WQ0033352_Application_20080813

• USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! I Application Number:
(to be completed by DWQ)
1.
Owner/Permittee:
1a.
MontgomeryMontgornery County
Full Legal Name (company, municipality, HOA, utility, etc.)
1 b.
Lance Metzler, County Manager
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):
1d.
PO Box 425 le. Troy
Mailing Address City
1f.
NC 1g. 27371
State Zip Code
1h.
910-576-4221 iii. 910-576-4566 1j. [e-mail]
Telephone Facsimile E-mail
2.
Project (Facility) Information:
2a.
Springdale Heights CDBG Sanitary Sewer Project 2b. Montgomery
Brief Project Name (permit will refer to this name) County Where Project is Located
:3.
Contact Person:
3a.
Brad Buc , Hobbs, Upchurch & Associates, P.A.
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b.
704-342-3000 33c. [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 8(2b))
3.
Town of Troy
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
4a
Troy WWTP 4b. NC-0028916
Name of WWTF WWTF Permit No.
5a.
Town of Troy 5b. 8" ® Gravity 5c.
Owner of Downstream Sewer ;Receiving Sewer Size ❑ Force Main Permit # of Downstream Sewer (Instruction E)
61
The origin of this wastewater is (check all that apply):
HOBBS, UPCHU CH & ASSOCIATr S, PA. BMT
CONSULTING ENGINEERS
P.O. BOX 1737, 300 S.W. BROAD STREET Branch Banking and Trust Company
SOUTHERN PINES, NC 28388 66-1121531
[phone]
Exactly Four hundred eighty and no / 100 Dollars
M
48660
48660
DATE AMOUNT
8/11/2008 $480.00
0
'AY —
FO THE
RDER N • C . DENR p°
)F. VO4AER 90 DAYS I 1
NC
THORIZED SIGNATURE
uonl-

OF W ArF9 State of North Carolina
Department of Environment and Natural Resources
E DE4R,1FV' Division of Water Quality
> VG
o Coo FAST -TRACK APPLICATION
C (FTA 12/07 )
D\NQfor 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 B(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 dow.,stream sewer, submit two copies of FCR9 TSE 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/iustification 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(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 Exten3ion
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 //www nccgl net/Engineering/Sewerlo 20Permits.html
or contact the Regional Office serving your county.
FTA12/07

USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number. W000333 52
(to be completed by DWQ)
1.
Owner/Permittee:
la.
Montgomery County
Full Legal Name (company, municipality, HOA, utility, etc.)
Z
11 b.
Lance Metzler, County Manager
0
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials!)
tic.
The legal entity who will own this system is:
❑ Individual ❑ Federal ❑ Municipality ® State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify):
0
Id.
PO Box 425 le. Troy
LL
Mailing Address City
Z
;if.
NC 1g. 27371
Z
State Zip Code
0
11 h.
910-5764221 1 i. 910-576-4566 1j. [e-mail]
Q!
Telephone :' Facsimile E-mail
V
2.
Project (Facility) Information:
J
12a.
Springdale Heights CDBG Sanitary Sewer Project 2b. Montgomery
IL
Brief Project Name (permit will refer to this name) County Where Project is Located
Q'3.
Contact Person:
3a.
Brad Buc , Hobbs, Upchurch & Associates, P.A.
Q
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b.
704-342-3000 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.
Town of Troy
Z
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
0
4a.
Troy WWTP 4b. NC-0028916
QName
of WWTF WWTF Permit No.
5a.
Town of Tro b. 8" ® Gravity c.
Owner of Downstream Sewer IReceiving Sewer Size ❑ Force Main I Permit # of Downstream Sewer (Instruction E)
0
'6.
The origin of this wastewater is (check all that apply):
Z
® Residential Subdivision El Retail (Stores, shopping centers) 100 % Domestic/Commercial
❑ Apartments/Condominiums ❑ Institution % Industrial (attach
❑ Mobile Home Park ❑ Hospital description.)
LJJ
El School ® Church (RO: contact your Regional Office
❑ Restaurant ❑ Nursing Home
a
Pretreatment staff) I
❑ Office' ❑ Other (specify):
% Other (specify):
.7.
Volume of wastewater to be allocated or permitted for this particular project: 18,870 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 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).
'52 units X 360 gpd = 18,720 gpd
50 seats in church X 3 gpd/seat = 150 qpd
Total = 18,870 gpd
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
feet Length New Gravity or Additional
Size (inches) g (feet) Force Main
8 5,188 Gravity
2" 1,222 Forcemain
4- 2,341 Forcemain
C11.
Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
LU
Pump Station Location ID
1
(self chosen - as shown on plans/map for reference)_
Z
Z(MGD)
Design Flow
Operational Point
Power Reliability Option
1 - permanent generator w/ATS; Force Main Size Force Main Length
0
GPM @TDH
2 - portable generator w/MTS
V
80 gpm
93
1 4" 2341
Z
0
-
Q!Pump
Station Location ID
2 (self chosen - as shown on plans/map for reference)
Design Flow
(MGD)
Operational Point
Power Reliability Option
1 -permanent generator w/ATS; Force Main Size Force Main Length
0
GPM @TDH
2 - portable generator w/MTS
LL
Z
20 gpm
92
2 2" 1222
H
Pump Station Location ID
(self chosen - as shown on plans/map for reference)
aDesign
Flow
(MGD)
Operational Point
Power Reliability Option
1 -permanent generator w/ATS; Force Main Size Force Main Length
6
GPM @TDH
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 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
r-1 A 12/U i

