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WQ0031165_Application (FTSE)_20061218
N FORMATION RACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 3 USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! A►PPIi , (to be cemP e#,_ WED 1. Owner. la. Hamett County Department of Public Utilities (HCDPU) DEC 1 8 NZ Full Legal Name (company, municipality, HOA, utility, etc.) lb. Rodney M. Tart — Director of Public Utilities i r}Pic .771f71; Signing Official Name 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 ❑ Municipality ® State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify): ld. 308 W. Duncan Street le. Lillington Mailing Address City 1 f. NC lg. 27546 O State Zip Code lh. (910) 893-7575 li. '(910) 893-6643 1 j. rtart@hamett.org Q Telephone Facsimile E-mail () 2. Project (Facility) Information: .J 2a. John W. Pope Convocation Center at Campbell University 2b. a Brief Project Name (permit will refer to this name) County Where Project is Located a Q 3. Contact Person: Q3a. Duane K. Stewart, P.E Name and Affiliation of Someone Who Can Answer Questions About this Application 3b. (919) 490-2999 Phone Number 3c. dstewart@dksa-tsi.com E-mail 1. Project is ® 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 ® Public (skip to Item B(3)) ❑ Private (go to Item 2(a)) ) . If nri�.ale. nnniine.w! wail h..• — T A LOVING COMPANY 07 FIELD CHECKING P 0 DRAWER 919 GOLDSBORO, NC 27533 ORDER TO THE OF /J `` >E'_ham-rP c 0/7/ems d WACHOVIA Wachovia Bank, N.A. wachovia.com ')I. 1S DATE . V Viui 11C VI wdbiewalei to ue dllucdieu iur trim parucurar project: i o JDO ganons per aay 'Do not include previously permitted allocations 8. If the permitted flow is zero, indicate why: ❑ Interceptor Line - 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 2973 66-211530 BRANCH 03131 DOLLARS 'K APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 1 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/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: This form may be photocopied for use as an original. t31, 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). ▪ II. Application Fee - Submit a check in the amount of $400 made payable to: North Carolina Department of Environment and Natural Resources (NCDENR). Checks shall be dated within 90 days of application submittal. ❑ 11I. 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 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. ❑ 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 COLOR 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 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 location in Section C of the permit application. ❑ 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 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/peres or by contacting the appropriate regional nffirp .FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 2 ❑ VIII. Environmental Assessments — If this project is subject to an Environmental Assessment (EA) [15A NCAC 01C], this application can not be used. Send the project application on Form PSFMGSA 10/99 to the PERCS Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. Applications can not 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. IN 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(1 b). 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. ® X. Downstream Sewer & Wastewater Treatment Plant Capacity The applicant has assured downstream pipe, pump station and treatment plant capacity. The addition of new sources of wastewater from this project has been evaluated along the route to the receiving treatment plant. 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 If the applicant is not the owner of the downstream sewer or receiving treatment plant, submittal of flow acceptance letter(s) indicates that owner has adequate capacity and will not violate G.S. 143-215.67(a). THE COMPLETED FTA 02/03 APPLICATION PACKAGE, INCLUDING ALL SUPPORTING DOCUMENTS AND $400 FEE, SHOULD BE SENT TO THE APPR REGIONAL OFFICE ADDRESS COUNTIES SERVED Asheville Regional Office 2090 US Highway 70 Swannanoa, North Carolina 28778 (828) 296-4500 (828) 299-7043 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 (910) 486-1541 - (910) 486-0707 Fax Anson, Bladen, Cumberland, Harnett, Hoke, Montgomery, Moore, Robeson, Richmond, Sampson, Scotland