WQ0041647_Application (FTSE)_20200427

V4001-06uI-7
State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION
This application is for sewer extensions invoh ing gravity sewers, pump stations and force mains, or any combination that has been
certified by a professional engineer and the applicant that the project meets the requirements of 15A NCAC 02T and the Division's
Minimum Design Criteria and that plans, specifications and supporting documents have been prepared in Accordance with, 15A
NCAC 02T, 15A NCAC 02T.0300, Division policies and good engineering practices.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design
documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans. design
calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimum design criteria. These
documents shall be available upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T.0303.
Projects not eligible for review via the fast track process (must be submitted for full technical review):
> Projects that require an environmental assessment in accordance with 15A NCAC 1C .0100;
> Projects that do not meet any part of the minimum design criteria (�MDC) document;
> Projects that involve a,,ariance from the requirements of 15A NCAC 2T;
> Pressure server systems utilizing septic tank -effluent pumps (STEPS) or simplex grinder pumps;
> STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains);
> Vacuum scv%cr systems.
General — When submitting an application, please use the following instructions as a checklist in order to ensure all required items
are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and
reduce the amount of requested additional information. Failure to submit all required items will necessitate additional
processing and review time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit
one original and one copy of the application and supporting documentation.
A. One Original and One Copy of Application and Supporting Documents
® Required unless otherwise noted
B. Cover Letter (Required for All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
�w Be specific as to the system type, number of homes served, flow allocation required, etc.
�- If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Major Modification Application Packages):
© Submit a check or money order in the amount of $480.00 dated within 90 days of application submittal.
Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track (Form: FTA 04-16) Application (Required for All Application Packages):
® Submit the completed and appropriately executed application.
If necessary for clarity or due to space restrictions, attachments to the application may be made.
❑ If the Applicant Type in Item 1.2 is a corporation or company, provide documentation it is registered for business with
the North Carolina Secretary of State.
❑ If the Applicant Type in Item 1.2 is a partnership or d-b/a, enclose a copy of the certificate filed with the Register of
Deeds in the county of business.
® The Project Name in Item 11. l shall be consistent with the project name on the flow acceptance letters, agreements, etc.
® The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North
Carolina licensed Professional Enaineer.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106(bl.
Per 15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is
provided from a person who meets the criteria in 15A NCAC 02T .0106(b).
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTINU DOCUMENTATION Page 1 of3

E. Flow Tracking/Acceptance Form (Form: FTSE 04-16) (If Applicable):
® Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility.
Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one
year prior to the application date.
i Submittal of this application and form FTSE 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 a project -specific FTSE.
F. Site Maps (All Application Packages):
® Submit an 8.5-inch x I I -inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project
area and closest surface waters.
Location of the project (gravity sewer, pump stations & force main)
Downstream connection points and permit number (if known) for the receiving sewer
® Include a street level map (aerial) showing general project area so that Division staff can easily locate it in the field.
G. Existing Permit (All Modification Packages):
❑ Submit the most recently issued existing permit.
❑ Provide a list of any items within the permit the Applicant would like the Division to address during the permit
modification (i.e., permit description, flow allocation, treatment facility, etc.).
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T .0305(h)(1), submit documentation of power reliability for pumping stations.
This alternative is only available for average daily flows less than 15,000 gallons per day
It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible
with the station, The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or proposed
contractor, stating that "the portable power generation unit or portable, independently -powered pumping units, associated
appurtenances and personnel are available for distribution and operation of this pump station."
If the portable power source or pump is dedicated to multiple pump stations, 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. (Required at time of certification)
I. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per 15A NCAC 02T .0115(a)(l) provide the Certificate of Public Convenience and Necessity from the North Carolina
Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by
the sewer extension, or
❑ Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an
application for a franchise has been received and that the service area is contiguous to an existing franchised area or that
franchise approval is expected.
J. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold):
❑ Home-Propertv Owners' Associations
❑ Per 15A NCAC 02T .01 15(c), submit the properly executed Operational Agreement (FORM HOA).
El Per 15A NCAC 02T .01 15(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 15A NCAC 02T .01 15(b), submit the properly executed Operational Agreement (FORM: DEV).
Foi-morei forniallon, visit the Division's collection systems 1NL'bsile
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 2 of3

