WQ0041430_Application (FTSE)_20200127

Vaughn & Melton
Consulting Engineers
January 16, 2020
Asheville Regional Office
Water Quality Section
2090 US Highway 70
Swannanoa, NC 28778
RE: Fast Track Sewer System Extension Application
I-440OBB Proposed Sewer Extension for City of Hendersonville
Attached is the permit application, permit application fee, and the Utility Construction
plans for the NCDOT I-440OBB project.
This project includes approximately 416 LF of 30" sewer trunkline that will be installed
as part of the interstate project and replacement of the existing bridge. The proposed
trunkline will be installed parallel to the existing trunkline but will be tied into the City
of Hendersonville collection system at a later date.
Please contact me at 865-546-5800 or [e-mail] if you have any
questions or need additional information.
Thank you,
/��ffvP�l I
U VIA
Sharon Deane, PE
JAN 17 2020
Water Quality Regional Opera;iois
Asheville Regional Office
Your Project. Our Promise.

State of North Carolina
DWR Department of Environmental Qualify,
Division of Water Resources
I5A 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 seiner extensions involving gravity sewers, punnp 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 nolteles and good engineering practices.
While no upfiront 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 criteria. These
documents shall be available upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T.0303.
Projects not eligible for review via the fast track process (must be submitted for full technical review):
➢ Projects that require an environmental assessment in accordance with 15A NCAC IC .0100;
➢ Projects that do not meet any part of the minimunm design criteria (MDC) document;
➢ Projects that involve a variance from the requirements of 15A NCAC 2T;
➢ Pressure sewer systems utilizing septic tank -effluent pumps (STEPs) or simplex grinder pumps;
➢ STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains);
D Vacuum sewer systems.
General — When submitting an application, please use the following insnuctions 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 slmall submit
one original and one copy of the application and supporting docummentation.
A. One Original and One Copy of Application mud Supporting Documents
E Required unless otherwise noted
D. Cover Letter (Required for All Application Packages):
E 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, nunnber of homes served, Row allocation required, etc.
➢ If necessary for clarity, include attachments to the application fonn.
C. Application Fee (All New mul Major Modification Application Packages):
E Submit a check or money order in the amount of $480.00 dated within 90 clays 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):
E 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 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 IL 1 shall be consistent with the project name on the Flow acceptance letters, agreennents, etc.
E The Professional Engineer's Certification on Page 5 of the application sliall 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 ilia), be designated as the signing othcrgl-il�leg�tior Itr�lvis T�
provided from a person who meets the criteria in 15A NCAC 02T .0106(b).
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION I `�(� ' 4Page I of 3 I'U
JAN 17
2020

E. Flow Tracking/Acceptance Form (Form: FTSE 04-16) (If Applicable):
❑ Submit the completed and executed FTSE form from the owners of Ilse downstream sewers and treatment facility.
➢ Multiple forms maybe required where the doo nstreanr 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 forni 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 project -specific FTSE.
Site Maps (All Application Packages):
® Submil an 8.5-inch x I [-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, now allocation, treatment facility, etc.).
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per I5A NCAC 02T.0305(h)(1), submit dOCmnentation 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 powergeneration 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)
Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per 15A NCAC 02T ,0I15(a)(O provide the Certificate of Public Convenience and Necessity front 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 front HOA/POA and Developers for lots to be sold):
❑ Home/Property Owners' Associations
❑ Per l5A 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 .0I 15(b), submit the properly executed Operational Agreement (FORM: DEV).
For more injiw-oration, visit the Division's collection systems website
INSTRUCTIONS FOR FORM: FTA 04-16 R 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,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Realonal Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section
Fayetteville, North Carolina 28301-5094
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[phone] Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Water Quality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
Raletah Realonal Office
1628 Mail Service Center
Chatham, Durham, Edgecombe, Franklin,
Water Quality Section
Raleigh, North Carolina 27699-1628
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Warren, Wilson
Washington Realonal Office
943 Washington Square Mali
Beaufort, Bartle, Camden, Chowan, Craven,
Water Quality Section
Washington, North Carolina 27889
Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilminaton Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section
Wilmington, North Carolina 28405
Hanover, Onslow, Pander
[phone]
[phone] Fax
Winston-Salem Realonal Office
450 W. Hanes Mill Road
Alamance, Alleghany, Ashe, Caswell, Davidson,
Water Quality Section
Suite 300
Davie, Forsyth, Guilford, Rockingham, Randolph,
Winston-Salem, North Carolina 27105
Stokes, Surry, Watauga, Wilkes, Yadkin
[phone]
INSTRUCTIONS FOR FORM: FTA 04-16 R SUPPORTING DOCUMENTATION Page 3 of 3

