WQ0041468_Application (FTSE)_20200121

State of North Carolina
DWR Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources I'yfFTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: /� N �p (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: City of High Point (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: Randy E. McCasl n per 15A NCAC 02T .0I06(b)
Title: Deputy City Manager NC Department of
Environmental Quality
4. Applicant's mailing address: 211 South Hamilton Street Received
City: Hiph Point State: NC Zip: 27260- JAN 2 1 2020
5. Applicant's contact information:
Phone number: [phone] Email Address: randy.mccaslinna hiehnointnc.eov Winston-Salem
Regional Office
II. PROJECT INFORMATION:
1. Project name: Cedrow Subdivision
2. Application/Project status: ® Proposed (New Permit) ❑ 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. County where project is located: Guilford
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.9753' Longitude:-79.96740
5. Parcel ID (if applicable):
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Terry A. Kuneff License Number: 29950
Firm: City of H hg Point
Mailing address: 211 South Hamilton Street
City: Hieh Point State: NC Zip: 27260-
Phone number: Q 36) 883-8583 Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (W WTF) INFORMATION:
1. Facility Name: Eastside W WTF Permit Number: NCO024210
Owner Name: City of High Point
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ_ Downstream (Receiving) Sewer Size: 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/Pro e�rty
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 / da preschool / p y care
El 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(f)? ®Yes ❑ No
➢ If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.01140
Daily Design Flow a,b
No. of Units
Flow
Single -Family Dwelling Unit
270 gal/day
12
3240 GPD
gaU
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
3240 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: 3240 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 pennitted 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
8 425 PVC SDR-26
➢ 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:
2. Approximate Coordinates (Decimal Degrees): Latitude: 0Longitude: - °
3. Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational point(s) of the pmnp(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)
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(t)):
1. Does the project comply with all separations found in 15A NCAC 02T.0305(f) & (g) ® Yes ❑ No
➢ 15A NCAC 02T.0305(f) contains 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-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
36inches
➢ 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
➢ If noncompliance with 02T.0305(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
➢ Seethe 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 pennits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ® No ❑ N/A
➢ If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and inspections
documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria (latest version) as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
1, TaQ4 A, KL'Aeff
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' ertificatio/nper 15ANCAC T.00 6(b):DEPtNC''�N�kn1k(,ER-
I, RA.Aytj 6. attest that this application for
itmature Authoritv'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.
Signature: C Date: � /6 20 20
FORM: FTA 04-16 Page 5 of 5

M N
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer l;xtension Applications
I)1vi~aioll of Vilater fle5oltrr.r (FTSE 10-18)
Application Number: 2019-.196
Entity Requesting Allocation: City of High Point
Project Name for which flow is being requested: Cedrow Subdivision Phase 2
More than ogle FTSE iunp be required fora single project (/the o/vner of Me jV{VTP 1s not responsible far all pump
stations along the route of the proposed ipasteivaterfloly.
1. Complete this section only if you are the owner of the wastewater treatment plant,
a. WWTP Facility name: Eastside WWTP
b. WWTP Facility Permit #: NC-0024210
C.
d.
e,
f.
9.
h.
A!! J!o)vs are !n iYIGD ` .
WWTP facility permitted flow: 26.0000
Estimated obligated flow not yet tributary to the WWTP:
WWTP facility's actual average flow:
Total flow for this specific request:
Total actual and obligated flows to the facility:
Percent of permitted flow used:
0,7672
16.7250
0,0032
17.4954
67.29%
11. 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)
(it)
(C)
(D)=(D+C)
(E)=(A-D)
Pump
Pump
Finn
Design
Approx.
Obligated,
Total Current
Available
Station
Station
Capacityt
Average
Current
Not Yet
Flow Plus
Capacity'
(Nmne, or
Permit
Daily Flow,
Avg. Daily
Tributary
Obligated
Number)
Number
(Firn/po,
Flow,
Daily Flow,
Flow
MGD
AIGD
AIGD
AIGD
AIGD
AIGD
Riverdale
W00008572
22,202
8.8817
an996
07497
9,1493
.02656
-- MN/A MN/A
MNIA #NlA MNIA
#N/A MNIA MNIA
MWA MIA
#NIA MWA
#WA MNIA
#NIA #WA
MN/A
MN/A
WA MN/A MN/A MWA WA #NIA
M The Film Capacity (design Don') of ally pump station Is defiled as the inoxtilmmn pumped flow that
can be achieved with the largest pump taken out of sevlce.
}° Design Average Flom is the Dam enpacity orthe pump station divided by the peaking factor (pl) not
less than 2.5, per -Section 2,02(A)(4)(e) of the A1lnimum Design Criteria.
MM• A Pleating Assessment Addendum shall he attached fateach pump station located between the
project connection point and the wwTP where tie Available Capacity is!; 0.
Downstream Pacility Name (Sewer):
Downstream Permit Number:
MNIA
W/A
MNIA
MWA
Page 1 of 6 FTSE 10.1 8

