WQ0036608_Application_20130624

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USE THE TAB KEY TO MOVE FROM FIELD TO FIELD!
.11
Application Number:
(to be completed by DWQ)
1.
Owner/Permittee:
1a.
Hoke Count , North Carolina
Full Legal Name (company, municipality, HOA, utility, etc.)
0
1 b.
Tim Johnson, County Manager
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials!)
Q
'1 c.
The legal entity who will own this system is:
❑ Individual ❑ Federal ❑ Municipality ® State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify):
O
1d.
227 N. Main Street
;1e. Raeford
LL
Mailing Address
City
Z
if.
North Carolina
I1g. 28736 -
Z
State
Zip Code
0
'1 h.
910.875.8751 1i. 910.875.9222
1j. [e-mail]
Telephone Facsimile
E-mail
L)
2.
Project (Facility) Information:
J
2a.
Health Pavilion Hoke
2b. Hoke
a
Brief Project Name (permit will refer to this name)
County Where Project is Located
Q
3.
Contact Person..
Q
3a.
Kevin S. Caldwell -
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b.
704.941.2252
3c. [e-mail]
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
El 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.
Public Works Commission (PWC) — Fayetteville, North Carolina
Z
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
4b.IN 005005
1A1WTF Permit No.
GEOSCIENCE GR
500-K CLANTON%J V, INC.
CHARLOTTE, NC 28217
[phone]
Four Hundred Eighty and no/100
NORTH CAROLINA BANK & TRUST 67-98
532 300881
DATE CHECK NO.
AMOUNT
NCDENR 03/11/13- 300RR1 _

F WATF State of North Carolina
\��� 9QG DENR—FRO Department of Environment and Natural Resources
v� Division of Water Quality
JUN 2 4 200
o FAST -TRACK APPLICATION
DWQ (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 sDecifications unless you respond NO to Item BO3).
Separate aDDlications should be made for non-contiquous 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
A sewer system project is within 100 feet of any surface water or wetlands, the Watershed Classification Attachment
rnh y 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 13(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(1 b). 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,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Hamett, Hoke,
Fayetteville, North Carolina 28301-5094
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[phone] Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
Raleigh Regional Office
1628 Mail Service Center
Chatham, Durham, Edgecombe, Franklin,
Raleigh, North Carolina 27699-1628
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] 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,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] 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
[phone]
[phone] Fax
Winston-Salem Regional Office
585 Waughtown Street
Alamance, Alleghany, Ashe, Caswell, Davidson,
Winston-Salem, North Carolina 27107
Davie, Forsyth, Guilford, Rockingham, Randolph,
[phone]
Stokes, Surry, Watauga, Wilkes, Yadkin
[phone] Fax
For more information, please visit our web site at:
http://h2o.enr.state.nc. us/peres/Collection%20Systems/CollectionSystemsHome. html
or contact the Regional Office serving your county.
FTA 12/07

'
USE TOE TAB KEY TO MOVE FROM FIELD TO FIELDI
Application Number:
(to be completed by DWQ) © Q�
1.
Owner/Permittee:
1 a.
Hoke County, North Carolina
Full Legal Name (company, municipality, HOA, utility, etc.)
Z
1 b.
_
Tim Johnson, CountyManager
0
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials!)
1 c.
The legal entity who will own this system is:
❑ Individual ❑ Federal ❑ Municipality Z State/County ❑ Private Partnership ❑ Corporation ❑ Other(specify):
0
1d.
227 N. Main Street le. Raeford
ILL
Mailing Address City
Z
1f.
North Carolina 1g. 28736
Z
State Zip Code
0
1 h.
910.875.8751 1 i. 910.875.9222 1 j. [e-mail]
QTelephone
Facsimile E-mail
V
2.
Proiect (Facility) Information:
J
2a.
Health Pavilion Hoke j b. Hoke
Brief Project Name (permit will refer to this name) County Where Project is Located
d
Q
3.
Contact Person:
Q
3a.
Kevin S. Caldwell -
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b.
704.941.2252 c. [e-mail]
Phone Number E-mail
1.
Project is Z New ❑ Modification (of an existing permit) If Modification, Permit No.:
2.
Owner is Z 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.
Public Works Commission (PWC) — Fayetteville, North Carolina
Z
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
0
4a.
Rockfish
4b. NC 005005
Q
Name of WWTF
WWTF Permit No.
5a.
PWC b. 8 inch Z Gravity 5c. WQ 0035727
Owner of Downstream Sewer Receiving Sewer Size JE1 Force Main Permit # of Downstream Sewer (Instruction E)
0
6.
The origin of this wastewater is (check all that apply):
Z
F-
❑ Residential Subdivision ❑ Retail (Stores, shopping centers) 100 % Domestic/Commercial
❑ Apartments/Condominiums ❑ Institution % Industrial (attach
❑ Mobile Home Park Z Hospital description.)
W
❑ School El Church
❑ Restaurant ❑ Nursing Home (RO: contact your Regional Office
0.
❑ Office Z Other (specify): Medical Office Pretreatment staff)
% Other (specify):
7.
Volume of wastewater to be allocated or permitted for this particular project: 0 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

USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! ! Application Number:
(to be completed by DWQ)
1.
Owner/Perm ittee:
,1a.
Hoke Coun ,North Carolina
Full Legal Name (company, municipality, HOA, utility, etc.)
O
1b.
Tim Johnson County Manager
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials!)
1 c
The legal entity who will own this system is:
El Individual Q Federal ❑ Municipality ®State/County ❑ Private Partnership Corporation El Other (speciiyj
1d.
227 N. Main Street `1a. Raeford
U.
Mailing Address I city
z
9f.
North Carolina 1I. 28736
Z
State Zip Code
,.,
Ah.
910.875.8751 1i. 910.875.9222 j1j. [e-mail]
QTelephone
Facsimile E-mail
U
2.
Proiect (Facility) Information:
J
2a.
Health Pavilion Hoke 12b. Hoke
CL
CL
Brief Project Name (permit will refer to this name) County Where Project is Located
Q:3.
Contact Person
Q
Pa.
Kevin S. Caldwell -
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b,
704.941.2252 13c. kcaldwell geosciencegroup.com
Phone NumberI 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.
Public Works Commission (PWC) — Fayetteville, North Carolina
ZZ
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
4a.
Rockfish
41b. NC 005Ob5
H
Q
Name of WWTF
WWTF Permit No.
5a.
PWC 6b, 8 inch Gravity 5c. WQ 0035727
Owner of Downstream Sewer eceiving Sewer Size rEl Force Main Permit # of Downstream Sewer (Instruction E)
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.)
❑ School El Church
LrU
❑ Restaurant El Nursing Home (RO: contact your Regional Office
a'
❑ Office Pretreatment staff)
® Other (specify): Medical Office_
m
% Other (specify):
7. Volume of wastewater to be allocated or permitted for this particular project: 0 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 1o>fi 1 � m u�. sequent permits that connect to this line
El Flow has already been allocated in Permit No. 4 L
❑ Rehabilitation or replacement of existing sewer with no new flow expect e (see 15A NCAC 02T .0303 to determine if a
permit is required)
FTA12/07

` 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).
0
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches) Length (feet) New Gravity or Additional
Force Main
8 701.74 �- Gravity
I
.-.
11. Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
W
=)
Pump Station ID
(self chosen - as shown on plans/map for reference)
Z-
-Location
--- -- ------ —
Design Flow
j Operational Point
Power Reliability Option
Z
(MGD)
GPM @TDH
1 - permanent generator w/ATS; Force Main Size Force Main Length
O
i
2 - portable generator w/MTS
U
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
O
2 - portable generator w/MTS
LL-----
-
Z
H
Pump Station Location ID _ (self chosen - as shown on plans/map for reference)
LIJ
a Design Flow Operational Point Power Reliability Option
(MGD) 1 - Permanent generator w/ATS; Force Main Size Force Main Length
GPM @TDH
m 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
FTA l 2/07

