HomeMy WebLinkAboutWQ0035391_Application_20110525flF W AT�R State of North Carolina
DENR—FRO Department of Environment and Natural Resources
Division of Water Quality
o MAY 2 5 2011 FAST -TRACK APPLICATION
DWO (FTA 12/07 very)
for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
(Pressure & Vacuum sewer systems are not to be included as part of this application package)
INSTRUCTIONS: Indicate that you have included/addressed the following list of required application package items by
checking the space provided next to each applicable item. Failure to submit all required items will lead to your application
being returned as incomplete. Forms are available from the web site or by calling the Regional Office serving your county:
http://h2o. enr state. nc. us/peres/Collection % 20Systems/CollectionSystemApplications. html
® A. Application Form - Submit one original and one copy of the completed and appropriately executed application
form. The application should include a project narrative describing the final build -out design (i.e. system and/or
pump station to ultimately serve 500 homes, but flow for only 100 homes being requested now). For modifications,
clearly explain the reason for the modification (i.e. adding another phase, changing line size/length, etc.). Only
include the modified information in this permit application - do not duplicate project information that has already
been included in the original permit.
Any changes to this form will result in the application being returned. The Division of Water Quality (Division) will
only accept application packages that have been fully completed with all applicable items addressed. You do not
need to submit detailed plans and specifications unless you respond NO to Item 13(13).
Separate applications should be made for non-contiguous sewer systems
® B. Application Fee - Submit a check in the amount of $480 made payable to: North Carolina Department of
Environment and Natural Resources (NCDENR). Checks shall be dated within 90 days of application submittal.
❑ C. Certificates of Public Convenience and Necessity — If the application is being submitted in the name of a
privately -owned public utility, submit two copies of the Certificate of Public Convenience and Necessity (CPCN)
which demonstrates that the public utility is authorized to hold the utility franchise for the area to be served by the
sewer extension. If a CPCN has not been issued, provide two copies of a letter from the North Carolina Utilities
Commission's Public Staff that states that an application for a franchise has been received, that the service area
is contiguous to an existing franchised area, and/or that franchise approval is expected. The project name in the
CPCN or letter must match that provided in Item A(2)a of this application.
❑ D. Operational Agreements — Submit one original and two copies of a properly executed operational agreement, as
per 15A NCAC 02T .0115, if the application is submitted by a private applicant and will be serving residential or
commercial lots (e.g., houses, condominiums, townhomes, outparcels, etc.) that will be sold to another entity. If
the applicant is a home or property owner's association, use Form HOA 02/03. If the applicant is a developer,
use Form DEV 02/03. EVEN IF THE PROJECT MAY BE TURNED OVER TO A MUNICIPALITY UPON
COMPLETION, FORM DEV 02/03 IS REQUIRED.
® E. Downstream Sewer, WWTF Capacity and Flow Tracking/Acceptance — FORM FTSE 10/07 (Flow
Tracking/Acceptance for Sewer Extension Permit Applications) is required with every application. The applicant
(and owners of downstream sewers, pump stations and/or treatment facilities submitting FORM FTSE-10/07)
certifies that the addition of the volume of wastewater to be permitted in this project has been evaluated along the
route to the receiving treatment plant, and that the flow from this project will not cause capacity related sanitary
sewer overflows or overburden any downstream pump station en route to the receiving wastewater treatment
plant. Where the applicant is not the owner of the downstream sewer, submit two copies of FORM FTSE 10/07
from the owner of the downstream sewer and owner of the WWTF, if different. The flow acceptance indicated in
FORM FTSE-10/07 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-10/07 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 project -specific FTSE 10/07.
® F Map — Submit an 8.5-inch by 11-inch COLOR copy of a USGS Topographic Map of sufficient scale to identify the
entire project area and the closest surface waters. Each map or maps must show the location of the sewer line
and pump stations and be of reproducible quality. Include a street level map showing the downstream connection
point, and the permit number for the downstream sewer, if known.
