HomeMy WebLinkAboutWQ0033744_Sewer Extension_20090113USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number:
(to be completed by DWQ)
1.
Owner/Permittee:
1 a.
Richmond County Schools
Full Legal Name (company, municipality, HOA, utility, etc.)
Z
1 b.
Dr. George E. Norris- Superintendent
O
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials!)
a1
c.
The legal entity who will own this system is:
❑ Individual ❑ Federal ❑ Municipality ❑ State/County ❑ Private Partnership ❑ Corporation ® Other (specify):
Richmond County Schools
0
1 d.
P.O. Box 1259 1 e. Hamlet
LL Z
Mailing Address City
1f.
NC 1g. 28345
Z
State Zip Code
1 h.
910-582-5860 1 i. 910-582-7921 1j. N/A
QTelephone
Facsimile E-mail
0
2.
Project (Facility) Information:
J
2a.
Chalk Road Elementary School 2b. Richmond
IIL
a
Brief Project Name (permit will refer to this name) County Where Project is Located
Q
3.
Contact Person:
Q3a.
Renee Pfeifer or Kenneth Lorin
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b.
919-319-6716 3c. rpfeifer@clhdesignpa.com
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))
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))
3.
City of Rockingham
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
0
4a.
City of Rockingham WWTP and Compost Facility 4b. NCO020427
F=
Name of WWTF WWTF Permit No.
5a.
City of Rockingham 15b. 8" ®Gravity 15c. WQCS0041
Owner of Downstream Sewer (Receiving Sewer Size ❑Force Main Permit # of Downstream Sewer (Instruction E)
0
6.
The origin of this wastewater is (check all that apply):
--
rayee wiouiu uetacn muo ana ueposit voucner at once
RICHMOND COUNTY SCHOOLS
` P.O. DRAWER 1259 NO. 010842
HAMLET, NC 28345 Unit
0
CAPITAL OUTLAY FUND No.
Date12/08/08
FIDELITY BANK THIS DISBURSEMENT HAS BEEN APPROVED AS REQUIRED 66-104
ROCKINGHAM, NC 28379 BY THE SCHOOL BUDGET AND FISCAL CONTROL ACT. 511
VOID AFTER ONE YEAR e� 1'
9 Y 9 �'
PAY
EXACTLY * * * * * * 4 8 0 DOLLARS AND NO CENTS WEAR FOUR :Mff ZM
TO
NCDENR
THE
ORDER
225 GREEN STREET, SUITE 714
OF
EMTENDEN ,
FAYETTEVILLE, NC 28301 1�
F ANCE OF ER
1100 L08 11, 20 l:0 S 3 LO 3 S8 SI: L 20 S 2 3 2 388P:
Eva
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
FAST -TRACK APPLICATION
O (FTA 12/07 ver5)
for GRAVITY SEWERS, 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://h2o. enr. state.nc. us/peres/Collection%20SystemsICollectionSystemApplications. 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 plans and specifications unless you respond NO to Item 1303).
Separate applications should be made for non-contiauous 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.
4 A
' ❑ 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 B(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(1 b). 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 12/07 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,
(828) 296-4500
Macon, Madison, McDowell, Mitchell, Polk,
(828) 299-7043 Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225.Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Fayetteville, North Carolina 28301-5094
Montgomery, Moore, Robeson, Richmond,
(910) 433-3300
Sampson, Scotland
(910) 486-0707 Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
(704) 663-1699
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) 791-4200
Northampton, Orange, Person, Vance, Wake,
(919) 788-7159 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,
(252) 946-6481
Jones, Lenoir, Martin, Pamlico, Pasquotank,
(252) 975-3716 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
(910)796-7215
(910) 350-2004 Fax
Winston-Salem Regional Office
585 Waughtown Street
Alamance, Alleghany, Ashe, Caswell, Davidson,
Winston-Salem, North Carolina 27107
Davie, Forsyth, Guilford, Rockingham, Randolph,
(336) 771-5000
Stokes, Surry, Watauga, Wilkes, Yadkin
(336)771-4630 Fax
For more information, please visit our web site at.
http://h2o.enr state.nc.us/peres/Collection%20Systems/CollectionSystemsHome.html
or contact the Regional Office serving your county.
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number:
(to be completed by DWQ)
1.
Owner/Permittee:
1a.
Richmond County Schools
Full Legal Name (company, municipality, HOA, utility, etc.)
Z
1 b.
Dr. George E. Norris- Superintendent
0
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials!)
Q1
c.
The legal entity who will own this system is:
❑ Individual ❑ Federal ❑ Municipality ❑ State/County ❑ Private Partnership ❑ Corporation ® Other (specify):
Richmond County Schools
0
1 d.
P.O. Box 1259 1 e. Hamlet
LL
Z
Mailing Address City
1f.
NC 1g. 28345
Z
0
State Zip Code
1 h.
910-582-5860 1 i. 910-582-7921 1j. N/A
QTelephone
Facsimile E-mail
C)
2.
Project (FaciiiW Information:
J
CL
2a.
