WQ0042475_Application (FTSE)_20210413

DocuSign envelope ID: 8274DA59-61A8-4D76-BB76-935D47B1740A
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: w—q- t1Z t{7 `s(lo be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
I. Applicant's name: CITY OF SANFORD (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ StatelCounty ® Municipal ❑ Other
3. Signature authority's name: PAUL M. WEEKS JR. P.E. per 15A NC;IC 02T .0106ft
Title: CITY ENGINEER
4. Applicant's mailing address: PO BOX 3729
City: SANFORD State: NC Zip: 27331
5. Applicant's contact information:
Phone number: 9( 19) 777-1 l 19 Email Address: PAUL.WEEKS[�SANFORDNC.NET
IL PROJECT INFORMATION:
I. Project name: GOLF COURSE ROAD RESIDENTIAL DEVELOPMENT
2. ApplicationlProject status: ® Proposed (New Permit) ❑ Existing Permit/Project
If modification, provide the existing permit number: WQ00 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00�
3. County where project is located: LEE
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.5133 Longitude:-79.1770'
5. Parcel ID (if applicable): 9644-71-3681
(or Parcel ID to closest downstream sewer)
Ill. CONSULTANT INFORMATION:
1. Professional Engineer: JEREMY R. THOMAS License Number: 027472
Firm: J THOMAS ENGINEERING INC.
Mailing address: 143 CHARLOTTE AVENUE, STE 104
City: SANFORD State: NC Zip: 27330
Phone number: (9j 9) 777-6010 Email Address: JTHOMAS a JTHOMASENGINEER iNG.COM
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I. Facility Name: BIG BUFFALO CREEK WWTP Permit Number: NCO024147
Owner Name: CITY OF SANFORD
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different titan WWTF):
1. Permit Number(s): WQ� Downstream (Receiving) Sewer Size. 8 inch
N 51 erTL Wide Collection S-,stem Pere it N,imber(s) U I a p p icahle : WQC80047
Owner Name(s): CITY OF SANFORD
FORM: FTA 04-16 Page I of 5

DocuSrgn Envelope ID: 8274DA59-61A84D7B-BB76-935D4781740A
Vl. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑No ®N. A
2. if the Applicant is a Developer of lots to be sold, has a Develorser's Operational ,Agrcement.fFDE
V1 been attached?
❑ Yes ❑No ®NIA
3. If the Applicant is a Home.'Pro nere Association, has an OperatiAnal ftypfUICOLLEQJRM; HOA1 been attached?
❑ Yes ❑No ®NiA
4. Origin of wastewater: (check al l 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 / veterinary facilities ❑ Swimming Pool iClubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool.Tilter Backwash
❑ Businesses 1 offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % DomesticrCommercial % Commercial
% Industrial N -0 103(20 )
bIs there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa Flow reduction been approved under 15A NCAC 02T .01 14(f)? ❑ Yes ®No
0_ If yes, provide a cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f)1
Daily Design Flow"
No. of Units
Flow
SF RESIDENTIAL - 3 BEDROOM
360 gal,'UNIT
5
1,800 GPD
SF RESIDENTIAL - 4 BEDROOM
480 gal. --'UNIT
5
2,400 GPD
gall
GPD
gall
GPD
gall
GPD
gall
GPD
Total
4,200 GPD
a See 15A NCAC Q)T .01,14141 ,100) aid {0for 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 G.5.4: -4).
b Per 15A NCAC 02T .01 14(c), design flow rates for establishments not identified [in table 15ANAC O2T.9I1 Ili shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 4?00 GPD (per ISA NCACO2T1.!A)
i 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):
l'ORM: FTA 04-16 Page 2 of 5

Docu&gn Envelope ID- 8274DA59-61AB4D7B-8B76-935D4781740A
VI1. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
I. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
467
PVC
8
92
DIP
q'
Section II & Ill of the MDC for Permitting of Gravity Sewer4 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
VII1. PUMP STATION DESIGN CRITERIA or Applicable) -- 02T.0305 & MDC (Pump Stations/Force 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 15AMC.AC.Q?L..4305(hW 1):
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B)r
i Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
i 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)(1)(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.
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: f;TA 04-I6 Page 3 of 5

DocuSign Envelope 10. 6274DA59-61AB4D75-BS76-935D4761740A
IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(t)):
1. Does the project comply with all separations found in 15AhCAC 02T .0305()L& e . ® Yes ❑ No
15A NCAC 02T.0305(f1 contains minimum separations that shall he nrnvided fnr server sysrems-
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
18 inches
Water mains horizontal
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 I or
Class II impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-1 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
Draina e s stems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade vertical
36 inches
9.5A NCAC 02T.0305N) contains alternatives where separations in L cannot be achieved.
**Stream classifications can be identified using the Division's NC Surface Water CIasi hcatioiis w L bRLLis6r
If noncompliance with 02T.0305(f) or (g). see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No ❑ NIA
Seethe 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
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 0213.0200? ❑ Yes ❑ No ®N-A
i This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project require coveragefauthorization under a 404 Nationwide or ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
i Information can be obtained from the 491 &,Buffer Permitting Branch
5. Does project comply with 15A NCAC _02T.0105(c)(6) (additional permits; certifications)? ® Yes [:]No
Per 15A NCAC 02T.0105(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 I A NCAC 02T.0407, "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

