WQ0041758_Application (FTSE)_20200616

1)WR
Division of Water Re-�our€c.,
State of North Carolina
Department of Environmental Quality
Division of Water Resources
I5A NCAC 02T .0300 - FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: LA/QoO � I 1 9_ ?tO k Lumpleled Iiy DWR)
All items must be completed or the r lication will be returned
1. APPLICANT INFORMATION:
I. Applicant's name: City of Henderson (company, municipality, HOA, utility, etc.)
2. Applicant type. ❑ Individual ❑ Corporation p ❑General Partnership
❑ Federal ❑ State County ® Municipal
3. Signature authority's name: Clark Thomas P.E. per 15A NCAC 02T .0106(b)
Title: City Engineer
4. Applicant's mailing address: PO Box 1434
City: Henderson State: NC Zip: 27536-_
5. Applicant's contact information:
Phone number: QL2) 430-5728 Email Address: cthomas(iki.henderson nc us
If. PROJECT INFORMATION:
L Project name: St. Charles Place Apartments — JV;1, C
2. ApplicationrProject status: d Proposed (New Permit)
If a modification, provide the existing permit number: WQ00_
❑ Privately -Owned Public Utility
❑ Other
NC Dept of Environmental Quality
JUN 16 2020
r:.3o $u
Raleigh Regional Office
❑ Existing Permit/Project
and issued date:
If new construction but part of master plan, provide the existing permit number: WQ00
3. County where project is located: Vance
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.3307. Longitude:-78.4537
5. Parcel ID (if applicable): Al 103004
(or Parcel ID to closest downstream sewer)
Ill. CONSULTANT INFORMATION:
I. Professional Engineer: Homer S. Wade License Number: 10666
Firm. Borum, Wade_& Associates PA
Mailing address: 621 Eugene CourtSuite 100
City; Greensboro State: NC Zip: 27401
Phone number: [phone] Email Address: hswade(@boruin-wade.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I. racility Name: Henderson Water Reclamation Facility Permit Number: NC0020559
Owner Name: City of Henderson
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
L Permit Number(s): WQ0014291 Downstream (Receiving) Sewer Size. 8 inch
System Wide Collection System Permit Numbers ifa plicable : WQCS Dc.Oy y
Owner Name(s): Cite of Henderson
FORM: FTA 04-16
Pad-e I of 5

VI
GENERAL REQUIREMENTS
8
L If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
[!]Yes ❑No ❑MA
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORrvf- DEV) been attached?
❑ Yes ❑No ON/A
3. If the Applicant is a 1-lome:Tro perty Owners' Association, has an -Operational Agreement FORM: I-IOA been attached?
❑ Yes ❑No ©NIA
4. Origin of wastewater: (check all that apply):
❑ Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
© Residential Leased ❑ Retail with food preparationiservice ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool 'Clubhouse
❑ Food and drink facilities ❑ Church
[3ffi
Businesses /oces /Factories ❑Swimming PoolrFilter Backwash
❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic/Commercial % Commercial
% Industrial (See 15A NCAC 02T .0103 20
�Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .01 14 ? ❑ Yes ❑ No
i Ir yes, provide a cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f) Daily Design FlowNo. of Units Flow
1 Bedroom Apartment 240 gal/day 12 2,880 GPD
2 Bedroom Apartment 240 gal/day 44 10,560 GPD 41
3 Bedroom Apartment 360 galiday 24 8,640 GPD
gall 30 GAD
gall GPD
gall GPD
Total ,pgq GPD
a See 15A NCAC 02T .01 14 b d e I and e 2 for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per 15A NCAC 02T .01 14(c), design flow rates for establishments not identified [in table 15A NCAC 02T.01 14] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
Wastewater generated by project: 22.080 GPD (per 15A NCAC 02T .01 14)CX
Do not include future flows or previously permitted allocations
If permitted now is zero, indicate why:
❑ Pump Station or Gravity Sewer where flo%v will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16 Page 2 of 5

