WQ0041990_Application (FTSE)_20200921

State of North Carolina
Department of Environmental Quality
Division of Water Resources
D of Watri tote 1SA NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: � Q (to be completed by OwR)
Al[tems must be completed or the analicatiou w01 be returned
L APPLICANT INFORMATION:
1. Applicant's name: City of Sanford (company, municipality, HOA, utility, etc-)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ Statecounty Municipal ❑ Other
3. Signature authority's name: Paul M. Weeks. PE per ISA NCAC„Q2T .OI OG(b)
Title: Qgy En¢ineer NC Dept ofEnvironrnental Quality
4. Applicant's mailing address: 225 E. Wcathersppon Street
City: Sanford State. 1K Zip:2.7331- 5EP % 1 2020
5. Applicant's contact information: P of -9W
Phone number. WD M-jam Email Address- [e-mail] Raleigh Regional office
II. PROJECT INFORMATION:
L Project name: 709 Md&gd Drive Sewer Extension
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. WQ04
3, County where project is located: jze
4- Approximate Coordinates (Decimal Degrees), Latitude: 35,477093 Longitude: -79.=07'
5- Parcel ID (if applicable); 9Q2-88.5604-00
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1 Profeuional Engineer. hmd E. Hilliard License Number: 03567Q
Firm- Hilliard
Mailing addreu' PQ Box 242
City- Sanford State NC Zip: 27331--
Phone number (Q0 M-2834 Email Address -
IV. WASTEWATER TREATMIM FAC IJrY (WWTF) INFORMATION:
Facility Name:lm=cntPermit Number. NOMI
Owner Names City of Sttaford
V. RECCBIM; DOWNSTREAM SEWER INFORMATION (if diRermt thou WWTF):
I. Permit Number(a) WQ} Downstmun (Rxaiyitto Sewer Sim, $ inch
Systat Wl& Collection Systcru Pts M Number(s) Cif applwablc). WQCSgW
Owner Nitme(s): Qof 5anfcmi
.—...J—

VL GENERAL REQUIREMENTS
I. IS 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 said. has a v • `s (INrational AgnIgent (1 been attached?
❑ Yes [--]No ®NIA
3. If the Applicant is a NOmeftomrtV t iwners' Association, hus an 00=ionalAerecment (F)RM: HO&) 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 preparationtservice ❑ Hotel and/or Motels
❑ School / preschool 1 day care ❑ Medical I dental / veterinary facilities ❑ Swimming Pool /Clubbouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Horne ❑ Other (Explain in Attachment)
5. Nature of wastewater: Ja% Domestic/Commercial % Commercial
% Industrial (Ste ISANCAC 02T .0103(2QI)
4 Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02'T ,0114(f)? ❑ Yes ®No
D If M provide a copy of now reduction approval letter
7. Summarize wastewater generated by project.
Establishment Type (see 22T.01140 Daily Design Flow 0 No. of Units Flow
Residential 120 gal/day 4 480 GPD
gay GPD
gall GPD
gall GPD
gall GPD
gall GPD
7braf 480 GPD
a See 15AMAC QZ' .01.14(b)td! (cX vZ) for caveats to wastewater design flow rates (Le., minimum pow per
dwelling; proposed unknown non-residential development uses; public access facolties located near high public use areas -
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rsmals as defined
b Per 15A NCAC 02T .0114(c), design now rates for establishments not identified tin table 15A NCAC 0Mt t ei zW be
determined using available flow data, water using futures, occupancy or operation patterns. and other measured data.
8. Wastewater generated by Project 4N GPD (pee
D Do not include future flows or previously permitted allocations If permitted flow is Zar% indicate why..
❑ Pump Station or Gmvity Sewer where flow will be permitted in subsequent permits that connect to this lice
❑ glow has already been aklocated in Permit Number;
❑ Rehabilitation or replaoaaent of existing sewer with no now flow expected
0 Other (Explain):

