WQ0041555_Application (FTSE)_20200313

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
15A NCAC 02T .0300 -- FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: (to be c0q;pleted by DWR)
All items must be completed or the t li ration will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Orange Water & Sewer Authority (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State. -County ❑ Municipal ® Other
3. Signature authority's name: Ed Kerwin per 15A NCAC 02T .0106(b)
Title: Executive Director
4. Applicant's mailing address: 400 Jones Ferry Road
City: Carrboro State: NC Zip: 27510-
5. Applicant's contact information:
Phone number: [phone] Email Address: n arker czowasa.or
H. PROJECT INFORMATION:
1. Project name: Kentfield Subdivision
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Orange
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.940757' Longitude:-79.09067
5. Parcel ID (if applicable): 9779-27-6322
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Charles Huffine License Number: NC 24924
Firm: The LEADS Group, PA
Mailing address: 505 East Davis Street
City. Burlington State: NC Zip: 27215
Phone number: [phone] Email Address: chuffine08 Otamail.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Mason Farm Wastewater Treatment Plant Permit Number: NC 0025241
Owner Name: OWASA
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ 13763 Downstream (Receiving) Sewer Size: R inch
System Wide Collection System Permit Number(s) (if applicable): WQCS00031
Owner Name(s): Orange Water & Sewer Authority
FORM: FTA 04-16 Page 1 of

VI. GENERAL REQUIREMENTS
I. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
[-]Yes [:]No ®N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (170ItNt: DEV) been attached?
[]Yes []No ®N.`A
3. If the Applicant is a Home_PrMeM Qwners' Assuciaiige, hi* an Operational Aereement (FORA: HO_A) been attached?
❑ Yes ❑No ®N:A
4. Origin of wastewater: (check all that apply):
®Residential Owned ❑Retail (stores, centers, malls) ❑Car Wash
❑Residential Leased ❑Retail with food preparation/service ❑Hotel and/or Motels
❑ School I preschool / day care ❑Medical ! dental 1 veterinary facilities ❑Swimming Pool ;Clubhouse
❑Food and drink facilities ❑Church ❑Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑Nursing Home ❑Other (Explain in Attachment)
5. Nature of wastewater: 100% Domestic/Commercial �% Commercial
% Industrial (See 15A NCAC 027 .0103('0))
lbIs there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under ]SA_NCAC 02T .0I 14fr�? El Yes ❑ No
➢ If es provide a co of flow reduction a roval letter
7. Summarize wastewater generated by project:
Establishment Type (see 021.01141f1;
Daily Design Flow °'b
No. of Units
Flow
20 residential homes @ 3 Bedrooms /home
120 gal/day
60
7,200 GPD
gal/
GPD
gal/
GPD
gal/
GAD
gal/
GPD
gal/
GPD
Total
7,200 GPD
a See 15A KCAC 02T .01 14(b). (dh a 1) iwd (ek ) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use
areas; and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals
as defined in G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0' 14] shall
be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 7,200 GPD (per 15A NCAC 02T .0114)
Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑Flow has already been allocated in Permit Number:
❑Rehabilitation or replacement of existing sewer with no new flow expected
[]Other (Explain):. _
FORM: FTA 04-16 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T.0305&MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) I Length (feet) I Material
1 8 1 552 1 DIP I
D Section 11 & 111 of the MDC for Permitting of Gravity Sewers contains information related to design criteria
> Section Ill contains information related to minimum slopes for gravity sewer(s)
D Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VII1. PUMP STATION DESIGN CRITERIA (If Applicable) -02T .0305&MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: -
3. Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
6. Power reliabilityin accordance with ] JA N 'AC 02T,0305jh1C]):
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B);
i Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
D Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C):
It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with thestation.
r If the portable power source or pump is dedicated to multiple pump stations, anevaluation of all the pump stations'
storage capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be
provided in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

1X. SETBACKS & SEPARATIONS — (020.0200&15A NCAC 02T.0305(f)):
1. Does the project comply with all separations found in 15A_NCAC 02T-0305{t) & (g) ® Yes ❑ No
➢ 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
24 inches
Water mains (vertical -water over sewer including in benched trenches)
18 inches
Water mains (horizontal)
10 feet
Reclaimed water lines vertical - reclaimed over sewer
18 inches
Reclaimed water lines horizontal - reclaimed over sewer
2 feet
"*Any private or public water supply source, including any wells, WS-1 waters of Class I or
Class 11 im ounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-1 or WS-V), B, SA, ORW, HQW, or SB from normal
hi h water or tide elevation and wetlands (see item IX.2)
50 feet
*"Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming ools
10 feet
Final earth g2de vertical
36 inches
Z 15A NCAC 02T.030R& contains alternatives where separations in 02T.0305tf1 cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifica iolis webpaTe
Z If noncompliance with 02T.0305(f) tar fa see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ❑ Yes ❑ No ® N:`A
See the Division's draft separation requirements for situations where separation cannot be meet
No variance is required if the alternative design criteria specified is utilized in design and construction
As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes❑ No ® N.-'A
�w This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project require coverage'authorization under a 404 Nationwide or ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
Information can be obtained from the 401 & Buffer Permitting, Branch
5. Does project comply with 15A NCAC 02T.0105(005) (additional permits:`certifications)? ®Yes ❑ No
Per 15A NCE, 02T_01 5 , directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
[:]Yes ® No ❑ N:'A
�- If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and
inspections documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-I6 Page 4 of 5

