WQ0042285_Application (FTSE)_20210125

Division of Water Resources
Slate of North Carolina
Department of Environmental Quality
Division of N1 titer Resources
15A NCAC 021 .0300 — FAST TRACK SE11'Ei2 SYSTEM rx rNSION ,U'PIACATIU.`
FTA 0.1-I6 S: SUPPORTING DOCUMENTATION
Application Numb--r: _T r Its hz4 axtstrmrtl U+ D11 Ri
All items roust he cola Ietecl or the application %Q1 he returned
1. APPLIC:IN'F IN FOR NIATION
I. Applicant's name: '1 own of Siler City (company. numicipaluy, I IO.1, ul[hly. etL; j
2. 1\13plmc1311 ty)?e: ❑ Indic iduai ❑ Corlioration ❑ General Partnership
❑ Federal ❑ SGIttfCOlm[t> ❑,\dLit] ic[Pal
3. SilInature authority's mite.' Chri; NcCornuodale per I; NC. -\C 02I li1t}M1i)
Title; Town of Sder City Public IWorle.; and tltilites Dire.aor
4. Applicant's mailin.: address 311 N ="'i At e.
City: SilerCity Slate; Zip: 273-i4-�
5. Applicant's contact inli>rtmauon:
Phnnc nuntbcr: {9191 7 t'_- (73? Email Address: c:mccorquodale'cr silercitv.ore
IL PROJECT INFORMATION:
❑ I'ublic liblity
❑ C)thrr
I . Project name: Chatham At c Alley
2. Application Project ;[aims: ❑ Proposed (Ncw Permit) ❑ Eci;unwg Penttn Project
IJ'a modificatim. provide the existing permit number: %VQ00`_ and is, tied dale:
If new construction but pail of a nta.ter plan, provide the t dining permit number: Wt;)t)0 -
3. County where project is located Chatlinm
q. Approximate Coordumte; (Decimal Degrees)- Latitude: 37,43.109. Longitude--79.27.75
5. Parccl ID (i!'applicable): 00152S4
(or Parcel ID to closest clot%n;1mmnt sev-rr)
M. CONSULTANT I\F(7litlATIUN;:
I. Professional Engineer: holier[ Candle L14cme Number: 04.1131
1-rnu- WithersRat enel Inc,
Mailin;, address: U 7 S. %Vilunneton Street. Suite 200
City: Raleigh State: NC Zip: '_7h01-_
Pli,rne number: (219) 69-3340 Email :Address: rcaudle rr n ithrr.;r.[t'eneLcctm
I1'. WASTEW,1TER TREAT\IF.Nf FACILH Y (11'll'•I 17) iNI Oli 11:�'i'IU\;
l Facility Nance: Tottn ofSilerCity 11'1171'Pennii Nunibcr: NC0026441
Ottner Nanie:'I'uwn of SilerCmty - Rov i-viicli
V. RECEIVING DO11'NS'1REA11 SI; YER INFORMATION (if differetu than WN17F);
I. Permit Nutnber(c): WQunkno%in Dunitstreant (Receivinu) Setter Size; C Itch
Sy.;tcm Wide,Colhetton Svslem I'mr.il 1\w-ih-: r s it a phc;iltld: 1VQC'5000M
Owner Nanie(,). Town of Siler City
FORUM, h 1'A 04-1 ft 1'adc 1 t;I' 3

DocuSign Envelope ID OCD51AA1-95CE-41FA-SD8C-97098EAI=B22F
VI. GENERAL REQUIREMENTS
I. If the Applicant is a Privately -Owned Public Utility. has a Certificate of Public Convenience and Necessity been attached?
[:]Yes [JNo ®NIA
2. If the Applicant is a Developer of lots to be sold. has a DeveloDg s Oneratioisal Avrrrrnrn[ I FORM: DEV) been attached?
[]Yes []No ®NIA
3. If the Applicant is a Home: -Pro crt Owners' :association hiLS an Operational :%I�reenicnL {FORM: HOA) been attached?
❑ Yes ❑No ®NIA
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 I preschool f day care ❑ Medical / dental I veterinary facilities ❑ Swimming Pool;Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filtcr Backwash
❑ Businesses ! offices factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 75 % Domestic(Commercial 25 % Commercial
0 % Industrial (See 15A NCAC 02T .0103(20))
L b Is there a Pretreatment Program in effect? ❑ Yes ® No
6. Hasa flow reduction been approved under 1.5A NCAC' 02T .0114(f)? []Yes [--]No
r If yes, provide a cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(0)
Daily Design Flow',6
No. of Units
Flow
Multi -Unit Residential (Apartment)
240 gal/dwelling unit
4
960 GPD
z-Ie( atr Nefw-�!v
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
960 GPD
a See 15A NCAC 02T .0114 b d e I and e 2 for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in [I.S� 42A4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.01.14] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 960 GPD (per 15A NCAC 02T .0114)
> Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number;
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16 Page 2 of 5

