in accordance with, 15A NCAC 02T, 15A NCAC 02T .0300, Division policies and good engineering 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 15A NCAC 02T .0305 and the applicable minimum design criteriap These documents shall be available upon request by the Division. �C^1 Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T.0303. 'o �F 2c Projects not eligible for review via the fast track process (must be submitted for full technical review): p 0, ➢ 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; f> o �r� �O ➢ Projects that involve a variance from the requirements of 15A NCAC 2T; 9�ss-P, ➢ Pressure sewers stems utilizing septic tank -effluent pumps (STEPs or simplex grinder pumps; ➢ STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains);90, ➢ Vacuum sewer systems. 100 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: FTA 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 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 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 North Carolina licensed Professional En ig neer. ® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106(b). 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 Pagel 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. 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 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 15A NCAC 02T .0305(h)(1), 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 15A 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 .0115(c), submit the properly executed Operational 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 Operational Agreement (FORM: DEV). 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, Water Quality Section Swannanoa, North Carolina 28778 Clay, Graham, Haywood, Henderson, Jackson, (828) 296-4500 Macon, Madison, McDowell, Mitchell, Polk, (828) 299-7043 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, (910) 433-3300 Sampson, Scotland (910) 486-0707 Fax Mooresville Regional Office 610 E. Center Avenue Alexander, Cabarrus, Catawba, Cleveland, Water Quality Section Mooresville, North Carolina 28115 Gaston, Iredell, Lincoln, Mecklenburg, Rowan, (704) 663-1699 Stanly, Union (704) 663-6040 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, (919) 791-4200 Northampton, Orange, Person, Vance, Wake, (919) 788-7159 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, (252) 946-6481 Jones, Lenoir, Martin, Pamlico, Pasquotank, (252) 975-3716 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 (910)796-7215 (910) 350-2004 Fax Winston-Salem Regional Office 450 W. Hanes Mill Road Suite 300 Alamance, Alleghany, Ashe, Caswell, Davidson, Davie, Forsyth, Guilford, Rockingham, Randolph, Water Quality Section Winston-Salem, North Carolina 27105 Stokes, Surry, Watauga, Wilkes, Yadkin (336) 776-9800 INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 3 of 3 State of North Carolina Department of Environmental Quality DWR Division of Water Resources 15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION 1 Application Number,\�arn . �Y� � (t be completed by DWR) All items must be completed or the application will be returned I. APPLICANT INFORMATION: 1. Applicant's name: City of New Bern (company, municipality, HOA, utility, etc.) 2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Federal ❑ State/County ® Municipal 3. Signature authority's name: Mark Stephens, PE per 15A NCAC 02T .0106(b) Title: City Manager 4. Applicant's mailing address: P.O. Box 1129 City: New Bern State: NC Zip: 28563- 5. Applicant's contact information: Phone number: 252) 639-2701 Email Address: stephensin@newbermic.gov II. PROJECT INFORMATION: ❑ Privately -Owned Public Utility ❑ Other 1. Project name: West New Bern - Phase