wq0042364_Application (FTSE)_20210223

DocuSign Envelope ID: 26F2CB93-5136-4788-AB49-242186851AO1
State of North Carolina
DW
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T.0300— FAST TRACK SEWER SYSTEM EXTENSION' APPLICATION
rllvls[an of Water Resources FTA 04-16 S SUPPORTING DOCUMENTATION
Application Number: w OO (to becompleted by MR) �
aq�
All items must he completed or the application will he returned
1. APPLICANT INFOR�iNIATION:
I. Applicant's name: Town ofholk tiprines (companN. municipalitN. I IOA, utility. etc.)
2. Applicant t%pe: ❑ Individual
❑ Corporation ❑ General Partnership ElI'rikateh-Owned Public Utility
❑ I-ederal ❑ State/Count} ® Municipal ❑ Other
3. Signature authorit%'s name: Kendra Parrish. P.E. per IS:\ NC1C 021 .Olf1h h
"title: Exceuti%e Dircclor nl' Utilities c. [nfrastruclure Son ices
4. Applicant's mailing address: 128 South Main Street
Cit%: Uolh Springs Stale: NC %ip: 275dO
5. Applicant's contact inibl-oration:
Phone number: (919)577-31�0 Email Address:kendra. arrishirholhs rinLsne.us
11. PROJECT INFORMATION:
1. Project name: Carolina 'Springs Pump Station 1
?• ApplicalionlProject status: ® Proposed (Nc%% Permit) ❑ Existing Permit/1'roject
11'a modification. pro% ide the existing permit number: 11'QOO_ and issued date:
I1'not construction but purl ofa master plan, pro%ide the existing permit number; 11'Q0O
3. Count) where pro ect is located: 11'akc
4. Approximate Coordinates (Decimal Degrees): latitude: 35.6782 Longitude:-78.8761
5. Parcel II) (il'applicable): 0730533714
(or Parcel ID to closest do►%nstream sc%%er)
Ill. CONSULTANT INFORMATION:
L I'rol''essional I:nLincer: Da+ id A. i%IcCiure- License Number: 030282
I'irrn: %Iither%Ra%enel
Mailing address: 115 MacKcnan Drive
City: Can State: NC Zip: 27�i 1_,,,_
Phone number: (919) d(,9-33-It1 Ismail Address; dmeciure it %tithersra%cnci cnm
IV. WASTEWATER TREATMENT FACILITY (11'N'TF) INFORMATION:
1. Facility Name: Utlo Creek IWaste�%aterTreatmenl Plant Pcrmit Number: NC0063096
Owner Namc: Town off loll% Springs
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than 11'WTF):
L Pcrmit Numbcr(s): WQ003037h Do%%nstream (Recei%ing) Seiner Sire: 18 inch
4}'Stcm Wide Colle • on S%stem Pgrmii N u h ti i `a li ahl : %%,QCSOII l92
Owner Namc(s):'I'ownol'loom SSrtrings
I-ORM: 1:'I'A 04-16
Page I o!'5

DocuSign Envelope ID: 26F2CB93-513B-47B8-AB49-242186851A01
%IL GENERAL REQUIREMENTS
I. II'the Applicant is a l'ri►atch•-O►sned Public Utilitp, has a Certificate ofl'ublic Comenienec and Nccessil� been attached?
❑ Yes ❑No OMA
2. If the Applicant is a De►eloper of lots to be sold, has a De►elo er's O erational Aerccment FORNI: DEV bccn altached7
❑ Yes [—]No ®NIA
3. If the Applicant is a I Tome/Pro ert► O►sners' Association. ha -,an Operational Agreement 0 010j: I10A been attached'?
❑ Yes ❑No ON. -'A
4. Origin of►eastewater. (check all that apply).
0 Residential Owned El Car Nash
® Retail (stares. centers. malls)
❑ Residential Leased ® Retail with food preparation'scr► ice ❑ I lotel and/or Motels
® School 1 preschool / day care ❑ Medical / dental I ► eterinar% facilities ❑ Sa imming Pool ?Clubhouse
®food and drink lacilities ❑ Church ❑ S►►imming Poold'ilter Back►►ash
® Businesses % oflices / lactorics ❑ Nursing I tome ❑ Other (Explain in Attachment)
5. Nature of►►aste►cater : % Domestic/Commercial
% Commercial
Industrial (tics I5A NUAC 021- .01 t1i1211 )
.Is there a Pretreatment Program in el-lect? [:]Yes ❑ No
6. 1las a 11o►► reduction been approved under 15A NC AC 02T .01 14(1)? ❑ Yes ❑ No
J_ If ves, provide a copy of flow reduction approval letter
7. Summarize ►►astewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow id) IiN'o. of Unitsl Flow
gal.:
GPD
gal..,
GPD
gal,'
GPD
gal'
GPD
gal
GPI)
gaI
GPD
Total
GPI)
a See 15A NC'AC m I_.n1 Idlhl. 1d). �c1( 1) and (e)f?) for ca►eats to ►►astc►►ater design Ito►► rates (i.e.. minimum Ilo►► per
dwelling: proposed unknown non-residential de►clopment uses: public access facilities located near high public use areas.
and residential property located south or cast ofthc Atlantic Intracoastal Watcr►►a► to be used as ► acation rentals as defined
in O.5.42A-4).
b Per 15A NCAC 02T .01 14(c). design Ilou rates liar establishments not identified tin table 15A `CAC 021 0I 1141 shall be
determined using available flow data, cater using fixtures. occupant% or operation patterns. and other measured data.
8. Wastc►►aler generated be project: 0 GPD (per BA NC A: ' 021' _1111
i Do not include luture Ilo►►s or previously permitted allocations
Ifpermitted flo►► is iero, indicate ►eh►•:
® Pump Station or Gravit)• Se►ccr where flow will be permitted in subsequent permits that connect to this line
❑ Flou has alread% been allocated in Permit Number:
❑ Rehabilitation or replacement of'existing serer ►►ith no nc%% Ilo►► expected
❑ Other ( Explain):
FORM: l I'A 0.1-16 Page 2 of, 5

