WQ0042000_Application (FTSE)_20200922

'
State of North Carolina
DWR Department
of Environmental Quality
Division of Water Resources
Dlvls[On Of Water Resources 15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
F!'A 04.16 & SUPPORTING
DOCUMENTATION
Application Number. A96&000 (to be wm;l.:ed by DVMIt
ll Itelgir must be c let e appilimLigg ]tflle retUrned
I. APPLICANT INFORMATION:
1- Applicant's name: Town of &1hylild (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; Div Lansing per I 5A N
Title: Town (yianagcr
4. Applicant's mailing address: 499_South Barnes St
City: Nashville State: 19 Zip: 27856-^
5. Applicant's contact information:
Phone number 2 2 459-4511 Email Address: randv.lansinena townatnashville.gov
+
M PROJECT INFORMATION:
p+ E
I. Project name: Cross Creek Du l�
O
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
u
E~
If a modification, provide the existing permit number: WQ00 . and issued date:
G Q
If new construction but part of a master plan, provide the existing permit number. WQ00
3. County where project is located: �s
o Cl?
4. Approximate Coordinates (Decimal Degrees): Latitude: 35,9684' Longitude;-77,9360'
5. Parcel ID (if applicable): 38101553,2563
(or Parcel ID to closest downstream sewer)
IEL CONSULTANT INFORMATION:
1. Professional Engineer J, Michael Socks License Number. 19843
Firm: Stocks Engineering. P.A.
Mailing address: PO Box 110$
City: Nashvillc State: hK Zip: 27856-
Phone number: 2(y52) 45 -8 Email Address: mstocks0stocksengineerins,.c9m
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Tar River Regional Permit Number: NC00�0317
Owner Name: City of Rocky Mount
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ9022819 Downstream (Receiving) Sewer Size_ 8 inch
System Wide Collection System Permit Number(s) (if applicable). WQCS_
Owner Name(s): Town of Nashville
FORM: FTA 04-16 Page I of 5

VI. GENERAL REQUIREMENTS
I. if the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been artached7
❑ Yes ❑No ®NIA
2. if the Applicant is a Developer of lots to be sold, has a Developer's O erati na A eeme t (FORM: DB been attached?
❑ Yes []No ED A
3. If the Applicant is a Ho e Association, has a tionai Agreement(FORM: HOA been attached?
❑ Yes ❑No ®NIA
Origin of wastewater: (check all that apply):
❑ Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
® Residential Leased ❑ Retail with food preparatian/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical I dental r' veterinary facilities ❑ Swimming Pool /Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: j W16 DomestidCommercial % Commercial
°% industrial (See 15A NCAC 02T .0103(20))
bIs there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .0I 14(f)? ❑ Yes ®No
➢ if ves. Provide a cony of flow reduction aaaroval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0€140)]
Daily Design Flow'-'
No. of Units
Flow
Single Family Residential
360 gallunit
16
5,760 GPD
gal/
GPD
gall
GPD
gay
GPD
gav
GPD
gall
GPD
Total
5,760 GPD
a See 15A NCAC 02T .0114(b1(d). (e)(D and (e)(2) for caveats In wastewater design flow rates (i.e., minimum flow per
dwalling; 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. 42 .
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.014 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
S. Wastzewwrrrgenerated by project: LM GPD (per I, A NCAC 02T .0I 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 rcplacentcnt of existing sewer with no new flow expected
❑ Other (!xp1ain): - --
FORM: FTA 04-16 Page 2 of 5

' GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (!gravitY Sowers :
l • Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 670 SDR-35 PVC
9 Section Ii & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
>a Section Ill contains information related to minimum slopes for gravity sewers)
D Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIIL PUMP STATION DESIGN CRITERIA (If Applicable) — 02T.0305 & MDC (Pump Stations/Force Main-5):
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 T feet total dynamic head CMH)
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)! I -
❑ Standby power suture or pump with automatic activation and telemetry - 1 SA NCAC 02T .0305(h)(1)(8)
9 Required for a1I 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 - 1 SA NCAC 02T
.0305(h)(IXC)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry -I SA NCAC 02T .0305(h)(1)(C):
D It AWI be demonstnded to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
> Ifthe portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule orthe portable power source or pump, including travel timeframes, shall be provided
is 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(f)):
1. Does the project comply with all separations found in 15A NCAC 02T .0305[fl&_Lai
4 ICA Xf, a&-..
:A1 A r - e—upr SVQ1PM5:
® Yes ❑ No
uG l.U}U] r COntamS mmunnm 5e UMUOUS 1U11L NUM U9 1 V ■lubu ay. +� • -
- ---- --
Se aration Re uired
Setback Parameter'
Storm sewers and other utilities not listed below vertical)
24 inches
Waf�mak�sertical-water over sewer includin in benched trenches
18 inches
Waorizontal
10 feet
Reclaimed water lines vertical - reclaimed over sewer
Is 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 B impounded reservoirs used as a source of drinkingwater
100 feeE
"Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
hiob 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
My basement
10 feet
Too sloe of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systerns and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade vertical
36 inches
D 15A NCAC 02T.0305(¢) contains alternatives where separations in 02T.0305M cannot be achieved.
D "*Stream classifications can be identified using the Division's NC Surface Water Classifications weboane
9 If noncompliance with 02T.0305M or (g_), see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No
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 all setbacks found in the river basin rules per 15A NCAC 02B .Q200? ® Yes ❑ No
D This would include Trout Buffered Streams per 15A_-NCAC 213.0202
4. Does the project comply with an individual 404 Permit or any 401 Certifications? ® Yes ❑ No
D Wefland-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 & B ff r PelMitting Branch
5. Does project comply with 15A-NCAC 02T,9105(ci(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0I05(eM directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained, Issuance or this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plaits, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per ISANCAC 02LO402. "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambimb 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 priarityllues shall be inspected by the permittee or its representative at least once every six -months and inspections
documented per ISA NCAC 02T,0403(a)(5) or the permitee's individual System -Wide Collection permit
FORM; FfA 04-15
Page 4 of 5

" X. CERTIFICATIONS:
I. Does the submitted system comply with 15A NCAC 02T, the Minimum Desi n Criteria F
or the Permitting of Pump Stations
04 F rc Mans ate v 'on and the Gmv' Sewer Minimum Desion criteria (latest version as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents far
review. Ai3proval of the ret
guest is required prior to submittal of the Fast Track ApPlication and supporting documents.
2. ProfessionaI Engineers Certification-.
attest that this application for
(Professional Engineer's name from Application Item III. l . )
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 S25,000 per violation,
North Carolina Professional Engineer's seal, signature, and date: �+'tl CAR •�e'ri
s 2 f MO,N T
SEAL 9r i
s •
I Applicant's Certification per I5A NCAC 02T .0106(b):
_attest that this application for
(Signature Authori s name & title tram Application Item 3.}
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if an 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,
Wunctive mlict and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
Of this permit be violated. I ttlsQ 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 wil! be returned to me as
incomplete.
NOTE — in eccotrdartce with General Statutes 14 ULM and 4 -2 i 5. B any person who knowingly makes any false
statement, fresentatian, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed S!r0 as well as civil penalties up to S25,000 per violation.
FORM: FTA 04-16
L_ Page 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
s Flow Tracking/Acceptance for Sewer Extension Applications
(FrSF 04-163
Entity Requesting Allocation. Town of Nashville
Project Name for which flow is being requested: Cross Creek Duplexes
,iftire than one ME uu+r ixr require! fur is single project if rile owner of il+e I t t1. Pl' is +u+r r•cpr+truhle ft)r till pun+p
stations along the rnme of the proprised wasretrater flog.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Tar River Regional
b. WWTP Facility Permit #: NC0030317Iry
All flaws are in AfG&—
c. WWTP i'ncility's permitted Ilow 21.00
M
0
d. Estimated obligated now not yet tributary to the WWTP 0.598 _
e
e. WW1'P tiicility's actual avg_ flow 10.83 •'� _
c•r
f. Total flow for this specific request 0.006 rJ
�
g. Total actual and obligated flows to the facility 11.434 0
�'
h. Percent of permitted flow used 54.45%
li. 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
Pump
Average Daily
station
Firm
Flow""
(Name or
Capaehy. '
(Firm / p(),
Number)
MOD
MOD
97 Lift St
30
12
(13)
(CI
(D)=(li+C)
Il~WA-D)
Obligated,
Approx.
Not Yet
Total Current
Current Avg.
rributar�,
Flow Plus
Daily Flow,
flail)' Flow.
Obligated
Available
MOD
MOD
Flow
Capacity'
6.5
0.598
7.{}98
4.902
T• The Firm Capacity of any pump station is defined as the maximum pumped flow that
can he achieved with the largest pump taken out of service.
•# Design Average Daily Flow is the firm capacity of the pump station die Ided In. a peaking
factor (pf) not less than 2.5.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WIY'1'P %here the Available Capacity is c 0.
Downstream Facility Name (Sewer): Tar River Regional
Downslreani Permit Number: NCOI130317
u
CJ
cz
2f
Page: I of 6
FISH 04-16

Ill. Certification Statement:
i William Brad Kerr 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
recciviitg wastewater trealmenl facility and that the now front this project is not anticipated to
cause tiny capacity related sanitary sewer overflows or overburden any downstream pump station
in route to the receiving treatment plant under normal circumstances, given the implementation or
the planned improvements identified in the planning assessment where applicable. This analysis
has heen performed in accordance with local established policies and procedures using the best
available data. This certification applies to those items listed above in Sections 1 and If plus all
attached planning assessment addendums For which 1 atn the responsible party. Signature of this
7fbrm;indicag1eacPeplance of this wastewater flow,
Ci
Signing Uncial SigrMillre J Dare
Page ? of 6
FTS E 04-16

State of North Caroling
Department of Environmental Quality
DWR Division of Water Resources
Division of Water Resources Flow Tracking/Acceptance for Sewer Extension A�pSEcations4 16)
Entity Requesting Allocation: Town of Nashville
Project Name for which flow is being requested: Cross Creek Duplexes
Afore than one ME maybe required for a singte project if the turner of the w im is not responsible for all pump
stations along the route of the proposed wastewaterflow
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Tar River Regional _
b. WW FI' Facility Permit # NCO030317
fill flows are in MGDo'
c. WWTP facility's permitted flow e�
d. Estimated obligated flow not yet tributnrp to the WWTP N
C. WWTP facility's actual arg, flow r
f. Total flow for this specific request 0-00576 o
'r
g. Total actual and obligated flo«s to the facility
h. Percent of permitted flow used ,
11. Complete this section for each pump station you are responsible for along the route ofthi;
proposed %wastewater flow.
List pump stations located between the project connection point and the WR9'P:
(A)
Design
Pump
Average Daily
station
Firm
Flow**
(Name or
Capacity, •
(Firm I pt),
Number)
MOD
MOD
Woodfield
0.122
0.049
(�)
(C)
(D)-(B+C)
(E)-(A-D)
Obligated,
ApprwL
Not Yet
Total Current
Current Avg.
Tributary
Flow Plus
Daily Flow,
Daily Flow,
Obligated
Available
MOD
MOD
Flow
Capacity* •'
0.028
0
0.029
0.021
* 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 (po not tens than 2.5.
*I'* 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):
Downstream Permit Number:
V
Page 1 of 6
FTSE 0a-16

Ill. Certification Statement:
d Randy Lansing 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 11 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
17e-
Dale
Vagc ? of 6
1" TSE 04-16

Sewer Project Narrative
For
Cross Creek Duplexes
The proposed Cross Creek Duplexes is a duplex development with 16 units in Phase 1.
This phase will generate 5,760 GPD of domestic flow. The wastewater generated from
the site will gravity flow into the existing Cross Creek Subdivision which ultimately
flows to the Woodfield Lift Station. Woodfield then pumps to the gravity outfall line that
flows to the City of Rocky Mount. The wastewater treatment plant facility that will be
handling this flow is the Tar River WWTF (Permit # NC 0030317). The permitted flow
for the WWTF is 21.0 MGD (NPDES).
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