WQ0041444_Application (FTSE)_20200130

Lq Odom
Engineering Puc
January 20, 2020
Mr. Tim Heim
NCDEQ— Asheville Regional Office
2090 US Highway 70
Swannanoa, North Carolina 28778
WGtoogIgq4
169 Oak Stroot - Forest City, NC 28043
office 828. 247.4495 • fax 82.8,247,4498
Subject: Fast Track Sewer System Extension Application
Town of Rutherfordton—Rutherfordton Sewer to RS Central HS
Dear Mr. Heim:
We are submitting a Fast Track Sewer System Extension Application for the Rutherfordton Sewer to RS
Central HS project located in Rutherford County. This submittal will include the following items:
Fast Track Sewer Application
Application Fee
• USGS Topographic Map
If you have any questions or need additional information, please contact me at 828-247-4495 or
[e-mail].
Sincerely,
I � �
David Odom, P.E.
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Fast Track Application rec'd 01/21/2020 RLITHE
woo
THISOIBBURSEMENTHAS SMAUROVED
ASAEQUIRBD BY THE LOCAL GOVERNMENT
41�11
Rutherfordton
NORTH CA LINA_
BUDOETA'D FISCAL CONTROLACT
L
NORTH CAROLINA
56111PJ531
-
- 129 NMAIN ST,
RUTHERFgRDTON,. NORTH CAROLINA 28139
6
DATE
AMOUNT,
o'
\
01/16/2620.
$48000
Four Hundred Eighty Dollars and 00 Cents
PAY
TOTHE
ORDER NC DEQ
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1617 MAIL SERVICE CENTER i?-
R4LEIGH NC 2769E r.

State of North Carolina
D" %� Department of Environmental Quality
w Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application NumberW@ooL11q qq(m ba campletcd by DWR)
All items must be completed or the application will be returned
L APPLICANT INFORMATION:
1. Applicant's name: Town ofRutherfordton (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
p ❑Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: Doug Barrick per 15A NCAC 02T 0106tb1
Title: Town Manager
4 Applicant's mailing address: 129 N. Main Street \� /
City: Rutherfordton State: NC Zip: 28139= n Jhi t, d Lo. G.7
5. Applicant's contact information:
Phone number:[phone] Email Address: dbarrick0initherfordeonit Water nliwllty 1flCJional OJBi2,I10IIS
Asheville Regionsd 0111CO
IL PROJECT INFORMATION:
1. Project name: Rutherfordton Sewer to RS Central HS
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If modification, provide the existing permit number: WQOO and issued date:
If new construction but part of a master plan, provide the existing permit number: W000
3. County where project is located: Rutherford
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.38494' Longitude:-81.9619-
5. Parcel ID (if applicable): _
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: David Odom License Number: 21130
Firm: Odom Engineerine PLLC
Mailing address: 169 Oak Street
City: Forest City State: NC Zip: 28043-_
Phone number: [phone] Email Address: davidodom(dodomengineerine com
IV. WASTEWATER TREATMENT FACILITY (WWTF)11INFORMATION:
1. Facility Name: Permit Number:NCCU µS0) 0(6
Owner Name:
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s):WQ Downstream (Receiving) Sewer Size:_ inch
System Wide Collection System Permit N b n) (if applicable): WQCS
Owner Name(s):
FORM: FTA 04-16 Pagel of 5