FTA 12/07
❑ G._ Stream Classifications — Watershed Classification Attachment (Form WSCAS-12/07) If any portion of the
sewer system project is within 100 feet of any surface water or wetlands, the Watershed Classification Attachment
may need to be completed. A variance must be requested for encroachment within required setbacks or buffers
pursuant to 2T .0305 (f) and be indicated in Item B-13 with supporting documentation/justification provided.
❑ H Environmental Assessments — If this project is subject to an Environmental Assessment (EA) [15A NCAC
01C], this application cannot be used. Send the project application on the most current version of Form
PSFMGSA to the Design Management Unit, 1633 Mail Service Center, Raleigh, NC 27699-1633. Applications
cannot be accepted until a Finding of No Significant Impact (FONSI) or Environmental Impact Statement (EIS)
has been issued. A copy is to be submitted with that permit application.
❑ I. Flow Direction — Many wastewater treatment systems are entering into agreements for regionalization efforts
and emergency treatment capacity. Parts of the system are installed so that the wastewater flow can be directed
to more than one treatment facility. If this is the case with this project, please indicate in B(12) and give the permit
number of the second treatment facility.
® J. Certifications — Section C
The application must be certified by both the applicant and the design engineer who is a North Carolina
Registered Professional Engineer (PE). The applicant signature must match the signing official listed in Item
A(lb). The PE should NOT certify the application if he/she is unfamiliar with 15A NCAC Chapter 2T, the Gravity
Sewer Minimum Design Criteria (most recent version) and the Minimum Design Criteria for the Fast -Track
Permitting of Pump Stations and Force Mains (most recent version), as applicable to the project.
THE COMPLETED FTA 12/07 APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
DOCUMENTS AND $480 FEE, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Swannanoa, North Carolina 28778
Clay, Graham, Haywood, Henderson, Jackson,
(828) 296-4500
Macon, Madison, McDowell, Mitchell, Polk,
(828) 299-7043 Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Fayetteville, North Carolina 28301-5094
Montgomery, Moore, Robeson, Richmond,
(910) 433-3300
Sampson, Scotland
(910) 486-0707 Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
(704) 663-1699
Stanly, Union
(704) 663-6040 Fax
Raleigh Regional Office
1628 Mail Service Center
Chatham, Durham, Edgecombe, Franklin,
Raleigh, North Carolina 27699-1628
Granville, Halifax, Johnston, Lee, Nash,
(919) 791-4200
Northampton, Orange, Person, Vance, Wake,
(919) 788-7159 Fax
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
Beaufort, Bertie, Camden, Chowan, Craven,
Washington, North Carolina 27889
Currituck, Dare, Gates, Greene, Hertford, Hyde,
(252) 946-6481
Jones, Lenoir, Martin, Pamlico, Pasquotank,
(252) 975-3716 Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Wilmington, North Carolina 28405
Hanover, Onslow, Pender
(910) 796-7215
(910) 350-2004 Fax
Winston-Salem Regional Office
585 Waughtown Street
Alamance, Alleghany, Ashe, Caswell, Davidson,
Winston-Salem, North Carolina 27107
Davie, Forsyth, Guilford, Rockingham, Randolph,
(336) 771-5000
Stokes, Surry, Watauga, Wilkes, Yadkin
(336) 771-4630 Fax
For more information, please visit our web site at:
http://h2o. enr.state.nc. uslperes/Collection%2OSystemsICollectionSystemsHome.htmi
or contact the Regional Office serving your county.
FTA 12/07
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number:
(to be completed by DWQ) Q
1.
Owner/Permittee:
1a.
Hoke Count
Full Legal Name (company, municipality, HOA, utility, etc.)
1 b.
Tim Johnson, County Manager
0
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials!)
1c.
The legal entity who will own this system is:
❑ Individual ❑ Federal ® Municipality ❑ State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify):
0
1 d.
