WQ0034918_Sewer Extension_20100728

OF W A TF,9 State of North Carolina
pG Department of Environment and Natural Resources
62t,Division of Water Quality
o JUL 2 8 2010 FAST -TRACK APPLICATION
nn��ee (FTA 12/07 )
for GRAM QWERS, PUMP STATIONS, AND FORCE MAINS
(Pressure & Vacuum sewer 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. Forms are available from the web site or by calling the Regional Office serving your county:
http.-Ah2o. enr. state. nc. us/peres/Collection % 20Systems/Collection SystemApplications_ html
® A. Application Form - Submit one original and one copy of the completed and appropriately executed application
form. The application should include a project narrative describing the final build -out design (i.e. system and/or
pump station to ultimately serve 500 homes, but flow for only 100 homes being requested now). For modifications,
clearly explain the reason for the modification (i.e. adding another phase, changing line size/length, etc.). Only
include the modified information in this permit application - do not duplicate project information that has already
been included in the original permit.
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 Dlans and specifications unless you resDond NO to Item 13(13).
Separate aDDlications should be made for non-contiguous sewer systems
® B. Application Fee - Submit a check in the amount of $480 made payable to: North Carolina Department of
Environment and Natural Resources (NCDENR). Checks shall be dated within 90 days of application submittal.
❑ C. 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(2)a of this application.
❑ D. Operational Agreements — Submit one original and two copies of a properly executed operational agreement, as
per 15A NCAC 02T .0115, if the application is submitted 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 home or property owner's association, use Form HOA 02/03. If the applicant is a developer,
use Form DEV 02/03. EVEN IF THE PROJECT MAY BE TURNED OVER TO A MUNICIPALITY UPON
COMPLETION, FORM DEV 02/03 IS REQUIRED.
® E. Downstream Sewer, WWTF Capacity and Flow Tracking/Acceptance — FORM FTSE 10/07 (Flow
Tracking/Acceptance for Sewer Extension Permit Applications) is required with every application. The applicant
(and owners of downstream sewers, pump stations and/or treatment facilities submitting FORM FTSE-10/07)
certifies that the addition of the volume of wastewater to be permitted in this project has been evaluated along the
route to the receiving treatment plant, and that 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. Where the applicant is not the owner of the downstream sewer, submit two copies of FORM FTSE 10/07
from the owner of the downstream sewer and owner of the WWTF, if different. The flow acceptance indicated in
FORM FTSE-10/07 must not expire prior to permit issuance and must be dated less than one year prior to the
application date. Submittal of this application and FORM FTSE-10/07 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 project -specific FTSE 10/07.
® F Map — Submit an 8.5-inch by 11-inch COLOR copy of a USGS Topographic Map of sufficient scale to identify the
entire project area and the closest surface waters. Each map or maps must show the location of the sewer line
and pump stations and be of reproducible quality. Include a street level map showing the downstream connection
point, and the permit number for the downstream sewer, if known.
FTA 12/07

