WQ0037882_Permit (Issuance)_20150702

AAA
l NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Donald R. van der Vaart
Governor Secretary
July 2, 2015
Dennis Baxley, City Manager
City of Raeford
315 N. Main Street
Raeford, NC 28376
Subject: Permit No. WQ0037882
City of Raeford
SIXTH AT MAIN
Wastewater Collection System Extension Permit
Hoke County
Dear Mr. Baxley:
In accordance with your application received June 18, 2015, we are forwarding herewith Permit No.
WQ0037882 dated July 2, 2015, to City of Raeford for the construction and operation upon certification
of the subject wastewater collection system extension. This permit shall be effective from the date of
issuance until rescinded, and shall be subject to the conditions and limitations as specified therein. This
cover letter shall be considered a part of this permit and is therefore incorporated therein by reference.
Please pay particular attention to the following conditions contained within this permit:
Condition 11.1: This permit shall not be automatically transferable; a request must be made and
approved.
Condition 11.4: Requires that the wastewater collection facilities be properly operated and maintained
in accordance with 15A NCAC 2T .0403 or any individual system -wide collection system
permit issued to the Permittee.
It shall be responsibility of the Permittee to ensure that the as -constructed project meets the
appropriate design criteria and rules. Failure to comply may result in penalties in accordance with North
Carolina General Statute §143-215.6A through §143-215.6C, construction of additional or replacement
wastewater collection facilities, and/or referral of the North Carolina -licensed Professional Engineer to
the licensing board.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right
zo request dii a_tiut:„ .gory hearing upon wni.«II 35 de,,, ;,,;;;,;,�;rb rt,, ­ „i of this, permit.
This request must U. in the form of a written petition, conforming to Chapter 150E of North Carolina
General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh,
NC 27699-6714. Unless such de..-'nds are m?de, this permit shall be final and binding.
If you need additional information concerning this ,�atter, please contact Trent Allen at [phone]
or via e-mail at [e-mail].
225 Green Street, Suite 714, Fayetteville, 28301
Phone: [phone] \ Internet: www.ncwatergualitv.org
An Equal Opportunity \ Affirmative Action Employer— Made in part by recycled paper

City of Raeford
Permit No. WQ0037882
.i
1
Sincerely,
for S. Jay Zimmerman, Director
Division of Water Resources, NCDENR
by Trent Allen
Fayetteville Region Surface Water Resources Assistant Supervisor
cc: James M. Kizer, Jr., P.E., Moorman, Kizer & Reitzel, Inc., P.O. Box 55374, Fayetteville, NC 28305
Fayetteville Regional Office Files
Water Resources Central Files
PERCS (electronic copy)
Page 2 of 8

k
SUPPLEMENT TO PERMIT COVER SHEET
City of Raeford is hereby authorized to:
Construct, and then operate upon certification the aforementioned wastewater collection extension.
The sewage and wastewater collected by this system shall be treated in the City of Raeford Wastewater
Treatment Plant in accordance with Permit Number NC0026514.
Permitting of this project does not constitute an acceptance of any part of the project that does not
meet 15A NCAC 2T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as
applicable; and the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations
and Force Mains adopted June 1, 2000 as applicable, unless specifically mentioned herein. Division
approval is based on acceptance of the certification provided by a North Carolina -licensed Professional
Engineer in the application. It shall be the Permittee's responsibility to ensure that the as -constructed
project meets the appropriate design criteria and rules.
II. STANDARD CONDITIONS
1. This permit shall not be transferable. In the event there is a desire for the wastewater collection
facilities to change ownership, or there is a name change of the Permittee, a formal permit request
shall be submitted to the Division accompanied by documentation from the parties involved, and
other supporting materials as may be appropriate. The approval of this request shall be considered
on its merits and may or may not be approved. [15A NCAC 02T.0104; G.S 143-215.1(d3)]
2. This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 15A NCAC 2T; the Division's Gravity Sewer Minimum
Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for
the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and
other supporting materials unless specifically mentioned herein. [15A NCAC 02T.0110]
3. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data. [15A NCAC 02T .01101
4. The wastewater collection facilities shall be properly --; -'oed and opeiat'Ci at all times. The
Permittee shall maintain compliance- •. ,,,i do individual system -wide collection system pern,,it Zvi the
ape��t ^n and maintenance of these facilities as required by 15A NCAC 2T .0403. If an individual
permit is not required, the following performance criteria ,^i! met: [15A ?SAC 02T .0108(b)]:
a. The sewer system shall be effectively ma;;,cained and operated at all times to prevent disch;31bC
to land or surface waters, and ",, prevent any contravention of groundwater ;"dndards or
surface water standard,,.
b. A mar of thf sewer system shall be deve'­.nr., and shall h� actively maintained.
c. An operation and maintenance plan including pumr station inspection frequency, preventative
maintenance schedule, spare parts inventory overflow response has been developed and
implemented.
Page 4 if

