WQ0041448_Application (FTSE)_20200122

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXWSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTI VOCUMENTATION
Application NumberW LLq S (to be completed by DWR) 114 �iyg
k
All items must be cornMeted or the auulication will be detur
•�� �, .'��;. aid,
L APPLICANT INFORMATION:
1. Applicant's name: Greenville Utilities Commission (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately ed Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: Clifton H. Cahoon per 15A NCAC 02T .0106(b)
Title: Construction/Contracts En ig neer
4. Applicant's mailing address: PO Box 1847
City: Greenville State: NC Zip: 27835-1847
5. Applicant's contact information:
Phone number: [phone] Email Address: cahoonch(a,) u� c.com
II. PROJECT INFORMATION:
1. Project name: Blackwood Ridge Subdivision Phase 3
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Pitt
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.536503' Longitude:-77.355783'
5. Parcel ID (if applicable): 84930
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: William K. Malpass License Number: PE 16823
Firm: Malpass & Associates
Mailing address: 1645 East Arlington Blvd. Suite D
City: Greenville State: NC Zip: 27858-
Phone number: [phone] Email Address: ken(a-)malpassandassociates.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Greenville Utilities Commission Permit Number: NCO023931
Owner Name: Greenville Utilities Commission
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ0038350 Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s):
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 % Commercial
% Industrial (See 15A NCAC 02T .0103(20))
bIs there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(()? ❑ 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 a,b
No. of Units
Flow
3 bedroom single family residence
360 gal/residence
7
2520 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
2520 GPD
a See 15A NCAC 02T .0114(b). (d), (e)(1) and (e)(2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-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, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 2520 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

VH. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
155
PVC
8
20
DIP
`l 5
➢ 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

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) & (a)
➢ t G A AT( AC n2T 0M5(fl enntains minimum senarations 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 H 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(Q) contains alternatives where separations in 02T.0305(fl cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webnage
➢ If noncompliance with 02T.0305 or 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.04021 "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ® No ❑ 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 Apmlication and supmortine documents.
2. Professional Engineer's Certification:
1, William K. Malpass 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. -___
.•``�N CA j %
North Carolina Professional Engineer's seal, signature, and date: ��•` ����
SEAL
' 16823
3. Applicant's Certification per 15A NCAC 02T .0106(b):7MIX100
1, Clifton H. Cahoon attest that this application for
(Signature Authority's name & title from Application Item I.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.
Signature:
Date: 01-1,q
FORM: FTA 04-16 Page 5 of 5

Division of Water Resources
Entity Requesting Allocation:
State of North Carolina
Department of Environmental Quality
Division of Water Resos
i
Flow Tracking/Acceptance for Sewer Extension Application
(FTSE t16)
2 �9
Greenville Utilities Commission �ar�ogr0, zv�z-o
x.• ix
Project Name for which flow is being requested: Blackwood Ridge, Phase 3
F 9�0
NV
9,0 cro�oa,
More than one ME may be required for a single project if the owner of the WWTP is not responsible for all p
stations along the route of the proposed wastewater flow. '`1010
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name:
Greenville Utilities Commission
b. WWTP Facility Permit #: NC0023931
All flows are in MGD
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
17.5
2.411
10.269
.0025
12.683
72.475
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
Obligated,
Pump
Average Daily
Approx.
Not Yet
Total Current
Station
Firm
Flow**
Current Avg.
Tributary
Flow Plus
(Name or
Capacity, *
(Firm / pf),
Daily Flow,
Daily Flow,
Obligated
Available
Number)
MGD
MGD
MGD
MGD
Flow
Capacity***
Southside
30.2
12.08
6.583
1.124
7.707
4.373
Fork 6.513 2.605 1.332 .231 1.563 1.042
* 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 (pi) not less than 2.5.
*** 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): Blackwood Ridge Subdivision
Downstream Permit Number: WQ0038350
Page 1 of 6
FTSE 04-16

III. Certification Statement:
I Clifton H. Cahoon, PE certify to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the
receiving wastewater treatment facility and that the flow from this project is not anticipated to
cause any capacity related sanitary sewer overflows or overburden any downstream pump station
en route to the receiving treatment plant under normal circumstances, given the implementation
of the planned improvements identified in the planning assessment where applicable. This
analysis has been performed in accordance with local established policies and procedures using
the best available data. This certification applies to those items listed above in Sections I and II
plus all attached planning assessment addendums for which I am the responsible parry.
Signature of this form indicates acceptance of this wastewater flow.
Signing Official Signature
�119'_,20,20
Date
Page 2 of 6
FTSE 04-16