® G. Stream Classifications — Watershed Classification Attachment (Form WSCAS-12/07) If any portion of the
sewer system project is within 100 feet of any surface water or wetlands, the Watershed Classification Attachment
may need to be completed. A variance must be requested for encroachment within required setbacks or buffers
pursuant to 2T .0305 (f) and be indicated in Item B-13 with supporting documentation/justification provided.
❑ H Environmental Assessments — If this project is subject to an Environmental Assessment (EA) [15A NCAC
01C], this application cannot be used. Send the project application on the most current version of Form
PSFMGSA to the Design Management Unit, 1633 Mail Service Center, Raleigh, NC 27699-1633. Applications
cannot 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.
❑ I. Flow Direction — Many wastewater treatment systems are entering into agreements for regionalization efforts
and emergency treatment capacity. Parts of the system are installed so that the wastewater flow can be directed
to more than one treatment facility. If this is the case with this project, please indicate in 13(12) and give the permit
number of the second treatment facility.
® J. Certifications — Section C
The application must be certified by both the applicant and the design engineer who is a North Carolina
Registered Professional Engineer (PE). The applicant signature must match the signing official listed in Item
A(lb). The PE should NOT certify the application if he/she is unfamiliar with 15A NCAC Chapter 2T, 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.
THE COMPLETED FTA 12107 APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
DOCUMENTS AND$480 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, Cherokee,
Swannanoa, North Carolina 28778
Clay, Graham, Haywood, Henderson, Jackson,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Hamett, Hoke,
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,
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,
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,
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
Wilmington, North Carolina 28405
Hanover, Onslow, Pender
[phone]
[phone] Fax
Winston-Salem Regional Office
585 Waughtown Street
Alamance, Alleghany, Ashe, Caswell, Davidson,
Winston-Salem, North Carolina 27107
Davie, Forsyth, Guilford, Rockingham, Randolph,
[phone]
Stokes, Surry, Watauga, Wilkes, Yadkin
[phone] Fax
For more information, please visit our web site at: http://www.nccgl.net/Engineerinp/Sewerlo20Permits.htmI
or contact the Regional Office serving your county.
FTA 12/07

USE THE TAB KEY TO MOVE FROM FIELD TO FIELD!
1. Owner/Permittee:
1 a. Windsor Crossing Ap
LP
Application Number:
(to be completed by DWQ)
Full Legal Name (company, municipality, HOA, utility, etc.)
0 1 b. Windsor Crossing Assoc. LLC c/o Bradley E. Parker, General Partner
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Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials!)
1 c. The legal entity who will own this system is:
❑ Individual ❑ Federal ❑ Municipality ❑ State/County ® Private Partnership ❑ Corporation ❑ Other (specify):
1 d. 140 East Main Street, Suite 410 le. Rock Hill
Mailing Address City
if. S.C. 1g. 29730
State Zip Code
1 h. [phone] 1 i. [phone] 1 j. [e-mail]
Telephone Facsimile E-mail
2. Project (Facility) Information:
2a. Windsor Crossing 2b. Robeson
Brief Project Name (permit will refer to this name) County Where Project is Located
3. Contact Person:
3a.
Harris Gupton, Consulting Engineer
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b.
336-723-2459 3c. [e-mail]
Phone Number E-mail
1.
Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.:
2.
Owner is ❑ Public (skip to Item B(3)) ® Private (go to Item 2(a)) i
2a.
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 C)
® Leasing units (lots, townhomes, etc. - skip to Item B(3)) ❑ Homeowner Assoc./Developer (Instruction D)
❑ Selling units (lots, townhomes, etc. - go to Item B(2b)) i
- - --- _ -
3.
- -.. __ - ------ - ------------ --------------1
City of Lumberton
Owner of Wastewater Treatment Facilitv (WWTF) Treatina Wastewater From This Proiert
4a. City of Lumberton WWTP 4b. 0024571
Name of WWTF WWTF Permit No.
5a. Cityof Lumberton 5b. 8" ®Gravity 15c. W00029293
Owner of Downstream Sewer iReceiving Sewer Size ❑ Force Main ! Permit # of Downstream Sewer (Instruction E)
6. The origin of this wastewater is (check all that apply):
❑ Residential Subdivision
® Apartments/Condominiums
❑ Mobile Home Park
❑ School
❑ Restaurant
❑ Office
❑ Retail (Stores, shopping centers)
❑ Institution
❑ Hospital
❑ Church
❑ Nursing Home
❑ Other (specify):
100 % Domestic/Commercial
% Industrial (attach
description.)
(RO: contact your Regional Office
Pretreatment staff)
% Other (specify):
7. Volume of wastewater to be allocated or permitted for this particular project: 9 gallons per day
*Do not include future flows or previously permitted allocations
8. If the permitted flow is zero, indicate why:
❑ Pump Station, Outfall or Interceptor Line where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit No.
❑ Rehabilitation or replacement of existing sewer with no new flow expected (see 15A NCAC 02T .0303 to determine if a
permit is required)
FTA 12/07

