WQ0042065_Application (FTSE)_20201027

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: D (to be aomplocd by Db1 R)
All items must be completed or the anmlication will be returned
I. APPLICANT INFORMATION:
I. Applicant's name: Town of Norlina (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State -County ® Municipal
3. Signature authority's name: Wayne Aycock. per 15A NCAC 02T .0106(b)
Tide: Miyor
4. Applicant's mailing address: 139 Hyco Street
City: Norlina State: NC Zip: 27563-__
5. Applicant's contact information:
Phone number: [phone] Email Address: to%vnclerk(@townofnorlina.com
Privately -Owned Public Utility
❑ Other
11. PROJECT INFORMATION:
r
1. Project name: Waste Water Pump Station Improvement
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: Warren
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.458180 Longitude:-78.205668
5. Parcel ID (if applicable): 2938367819
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
I. Professional Engineer: David G. Malinauskas
License Number: 029997
Firm: The Wooten Company
Mailing address: 120 North -Boylan Avenue,
City: Raleigh State: NC Zip: 27603-1423
Phone number: 919) 828-0531 Email Address: dmalinauskas thewootencom an .com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Warren County WWTP Permit Number: NC 0020834
Owner Name: Warren County
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
I. Permit Number(s): WQ Downstream (Receiving) Sewer Size: inch
System Wide Collection $ystem Permit Number(s) of applicable): WQCS_ _1Q6�
Owner Name(s): _ v
w�
FORM: FTA04-16 Page I of

V1. GENERAL REQUIREMENTS
I. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑No (EM-A
2. If the Applicant is a Developer of lots to be sold, has a Develoyer's Operational At4reement (FOR i:.DEV) been attached?
❑ Yes ❑No ®N'A
3. If the Applicant is a llorne-11royero, Owners' Assuciation, has an Operational Agreement (FORM:.HOA) been attached?
❑ Yes [:]No ON -A
4. Origin of wastewater: (check all that apply):
❑ Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food preparationiservice ❑ Hotel and/or Motels
❑ School preschool day care ❑ Medical! dental : veterinary facilities ❑ Swimming Pool 'Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool,'Filter Backwash
El Businesses offices factories El Nursing Home ® Other (Explain in Attachment)
5. Nature of wastewater. 100 °o Domestic."Commercial _ % Commercial
0 0o Industrial (See 15.A.NCAC 02T,Q103(20))
�Is there a Pretreatment Program in effect? ❑ Yes ® No
6. Has a flow reduction been approved under 15A NCAC 02T .01 14A? ❑ Yes ® No
I r ves, provide a coov or now reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.01140
Daily Design Flow ° b
No. of Units
Flow
gall
GPD
gall
GPD
gall
GPD
gal/
GPD
gal/
GPD
gall
GPD
Total
0 GPD
a See 15A NCAC 02T .0I 14(b), [d), (e)(1) and COL2J 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 .01144(c), design flow rates for establishments not identified [in table 15A-NCAC 02T,01 14] shall
be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 0 GAD (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): Replacement of existing sewer infrastructure. No proposed expansion of system.
FORM. FTA 04-16 Page 2 of 5

Vil. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
I. Summarize gravity sewer to be permitted:
Vill.
l
2
3
4
5
Size (inches) Length (feet) Material
8 955 PVC
> Section 11 & III 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)
D Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
PUMP STATION DESIGN CRITERIA (If Applicable) — 02T.0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
Pump station number or name: Old Lagaon
Approximate Coordinates (Decimal Degrees): Latitude; 36.458189 Longitude:-78.205852
Design flow of the pump station: 0.57 millions gallons per day (firm capacity)
Operational point(s) of the pump(s): 400 gallons per minute at 161 feet total dynamic head (TDH)
Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
8
5275
PVC
8
375
DIP
4
360
PVC
6. Power reliability in accordance with I SA NCAC 02T 0. 305(h_Xl:
r-
S
® 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 - 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_
i 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

IX. SETBACKS & SEPARATIONS - (0213.0200 & 15A NCAC 02T .0305(f)):
I _ Does the project comply with all separations found in 15A NCAC 02T .0305(f) & t
:- 15A NCAC 02T.0305(f) contains minimum separations that shalt he provided Fnr sewer Cyupmv
© 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 (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-1 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, FIQW, 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
An basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage s stems and interceptor drains
5 feet
Any swimming pools
10 Feet
Final earth grade (vertical)
36 inches
15A NCAC 02T.03. 05(g) contains alternatives where separations in 02J.03305(Jo cannot be achieved.
**Stream classifications can be identified using the Division's NC Surface Water Classifications webRaee
If noncompliance with 02T.0305(f) or (6, see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No ❑ N:A
;w See the Division's draft separation requirements for situations where separation cannot be meet
i No variance is required if the alternative design criteria specified is utilized in design and construction
i 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 NCAC 0213 .0200-2 ® Yes ❑ No ❑ N A
This would include Trout Buffered Streams per I SA NCAC 2B.0202
4. Does the project require coverage.:authorization under a 404 Nationwide or ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
;,- Information can be obtained from the 401 & Buffer Permittine Branch
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
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, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC .-02_T.0�402, "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 ❑ N;'A
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 I5A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
I. Does the submitted system comply with 15A NC.AC 02T, the Minimum Design Criteria for he.permjltin�,, of Pump Stations
and Force Mains i latest versionl; and the Gravity Sewer Minimum Design Crileria I 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 required prior to submittal of the Fast Track Application and supporting
documents.
2. Professional Engineer's Certification:
1 '� o-- - J to . {Y1 is t : n o. v. s l.t c,r
_,. _attest that this application for
(Professional Engineer's name from Application Item 11I.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 (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:
Appplica/nt's Certification per 15A NCAC 02T .0106(b):
I, Wah tt-., A44m_
ature Authority's name & title from Application Item 1.3.)
•oF
9� •,
029997 =
GINEE• J
• MWWN ,,%"
. ........ �! 1, P.A a
attest that this application for
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 143-215.6.B, 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: - 2 o' z o
FORM: FTA 04-16 Page 5 of 5

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October 26, 2020
Reviewer
THENCDEQ - Division of Water Resources
Water Quality Permitting Section
wooTEN
Wastewater Branch — PERCS Unit
COMPANY 512 N. Salisbury St.
Archdale Building, 9"' Floor
Raleigh, NC 27604
120 North Boylan Ave.
Raleigh, NC 27603
919328 0531
fax [phone]
CDept opEnvironn7ent;�l 11alit
Y
OCT 2 7 2020
Raleigh Regioll,11 Ofr
ee
Re: Sewer Fast Track Application
Sanitary Sewer Force Main and Waste Water Pump Station Improvements
Town of Norlina
Norlina, North Carolina
TWC No. 251 1-BW
Dear Reviewer:
On behalf of the Town of Norlina, we are submitting one (1) original and one
(1) copy of the following documents related to the above referenced project for
your review and approval:
• Application Fee ($480.00)
• Sewer Fast -Track Application (FTA 04-16)
• Cover Letter Narrative (see paragraphs below)
• USGS Topographic Map showing proposed utilities
• Aerial map showing general project area
This project will replace a sewer pump station (Old Lagoon), upgrade existing
sewer pump stations, and install approximately 5,275 linear feet of 8" PVC and
375 LF of 8" DI force main, approximately 360 linear feet of 4" C900 PVC
force main, and approximately 950 feet of 8" PVC and DI gravity sewer. In
addition, by extending the new 8" gravity sewer and 4" force main, the Town
will be able to decommission an existing pump station. The project area is
currently served with sewer.
This project is a replacement of infrastructure that is beyond design life. The
collection system is not expanding due to this project. New gravity sewer will be
installed, but only to decommission the existing pump station - it will not serve
any existing or proposed connections. As no expansion of the collection system
is proposed, this is a zero -flow project. As such, no Flow Tracking form is
included with this submission.
Sewer force main from Old Lagoon Pump Station will be installed parallel to
existing force main and connected to gravity sewer. Force main and gravity

THE
WOOTEN
COMPANY
120 North Boylan Ave.
Raleigh, NC 27603
919 82B 0531
fax [phone]
sewer will be installed adjacent to US 1 and its intersection with Elementary
Avenue.
Please see the table below for improvements proposed to the Town's pump
stations. The Town of Norlina will own and maintain the proposed pump
stations, force main, and gravity sewer after construction. All new sewer
improvements have been designed in accordance with the 15A NCAC 02T
requirements.
Puma Station Imorovements
Pump Station
Improvement Old La oon Elm St. Pines Hillto Oaks Kin Dr. Shaw Dr
Decommission Station
X
X
Constrtuct New Station
X
Install SCADA System
X
X
Install Spare Pump
X
X
X
X
X
Install Backup Generator
X
X
X
X
Install Bypass Connection
X
X
X
X
Install Trash Basket with Manhole
X
X
Replace Security Fencing
X
Replace Grass with 6" ABC
X
X
X
X
X
We think the information provided is a complete submission and adequate for
your review. If we can provide additional information or answer questions you
may have, please feel free to contact us at [phone] or email me directly
at dmalinauskasthewootencompany.corn.
Sincerely,
THE WOOTEN COMPANY
)-k Ja
David G. Malinauskas, PE
Water Resources Practice Manager
Enclosures: as stated.
cc: Blaine Reese, Town of Norlina (letter only)
TWC Reading rile (letter only)