I Express Development 2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project If a modification, provide the existing permit number: WQOON/A and issued date: N/A If new construction but part of a master plan, provide the existing permit number: WQ000 3. County where project is located: Craven 4. Approximate Coordinates (Decimal Degrees): Latitude: 35.130654' Longitude:-77.122748' 5. Parcel ID (if applicable): 64673 & 62238 (or Parcel ID to closest downstream sewer) III. CONSULTANT INFORMATION: 1. Professional Engineer: Brian T. O'Kane License Number: 037468 Firm: Ark Consulting Group, PLLC Mailing address: 2755-B Charles Blvd. City: Greenville State: NC Zip: 27858- Phone number: 252) 702-7104 Email Address: brian.okaneaarkconsultinggroup.com IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION: 1. Facility Name: City of New Bern WWTF Permit Number: NCO02538+4"/& Owner Name: City of New Bern V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF): 1. Permit Number(s): WQ0035810 Downstream (Receiving) Sewer Size: 10 inch System Wide Collection System Permit Number(s) (if applicable): WQCS00052 Owner Name(s): City of New Bern 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 0 % Commercial 0 % Industrial (See 15A NCAC 02T .0103(20)) 1Is there a Pretreatment Program in effect? ❑ Yes [:]No 6. Hasa flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes ®No ➢ If yes, provide a copy of flow reduction approval letter 7. Summarize wastewater generated by project: Establishment Type (see 02T.0114(f)) Daily Design Flow °" No. of Units Flow Single Family Residential Lots 360 gal/lot 50 18,000 GPD gal/ GPD gal/ GPD gal/ GPD gal/ GPD gal/ GPD Total 18,000 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. 42A4). b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0114] 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: WO0035810 ❑ Rehabilitation or replacement of existing sewer with no new flow expected ❑ Other (Explain): FORM: FTA 04-16 Page 2 of 5 VU. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers): 1. Summarize gravity sewer to be permitted: Size (inches) Length (feet) Material 8 1795 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 (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) Length (feet) Material 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 '0* . V . IX. SETBACKS & SEPARATI( - (02B .0200 & 15A NCAC 02T.0305(f)): 1. Does the project comply with all separations found in 15A NCAC 02T.0305(f) & (g) ➢ 15A NCAC 02T.0305(fl contains minimum separations that shall be provided for sewer systems: ® 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 Draina e systems and interceptor drains 5 feet Any swimming 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 webpage ➢ 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 ® 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 02B .0200? ® Yes ❑ No ❑ N/A ➢ This would include Trout Buffered Streams per 15A 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 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.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 ❑ 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 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: 1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations and Force Mains (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 10-14) 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: I, SU.I•.. T. 01&4" _ __ _ _attest that this application for (Professional Engineer's name from Application Item III.