DocuSign Envelope ID- 26F2CB93-5136-47B8•AB49-242186851A01
VII. GRAVITY SEWER DES1GiN CRITERIA (If Applicable) - 02T .0305 & NlDC (Gra%ily Sc►vcrs):
I. Summarize gra+ it} sc++er to be permitted:
Size (inches)
Length (feet)
Material
8
[90
PVC
8
30
DIP
18
205
Dill
Section II & II[ oNhe MDC tier Permitting ol'Gra+ith Sewers contains inlbrmation related to design criteria
Section III contains inlbrmation related to minimum slopes fin gra+itN se%%cr(s)
% Oversizing lines to meet minimum slope requirement is not allowed and it violation of the MDC
VI11. PUiNIPSTATIONDESIGNCRITCRIA(IfApplicable)-02T.t130a&i11DC(PumnStationslForcc\lains):
COMPLETE FOR EACH PUNIP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: Carolina Springs Pum Station
2. Approximate Coordinates (Iaecimal Degrees): Latitude: 35.6782' Longitude:-79.8761'
3. Design Ilo►+ of`the pump station: 1.97 millions gallons per duy (firm capacit} )
d. Operational point(s) of the pump(s): 1.366 gallons per minute at 231 feet total d%namic head (TDl [)
5. Summarizze the Force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
11
18.450
PVC
8
20
PVC
6. ['o+cer reliabilit-, in accordance ++ith I5A M'AC 021 .0;03 h I :
® Standb} power source or pump \+ith automatic acti\utiun and telemetr\ - 15A NCAC 02 f .0305(h)( 1)(I3)_
Required fior all pump stations N+ith an a\ erage daih Flo++ greater than or equal to 15.000 gallons per da}
Must be permanent to Iacilit}
Or ifthe pump station has an a\ erase daih lloa- less than 15.000 gallons per da\ :
❑ Portable po++cr source ++ith manual acti+ation. quick -connection receptacle and telemetr% - 15A NCAC 02 F
.0305(h)(1)(C)
or
❑ Portable pumping unit ++ith plugged emergcnc� pump connection and telemetr+ - I5A NCAC 02 r .0305(h)(1)(C):
It shall be demonstrated to the Dix ision that the portable source is ot+ned or contracted b% the applicant (draft agreement
and is compatible %\ith the station.
% I t'the portable po++er source or pump is dedicated to multiple pump stations. an e\ aluation ol'all the pump stations' storage
capacities and the rotation schedule ot'the portable po++er source or pump. including travel timelrames. shall be pro+ ideL
in the case ol'a multiple station po++er outage.
FORM: VFA 04-16