PO Box 210 1 e. Raeford
LL
Mailing Address City
Z
1f.
NC 1g. 28376
Z
State Zip Code
0
1h.
910-875-8751 1i. 910-875-9222 1j.
QTelephone
Facsimile E-mail
V
2.
Project (Facility) Information:
J
2a.
Sanitary Sewer Improvements to Serve Wedgefield Phase 3A 2b. Hoke
a
Subdivision County Where Project is Located
a
3.
Contact Person:
Q3a.
Lee Humphrey
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b.
(910) 692-5616 3c. LHumphrey@Hobbsupchurch.com
Phone Number E-mail
1.
Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.:
2.
Owner is ® Public (skip to Item B(3)) ❑ Private (go to Item 2(a))
2a.
If private, applicant will be: 2b. If sold, facilities owned by a (must choose one)
❑ Retaining Ownership (i.e. store, church, single office, etc.) or ❑ Public Utility (Instruction C)
❑ Leasing units (lots, townhomes, etc. - skip to Item B(3)) ❑ Homeowner Assoc./Developer (Instruction D)
❑ Selling units (lots, townhomes, etc. - go to Item B(2b))
3.
City of Fayetteville PWC
Z
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
0
4a.
Rockfish Creek WRF 4b. NCO050105
a
Name of WWTF WWTF Permit No.
5a.
City of Fayetteville PWC 5b. 8" IM Gravity 5c. N/A
Owner of Downstream Sewer IReceiving Sewer Size ❑ Force Main Permit # of Downstream Sewer (Instruction E)
0
6.
The origin of this wastewater is (check all that apply):
Z
® Residential Subdivision ❑ Retail (Stores, shopping centers) 100 % Domestic/Commercial
❑ Apartments/Condominiums ❑ Institution % Industrial (attach
❑ Mobile Home Park ❑ Hospital description.)
LLJ
❑ School El Church
contact your Regional Office
❑ Restaurant [I Nursing Home
d
Pretreatment
El Office El Other (specify): Pretreatment staff)
�
%Other (specify):
7.
Volume of wastewater to be allocated or permitted for this particular project: 18,480 gallons per day
'Do not include future flows or previously permitted allocations
8.
If the permitted flow is zero, indicate why:
❑ Pump Station, Outfall or Interceptor Line where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit No.
❑ Rehabilitation or replacement of existing sewer with no new flow expected (see 15A NCAC 02T .0303 to determine if a
permit is required)
FTA 12/07
9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T .0114 for
the value in Item 13(7) AND/OR the design flow for line or pump station sizing if a reduced or zero flow is being requested in
Item B(7). Values other than that in 15A NCAC 2T .0114 (b) and (c) must be supported with actual water or wastewater use
data in accordance with 15A NCAC 2T .0114 (f).
88 single family residences @ 210gpd = 18,480 gpd
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches) Length (feet) New Gravity or Additional
Force Main
8" 3808 Gravity
11. Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
W
Pump Station Location ID
(self chosen - as shown on plans/map for reference)
H
Design Flow
Operational Point
Power Reliability Option
Z
(MGD)
GPM @TDH
1 - permanent generator w/ATS; Force Main Size Force Main Length
0
2 - portable generator w/MTS
Z
O
QPump
Station Location ID
(self chosen - as shown on plans/map for reference)
Design Flow
Operational Point
Power Reliability Option
(MGD)
GPM @TDH
1 - Permanent generator w/ATS; Force Main Size Force Main Length
0
2 - portable generator w/MTS
LL
Z
1-
Pump Station Location ID
(self chosen - as shown on plans/map for reference)
W
0..
Design Flow
Operational Point
Power Reliability Option
(MGD)
GPM @TDH
1 - permanent generator w/ATS; Force Main Size Force Main Length
Cd
2 - portable generator w/MTS
12. Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
❑ Yes ® No If Yes, permit number of 2"d treatment facility
(RO — if "yes" to 13,12 please contact the Central Office PERCS Unit)
13. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force
Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chapter 2T as
applicable?