Mooresville Regional Office 610 E. Center Avenue, Suite 301 Mooresville, North Carolina 28115 (704) 663-1699 Alexander, Cabarrus, Catawba, Cleveland, Gaston, Iredell, Lincoln, Mecklenburg, Rowan, Stanly, Union Raleigh Regional Office 1628 Mail Service Center Raleigh, North Carolina 27699-1628 (919) 571-4700 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, Alleghany, Ashe, Caswell, Davidson, Davie, Forsyth, Guilford, Rockingham, Randolph, Stokes, Surry, Watauga, Wilkes, Yadkin For more information, visit our web site at: httpl/h2o.enr.state.nc.us/peres/ BAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 3 USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! APplication Number: W0003116 5 (to be completed by DWQ) 1. Owner 1a. Harnett County Department of Public Utilities (HCDPU) Z Full Legal Name (company, municipality, HOA, utility, etc.) O 1 b. Rodney M. Tart — Director of Public Utilities F- 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: • Individual ■ Federal ■ Municipality State/County ■ Private Partnership ■ Corporation ■ Other (specify): EZ 0 Id. 308 W. Duncan Street le. Lillington Mailing Address City Z — I f. NC 1 g. 27546 Z State Zip Code . 1 h. (910) 893-7575 1 i. (910) 893-6643 1j. rtart@hamett.org hamett.org Q Telephone Facsimile E-mail V 2. Project (Facility) Information: J 2a. John W. Pope Convocation Center at Campbell University 2b. Cl- Brief Project Name (permit will refer to this name) County Where Project is Located CL < ° 3. Contact Person: Q3a. Duane K. Stewart, P.E Name and Affiliation of Someone Who Can Answer Questions About this Application 3b. (919) 490-2999 3c. dstewart@dksa-tsi.com Phone Number E-mail 1. Project is El 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 ►5 Public (skip to Item 8(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) Z ■ Leasing units (lots, townhomes, etc. - skip to Item 8(3)) • Homeowner Assoc./Developer (Instruction IV) 0 • Selling units (lots, townhomes, etc. - go to Item B(26)) I-- 3. Harnett County Department of Public Utilities (HCDPU) < Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project te 4a. Buies Creek WWTP & North Harnett Regional WWTP 4b. NC0030091 & NC0021636 0 Name of WWTF WWTF Permit No. LL 5a. HCDPU 5b. 8' L Gravity 5c. WQ0001495 Z Owner of Downstream Sewer Receiving Sewer Size ■ Force Main Permit Number Downstream of Sewer (if known) I-- 6. The origin of this wastewater is (check all that apply): 2 • Residential Subdivision • Car Wash W• Apartments/Condominiums �� Institution 100 % Domestic/Commercial II Mobile Home Park • Hospital a ■ School ■ Church % Industrial m • Restaurant ■ Nursing Home • Office % Other (specify): • Other (specify): 7. Volume of wastewater to be allocated for this particular project: 15.355 gallons per day *Do not include previously permitted allocations . If the permitted flow is zero, indicate why: El Interceptor Line - Flow will be pernitted 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 ,FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 4 0 1 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 supported with actual water or wastewater use data in accordance with 15A NCAC 2H .0219(1)(3). Stadiums, auditoriums, theaters, community centers: 3,071 seats @ 5 gallons per seat = 15,355 gpd 10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary) Size (inches) 8" ENTER TOTAL LINE LENGTH IN MILES Length (feet) Gravity or Force Main (use the pull down menu) 805 (new PVC) Gravity 462 (ex. Terra Cotta) Gravity 0.24 mi. 11. Summary of Pump Stations to be Permitted (attach additional sheets as necessary) Location ID (self chosen - as shown on Design Flow Operational Point plans for cross-reference) (MGD) GPM @ TDH Gravity Power Reliability Option (1- dual line feed; 2- permanent generator w/ATS; 3- portable generator w/telemetry; 4-wet well storage) 2 12. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force; iX Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H .0200 as applicable? W' ® Yes 0 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 In 13. Have the following permits/certifications been submitted for approval? Wetland/Stream Crossings - General Permit or 401 Certification? 