WQ0028794_Application (FTSE)_20100323

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7
MAR 2 3 2010
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
FAST -TRACK APPLICATION
(FTA 12/07 ver5)
r GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
(Pressure & Vacuum sewer systems are not to be included as part of this application package)
INSTRUCTIONS: Indicate that you have included/addressed the following list of required application package items by
checking the space provided next to each applicable item. Failure to submit all required items will lead to your application
being returned as incomplete. Forms are available from the web site or by calling the Regional Office serving your county:
http.//h2o. enr. state. nc. us/peres/Collection % 20Systems/CollectionSystemApplications. html
X A. Application Form - Submit one original and one copy of the completed and appropriately executed application
form. The application should include a project narrative describing the final build -out design (i.e. system and/or
pump station to ultimately serve 500 homes, but flow for only 100 homes being requested now). For modifications,
clearly explain 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 that has already
been included in the original permit.
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(13).
Separate applications should be made for non-contiquous sewer systems.
X B. Application Fee - Submit a check in the amount of $480 made payable to: North Carolina Department of
Environment and Natural Resources (NCDENR). Checks shall be dated within 90 days of application submittal.
❑ C. 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(2)a of this application.
❑ D. Operational Agreements — Submit one original and two copies of a properly executed operational agreement, as
per 15A NCAC 02T .0115, if the application is submitted 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 home or property owner's association, use Form HOA 02/03. If the applicant is a developer,
use Form DEV 02/03. EVEN IF THE PROJECT MAY BE TURNED OVER TO A MUNICIPALITY UPON
COMPLETION, FORM DEV 02/03 IS REQUIRED.
X E. Downstream Sewer, WWTF Capacity and Flow Tracking/Acceptance — FORM FTSE 10/07 (Flow
Tracking/Acceptance for Sewer Extension Permit Applications) is required with every application. The applicant
(and owners of downstream sewers, pump stations and/or treatment facilities submitting FORM FTSE-10/07)
certifies that the addition of the volume of wastewater to be permitted in this project has been evaluated along the
route to the receiving treatment plant, and that the flow from this project will not cause capacity related sanitary
sewer overflows or overburden any downstream pump station en route to the receiving wastewater treatment
plant. Where the applicant is not the owner of the downstream sewer, submit two copies of FORM FTSE 10/07
from the owner of the downstream sewer and owner of the WWTF, if different. The flow acceptance indicated in
FORM FTSE-10/07 must not expire prior to permit issuance and must be dated Tess than one year prior to the
application date. Submittal of this application and FORM FTSE-10/07 indicates that owner has adequate
capacity and will not violate G.S. 143-215.67(a). Intergovernmental agreements or other contracts will not be
accepted in lieu of project -specific FTSE 10/07.
Map — Submit an 8.5-inch by 11-inch COLOR copy of a USGS Topographic Map of sufficient scale to identify the
entire project area and the closest surface waters. Each map or maps must show the location of the sewer line
and pump stations and be of reproducible quality. Include a street level map showing the downstream connection
point, and the permit number for the downstream sewer, if known.

auream 'iassnications — Watershed Classification Attachment (Form WSCAS-12/07) If any portion of the
sewer system project is within 100 feet of any surface water or wetlands, the Watershed Classification Attachment
• may need to be completed. A variance must be requested for encroachment within required setbacks or buffers
pursuant to 2T .0305 (f) and be indicated in Item B-13 with supporting documentation/justification provided.
❑ H Environmental Assessments — If this project is subject to an Environmental Assessment (EA) [15A NCAC
01C], this application cannot be used. Send the project application on the most current version of Form
PSFMGSA to the Design Management Unit, 1633 Mail Service Center, Raleigh, NC 27699-1633. Applications
cannot be accepted 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.
❑ I. Flow Direction — Many wastewater treatment systems are entering into agreements for regionalization efforts
and emergency treatment capacity. Parts of the system are installed so that the wastewater flow can be directed
to more than one treatment facility. If this is the case with this project, please indicate in B(12) and give the permit
number of the second treatment facility.
X J. Certifications — Section C
The application must be certified by both the applicant and the design engineer who is a North Carolina
Registered Professional Engineer (PE). The applicant signature must match the signing official listed in Item
A(1 b). The PE should NOT certify the application if he/she is unfamiliar with 15A NCAC Chapter 2T, 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.
THE COMPLETED FTA 12/07 APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
DOCUMENTS AND $480 FEE, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
Asheville Regional Office
ADDRESS
COUNTIES SERVED
Fayetteville Regional Office
Mooresville Regional Office
Raleigh Regional Office
2090 US Highway 70
Swannanoa, North Carolina 28778
[phone]
[phone] Fax
Avery, Buncombe, Burke, Caldwell, Cherokee,
Clay, Graham, Haywood, Henderson, Jackson,
Macon, Madison, McDowell, Mitchell, Polk,
Rutherford, Swain, Transylvania, Yancey
225 Green Street Suite 714
Fayetteville, North Carolina 28301-5094
[phone]
[phone] Fax
Anson, Bladen, Cumberland, Harnett, Hoke,
Montgomery, Moore, Robeson, Richmond,
Sampson, Scotland
610 E. Center Avenue
Mooresville, North Carolina 28115
[phone]
[phone] Fax
Alexander, Cabarrus, Catawba, Cleveland,
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
Stanly, Union
Washington 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
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
Winston-Salem Regional Office
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
[phone]
[phone] Fax
Brunswick, Carteret, Columbus, Duplin, New
Hanover, Onslow, Pender
585 Waughtown Street
Winston-Salem, North Carolina 27107
[phone]
[phone] Fax
Alamance, Alleghany, Ashe, Caswell, Davidson,
Davie, Forsyth, Guilford, Rockingham, Randolph,
Stokes, Surry, Watauga, Wilkes, Yadkin
For more information, please visit our web site at:
http://h2o. enr. sta te. nc. us/peres/Collection%20Systems/CollectionSystemsHome. html
or contact the Regional Office serving your county.

