WQ0028794_Application (FTSE)_20050504

f-TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 1
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD!
A. APPLICATION INFORMATION
1. Owner:
1 a. Town of Angier
Full Legal Name (company, municipality, HOA, utility, etc.)
1 b. Coley Price - Town Manager
Application Number:
(to be completed by DWQ)
.eoa,P7.9�
Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorized signing officials!)
c. The legal entity who will own this system is:
❑ Individual ❑ Federal ® Municipality 0 State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify):
1d. PO Box 278 le.
Street Address
1 f. NC
1h.
State
919 639 2071
li. .919.639.6130
Telephone Facsimile
2. Project (Facility) Information:
1g 27501
Zip Code
1 j.
E-mail
2a. The Landings ?b. Wake and Harnett Coun
Brief Project Name (permit will refer to this name) County Where Project is Located
3. Contact Person:
3a. John Tucker - Designer
Name and Affiliation of Someone Who Can Answer Questions About this Application
3c. johnakohntuckerpe.com
3b. 919.567.048
Phone Number
3
E-mail
1 Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.:
2. Owner is ❑ Public (skip to Item B(3)) ® Private (go to Item 2(a))
2a 1
JOHN A K TUCKER PE 02-05
PO BOX 297
FUQUAY VARINA, NC 27526-0297
Pay to the
Order of ,t'c- b /17tA
4a. 1
5a. 1 / FIRST CITIZENS 204
!' !� BANK Fir�citiaern Bank & Trust Company
I�r`t �i� Fuquay Vanna. N.C. 27526
www.firstciti ns.com
6. 1 /
tc-

❑ Other (specify):
CIIABB.g69SAFFTV BLUE Wt.
% Industrial
% Other (specify):
7. Volume of wastewater to be permitted in this project: 11,160 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
❑ Flow has already been allocated in Permit No.
❑ Rehabilitation or replacement of existing sewer with no new flow expected
•cial
FTA 02/03

_-,
rRE . c,
MA � 4 — 2005
DENR - FAYETTEVLLE REGIONAL OFFICE
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.
© 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 to submit detailed plans and specifications unless you respond NO to Item B(12).
E II. Application Fee - Submit a check in the amount of $400 made payable to: North Carolina Department of
Environment and Natural Resources (NCDENR).
❑ in. 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)
which 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 will be serving residential or commercial lots (e.g., houses, condominiums, townhomes,
outparcels, etc.) that will be owned by a homeowners' association or developer (Item B(2b)). 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.
❑ 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/WWTF. The flow acceptance must not
expire prior to permit issuance and must be dated less than a year prior to the application date.
Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific flow acceptance
letter.
® VI. Map — Submit an 8.5-inch by 11-inch copy of the portion of a 7.5-minute USGS Topographic Map along with this
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,
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
for each different waterbody (where the sewer line is within 100 feet of such waterbody - see Instruction VII).
• Watershed 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 slope 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.
INSTRUCTIONS FOR FORM FTA 02/03

❑ VIII. Environmental Assessments — If this project is subject to an Environmental Assessment (EA) ]15A NCAC
01C .0500], 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.
® 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 $400
FEE, SHOULD BE SENT
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
59 Woodfin Place
Asheville, North Carolina 28801
[phone]
[phone] Fax
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
[phone]
[phone] Fax
Anson, Bladen, Cumberland, Harnett, Hoke,
Montgomery, Moore, Robeson, Richmond,
Sampson, Scotland
Mooresville Regional Office
919 N Main Street
Mooresville, North Carolina 28115
[phone]
[phone] Fax
Alexander, Cabarrus, Catawba, Cleveland,
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
Stanly, Union
Raleigh Regional Office
1628 Mail Service Center
Raleigh, North Carolina 27699-1628
[phone]
[phone] 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
[phone]
[phone] 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
[phone]
[phone] Fax
Brunswick, Carteret, Columbus, Duplin, New
Hanover, Onslow, Pender
Winston-Salem Regional
Office
585 Waughtown Street
Winston-Salem, North Carolina
27107
[phone]
[phone] Fax
Alamance, Alleghany, Ashe, Caswell,
Davidson, David, Forsyth, Guilford,
Rockingham, Randolph, Stokes, Surry,
Watauga, Wilkes, Yadkin
For more information, visit our web site at: http:IIh2o.enr.state.nc.uslndpu/
INSTRUCTIONS FOR FORM FTA 02/03