WA
AL
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NCDENR
STATE OF NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations, permission is hereby granted to the
City of Raeford
Hoke County
for the construction and operation of approximately 390 linear feet of 8-inch gravity sewer as part of the
SIXTH AT MAIN project, and the discharge of 2,520 gallons per day of collected domestic wastewater
into the City of Raeford Wastewater Treatment Plant existing sewerage system, pursuant to the
application received June 18, 2015, and in conformity with 15A NCAC 2T; the Division's Gravity Sewer
Minimum Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design
Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as
applicable; and other supporting data subsequently filed and approved by the Department of
Environment and Natural Resources and considered a part of this permit.
This permit shall be effective from the date of issuance until rescinded and shall be subject to the
specified conditions and limitations contained therein.
for S. Jay Zimmerman, Director
Division of Water Resources, NCDENR
By Authority of The Environmental Management Commission
Permit Number: W00037882
Permit IssuPrf- July 2, 2015
Page 3 L 8

d. Pump stations that are not connected to a telemetry system shall be inspected every day (i.e.
365 days per year). Pump stations that are connected to a telemetry system shall be inspected
at least once per week.
e. High -priority sewer lines shall be inspected at least once per every six -months and inspections
are documented.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. Overflows and bypasses shall be reported to the appropriate Division regional office in
accordance with 15A NCAC 2B .0506(a), and public notice shall be provided as required by North
Carolina General Statute §143-215.1C.
h. A Grease Control Program is in place as follows:
1. For public owned collection systems, the Grease Control Program shall include at least
biannual distribution of educational materials for both commercial and residential users and
the legal means to require grease interceptors at existing establishments. The plan shall also
include legal means for inspections of the grease interceptors, enforcement for violators and
the legal means to control grease entering the system from other public and private satellite
sewer systems.
2. For privately owned collection systems, the Grease Control Program shall include at least bi-
annual distribution of grease education materials to users of the collection system by the
permittee or its representative.
3. Grease education materials shall be distributed more often than required in Parts (1) and (2)
of this Subparagraph if necessary to prevent grease -related sanitary sewer overflows.
i. Right-of-ways and easements shall be maintained in the full easement width for personnel and
equipment accessibility.
j. Documentation shall be kept for Subparagraphs (a) through (i) of this Rule for a minimum of
three years with exception of the map, which shall be maintained for the life of the system
5. The Permittee shall report by telephone to a water resources staff member at the Fayetteville
Regional Office, telerhone ntimbpr [phone], as as r�obsible, but in no case more than 24
hours, following tie occurrence or first knowledge of the occurrence of either of the following:
a. Any process unit due to known or unknown reasons, that renders the facility
incapable of adequate w4stewater transport, such as mechanical or electrical failures of
nvomnc l!.np hlnclab or break,;Qe, etc.; or
b. Ai-,'; SSO and/or spin over 1,%Ij0rIbai.'�ns; or
c. Any SSO and/or spi;!. regardless of volui-ne, that reaches surface water
Voice mail messages or faxed iniori;,ation is permissib;0, Uur this shall not be considerea as L;11--
initial verbal report. Overflows and s�ills occurring outside normal business hours may also be
reported to the Division of Emergency Mai`agement at telephone number [phone] or (919)
733-3300. Persons reporting any of the above occurrences shall file a spill report by completing and
submitting Part I of Form CS-SSO (or the most �urrerit Division approved form) within five days
following first knowledge of the occurrence. This report must outline the actions taken or proposed
Page 5 of 8

