WQ0041450_Application (FTSE)_20200214

Permit Number WQ0041450
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
dean.hunkele
Coastal SWRule
Permitted Flow
Facility
Facility Name
Burgess Warehouses Private Pump Station
Location Address
Owner
Owner Name
Burgess Group Consolidated LLC
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 Wilmington
County
New Hanover
Facility Contact Affiliation
Owner Type
Non -Government
Owner Affiliation
Vincent O. Burgess IV
6901 Running Brook Ter
Wilmington NC 28401
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
1/28/2020

TRIPP ENGINEERING, P.C.
0 419 Chestnut Street
Wilmington, North Carolina 28401
[phone] • [e-mail]
January 27, 2020
NCDEQ RECEIVED/NCDENR/DWR
Division of Water Quality
127 Cardinal Drive Ext.
Wilmington, NC 28405 JAN 2 9 2020
Attn: Dean Hunkele Water Quality Regional
Operations Section
Wilmington Regional Office
Re: Burgess Corporation
New Hanover County, NC
TE 19017
Dear Mr. Hunkele:
JAN 2 8 2020
►+ �....
Enclosed please find one (1) original and one (1) copy of the fast -track
applications, flow tracking/acceptance form, calculations, topo map, street map, and a
check to cover the application fee for the above referenced project.
We are proposing 795 If of 1.5" SDR 21 PVC public force main to tie into an
existing 8" force main and one pump station. We are requesting flow of 500 gpd to
provide sewer service to the two proposed warehouse buildings.
Please review for approval and contact us with any questions, comments or if you
need additional information. Thank you.
Sincerely,
rr EnPincer,.C.
Phillip G. Tripp, P.
PG'F:dcb
Enc.

State of North Carolina
nWR Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: W M�Ud tto be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Burgess Group Consolidated LLC (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: Vincent O. Burgess IV per 15A NCAC 02T .0106(b)
Title: Member Manager
4. Applicant's mailing address: 6901 Running Brook Terrace
City: Wilmington State: NC Zip: 28411-
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail]
II. PROJECT INFORMATION:
1. Project name: Burgess Corporation
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: New Hanover
4. Approximate Coordinates (Decimal Degrees): Latitude: 34.294413' Longitude:-77.972085'
5. Parcel ID (if applicable): R03200-002-001-014
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
I. Professional Engineer: Phillip G. Tripp License Number: 17374
Firm: Tripp En ing eering
Mailing address: 419 Chestnut Street
City: Wilmington State: NC Zip: 28401-
Phone number: (21-0) 163-5100 Email Address: office�ineering com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: CFPUA Northside Permit Number: NCO023965
Owner Name: Cane Fear Public Utility Authority
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF): W�iOQ �ga83
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 Page 1 of 5

VI. GENERAL REQUIREMENTS
I. 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. Has a flow reduction been approved under 15A NCAC 02T .01 14(t)? ❑ Yes ® No
➢ If yes, provide a cony of flow reduction anoroval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(t))
Daily Design Flow a,n
No. of Units
Flow
Warehouse
25 gal/employee
20
500 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
500 GPD
a See 15A NCAC 02T 01 14(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 .01 14(c), design flow rates for establishments not identified [in table I5A NCAC 02T.01 141 shall be
determined using available flow data, water using 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 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

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
➢ 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
Vlll. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T.0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
I. Pump station number or name: 1
2. Approximate Coordinates (Decimal Degrees): Latitude: 34.295340' Longitude:-77.970959'
3. Design flow of the pump station:.0005 millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 15 gallons per minute at 93 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
1.5
795
SDR21 PVC
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)):
I. Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (_0
➢ 15A NCAC 02T.0305 contains minimum separations that shall be provided for sewers stems:
® 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 lI impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-I or WS-V), B, SA, ORW, HOW, 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 weboage
➢ 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 draft separation requirements for situations where separation cannot be meet
No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No ® N/A
➢ This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project require coverage/authorization under a 404 Nationwide or [--]Yes ® No
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T 0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per I5A 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:
s name from Application Item 111.1.)
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
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 1 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 143-215.6B, 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):
name & title from Application Item 1.3.)
Es'sio2;�2;
SEAL l
ff 4-t•1 1
that this application for
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. 1 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 143-215.613, 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.
Signature:(i Datel l,c r+tr1@lZ
FORM: FTA 04-16 Page 5 of 5

