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HomeMy WebLinkAboutWQ0023072_Application (FTSE)_2003091009/16/03 Permit Number WQ0023072 Permit Tracking Slip Program Category Non -discharge Permit Type Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions Primary Reviewer grady.dobson Permitted Flow 1200 Facility Fast Track Status Project Type In review New Project Version Permit Classification Individual Permit Contact Affiliation Facility Name Roy Road Sewer Extension Location Address Owner Major/Minor Minor Region Fayetteville County Harnett Facility Contact Affiliation Owner Name Town of Angier Dates/Events Owner Type Government - Municipal Owner Affiliation Coley Price Post Office Box 278 Angier NC 27501 Scheduled Orig Issue App Received Draft Initiated Issuance 09/10/03 Regulated Activities Public Notice Issue Effective Subdivision Outfall NULL Requested/Received Events Expiration Additional information requested Additional information received Waterbody Name Stream Index Number Current Class Subbasin ''AST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 3 A APPLICATION INFORMATION USE THE TAB KEY rO MOVE FROM FIELD TO FIELD! Application Number: (to be completed by DWQ) lit' 1. Owner: 1 a. Town of Angier, North Carolina Full Legal Name (company, municipality, HOA, utility, etc.) lb. Coley Price, Town Manager Signing Official Name and Title (Please review 15A NCAC 2H .0206(h) for authorized signing officials!) 1c. The legal entity who will own this system is: ❑ Individual ❑ Federal X Municipality ❑ State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify): 1 d. Post Office Box 278 1 e. Angier Street Address City if. North Carolina 1 g. 27501 State Zip Code lh. 919-639-2071 1 i. 919-639-6130 1 j. cpriceC ngier.org Telephone Facsimile E-mail 2. Project (Facility) information: 2a. Roy Road Sewer Extension 2b. Harnett Brief Project Name (permit will reefer to this name) 3. Contact Person: 3a. William W. Dreitzler, P.E. County Where Project is Located Name and Affiliation of Someone Who Can Answer Questions About this Application 3b. 919-834-1113 3c. bdreitzler@mindspring,com Phone Number E-mail 1. Project is X New ❑ Modification (of an existing permit) If Modification, Permit No.: For modifications, attach a separate sheet clearly explaining the reason for the modification (I.e. adding another phase, changing line size/length, etc.). Only include the modified information In this permit application - do not duplicate project information in B(7) and B(10-11) that has already been Included in the original permit. 2. Owner is X Public (skip to Item B(3)) ❑ Private (go to Item 2(a)) 2a, If private, applicant will be: 2b. If sold, facilities owned by a (must choose j) Town of Angier Post Office Box 278 Angier, North Carolina 27501 919-639-2071 FIRST CITIZENS BANK ANGIER, NC 27501 66-30/531 001 PAY EXACTLY DOLLARS AND CENTS w a ooa volD AFTER 60 DAYS No. 15973 AMOUNT ***Four Hundred Dollars & 00/100*** 9-4-03 15973 ***400.00*** P TO THE ORDER OF NCDENR 1617 Mail Service Center Raleigh, NC 27699 THIS DISBURSEMENT HAS BEEN APPROVED AS REQUIRED BY THE LOCAL GOVERNMENT A • ISCAL CONTROL ACT 1,00Atbd MAYOR riow rids alt5auy teen avecavec in rennet r o. ❑ Rehabilitation or replacement of existing sewer with no new flow expected FINANCE OFFICER FTA 02/03 - Rev. 1 06/03 FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE . 1SEP 1 0 2003 D1\`C State of North Carolina Department of Environment and Natural Resources Division of Water Quality FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS (Pressure sewers systems are not to be included as part of this application package) INSTRUCTIONS: indicate that you have included the following list of required application package items by checking the space provided next to each item. Failure to submit all required items will lead to your application being returned as incomplete or additional processing and review time. This form may be photocopied for use as an original. X I. Application Form - Submit one original and one copy of the completed and appropriately executed application form. Any changes to this form will result in the application being returned. The Division of Water Quality (Division) will only accept application packages that have been fully completed with all applicable items addressed. You do not need try submit detailed plans and specifications unless you respond NO to Item B(121. X II. Application Fee - Submit a check in the amount of $400 made payable to: North Carolina Department of Environment and Natural Resources (NCDENR). Ir. Certificates of Public Convenience and Necessity — If the application is being submitted in the name of a privately -owned public utility, submit two copies of the Certificate of Public Convenience and Necessity (CPCN) whicri demonstrates that the public utility is authorized to hold the utility franchise for the area to be served by the sewer extension. If a CPCN has not been issued, provide two copies of a letter from the North Carolina Utilities Commission's Public Staff