14. Have the following permits/certifications been submitted for approval for the system or project to be served?
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)
1, Lance Metzler, attest that this application for Springdale Heights CDBG Sanitary Sewer Project 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 143-215.6B, 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.
la. o4-,a
Signing Official Signature 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
Z
O
Q2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
V 1, Brad Bucv. attest that this application for Springdale Heights CDBG Sanitary Sewer Project has been reviewed by me
LL 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
W 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
CS 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. Bradlev H. Buc
Professional Engineer Name
2b. Hobbs Upchurch & Associates, P.A.
Engineering Firm
2c. 1300 Baxter St. Suite 108
2d
29.
Mailing Address
Charlotte
City
704-342-3000 2h. 704-342-3077
Telephone Facsimile
2e. NC 2f. 28204
State Zip
2i. [e-mail]
E-mail
H CARO��',,
OQPOFE
L O
w -2709z _
CGS
NC PE Seal, Signature & Date
FTA 12/07

�0F W A 7- RQ State of North Carolina
`O G Department of Environment and Natural Resources
CO 7 Division of Water Quality
o �c Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE—10/07)
Project Applicant Name: Montao_mery Coun
Project Name for which flow is being requested: Springdale Heights CDBG Sanitary Sewer
Project
More than one F17SE-10/07 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: Troy WWTP
b. WWTP Facility Permit #: NCO028916
All flows are in MGD
c. WWTP facility's permitted flow
1.2
d. Estimated obligated flow not yet tributary to the WWTP
0.40
e. WWTP facility's actual avg. flow
0.45
f. Total flow for this specific request
0.02
g. Total actual and obligated flows to the facility
0.87
h. Percent of permitted flow used
72.5
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
Smith Street 325 GPM &a, 108' TDH 0.039 MGD (2 HRS/DAY)
III. Certi 3 ration States en
I i '8, , certify that, to the best of my knowledge, the addition of the
volume of waste ater 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 H for which I am the responsible party. Signature of this form indicates
acceptance of wa
zr v
Signing

+ .� Vo �
�■
Discharge to
, +
�f'
Town of Troy System
_
Permit# NC0028916
39
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j 45 %
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36
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it
Pump Station is
34 _
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ti IL
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Greater than 100{ �32 7 s 7,� '', ,, ior �•
to unnamed tributary "$
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Legend i �,4>
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1 3.
0 Prop. Pump Sta.
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Prop. Gravity * PS
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Prop. Force Main 2.. 1
® Ex. Manhole z z2 ;� 9pa/e 30
1 � � ej9h fs
— Ex. Gravity
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— — Project Area t 20 _i (\
31�
LMI Houses � { � � ,•. � '~ s '
Over Income
is
USGS
RGB
Red: Band_1 w E _ ,J�Springdale'Heights ,
_ Green: Band_2 �jz S ;1-,CDBG Sanitary Sewer, Project
Blue: Band-3 0-. 80 160 320 Project Area,Map ['
Feet , V. 1 T 1

RE: Springdale Heights
• A
Subject: RE: Springdale Heights
From: 'Brad Bucy" <[e-mail]>
Date: Mon, 25 Aug 2008 09:49:45 -0400
To: "Trent Allen" <[e-mail]>
CC: "Wes Carter" <[e-mail]>
Trent:
Breakdown is as follows...
Pump Station #2:
19 Residential @ 360 gpd/unit = 6840 gpd u 2 J ° / 7 /AO
Zegl�►+.� x r vtle c ZS, $ o eLk—
s
Pump Station #1:
Pump Station #2 + 33 Residential (360 gpd/unit) + Church (50 seats @ 3 gpd/seat) _
18,870 gpd ArPr2O K Z, $ s V-7, / 7 5-
P�1x��e'!/4.Zae
Bradley H. Bucy, PE
Hobbs, Upchurch & Associates, P.A.
1300 Baxter Street, Suite 108
Charlotte, NC 28204
704.342.3000 (P) 3077 (F)
-----Original Message -----
From: Trent Allen (mailto:[e-mail]]
Sent: Monday, August 25, 2008 8:15 AM
To: Brad Bucy
Subject: Springdale Heights
Mr. Bucy,
Can you tell me the individual flows to each pump station?
Thanks
Trent
Trent Allen
Environmental Engineer
NC DENR-Division of Water Quality
Surface Water Protection Section
Fayetteville Regional Office
910-433-3322
1 of 1
8/27/2008 9:48 AM