DK-Islon Wate, i ,.,,,:.,.,. <
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: _ Burgess Group Consolidated Inc.
Project Name for which flow is being requested: Burgess Corporation
More than one FTSE may be required for 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: _James A. Loughlin (Northside) WWTP
b. WWTP Facility Permit #: NPDES NC 0023965
All flows are in MGD
c. WWTP facility's permitted flow 16.000
d. Estimated obligated flow not yet tributary to the WWTP 3.364
e. WWTP facility's actual avg. flow 10.661
f. Total flow for this specific request 0.000500
g. Total actual and obligated flows to the facility 14.025
h. Percent of permitted flow used 87.7
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
Average
Approx.
Obligated,
Pump
Pump
Daily
Current
Not Yet
Total Current
Station
Station
Firm
Flow**
Avg. Daily
Tributary
Flow Plus
(Name or
Permit
Capacity, *
(Firm / pt),
Flow,
Daily Flow,
Obligated
Available
Number)
No.
MGD
MGD
MGD
MGD
Flow
Capacity***
_10
N/A
14.832
5.933 _ _
3.472
0.567
4.039
1.89.4
12 W 0039517 4.920 1.970 0.672 0.221 0.893 1.077
* The Firm Capacity (design flow) 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, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
*** 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): Cape Fear Public Utility Authority
Downstream Permit Number:
Page 1 of 6
FTSE 10-18

I11. Certification Statement:
I Jeff Theberge, CFPUA Eng. Mgr 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 certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
Title of Signing Official
Page 2 of 6
FTSE 10-18

---- SOSID:0761892
CA201931100987 Date Filed: 11/22/2019 11:59:00 PM
Elaine F. Marshall
North Carolina Secretary of State
LIMITED LIABILITY COMPANY ANNUAL I CA2019 311 00987
ienni 1 CA201931100987 _
NAME OF LIMITED LIABILITY COMPANY: Burgess Group Consolidated, LLC
SECRETARY OF STATE ID NUMBER; 0761692 STATE OF FORMATION: NC 4 Mgt sy
REPORT FOR THE CALENDAR YEAR: 2018 2019 ❑� 717Na
SECTION A: REGISTERED AGENT'S INFORMATION{ �E } ❑Changes
1. NAME OF REGISTERED AGENT: Vincent O. Buroess . IV
2. SIGNATURE OF THE NEW REGISTERED AGENT:
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
Warsaw Road
605 Warsaw Road
Clinton, NC 28328-3631 Sampson Clinton, NC 28328-3631 Sampson
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS:
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3.PRINCIPAL OFFICE EMAIt] Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS 5. PRINCIPAL OFFICE MAILING ADDRESS
60S Warsaw Road 605 Warsaw Road
Clinton, NC 28328-3631 Sampson Clinton, NC 28328.3631 Sampson
6. Select one of the following If applicable. (Optional see instructions)
❑ The company is a veteran -owned small business
❑ The company is a service -disabled veteran -owned small business
SECTION C: COMPANY OFFICIALS (Enter additional company officials In Section E.)
NAME: Vine Burgess NAME:
TITLE: Manager TITLE:
NAME:
TITLE:
ADDRESS: ADDRESS: ADDRESS:
104 Channel Drive South
Wrightsville Reach, NC 28480 New Hanover
$ECTIOltDraEfthEjGAnMgE ANNUAL REPORT. Section D must be completed in Its entirety by a personibusiness entity;
lttr
SIGNATURE DATE
Form molt be S"d by a company OIIklai Isted under section C of TNs farm.
r\ EA� (C) piura ��
Print or Typ Ne orcompeny Of6dal Pant or Type This of Compsry Official
SUBMIT THIS ANNUAL REPORT WITH THE REQUIRED FILING FEE OF $200
MAIL TO: secret" of Sbte, Business Regtstralicn OMSIM Pot cake Box 26525. Ralelgh, NC 27626-0525

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