WQ0041301_Regional Office Historical File Pre 2018

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: ,5(21 no he con-wk.:Rd b DWR)
All items must he completed or the application will be returned
1. APPLICANT INFORMATION:
I: =.
Applicant's name: Tltv Flickory(company, municipality, HOA, utility, etc„)
Applicant tpe L lndividual Corporation j General Parmership Privately -Owned Public Utility
LI Federal 111 State/County Municipal El Other
3, Signature authority's name: WarrenVood per 15A NCAC 02T .0 I 06(b)
Title: City Manager
4, Applicant's mailing address: PO Box 398
City: IA ielKory State: NC Zip: 28603-
5. Applicant's contact information:
Phone number: (82,8t 323-7550 E-maildress: spe.
IL PROJECT INFORMATION:
I. Project name: 1'31 Street NVSe er F\
2. . Application/Project status: Z Proposed (New Permit) Ell Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date.
1r new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Catawba
4, Approximate Coordinates (Decimal Degrees): Latitude: 35.4752Isr Longitude: -81.1829W'
5. Parcel ID (it:applicable): 371.515538414
(or Parcel ID to closest downstream sewer)
M. CONSULTANT INFORMATION:
Professional Ei)ineer: Brian Cone License Number: 36791
Firm: Providenceyarmirsliklitc„
Mailing address,. 1234 Mann Drive, Suite 100
,Matthews State: NC Zip: 28105-
Phone number: [phone] Email Address: bcone(4rovidencepartncrsinc.com
IV, WASTEWATER TREATMENT FACILITY (WWTE) INFORMATION:
1, Facility Name: Northcst WWFF Permit Number: NC0020401
Owner Name: City of Hickory
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTE):
I. Permit Numbers ): WQCS00020 Downstream (Receiv'ing) Sewer Size: 8 inch
System Wide Collection System Perri -di: N LIIT-1berts) Of applicable), WQCS
Owner Name(s) : Citv or ,Ilickory
FORM: ETA 04-,16 Page 1 of5

4
VIL, GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and 'Necessity been attached?
El Yes EjNo
If the Applicant is a Developer of lots to be sold, has a Develiver's Operi,itional ..AgreementAEORM: DI V) been attached?
El Yes ON° ZN/A.
If the Applicant is a I lorne/Ptertv Owners' Association, has an Operational AgreementITORM; 111 /A) been at(ached?
El Yes LjNo N/A
4, Origin of wastewater: ( heck all
Z Residential ()wiled
El Residential Leased
rj School / preschool / day care
Z Food. and drink facilities
Z Businesses I offices / factories
t apply):
fl Retail (stores, centers, malls)
El Retail with food preparationlservice
fl Medical I dental / Veterinary facilities
Chur(1)
Nursing Itome
El Car Wash
IiiiJ Flotel and/or ,Motels
LI Swimming Pool /Clubhouse
[11 Swimming Pool/Filter Backwash
El other (Explain in Attachment)
5, Nature olwastewater 1.00".!/0 Domestic/Commereial 0,;`) Commercial
% Industrial (See 15A 'CAC 021 .0103(20))
15 there a Pretreatment Program in effect? 7 Yes El No
6. Ilas a flow reduction been approved under I 5A NCAC 02-r .01 kJ)? fl Yes No
'';•, 1-f yes, provide a co pv of flow reduction approval letter
7„ Summarize wastewater generated by project:
Establishment Type (see 021.01 14(1))
Residential !tomes on Seven Lots
Daily Design Flow ',1" 1No. of units Flow
360 ga1/3 Bedroom House 7
2520 GPD
gal/ (BID
gal/ GPD
gal GPI)
gal/ GPI)
ga
r) D
Ito/ 2520 GPI)
a See 15A NCAC 02T .011411)1„fd). (e)(11and_(001 for caveats to wastewater design flow rates (i,e., minimum flow per
dwelling:, proposed unknown non-residential development use public access facilities located near high public use areas:
and residential property located.south t.ir east of the Atlantic lntracoastal Waterway to he used as vacation rentals as defined.
n G.S. 42A-4),
0 Per 15A NCAC 02T .0114(c)„ design flow rates for establishments not identified 1 in table I 5A NCAC 02-1.01141 shall be
determined using available flow data, water using, fixtures, occupanc,2,, or operation patterns, and other measured data,
Wastevvater generated by project: 2520 GPI) (per 15A N( AC 02'1 .0114)
Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
LI Pump Station or Gravity Sewer where flow will be perm rucd in suhscq tient permits that connect to this line
LI Flow has already: been allocated in Permit Number:
El Rehabilitation or replacement of existing sewer with no new flow expected
[11 Other (Explain):
1ORM: ETA 04-16 Pape 2 of 5