to be taken to ensure that the problem does not recur. Part II of Form CS-SSO (or the most current
Division approved form) can also be completed to show that the SSO was beyond control. [G.S. 143-
215.1C(a1)]
6. Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to
interrupt service by the existing utilities nor result in an overflow or bypass discharge of wastewater
to the surface waters of the State. [15A NCAC 02T.0108(b)]
7. Upon completion of construction and prior to operation of these permitted facilities, the completed
Engineering Certification form attached to this permit shall be submitted with the required
supporting documents to the address provided on the form. A complete certification is one where
the form is fully executed and the supporting documents are provided as applicable. Any
wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Engineer's Certification shall be considered a violation of the permit and shall subject the
Permittee to appropriate enforcement actions.
If the permit is issued to a private entity with an Operational Agreement, then a copy of the
Articles of Incorporation, Declarations/Covenants/Restrictions, and Bylaws that have been
appropriately filed with the applicable County's Register of Deeds office shall be submitted with
the certification.
A complete certification is one where the form is fully executed and the supporting documents are
provided as applicable. Supporting documentation shall include the following:
a. One copy of the project construction record drawings (plan & profile views of sewer lines &
force mains) of the wastewater collection system extension. Final record drawings should be
clear on the plans or on digital media (CD or DVD disk) and are defined as the design drawings
that are marked up or annotated with after construction information and show required buffers,
separation distances, material changes, etc.
b. One copy of the supporting applicable design calculations including pipe and pump sizing,
velocity, pump cycle times, and level control settings, pump station buoyancy, wet well storage,
surge protection, detention time in the wet well, and force main, ability to flush low points in
force nizins with a pump cycle, and downstream sewer capacity analysis. If a portable power
source or pump �-- dedicated to multiple stations, an evaluation of all the pump stations' storage
capacities and the rotatiuii bL;1CUui0 ^f the portable nnwar sourct or pump, include travel
timeframes, shall be provided.
c. Changes to the project that do not result in non-compli;,,(ce with this permit, regulations, or the
Minimum Design Criteria should be clearly identifier+ in the record drawings, on the certifi"+_:,,n
in the space provided, or in written summary fr,•,n.
Prior to if=mtinn (Final or Partial): PP; mit modifications ar:; required for any changes resulting
in n.,n-compliance wit;; *his permit #including pipe leno;n increases of 10% or greater, increased
flow, pump station design .;opacity design increases of 5% or greater, and increases in the
number/type of cone; ctions), regulations, or the Minimum Design Criteria. Requested
modifications or variances to the Minimum DF;ign Criteria will be reviewed on a case -by -case basis
and each on its own merit. Please note '' ,at variances to the Minimum Design Criteria should be
requested and approved during aiie r =emitting process prior to construction. After -construction
Page 6of8

requests are discouraged by the Division and may not be approved, thus requiring replacement or
repair prior to certification & activation. [15A NCAC 02T .01161
8. Gravity sewers installed greater than ten percent below the minimum required slope per the
Division's Gravity Sewer Minimum Design Criteria shall not be acceptable and shall not be certified
until corrected. If there is an unforeseen obstacle in the field where all viable solutions have been
examined, a slope variance can be requested from the Division with firm supporting documentation.
This shall be done through a permit modification with fee. Such variance requests will be evaluated
on a case -by -case basis. Resolution of such request shall be evident prior to completing and
submitting the construction certification. [ 15A NCAC 02T.0105(n)]
9. A copy of the construction record drawings shall be maintained on file by the Permittee for the life
of the wastewater collection facilities. [15A NCAC 02T .0116]
10. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 2T; the
Division's Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the Division's
Minimum Design Criteria for the Fast -Track Permitting of Pump Station and Force Mains adopted
June 1, 2000 as applicable; and other supporting materials may subject the Permittee to an
enforcement action by the Division, in accordance with North Carolina General Statutes §143-215.6A
through §143-215.6C, construction of additional or replacement wastewater collection facilities,
and/or referral of the North Carolina -licensed Professional Engineer to the licensing board. [15A
NCAC 02T .0104;15A NCAC 02T .0108(b-c)]
11. In the event that the wastewater collection facilities fail to perform satisfactorily, including the
creation of nuisance conditions, the Permittee shall take immediate corrective action, including
those as may be required by this Division, such as the construction of additional or replacement
facilities. [15A NCAC 02T .0110; 15A NCAC 02T .0108(b)]
12. The issuance of this permit shall not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances that may be imposed by the Division any other Federal, State, or
Local government agencies which have jurisdiction or obtaining other permits which maybe required
by the Division or any other Federal, State, of local government agencies. [G.S. 143-215.1(b)]
Page 7 of 8

