WQ0042393_Application (FTSE)_20210317

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: 010 47"m 3 (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: City of Wilson. North Carolina (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
El Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: W.T. Bass, IV, P.E. per 15A NCAC 02T .0106 b
Title: Public Works Director
4. Applicant's mailing address: 112 Goldsboro St E / P.O. Box 10
City: Wilson State: North Carolina Zip: 27894-0O10
5. Applicant's contact information:
Phone number: (ZL2) 399-2467 Email Address: bbassQwilsonnc.org
II. PROJECT INFORMATION:
1. Project name: Hwy. 301 Commercial Center (Gravity Sewer Relocation and Extension
2. Application/Project status: ❑ Proposed (New Permit) ® Existing Permit/Project
If a modification, provide the existing permit number: WQOO_ and issued date:
If new construction but part of a master plan, provide the existing permit number: WQOO�
3. County where project is located: Wilson
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.703149` Longitude:-77.926073`
5. Parcel ID (if applicable): 3711-82-8064
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
I . Professional Engineer. Jonathan L. Meade,• PhD PE license Number: 043222
Firm: Green Engineering, PLLC
Mailing address: 303 Goldsboro St E / P.O. Box 609
City: Wilson State: North Carolina Zip: 27893-
Phone number: [phone] Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Hominy Creek Water Reclamation Facility Permit Number: NCO023906
Owner Name: City of Wilson, North Carolina
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: inch
System Wide Collection System Permit Number(s) (if applicable): WQCS�
Owner Name(s): City of Wilson, North Carolina
FORM: FTA 04-16 Page l of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
[:]Yes [:]No ®NIA
2. If the Applicant is a Developer of lots to be sold, has a Developer's O erational Agreement FORM: DEV been attached?
❑ Yes ❑No ®NIA
3. If the Applicant is a Home/Property Owners' Association, has an Operational Agreement (FORM: HOA} been attached?
❑ Yes ❑No ®N.'A
4. Origin of wastewater: (check all that apply):
❑ Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical I dental I veterinary facilities ❑ Swimming Pool (Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic/Commercial % Commercial
% Industrial See 15A NCAC 02T .0103 20 )
�-->Is there a Pretreatment Program in effect? ® Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .0114f fl? ❑ Yes ® No
If yes, provide a c0RX of flow reduction apDroval letter
7. Summarize wastewater generated by project:
Establishment Type (see 021._0.1140
Daily Design Flow'-e
No. of Units
Flow
gall
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
0 GPD
a See 15A NCAC 02T .0114 b d e 1 and e 2 for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property Iocated 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 .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.01141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 0 GPD (per 15A NCAC 02T .0114)
D Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
® Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewer:
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8"0 207 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 (Puma StationslForce 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 I5A NCAC_ 02T .0305(h)(1):
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B)_
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(l)(C):
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
D If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(i)):
1. Does the project comply with all separations found in I5A NCAC 02T .0305(f) & (a) ® Yes ❑ No
15A NCAC 02T.0305(f) contains minimum separations that shall he nrnvided fnr sewer systems -
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
I8 inches
Water mains horizontal
I0 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 I or
Class II impounded reservoirs used as a source of drinking water
100 feet
"Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water or tide elevation and wetlands see item IX.2
50 feet
"Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage s stems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grode vertical
36 inches
D 15A NCAC 02T.0305(u) contains alternatives where separations in 02T.0305(i) cannot be achieved.
D "Stream classifications can be identified using the Division's NC Surface Water Classifications webpaee
If noncompliance with 02T.0305(f) or (e). see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ❑ Yes ❑ No ® Nr'A
D See the Division's draft separation requirements for situations where separation cannot be meet
D No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No ® N/A
D This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project require coverage/authorization under a 404 Nationwide or ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
D Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.0 I 05(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0I05(c)(6), directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ® No ❑ N,'A
D If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and inspections
documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pum12 Stations
and Force Mains (latest version), and the Gravitv Sewer Minimum Desi m Criteria latest version as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is required Rrior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
I,
(Professional Engineer's name from
Application Item III.1.)
attest that this application for
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE - In accordance with General Statutes 143-215.6A and 143-215.6B, 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 S10,000, as well as civil penalties up to $25,000 per violation.
.......... .
North Carolina Professional Engineer's seal, signature, and date: \\�1}jCAjpQ�i��i
4A_ p.oFESS�O.�iy E
�_ :a SEAL
43222
3 o. �'
NQINE�.•,
AN
..... ............ ......
Applicant's Certification per ISAA NCAC 02T .0106(b): l
I, bill 8255 _ e' C b;iV4V, ' r 1 _attest that this application for
(Signature Authority's name & title from Application Item 1.3.)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the Iand will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
of this permit be violated. I also understand that if all required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
NOTE - In accordance with General Statutes 143-215.6A and I43-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: Date:
FORM: FTA 04-I6 Page 5 of 5