VII. GRAVITy SEWER DESIGN CRITERI, pplieable) - 02T .0305 & MD( (Gravitv Sewers):
Summarize gravity sewer to be pertnitted:
Size (inches) Length (feet) Material
1
828 PVC 'DR-35
• Section 11 & 111 ot the M.:DC for Permittini4 of Gravity Sewers contains information reiuted to design criteria
• Section Ili contains information related LO Minimum slopes for gravity sewer(s)
• Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MI)(
VIII. PUMP STATION. DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stationsiforce .Mainsl:
COMPLETE FOR .EACII PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2, Approximate Coordinates (Decimal Degrees): 'Latitude: Longitude: - .
3. Design flow oldie pump station; millions gallons per day (firm capacity)
4, Operational point(s) of the pumprs): gallons per minute at feet total dynamic head
5, Summarize the force main to be permitted (for this Pump Stati)n):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 02T M305111)0):
1
Standby power source or pump with automatic activation and telemetry I 5,A NCAC 02 1 0305119(1)(13):
• Required ITor.- all purnp stations with an average daily flow greater than or equal to 1.5,000 gallons per day
;;- Must be permanent to facility
Or if the pump snition has an average daily .flow Iess than 1 000 galkms per day:
Portable power source with manual activation, quick-conriection receptacle and telemetry - 15A NCAc 02T
.0305(h)(1)(C)
or
Portable pumping, unit with plugged emergency pump connection and telemetry 1,5A NCAC 02) .0305011( 1 )(( ):
• It shall he demonstrated to the Division that the ponable source is owned or contracted by the applicant (draft itgreement)
and is. compatible with. the station.
lithe portable power source or pump is dedicated to multiple pump stations, an evaluation of all the purnp stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timefraires, shall be provided
in the case of a multiple station power outage,
FORM: LTA 04-16
Page 3 of 5