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE:
City of Raeford
PERMIT #:
WQ0037882
PROJECT:
SIXTH AT MAIN
ISSUE DATE:
July 2, 2015
This project shall not be considered complete nor allowed to operate in accordance with Condition 7 of
this permit until the Division has received this Certification and all required supporting documentation.
It should be submitted in a manner that documents the U vision's receipt. Send the required
documentation the Regional Supervisor, Water Quality Regional Operations Section at the address at
the bottom.
Any wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Certification shall be considered a violation of the permit and shall subject the Permittee to
appropriate enforcement actions. The Permittee is responsible for tracking all partial certifications up
until a final certification is received. A Final Certification shall be a complete set of record drawings and
design calculations regardless of whether partials have been submitted.
PERMITTEE'S CERTIFICATION
I, the undersigned agent for the Permittee, hereby state that this project has been constructed pursuant
to the applicable standards & requirements, the Professional Engineer below has provided applicable
design/construction information to the Permittee, and the Permittee is prepared to operate & maintain
the wastewater collection system permitted herein or portions thereof.
Printed Name, Title Signature Date
ENGINEERS CERTIFICATION
1, , as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe (❑ periodically, ❑ weekly, ❑ full time) the construction of the
project name and location as referenced above for the above Permittee hereby state that, to the best of
my abilities, due care and diligence was used in the observation of the construction such that the
construction was observed to be built within substantial compliance of this permit; 15A NCAC 02T; the
Division of Water Resources' (Division) Gravity Sewer Minimum Design Criteria adopted February 12,
1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump
Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting materials.
North Carolina Professional Engineer's Seal w/signature & date:
❑ Final ❑ Partial (include description)
Certification Comments/Qualifiers (attach if necessary):
NC DWR — Water Quality Regional Operations Section 225 Green Street, Suite 714, Fayetteville, NC 28301
Fayetteville Regional Office Phone: [phone] FAX: [phone]

RECENWOENROWIR State of North Carolina
Department of Environment and Natural Resources
DWR JUN 18 Division of Water Resources
FAST -TRACK APPLICATION (FTA 08-13)
Division of Water Resource for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
General — When submitting this 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.
For more information, visit the Surface Water Section's Collection Systems website or;
contact the Regional Office serving your county
Unless otherwise noted, the Applicant shall submit one original and one copy of the application and supporting
documentation to the appropriate Regional Office (see page 6).
A. Cover Letter:
® Include a brief project narrative describing the final 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).
B. Application Form (FTA 08-13):
® Submit the completed and appropriately executed Fast -Track (FTA 08-13) Application. Any
unauthorized content changes to this form shall result in the application being returned. If necessary
for clarity or due to space restrictions, attachment to the application may be made, as long as the
attachments are numbered to correspond to the section and item to which they refer. You do not need
to submit detailed plans and specifications unless you respond NO to item 13(13).
® The Professional Engineer's Certification of the application shall be signed, sealed and dated by a
North Carolina licensed Professional Engineer.
® The Applicant's Certification of the application shall be signed in accordance with 15A NCAC 02T
.0106(b). Per 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).
C. Application Fee:
® Submit a check in the amount of $480 to: North Carolina Department of Environment and Natural
Resources (NCDENR).
➢ Checks shall be dated within 90 days of application submittal.
D. Certificate of Public Convenience and Necessity (For Privately -Owned Public Utilities Only):
❑ Per 15A NCAC 02T .0115(a)(1), provide two copies of 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 two copies of 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.
❑ The project name in the CPCN or letter must match that provided in Item A(2)a of this application.
E. Operational Agreements (For Home/Property Owners' Associations and Developers of lots to be sold):
Home/Property Owners' Associations
❑ Per 15A NCAC 02T .0115(c), submit the properly executed Operational Agreement (HOA 08-13).
❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
➢ Developers of lots to be sold
❑ Per 15A NCAC 02T .0115(b), submit the properly executed Operational Agreement (DEV 08-13).
Even if the project may be turned over to a municipality upon completion, Form DEV 01-12 is required.
INSTRUCTIONS FOR APPLICATION FTA 08-13 & SUPPORTING DOCUMENTATION Page 1 of 6