0 Yes 0 No ® N/A Sedimentation and Erosion Control Plan? ® Yes 0 No ❑ N/A Stormwater? ® Yes ❑ No ❑ N/A 14. Does this project involve aerial lines or siphons? Check if yes: ❑ These lines will be considered hioh priority and must be checked once every six months 15. Does this project have gravity sewer lines designed at minimum slopes? Ej Be aware that the Division will not accept installed lines more than 10% flatter than the minimum slope. Lines installed outside this tolerance should be corrected prior to submitting the final engineering certification.. -FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 5 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: ❑ 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 storage as a power reliability option for any pump station near a Class C down slope waterbody. Location ID on Map (self chosen - as shown on Name of Waterbody Stream Waterbody map for cross-reference) Waterbody County River Basin Index Classification Submit the $.5" x 11" COLOR topographic map as required in Instruction VI regardless of whether a classification is provided! 1a. Applicant's Certification: 1, Rodney M. Tart , attest that this application for John W. Pope Convocation Center at Campbell University 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 a • = i' at if all required supporting documentation and attachments are not included, f this application package is subjing returned as incomplete. Note: In accordance with North Carolina General Statutes 143-215.6A and 14 .6B, any person who knowingly makes any false statement, representation, or certification in any applic.:. hall be guilty oflass 2 misdemeanor which may include a fine not to exceed $10,000 as well as civil penaltie j . to $25, 000iol on. Signing Offici Signature Professional Engineer's Certification: Date I attest that this application for Duane K. Stewart, P.E 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 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 / 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 143-215.6B, 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. 2a. Duane K. Stewart, P.E. Professional Engineer Name 2b. Duane K. Stewart and Associates, Inc. Engineering Firm 2c. 3715 University Drive Mailing Address 2d. Durham City 2g. (919) 490-2999 2h. (919) 490-6165 2i. dstewart@dksa-tsi.com Telephone Facsimile E-mail 2e. NC 2f. 27707 State Zip �• •O ES SiSey/may_ .a SEAL ter: 5987 • • % G • • tiG I Tip % •.,* Seal, Signature & Date Q'i --N35 r tN35° -',,..,,_ --N35 t i `'ill �� �I iI ( • it cr�' +� .,.., ; 1• 1 l R 1s a 0 I ( 4 yl" f, 2.--I- 75I"= 1- I"' t i if IL y fit tier * IItl ,k i .mow k 1 II II - �f �r � E i � i? N M ,� 'F i * �t� ] '�''3 �i 1, r .4. 11. s3a ■ `j `-,`a�•~, "-^yr ` ¢ y ,/� " .,i-..�.-•,.;.. �. . *"t # r` - I� i Ste^ 1 ' i. y I{ y g -- ? t Ill 16tr lf b J I.� 4 t f11' ^-, • l + f i; ' r--- �y h � =Boles Creek �24 1 S + !, •/'.,. t -- - i }ti , �jI ■ a am-`` r- t "` t .' il el r lt: tr r r i we t , l• i 1 fe ! 3 , . 24 5 ' I / i - s-`�� 1 / 106,11114:S11 :„ r .. it4 t 114111rAll At, ■fir_--,,.. i,^ * i= _•,,- . , m .- lift if t ' ' 4�`t •"-tom..-,�, �+ y (F }, i t1ti ` f 25"` ' � T 1 �' ',� ,i. �+:; IV II x "it ` 1 .• o } - � , ter' _. '�' 'l .^'.. 4 •• 1*4ir { RJ n �Y/ , „, R4 1 1 / \ _ � � + , #...1,:f1)....-1,-' ` `S� * ' ���iii... `'y .'�r..- �•'" 'i ,r� j s.A iJJJ t z' ri "" . * t r lZ jf/if f r i .` " 1 f�,r'" J+' 1 f rf y rif. )5 -24' rr •%j .+`-� 'IM 3-D TgroQuads c i ebt g 1999 Delorme I arnwuth, MI 04096 Sauce Data: L SGS E—� 100 rt &ale:1: 7,200 Detail: 14-0 Datunt W GSS1 4 Duane K.Stewart & ASSOCIATES, INC. Letter of Transmittal To: Belinda Henson From: Duane K. Stewart, PE Company/Dept: NCDENR - DWQ Date: 12/15/06 Project Name: Campbell University - Convocation Center Project #: 1236-01.10 Via: US Mail ❑ Delivery ❑ Express ❑ Pick-up [1 Fax # Pages Fax # ❑ For Your Use ❑ For Approval ❑ As Requested ❑ Please Reply ® For Review & Comment Other: Item: Date Sets/Pages Application Fee ($400.00) Fast -Track Sewer Application 12/15/06 2/5 USGS Topographic Map 2/1 Comments: RECEIVED DEC 18 2006 DENR-FAYE17EY1LLEREGIONAL ORE cc: Charles Todd, Jim Roberts, Dale McCoy Duane K. Stewart & Associates, Inc. Consulting Engineers 3715 University Drive, Durham NC 27707 (919) 490-2999 fax (919) 490-6165 www.dksa-tsi.com