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WQ0029942_Return Application_20060607
r- n_ a Postage $ T O :3 Certified Fee 9 Postmark Return Receipt Fee Here TI (Endorsement Required) f �� =1 Restricted Delivery Fee :3 (Endorsement Required) 7 Total Postage & Fees 4. q' Is J1 Sent To ti--------------- a ae------ l-3re----------------------------------------- Street, APt. No.; aaff�-� -- PO Box No. V �--- --- �J------- • --_I--D--'_-^! F I 5.2V ----- City, Sta ZIP+4 ti'C 'ertified Mail Provides: A mailing receipt . ► III A unique identifier for your mailpiece A signature upon delivery A record of delivery kept by the Postal Service for two years mportant Reminders. Certified Mail may ONLY be combined with First -Class Mail or Priority Mail. Certified Mail is not available for any class of international mail. NO INSURANCE COVERAGE IS PROVIDED with Certified Mall. Fol valuables, please consider Insured or Registered Mail. For an additional fee, a Return Receipt may be requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Returr Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mailpiece 'Return Receipt Requested". To receive a fee waiver foi a duplicate return receipt, a USPS postmark on your Certified Mail receipt ie required. For an additional fee, delivery may be restricted to the addressee of addressee's authorized agent. Advise the clerk or mark the mailpiece with the endorsement "Restricted Delivery". If a postmark on the Certified Mail receipt is desired, please present the arti• cle at the post office for postmarking. If a postmark on the Certified Mai receipt is not needed, detach and affix label with postage and mall. MPORTANT. Save this receipt and present it when making an inquiry. IS Form 3800, January 2001 (Reverse) 102595-01-M-1041 UNITED I I E IE Q,�TA Ry?E g n ...t.:k':^0.::aL..At-�i ����.t�a.,i1,. u151 t • fly, IT 2P_".I t. ` Sender: Please print your name, address, and ZIP+-4"irrtTN box • �ra y Ctw cUL, %��, o�83UI- 5Ug3 ■ Complete items 1, 2, and 3. Also complete A i nature 0 Agent Item 4 if Restricted Delivery is desired. X iQm r1 l �� ❑Addressee ■ Print your name and address on the reverse so that We can return the Card to you. B. Received by (Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1.Article Addressed to: / WQUiXR� � L[-�U �pAtC Po �CqL i3�g LW,*V,",, nc- D. Is del very diffexeM irolt� 1 ❑ Yes If YES, ent �4Bfiv address beb ❑ No r 1 A 3. Service Type Certified Mail ❑ Express Mail Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7001 2510 0003 8089 1759 (liar►ster from service /abeQ nn r-- 404 i -_.__. nnnw' • �O� W ATFgQ Michael F. Easley, Governor �Q G William G. Ross Jr., Secretary r North Carolina Department of Environment and Natural Resources Y Alan W. Klimek, P.E., Director Division of Water Quality June 7, 2006 CERTIFIED MAIL/RETURN RECEIPT REQUESTED Wayne Horne, Town Manager City Of Lumberton 501 East 5th Street Lumberton, NC 28358 Subject: Return of Permit Application Package Application Number WQ0029942 Hornet Road Sanitary Sewer Wastewater Collection System Extension Robeson County Dear Mr. Horne: This letter is in reference to your permit application received on March 3, 2006 for the construction and operation of the subject wastewater collection system extension. In a letter dated April 12, 2006, Marie Doklovic of the Division asked for additional information when resubmitting the application to the region(copy of letter attached). Several questions surrounded the use of a 12-inch line for the low flow to be allocated. There was no mention of a variance request at the time. No further supporting information was provided as requested. As of today, this information has not been received. Therefore, the Division cannot evaluate a variance to the regulations and design criteria and thus cannot issue the permit. We are returning your application as incomplete in accordance with North Carolina General Statute §143-215.1. Unfortunately in this case, the application fee cannot be refunded. Please be advised that construction and/or operation of wastewater collection system without a valid permit is a violation of North Carolina General Statute §143-215.1 and may subject the owner/operator to appropriate enforcement actions in accordance with North Carolina General Statute §143-215.6A-6C. Civil penalties of up to $25,000 per day per violation may be assessed for failure to secure a permit required by North Carolina General Statute §143-215.1. One Fayetteville Regional Office Internet http:i-www.ncwaterquality.org NorthCarolina 225 Green Street, Suite 700, Fayetteville, NC 28301-5043 An Equal Opportunity Action Employer Naturally Telephone (910) 486-1541 Fax (910) 486-0707 50% recycled'10% post -consumer paper Mr. Horne Page 2 of 2 Enclosed are any unmarked permit application documents. When you have obtained the requested information that is needed to make your application package complete, you may submit a new application package and appropriate permit processing fee. If you have any questions or comments concerning this matter, please contact Trent Allen at (910) 486-1541 or Marie Doklovic at 919-733-5083 x 371, or via E-mail at trent.allen@ncmail.net or marie.doklovic@ncmail.net respectively. Sincerely, &&C4) 41 OYO Alan W. Klimek, P.E. Enclosures cc; Marie Doklovic, PERCS Unit Larry Anderson, PE, President Anderson Engineering & Associates,PA Permit Application File WQ0029942 # 0�0� WA7' Michael F. Easley, Governor William G. Ross Jr., Secretary ,i - North Carolina Department of Environment and Natural Resources > =a O < Alan W. Klimek, P.E., Director Division of Water Quality April 12, 2006 Larry W. Anderson, PE, President Anderson. Engineering & Associates, PA PO Box'1736 Ly erton, NC 28359 Subject: Application No. WQ0029942 Additional Information Request Hornet Road Sewer Wastewater Collection System Extension Robeson County Dear Mr. Anderson: The Pretreatment, Emergency Response and Collection Systems (PERCS) Unit has been forwarded your letter of April 4, 2006 regarding the subject project for review. The Division has been placing increased emphasis on ensuring new sewer projects meet our design standards and regulations as this criteria is believed to be supportive of the environment and public health. The permit application