WQ0042480_Application (FTSE)_20210416

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 ITTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: _ IV 06014 Z tf$ (1 (to be Completed by DWtt)
All items must be completed or the application will be returned
1. APPLICANT INFORMATION:
I. Applicant's name: City of Wilson (company, municipality, I IOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation rp ❑General Partnership El Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3, Signature authority's name: W.T. Bass IV PE per 13ANCAC 02T A 106(b)
Title: Director of Public Works
4. Applicant's mailing address: _1800 Herring Ave. E.
City: Wilson State: NC Zip: 27893-
5. Applicant's contact information:
Phone number: [phone] Email Address: bbass wilsonne.org
11. PROJECT INFORMATION:
I. Project name: Bright Leaf _Phase 1
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project n
If modification, provide the existing permit number: WQ00 and issued date: d
If new construction but part of a master plan, provide the existing permit number: WQ00 1
3. County where project is located: Wilson rjaV,
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.728Longitude:-77.962' ' ,� c
5. Parcel ID (if applicable): 3742-71-5246 rfo Cn VS
(or Parcel ID to closest downstream sewer)
Ill. CONSULTANT INFORMATION: C IC
1. Professional Engineer: Robert S. Bartlett License Number: 20106 r
Firm: Bartlett Engineering & Surveying, PC f
Mailing address: 1906 Nash Street N
City: Wilson State: NC Zip: 27893-1726
Phone number: [phone] Email Address: robertf(@,bartletteniz.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Hominy Creek Water Reclamation Facility Permit Number: NC 0023906
Owner Name: City of Wilson
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS00021
OwnerName(s): City of Wilson
FORM: FTA 04-16 Page I of

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 ®N;`A
2. If the Applicant is a Developer of lots to be sold, has a 13eveloper's Operational Agreement
f FORIwt: D_ EyJ been attached?
❑ Yes [—]No ®N.'A
3. If the Applicant is a Hie}Pro exy Owners' Association, has an Operational Agreement 4EQ MOAI 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 preparationiservice
❑ Hotel andlor Motels
❑ School / preschool / day care ❑ Medical ? dental! veterinary facilities
❑ Swimming Pool /Clubhouse
❑ Food and drink facilities ❑ Church
❑ Swimming PoaUFilter Backwash
❑ Businesses.! offices / factories ❑ Nursing Home
❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic.'Commercial % Commercial
_ % Industrial See_ 15A N'C'AC 02T .O I. 03[20)
�Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .01 14 ? ❑ Yes ® No
If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (sec 02T.0114(f)}
Residential
Daily Design Flow 0 No, of Unitsl Flow
360 gal/day 1 64 1 23,040 GPD
gall
GPD
gall
GPD
gall
GPD
gall
GPD
gall
GPD
Total
23,040 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 located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A4).
b Per 15A NCAC 02T .01 14(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0114 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 23,040 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: F rA 04-16 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravitv Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 2,492 PVC
8 51 DIP
➢ 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 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 15A NCAC 02T .0305( i)(I ):
❑ 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 I5,000 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):
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 timeframes, shall be provided
in the case of a multiple station power outage.
FORM: FTA 04-I6 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (0213.02041 & 15A NCAC 02T .0305(o):
I. Does the project comply with all separations found in I5A NCAC 02T .0305(fl & (9)
1✓ 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer sysiems-
® Yes ❑ No
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-1 waters of Class I or
Class II impounded reservoirs used as a source of drinking water
I00 feet
*'"Waters classified WS (except WS-1 or WS-V), B, SA, ORW, I-IQW, or SB from normal
high water (or tide elevation) and wetlands see item IX?)
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 systems and interceptor drains
5 feet
AnX swimming pools
10 feet
Final earth grade (vertical)
36 inches
15A NCAC 02T.0305(a) contains alternatives where separations in 02T.0305(fl cannot be achieved.
"Stream classifications can be identified using the Division's NC Surface Water Classifications web age
If noncompliance with 02T.0305 or see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ❑ Yes [:]No ® N.--A
t 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
z 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 ®NSA
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 Permittine Branch
5. Does project comply with 15A NCAC 02T.0I05(e)(6) (additional pen-nits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0 I 05(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
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 permitice 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 Permitt of Pump -Stations
and Force Mains (latest version), and the Gravfty Sewer Minimum Design Criteria latest version as applicable?
® Yes ❑ No
IfNo, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of (lie request is rc uired Prior to submittal orthe Fast Track Application and su ortin documents.
2. Professional Engineer's Certification:
,-�Zo��k-t ' q::)�tL_t L,tc T attest that this application for
(Professional Engineer's name from Application Item IH.I.)
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: _W-SE�
O��• 1\%11.'
20106-pg
=
...
3. Applicant's Certification per 15A NCAC 02T .0106(b):
attest that this application for
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. 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. 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 143-215.613, 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.
Signature: Date:
rORM: FTA 04-16 Page 5 of 5

LU-11V �U
Division of Water Resources
State of North Carolina
Department of Environmental Quality
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: Bright Leaf Subdivision Phase I
More than one FTSE may he required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewaterJlow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Hominy Swamp Water Relcamation Facility
b. WWTP Facility Permit #: NCO023906
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 MGD
e. WWTP facility's actual avg. flow 8.86 MGD
f. Total flow for this specific request 0.023 MGD
g. Total actual and obligated flows to the facility 10.07789 MGD
h. Percent of permitted flow used 71.98
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 / p0,
Flow,
Daily Flow,
Obligated
Available
Number)
No.
MGD
MGD
MGD
MGD
Flow
Capacity***
3
WQCS00021
4.320
1.728
1.06
0.427911
1.4879
0.2401
4
WQCS00021
6.264
2.506
1.66
0.397607
2.0576
0.4480
* 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 dumber: NC 0023906
Page 1 of 6
FTSR 1 fl-1 R