V1I.
VIII
GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
I. Summarize gravity sewer to be permitted:
I.
2.
3.
4.
5.
Size (inches)
Length (feet)
Material
8
42
DIP
8
524
SDR-35
Section II & 111 of the MDC for Pennitting of 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
PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
Pump station number or name:
Approximate Coordinates (Decimal Degrees): Latitude: _ . ° Longitude: -__ . {
Design flow of the pump station: millions gallons per day (firm capacity)
Operational points) of the pump(s): gallons per minute at feet total dynamic head (TDH) l
Summarize the force main to be permitted (for this Pump Station): )5
6. Power reliability in accordance with 15A NCAC 02T .0305 h l :
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B)_
Required for all pump stations with an average daily flow 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(h)(1)(C)
or
-'Gy IL
py
y
❑ Portable pumping unit with plugged emergency pump connection and telemetry - I5A NCAC 02T .0305(li)(1 XC):
.- It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (drab agreement)
and is compatible with the station.
I f the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storase
capacities and the rotation schedule of the portable power source or pump, including travel tinieframes, shall be provided
in the case of a multiple station power outage.
rORM. F fA 04-16 Page 3 of

1X. SETBACKS & SEPARATIONS — (0213.0200 & 15A NCAC 02T .0305(f)):
i . Does the project comply with all separations found in liLNCAC
❑X Yes ❑ No
15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(fa cannot be achieved.
"Stream classifications can be identified using the Division's NC Surface Water Classi fications w_ eboa,,e
If noncompliance with 02T.0305 or see Section X of this application
?. Does the project comply with separation requirements for wetlands? (50 feet of separation) ❑ 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 ISA NCAC 0213.0200? © Yes ❑ No ❑ N:-A
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 40I & Buffer Perm itting_Branch
5. Does project comply with 15A NCAC 02T.0105 c 6) (additional permits/certifications)? © Yes ❑ No
Per 15A NCAC 02T.0I05(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 ISA NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewerpositioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ❑X No ❑ N.-,A
If Yes, include an attachment %vith details for each line. including type (aerial line, size, material, and location)
High priority lines shall be inspected by the permittee or its represenladve at least once every six -months and inspections
dpennlellted per 15A NCAC 02T_0403(a)(5) or the perntitee's individual Slstem-Wide Collection permit.
FORM- FTA 04-16 Paue 4 of

X. CERTIFICATIONS:
Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria latest version as applicable?
El Yes ❑ No
If No, complete and submit the Variance.'Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is re uired prior to submittal of the Fast Track Application and su ortin documents.
2. Professional Engineer's Certification:
3.
(Professional Eng
name from Application Item III.1.)
that this application for
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per violation.
North Carolina Professional Engineer's seat, signature, and date:
``ti�lltlll�f
-N CARO',
•' t<ssi'• �
QQ'0
SEAL
._ ­T.r.'.ITVI._ ... .....
Applicant's Certification per 15A NCAC 02T .0106(b): 2 ¢/�Zo
J&Zattest that this application for
(Signature Auth rity's name & title from Application Item 1.3.
PP )
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 system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and, -'Or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
of this permit be violated. I also understand that if all required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
NOTE — In accordance with General Statutes 143-215.6A and I43-215.6Q, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25.000 per violation.
Signature;
Date:
1=011M: VI 04-16
Page 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
131vi.,iup.I u+ V,.,,,,.r FI-I,,;>;,,, Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: City of Henderson
Project Name for which flow is being requested. ST. Charles Place
More than one FTSE maybe required for a single project ff the owner of the WWTP fs not responsible for all pump
stations along the route of the pipposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Henderson Water Reclamation Facilit
b. WWTP Facility Permit M NC 0020559
All flows are in MGD
c.
WWTP facility's permitted flow
4.14
d.
Estimated obligated flow not yet tributary to the WWTP
0.1364
e.
WWTP facility's actual avg. flow
1.95
f.
Total flow for this specific request
0.002208
g.
Total actual and obligated flows to the facility
2.0356
h.
Percent of permitted flow used
49.17 %
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)2(B+'C)
(E)=(A-D)
Design
Obligated,
Pump
Average Daily
Approx.
Not Yet
Total Current
Station
Firm
Flow**
Current Avg.
Tributary
Flow Plus
(Name or
Capacity, *
(Firm / po,
Daily Flow,
Daily Flow,
Obligated
Available
Number)
MGD
MGD
MGD
MGD
Flow
Capacity***
RedBud
2.952
1.181
0.65
0.07412
0.72412
0.4568
Zeb
—
0.18
0.072
0.021
0.02208
0.04308
0.137
* The Firm Capacity of any pump station is defined as the maximum pumped flow that
can be achieved with the largest pump taken out of service.
** Design Average Daily Flow is the flrm capacity of the pump station divided by a peaking
factor (pf) not less than 2.5.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): Bctvt9ERSpAl WATER RMAftifi irate t'AULZTy
Downstream Permit Number: NC QQ 0552
Page 1 of 6
FTSE 04-16

