WQ0041915_Application (FTSE)_20200817

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: �q���! (� (to be completed by DWR)
All items must be completed or the application will be returned
1. APPLICANT INFORMATION:
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I . Applicant's name: City of Sanford (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: Paul Weeks Jr. PE per 15A NCAC 02T .0106(b) NODePt of Environmental QualitY
Title: City Engineer AUGA17 2020 ©,rti jo f�/
4. Applicant's mailing address: P.O. Box 3729 +�-
City. Sanford State: NC Zip: 27331-3729
Raleigh Regional afflco
5. Applicant's contact information:
Phone number: [phone] Email Address: paul.weeksesanfordnc.net
IL PROJECT INFORMATION:
1. Project name: Little Buffalo Creek Outfall Replacement
2. Application;'Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
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: Lee
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.4785 Longitude:-79.1732
5. Parcel ID (if applicable):
(or Parcel ID to closest downstream sewer)
I11. CONSULTANT INFORMATION:
1. Professional Engineer: Leonard McBrvde Ill. PE
License Number: 036163
Firm: WithersRavenel
Mailing address: 424 Gallimorc Road, Suite C
City: Greensboro State: NC Zip: 27409-
Phone number: [phone] Email Address: Imcbrvdc(@..withersravenel.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Big Buffalo Wastewater Reclamation Facility Permit Number: NCO024147
Owner Name: City of Sanford
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
I. Permit Number(s): WQ Downstream (Receiving) Sewer Size: 30 inch
System Wide Collection S ,tem Permit Numbers if applicable : WQCS D004
Owner Name(s): City of Sanford
FORM: FTA 04-16 Page I of 5

Vl. GENERAL REQUIREMENTS
f. 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 Devcloner's Operational Agreement (FORM: DEV) been attached?
❑ Yes ❑No ON A
3. If the Applicant is a I Iorne Fruperty Owners' �Association, has an Olrerational Aereemc t t FORM. HOA 1 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 PoolClubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pooh Filter Backwash
® Businesses offices factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater, 100 % Domestic.:Commercial % Commercial
% Industrial (See 15A NUAC 02T .0101 201)
I -Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa Flow reduction been approved under 15A NCAC 02T A114(f)? ❑ Yes ® No
If ves, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 0ZT.0114(fl)
Daily Design Flow °''
No. of Units
Flow
gall
GPD
gall
GPD
gal!
GPD
gall
GPD
gall
GPD
gal/
GPD
Total
GPD
a See 15A NC -AC- 02T .0I 14tb1. (d),(c1Ll) unci (c)(?1 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 .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0„1 141 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 15 A NC'AC 02T .01 14
". Do not include future flows or previously permitted allocations
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

VI1. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
18 5,280 DIP
D Section 11 & 1II 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
VII1. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Puma Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
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 NCAC 02T .0305(h)(1):
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B)_
D 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 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 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(t)):
1. Does the project comply with all separations found in ISA NCAC ® Yes [-]No
D 15A NCAC 02T.0305 contains miaimum separations that shall be provided for sewers stems
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-I waters of Class I or
Class 11 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 buil4tg foundation
5 feet
Any basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainaae systems and interceptor drains
5 feet
Anyswimming is
10 feet
Final earth vertical
36 inches
D 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(t) cannot be achieved.
D "Stream classifications can be identified using the Division's NCurface Water Classifications weboage
D If noncompliance with 02T.0305(t) or fel_ see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ❑ Yes ❑ No ®N/A
D See the Division's draft separation requirements for situations where separation cannot be meet
D 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 15A N&AC 02B.0200? ❑ Yes ❑ No ® NIA
D This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project require coveragetauthorization under a 404 Nationwide or ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
D Information can be obtained from the 401 & Bsiffer Permitting Branch
5. Does project comply with 15A NCAC 02T.010 c (additional perm its/certi6cations)? ® Yes ❑ No
Per 15A NCAC 02;);',Q105(c)(61. 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 13A NCAC 02T.0402. "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 ❑ NIA
9 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 CritedaPermitting ti
anti Force Mains (IpMst version). and the Gravily Seweras applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of th uest is reguired vrior to submitttalof the Fast Track ! ti and u rti documents.
2. Professional Engineer's Certification:
I, ---
(Professional Engineer's name from Application Item III.1.)
attest 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 143 215.6B, 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 S10,000, as well as civil penalties up to $25,000 per violation. _,flff,._
3. A
I,
11
or
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 Iand 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 143-215.6B. any person who knowingly makes any false
statement, representation, or certification in ication package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed S 10,000 as we as civil pe . up to $25,000 per violation.
Signature: Date: ivZ)
FORM: FTA 04-16 Page 5 of 5

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0 WithersRavenel
Our People Your Success
August 13, 2020
Scott Vinson
North Carolina Department of Environmental Quality
Water Resources/Water Quality Environmental Regional Supervisor
3800 Barrett Drive, Raleigh, NC 27609
RE: Little Buffalo Creek Outfall Replacement Fast Track Application
WR Project #: 02180604.00
Dear Mr. Vision,
NC Dept of Environmental Quality
AUG 17 2o@
Raleigh Regional Office
Please find attached the Following for the Little Buffalo Creek Outfall Replacement Fast Track
Application submittal.
1) $480.00 Check For Application Fee
2) Original and One Copy of Application
3) Original and One Copy of Site Maps
Please feel free to contact me if there are any questions or comments.
Sincerely,
WithersRavenel
Leonard McBryde III, PE
Project Manager
424 Gallimore Dairy Road, Suite C I Greensboro. NC 27409
t: 336.605.30091 t: 919.467.6008 i www.withersravenel.com I License No. C-0832
Asheville I Cary I Greensboro I Pittsboro I Raleigh Southern Pines I Wilmington