Chalk Road Elementary School 2b. Richmond
IL
Brief Project Name (permit will refer to this name) County Where Project is Located
Q
3.
Contact Person:
Q3a.
Renee Pfeifer or Kenneth Lorin
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b.
919-319-6716 3c. rpfeifer@clhdesignpa.com
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))
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))
3.
City of Rockingham
Z
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
0
4a.
City of Rockingham WWTP and Compost Facility 4b. NCO020427
Name of WWTF WWTF Permit No.
Q
5a.
City of Rockingham 8" ® Gravity 5c. WQCS0041
Owner of Downstream Sewe�5b.
Receiving Sewer Size ❑ Force Main Permit # of Downstream Sewer (Instruction E)
0
6.
The origin of this wastewater is (check all that apply):
LL
Z
❑ Residential Subdivision ❑ Retail (Stores, shopping centers) % Domestic/Commercial
F—
❑ Apartments/Condominiums ❑ Institution % Industrial (attach
❑ Mobile Home Park ❑ Hospital description.)
® School ❑ Church
contact your Regional Office
❑ Restaurant El Nursing Home
LU
a
Pretreatment
El Office El Other (specify): Pretreatment staff)
% Other (specify):
7.
Volume of wastewater to be allocated or permitted for this particular project: 7,200 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)
Y_ f A 1 '7 /n'7
0
W
Z
H
O
V
Z
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U.
Z
H
W
a
vif
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).
600 students x 12 gpd per student = 7,200 gpd.
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches) Length (feet) New Gravity or Additional
Force Main
—Grauaty-
6" PVC 274' Gravity
8" PVC 354' Gravity
3" PVC 3,672' Force Main
11. Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
Pump Station Location ID (self chosen - as shown on plans/map for reference)
Design Flow Operational Point Power Reliability Option
(MGD) GPM @TDH 1 - permanent generator w/ATS; Force Main Size Force Main Length
2 - portable generator w/MTS
.024 57 GPM @ 78' 1- Permanent generator w/ ATS 3"
Pump Station Location ID
3,672'
(self chosen - as shown on plans/map for reference)
Design Flow Operational Point Power Reliability Option
(MGD) GPM @TDH 1 - permanent generator w/ATS; Force Main Size Force Main Length
2 - portable generator w/MTS
Pump Station Location ID
Design Flow
(MGD)
(self chosen - as shown on plans/map for reference)
Operational Point Power Reliability Option
GPM @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 B,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
14. Have the following permits/certifications been submitted for approval for the system or project to be served?
A
u
Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes ❑ No ® N/A
Sedimentation and Erosion Control Plan?
Stormwater?
® Yes ❑ No ❑ N/A
❑ 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
1. Owner/Permittee's Certification: (Signature of Signing Official and Project Name)
1, Dr. George E. Norris, attest that this application for Chalk Road Elementary School 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 as well as civil penalties up to
$25, 0(j0 per violation. _ , .
FAVJWA F, %/l�l�s
. • . lm
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
Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
1, Kenneth Loring, attest that this application for Chalk Road Elementary School 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 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. Kenneth Loring
Professional Engineer Name
2b. CLH Desian P.A.
Engineering Firm
2c. 900 ggc-eNc�y Fvfz-OT DR-. rbulm IZ.O
Mailing Address
2d. Cary 2e. NC 2f. 2751
City State Zip
2g. 919-319-6716
Telephone
2h. 919-319-7516 2i. kloring@clhdesignpa.com
Facsimile E-mail
04'9
0
�5� S
NC PE Seal, Signature & Date
FTA 12/07
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AMP PORTIONS TAKEN FROM:
USGS H4MLET, NC QUADRANGLE 2002- NNA 5053 1 NW SERIES V842
AND
LISCS ROCIONGMA4 NC QUADRANGLE 195E PHOTOREVISED 1982- DAM SW IV NE SERIES V842
CHM ROAD B.EMWARY SCHOOL
RICNMOND COUNTY SCHOOLS
DATE JANUARY, 2009
PROJECT NO: 07 US
RR1 COUNTY AND HAMLET
OUAD MAP
%J7
SCALE 1" = 2000'
CLH DESIGN, P.A.
Regency Park
400 Regency Forest Drive
Suite 120
Cary, North Carolina 27518
Phone: 919 319-6716
Far: 919 319-7516
Richmond County, NC Online GIS
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Richmond County GIS
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About
17
http://www.riclunondnc.org/rc—ims/ 1/12/2009
Certification of Sewer Availability
ROCKINGHAM
A CITY LOOKING FORWARD
Date: 12/10/2008
To: Renee C. Pfeifer, Project Manager CLH Design, P.A.
From: Richard Haugen
RE: Certification of Sewer Availability
Currently, the City of Rockingham owns and operates a WWTP (NC 0020427) rated
for 9.0 MGD of treatment. We currently process approximately 3.8 MGD of our rated
flow. The City of Rockingham has committed to providing offsite sewer
improvements to serve the proposed Chalk Road Elementary School located near
the intersection of Chalk Road and Airport Road.