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,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Favetteville 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,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
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, Surry, Watauga, Wilkes, Yadkin
[phone]
INSTRUCTIONS FOR FORNf: rTA 04-16 & SUPPORTING DOCUMENTATION Page 3 of 3

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
15A NCAC 02T .0300 a FAST TRACK SEWER SVSTE-*vI EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: Uy J 0V -11613 (to be eomptcRd by DWR)
All items must be completed or the anmlication will be returned
1. APPLICANT INFORMATION:
1. Applicant's name: Town of Pittsboro (company, municipality. I IOA. utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State. -'Count,, ® Municipal ❑ Other
3. Signature authority's name: John Poteat per l5A NCAC 021- .0106(h)
Title: Utilities Director
4. Applicant's mailing address: PO Box 759
City: Pittsboro State: NC Zip: 27 12-07_59
5. Applicant's contact information:
Phone number: [phone] Email Address: jpnteat it pittshomnc.�ov
IL PROJECT INFORMATION:
I. Project name: Pittsboro Eagles Main Relocation
2. ApplicationlProject status: ® Proposed (New Permit) ❑ Existing Permi0roject
If a modification, provide the existing permit number: WQOO and issued date:
If new construction but part of a master plan, prov ide the existing permit number. WQOOO
3. County where project is located: Chatham
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.720592` Longitude:-79.174508--
5. Parcel ID (if applicable). 0007690
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Wyatt Bone License Number: 040241
Firm: Bohler Engineering, NC PLI.0
Mailing address: 4130 Parklake Avenue, Suite 130
Citv: Ralei-,h State: NC Zip: 27612-_
Phone number: [phone] Email Address: whone-ci bohlereng:com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I. Facility Name: Town of Pittshoro WWTP Permit Number: NC20354
Owner Name: Town of Pittshoro
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: inch
System Wide Collection System Permit Number(s)_dfanplicahle): WQCS
O«ner Namc(s):
FORM: FTA 04-16 Page I of 5

V1. GENERAL REQUIREMENTS
1. Ifthe Applicant is a Privately-ONtincd Public Utility. has a Certificate of Public Convenience and Necessity been attached?
❑ Yes [:]No ®N/A
2. Ifthe Applicant is a Developer of lots to be sold. has a Developer's Operational Agreement (FORM: Dry-) been attached?
❑ Yes ❑No ZMA
3. If the Applicant is a I lomefro erty Owners' Association. has an Operational Agreement FORM: 1-IOA been attached?
❑ Yes ❑No ®N1A
4. Origin of wastewater: (check all that apple):
❑ Residential Owned ❑ Retail (stores. centers. malls) ® Car Wash
❑ Residential Leased ® Retail with food preparationrservice ❑ Hotel and/or Motels
❑ School � preschool!" day care ❑ Medical i dental .' %eterinary facilities ❑ Swimming Pool;Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool,
Backwash
Businesses l offices I factories ElNursing I lome ❑ Other ( Explain in Attachment)
5. Nature of wastewater : % Domestic; Commercial 100 !111, Commercial
% Industrial (See I5A NCAC 02T .0103(20))
,Is there a Pretreatment Program in effect'? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .0114(I)? ❑ Yes ® No
i If yes, Provide a cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 42T.01141(f)
Daily Design Flow 4-1)
No. of Units
Flow
Service Station
250 gallPlumhing f ixturc
8
2000 GPD
Car Wash - Used flow data from Client
which exceeded 02T flows
65 washesldaN `i 75 galiwash
}
I
4875 GPD
gal+
GPD
gal
GPD
gal?
GPD
gal,'
GPD
Toro!
6875 GPD
a See 15A NCAC 02T .01 14(h). (d). (c)(1) and (c)(2) for caveats to %%astewater design flow rates (i.e., minimum flow per
d+velling: proposed unknown non-residential development uses: public access facilities located near high public use areas:
and residential property located south oreast ofthe Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per I5A NCAC 02T .0I 14(c), design flow rates for 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.
8. Wastewater generated by project: 6875 GPD (per I5A NCAC 02T .0l 14)
Do not include future flows or previously permitted allocations
11'permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Plow has already been allocated in Permit Number;
❑ Rehabilitation or replacement of existing sewer with no nc%v flow expected
❑ Other (E..xplain):
FORM: FTA 04-16 page 2 of 5