V1. GENERAL REQUIREMENTS
1. If the Applicant is aPrivately-Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑Nc NN/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/Proverry Owners' Association, has an Operational Agreement (FORMi HOM been attached?
❑ Yes ❑No NN/A
4. Origin of wastewater: (check all that apply):
❑ Residential Owned ❑ Retail (stores, centers, malls)
❑ Residential Leased ❑ Retail with food preparation/service
N School / preschool / day care ❑ Medical / dental / veterinary facilities
N Food and drink facilities ❑ Church
N Businesses / offices / factories ❑ Nursing Home
5. Nature ofwastewater 100 % omestic/Commercial % Commercial
o Industrial (See 15A NCAC 02T 0103(20))
"Is there a Pretreatment Program in effect?
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool /Clubhouse
❑ Swimming Pool/Fiher Backwash
❑ Other (Explain in Attachment)
❑ Yes N No
6. Hasa flow reduction been approved under 15A NCAC 02T 0114(f)7 ❑ Yes N No
➢ If yes. Provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project
Establishment Type (see 02T.0114(D)
Daily Design Flow •^
No. of Units
Flow
School
15 gal/student
2000
30,000 PD
Restaurant
40 gal/seat
200
8,000 TD
gal/bedroom
GPD
gal/
GPD
gal/
GPD
gal/
GPD
To[p[
38,00 PD
a See 15A NCAC 02T 0114(b). (d) (e)(1) and (e)(2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
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,;w t r using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 38 000 C(per 15A NCAC 02T .0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is to, indicate why:
❑ Pump Station or Gravity Sewer where flaw 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

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
8,100
SDR-21
8
80
CL350 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 sewers)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
Vlll. 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: RS Central Lift Station
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.38484° Longitude:-81.9619°
3. Design flow of the pump station:,�O millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s):rJjy gallons per minute at IS-1) feet total dynamic head (TDID
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
6
3,830 7
C900 DR-18
6. Power reliability in accordance with 15A NCAC 02T.0305(h)(I):
® tandby 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
D Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C):
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B.0200 & 15A NCAC 02T.0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T.0305(f) & (g) ® Yes ❑ No
➢ tsa Nrnr mT moon,.,.�.";"�...;�;..,,....�o..a.o.:,,.,...xa. oxen xe ......,:asa �..e..,e.......�_...
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 B impounded reservoirs used as a source of drinking water
100 feet
**Waters classified W S (except WS-I or WS-V), B, SA, DEW, HQW, or SIB 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
Drains e s stems and inter¢¢ for drains
5 feet
An swimmin cols
10 fee[
Final earth grade vertical
36 inches
➢ 15A NCAC 02T 0305(g) contains alternatives where separations in 02T.0305(tl cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications welmage
➢ If noncompliance with 02T.0305(f) or (9) 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 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, 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
sitione pod 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:
Does the submitted system comply with t5A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains (latest version) and the Gravitv Sewer Minimum Design Criteria (latest version) as applicable?
X Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval ofthe reauest' d prior to submittal ofthe Fast Tk Application and supporting documents.
2. Professional Engineer's Certification:
I David Odom attest that this application for
(Professional Engineer's name from Application Item IR.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
havejudged it to be consistent with the proposed design.
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.
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T.0106(b):
I Doug Barrick attest that this application for
(Signature Authority's name & 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 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.
rn-�D
Signature: Date: IO Zo20'�
FORM: ETA 04-16 Page 5 of 5

s
e
171vtsion of Water flat+w�rra,c
Entity Requesting Allocation:
W Qo d q' q State of North Carolina
Depart ent of Environmental Quality
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Town of Rutherfordton
Project Name for which flow is being requested: Rutherfordton Sewer to RS Central HS
More than one FTSE may be required for a single project ithe owner ofthe WWTP is not
stations along the route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment
a. W WTP Facility Name: Town of Rutherfordton
b. W WTP Facility Permit #: NC0025909
c. W WTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the W WTP
e. W WTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
It. Percent of permitted flow used
0.637
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 W WTP:
(A)
(B) (C) (D)=(B+C) (E)=(A-D)
Design
Obligated,
Pump Average Daily
Approx. Not Yet Total Current
Station Firm Flow**
Current Avg. Tributary Flow Plus
(Name or Capacity, * (Firm / pt),
Daily Flow, Daily Flow, Obligated Available
Number) MOD MOD
MGD MGD Flow Capacity***
* The Firm Capacity 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.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the W WTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer):
Downstream Permit Number:
Page 1 of 6
FTSE 04-16

III. Certification Statement:
`IY��d.� certify to the best of my knowledge that the addition of
the volume of wastew tamer 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 indicates acceptance of this wastewater flow.
Page 2 of 6
F I'SF.04-16

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