The City of Rockingham has sufficient capacity at this time within its VW1 TP to meet
the demand for a new school. We understand the average daily flow is not expected
to exceed a total of 7,200 GPD.
If you have any further questions, please feel free to contact me directly at (910) 895-
2488.
Signature:
Print: Richard J. Haugen
Date: g--/0'd '�-'
12/102008 Confidential 1
514 Rockingham Road, Rockingham, NC 28379 • Phone (970) 895 9088 - Fax (970) 997 6617 * www.gorockingham.com
CLH design, p.a.
Regency Park, 400 Regency Forest Dri ve, Suite 120
Cary, North Carolina 27918
Phone. (919) 319-6716 Fax: (919) 319-7916
Email. clhdesign@clhdesignpa.com
LETTER OF TRANSMITTAL 12-Jan-09
To: Division of Water Quality- Attention: Trent Allen
Company: NCDENR- DWQ
Address: 225 Green Street, Suite 714
City, State Zip: Fayetteville, NC 28301
Phone: 910-433-3300
Fax:
Method: UPS Ground
Subject: Chalk Road Elementary School- Fast Track Sewer App. CLH Project Number: 07-145-Prmt
❑
E
Prints
Reports
❑ Originals
❑ Copy of Letter
❑ Specifications ® Applications
❑ Submittals E Other: $480.00 Fee
We are sending you the following items:
No. of Copies Date
Description
•
2
12-Jan-09
Fast Track Application
•
1
12-Jan-09
$480.00 Application Fee
•
2
12-Jan-09
Form FTSE 10/07
•
1
12-Jan-09
Flow Acceptance letter from City of Rockingham
•
1
12-Jan-09
8.5x11 USGS Topo Map
•
1
12-Jan-09
Street Level map
•
1
12-Jan-09
Project Narrative
Additional Remarks:
Enclosed is all of the information for a Fast Track Sewer permit. Please feel free to contact me if you have
any questions at 919-319-6716 x 4016.
1 look forward to hearing from you.
Thanks,
Renee
Renee C. Pfeifer
Signed
cc: File
07-145/Permit
CLH design,
Regency Park, 400 Regency Forest Dri ve
Cary, North Carolina 27918
Phone: (919) 319-6716 Fax: (919) 319-7916
1/12/09
TO: Division of Water Quality- Attention Trent Allen
FROM: Renee Pfeifer — CLH Design, P.A.
RE: CHALK ROAD ELEMENTARY SCHOOL
CC: (07-145-prmt)
Dear Mr. Allen:
Attached are the following applications, plans and specs for your review:
• 2- Fast -Track Applications- 1-original and 1-copy
• Project Narrative below.
• $480.00 Application Fee
• 2- Form FTSE 10/07
• 1- Flow Acceptance Letter from the City of Rockingham
• USGS Topographic Map
• Street Level Map indicating where the downstream connection point is located and the permit
number for this downstream connection.
Project Narrative:
A new elementary school and associated site work is proposed on the south side of Chalk Road, east of
the intersection of Airport Road and Chalk Road in Hamlet, North Carolina.
Site work for this project consists of substantial clearing and grading for the construction of a new
elementary school, access drives, parking lots, multipurpose play fields, play areas and utility services.
The final sewer build out design is a series of gravity sewer lines leading to a pump station that is
located at the southern end of the school site to provide sewer for a new 800 student capacity
elementary school. A 3" force main will then leave the pump station and travel approximately 3/ mile
and connect to an existing manhole located along Airport Road in Richmond County, NC. From this
manhole, the system is an existing gravity line that will flow to the City of Rockingham's WWTP and
Compost Facility.
Please let me know if you have any questions or concerns about the attached application. I look
forward to receiving the approved application from your division.
Thanks,
Renee
Renee C. Pfeifer
Project Manager
(919)319-6716
OF W A rF,q State of North Carolina
O� PG Department of Environment and Natural Resources
Division of Water Quality
o Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE-10/07)
Proj ect Applicant Name: Rl c. W+-i c, N e Co u rU t-2:1 '--2ch on 1
Project Name for which flow is being requested: GH-Auc_ RoAb PLE► f. NUUZ-� SC4{,nO L-.
More than one FTSE-10107 may be 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: G„-y or 94:)r-�,.,oN.�y,,.,� W r-p a,�t, Co►�►po� �; �; F�
b. WWTP Facility Permit #: (c.Oo Zo 12-1
All flows are in MGD
c. WWTP facility's permitted flow
MZD
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
— L$
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
A. , %� 11
h. Percent of permitted flow used
4;- - JL
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.
(Firm/Design))
Daily Flow, MGD
.}
IAOUA ��l»,D ✓/��l�t� J a60
III. Certifici tion tatement:
1, a►r� , certify that, to the best of my knowledge, the addition of the
volume of wastewater to ia 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 responsible party. Signature of this form indicates
accepte of Vs iwa ewater flow.
Signing Df ciaUignaturk) Date