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - QZT .0305 & =ravi
I- Summarize gravity sewer to be permitted:
Sire (inches) Length (feet) Material
B 98 PVC
D Section H & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
D Section III contains information related to minimum elopes for gravity sewer(s)
D Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIM PUMP STATION DESIGN CRITERIA (If Applicable) — 24 T g, 5 & MDC (Puma 5tations/Farce Malnsl:
COMPLETE FOR EACH PIMP STATION INCLUDED IN TlM I!QB LT
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 t12T A3050X 1K$)i
D Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
D Mast be permanent to facility
Or if the pump station bas an average daily flow less than 15,000 gallons per day:
❑ Portable power seem with manual activation, quick -connection receptacle and telemetry -15A NCAC 02T
.0305(bXlXQ
or
❑ Por W& pumping unit with plugged emergency pump connection and telemetry -15A NCAC 02T A3p XIXC),
> It aball be demonstrated to the Division that the portable solute is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
> If the portable power ounce of pump is dahcated to multiple pump stations, an evaluation of all the pump stations' stnraga
capacities and the wtation Schedule of the portable power soufca or pump, including travel timef =as<, shall be provided
in the Case of a midtiple station power outage.
FORM. FTA 04-16 Fnge 9 of

IX, SETBACKS & SEPARATIONS -- (02B .0200 tit ISA NCAC 02T .0305(f)):
I. Does the project comply with all separations found in 15A NCAC 021.0_V5tfr) & W
D 15A NCAC 02T_030sff1 contains minimum separations that shall be orovided for sewer systems:
® Yes ❑ No
Setback Parameter*
Se aratioa Reattired
Storm sewers and other utilities not listed below vertical
24 inches
Water maims vertical -water over sewer includinjg in benched trenches
Is inches
Water mains orizontal
10 feet
Reclaimed water lines vertical - reclaimed over sewer
19 inches
Reclaimed water lines horizontal - reclaimed over sewer
2 fact
"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-1 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
Draima e s stems and interceptor drains
5 feet
Any swimming Is
10 feet
Final earth grade vertical
36 inches
D 15A NCAC 02T.0305(gl contains alternatives where separations in OZT.0705(l1 cannot be achieved.
D **Stream classifications can be identified using the Division's NC Surface Water Classifications welXlaae
D If noncompliance with 02T.0305(f) or (gJ sex Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No
D Seethe 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 all setbacks found in the river basin rules per .15A NCAQ Q20.0=,? ® Yes ❑ No
D This would include Trout Buffered Streams per,1_16 NCAC 213.0202
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 adhated to for projects that impact wetlands or surface waters
D Wotmation cam be obtained from the
S. Dora project comply with 15A NCAC_02T.01 Q5tcx61(additional permits/certificstions)? ® Yes ❑ No
Per .15A-NCAC Q=103(00). directly related environmetta] percents or certification applications am being prepared, have
been applied for. or have been obtained. issuance of this permit is contingent on iuuanee of dependent permits (erosion and
sedimentation control phtna. stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per M XAC MUM "high -priority sewer" mum "any atrial sewer. sewer corseting sutfasa wattus, siphon, or sewer
positioned parallel to surambanks that is subject to cession dul undermines or deteriorates the sewer.
❑ Yes ®No
D If yea, include an ann hruent with details for each line, including type (aerial line, sire, material and location).
High Priority liars shall be inspected by their , I tm a or its representative at least otrceemy abr-maths and lmpect�
deeammted per 15A NCAC 02T.0MaX5) or the pertaftee s fndMdual Systata-Wide Coaaction permlL
FORM: FTA 04-16 Page 4 of 5