DocuSign Envelope ID: 26F2CB93-513B-47B3-AB49-242186851AC1
IX. SETBACKS & SEPARATIONS—(0213.0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply %%ith all separations found in 151 NCAC 02T ,n 3n5(I'l &, (e)®Yes ❑ No
> 15A NCAC 02'I'.0305t I) contains minimum senarations that shall he nrnx idt-d fnr seaor m drmc•
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
24 inches
Water mains (vertical -eater over se%cer includins in benched trenches)
18 inches
Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed %cater lines (horizontal - reclaimed over se%%er)
2 feet
*'Any private or public water supply sourer. including any wells. WS-1 %%aters of'Class 1 or
Class II impounded reservoirs used as a source ol'drinking %cater
100 Icct
**Waters classilied WS (except WS4 or WS-V).13. SA.OR11'. I IQ\V. or S13 from normal
high %cater (or tide elevation) and wetlands (see item 1X.2)
50 feet
**Any other stream. lake. impoundment. or ground %rater lowering and surface drainage
ditches
10 feet
Any building foundation
5 IM
Anv basement
10 feet
Top slope of embankment or cuts ol'2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 lect
Final earth grade (vertical)
36 inches
3A NCAC 02T.t1.;(litg l contains alternatives %\here separations in 02 C.0 305(Il cannot be achieved.
"Stream classifications can be identified using the Division's NCtiurtuce heater Classifications %%ehnavr
> ll'noncompliance with 02'1',0305(f') or (U1. see Section X ofthis application
2. Does the project comply %cith separation requirements for %cellands? (50 leet ol'scparation) ®Yes [:]No [IN -'A
Sec the Division's draft separation requirements for situations \%,here separation cannot be meet
No variance is required ifthe altcrnati%e design criteria specified is utilized in design and construction
As built documents should reference the location of areas et'lected
3. Does the project comply %cith setbacks lound in the ri%er basin rules per I fA N('AC 0213 ,0200? ® Yes ❑ No ❑ N'A
> phis %could include Trout Bul'Icred Streams per 15A N('AC 211,0202
4. Does the project require coverage/authorization under a 404 Nation%%ide or ® Yes ❑ No
indi% idual permits or 401 Water Qualit-, Certifications?
Information can be obtained from the 401 & Buller Permitting 11ranch
5. Does project comply with I5A NC'A(' 02 LO 1 05c 6) (additional permits/certifications)? ® Yes ❑ No
Per I51 NUAC 021'.0105(c)(6). direct% related en\ironmental permits or cerlilication applications are being prepared. ha\c
been applied for. or have been obtained. Issuance ol'this permit is contingent on issuance ol'dependent permits (erosion and
sedimentation control plans. storm%%ater management plans, etc.).
6. Does this project include any serer collection lines that are deemed high priority""
Per 15A NCAC 021-0402. " Ihigh-priorit} sc%%er" means "any aerial se%%cr. serer contacting surface %raters. siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the serer.
❑ Yes ® No ❑ NIA
If} es. include an attachment with details liter each line. including type (aerial line. size. material. and location).
I ligh priority lines shall be inspected by the permittee or its representative at least once every six -months and inspections
documented per 15A NCAC 02T.0303(a)(5) or the permitec's individual System -Wide COIICCtiOn permit.
I ORM: i- TA 04-16 Page 4 of 5

DocuSign Envelope ID: 2BF2CB93-513B47B8•AB49-242186851A01
X. CERTIFICATIONS:
1. Does the submitted s%stem comply with 15A NCAC 02T, the Minimum Design -Criteria fOr the Permitting of Pump slatiow;
and I-orce Mains Ilatesl \ersionl. and the Gravily Seger Minimum Desiun Criteria (latest \ersion) as applicable?
® yes ❑ No
[I'No. complete and submit the Variance. -'Alternative Design Request application (VADC 10-14) and supporting documents for
re%iete. Awroval of the request is required prior to submittal „of the Fast Track Application and supportine documents.
2, Professional Engineer's Certification:
David A. McClure, P.E.
(I'rol'essional Engineer's name from Application Item 111.1.)
attest that this application liar
has been re%iewed b% me and is accurate. complete and consistent %%ith the infirrmation supplied in the plans. specifications.
engineering calculations, and all other supporting documentation to the best ol'm% kno«lcdgc. I further attest that to the best
of n» knox%ledge the proposed design has been prepared in accordance %%ith the applicable regulations. Graz its Se%%er
Minimum Design Criteria lbr Gravity Sewers (latest version). and the ,Minimum Design Criteria liar the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals ma% ha%c deN eloped certain portions ofthis
submittal package. inclusion ol'these materials under m% signature and seal signifies that [ ha%c revicucd this material and
ha%e judged it to be consistent N%ilh the proposed design.
NOI E - In accordance with General Statutes 143-215.6A and 143-215.613. an} person %%ho kno%�ingly makcs any false
statement. representation. or certification in any application package shall be guilt} ofa Class 2 misdemeanor. %%high may
include a line not to exceed S10.000. as %%ell as civil penalties up to $25.000 per % iolalion.
North Carolina Professional Engineer's seal, signature, and date:
EDocuSigned by:
ajalcuk�3_
300771882CM405 .
2/11/2021
3. Applicant's Certification per 15A NCAC 02T .0106(b):
Kendra Parrish Director of utilities & Infrastructure
(Signature Authorit%'s name K title Ihim Application Item 1.3.)
attest that this application Ibr
has been rc%ic%%cd b% me and is accurate and complete to the best ot'm% knoMedge. I understand that Wall required parts of
this application are not completed and that if all required supporting documentation and attachments are not included. this
application package is subiect to being returned as incomplete. I understand that am• discharge ol'%%as1e%%alcr Isom this non -
discharge system to surface %%aters or the land will result in an immediate entoreement action that ma} include ci% it penalties,
injuncliN a relief. and.'or criminal prosecution. I %%i II make no claim against the Di% ision ol'Water Resources should a condition
of this permit be % iolated. I also understand that Wall required parts ol'this application package are not completed and that it'
all required supporting inibi-mation and attachments are not included. this application package will be returned to me as
incomplete.
NOTE - In accordance %%ith General Statutes 14+-11i.f,A and am• person who kno%%ingl% makes am false
statement. representation. or certification in am application package shall be guilty ol'a Class 2 misdemeanor. �%hich maN
include a fine not to exceed S 10.001) as �wll as ciN it penalties up to S23.000 per % iolation.
—, 11"1519"41 bp'
1t��r& PAMS�C 2/23/2021
Signature: Date:
FORM: FTA 04-16 Page 5 ol'5