is marked and sealed that the subject project meets our rules and design criteria. It is our understanding that no information such as plans, build -out calculations or support from the City was provided for specifying an oversized line with extremely little expected flow other than the statements in your April 4, 2006 letter. Although older sewers may have been oversized to maintain grade, the Division expects today's sewers to be appropriately designed to minimize odor, corrosion and blockages that can occur with low flow/low depth of flow sewer lines. As you are aware, an 8-inch sewer at minimum grade can handle almost 500,000 gallons per day of flow. If grade cannot be met with the minimum required size, other alternatives than gravity sewer should be evaluated. Currently there is no support as to when or if the collection area for this proposed line would exceed this value. Please further address the following items no later than May 12, 2006. 1. Explain how this project meets 15A NCAC 2H .0219 (i) (2) (B) with regard to velocity. 2. Explain how this project meets our Gravity Sewer Minimum Design Criteria Section III (D)(3) which states, "The pipe diameter and slope shall be selected to obtain the greatest practical velocities to minimize settling problems. Designs must include a minimum scouring velocity of 2 feet per second Sewers shall not be oversized to iustify using flatter slopes. If the minimum scouring velocity can not be maintained during Initial operation prior to the design flow capacities being reached, the ability to periodically flush the system shall be required." It is understood that no variance would be checked if using the minimum required line size of 8-inches. However, requesting two sizes above the minimum for the expected flow should have been noted. 3. The flow calculation for the church in Item (B)(9) does not match our rules. Flow must be calculated by 3 gpd/seat or by 250 gpd/water closet plus any flow from kitchen or daycare faculties, as applicable. One Pretreatment, Emergency Response and Collection Systems Unit Internet http://h2o.enr.nc.state.us/ndpu N�iM Carolina 1617 Mail Service Center, Raleigh NC 27699-1617 An Equal Opportunity Action Employer )Vatmrally Telephone (919) 733-5083 Fax (919) 733-0059 50%recycled/10%post-consumer paper 4. Indicate why the church cannot be served by their own pump station and force main to the public main. The pump station and the force main, if it did not cross other property or travel along a street right of way, would not require a permit if the local building inspector certifies the installation. At a later time, the City could then apply for an extension permit when the upper end of the area develops and the larger line size can be justified. It is expected that all other sewer alternatives that meet the criteria be explored prior to asking for any variance. Please reference the subject application number when providing your response. Two copies of all revised and/or additional documentation should be signed, sealed, dated, and submitted to my attention at the letterhead address. Please note that failure to provide this additional information on or before the above requested date may result in your application being returned as incomplete. The Division has recently reorganized. All sewer related matters are now handled through the Pretreatment, Emergency Response and Collection Systems Unit under the Point Source Branch EXCEPT FOR FAST -TRACK SEWER EXTENSION PERMITTING WHICH CONTINUES TO BE ADMINISTERED THROUGH OUR REGIONAL OFFICES. The Unit is located on the 13th floor of the Archdale building in downtown Raleigh. Please see http://h2o.enr.state.nc.us/documents/dwg orachart.pdf for our new organizational chart. If you have any questions regarding this request, please do not hesitate to contact me at (919) 733- 5083, extension 371 or via E-mail at marie.doklovic@ncmail.net. Thank you for your cooperation. Sincerely, K. Marie Doklovic, PE Environmental Engineer Cc: Trent Allen, Fayetteville Regional Office; Surface Water Protection Section Wayne Home, City of Lumberton (501 E. 5th St., Lumberton, NC 28358) Rob Armstrong, City of Lumberton (501 E. 5th St., Lumberton, NC 28358) Permit Application File W00029942 fRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 3 USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! ` Application Number: W00029942 (to be completed by DWO) 11. Owner. �1a. CITY OF LUMBERTON----------.__..._ __---- -----—_-------_-___-------------___ ------------_------------ i Full Legal Name (company, municipality, HOA, utility, etc.) Z -. _ 0 11 b. WAYNE HORNE CITY MANAGER Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorized signing officials!) --------- - -----.-----..-----.__—..._.------------ ----------------- --- --- ------------ — -- -----...-- ------ - --------- I c. The legal entity who will own this system is: _❑ Individual ❑ Federal ® Municipality ❑ State/County ❑ Private Partnership 0 C_orporation Other (specify): ___ 0 !1d. 501 EAST 5' STREET ile.LUMBERTON Z— Mailing Address E City -- - ------ --- ------ ---- ----- -- -- ---- --- j1f. NORTH CAROLINA 1g. 28358 Z I State Zip Code 0 — h ;1 ~ 910-671-3800 1 i. 910-8671-3814 1 j. ! Telephone 1 Facsimile E-mail tJ .�2. Project (Facility) Information: J _ Via. O ROAD SANITARY SEWER b. ROBESON CL CL Brief Project Name (permit will refer to this name) County Where Project is Located Q 3.. Contact Person: Q. 13a. LARRY W. ANDERSON P.E. ANDERSON ENGINEERING & ASSOC. PA Name and Affiliation of Someone Who Can Answer Questions About this Application b. 910-671-9530 andersonftcarolina.riet E-mail Phone Number 1. Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.: For modifications, attach a separate sheet clearly explaining the reason for the modification (i.e. adding another phase, changing line sizellength, eta). Only include the modified information in this permit application - do not duplicate project information in B(7) and B(10-11) that has already been included in the original permit 12. Owner is ® Public (skip to Item B(3)) ❑ Private (go to Item 2(a)) a. If private, applicant will be: I J 2b. If old, facilities owned by a (must choose ne ❑ Retaining Ownership (i.e. store, church, single office, etc.) or ❑ Public Utility (Instruction III) Z ❑ Leasing units (lots, townhomes, etc. - skip to Item B(3)) ❑ Homeowner AssocJDeveloper (Instruction IV) Q ; ❑Selling units (lots, townhomes, etc. - go to Item B(2b)) i'- 3 CITY OF LUMBERTON '� Owner of Wast�ter Treatrrant Fari�iry rwu►rrc� r......:.....