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted;
Size (inches) Length (feet) Material
12 35=4 SDR - 26
Section II & III of the MDC for Permitting o1' Gravity Sewers contains information related to design criteria
Section III contains information related to minimum slopes for gravity sewer(s)
i Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
V111. PUMP STATION DESIGN CRITERIA (If Applicable) —02T .0305 & MDC (Puntn StationslForce N1.9ins):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: - Longitude: -
3. Design flo%% 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 (TDI-1)
5. Summarize the force main to be permitted (fur this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 021- .0305(h)(I ):
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(43).
Required for all pump stations with an average daily now greater than or equal to 15.000 gallons per day
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(0(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 021' .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 %%ith the station.
If the portable power source or pump is dedicated to multiple pump stations, an e%aluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes. shall be pro%ided
in the case of a multiple station power outage.
FORM: FTA 0 4-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS— (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T .03050) & N) ® Yes [:]No
:- 15A NCAC 02T.0305(t) contains minimum senarations that shall be nrovided 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-I haters of Class I or
Class II impounded reservoirs used as a source of drinking water
100 feet
** Waters classified WS (except WS-1 or WS-V), B. SA. ORW. I IQW, or SB from normal
high water (or tide elevation) and wetlands (see item IX.2)
50 1eet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Anv 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 pools
10 feet
Final earth grade (vertical)
36 inches
15A NCAC 02T.0305(g) contains alternathes where separations in 02T.0305(f) cannot be achic%ed.
**Stream classifications can be identified using the Division's NC Surface Water Classifications wch age
If noncompliance with 02T.0305(l) or (1 see Section X of this application
2. Does Elie project comply with separation requirements for wetlands? (50 feet ofseparation) ® 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 ❑ NfA
This would include Trout Buffered Streams per 15A NCAC 213.0202
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 02'f,0105(c)(6) (additional permitsicertifications)? ® Yes ❑ No
Per 15A NCAC 027'.0105(c)(6), 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
Ifyes, 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 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply %%ith 15A NCAC 02T, the Minimum Design Criteria fir the Permitting of Pumn Stations
and Force Mains (latest version). and the Gra-,itN Se%Ncr Minimum Design Criteria latest %ersion as applicable?
® Yes ❑ No
If No. complete and submit the Variance`Alternati%a Design Request application (VADC 10-14) and supporting documents for
review. Annroval orthe re uest is reuired Prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
I Wyatt Bone attest that this application for
(Professional Engineer's name from Application Item 111.1.)
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 %%ith the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest.er3ion), 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
ha%ajudged it to be consistent with the proposed design.
NOTE — In accordance +pith General Statutes 143-215-6A and 143-215.68. any person who kno%%ing]} makes any false
statement, representation, or certification in am 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 $23,000 per violation.
North Carolina Professional Engineer's seal, signature, and date:
Applicant's Certification per I5A NCAC 02T .0106(b).
John Poteat, Utilities Director
(Signature Authority's name & title from Application Item 1.3,)
attest that this application for
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 are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge sy stem to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injuncti%c relief, and/or criminal prosecution. 1 %vill make no claim against the Division of Water Resources should a condition
of this permit be violated. 1 also understand that if all required parts of this application package are not completed and that if
all required supporting infon-nation and attachments are not included, this application package «ill be returned to me as
incomplete.
NOTE — In accordance with General Statutes 143-215,6A and a1.1-215,6Q. any person %rho knowingly makes ann 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: 6-17-20
!'ORNI: FTA 04-16 Page 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Eagles Enterprises
Project Name for which flow is being requested: Pittsboro Eagles "
Afore than one FTSE may he requiredfor a single project if the moner of the WPVTP is oat responsible for al! pump
stations along the route of the proposed tuastovater. flog.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Town of Pittsboro WWTP
b. WWTP Facility Permit #: NCO020054
All flaws are its MGD
c. WWTP facility's permitted flow 0.75
d. Estimated obligated flow not yet tributary to the WWTP 0.211
e. WWTP facility's actual avg. flow 0.45
f. Total flow for this specific request 0.006875
g. Total actual and obligated flows to the facility 0.661
h. Percent of permitted flow used 88°}o
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 Pump Average Approx. Not Yet Total Current
Station Station firm Daily Flow** Current 7'ributan Floe Plus
(Name or Permit Capacity, * (Firm / pf). A%g. Daih Drily Flow. Obligated A,.uilable
Number) No. MG6 MGD Floe, MGD MGD Flow Capacity***
* The Firm Capacity (design flow) 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
(pf) not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
*** 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): Town of Pittsboro WWTP
Downstream Permit Number: NCO020054
Page 1 of 6
FTSE 10-18