F. ' Downstream Sewer, WWTF Capacity and Flow Tracking/Acceptance Form (FTSE 08-13)
® Submit the completed and appropriately executed Flow Tracking/Acceptance for Sewer Extension
Permit (FTSE 08-13) Form for all applications.
➢ The applicant (and owners of downstream sewers, pump stations and/or treatment facilities submitting
form FTSE 08-13 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 08-13
from the owner of the downstream sewer and owner of the WWTF, if different.
➢ The flow acceptance indicated in form FTSE 08-13 must not expire prior to permit issuance and must
be dated less than one year prior to the application date.
);o Submittal of this application and form FTSE 08-13 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 08-13.
G. Site Map (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. Each map must include at a minimum:
➢ The location of the sewer line and pump stations and be of reproducible quality.
➢ Downstream connection points and the permit number for the receiving sewer (if known)
➢ Pump Station Locations and the longitude and latitude for each pump station (if applicable)
® Include a street level map showing all relevant project areas.
H. Stream Classification (WSCAS 08-13)
❑ Submit the completed and appropriately executed Watershed Classification Attachment form
(WSCAS 08-13) if any portion of the sewer system project is within 100 feet of any surface water or
wetlands.
➢ A variance must be requested for encroachment within required setbacks or buffers pursuant to 15A
NCAC 02T .0305(f)
Environmental Assessments (Projects subject to an Environmental Assessment (EA)):
➢ Projects involving an Environmental Assessment per 15A NCAC 01 C .0408, must be submitted for a
full technical review and must be submitted to the PERCS Unit on application forms provided by the
Division.
J. Alternative Sewer Systems
➢ Projects involving low pressure sewer systems, vacuum sewer systems and other alternative sewer
systems must be submitted for a full technical review and must be submitted to the PERCS Unit on
application forms provided by the Division.
K. 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 the project, please indicate in B(12)
and give the permit number of the second facility.
L. 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 21 The Gravity Sewer Minimum Design Criteria (most recent version) and the Minimum
Design Criteria for the Permitting of Pump Stations and Force Mains (most recent version), as
applicable to the project.
INSTRUCTIONS FOR APPLICATION FTA 08-13 & SUPPORTING DOCUMENTATION Page 2 of 6

USE THE TAB KEY TO MOVE FROM FIELD TO FIELD Application Number. p
(to be completed by DWR) 003 p p p k
1.
Owner/Permittee:
la.
CITY OF RAEFORD
Full Legal Name (company, municipality, HOA, utility, etc.)
Z
1 b.
Dennis Baxley, City 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:
❑ Individual ❑ Federal ® Municipality ❑ State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify):
O
1 d.
315 N. Main Street le. Raeford
LL
Mailing Address City
Z
1 f.
NC 1 g. 28376
Z
State Zip Code
0
1 h.
910-875-8161 1 i. 910-875-8165 1 j.
QTelephone
Facsimile E-mail
V
2.
Project (Facility) Information:
J
2a.
SIXTH AT MAIN 2b. Hoke
IZ
Brief Project Name (permit will refer to this name) County Where Project is Located
a
Q
3.
Contact Person:
Q
3a.
David A. Matthews, Senior Designer, Moorman, Kizer & Reitzel, Inc.
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b.
910-484-5191 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 ❑ Public Utility (Instruction D)
❑ Leasing units (lots, townhomes, etc. - skip to Item B(3)) ❑ Homeowner Assoc./Developer (Instruction E)
❑ Selling units (lots, townhomes, etc. - go to Item B(2b))
Z
3.
City of Raeford
0
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
F'
4a.
City of Raeford WWTP 4b. NCO026514
Name of WWTF WWTF Permit No.
5a.
City of Raeford b. 8" ® Gravity c. W00033891 Modification
Q
Owner of Downstream Sewer Receiving Sewer Size ❑ Force Main Permit # of Downstream Sewer (Instruction F)
LL
Z
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6.
The origin of this wastewater is (check all that apply):
H
® Residential Subdivision ❑ Retail (Stores, shopping centers) % Domestic/Commercial
❑ Apartments/Condominiums ❑ Institution % Industrial
❑ Mobile Home Park ❑ Hospital
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❑ School ❑ Church (Attach Description)
Q.
❑ Restaurant ❑ Nursing Home % Other
❑ Office ❑ Other (specify):
m
(Attach Description)
7.
Volume of wastewater to be allocated or aermitted for this particular project: 2,520 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 08-13 APPLICATION Page 3 of 6