DocuSign Envelope ID 26F2CB93.513B4768-AB49-242186851AO1
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sciver Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Town of Holly Springs _
Project Name for which flow is being requested. Carolina Springs PUM2 Station I ^
More than oire FTSC iney he requiredfor a single project if the owner r f the 11 117P is not responsible for all pump
stations along the route of the proposer) wostcnralerJlow.
I. Complete this section only ifyou are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Utley Creek Water Reclamation Facility
b. WWTP Facility Permit #: NC 0063096
All flows are itr MGD
c. WWTP facility's permitted flow 6.0
d. Estimated obligated flow not yet tributary to the WWTP 0.658
e. WWTP facility's actual avg. Flow 2.426
f. Total flow for this specific request 0.0
g. Total actual and obligated flows to the facility 3.084
h. Percent of permitted flow used 51.4%'
II. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pomp stations located between the project connection point and the WWTP:
(A) (B) (C) (D)-(B+C) (E)�(A-D)
Design Obligated.
Pump Pump Averaue Appro,\. Not Yet Total Current
Station station firm Dail% I"lo%%** Current 1'ributan I:loN% Plus
(Name or Permit Capacit; . * (Firm 1 pl), A%L. Daih Dail% 1' lo1\. Oblieated A%ailable
Number) No. ,mc,,6 MGD Flo%%. NIGD N[GD Floc Capacit}***
* The Firm Capacity (design now) 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, 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): Utley Creek Water Reclamation Facilit
Downstream Permit Number: NC0063096, WQCS00192
Page I of 6
FTSE 10-18

DocuSign Envelope ID: 26F2CB93-5138-4788-AS49-242165851AO1
III. Certification Statement:
I Kendra Parrish certify to the best ofmy 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
w4h loc;il 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.
-D«uslgn.e by
"Jr,% PArr k
2/23/2021
,5js,ning Of icial ftnana-,e Dale
Director of utilities & Infrastructure
Tille ol" giling OJ]iClal
Page 2 of.'6
F1-S E 10-18

OocuSign Envelope ID: 26F2CB93-513B-47B8-AB49-242186851Ao1
PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum ror each pump station listed in Section 11 where Available Capacity is <
0.
Pump Station (Name or Number):
Given that:
a. The proportion and amount of Obligated. Not Yet Tributary Daily Flow (C) accounts for
% and MGD of the Available Capacity (E) in Pump Station
; and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately
MGD per year; and that
c. A funded Capital Project that will provide the required planned capacity, namely
is in design or under construction with
planned completion in ; andlor
d. The following applies:
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to allow
this flow to be permitted. NN-ithout a significant likelihood of over -allocating capacity in the system
infrastructure.
I understand that this does not relieve the collection system owner from complying with G.S. 143-
215.67(a) which prohibits the introduction of any i%aste in excess of the capacity of the waste disposal
system.
Mgiiting Official.Signalitre pale
Rage 3 of 6
FTSE 10-18