that states that an application for a franchise has been received, that the service area is contiguous to an existing franchised area, and/or that franchise approval is expected. The project name in the CPCN or letter must match that provided in Item A(2a) of this application. ✓ _ IV. Operational Agreements — Submit one original and two copies of a properly executed operational agreement if the sewer extension is permitted by a private applicant and will be serving residential or commercial lots (e.g., houses, condominiums, townhomes, outparcels, etc.) that will be sold to another entity. If the applicant is a homeowners' association, use Form HOA 02/03. If the applicant is a developer, use Form DEV 02/03. EVEN IF THE PROJECT WILL BE TURNED OVER TO A MUNICIPALITY, FORM DEV 02/03 IS REQUIRED. [l V. Flow Acceptance Letters — If the owner of the downstream sewers and/or WWTF is different from the applicant, submit two copies of a flow acceptance letter from the owner of the downstream sewers and WWTF, if different. Flow acceptance letters must contain the following minimum information: applicant and project name, amount of flow accepted. and name and permit number of the receiving sewers/VVWTF. The flow acceptance must not expire prior to permit issuance and must be dated less than a year prior to the application date. Iritergovernmentai agreements or ether contracts will not be accepted in lieu of a project -specific flow acceptance letter. 71 X VI. Map — Submit an 8.5-inch by 11-inch COLOR copy of the portion of a 7.5-minute USGS Topographic Map along with th:s form. The map should identify the entire project area location as well as the closest downslope surface waters as clearly as possible. Each map portion must be labeled with the map name and number, the identified location of the sewer line and pump stations, and be of clear and reproducible quality. For instance, if the project involves 4 miles of interceptor sewer that traverses over or near several different waterbodies (or counties, basins, etc.), the map should have location ID's shown for each different waterbody (where the sewer line is within 100 feet of such waterbody - see Instruction ViI). This location ID is self chosen and used to cross reference the iocatiort in Section C of the permit application. X VII. Stream Classifications — Section C • If any portion of the project is within 100 feet of any down slope surface water, Section C must be completed for the pertinent sections. • If the entire project area is a minimum of 100 feet away from any down scope surface waters BUT there is a pump station involved where a history of power outage is to be used to provide adequate design storage instead of dual feed or permanent or portable generator, Section C must be completed to demonstrate that the closest down slope surface water is Class C (see 15A NCAC 2H .0219(h)(3)(D)). • Use the guidance document entitled, "Determining Watershed Classifications for Form FTA 02/03 (Fast -Track Sewer Systems)" available from http:!/h2o.enr.state.nc.us/ndpu or by contacting the appropriate regional office. FTA 02/03 - Rev. 1 06/03 FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 2 i ] VIII. Environmental Assessments — If this project is subject to an Environmental Assessment (EA) [15A NCAC 01C .05001, this application can not be used. Send the project application on Form PSFMGSA 10/99 to the Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. Applications can not be processed until a Finding of No Significant Impact (FONSi) or Environmental Impact Statement (EIS) has been issued. A copy is to be submitted with that permit application, X IX. Certifications — Section D The application must be certified by both the applicant and a North Carolina Registered Professional Engineer (PE). The applicant signature must match the signing official listed in item A(1b). The PE should NOT certify the application if he/she is unfamiliar with 15A NCAC 2H .0200, the Gravity Sewer Minimum Design Criteria (most recent version) and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains (most recent version), as applicable to the project. Certification by a PE who is unfamiliar with these documents is subject to NC Board referral. THE COMPLETED FTA 02/03 APPLICATION PACKAGE, INCLUDING ALL. SUPPORTING DOCUMENTS AND 5400 FEE, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE REGIONAL OFFICE ADDRESS COUNTIES SERVED Asheville Regional Office 59 Woodfin Place Asheville, North Carolina 28801 (828) 251-6208 (828) 251-6452 Fax I Avery, Buncombe, Burke, Caldwell, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Yancey Fayetteville Regional Office 225 Green Street Suite 714 Fayetteville, North Carolina 28301 (910) 486-1541 (910) 486-0707 Fax Anson, Bladen, Cumberland, Harnett, 1 Hoke, Montgomery, Moore, Robeson, Richmond, Sampson, Scotland Mooresville Regional Office 919 N Main Street Mooresville, North Carolina 28115 (704) 663-1699 (704) 663-6040 Fax Alexander, Cabarrus, Catawba, Cleveland, Gaston, iredell, Lincoln, Mecklenburg, Rowan, Stanly, Union