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9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T .0114 for
the value in Item B(7) AND/OR the design flow for line or pump station sizing if a reduced or zero flow is being requested in
Item 13(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).
7 Lots with 3 bedrooms @ 120 gpd per bedroom = 7 x 360 = 2,520 gpd for SIXTH AT MAIN Development.
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches)
0
Length (feet) New Gravity or Additional
Force Main
390 New Gravity
11. Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
Pump Station Location ID:
Longitude:
Design Flow
(MGD)
Pump Station Location ID:
Longitude:
(self chosen - as shown on plans/map for reference)
Latitude:
Operational Point Power Reliability Option
GPM @TDH 1 -permanent generator w/ATS; Force Main Size Force Main Length
2 - portable generator w/MTS
Latitude:
(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
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 B,12 please contact the Central Office PERCS Unit)
13. Does the sewer system comply with the Minimum Design Criteria for the Permitting of Pump Stations and Force Mains
(latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chaoter 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 08-13 APPLICATION Page 4 of 6

14. Have the following permits/certifications been submitted for approval for the system or project to be served?
A
u
Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes [:]No ® N/A
Sedimentation and Erosion Control Plan? ❑ Yes [--]No ® N/A
Trout Buffer Waiver? ❑ Yes ❑ No ® N/A
Stormwater? ❑ Yes ❑ No ® N/A
15. Does this project include any high priority lines (15A NCAC 02T .0402 (2)) involve aerial lines, siphons, or interference
manholes)? These lines will be considered high oriority 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, Dennis Baxley attest that this application for SIXTH AT MAIN 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. Note: In accordance with North Carolina 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
per violation.
1 a. l�.o
Signing Official Si
Date
ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THIS
APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMITY
TO OTHER UTILITIES, DESIGN CALCULATIONS, ETC. REFER TO 15A NCAC 02T .0305
2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
1, Jiames M. Kizer, Jr., P.E. attest that this application for "SIXTH AT 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. 1 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. James M. Kizer, Jr., P.E.
Professional Engineer Name
2b. Moorman, Kizer & Reitzel, Inc.
Engineering Firm
2c. P.O. Box 55374
Mailing Address
2d. Fayetteville 2e. NC 2f. 28305
City State Zip
2g. 910-484-5191 2h. 910-484-0388 2i. [e-mail]
Telephone Facsimile E-mail
,q�111111/I11�,
Edo
rr
`•'
NC PE Seal, Signature & Date
FTA 08-13 APPLICATION Page 5 of 6

THE COMPLETED APPLICATION AND SUPPORTING DOCUMENTATION (ORIGINAL AND COPY) SHALL BE
SUBMITTED TO THE APPROPRIATE REGIONAL OFFCE:
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, Suite 301
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
FTA 08-13 APPLICATION Page 6 of 6

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ENGINEERS •
PLANNERS
SURVEYORS
MOORMAN, KIZER & REITZEL, INC.
June 16, 2015 115 Broadfoot Ave.
P.O. Box 53774
Mr. Trent Allen
NCDENR
225 Green Street
Suite 714 Systel Building
Fayetteville, NC 28301
Re: Fast -Track Application for Gravity Sewer Mains
SIXTH AT MAIN
Raeford, NC
Dear Mr. Allen,
Fayetteville, NC 28305
[phone]
Fax: [phone]
www.mkrinc.com
Enclosed are one original and one copy of the Fast -Track Application, check for $480.00
and attachments for gravity sewer mains for the SIXTH AT MAIN Development in
Raeford, Hoke County. This project is located off of Main Street, Sixth & Seventh
Avenues in Raeford, Hoke County and is an addition to existing City of Raeford sewer
system.
The work associated with this section will include gravity sewer infrastructure to serve a
total of 9 lots at build out. Flows generated from this development will discharge into
existing Raeford WWTP.
I would appreciate you reviewing this application as soon as possible and letting me
know if you have any questions or need additional information. Please feel free to give
me a call or e-mail me at the (910-484-5191) or davidm e,mkrinc.com.
Sincerely,
David A. Matthews, Senior Designer
DAM:dam
Encl.
Cc: Michael Steadman, THE LANDSOUTH CO.
Dennis Baxley, Raeford City Manager
Trudy McVicker, Operation Manager