DocuSign Envelope ID, 26F2CB93-513B-47B8-AS49-242186851AO1
Instructions for Flow Tracking form (FTSE) and Planning Assessment Addendum (PAA)
Section 1
a. 1'V1,'4'TP Facilitv Name: Enter the name of the WWTP that will receive the wastewater flow.
b. WWTP Facilitv Permit #: Enter the NPDES or Non -Discharge number for the WWTP receiving the
wastewater flow.
c. WWTP facility's ermitted now, MGD: From WWTP owner's NPDES or Non -Discharge permit.
d. Estimated obligated flow not vet tributary to the WWTP. MGD: This includes flows allocated to other
construction projects not yet contributing flow to the collection system. Flows allocated through interlocal
agreements or other contracts not yet contributing flow to the collection system are also included. For POTWs
that implement a pretreatment program, include flows allocated to industrial users who may not be using all of
their flow allocation. Please contact your Pretreatment Coordinator for information on industrial flow tributary
to your WWTP.
As of January 15, 2008 the POTW should have reviewed flow allocations made over the last two years and
reconciled their flow records, to the best of their ability, so it is known how much flow has been obligated and
is not yet been made tributary to the WWTP, in accordance with local policies and procedures employed by the
reporting entity.
e. WW"fP facility's actual ave. flow. MGD: Previous 12 month average.
f. Total flow for this specific request. MGD: Enter the requested flow volume.
g. Total actual and obligated flows to the facility. MGD Equals [d + e + f1
h. Percent of permitted flow used: Equals [(g c)* 1001
For example:
On January 15 a POTW with a permitted now of 6.0 MGD, reported to the Regional Office that there is 0.5
MGD of flow that is obligated but not yet tributary. The annual average flow for 2007 is 2.7 MGD. There is a
proposed flow expansion of0.015 MGD.
The first Form FTSE submitted after January 15. 2008 may have numbers like this:
c. = 6.0 MGD
d. =- 0.5 MGD
e. = 2.7 MGD
f. = 0.015MGD
3.215 MGD
h. = 53.6 %
The next Form FTSE may be updated like this with a proposed flow expansion of0.102 MGD:
c. = 6.0 MGD
d. = 0.515 MGD
e. _ 2.73 MGD
f. = 0.102 MGD
g. - 3.349 MGD
h. - 55.8 %
Each subsequent FTSE form will be updated in the same manner.
Page 4 of 6
["I SF 10-18

DotuSign Envelope ID- 26F2CB93-513E-4788-AB49-242186851Ao1
Section I1
List the pump station name or number and approximate pump station firm capacity, approximate design average
daily flow (A) approximate current average daily Flow (B), and the obligated, not yet tributary now through the
pump station (C) for each pump station that will be impacted by the proposed sewer extension project. Calculate
the total current flow plus obligated flow (D=13-+C) and the available capacity (E=A-D). Include the proposed flow
for this project with other obligated flows that have been approved for the pump station but are not yet tributary
(C).
Firm capacity is the maximum pumped Flow that can be achieved with the largest pump out of service as per the
Minimum Design Criteria.
Design .Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pl) of not less than
2.5.
If the available capacity (E) for any pump station is ¢ 0, then prepare a planning assessment for that pump station
if the system has future specific plans related to capacity that should be considered in the permitting process.
(A)
(B)
(C)
(D)=(B+C)
(E)=(A-D)
Obligated.
Design
Approx.
Not Yet
Total Current
Firm
Average
Current Avg.
Tributary
Flow Plus
Pump Station
Capacity
Daily Flow
Daily Flow.
Daily Flow.
Obligated
Available
(Name or Number)
MGD
(Firm / pl)
MGD
MGD
Flow
Capacity*
Kaw Creek PS
0.800
0.320
0.252
0.080
0.332
-0.012
Valley Road PS
1.895
0.758
0.472
0.135
0.607
0.151
Page 5 of 6
FTSE 10-18

DocuSign Envelope ID 26F2CB93-513B-4788-AB44-242186851AO1
Piannine Assessment Addendum Instructions
Submit a planning assessment addendum for each pump station listed in Section 11 where available capacity is < 0
A planning assessment for Kaw Creek PS (see example data above) may be performed to evaluate whether there is
significant likelihood that needed improvements or reductions in obligated flows will be in place prior to activating
the slows from the proposed sewer extension project.
If the system decides to accept the flow based on a planning assessment addendum, it is responsible to manage the
flo« %% ithout capacity related sanitary overflows and must take all steps necessary to complete the project or control
the rate of flow to prevent sanitary sewer overflows.
The planning assessment may identify a funded project currently in design or construction, or a planned project in
the future not yet funded but in a formal plan adopted by the system. The system should carefully weigh the
certainty of successful timely project completion for any expansion, flow management diversion or infiltration and
inflow elimination projects that are the foundation of a planned solution to capacity tracking and acceptance
compliance.
For example:
Gi,#en that:
a. The proportion and amount of obligated, not yet tributary flow accounts for 24 % and 0.090 MGD of the
committed flow in Pump Station Kaw Creek; and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately 0.01 MGD
per year; and that
c. A funded capital project that will provide the required planned capacity, namely
is in design or under construction with planned
completion in ; and/or
d. The following applies:
The master .plan and ten year capital plan contain recommended scope and funding Ipr a capital proiect entitled
Kaw Creek Pum2 Station upgrade with Funding l2lanned in July 2014. This roiect is planned to add 0.100 MGD
to the firm capacity of the pump station by October 2015. Inclusion of this_proposed capital project as a condition
of this Flow Trackine/Acce tance for Sewer Extension Perinit-Application elevates this roject's l2riority for
funding and construction_ to be implemented ahead of the activation of obligated. not vet tributary flows in amounts
that exceed the firm pump station capacities identified in Section 11 above.
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to allow this now
to be permitted. without a significant likelihood ofover-allocating capacity in the system infrastructure.
Page 6 of 6
FTSE 10-18