III. Certification Statement:
1 John Poteat 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 1 and II plus all attached planning assessment addendums for which 1
am the responsible party. Signature of this form certifies that the receiving collection system or treatment
works has adequate capacity to trainport and treat the proposed new wastewater.
St" ring Of cial Signature
Title of Signing Official
..._ Dale ---__.
Page 2 of G
FTSE 10-18

PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum for each pump station listed in Section H where Available Capacity is <
0.
Pump Station (Name or Number):
Given that:
a. The proportion and amount of Obligated, Not Yet Tributary Daily Flow (C) accounts for
% and _ MGD of the Available Capacity (E) in Pump Station
and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately
MGD per year; and that
c. A funded Capital Project that will provide the required planned capacity, namely
is in design or under construction with
planned completion in ; and/or
d. The following applies:
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to allow
this flow to be permitted, without a significant likelihood of over -allocating capacity in the system
infrastructure.
I understand that this does not relieve the collection system owner from complying with G.S. 143-
215.67(a) which prohibits the introduction of any waste in excess of the capacity of the waste disposal
system.
Si.�W!uI41,�zicial Signature
Page 3 of 6
Date
1~TSE 10-18

Instructions for Flow Tracking form (FTSE) and Planning Assessment Addendum (PAA)
Section
a. WWTP Facility Name: Enter the name of the WWTP that will receive the wastewater flow.
b. WWTP Facility Permit #: Enter the NPDES or Non -Discharge number for the WWTP receiving tite
wastewater flow.
c. WWTP facility's permitted flow. MGD: From WWTP owner's NPDES or Non -Discharge permit.
d. Estimated obligated flow not yet tributary to the WWTP, MGD: This includes flows allocated to other
construction projects not yet contributing flow to the collection system. Flows allocated through interlocal
agreements or other contracts not yet contributing flow to the collection system are also included. For POTWs
that implement a pretreatment program, include flows allocated to industrial users who may not be using all of
their flow allocation. Please contact your Pretreatment Coordinator for information on industrial flow tributary
to your WWTP.
As of January 15, 2008 the POTW should have reviewed flow allocations made over the last two years and
reconciled their flow records, to the best of their ability, so it is known how much flow has been obligated and
is not yet been made tributary to the WWTP, in accordance with local policies and procedures employed by the
reporting entity.
e. WWTP facility's actual avg. flow, MGD: Previous 12 month average.
f. Total flow for this specific request. MGD: Enter the requested flow volume.
g. Total actual and obligated flows to the facility. MGD Equals [d + e + f]
h. Percent of permitted flow used: Equals [(g c)* 100]
For example:
On January 15 a POTW with a permitted flow of 6.0 MGD, reported to the Regional Office that there is 0.5
MGD of flow that is obligated but not yet tributary. The annual average flow for 2007 is 2.7 MGD. There is a
proposed flow expansion of 0.015 MGD.
The first Form FTSE submitted after January 15, 2008 may have numbers like this:
c. = 6.0 MGD
d. = 0.5 MGD
e. = 2.7 MGD
f. - 0.015 MGD
g. = 3.215 MGD
h. = 53.6 %'
The next Form FTSE may be updated like this with a proposed flow expansion of 0.102 MGD:
c.=6.0 MGD
d. = 0.515 MGD
e. = 2.73 MGD
f = 0.102 MGD
g. = 3.349 MGD
h. = 55.8 %
Each subsequent FTSE form will be updated in the same manner.
Page 4 of 6
FTSE 10-18

Section 11
List the pump station name or number and approximate pump station firm capacity, approximate design average
daily flow (A) approximate current average daily flow (B), and the obligated, not yet tributary flow through the
pump station (C) for each pump station that will be impacted by the proposed sewer extension project. Calculate
the total current flow plus obligated flow (D=B+C) and the available capacity (E=A-D). Include the proposed flow
for this project with other obligated flows that have been approved for the pump station but are not yet tributary
(C).
Firm capacity is the maximum pumped flow that can be achieved with the largest pump out of service as per the
Minimum Design Criteria.
Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pf) of not less than
2.5.
If the available capacity (E) for any pump station is { 0, then prepare a planning assessment for that pump station
if the system has future specific plans related to capacity that should be considered in the permitting process.
(A)
(B)
(C)
(D)=(B+C)
(E)=(A-D)
Obligated,
Design
Approx.
Not Yet
Total Current
Firm
Average
Current Avg.
Tributary
Flow Plus
Pump Station
Capacity
Daily Flow
Daily Flow,
Daily Flow,
Obligated
Available
(Name or Number)
MGD
(Firm r' pf)
MGD
MGD
Flow
Capacity*
Kaw Creek PS
0.800
0.320
0.252
0.080
0.332
-0.012
Valley Road PS.,
1.895
0.758
0.472
0.135
0.607
0.151
Page 5 of 6
FTSE 10-18