��.........--.•-_ �__-- n. ., ._._ _. CITY OF LUMBERTON GENERAL ACCOUNT P.O. BOX 1388 LUMBERTON, N.C. 28359 PAY ****400 DOLLARS AND NO CENTS**** F PAY NCDENR TO THE DIVISION OF WASTE MANAGEMENT ORDER 1637 MAIL SERVICE CENTER OF RALEIGH, NC 27699-1G37 BRANCH BANKING AND TRUST COMPANY LUMBERTON. NC 28358 66-112/531 Void if not cashed in 120 days of issue date. FEB 10.2006 139339 139339 $400.00 THIS INSTRUMENT HAS BEEN PREAUDITED IN THE MANNER REQUIRED BY THE LOCAL GOVERNMENT BUDGET AND FISCAL CONTROL ACT. t. s CE DIRECTOR CITY MANAGER M•• nnlnl T___ •1 AA/AG PAY ****400 DOLLARS AND NO CENTS**** PAY NCDENR TO THE DIVISION OF' WASTE MANAGEMENT ORDER 1637 'WAIL SERVICE CENTER OF RALEIGH, NC 27699-1637 FEB 10.Z006 139339 6400.00 THIS INSTRUMENT HAS BEEN PREAUDITED IN THE MANNER REQUIRED BY THElOCAL G©AMMENt BUDGET AND FISCAL CONTROL ACT ,....,......wz �;•. oe IRECTOA elk ITY MANAGER - V 1 FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 1 OF WATF9 State of North Carolina O� pG Department of Environment and Natural Resources r Division of Water Quality FAST -TRACK APPLICATION folj"TY SEWERS, PUMP STATIONS, AND FORCE MAINS V V (Pressure sewers systems are not to be included as part of this application package) INSTRUCTIONS: Indicate that you have included/addressed the following list of required application package items by checking the space provided next to each applicable item. Failure to submit all required items will lead to your application being returned as incomplete. This form may be photocopied for use as an original. ® I. Application Form - Submit one original and one copy of the completed and appropriately executed application form. Any changes to this form will result in the application being returned. The Division of Water Quality (Division) will only accept application packages that have been fully completed with all applicable items addressed. You do not need to submit detailed plans and specifications unless you respond NO to Item B(12). oil. Application Fee - Submit a check in the amount of $400 made payable to: North Carolina Department of Environment and Natural Resources (NCDENR). Checks shall be dated within 90 days of application submittal. ❑ III. Certificates of Public Convenience and Necessity — If the application is being submitted in the name of a privately -owned public utility, submit two copies of the Certificate of Public Convenience and Necessity (CPCN) which demonstrates that the public utility is authorized to hold the utility franchise for the area to be served by the sewer extension. If a CPCN has not been issued, provide two copies of a letter from the North Carolina Utilities Commission's Public Staff that states that an application for a franchise has been received, that the service area is contiguous to an existing franchised area, and/or that franchise approval is expected. The project name in the CPCN or letter must match that provided in Item A(2a) of this application. ❑ IV. Operational Agreements — Submit one original and two copies of a properly executed operational agreement if the sewer extension is permitted by a private applicant and will be serving residential or commercial lots (e.g., houses, condominiums, townhomes, outparcels, etc.) that will be sold to another entity. If the applicant is a homeowners' association, use Form HOA 02/03. If the applicant is a developer, use Form DEV 02/03. EVEN IF THE PROJECT WILL BE TURNED OVER TO A MUNICIPALITY, FORM DEV 02/03 IS REQUIRED. ❑ V. Flow Acceptance Letters — If the owner of the downstream sewers and/or WWTF is different from the applicant, submit two copies of a flow acceptance letter from the owner of the downstream sewers and WWTF, if different. Flow acceptance letters must contain the following minimum information: applicant and project name, amount of flow accepted, and name and permit number of the receiving sewers/WWTF. The flow acceptance must not expire prior to permit issuance and must be dated less than a year prior to the application date. Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific flow acceptance letter. ® A. Map — Submit an 8.5-inch by 11-inch COLOR copy of the portion of a 7.5-minute USGS Topographic Map along with this form. The map should identify the entire project area location as well as the closest downslope surface waters as clearly as possible. Each map portion must be labeled with the map name and number, the identified location of the sewer line and pump stations, and be of clear and reproducible quality. For instance, if the project involves 4 miles of interceptor sewer that traverses over or near several different waterbodies (or counties, basins, etc.), the map should have location ID's shown for each different waterbody (where the sewer line is within 100 feet of such waterbody - see Instruction VII). This location ID is self chosen and used to cross reference the location in Section C of the permit application. ® VII. Stream Classifications — Section C • If any portion of the project is within 100 feet of any down slope surface water, Section C must be completed for the pertinent sections. • If the entire project area is a minimum of 100 feet away from any down slope surface waters BUT there is a pump station involved where a history of power outage is to be used to provide adequate design storage instead of dual feed or permanent or portable generator, Section C must be completed to demonstrate that the closest down slope surface water is Class C (see 15A NCAC 2H .0219(h)(3)(D)). • Use the guidance document entitled, "Determining Watershed Classifications for Form FTA 02/03 (Fast -Track Sewer Systems)" available from http://h2o.enr.state.nc.us/peres or by contacting the appropriate regional office. FTA 02/03 - Rev. 3 04/05 FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 2 ❑ Vill. Environmental Assessments — If this project is subject to an Environmental Assessment (EA) [15A NCAC 01C], this application can not be used. Send the project application on Form PSFMGSA 10/99 to the