WQ0041571_Application (FTSE)_20200319

State of North Carolina
Department of Environmental Quality
Division of Water Resources
D. WR 15A NCAC 02T .0300 -� FAST TRACK T oa 6 & SUPPORTING DOCIJ141E �TATIOti
Division of Water Resources
U1� 1 (to be contpfacd by DWRt
Application Dumber! `11571__— —
All items must be com feted or the a lication vs -ill be returned
1. APPLICANT INFORMATIOti
I, Applicant's name. �Vrison Count (company. municipality, l{OA, utility. etc.) Privately -Owned Public Utility
2. Applicant ❑ Individual ❑ Corporation ❑ General Partnership ❑
pp �� Other
❑ Federal El5twe/County ® Municipal ❑
3. Signature authority's name: Denise 5tinaelc per I5A NC'AC 021 .010(,b
Title. County )tiara ,er utility
rIC Dept of Eavimocntal Q;'`
-I. Applicant's mailing address P.Q. T;! o'� 17-'�
City Wilson State: NC Zip: 27893 MAR 19 2020 t 7'
5. Applicant's contact information:
Phone number (252) 3, 99-2801 Email Address: dstinaelerIuu
a.wrilson co.come1l5'" al RegionOffice
11. PROJECT INFORMATION;
I . Project name; Wilson County Anima! Shcitcr
2 Application/Project status' ® Propm cd (New Permit) ❑ Exisdng Permit/Projcct
If a modification, pro%ide the existing permit number WQOO— and issued date.
if new construction but part of a master plan. provide die existing permit number; WQ00
3. County where project is located- Wilson
Approximate Coordinates (Decimal Degrees). Latitude. 35.732 Longitude--77.964-
5 Parcel ID (if applicable): 37 2- 2-9078
(or Parcel ID to closest dowT6tream sewer)
III. CO\SULT&NT INFORMATION:
I Professional Engtnecr. Robert S. Bartlett License Number. r0106
Firm. gardi .n m n & Sun' PC
Niailmg address 1906 Naah_Suret
City W n State jK Zip- Z789 -�
Phone number (IL2) �-0M Email Address: robert ci_banlettcttu cool
w'ASTEWATE:R TREATMENT FACILITI' INFORMATION:
1 Facility Name City of Permit Number NC 00239[�i
Owner Namc Cur of %V[ Li
RECEIVING DOWNSTREAM SEWER INFORMATION (if different than N'% ):
I. Pcrrna Numbcr(s)• WQ Do%mstmam (Receiving) Sewer Size. I inch
,a%irm t ids( ti,4ri,i. tc Pc u ihcKt. i11 _tI'P?i j 31'QCS 1
Owner Name(s). Qty of Wilson
FORM ETA 04-16 Page 1 of 5

A
I
a
GENERAL REQUIRESIENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ }'es []No ON -A
"_. If the Applicant is a developer of lots to be sold, has a Develn er'; A Ureerrrent FORM. D'i been attached?
❑ Yes [—]No ®N/A
3. If the Applicant is a haN an n erational A -reement FORM• 110A been attached`!
❑ Ycs ❑No ®NIA
4. Origin of wastewater. (cltcck all drat apply)
❑ Residential Owned ❑ Retail (stores, centers. malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food preparation/scrvice ❑ Hotel and/or Motels
❑ School i preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool iClubhouse
❑ food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ® Other (Explain in Attachment)
5_ Nature of wastewater: 100 % DomesticlCommemial % Commercial
°b Industrial 5cc 15A E! AC 02T .0103 20 )
—*Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6 Has a flow reduction been approved under I5A NCAC 02'F.0114 1 ? ❑ Yes ❑ No
:- If yes, provide a coax of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type {see 021'.0114 Daily Design Flaw a>< No. of Units Flow
Animal kennels 20 gal/kennel 44 880 GPD
Gereml Office 25 gal/etnployee/shift 4 100 GPD
gap GPD
gall GPD
gay GPD
gal; GPD
Tara! 980 GPD
a See ?SA NCAC` 021 _0114fh1. fdt (c)f 1! and (e}f21 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 t.', 42A4).
b Per I5A NCAC 02T .01 14(c), design flow rates far establishments not identified [in table 15A NCAC 021.01141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
g_ Wastewater generated by project: 980 GPD (per I `+A NC'A( OT I ill i4)
Y 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 (Etplain).
FORht' FTA D4-16
Page 2of5

