WQ0022669_Permit (Issuance)_20030602

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
June 2, 2003
Mr. David M. Smitherman, Town Manager
Town of Elizabethtown
PO Box 716
Elizabethtown, NC 28337
SUBJECT: Permit No. WQ0022669
3rd Avenue Sanitary Sewer Extension
Wastewater Collection System Extension
Bladen County
Dear Mr. Smitherman:
In accordance with your application received May 19, 2003, we are forwarding herewith Permit
No. WQ0022669, dated June 2, 2003, to the Town of Elizabethtown for the construction and operation of
the subject wastewater collection system extension. This permit shall be effective from the date of
issuance until rescinded and shall be subject to the conditions and limitations as specified therein. This
cover letter shall be considered a part of this permit and is therefore incorporated therein by reference.
Please pay particular attention to Permit Condition 3 which requires that the wastewater collection
facilities be properly operated and maintained in accordance with 15A NCAC 2H .0227 or any individual
system -wide collection system permit issued to the Permiee.
Permitting of this project does not constitute an acceptance of any part of the project that does not
meet 15A NCAC 2H .0200; the Division of Water Quality's (Division) Gravity Sewer Minimum Design
Criteria adopted February 12, 1996 as applicable; and the Division's Minimum Design Criteria for the
Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable, unless
specifically mentioned therein. Division approval is based on acceptance of the certification provided by
the North Carolina -licensed Professional Engineer named in the application. It shall be the Permittee's
responsibility to ensure that the as -constructed project meets the appropriate design criteria and rules.
Failure to comply may result in penalties in accordance with North Carolina General Statute § 143-
215.6A through § 143-215.6C, construction of additional or replacement wastewater collection facilities,
and/or referral of the North Carolina -licensed Professional Engineer to the licensing board.
In accordance with provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations, permission is hereby granted to the Town of
Elizabethtown for the construction and operation of approximately 1003 linear feet of 8-inch gravity
sewer to serve ten, three bedroom residences as part of the 3rd Avenue Sanitary Sewer Extension project;
Ric t
N. C. Division of Water Quality 225 Green Street -Suite 714 Fayetteville, NC 28301-50431 910-486-1541 / 910-486-0707 Fax
Internet http://h2o.enr.state.nc.us/ndpu
Customer Service 1- 800 623-7748
1

Mr. Smitherman
Page 2
and the discharge of 3,600 gallons per day of collected domestic wastewater into the Elizabethtown
Wastewater Treatment Facility's existing sewerage system, pursuant to the application received May 19,
2003 and in conformity with 15A NCAC 2H .0200; the Division's Gravity Sewer Minimum Design
Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -
Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other
supporting data subsequently filed and approved by the Department of Environment and Natural
Resources and considered as part of this permit.
The sewage and wastewater collected by this system shall be treated in the Elizabethtown
Wastewater Treatment Facility (Permit No. NC0026671) prior to being discharged into the receiving
stream.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the
right to request an adjudicatory hearing upon written request within 30 days following receipt of this
permit. This request must be in the form of a written petition, conforming to Chapter 150B of North
Carolina General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service
Center, Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and binding.
If you need additional information concerning this matter, please contact Grady Dobson at (910)
486-1541 extension 729.
Sincerely,
(di --,
for Alan W. Klimek, P.E.
cc: Bladen County Health Department
Fayetteville Regional Office, Water Quality Section (WWTF Permit No. NC0026671)
Mr. Robert P. Armstrong, Jr.
Water Quality Central Files
NPDU Files

