WQ0041662_Application (FTSE)_20200428

DWR
c, f C
State of North Carolina
I Department of Environmental Quality
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: 4 tJ(-) i (tow completed b} DWR)
All items must be comnleted or the annlication will be returned
I. APPLICANT'INFORMATION:
`r�
I. Applicant's name: Orange Water & Sc++er Authorit-, (compan%. municipalit} .1 IOA. utility. etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privatcl}-Owned Public Utilit)
❑ Federal ❑ State. -County ❑ Municipal ® Other
3. Signature authority's name: Ed Kerwin per l SA NG1C 02 T .(1106(h)
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: nparkerlro%%asa.org
IL PROJECT INFORMATION:
I. Project name: Park Al2artments Phase I A & I B - Public
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If 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. Count} ++here project is located: Orange
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.99330: Longitude:-79.0209"
5. Parcel ID(ifapplicable): 9799 46446
(or Parcel ID to closest downstream sever)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Z. Nathan Bales License Number: 044862
Firm: McAdams Company
Mailing address: 2905 Meridian Parkway
City: Durham State: NC Zip: 27731-
Phone number: [phone] Email Address: bales umcadamsco.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Mason Farm Wastewater Treatment Plant Permit Number: NC 0025241
Owner Name: O W ASA
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF): (
1. Permit Numbers}: WQ Do++nstream (Receiving) Se++cr Size: —P— inch fj
System Wide Collection System Permit Number(s) (if applicable): WQCS00031
Owner Name(s): Orange Water &_Sewer Authority
FORM: FTA 04-16 Page 1 of5

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, 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,
Water Quality Section
Swannanoa, North Carolina 28778
Clay, Graham, Haywood, Henderson, Jackson,
(828) 2964500
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section
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,
Water Quality Section
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,
Water Quality Section
Raleigh, North Carolina 27699-1628
Granville, Halifax, Johnston, Lee, Nash,
(919) 7914200
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Warren, Wilson
Washington Regional Office
943 Washington Square Mail
Beaufort, Bertie, Camden, Chowan, Craven,
Water Quality Section
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
Water Quality Section
Wilmington, North Carolina 28405
Hanover, Onslow, Pender
[phone]
[phone] Fax
Winston-Salem Regional Office
450 W. Hanes Mill Road
Alamance, Alleghany, Ashe, Caswell, Davidson,
Water Quality Section
Suite 300
Davie, Forsyth, Guilford, Rockingham, Randolph,
Winston-Salem, North Carolina 27105
Stokes, Sury, Watauga, Wilkes, Yadkin
[phone]
INSTRUCTIONS FOR FORM: FTA 04-I61L SUPPORTING DOCUMENTATION Page 3 ol'3