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 $10,000, as well as civil penalties up to $25,000 per violation. North Carolina Professional Engineer's seal, signature, and date: 3. Applicant's Certification per 15A NCAC 02T .0106(b): I, (Signature Authority's nalhe & titlefrom Applfation Item I.3.) O . ?: O 4, .y ; a SEAL • 037468 'I'G I t4E (0, - ---- - -//---- -- - \ \ attest that this application for 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 143-215.6B, 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. Signature: ✓`i Date: / FORM: FTA 04-16 Page 5 of 5 State of North Carolina Department of Environmental Quality Division of Water Resources N: Division of Water Resources Flow Tracking for Sewer Extension Applications (FTSE 10-18) Entity Requesting Allocation: City of New Bern Project Name for which flow is being requested: West New Bern - Phase I Express Dev. More than one FTSE may be 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. O �6� 2 I. Complete this section only if you are the owner of the wastewater treatment plant. �..o o f s O m a. WWTP Facility Name: City of New Bern WWTF b. WWTP Facility Permit #: NC00253S4 Lf 8 All flows are in MGD d. c. WWTP facility's permitted flow 6.500 d. Estimated obligated flow not yet tributary to the WWTP 0.583 e. WWTP facility's actual avg. flow 4.276 f. Total flow for this specific request 0 g. Total actual and obligated flows to the facility 4.859 h. Percent of permitted flow used 74.75% 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: (A) (B) (C) (D)=(B+C) (E)=(A-D) Design Average Approx. Obligated, Pump Pump Daily Current Not Yet Total Current Station Station Firm Flow** Avg. Daily Tributary Flow Plus (Name or Permit Capacity, * (Firm / p fl, Flow, Daily Flow, Obligated Available Number) No. MGD MGD MGD MGD Flow Capacity*** LS-110 WQ0035161 1.656 0.662 0.000 0.100 0.100 0.562 * 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): New Bern WWTF Downstream Permit Number: NCO025348 Page 1 of 6 FTSE 10-18 III. Certification Statement: I M Wk- n . <� herG certify to the best of my knowledge that the addition of the volume of wastewatei 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 VLna.geY Title e Page 2 of 6 FTSE 10-18 Zwo tSGS U.S. DEU SRGEOL GC ALTHE SURVEYERIOR ASKIN QUADRANGLE NORTH CAROLINA-CRAVEN CO. relre�M�ei�iMlrwuAr 7.5-MINUTE SERIES _ Qr \J Washington In r,qr�s N 43 ForSIP ,25 , N Ln 25 5 25 �N Sits y FA _ -- = oU�r'wq — 01 e� ALI. ,10 2' 1 0 500 1000 200o RECEI V�D/N�pE�R ASKVJW°We 21 MILSFeet 1:12000.000 2016 UTM GRID AND 2 T C MAGNNTER O IC NORTH HEFT CONTOUR INTERVAL 5 FEET DECLINATION AT CENTER a SHEET NORTH AMERIUN VERTICAL DATUM OF 1988 Project Mgr.: BTO Project No.: 18089 NC License: P-,199 SITE L FItAN .` EXHIBIT Drawn By: KLG Scaie: AS SHOWN A D CONSULTING e� ora/ GROUP• PLLc WEST NEW BERN 1011jee Checked By: BTO Date: 04/10/19 Engineers & Planners EXPRESS DEVELOPMENT - PHASE I A 1 2755-B Charles Blvd. I Greenville, NC 27858 NEW BERN TWSP., CRAVEN COUNTY, NORTH CAROLINA m w 7 m m 3 �. �_ o w En Nn 00 C7 j n LD IV Fri z _O � E PLANNED UNIT DEVELOPMENT DESIGN DEVELOPMENT PLANS FOR D.R. HORTON - PHASE I EXPRESS DEVELOPMENT WEST NEW BERN Utility Providers / Agency Contacts: sxwal D.MNxr�E/snRErs: RErncuTxnrs: n�iwaaw m�n...nMEwr x�ePwv♦xc� New ra.xc meo NADLE: In21Ms192r Pxar: yn[goS2T P-w2r Gu •wowAVAGun:TM irixcir� Anc mE narAl. p>v1 n2.21Da WANT 1>NlTnata [IpSgN COMIIgL: SnIMAYATFILMMM AvocrnfxNxaxMExru wEiuww�clw;xc2> TZ xDTa. m Fro :IiuiMss�u� = 1121 wL LEGEND: EIIGTING/FW P PxGPOSED 1PK - CAAxw P 5f) ,eixP - Ar �rm wL o W -ENr.G FEN.Mx) • o - rmr AALTFP Da Nv- wLNR nIl( N FIfE RO.D REYAUW AxNsasED +xwP LxuY nA� xr orsnnM.Mx N src r aMa — - - IEYSWMY D/1EN5/pi D/IC2/ —�— /v` FP]L'//TALC) FDMN) nxlP NC Highway 43 West, City of New Bern Craven County, North Carolina B-H-HOMNO 'itte I; .071 S ® GPO PwRETNRAL �— — _ n oil F1ITURESTREET-B• \ -- =ram ® ® 97T-, BLUE ATLASp11ryrB ff \ \ r / ® L 1 BLUEy7EM WAY VE I I I SD SCALE 1 Mdl+ 100 R �$ITE Vicinity�M `ap Site Data u. ,x wMr . Fs c �..Es. �xuxfeLT,x NrororosrErs. Sheetindex iunlE SHEET NO. C-1 COVER SHEET SHEET NO. C-2 PROJECT NOTES SHEET NO. C-3 TYPICAL SECTIONS 6 LOT SETBACKS SHEET NO. CW KEY PLAN SHEET No. C-5 DEMOLITION B EROSION CONTROL PLAN SHEET NO. C-6 EROSION CONTROL PLAN - PHASE 1 SHEET NO. C-7 FROSNMI CONTROL PLAN -PHASE 2 SHEET No. C-B OVERALL PROJECT SITE LAYOUT SHEET NO. C-9 OVERALL PROJECT GRADING AND DRAINAGE (SOUTH) SHEET NO. C-10 OVERALL PROJECT SITE LAYOUT, GRADING AND DRAINAGE (NORTH) SHEET NO. C-11 OVERALL PROJECT UTILITIES PLAN SHEET NO. C-12 CONSTRUCTION PUN - ALLEY'E' &'T+ SHEET NO. C-ID CONSTRICTION PLAN - STREET'C SHEET NO. C-11 CONSTRUCTION PUN - STREET SHEET NO. C-15 CONSTRUCTION PUN - STREET -D' SHEET NO. C-16 LANDSCAPING PUN SHEET NO. C-17 CIVIL DETAILS SHEET NO. C-18 CIVIL DETAILS SHEET NO. C-19 CIVIL DETAILS SHEET NO. C-20 CIVIL DETAILS SHEET NO. C-21 CIVIL DETAILS SHEET NO. C-22 CIVIL DETAILS Developer Landowner D.11.NgrtpA 1000 AENM IFR PMRY/AY WEYEIMAEUFFR ICF AlATF OfVELOPAIEIl1 COMPAM M SUITE LLD IraJN4Y[MIAW2 ROILD xalwmrLLE, Nc xT9Eo carrtAcr: rACN AIOERSON AEACTsoRo, NC xersw CpRACf:nM uclaoN. R. NC) ILgIIE'. N1N.EGx9s9 rNGFAE:lxsxl633-]3l6 EMAIL: IANDERSONpDRNgUON.COM ExuA:nMJAC160NlVliY[xHAFUSf11.COM Engineer CON —G GE , PLLC �xns-e cNMLIES EIw. xn GREENSSllE, 12Cx]EX CON 1pMXx10'EANf, PE CpxTI2T'.E Surveyor MCgM i CIRiO, MC. NDRrN EwIr sTREEr WAMINGrON. NC aM01 IE; NS, CiS E: PNdAE:(I „12PNONF: I—)191011.i1d! fMAiC. ERMN.qunEpARECONSunNGGxOUP<OM EMAIL OlONFSlMCEPAdFFO.COM NOTES: 2REFERENCE r==w IUIE. MifSBKIOFF. rxxDl.EEof..Ex2 Tx,MruTwEro,xLo.EwLwE:rMw Cal rr.rwft PLANNED UNIT DEVELOPMENT I� DESIGN DEVELOPMENT PLANS FOR D.W-aHORTON SO �O Utility Providers / Agency Contacts: sTGRM IRwNRAE/shims: eLmiRc� s EHoffL. as�Un�fRNn E.»�e:ixvis»tln sRNNANr sfweR: NKRN: f>snA»xsx�s N»NL. 1lnai»-nxx Nq,N INelxv�iwEK b lxsxl xrs fm � LRosRxN coNIRu: NARfR.MfNru sraNNx•TEN~ ENT .oN..En.f wNc �E rf .v.�Nc�ons� u �-. I::h s«..f N»nL. lansEA�eaf LEGEND: unnw 3KGrosEP �s - ex�rsnAc Erov RRE RARr srI R/tY - RA7lEIOI N3Y B/P - ARG R) eROE RS,EEN - EE3KEIAf a � - NNRNI o - rmE RCNN N PC N- RN 1EI1 NA:K N fIEF AORO QE3N IAA' �f nfsosrP NGP wAPe ANI M 0/SMBHMY � SR I /FAeF _ _ _ — IMI.YtR NA ONCE AFxp/Rx Y MWN!D fI1[ilIICACRM QLCIRA' R3R+CMRIO/LflES/W—�— iv-v vv� 1I1EffK �� RL3]Y M[I SfaKN1 TZAR FARa� NEC33A0 RACIERAYQ'./Gl SwY! RANI - PHASE I EXPRESS DEVELOPMENT WEST NEW BERN NC Highway 43 Wes4 City of New Bern Craven County, North Carolina B-B-HORION Site Data I NNA —R\ MrARNORfnnrv—sm.rs. x, m0 9 3ER3RTAIfA �— — — � — y � !► _ —_ �8— STR� •B• � \ e \ BL'UESTEIH WAY 1 \ 5-4% ®L y TONING: C.3 `\ =NpBFI AVE ® ------- � I » Vicinity Map µ SHEET NO. C-1 COVER SHEET SHEET NO. C-2 PROJECT NOTES SHEET NO. C-3 TYPICAL SECTIONS 6 LOT SETBACKS SHEET NO. C-4 KEY PLAN SHEET No. C-S DEMOLITION A EROSION CONTROL PLAN SHEET NO. G6 EROSION CONTROL PLAN - PHASE 1 SHEET NO. C-7 EROSION CONTROL PLAN - PHASE 1 SHEET NO. C2 OVERALL PROJECT SITE LAYOUT SHEET NO. C-9 OVERALL PROJECT GRADING AND DRAINAGE (SOUTH) SHEET No. C-10 OVERALL PROJECT SITE LAYOUT, GRADING AND DRAINAGE (NORTH) SHEET NO. C-11 OVERALL PROJECT UTILITIES PLAN SHEET NO. C-12 CONSTRUCTION PLAN - ALLEY'E' B'F' SHEET NO. C-1' CONSTRUCTION PLAN - STREET'C' SHEET NO. C-14 CONSTRUCTION PLAN - STREET'C- SHEET NO. C-15 CONSTRUCTION PUN - STREET'D' SHEET NO. C-16 LANDSCAPING PUN SHEET NO. C-17 CML DETAILS SHEET NO. C-18 CML DETAILS SHEET NO. C-19 CIVIL DETAILS SHEET NO. C-20 CIVIL DETAILS SHEET NO. C-21 CIVIL DETAILS SHEET NO. C-22 CIVIL DETAILS Developer Landowner O.R.xON101f 3000 AERML aRTIR I.