PERCS Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. Applications can not be accepted until a Finding of No Significant Impact (FONSI) or Environmental Impact Statement (EIS) has been issued. A copy is to be submitted with that permit application. ® IX. Certifications — Section D The application must be certified by both the applicant and a North Carolina Registered Professional Engineer (PE). The applicant signature must match the signing official listed in Item A(1 b). The PE should NOT certify the application if he/she is unfamiliar with 15A NCAC 2H .0200, the Gravity Sewer Minimum Design Criteria (most recent version) and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains (most recent version), as applicable to the project. Certification by a PE who is unfamiliar with these documents is subject to NC Board referral. ® X. Downstream Sewer & Wastewater Treatment Plant Capacity The applicant has assured downstream pipe, pump station and treatment plant capacity. The addition of new sources of wastewater from this project has been evaluated along the route to the receiving treatment plant. The flow from this project. will not cause capacity related sanitary sewer overflows or overburden any downstream pump station en route to the receiving wastewater treatment plant. - If the applicant is not the owner of the downstream sewer or receiving treatment plant, submittal of flow acceptance letter(s) indicates that owner has adequate capacity and will not violate G.S. 143-215.67(a). THE COMPLETED FTA 02/03 APPLICATION PACKAGE, INCLUDING ALL SUPPORTING DOCUMENTS AND $400 FEE, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE REGIONAL OFFICE ADDRESS COUNTIES SERVED Asheville Regional Office 2090 US Highway 70 Avery, Buncombe, Burke, Caldwell, Swannanoa, North Carolina 28778 Cherokee, Clay, Graham, Haywood, (828) 296-4500 Henderson, Jackson, Macon, Madison, (828) 299-7043 Fax McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Yancey Fayetteville Regional Office 225 Green Street Suite 714 Anson, Bladen, Cumberland, Harnett, Fayetteville, North Carolina 28301 Hoke, Montgomery, Moore, Robeson, (910) 486-1541 Richmond, Sampson, Scotland (910) 486-0707 Fax Mooresville Regional. Office 610 E. Center Avenue, Suite 301 Alexander, Cabarrus, Catawba, Mooresville, North Carolina 28115 Cleveland, Gaston, Iredell, Lincoln, (704) 663-1699 Mecklenburg, Rowan, Stanly, Union (704) 663-6040 Fax Raleigh Regional Office 1628 Mail Service Center Chatham, Durham, Edgecombe, Franklin, Raleigh, North Carolina 27699-1628 Granville, Halifax, Johnston, Lee, Nash, (919) 571-4700 Northampton, Orange, Person, Vance, 019 571-4718 Fax Wake, Warren, Wilson Washington Regional Office 943 Washington Square Mall Beaufort, Bertie, Camden, Chowan, Washington, North Carolina 27889 Craven, Currituck, Dare, Gates, Greene, (252) 946-6481 Hertford, Hyde, Jones, Lenoir, Martin, (252) 975-3716 Fax Pamlico, Pasquotank, Perquimans, Pitt, Tyrrell, Washington, Wayne Wilmington Regional Office 127 Cardinal Drive Extension Brunswick, Carteret, Columbus, Duplin, Wilmington, North Carolina 28405 New Hanover, Onslow, Pender (910)395-3900 (910) 350-2004 Fax Winston-Salem Regional Office 585 Waughtown Street Alamance, Allegheny, Ashe, Caswell, Winston-Salem, North Carolina 27107 Davidson, Davie, Forsyth, Guilford, (336) 771-4600 Rockingham, Randolph, Stokes, Surry, (336) 771-4631 Fax Watauga, Wilkes, Yadkin For more information, visit our web site at: http✓lh2o.enr.state.nc.uslperes/ FTA 02/03 - Rev. 3 04/05 FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 3 USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number: W00029942 (to be completed by DWQ) 1. Owner: 1a. CITY OF LUMBERTON Full Legal Name (company, municipality, HOA, utility, etc.) rZ-..._.._.-_..._..__..._._.__.._...._...._........__._.._._...._....__........._......_.............._...._................. --._..... ....... 0 1b. WAYNE HORNE CITY MANAGER I Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorized signing officials!) ..__._._. —...---...__._._......- -.... ---- - ---......_._._.....__._.._._._.._....._._..._.... - --.....__..__.... - .... - -- -.._._._....._-.._._.._....._..... - - -- - - - ...------ --- ---- ------- _ 1 c. The legal entity who will own this system is: 2 11 11 Individual ❑ Federal ®-Municipality ❑ State/Cou ❑Private Partnership ❑Corporation ❑Other �Z — Q '1d. 501 EAST 57" STREET le. LUMBERTON ZMailing Address --� City-^- _- -__- - _ ,j1f. NORTH CAROLINA 1g. 28358 Z State Zp Code ------ h 910-671-3800 1 i. 910-8671-3814 1 ;1 j. Telephone_ Facsimile E-mail _ Project (Facility) Information: J HORNET ROAD SANITARY SEWER b. ROBESON dBrief Project Name (permit will refer to this name) County Where Project is Located Q ' 3 Contact Person: Q _ LARRY W. ANDERSON P.E. ANDERSON ENGINEERING & ASSOC. PA Name and Affiliation of Someone Who Can Answer Questions About this Application 13b• 910-671-9530 anderson@carolina.net Phone Number E-mail 1. Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.: �r For modifications, attach a separate sheet dearly explaining the reason for the modification (i.e. adding another changing line size/length, etc.). Only include the information In this do phase, modified permit application - not ,r duplicate project Information In B(7) and B(10-11) that has already been Included in the original permit . Owner is ® Public (skip to Item B(3)) ❑ Private (go to Item 2(a)) a. If private, applicant will be: 2b. If sold, facilities owned by a (must choose one ❑Retaining Ownership (i.e. store, church, single office, etc.) or ❑ Public Utility (Instruction 111) ❑ Leasing units (lots, townhomes, etc. - skip to Item B(3)) ❑ Homeowner AssocJDeveloper (Instruction m ❑ Selling units (lots, townhomes, etc. - go to Item B(2b)) CITY OF LUMBERTON . Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project a. CITY OF LUMBERTON 4b.0024571 Name of WWTF' WWTF Permit No. a. CITY OF LUMBERTON 15b. 12" Gravity Owner of Downstream Sewer lReceiving Sewer Size Force Main Permit Number of Downstream Sewer (if known) j- . The origin of this wastewater is (check all that apply): 'a ❑ Residential Subdivision j ❑Car Wash ii ;: ' ❑ Apartments/Condominiums ❑ Institution 100 % Domestic/Commercial `° ❑ Mobile Home Park ❑ Hospital -.d School ® Church % Industrial m ❑ Restaurant ❑ Nursing Home o ' /° Other (specify): ❑ Office El Other (specify): 7. Volume of wastewater to be allocated for this particular project: 240 gallons per day *Do not include previously permitted allocations ,A j 8. If the permitted flow is zero, indicate why: ❑ Interceptor Line - Flow will be permitted in subsequent permits that connect to this line :-i ❑ Flow has already been allocated in Permit No. ❑ Rehabilitation or replacement of existing sewer with no new flow expected t F17A 02/03 - Rev. 3 04/05 FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 4 9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2H i .0219(I) for Item 13(7) or the design flow for line or pump station sizing if zero flow in the space below. Values other than that in 15A NCAC 2H .0219(Ix1-2) must be supported with actual water or wastewater use data in accordance with 15A NCAC 2H .0219(Ix3). 2 Bathrooms @ 120 gallons per bathroom per day = 240 gallons per day - ....----....._...---- - __.._...._._..__._... _ - -- --- - ------------ -- 10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary) _ ........... .......... ............. _........... _....... _.._._._.__................ ........... _................. ............. ......................... _.._.................... _.... _...... _.._...._......................... ---........ --............. ............. -...._....__........ _............ -- ........... _... _... _................. ............._.._._.._......... ..--....... __........ ---._.......... _..... ..... -- Size (inches) Length (feet) Gravity or Force Main use the pull down menu 12" 0 250 GRAVITY W � " ENTER TOTAL LINE LENGTH IN MILES 0.05 3 - 11. Summary of Pump Stations to be Permitted (attach additional sheets as necessary) — — --- — — Location ID Q (self chosen - as shown on Design Flow i Operational Point Power Reliability Option (1- dual line feed; 2- permanent generator w/ATS; 3- -reference) for cross-reference p 1 _ MGD ._...._���.I_— GPM TDH _ ble generator w/telemetry; 4-wet well storage) Pia _ 12. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H .0200 as applicable? i,- ® Yes ❑ No If no, please reference the pertinent minimum design criteria or regulation and Indicate why a variance is requested. SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS r` s. PERTINENT TO THE VARIANCE WITH YOUR APPLICATION 13. Have the following permits/certifications been submitted for approval? Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes ❑ No ® N/A Sedimentation and Erosion Control Plan? ❑ Yes ❑ No ® WA I Stormwatel? ❑ Yes ❑ No ® WA 14. Does this project involve aerial lines or siphons? Check if yes: ❑ ---- 115. Does this project have gravity sewer lines designed at minimum slopes? j Be aware that the Division will not accept installed Ones more than 10% flatter than the minimum slope. Lines installed outside this tolerance should be I corrected prior to submitting the final engineering certification.. FTA 02/03 - Rev. 3 04/05 FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 5 1. Use the Division's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02103 (FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach additional sheets as necessary). This document is available from our web site or by contacting the appropriate Division of Water Quality ! Z regional office (see instructions for addresses) OR indicate the following: A Stream Classification is not needed because all parts of the project are at least 100 feet away from any down slope AND, Qwaterbody; 0 ® A Stream Classification is not needed because the design does not depend on wet well storage as a power reliability option for any pump station near a Class C down slope waterbody. j LL _..._ Location ID on Map to (self chosen - as shown on Name of Waterbody Stream' Waterbody map for cross-reference) i _Waterbody County River Basin Index Classification _.. i........ ...._._.._....... - .... _ ..._..— .—--._..... - -- ....._ �- V' --..._._........ .......... ------- -- -- ----- — • t k i I Submit the 8.5" x 11" COLOR topographic map as required in Instruction VI regardless of whether a classification is provided! .1. Applicant's Certification: 11 WA ME HORNE. attest that this application for HORNET ROAD SANITARY SEWER EXTENTION 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. Note: In accordance with North Carolina General Statutes 143- 215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or certifcation in any -, application shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed $10,000 as well as civil s penalti $25, 000 per violation. _ =ha. s--- cn t✓ — 3- G S' Signature Date } . —Proe al Engineer's Certification: - - -- �� I attest that this application for HORNET ROAD SANITARY SEWER EXTENTION has been reviewed by me and is accurate, complete and consistent with the Information in the engineering plans, 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 adopted February12, 1996, and the Minimum Design Criteria for the Fast -Track Pennitti of Pump Stations and Force Mains adopted June 1, 2000 and the watershed classification in accordance with Division guidance. 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. Note: In accordance with NC General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or certitication In any application 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. 11� 2a. LARRY W. ANDERSON PE Professional Engineer Name , gJ01,11 ittli ` 0 to, Fb. ANDERSON ENGINEERING & ASSOC,.P.A. Engineering Firm -------------------------- -- - � �,•' t SEAL = i 13325 j r----------- 'c. 305 N. CHIPPEWA STREET Mailing Address 12d. LUMBERTON------- ------ e. NC f. 28358%19,9'.FNQINE'ea���� - -City ---- ---�-----...------....-- --State - --Zip--- ---- ���r�4 tv 2g. (910) 671-9530 2h. 910 618-0838 2i. anderson@carolina.net itNt+lttuNi�� Telephone Facsimile E-mail I Seal, Signature & Date FTA 02/03 - Rev. 3 04/05 1 t ` ,• .__yam_.