%rll- GRAVITY SEVER DESIGN CRITERIA (If Applicable) - 02 l' .03(15 8 %l()C GE11%it% SenerO :
1 _ Summarize gravity sewer to be permitted.
Size (inches) Length (feet) Material
N'A N A N A
:- Section 11 &: Ill of the MDC for Permitting of Gravity Sewers contains information related to design criteria
i Section III contains information related to minimum slopes for gravity scwer(s)
Oversizing lines to meet minimum slope requirement Is not allowed and a violation of the NiDC
VII1. PMIP STATION DESIGN CRITERIA (If Applicable) — 02l 5 & ll1)C (ptinly Statiun-uFbrce Slalns :
COMPLETE FOR EACH PU11P STATION INCLUDED IN THIS PROJECT
1. Pump station number or name- 1
2_ Approximate Coordinates (Decimal Degrees): Latitude: 35.7 1 i4 Longitude:-77.864572
3. Design flow of the pump station- 0.(i7x millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s); LO gallons per minute at go feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
2.5 433 FIDPE
6. Power reliability in accordance with 15A NCAC 021.Q3115 WLU-
❑ Standby power source orpump 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
Y Must be permanent to facility
Or if the pump station has an average daily flow IM 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)(I XC):
> it shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
If the portable power source or pump is dedicated to multiple pump stattoits, an evaluation 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

SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
I Does the project comply with all separations found in 1I SA NCAC 021 .0305 l , ® Yes El No
!- _ 15A NCAC' VT ttirtSM vnnt ;.. ,,,:.,:..,�..., � . ,�:, ..w....w n L.- :a_a r
Setback Parameter'
SSparation Required
Storm sewer and other utilities not listed below (vertical)
24 inches
Water mains vertical -water over sewer including in benched trenches
IS 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-I waters of Class I or
Class 11 impounded reservoirs used as a source of drinking water
100 feet
"Waters classified WS (except WS-I or WS-V), B, SA, ORW, IIQW, or SB from normal
high uater or tide elevation) and wetlands sec item IX.2)
50 feet
**Any other stream, lake. impoundment, or ground water lowering and surface drainage
ditches
10 feet
An • building foundation
5 feet
An • basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and inert for drains
5 feet
Any swimming pools
10 feet
Final earth =rade (vertical)
36 inches
:- 15A NCAC 02T.0305o, contains alternatives where separations in 021'.0305(f) caitnot•be achieved.
i •'Stream classifications can be identified using the Division's NC Surface R'atcr Cla..ificatrnns u-chpaac
If noncompliance with (12 f.0105(f) or (e), see Section X of this application
2. Does the project comply with separation requircmenta for %vetlands? (30 feet of separation) ®Yes ❑ No ❑ N A
r i 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
'r 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
r This would include Trout Buffered Streams per 15A NCAC 2110202
4. Does the project require coverage/authorization under a 404 Nationwide or ❑ Yes ® No
t individual permits or 401 Water Quality Certifications?
i Information can be obtained from die 401 & Buflcr Ile niutung Branch
5. Does project comply with 15A NCAC 02T.r1105 c � (additional permiti�cenifications)? ®Yes ❑ Na
Per j�A Nc %C 021 01t?51c1(L+1, 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 decnted "high-priorit)?"
Per 15A N( AC 021 W02, "high-prionty scuer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to strcambaaks that is subject to erasion that undermines or deteriorates the sewer
❑ Yes ® No ❑ N -A
:- If yes, include an attachment with details for each line, including tyke (aerial line, sue, matenal, 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 ITA 04-16 Page 4 of 5

