WQ0042067_Application (FTSE)_20201020

DWR
State of North Carolina
Department of Environmental Quality
Division of Water Resources
✓',d°r 15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources ETA 04-16 & SUPPORTING DOCUMENTATION
.._ I
Application Number: v✓ U l7 -�QIk�- (to be completed by DWR) to a (} V IC? 1
All items must be completed or the a tlication will be returned
I. APPLICANT INFORMATION:
I . Applicant's name: Orange Water & Sewer Authority (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. ];d44ern4n per 15A NCAC 02T .0106 b Todd Taylor, P.E.
Title: Executive Director
4. Applicant's mailing address: 400 Jones Ferry Road
City: Carrboro State: NC Zip: 275I0-
5. Applicant's contact information:
Phone number; U 537-4201 Email Address: nnarker cr owasa.orQ
II. PROJECT ]INFORMATION:
1. Project name: Sanderway Subdivision Gk— 0 r-
6�45
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: Qrange
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.9310 4' Longitude:-79.097931
5. Parcel ID (if applicable): 9779142354
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: William Credle License Number: 25522
Firm: Credle Engigeering Company Inc
Mailing address: 204 E Markham Avenue
City: Durham State: NC Zip: 27701-_._
Phone number; L) 6,92-2006 Email Address: Cliff
(a?CredleEntrineeine.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFOILV1ATION:
1. Facility Name: Mason Farm Wastewater Treatment Plant Permit Number: NC 0025241
Owner Name: OWASA
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ 'Not Available Downstream (Receiving) Sewer Size. S inch DI "Barrington Hills Outfalll
System Wide Collection System Permit Number(s) (if applicable): WQCS00031 Newsome Subdivision" '96
Owner Name(s): Orange Water & Sewer Auth ri
FORM: FTA 04-16 Page 1 of 5

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFT ICE -
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Realonal Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Quality Section
Swannanoa, North Carolina 28778
Clay, Graham, Haywood, Henderson, Jackson,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Realonal Office
225 Green Street Suite 714
Anson, Biaden, Cumberland, Harnett, Hoke,
Water Duality Section
Fayetteville, North Carolina 28301-5094
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[phone] Fax
Mooresville Re tonal Office
610 E. Center Avenue
Alexander, Cabairus, Catawba, Cleveland,
Water Quality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
Raleigh Realonal Office
1628 Mail Service Center
Chatham, Durham, Edgecombe, Franklin,
Water Quality Section
Raleigh, North Carolina 27699-1628
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
Beaufort, Berne, Camden, Chowan, Craven,
Water Quality Section
Washington, North Carolina 27889
Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section
Wilmington, North Carolina 28405
Hanover, Onslow, Ponder
[phone]
(9 10) 350-2004 Fax
Winston-Salem Regional Office
450 W. Hanes MITI Road
Alamance, Allegheny, Ashe, Caswell, Davidson,
Water Quality Section
Suite 300
Davie, Forsyth, Guilford, Rockingham, Randolph,
Winston-Salem, North Carolina 27105
Stokes, Sung, Watauga, Wilkes, Yadkin
[phone]
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 3 of 3

VI. GENERAL RE, QUIREMENTS
1. 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 Develo er's Operational Agreement FORM: DE been attached?
❑ Yes ❑No ®NfA
3. If the Applicant is a Home/Property Owners' Association has an Operational A Bement FORM: HOA been attached?
❑ Yes [--]No ®NIA
4. Origin of wastewater: (check all that apply)-
0
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 Pool /CIubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic/Commercial �r.. __ _% Commercial
% Industrial {See 15A NCAC 02T ,0103(20))
4Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .0114 ? ❑ Yes ® No
If Yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114ff))
Daily Design Flow"4
No. of Units
Flow
Residential Units
360 galiday
18
6480 GPD
gal/
GPD
gall
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
6,480 GPD
a See 15A NCAC 02T .0114 d e 1 and e ? 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 .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T :01141 shall be
determined using available Flow data, water using fixtures, occupancy or operation patterns, and other measured data.
S. Wastewater generated by project: 648(bPD (per 15A NCAC 02T .0114) /
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: F TA 04-16 Page 2 of 5

VU. GRAVITY SEFVER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted -
Size (inches) Length (feet) Material
8 1338 DIP
➢ Section II & Ill 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)
i Oversizing lines to meet minimum slope requirement is not allowed and a violation of the NEDC
VIH. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stntions/Force Mains):
COMPLETI; 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 (fine capacity)
4. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (TDII)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feel) Material
6. Power reliability in accordance with 15A NCAC 02T .0305 i 1):
❑ 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 - I SA 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 lie portable power source or pump, including travel timeframes, shall be provided
in the case of a multiple station power outage.
FORM: PTA 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B ,0200 & 15A NCAC 02T ,0305(f)):
I. Does the project comply with all separations found in 15A NCAC_02T .0305M & (e) ® Yes ❑ No
➢ 15A NCAC 02T.0305(f) contains minimum separations that shalt he nmvided fnr RPwer %vStPma•
Setback Parameter*
Separation Required
Stonn 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
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 II impounded reservoirs used as a source of drinicing 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, fake, 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 systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 incltes
15A NCAC 02T.0305(s) contains alternatives where separations in 02T.0305(f) cannot be achieved.
"Stream classifications can be identified using the Division's NC Surface Water Classifications web a e
Y If noncompliance with 02T.0305(f) or (e). see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ❑ Yes ❑ No 4ilk
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
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 NQAC 02B .0200? ® Yes ❑ No
9 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? El Yes [INoN 1
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 15A NCAC 02T.0105(c)(6) (additional pennitslcertifications)7 ❑ Yes ❑ No 1111&
Per 15A NCAC 02T.0105(c)(6), 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, stomiwater 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 the sewer.
❑ Yes ® No
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 Criteria for the Permitting of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria latest version as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is renulred urior to submittal of the Fast Track AanlIcation and supporting documents.
2. Professional Engineer's Certification:
I,
(Professional Engineer's name from Application Item 11L1.)
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 1 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 $25,000 per violatiritgtllN4i'P/pB�,�
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, Todd Taylor, P.E.,_Executive Director attest that this application for
(Signature Authority's name & title from Application item 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 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.
Signature:
Date. 10/7/2020
FORM: FTA 04-16 Page 5 of 5

State of North Carolina
DW.Department of Environmental Quality RDivision of Water Resources
Division of Water Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Orange Water and Sewer Authority
Project Name for which flow is being requested: Sanderway Subdivision
More than one FTSE wav be required far a single project if the owner oJ'the 1ViVTP is not revponsihh! for all pump
stations along the route of rite proposed wasteu ester jlow,
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Mason Farm Wastewater Treatment Plant
b. WWTP Facility Permit #: NCO025241
Allfloivs are hi MGD
c. WWTP facility's permitted flow 14.5
d. Estimated obligated flow not yet tributary to the WWTP 0.359
e. WWTP facility's actual avg. flow 7.600
f. Total flow for this specific request 0.007 (6480 GPD)
g. Total actual and obligated flows to the facility 7.966
h. Percent of permitted flow used 55%
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) (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 / po, Daily Flow, Daily Flow, Obligated Available
Number) MGD MGD MGD MGD Flow Capacity***
Rogerson
n- _ 18 7.2 3.34 0.21 3.55 3.65
* 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 located
between the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): OWASA
Downstream Permit Number: WQCS00031
Page 1 of 6
FTSE 04-I6

1I1. Certification Statement:
1 Todd Taylor, F.E. 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.
Signink Official
10/7/2020
Date
Page 2 of b
FTSE 04-16

Cashion, Ted
From: Nick Parker <[e-mail]>
Sent: Tuesday, October 20, 2020 12:53 PM
To: Cashion, Ted
Cc: Robinson, Jason; Jessica Godreau; Bill Spang; Donnie Nolf; Cliff Credle
Subject: [External] Sanderway Subdivision
Attachments: Signed Fast Track 10 07 20.pdf; Street Map for SS App 10 19 20.pdf; Signed USE form
10 07 20.pdf; USGS Map for SS App 10 20 20.pdf
:External, email. Domot click links or open attachments unless you verify. send all suspicious eri;ail.as an attaehmentto
r. eport.spamEnc.Rav
Ted,
Attached are the following application documents for a proposed gravity sanitary sewer main extension to serve subject
project, a residential subdivision with 18, 3 bedroom single family homes:
• Fast Track application form
• Flow Tracking and Acceptance form
• Street Map
+ USGS Topo Map
I am mailing the check for the review fee directly to your office. Please contact me as soon as possible if additional
information is required or if any errors are found. The developer is eager to begin for water and sewer infrastructure.
We already sent the application dots to PWSS for the water main extension.
Thanks again, in advance for helping us to keep this project moving forward.
Nick Parker
OWASA
Sent from Mail for Windows 10
NOTICE: In accordance with the North Carolina general statutes, chapter 132, this email address is subject to North
Carolina public records law. As such, please note that all inbound and outbound messages are subject to requests for
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