— wERERNAftNER REAL MATE OFVELCWMEMT CORMAMY SURE ISO M011R6VN1E, NC I]5A0 I705-R YI[YFRMA[INER ROAD VAMCFRAO, NC 36R6 CONTACT: UCII ANDEROM COMTA[r:hM IACKSON, ME, AIO RI3ONE: naNE:l@A3)RW E IIPAU193A fRMiL lANOfRSON@OIIHgxf011.COM EMAA:TFE.MRSONlYIEV[RNAFUSfl1.C[AE C Engineer Surveyor ARK CONSULTING GR—. KLC MxlM4QEED, NC. IzISSR CNMI[S RLw. N31—"FNONTS F GREENVNLE, ILC3]RSR CONTACT.NRANOKANE, PE VALMRRGION. NC 74ROl CONTACT: WVN310M[S. nS. CES PHONE:Izu13Rz-Ilw EMAIL. RRIAN.OMNfpARRCOM51AhMGGROUR.COM N— 1OR-K }S E EMAN:O)ONESlMCKNKREED.COM REFERENCE NOTES: „N KR.. NIifN0410N. NRNaNE�Nx ,N»,f»,NNu.NL.�x»L�LM,<,�L,M., crirE..3.NsE l U ��� U.S. DEPARTMENT OF THE INTERIOR ASKIN QUADRANGLE U.S. GEOLOGICAL SURVEY NORTH CAROLINA-CRAVEN CO. aeiMcrlYreolrylrworl/ 7.5-MINUTE SERIES L r Washington Ln 43 For w _ 6 c^ 1S �s Sq r�Gq��N site y F z �UNl-,►yq > 1;4�61jvco 17161 10 � ' ULS 1 0 500 1000 2000 ENR/0�� 1.11' ASKIN NC 21 MLS + t 1:12000.000 j 8 �2016 n UTM GRIDAND 2016 MAGNETIC NORTH CONTOUR INTERVAL 5 FEET 7 DECLINATION AT CENTER OF SHEET NORTH AMERICAN VERTICAL DATUM OF 1988 ProjectM r.: Project f E LOCATION PLAN EXHIBIT 1 9 BTO rol � 8Q69 n ^ NC Lkense: P-1199 .�.� Drawn By: KLG scale: AS SHOWN A D CONSULTING �!` Checked By: gTp Date: 04/10/19 5t:%([ `, `GROUP, PLLC WEST Ni4IBERN Engineers & Planners EXPRESS DEVELOPMENT • PHASE 1 A 1 2755-B Charles Blvd. I Greenville, NC 27856 NEW BERN TWSP., CRAVEN COUNTY, NORTH CAROLINA PWRI...-.- Division of Titter Resoierce State of North Carolina Department of Environmental Quality Division of Water Resources Flow Tracking for Sewer Extension Applications (FTSE 10-18) Entity Requesting Allocation: City of New Bern Project Name for which flow is being requested: West New Bern - Phase I Express Dev. 9k, More than one FTSE may be required for a single project if the owner of the WWTP Is not responsible for all p� stations along Cite route of the proposed wastewater flow. !n , �O 1. Complete this section only if you are the owner of the wastewater treatment plaitt�-76,�o ' a. WWTP Facility Name: City of New Bern WWTF ?o511 51)-1 0� b. WWTP Facility Permit #: NCO025384 c. WWTP facility's permitted flow d. Estimated obligated flow not yet tributary to the WWTP 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 MGqp D'° 6.500 0.583 4.276 0 4.859 74.75% 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: (A) (B) (C) (D)=(B+C) (E)=(A-D) Design Average Approx. Obligated, Pump Pump Daily Current Not Yet Total Current Station Station Firm Flow* * Avg. Daily Tributary Flow Plus (Name or Permit Capacity, * (Firm / pf), Flow, Daily FIow, Obligated Available Number) No. MGD MGD MGD MGD Flow Capacity*** LS-110 WQ0035161 1.656 0.662 0.000 0.100 0.100 0.562 * 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): New Bern W WTF Downstream Permit Number: NCO025348 Page 1 of 6 III. Certification Statement: I i v U ��C q , al-e- e r��� certify to the best of my knowledge that the addition of the volume of wastewate 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 OL11AW Title Page 2 of 6 State of North Carolina nw Department of Environmental Quality "up"h 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 15A NCAC 02T and the Division's Minimum Design Criteria and that plans, specifications and supporting documents have been prepared in accordance with, 15A NCAC 02T, 15A NCAC 02T .0300, Division Dolicies and good engineerine 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 15A NCAC 02T .0305 and the applicable minimum design eria. These documents shall be available upon request by the Division. cam, Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T.03 Projects not eligible for review via the fast track process (must be submitted for full technical review): - O0 , ➢ Projects that require an environmental assessment in accordance with 15A NCAC I .