DocuSian Envelope ID: 26F2CB93-513B-47B8-AB49-242186851AO1

)ocuSign Envelope ID 26F2CB93-513B-47BB-AS49-242186851A0I
*T, --VV , 47; -•7%
016' 01 a I W-
t-
q
1 4�,
Proposed Carolina Springs Pump Station
77'
0.
-MIN Pf
-AWN,it
. . . . . . . . . . ...
Ar.
175
-Ty. , -
Proposed 14r'DR-18 C-900 PVC Force Main
-44; Carol -n a S-or i ---J� --:1u r--1 p S'ci Lion I
Wit hersRavenel
.7, -1
0 LOW 2.0 CC
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❑ocuSign Envelope ID: 26F2CB93-5138.4788-AB49-242186851A01
WithersRavene!
O.ir People, Your Success.
To: North Carolina Department of Environmental Quality - Division of Water Resources
Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27699-1628
Phone: [phone]
Attn: Fast Track Sewer Extension Applications Review
CC. Town Holly Springs, NC
From: David A. McClure, PE
Datr: February 11, 2021
Project: Town Holly Springs, NC
Carolina Springs Pump Station 1
Project Number: WR #021-0372,10
Subject: Fast Track Sewer Extension Application
To whom it may concern,
Attached is an application for a Fast Track Sewer Extension Permit WithersRavenel is submitting on behalf
of the Town of Holly Springs, NC.
The Carolina Springs Pump Station 1 project is generally located to the north of Woods Creek Road between
Old holly Springs/Apex Road and US Hwy 1. See the attached maps in the submittal package for project
location.
The project includes the construction of a submersible sewage pump station and 14-inch force main along
with some onsite gravity sewer for future connections. The pump station will serve a large development
consisting of approximately 1,700 residential units and 2.82 million square feet of commercial space in
addition to two Wake County schools.
115 MacKenan Drive j Cary, NC 27511
t: 919.469.33401 f: 919.467,6008 www.withersravenel.com I License No. C-0832
Cary I Greensboro Pittsboro I Raleigh I Wilmington

DocuSign Envelope 10: 26F2CB93-513E-4788-AB49-242186851Ao1
WithersRavenel
A permit is requested for the following:
Pipelines
Gravity Sewer
8-inch
190 ft
PVC
Gravity Sewer
8-inch
30 ft
DIP
Gravity Sewer
18-inch
205 ft
DIP
Force Main
8-inch
20 ft
PVC
Force Main
14-inch
18,450 ft
PVC
Pump Station
Pump Station
Pumping Rate
Total Dynamic Head
Carolina Springs Pump Station 1
1,366-gpm
231-feet
The 8-inch force main if for a future connection. The permit will be for zero flow as no flow will be coming
online at this time. Flow will be permitted as development occurs within the basin.
This Fast Track Application Package includes the following items:
• Fast Track Application (Form FTA 04-16)
• Flow Tracking/Acceptance Form (Form FT5E 10-18)
• Site Maps
Please do not hesitate to contact me at [phone] or [e-mail] should you have
any questions or concerns.
Sincerely,
WithersRavenel
DocuMgrt+edhblJyr'
�Vl 1 I�VlJ1�1...
3DC771B82C9A OS
David A. McClure, PE
Project Manager
Page 2 of 2

