WQ0041854_Application (FTSE)_20200728

State of North 'Carolina
Department of Environmental Quality
Division of Water Resources
W
�" 15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number. 14q o 0 (lo be completed by pWR)
All items must be completed ar the application will be returned
1. APPLICANT INFORMATION:
I. Applicant's name: CITY OF WILSON. NC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: W.T.BASSs I V per 15A NC AC 02T .0106(1
Title: CITY ENGINEER
4. Applicant's mailing address: P.Ozox ii 0
City: WILSON State: NORTH CAROLINA Zip: 27896-
5. Applicant's contact information:
Phone number: 2(, 52) 399.2453 Email Address: [e-mail]
If. PROJECT INFORMATION:
I. Project name: JANICE PLACE �►
2. Application/Project status: Proposed (New Permit) Existing n
Permit/Project '� d
CD
If a modification, provide the existing permit number. WQ00 and issued date:
If new construction but part of a master plan, provide the existing permit number. WQ00
3. County where project is located: WILSON
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.751297' Longitude:-77.96502.0 co D
5. Parcel ID (if applicable): 3702-69-9951 N
(or Parcel ID to closest downstream sewer) *— r
III. CONSULTANT INFORMATION: O
n '✓
1. Professional Engineer: RONNIE L. SUTI'ON PE License Number: 10180
Firm: HERRING- UTTON & ASSOCIATES P.A.
Mailing address: 2201 NASH STREET NW
City: WILSON State: NORTH CAROLINA Zip: 27896-
Phonc number: 252 291-8887 Email Address: rsutton hemp-sutton.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: HONINY SWAMP W WTP Permit Number. NC 0023906
Owner Name: CITY OF WILSON NC
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQNOT AVAILABLE Downstream (Receiving) Sewer Size: 8" & 12"
inch
torn Wide Collecrio.n S stem -Permit Numher if a 1icabT� J: WQCS00021
Owner Name(s): CITY OF WILSON. NC
FORM: FTA 04-16 Page 1 of

VI, GENERAL REQUIREMENTS
I. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑No ®N/A
2. if the Applicant is a Developer of lots to be sold, has a !iv- ope s pnera 'ono ement (FORM: DGY) been attached?
❑ Yes ❑No ®N/A
3. If the Applicant is a Horne PryPert� c cyners' .has an t),onal AUcLment FORM. HOA) been attached?
❑ Yes ❑No ®N/A
4. Origin of wastewater. (check all that apply):
❑ Residential Owned ❑ Retail (stores, centers, malls)
❑ Car Wash
® Residential Leased ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool /Clubhouse
❑ Food and drink facilities ❑ Church
❑ Businesses 1 offices /factories El Swimming Pool/Filter Backwash
❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: I o0 % Domestic/Commemial %Commercial
% Industrial See I5A NCAC 02T .0103.(20])
Its there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A_114 'AC 02T At 14 ? ❑ Yes ® No
It yes, vrovide a Copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see AII&I 14Daily Design Flow ' -a
Na. of Units
Flow
Residentia (3 BDR)! 360 gal/Unit
I2
4,320 GPD
gay
GPD
gall
GPD
gav
GPD
gal/
GPD
gall
GPD
Total
4,320 GPD
a See i $A NC'AC Q2T k. 114 b), fd), (eX I I and JgQ 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.5_ �2A-4).
b Per 15A NCAC 02T .0I 14(c), design flow rates for establishments not identified [in table 15A NC C 02T,01141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
S. Wastewater generated by project: 4,320 GPD {per .1 A NCA ...21" .0
Do not include future flows or previously permitted allocations JJ�J �Z
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow 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

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T.0305 &MDC (Grpvity Sewersl,:
L Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 370 SDR 35 PVC
8 so CL 50-DI
D Section II & Ill of the MDC for Permitting of Gravity Sewers contains information related to design criteria
D Section III contains information related to minimum slopes for gravity sewer(s)
t Oversizing lines to meet minimum slope requirement Is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC(Pump StationsfFnrce Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: NIA
2. Approximate Coordinates (Decimal Degrees): Latitude:._,_, Longitude: -_,�
3. Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): gallons per minute at_ feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A N AC 02T ,0 0 h I :
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)($)_
Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
D 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(hx i )(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(I XQ:
> It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of

lX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(1)):
1. Does the project comply with all separations found in .15A._ NCAC 0 T .0301&& ® Yes []No
Y A,_ tiCAC 22LO-LO-51g)contains alternatives where separations in 0 T OS cannot be achieved.
> "Stream classifications can be identified using the Division's NC Surface Water la ific s w e
> If noncompliance with 2T.0 ,4. { fl f I, see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ❑ Yes ❑ No ® NIA
> Seethe 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
D As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per I SA... NCAC_ 02BT02U0? ® Yes ❑ No ❑ NIA
> This would include Trout Buffered Streams per ] SA NCAC,2BA202
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 40 f k Buffer Pennirting BninC
5. Does project comply with 15A NCAC 021_OI05(c 6) (additional permits/certifications)? ® Yes ❑ No
Per I SF1.tiAC 02T.O10Sc, 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, storm water management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per i SA NC &g O T.ol02 "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ❑ No ® N!A
> If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and inspections
documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16
Page 4 of 5