Plannint3 Assessment Addendum Instructions
Submit a planning assessment addendum for each pump station listed in Section I1 where available capacity is < 0.
A planning assessment for Kaw Creek PS (see example data above) may be performed to evaluate whether there is
significant likelihood that needed improvements or reductions in obligated flows will be in place prior to activating
the flows from the proposed sewer extension project.
If the system decides to accept the flow based on a planning assessment addendum, it is responsible to manage the
flow without capacity related sanitary overflows and must take all steps necessary to complete the project or control
the rate of flow to prevent sanitary sewer overflows.
The planning assessment may identify a funded project currently in design or construction, or a planned project in
the future not yet funded but in a formal plan adopted by the system. The system should carefully weigh the
certainty of successful timely project completion for any expansion, flow management diversion or infiltration and
inflow elimination projects that are the foundation of a planned solution to capacity tracking and acceptance
compliance.
For example:
Given that:
a. The proportion and amount of obligated, not yet tributary flow accounts for 24 % and 0.080 MGD of the
committed flow in Pump Station Kaw Creek; and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately 0.01 MGD
per year; and that
c. A funded capital project that will provide the required planned capacity, namely
is in design or under construction with planned
completion in ; and/or
d. The following applies:
The master vlan and ten year capital plan contain recommended scope and funding for a capital vropect entitled
Kaw Creek Pump Station upgrade with funding planned in July 2014. This Project is planned to add 0.100 MGD
to the firm car)acily of the pump station by October 2015. Inclusion of this proposed capital projectas a condition
of this Flow Track inarAccentance for Sewer Extension Pen -nit elevates this project's priority for
fundina and construction to be implemented ahead of the activation of obligated, not yet tributa flaws in amounts
that exceed the firm numn station capacities identified in Section II above.
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to allow this flow
to be permitted, without a significant likelihood of over -allocating capacity in the system infrastructure.
Page 6 of 6
FTSE 10-18

H L E #
BOHLER ENGINEERING NC, PLLC
NCDEQ — Water Quality
1628 Mail Service Center
Raleigh, NC 27699
Rg�: Eagles Gas Station
165 East Street
Pittsboro, NC 27312
Chatham County
BE # NCR192034
NCDEQ Water Quality:
4130 Parklike Avenue, Suite 130
Raleigh, NC 27612
PHONE [phone]
Date: 6:` 17 2020
The included package is a resubmitial for the "Pittsboro Eagles Main Relocation" for review and
approval. The subject site is located at 165 East Street in Pittsboro NC. Currently the site is vacant and the
project is a proposed Eagles gas station with accompanied parking, utilities, and stormwater system.
Specifically, the proposed project has a sewer extension on to an existing 12" sewer line on East Street
with a proposed doghouse manhole. This new 12" line is relocating an existing 12" line that goes under
the proposed building and is being abandoned. The total wastewater generated from the site, including 8
service stations and 1 carwash is 6,875 GPD.
Included in this package is the following:
• Fast track Sewer System Extension Application
• Flow Tracking for Sewer Extension Application
• Aerial Map of Site
• USGS Topo Map
• Utility Plan Set Pages
Should you have any questions regarding this project or require additional information, please do not
hesitate to contact me at [phone].
Sincerely,
Wyatt Bone, P.E►
Bohler Engineering NC PLLC
CIVIL AND CONSULTING ENGINEERS • PROJECT MANAGERS • SURVEYORS • ENVIRONMENTAL CONSULTANTS
• LANDSCAPE ARCHITECTS
WWW.BOHLERENGINEERING.COM