DocuSign Envelope ID 00051AA1-95CE41FA-8D8C-97098EAEB22F
VI1. GRAViTV SEWER DESIGN CRITERIA (If Applicable)- 02T.0305 & MDC(Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 160 DIP
Section 11 & [1[ 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)
D Oversizing lines to meet minimum slope requirement is not allowed and a violation or the MDC
Vill. PUMP STATION DESIGN CRITERIA (If Applicable)— 02T .0305 & MDC(PUMP Stations/Force Mains:
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
I . Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: T° Longitude:
3. Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station) -
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 02TT .0�0aWf 1}(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 - ISA NCAC 02T .0305(h)(1)(C):
D It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel limeframes, shall be provided
in the case of multiple station power outage.
FORM: FTA 04-16 page 3 of 5

DocuSign Envelope ID- OCD51 AA1 -95CE-41 FA-8D8C-97098EAEB22F
IX. SETBACKS & SEPARATIONS—(02B .0200 & 15A NCAC 02T .0305(I)):
1. Does the project comply with all separations found in 13A NCAC 021 -PM(n &fgj ® Yes ❑ No
D 15A NCAC 02T.0305contains minimum se arations that shall be rovided for sewers stems:
Setback Parameter"
Separation Require d
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
I8 inches
Reclaimed water lines horizontal - reclaimed over sewer
2 feet
"Any private or public water supply source, including any wells, WS-1 waters of Class I or
Class 11 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
Anv buildina 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
➢ 15A NCAC 02T.03051 g) contains alternatives where separations in D2T.03051 U cannot be achieved.
"*Stream classifications can be identified using the Division's NC Surface Water Classi(i 1jpns webmLle
> If noncompliance with 02T.03051 f) or ig). see Section X of this application
2. 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
i 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 ❑ NiA
i This would include Trout Buffered Streams per 15A NCAC 2B.0?02
4. Does the project require coveragelauthorization under a 404 Nationwide or ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.010-is fi) (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.04021 "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 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

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X. CERTIFICATIONS:
1. Does the submitted system comply with I5A NC AC 0 T, the Minimurn Desi wn ilwi2 rcw tlw Pennitfing 2f Pionill %2tio!Ls
and Force Maim; [late.sr %-cr.;itm }. and the Gravity 5cwcr Minimum QC;i1!r1Critcr4t f lat"t va `onl as applicable?
® Yes ❑ No
lfNo, complete and submit the Variance/Altemative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the re nest is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
I, Robert Candle _attest that this application for
(Professional Engineer's name from Application Item 111.1.)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE - In accordance with General Statutes 143-215.6A and 143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000, as well as civil penalties up to S25,000 per violation.
North Carolina Professional Engineer's seal, signature, and date: 6'see Mate,,%
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043137IN
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3. Applicant's Certification per 15A NCAC 02T .0106(b): 1=2DOM 40C ""0561°
Roy h Lynch, Town of Siler City Town Manager _ _ attest that this application for
(Signature Authority's name & title from Application Item I.3.)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a
condition of this permit be violated. I also understand that if all required parts of this application package are not completed
and that if all required supporting information and attachments are not included, this application package will be
returned to me as incomplete.
NOTE .- In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any
false statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which
may include a fine not to exceed S 10.000 as well as civil penalties up to $25,000 per violation.
srgn•d W. Doeu
Signature: �") -t�ww katw Date: 1/20/2021
FORM: FTA 04-16 Page 5 of 5