III. Certification Statement:
I ,4 j�-, C S , it 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 party. Signature of this
form indicates acceptance of this wastewater flow.
Signature
Date
Page 2 of 6
FTSE 04-16

PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum for each pump station listed in Section II where Available
Capacity is < 0.
Pump Station (Name or Number):
Given that:
a. The proportion and amount of Obligated, Not Yet Tributary Daily Flow (C) accounts for
% and MGD of the Available Capacity (E) in Pump Station
; and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately
MGD per year; and that
c.— A -funded -Capital Project that will provide the required planned capacity, namely
is in design or under construction with
planned completion in
d. The following applies:
; and/or
The City of High Point met with NCDEQ on February 9, 2017 to discuss the flow
allocation to the Riverdale Pump Station while the station was being studied for an
additional increased capacity of 2.0 MGD. As a result of the meeting, the City and DEQ
agreed that the current average daily flow for the Riverdale Pump Station was 8.4 MGD.
The City of High Point has contracted with 3 engineering firms to expand the capacity of
the Riverdale Pump Station to 30 MGD. The pump station upgrades are anticipated
to be completed in late January 2020.
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to
allow this flow to be permitted, without a significant likelihood of over -allocating capacity in the
system infrastructure.
I understand that this does not relieve the collection system owner from complying with G.S. 143-
215.67(a) which prohibits the introduction of any waste in excess of the capacity of the waste
disposal system.
Signature
Page 3 of 6
FTSE 04-16

r,"
)Jr/_
�' }
all
SITE LOCATION
Water F'l. rati �n-�'/ r
Pi n oil
an
a
y, r�
TI
..LJ r�
arnlel saaoo
nm�°Gm ue `"l± In �w°kns."nm m a
x _ :®�„
OE
w nramecweuommarne.wrc.we.mce.vuway.nwrs. ��wxen HlmuN mOxwm5T4NC §ise
Y009 ��

_
r
5 ¢ Q
31
Q
��
k
a
8
�
o
'gym
cnOmv
o ^
m
a„pao
.
©
G
a:ire.^v
n3
viarae_a Q O
B�
i31ulod 44H
e1
� o ;RCN
�>
Q
q'a
O
I
Q
o
Q
m3
`s
m
k O
O
o
m
O
`•y
3
Sg
a, s
�
2 t
r31
�9'y
P
©
O
A
O p
O
t
O �
�
snnro
x
A
m•q .
N
m
3
p
5
3i
^
q 'Q
- 1591�NvcsS
'
Nsdentifk5t
� �^�o,,,ew
i
i
Q,
n•mv.•M
P
Sni n+emav
N6canti5c 51 g
em44p
eNev
mnA
s
4..

