WQ0016579_Regional Office Historical File 1999 to 2003

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
Kerr T. Stevens, Director
Mr. David Wright, Mayor
Town of Crossnore
Post Office Box 129
Crossnore, North Carolina 28616
Dear Mr. Wright:
c
_-- - No
!.­NORTF9-Ci4ROLINA DEPARTMENT OF
�,:�,,,
ENVIRONMENT AND NATURAL ,RES„OURCES
VA
May 13 1999_-
Subject: Application No. WQ0016579
Additional Information Request
Crossnore Elementary School
Sewer -Public
Avery County
The Non -Discharge Permitting Unit has completed a preliminary engineering review of
the subject application. Additional information is required before we can continue our review.
Please address the following items no later than June 14, 1999:
General:
1) Please confirm whether or not the six-inch diameter sewer service from the school
building to Manhole No. 4 is to be permitted by the Town of Crossnore under this
application. If this is the case, Regulation NCAC 15A 2H .0219 (i) (2) (F) requires
that all public sewers shall be constructed of minimum eight -inch diameter pipe.
Please amend the design documents and Page 2 of 10 and Page 3 of 10 of the
submitted application form accordingly. Note that a profile of the subject sewer
will be required for submission as well.
Wastewater Flows:
1) The wastewater flow rate used to compute the total flow to be generated by this
proposed project is one that is typically used for day schools with a cafeteria,
gymnasium, and showers. Please verify that the Crossnore Elementary School will,
in fact, have these types of facilities.
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

pr
Pumping Station Design:
1) It is the Division of Water Quality's (hereinafter Division) understanding that relief
is being requested with respect to the pumping station power reliability
requirements, as allowed for by Regulation 15A NCAC 2H .0219 (h) (3) (D). If
this is the case, please provide a letter from the power supplier that gives three
years' worth of data regarding the nature, frequency, and length of all power
outages affecting the feeder circuit from which the subject pumping station is to be
served. Finally, in light of the recent enforcement guidelines affecting collection
system and sanitary sewer overflows, please revisit the design approach to this
issue. Note that if a portable generator is to be proposed by your resubmission for
use at this site in the event of a power failure, please provide the Town's
contingency plan for handling such a situation. Specifically, this plan should clarify
how many pumping stations the stand-by generator is going to serve, the anticipated
response time, notification procedures, and responsible personnel.
2) Note 10 on Sheet 4 of 5 of the drawings states that an autodialer is to be provided at
the proposed pumping station control panel; however, the electrical plan and riser
diagram do not indicate that an autodialer is to be installed. Please clarify this
apparent discrepancy, and amend the design documents as necessary.
3) The pump elevation is higher than the outfall elevation. Please describe or
otherwise show how siphon conditions will be prevented.
4) The selected pump for the proposed pumping station will have an efficiency of less
than 30 percent at the selected design point. Please confirm that there is not a more
applicable pump for this situation.
5) Please submit the following:
♦ Dimensions for the final pump selected.
♦ Flotation calculations for the proposed pumping station.
6) It was difficult to determine from the "Pump Station Site Layout" detail on Sheet 4
of 5 of the drawings whether or not an all-weather roadway is being provided to the
site, as required by Regulation 15A NCAC 2H .0219 (h) (8). Please amend the
design documents to reflect this requirement.
7) Regulation 15A NCAC 2H .0219 (h) (2) requires that pump on/off float elevations
shall be set such that between two and eight pumping cycles per hour are effected.
Verification calculations show that, when the average daily flow is prorated for an
eight -hour school day, 11 cycles per hour will occur with the current design. Please
amend the design, and submit revised calculations and design documents
accordingly.