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
This permit shall be effective from the date of issuance until rescinded and shall be subject to the
following specified conditions and limitations:
1. This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 15A NCAC 2H .0200; the Division of Water Quality's
(Division) Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as applicable; the
Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force
Mains adopted June 1, 2000 as applicable; and other supporting materials unless specifically
mentioned herein.
2. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data.
3. The wastewater collection facilities shall be properly maintained and operated at all times. The
Permittee shall maintain compliance with an individual system -wide collection system permit for the
operation and maintenance of these facilities as required by 15A NCAC 2H .0227. If an individual
permit is not required, the following performance criteria shall be met as provided in 15A NCAC 2H
.0227:
a. The sewer system shall be effectively maintained and operated at all times to prevent discharge
to land or surface waters, and any contravention of the groundwater standards in 15A NCAC 2L
.0200 or the surface water standards in 15A NCAC 2B .0200.
b. A map of the sewer system shall be developed prior to January 1, 2004 and shall be actively
maintained.
c. An operation and maintenance plan shall be developed and implemented.
d. Pump stations that are not connected to a telemetry system shall be inspected every day (i.e. 365
days per year). Pump stations that are connected to a telemetry system shall be inspected at least
once per week.
e. High -priority sewer lines shall be inspected at least once per every six-month period of time.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. Inspection and maintenance records shall be maintained for a period of at least three years.
h. Overflows and bypasses shall be reported to the appropriate Division regional office in
accordance with 15A NCAC 2B .0506(a), and public notice shall be provided as required by
North Carolina General Statute § 143-215.1 C.
1

4. This permit shall not be transferable. In the event there is a desire for the wastewater collection
facilities to change ownership, or there is a name change of the Permittee, a formal permit request
shall be submitted to the Division accompanied by documentation from the parties involved, and
other supporting materials as may be appropriate. The approval of this request shall be considered on
its merits and may or may not be approved.
5. Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to
interrupt service by the existing utilities nor result in an overflow or bypass discharge of wastewater
to the surface waters of the State.
6. Upon completion of construction and prior to operation of these permitted facilities, a certification, a
copy of the construction record drawings, as well as supporting design calculations for any pump
stations permitted as part of this project shall be received from a North Carolina -licensed Professional
Engineer certifying that the facilities have been installed in accordance with this permit; 15A NCAC
2H .0200; the Division's Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the
Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Station and Force Main
adopted June 1, 2000 as applicable; and other supporting materials. If this project is to be completed
in phases and partially certified, you shall retain the responsibility to track further construction
approved under the same permit, and shall provide a final certificate of completion once the entire
project has been completed. A copy of the construction record drawings, indicating the facilities
constructed in the phase being certified, shall be submitted with each partial certification. Mail the
Engineer's Certification, one copy of the "Construction Record Drawings," and one copy of the
supporting design calculations to the Non -Discharge Permitting Unit, 1617 Mail Service Center,
Raleigh, NC 27699-1617.
7. A copy of the construction record drawings shall be maintained on file by the Permittee for the life of
the wastewater collection facilities.
8. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 2H .0200; the
Division's Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the Division's
Minimum Design Criteria for the Fast -Track Permitting of Pump Station and Force Mains adopted
June 1, 2000 as applicable; and other supporting materials may subject the Permittee to an
enforcement action by the Division, in accordance with North Carolina General Statutes § 143-
215.6A through §143-215.6C.
9. In the event that the wastewater collection facilities fail to perform satisfactorily, including the
creation of nuisance conditions, the Permittee shall take immediate corrective action, including those
as may be required by this Division, such as the construction of additional or replacement facilities.
10. The issuance of this permit shall not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances that may be imposed by other government agencies (local, state and
federal) which have jurisdiction, including but not limited to applicable river buffer rules in 15A
NCAC 2B .0200, erosion and sedimentation control requirements in 15A NCAC Ch. 4 and under the
Division's General Permit NCG010000, and any requirements pertaining to wetlands under 15A
NCAC 2B .0200 and 15A NCAC 2H .0500.
2

11. Noncompliance Notification:
The Permittee shall report by telephone to the Fayetteville Regional Office, telephone number (910)
486-1541, as soon as possible, but in no case more than 24 hours or on the next working day,
following the occurrence or first knowledge of the occurrence of either of the following:
a. Any process unit failure, due to known or unknown reasons, that renders the facility incapable of
adequate wastewater transport, such as mechanical or electrical failures of pumps, line blockage
or breakage, etc.; or
b. Any failure of a pumping station or sewer line resulting in a by-pass directly to receiving waters
without treatment of all or any portion of the influent to such station or facility.
Persons reporting such occurrences by telephone shall also file a written report in letter form within
five days following first knowledge of the occurrence. This report must outline the actions taken or
proposed to be taken to ensure that the problem does not recur.
Permit issued this the second day of June 2003
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for Alan-W. Klin mac, .E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0022669
3