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. 11'the Applicant is a Developer of lots to be sold, has a De%clo er's Operational Agreement FORM: DFV been attached'?
❑ Yes ❑No ®N/A
3. If the Applicant is a I Tome Property Ounerti Association, has an Operational Agreement 0:011M: I IOA) been attached?
[--]Yes [:]No ®NIA
4. Origin of wastewater: (check all that apph ):
❑ Residential Owned ❑ Retail (stores. centers, malls)
❑ Car Wash
® Residential Leased ❑ Retail a ith food preparation/service
❑ Hotel an&or Motels
❑ School ! preschool ! day care ❑ Medical ! dental ! veterinary facilities
® Su imming Pool .-'Clubhouse
❑ Food and drink facilities ❑ Church
❑ Su imming Pool! Filter Backwash
❑ Businesses / offices I factories ❑ Nursing Home
❑ Other (Explain in Attachment)
5. Nature of wastewater : 100 % Domestic'Commercial %Commercial
% Industrial (See_ 15A NCAC 02T .0103(20))
_T_-3.Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a floe reduction been approved under l5A NCAC 021' .0I 140i? ❑ Yes ® No fl o et tr
i If ves provide a co of flow reduction approval letter "[�
7. Summarize ►tastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow a.b
No. of Units
Flow
I BR Apartments
240 gal/DU
227
54,480 GPD
2 BR Apartments
240 gal/DU
177
42,480 GPD
3 BR Apartments
360 gal/DU
6
2.160 GPD
Clubhouse
50 gal/100 Sr
13.684 SF
6,842 GPD
Pool
10gal/user
191 users
I, GPD
gall
GPD
Total
107. EGPD
a Sec I5A NCAC 02T .01 14(b), (d). (cXL and,(,)(2) f'or caveats to uastewater design flow rates (i.e.. minimum flow per
duelling; proposed unknown non-residential de%clopment uses; public access facilities located near high public use areas;
and residential property located south orcast ofthe Atlantic Intracoastal Waterway to be used as %acation rentals as delined
in G.S. 42A-4).
b Per 15A NCAC 02T .01 14(c), design flo%% rates for establishments not identified [in table 15A NCAC _02T.01 141 shall be
determined using available flow data, eater using fixtures, occupancy or operation patterns. and other measured data.
8. Wastewater generated ky project: 107.872 GPD (per I5A NCAC 02 f .0114) /
Y Do not include future floes or previously permitted allocations V
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow w ill 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):
r0Rlvl: rTA 04-16 Page 2 of5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T.0305 & NIDC (Gravity Sewers):
I. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Nlnterial
x
470
DIP
12
395
DIP
Section 11 & Ill of the MDC Ibr Permitting of Gravity Se%%ers contains information related to design criteria
Section Ill contains information related to minimum slopes for gravity sc%%Cr(s)
i Oversizing lines to meet minimum slope requirement is not allowed and a violation of the NI DC
Vlll. PUMP STATION DESIGN CRITERIA (if Applicable) — 02T .0305 & NIDC (Pump Stations/Force Nlaius :
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
I. Pump station number or name:
i
2. Approximate Coordinates (Decimal Degrees): Latitude: - Longitude: -
3, Design flow of the pump station: millions gallons per dad (firm capacity)
4. Operational point(s) oi'the pump(s): gallons per minute at ! feet total dynamic head (TDI1)
5. Summarize the force main to be permitted (f'orthis Pump Station).
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 42T .0305(h)(1):
❑ Standby po%�cr source or pump %%ith automatic activation and telemetr% - 13A NCAC 02T .0305(h)(1)(13)_
Required far all pump stations with an average daily Ilo%% greater than or equal to 15.000 gallons per day
Must be permanent to facility
Or if the pump station has an average daily tlo%% 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 - I SA 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 the station.
Ifthe portable power source or pump is dedicated to multiple pump stations. an evaluation ofall the pump stations' storage
capacities and the rotation schedule ol'the portable power source or pump. including travel timeframes, shall be provided
in the case of a multiple station power outage.
FORM: ETA 04-16 Page 3 of 5

IN. SETBACKS& SEPARATIONS—(02B.0200 & 15A NCACO2T.0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T .03( 0) & (0
13A NCAC 02T.0305(f) contains minimum separation-, that shall be rovided fiir sewers% ­
® Yes ON'. o
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (%ertical)
24 inches
Water mains (Vertical -water over sewer including in benched trenches)
18 inches
Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaimed o%cr sewer)
18 inches
Reclaimed water lines (horizontal - reclaimed o%er sc+ver)
2 feet
"*Any private or public water supple source, including any «ells, WS-1 «alas ol'Class I or
Class I I impounded reservoirs used as a source of drinking %%ater
I '
**Waters classified WS (except WS-I or WS-V). 13. SA. ORW. I IQ1l', or S13 from normal
high water (or tide elevation) and wetlands (see item IX.2)
50 ]ect
**Any other stream, lake, impoundment. or ground «ater lo"ering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Anv basement
10 feet
To slo a of'embankment or cuts of 2 IM or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
i 1.5A NCAC 02T,0305(1) contains alternatit es %there separations in 02T.0305t t) cannot be achieved.
"*Stream classifications can be identified using the Division's NC SurIl1Ce Water Classifications Stich ague
11'noncompliance with 02T.03050) or (u), see Section X ol'this application
2. Does the project comply ►%ith separation requirements for %%etlands? (50 fleet of separation) ® Yes ❑ Flo
Seethe Division's draft separation requirements for situations Where separation cannot be meet
No %ariance is required ifthe 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 «ith all setbacks Found in the river basin rules per 15A NCAC 02B .0200? ® Yes ❑ do
This «ould include Trout Buffered Streams per 15A NCAC 213.I1202
4. Does the project comply with an individual 404 Permit or any 401 Certifications? ®tiles ❑ No
Wetland -related permits shall be requested. obtained, and adhered to for projects that impact wetlands or surface eaters
Information can be obtained from the 401 K But'ter Permittine Branch
5. Does project comply with I5A NCAC 02 I'.0105 c G) (additional permits'certilications)? ® Yes ❑ No
Per 15A NCAC 02T.0105(c)(6). directly related em ironmental permits or certification applications are being prepared, ha%c
been applied for, or have been obtained. Issuance ol'this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormnater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority ?"
Per 15A NCAC 02J.0402. "high -priority sewer' means "am aerial setter, se%%cr contacting Surlacc waters, siplion, or setter
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sc%%cr,
❑ Yes ® No
f'yes. include an attachment with details l'or each line. including n pe (aerial line, size, material. and location).
Iligh priority lines shall he inspected by the permittee or ils representativ a at least once every sir -months and inspections
documented per I SA NCAC 02T.0403(a)(5) or the perm itee's individual System -Wide Collection permit.
FORM: F FA 04-16 ]'age 4 o f 5