FV
Pumping Station Design (continued):
8) The Division suggests placing the high water alarm float at the same elevation level
or below the lag pump on float in the pumping station wet well. This setting will
indicate a failure of the lead pump while the lag pump is still available. Please
consider amending the proposed pumping station design to provide this additional
guarantee against failure.
9) Sheet 4 of 5 of the drawings do not detail of what material the chain hook, the rail
guide support, and the upper holddown are to be manufactured. Please provide
additional information about the construction of these items proposed for
installation within the pumping station wet well.
10) Page 5 of 10 of the submitted application form states that the proposed pumping
station is not subject to flooding. The drawings, however, indicate that the wet well
is elevated at least a foot above the 100-year flood elevation. Please amend and
resubmit this page to reflect the fact that the proposed pumping station is subject to
flooding as well as that the top of the pumping station wet well will be elevated
above the 100-year flood elevation, as shown in the drawings.
11) Note 4 on Sheet 4 of 5 of the drawings indicate that NEMA 4X electrical and
control cabinets are required for installation at the proposed pumping station site.
The electrical plan and riser diagram, however, state that NEMA 3R-rated cabinets
are sufficient. Please correct this apparent discrepancy.
12). Please describe what type of cross -connection control device will be provided on
the water service to the yard hydrant at the proposed pumping station site. Submit
revised design documents accordingly.
Force Main Design:
1) The crossing between the proposed force main and a storm sewer at STA 9+00 is
not shown in the profile view. Please amend and resubmit the drawings, so that
adherence to Regulation 15A NCAC 2H .0219 (i) (2) (G) (i) may be verified.
2) The crossing between the proposed force main and a water line at STA 9+20 is not
shown in the profile view. Please amend and resubmit the drawings, so that
adherence to Regulation 15A NCAC 2H .0219 (i) (2) (G) (ii) may be verified.
Gravity Sewer Design:
1) Page 3 of 10 of the submitted application form states that the maximum
infiltration/exfiltration rate for sewers is to be 200 gallons per day per inch of pipe
diameter per mile of pipe. Note that Regulation 15A NCAC (i) (2) (D) requires that
this criterion not exceed 100 gallons per day per inch of pipe diameter per mile of
pipe. Please submit a revised page for the Division's inclusion in the approved
permit file.

Gravity Sewer Design (continued):
2) There appears to be typographical error on Sheet 2 of 5 of the drawings.
Specifically, the leg of gravity sewer between the proposed pumping station and
Manhole No. 1 should be at a slope of 3.36 percent according to the provided invert
elevations and station locations.
3) The crossing between the gravity and storm sewer at STA 29+50 on Sheet 2 of 5 of
the drawings appears not to comply with the minimum vertical separation
requirements spelled out in Regulation 15A NCAC 2H .0219 (i) (2) (G) (i). Please
amend the sewer profile or specify a ferrous material with joints equivalent to water
main standards at this location. The revisions should be resubmitted for the
Division's review.
4) The crossing between the gravity and water line at STA 30+00 on Sheet 1 of 5 of
the Onsite Water and Sewer Plan is not shown in the plan/profile provided on Sheet
2 of 5 of the main drawings. Please amend the drawings, so that compliance with
the minimum vertical separation requirements spelled out in Regulation 15A NCAC
2H .0219 (i) (2) (G) (ii) may be confirmed.
Please reference the subject permit application number when providing the requested
information. All revised information, including letters, calculations, drawings, and
specifications, should be signed, sealed, and submitted in triplicate to my attention at the address
above. Please note that failure to provide this additional information on or before the above
requested date can result in your application being returned as incomplete.
If you have any questions regarding this request, please call me at [phone],
extension 353. Thank you in advance for your cooperation and timely response.
Sincerely,
i
''(�iL l�v�fittr
Shannon Mohr Thornburg
Environmental Engineer
Non -Discharge Permitting Unit
cc: Asheville Regional_ Office,_ Water_Quality_Section,
Permit File WQ0016579
Ledford Engineering, Inc.

Prate of North -Carolina=_
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Kerr T. Stevens, Director
April 2, 2001
1�TOWN OF CROSSNORE
DAVID WRIGHT
P O BOX 129
CROSSNORE NC 28616
ad.N0 0 19 .0Jk a
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: Permit No. WQ0016579
Crossnore School
Sewer -Public
Avery County
Dear Mr. Wright:
The Division's Non -Discharge Permitting Unit has received your signed and sealed certification
with record drawings. The Division hereby accepts this certification based upon its execution and
submittal by a North Carolina Professional Engineer. Please note that the record drawings will be
forwarded to the Asheville Regional Office and have not been reviewed. If a review is conducted,
you will be notified of any non -conformity with the Minimum Design Criteria.
If it would be helpful to discuss this matter further, I would suggest that you contact the Water
Quality Regional Supervisor at the Asheville Regional Office at [phone].
Sincerely,
Thelma Williams
cc: Asheville Regional Office, Water Quality Section
Central Files
Ledford Engineering
1617 Mail Service Center, Raleigh, NC 27699-1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50 % recycled/10 % post -consumer paper