DocuSign Envelope ID, 8274DA59-61AB-4D7B-BB76-935D47B7740A
X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NUAf. 02T, the 41iniotum. Design Criteria for the Penn itting or Furnp Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria {latest version as applicable?
® Yes ❑ No
IFNo, complete and submit the Varian ce'Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is required prior to submittal of (lie Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
I, Jeremy_B_ Thomas, p _ attest that this application for
(Professional Engineer's name from Application Item I11.1.)
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 $25,000 per violation.
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
Paul M. Weeks Jr. P.E.
City Engineer
(Signature Authority's name & title from Application Item I.3.)
"rrL-5p'
�r 027472
C-)
� s/ui1
-attest that this application for
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 143-315-6F3, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class ? misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature:
IDocuSW*d by:
fit[, At.. Woks ,fir, p.t.
6BC30EGUT11 119-
Date.
4/6/z021
rORM: FTA 04-16 Page 5 of 5

DocuS,gn Envelope IU: 9B571A77-54OF-4857-AF3D-AIAEAIC20760
State of North Carolina
,ram W ". # .
Division of Water Resources
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Application Number: I FT-325 t
Entity Requesting Allocation: City of Sanford
Project Name for which flow is being requested: Golf Course Rd. Subdivision
More than one FTSE may be required for a single project if the otuner of the WIVTP is not responsible for aM punrp
stations along the route of the proposed wastewater flow.
Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility name: Big Buffalo Wastewater Treatment Plant
b. WWTP Facility Permit #: NCO024147
A11 flows are in MGD
c. WWTP facility permitted Flow: 12.0000
d. Estimated obligated flow not yet tributary to the WWTP: 1.0503
e. WWTP facility's actual average flow: 5.7330
f. Total Flow for this specific request: 0.0042
g. Total actual and obligated (lows to the facility: 6.7875
h. Percent of permitted flow used: 57%
II. Complete this section for each pump station you are responsible for along the route of this proposed
List pump stations located between the project connection point and the WWTP.
(-A)
(a)
(C)
(D)=(B+C)
(E)=(A-D)
Pump
Pump
Firm
Design
Approx.
Obligated,
Total Current
Available
Station
Station
Capacity'
Average
Current
Not Yet
Flow Plus
Capacity'
(Name or
Permit
Daily Flown
Avg. Daily
"tributary
Obligated
Number)
Number
(Firm''nt)
Flow,
Daily Flow,
Flow
MGD
MGD
11GD
NIGD
AIGD
►1GD
Little Buffalo
#WQ0040285
00000
2,5459
1,3046
0,2022
1.5069
1.039f.
ZBi _Buffalo
#NIA
#N/A
#NIA
#NIA
#N/A
#N?A
x
#NIA
MIA
MIA
#N/A
#NIA
#N.-A
x
#N/A
#NIA
#NIA
MIA
MIA
MA
x #NIA #N/A #NIA #NIA #NIA #NIA
x #NIA #NIA #NIA #NIA #NIA #NfA
1. The Firm Capacity, (design flurv) of any pump station is defined as the maximum pumped tlo%v that
can be achieved with the largest pump taken out of sen ice.
2. Design Average Flow is the farm capacity of the pump station divided by the peaking factor (pi) not
less than 2.5, per Section 2.02(a)(4)(c) of the Minimum Design Criteria.
3. A Planning assessment Addendum shall be attached for each pump station located between [lie
project connection point and the 1" TP where the ;kinilable Capacity is 5 0.
Downstream Facility Name (Sewer): City of Sanford Collection System
Downstream Permit Number: WQCS00047
Page 1 of 6 FTSE 10-18

DocuSign Envelope ID 98571A77-540E-4857-AF3D-A7AEA1C20760
111. Certification Statement
I, Paul Weeks, Jr. 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 (low 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 11 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.
nae1aSlpn.d br.
escsoEeae�8"89.. 04/06/21
Signing Official Signature Date
City Engineer
Vile of Signing Official
Page 2 of 6 FTSE 10-18

J THOMAs ENGINEERING, INC.
C Vlt- ENGINEERING a PLANNING
April 8, 2021
Mr. S. Daniel Smith
Regional Supervisor — Water Resources Water Quality Operations
NCDEQ Raleigh Regional Office
1628 Mail Service Center
Raleigh, North Carolina 27699
Reference: Fast Track Application — Gravity Sewer Extension
Golf Course Road Residential Development
Sanford (Lee County), North Carolina
Dear Mr. Smith:
143 Charlotte Avenue, Suite 104
Sanford, North Carolina 27330
�tr'D 919-777-6010 phone
w;kk l&tVsengineeringxom
p e No. C-3389
ApR hment$1 Qua)1ry
ofn°e
Please find enclosed the application package for the Golf Course Road Residential Development
Project located in Sanford, North Carolina. The package includes the following items (original and
one copy):
• Fast Track Sewer System Extension Application (FTA 04-16)
• $480 check for application fee
• Flow Tracking/Acceptance Form (FTSE-04-16)
• USGS Map showing project location
• Google Earth Map showing project location
This proposed 10-lot residential development will entail installation of approximately 559 11. of new
gravity sanitary sewer main (8-inch).
Please do not hesitate to call with any comments or questions regarding this submittal.
Sincerely,
J Thom s Engineering,
X
Jeremy R. Thomas, P.E.
President

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