X. CERTIFICATIONS:
I. Does the submitted system comply with 15A NC'AC 02T, the Minimum Design Criteria for the Permitting -of Pump Statiolly
and Force Mains tlatesT version), and the Gravity Sewer Minimum Dcsig,t_C'riteria hdest version as applicable?
® Yes ❑ No
If No, complete and submit the VartancelAlternative Design Request application (VADC 10-14) and supporting documents for
review. Annroval of the reauest Is required nrlor to submittal of the Fast Track Annlicution rind aunnortine documents.
2. Professional Engineer's Certification: ark � , �plsidi�.l
JATMAh 3A ej _ _ attest that this application for
(Professional Engineer's name from Application Ilem Ili.:.)
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 I 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 snakes 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 S 10,000, as well as civil penalties up to $25.000 per violation.
North Carolina Professional Engineer's seal, signature, and date: �1�,11lClAi l'�r�/
SE
HaimE
;. Applicant's Certification per 15A NCAC 02T .0106(b):
Ed Kerwin, Executive Director _ attest that this application for
(Signature Authority's name & title from Application Itcin 1.3.)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments arc 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 arc 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 1.13-215.611, 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:-- Date; -� 4/28/2020
FORM: PTA 04-16 Page 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Orange Water & Sewer Authority
Project Name for which flow is being requested: Park Apartments -
.tlore than one ME mats be roquirwiji2r a single project if the ois:ner of the 11117P is nal responsible for all pump
stations along the rattle of the proposed waste rater fl ow..
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 #: NC 0025241
All flows are ih AIGD
c. WWTP facility's permitted flow
14.500
d. Estimated obligated flow not yet tributary to the WWTP 0.596
e. WWTP facility's actual avg. flow
7.600
f, Total flow for this specific request
0.099 (99,120 GPD)
g. Total actual and obligated flows to the facility
8.295
h. Percent of permitted flow used
57.2%
IL 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 Floc** Current Avg.
Tributary Flow Plus
(Name or Capacity. * (Firm I pl), Daily Flow.
Dail) Flow. Obligated A%ailable
Number) MGD MGD MGD
MGD Flow Capacity***
Rogerson
n- rsc _ I8.5 7.4 3.5
0.36 3.86 3.54
* 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 (pn 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.
Downstream Facility Name (Sewer): OWASA
Downstream Permit Number: WQCS0003I
Page 1 of 6
FTSE 04-16

Ill. 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 II plus all
attached planning assessment addendurns for which I am the responsible party. Signature of this
form indicates acceptance of this wastewater flow.
it _ . 1 5/4/2020
Signing Official Signature
Dale
Page 2 of 6
PTS E 04-16

k
�
�§
«
3
=«!2
}
2§§!
a
t�k
})%
222
£|■2
�f!§
}\\j
2 w 7E
f§Sf
!;�@
/§s}
/65a
FL £}A
�k22
w 0
I §
§§c
.,
Wit!{
�.§!
\k§|
£ CL
©
�
®
@1
f
E §
E !
7
.
\ \
-
� h
(
2
!
|
k
f
§

�
22
|
k9
.
kc
/
£®
�
■�
#
�!
kk
|
a■
§I
f%
I�
$$
�ƒ
#7
_
§ %
Id
a s
,
22
k
k�E
6\$
k�I
$k !\ |

►;l\.
Wil
INK
Al
;:: ' I,' r,.-ir",. �, .~ , ��J:1 I7J.Y �.JJLu
�' iin I
� ._�..- - i/ .i�1'� `I+'`nt
Lj