WQ0041508_Application_20200226

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DEfWR
State of mCarolina
JWR ' FEB 2 6101.0 Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources pp pQj77e?'R S IONS FOR FORM: PTA 04-16 & SUPPORTING DOCUMENTATION
This application is for sewer extensions involving gravity sewers, pwnp stations and force mains, or any combination that has been
certified by a professional engineer and the applicant that the project meets the requiretents of ISA NCAC 02T and the Division's
Minimum Design Criteria and that plans, specifications and supporting doet0 regs have been prepared in accordance with, 1_$A
NCAC 02T,15A NCAC.• Dhlsioa policies and good eneineerin Imentce .
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design
documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans, design
calculations, and project specifications referenced in 15A NCAC Q210305 documents shall be available upon request by the Division. and the applicable minimum design criteria. These
Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T 030x.
Projects not eligible for review via the fast track process (must be submitted for full technical review):
➢ Projects that require as environmental assessment in accordance with 15A NCAC 1C .0100;
➢ Projects that do not meet any part of the minimum design criteria (_MDC) document;
➢ Projects that involve a variance from the requirements of 15A NCAC 2T; ➢ Pressure sewer systems utilizing septic tank -effluent Pinups (S'TEPs) or simplex grinder pumps;
➢ STEP m simplex grinder pumps connecting to pressurized systems (e.g. force mains);
➢ Vacuum sewer systems.
General— When submitting an application, please use the following instructions as a checklist in order to ensure all required items
are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and
reduce the amount of requested additional information. Failure to submit all required items will necessitate additional
processing and review time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit
one original and one copy of the application and supporting documentation.
A. One Original and One Copy of Application and Supporting Documents
0 Required unless otherwise noted
B. Cover Letter (Required for All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
➢ Be specific as to the system type, number of homes served, flow allocation required, etc.
➢ If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Major Modification Application Packages):
0 Submit a check or money order in the amount of $480.00 dated within 90 days of application submittal,
➢ Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track (Form: FTA 04-16) Application (Required for All Application Packages):
9 Submit the completed and appropriately executed application.
➢ If necessary for clarity or due to space restrictions, attachments to the application may be made.
❑ If the Applicant Type in Item I.2 is a corporation or company, provide documentation it is registered for business with
the North Carolina ec qlary Of crate.
❑ If the Applicant Type in Item I.2 is a partnership or d/b/a, enclose a copy of the certificate filed with the Register of
Deeds in the county of business.
® The Project Name in Item II.1 shall be consistent with the project name on the flow acceptance letters, agreements, etc.
® The Professional Engineer's Certification on Page .5 of the application shall be signed, sealed and dated by a North
Carolina licensed Professional En inter.
El The Applicant's Certification on page 5 of the application shall be signed in accordance with 15A NCAC 02TI 0106(b),
Pox 15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is
Provided from a person who meets the criteria in 15A NCAC 02T .0106(b).
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION
Page 1 of 3

E. Flow Tracking/Acceptance Form (Form: FTSE 04-16) (If Applicable):
M Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility.
➢ Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
➢ The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one
year prior to the application date.
➢ Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-
215.67 a .
➢ Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific FTSE.
F. Site Maps (All Application Packages):
Submit an 8.5-inch x 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project
area and closest surface waters.
➢ Location of the project (gravity sewer, pump stations & force main)
➢ Downstream connection points and permit number (if brown) for the receiving sewer
® Include a street level map (aerial) showing general project area so that Division staff can easily locate it in the field.
G. Existing Permit (All Modification Packages):
❑ Submit the most recently issued existing permit.
❑ Provide a list of any items within the permit the Applicant would like the Division to address during the permit
modification (i.e., permit description, flow allocation, treatment facility, etc.).
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T .0305(hl(1), submit documentation of power reliability for pumping stations.
➢ This alternative is only available for average daily flows less than 15,000 gallons per day
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible
with the station. The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or proposed
contractor, stating that "the portable power generation unit orportable, independently -powered pumping units, associated
appurtenances and personnel are available for distribution and operation of this pump station."
➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump
stations' storage capacities and the rotation schedule of the portable power source or pump, including travel
ttmeframes, shall be provided in the case of a multiple station power outage. (Required at time of certification)
Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per 15A NCAC 02T .0115 a 1 provide the Certificate of Public Convenience and Necessity from the North Carolina
Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by
the sewer extension, or
❑ Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an
application for a franchise has been received and that the service area is contiguous to an existing franchised area or that
franchise approval is expected,
J. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold):
❑ Home/Property Owners' Associations
❑ Per 15A NCAC 02T .0115(cl, submit the properly executed Overational Aereement (FORM' HOAI.
❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
® Developers of lots to be sold
N Per 15A NCAC 02T .0115(b), submit the, properly executed Operational Aereement (FORM: DSVI.
For more information, visit the Division's collection systems website
INSTRUCTIONS FOR FORM: FTA 04.16 & SUPPORTING DOCUMENTATION Page 2 of 3

