WQ0042001_Application (FTSE)_20200922

State of North Carolina
1) Department of Environmental Quality
Division of Water Resources
.. wW., R
Divi5lon of Water Resources ISA NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number. W 004 400 1 (m be completed by DWR1
All items must be completed or the application will be returned !1 UUUIIf
L APPLICANT INFORMATION;
1, Applicant's name: Town of Nashville (company, municipality, FIOA, utility, etc.)
2. Applicant type' ❑ Individual ❑ Corporation ❑General Partnership ❑ Privately4:)wned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3_ Signature authority's name: Randy Lansine per 15A NCAC 02T .0106(b)
Title: Town_Manazer
4. Applicant's mailing address: 4aSouth_Barnes_St
City: Nashville State: NC Zip: 27856
5. Applicant's contact information:
Phone number: (ZQ 459-4_11 Email Address. ke.brown a)townofnashville.gov
11. PROJECT INFORMATION:
I. Project name: Bradford Plata Subdivision - Phase I
2. Appliration/Prc jest status: ® Proposed (New Permit) ❑ Existing Permit/Project01
v
If a modification, provide the existing permit number: WQOOT and issued date: O
r
If new construction but part of a master plan, provide the existing permit member. WQ00 _ " .
a �
3. County where project is located: Nash � N 'e
a e�
4. Approximate Coordinates (Decimal Degrees). Latitude: 359684- Longitude_ -77.9 ' aj ep Q O
5. Parcel ID (if applicable): 38¢064M519U ° Cr
(or Parcel ID to closest downstream sewer) i
r.
III. CONSULTANT INFORMATION: U
1 _ Professional Engineer. J. Michael Socks License Number: 19843
Firm: Stocks Engineering P_A.
Mailing address: PO Box 1108
City: Nas v' le State: NC lip: 27856-
Phone number. GJ-2J AR9 -8199 Finail Address: mstocksna stockscnginceriny.corrt
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Tar River Regional Permit Number NCO030317
Owner Name: City of Rocky M unt
v. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s). WQ_ Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable); WQCS
Owner Name(s); City of Rocky Mount
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 ®NfA
2. if the Applicant is a Developer of lots to be sold, has a Develpoer's Operational Agreement (FORM_' DFV) been attached?
[:]Yes [:]No ®NiA
3. If the Applicant is a H9MdProIKrty Ownea's fation, bg an Or&rational kgreement (FORM: HOA bccn 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 prepamtion/service ❑ Motel and/or Motels
❑ School / preschool / day care ❑ Medical f dental r' veterinary facilities ❑ Swimming Pool !Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Poole'Filter Backwash
❑ Businesses I offices I factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater : J °/o DomestiOCommercial __ d Commercial
% Industrial ($ce 15A NCAC„921 .0103(20))
�Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under.15A NCAC 023: i0I 14(t)? [:]Yes ®No
D JJVVM Provide g cony or now reduction aroval letter
7. Summarize wastewater generated by project
Establishment Type (see 02LQI140
Daily Design Flow'"
No. or Units
Flow
Single Family Residential
360 gal/unit
41
14,760 GPD
gall
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
14,760 GPD
a See _15A NCAC 02T .0114(b), (d). (e)(1) and i gQXM 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. 42A4).
b Per 15A NCAC 02T .01 14(c), design flow rates for establishments not identified (in table 15 A NCAC 02T.0114) shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8, Wastewater generated by project: 14.764 GPD (per 15A NCAG 02T .01 I4)
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: FrA 04-16
Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 1,816 SDR-35 PVC
8 20 DIP
➢ Section II & III 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)
L Oversizing lines to meet minimum slope requirement is not allowed and a violation or the MDC
VIII. PUMP STATION DESIGN CRITERIA (if Applicable) w 02T.0305 & MDC (Pump Stations/Force Mains).
COMPLETE FOR EACH -PUMP STATION INCLUDED IN THIS PROJECT
L 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)(13)-
> 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(hX I XC)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - I SA NCAC 02T .0305(h)(I XQ:
r 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

L:J1
DC. SETBACKS & SEPARATIONS — (0213.0200 & 15A NCAC 02T .0305(o):
1 • Does the project comply with all separations found in j SA NCAC 02T .0305(1) & (g)
_ 15A NCAC 02T.0305(f) contains minimum senara�innc !hat ahnn kw .,r„v;rinrE f �a.var
® 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 orizontal
10 feet
Reclaimed water lines fvertical - reclaimed over sewer
18 inches
Reclaimed water lines orizontal - reclaimed over sewer
2 feet
"Any private or public water supply source, including any wells, WS-I waters of CIass I or
Class 11 im ounded reservoirs used as a source of drinking water
I00 feet
"Waters classified WS (except WS-I or WS-V), B, SA, ORW, IIQW, or SB from normal
hig 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 oft feet or snore vertical height
10 feet
DrainMe systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade vertical
36 inches
D 15A NCAC 02T 05 contains alternatives where separations in 02T.0305(f) cannot be achieved.
9 "Stream classifications can be identified using the Division's NC Surface Water ClassificationA web age
if noncompliance with QZT.0305(f) or (g), see 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
No variance is required if the alternative design criteria specified is utilized in design and construction
Y 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 .0200? ® Yes [:]No
D This would include Trout Buffered Streams per 15�AC 213.0202
4. Does the project comply with an individual 404 Permit or any 401 Certifications? ® Yes ❑ No
Wetland -related permits shall be requested, obtained, and adhered to for projects that impact wetlands or surface waters
➢ Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A N C6 C 02T.010 c IM (additional Penn its/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0I05(c)(6l, 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 15A 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 site 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 perm ittee or its representative at least once every six -months and inspections
documented per 1SA 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 021, the Minimum Des' n Critcria for the Permlajosi of EU03V 51gtion
F e Main !aq9 -vefq'101 and the Gravity Sewer MjaiMMM De ' n Criteria latest v i n as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Altemative Design Request application (VADC 10-14) and supporting documents for
review. Anproval of the re u t Is required Prigr to submittal of the Fast Track Application and suppordine documents.
2. Professional Engineers Certification:
Engineer's name from Application Item 111. L.
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 sea] 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 $10,000, as well as civil penalties up to S25,000 per violation.-•,�„r„
North Carolina Professional Engineer's seal, signature, and date: �.`%V......
=2=0 dfeS5
SEAL `
z 19843 = '.
j6 C'J
3. Applicant's Certification per 15A NCAC 02T .0106(b)-.
I' V--'0. - attest that this application for
ature Authority's nami & title from Application Item L3,)
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. l 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 L43-2.15.6% 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 Slfas well asivil penalties up to S25,000 per violation.
FORM; FTA 04-I6 Page 5 of 5