X. CERTIFICATIONS:
I. Does the submitted system comply with ISA NCAC Q21 the Minimum Desir�i Criteria for theeecrmitting of Pum S� tatio s
and Force Mains i larist.version-), and the GravityS�:wer Minimum Design Criteria f latest version) as applicable?
® Yes ❑ No
IfNo, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents
for review.A roval of the request is re uired prior to submittal of the Fast Track A lication and supporting
documents.
2. Professional Engineer's Certification:
M
(Professional Engineer's name from Application Item I11.1.)
that this a plication for
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. 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 (latest version), and the Minimum Design Criteria for the Fast -Track
Permitting of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain
portions of this submittal package, inclusion of these materials under my signature and seal signifies that 1 have reviewed this
material and have judged it to be consistent with the proposed design.
NOTE In accordance with General Statutes 143-215.6A and 143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per violation.
North Carolina Professional Engineer's seal, signature, and date: _ �;;,/• f Jwf�
SEALI VI ;
N
..........•••••,y •k' •�,� i
3. Applicant's Certification per15A NCAC 02T .0106(b):
attest that this application for
(SignatureAuthority's name& title from Application Item I.3.)
has been reviewed by me and is accurate and complete to the best of my knowledge.) understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a
condition of this permit be violated. I also understand that if all required parts of this application package are not completed
and that if all required supporting information and attachments are not included, this application package will be returned to
me as incomplete.
NOTE In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature' Dater
FORM: FTA 04-16 Page 5 of

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I

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
Division of Water Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Orange Water and Sewer Authority
Project Name for which flow is being requested. Kentfield Subdivision
More than one FTSE mar he required for• a single prgject if the on-ner of the 112IYTP is not responsible for all pinup
stations along the rortte of the proposed waslewaler flow,
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Mason Farm Wastewater Treatment Plant
b. WWTP Facility Permit : NCO025241
All flo►vs are in MGD
c. WWTP facility's permitted flow 14.5
d. Estimated obligated flow not yet tributary to the WWTP 0.710
e. WWTP facility's actual avg. flow 7.600
f. Total flow for this specific request 0.007 (7200 GPD)
g. Total actual and obligated flows to the facility 8.317
h. Percent of permitted flow used 57.4
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) (B) (C) (D)=(B+C) (E)=(A-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***
Rogerson 18 7.2 3.34 0.47 3.81 3.39
* 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 (pi) 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 < d.
Downstream Facility Name (Sewer):
Downstream Permit Number:
Page 1 of 6
FTSE 04-16

III. Certification Statement:
I Ed Kerwin 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 11 plus all
attached planning assessment addendums for which I am the responsible party. Signature of this
form indicates acceptance of this wastewater flow.
SigPg O/ icicil Signature
W-J4
Date}
Page 2 of 6
FTSE 04-16

Kentfield Narrative:
Orange County North Carolina
Carrboro
Homestead Road
Project proposes 20 single family residential units of 3 bedrooms each connecting to existing public
OWASA and Carrboro infrastructure. Project to be completed in one phase.
No surface waters present.
Land disturbance permitting through Orange County.
Project to begin Spring 2020 upon permitting.
Project Engineer:
The L.E.A.D.S. Group, PA 1 505 East Davis Street Burlington, North Carolina 27215
Project Owner:
Parker Louis, LLC 1 301 Mont Clair Way, Chapel Hill, North Carolina 27516
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Orange Water and Sewer Authority
OWASA is Carrboro-Chapel HIN's not -for -profit public service agency
delivering high quality water, wastewater, and reclaimed water services.
March 9, 2020
NCDEQ Water Quality Section
1628 Mail Service Center
Raleigh, NC 27699-1628
SUBJECT: Permit Application for Kentfield Subdivision
DWR Staff,
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t *RR �3 �alp`'a�'ty
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Enclosed are the following items for your review and approval. The project includes an
extension of the public sanitary sewer system to serve a single family home development
with 20, 3 bedroom homes.
Fast -track Application form FTA 04-16 (original and copy)
Flow Tracking/Acceptance form FTSE 04-16 (original and copy)
Check in the amount of $480.00
Project Narrative
Please contact me by telephone at 919 537-4201 or email [e-mail] if you
have any questions or comments.
Respectfully,
AParker
Nic ola
Engineering Associate
cc: Jessica Godreau, PE — OWASA
Chad Huffine — The LEADS Group, PA
Adam Zinn, Omar Zinn — Parker Louis LLC
400 ]ones Ferry Road, Carrboro, NC 27510 0 919-958-4421 ID [e-mail] 0 @OWASAI a www.owasa.org