—_ i IL Xiiii 137 • L l 1 I �50 � 1 • __ Q� 1434'3t5 .. umbn cl ,• .. • 51 — - •) v ': • - • as •� f, a ,A•M J nGr Mod �• v % 7Q� - -: ii r , I11 U j 11.3 \+ I �\nA 5 Parts '• ���� t I' �\ { 2113 1 10} 1•D T"oQaad. Ce"ri¢f 0 19" Del.arm Yarmo§W ME 04u96 bouree uaa: ux•a i --7iw n eau: a : i i^m uewu: iri unas: vvi a + r FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 1 of W ATF9 State of North Carolina Department of Environment and Natural Resources co r Division of Water Quality FAST -TRACK APPLICATION t.no..m VITY SEWERS, PUMP STATIONS, AND FORCE MAINS (Pressure sewers systems are not to be included as part of this application package) INSTRUCTIONS: Indicate that you have included/addressed the following list of required application package items by checking the space provided next to each applicable item. Failure to submit all required items will lead to your application being returned as incomplete. This form may be photocopied for use as an original. 01. Application Form - Submit one original and one copy of the completed and appropriately executed application form. Any changes to this form will result in the application being returned. The Division of Water Quality (Division) will only accept application packages that have been fully completed with all applicable items addressed. You do not need to submit detailed plans and specifications unless you respond NO to Item B(12). ® It. Application Fee - Submit a check in the amount of $400 made payable to: North Carolina Department of Environment and Natural Resources (NCDENR). Checks shall be dated within 90 days of application submittal. ❑ III. Certificates of Public Convenience and Necessity — If the application is being submitted in the name of a privately -owned public utility, submit two copies of the Certificate of Public Convenience and Necessity (CPCN) which demonstrates that the public utility is authorized to hold the utility franchise for the area to be served by the sewer extension. If a CPCN has not been issued, provide two copies of a letter from the North Carolina Utilities Commission's Public Staff that states that an application for a franchise has been received, that the service area is contiguous to an existing franchised area, and/or that franchise approval is expected. The project name in the CPCN or letter must match that provided in Item A(2a) of this application. ❑ N. Operational Agreements — Submit one original and two copies of a properly executed operational agreement if the sewer extension is permitted by a private applicant and will be serving residential or commercial lots (e.g., houses, condominiums, townhomes, outparcels, etc.) that will be sold to another entity. If the applicant is a homeowners' association, use Form HOA 02/03. If the applicant is a developer, use Form DEV 02/03. EVEN IF THE PROJECT WILL BE TURNED OVER TO A MUNICIPALITY, FORM DEV 02/03 IS REQUIRED. ❑ V. Flow Acceptance Letters — If the owner of the downstream sewers and/or WWTF is different from the applicant, submit two copies of a flow acceptance letter from the owner of the downstream sewers and WWTF, if different. Flow acceptance letters must contain the following minimum information: applicant and project name, amount of flow accepted, and name and permit number of the receiving sewers/WWTF. The flow acceptance must not expire prior to permit issuance and must be dated less than a year prior to the application date. Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific flow acceptance letter. ® VI. Map — Submit an 8.5-inch by 11-inch COLOR copy of the portion of a 7.5-minute USGS Topographic Map along with this form. The map should identify the entire project area location as well as the closest downslope surface waters as clearly as possible. Each map portion must be labeled with the map name and number, the identified location of the sewer line and pump stations, and be of clear and reproducible quality. For instance, if the project involves 4 miles of interceptor sewer that traverses over or near several different waterbodies (or counties, basins, etc.), the map should have location ID's shown for each different waterbody (where the sewer line is within 100 feet of such waterbody - see Instruction VII). This location ID is self chosen and used to cross reference the location in Section C of the permit application. ® VII. Stream Classifications — Section C • If any portion of the project is within 100 feet of any down slope surface water, Section C must be completed for the pertinent sections. • If the entire project area is a minimum of 100 feet away from any down slope surface waters BUT there is a pump station involved where a history of power outage is to be used to provide adequate design storage instead of dual feed or permanent or portable generator, Section C must be completed to demonstrate that the closest down slope surface water is Class C (see 15A NCAC 2H .0219(h)(3)(D)). • Use the guidance document entitled, "Determining Watershed Classifications for Form FTA 02/03 (Fast -Track Sewer Systems)" available from http://h2o.enr.state.nc.us/peres or by contacting the appropriate regional office. FTA 02/03 - Rev. 3 04/05 FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 2 ❑ Vlll. Environmental Assessments — If this project is subject to an Environmental Assessment (EA) [I SA NCAC 01C], this application can not be used. Send the project application on Form PSFMGSA 10/99 to the PERCS Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. Applications can not be accepted until a Finding of No Significant Impact (FONSI) or Environmental Impact Statement (EIS) has been issued. A copy is to be submitted with that permit application. ® IX. Certifications — Section D The application must be certified by both the applicant and a North Carolina Registered Professional Engineer (PE). The applicant signature must match the signing official listed in Item A(1b). The PE should NOT certify the application if he/she is unfamiliar with 15A NCAC 2H .0200, the Gravity Sewer Minimum Design Criteria (most recent version) and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains (most recent version), as applicable to the project. Certification by a PE who is unfamiliar with these documents is subject to NC Board referral. ® X. Downstream Sewer rtk Wastewater Treatment Plant Capacity The applicant has assured downstream pipe, pump station and treatment plant capacity. The addition of new sources of wastewater from this project has been evaluated along the route to the receiving treatment plant. The flow from this project. will not cause capacity related sanitary