X CKRTIFIVATIONti:
Roes the rubntiGtctil systrnt cungtly wiQn j Q NCA(, W, 0lo hJWfi tin i)ofan �ritcrig _fou"_rM1L0ngQS W1,P..-ARC' 1
gW.kgnX is nL[] = vcisign , and rho [splyity ew1 ! i�111y1uL12( sJ1W C.ri erin 01LOLUMI pI as applicable?
S Yes ❑ No
If No, caniplete and submit the Vaniatnce/Altemative Design Request application (VADC 10-14) and supporting documents for
review > > r r r r d trio n that lortheras '1'r ck Icatlonand u r11n document
2. }'roft��i�utsl [Mrghnccrs C'crtifrcnEian
l`) attest that this application for
(Professional Engineer's name from Application item I11.1.)
has been renewed by me and Is accurate, complete and consistent with file information supplied In the plans, specifications,
engineering cnlculati nts, and till other, supporthig ducuincatution to the best of my knowledge. I further attest that to the best
of my knoll ledge the pmpused design has been prepared in accordance with the appUcable regulations. Gravity Sewer
Minimum Design Criteria for Gravity ;ewers (Inicst version), and the Minimum Design Criteria for the Fast -Track Permitting
Of Pump Stations and force Mains (latest version), Although other pmfcssionnis may have developed certain portions of this
submittal pacLagc, Inclusion of these mnterials under my signature and scat signifies that I have reviewed this material and
have judged it io be consistent with the proposed dmign.
NOTIi - In accordance with Gencrul Statutes 143.215.6A and 143-215.6I3, any person who knowingly snakes any false
statematt, 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. , k • ••
North Catalina Profcxsional Criglncer's seal, signature, rind date:
SEAL
20m ti ti
o-
/ V
3. AppH nt's Ccrtificatlon per 15A NCAC 021' .0106(b):
tbiy
that this application for
(signature ulhor[t 's sea ne & title front An lie r 1.3has been reviewed by me and is accumie and complete to the knowledge. 1 understand that if all required parts of
this application am not completed and that if all required supportirng 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-
dlscitatge system to surface waters or the land will result in an immediate cnfarcement action that may include civil penalties,
injunctive relief, and/or criminal proseculion. I will:nakc 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 l43 215¢A and 14_ __3.21S,6E, any person who knowingly makes any false
statement, represenlation, or certification In any application package shall be guilty of a Class 2 misdemeanor, which may
Include a fine not In exceed $10,00 s well as civil pcnaitiea up to $2S,000 per violation.
SignatureI--, Date; Q ':) I —Ql=
FORM: FfA 04-16 Page 5 of 5