IX. SETBACKS & SEPARAT1ONS - (02B .0200 & I5A NCAC 02T .0305(fM
I. Does the project comply with all separations found in 1.5jkiNKACI(1211M(15(tIklu)
r —> CAC 021.0305(f -ontains minimum separations that shall hellroded for sewer systems:
_
Setback Parameter * ' Separation R[13eqe Yuires
I5A Nd
Storm sewers and other utilities not listed below vertical) 24 inches _
r water mains (vertical -water over sewer including in benched trenches)
„-_ ' 18 inches
Water mains (horiz., a )
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 11 'impounded reservoirs used as a source of drinking water 100 feet
**Waters classified WS (except \\ or WS-V), B, SA, OR W, HOW, 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 Iocrino and surface drainage
ditches 10 feet
Any building foundation 5 feet
Any basement
10 feet
Top slope of embankment or cars of 2 feet or more vertical height
_ 10 feet
L Drainage systems and interceptor drains 5 feet
Any swimmingpools 10 feet
I Final earth urade (vertical)
, 36 inches
15A NCAC 024'.0305(g) contains alternatives .where separations in 021",(4305114 cannot be achieved.
"Streain classifications can be identified using the Division's NC Surface Water Classifications webpage
If noncompliance vvith 02I,0305(1) or (f see Section X of this 'application
2, Does the project comply with separation requirements for wet)ands? (50 feet of separation) El Yes
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 itt design and construction
As built documents should reference the location of areas effected
Does the project comply ‘vith setbacks found in the river basin rules per I 5A N(,."AC 02B .0200
This would include 'From Buffered Streams per 1.5A NCAC 2E1,0202
Does the project require coveragelauthorization under a 404 Nationwide or
individual permits or 40 I Water Quality Certifications?
Information can be obtained from the 4(11 & Buffer Permitting Branch
No
El Yes JNu
NA
5. Does project comply 'with, 15A NCAC 02 1.0 1(5(00) (additional perrnits certi ation) j Ves Li No
Per 1.5A NCA( 021 (110,504(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 I 5A NCAC 02-1.0j40f1_ "high -priority sewer- means "itny aerial sewer, sower contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subjectto erosion that 'undermines or deteriorates the sewer.
El Yes E No •N/A
If yes, include an attachment with details for each line, including 'type (aerial line, size,. material, and locati
Fligh priority lines shall be inspected by the perm ittee or its representative at least once every six -months and inspections
documented per 15A NCAC 02.T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
L FORM: FIA 04-16
['age z-1 of 5

CERTIFICATIONS:
1, Does the submitted system comply with 15A t :AC 02 F. the Minimum Design Criteria for the Permitting of.f!tairip_Statioti
and Force Mains (latest version), and the Gravity Sewer Minilnalll Design Criteria_aatest version) as applicable?
Z Yes No
lf No, complete and submit the Variance/ A Itemative .Design Request application (VADC 10- 14) and Slipportin2, documents for
rev le w, Approval of the request is required prior to submittal of the Fast Track Application and supportingdocuments.
2. Professional Engineer's Certification:
attest that this application for
Prolessioi name from Application Item 111,1,1
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 in knowledge, 1 further attest that to the best
of My knowledge the proposed design has been prepared in accordance \vitt'the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the tjast-jt rack Permitting
of Pump Stations and Force Mains (latest version), Althoo2h 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. ‘vith the proposed design.
-- In accordance with General Statutes 14-2.15.6A. and 143-215.6B, any person who knowingly makes any false
statement.. representation, or certification in any application package shall he 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: \\\\ C A R
3 Applicant's Certification per 15A NCA 021 .0101'
[OM NIOJE: CI HO (jtj Cf—
(Signature Authorityname & title jk m .Application Item 1.3.)
•*(c-ss,
. ....
. —
_...▪ .
. E.
. —
t4•
• •
NIAN
'if/11111,0\
attest that this application 'for
has been reviewed me and is accurate irJcomplete 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 returned 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
°faits permit he violated, 1 also understand that if all required parts of this application. package are not completed and that if
all required suppotting information and attachments ttre not included, this application package will he returned to tne
incomplete,
NOTE. --In accordance with General Statutes 143-215,6A and 143-2 I 5.6B, any person W ho knowingly makes any -raise
stateinent, representation, or certification n any application package shall he guilty of a Class 2 misdemeanor, which may
include a tine not to exceed $10,000 as .well as civil penalties up to $25,000 per violation,
Signature;
1ORM: 11 A 04- 16 Page 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
'Flow 1 racking for Scwer Extension Applications
WISE 1.0-18)
Entity Requesting Allocation: City of I lickory
Project Name for \\hich flowis being requested: ri St. NW Sewer Extension
More than one FTSE may he required for u single project if the owner of the WICTP is not responsible Jar all pump
stations along the route of the proposed wastewater flow
1. Complete this section only if you are the owner of the wastewater treatmentplat
a. WWII' Facility Name: Northast WWTF
b. WWTP Facility Permit NC00204
c. WWFP facility's permitted flow
Allflows are in MGD
6.0
d. Estimated obligated flow not yet tributar to the WW ! P 0,30158
c. WWII' facility's actual -avg, flow
f. Total flow tbr this specific request
3.2675
0.00252
g. Total actual and obligated flows to the facility 3.5716
h. Percent of permitted flow used
59.53?/0
II. Complete this section -for each. pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations locate .CtWeell the project connection point and the :
(..A) (it) (( ) (0)—(B+( ) (F,)-(A-D)
Design Obligated.,
Pump Pump Average Approx. Not Vet Total Current
Station Station Firm Dail)/ How** Current Tributary Flow "'kis
(Name or Permit Capacity,* (Firm i pf). Avg. Daily Daily Prow, Obligated Available
Number) N. MG.L) MGD How, MGD MGD Flow Capacity*"
Lakeshore
1,728 0,6912 0.0963 0.04543 0.14173 0.54947
* 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
(pl.) not less than 2.5, per Section 2.02(A)(4)(c) of the Minim 111 .Design Criteria.
*** A Planning Assessment Addendum shall he attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is <O.
Downstream Facility Name (Sewer): Hickory Cone S 'stem
Downstream Permit Number: \VQCS00020
Page 1 of 6
1-1-C' T.' I (1 10