14. Have the following permits/certifications been submitted for approval for the system or project to be served?
' Wetlanfl/Stream Crossings - General Permit or 401 Certification? ❑ Yes ❑ No ® N/A
U)
Z
O
H
Q
_U
LL
H
W
U
A
u
Sedimentation and Erosion Control Plan?
Stormwater?
® Yes ❑ No ❑ N/A
® 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)
1, Tim Johnson , attest that this application for a New 8" Sanitary Sewer Main 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 $10,000
as well as civil penalties ups-$?5,, 000 per violation.
Official
// 6.
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, Kevin S. Caldwell , attest that this application for a New 8" Sanitary Sewer Main
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 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 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 143-215.6B, 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 $10,000 as well as civil penalties up to $25,000 per violation.
2a. Kevin S. Caldwell
Professional Engineer Name
2b. Geoscience Group
Engineering Firm
2c. 500 — K Clanton Road
Mailing Address
2d. Charlotte
City
2g. 704.941.2252
Telephone
2h. 704.525.2051
Facsimile
2e. NC 2f. 28217
State Zip
2i. [e-mail]
E-mail
,,ESe else
1-0725 �{
Q dfeSteCA9 6
NC PE Seal, Signature & Date
FTA 12/07

460 000
FEET
35°00' '
79°07'30" I $72 673
���0 Mapped by the Army Map Service
\QP Edited and published by the Geological Survey
Control by USGS, NOS/NOAA, and USCE
Topography by photogrammetric methods from aerial photographs
taken 1946-1947. Field checked 1948
Polyconic projection. 10,000-foot grid ticks based on North
Carolina coordinate system. 1000-meter Universal Transverse
MN
GN
6' 1
107 MILS i 1 1'07'
20 MILS
rlv
ROCKPISH 0.8 M1. \I (PARKTON) ' 877
51.57 I NE
SCALE 1:24 000
1 2 0
1000 0 1000 2000 3000 4000 5000
1 - .5 0
CONTOUR INTERVAL 10 FEET
NATIONAL GEODETIC VERTICAL DATUM OF 1929

OF W A T�c9 State of North Carolina
Department of Environment and Natural Resources
7 Division of Water Quality
O < Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE—10/07)
Project Applicant Name: Hoke County, North Carolina
Project Name for which flow is being requested: Health Pavilion Hoke
More than one FTSE-10107 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.
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 NC0050105
All flows are in MGD
c. WWTP facility's permitted flow
21.0
d. Estimated obligated flow not yet tributary to the WWTP
4.795
e. WWTP facility's actual avg. flow
12.9
f. Total flow for this specific request
0.000
g. Total actual and obligated flows to the facility
17.695
h. Percent of permitted flow used
84.26%
*Flow far this request is Ogpd as it was allocated as part of a previous permit
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.
(Finn/Design) Daily Flow, MGD
#96 - Bridgeport
11
.075
III. Certification Statement:
I, 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
certi tion applies to those items listed above in Sections I and II for which I am the responsible party. Signature
oft is rm indiante cept f this wastewater flow.
Sig4ing OUTicial Signature Date