® Yes ❑ No If No, please reference the pertinent minimum design criteria or regulation and indicate why a
variance is requested. SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS
PERTINENT TO THE VARIANCE WITH YOUR APPLICATION
FTA12/07
14. Have the following permits/certifications been submitted for approval for the system or project to be served?
U)
Z
O
H
Q
U_
tL
F—
LU
U
Wetland/Stream Crossings - General Permit or 401 Certification?
❑ Yes
❑ No
® N/A
Sedimentation and Erosion Control Plan?
® Yes
❑ No
❑ N/A
Stormwater?
® Yes
❑ No
❑ N/A
15. Does this project include any high priority lines, [see 15A NCAC 02T .0402 (2)] involve aerial lines, siphons, or interference
manholes)? These lines will be considered high priority and must be checked once every six months
Check if Yes: ❑ and provide details
1. Owner/Permittee's Certification: (Signature of Signing Official and Project Name)
I, Tim Johnson , attest that this application for Sanitary Sewer Improvements to Serve Wedciefield
Subdivision Phase 2 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. Note: In accordance
with North Carolina General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor, which may include
a fine not to exceed $10, as well as civil penalties up to $25, 000 per violation.
Date
ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THIS
APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIM
TO OTHER UTILITIES, DESIGN CALCULATIONS. ETC. REFER TO 15A NCAC 02T .0305
Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
1, Fred M. Hobbs attest that this application for Sanitary Sewer Improvements to Serve Wedgefield
Subdivision Phase 2 has been reviewed by me and is accurate, complete and consistent with the information in the
engineering plans, calculations, and all other supporting documentation to the best of my knowledge. I further attest that t
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 adopted February 12, 1996, and the Minimum Design Criteria for the
Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 and the watershed classification in
accordance with Division guidance. 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 NC General Statutes 143-215.6A and 143-
215.68, any person who knowingly makes any false statement, representation, or certification in any application 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
2a. Fred M. Hobbs
Professional Engineer Name
2b. Hobbs, Upchurch and Assoiciates, P.A.
Engineering Firm
2c. 300 S.W. Broad Street
Mailing Address
2d. Southern Pines
City
2e. NC 2f. 28387
State Zip
2g. (910) 692-5616 2h. (910) 692-7342 2i. F.Hobbs@hobbsupchurch.com
Telephone Facsimile E-mail
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NC PE Seal, Signature & Date
FTA 12/07
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number:
(to be completed by DWQ) J7-63
1.
Owner/Permittee:
1 a.
Hoke Count
Full Legal Name (company, municipality, HOA, utility, etc.)
1 b.
Tim Johnson, Count Manager
0
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials!)
0
1 c.
The legal entity who will own this system is:
❑ Individual ❑ Federal ® Municipality ❑ State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify):
0
1 d.
PO Box 210 1 e. Raeford
LL
Mailing Address City
i Z
1 f.
NC 1 g. 28376
Z
State Zip Code
LD
1 h.
910-875-8751 1 i. 910-875-9222 1j.
QTelephone
Facsimile E-mail
U
2.
Proiect (Facility) Information:
J
2a.
Sanitary Sewer Improvements to Serve Wedgefield Phase 3A 2b. Hoke
aSubdivision
County Where Project is Located
Q
3.
Contact Person:
3a.
Lee Humphrey
Q
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b.
(910) 692-5616 3c. LHumphrey@Hobbsupchurch.com
Phone Number E-mail
1.
Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.:
2.
Owner is ® Public (skip to Item B(3)) ❑ Private (go to Item 2(a))
2a.
If private, applicant will be: 2b. If sold, facilities owned by a (must choose one)
❑ Retaining Ownership (i.e. store, church, single office, etc.) or ❑ Public Utility (Instruction C)
❑ Leasing units (lots, townhomes, etc. - skip to Item B(3)) ❑ Homeowner Assoc./Developer (Instruction D)
❑ Selling units (lots, townhomes, etc. - go to Item B(2b))
3.