THE COMPLETED APPLICATION PACKAGE ItNCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
Wafer Quality Section
2090 US Highway 70
Swannanoa, North Carolina 28778
Avery, Buncombe, Burke, Caldwell, Cherokee,
[phone]
Clay, Graham, Haywood, Henderson, Jackson,
Macon, Madison, McDowell, Mitchell, Palk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Faveitavilla Regional Office
Water Quality Sactian
225 Green Street Sulte 714
Fayetteville, North Carolina 28301-5094
Anson, Bladen, Cumberland, Harnett, Hoke,
[phone]
Montgomery, Moore, Robeson, Richmond,
[phone] Fax
Sampson, Scotland
Mooresville Regional Office
Water Quad.
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Mooresville, North Carolina 28115
Gaston, Iredeil, Lincoln, Mecklenburg, Rowan,
[phone]
Steely, Union
[phone] Fax
Raleigh Realonal OMOa
Water Quallty Section
1628 Mail Service Center
Chatham, Durham, Edgecombe, Franklin,
Raleigh, North Carolina 27699-1628
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
Washington Realonal Office
[phone] Fax
943 Washington Square Mali
Warren, Wilson
Water Quq{SY Section
Washington, North Carolina 27889
Beaufort, Bertie, Camden, Chewer, Craven,
Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone]
[phone] Fax
Jones, Lenoir, Martin, Pamlico, Pasquotank,
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wlimingio _&e ,tonal Offica
Watef Quallty Section
127 Carolina[ Drive Extension
Wilmington, North Carolina 28405
Brunswick, Carteret, Columbus, Duin, New
p
[phone]
Hanover, Onsiow, Pander
[phone] Fax
WlnstoRSalem Realonal Office
�llater Quality Section
450 W. Hanes Mill Road
Suite 300
Aiamance, Allegheny, Ashe, Caswell, Davidson,
Winston-Salem, North Carolina 27105
Davie, Forsyth, Guilford, Rockingham, Randolph,
Stokes, Surry, Watauga, Wilkes, Yadkin
[phone]
INSTRUCTIONS FOR FORM: FTA 04-16 &z SUPPORTING DOCUMENTATION
Page 3 of 3

DWR
Division of Water Resources
State of North Caroliuna-- — -
Department of Environmental Quality
Division of eater Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
ETA 04-16 & SUPPORTING DOCUMENTATION
Application Number: JA&DqISO(tobe,..pkwd by Ewa)
All items must be comnletedor the application will be returned
I. APPLICANT INFORMATION:
1. ApplicanPs name: Moore County (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State/County ® Municipal
3. Signature authority's name: Randy Gould per 15A NCAC 02T 01W(b)
Title: Moore County Pubhe Works Director -
4. Applicant's mailing address: PO Box 1927
City: Carthage State: NC Zip: 28327
5. Applicant's contact information:
Phone number: 910 947-6315 Email Address: rgould moorecoun c. ov
11. PROJECT INFORMATION:
1. Project name: Vass -Cameron
❑ Privately -Owned Public Utility
❑ Other
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: W Q00_ and issued date: —
If new construction but part of a master plan, provide the existing permit number: WQ00_
3. County where project is located: Moore
4. Approximate Coordinates (Decimal Degrees): Latitude: 35,259164' Longitude: - 9.27 75784°
5, Parcel ID (if applicable): 00033664
(or Parcel ID to closest downstream sewer)
ffi. CONSULTANT INFORMATION:
1. Professional Engineer. Jeff McCluskev License Number: 29606
Firm: Mc2 Engineering Tnc
Mailing address: 2110 Ben Craig Drive
City: Charlotte State: NC Zip: 28262
Phone number: [phone] Email Address: ieff ciinic2eng.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Moore County Water Pollution Control Plant Permit Number: NC0037508
Owner Name: Moore County
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than N"VfF):
1. Permit Number(s): W00038921 Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(sl [if applicable W0CS00034
Owner Name(s): Moore County
FORM: FTA 04-16 Page 1 of 5