)16579
ENGINEER'S CERTIFICATION
Partial Final
I, CAaa_ 1✓ GyjuE%.i_ , 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,
CQ65 U oPi SLEMmwACH Sc-uppL. `rbuili of C 4--s iLG ,, AV Co .
Project Name Location and County
for the 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 and intent of
this permit, the ap ved plans and sp ific 'ons, and other supporting materials.
(-*SignatureLL .,`�� CRRU/ .'i,. Re gistratior, No. O22"Llo'J
Date Vv
w VEAL °
0
•
4 ao
MCC&
`,111111 WW"*\
' j'Q B SA&fk gxfg�f « uaiityherft
0136M Os
r...
1��iRCER (}1,N ,-�
JT
�rJ�-Dim" ge pa{ {„Ltn

NON NPDES
FACILITY AND PERMIT
DATA 03/30/01
09:07:03
ION TRXIU
5OU KEY WQ0016579
rDALTA
FACILITY APPLYING
FOR PERMIT APP/PERMIT
FEE-$ 400.00
REGION
> CROSSNORE,TOWN-CROSSNORE SCH 1
COUNTY> AVERY
01
DRMAILING (REQUIRED)
ENGINEER:
LEDFORD ENGINNERING,INC
STREET: PO BOX 129
STREET:
PO BOX 2217
CITY: CROSSNORE ST
NC ZIP 28616 CITY:
ASHEVILLE ST NC
ZIP 28802
TELEPHONE [phone]
TELEPHONE:
828 255 7596
STATE CONTACT> THORNBURG
FACILITY
CONTACT DAVID WRIGHT,
MAYOR
TYPE OF PROJECT> SEWER -PUBLIC
LAT: LONG:
DATE APP RCVD 03/12/99
N=NEW,M=MODIFICATION,R=REISSUE>
N
DATE ACKNOWLEDGED 03/16/99
DATE REVIEWED
05/25/99 RETURN DATE
REG COMM REQS 03/16/99
DATE DENIED
/ / NPDES #-
REG COMM RCVD 03/31/99
DATE RETURNED
/ / TRIB Q
.0000 MGD
ADD INFO REQS 05/13/99
OT AG COM REQS
/ / TRIB DATE-
/ y
ADD INFO RCVD 05/17/99
OT AG COM RCVD
/ /
END STAT APP P 08/15/99
DATE ISSUED
05/28/99 DATE EXPIRE
FEE CODE( 7)1=(>1MGD),2=(>10KGD),3=(>1KGD),4=(<1KGD+SF),5=(S>300A),6=(S<=300A),
7=(SENDEL),8=(SEDEL),9=(CLREC),0=(NO FEE) DISC CODES 03 ASN/CHG PRMT
ENG CERT DATE 04/10/00 LAST NOV DATE / / CONBILL( )
COMMENTS: 6,000 GPD; 1,250 LF OF 8" GS, 1 83-GPM PS, 1,860 LF OF 4" FM
MESSAGE: *** DATA MODIFIED SUCCESSFULLY ***

April 4, 2000
Kerr T. Stevens
NCDENR
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Crossnore Elementary School -
Sanitary Sewer Line
Permit # WQ0016579
Certification & As -built Enclosed
Dear Mr. Stevens,
i � J
CAVANAUGH
Solutions through integrity and partnership
APR 0 i 2000
DIV. OF WATER QUALITY
DIRECTOR'S OFFICE
Please find enclosed one Engineer's Certification and one As -built for the project
referenced above. This should be all you need to complete this project. If you
need anything else, please contact me. Thank you for your cooperation.
Sincerely,
C��
arty K. Barthelemy, IV, E.I.
Enclosures
CC: Mr. Gary Summers, Martin Boal, Anthony, & Johnson
G:\ADWGS\98-161\DOCS\SWRCERT.DOC