B. PERMIT INFORMATION
USE THE TAB KEY TO MOVE FROM FIELD TO FIE:.D!
1. Owner/Permittee:
1 a. Town of Angier
Application Number
(to be c
ompleted by DWQ) �(K/ J� aaRg.79¢ ,7
Full Legal Name (company, municipality, HOA, utility, etc.)
1 b. Coley Price — Town Manager
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials!)
1 c. The legal entity who will own this system is:
❑ Individual ❑ Federal x Municipality 0 State/County ❑ Private Partnership ❑ Corporation 0 Other (specify):
ld. PO Box 278
Mailing Address
lf. NC
State
1 h. 919 639 2071 li. 919 639 6130 1j.
Telephone Facsimile E-mail
2. Project (Facility) Information:
2a. The Landings ph ase. 7 j 7 2b. Harnett
Brief Project Name (permit will refer to this name) County Where Project is Located
3. Contact Person:
3a. John Tucker - Designer
le. Angier
City
1 g. 27501
Zip Code
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. 919 567 0483
Phone Number
Project is 0 New x Modification (of an existing permit)
3c. [e-mail]
E-mail
If Modification, Permit No.: WQ0028794
2. Owner is x Public (skip to Item B(3))
2a. If private, applicant will be:
0 Retaining Ownership (i.e. store, church, single office, etc.) or
❑ Leasing units (lots, townhomes, etc. - skip to Item B(3))
El Selling units (lots, townhomes, etc. - go to Item B(2b))
3. Town of Angier
0 Private (go to Item 2(a))
2b. If sold, facilities owned by a (must choose one)
❑ Public Utility (Instruction C)
❑ Homeowner Assoc./Developer (Instruction D)
Owner of Wastewater Treatment Facility (WW TF) Treating Wastewater From This Project
4a. Town of Angier
Name of WWTF
5a. Town of Angier 5b. 8
Owner of Downstream Sewer Receiving Sewer Size ❑ Force Main
6. The origin of this wastewater is (check all that apply):
❑ Residential Subdivision
❑ Apartments/Condominiums
❑ Mobile Home Park
❑ School
❑ Restaurant
❑ Office
4b. NC0082597
WWTF Permit No.
x Gravity ,5c. WQ0028794
Permit # of Downstream Sewer (Instruction E)
X Retail (Stores, shopping centers)
❑ Institution
0 Hospital
❑ Church
❑ Nursing Home
❑ Other (specify):
7. Volume of wastewater to be allocated or permitted for this particular project:
*Do not include future flows or previously permitted allocations
8. If the permitted flow is zero, indicate why:
❑ Pump Station, Outfall or Interceptor Line where flow will be permitted in 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 (see 15A NCAC 02T .0303 to determine if a
permit is required)
100 % Domestic/Commercial
% Industrial (attach
description.)
(RO: contact your Regional Office
Pretreatment staff)
% Other (specify):
2400 gallons per day