w
DWR
State of North Carolina
Department of Environmental Quality
Division of Water Resources
brut -&in at tVatet Rr"is<r',� now Tracking/Acceptance for Sewer Extension Applications
(r7SE 04-16)
Entity Requesting Allocation: Town of Nashville
Project Name for which flow is being requested: Bradford Place — Phase 1
Alom than one FTSE mtrr be misfired for a smyle pwjert tf the on ner of the It 11110 n not respousihle for all nutty
vallonc alwtg the mule of the pmlxt_t+'tf ►►vtsteu ater flrnt
1. Complete this Section only if you are the owner of the wuslcwater treatment plant.
P. WWTP Fucility Namc: Tar River Regional--
b. WWTP Facility Permit #: NCO030317
A11 f rows are in AIGI&
p
c- WV171' facility's permitted flog'
21.00
A
d. Estimated abligated flow not yet tributary- to the \VWTP 0.583
� o
e. WWI? facility's actual mg. flat%
10.83
f. Total flow for this specific request
0.015
g. Total actual and obligated flows to the 1•acility
11.428
tti.._ a_
C4
h. Percent of permitted flow used
54.42%
o ct"`In
H. Complete this section for each pump station you are responsible for along the route of
d
oi�
a
proposed wastewater flow.
z
List pump stations located bet% cen the project connection point and the WVVTP:
(A) Ili)
(C) iW=t[t+C T
Ir)=1+1-t1f
Design
Obligated,
Pump Averagc Daily Approx.
Not Yet Tolal Current
station First Flow •' Current Avg.
Tribulary ['low Plus
(Nam or Capacity, • (Firm i PI). Daily Ism..
Daily Fluty, Obligated
Availahle
Number) MOD MOD MOD
MOD Finu
Capacliv-
97 Lift St 30 12 6.5
.583 7.083
4.917
• 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 dI%ided by a peaking
radar (pO not less than 2.5.
rsr A Planning Assessment Addendum shall he attached for each pump station located
between the project connection point and the WWTP where the Av.jilahle Cnpacity is < 0.
Downstream Facility Name (Sewer): Tar River lee} ional
Downstream Permit Number: NC 0030317
Page I of 0
FTSE 04-1 h

III. Certification Statement;
I William B. 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
receiving wastewater treatment facility and lhai the flow from this project is not anticipated to
cause any capacity related sanilary sewer overflows or overburden any downstream pump station
in route to the receiving treatment plant under normal circumstances. given the implementation of
the planned improvements idenliGed in the planning assessment where applicable. ,rhos 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
Page ? of h
;?" % 5 - ZD
Dare
FTSE 04-16

r•
� DWR
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Dlrtslon of Water Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Town of Nashville
Project Name for which flow is being requested: Bradford Place— Phase l
More than one ME may be required for a single project if the owner of the IP147P is not responsible for all pump
stations along the route of the proposed wastewater flow
1. Complete this section only if you are the owner of the wastewater treatment plaint.
a. WWTP Facility Name: Tar River Regional
b. WWTP Facility Permit #. NC0030317
Allflows are in MGD
C. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
f. Total flow for this specific request 0.01476
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
11. 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
Capacity,
{Firm f pt),
Number)
MGD
MGD
Eg�eng
0.101
0.040
(e)
(C)
(D)-(s+C)
(E)=(A-D)
Obligated,
Approx,
Not Yet
Total Current
Current Avg.
Tributary
Flow Plus
Daily Flow,
Daily Flow,
Obligated
Available
MGD
MGD
Flow
Capacity "
0.0I0
0
0.010
0,031
—;'"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 few than 2.5.
*** A Planning Assessment Addendum shall be attached for cacti pump station located
between the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer):
Dawnst»am Permit Number,
Pagc I of 6
I-. TSI: 04-16

i
4 III. Certification Statement.
1 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 II plus all
attached planning assessment addendums for which I am the responsible party, Signature of this
form indicates acceptRp<bf th6 wastewater flow.
Signing
`WDar
Page 2 of 6
N F'I'Sr 04-16

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Sewer Project Narrative
For
Bradford Place Subdivision — Phase 1
The proposed Bradford Place Subdivision Phase 1 is a single family subdivision with 41
lots in Phase I. This phase will generate 14,760 GPD of domestic flow. The wastewater
generated from the site will gravity flow into the existing sewer system that flows down
Eastpointe Avenue which ultimately flows to the Regency Lift Station. Regency 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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