III. Certification Statement:
L - --T AMA-, certify to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the
receiving wastewater treatment facility and that the flow from this project is not anticipated to
cause any capacity related sanitary sewer overflows or overburden any downstream pump station
en route to the receiving treatment plant under normal circumstances, given the implementation of
the planned improvements identified in the planning assessment where applicable. This analysis
has been performed in accordance with local established policies and procedures using the best
available data. This certification applies to those items listed above in Sections I and II plus all
attached planning assessment addendums for which I am the responsible party. Signature of this
form indicates acceptance of this wastewater flow.
US& - 3 -zo
Signing Official Signature
Date
Page 2 of 6
1=TSE 04-16

WL
j E
VA
,
0 We
S .
t
o
► cs it
o
t:46� _ a
Wo-d- d
x
Igpo .0.3

SITE

I ngincers
I'lannvr4
Surveyors
Boritni, W'adr and A ,snciate�;, 1. A.
June 11, 2020
North Carolina Department of Environment Quality
Water Quality Section
Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27699-1628
[phone]
Regarding: St. Charles Place Apartments
Charles Rollins Road
Henderson, NC
To Whom It May Concern:
NC Dept olrEnvironmental Qualih
JUN 16 2020
Raleigh Regional 4fffce
Please find attached fast track application for the gravity sewer line for the above referenced project.
Included in this package are the following:
1. One original and one copy of the Fast Track Application
2. One check for $480
3. One original and one copy of the Downstream Sewer Flow
Tracking/Acceptance Form
4. One original and one copy of the LISGS Topographic map and street level map
The proposed sanitary sewer extension will serve 24 — three bedroom units, 44 — two bedroom units
8— one bedroom units for St. Charles Place Apartments, The project is located off Charles
ollins Road in Henderson, North Carolina. The sewer extension will tie into the existing City of
Henderson's 8" sanitary sewer located in Charles Rollins Road, The 57 gpm at 35 feet total dynamic
head pump station associated with the project will be privately. The proposed gravity sewer and
forcemain extension will be owned and maintained by the City of Henderson and permitted
separately. The flow associated with this project will be permitted with the public portion of this
project.
Please call if you have any questions.
Very Truly Yours,
?lam vx//�
Matt Williams, P.E.
Enclosures
621 Eugene Court, Suite 100, Greensboro, NC 27401.2711 - 110 00� 21882, Greensboro, NC 27420-1882
Phone [phone] - fas 136-275.371')
Website % itu .bo Ism uadt .a )m
NC License # C-0868