V1. 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/Properly 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 chink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater : 100 %Doruestic/Commereial _% Commercial
_ % Industrial (See 15A NCAC 02T .0103(201)
"Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T O114(f)? ❑ Yes []No
➢ ifovide a cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T. 114
Daily Design Flow n,n
No. of Units
Flow
Single Family (4 bedrooms)
120 gallbedroom/lot/day
15 lots
7,200 GPD
gap
GPD
gay
GPD
gay
GPD
gay
GPD
gal/
GPD
Total
7,200 GPD
a See 15A NCAC 02T 0114& (d) (e)(1) and (e)t2) 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 L5A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15ANCAC 02T.0114] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 7 200 GPD (per 15A NCAC 02T .01 I4)
➢ 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): _
FOMI: FTA 04-16 Page 2 of 5

V1L GRAVITY SESVER DESIGN CRITERIA (If Applicable) - 02 .0305 & AMC (Gravity Sewersal;
L Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 354.58 PVC
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section Ili 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
VIH. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROTECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: ° Longitude: -_i°
3. Design flow of the prune station: —_ millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): _ gallons per minute at _ feet total dynamic head (TDM
5. Summarize the force main tube permitted (for this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 02T .0305fh)(l):
❑ Standby power source orpump 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)(I)(C):
A 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.
➢ Ifthe 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 I SA NCAC 02T .0305(f) & W
...1:­ it,.,r A.II hP ..rm,irleA for sewer aystems:
® Yes ❑ No
➢ 0A NUAu uzr.0305 I contulm ­m,rmu....... .....-....- 1....."-_____..
Setback Parameter*
Separation Re fired
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 orizental
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, HQW, or SB from normal
hi h water or tide elevation and wetlands see item IX.2
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
10 feet
ditches
Any building foundation
5 feet
10 feet
Any basement
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(e) contains alternatives where separations in 02 305 cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications w6_naaa
➢ If noncompliance with 02T 0305(f) or (e). 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 .02007 ® Yes []No ❑ N/A
➢ This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project require coveragelauthorization 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/certificatons)? ® Yes ❑ No
per 15A NCAC 02T.010 c b , 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 attaclunent 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

S.
1. Does the submitted system comply with liA NCAL' 02T, the Minimum Design Criteria br the Permittiug of Pump Stations
and Force Mains (latest version) and the Gravity Sewer M mmtun Design Criteria (latest VersigIII as applicable?
® Yes ❑ No
YNo, complete and submit the Variance/Altemative Design Request application (VADC 10-14) and supporting documents for
reviow. Apnroyalofthe reauest is reel"pred prior to submittal of the Eau lracl Apnlication and supporting documents
2. Professional Engiucer's Certification:
name
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. 1 further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minirmun Design Criteria for Gravity Servers (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 seat signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215AA 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 violatioa._4,
North Carolina Professional Engineer's seal, signature, and date:
SEAL
29608
tst
3. Applicant's Certification per 15A NCAC 02T .0106(b):' O V 99°'°--
I, '2Ci , L 6 U 14 , I za'c �Iao✓les attest that this application for
(Signature Aufficinty's name & title from Application Item 13.)
has been reviewed by me and is accurate and complete to the best of my knowledge. 1 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 cMI penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
of this pemnit 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 143-215.66, 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 notto exceed $10,000 as well as civ ens. ties up to $25 0 per violation.
Signature: Date:
FORM: FTA 04.16 Page 5 of 5

