WQ0042322_Application (FTSE)_20210212

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
I5A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number:
(to be completed by MR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Rodriguez Glass. Inc. (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership 0 Privately -Owned Public Utility
❑ Federal ❑ State/County ❑ Municipal ❑ Other
3. Signature authority's name: Pedro Rodriguez per I5A NCAC 02T _0106tbil
Title: President NC Dept of Environmental Quality
4. Applicant's mailing address: 434 Obie Drive
City: Durham State: NC Zip: 27713- FEB ¶ 2 2021
5. Applicant's contact information:
Phone number: [phone] Email Address: rodriguez19I3 a,gmail.com Raleigh Regional Office
Ho\
II. PROJECT INFORMATION:
1. Project name: Rodriguez Glass. Inc.
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: Durham
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.918413') Longitude:-78.889088
5. Parcel ID (if applicable): 0738-01-29-7139 & 0738-01-29-7122
(or Parcel ID to closest downstream sewer)
I11. CONSULTANT INFORMATION:
I. Professional Engineer: Thomas A. Perdue License Number: 042668
Firm: MacConnell & Associates. P.C.
Mailing address: P.O. Box 129
City: Morrisville State: NC Zip: 27560-�
Phone number: [phone] Email Address: thomas.perdue(c�r�macconnellandassoc.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I. Facility Name: Triangle Wastewater Treatment Permit Number: NC0026051
Owner Name: Durham County
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
I . Permit Number(s): WQ Downstream (Receiving) Sewer Size: . inch
System. Wile culledii n System Permit Number(5) i if applicablel: WQCS00038
Owner Name(s):
FORM: FTA 04-16 Page I 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?
0 Yes ❑No ®NIA
If the Applicant is a Developer of lots to be sold, has a Develog_er's One ar )ior =ement t FORN1i DEV I been attached?
D Yes ❑No ®N/A
3. lithe Applicant is a J-Iome, Pro erty Owners Association, has an Operational Nueer cnt (FORM: HOA) been attached?
0 Yes ❑No ®NIA
2.
4. Origin of wastewater: (check all that apply):
❑ Residential Owned
❑ Residential Leased
❑ School i preschool I day care
❑ Food and drink facilities
® Businesses/ offices 1 factories
O Retail (stores, centers, malls)
❑ Retail with food preparation,service
❑ Medical ,' dental i veterinary facilities
O Church
O Nursing Home
5. Nature of wastewater : - % Domestic:Commercial
100 %Commercial
0 % Industrial (SEE 1 i•'. NC.. C 02T .010;+ )
�ls there a Pretreatment Program in effect?
6. Has a flow reduction been approved under I ;xl 'AC 02T .0I 14(I)? ❑ Yes
i- If ves, provide n cony allow reduction approval letter
7. Summarize wastewater generated by project:
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool /Clubhouse
❑ Swimming Pool:Filter Backwash
❑ Other (Explain in Attachment)
Cl Yes ❑ No
® No
Establishment Type (see 02T,0114(f1)
Daily Design Flow a,b
No. of Units
Flow
Warehouse Structure
25 gal/employee/shift
20
4 GPD
Office Structure
25 gal/employee/shift
5
125 GPD
gall
GPD
gal/
GPD
gal:`
GPD
T
gal/
GPD
Total
625 GPD
y00
a See 15A NCAC 02T .n I I4{b}_ (d), lep(1) and (ex 2j 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 .0I 14(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0 I 14] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: _ GPD (per I5A 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:
0 Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16
Page 2 of 5

Vll. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
I . Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
4
72
PVC
6
213
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 1 A NCAC 02T .0305 Eli 1j:
❑ Standby power source or pump with automatic activation and telemetry - I5A 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 - I5A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - I5A NCAC 02T .0305(h)(1)(C):
i 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.
lithe 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