1120/2020
Mail - Cashion, Ted - Outlook
Re: [External] RE: St. Charles Place Apartments - Public
Cashion, Ted <[e-mail]>
Mon 7/20/2020 9:33 AM
To: Matt Williams <[e-mail]>
Cc: [e-mail] <[e-mail]>; Robinson, Jason <[e-mail]>
thanks Matt
Ted Cashion
Water Quality Regional Operations
Division of Water Resources
NC Department of Environmental Quality
Raleigh Regional Office
919-791-4254
ted.cashion@ncdenrgnv
1628 Mail Service Center
Raleigh, NC 27699-1628
3800 Barrett Drive
Raleigh, NC 27609
Subscribe to Collection System & Sewer Permitting Updates
Email correspondence to and from this address may be subject to the North Carolina Public Records Law and may
be disclosed to third parties unless the content is exempt by statute or other regulation.
From: Matt Williams <[e-mail]>
Sent: Monday, July 20, 2020 9:20 AM
To: Cashion, Ted <ted.cashion@ncdenrgov>
Cc: [e-mail] <[e-mail]>
Subject: [External] RE: St. Charles Place Apartments - Public
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment
to [e-mail]
The application is correct showing 12 one bedroom units.
Matt Williams, P.E.
Borum, Wade & Associates, P.A.
621 Eugene Court
Greensboro, NC 27401
[phone] ext. 118
httpslloutlook.office365.com/mailldeeplink7version=2020070601.02&popoutv2=1 in

7120/2020
Mail - Cashion, Ted - Outlook
From: Homer Wade [mailto:[e-mail]]
Sent: Monday, July 20, 2020 8:59 AM
To:'Matt Williams' <[e-mail]>
Subject: FW: St. Charles Place Apartments - Public
See below
Homer S. Wade, P.E., P. L.S
Borum, Wade and Associates, PA
621 Eugene Court — Suite 100
Greensboro, NC 27401
Ph: 336-275-0471 (102) (o)
Fax: [phone]
www.borum-wade.com
B A
Hamm. Wadr &nil Atsorlairs, i'_.1,
From: Cashion, Ted[mailto:ted.cash [e-mail]_]
Sent: Monday, July 20, 2020 8:57 AM
To: Homer Wade <[e-mail]>; [e-mail]
Cc: Robinson, Jason <]ason.t.ro [e-mail]>
Subject: St. Charles Place Apartments - Public
Hi Clark and Homer,
We are drafting the sewer extension permit for the subject project. The narrative submitted states there
are 24 - one bedroom apartments. The application notes there are 12 - one bedroom apartments.
Please confirm the number of 1 bedroom apartments for this project, and corresponding flow.
thx
ted
Ted Cashion
Water Quality Regional Operations
Division of Water Resources
NC Department of Environmental Quality
Raleigh Regional Office
919-791-4254
[e-mail]
1628 Mail Service Center
Raleigh, NC 27699-1628
3800 Barrett Drive
Raleigh, NC 27609
Subscribe to Collection Sy tem & Sewer permitting Up tes
httpsJlouUook.office365.com/maiUdeeplink?version=2020070601.02&popoutv2=1 213

Cashion, Ted
From: Cashion, Ted
Sent: Friday, June 19, 2020 12:35 PM
To: [e-mail]; 'Homer Wade'
Cc: Robinson, Jason
Subject: St. Charles Place Apartments fast track sewer extension applications
Clark and Homer,
We have received the subject 2 applications and want to let you know of a modification we will make.
For the app where the City of Henderson is the applicant, we will add "Public" at the end of the project name.
For the app where St. Charles Place Apartments, LLC is the applicant, we will add "Private" at the end of the project
name.
This distinction helps us to keep it straight in our office and our database.
Any objections to our modifications?
We are 5-7 weeks from issuing these permits.
Thx
ted
Ted Cashion
Water Quality Regional Operations
Division of Water Resources
NC Department of Environmental Quality
Raleigh Regional Office
919-791-4254
ted.cashion(Mncdenr.eov
1628 Mail Service Center
Raleigh, NC 27699-1628
3800 Barrett Drive
Raleigh, NC 27609
D-.E
tk�uz,ere cr ia,rm'+er.�l q�.a��:r\ r
Subscribe to Collection System & Sewer Permitting Updates
i