sewer overflows or overburden any downstream pump station en route to the receiving wastewater treatment plant. - If the applicant is not the owner of the downstream sewer or receiving treatment plant, submittal of flow acceptance letters) indicates that owner has adequate capacity and will not violate G.S. 143-215.67(a). THE COMPLETED FTA 02103 APPLICATION PACKAGE, INCLUDING ALL SUPPORTING DOCUMENTS AND $400 FEE, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE REGIONAL OFFICE ADDRESS COUNTIES SERVED Asheville Regional Office 2090 US Highway 70 Avery, Buncombe, Burke, Caldwell, Swannanoa, North Carolina 28778 Cherokee, Clay, Graham, Haywood, (828) 296-4500 Henderson, Jackson, Macon, Madison, (828) 299-7043 Fax McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Yancey Fayetteville Regional Office 225 Green Street Suite 714 Anson, Bladen, Cumberland, Harnett, Fayetteville, North Carolina 28301 Hoke, Montgomery, Moore, Robeson, (910) 486-1541 Richmond, Sampson, Scotland (910) 486-0707 Fax Mooresville Regional. Office 610 E. Center Avenue, Suite 301 Alexander, Cabamrs, Catawba, Mooresville, North Carolina 28115 Cleveland, Gaston, Ir+edell, Lincoln, (704) 663-1699 Mecklenburg, Rowan, Stanly, Union (704) 663-6040 Fax Raleigh Regional Office 1628 Mail Service Center Chatham, Durham, Edgecombe, Franklin, Raleigh, North Carolina 27699-1628 Granville, Halifax, Johnston, Lee, Nash, (919) 571-4700 Northampton, Orange, Person, Vance, 019 571-4718 Fax Wake, Warren, Wilson Washington Regional Office 943 Washington Square Mall Beaufort, Bertie, Camden, Chowan, Washington, North Carolina 27889 Craven, Currituck, Dare, Gates, Greene, (252) 946-6481 Hertford, Hyde, Jones, Lenoir, Martin, (252) 975-3716 Fax Pamlico, Pasquotank, Perquimans, Pitt, Tyrrell, Washington, Wayne Wilmington Regional Office 127 Cardinal Drive Extension Brunswick, Carteret, Columbus, Duplin, Wilmington, North Carolina 28405 New Hanover, Onslow, Pender (910) 395-3900 (910) 350-2004 Fax Winston-Salem Regional Office 585 Waughtown Street Alamance, Alleghany, Ashe, Caswell, Winston-Salem, North Carolina 27107 Davidson, Davie, Forsyth, Guilford, (336) 771-4600 Rockingham, Randolph, Stokes, Surry, (336) 7714631 Fax Watauga, Wilkes, Yadkin For more information, visit our web site at: httpJ/h2o.enr.state.nc.us/peres✓ FTA 02/03 - Rev. 3 04/05 FA§T-TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 3 f USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number: (to be completed by DWQ) 1. Owner. _ I 1a. CITY OF LUMBERTON ! Full Legal Name (company, municipality, HOA, utility, etc.) Z_....._.... - --.._.._...__..._......_._....._._._.._...... - .._. !I b. WAYNE HORNE, CITY MANAGER Signing Official Name and Tide (Please review 15A NCAC 2H .0206(b) for authorized signing officials!) .....-._.._......__..._..__...__._......_.._..--........... _.._.._..............._..._....._....._..._.. _.........._.. --....._................---- ...__..------..._._._.._..._....._...._.._-- ..... - - - ._... --.._._._....._......._...__..._...__._...__.._.............. --............ I Q 11c. The legal entity who will own this system is: -❑ Individual ❑ Federal ® MunicipalityQ_State/C unty ❑ Private_ Partnership ❑ C_orporabog ❑Other spgd Q 1d. 501 EAST 5T" STREET jle. LUMBERTON LL I Mailing Address City `1f. NORTH CAROLINA --_ 1g. 28358 0 State - - -- Zip Code ---- - 1 h. 910-671-3800 1 i. 910-8671-3814 1 j. Telephone Facsimile E-mail U : - ----- —, -- -- -�-- ---_ 2. Project (Facility) Information: _J 2a. HORNET ROAD SANITARY SEWER 2b. ROBESON Brief Project Name (permit will refer to this name) County Where Project is Located a- Q . Contact Person: _---- " Q --- --- -- — - _ LARRY W. ANDERSON P.E. ANDERSON ENGINEERING & ASSOC. PA Name and Affiliation of Someone Who Can Answer Questions About this Application 910-671-9530 Sc. anderson@carolina.net Phone Number E-mail 1. Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.: 4, For modifications, attach a separate sheet clearly explaining the reason for the modification (i.e. adding another phase, changing line size/length, eta). Only include the modified information in this permit application - do not duplicate project information in B(7) and B(10-11) that has already been included in the original permit. . Owner is ® Public (slop to Item B(3)) ❑ Private (go to Item 2(a)) a. If private, applicant will be: 2b. If sold, facilities owned by a (must choose one) K ❑ Retaining Ownership (i.e. store, church, single office, etc.) or ❑ Public Utility (Instruction 111) ❑ Leasing units (lots, townhomes, etc. - SIP to Item B(3)) ❑ Homeowner AssocJDeveloper (Instruction M ❑ Selling units (lots, townhomes, etc. - go to Item B(2b)) CITY OF LUMBERTON Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project a. CITY OF LUMBERTON 4b.0024571 Name of WWTF WWTF Permit No. a. CITY OF LUMBERTON 15b. 12" Gravity Permit Number of Downstream Sewer (if known) Owner of Downstream Sewer receiving Sewer Size Force Main j*- The origin of this wastewater is (check all that apply): ❑ Residential Subdivision j ❑Car Wash ❑ Apartments/Condominiums ' ❑ Institution 100 % Domestic/Commercial ❑ Mobile Home Park ❑ Hospital i ❑School ®Church % Industrial ■, S ❑ Restaurant ❑ Nursing Home j ❑ Office ElOther (specify): %Other (specify): 7. Volume of wastewater to be allocated for this particular project: 240 gallons per day j *Do not include previously permitted allocations 8. If the permitted flow is zero, indicate why: ❑ Interceptor Line - Flow will be permitted in subsequent permits that connect to this line I ❑ Flow has already been allocated in Permit No. ❑ Rehabilitation or replacement of existing sewer with no new flow expected i FTA 02/03 - Rev. 3 04/05 FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 4 9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2H .0219(I) for Item B(7) or the design flow for line or pump station sizing if zero flow in the space below. Values other than that in 15A NCAC 2H .0219(Ix1-2) must be supported with actual water or wastewater use data in accordance with 15A NCAC 2H .021%Ix3). --__......_.__.._____._..__......_.__.__ __---_.._ _ 1 2 Bathrooms @ 120 gallons per bathroom per day = 240 gallons per day -- ......._.. j 10. -------------------------.-- ..__..... - - ......