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; 9�bsm` �,o ➢ Pressure sewer systems utilizing septic tank -effluent pumps (STEPs) or simplex grinder pumps; �dj °� 10i ➢ STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains); ➢ Vacuum sewer systems. 0 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: FTA 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 North Carolina Secretary of State. ❑ 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 11.1 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 North Carolina licensed Professional Engineer. ® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106(b). 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 1 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. 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 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 15A NCAC 02T .0305(h)(1), 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 15A 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 .0115(c), submit the properly executed Operational 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 Operational Agreement (FORM: DEV). 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, Water Quality Section Swannanoa, North Carolina 28778 Clay, Graham, Haywood, Henderson, Jackson, (828) 296-4500 Macon, Madison, McDowell, Mitchell, Polk, (828) 299-7043 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, (910) 433-3300 Sampson, Scotland (910) 486-0707 Fax Mooresville Regional Office 610 E. Center Avenue Alexander, Cabarrus, Catawba, Cleveland, Water Quality Section Mooresville, North Carolina 28115 Gaston, Iredell, Lincoln, Mecklenburg, Rowan, (704) 663-1699 Stanly, Union (704) 663-6040 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, (919) 791-4200 Northampton, Orange, Person, Vance, Wake, (919) 788-7159 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, (252) 946-6481 Jones, Lenoir, Martin, Pamlico, Pasquotank, (252) 975-3716 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 (910) 796-7215 (910) 350-2004 Fax Winston-Salem Regional Office 450 W. Hanes Mill Road Suite 300 Alamance, Alleghany, Ashe, Caswell, Davidson, Davie, Forsyth, Guilford, Rockingham, Randolph, Water Quality Section Winston-Salem, North Carolina 27105 Stokes, Surry, Watauga, Wilkes, Yadkin (336) 776-9800 INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 3 of 3 DWR Division of Water Resources State of North Carolina Department of Environmental Quality Division of Water Resources 15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION FTA 04-16 & SUPPORTING DOCUMENTATION Application Number: (to be completed by DWR) All items must be completed or the application will be returned I. APPLICANT INFORMATION: 1. Applicant's name: City of New Bens (company, municipality, HOA, utility, etc.) 2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Federal ❑ State/County ® Municipal 3. Signature authority's name: Mark Stephens. PE per 15A NCAC 02T .0106(b) Title: City Manager 4. Applicant's mailing address: P.O. Box 1129 City: New Bern State: NC Zip: 28563- 5. Applicant's contact information: Phone number: 252) 639-2701 Email Address: stephensm(a-,newbernnc.gov H. PROJECT INFORMATION: ❑ Privately -Owned Public Utility ❑ Other 1. Project name: West New Bern - Phase I Express Development 2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project If a modification, provide the existing permit number: WQOON/A and issued date: N/A If new construction but part of a master plan, provide the existing permit number: WQ000 3. County where project is located: Craven 4. Approximate