WILSON A. LACY, COMMISSIONER PUBLIC WORKS COMMISSION 955 OLD WILMINGTON RD
MICHAEL G. LALLIER, COMMISSIONER P.O. BOX 1089
WICK SMITH, COMMISSIONER OF THE CITY OF FAYETTEVILLE FAYETTEVILLE, NORTH CAROLINA 28302-1089
LYNNE B. GREENE, COMMISSIONER TELEPHONE [phone]
STEVEN K. BLANCHARD, CEO/GENERAL MANAGER ELECTRIC & WATER UTILITIES WWW.FAYPWC.COM
June 7, 2013
Mr. Tim Johnson
County Manager
Hoke County
227 North Main Street
Raeford, NC 28376
SUBJECT: Approval of Plans for Health Pavilion Hoke
Dear Mr. Johnson:
The review for completeness and adequacy of the project construction plans has been
concluded by the Water Resources Engineering Department of the Public Works Commission
(PWC). Said plan documents are hereby approved and are ready for permitting by the State.
Upon completion of the project construction, the engineer must confirm that the project has
been constructed in accordance with the plans approved by the Water Resources Engineering
Department of PWC.
The engineer shall submit "as -built" plans, with project changes noted, to Hoke County.
PWC requests that Hoke County forward a copy of the "as -built" plans to PWC's Water Resources
Engineering Department for review and approval. Upon review and approval, PWC will notify
Hoke County in writing, and request final "as -built" drawings and a copy of the Engineer's
certification. According to North Carolina State Law, the "as -built" plans and certifications, signed
and sealed by the engineer, must be submitted to NCDENR prior to providing any services.
If you have any questions or require additional information regarding this letter, please contact Mr.
Chris Rainey at [phone].
Sincerely,
I'j0`BLIC WORKS COMMISSION
?seph E. Glass, P.E.
Manager
Water Resources Engineering
cc: Dennis Baxley (Hoke County)
Kevin Caldwell, PE (Geoscience Group)
Project file
BUILDING COMMUNITY CONNECTIONS SINCE 1905
AN EQUAL EMPLOYMENT OPPORTUNITY / AFFIRMATIVE ACTION EMPLOYER

DENR-FRCS
JUN 2 0 2013
GEOSCIENCE nwo
GROUP LETTER OF TRANSMr"AM
To: DENR —Division of Water Quality
225 Green Street Suite 714
Fayetteville, NC 28301-5094
Attn: Trent Allen 910-433-3300
We are sending you:. Attached F-] Under separate cover
VIA: F7Overnight F7Regular Mail
The following items: HSpecifications Shop Drawings 8 Prints
Copy of Letter
Consulting Engineers
DATE:6-19-13
CH10.0011.GE
TASK:
PHASE:
Fast Track Application Gravity Sewer
Hoke Communfly Medical Center
EJ Pick-up . Hand Delivered/Couriered
Calculations Disks
Change Order Other
Copies
Date
No.
Description
1
Fast Track Application Original
1
Fast Track Application Copy
1
Check $480
1
Capacity and Flow Tracking Acceptance
1
USGS To o Ma
THESE ARE TRANSMITTED as checked below:
For Approval
For your use
Copy To:
As Requested
For Review and Comment
Approved as Submitted
Approved as Noted
Signed: Josh Rine
Returned for Corrections
500 Clanton Road Charlotte, North Carolina Telephone Facsimile
Suite K 28217 704.525.2003 704.525.2051

PWC Sewer Capacity Analysis Date: January 11, 2012 1st.
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Project Name: Health Pavilion (Hoke County)
Location: Johnson Mill Road (Hoke County) PIN(s): 94660001046
Type of Development: Commercial
Anticipated Demand: 25,410 gpd
The existing gravity sewer pipe, upon which this evaluation is based, is located @ Facility ID: 56793
Pipe Size: Pipe Material: WWTF: Approx. Flow: Residual Capacity:
8-inch PVC Rockfish 36,520 gpd 453,600 gpd
Should the existing Gravity Sewer System be sufficient to serve the needs of this development? to Yes r No r Unknown
Are there any downstream Sewer Lift Stations which could be impacted by this development? G Yes r No r Unknown
Lift Station(s): Pump Rate: Pump Run Time: Current Inflow: Residual Capacity:
#96 - Bridgeport 175 gpm 3.48 hours per day 36,520 gpd 68,480 gpd
None
None
None
Should the existing Pressure System be sufficient to serve the needs of this development? r N/A (' Yes r No r Unknown
Remarks:
The entire sewer flow route, from one probable point of connection, to the treatment plant, has been analyzed using PWC's
electronic Sewer System Model, and is based on recent wet weather conditions. The residual capacity is the difference
between the current actual flow and a calculated flow increase to 100% of each pipe's diameter. A detailed analysis was
then conducted on the one existing pipe, indicated as having the least amount of residual capacity. All lift station information
is based on recently collected SCADA data. The lift station residual capacities are based on an increase of the total pump
run time to 10 hours per day. The above estimated residual pipe capacity excludes allocations for projected build -out of
current projects within the system.