WQ0040047_Application (FTSE)_20200124

State of North Cat-olina
DWR
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
i /�Wl �[ RECEIVED/NCDENR/DWI :
Application Number : Od'T (to be completed by DWR)
BAN 1. 5 `02.0
All items must be completed or the application will be returned
I. APPLICANT INFORMATION: WQROS
MOORESVILLE REGIONAL OFFICE
1. Applicant's name: Charlotte Water (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State/County ® Municipal
3. Signature authority's name: Joseph C. Wilson, PE per 15A NCAC 02T .0106(b)
Title: Chief Engineer
4. Applicant's mailing address: 5100 Brookshire Blvd
City: Charlotte State: NC Zip: 28216-
5. Applicant's contact information:
Phone nurnber: [phone] Email Address: cwilson cr,charlottenc.Rov
II. PROJECT INFORMATION:
❑ Privately -Owned Public Utility
❑ Other
1. Project name: Stevens Creek Lift Station Forcemain & Gravity Sewer
2. Application/Project status: ❑ Proposed (New Permit) ® Existing Permit/Project
If a modification, provide the existing permit number: WQ0040047 and issued date: 06/22/2018
If new construction but part of a master plan, provide. the existing permit number: WQ00
3. County where project is located: Mecklenburg
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.14230' Longihide:-80.64045'
5. Parcel ID (if applicable): 19701145
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
I . Professional Engineer: Dale Stewart, PE License Number: 6988
Firm: Land Design
Mailing address: 223 N Graham Street
City: Charlotte State: NC Zip: 28202-
Phone number: [phone] Email Address: dstewartalanddesi n.corn
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: McAlpine Creek WMF Permit Number: NCO024970
Owner Name: Charlotte Water
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS00001
Owner Name(s): Charlotte Water
FORM: FTA 04-16 Page i 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
❑ Businesses /offices !factories ❑Swimming Pool/Filter Backwash
❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic/Commercial % Commercial
% Industrial (See 15A NCAC 02T .0103(20))
`--GIs 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(f1)
Daily Design Flow AEU
No. of Units
Flow
0 gpd
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
GPD
a See 15A NCAC 02T .0114(b) (d), (e1 and (e)(2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.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:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16 Page 2 of 5

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8'
4,350
PVC/ DIP
16"
4,080
PVC/ DIP
20"
4,170
PVC/ DIP
24"
222
DIP
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: Stevens Creek Lift Station
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.14230° Longitude:-80.640450
3. Design flow of the pump station: 4.32 millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 650, 960, 1300, 1600 3000 gallons per minute at 164, 168, 174, 181 226 feet total
dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
12"
50
DIP
20"
14,560
PVC/ DIP
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)
KI
❑ 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(t)):
1. Does the project comply with all separations found in 15A NCAC 02T .0305(fl & (g) 0 Yes ❑ No
➢ 15A NCAC 02T.0305 contains minimum separations that shall be provided for sewers stems•
Setback Parameter*
Se aration 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-1 or WS-V), B, SA, ORW, HQW, or SB fi•om normal
high water or tide elevation) and wetlands see item 1X.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 fiom the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.0 I 05(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0I05(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, storrnwater 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 st•eambanks 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:
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 Traelc Application and supportinL documents
2. Professional Engineer's Certification:
I, Rca f, C• S +'tt- o—r t" attest that this application for
(Professional Engineer's name fi•om Application Item Ill. I.)
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 loiowledge. I filrther 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 Class 2 nnis et nor, which may
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per violatio4
North Carolina Professional Engineer's seal, signature, and (late:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
1, N1 O5(-,21 CLA,) t 1<_m C-111 P-F 9 r
(Signature Authority's name & title
a
Application Item I1)
9 "•�'G/NEB'' �a
®®� s••ST
.» owIll's 111600"1
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 fi•om 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 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 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: V L Date: I Lzo1
FORM: FTA 04-16 Page 5 of 5

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Polaris 3G Map — Mecklenburg County, North Carolina
This map or report is prepared or the inventory o real property within Mecklenburg County and rs compile rom repor a ee s, p ats, tax maps, surveys,
planimetric maps, and other public records and data. Users of this map or report are hereby notified that the aforementioned public primary information sources
should be consulted for verification. Mecklenburg County and its mapping contractors assume no legal responsibility for the information contained herein.

Polaris 3G Map — Mecklenburg County, North Carolitci I
Date Printed: 1/10/2018 11 :06:39 AM
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T1Er'EIVED/NCDENR/DWR
LandDesgn.
CREATING PLACES
THAT MATTER.
NCDENR Division of Water Quality
Mooresville Regional Office
610 E. Center Avenue
Mooresville, North Carolina 28115
JA N 15 2,92n
VIOORI'� �,ALOFFICE
January 15, 2020
Subject: Fast Track Sewer System Extension Application for Permit Modification
Project: Stevens Creek Lift Station, Forcemain and Gravity Sewer
LanclDesign PN: 1016224
SEWER SYSTEM APPLICANT:
Charlotte Water
5100 Brookshire Blvd
Charlotte, NC 28216
ITEMS INCLUDED:
Enclosed is the Fast Track Application for Permit Modification for Charlotte Water's Stevens Creek Lift Station,
Force Main, and Gravity Sewer Improvements project located in Mint Hill, North Carolina. Included you will find
a complete application form, application fee, project USGS Topographic Map, and multiple street level aerial
maps identifying the location of proposed sanitary sewer improvements. One additional copy of the application
and supporting documentation is also provided.
DESCRIPTION:
The proposed sanitary sewer improvements include the installation of a regional tri-plex pump station (4.32
MGD capacity), approximately 14,610 LF of PVC/DIP force main, and approximately 12,822 LF of PVC/DIP
gravity sewer. The proposed modification is to upsize several of the gravity sewer as follows:
CURRENTLY PERMITTED GRAVITY SEWER
Size inches
Length feet
Material
8
4,350
PVC/DIP
12
4,080
PVC/DIP
16
4,170
PVC/DIP
24
222
D I P
PROPOSED GRAVITY SEWER
Size inches
Length feet
Material
8
4,350
PVC/DIP
16
4,080
PVC/DIP
20
4,170
PVC/DI P
24
222
DIP
Flow to the proposed lift station and gravity sewer will be subsequently permitted and sent to the McAlpine
Creek Wastewater Treatment Plant (NPDES permit number NC0024970).
The lift station, forcemain, and gravity sewer will be constructed per Charlotte Water Standards and
Specifications. Activation of the proposed Stevens Creek Lift Station, Force Main, and Trunk Sewer project is
contingent upon the construction and activation of Charlotte Water's Irvins Creek Tributary Trunk sewer
improvements (Charlotte Water Project No. 7030600111-17-571).
Sincerely,
,44W
Dale C. Stewart, PE
LANDDESIGN.COM
223 N. GRAHAM STREET • CHARLOTTE, NC 28202 - 704.333.0325
CHARLOTTE • WASHINGTON D.C. - DALLAS - ORLANDO - SAN FRANCISCO - BOULDER