1V 9 ?
lgias cit. �ty/?
Engineers Report for Pu ticA ss����o,,a�
Sanitary Sewer Main Extension����
for
Blackwood Ridge Phase 3
Greenville, North Carolina
December 5, 2019
Project: Blackwood Ridge Phase 3
Greenville, NC
Water Supplier: Greenville Utilities Commission
PO Box 1847
Greenville, NC 27835-1847
[phone] - Phone
[phone] — Fax
Sanitary Sewer Greenville Utilities Commission
Service: PO Box 1847
Greenville, NC 27835-1847
[phone] - Phone
[phone] — Fax
Developer: Blackwood, Parrott & Roberson
1003 Red Banks Road
Greenville, NC 27858
[phone] - Phone
[phone] - Fax
Engineer: Malpass & Associates
1645 East Arlington Boulevard, Suite D
Greenville, NC 27858
IIllllllf{{{f111
[phone] - Phone �.•''C,ARO4;A%,,
[phone] -Fax jtA, O-�'s"sioNg4,,.y -,;
R
C
William K. Malpass

Project Description:
Area to be Served
The project is a proposed sanitary sewer main extension to serve 7 single family
homes/residences.
Proposed Facilities
Approximately 175 LF of 8" sanitary sewer main, seven (7) four inch sewer
services, one (1) manhole and appurtenances are proposed for this sanitary
sewer main extension.
Demands
Assuming 3 bedrooms per home at 120 gpd/bedroom yields a daily flow rate of
360 gpd/home. There are 7 homes proposed on this development therefore the
daily demand for Blackwood Ridge Phase 3 would be 2,520 gallon per day.
Existing Greenville Utilities System Description:
Location of project in relation to existing sanitary sewer system
The sanitary sewer system for the proposed Blackwood Ridge Phase 3
subdivision is proposed to be connected to the existing Blackwood Ridge Phase
2 subdivision which has an existing eight inch (8") sanitary sewer system which
has been stubbed into the proposed Phase 3 development.

A
Lo
J
EXISTING
c� BLACKWOOD `
PHIASEE2°IPROPOSED
`�••
8" SANITARY
�`Q • I I I SEWER
` MAIN
Y V•
/ /
•
BROOK FIELDS DRIIE
dim-
ENOF EXISTING
8" SANITARY
SEWER MAIN
Ii
PERMIT NO.
W00038350
PROPOSED
�q/V
BLACKWOOD
RIDGE
PHASE 3l�jia 0,0&!•QOo'/%ty��
ngt0") &,U �a9oo ai
0;�c,9
SITE MAP
FAST TRACK USGS MAP SECTION FOR
BLACKWOOD RIDGE PHASE 3
CITY OF GREENVILLE WINTERVILLE TOWNSHIP PITT COUNTY NORTH CAROLINA
GREENVILLE SE, NC USGS MAP

STREET LEVEL AND AERIAL MAP OF PROJECT
BLACKWOOD RIDGE PHASE 3 - SANITARY SEWER EXTENSION
CITY OF GREENVILLE WINTERVILLE TOWNSHIP PITT COUNTY NORTH CAROLINA

Greenville
Utilities
January 14, 2020
PO Box 1847
Greenville, NC
27835
ww•w.guc.com
Mr. Robert Tankard
Assistant Regional Supervisor
North Carolina Division of Water Quality
943 Washington Square Mall
Washington, NC 27889
Subject: Blackwood Ridge Subdivision
Phases 3
Sewer Main Extension
Dear Mr. Tankard:
We are submitting herewith one (1) original and one (1) copy of the executed
Non -Discharge Permit Application and Flow Tracking/Acceptance for Sewer
Extension Permit Applications along with a check for $480.00 for the subject
project. We request your approval of the sewer improvements.
We trust that you will find this submittal to be in order and that your approval will
be forthcoming. In the meantime, should you have any questions or require any
additional information, please let us know.
Sincerely,
Clifton H. Cahoon, PE
Construction / Contracts Engineer
Enclosures
c: Mr. Randall D. Emory, PE, Director Water Resources
Mr. William K. Malpass, PE, Malpass & Associates
Your Local
Advantage

4
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of tk ate Kc!"(Yvt<Cs Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Greenville Utilities Commission
Project Name for which flow is being requested: Blackwood Ridge, Phase 3
More than one FTSE may be requiredfor a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Greenville Utilities Commission
b. WWTP Facility Permit #: NC0023931
All flows are in MGD
c. WWTP facility's permitted flow 17.5
d. Estimated obligated flow not yet tributary to the WWTP 2.411
e. WWTP facility's actual avg. flow 10.269
f. Total flow for this specific request .0025
g. Total actual and obligated flows to the facility 12.683
h. Percent of permitted flow used 72.475
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 Obligated,
Pump Average Daily Approx. Not Yet Total Current
Station Firm Flow** Current Avg. Tributary Flow Plus
(Name or Capacity, * (Firm / pf), Daily Flow, Daily Flow, Obligated Available
Number) MGD MGD MGD MGD Flow Capacity***
Southside 30.2 12.08 6.583 1.124 7.707 4.373
Fork 6.513 2.605 1.332 .231 1.563 1.042
* 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 WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): Blackwood Ridge Subdivision
Downstream Permit Number: WQ0038350
Page 1 of 6
FTSE 04-16