State of North Carolina
Department of Environmental Quality
' Division of Water Resources
Division of Water Resources Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: City of Wilson
Project Name for which flow is being requested: HWY 301 Commercial Center
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for allpurap
stations along the route of the proposed wastewaterflow.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Hominy Swamp Water Relcamation Facili
b. WWTP Facility Permit #: NC0023906
All flows are in MGD
c. WWTP facility's permitted flow 14 MGD
d. Estimated obligated flow not yet tributary to the WWTP 1.194886
e. WWTP facility's actual avg. flow 8.86 MGD
f Total flow for this specific request 0
g. Total actual and obligated flows to the facility 10.05489
h. Percent of permitted flow used 71.82
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
Average Approx. Obligated, Total
Pump Pump Daily Current Not Yet Current Flow
Station Station Firm Flow** Avg. Daily Tributary Plus
(Name or Permit Capacity, * (Firm 1 pf), Flow, Daily Flow, Obligated Available
Number) No. MGD MGD MGD MGD FIow Capacity***
5 WQCS00021 0.576 0.230 0.0882 0 0.0882 0.1422
* 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 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): Hominy Swamp Water Reclamation
Downstream Permit Number: NC 0023906
Page 1 of 6
t~TCF t n-1 Q

III. Certification Statement:
I W.T. Bass IV, PE certify to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the receiving
wastewater treatment facility and that the flow from this project is not anticipated to cause any capacity
related sanitary sewer overflows or overburden any downstream pump station en route to the receiving
treatment plant under normal circumstances, given the implementation of the planned improvements
identified in the planning assessment where applicable. This analysis has been performed in accordance
with local established policies and procedures using the best available data. This certification applies to
those items listed above in Sections I and II plus all attached planning assessment addendums for which I
am the responsible party. Signature of this form certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
T,-�r"r OP FAL, je:6s
Title of Signing Official
Page 2 of 6
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March 15, 2021
NCDEQ
Water Quality Regional Operations Section
Raleigh Regional Office
3800 Barrett Drive
Raleigh, North Carolina 27609
Attention: Mr. Scott Vinson
Water Resources Regional Supervisor
NC Dept of Environ,nental Quality
MAR 17 2021
Raleigh Regional Office
SUBJECT: Fast -Track Sewer System Extension Application
Hwy. 301 Commercial Center (Gravity Sewer Line Relocation and Extension)
City of Wilson, North Carolina
PN: 20-123
Dear Mr. Vinson:
As part of the Hwy. 301 Commercial Center project, an existing 8" gravity sewer line owned and
operated by The City of Wilson that crosses the subject property, will need to be relocated to avoid being
located under one of the proposed buildings. The relocation will require approximately 207 additional
feet of 8" gravity line with no additional flow to be allocated.
Please find attached two (2) copies of each of the following documents for your review and
approval:
• Fast -Track Sewer Application Form One (1) original and one (1) copy
• 8 %2" x I I" copy of project location on USG Quadrangle Maps
+ Street Level Aerial Photography for location referencing.
Also, please find attached check in the amount of $480.00 to cover the application review fee. 1f
you should have any questions or require additional information, please call.
Respectfully,
JY
Jonathan Meade, P.E.
Enclosures: As stated.
cc: Mr. W. T. Bass, IV, P.E. — Public Works Director, City of Wilson
Mr. Barry Parks -- Director of Water Resources, City of Wilson
W 110DGP20123 Offcc-PermttrSewer Permirscoe vinson - NCDEQ- last track sewer 1tr(3•5-2021).doe