VAUGHN & 'MELTON'
Consulting Engineers
1318-F PATTON AVENUE
s ASHEVILLE, NORTH CAROLINA 28806
[e-mail]
[phone] • FAX [phone]
TO nU [)trig b �-Q
.5�q U0C,aA_-RM 00-ce-
R's�.e-Q;1kle INC XM I
1
D UI a0�
WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via
❑ Shop drawings ❑ Prints
❑ Copy of letter ❑ Change order
❑ Plans
LIETTIE �3 OF TUO S M&L
ATTENT
RE:
�<< LT—s
the following items:
❑ Samples ❑ Specifications
03
COPIES
DATE
NO.
DESCRIPTION
/� ,/ j�'� / ,.� ra'
C\ , ` cr,v v i\-
b11�4
THESE ARE TRANSMITTED as checked below:
❑ For approval ElApproved as submitted
Door your use ❑ Approved as noted
❑ As requested ❑ Returned for corrections
❑ For review and comment ❑
❑ FOR BIDS DUE 20
MLVITLL'121W
❑ Resubmit copies for approval
❑ Submit copies for distribution
❑ Return corrected prints
❑ PRINTS RETURNED AFTER LOAN TO US
COPY TO SIGNED: ZnJ4
If enclosures are not as noted, kindly notify us at once.

Ps::mit No. WQ0021557
July 24, 2002
ENGINEER'S CERTIFICATION
Partial Final
I, Vie- .A.-f A. Ce-11mu ; 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
C,.�ossr�'ove SGhovti - Gcoss,�or2 •
project, Sewer System Replacement and Rehabilitation, T , N.C., Avery County
Project Name Location and County
for the 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 2H .0200; the Division of Water Quality's (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.
--\N CAROXz
~'�.
North Carolina Professional Engineer's seal, signature, and date: = SEAL
16267
��.y•' FNGINo-� 0J'
�4••
M"a a. C_'-ka-w-
3 z,7•-03
The above Engineer's Certification shall be completed and submitted to the address below with one
copy of the "Construction Record Drawings" of the wastewater collection system extension as well
as supporting design calculations for any pump stations permitted as part of this project. This project
shall not be considered complete nor allowed to operate until this Engineer's Certification and all
required supporting documentation have been received by the Division. 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.
NORTH CAROLINA DIVISION 'OF' WATER QUA C [ .
WATER QUALITY SECTION 11 7AP '71
NON -DISCHARGE PERMITTING UNIT 2003 l;
s
1617 MAIL SERVICE CENTER
4.LASFJEViL4
RALEI
GH, NORTH CAROLINA 27699-161-;- I
loJ

To.
State Review Group
From: Forrest R. Westall
Water Quality Regi
Asheville Regional
Date: March 25, 1999
SUBJECT: Procedure Four (4)
APN W00016579
New Crossnore School
Sewers -Public
Avery County
isor,
State Review Group
Review Engineer Shannon Thornburg
Regional Office Contact Mike Parker
4
1) Name of wastewater treatment plant to receive the wastewater
Town of Crossnore
2) WWTP design capacity 0.070 MGD
3) NPDES Permit No. NCO026654 Expiration Date 04/30/00
4) Compliance Information:
Present treatment plant performance
for previous _12_ months - beginning 01L02L98
Permits/SOC Limits
SEE ATTACHED
Monthly Average
5) Quantity and type of wastewater`froni proposed sewers:
6000 GPD
domestic XX
industrial
other
6) Volume from previously approved projects not yet tributary to
WWTP NA GPD
7) Regional R commendations: Approval XXX Denial

Fantate 'of North Carolina 0
Department of Environment
d Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
Kerr T. Stevens, Director
March 16, 1999
Mr. David Wright, Mayor
Town of Crossnore
Post Office Box 129
Crossnore, North Carolina 28616
Dear Mayor Wright:
NoR-
ENvIRor
Subject:
AT
New Crossnore School
Sewer -Public
Avery County
The Division's Permits and Engineering Unit acknowledges receipt of your permit application and
supporting materials on March 12, 1999. This application has been assigned the number listed above.
Your project has been assigned to Ms. Shannon Thornburg for a detailed engineering review. Should
there be any questions concerning your project, the review will contact you with a request for additional
information.
Be aware that the Division's Regional Office, copied below, must provide recommendations from the
Regional Supervisor or a Procedure Four Evaluation for this project, prior to final action by the division.
If you have any questions, please contact Ms. Shannon Thornburg at 919/733-5083 ext. 353. If the
engineer is unavailable, you may leave a message on their voice mail and they will respond promptly.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIRES ON
THIS PROJECT.
Sincerely,
h-Mr. Kim H. Colson, P.E.
Supervisor, Non -Discharge Permitting Unit
cd7-Rrsheville Regional Office, Water_Quality
`Ledford Engineering, Inc.
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