I11. Certification Statement:
I W.T. Bass IV, PE certify to the best of my knowledge that the addition of
the volume of wastewater to he 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 1 and I1 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.
ZZY
Signature Date
l-
Title of Signing Official
Page 2 of 6
FTCF t MR

ENGINEERING REPORT
SEWER SYSTEM EXTENSION
BRIGHT LEAF — PHASE 1
CITY OF WILSON, NORTH CAROLINA
March 10, 2021
Wastewater Treatment Facility
Hominy Creek Water Reclamation Facility
NPDES Permit No. NCO023906
Applicant/owner Name & Address
City of Wilson
Post Office Box 10
Wilson, North Carolina 27894-0010
Project Name & Location
Bright Leaf — Phase 1
Heritage Drive
Wilson, North Carolina
Project Summary
_ 20106
L\
. FNGINE� • �;'
The project is for a new sixty-four (64) lot residential subdivision located east of Baybrooke
Drive, at the existing terminus of Heritage Drive. It will include the installation of approximately
2,492 linear feet of 8-inch diameter PVC gravity sewer line, 51 linear feet of 8-inch diameter DIP
gravity sewer line, three (3) standard manholes, eight (8) 5-foot diameter manholes, 24 L.F. 16-
inch steel casing & bore & jack at existing manhole connection, 4-inch sewer services and other
necessary appurtenances. This sewer system will connect to an existing 8-inch gravity sanitary
sewer main within Baybrooke Drive, as shown on the attached plans.
P' PROJECT FILESWght Leaf (Wmdw mJTwmiuZ1"ttary fever main extension (NCDEQ)520 018 Enginmring Reparl.dw

t9t16 Nash Street North Wilson, NC 27893-1726
Phone: [phone] Fax: [phone]
www.hartictt.us.com
April 13, 2021
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
Raleigh Regional Office
1628 Mail Service Center
Raleigh, North Carolina 27699-1628
Reference: Fast Track Application for Gravity Sewers
Public Sewer Extension
Bright Leaf -Phase 1
Heritage Drive
Wilson, North Carolina
To Whom It May Concern:
NC Dept of Environmental Quality
APR 16 2021
Raleigh Regional Office
Enclosed for your review and approval are two (2) copies of the following items related to the
above referenced project:
■ Fast Track Application for Gravity Sewers
■ Engineering Report
■ Flow Tracking / Acceptance Form
a USGS Topographic Map
■ Feature Report
■ GIS Aerial Location Map
Also enclosed is the $480.00 sewer permit application fee. Should you have any questions or
require further information during your review, please let us know.
Respectfully,
Steve Oliv�er�io
Project Manager
Enclosures
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10/5/2020 Wilson County, GIS - Property Report
Wilson County Parcel Report
PIN:
3702-a1-9733.000
Parcel Number.
3702819733.000
Current Owner ID:
Physical Address:
1111537
NC 42 HWY W
Owner & Address:
UNIVERSAL FOREST & LAND INC
5808 BLOOMERY RD
Date Sold:
1533859200000
Deed Reference;
2753 - 850
Deed Year.
2018
Plat Reference:
Deed ems:
27.26
Actual Year Built
Effective Year Bulk:
Main Improvement
Finlshed Area:
Tax Year,
2020
Assessed Current
Land Value:
$47.255
Assessed Current
Improvement Value:
$0
Total Assessed
Current Value:
$47,255
Current Land Use
Yes or No:
N
Current Land Use Value:
$47.255
Current Land
Fair Market Value:
$47,255
Current Improvement
Fair Market Value:
$0
Current Total
Fair Market Value:
$47,255
Total Tax Owed:
$400
Grantor.
CARR WILLIAM GRAY,
Previous ParcelNumber.
PreVIoUS Deed Reference:
Plat BooklPage:
Legal Description:
NC 42 HWY W
27.25AC
Sales Amount:
5115,O00
Sales Instrument:
WD
Sales Instrument Description:
WARRANTY DEED
Sales Disqualifaction Code:
Sales Disquallfaction Code Description:
Date Sold:
20180810
Vacant Improved Code;
Land Current Usage Code:
CLR
Land Rate:
AC - ACRES
Fair Market Value
Land Rate Code:
5113
Parcel Description Code 1:
50 - RURAL HOMESITE
Parcel Description Code 2:
00 - VACANT
Multiple Land Segments:
MLT
GIS Calculated Acres
of Selected Polygon:
27.04
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1t7XM20
Man County, ors - Property Report
ter.
Road Frontage:
Current Use Code MaM Improvement:
Mal" Improvement Decrotim Code.
Main Improvement DeeWpHan:
CanWmcBon Qualty Grade DeMption Code:
Depredation Tirble:
Number of Bedrooms:
Number of Half Bathnx me:
HVAC:
F6eplaoe Yes or No:
Basement Yes or No:
Attached Garage Yes or No:
Percent of Construction CompWets:
Number of Improvements:
Netghbodwod Cods:
CUy:
Tint District:
TowneNp:
Area:
Vacinity Ma
orthophotowaphv Mae
13.38
VACJINT -
-SF
N -
N -
N -
DOD
8M - W1LW WEST A-1
13 - C/SWICONTENTNEA FD
1- WILSON TOWNSHIP
34 - MKTZQNE-WILSON COUNTY W
httpsJ/gls.wilson-co.OMWmepa/assets/w lson/PmpertyRepori.htm1737a2819733.000