DotuSign Envelope ID 26F2CB93.513B-47B8-AB49-242186851Ao1
E. Flow Tracking/Acceptance Form (Form: FTSE 0.1-16) (If Applicable):
® Submit the completed and executed FTSE form from the owners of the downstream severs and treatment facility.
:- Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
e The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one
year prior to the application date.
Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-
215.67 a .
Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific FTSE.
F. Site Maps (All Application Packages):
® Submit an 8.5-inch x I l-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project
area and closest surface waters.
Location of the project (gravity sewer, pump stations S force main)
Do►%nstream connection points and permit number (if known) for the receiving sewer
® Include a street level map (aerial) showing general project area so that Division staff can easily locate it in the field.
G. Existing Permit (All Modification Packages):
❑ Submit the most recently issued existin- permit.
❑ Provide a list of any items within the permit the Applicant would like the Division to address during the permit
modification (i.e., permit description, flow allocation, treatment facility, etc.).
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T .0305(h)(1). submit documentation of power reliability for pumping stations.
This alternative is only available for average daily flows less than 15,000 gallons per day
> It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible
with the station. The Division will accept a letter si;=ned b} the applicant (see 15A NCAC 02T .0106(b)) or proposed
contractor, stating that "the portable power generation unit or portable, independently -powered pumping units, associated
appurtenances and personnel are available for distribution and operation of this pump 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 travel
timeframes, shall be provided in the case of a multiple station povier outage. (Required at time of certification)
I. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per I ;A NCAC 02T .01 I Slay( I ) provide the Certificate of Public Convenience and Necessity from the North Carolina
Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by
the sewer extension, or
Cl Provide a letter from the North Carolina Utilities CommissinW.-. Water and Se%%er Division Public Staff stating an
application for a franchise has been received and that the service area is contiguous to an existing franchised area or that
franchise approval is expected.
J. Operational Agreements (Applications from HOA/POA and Dc�clopers for lots to be sold):
❑ Home/Property Owners' Associations
❑ Per 1_5A NCAC 02T .01 15(c), submit the properly executed Operational Agreement (FORM: I10A).
❑ Per 15A NCAC 02T .01 15(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 15A NCAC 02T .01 15(b), submit the properly executed Operational Agreement FORM: DEV .
Fvi-1now bijbi-111Q1ion, vi l 1he Divifio11 .v collectio11 vy.vlesrs trch.vile
INSTRUCTIONS FOR FORM: ].TA 04-16 K SUPPORTING DOCUiNIEN'1ATION Pace 2 ol'3

DocuSign Envelope ID. 26F2CS93-513E47B8-AB49-242186851A01
THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Quality Section
Swannanoa, North Carolina 28778
Clay, Graham, Haywood, Henderson, Jackson,
(828) 2964500
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section
Fayetteville, North Carolina 28301-5094
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[phone] Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Water Quality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
Raleigh Regional 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, Bertie, 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, Pender
[phone]
[phone] Fax
Winston-Salem Regional Office
450 W. Hanes Mill Road
Alamance, Alleghany, Ashe, Caswell, Davidson,
Water Quality Section
Suite 300
Davie, Forsyth, Guilford, Rockingham, Randolph,
Winston-Salem, North Carolina 27105
Stokes, Surry, Watauga, Wilkes, Yadkin
[phone]
INSTR('C HONS I OR I-ORNI: I. I -A 04-16 K SUPPORTING DOCUMENIWWON 1'aue 3 01'3

DocuSign Envelope ID: 26F2CB93-513B-47B8-AB49-242186851A01
1�
h +lie4F
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
t5A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
INSTRUCTIONS FOR FORM: FTA 04-16 sic SUPPORTING DOCUMENTATION
This application is for sewer extensions in%olving gravity sewers. pump stations and lorce mains, or am combination that has been
certified by a proleasiona) engineer and the applicant that the project meets the requirements of 15A NCAC 021- and the Mision's
Minimum I)csign Criteria and that plans, specirications and supporting documents have been prepared in accordance wvith, I5A
NCAC 02T, I5A NCAC 02T .0300, Division policies and good engineerina practices.
While no upfront engineering design documents are required ]or submittal, in accordance with I5A NCAC 021' .0305(b). design
documents must be prepared prior to submittal of a last track permit application to the Di%ision. 'I his %%ould include plans. design
calculations. and project specifications referenced in I A NC, C 011 0'M and the applicable minimum design criteria. 'These
documents shall be availahle upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Dn ision) are explained in 15.1 NCAC 021.030+.
Projects not eligible for review via the fast track process (must be submitted lbr Cull technical rc%ie%%):
> Projects that require an environmental assessment in accordance %%ith 15A NCAC IC .0100:
Projects that do not meet any part ol'the minimum design criteria (NIDC) document:
Projects that involve a variance from the requirements of" I SA NCAC 21':
Pressure sewer systems utilizing septic tank-ellluent pumps (STE13s) or simple\ grinder pumps:
STEP or simplex grinder pumps connecting, to pressurized systems (e.g. large mains):
". Vacuum sewer systems.
General — When submitting an application, please use the following instructions as a checklist in order to ensure all required items
are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and
reduce the amount of requested additional information. Failure to submit all required items will necessitate additional
processing and review time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit
one original and one copy of the application and supporting documentation.
A. One Original and One Copy of Application and Supporting Documents
® Required unless otherwise noted
B. Cover Letter (Required for All Application Packages):
0 List all items included in the application package, as well as a brief description of the requested permitting action.
Be specific as to the system type, number of homes served, flow allocation required, etc.
If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Major Modification Application Packages):
® Submit a check or money order in the amount of Sa80.00 dated within 90 days of application submittal.
I'm able to North Carolina Department of Environmental Quality (NCDI Q)
D. Fast Track (Form: FTA 04-16) Application (Required for All Application Packages):
® Submit the completed and appropriately executed application.
If necessary for clarity or due to space restrictions, attachments to the application may be made.
❑ If the Applicant Type in Item 1.2 is a corporation or company, provide documentation it is registered for business with
the North Carolina Secretar of State.
❑ If the Applicant Type in Item I.2 is a partnership or d;'b;'a, enclose a copy of the certificate tiled with the Register of
Deeds in the county of business.
® The Project Name in Item 11.1 shall be consistent %%ith the project name on the flow acceptance letters, agreements, etc.
® The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North
Carolina licensed Professional Fneincer.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 021 .0106(h).
Per 15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is
provided from a person who meets the criteria in 15A NCAC 02T .0106(b).
INS I-RUC''I IONS FOR FORM: FTA 04-16 & S(TPORHNG DOCUMENTATION ['age I ol'3