9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T .0114 for
the value in Item B(7) AND/OR the design flow for line or pump station sizing if a reduced or zero flow is being requested in
Item B(7). Values other than that in 15A NCAC 2T .0114 (b) and (c) must be supported with actual water or wastewater use
data in accordance with 15A NCAC 2T .0114 (f).
20,000 SF retail space x 120 gpd/1000 sf = 2400 gpd
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches) Length (feet)
8
New Gravity or Additional
Force Main
558 Gravity
(] 11. Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
W
Pump Station Location ID (self chosen - as shown on plans/map for reference)
Design Flow
(MGD)
Z Operational Point
0 GPM @TDH
U
Z
O
QPump Station Location ID (self chosen - as shown on plans/map for reference)
Design Flow Power Reliability Option
Operational Point
(MGD) GPM @TDH 1 - permanent generator w/ATS; Force Main Size Force Main Length
Q
2 - portable generator w/MTS
LL
Z
Power Reliability Option
1 - permanent generator w/ATS; Force Main Size Force Main Length
2 - portable generator w/MTS
H
cc
W
a
m
Pump Station Location ID (self chosen - as shown on plans/map for reference)
Design Flow Power Reliability Option
Operational Point
(MGD) GPM @TDH 1 - permanent generator w/ATS; Force Main Size Force Main Length
2 - portable generator w/MTS
12. Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
❑ Yes x No If Yes, permit number of 2nd treatment facility
(RO — if "yes" to B,12 please contact the Central Office PERCS Unit)
13. 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 Chapter 2T 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

14. Have the following permits/certifications been submitted for approval for the system or project to be served?
Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes 0 No x N/A
Sedimentation and Erosion Control Plan? x Yes ❑ No
Stormwater?
x Yes ❑ No
❑ N/A
❑ N/A
15. Does this project include any high priority lines, [see 15A NCAC 02T .0402 (2)] involve aerial lines, siphons, or interference
manholes)? These lines will be considered high priority and must be checked once every six months
Check if Yes: 0 and provide details no
1. Owner/Permittee's Certification: (Signature of Signing Official and Project Name)
1, Cote, y 3 Parr r
1 a.
, attest that this application for �4 n 1r , 6r +vc n Pam,1, -, s i o -,) 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 143-215.68, 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.
/ ,-s•Ge-:
Signing Official Signature
ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THIS
APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMITY
w TO OTHER UTILITIES, DESIGN CALCULATIONS. ETC. REFER TO 15A NCAC 02T .0305
Z
0
Q 2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
U 1, _John A, K. Tucker attest that this application for The Landings
accurate, complete and consistent with the information in the g has been reviewed by me and is
.3-/ 7-/O
Date
IX
b a best of my knowledge
vity Sewer Minimum Design Criteria for Gravity
W adopted February 12, 1996, and the Minimum Design regulationsC terra for the Fast —Track Permitting of Pump Stations and Force
O Mains adopted June 1, 2000 and the watershed classification in accordance with Division guidance. Although other
CS professionals may have developed certain portions of this submittal package, inclusion of these materials under my
signature and seal signifies that 1 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.
LL engineering plans, calculations, and all other supporting
- documentation to the best of my knowledge. I further attest that tothe
been prepared in accordance with the applicable the proposed design has
2a. John A.K. Tucker, PE
Professional Engineer Name
2b. John A.K. Tucker, PE, Consulting Engineer
Engineering Firm
2c. PO Box 297
Mailing Address
2d. Fuquay Varina 2e. NC 2f.
City
2g. 919 567 0483
27526
State Zip
2h. 919 567 3611 2i. [e-mail]
Telephone Facsimile
E-mail
<rst-1 CA1,?0,1/,,,