•
FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
PAGE 1
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number . x,' a�/ 9fL ,/
— — -- (to be completed by DWQ) !i(/ !•v Cl ✓
1. Owner.•
1 a. Town of Angier
Full Legal Name (company, municipality, HOA, utility, etc.)
z 1b. Coley Price - Town Manager
O Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorized signing officials!)
Q lc. The legal entity who will own this system is:
III Individual ■ Federal I7 Municipals_ ■ State/County 0 Private Partnership-■
- ---- -- -- -----
Corporation ■ Other
(specify):
i-
ce1 d. PO Box 278 Ile. Angier
0
Street Address
LL
z if. NC
City
419 27501
Z State ! Zip Code
O 919 639 2071
— 1 h. Ili. .919.639.6130 i1 j.
QTelephone j Facsimile
U 2. Project (Facility) Information:
""I 2a. The Landings 0.. g
f E-mail
12b. Wake and Harnett County
a Brief Project Name (permit will refer to this name)
Q 3. Contact Person:
Q 3a. John Tucker - Designer
County Where Project is Located
Name and Affiliation of Someone Who
3b. 919.567.0483
Can Answer Questions About this Application
3c. iohnakta'�-iohntuckerpe.com
Phone Number
E-mail
1. Project is L1 New ■ Modification (of
an existing permit)
If Modification, Permit No.:
to Item 2(a))
2. Owner is • Public (skip to Item 8(3)) '3 Private (go
2a. If private, applicant will be:
single office, etc.)
- skip to Item 8(3))
- go to Item B(2b))
; 2b. If sold, facilities
owned by a (must choose one)
(Instruction III)
Assoc./Developer (Instruction IV)
• Retaining Ownership (i.e. store, church,
ILI Public Utility
• Leasing units (lots, townhomes, etc.
• Homeowner
ut Selling units (lots, townhomes, etc.
Z
O 3. Town of Angier
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
< 4a. Town of Angier WWTP
4b. NC0082597
2 Name of WWTF
0 5a. Town of Angier 15b. 8 inch
WWTF Permit No.
5c. Unknown
ZOwner of Downstream Sewer I Receiving Sewer Size
Permit Number of Downstream Sewer
6. The origin of this wastewater is (check all that apply):
per day
that connect to this
flow exoectarl
100
Residential Subdivision i III Car Wash
CC4
L1.1 • Apartments/Condominiums • Institution
• Mobile Home Park 1 • Hospital
% Domestic/Commercial
% Industrial
__
■ School
■ Church
• Nursing Home
CO • Restaurant
% Other (specify):
IIOffice
• Other (specify):
7. Volume of wastewater to be permitted in this project: 11,160 gallons
line
8. If the permitted flow is zero, indicate
why:
is subsequent permits
Permit No.
sewer with no new
• Interceptor Line - Flow will be permitted
• Flow has already been allocated in
• Rehabilitation or replacement of existing
FTA 02/03

•
FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 2
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 design 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(I)(3).
31 homes @ 120 gpd/bedroom x 3 bedroom = 11,160 gpd
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches) j
Length (feet)
1939
Gravity or Force Main
Gravity
0
W
Z
17-
Z
O
ENTER TOTAL LINE LENGTH IN MILES 0.36
0
11. Summary of Pump Stations to be Permitted (attach additional sheets as necessary)
Power Reliability Option
cc Location ID Design Flow Operational Point ; (dual line feed, permanent generator wlATS,
O LL (as shown on plans) (MGD) GPM @ TDH _portable generator w/autodialer, wet well storage)
Z
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?
fe 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 ® N/A
Sedimentation and Erosion Control Plan? ® Yes ❑ No ❑ N/A
Stormwater? ❑ Yes ❑ No 23 N/A
FTA 02/03

FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 3
C. WATERSHED 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) OR indicate the following:
El A Watershed Classification is not needed because all parts of the project are at least 100 feet away from any down
slope waterbody; AND,
Watershed Classification is not needed because the design does not depend on wet well storage as a power
reliability option for any pump station near a Class C down slope waterbody.
Location ID
on Map
Name of
Waterbody t. County
I
River Basin
Waterbody Stream Waterbody
Index Classification
Submit the 8.5" x 11" topographic map as required in Instruction VI regardless of whether a classification is provided!
1. Applicant's Certification:
1 a.
2a. John A.K. Tucker
Professional Engineer Name
2b. John A.K. Tucker. P.E. - Consulting Engineer
Engineering Firm
2c. PO Box 297
Address
2d. Fuquay-Varina
City
2g. 919
y-2 7-o s
2e. NC 12f. 27526
State i Zip
-1-
567.0483 2h. 919.567.3611
Telephone Facsimile
2i. [e-mail]
E-mail
Date
I attest that this application for The Landings -Phase 1 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. Note: In accordance with North Carolina General Statutes 143-215.6A and 143-215.6B,
any person who knowingly makes any false statement, representation, or certification in 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.
I A.;
Signing Official Signature
Professional Engineer's Certification:
I attest that this application for The Landings -Phase 1 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. 1 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 adopted February
12, 1996, and the Minimum Design Criteria 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 in 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.c.iA,cC:s,
``���,,, �,� �,,,����'
Seal, Signature & Date
FTA 02/03

John A.K Tucker; P.E.
Consulting Engineer
P.O. Box 297 Fuquay—Varina, North Carolina 27526
Project THE LANDINGS
Sheet of
Date
Scale
AS NOTED

I I.
John A.K. Tucker, P.E.
Consulting Engineer
To:
NCDENR
Divsion of Water Quality
We are sending the following:
Letter of Transmittal
Date:
05/02/2005
Project:
The Landings Phase 1
Attention:
Non -Discharge Permits
Prints
✓
Photocopies
By Mail
By UPS/FEDEX
✓
Originals
Shop Dwgs
By Hand
By Pickup
Disk
Samples
By Courier
By Fax
For your:
Approval
As Requested
For Your Action
Your Use
For Review and Comment
Other (See Remarks)
Quantity
Revision
Description
1
Fast Track Application - Original
1
Fast Track Application - Photo Copy
1
Check in the amount of $400.
C
Lk- SGS C
Remarks:
Copy:
Signed:
John A.K. Tucker, P.E.