EUMLETT
BOMM & MPc
1%6 Nash Surcct N+11111 Wilson. NC'_7993-172t,
monc [phone] fax (252)399.OW
wws4 hardett us wm
November 21, 2019
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
Raleigh Regional Office
1628 Mail Service Center
Raleigh, North Carolina 27699-1628
Reference: Fast Track Applicat,on for Gravity Sewers
Private Sewer Extension Force Main
Wilson County Animal Shelter
NC Hwy 42 E & Tucker Court (SR 1501)
Wilson County, North Carolina
To Whom It May Concern:
NC Dept of Environmental Quality
MAR 19 2020
Mcigh Regional Office
Enclosed for your review and approval are two (2) copies of the following items related to the
above referenced project:
■ Fast Track Application for Force Main Sewers
■ Flow Tracking / Acceptance Form
■ Power Reliability Plan Letter
■ Location Map
■ Aerial Photo
■ $480.00 Sewer Permit Application Fee
This project consists of a 2-1/2" private force main sewer extension to serve a proposed 7,600 S.F.
County Animal Shelter in Wilson County, NC. This private force main extension is proposed to
discharge into the existing 3" public force main sewer line within the north right-of-way of NC Hwy
42 E. This proposed force main sewer extension will also include installation of a private sewer
pump station and separator tank,
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Should you have any questions or require further information during your review, please let us
know.
Respectfully,
Steve Oliverio
Project Manager
Enclosures
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Wilson
- County
North Carolina
February 20, 2020
Wilson County Government
CountyManager'S Office
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Raleigh Regional Office
Water Quality Section
1628 Mail Service Center
Raleigh, NC 27699
� t o�Envirnuu►�°tal quality
Repoaal Qf�ica
gmleigh
Re; Letter of Power Reliability
Wilson County Animal Shelter Pump Station,
NC Hwy 42 E & Tucker Court (SR 1501), Wilson County, NC
To whom it may concern:
As per 15A NCAC 02T.0305(h)(1)(C) criteria for pump station power reliability, a portable power
generation unit or portable, independently powered pumping units, associated appurtenances
and personnel are available for distribution and operation of the pump station.
Sincerely,
r�S
Denise le
County Man g

Robinson, Jason
From: Robert Bartlett <[e-mail]>
Sent: Wednesday, April 15, 2020 1:54 PM
To: Robinson, Jason; [e-mail]; Steve Oliverio; Ronald Fuentes
Cc: Cashion, Ted; Deck, Erin M
Subject: [External] RE: Wilson County Animal Shelter
• fixV�rnatemaIL Do not4 inks oral' ' attachments unless you verity. Send aff suspicious email as an at &mentu
Mr. Robinson:
The proposed private pump station will be duplex station.
The private pump station will discharge to a public 3" force main and the public 3" force main discharges downstream to
a public 15" gravity sewer. Let me know if we need to revise item V.1 or if there are other questions or concerns.
Thanks,
Robert S. Bartlett
BARTLETT ENGINEERING & SURVEYING, PC
1906 Nash Street North
Wilson, NC 27893
252-399-0704 Ext 224
252-205.1852 cell
www.bartiett.us.com bartlett.us.com
OUR MISSION: We will change the world ...
intentionally becoming better at providing
engineering and surveying solutions ...
serving others ... serving Jesus Christ!
From: Robinson, Jason <[e-mail]>
Sent: Wednesday, April 15, 20201:40 PM
To: [e-mail]; Robert Bartlett <[e-mail]>
Cc: Cashion, Ted <ted.cashion @ncdenr.gov>; Deck, Erin M <[e-mail]>
Subject: Wilson County Animal Shelter
Mr. Bartlett & Ms. Stinagle,
We are reviewing the referenced sewer extension application and have the following questions:
1. The narrative mentioned a private sewer pump station and separator tank (STEP system). Is this proposed to be
simplex or duplex? (a simplex would need to through the full review process, not fast -track. We confirmed this
with our Permit Coordinator).
2. The narrative states that the proposed private forcemain will discharge to a public 3" forcemain. But the Item
VA in the application states that the downstream sewer is 15". Please explain.
Thanks,

Jason
------------
Jason T. Robinson, P.E.
Raleigh Regional Office
Water Quality Regional Operations
NC Division of Water Resources, DEQ
919-791-4200
"Subscribe to Collection System & Sewer Permitting Updates"
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Low and may be disclosed to
third parties.
Based on the current guidance to minimize the spread of COVID-19, the Department of Environmental Quality has
adjusted operations to protect the health and safety of the staff and public. Many employees are working remotely or
are on staggered shifts. To accommodate these staffing changes, all DEQ office locations are limiting public access to
appointments only. Please check with the appropriate staff before visiting our offices, as we may be able to handle your
requests by phone or email. We appreciate your patience as we continue to serve the public during this challenging
time.
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