USE THE TAB KEY TO MOVE FROM FIELD TO FIELD!
1. Owner/Permittee:
1 a. Town of Angier
Application Number:
(to be completed by DWQ)
WQ o oa8 794
Full Legal Name (company, municipality, HOA, utility, etc.)
O 1 b. Coley Price — Town Manager
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials!)
• lc. The legal entity who will own this system is:
❑ Individual 0 Federal x Municipality 0 State/County ❑ Private Partnership 0 Corporation ❑ Other (specify):
Ce
• ld. PO Box 278 1 e. Angier
LL Mailing Address City
1f. NC lg. 27501
Z State Zip Code
O 1 h. 919 639 2071 li. 919 639 6130 1j.
QTelephone Facsimile E-mail
✓ 2. Project (Facility) Information:
J 2a. The Landings 2b. Harnett
a Brief Project Name (permit will refer to this name) County Where Project is Located
a' a 3. Contact Person:
Q3a. John Tucker - Designer
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. 919 567 0483 3c. [e-mail]
Phone Number E-mail
Z
0
I• —
a
1. Project is 0 New x Modification (of an existing permit) If Modification, Permit No.: WQ0028794
2. Owner is x Public (skip to Item B(3))
0 Private (go to Item 2(a))
2a. If private, appiicant will be:
❑ Retaining Ownership (i.e. store, church, single office, etc.) or
❑ Leasing units (lots, townhomes, etc. - skip to Item B(3))
0 Selling units (lots, townhomes, etc. - go to Item B(2b))
2b. If sold facilities owned by a (must choose one)
❑ Public Utility (Instruction C)
❑ Homeowner Assoc./Developer (Instruction D)
3. Town of Angier
Owner of Wastewater Treatment Facility (VVWTF) Treating Wastewater From This Project
4a. Town of Angier 4b. NC0082597
Name of WWTF WWTF Permit No.
2 5a. Town of Angier 5b. 8
IX Owner of Downstream Sewer Receiving Sewer Size
0 6. The origin of this wastewater is (check all that apply):
x Gravity 5c. WQ0028794
❑ Force Main Permit # of Downstream Sewer (Instruction E)
PAY TO THE
ORDER OF.
20/20 MANAGEMENT SERVICES
104 S MAIN ST
LILLINGTON, NC 27546-8968
[phone] FAX [phone]
NCDENR Land Quality
FIRST BANK
66-456-531
2675
3/19/2010 a
*"480.00
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2675
20/20 MANAGEMENT SERVICES
104 S MAIN ST
LILLINGTON, NC 27546-8968 66-456-531
[phone] FAX [phone]/2010
PAY TO THE
ORDER OF. NCDENR Land Quality $ **480.00
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NCDENR Land Quality 3/19/2010
Angier Sewer Permit 480.00
DENR-FRO
MAR 2 3 rig ?g

Permit Number
Central Files: APS SWP
04/26/10
Permit Tracking Slip
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer
Extensions
Primary Reviewer
trent.allen
Coastal SW Rule
Permitted Flow
57120
Facility
Facility Name
The Landings Phase 2
Location Address
Owner
Status
Active
Project Type
Major modification
Version Permit Classification
1.30 Individual
Permit Contact Affiliation
Major/Minor Region
Major Fayetteville
County
Harnett
Facility Contact Affiliation
Owner Name Owner Type
Town of Angier Government - Municipal
Owner Affiliation
Coley Bryan Price
PO Box 278
Angier
Dates/Events
NC 275010278
Orig Issue App Received Draft Initiated
05/06/05 03/23/10
Scheduled
Issuance
Public Notice Issue
04/26/10
Regulated Activities Requested/Received Events
Subdivision Additional information requested
Wastewater collection Additional information received
OutfaII NUI_I_
Effective Expiration
04/26/10
Waterbody Name Stream Index Number Current Class Subbasin

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35° 33' 30" N
35° 31' 30°

The Landings Sewer Modification
Purpose of modification is to extend approximately 500 of 8 inch gravity sewer to serve 20,000 square
feet of retail space.

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DF'hi=, State of North Carolina
0� QG Department of Environment and Natural Resources
r Division of Witter Quality
c Flow Traclingl_aoceptance for Sewer Extension Permit Applications
(FTSE—10.11J7)
Project Applicant Name: Town of Angier
Project Name for witich flow is benrequested: Landings
More than one FTS-1e2+1D? may he reqUiredictr a single project if the m.rer afthe iFilf7P is Not resp_irsihle Jut all
pwnp Anions s along the rx:niw of the prwosed weentl ate, flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Town of AngierNWWTP, Town of Angier Lagoon
b. WWTP Facility Permit #: NC0082597 / W00002638
All flown are in MGD
c. WWIP facility's permitted flow .758
d. Estimated obligated flow not yettributary to the W WTP .0625
e. WWTP facility's actual avg. flow .435
£ Total flow for this specific rarest .002.4
g. Total actual and obligated flows to the facility .499
h. Percenttof permitted flow used 65 . S%
II. Complete this section for each pump station you are responsible for along the route of this
proposed wastewater flow.
Listpump stations located between the project connection point and the WWTP
Pump Station Name Approx. Capacity, MGD Approx. Current Ave.
(FirmtDesign) Daily Flow; MGD
Landing Subdivision PS # 3 _08S .020
Pump Station # 6 .979 .499
t�Certirication Statement:
I, 14411(.1 cSarwes Co4, certify, that, to the best of ray laaowledge, the addition of the
volume of wastewater to be permitted ie this project has been evaluated along the route to the receiti
wastewater treatment facility and that the flow from this project is not anticipated to cause any capacity
related sanitary server overflows or overburden any downstream pu,np station ea route to the receiving
treatment plait under normal circumstances. This analysis has been performed in accordance with local
established policies and procedures using the beet avadabte data. This certification applies to those items
listed above in Sections I and II for which I am the responsible panic Signature of this forme indicates
Bow. Pto.1 .r, tttn+it$ 1cJiric se
f
Si�ninp ?f}'tda1 Sr v • ;„ Date