State of North Carolina
Department of Environment, Health, and Natural RIPei ri<<n@
Division of Environmental Management
Non -Discharge Permit Application
(THIS FORM MAYBE PHOTOCOPIED FOR USE AS AN ORIGINAL)
GRAVITY SEWER EXTENSION
PUMP STATIONS, AND PRESSURE SEWERS
I. GENERAL INFORMATION:
1. Applicant (corporation, individual, or other): �✓ h o -�' �. i' rn S % r! rJ
2. Print Owners or Signing Official's Name and Title (the person who is legally
responsible for the facility and its compliance): 104 ✓ . r� LJ,, -' s; Sd- /1l q `, 0,-
3. Mailing Address: 106 4 o k 12.17
City: 4 /'v SS A o State: /j L Zip: 2-'s? is / h
Telephone No.: ( ef'21- ) ?3 Z - O 3 (, p
4. Project Name (subdivision, facility, or establishment name - should be consistent with
project name on plans/specs., letters of flow acceptance, Operational Agreements, etc.):
&e
" 5. Application Date: Z, $P) 6. Fee Submitted: $ 400.OJ-
7. County where project is located: _ 1/ay
II. PERMIT INFORMATION:
1. Permit No. (will be completed by DEM):M 1_��
2. Specify whether project is: V new;' renewal*; modification.
*If renewal, complete only sections I through III and applicant signature -
(on pg.9). Submit o6ly pgs. 1, 2, 9..(original and 3 copies of each).'Engineer
signature not required for renewal.
3. If this, application is being submitted as a result of a renewal or modification to an
existing permit, list the existing permit number and issue date
4. Specify whether the applicant. is public or private. �
FORM: GSPS 4191 Page 1 of 10

GRAVITY SEWER EXTENSION & PUMP STATION
PAGE 2 (4/91)
III. INFORMATION ON WASTEWATER:
I . Nature of Wastewater: —�% Domestic; % Commercial;
% Industrial; % Other waste (specify):
2. Please provide a one or two word description specifying the origin of the wastewater,
such as school, subdivision, hospital, commercial, industrial, apartments, etc.:
L Eii7 r�arr3t2s� SChlC�1�L
3. Indicate any parameter (and its concentration) that will be greater than normal domestic
levels:
4. If wastewater is not domestic in nature, what level of pretreatment has been provided to
ensure protection of the receiving wastewater treatment facility?
5. Volume of wastewater generated by this project: CUO _ gallons per day
6. Explanation of how wastewater volume was determined: y"(-V J iZ'l ivisr Fi4Cwr y
IV. DESIGN INFORMATION:
1. Brief project descriptions:: &AXIQxirrfrtzY
2. Name of wastewater treatment facility receiving wastewater: /0wAJ 6,C6eoss.vo�cE
a. Facility permit no.: Nc ooa �6,s�
b. Engineer should provide statement of his evaluation of downstream sewers to
accept the wastewater: 16.ws772,5:*rh 7y *—/Ais
_�; &-z-a z.Lj" /c i s fri ' /:) 44C
2 of 10

GRAVITY SEWER EXTENSiuN & PUMP STATION
PAGE 3 (4/91)
3. Summary of sewer pipe by diameter size and pipe material. Indicate here whether C
factor or N factor is used and circle C or N below: Al
Dia. Length Pipe C or N Min. Max. Minimum Max. Minimum
(In.) (Lin. Ft) Material Factor Slope % Slope % Velocity (fps) Vel.(fps) Cover. (in)
1;33 93 2- 10/ 3, 7/ S, 7 36
i f�1/C _o_.o/� O,
2—O �i/U.o l/ c-. 3 D�3 3 ,�1 3.7/ 36
4-1 IE62-
NOTE: The minimum velocity must not be less than 2 fps.
For public sewers the minimum diameter is 8 inches.
4. Anchors shall be provided for sewers with slopes greater than 20 %. The anchor
spacing shall be as follows:
a. 36 feet separation for slopes of 21 % to 35%;
b._24 feet separation for slopes of 36% to 50%;
c. 16 feet separation for slopes of 50% and greater..
For velocities -greater than 15 fps, it is strongly recommended that measures be
considered which will protect the sewers and manholes from erosion. For velocities
greater than 20 fps, erosion control measures must be specified
For any excessive slopes or velocities that will occur in any sewer line segment, what
measures have been taken to protect the sewer pipe and manholes?
5. Maximum sewer reach length between manholes: 3W7 6 linear feet.
6. This sewer line segment occurs between manhole no. and manhole no. S�
7. Does the owner/operator have the ability to clean this length? Yes No.
8. Sewer subject to existing or planned traffic bearing loads? Yes No.
If yes, what measures are being taken to enable the sewers to withstand the loads?
%�� i� �� �'/h ETt l� 0. / r� r� %�1G1� �/�ffSL�Y77F.r✓T U�J c /(
US
9. Outside drop manholes are provided where invert separations exceed: -AIIA "7---feet.'
10. Identify (by manhole number) those manholes that have drop connections: N
3of10