E)EUDWc=
G'
2
ENSINEERINI3
SITE/CIVIL ENGINEERING
LAND PLANNING
STORM WATER MANAGEMENT
UTILITY ENGINEERING
CONSTRUCTION ADMIN
Ff B 2 v 2t�U
October 17, 2019
(I 11 I!'i�`. 1�.'�i...;.'1::. i:JF V,•�P .fir �_-!r.
Fayetteville Regional Office
Water Quality Section
225 Green Street Suite 714
Fayetteville, NC 28301-5094
Re: Sanitary Sewer Collection for Vass -Cameron.
The proposed project is located at 238 Cameron Avenue in Vass, NC. The project
consists of installing 354.58 linear feet of 8" PVC gravity sanitary sewer to serve the
proposed single-family homes. The system will include adding 2 new public sanitary
sewer manholes. The project includes 15 single family homes that will be 4-
bedrooms each. There are 8 homes that will be served by a private low pressure
forcemain that is being permitted separately.
The proposed sanitary sewer extension will be a public sewer system that will be
owned, maintained, and operated by Moore County Public Works. The system will
include a total of 7 sewer lateral connections, 6 of which will be gravity, 1 of which
will include a low pressure forcemain and a package pump station at the home. The
proposed sewer will connect into the existing sanitary sewer system on Cameron
Avenue.
Civil Engineering:
Mc2 Engineering
2110 Ben Craig Drive, Ste. 400
Charlotte, NC 28262
(704)-510-9797
[e-mail], Jeff McCluskey, PE (POC)
�L
Jeffrey D. McCluskey Ft
President

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Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Moore Coun _
Project Name for which flow is being requested: Vass -Cameron Avenue
Plore than one FTSE maybe 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.
Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Moore Coun Water Pollution Control
b. WWTP Facility Permit #: NC 0037508
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
All flows are in MGD
10
.58934
4.366
.0072
4.96
49.62
I.I. 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:
Pump
Pamp
Station
Station
(Name or
Permit
Number)
No.
V3
LR-1
(A)
Design
Average
Firm Daily Flow**
Capacity, * (Firm / pf),
MGD MGD
17280 .06912
.46080 .18432
LR-2 .50400 .20160
B)
(C)
(D)=(B+C)
(E)=(A-D)
Obligated,
Approx.
Not Yet
Total Current
Current
Tributary
Flow Plus
Avg. Daily
Daily Flow,
Obligated
Available
Flow, MGD
MGD
Flow
Capacity***
.0044
.0174
.02181
.04731
.0913
.0198
.1111
.07322
_ .0423
.0198
.06205
.13955
SP-4 5 2 1.0484 10198 _ 1.0682 .9318
* 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 WWTP where the Available Capacity is <0.
Downstream Facility Name (Sewer): Moore County Water Pollution Control
Downstream Permit Number: WQCS00034
Page 1 of 6
__ _ FTSE 10-I8

III. Certification Statement:
I Randy Gould - Moore County certify to the best of my knowledge that the addition of
Public Works
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 uate capacity to transport and treat the proposed new wastewater.
) tC INU/� .5 '
of Signing Official
Date
Page 2 of 6
FTSE 10•18_ _