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Robinson, Jason
From: Wyatt Bone <wbone@bohlereng_com>
Sent: Thursday, June 18, 2020 7:47 AM
To: Vinson, Scott; Ryan Gallagher; John Poteat
Cc: ncr192034@nf,bohlereng.com; Deck, Erin M; Cashion, Ted; Manuel, Vanessa; Robinson,
Jason
Subject: RE: [External] RE: Resubmittal still missing information-Pittsboro Eagles Main Relocation
r. a email"Da~d not idliGk:.linit5 or open afhachtt we unless you verify. Send all suspraious email as an attac m to �
e a rr v ..�. �__
Scott,
Please accept our apologies. I am truly hat in hand on this one. I take your feedback to heart and will heed it. We
appreciate your staffs patience and apologize for the back and forth. We view you and other regulatory agencies as
valuable development partners. Thank you.
Wyatt Bone, P.E., LEED AP BD+C
Project Manager
Bohler Engineering NC, PLLC
4130 Parklake Ave, Suite 130
Raleigh, NC 27612
o 919-578-9000 / c 919-717-2163 / [e-mail]
Check out our new website [bohlerengineerini~.com]
Confidentiality Note: This e-mail, and any attachment to it, contains confidential information intended only for the use of the designated recipients,
which information may also be privileged. if the reader of this e-mail is not the intended recipient, the document has been received in error and any
use, review, dissemination, distribution, disclosure or copying of this message is strictly prohibited. if you have received this e-mail in error, please
notify the sender via reply e-mail and immediately delete this e-mailfrom your system.
From: Vinson, Scott <[e-mail]>
Sent: Thursday, June 18, 202012:08 AM
To: Ryan Gallagher <[e-mail]>; John Poteat <[e-mail]>; Wyatt Bone
<[e-mail]>
Cc: [e-mail]; Deck, Erin M <[e-mail]>; Cashion, Ted <[e-mail]>;
Manuel, Vanessa <[e-mail]>; Robinson, Jason <[e-mail]>
Subject: RE: [External] RE: Resubmittal still missing information-Pittsboro Eagles Main Relocation
EXTERNAL: Use caution with attachments and links.
Ryan & Wyatt,
It is imperative that these Fast Track permitting applications are submitted complete, with all items addressed on the
first submittal if at all possible. In the future, please provide the utmost QA/QC when reviewing these prior to
submittal. The extra time spent by staff going back and forth and having to review the information again and again

creates a backlog, lengthens the review times for other applications and prevents staff from addressing other important
issues. If there are questions regarding the projects, please try to address these with staff prior to submittal to aid with
processing turnaround time after the applications are submitted. Thank you for your consideration of these matters and
of our staffs time.
Sincerely,
Scott Vinson
Regional Supervisor
Raleigh Regional Office
Water Quality Regional Operations Section
NCDEQ — Division of Water Resources
3800 Barrett Drive
Raleigh, NC 27609
[phone] office
[phone] direct line
Email: Scott.Vinson(@ncdenr.nov
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties
From: Robinson, Jason <"ason.t.robinson ncdenr. ov>
Sent: Wednesday, June 17, 202011:54 AM
To: Ryan Gallagher <Egallagher@bohlereng com>; John Poteat <i.poteat pittsboronc.gov>
Cc: ncr192034CcDnf.bohlerene.com; Wyatt Bone <[e-mail]>; Deck, Erin M <[e-mail]>;
Cashion, Ted <[e-mail]_v>; Manuel, Vanessa <[e-mail]>; Vinson, Scott
<[e-mail]>
Subject: RE: [External] RE: Resubmittal still missing information-Pittsboro Eagles Main Relocation
Ryan/Wyatt/John,
This is our third review of a sealed application. It is still missing information.
1. Item IX.1 is not checked.
2. The applicant's name and signature were left blank (Item X.3)
Please complete the application, and make sure that all sections are complete. When re -submitting, please include all
required items, including the FTA Form, FTSE form, narrative and both maps.
------------
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 Ugdates**
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law 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.
From: Ryan Gallagher imailto:reailaeher(@bohlereng.coml
Sent: Tuesday, June 16, 2020 2:17 PM
To: Robinson, Jason <iason.t.robinsonccDncdenr.sov>
Cc: ncr192034 nf.bohleren .com; Wyatt Bone <[e-mail]>
Subject: RE: [External] RE: Resubmittal still missing info rmation-Pittsboro Eagles Main Relocation
Epaernal email. Do not-diiek.links- or open atta mehU utffess youverifV. Send all suspicious email as an a ahnaenSto
re�art.sflacn �r�c,go+�..,� L
Jason,
Attached are the revised applications and project narrative, please let us know if there are any additional items needed.
Thank you,
Ryan
From: Robinson, Jason <iason.t.robinsonAncdenr.eov>
Sent: Friday, June 12, 2020 2:16 PM
To: Ryan Gallagher <rgallaeher(@bohlerene.com>
Cc: ncr192034CcDnf.bohlereng.com; Wyatt Bone <wbone bohleren .com>; Deck, Erin M <erin.deckpncdenr.eov>;
Cashion, Ted <ted.cashionCZDncdenr.eov>
Subject: RE: [External] RE: Resubmittal still missing information-Pittsboro Eagles Main Relocation
EXTERNAL: Use caution with attachments and links.
Thanks Ryan, this seems to address our questions in my 5/28 email below (a-c).
We'll need a new application that addresses items 1-6 in that same email.
The narrative should also be revised to explain the situation ,that this new 12" is relocating an existing 12" that goes
under the proposed building and is being abandoned. if possible, we'd want to know the original permit number for
that 12", and we'd issue a revised a permit. But more than likely, since that appears to be an outfall to the treatment
plant, it's probably pretty old and it may be difficult to determine the original permit number. And if that's the case,
we'd issue a new permit for this relocation.
Please let us know if you have any questions.
-Jason
------------
Jason T. Robinson, P.E.
Raleigh Regional Office
Water Quality Regional Operations
3

