WQ0041882_Application (FTSE)_20200730

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
I5A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number. E� 1 �� ON
1 A y/��n he cnmpldod by DWR)
All items must be com feted or the avolication will be returned
L APPLICANT INFORMATION:
1. Applicant's name: Fra i unt (company, municipality, HOA, utility, etc.) ,,'k,
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: Chris Doherty per 15A NCAC 02T .0106(b)
Title: Public Qtilities Director
4. Applicant's mailing address: 1630 US Hwy 1
City: Youngsville State: NC Zip: 27596-
5. Applicant's contact information:
Phone number. 9( 19) 556-6177 Email Address: cdoheM(Wranklincountyric.us n
d
H. PROJECT INFORMATION:on
..
1. Project name: Essex South Lift Station G
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2. Application/Project status: ®Proposed (New Permit) ❑Existing Permit/ProjectCD
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If a modification, provide the existing permit number. WQ00 and issued date: ,
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If new construction but part of a master plan, provide the existing permit number. WQ00 0
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3. County where project is located: Franklin Q �p
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4. Approximate Coordinates (Decimal Degrees): Latitude: 63 0857' Longitude: -78.4712" � G'
5. Parcel ID (if applicable): 1855-614669
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer. J. Michael Stocks. PE. License Number 19843
Firm: Stocks Eneineerina, PA
Mailing address: PO Box 1109
City: Nashville State: NQ Zip: 27856-
Phone number 2( 52) 459-819_6 Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Franklin County WWTP Permit Number NCO069311
Owner Name: Franklin County
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQUnknown Downstream (Receiving) Sewer Size. a inch
System Wide Collection System Permit Number(s) (if applicable): WQCSUn 00
Owner Name(s): Franklin County
FORM: FTA 04-16 Page I of 5

Vl. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes [--]No ®NIA
2. If the Applicant is a Developer of lots to be sold, has a Devclaner's Ouctational Agreement (FORM: DEVI been attached?
❑ Yes ❑No ®N/A
3. If the Applicant is a tiornc Pmpert ri wness' . SSOCiBtion_ has an Operational Ag_reecraeni F ]RM: I QAA) 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 preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical i dental I veterinary facilities ❑ Swimming Pool /Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
® Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attaclunent)
5. Nature of wastewater: 100 % Domestic/Commercial % Commercial
% Industrial (See I5A NCAC_02T .0103(201)
bIs there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T:0114f fl? ❑ Yes ® No
If Yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see Q2T.01140
Daily Design Flow'"
No. of Units
Flow
Municipal
gal/day
NIA
0 GPD
gal/
GPD
gaU
GPD
gaU
GPD
gal/
GPD
Sal/
GPD
Total
0 GPD
a See 15A NCAC 02T .0114(b). (d)L(e)(1) 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. . 42A-4}.
b Per 15A NCAC 02T .0l 14(c), design flow rates for establishments not identified [in table 15A NCAC 027_9114] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 0 GPD (per 15A NCAC 02T� ,0J 14)
D Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why.-
0 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) - #i2T .0305 & MDC (Gravity 5ewer5l:
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 20 PVC
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0W & INMC Mgmp Nlainsl:
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: Essex South Lift Station
2. Approximate Coordinates (Decimal Degrees): Latitude: 36.08570 Longitude:-78.4712'
3. Design flow of the pump station: 0.108 millions gallons per day (firm capacity)
4. Operational point(s)of the pump(s): 187.50 gallons per minute at 0 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
4
4840
PVC
6. Power reliability in accordance with I SA NCAC 02T .0305(hlf i 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
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C):
It shall be demonstrated to the Division that die 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 timcframes, shall be provided
in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & l5A NCAC 02T .0305(t)):
1. Does the project comply with all separations found in 15 NCAC 02T .0305M & (g]
D 15A NCAC 02T.0305(f) contains minimum separations that shall he nrovided for sewer systems-
® Yes ❑ No
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below vertical
24 inches
Water mains vertical -water over sewer including in benched trenches
18 inches
Water mains horizontal
10 feet
Reclaimed water lines vertical - reclaimed over sewer
18 inches
Reclaimed water lines horizontal - reclaimed over sewer
2 feet
"Any private or public water supply source, including any wells, WS-1 waters of Class I or
Class II impounded reservoirs used as a source of drinking water
100 feet
"Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water or tide elevation and wetlands see item IX.2
50 feet
"Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage s stems and intme for drains
5 feet
-Any swimming pools
10 feet
Final earth grade vertical
36 inches
D 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305ff) cannot be achieved.
A "Stream classifications can be identified using the Division's NC Surface Water Classifications webLm e
If noncompliance with aZ �,({i5(#] ce f}. see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No
Y 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
D As built documents should reference the location of areas effected
3. Does the project comply with all setbacks found in the river basin rules per I5A NCAC 02B .0200? ® Yes (—]No
Y This would include Trout Buffered Streams per 15A NCAC 213.020�
4. Does the project comply with an individual 404 Permit or any 401 Certifications? ® Yes ❑ No
D Wetland -related permits shall be requested, obtained, and adhered to for projects that impact wetlands or surface waters
D Information can be obtained from the 401 &. Buffer Permitting Branch
5. Does project comply with I SA NCAC 027.0105(c)(6) (additional permits/certifications)?
® Yes ❑ No
Per 15A NCAC 02T_M 05(c)f6). 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 (crosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 136 14CAC 02T.M2. "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to strcambanks that is subject to erosion that undermines or deteriorates the sewer.
[:]Yes ® No
D 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 15A NCAC 02T, the Minimum Design tvriteria for the Permitting of Punw ,%atigo
and Force Mains (latest versionl. and the Gravity Sewer Minimum Design Criteria (la[em version,) as applicable?
® Yes ❑ No
If No, complete and submit the Variance?Altemative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the rgguest is required prior to submittal of the Fast Track A00lication and supportine documents.
2. Professional Engineer's Certification:
1, � � C. _Cx�.1 � attest that this application for
(Professional Engineer's name from Application Item III.1_)
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 143-215.6B, 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.
%.- f
North Carolina Professional Engineer's seal, signature, and date: `` ��` �1� C�+AcRQL AP.-
i ',`'Cj�•• ••SSI �• , .
0� •.9
w : °' SEAL
r 19843
:mac! '•,tcNGiNE�•• �.`
S
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, -t- ,, �,. x : 4 attest that this application for
(Signature Authority's n me & title from Application rtem I.3.)
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 14 �2 f 6 , 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.
igna JX_ _ — — Date:
FORM: FTA 04-16 Page 5 of 5