X CERTIFICATIONS:
1. Does the submitted system comply with ISA NCAC 0?T, the Minimum Design Criteria fir the Permitting of emmo Stations
d ui s tc. vcrs and the G • i Criteria (latest verxo as applicable?
® Yes ❑ No
If No, complete and submit the VariancelAlteraadve Design Request application (VADC 10-14) and supporting documents for
review.ARRIC0121 2f th u riot to submittal of JbgLaTrack Aeolicefignt4.
2. Professional Engineer's Certification:
1, " `� r � 'g-7- t I Q r t 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 Qatest 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 he 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 scat, signature, and date:
Q�OFEE&�
gam_ Z
d `•SC 7
�'�,yF hIl,L3N�
'Fills/M
y /s Za
3. Applicant's Certification per 15A NCAC 02T .0106(b):
�Applicati
(Signature Authority's name & ti a.3.) attest that this application for
has been reviewed by me and is accurate and complete to the best of m knowledge. I understand _
of
this application are not completed and that if all required su y g �d that if ailrequJW
application package is subject to being returned as incomplete pI understand that documentation
i n � attachments am not iactuded, this
discharge system to surface waters or the land will result in an immediatenUnderstand
enforcement annt action of wastewater from this non -
of injunctive relief, and/or crirI ale prosecutiao. I will make no claim against the Division of Water May include civil pmadM
of this permit be violated. I also understand that if all required parts of this should a condition
all required supporting in formaq attachrtteats arts not included, t lication Package are not COmpleted and dtat if
incomplete app 'cation package will be
mtirtted to too as
NOTE -stiaemen41n ==dance with Gen "W Statutes 14L215 M � 3
representation, or certification is any applicatioa `'ALa any person who knowingly makes any false
include a floe not to cxceod S 10,000 as well as civil penalties u �p00 be guilty of a Qass 2
; " per Violafim
�. whlcEt may
Signature:
DORM: FfA 04-t6

September 14, 2020
NOM DWR, Raleigh Regional Office
Water Quality Section
1628 Mail Service Center
Raleigh, NC 27699-1628
Re: 709 McLeod Drive Sewer Extension
HEM SF2007.300
Please find enclosed the following,
VILLI
NGINE RING
NC Dept of Environmental. Quality
SEP 71 2020
Raleigh Regional Office
1. One (I) -Original and One (1)-Copy of Fast -Track Application and Supporting Documents
2. Check M 2664 in the amount of $480.00 for application fee
This project is being submitted for gravity sewer extension approval. The project required an
approximate 98 If extension of the existing gravity sewer system in order for the existing gravity system
to reach the project property. The project is an existing residential lot with 3 bedrooms and potential
for one additional future bedroom @ 120 gallons/day/bedroom for a total of 480 gal/day design sewer
flow allocation.
If you have any questions, or require additional information related to the aforementioned
project, please do not hesitate to contact me at this office.
Jarrod E. H11119 CFE, CFM
Hilliard Engineering, PLLC
Copy to. nk, SF2M
Page 1
P.Q. Box 249. Sanford. NC 27331 Nei Nor- P4XW
Omrr 919$82.2834 JhIft Uam

DWR
State of North Carolina
Department of Environmental Quality
Division of Water Resources
t]NIVan of WAter Resources Floc' Tracking/Acceptance for Sewer Extension Applications
(F1'SE 04-16)
Entity Requesting Allocation: City of Sanford
Project Name for which flow is being requested: 709 McLeod Drive Sewer Extension
More than one FTSE may be required far 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 arm the owner of the wastewater treatment plant.
a. WWTP Facility Name: Big Buffalo Waste Water Treatment Facility
b. WWTP Facility Permit #: NC0024147
All}lows are in MGD
e. WWTP facility's permitted flow 12.00000
d. Estimated obligated flow not yet tributary to the WWTP 094802
e. WWTP facility's actual avg. flow 5.7330
f. Total flow for this specific request 0.000480
g. Total actual and obligated flows to the facility 6.6781
h. Percent of permitted flow used 55.68
H. 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)
Design
(a)
(C)
(D)=(B+C) (E)=(A-D)
Sudan Pump
Firm Average Daily
"'
Approx.
Obligated,
Not Yet
Total Current
(Name or
w
Capacity,(Firm / pl),
Current Avg.
Dail Flow
Y
Tributary
Dail Y Flow
Flow Plus
Obligated
Number)
MOD MOD
MOD
MOD
Available
Flow Capacity+•
• The F Cairm padty of any pump station is end ned as themaximumcan be achieved with the largest pump taken out of servie L Pumped flop that
;* Design Average Daily Flow is the firm capacity of the pump station divided by a peaking
factor (Pn not less than 2-5.
e'a A Mfg Assessment Addendum shay be attached for each um
between the project connection point Ond the WWTP where the Available
Caption cityloaISd
Capacity is c O.
Downstream Facility Name (Sewer): MY of Samford
Downstream Permit Number. 34106
W
Page 1 of 6
FTSE 04-16

M. Certification Statement:
I Paul M. Weeks, Jr. _ 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.
Signing Official Signature
Page 2 of 6
qll
Date
FTSE 04.16

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