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9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T .0114 for
the value in Item 13(7) AND/OR the design flow for line or pump station sizing if a reduced or zero flow is being requested in
Item 13(7). Values other than that in 15A NCAC 2T .0114 (b) and (c) must be supported with actual water or wastewater use
data in accordance with 15A NCAC 2T .0114 (f).
Residential Townhome Units:
40 two bedroom units x 240 gpd = 9,600
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches)
8
Length (feet) New Gravity or Additional
Force Main
660 gravity
11. Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
Pump Station Location ID
Design Flow
(MGD)
(self chosen - as shown on plans/map for reference)
Operational Point Power Reliability Option
GPM a@TDH 1 - permanent generator w/ATS; Force Main Size Force Main Length
2 - portable generator w/MTS
Pump Station Location ID (self chosen - as shown on planslmap for reference)
Design Flow Operational Point Power Reliability Option
(MGD) GPM a@TDH 1 -permanent generator w/ATS; Force Main Size Force Main Length
2 - portable generator w/MTS
12. Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
❑ Yes ® No If Yes, permit number of 2nd treatment facility
(RO — if "yes" to 6,12 please contact the Central Office PERCS Unit)
13. 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 Chapter 2T 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
PERTINENT TO THE VARIANCE WITH YOUR APPLICATION
FTA 12/07

14. Have the following permits/certifications been submitted for approval for the system or project to be served?
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Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes ❑ No ® N/A
Sedimentation and Erosion Control Plan? ® Yes ❑ No ❑ N/A
Stormwater?
® Yes ❑ No ❑ N/A
15. Does this project include any high priority lines, [see 15A NCAC 02T .0402 (2)] involve aerial lines, siphons, or interference
manholes)? These lines will be considered high priority and must be checked once every six months
Check if Yes: ❑ and provide details
la.
Owner/PermittteJe's Certification: (Signature of Signing official and Project Name)
I, Fr a GC T&V kfi/ , attest that this application for Windsor Crossing 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 143-215.68, 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
a 11 as civil pgnalge-sVp to $25, 000 per violation. I
Date
ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THIS
APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIM
TO OTHER UTILITIES, DESIGN CALCULATIONS. ETC. REFER TO 15A NCAC 02T .0305
2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
1, "awriS b• C;a!- a-, , attest that this application for Windsor Crossing 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 1 Z 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 other professionals may have developed certain portions of this submittal package, inclusion of these materials
under my signature and seal signifies that I have reviewed this material and have judged it to be consistent with the
proposed design. Note: In accordance with NC 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 penalties up to $25,000 per violation.
2a. Harris Gupton
Professional Engineer Name
2b. Gupton & Associates, P.A.
Engineering Firm
2c. 2200 Silas Creek Pky. Ste. 26
Mailing Address
2d. Winston-Salem 2e. NC 2f, 27103
Ciry State Zip
2g. 336-723-2459
Telephone
2h. 336-761-1425 2i.
Facsimile E-mail
NC PE Seal, Suture & Date
FTA 12/07

Central Files: APS SWP
08/24/10
Permit Number WQ0034918
Permit Tracking Slip
Program Category
Status Project Type
Non -discharge
Active New Project
Permit Type Fast Track
Version Permit Classification
Gravity Sewer Extension, Pump Stations, & Pressure Sewer
1.00 Individual
Extensions
Primary Reviewer
Permit Contact Affiliation
trent.allen
Coastal SW Rule
Permitted Flow
9600
Facility
Facility Name
Windsor Crossing
Location Address
Major/Minor Region
Major Fayetteville
County
Robeson
Facility Contact Affiliation
Owner Name
Owner Type
Windsor Crossing Apartment LP
Non -Government
Owner Affiliation
Bradley Parker
General Partner
140 E Main St
Rock Hill SC 29730
Dates/Events
Scheduled
Orig Issue App Received Draft Initiated Issuance
Public Notice Issue Effective Expiration
07/28/10 07/28/10
08/24/10 08/24/10
Regulated Activities Requested/Received Events
Wastewater collection Additional information requested 08/16/10
Additional information received 08/17/10
Outfall NULL
Waterbody Name Stream Index Number Current Class Subbasin