City of Fayetteville PWC
Z
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
4a.
Rockfish Creek WRF 4b. NCO050105
~
Name of WWTF WWTF Permit No.
5a.
City of Fayetteville PWC 5b. 8" ® Gravity c. N/A
Owner of Downstream Sewer Receiving Sewer Size ❑ Force Main Permit # of Downstream Sewer (Instruction E)
O6.
The origin of this wastewater is (check all that apply):
Z
I inn of
HOBBS, UPCHURCH & ASSOCIATES, PA 098
PO BOX 1737 W112/531
SOUTHERN PINES, NC 28388
DATE
PAY
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Central Files: APS SWP
06/07/11
Permit Number WQ0035391 Permit Tracking Slip
Program Category
Status
Project Type
Non -discharge
Active
New Project
Permit Type
Version
Permit Classification
Gravity Sewer Extension, Pump Stations, & Pressure Sewer
1.00
Individual
Extensions
Primary Reviewer
Permit Contact
Affiliation
trent.allen
Coastal SW Rule
Permitted Flow
18480
<ncility
Facility Name
Wedgefield Subdivision, Phase 3A
Location Address
Owner
Major/Minor Region
Major Fayetteville
County
Hoke
Facility Contact Affiliation
Owner Name Owner Type
Individual
Tim Johnson Owner Affiliation
Tim Johnson
County Manager
PO Box 210
Raeford NC 28376
Dates/Events
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
06/07/11 05/25/11 06/07/11 06/07/11
Rectulated Activities Reaues'ied/Received Events
Wastewater collection Additional information requested
Additional information received
Outfall NULL
Waterbody Name Stream Index Number Current Class Subbasin
DENR-FRO
State of North Carolina
MAY biAlnent of Environment and Natural Resources
DWQ Division of Water Quality
o_� c Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE—10/07)
Project Applicant Name: Hoke County
Project Name for which flow is being requested: ss Improvements to serve wedgetield subdivision Phase 2_
More than one FTSE-10107 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: Rockfish Wastewater Treatment Facility
b. WWTP Facility Permit #: NPDES NCO050105
c. WWTP facility's permitted flow All flows are in MGD
21.0
d. Estimated obligated flow not yet tributary to the WWTP 3.341_
e. WWTP facility's actual avg. flow 12.9
f. Total flow for this specific request _ 0.0367
g. Total actual and obligated flows to the facility 16.278
h. Percent of permitted flow used 77.51%
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
Pump Station Name Approx. Capacity, MGD Approx. Current Avg.
(Firm/Design) Daily Flow, MGD
—#82 — Hoke County .262 .120
III. Certification Statement:
1, Joseph E. Glass , certify that, to the best of my knowledge, 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. 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 for which I am the responsible party. Signature
o th form iroicjtfs acgotppce of this wastewater flow.
7. Is- r �1
ial Signature Date
Hobbs Upchurch Associates
FJ4
TRANSMITTAL
TO: Division of Water Quality
Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301
FROM: Lee Humphrey
Hobbs, Upchurch &t Associates, P.A.
DATE: May 24, 2011
RE: Sanitary Sewer Improvements to Serve
Wedgefield Subdivision - PHASE 2
Enclosed please find:
(1) Original and (1) copy of the Fast Track Application
HUA PROJECT # HC1011
DENR-FRO
MAY 2 5 2011
DWO
(2) Copies of the Flow Tracking/Acceptance for Sewer Extension Permit Applications
(1) USGS color map of the project area
(1) Check for $480.00
Please call this office if you have any questions.
T: 910-692-5616 • F: 910-692-7342 • 300 SW BROAD STREET • SOUTHERN PINES, NC 28374 • WWW,HOBBSUPCHURCH.COM
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