Sewer Project Narrative
For
Essex South Lift Station
The Essex South Lift Station Project involves the installation of approximately 4,840 LF
4" Forcemain and a new sewer lift stationcapable of pumping 187.5 GPM at 65' of Total
Dynamic Head. The proposed project is expected to provide sewer to a portion of the
County currently not served. The Lift Station is not associated with a specific
development and all connections and flows subject to the Lift Station will be permitted
with the actual projects proposed to connect. Therefore, this project is being permitted
with 0 GPM flow at this time.
NC Dept of Environmental Quality
JUL 3 0 2020
Raleigh Regional Office

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State of North Carolina
Department of Environmental Quality
r. Division of Water Resources
Division of airier Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Franklin Count
Project Name for which flow is being requested: Essex South Lift Station
More titan one FTSE maybe required for a single project if the owner of the WIVTP is not responsible far 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.
n
a. WWTP Facility Name: Franklin County WWTP '
o
_
b. WWTP Facility Permit M NCO069311 c
All flows are in MGD is C
trt
c. WWTP facility's permitted flow 3.00
e
d. Estimated obligated flow not yet tributary to the WWTP t .25 1
e. WWTP facility's actual avg. flow
f. Total flow for this specific request 0 o
g. Total actual and obligated flows to the facility -L
h. Percent of permitted flow usedIrJ
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 Average Daily Approx. Not Yet Total Current
Station Firm Flow** Current Avg. Tributary Flow Plus
(Name or Capacity, * (Firm i pf), Daily Flow, Daily Flow, Obligated Available
Number) MGD MGD MGD MGD Flow Capacity***
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 firm 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 Iocated
between the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): 5' c!r4 kL-
Downstream Permit Number: VAQ GSaC� 1'}
Page 1 of 6
FTSE 04-16

II1. Certification Statement:
I tg -r o P a k 6 2--r4 certify to the best of my knowledge that the addition of
the volume of wastewater to be pernlittcd 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 1 am the responsible party.
Signature of this form indicates acceptance of this wastewater flow.
Date
Pv ��►��T►�. t-r►�S�2Cc---td4_
Page 2 of 6
FTSE 04-16