WINDSOR CROSSING APARTMENTS. LP
XQoo3-17i8
NCDENR N C D E N R
6-16-10 061610 WNDSR-SAN SEWER PERM
480.00
480.00
77
JUL 2 8 20%
CHECK 6 -16 -10
PECK
21
TOTAL > 4 8 0. 0 0
480. 0 0
DATE
NUMBER
PLEASE DETACH AND RETAIN FOR YOUR RECORDS
WINDSOR CROSSING APARTMENTS, LP
22720 Fairview Center DR
Suite 150
Fairview Park, Ohio 44126
Carolina Bank
Greenboro, NC 27408
DATE CHECK NO.
June 16, 2010 21
Pay: ********************************Four hundred eighty dollars and no cents
PAY NCDENR
TO THE 1612 Mail Service Center
ORDER OF Raleigh, NC 27699-1612
1180000000
7401
531
AMOUNT
$********480.00

OF WA TFq State of North Carolina
O� OG Department of Environment and Natural Resources
Division of Water Quality
co r Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE—10/07)
Project Applicant Name: City of Lumberton
Project Name for which flow is being requested: Windsor Crossing
More than one FFSE-10107 maybe required for a single project if the owner of the WWTP is not responsible for all
pump stations along the route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: City of Lumberton WWTP
b. WWTP Facility Permit #: 0024571
All flows are in MGD
c. WWTP facility's permitted flow 20
d. Estimated obligated flow not yet tributary to the WWTP 1.06
e. WWTP facility's actual avg. flow 6.0
f. Total flow for this specific request 0
g. Total actual and obligated flows to the facility 7.095
h. Percent of permitted flow used 35%
H. 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
Pump Station Name Approx. Capacity, MGD Approx. Current Avg.
(Firm/Design) Daily Flow, MGD
3) % , 7 Cg /yl
III. Certification Statement:
I, Robert P. Armstrong_h, certify that, to the best of my knowledge, 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 treaunent
plant under normal circumstances. This analysis has been performed in accordance with local established
policies and procedures using the best available data. This certification applies to those items listed above
in Sections I and H for which Ism the ible party. Signature of this form indicates acceptance of
this wastewater flow. ^ �J
WJL 17T 'l - 2 1 -
Sigrring Official Signature Date

FORM WSCAS-12/07 0 0O WATFRoG
WATERSHED CLASSIFICATION ATTACHMENT > 7,
o
FOR SEWER SYSTEMS
Applicant Name
Project Name
Windsor Crossing Apartment, LP
Windsor Crossing
Professional Engineer Name
Engineering Finn Name
Harris B. Gupton, PE
Gupton & Associates, P.A.
Location
ID
Name of Waterbody'
County
River
Basin
Waterbody Stream
Index No.
Waterbody
Classification
1
Delineated Wetlands
Robeson
Lumber
' If unnamed, indicate "unnamed tributary to X", where X is the named waterbody to which the unnamed tributary joins.
1 certify that as a Registered Professional Engineer in the State of
North Carolina that I have diligently followed the Division's instructions
for classifying waterbodies and that the above classifications are
inclusive of the stated project, complete and correct to the best of my
knowledge and belief.
PE Seal, Signature and Date
*** END OF FORM WSCAS-12/07 ***
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FORM: WSCAS-12/07 Page 1 of 1

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Allen, Trent
From: Ashley S. Webb [[e-mail]
Sent: Wednesday, August 04, 2010 4:22 PM
To: Allen, Trent
Subject: Windsor Crossing - updated flows
Attachments: Club House.pdf
Trent,
Attached is a copy of the architect's floor plan for the proposed clubhouse for Windsor
Crossing. Judging by this, I would assume the revised flows to be the following:
(40) 2-bed units x 240 gpd = 9600 gpd
Clubhouse:
(2) self-service laundry x 500 gpd = 1000 gpd
(2) public restrooms x 325 gpd = 650 gpd
(1) kitchen x 250 gpd = 250 gpd
Total Flow: 11,500 gpd
Let me know if you have any other questions or concerns regarding the application. Thanks,
Ashley S. Webb
Gupton & Associates, P.A.
2200 Silas Creek Pkwy, Ste. 2B
Winston-Salem, NC 27103
[phone] ext. 33
1