-40 WithersRavenet
Our People. Your Success.
January 19, 2021
Department of Environmental Quality
Division of Water Resources
Attn: Jason Robinson
3800 Barrett Drive
Raleigh, NC 27609
RE: Chatham Avenue Alley - Sewer System Extension Permit
Dear Mr. Robinson,
HC Dept of Environmental Quality
JAN 2 5 2921
lWeigh Regional office
On behalf of the Town of Siler City, please find the attached documentation in support of a Fast Track
Application (FTA 04-16) for the referenced project. As noted in the application, this project will consist of
160 LF 8" DIP sewer pipe that will serve the buildings along Chatham Avenue.
The proposed project will meet all of DWR's minimum design criteria for sanitary sewer extensions. The
design flow rate for this project is calculated at 960 GPD based on NCAC 2T Rules for wastewater flow
rates and the anticipated flow from the apartment building (4 one -bedroom units). The proposed sanitary
sewer line sizes are more than adequate to convey the design flow rates.
Please find attached the following information in support of the application:
• Fast Track Sewer System Extension Application (FTA 04-16)
• Flow Tracking/Acceptance Form for Sewer Extension Applications (FTSE 04-16)
• USGS Map
• Street Level Map
• $480 Check for payment of Application Fee
If you have any questions regarding this request or if you require any additional information, please feel free
to contact me at 919-238-0359 or [e-mail].
Sincerely
WithersRavene)
tr/�_ ��_
Robert Caudle, P.E.
115 MacKenan Drive Cary, NC 27511
t: 919.469.33401 6: 919.467.6008 www.withersravenel.com License No. C-0832
Cary I Greensboro I Pittsboro 1 Raleigh I Wilmington

NC Dept of Environmental Quality
JAN 2 5 2921 State of North Carolina
Department of Environmental Quality
DWR Ra.Ieigh Regional Office Division of Water Resources
Division of Water Resources Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Town of Siler City
Project Name for which flow is being requested: Chatham Ave Alle
More than one FTSE maybe required for a single project f the owner of the WWTP is not responsible jar all pump
stations along lire route of the proposed wastewater flow.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Town of Siler City WWTP
b. WWTP Facility Permit #: NCO026441
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
Al! flaws are in MGD
4.0
0.750
3.166
.000960
3.91696
97.924
I1. 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! pl), Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***
* 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
(po not less than 2.5, per Section 2r02(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):
Downstream Permit Number:
Page I of 6
FTSE 10-18

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III. Certification Statement:
I Roy Lynch 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.
f—OocuSIgned W.
'-DunL Ma�a�Cr
Signature
Town of Siler City Town Manager
Title of Signing Official
1/20/2021
Date
Page 2 of 6
FTSE 10-18

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1%WitheFsRavenet
Our Peopte. Your Success
137 South Wilmington Street, Suite 200
Raleigh, NC 27601
919,469.3340 1 f: 919.467.6008
TO: NC DEQ — Raleigh Regional Office
Division of Water Resources
3800 Barrett Drive, Raleigh, NC 27609
WE ARE SENDING YOU ® Attached
THE FOLLOWING ITEMS ❑ Shop Drawings
❑ Copy of Letter
Letter of Transmittal
•
1/20/2021 • : • 09190635.00
Jason Robinson
Chatham Ave Alley - Sewer Extension Permit Application
❑ Under Separate Cover via
❑ Prints ❑ Plans
❑ Change Order ❑ Diskette
❑ Samples ❑ Specifications
❑ Other
••
tag
•
i •
Cover Letter NC Dept ofEnvimamertial Qµai
1
1/19/2021
1
1/20/2021
Fast Track Sewer Application
1
1/20/2021
FTSE Form 7921
USGS Map •
Street Level Map
$480 Check for payment of Application Fee
Plan Set 24" x 36"
Plan Set 12" x 18"
1
1
1
1
1
THESE ARE TRANSMITTED as checked below-
® For approval ❑ Approved as submitted
❑ For your use ❑ Approved as noted
❑ As requested ❑ Returned for corrections
® For review and comment ❑ Other
❑ Resubmit copies for approval
❑ Submit copies for distribution
❑ Return corrected prints
❑ FOR BIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS:
COPY TO: Alissa Pelham
SIGNED: Rob Caudle
If enclosures are not as noted, kindly notify us at once.
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