-------------- ---- - - ..._.. - --------- ------------ -- - - -- — ---.. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)_ __..__._....__._._.....- - - - — Size (inches) Length (feet) Gravity or Force Main pull down menu) -...._..- --- -- - ..__........_...._.. ----- ....._ .-- ...._..-- -- .._.... ------------ ----- -- -- - (use the -- 12" fd 250 GRAVITY 1 I t I 3 Z ENTER TOTAL LINE LENGTH IN MILES' 0.05 11. Summary of Pump Stations to be Permitted (attach additional sheets as necessary) Zs _ Location ID ; _ ; — Power Reliability Option s (self chosen - as shown on I Design Flow I Operational Point (1- dual line feed; 2- permanent. generator w/ATS; 3- ` lans for cross-reference i MGD GPM TDH ble nerator w/tele , 4-wet well stora t ,¢ I T 12. Does the sewer system c ommply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H .0200 as applicable? ® Yes ❑ No If no, please reference the pertinent minimum design criteria or regulation and Indicate why a variance Is requested. SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS x� i j PERTINENT TO THE VARIANCE WITH YOUR APPLICATION 1.13. Have the following permits/certifications been submitted for approval? Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes ❑ No ® N/A Sedimentation and Erosion Control Plan? ❑ Yes ❑ No ® WA Stormwater'? ❑ Yes ❑ No ® N/A _......_.__..._.....__ 14. ................._..........._...._..._.._............__._........_........_..._.._....._.........._......_..__.............-._._.._....--------....._._..........._............._.__... ..___........._..._..........................__..............._.-...._...._._..._._.._-...----................_._._.__. Does this project involve aerial lines or siphons? Check if yes: ❑ Then�Jin��rill. t�cu[asiQec�kiis�.h.nriQdL�_at�tmust..bs s�1se��r� er�.n six rtzanths------.--.....--.--------. --- -' 15. Does this project have gravity sewer lines designed at minimum slopes? Be aware that the Division will not accept installed lines more than 10% flatter than the minimum slope. Lines installed outside this tolerance should be corrected prior to submitting the final engineering certification.. FTA 02/03 - Rev. 3 04/05 FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 5 1. Use the Division's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02103 (FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach additional sheets as necessary). This document is available from our web site or by contacting the appropriate Division of Water Quality I Z regional office (see instructions for addresses) OR indicate the following_--_._..-___._.__.__._--_.________.____._-____ ® A Stream Classification is not needed because all parts of the project are at least 100 feet away from any down slope AND, Qwaterbody; V ® A Stream Classification is not needed because the design does not depend on wet well storage as a power reliability option for any pump station near a Class C down slope waterbody. ---......__............ _....... __...... - ------ -- ------ --- - -- -- ..._....-- -- --- - - (/� Location ID on Map y (self chosen - as shown on Name of Waterbody Stream Waterbody Qmap J for cross-reference) IWaterbody -County _ River Basin Index Classification _ ------- _ _....--..._._.—icatio-- i E f l 1 _ Submit the 8.5" x 11" COLOR topographic map as required in Instruction VI regardless of whether a classification is providedi A. Applicant's Certification: :I 1, WAYNE HORNE. attest that this application for HORNET ROAD SANITARY SEWER EXTENTION 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 subjed to being returned as incomplete. Note: In accordance with North Carolina General Statutes 143- ;. 215.6A and 143-215.68, any person who knowingly makes any false statement, representation, or certification in any ? application shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed $10,000 as well as civil penalti- $25,000 per violation. -- — - s.-- t✓ ✓ - 3- G C y �1a. ' S Signature Date . Pro(es at Engineer's Certification: I attest that this application for HORNET ROAD SANITARY SEWER EXTENTION has been reviewed by me and is accurate, complete and consistent with the Information in the engineering plans, 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 adopted February 12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 and the watershed classification in accordance with Division guidance. Although certain portions of this submittal package may have been developed by other professionals, inclusion of these materials under my .j 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 NC General Statutes 143-215.6A and 143-215.68, any person who knowingly makes any false 1r j statement, representation, or certfcation in any application 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. 13r a. LARRY W. ANDERSON PE Professional Engineer Name `````� tttttili ttryl r 0 /O,y~• -_ b. ANDERSON ENGINEERING & ASSOC., P.A. Engineering Firm _ {r e I S�� % 2c. 305 N. CHIPPEWA STREET ----------- ------------------- Mailing Address 1 %,�qp �.,FNQiN;.•SQ?�� 2d. LUMBERTON 2e. NC f. 28358 City - -- --- -- -- ---- -- State ----- Zip �,��'9Y •••••••••• �� ���� rrrrtittt11111t����� - �(910) 671-9530 �h. 910 618-0838 2i. anderson carolina.net E-mail Telephone Facsimile Seal, Signature &Date FTA 02/03 - Rev. 3 04/05 11 / U • , • lei , 19 . � ` \ � + 137 t /�,_. ` ` der v / • I N341-38:5 _ . ,lfj .• ... • .:�� o Cb Trader Pad }� A � {2113+ �� •� � ' 3-DTopoQssdaCopyrWC19"DeLormelarmouth.W 04096 ImurceData:UMib r------j7U11ft Scale: 1:17.6011 Detail:13-5 Datum WGSX4 Anderson Engineering & Assoc., P.A. P.O. Box 1736 305 North Chippewa Lumberton, N.C. 28359 DENR --FRCS March 1, 2006 NCDHNR-DEM 225 Green Street Suite 714 Fayetteville NC 28301 Ref.: Hornet Road Sanitary Sewer Extension Fast Track Application Dear Sir or Madam: Larry Anderson, P.E. President Please find enclosed the following on the above referenced project for your review and approval: - 3 copies of the Fast Track Application, Application Fee ($400.00). Should you have any questions, please do not hesitate to contact me. Sincerely, A DERSON E GINEERING & ASSOCIATES, P.A. aim Dwayne John on CAD Designer DJ/rrc Enclosures National Society of Professional Engineers® HSPE Licensed Member Phone: (910) 671-9530 • Fax: (910) 618-0838 • Email: anderson@carolina.net