Lupton
Engineering -Planning -Surveying
Project Narrative for
Windsor Crossing Townhomes
The project consists of a 5.7t acre site off Medley Lane in Lumberton, NC. The proposed
development consists of 40 2-bedroom townhome units located within 6 buildings, with an
additional ',••'Idirlg and oommen saws. Also proposed on the site are two permanent
dry detention devices for stormwater use, along with a series of retaining walls to avoid
encroaching into several delineated wetlands. The circulation of traffic through the site will be
facilitated by a private one-way drive with angled parking on both sides, which will loop through
the property. The private drive will connect on both ends to Medley Lane. A 6" public water line is
proposed to connect to the existing main line along Medley Lane, and will be located along the
length of the private drive through the site. The property is bordered on one side by Ivey's Branch
and lies partially in the 100-year flood plain. Care has been taken to ensure that all b—Odings and
all sanitary sewer manholes lie above the established flood plain. Wastewater generated onsite
will flow through a private onsite system before being gravity fed to an existing 8" public system in
the pavement of Medley Lane. Wastewater calculations are below.
(40 2-bedroom units) x (240 gals/day/unit) = 9,600 gals/day
This project is being proposed on a piece of land that was previously a part of the Medley Lane
subdivision. Therefore, the flows for this project were accounted for during permitting of the initial
subdivision and have not been duplicated in this application.
2200 Silas Creek Pkwy. Suite 213 Winston-Salem, NC 27103 336-723-2459 Fax: [phone] E-mail guptonpa,g auptonco.com

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August 17, 2010
Windsor Crossing Assoc. LLC
c/o Bradley E. Parker, General Partner
140 E Main Street, Suite 410
Rock Hill, SC 29730
RE: Windsor Crossing Sewer Allocation
Dear Mr. Parker:
Based on discussions with your engineer, the City is allocating 11,500 gallons per day of
sanitary sewer flow to your project located on Medley Lane.
We look forward to working with you on this project. If you have any questions, please
feel free to contact me at 910-671-3851.
Sincerely,
Rob Armstrong, P.E.
Public Works Director
2 15 -S. 6-11 cStl—t • q 1 o-67 1-38g 1 * lax 91 o-6y 1-3884

OF W ATF9 State of North Carolina
�11 pG Department of Environment and Natural Resources
77
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Division of Water Quality
Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE—10/07)
Project Applicant Name: City of Lumberton
Project Name for which flow is being requested: Windsor Crossing
More than one FTSE-10107 maybe required for a single project :f the owner of the WWTP is not responsible for all
pump stations along the route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: City of Lumberton WWTP
b. WWTP Facility Permit #: 0024571
All flows are in MGD
c. WWTP facility's permitted flow 20
d. Estimated obligated flow not yet tributary to the WWTP 1.06
e. WWTP facility's actual avg. flow 6.0
f. Total flow for this specific request .0115
g. Total actual and obligated flows to the facility 7.095
h. Percent of permitted flow used 35%
II. 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
Pump Station Name Approx. Capacity, MGD Approx. Current Avg.
(Finn/Design) Daily Flow, MGD
Cricklewood 035) 0.108 0.009
Ramada (#31) 1.4 0_8
Ford 03) 5.7 1.2
III. Certification Statement:
I, Robert P. Armstrong Jr, certify that, to the best of my knowledge, 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. This analysis has been performed in accordance with local established
policies and procedures using the best available data. This certification applies to those items listed above
in Sections I and II for which I am the re pons}ble geµ ty. Signature of this form indicates acceptance of
this wastewater flow. r. a � fi 1tC j
Signing Official Signature
Date