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 Law 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.
From: Ryan Gallagher mailto:r alla her bohleren .com]
Sent: Thursday, June 11, 2020 12:59 PM
To: Robinson, Jason <'ason.t.robinson ncdenr. ov>
Cc: ncr192034 nf.bohleren .com; Wyatt Bone <wbone@bohlerene_com>
Subject: [External] RE: Resubmittal still missing information-Pittsboro Eagles Main Relocation
Uterno email. Do notdlickrlinks or open attachments uniessyou vern. Send'all suspicious edrail as-an-attathmentto
Vewgo s v .. _ —J
Jason,
We haven't been able to get a hold of John but we spoke to the previous town engineer and he confirmed with us that
the traffic circle down shown below was all gravity line.
Thank you,
Ryan
From: Ryan Gallagher
Sent: Wednesday, June 3, 20201:43 PM
To: Robinson, Jason <[e-mail]>
Cc: ncr192034 nf.bohleren .com; Cashion, Ted <[e-mail]>; Deck, Erin M <[e-mail]>;
Vinson, Scott <[e-mail]>; Manuel, Vanessa <[e-mail]>; Wyatt Bone

<wbone@bohlereni;.com>
Subject: RE: Resubmittal still missing information-Pittsboro Eagles Main Relocation
Jason,
We are working on getting an answer from Pittsboro on part A. For part B, yes there was an existing service. It is being
demoed/abandoned and a new main is being constructed. I've attached the utility plan with the note boxed for the
existing service for clarity. For part C, we are relocating an existing main which was under the footprint of the new gas
station. Accordingly this application is for the main relocation to an area of the site outside the proposed building
footprint. There is additionally a 4" sewer line that runs to the car wash.
Thank you,
Ryan
From: Robinson, Jason <[e-mail] >
Sent: Thursday, May 28, 202011:35 AM
To: Wyatt Bone <[e-mail]>; John Poteat <' Po tea t Pitts boronc. ov>
Cc: ncr192034 nf.bohleren .com• Cashion, Ted <[e-mail]>; Deck, Erin M <[e-mail]>;
Vinson, Scott <[e-mail]>; Manuel, Vanessa <vanessa.manuel ncdenr.gov>; Ryan Gallagher
<rgallaeher(Mbohlereng com>
Subject: RE: Resubmittal still missing information-Pittsboro Eagles Main Relocation
Importance: High
EXTERNAL Use caution with attachments and links.
Mr. Bone & Mr. Poteat,
We are reviewing the revised application that was recently submitted, and there are still numerous issues with it:
1. Section 11.1 on the application (FTA) is marked as "Existing", but there is no permit number provided. Is
this a rehab/replacement of an existing line? Or is it new (The original submittal stated it was
"Proposed/New Permit").
2. Please provide the downstream sewer information in Section V. (this doesn't need to be submitted only
if the proposed project will be tied directly into the WWTP, and not into existing lines)
3. Item VI.1 was not completed.
4. IV-4 only has "Retail w/ food" checked, but the flow calcs also show a car wash, so "Car Wash" should be
checked too.
5. VI.7 provides a flow for the car wash that was provided by the client, and states it exceeds the 2T
Rules. Either calcs showing that the proposed design flow exceeds the 2T Rules should be provided, or
the data where the proposed flow was calculated should be provided with the app.
6. On the flow Tracking Sheet (FTSE), the information at the bottom of page 1 should be complete
(Downstream Facility Name and Permit Number)
And a few other questions:

a) The FTSE doesn't show any downstream pump stations in Item II. Please
confirm that there are no downstream pump stations, and the receiving system
flows directly to the WWTP via gravity.
b) The aerial map that was provided shows that there is/was an existing building
on this site. Was there existing sewer that served this building?
c) The application proposes a 12" sewer to serve this gas station. This
proposed line seems to only serve the gas station, and it would seem
that an 8" would be capable of doing this. Please explain why a 12" line
is being proposed to serve this gas station. Will minimum scouring
velocity be able to be achieved with the relatively low flow?
Please first respond to questions a-c above. Once we work through
those questions (a-c), a new application (FTA & FTSE) addressing Items
1-6 above will need to be resubmitted with new signatures from the
applicant and the engineer. In the future, please make sure the
application is complete and accurate before signing/sealing/submitting.
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 Law 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.
From: Ryan Gallagher <r alla her bohleren .com>
Sent: Wednesday, May 27, 2020 3:36 PM
To: Deck, Erin M <[e-mail]>
Cc: ncr1920342nf.bohleren .c�om; Wyatt Bone <wboneRbohlerene.com>
Subject: RE: [External] RE: Fast Track Sewer Extension Application-Pittsboro Eagles Main Relocation
• rnal email. Do notclick links or open -attachments unlessyou verify -Send all suspicious.erriall as an attachmentto
e -s a

Erin,
My apologies, attached are the revised application, aerial map, and USGS map.
Thank you,
Ryan
From: Deck, Erin M <erin.deck@ncdenr.g-ov>
Sent: Wednesday, May 27, 2020 3:27 PM
To: Ryan Gallagher <[e-mail]>
Cc: [e-mail]; Wyatt Bone <[e-mail]>
Subject: Re: [External] RE: Fast Track Sewer Extension Application-Pittsboro Eagles Main Relocation
EXTERNAL Use caution with attachments and links.
You will need to attach as a pdf. We cannot click on drop box links. Thank you
Erin Deck
Department of Environmental Quality
Division of Water Resources
Raleigh Regional Office
919-791-4200
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed
to third parties.
From: Ryan Gallagher <rsallagher@boh,lerene.com>
Sent: Wednesday, May 27, 2020 3:20:32 PM
To: Deck, Erin M <[e-mail]>
Cc: [e-mail] <[e-mail] com>; Wyatt Bone <wbone bohleren .com>
Subject: [External] RE: Fast Track Sewer Extension Application-Pittsboro Eagles Main Relocation
External email. Do not click links or open attachments unless you verify. 5end'aIl sdspieious ennail:m anan atlachmentto
g2art.saam O nc ar c v
_ ._- _ - _ _ J
Erin,
Here is all of the revised applications and additional information requested for the Fast Track Sewer Extension
Application.
Download all associated files [infoex.bohlereng.nctl
Thank you,
Ryan
From: Deck, Erin M <[e-mail]>
Sent: Friday, May 15, 202012:13 PM

To: Wyatt Bone <[e-mail]>; John Poteat <[e-mail]>
Subject: Fast Track Sewer Extension Application-Pittsboro Eagles Main Relocation
EXTERNAL- Use caution with attachments and links.
Good Afternoon,
As per our discussion, I am returning the attached application as multiple sections were not completed/left blank and in
consistent with other information that was provided. Please also mark the site location on the USGS topo map and
submit the street level as required in the general instructions section F.
You can re -submit the completed application to me via email. Both the engineer and the applicant will need to approve
the changes- this can be done with an email from the applicant saying they agree to the changes.
Thank you,
Erin Deck
Department of Environmental Quality
Division of Water Resources
Raleigh Regional Office
Office: 919-791-4258
<image001.png>
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed
to third parties.
a