Coordinates (Decimal Degrees): Latitude: 35.130654' Longitude:-77.122748' 5. Parcel ID (if applicable): 64673 & 62238 (or Parcel ID to closest downstream sewer) III. CONSULTANT INFORMATION: 1. Professional Engineer: Brian T. O'Kane License Number: 037468 Firm: Ark Consulting Group, PLLC Mailing address: 2755-B Charles Blvd. City: Greenville State: NC Zip: 27858- Phone number: 252 702-7104 Email Address: brian.okanena arkconsultinggroup.com IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION: 1. Facility Name: City of New Bern WWTF Permit Number: NC0025384 Owner Name: City of New Bern V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF): 1. Permit Number(s): WQ0035810 Downstream (Receiving) Sewer Size: 10 inch System Wide Collection System Permit Number(s) (if applicable): WQCS00052 Owner Name(s): City of New Bern FORM: FTA 04-16 Pagel 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 0 % Commercial 0 % Industrial (See 15A NCAC 02T .0103(20)) 1Is there a Pretreatment Program in effect? ❑ Yes ❑ No 6. Hasa flow reduction been approved under 15A NCAC 02T .0114(fl? [:]Yes ®No ➢ If yes, provide a copy of flow reduction approval letter 7. Summarize wastewater generated by project: Establishment Type (see 02T.0114(f)) Daily Design Flow'" No. of Units Flow Single Family Residential Lots 360 gal/lot 50 18,000 GPD gal/ GPD gal/ GPD gal/ GPD gal/ GPD gal/ GPD Total 18,000 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. 42A4). 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: WO0035810 ❑ Rehabilitation or replacement of existing sewer with no new flow expected ❑ Other (Explain): FORM: FTA 04-16 Page 2 of 5 N 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 1795 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 VHI. 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) Length (feet) Material 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(hxl)(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. 1 SETBACKS & SEPARATIO,.a — (02B .0200 & 15A NCAC 02T .0305(f)): 1. Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (g) ➢ 15A NCAC 02T.0305(f) contains minimum separations that shall be vrovided for sewer systems: ® 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 swimming pools 10 feet Final earth grade vertical 36 inches ➢ 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(fl cannot be achieved. ➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage ➢ If noncompliance with 02T.0305(fl or (g), 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 02B .0200? ® 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 & 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.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 ❑ 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 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 ti R CERTIFICATIONS: 1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations and Force Mains (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 10-14) 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: I, 1. olt� rN(/ attest that this application for (Professional Engineer's name from Application Item III.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 $10,000, as well as civil penalties up to $25,000 per violation. North Carolina Professional Engineer's seal, signature, and date: 3. Applicant's Certification per 15A NCAC 02T .0106(b): I, (Signature Authority's nafne & titlefTom Applfation Item I.3.) \\11111111// Uh:: - S / O SEAL 4-•9 037468 FN �Q:•'k. �B GINS *igti T . O;�P /11111\ `IZ17L attest that this application for 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 143-215.6B, 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. Signature: ✓G Date: / FORM: FTA 04-16 Page 5 of 5