STATE OF NORTH CAROLINA
COUNTYOF MOOre Permit No.
DEVELOPERS OPERATIONAL AGREEMENT
This AGREEMENT made pursuant to G.S. 143-215.1 (d1) and entered into this 17th day of
Oglober, 2019 by and between the North Carolina Environmental Management
Commission, an agency of the State of North Carolina, hereinafter known as the COMMISSION; and
Ace Homes, LLO a corporation/general partnership registered/licensed to do
business in the State of North Carolina, hereinafter known as the DEVELOPER.
WITNESSETH:
1. The DEVELOPER is the owner of the certain lands lying in M®®re County, upon
which it is erecting and will erect dwelling units and other improvements, said development to beknown
asyaac-Cameron (hereinafter the Development).
2. The DEVELOPER desires, to construct a wastewater collection system with pumps, wastewater treatment
works, and/or disposal facilities (hereinafter Disposal System) to provide sanitary sewage disposal to serve
the Development on said lands.
3. The DEVELOPER has applied to the COMMISSION for the issuance of a permit pursuant to G.S. 143-
215.1 to construct, maintain, and operate the Disposal System.
4. The DEVELOPER has created or shall create unit ownership in said dwellings units, other improvements
and lands through filing of a Declaration of Unit Ownership (hereinafter Declaration), pursuant to Chapter
47C or 47F of the North Carolina General Statutes.
5. The DEVELOPER has caused to be formed or will cause to be formed at the time of filing of the
Declaration, v (hereinafter
Association), a non-profit corporation organized and existing under and by the virtue of the laws of the State
of North Carolina, for the purpose, among others, of handling the property, affairs and business of the
Development; of operating, maintaining, re -constructing and repairing the common elements of the lands
and improvements subject to unit ownership, including the Disposal System; and of collecting dues and
assessments to provide funds for such operation, maintenance, re -construction and repair.
6. The COMMISSION desires to assure that the Disposal System of the Development is properly constructed,
maintained and operated in accordance with law and permit provisions in order to protect the quality of the
waters of the State and the public interest therein.
NOW, THEREFORE, in consideration of the promises and the benefits to be derived by each of the parties
hereto, the COMMISSION and DEVELOPER do hereby mutually agree as follows:
1. The DEVELOPER shall construct the Disposal System in accordance with the permit and plans and
specifications hereafter issued and approved by the COMMISSION, and shall thereafter properly operate
and maintain such systems and facilities in accordance with applicable permit provisions andlaw.
2. The DEVELOPER shall not transfer ownership and/or control of the Disposal System to the Association
until construction has been completed in accordance with the permit and approved plans, and the staff of
the Division of Water Resources has inspected and approved of the facilities. In order to change the name
of the permit holder, the DEVELOPER must request that the permit be reissued to the Association. The
request must include a copy of the Association Bylaws and Declaration.
3. The DEVELOPER shall not transfer, convey, assign or otherwise relinquish or release its responsibility for
the operation and maintenance of its Disposal System until a permit has been reissued to the DEVELOPER's
successor.
FORM: DEV 03-19 Page I oft

4. The DEVELOPER shall provide in the Declaration and Association Bylaws that the Disposal System and
appurtenances thereto are part of the common elements and shall thereafter be properly maintained and
operated in conformity with law and the provisions of the permit for construction, operation, repair, and
maintenance of the system and facilities. The Declaration and Bylaws shall identify the entire wastewater
treatment, collection and disposal system as a common element which will receive the highest priority for
expenditures by the Association except for Federal, State, and local taxes and insurance.
5. The DEVELOPER shall provide in the Declaration and Association Bylaws that the Disposal System will
be maintained out of the common expenses. In order to assure that there shall be funds readily available to
repair, maintain or construct the Disposal System, beyond the routine operation and maintenance expenses,
the Declaration and Association Bylaws shall provide that a fund be created out of the common expenses.
Such fund shall be separate from the routine maintenance funds allocated for the facility and shall be part
of the yearly budget.
6. In the event the common expense allocation and separate fund are not adequate for the construction, repair,
and maintenance of the Disposal System, the Declaration and Association Bylaws shall provide for special
assessments to cover such necessary costs. There shall be no limit on the amount of such assessments, and
the Declaration and Bylaws shall provide that such special assessments can be made as necessary at any
time.
7. If a wastewater collection system and wastewater treatment and/or disposal facility provided by any city,
town, village, county, water and sewer authorities, or other unit of government shall hereinafter become
available to serve the Development, the DEVELOPER shall take such action as is necessary to cause the
existing and future wastewater of the Development to be accepted and discharged into said governmental
system, and shall convey or transfer as much of the Disposal System and such necessary easements as the
governmental unit mayrequire as condition of accepting the Development's wastewater.
8. Recognizing that it would be contrary to the public interest and to the public health, safety and welfare for
the Association to enter into voluntary dissolution without having made adequate provision for the continued
proper maintenance, repair and operation of its Disposal System, the DEVELOPER shall provide in the
Association Bylaws that the Association shall not enter into voluntary dissolution without first having
transferred its said system and facilities to some person, corporation or other entity acceptable to and
approved by the COMMISSION by the issuance of apermit.
9. The agreements set forth in numbered paragraphs 1, 2, 3, 4, 5, 6, 7, and 8 above shall be conditions of any
permit issued by the COMMISSION to the DEVELOPER for the construction, maintenance, repair and
operation of the Disposal System.
10. A copy of this agreement shall be filed at the Register of Deeds in the County(ies) where the Declaration is
filed and in the offices of the Secretary of State of North Carolina with the Articles of Incorporation of the
Association.
IN WITNESS WHEREOF, this agreement was executed in duplicate originals by the duly authorized
representative of the parties hereto on the day and year written as indicated by each of the parties named below:
FOR THE ENVIRONMENTAL Ace Homes, LLC
MANAGEMENT COMMISSION Name ofDEVEMPER
B:
Linda Culpepper (Si re)
Director, Division of Water Resources
(Date)
Allan Casa
Print Name a itie
(Da°/VI
FORM: DEV 03-19 Page 2 of 2