Dlvlslon of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resoumes
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
1. APPLICANT INFORMATION:
I. Applicant's name: City of Hendersonville (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Painership
❑ Federal ❑ State/County ® Municipal
3. Signature authority's name: Lee Smith per 15A NCAC 02T 0106(b)
Title: Utilities Director
4. Applicant's mailing address: 305 Williams Street
City: Hendersonville State: NC Zip: 28792-
5. Applicant's contact inforniation:
Phone number. [phone] Email Address: [e-mail]
11. PROJECT INFORMATION:
❑ Privately -Owned Public Utility
❑ Other
1. Project name:)-4400BB/4400C UC Plans for City of Hendersonville
2. Application/Project status: ® Proposed (New Pennit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: W000_ and issued date:
If new construction but part of a master plan, provide the existing permit number: W000_
3. Countywhere project is located: Henderson
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.3493' Longitude:-82.4528'
5. Parcel ID (if applicable): PIN 9 9579-18-3554
(or Parcel ID to closest downstream sewer)
Ill. CONSULTANT INFORMATION:
I. Professional Engineer: Sharon Deane License Number: 046557
Firm: Vaughn & Melton Consultine Ennhneers, Inc
Mailing address: 1909 Ailor Ave
City: Knoxville State: TN Zip: 37921-_
Phone number. [phone] Email Address: ssdeane .vauehnnnelton cony
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I. Facility Name: City of Hendersonville WWTP
Owner Name: Citv of Hendersonville
Permit Number: NCO025534
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
I. Permit Number(s): WQ_ Downstream (Receiving) Sewer Size: _ inch
System Wide Collection System Permit Number(s) (if applicable): WQCS00070
Owner Name(s): City of Hendersonville
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 solo, 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: FICA) 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 [Ionic ❑ Other (Explain in Attachment)
5. Nature of wastewater : % Domestic/Commercial %Commercial
_ % Industrial (See 15A NCAC 02T 0103(20))
"Is there a Pretreatment Program in effect? ❑ Yes [:]No
G. Hasa flow reduction been approved under 15A NCAC 02T .01 14(f)? [-]Yes ❑ No
If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 021.01140
Daily Design Flow n,n
No. of Units
Flow
gau
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
0 GPD
a See 15A NCAC 02T .0114(b). (d). (e)(1) and (e)(2) for caveats to wastewater design flow rates (i.e., mininnun 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 .0I 14(c), design flow rates for establishments not identified [in table 15A NCAC 02T.01141 shall be
determined using available flow data, water rising fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: _GPD (per 15A NCAC 02T.0114)
➢ Do not include future flows or previously pennitted 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):
I. Summarize gravity sewer to be permitted:
Size (inches) Length (feel) Material
30 416 PVC, C905
➢ Section 11 & 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 mininurm slope requirement is not allowed and a violation of the MDC
Vill. PUMP STATION DESIGN CRITERIA (If Applicable) — 20 T.0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Punlp station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: -
3. Design Row of the prunp station: millions gallons per day (firm capacity)
4. Operational points) of the puntp(s): _ gallons per minute at _ feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Puntp 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)(I)(13):
➢ Required for all pump stations with an average daily now greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily Row less than 15,000 gallons per day:
❑ Portable power source with manual activation, quit!: -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pinup connection and telemetry - 15A NCAC 021" .0305(h)(l)(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, air evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timefrantes, stall be provided
in the case of a multiple station power outage.
PORIVI: PTA 0-1-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T.0305(f);
I. Does the project comply with all separations found in 15A NCAC 02T 0305(B & (a) ® Yes ❑ No
➢ 15A NCAC 02T.0305(f) contains minimum senaratinns that shall hn nrnvided far <e.vPr
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 server
18 inches
Reclaimed water lines horizontal - reclained over sewer
2 feet
**Any private or public water supply source, including any wells, WS-1 waters of Class I or
Class Il impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-1 or WS-V), B, SA, ORIN, HQW, or SB front 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 buildiraz foundation
5 feet
Any basement
10 feet
Top sloe 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
➢ I5A NCAC 02T.0305(2) contains alternatives where separations in 02T.0305 cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webnage
➢ 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 clmR 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 PermittingBranch
ranch
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional pennits/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, stonnwater 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 tine pernnittee or its representative at least once every six -months and inspections
documented per ISA NCAC 02T.0403(a)(5) m• the pernlitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Paae 4 of 5

X. CERTIFICATIONS:
I. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permittingof f 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:
name from
Rem 111.1.)
_attest that this application for
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
Mininuntt 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
havejudged 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 510,000, as well as civil penalties up to $25,000 per violation.
North Carolina Professional Engineer's seal, signature, and slate:
Applicant's Certification per 15A NCAC 02T .0106(b):
that this application for
(Signature Aittluority's name Rc title from Application Item 1.3.)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to behig rtimrned 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 retunred to me as
incomplete.
NOTE — In accordance with General Stantte5 143-215.6A and 143-215.6B, any person who knowingly stakes 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.
Signatnr� l l Date:
FORM: FTA 04-16 Page 5 of 5

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