Raleigh Regional Office 1628 Mail Service Centerg Raleigh, Raleigh, North Carolina 27699-1628 571-4700 (919)(919) 571-4718 Fax Chatham,Durham, Edgecombe, Franklin, Granville, Halifax, Johnston, Lee, Nash, Northampton, Orange, Person, Vance, Wake, Warren, Wilson Washington Regional Office 943 Washington Square Mall Washington, North Carolina 27889 (252) 946-6481 (252) 975-3716 Fax Beaufort, Bertie, Camden, Chowan, Craven, Currituck, Dare, Gates, Greene, Hertford, Hyde, Jones, Lenoir, Martin, Pamlico, Pasquotank, Perquimans, Pitt, Tyrrell, Washington, Wayne Wilmington Regional Office 127 Cardinal Drive Extension Wilmington. North Carolina 28405 (910) 395-3900 (910) 350-2004 Fax Brunswick, Carteret, Columbus, Duplin, New Hanover, Onslow, Pender Winston-Salem Regional Office 585 Waughtown Street Winston-Salem, North Carolina 27107 (336) 771-4600 (336) 771-4631 Fax Alamance, Allegheny, Ashe, Caswell, Davidson, Davie, Forsyth, Guilford, Rockingham, Randolph, Stokes, Surry, Watauga, Wilkes, Yadkin For more information, visit our web site at: http://h2o.enr.state.nc.us/ndpu/ FTA 02/03 - Rev. 1 06/03 FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 3 USE THE TAB KEY TO MOVE FROM FIELD TO FIELDI z Application Number: "�— ______."__ — 1. Owner: — (to be completed by DWQ) — 1 a. Town of Angier, North Carolina Full Legal Name (company, municipality, HOA, utility, etc.) lb. _Coley Price, Town Manager Signing Official Narne and Title (Please review 15A NCAC 2H .0206(b) for authorized signing officials!) lc. The legal entity who will own this system is: ❑ Individual ❑ Federal X Municipality ❑ State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify): ld. Post Office Box 278 1 e. Angier Street Address City A APPLICATION INFORMATION B. PERMIT INFORMATION 1f. North Carolina 1g. 27501 State Zip Code 1h. 919-639-2071 1i. 919-639-6130 1j. cpriceQangier.org Telephone Facsimile E-mail 2. Project (Facility) Information: 2a. Roy Road Sewer Extension 2b. Harnett Brief Project Name (permit will refer to this name) County Where Project is Located 3. Contact Person: 3a. William W. Dreitzler, P.E. Name and Affiliation of Someone Who Can Answer Questions About this Application 3b. 919.834-1113 3c. bdreitzler@mindspring.com Phone Number E-mail 1. Project is X New ❑ Modification (of an existing permit) If Modification, Permit No.: For modifications, attach a separate sheet clearly explaining the reason for the modification (I.e. adding another phase, changing line sizeiiength, etc.). Only include the modified information In this permit application - do not duplicate project information in B(7) and B(10-11) that has already been Included in the original permit. 2. Owner is X Public (skip to Item B(3)) ❑ Private (go to Item 2(a)) 2a. If private, applicant will be: 2b. If sold, facilities owned by a (must choose one) ❑ Retaining Ownership (i.e. store, church, single office, etc.) or ❑ Public Utility (Instruction III) ❑ Leasing units (lots, townhomes, etc. - skip to Item E313)) ❑ Homeowner Assoc./Developer (Instruction iv) ❑ Selling units (cots, townhomes, etc. - go to Item B(2b)) 3. Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project 4a. Town of Angier WWTP 4b. NC0082597 Name of WWTF _ WWTF Permit No. 5a. 7ow'n oiAngier —'�—^^ 12-inch diameter Owner of Downstream Sewer • ReceivingSewer Size Permit Number of Downstream Sewer (If f 6. The origin of this wastewater is (check all that apply). .... ................ X Residential Subdivision ❑ Car Wash [j Apartments/Condorniniums ❑ Institution Mobile Home Park ❑ Hospital 0 School ❑ Church ❑ Restaurant 0 Nursing Home ❑ Office ❑ Other (specify): /Cif % Domestic/Commercial Industrial % Other (specify): 7. Volume of wastewater IQ perrnittesi in this project: 120Q gallons per day ........ ..... . 8. if the permitted flow is zero, indicate why: ❑ Interceptor Line - Flow will be permitted is subsequent permits that connect to this line 17 Flow has already been allocated in Permit No. ❑ Rehabilitation or replacement of existing sewer with no new flow expected FTA 02/03 - Rev. 1 06/03 FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 4 9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2H 0219(1) for item B(7) or the resign flow for line or pump station sizing if zero flow in the space below. Values other than that in 15A NCAC 2H .0219(1)(1-2) must be approved prior to submittal of this application. Submit a separate request to the Division of Water Quality, Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617 in accordance with 15A NCAC 2H .0219(1)(3). 3 existing residential homes X 400 gpd/residence = 1,200 gpd '10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary) Size (inches) Length (feet) 8-inches dia Gravity or Force Maln (use the pull down menu) 302 If gravity CI W Z h Z 0 U Z ENTER TOTAL LINE LENGTH IN MILES . 0 Q11. Summary of Pump Stations to be Permitted (attach additional sheets as necessary) Location ID Power Reliability Option Ce (self chosen - as shown on Design Flow Operational Point (1- dual line feed; 2- permanent generator w/ATS; 3- 0 plans for cross-reference) (MGD) GPM © TDH portable generator w/telemetry; 4-wet well storage) LL. Z 1- W CL 12. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H .0200 as applicable? X Yes ❑ No If no, please reference the pertinent minimum design criteria or regulation and indicate why a variance is requested: SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS PERTINENT TO THE VARIANCE WITH YOUR APPLICATION 13. Have the following permits/certifications been submitted for approval? Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes ❑ No X N/A Sedimentation and Erosion Control Plan? ❑ Yes ❑ No X N/A Storrnwater? [] Yes O No X N/A FTA 02/03 - Rev. 1 06/03 FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 5 C. STREAM CLASSIFICATION D. CERTIFICATIONS 1. Use the Division's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02/03 (FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach additional sheets as? necessary). This document is available from our web site or by contacting the appropriate Division of Water Quality regional office (see instructions for addresses) QB indicate the following: A Stream Classification is not needed because all parts of the project are at least 100 feet away from any down slope waterbody; AND, ❑ A Stream Classification is not needed because the design does not depend on wet well sto option for any pump station near a Class C down slope waterbody. rage as a power reliability Location ID on Map (self chosen -as shown on Name of Waterbody Stream Waterbody map for cross-reference) Walerbody County River Basin index Classification Sewer Connection West Bules Creek Hamett Cape Fear 18-18-2-(1) c Submit the 8.5" x 11" COLOR topographic map as required in Instruction VI regardless of whether a classification Is provided! Applicant's Certification: 1, Coley Price, Town Manager, attest that this application for Roy Road Sewer Extension has been reviewed by me and is accurate and complete to the best of my knowledge, 1 understand that if all required parts of this application are not completed and that if all required supporting documentation and attachments are not included, this application package is subject to being returned as incomplete. Note: In accordance with North Carolina General Statutes 143- 215.6A and 143-215.68, any person who knowingly makes any false statement, representation, or certification in any application shall be guilty of e Class 2 misdemeanor which may include a fine not to exceed $70,000 as well as civil penalties up to $25 00 per violation. la. Signing Official Signature 2. Professional Engineer's Certification: i attest that this application for Roy Road Sewer Extension has been reviewed by me and is accurate, complete and consistent with the information in the engineering plans, 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 regulattions, Gravity Sewer Minimum Design Criteria for Gravity Sewers adopted February 12, 1996, and the Minimum Design Critena for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 and the watershed classification in accordance with Division guidance. Although certain portions of this submittal package may have been developed by other professionals, 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 NC General Statutes 143-215.6A and 143-215.68, any person who knowingly makes any false statement, representation, or certification ir7 any application 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. 9r-n3 2a. William W. Dreu zIer, P.E. Professional Engineer Name 2b. Marlowe, Dreltzler & Associates Engineering Firm 2c. 211 East Six Forks Road, Suite 203 Address 2d. Rsleiti 2e. N.C. 2f. 27609 City State Zip 2.g. 010 834-1113 2h. 919-634-0000 21. Bareitziereminds�sing.com Telephone Facsimile E-mail Date FTA 02/03 - Rev. 106103 MARLOWE, DREITZLER & ASSOCIATES Consulting Engineers 211 East Six Forks Road, Suite 203 Raleigh, N.C. 27609 September 8, 2003 N.C. Department of Environment and Natural Resources Division of Water Quality Fayetteville Regional Office Non -Discharge Permitting Unit 225 Green Street Suite 714 Fayetteville, N.C. 28301 919 334-1113 919-834-6060 (Fax) I 0 '103 I Reference: Roy Road Sewer Extension: Angier, North Carolina FTA 02/03 Application Dear Sirs: Please find attached one (1) original and one (1) copy of the Non -Discharge Permit Application (FTA 02/03 — Rev. 1 06/03), and a $400.00 check for the permit processing fee. The project shall provide a 302 linear foot extension to the Town of Angier Wastewater Collection System. The extension is being completed to address a failing septic tank at a residence along Roy Road. In addition to the residence with the septic tank issues, two other homes will be allowed access to the extension. If you have any questions or if you require any additional information, please contact me at your convenience. Sincerely, M OWE, DREITZLER & ASSOCIATES 1, -1);; �j. William W. Dreitzler, P.E. Partner Director of Engineering Services cc: Mr. Jimmy Cook, Public Works Director, Town of Angier