Fast Track Engineering Certification
Permit No. WQ0022669
June 2, 2003
Complete and submit this form to the permit issuing regional office with the following:
• One copy of the project record drawings (plan & profile views of sewer lines) of the wastewater collection system
extension
• supporting design calculations (selected pumps, system curve, operating point, available storage if portable generator(s) or
storage greater than longest past three year outage reliability option selected) for any pump stations permitted as part of
this project
• Changes to the project should be clearly identified on the record drawings or in written summary form. Permit
modifications are required for any changes resulting in non-compliance with this permit, regulations or minimum design
criteria.
This project shall not be considered complete nor allowed to operate until this Engineer's Certification and all required
supporting documentation have been received by the Division. Therefore, it is highly recommended that this certification
be sent in a manner that provides proof of receipt by the Division.
ENGINEER'S CERTIFICATION
❑ Partial ❑ Final
, as a duly registered Professional Engineer in the State of North Carolina, having been authorized
to observe (❑ periodically, ❑ weekly, ❑ full time) the construction of the 3rd Avenue Sanitary Sewer Extension, Bladen
County project for the Permittee hereby state that, to the best of my abilities, due care and diligence was used in the
observation of the construction such that the construction was observed to be built within substantial compliance of this permit;
15A NCAC 2H .0200; the Division of Water Quality's (Division) Gravity Sewer Minimum Design Criteria adopted February
12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force
Mains adopted June 1, 2000 as applicable; and other supporting materials.
North Carolina Professional Engineer's
seal, signature, and date:
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
FAYETTEVILLE REGIONAL OFFICE
225 GREEN STREET, SUITE 714
FAYETTEVILLE NC 28301
The Permittee is responsible for tracking all partial certifications up until a final certification is received. Any wastewater flow
made tributary to the wastewater collection system extension prior to completion of this Engineer's Certification shall be
considered a violation of the permit and shall subject the Permittee to appropriate enforcement actions.

05/29/03
Permit Number WQ0022669 Permit Tracking Slip
Program Category Status Project Type
Non -discharge In review New Project
Permit Type Fast Track Version Permit Classification
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Individual
Extensions
Primary Reviewer Permit Contact Affiliation
grady.dobson
Permitted Flow
3600
Facility
Facility Name
3rd Avenue Sanitary Sewer Extension
Location Address
Owner
Major/Minor Region
Major Fayetteville
County
Bladen
Facility Contact Affiliation
Owner Name Owner Type
Town of Elizabethtown Government - Municipal
Owner Affiliation
David Smitherman
P.O. Box 716
Elizabethtown
Dates/Events
NC 28337
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issya Effective Expiration
05/19/03 / aio3
Regulated Activities Requested/Received Events
Subdivision
Outfall NULL
Additional information requested
Additional information received
Waterbody Name Stream Index Number Current Class Subbasin

FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
PAGE 3
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD!
. Owner:
1 a. Town of Elizabethtown
Full Legal Name (company, municipality, HOA, utility, etc.)
z lb. David M. Smitherman, Town Manager
Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authored s
Application Number: , , ) v ��a
(to be completed by DWQ) Gv /
NFORMATION
1c.
gnI4 ffiti 9!)2003
The legal entity who will own this system is:
0 Individual ❑ Federal ® Municipality 0 State/County 0 Private Partnership I Corporatiegl O•
ttler (specify):
ld. PO Box 716
Street Address
1f. NC
State
1 h. 910-862-2066 li. 910-862-7117
Telephone Facsimile
2. Project (Facility) Information:
2a. 3rd. Ave. Sanitary Sewer Extension
Brief Project Name (permit will refer to this name)
3. Contact Person:
3a. Robert P. Armstrong, Jr.
1 e. Elizabethtown
City
1 g. 28337
Zip Code
[e-mail]
E-mail
2b. Bladen County
County Where Project is Located
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. 910-863-3205
Phone Number
3c. [e-mail]
E-mail
1. Project is ® New 0 Modification (of an existing permit) If Modification, Permit No.:
2. Owner is ® Public (skip to Item B(3)) 0 Private (go to Item 2(a))
2a. If private, applicant will be: 2b.
❑ Retaining Ownership (i.e. store, church, single office, etc.) or
❑ Leasing units (lots, townhomes, etc. - skip to Item B(3))
❑ Selling units (lots, townhomes, etc. - go to Item B(2b))
3. Town of Elizabethtown
If sold, facilities owned by a (must choose one)
❑ Public Utility (Instruction III)
❑ Homeowner Assoc./Developer (Instruction IV)
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
4a. Elizabethtown WWTP
Name of WWTF
5a. Tt
0
NANCY W. PAIT NCDL 2539766 06/88
HAROLD J. PAIT NCDL 2337289
PH. 910-648-4004
1068 GUYTON ROAD
BLADENBORO, NC 28320
Tay rofc hi, n /9/R
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BRANCH BANKING AND TRUST COMPANY
500 NORTH CHESTNUT STREET
LUMBERTON, NC 28358
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1:0531011211:5/1703116211' 86.66
4b. NCo0l(40-1 I
WWTF Permit No.
88-112i531
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Date -_5- /y - a3
Security Femme
<Do((nrs + Ian--- Details nCBack
"Trust in the .Cord with a((thine heart;..."
Prr>,rc{s 35
111-1,MAGE CHECKS, 1997
INSPIRATION
1-800-562-8768
www
mercial

FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 1
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
FAST -TRACK APPLICATION
for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
(Pressure sewers systems are not to be included as part of this application package)
INSTRUCTIONS: Indicate that you have included the following list of required application package items by checking the
space provided next to each item. Failure to submit all required items will lead to your application being returned as
incomplete or additional processing and review time. This form may be photocopied for use as an original.
® I. Application Form - Submit one original and one copy of the completed and appropriately executed application
form. Any changes to this form will result in the application being returned. The Division of Water Quality
(Division) will only accept application packages that have been fully completed with all applicable items
addressed. You do not need to submit detailed plans and specifications unless You respond NO to Item B(12).
® II. Application Fee - Submit a check in the amount of $400 made payable to: North Carolina Department of
Environment and Natural Resources (NCDENR).
❑ III. Certificates of Public Convenience and Necessity — If the application is being submitted in the name of a
privately -owned public utility, submit two copies of the Certificate of Public Convenience and Necessity (CPCN)
which demonstrates that the public utility is authorized to hold the utility franchise for the area to be served by the
sewer extension. If a CPCN has not been issued, provide two copies of a letter from the North Carolina Utilities
Commission's Public Staff that states that an application for a franchise has been received, that the service area
is contiguous to an existing franchised area, and/or that franchise approval is expected. The project name in the
CPCN or letter must match that provided in Item A(2a) of this application.
❑ IV. Operational Agreements — Submit one original and two copies of a properly executed operational agreement if
the sewer extension is permitted by a private applicant and will be serving residential or commercial lots (e.g.,
houses, condominiums, townhomes, outparcels, etc.) that will be sold to another entity. If the applicant is a
homeowners' association, use Form HOA 02/03. If the applicant is a developer, use Form DEV 02/03. EVEN IF
THE PROJECT WILL BE TURNED OVER TO A MUNICIPALITY, FORM DEV 02/03 IS REQUIRED.
❑ V. Flow Acceptance Letters — If the owner of the downstream sewers and/or WWTF is different from the applicant,
submit two copies of a flow acceptance letter from the owner of the downstream sewers and WWTF, if different.
Flow acceptance letters must contain the following minimum information: applicant and project name, amount of
flow accepted, and name and permit number of the receiving sewersNVWTF. The flow acceptance must not
expire prior to permit issuance and must be dated less than a year prior to the application date.
Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific flow acceptance
letter.
® VI. Map — Submit an 8.5-inch by 11-inch copy of the portion of a 7.5-minute USGS Topographic Map along with this
form. The map should identify the entire project area location as well as the closest downslope surface waters as
clearly as possible. Each map portion must be labeled with the map name and number, the identified location,
and be of clear and reproducible quality. For instance, if the project involves 4 miles of interceptor sewer that
traverses over or near several different waterbodies (or counties, basins, etc.), the map should have location ID's
for each different waterbody (where the sewer line is within 100 feet of such waterbody - see Instruction VII).
❑ Vil. Stream Classifications — Section C ,
• If any portion of the project is within 100 feet of any down slope surface water, Section C must be completed
for the pertinent sections.
• If the entire project area is a minimum of 100 feet away from any down slope surface waters BUT there is a
pump station involved where a history of power outage is to be used to provide adequate design storage
instead of dual feed or permanent or portable generator, Section C must be completed to demonstrate that
the closest down slope surface water is Class C (see 15A NCAC 2H .0219(h)(3)(D)).
• Use the guidance document entitled, "Determining Watershed Classifications for Form FTA 02/03 (Fast -Track
Sewer Systems)" available from http://h2o.enr.state.nc.us/ndpu or by contacting the appropriate regional
office.
FTA (17/(Y

• FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 2
❑ VIII. Environmental Assessments — If this project is subject to an Environmental Assessment (EA) [15A NCAC
01C .0500], this application can not be used. Send the project application on Form PSFMGSA 10/99 to the
Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. Applications can not be
processed until a Finding of No Significant Impact (FONSI) or Environmental Impact Statement (EIS) has been
issued. A copy is to be submitted with that permit application.
® IX. Certifications — Section D
The application must be certified by both the applicant and a North Carolina Registered Professional Engineer
(PE). The applicant signature must match the signing official listed in Item A(1 b). The PE should NOT certify the
application if he/she is unfamiliar with 15A NCAC 2H .0200, the Gravity Sewer Minimum Design Criteria (most
recent version) and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains
(most recent version), as applicable to the project. Certification by a PE who is unfamiliar with these documents
is subject to NC Board referral.
THE COMPLETED FTA 02/03 APPLICATION PACKAGE, INCLUDING ALL SUPPORTING DOCUMENTS AND $400
FEE, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
59 Woodfin Place
Asheville, North Carolina 28801
[phone]
[phone] Fax
Avery, Buncombe, Burke, Caldwell,
Cherokee, Clay, Graham, Haywood,
Henderson, Jackson, Macon,
Madison, McDowell, Mitchell, Polk,
Rutherford, Swain, Transylvania,
Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Fayetteville, North Carolina 28301
[phone]
[phone] Fax
Anson, Bladen, Cumberland, Harnett,
Hoke, Montgomery, Moore, Robeson,
Richmond, Sampson, Scotland
Mooresville Regional Office
919 N Main Street
Mooresville, North Carolina 28115
[phone]
[phone] Fax
Alexander, Cabarrus, Catawba,
Cleveland, Gaston, Iredell, Lincoln,
Mecklenburg, Rowan, Stanly, Union
Raleigh Regional Office
1628 Mail Service Center
Raleigh, North Carolina 27699-1628
[phone]
[phone] Fax
Chatham, Durham, Edgecombe,
Franklin, Granville, Halifax, Johnston,
Lee, Nash, Northampton, Orange,
Person, Vance, Wake, Warren,
Wilson
Washington Regional Office
943 Washington Square Mall
Washington, North Carolina 27889
[phone]
[phone] Fax
Beaufort, Bettie, Camden, Chowan,
Craven, Currituck, Dare, Gates,
Greene, Hertford, Hyde, Jones,
Lenoir, Martin, Pamlico, Pasquotank,
Perquimans, Pitt, Tyrrell, Washington,
Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
[phone]
[phone] Fax '
Brunswick, Carteret, Columbus,
Duplin, New Hanover, Onslow,
Pender
Winston-Salem Regionals Office
585 Waughtown Street
Winston-Salem, North Carolina 27107
[phone]
[phone] Fax
Alamance, Alleghany, Ashe, Caswell,
Davidson, Davie, Forsyth, Guilford,
Rockingham, Randolph, Stokes,
Surry, Watauga, Wilkes, Yadkin
For more information, visit our web site at: http://h2o.enr.state.nc.uslndpu/

- FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
PAGE 4
. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2H
.0219(1) for Item B(7) or the design flow for line or pump station sizing if zero flow in the space below. Values other than
that in 15A NCAC 2H .0219(1)(1-2) must be approved prior to submittal of this application. Submit a separate request to
the Division of Water Quality, Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617 in
accordance with 15A NCAC 2H .0219(1)(3).
10 homes * 3 Bedrooms * 120 gpd per bedroom = 3600 gpd
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches)
8„
•
Length (feet)
1003
ENTER TOTAL LINE LENGTH IN MILES .19
I F- 11. Summary of Pump Stations to be Permitted (attach additional sheets as necessary)
Power Reliability Option
Operational Point (dual line feed, permanent generator w/ATS,
GPM @ TDH portable Lenerator w/telemetr r,, wet well storage)
Ce
Q
i>
BMW
ce
LU
C" 12. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force.
CO Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H .0200 as applicable?
Yes 0 No If no, please reference the pertinent minimum design criteria or regulation and indicate why a
variance is requested:
Location ID
as shown on plans)
Design Flow
(MGD)
Gravity or Force Main
(pull down menu)
Gravity
Gravity
Gravity
Gravity
Gravity
Gravity
Gravity
SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS PERTINENT TO THE VARIANCE WITH YOUR APPLICATION
13. Have the following permits/certifications been submitted for approval?
Wetland/Stream Crossings - General Permit or 401 Certification? 0 Yes 0 No ® N/A
Sedimentation and Erosion Control Plan? ❑ Yes 0 No ® N/A
Stomiwater? 0 Yes ❑ No ® N/A

• FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 5
LL
1. Use the Division's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02/03
(FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach additional sheets as
necessary). This document is available from our web site or by contacting the appropriate Division of Water Quality
regional office (see instructions for addresses) OR indicate the following:
® A Stream Classification is not needed because all parts of the project are at least 100 feet away from any down slope
waterbody; AND,
® A Stream Classification is not needed because the design does notdepend
ge as a power reliability
depenon wet well storage as a reliability
option for any pump station near a Class C down slope waterbody.
Location ID
on Map
Name of
Waterbody__
County
River Basin
Waterbody Stream Waterbody
Index Classification
Submit the 8.5" x 11" topographic map as required in Instruction VI regardless of whether a classification is provided!
1. Applicant's Certification:
1 a.
1, SIGNING OFFICIAL NAME, attest that this application for PROJECT NAME
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 retumed as incomplete. Note: In accordance with North Carolina
General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or
certification in any application shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed $10,000
as civ yes up to ', 5,000 per violation.
Signing • ici- a "e
Professional Engineer's Certification:
p4"4 Z-/O?
Date
I attest that this application for 3'd Ave. Sanitary Sewer Extension has been reviewed by me
and is accurate, complete and consistent with the information in the engineering plans, calculations, and all other
supporting documentation to the best of my knowledge. 1 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 adopted February 12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump
Stations and Force Mains adopted June 1, 2000 and the watershed classification in accordance with Division guidance.
Although certain portions of this submittal package may have been developed by other professionals, 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 NC General Statutes 143-215.6A and 143-215.6B, any person who
knowingly makes any false statement, representation, or certification in any application 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.
2a. Robert P. Armstrong, Jr.
Professional Engineer Name
2b. Robert P. Armstrong, Jr.
Engineering Firm
2c. PO Box 995
Address
2d. Bladenboro
City
2e. NC 2f. 28320
State Zip
2g. 910-863-3205 2h. 910-642-8048 2i. [e-mail]
Telephone
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Phone: [phone]
NCDENR
Division of Water Quality
Fayetteville Regional Office
225 Green Street Suite 714
Fayetteville, NC 28301
ROBERT P. ARMSTRONG, JR., P.E.
PROFESSIONAL ENGINEERING SERVICES
PO BOX 995
BLADENBORO, NORTH CAROLINA 28320
EMAIL: [e-mail]
May 16, 2003
RE: Sanitary Sewer Extension for the Town of Elizabethtown to Serve 3`d. Ave.
Please find enclosed the following items for the above referenced project:
•
One Original and One Copy of the completed and executed Fast -Track Application.
A check for the $400.00 Application Fee.
A copy of the USGS Topographic Map for the project area.
If you have any questions or need additional information, please feel free to call me at 910-863-3205.
Sincerely,
Robert P. Armstrong, Jr.