III. Certification Statement:
I Clifton H. Cahoon, PE certify to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the
receiving wastewater treatment facility and that the flow from this project is not anticipated to
cause any capacity related sanitary sewer overflows or overburden any downstream pump station
en route to the receiving treatment plant under normal circumstances, given the implementation
of the planned improvements identified in the planning assessment where applicable. This
analysis has been performed in accordance with local established policies and procedures using
the best available data. This certification applies to those items listed above in Sections I and II
plus all attached planning assessment addendums for which I am the responsible parry.
Signature of this form indicates acceptance of this wastewater flow.
(p-1 0-6(�,��.� of ��-�o�
Signing fcial Signature Date
Page 2 of 6
FTSE 04-16

M11,4
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: Greenville Utilities Commission (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: Clifton H. Cahoon per 15A NCAC 02T .0106(b)
Title: Con struction/Contracts Engineer
4. Applicant's mailing address: PO Box 1847
City: Greenville State: NC Zip: 27835-1847
5. Applicant's contact information:
Phone number: [phone] Email Address: cahoonch(i� uguc.com
II. PROJECT INFORMATION:
1. Project name: Blackwood Ridge Subdivision Phase 3
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Pitt
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.536503' Longitude:-77.355783'
5. Parcel ID (if applicable): 84930
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: William K. Malpass License Number: PE 16823
Firm: Malpass & Associates
Mailing address: 1645 East Arlington Blvd. Suite D
City: Greenville State: NC Zip: 27858-
Phone number: [phone] Email Address: ken(a-)malpassandassociates.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Greenville Utilities Commission Permit Number: NCO023931
Owner Name: Greenville Utilities Commission
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ0038350 Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s):
FORM: FTA 04-16 Page] of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑No ®N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been attached?
❑ Yes ❑No ®N/A
3. If the Applicant is a Home/Property Owners' Association has an Operational Agreement (FORM: HOA) been attached?
[]Yes [-]No ®N/A
4. Origin of wastewater: (check all that apply):
® Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool /Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic/Commercial % Commercial
% Industrial (See 15A NCAC 02T .0103(20))
'Is 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 "b
No. of Units
Flow
3 bedroom single family residence
360 gal/residence
7
2520 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
2520 GPD
a See 15A NCAC 02T .0114(b). (d). (e)(1) and (e)(2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0114shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 2520 GPD (per 15A NCAC 02T .0l 14)
➢ 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

VH. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
155
PVC
8
20
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 (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) FLength (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)
rri
❑ 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(fl & (g) ❑ Yes ❑ No
1� 1 c e ufrer- r»T 030';tfl rnntains minimum separations that shall be provided for sewer systems:
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-1 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 webpag
If noncompliance with 02T.0305(fl or (PA 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 0213.0200? ® 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.04021 "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ® No ❑ 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 n of PumStations
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 sum)ortine documents.
2. Professional Engineer's Certification:
I, William K. Malpass 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):
Clifton H. Cahoon
(Signature Authority's name & title from Application Item I.3.)
o•''••••—N CAA����'''%
••`OQ`�
SEAL
16823
4%
M1 o4
7ill- to
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:
Date:
FORM: FTA 04-16 Page 5 of 5

Engineers Report for Public
Sanitary Sewer Main Extension
for
Blackwood Ridge Phase 3
Greenville, North Carolina
December 5, 2019
Project: Blackwood Ridge Phase 3
Greenville, NC
Water Supplier: Greenville Utilities Commission
PO Box 1847
Greenville, NC 27835-1847
[phone] - Phone
[phone] — Fax
Sanitary Sewer Greenville Utilities Commission
Service: PO Box 1847
Greenville, NC 27835-1847
[phone] - Phone
[phone] — Fax
Developer: Blackwood, Parrott & Roberson
1003 Red Banks Road
Greenville, NC 27858
[phone] - Phone
[phone] - Fax
Engineer: Malpass & Associates
1645 East Arlington Boulevard, Suite D
Greenville, NC 27858
[phone] - Phone �. °°C,P,RO4���.,,�
[phone] - Fax lO4,4, lyq�
�Q
1
nvran
C�/AM Y-a
William K. Malpass