IX. SETBACKS & SEPARATIONS — (02B .0200 & I5A NCAC 02T .0305(0):
1. Does the project comply with all separations found in 15A NCAC 02T .031,liipAigi
I5A NCAC 02T,0305{f) contains minimum separations that shall be provided for sewer systems:
® 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-I waters of Class 1 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, HOW, or SB from normal
high water (or tide elevation) and wetlands (see item 1X.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
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
i 15A NCAC 0?T.0305(g) contains alternatives where separations in 02T.0305 f] cannot be achieved.
!= **Stream classifications can be identified using the Division's NC Siirrace Water Classifications wchpa,c
i If noncompliance with 02T.030 it nr;d, see Section X of this application
Does the project comply with separation requirements for wetlands? (50 feet of separation) ® 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 I SA NCAC 02B .0200? ® 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
individual permits or 401 Water Quality Certifications?
i Information can be obtained from the 401 & Buffer Permittine Branch
El Yes ®No
5. Does project comply with I5A NCAC 02T.0105(c)16) (additional permits/certifications)? ® Yes ❑ No
Per I5A NCAC 02T.0IO2(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 15.1 N 'AC 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 ❑ 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:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Pcrmitting gf Pump Stations
and Force Mains (infest version), and the Gravity Sewer MinimumEtssixp Criteria Detest version) as applicable?
es ❑ No
If No. complete and submit the Variance/Altcmative Design Request application (VADC 10-14) and supporting document for
review. j ppnp t1,pf tire rsaaest Is required prior to submittal of the Fast Track Application and su000rtig4 documents,
2. Professional Engineer's Certification:
1, I /1•061 e " o k attest that this application for
(Professional Engineer's name from Application item I11.1.)
has been reviewed by me and is accurate, complete and consistent with the informtion supplied in the plans, specifications,
engineering 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 (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 143-215.6B, 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 SI0,000, as well as civil penalties up to S25,000 per violation.
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b :
I, PAS ' d o e Z 1 k5 l 6.0 4\k attest that this application for
ignature Authorir' name & tide m Application item 1.3.)
has been reviewed by me and is accurate and complete to the best of my knowledge. 1 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 rew ned as incomplete. 1 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. 1 will make no claim against the Division of Water Resources should a condition
of this permit be violated. 1 also understand that if all required parts of this application package are not completed and that if
all requited 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 I43-215.613, 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 SI0.000 ns well as civil Mathes up to S25,000 per violation.
Signature:
a o
FORM: FTA 04-16 Page 5 of 5

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Business Corporation
Legal Name
Rodriguez Glass Inc
Information
Sosld: 1370294
Status: Current -Active 0
Date Formed: 3/31/2014
Citizenship: Domestic
Fiscal Month: December
Annual Report Due Date: April 15th
CurrentAnnual Report Status:
Registered Agent: Alecio, Tammy
Addresses
Reg Office Reg Mailing
1100 MAYNARD RD SUITE 130 1100 MAYNARD RD SUITE 130
CARY, NC 27513 CARY, NC 27513
Mailing Principal Office
1100 NW MAYNARD RD SUITE 130 1100 NW MAYNARD RD SUITE 130
CARY, NC 27513 CARY, NC 27513
Officers
President
PEDRO RODRIGUEZ
434 OBIE STREET
DURHAM NC 27713

1
PUBLIC WORKS
CITY OF DURHAM
February 9, 2021
N.C. Department of Environmental Quality
Division of Water Resources
Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27699-1628
Dear Sirs:
Subject: Sewer Permit Application
RODRIGUEZ GLASS
NC Dept of Environmental Quality
FEB 12 2021
Raleigh Regional Office
Please find enclosed the subject application package, which includes one FTA 04-16's, two forms
FTSE 10-18, one from the City of Durham and one from Durham County, (one public and one private),
the appropriate topographic maps, and a check for the $480.00 application fee for the application.
Should you have questions or comments, please do not hesitate to contact me at [phone], ext.
30229.
Sincerely,
Redeye i P . P.
Robert N. Joyner, Jr., P.E.,
Development Review Group Manager
City of Durham
Dept. of Public Works
101 City Hall Plaza, Third Floor, Durham, NC 27701
919.560.4326 I DurhamNC.gov
Follow Us @CityofDurhamNC
0 0 0

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: City of Durham
Project Name for which flow is being requested: Rodriguez Glass
More than one FTSE may be required for a single project if the owner of the WFVTP is not responsible for all pump
stations along the route of the proposed wastewaterjlow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name:
b. WWTP Facility Permit #:
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
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
A1I flows are in MGD
331110 1puot50g 11d1alult
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 Average Daily Approx. Not Yet Total Current
Station Firm Flow** Current Avg. Tributary Flow Plus
(Name or Capacity, * (Firm / pf), Daily Flow, Daily Flow, Obligated Available
Number) MGD MGD MGD MGD Flow Capacity***
NOCCITY OF DURHAM PUMP STATIONS INVOLVED, EXISTING DOWNSTREAM SEWER MAIN FROM
-�Ofl T t?F TtE-IN-TO-PO!NT-OF- SFER-Te-Dt RH*M eeuNT'f MAIN -IS GRAVITY -FEW-KW-
SUFFICIENT CAPACITY TO SERVE PROPOSED EXTENSION.
* 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):
Downstream Permit Number:
Page 1 of 6
FTSE 04-16

Dh'kiocn of ll:.rter Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Rodriguez Glass, Inc.
Project Name for which flow is being requested: Rodriguez Glass
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 route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant,
a. WWTP Facility Name: Triangle Wastewater Treatment Plant
b. WWTP Facility Permit #: NC0026051
All flaws are in MGD
c. WWTP facility's permitted flow 12
d. Estimated obligated flow not yet tributary to the WWTP 2.137
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
3,503
0.000625
5.641
47,0
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 / pf), Avg Daily Daily Flow, Obligated Available
Number) No MGD MGD Flow, MGD MGD Flow Capacity***
N/A
* The Firm Capacity (design flow) 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 Tess than 2.5, per Section 2.02(A)(4Xc) 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): Durham County Sewer
Downstream Permit Number: WQCS00038
Page 1 of 6
FTSE 10-18