State of North Carolina
Department of Environmental Quality
DWR
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:
(to be completed by DWR)
All items must be comnletedor the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Moore County (company, municipality, HOA, utility, etc,)
2. Applicant type: ❑ Individual Corporation
❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ state/County
® Municipal ❑ Other �. eLU, d V LD
3. Signature authority's name: Randy Gould per 15A NCAC
02T .0106 bl D qi 1r� JR
tL� Y\
Title: Moore County Public Works Director
4. Applicant's mailing address: PO Box 1927
F LB 2 6 '?02i1
City:Carthae State: NC Zip:28327•_
41)0SP
5. Applicant's contact information:
-
na,..,> n,.mher f9101947-6315 Email Address: rgould
moorecoun c. ov '' 1'..-;
mr ��E, �p ��� l.t._R�L63fQ��t�p_a� *r[" k.,
ISSUING BRANCH
6063601-GREATER WILMINGTON-MAIN-
' m
DATE January 17, 2020
o
PAY TO THE
NCDEQ
$480.00
ORDER OF
i
Four Hundred Eighty
and 00/100ths Dollars
9
BB&Tm
- #
AUTHORIZED SIGNATURE
a
ACE
MEMOIPURCHASER
HOMES CAMERON AVE VASSfM

Permit Number WQ0041508
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
stephanie.zodo
Coastal SWRule
Permitted Flow
7,200
Facility
Facility Name
Vass -Cameron
Location Address
Owner
Central Files: APS _ SWP
3/2/2020
Permit Tracking Slip
Status
Project Type
Active
New Project
Version
Permit Classification
1.00
Individual
Permit Contact Affiliation
Major/Minor Region
Minor Fayetteville
County
Moore
Facility Contact Affiliation
Owner Name Owner Type
Moore County Non -Government
Owner Affiliation
Randy G. Gould
Director Public Works
PO Box 1927
Dates/Events Carthage NC 28327192
Scheduled
Ong Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
3/2/2020 2/26/2020 3/2/2020 3/2/2020
Regulated Activities Requested /Received Events
Wastewater collection Additional information requested
Additional information received
lJOTINIM
Waterbody Name Streamindex Number Current Class Subbasin

)W r Cz
ENGINEERING
Transmittal
Mc2 Engineering, Inc.
2110 Ben Craig Dr., Ste. 400
Charlotte, NC 28262
Phone [phone]
Fax [phone]
[e-mail]
To: NCDEQ
225 Green Street, Suite 714
Fayetteville, NC 28301
Attention: Sewer Permitting
910.433.3300
Project:
Project 11 19-O j 2,
� a gm
Date: DUMP
FEB 2 6 2020
WOROS
f ! lET'tt t'i�i,F;vs=CIOi Af OrRcC:
❑
For Your Information
❑
As Requested
®
For Your Approval
❑
For Your Review
)division — Vass
Moore Co.. NC
rDi'[ DIt4}Y t ��VV rlpt�on
s
2 Cover Letter
2 Fast Track Application
1 Application fee of $480
2 Developer Operational Agreement
2 Downstream Flow Tracking (Moore Co.)
2 Color Map
2 Street Map
Comments: Let me know if you need any additional information.
Jeffr y D. ,jlcClusk .E.
President
CC: