WQ0042122_Application (FTSE)_20201207

Permit Number WQ0042122
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
dean.hunkele
Coastal SWRuIe
Permitted Flow
Facility
Facility Name
Healing Place of New Hanover Private Sewer
Location Address
Owner
Owner Name
New Hanover County
Dates/Events
Scheduled
Orig Issue App Received Draft Initiated Issuance
Central Files: APS _ SWP _
11/20/2020
Permit Tracking Slip
Status
Project Type
In review
New Project
Version
Permit Classification
A
Individual
Permit Contact Affiliation
Major/Minor Region
Minor Wilmington
County
New Hanover
Facility Contact Affiliation
Owner Type
Government - County
Owner Affiliation
Chris Coudriet
230 Government Ctr Dr
If (&-ed ox) --.L0
Public Notice Issue Effective

MEM
TO: NCDENR Wilmington
Regional office
DEQ-Division of Water Resources
M OF 127 Cardinal Drive Extension
Wilmington, NC
M
TEL: [phone]
ATTN:
JOB CODE: HTW
DATE: 12 November 2020
Attached:
Under separate cover:
RE: THE HEALING PLACE OF NEW HANOVER COUNT $ ,
(PRIVATE SEWER EXTENSION) j 3 2020 —
No. Copies Description'------
2 Cover Letter
2 Sets
Christyn,
Fast Track Sewer System Extension Application (FTA 04-16)
Sewer Extension Plans & Specifications
CFPUA FLOW Acceptance Letter
CFPUA Flow Tracking for Sewer Applications
USGS Site Map
Application Fee ($480.00)
Please call me at [phone]x236 (o) or [phone] (m) if you have any questions or need anything else.
VIA FAX PAGES Including this Cover
OVERNIGHT
_ MAIL
HAND CARRY
TO BE PICKED UP
COPIES TO:
The Site Group, PLLC
1111 Oberlin Road
Raleigh, North Carolina 27605-1136
FOR YOUR REVIEW
FOR YOUR APPROVAL
FOR YOUR USE
AS REQUESTED
RETURN _ COPY EACH
SIGNED:
Ed Sconfienza, . .
Phone: [phone]
Fax: [phone]
www.thesitearou o. net
Please notify us immediately if enclosures are not as noted

MEN
VNIRM
C1007M
12 November202O
JOB: HTW
State of North Carolina
Department of Environmental Quality
Division of Water Resources
127 Cardinal Drive
Wilmington, NC 28405
Reference: Fast Track Sewer System Extension Application — PRIVATE SYSTEM - Cover Letter
The Healing Place of New Hanover County
1000 Medical Center Drive
Wilmington, NC 28401
Items included in application package:
- Application (original plus one copy)
- Plan set for sanitary sewer extension
SITE 001 COVER SHEET
SITE 100 EXISTING CONDITIONS & DEMOLITION PLAN
SITE 101 WETLAND & SOLD MAPS
SITE 400 UTILITY PLAN
SITE 401 SANITARY SEWER PLAN & PROFILE
SITE 603 & 604 SITE UTILITY DETAILS
- USGS MAP WITH SITE IDENTIFIED
- FLOW ACCEPTANCE LETTER
- $480.00 APPLICATION FEE (FROM NEW HANOVER COUNTY TO NCDEQ)
Applicant: New Hanover County
200 Division Drive
Wilmington, NC 28401
Attention: Kevin E. Caison, Facility Project Manager
Design Engineer: The Site Group, PLLC
1111 Oberlin Road
Suite 200
Raleigh, NC 27605
Attention: Ed Sconfienza. P.E.
Wastewater Treatment Facility: Facility Name: M'Kean-Moffit SSWWTF
Permit Number: NPDES NC 0023973
Owner Name: Cape Fear Public Utility Authority
Requested Permitting Action:
Permit approval of 614 LF of 8" private sanitary sewer to serve 200 bed drug & alcohol rehabilitation facility.
Wastewater generation per 02T.0114(f) is 24,000 GPD.
The SITE Group
1111 Oberlin Road 919-832-6658 (o)
Raleigh NC 27605 1/1 919-839-2255 (f)

1
i
State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: wu q 71 ��
pp (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: New Hanover County (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ® State/County ❑ Municipal
3. Signature authority's name: Kevin E. Caison per 15A NCAC 02T .0106(b)
Title: Project Facilities Manager
4. Applicant's mailing address: 200 Division Drive
City: Wilmington State: NC Zip: 28401-_
5. Applicant's contact information:
Phone number: 910) 798-4338 Email Address: kcaisonAnhcgov.com
II. PROJECT INFORMATION:
❑ Privately -Owned Public Utility
❑ Other
1. Project name: The Healing Place of New Hanover County
2. Application(Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: W000_ and issued date: _
If new construction but part of a master plan, provide the existing permit number: W000_
3. County where project is located: New Hanover
4. Approximate Coordinates (Decimal Degrees): Latitude: 34.199°Longitude:-77.931'
5. Parcel ID (if applicable): R06018.003-047-000
(or Parcel ID to closest downstream sewer)
III, CONSULTANT INFORMATION:
1. Professional Engineer: Ed Sconfrenza, P.E. License Number: 18303
Firm: The Site Group. PLLC
Mailing address: I I11 Oberlin Road, Suite 200
City: Raleigh State: NC Zip: 27605-
Phone number: [phone] Email Address: ed .thesite ZroW.net
IV. WASTEWATER TREATMENT FACILITY (W WTF) INFORMATION:
1. Facility Name: M'Kene-Moffit SSW WTFPermit Number: NPDES NC 0023973
Owner Name: Cape Fear Public Utilitiy Authority
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than W WTF):
1. Permit Number(s): WQ Unknown Downstream (Receiving) Sewer Size: 8 inch
System wide Collection System Permit Number(s) (irapplicable): WQCS
Owner Name(s): _
FORM: FTA 04-16 Page 1 of 5

VI. GENERAL REQUIREMENTS
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 Developer's Operational Agreement (FORM: DEV) been attached?
❑ Yes ❑No ®N/A
3. If the Applicant is a Home/Property Owners' Association, has an Operational Agreement (FORM: HOA) been attached?
❑ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
❑ 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 /Clubhouse
❑ 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 % Commercial
Industrial (See 15A NCAC 02T .0103(20))
"Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes ❑ No
➢ If yes, provide a cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(fl)
Daily Design Flow',h
No. of Units
Flow
Convalescent Home w/ laundry facilites
120 gal/bed
200
24,000 GPD
gal/
GPD
gal/
GPD
gall
GPD
gall
GPD
gal/
GPD
Total
24,000 GPD
a See 15A NCAC 02T .0114(b). (d). (e)(1) and (e)(2) 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. 42A-4).
b Per 15A NCAC 02T .01 14(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0I 14] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 24 000 GPD (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: FTA 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
8 614 PVC
➢ Section II & 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)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable)-02T.0305 & MDC (Pump Stations/Force Mains):
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 _ 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)(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.
➢ 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 trayol timoframea, shall be provided
in 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(f) & (g) N Yes ❑ No
➢ 15A NCAC 02T.0305(f) contains minimum separations that shall he nrnvided for sewer systemc-
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 II impounded reservoirs used as a source of drinking 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, 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
Drainages stems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade vertical
36 inches
➢ 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webnage
➢ If noncompliance with 02T.0305(f) or ( see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) N Yes ❑ No ❑ N/A
➢ See the 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
➢ 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 02B .02009 N Yes ❑ No ❑ N/A
➢ This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project require coverage/authorization under a 404 Nationwide or N Yes ❑ No
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? N 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 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 N 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 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 Desien 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/Altemative 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:
\l1t�) i—�. G,0 mac/
name from Application Item III.1.)
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 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 $25,000 per violation.
North Carolina Professional Engineer's seal, signature, and,
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, Kevin, Caison, Project Facilities Manager 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: XV�caz�teel Date:_A/91/9n90
FORM: FTA 04-16 Page 5 of 5

State of North Carolina
Department of Environmental Quality
i^G"F Division of Water Resources
Division of water Resources Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: New Hanover County
Project Name for which flow is being requested: The Healing Place of NHC
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all pump
stations along the rode of the proposer/ wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: M'Kean Maffitt (Southside) WWTP
b. WWTP Facility Permit #: NPDES NC 0023973
All flows are in MGD
c. WWTP facility's permitted flow 12.000
d. Estimated obligated flow not yet tributary to the WWTP 2.537
e. WWTP facility's actual avg. flow 8.044
f. Total flow for this specific request 0.02400
g. Total actual and obligated flows to the facility 10.605
It. Percent of permitted flow used 88.4
II. 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 Pump Average Approx. Not Yet Total Current
Station Station Firm Daily Flow** Current Tributary Flow Plus
(Name or Permit Capacity, * (Firm / po, Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***
N/A 1.944 0.778 0.507 0.031 0.538 0.240
* The Firm Capacity (design flow) of any pump station is defined as the maximum pumped now
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, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
*** 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): Cape Fear Public Utility Authority
Downstream Permit Number:
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Jeff Theberge, CFPUA Eng. Mgr 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 certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
9/24/2020
Official Signature Date
Engineering Manager
Title of Signing Official
Page 2 of 6
FTSE 10-18

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Project Manager:
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Scale:
1" = 626'
Date:
8/1/16
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Figure 1 - USGS Map
1000 Medical Center Dr Site
New Hanover County, NC
)urce: NBC 2016
Wilmington Quadrangle
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