DocuSign Envelope ID: 26F2CB93-513E-47B8-AB49-242186851A01
1'
T l I E T O 4V N O F
February 17, 2021
Director, Division of Water Resources
Raleigh Regional Office
Water Quality Operation Section
1628 Mail Service Center
Raleigh, NC 27699-1628
�oily prius
Re: Application for Sewer Extension Permit
Project: Carolina Springs Pump Station I
Dear Sir or Madam:
Please find enclosed the following items in application for a server extension permit to the Town
of Holly Springs existing sewer distribution system:
0 One original and one copy cover letter including a project narrative
o A check in the amount of $480.00
0 One original and one copy of the State of North Carolina Fast Track seller system
Extension tlppliccttion (FTA 04-16)
0 Two copies of FTSE 04-16 Flow Tracking/Acceptance Form
0 Two color copies of a 8.5-inch by 11-inch portion of a 7.5 minute USGS Topographic
Map showing project area
0 Two copies of a street level map showing all relevant project areas
0 One copy of the locally -required Design and Application Certification
Feel free to contact me at 919-577-3150 should you have any questions or need additional
information in order to process this application.
Sincerely,
,ns
FICCYSIa11fA OY' I 2�
c a PnyviSG 2/23/2021 I 2/17/2021
Kendra"' V4''arrish, P.E., CFM
Director of Engineering Rachel Ingham
Utility Engineer
KP/tr
cc: Project Consultant Engineer,
Rachel Ingham, Utility Engineer
Drew Johnson, Development Construction Manager
Theresa Randall, Utility Permitting Specialist
Project file/Correspondence #41861
3002
04.17.2018
Utilities and lufrastructure Services
P.O. Box 8 • 128 S. Main Street • Holly Springs, NC 27540 • ww%v.I1oIlvspril1gS11CA1S

DotuSign Envelope ID: 26F2CB93-513B-47BB-AB49-242186851A01
DO NOT SUBMIT SEWER EXTENSION APPLICATIONS UNTIL
CONSTRUCTION DRAWINGS HAVE BEEN APPROVED BY STAFF!
Sewer Design and Application Certification
Note: This fonn must be submitted with the Fast Tract Aoolication for extension to the Town of
Holly Springs Sewer System
Project: Carolina Springs Pump Station 1
Design Engineer:
Address:
David A. McClure, P.E.
115 MacKenan Drive, Cary, NC 27511
Phone Number: 919 .4 6 9 .3 3 4 0
Email: [e-mail]
02/16/21
Date Complete Application Package Received by Town:
Date Approved: y roved: 2/17/2021 (b RI 2/23/2021 �Vj 2/17/2021
(by KDP)T (by DJ)
As design engineer for this project, I certify the following (please check (t) each applicable bar):
El That the design of the project is in complete conformance with the Town of Holly
Springs Engineering Design and Construction Standards and NC DEQ Sanitary Sewer
Design Regulations;
® That each of the following items are completed and enclosed for submittal to the State for
a sewer extension permit:
0 One cover Ietter that includes a project narrative
o A check in the amount of $480.00 to NC DEQ
o A check in the amount of $200.00 to the Town of Holly Springs
0 One State of North Carolina form FTA 04-16 Fast Tract Seiver Sjweln
E.ctension Application
0 One FTSE 10-18 Flow Tracking for Seiner Cviension Applications
0 One color copy of an 8.5-inch by 11-inch portion of 7.5-minute USGS
Topographic Map showing project area
0 One copy of a street level map showing all relevant project areas
0 One copy of the locally -required Design and Application Certification (this
form)
Design Engineer's Signature
Date 02.10.2021
Please contact Theresa Randall at (919) 5674009 or lheresa.randalI a hollysprineanc._sov if you
have any questions.
2003 Se%%cr bcsign Application Certification
01.14.21
Utilities and Infrastructure Services
P.O. Bov 8 • 128 S. 1Jahn Street 0 Holly Springs, .NC27540 • tr,tvftatnll}spri)tgstic.gov