GRAVITY SEWER EXTENSION & PUMP STATION
PAGE 4 (4/91)
11. Maximum allowable infiltration/exfiltmdon test rate: '40_0 GPD/ pipe dia. in./ mile.
Note: Must not exceed 200 GPD/ pipe dia. in./ mile.
12. Minimum separation distances as shown on the plans or addressed in the specifications:
a) 100 ft. horizontal separation from wells or other water supplies? ZYes _ No
b) 12 in. vertical separation from storm sewer or ferrous pipe '
sanitary sewer specified? ✓ Yes _ No
c) 10 ft. horizontal separation from water mains or 18 in. vertical
separation (water over sewer) or ferrous pipe specified? ZYes _ No
13. Are manholes subject to flooding? S Lffes ✓No
14. If yes, are manhole rim elevations 1 foot above 100-year flood level, Z Yes —No
(100 year flood elevation should be indicated on plans)
15. Or are manholes watertight and vented 1 foot above the 100-year
flood elevation ( should be, shown on plans): /Yes —No
16: Identify (by manhole number) those manholes that are vented: PdA
17. Does this project involve any stream crossings? _ yes Zo. If yes, what precautions
or special features have been utilized to ensure protection of the sewer line and not
restrict stream flow? Identify the sheet of the plans and station number where stream
crossings are located:
4 of 10

GRAVny SEWER EXTEN.,.JN & PUMP STATION
PAGE 5 of 10 (/9 )
V. PUMP STATION INFORMATION
1. Pump Station No.: (A separate sheet V.1 through V.15 should be
submitted for each pump station)
2. Name of closest downslope surface waters:
GSA
C (as established
3. Classification of closest downslope surface waters: 6 of this applic.).
by the Environmental Management Commission &specified on page
4. If a power failure at this pump station could impact
waters
class to preifivent such �impacBt, as
SB, describe which of the measures are
t
k q g
im required in 15A NCAC 2H .0200: N'
GPM .
5. What size pumps are provided? ©o
6. How many pumps are provided?
� /S CJl�4 GPD
7. What is the maximum capacity of the pump station. feet
g. What is the design total dynamic head.'
l. z _ cycles per hour
9. How many pumping cycles will occur at the design flow rate? c
10. Check if provided at pump station:
Alternate Power Source
Wet Well Vented with Screen
Fillets in Wet Well
Check Valves and Gate Valves
Security Fencing
Lockable Wet Well Cover
Area Light
enience Outlet
110V Electrical Conv
Flood/}3uoyancy Protection/ Audible and Visu Auto Dialer
High Water Alarm ' �--.
11.
Diameter LengthFt)
(Inches) (Linear
Summary of force main (by diameter size and pipe material):
Minimum Maximum Mirtunum
Velocity(fps) Vel.(fps) Cover (in)
Pipe
Material
PV6
High
Elevation
110
Low
Elevation
Are air release valves provided at all high points along the force main (must be provided
where the elevation difference exceeds 10 feet)? _yes .Zno
Is pump station subject to flooding? yes Z no. If yes, what measures are
being taken to protect against flooding
If subject to flooding, specify the 100-year flood elevation: i✓ A Feet MSL
Are there existing or planned pump stations downstream of this station? _yeS no
_
If yes, the engineer shall evaluate the ability of those pump stations to adequately handle
the subject flows.