State of North Carolina
Department of Environment and Natural Resources
DWR Division of Water Resources
Division of WAtet Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 08-13)
Project Applicant Name: City of Raeford
Project Name for which flow is being requested: Sixth and Main
More than one M. E maybe required for a single project if the owner of the WIM is not responsible for all pump
stations along the route of the proposed wasrewaterflow.
Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: City of Raeford POTW
b. WWTP Facility Permit #: NCO026514
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
Mflows are in MGD
3.0
1.54
1.46
.00252
3.0
100%
11. Complete this section for each pump station you are responsible
for along the route of this
proposed wastewater flow.
List pump stations located between the project connection point
and the WWTP:
(A) (R)
(C) (D)=(B+C) (EHA-D)
Design
Obligated.
Pump Average Daily Approx.
Not Yet Total Current
Station Firm Flow" Current Avg.
Tributary Flow Plus
(Name or Capacity.* (Firm / pf). Daily Flow,
Daily Flow, Obligated Available
Number) MGD MGD MGD
MGD Flow Capacity***
* The Firm Capacity 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.
*** 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.
Page I of 6
FTSE 08-13

III. Certification Statement:
I Dennis Baxley, City Manama 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 I1
plus all attached planning assessment addendums for which I am the responsible party.
Signature of this form indicates acceptance of this wastewater flow.
Signing Official
►1. -
Page 2 of 6
FTSE 08-13

ix' kCEI V %YI Y DWR
Weteroudtypad"
Application Number: JVr ai
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD (to be
(to be completed by OWR)
1.
Owner/Permittee:
1a.
CITY OF RAEFORD
Full Legal Name (company, municipality, HOA, utility, etc.)
1 b.
Dennis -Baxley, CityManager
0
0
for
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) authorized signing officials)
1 c.
The legal entity who will own this system is:
❑ Individual ❑ Federal ® Municipality ❑ State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify):___
0
1 d.
315 N. Main Street 1 e. Raeford
LL
Mailing Address City _
Z
1 f.
NC 1 g. 28376
Z
State Zip Code
0
1 h.
910-875-8161 1 i. 910-875-8165 1 j.
QTelephone
Facsimile E-mail
V
2.
Project (Facility) Information:
J
2a.
SIXTH AT MAIN 2b. Hoke
a
Brief Project Name (permit will refer to this name) County Where Project is Located
Q
3.
Contact Person
3a.
David A. Matthews, Senior Designer, Moorman, Kizer & Reitzel, Inc.
Q
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b.
910-484-5191 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 ❑ Public Utility (Instruction D)
❑ Leasing units (lots, townhomes, etc. - skip to Item B(3)) ❑ Homeowner Assoc./Developer (Instruction E)
❑ Selling units (lots, townhomes, etc. - go to Item B(2b))
Z
3.
City of Raeford
0
_
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
THE LANDSOUTH COMPANY, LLC
PO Box 87309
Fayetteville NC 28304
BANK OF AMERICA, NA
MERRILL LYNCH
Fayetteville NC
87.176/843
6/12/2015
2081
PAY TO THE NCDENR $**480.00
ORDER OF g
Four Hundred Eighty and 00/100****************.************************************************************************** DOLLARS
- x
NCDENR
Sixth at Main Project (App. for gravity sewer approval)
/ N
Y
O
NP W
I�
FTA 08-13 APPLICATION Page 3 of 6

Permit Number W00037882
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
trent.allen
Coastal SWRule
Permitted Flow
2,520
Facility
Facility Name
SIXTH AT MAIN
Location Address
Owner
Owner Name
City of Raeford
Central Files: APS _ SWP
7/2/2015
Permit Tracking Slip
Status
Project Type
Active
New Project
Version
Permit Classification
1.00
Individual
Permit Contact Affiliation
Major/Minor
Minor
Facility Contact Affiliation
Owner Type
Government - Municipal
Owner Affiliation
Dennis Baxley
Region
Fayetteville
County
Hoke
423 E Central Ave
Dates/Events Raeford NC 28376
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
7/2/2015 6/18/2015 7/2/2015 7/2/2015
Regulated Activities Requested /Received Events
Wastewater collection Additional information requested 7/1/15
Additional information received 7/1115
Outfa II
Waterbody Name Streamindex Number Current Class Subbasin