Illivcertifination.Statettienti
arren otid
certify to the best of illy know ledge that the addition of
the volume of wastewater to be permitted in this project has being CValtiated along the route to the receiving
VS:astewater treatment facility and that the flow from this project is not anticipated to cause any capacity
related sanitary sewer overflows or oVcrhurden any dovimstream purnp station en route to the receiving
treatment plant under normal circumstances, given the implementation of the planned improvements
identified in the planning assessnient sshere appUc h e 1 his analysis has been performed in accordance
with local established policies and procedures usilitg the hest available data. This certification applies to
those items listed above in Sections I and 11 plus all attached planning assessment addendums for which I
am the responsible party. Signature of this forrn certifies that the receiving ccillection system or treatment
works has adequate eimacity to transport and treat the proposed new wastewater.
Signing Oficial Signature
Citv Nlanager
egg errs,
Title (:),{Sigulilg
c:\
Date
V- I c",,1

[XIS""" N(; .ANUO
NOR -IIA T WWT1
NE0020401
NE PIPING
NF\V ,I: MICE:
T'AWRA
RIVER

�` �4�� A

PROVIDENCE
PARTNERS
November 6, 2019
Re: IStreet NW Sewer Extension
To whom it may concern:
'Ntf)A.1
'The project proposes to instal 828 feet of gravity seer along the south side of Street
NW, 'Hickory. NC 28601. The new gravity sewer will include $ new manholes and Wifl
tie into an existing manhole in the City of .Hick.ory system. The natural topography for
the project slopes downward toward the existing in.anhole.
This new 8" PVC SI)R-35 line will serve 7 residential lots on the south side of the street.
Each of the new houses is to he a three bedroom and all the lots have the same owner
currently. The total flow is 2520 gallons per day. "The City ofHickory has reviewed the
blueprints and approved them pending this process.
There are no streams or water bodies near this proposed sewer extension.
Based on Mr. Bellow's photographs, the shingles do appear to be asbestos tiles and not
actual slate, The roofing type was misidentified in the original report. The effects of hail
to slate, 'faux slate, concrete, clay, and other tiles shingles are generally the same,
Although some materials are more durable than others concerning various sizes of hail
strikes, the damage manifests in the same fashion. The original report found no evidence
consistent with hail impact damage to the roof tiles/shingles, and the .new photographs do
not amend these findings.
This packet includes:
I.. 2 applications w/ PE Seal
2. A check for 480.00
3. Completed Permit
4. Topo and Aerial Page
Regards,
K. Brian Cone. P.E
NC COA: C-4456
704-773-2925
into@prgyjclencepart nersinc „COM
Providence Partnersil, Inc.
1234 Mann Drive, Suite 100
Matthews, NC 28105