X CERTIFICATIONS:
1. Does the submitted system comply with SA NCAC 02T, the Minim u Des[ n Cr' rna ar �h e i ' PUM, Sutions
and Force hiairns latest version), and the GmvA-Sewe in' 4 D s n Criteria latest v i n as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Aimroval ofthe reguest is re uired prior to submittal orthe Fast Track ApDlication and supRorting documents.
2. Professional Engineer's Certification:
1
11 -- — �- • _attest that this application for
(Professional L gineer's name from Appiic tion Item HU.)
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 S 10,000, as well as civil penalties up to $25,000 per violation +u��+""�E„''Al"I'rlill..J
1.
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
v J- LA.ur 01 % wi t L tNdf fn-S
(Signature Authority's name & title from Application Item 1.3.)
E�SS/0--
-SE
AL
10180 4
that this application for
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, andior 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—
] 5—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 S 10,000 as well as civil penalties up to $25,000 per violation.
Signature:
Date: ZL zo
FORM: FTA 04-16 Page 5 of5

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: City of Wilson
Project Name for which flow is being requested: Janice Place
More than one FTSE may be required for a single project if the owner of the FVWTP is not responsible far all ptunp
stations along the route of the proposerl wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Hominy Swamp Water Relcamation Facility
b. WWTP Facility Permit #: NCO023906
All flows are in MGD
c. WWTP facility's permitted flow 14 MGD
d. Estimated obligated flow not yet tributary to the WWTP 1.12867
e. WWTP facility's actual avg. flow 8.86 MGD
f. Total flow for this specific request 0.00432
g. TotaI actual and obligated flows to the facility 9.98867
h. Percent of permitted flow used 71.35
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:
(A)
(B)
(C)
(D)=(B+C)
(E)=(A-D)
Design
Obligated,
Pump
Pump
Average
Approx.
Not Yet
Total Current
Station
Station
Firm Daily Flow**
Current
Tributary
Flow Pius
(Name or
Permit
Capacity, (Firm,' po,
Avg. Daily
Daily Flow,
Obligated
Available
Number)
No.
MGD MGD
Flow, MGD
MGD
Flow
Capacity***
* The Firm Capacity (design flow) of any pump station is defined as the maximum pumped flow
that can be achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor
(pf) not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is ¢ 0.
Downstream Facility Name (Sewer): Hominy Swamp Water Reclamation
Downstream Permit Number: NC 0023906
Page 1 of 6
FTCF 1 n-1 Q

111. Certification Statement:
I W.T. Bass IV, PC 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 certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
Signature
1 1rec-�' CI `Ptkic k
Title of Signing Official
t Z foz.
Date
Page 2 of b
T'TQP 1n 1Q

JANICE PLACE
USGS QUAD SHEET WINSTEAD CROSSROADS
NTS

N
8
4 '
/r
Ashbr-. ok Dr ONO
JANICE PLACE
! ' 1 usdp
r
i
STREET LEVEL MAP
NTS

dHerring -Sutton
St ASSOCIATES • P.A.
ENGINEERS • SURVEYORS •PLANNERS
Scott Vinson
Regional Supervisor
NCDEQ-DWQ
Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27699-1628
SUBJECT:
Gentlemen:
July 26, 2020
�cb�ptof
�c�lo
n�fOf�ce
Fast -Track Sewer System Extension Application
Janice Place
City of Wilson
Enclosed for your review and processing with one original and once copy are the
following items concerning the proposed installation of approximately 450 linear
feet of 8" diameter gravity sewers, and other appurtenances to serve 6 each
duplex 3-bedroom dwelling units along Ashbrook Drive within Heritage Place
Subdivision for project entitled "Janice Place" located in Wilson, North Carolina.
The proposed project will require a requested flow allocation of 4320 gallons per
day. The enclosed items are as follows:
• Fast -Track Application Form "FTA 04-16"
• Colored USGS Quad Sheet with approximate system layout
• Street level map of Project Area
• Flow Tracking/Acceptance for Sewer Ext. Permit Application (FTSE 04-16)
• Check in the Amount of $480.00 (Application Fee).
Thank you very much for your assistance with this matter, and if further
information is needed, please do not hesitate to contact us.
-Sutton and Associates, P.A.
nie L. Sutton, P.E.
Enclosures
cc: Bill Bass, P. E
2201 Nash Street NW • Wilson, North Carolina 27896 - [phone] • Fax [phone]