0
GRAVITY SEWER EXTENSION & PUMP STATION
PAGE 6 (4/91)
TO: REGIONAL WATER QUALITY SUPERVISOR
Please provide me with the classification of the surface waters identified in number 5
below and on the attached map segment:
Name of surface waters: 6LA#L1(- i S iLA,✓c 14
Classification (as established by the Environmental Management Commission):
Proposed Classification, if applicable:
Signature of regional office personnel:�14uv �Date:..�• i
INSTRUCTIONS TO ENGINEER
In order to determine whether provisions for dual or standby power may be required for the
subject facility, the classification of the closest downslope surface waters (the surface waters that
any overflow from the facility would flow toward) must be determined. You are required to
submit this form, with items 1 through 10 completed, to the appropriate Division of Environmental
Management Regional Water Quality Supervisor (see attached listing). At a minimum, you must
include an 8.5" by 11" copy of the portion of a 7.5 minute USGS Topographic Map which shows
the subject surface waters. You must identify the location of the facility and the closest downslope
surface waters (waters for which you are requesting the classification) on the submitted map copy.
The application may not be submitted until this form is completed and included with the submittal.
1.
2.
Applicant (corporation, individual, or other):'
/ otu/JyF t-.l2.f/_S/( 6rK
Name and Complete Address of Engineering Firm: Ld DO oP-,b
City: &Sift
Telephone No.
3.
State: AVM Zip: 0- 0 RO/
Project Name: CiZos.s uo4c �Lt'mrvn�2� SGifpo[
4. Pump station design flow:-4±�M,19 GPD; /00. GPM
5. Name of closest downslope surface waters: 1,2A VC -If t✓,e
6. County(s) where project and surface waters are located: &t= Q,Y
7. Map name and date: _ uECULAAJb QU. DR-Anl6e r
8. North Carolina Professional Engineer's Registration No.
9. Print Name of Engineer CARL ilG (_O.U&yELL
10. Seal and Sign06�0#Eq
6 of 10
,,'',�� �Il7�111 O,�,t'L'•

FDIVISION OF ENVIRONMENTAL MANAGEMENT REGIONAL OFFICES (4/91)
Asheville Regional WQ Super
59 Woodfin Place
Asheville, NC 28802
7041251-6208
Avery r.
Buncombe
Burke
McDowell
Caldwell
Mitchell
Cherokee
Polk
Clay
Rutherford
Graham
swain
Haywood
Transylvania
Henderson
Yaney
Jackson
Fayetteville Regional WQ Super
Wachovia Building, Suite 714
Fayeueville, NC 28301
-9:9/486-1541
9/0
Anson Moore
Bbckn Robeson
Cumberland Richmond
Harnett Sampson
Hoke Scotland
Montgomery
Winston-Salem Regional WQ Super.
8025 Notch Point Boulevard, Suite 100
Winston-Salem, NC 27106
1"91761-2351
Alarrtance
Roclangham
Alleghany
Randolph
Ashe
Stokes
Caswell
Surry
Davidson
Watauga
Davie
Wilkes
Forsyth
Yadkin
Guilford
Washington Regional WQ Super. Raleigh Regional WQ Super.
P O Box 1507 3800 Barnett Dr., Suite 101
Washington, NC 27889 Raleigh, NC 27609
919/946-6481 919/733-2314
Beaufort
Jones
Chatham
Nash
Berge
Lenoir
Durham
Northampton
Camden
Martin
Edgecornbe
Orange
Chowan
Pamlico
Franklin
Person
Craven
Pasquotank
Granville
Vance
Currituek
Perquimans
Halifax
Wake
Dare
Pitt
Johnston
Warren
Gates
Tyrell
Lee
Wilson
Greene
Washington
Hertford
Wayne
Hyde
Mooresville Regional WQ Super.
919 North Main Street
Mooresville, NC 28115
704/663-1699
Alexander Mecklenburg
Cabarrus
Rowan
Catawba
Stanly
Gaston
Union
Iredell
Cleveland
Lincoln
7 of 10
Wilmington Region. WQ Super.
127 Cardinal Drive Extension
Wilmington, NC 28405-3845
919/395-3900
Brunswick New Hanover
Carteret Onslow
Columbus Pender
Duplin