\oaOF W ArF9QG
Michael F. Easley, Govemor
Wiliam G. Ross dr:, Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Divlslon of water Quality
June 27 2007
_... _.
RFCEfvEO
Terry L. Houk, Asst. Director of Public Services w root or Evn
CityofHighPoint JUN 2 9.200
P.O. Box 230
High Point, North Carolina 27261 I Winston-Salem
6eglonal Office
Subject: EastsldeWWTP(N00024210)
& Westside WWTP (NC0024228)
Residential Flow Reduction Approval
Guilford County
Dear Mr, Houk:
On June 25, 2007, the Division of Water Quality received a flow reduction request for residences in
the city of High Point served by the Eastside W WTP (NC0024210) & the Westside W WTP
(NC0024228). The letter requests an.allowable flow rate of 240 GPD per 3 bedroom residential
connection based on the evaluated data from the W W1P and the active number of residential
connections.
The DMR data provided between January N05 and December 2006 with daily reading's taken during
November 2006 was analyzed by central office and regional office staff. Based upon this data the
Division hereby approves the use of 90 GPI) per residential bedroom, with a minimum of 180 gpd
for one and two bedroom units in all applicable non -discharge permit applications. Flow shall be
incremented by 90/gpd for each bedroom above two. Regardless of the adjusted design daily
wastewater flow rate at no time shall the wastewater flows exceed the effluent limits defined in the
NPDFS hermit for the treatment facility or exceed the capacity of the sewers downstream of any new
sewer extension or service connectiont
The residential water usage data include 13 residences with "0" flow. These residences were excluded
from the calculations. This resulted in an average daily flow of 150 GP.D.
If you have any questions or comments regarding this matter, please contact Deborah Gore at
[phone] ext. 593 [email: Deborah.Gore ajtcmail.net].
Sincere
it 0.teen H. Sullins
cc: Steve Tedder, Winston-Salem Regional Office —
Steve Mauney, Winston-Salem Regional Office
NPDES Permit File No. NCO024228
PERCS Flow Reduction File
One PreUeaUnent, Emergency Response and Collection Systems Unit Internet htlp:Uh2o.enr.nastate.usfPERCS
NOrt[1Car01111a 161t1 Mail Servke Center,, Raleigh, NC27699-1617 An Equal Opportunity Action Employer
N" t "tile/ Telephone [phone] Fax [phone]%recycled/10%post-consumer paper

Engineering Services Department
Terry A. Kuneff, P.E., CFM
INTERIM DIRECTOR
January 6, 2019
450 West Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
Re: Sewer Extension
Cedrow Subdivision
City of High Point, Guilford County
Design Project Number P00446
Dear Sir or Madam:
NORTH CAROLINNS INTERNATIONAL CIT_)�"
N C Department of
Environmental Quality
Received
JAN 21 2020
Winston-Salem
Regional Office
Recently, the final construction drawings for the Cedrow Subdivision, Design Project Number P00446 were
completed. This project is slated for construction in the Spring of 2020. A sewer extension connecting existing
sewer lines on Kingsway Drive and Rolling Green Drive is proposed and will serve 12 homes while allocating a
design flow of 3240 GPD.
For your consideration, we have enclosed one original and one copy of the following items relating to the City of
High Point's Fast Track Sewer System Extension Application for the Cedrow Subdivision project:
1) Fast Track Application — Form FTA 04-16
2) Flow Tracking/Acceptance Form — Form FTSE 04-16
3) Site Maps identifying the entire project area and closest surface waters as well as a street level map
showing general project area
4) The plan review check made payable to NC DEQ in the amount of $480.00.
5) Copy of Flow Reduction Approval Letter
Please review the enclosed plans and corresponding Application, and if you have any questions, do not hesitate to
contact this office.
Sincerely,
64(Z7
Christopher Bingham,
Engineering Services Department
[phone]
City of High Point, P.O. Box 230, 211 South Hamilton Street, High Point, NC 27261 USA
Fax:[phone] Phone:[phone] TDD:336.883.8517