Project Description:
Area to be Served
The project is a proposed sanitary sewer main extension to serve 7 single family
homes/residences.
Proposed Facilities
Approximately 175 LF of 8" sanitary sewer main, seven (7) four inch sewer
services, one (1) manhole and appurtenances are proposed for this sanitary
sewer main extension.
Demands
Assuming 3 bedrooms per home at 120 gpd/bedroom yields a daily flow rate of
360 gpd/home. There are 7 homes proposed on this development therefore the
daily demand for Blackwood Ridge Phase 3 would be 2,520 gallon per day.
Existing Greenville Utilities System Description:
Location of protect in relation to existing sanitary sewer system
The sanitary sewer system for the proposed Blackwood Ridge Phase 3
subdivision is proposed to be connected to the existing Blackwood Ridge Phase
2 subdivision which has an existing eight inch (8") sanitary sewer system which
has been stubbed into the proposed Phase 3 development.

PROPOSED
BLACKWOOD
RIDGE
PHASE 3
�•44!Iz
/
/
`��f�/r�, EXISTING
0 �N BLACKWOOD
RIDGE
,.
I
I
`--
PROPOSED
r PHASE
`•\���•$�i�
I i
8" SANITARY
SEWER
I
MA
�
�� � .
BROOK FIELDS DRIVE
J . _ (fi0 P•48UC RhV .
.. .) ..END
OF EXISTING
Ili8"
I1
SANITARY
I I SEWER MAIN
PERMIT NO.
-moo
! !
I I W00038350
ffic•—
SITE MAP
FAST TRACK USGS MAP SECTION FOR
BLACKWOOD RIDGE PHASE 3
CITY OF GREENVILLE WINTERVILLE TOWNSHIP PITT COUNTY NORTH CAROLINA
GREENVILLE SE, NC USGS MAP

STREET LEVEL AND AERIAL MAP OF PROJECT
BLACKWOOD RIDGE PHASE 3 - SANITARY SEWER EXTENSION
CITY OF GREENVILLE WINTERVILLE TOWNSHIP PITT COUNTY NORTH CAROLINA

Average Yearly Flow for:
Jan.2018
Feb.2018
Mar.2018
Apr.2018
May2018
Jun2018
Ju12018
Aug2018
Sept2018
Oct2018
Nov2018
Dec2018
GUC WWTP, NCO023931
Permitted Flow:
12.08
12.4964286
12.0216129
11.3716667
9.2719355
9.576
9.2222581
9.496129
10.3771356
9.1580645
8.9533333
8.8184839
10.23692068 Avg. Flow
2018 % of Permitted Flow:
(< 80% / 90% OK)
17.5

Permit Number WQ0041448
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
sarah.toppen
Coastal SWRule
Permitted Flow
Facility
Facility Name
Blackwood Ridge Subdivision Phase 3
Location Address
Owner Name
Greenville Utilities Commission
Dates/Events
Central Files: APS _ SWP _
1 /29/2020
Permit Tracking Slip
Status
Project Type
In review
New Project
Version
Permit Classification
A
Individual
Permit Contact Affiliation
Major/Minor Region
Minor Washington
County
Pitt
Facility Contact Affiliation
0
Owner Type
Government - Municipal
Owner Affiliation
Clilfton H. Cahoon
PE
PO Box 1847
Greenville
NC 27835184
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
1 /22/2020
Malpass & Associates Branch Banking and Trust Company 10267
1645,East Arlington Blvd Suite D
Greenville, NC 27858 12/6/2019
_- [phone]
FADER THE NC Department of Environmental Quality **480.00
Four Hundred Eighty and
DOLLARS
NC Department of
Environmental Quality
1628 Mail Service Center
Raleigh, NC 27699-1628
MEMO P-1153, Blackwood Ridge Phase 3, Sanitary Sewer AUTHORIZ D SIGNATURE
8o SECURITY FEATURES INCLUDED. DETAILS ON BACK �o
II 1; III

Greenville
Utilities
PO Box 1847
Greenville, NC
27835
www.guc.com
January 14, 2020
Mr. Robert Tankard
Assistant Regional Supervisor
North Carolina Division of Water Quality
943 Washington Square Mall
Washington, NC 27889
Subject: Blackwood Ridge Subdivision
Phases 3
Sewer Main Extension
Dear Mr. Tankard:
We are submitting herewith one (1) original and one (1) copy of the executed
Non -Discharge Permit Application and Flow Tracking/Acceptance for Sewer
Extension Permit Applications along with a check for $480.00 for the subject
project. We request your approval of the sewer improvements.
We trust that you will find this submittal to be in order and that your approval will
be forthcoming. In the meantime, should you have any questions or require any
additional information, please let us know.
Sincerely,
Clifton H. Cahoon, PE
Construction / Contracts Engineer
Enclosures
c: Mr. Randall D. Emory, PE, Director Water Resources
Mr. William K. Malpass, PE, Malpass & Associates
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