GRAVITY SEWER EXTFN! .4 & PUMP STATION
PAGE 8 (4/91)
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BY THE
DIVISION OF ENVIRONMENTAL MANAGEMENT UNLESS ALL OF
THE APPLICABLE ITEMS ARE INCLUDED WITH THE SUBMITTAL
Required Items
a. One original and three copies of the completed and appropriately executed application form.
b. Three sets of detailed plans and specifications signed and sealed by a North Carolina
Professional Engineer. The plans must include a general location map, a plan view of the
sewer extension, a profile of the sewer extension, details on the pump station, and must
show the proximity of the sewer extension to other utilities and natural features.
Specifications may be omitted for delegated authorities. Each sheet of the plans and the first
page of the specifications must be signed and sealed. Three copies of the existing permit if
a renewal or modification.
c. Three copies of all calculations, including pump selection, friction calculations, cycle
time, pump curves (including system curves applicable with one pump running, two
pumps running, three pumps running, etc.), and evaluation of downstream pump stations.
These items must be submitted under the signature and seal of the North Carolina
Professional Engineer.
d. The appropriate permit processing fee, in accordance with 15A NCAC 2H .0205(c)(5).
e. If the owner/authority of the wastewater treatment facility (WWTF) that will be accepting
the wastewater flow from this project is different from the applicant of the project, then a
letter must be provided from the owner/authority of the WWTF specifying the volume of
flow that will be accepted. The letter should be a recent letter and should refer to the project
by the same name as that identified on the application and the plans/specifications.
f. An Operational Agreement (original and two copies) must be submitted if the sewer
extension will be serving single family residences, condominiums, mobile homes, or town
houses and if the subject sewer extension is owned by the individual residents, a
homeowners association, or a developer.
8 of 10

GRAVITY SEWER EXTENSION & PUMP STATION
PAGE 9 (4/91)
Name and Complete Address of Engineering Firm: L67o,-na Z;JZ1 .J6EPJJU /NC.
City:
Telel
Professional Engineer's Certification:
I, C&[LL M.;: Co"ge. LL— , attest that this application for A,1F e_i
_&LE1n &V7*,4P_? 3C'(j6-2 H 4 0 has been reviewed by me and is accurate
and complete 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. Although certain
portions of this submittal package may have been developed by other professionals, 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.
North Carolina Professional Engineer's Registration No.
Print Name of Engineer CA 9-L, I-AC-Cr ML, EE J
Seal and Signature (specify date):
.ram •. S FR F C E , i, � r�
9,Q . V11JE'�
Applicant's Certification: ''•,McCON`,,��
%.Jr ,'e �,�-- , attest that this application for NFw cl?_C s�-
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
information and attachments are not included, this application package will be returned as
incomplete.
Signature Date
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
INFORMATION AND MATERIALS, SHOULD BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DIVISION OF ENVIRONMENTAL MANAGEMENT
WATER QUALITY SECTION
PERMITS AND ENGINEERING UNIT
POST OFFICE BOX 29535
512 NORTH SALISBURY STREET
RALEIGH, NORTH CAROLINA 27626-0535
TELEPHONE NUMBER: 919/733-5083
9 of 10

- • • •,• . •• �n �n i i:i��ivi� & rUMP STATION
PACE 10 (4/91)
• ' ` PER MIT`S-- _"
PLICATION PROCESSING FEES
(effective October 1, 1990)
Y
QATF YoRY NEW APPLI CATIONS/ RENEWAI S WTT'FIOLJT
-MODIFICATIONS MODMICATIONS
> 1,000,000 GPD
Industrial $400
$300
Domestic/Cooling Water $400 $300
10,001 - 1,000,000 GPD
Industrial $400 $250
Domesdc/Cooling Water $400 $250
1,001 - 10,000 GPD
Industrial - $4()0 $200
Domesdc/Cooling Water $400
$200
< or = 1,000 GPD and
Single Family Dwelling $240
$120
Sludge < or = 300 Acres $400
$250
Sludge > 300 Acres $400
$250
Sewer Extensions
(nondelegated) $400
0
Sewer Extensions
(delegated) $200
0
Closed -Loop Recycle
or Evaporative $400
$200
NOTE; The Fees for Soil Remediation Projects are the same as for Sludges.
Under the Sewer Extension Fee, "delegated to municipalities" applies
only to those governmental jurisdictions that have specific delegation
review authority, as granted by the Division of Environmental
Management.
10 of 10